Discussion in 'MRCP Forum' started by OREOLUWA, Nov 24, 2006.
I sgree---good job,where ere U before
ANOTHER QS-------A 78 YRS OLD INDIAN WOMAN.PRESENTED WITH OSTEOPOROSIS-PREVIOUS HISTORY OF CA. BREAST RESECTIO.WHAT WOULD U GIVE
5-CALCIUM AND PHOSPHATE SUPPLIMENTS
SORRY I DIDN'T WRITE MY ANSWER----ALENDRONATE----PLEASE COMMENT---MAY BE TODAY IS HTE LAST DAY---I WANNA PUT ALL THE 25 MORE I KNOW----IT IS ONLY POSSIBLE IF U KEEP IN TOUCH AND KEEP ON COMMENTING---THANKS
YOUR QS ARE SHORT AND INCOHERENT.NOW COMMENTS TO THE QS
1.THE ONE WITH ARTHRALGIA,RAISED CRP AND RAISED ANTI-DNA AB.YOU SAID IT IS BRUFEN.THE QS FIRST OF ALL IS CONFUSING BECAUSE ANTI-DNA AB IS SPECIFIC FOR SLE AND IN SLE ESR IS RAISED BUT CRP IS NORMAL.BUT YOU HAVE SAID CRP IS RAISED.THE NORMAL VALUE SHOULD BE <21.
2.STRONTIUM - THE ONLY QS IN THE EXAM WITH STRONTIUM AS AN OPTION WAS THE ONE WHICH YOU LEFT OUT A VERY IMPORTANT HISTORY - THE PATIENT HAD A HISTORY OF ACHALASIA.SO BISPHOSPHONATES ARE CONTRAINDICATED.THEREFORE,THE BEST POSSIBLE OPTION IS STRONTIUM WHICH IS A NEW DRUG AND IS USEFUL IN THE TREATMENT AND PREVENTTION OF OSTEOPOROSIS.IT IS ALSO USEFUL IN MALIGNANT CONDITIONS LIKE THIS.CHECK YOUR BNF AS A REFERENCE.
THANKS FOR UR HARD CORE OPINION.PLEASE REMEMBER THAT I HAVE NOT MADE THE QS.I AM TRYING TO REMEMBER THEM WITH BEST OF MY MEMORY.ALSO NOTE THAT UR SUPPOSED TO GIVE UR OPINION NOT VERDICT.IF U SEE MY WORDING,I AM SAYING THAT MY ANSWER.IF U THINK UR ANSER IS BEST.LET IT BE.U WILL PASS I WILL FAIL.THAT IS WHY I AM DISCUSSING IT SO THAT IT SHOULD BE OF SOME BENEFIT. TO ME.
really good work keep on going any expectations about the results?!!!
I FAILED TWICE.IT HAS MADE ME HUMBLE.I TRY TO SHARE.THIS SMILEY GUY KNOWS EVERY THING.I AM NOT HOPEFUL.I TRIED MY BEST,WE WILL SEE.----PLEASE COMMENT ON QS.WE WILL KEEP THE HEAT ON---THANKS
I THINK THE PASS MARK WILL BE 56 - 58%.I HOPE WE WILL ALL PASS BY GOD'S GRACE.
IT HAS HAPPENED TO ME TWICE.FIRST TIME BY HALF A PERCENT AND SECOND TIME BY 4%,ALTHOUGH I HAD STUDIED MORE SECOND TIME.IT IS VERY UNPREDICTABLE.BEST OF LUCK TO EVERYBODY.
DO U STILL HAVE THE APPETITE FOR MORE ?---I AM READY
QS--WHICH PEOPLE HAVE BEEN DISCUSSING,I DISCUSSED WITH THE UROLOGY CONSULTANT YESTERDAY AND HIS ANSWER WAS SURPRISINGLY DIFFERENT:
76 YR OLD MAN WITH FEVER.GP GIVEN ERYTHROMYCIN.NORESPONSE.WITH PSA OF 20(4)--
HIS ANSER WAS PROSTATITIS.
MOST OF US INCLUDING ME HAD PUT--RCC--BUT HIS ARGUMENT WAS--
1--RASED PSA HAS NO RELATION WITH RCC
2--PATIENT WAS SIMPLE UTI WHICH WAS GIVEN THE ABX-ERYTHROMCIN-WHICH HAS NO GOOD COVER FOR UTI--
TO HOM THE BEST ANSWER WAS --PROSTATITIS---PLEASE COMMENT,THANKS
RENAL TB - I THINK IN THE HISTORY THERE WAS STERILE PYURIA,FEVER,LOIN PAIN AND HAEMATURIA OR BLOOD IN THE URINE.IN PROSTATITIS THE SYMPTOMS WILL BE VAGUE AND THE PSA WILLNOT BE ALL THAT RAISED.ABOVE 10 WILL INDICATE PROSTATIC CA,WHICH WAS NOT ON THE HISTORY AND DIDNOT MATCH WILL THE OTHER SYMPTOMS AND INVESTIGATION.I MIGHT BE WRONG.
WITH MY POOR MEMORY,THE HISTORY WAS VERY VAGUE OR LITTLE.THERE WERE QS.LIKE THIS IN THE OTHER PAPERS,LONGER IT IS GETTING WE ARE TRYING TO MIX.TO ME THE HISTORY WAS LITTLE.IF THE BLEEDING WAS THERE,IT WOULD HAVE BEEN RCC.SO RAISED PSA--RULE THAT OUT.ALSO RENAL TB IS VERY RARE.WHAT IT HAD TO DO WITH RAISED PSA.YES IF IT WAS CA-PROSTATE,IT CAN BE A POSSIBILITY--PLEASE KEEP DISCUSSING,IT WILL BE HELPFUL TO ME FOR THE FUTURE,THANK,BEST OF LUCK.
THERE IS DEFINITE ASSOCIATION OF PROSTATITIS AND RAISED PSA
IS THE RESULT OUT YET?????
I AM NOT SUE?
A 56 YRS OLD LADY DEPRESS.SISTER DIED RECENTLY.SAYS THAT SHE WOULD COMMIT SUICIDE.WHICH DRUG U WOULD SUBSCRIBE:
MY ANSWER WAS----CILATLOPRAM
COMMENTS AWAITING,THANKS--TAREEK ?THOUGHTS ?
AMYTRIPTILINE - IF THERE IS A HISTORY OF SUICIDE(ATTEMPTED/INTENTED), THEN AMYTRIPTILLE WILL BE THE BEST POSSIBLE OPTION.OTHER WILL BE LESS EFFECTIVE.WITHOUT A HISTORY OF SUICIDE,GO FOR SSRI'S.
I REMEMBER ONE QUESTION
A 71 YEARS MAN PRESENT WITH 3 WEEKS BREATHLESSNES . NO HISTORY OF COUGH .HE HAD UTI GIVEN COURSE ANTIBIOTIC STILLFATIGE.
HE HAD HISTORY OF PROS HYPER ATROPY.
ON EXAM PALE TEMP 37.8 PULSE 72 REGULAR BP130/65
SYSTOLIC MURMER AT LEFT STERNAL EDGE AND AT ABEX.
TWO SETS OF BLOOD CULUTERS SHOW NO GROTH AFTER 24 HOURS
ECH SHOW THIC AORTIC VALVE &MILD AORTIC REGIRGITATION.
WHAT IS BEST TREATMENT
1-CONTINE TO MONITER
2-REPET MID STREAM
3-START IV BENZYL PENCILLINE+GENTAMYCINE
4-START BENZYLBENCILLINE ALONE PENDING FURTER TEST
5-WAIT 48 HOURS AND THEN TAKE MORE BLOOD CULTER
MY ANSER WAS N 1
hi,guys there were 2 qs.on male osteoporosis--
1---lower limit of normal FSH/LH AND TESTOSTERONE--9(6-9)---I PUT BISPHOSPHONTE
2---TESTOSTERONE DECREASED---I PUT TESTOSTERONE
I HAVE THIS STUDY,WHICH I HAD READ----PLEASE COMMENT,THANKS
R Eastell, IT Boyle, J Compston, C Cooper, I Fogelman, RM Francis, DJ Hosking, DW Purdie, S Ralston, J Reeve, DM Reid, RG Russell and JC Stevenson
University of Sheffield Medical School, UK.
Although osteoporosis is generally regarded as a disease of women, up to 30% of hip fractures and 20% of vertebral fractures occur in men. Risk factors for osteoporotic fractures in men include low body mass index, smoking, high alcohol consumption, corticosteroid therapy, physical inactivity, diseases that predispose to low bone mass, and conditions increasing the risk of falls. The key drugs and diseases that definitely produce a decrease in bone mineral density (BMD) and/or an increase in fracture rate in men are long-term corticosteroid use, hypogonadism, alcoholism and transplantation. Age-related bone loss may be a result of declining renal function, vitamin D deficiency, increased parathyroid hormone levels, low serum testosterone levels, low calcium intake and absorption. Osteoporosis can be diagnosed on the basis of radiological assessments of bone mass, or clinically when it becomes symptomatic. Various biochemical markers have been related to bone loss in healthy and osteoporotic men. Their use as diagnostic tools, however, needs further investigation. A practical approach would be to consider a bone density more than one SD below the age-matched mean value (Z < -1) as an indication for therapy. The treatment options for men with osteoporosis include agents to influence bone resorption or formation and specific therapy for any underlying pathological condition. Testosterone treatment increases BMD in hypogonadal men, and is most effective in those whose epiphyses have not closed completely. Bisphosphonates are the treatment of choice in idiopathic osteoporosis, with sodium fluoride and anabolic steroids to be used as alternatives.
1-in the renal qs the history was 76 years old man with loin pain+fever+high ESR+Impaired renal function and Hb of 18 the answer is HCC the only possible option that can give secondary polycythemia
2-the psychiatry qs i cant remember but please give a detailed history if possible
3-Guy with hypopitiutrism and osteoporosis give TESTOSTERONE as it is low and it inhibitis bone resorption
4-girl said to commit suicide give TCA
5-old guy with endocarditis its really vague as the history is not complete i cant remember what did i put
BENZYLPEN AND GENTAMYCIN - ANY CASE OF FEVER AND MURMUR YOU SHOULD SUSPECT INFECTIVE ENDOCARDITIS TILL PROVEN OTHERWISE.FROM THE HISTORY THE PATIENT HAS GOT A BLOOD CULTURE NEGATIVE RESULT INDICATING HACEK ORGANISMS,Q FEVER OR FUNGAL INFS.THEREFORE,WHILE TRYING TO KNOW THE RIGHT ORGANISM IT WILL BE ADVISABLE TO COVER THE PATIENT WITH BENZYLPEN AND GENTAMYCIN.
I REMEMBER THERE WERE TWO QS-OF HAEMATOLOGY.
results coming out in 8 hours time!!
good luck guys
THANKS FOR BEING SO PRECISE,NOW TELL US THE PASS PERCENTAGE AS WELL,SIR/MADAM/INBETWEEN(SORRY I WAS NOT POLITICALLY CORRECT)
GUYS,THERE WAS A QS.ON PLEURAL EFFUSION---PLEASE REMIND ME,THANKS
COMME ON,WE HAVE NOT DONE ANY POST MORTEM ON NEUROLOGY YET.
guys the results will appear on monday by 17:00 pm as mentioned on the website .......stragnge isnt it it should have appeared today
anuhow lets keep discussing as to gain knowledge
THAT IS THE SPIRIT--TAREEK
IF U COULD REMEMBER PLEURAL EFFUSION QS.THANKS
EVERYBODY,HAVE A NICE WEEKEND
hey is results out on monday jan 8th?
to scared to check
its not out today right?
coming out on sunday apparently
the male sea lion
the answer is continue to monitor for the question on infective endocarditis
with 2 negative bld culture as there is no urgency to treat
didier drogba, the english plays football on sunday so results thank god
comes out on monday jan 8 th at 1700hrs as tareekdeema says
at least my sunday will not be ruined now
good luck to all
Oh, its got to be Monday. Can't imagine them working on the website on Sunday.
Anyways, good luck everybody!
They managed to ruin the weekend.
the measure of a man
hahaaha u crack me up michela
good luck everyone!
lets just enjoy one more day of absolute bliss of not knowing
ignorance is heaven sometimes
hell is when reality comes crashing down
the results are already on the net
TILL NOW RESULT NOT READY ON NET
Whaddya mean trying to scare us like that mate? Its on the the mrcp site for tomorrow.
Ok all, ignorance is bliss. Good lets not scare each other.
hope u enjoyed ur day of absolute bliss... u r right, reality is looming large.
Along with that queasy feeling pervading the entrails.
To pass or not to pass... :cry:
READY FOR ANOTHER QS ?
YES,GIVE MORE QS.
i'm quaking in my skin now
but i did have a good weekend
i chased my butterflies in me stomach away by going to a buffet dinner and swallowing heaps of sea-food on sunday
how wuz ur weekend?
Inshallahuta'la the results are going to be posted on website today.
Good Luck to you all and all of us.
May Allah give us all a great success in MRCP part 2 exam
-Aameen ya Allah Aameen.
U ANNA,MICHAELA AND DANNY BEST OF LUCK.U HAVE ENJOYED WEB CHATTING IN THE LAST FEW DAY.HOPE EVERY BODY IS CALM.BEST OF LUCK.---ONCE IT IS ALL OVER MORE QS,--- I WILL BE NEEDING IT ANYWAY.
good luck GUEST
hi guest i juz checked the website and the results are still not posted yet
but yes good luck to you too!
by GOD's grace let us pass the exam then!
RESULT WILL BE POSTED ON 17 HRS GMT TODAY 8.1.2007 ON
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