MRCP2 july 2009 recall questions

Discussion in 'MRCP Forum' started by Guest, Jul 30, 2009.

  1. Guest

    Guest Guest

    hi every one how finished today mrcp2 July 2009,
    it wasnt easy examine but i think any body who prepare him self and know how to set the examine he can easly pass it. regard me i dont know till now if i can pass or not ,put i feel i did well.
    so please to all whom who set the examine let us start to remmber the questions and the answer again for the sake of us and other as i read the past test question written her from recall and i answer around ten question from them . :D
  2. dr atif

    dr atif Guest

    plz recall n dscuss wat we did.im confused abt my perfrmanc
    e
  3. Salboy

    Salboy Guest

    Have cardiology section from my side please feel free to add in this list and correct if wrong

    CARDIOLOGY

    1. Acute stent thrombosis
    2. Ant MI
    3. mobitz type 1 block
    4. monitoring in the next question
    5. One picture of pericardial effusion on CT in 3rd paper
    6. Post PPM low BP???dullness on the R side of the chest?? Temponade
    7. 1st quation of the first paper where Cath findings were given ..I have written increased pressure in All with Out put 2.5 L ???
    8. HCM
    9. AVRT
    10. young 25 year old patient in ???VT???AF rate 150 which drug to give IV
    11. patient with enlarged heart with SOB ???DCM??MS as double shadow of the R border of Heart
    12. aortic root abcess
    13. patient in AF on ECG TTE shows MS what investigation do next ???
    14. CT with Coarctation of Aorta
    15. what will you see in IE…low C3
    16. how to warfanise some one who had aspirin and warfarin last time and had UGI bleed presenting with proxysmal AF ..warfarin
    17. bifascicular block
    18. which IV drug improves mortality post MI??SK??altelase??Metoprolol
    19. dual chamber pace maker with normal working .I think it was option D in first paper
    20. Radiation induce cardiomyopathy ….as it was apical and and partial L ventricular akinesia on ECHO
    21. Peripartum cardiomyopathy
    22. Hyperkalemia on ECG
  4. Guest

    Guest Guest

    MVP

    there were also question on MVP associated with arrhythmia . ttt : Verapamil?
  5. Guest

    Guest Guest

    picture of foot pompholyx.
    2nd dig AV BLOCK TYPE ONE ON ECG.
    CXR OF BRONCHIACTASIS IN FEMALE PATIET.
    CT CHEST SHOWING BRONCHIACTASIS
    POSTERIOR MI ON ECG.
    MENINGIOMA ON BRAIN CT.
    TOXOPLASMOSIS ON CT HEAD.
    XRAY WITH WEGNERS.
    WARFARIN FOR 6/12 IN A PATIENT WITH PREVIOUS DVT POST UP.
    ERCP PANVREATIC HEAD CANCER.
    MAN WITH DELUSIN OF BUGS PARAPHERIA.
  6. Guest

    Guest Guest

    1-78 year man with ACB BY 2 got ca prostate... treatment nothing regard his age

    2-painful gential ucler its for chancroid ( Haemophilus ducreyi.) as in chlamida the lymph node is the painful and the ulcer is not

    3-hiv positve female cd4 180 give septrin

    4-travelar diarrheo give ciprodar
    5-post mi best drug i think its updated question and the answer is mg iv?
  7. guest Dr A

    guest Dr A Guest

    traveller diarrhea .. i think right away we shudnt give cipro ...
    it was wat will shorten the duration of his diarrhea ,, thats loperamide ??
    wat u say ?
  8. drks

    drks Guest

    MRCP 2 July 2009

    This was my first attempt and i thought it was tough and needs a good preparation.
  9. duckgirl

    duckgirl Guest

    ciproflox shortens duration of travellers diarrh. Should never give loperamide for infective diarrhoea.
  10. guest Dr A

    guest Dr A Guest

    antibiotic is recommended for bloody diarrhea ..if a person is having frequent traveller diarrhea wud he take antibiotic everytime .. n for any traveller diarrhea antibiotic is never the first line .. first try conservative methods .. only if it persist n the patient gets worse .. then go for antibiotic .. i still go with loperamide
  11. guest dr A

    guest dr A Guest

    what was the answer to that one .. tht a person has atrial fibrillation n on transthoracic eho .. pt has calcified Mitral valves ..which investigation to for next ???
  12. guest Dr A

    guest Dr A Guest

    which was orf ??? the patient having pustules on the sole of the feet .. wat was it ?? eczema or pustulosis ? or wat ??
    yea derma was tricky ! ... rather everything was tricky .. nuthing straightforward ..
    there was a pateint ... with deranged RFT's but the urinary protein n creatinin ratio plus the Na excretion was normal .. was it pre renal failure >>
  13. AM

    AM Guest

    cardiomyopathy

    Guys, I would not go for radiation cardiomyopathy in this patient with partial LV akinesia as radiotheraphy will give overall LV dysfunction not reginal abnormalities. I went for ischaemic one.
  14. Guest

    Guest Guest

    kindly check some of my ans too.

    -hypocalcemia
    -superimposed HDV infection
    -risperidone
    -DKA
    -olanzapine
    -cessation of smoking
    -myelofibrosis
    -fibromyalgia
    -alteplase
    -burgada
    -
  15. Guest

    Guest Guest

    wait till dr manoj comes and give us all the questions
  16. Guest

    Guest Guest

    1-one slide is palmoplantar pustulosis
    2-erythrovirus infection.
    3-one side paget disease?
    4-thoracic vertebra lesion answer to take biopsy from the vertebra?
    5-one slide of the hand its osteoarthritis
    6-TOXOPLASMOSIS on fundoscopy
    7-one case sic euthyroid syndrom
    8-postural hypotension treatment with fludracortizone
    9-lady with syncope do tilt test
    10-fe deficiency anemia, does not tolerate oral iron, i chose i/v iron?
    11-cocaie poising dont give b blocker
  17. dr ahmed

    dr ahmed Guest

    hey guys lets put more questions
    1 a woman with c1 esterase defiency what to avoid latex
    2 hyponatremia with urinary sodioum 59 fluid restriction
    3 was it pompholyx or pustulosis?
    4 renal failure patint with hypercalcemia heperparathyroidism stop alfacalcidol
    5 a patint with hyperbilirubinemia urinary sodium 10 prerenal
    6 an immunosupressed patint with hemoptysis what to give amphotericin
    7 patient with pseudomemberanous colitis continue metronidazole for 10 days
    8 patient with pas stain cell from jejunal biopsy with diahreah tinidazole9 9young male patient with arthritis and lymphopenia sarcoidosis
    10 mri brain viral encephalitis aciclovir
    11old female patint found collapsed with temperature 35 and j wave in ecg was it hypothermia?
    12 patient with history of partial gastrectomy presented by bilious vomiting with uncontrolled diabetus gastroparesis
    13 a case of histoplasmosis
    14 rash in atopic patient after antimalarial was it angioedema?
    15 atopic patint with fever eczema gherpeticum
    16a cae of macroprolactinoma first line trearment dopamine agonist
    17 a case of pituitary adenoma with hypogonadism transphenoidal surgery
    18 a patient with history of breast cancer presented by convulsions mri brain menengioma
    19 an old patint with inoperable breast cancer knwon social alchololic after two attcks of convulsions what to gie to prevent convulsion phynetoin
    20 a patient with bleeding oeophageal varices known alcoloic band ligation
    21 patient presented by hypoglycemia denies hisotry of drug intake what to do measure sulphonyl urea level
    22 young female patint with paracetamol toxicity spider nive acute liver injury wjhat to do refer for transplantation
    23 in paracetamol toxicity the best prognostic indicator is arterial ph
    24 femal patient with cystic fibrosi with heavy pseudomonas infection what to do eradicate pseudomonas then get pregnant
    25 femal patints postmenoposal with history of hysterectomy taking alendronate what to give raloxifen
    26female patint with t score-3 cause of fracture osteoporosis
    27 a case of watery diahrea with enlarged tender liver carcinoid
    28 a case of gastinoma what to do double dose of ppi and do serum gastrin
    29 apatient with refeeding syndrome hypophosphatemia
    30 a case of chronic demyelinating polyneuropathy
    31 patint with sickle cell anemia ethmoid bone infarction
    food boisoning fom meeat clostridiou birfiringence
  18. gust

    gust Guest

    more qz

    renal failure with anaemia & ferritin give iv iron also!
  19. guest2

    guest2 Guest

    pt with features of methahemoglobinaemia what test to do spectrophotometer?
  20. Guest

    Guest Guest

    this exam is very easy exam , i think the pass score will be high , i hope any one to pass inshallah
  21. Guest

    Guest Guest

    in paracetamol toxicity he asked about the initial management not the best management , so that i think acetylcytiene is right
  22. Guest

    Guest Guest

    24 hours post ingestion with derranged clotting,increased creatinine and confused the intial mangement is refferal if if you delay by giving acetylcytine the patient would die.Giving acetylsytine shouuld be your second priority.
  23. Guest

    Guest Guest

    1-a case of alport syndrom the answer is female less than 5% and male more than 90%.
    2-wide qrs tachycardia versus nonsustain tachycardia? i wrote lidnocaine as it the only one for ventricle if we consider it svt with block so diagnostic measure will start with adenosine then if not improved we go to lidnoacine.
    3-post cardiac arrest in respiratory failure patient ,i consider the ABG with metabolic and respiratory acidosis with ph 7.04 ?
    4-patient with painful nodule in his finger i consider it endocarditis ?
    5-old lady with primitive reflex i wrote alhzimer disease?
    6-
    ecg of wpw i wrote atrial ventricular reentery ?
    7-hasband with sexual dysfunction high transferritin level its haemocromatosis
    8-cardiac chamber pressure in percardial effusion i think the answer the cahmber with same pressure in pulmonary and right atrium
    9-X-R for abdomen i wrote smaill intestine obstruction?
    10-in arthritis paitent to decrease the effect of steroid we add azathioprine
    10-acase of skin bullous pmphgoid.
    11-hyperthermia form chloropromazine.
    12-blister in dorsum of the hand porphyria cutanea tarda.
    13-malgnancy with protienuria i wrote membranous.
    steroid side effect is thining and atrophy of skin.
    14-acase of gmu bleeding i consider it acute leukemia
    15-post gastrectomy i consider ca stomach
    16-thrombosis with miss carriage one i think sle and the other antiphospholipid syndrom.
    barret esophagus with mild dysplasia?
    17prolactinoma with sexual dysfunction cabergoline
    18-acase of malgnacy involve the shoulder with multiple neurologylevel as c5 c6.
    19-HIV with pneumonia the diagnosis is bronhcal lavage to diagnose pcp
    20-behcet disease and the diagnosis is pethrgin test.
    patient with plural effusion and clubbing ...squmaous ca biopsy?perihpheral

    i hope all will answer the questions. good luck Dr halasah
  24. Guest

    Guest Guest

    Alport has three mode of inheretances Xlinked
    Autosomal recessive
    Autosomal dominent

    In the scenario it was x likned
  25. Guest

    Guest Guest

    Question 2 above

    It was SVT with LBBB--- not VT so answer should be Adensosine
  26. Doctor Who

    Doctor Who Guest

    I agree that delayed paracetamol presentation first action is to give N-Acetylcysteine.

    Having treated this scenario myself when you phone King's the most important marker for them is Arterial pH.

    It then takes time for them to assess the case and look for a donor if the pt needs a transplant. You also have to organize transport.

    You could have saved some hepatocytes already by giving N-Acetylcysteine, so it should always be the FIRST response.

    This is just my opinion! It's the RCP's that really counts.
  27. duckgirl

    duckgirl Guest

    Alports was described as XLR hence no male-male transmission and all girls will be carriers. Ans was <5% for boys and >90% girl carriage
  28. Doctor Who

    Doctor Who Guest

    Agreed with duckgirl's Alports answer.

    Also agree with Adenosine - I though the the ECG was SVT.

    Also agree with steroid cream SE - thinning of skin.
  29. Guest

    Guest Guest

    Another question of a unconscious girl found to have high pcm level on admission 2 days later of previous admission. Immediate investigation blood glucose as low b.m usually after 2 days of pcm toxicity.

    What will be the change in the meds of a diabetic with high glucose and creatinine 130...stop metformin or add gliclazide/sulfonyl urea

    description with plaque and ulcer on temple...squamous cell ca

    photograph of face lesion was melanoma d/d sq cell ca, granuloma

    lateral cxr was it achalasia or calcified aorta

    CT was it foreign body in oesophagus. Pt wheezy

    Off and on aphasia in alcoholic. Was it Chronic sub dural haematoma/partial ant. circulation infarct/ KorsAKOFF

    Pt returned from kenya low platelet ...dengue..do symptomatic treatment

    12 days post meat pie diarrhoea...salmonella/e coli c. perfingens
  30. Doctor Who

    Doctor Who Guest

    I remember a picture of skin mole - I went for Malignant Melanoma.

    The man with the lesion on his forehead (wearing glasses) I thought was a Basal Cell Ca.

    The unconscious girl after paracetamol OD - I picked ABG (best indicator of liver failure/imminent death).

    Every time I check these threads the exam just seems tougher :( You could make an argument for so many of the answers!
  31. Guest

    Guest Guest

    barrets oesophagus with 6 cms involvement of intestinal type...surveillence

    Recurrent PMR...add MTX/AZA

    In CRF po4/ ca was high and it was mentionened that they had reduced ca supplement wat next. I thought sevelmear would decrease po4 level.

    Pneumothorax <10 percent on chest x ray. pt presented withchest pain. wat was the next management... Oxygen

    Partial diabetes insipidus. The numerous data on water deprivation test.

    Kallman syndrome

    Photograph of erythema on the extensor of a taxi driver . Dermatitis herp.

    Vertical nystagmus....stroke.
    Pt with visual probem and dizziness...vertebral artery insufficiency

    Ct showing iunilateral infarct...homonymous hemianopia

    Ct as well as a man having unilateral sensorineural hearing loss ...accoustic neuroma.

    Nursing home old gentleman having listeria meningitis

    wasnt the xray abdomen of toxic megacolon.

    wat would be the answer to the old man having glucose 13 high na/ k and acidotic with ketone

    Autoimmune hepatitis

    Myeloid leukemia with wat organism...schistosoma mansoni/trichuris trichura

    diabetic having paraspinal abscess ..wat organism..staph aureus/strep milleri

    greenish,sweet smelling discharge...pseudomonas

    Neutropenic sepsis...wat antibiotics

    periodic rectal bleed...endometriosis

    n small cell ca with ipsilaterallymph node inolvement ..
    treatement?surgery/radi/chemo
  32. Guest

    Guest Guest

    Hi Guys...

    Hot moment going on...am i right?

    anyway...nice to see u all with productive discussions.

    I am late, coz still i am in a hallucination.
    I couldnt forget the horror moment of my 2nd part of this exam.
    and at the same time,i am depressed.
    Coz..this was my 2nd attempt.
    My last attempt was far better than this time.
    Last time i was almost sure to pass....but bad luck.
    and this time...i am not expecting to pass.

    I could recall a lot of ques but I found most of my answers are being wrong.
    Now a days..i am so afraid of my upcoming result that i dont think i can bear the load of another bad reasult...but i have to do that.....pray for me......
  33. Guest

    Guest Guest

    :D
  34. Guest

    Guest Guest

    hi , friends i think discussion is going so weak & slowly what happened ????
  35. Guest

    Guest Guest

    Many of us here are in trauma after the exam, that's why the discussion here is slow. The test might look simple to some but in fact the answers are very tricky to choose from all looks possible.
  36. My first attempt.

    Very disappointing.

    All the reading from Sharma, onexamination didn't help one bit.

    Should have just sat for it blindly without any reading.

    No difference anyway.
  37. guest Dr A

    guest Dr A Guest

    hey guys ..dont be so disappointed .. lets see wat the exam result turns out to be
    yes u are right ...the exam ques were nuthing like wat we saw in sanjay sharma or on examination or pastest
    dnt knw abt master class.. if it helped or not
    the discussion is slow coz some of us cant recall all the ques ..
  38. Guest

    Guest Guest

    The reason why the older books and websites do not help is because the rcp is changing the emphasis of the exam
    They are placing a lot of emphasis on basics and practical investigation and management as you can see from the questions being asked
  39. guest 008

    guest 008 Guest

    there was a pateing with wheeze n dysphagi ..n Ct of chest showing esopahgus n trachea ..wat it was ???foriegn body ? carcinoma ? or wat ??
    there was also a history of weight loss .
  40. I put esophageal Ca as the answer cos it was progressive and associated with weight loss.

    I don;t know what the CT scan was trying to show though.
  41. CT scan for young man with hemoptysis and died - what was it trying to show?

    Lung ca with erosion into vessel?

    Aortic aneurysm?
  42. Doctor Who

    Doctor Who Guest

    Don't forget there is also another thread here with questions from the July exam - Target MRCP Part 2 July 2009.
  43. Geust 211

    Geust 211 Guest

    Dr. Manoj,, helllllp !!!!!
    we are in need of your sharp memory to put all the questions as you did before,,
    pls, that would be a great job for us, as well as future candidates,,,
    thanx
  44. Guest

    Guest Guest

    HI Guys...

    I am almost sure about my faiure this time...
    So,dont think that i am remembering part of the ques so i will pass like what happened last time.

    Anyway...i became able to recall 220 ques but not with full scenario....but u can understand which ques i am indicating very easily...

    Currently i am typing my ques....hopefully will start to provide from tomorrow..............

    Take care....
  45. Other questions i remember:

    1. Young homosexual with hx of giardia infection presenting with respiratory symptoms. Transbronchial lung biopsy shows non-caesating granulomas.
    asnwers available: HIV, sarcoidosis, chronic variable immunodeficiency, congenital hypogammaglobulinemia,

    2. Young man with occassional short lasting loss of consciousness and habit of smoking cannabis.

    Answers available: Cannabis smoking? subdural hematoma?

    3. Young lady with hirsutism and normal levels of 17 hydroxyprogesterone, elevated testosterone, elevated prolactin, and positive dexa suppression test.

    Answers available: Cushing's Syndrome, PCOS, Congenital adrenal insufficiency, Prolactinoma

    4. Young man with hypogonadism and hx of undesended testis. Elevated BHCG.

    Next investigation: ? Ultrasound testis, ? MRI pituitary

    5. Lady with easy bruising, menorrhagia, prolonged PTT and pancytopenia.

    Available answers: SLE, Antiphospholipid Syndrome, von Willbrand's Ds,

    6. Lady with rash and arthralgia and lymphopenia.

    Available answers: SLE, Erythrovirus infection, Rheumatoid arthritis

    7. Patient 24 hrs post pacemaker insertion. Collapsed with 38 degrees fever, hypotension, dullness on left side of chest, surgical wound clean.

    Choices: Septic shock, cardiac tamponade, etc

    8. Asian man who works as packer in supermarket with low back pain, tenderness on palpation, markedly decreased spinal movement and mildly raised ESR.

    Choices: Ankylosing spondylitis, Mechanical back pain, metastatic prostate ca,
  46. Guest

    Guest Guest

    Patients with CVID often have a history of recurrent infections.

    * The recurrent infections commonly affect the upper and lower respiratory tracts. Patients come to medical attention due to infectious diseases at the time of onset, the most common being otitis media, diarrhea, pneumonia, and sinusitis.10 Almost all have acute and recurrent infections.
    * Persistent diarrhea and malabsorption caused by Giardia lamblia infection occur in patients with CVID.
  47. Guest

    Guest Guest

    5. Lady with easy bruising, menorrhagia, prolonged PTT and pancytopenia.

    Available answers: SLE, Antiphospholipid Syndrome, von Willbrand's Ds,
    I think it was Primary Antiphospholipid Sndrome.

    Note: Primary antiphospholipid syndrome is diagnosed in patients demonstrating the clinical and laboratory criteria without other recognized autoimmune disease. Secondary antiphospholipid syndrome is diagnosed in patients with other autoimmune disorders such as SLE.
  48. Guest Dr A

    Guest Dr A Guest

    there was arthalgia also in that ques ..
    with pancytopenia n menorrhagia and raised APTT
  49. Guest

    Guest Guest

    ct san with sinusitis.
    when giving sumatryptan stop trptophan before starting.
    infective diarrohea ,do not give loperamide whatsoever.
  50. Guest

    Guest Guest

    I think the chap was not able to open his left eyes and eventually in A&E was able to do so
    Note:
    # Frontal sinusitis can cause pain just above eyebrows, and forehead may be tender to touch.
    # Maxillary sinusitis can cause upper jaw, teeth and cheeks to ache and may be mistaken for toothache.
    # Ethmoid sinusitis can cause pain around eyes and the sides of nose.
    # Sphenoid sinusitis can cause pain around eyes, at the top of head or in your temples.

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