MRCS 2012 sept part A

Discussion in 'MRCS Forum' started by meenal, Sep 12, 2012.

  1. meenal

    meenal Guest

    part a paper 2

    patient travel to zembabwi fever nausea

    patient underwent op possibly decrease immunity
    + pneumonitis

    h B v
    if u know answer?
  2. meenal

    meenal Guest

    Some neuro q-
    ---man with some eye sign . Diplopia--o/e 3rd n 6th CN palsy with forehead paraesthesia - the ans will be cavernous sinus lession but i put something else . Same que is in passmedicine.
  3. meenal

    meenal Guest

    Some more
    - 70 yr old man with hemiballism, better when asleep - shoud be subthamic nucleaus but i don't remeber if it was in the ans because i ticked red nucleaus again wrong sob sob..
    -upper limb ' weak abductor pollicis longus or brevis with decreased sensation of index finger -- ? Ans
    - another diplopia que - that was recurrent episode of self limiting diplopia. O/e ptosis and some other eye movement problem well i don't recall the ans for this i think MS/ MD was among them.
    -headache +vomiting for 2/7, low BP on presentation . I think there was 3 nerve palsy again - ?. Could it be pituatary apoplexy well no recall of ans i think imight have done wrong
    -some limb weakness with post hypotension - GBS ( i think somebody already mentioned this Q
    -homonemous quadrantonopia one

    -obese lady with headahce, false localising signs , high BP abt 169 sys-? IICH

    -galactorrperoa with hogh prolactin - which drug - ?? Metoclopramide-- pharma though

    -HIV cerebral involvement what will differentiate cryptococcus frm toxoplasmosis-- ?? I put CT but the CT finding might be similar in both so wonder what was the ans.--
  4. meenal

    meenal Guest

    upper limb ' weak abductor pollicis longus or brevis with decreased sensation of index finger -- Sensory Loss In C6 Dermatomes+Abductor Pollaces Weak
    night pain ,relieved by shaking arm etc
    A C6 Entrapment Neuropathy
    B carpal tunal syndrome
    C thoracic outlet syndrome
    D cervical rib
    E oat cell carcinoma
  5. meenal

    meenal Guest

    1. Rx for chlamidia in pregnancy - erythromyci

    2. HIV pt with CD count 300- start HAART
    3. Ix to confirm post bowel surgery bile acid ind diarrhoea-?? Sehcat
    4. young pt with RA-lower limb - sensory loss dorsum of foot with weak dorsiflexion - ?? mono
    5. A patient with partial third and fourth nerve palsy right with absent sensations on ipsilateral of lesion..midbrain, orbit, cavernous sinus, brainstem ???
    6. cystic fibrosis which chromosome Cftr Gene In Cystic Fibrosis-Code For Amino Acid
    7. lady with neck pain post fall in past ..some arm weekness

    8. asthma next treatment - IgE level given prednisolone
    9. SE of fenesteride – gynaecomastia
    10. middle age guy with recurrent ulcers on OGD while on Max dose PPI- next IX-?? Gastrin level

    11. prone to miscarriega- AB - anti b2 glycoprotein.
    12. light reception photopsin
    13. UC- goblet cell depletion
    14. Papules And Vesicles On Extensors With Itching : Dermatitis Herpatiformis
    15. Polygonal Voilaciouse Papules Then Plaque Eruptions : Lichen Planus
    16. Picture Of Jaundice Hepatospenomagaly With Lymphnode Malaria Or Hiv Seroconversion (Ip Was 4 Month But Pt Have Lyphadenopathy So I Choose Hiv Sero Conversion
    17. Sumatriptan 5ht1a Agonist
    18. Infective Endocarditis By Staph.Aureus: Penicillin Allergic So Answer Would Be Vancomycin
    19. Tpo Positive + Goiter +Tsh Low =Grave Ds ?????
    20. Thyroid Carcinoma Causing Laryngeal N Palsy stridor
    Anaplastic Carcinoma
    21. Sick Euthyroid Syndrome (Patient In Intensive Care Unit)
    Tsh n T3 Low T4 low
    22. Skin Lesion Voilaciouce Pruritic Lesion On Leg
    23. Porphyria Cutis Tarda
    24. Hyper Prolactaemia Drug –Metaclopromide
    25. One Male Having Rta Compressive Myelopathy Level T4 But After Few Month Level Go Up To T2 Cause Post Traumatic Syrinx ,Compression Increase.....
    26. Malaria Prophylaxis –With Ho Seizure –Atovaquine +Proguinil
    27. Also Post-Transplant Lymphoproliferative Disorders Caused By----- Ebv

    28. One Case Hyperbilurubinaemia –Gilbert Syndrome

    29. 50 Shipyard Worker A Case Of Sever Left Plueral Effusion Also Calcific Pleural Plaqes , Fever , Pleural Sample Exudate Lymphocytes 60% With 2% Methothelial Cells ----------- Tb Or Methothelioma ( I Am More With Tb As Methoselial Cells Only Exclude Tb If More Than 5% And Dosent Indicate Methothelioma Also Pleural Plaqes Is Not Premalignant, Also Fever .)
    30. A Case Of Shills Fever After 6 Monthes Returning From West Africa ---Malaria Ovale

    31. .A Case Of Post Mi Artery-Stemi V1 - V2 ----- Circumflex (In 15% Postdesending)
    32. A Case 2 Days H/O Headach & Visual Loss With Paracentral colour Scotma ? Ms

    33. One Case Like Face Upper limb,Lower limb Muscle weakness & Wasting With Increase DTR ?Mnd

    34. A Question Recurrent Weakness, Sudden Fall Down But No Loss Of Conceousness- cataplexy
    35. One Case Old Age But Presented Like Ms eye squint
    36. elder female with suicide attempt: embarassed after sum medical intervention: highest risk of suicide with in 2 weeks : most probably 65 years of age ?? --------- alcohol???
    37. Iron Poisoning-Treatment There Is A Q About Iron Poisining 24 Hours After With Sever Manifestations I Guess ------- Desferrioxamine
    38. Acut Monoarthritis –Aspiration wrist
    39. Arthritis Conjunctivitis Clear Urithal Discharge Travelling +
    --Reactive Arthritis

    40. Recurunt Urticaria Treatment –Antihistamin,Steroid Renitidin
    41. Ch articaria eye oedema
    42. Post Mi Lip Sweeling Angioedema Like Due Prindopril

    43. Fsgs- 24 urine 0.9 gm Proteinuria Treatment Ramipril
    44. 20 male proteinuria minimal change??
    45. Most Common Eye Feature Of Wernickes Encephalopathy
    Option Ophthalmoplasia Nystagmus,
    46. Post-Splenectomy -->howel joly
    47. Sle Is Membranous Gn (Stage 5) Because Of The Nephrosis
    48. Achalasia Investigation-Manometry

    49. It Was Alcoholic Liver Disease Due To High Gama Gt And In Nash Ast To Alt Ratio Is Typically Less Than One, Which In This Case Is More Than 1....Plus It Is Not Associated With Gama Gt
    50. Gastrin Inceased By-Peptide

    51. Ankylosin which chromosome 6
    52. Ondensteron Site Of Action-Medula

    53. Enzyme up to 10 Day Post Mi----Ldh
    54. Hocm- B Myosin heavy chain
    55. Turner Syndome +Intestinal Obstruction?? Intussus/Crohn Ds

    56. Pitz jugar s- AD
    57. Inflamatory bowel s invest ----C-rp
    58. Metaanalysis----Forest Graph???
    59. Age & Bp Variables- ? Scatered Graph
    60. Mody Most Common glucokinase
    61. Hb E, beta Thalacaemia Trait@ Thala Major 25%?
    62. Lmwh----Factor X / anti t3 ???
    63. Yonge Lady S2 Loud ----Sob Syncope--Family Ho --Pah
    64. Homocysteinuria- Reduced Activity Of Cystathione Betasynthase.
    65. Post renal transplant 4 years With Reduced 25 Dihydroxy Vit D, Increased Pth normal c.CA normal kidney -Secondary And Tertiary Hyperparathyroidism ??

    66. Live Attenuated Vaccine- Yellow Fever
    67. Neisseria Gonorrhea- Aerobic Diplococcus- Male Urethritis

    68. To exclude Cushings- Overnight Dexamethasone Suppression Test
    69. Essential Tremor- Family History+ - Propanalol

    70. Specificity= 890/950
    71. Acute Episode Of Hematemesis- Terlipressin
    72. Long Term Prophylaxis For Gi Bleed- Propanalol

    73. Angiodysplasia- aortic stenosis

    74. . Extrinsic Allergic Alveolitis- Hay
    75. Restless Leg Syndrome- Ropinirole

    76. Clopidogrel- Adp Agonists
    77. Allergic Reaction Following Food Intake – Trypase
    78. Pda- Collapsing Pulse
    79. Depression- Early Morning Wakening/ suicidal thougts
    80. For The Contact With Afb +Ev TB Mantox Test then Cxr
    81. Recent Immigration From Uganda With Multiple Hypopigmented Areas And Reduced Sensation - Leprosy.

    82. Uti Treatment In Hosp After 3 Days Becomes Agitated - Delirium.

    83. Nodular Lesion On temporal telangectasic Face With Pearly Margine =?Bcc= -Biopsy true cut ??
    84. Lower Zone Fibrosis =Asbestosis
    85. Decrease Kco Methotrexate Pneumonitis
    86. Increase Kco Pulmonay Hemorrage

    87. Recurrent Oral +Srotal Ucer =En= Becets Ds
    88. Hypercalcaemia------ Thiazide
    89. Best Evidence =Metanalysis

    90. Face desease statistic paired t test
    91. Intention To Treat- All Included
    92. Methadon -Sudden Death -Long Qt Syndrome
    93. Schizophrenia Vs cannabis one
    94. teenage with hallucinosis and sum other complaint: inatke of alcohol 100 units and regular cannbinoid user: on examination: oriented with tym, place: cannabinoid psychosis or alcoholic but alcohol withdrawal can give hallucinosis not by itself ?? paranoid schizo she have auditory third party persecutory i thnk it is 1 rank symptoms?? ----------- Schizophrenia???
    95. Asymptomatic Ealy Latent Syphlis pregnant Treatment- Penicilin
    96. Post Temporal Lobe Surgery -Homonemous Qudrintonopea
    97. Sensory Loss In C6 index finger Dermatomes+Abductor Pollaces Weak ? C6 Entrapment Neuropathy
    98. Pain shoulder then lmnl in UL Post Viral Neuralgic Amyotrophy
    99. Choria-Caudate Nu

    100. Lady Bmi 40 Short Neck Hypoxia Leg Edema=Osa/Obesity Hypoventilation Syndrome
  6. meenal

    meenal Guest

    101. Becet Ds Lg Sweeling=Dvt

    102. Myoclonus--Doc Clonazipam/Valproat

    103. Rhabdomylysis Responsible =Simvastatin

    104. Lady Polyurea +Polydipsia With High Blood Na + High Blood Osmolality +Urine Na Less Then +==?Diabetic Incipidus
    =mangement ?Oral Desmopressin .Fluid Restriction
    105. Hyponateremia mild hyperkalemia high urine NA -----Addison
    106. Azothiopurin Befor Start Test -----Tioprine mt
    107. Digoxin Loading Dose --half life
    108. Salbutamol Oral Vs Inhalar High Bioavailibility ????
    109. Complete heart block + Inf Mi 2 hours +Stable pulse 50 appropriate immediate action=Pci
    110. Post Alteplase Bleeding ---Ffp, Prothrombin Complex??
    111. Paroxism svt- not distressed return to sinus after vagal manage Definate Treatment –vagal manover or flecainide
    112. Lyme Ds Treatment Penicilline Allergy-Doxycy
    113. Csf finding Vial Meningitis
    114. Cause Of Wide Qrs During Exercise Test- In Wpw Syndrome-? Increase Refractory Of Accessory Pathway???
    115. Paget Ds With Mri + Bone Pain Nsaids\Bisphosphonates
    116. Cisplatin -Side Effect-Peripheral Neuropathy/?
    117. 2 Sd above the mean =95%
    118. Female With Primary Amenorrhoea +Virulising= Congenital Adrenal Hyperplasia=Investigation-17 Oh Progesterone

    119. Acute Mania---lithium Or haloperidol
    120. RA pt rec UTI on methotrexate Apastic Anemia -Trimethoprim ??
    121. Myelofibrosis-Tear Drop Cell

    122. Diabetic Pt With Hypokalaemia Hyperchloramic Acidosis-Renal Tubular Acidosis
    123. In transplanted PT A Non Responding Pt Of Febrile Neutropenia 4 days ??? Candida Fungemia
    124. Tronchataric Bursitis
    125. After 3 days of Treatment Of Temporal Artitis neutrophilia Steroid Induced Leucocystois
    126. Rest Less Leg.. Ropironole..
    127. Abdo Pain And Tenesmus Rectal Exam Normal – Sigmoidoscopy//Colonoscopy
    128. Heart Failure Already On Furosemide, Ace, B. Blocker, Aspirin To Optimise Add – Spironolactone
    129. Pancreas Ca Treated With Chemo - Monitor Tumour Marker Ca 19.9
    130. Woman With T2dm And Copd Exacerbation, Lactate Normal, Abg Ph 7.30, Pco2 10, Po2 9, H+ 50 - Acute On Chronic Resp Acidosis.
    131. Advanced liver d raised creat , urine NA below 5 off diuretic Hepatorenal $ pathogenesis ----------renal vascular vasoconstriction
    132. Man previous MI done CATH 4 monthes mottled skin levido reticularis ----- cholesterol emboli
    133. Woman With Recurrent Collapse And Wt Gain low c peptide ---- - Insulin Overuse.
    134. Treatment Of Choice replace Sod Valproate to Lamotrigine.. ?? Ans
    135. Locked In Syndrome Lesion In man Has Vertical Gaze Paralysis Plus Quadriplegia . Can Not Wake Up After Intubation What Is Teh Cause? ------ Pons? (Ventral Pons)
    136. Lady Develops Abdominal Pain Followed By Loc And Developes Lip Smacking And Staring Where Is Lesion? ----- Temporal
    137. 18 Yr Female Running Behind Bus Sudden Death Girl Running After Bus, There Was No Option As Prolonged Qt Interval, There Was Only Arythmia, Seizure, Vasovagal, Cardiogenic...So It Would Be Cardiogenic..-----------.Hocm Cardiodenic Syncope
    138. Vt Drud Contraindicated.. Verapamil
    139. P53= Cell Cycle Delays/Apoptosis
    140. Stressed Lady Recently Stopped All Meds ? Diazepalm Withdrawel/ Thyrotoxicosis
    141. Pulmonary Surfactant-------phospholipid
    142. Osteoporosis In Males-Testosterone
    143. Oral+Genital Ulcers-Behcets

    144. Cryoglobulinemia-Hep C
    145. Hereditory Angioedema-,Ci Esterase, C4 Level In Between Attacks
    146. Fragile x chromosome female carier -------------- 50%
    147. Ifosfamide-Mesna To Prevent H Cystitis
    148. No Surgery For Ca Lung If ------------- vocal cord Paralysis
    149. Pulm Emb-CTPA
    150. Burkitts lymphoma- Tumor Lysis Syn
    151. Rh Arthritis -------------Anti Cyclic Citrullinated Abs-
    152. Amiodarone-K Channel
    153. Factor 5 Leiden-Activated Protein C
    154. Strep Bovis bacterimia-Colorectal Ca
    155. A male with hemoptysis and renal failure..renal biopsy shows cresentic glomerulonephritis with linear igG deposition...which antibody to order to confirm diagnosis. -----------------------Anti-Gbm

    156. Stag Horn Calculi- Composition Mg Ammm Phosphate
    157. anorexia nervosa hypokalemia refeeding syndrome what to look for next --------hypophosphatemia
    158. Pcp treatment -----------cotrimexazole
    159. Traveler shocked 88/50 what to do next ------------isotonic saline
    160. young male recurrent hemoptysis upper lope lung collapse ----------- carcinoid tumor
    161. swollen knee xray chondrcalcinosis sterile- pseudogout
    162. 5 attacks of gout in 12 monthes ------------------allopurinanol
    163. Young female RA to start methotrexate --------------contraception
    164. increasing dyspnea, low transer factor- emphysema
    165. toxoplasmosis from Cryptococcus in HIV ------------Ct scan mass effect????
    166. A 72 yr old man with acute mono ocular visual loss. On exam pale optic disk in affected eye..diagnosis...-0--------- giant cell artiritis,
    167. A patient with sudden onset occipital headche and vomiting..on exam has gcs 15, and neck stiffness..ct brain investigation...-----------.csf
    168. What does a codon encode...--------------------------- aminoacid
    169. Patient on LAnsoprazole X 2yrs, decreased platelet 15000 and megarkaryocyte in peripheral smear Dx: ITP
    170. young lady ans can be vasovagal as recovery was very rapid
    171. female patient with difficulty climbing stairs weekness of proximal and distal muscles of limbs no sensory deficit deep tendon reflexes absent and postural drop in blood pressure --------------------GB $
    172. A hypothyroid female on thyroxin with adequate control suffers MI..she is thrombolysed and discharged on aspirin, clopidogrel, simvastatin, ferrous sulfate, ramipril,.. 6 weeks later she comes back with increased TSH..which drug has interacted with thyroxin...----------iron sulphate
    173. Spontaneous pneumothorax scenario...xray shows 3.5 cm pneumothorax in left lateral side...mangement...------------- needle thoracocentesis?????
    174. which food product has the maximum amount of calories/kg?? Ans: white wheat
    175. giant v wave and systolic murmur? Ventr pre excitation Ans: Ebstein anomaly
    176. old male gait disturbance ataxia few hours deterioration conscious bilateral planter bp rises 190/100 ---------------herniation brain stem
    177. What causes pul vasodilatn in healthy adult? Ans: Postracyclin
    178. another diplopia que - that was recurrent episode of self limiting diplopia. O/e ptosis and some other eye movement problem well i don't recall the ans for this i think MS/ MD was among them.
    179. Complete heart block-------------------rt coronary artery
    180. Abdominal pain, bleeding--------------------------ulcerative colitis
    181. Febril neutropenia what first ----------------broad spectrum antibiotics
    182. dm, no family history, bmi high : mechanism insulin resistance and weight loss ----------increased catecholamine??????
    183. A question about somatization syndrome

    184. 45 year old female tlc 100 000 splenomegaly ---------------chronic myloid leukemia
    185. Guillan Barre syndrome: check VITAL CAPACITY.
    186. Albumin low, total protein high _ myeloma -------------plasma protein electrophoresis).
    187. Young femal have completed chemotheraby 6 monthes ago presented with hip pain--------------avascular necrosis of the hip

    188. A case of hemolytic uremic syndrome (low platelet and raised creat post diarrhea)----------------- E coli O157:H7
    190. Chances of inherting cystic fibrosis
    191. Strep. Pneumonia- most common cause of pneumonia
    192. Tuberculosis mediated by- T cells.
    193. Boy e recurrent abscess and family hx of a cousin who died of a chest infectio---------------------------- neutrophil defect
    194. Addison’s best test- short syncathen test
    195. Ptyriasis versiclour man came from vacation

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