Discussion in 'MRCP Forum' started by drrajib, Jan 19, 2010.
Lets start memorizing questions and discuss them....
just came back, paper 1 was hard as hell
one qiuz about difference between 5FU and Capecitabine unfortunaitly i answered wrong the difference was it is used orally
sorry very tired i'll re post later
thnks for starting, I answered orally, Thanks god
one hardddd paper 1 and 2m why so many endocrine qs?
1. Skin lesion and lt ankle sweling..prognosis??
2. Cause of death in a renal pt receiving HD for 5 yrs??
3. Causative organism for infected peritoneal dialysis patient??
4. Ant ST seg elevation MI following GI surgery..Rx option besides anti platelets??
5. What to do in a patient receiving clopidogrel prior to abd surgery??
6. Empyema inv.??USG/CT?
7. Primary pneumo with rim of air <2 cm??
8. Anti TB with decreased visual acity??
1 suspected pe findings on cxr
2 person has hematuria father and brother had same
3 herpetic virus 8 virus causes
4 type amylodosis al /aa in person with myeloma
5speceked pattern with tight skin ?scl 70
6baby lupus ? ro antibodies
7investigation for pulmonary hypertension
8 restrictive lung function with raised KCO ?pul heamorraghe
9obstructive fev/fvc ratio with reduced kco emphysema
10dna probe to identify rna
1. Resp Pathogen for CF pt?
2. HOCM poor prognostic criteria on Echo?
3. Footballer with sudden cardiac arrest?
4. Inf MI ECG?
5. Cons pericarditis ECG??
6. Poor outcome in a VSD pt with pg??
7. Her angio neurotic oedema cause of plasma leakage?
8. CxR of PE?
9. Dx of PE?
1.APCKD pt brother refused for kidney donation?
* seizures, hypomelanotic patches, multiple renal cysts, periungua fibromas -TUBEROUS SCLEROSIS
psychogenic aphonia or mustism in the woman whom here son disobey here
ATN OR AIN OR minimal change nephropathy In diclofenac in woman aged 60
traces of canaboid ??? canboid abuse or psychotic depression
HCM ?? lft vent out flow more than 30 mmhg or septum thickness more than 3 cm
burgada or rt vent hypoplasia or HCM in young age collapse after football match
ANKYLOSING SPONDYLIS WHAT TO SEE IN X RAY OF LUMBO SACRAL
XRAY IN PUL . EMBOLISM ???
CLOPIDOGREL STOP TO AVOID BLEEDING AFTER 24H OR STOP AND USE LMWH
ODD RATIO ?? QUESTION
PLEURAL EFFUSION DIDNT GET ASPIRATED ?? I ANSWER LAT CHEST XRAY
ANATOMY: SCIATICA AND LONG THORACIC NERVE AND ABDUCTOR POLLICES PREVIS
DISSOCIATED SENSORY LOSS ?? CENRAL CANAL !
1. Subacute IE. treatment? Benpen + gent
2. litium toxicity. precipitant. ?ramipril
3. chronic CML, (?not candodate for imintab). ? a-interferon or ?hydroxycarbamide
4. Discoid lupus on steroids. ?next treatment. ? hydroxychloroquine.
5. Young pt had appendicectomy then went into shock (?sepsis - abscess). investigations ?clotting screen ?DIC
6. Pt with face swelling (on ACEi, Statins ..) ? precipitant
7. Macrocytic aneamia with antibodies to parietal cells. ?biopsy (?gastric wall)
8. chikenpox developed pneumonia ?treatment
9. ?mediator in anaphylaxis
10. ?test to confirm transfusion haemolytic reaction
11. A student's girlfriend kicked his ass after he came back from USA. He thought he's the Dean (?delusional syndrome or ? schizophrenia !!!!!!!)
12. Lady with abdo pain and all Ix NAD --> ?factious disorder
13. Pt thinks he's got cancer --? hypochondria disorder
14. intermittent painful defecation with fresh blood in young lad (?polyp ? haemorrhoids ?anal fissure)
15. Jaundiced pt with deranged LFTs (AST 1453) and tender hepatomegaly recently come back from holiday abroad (?Hep A)
EGYPT?? SALMONELA OR SHIGELLA
ANKLE SWELLING----CA CH BLOCKER
CONTROL HT RATE IN AF ---BISOPROLOL
AF ---HAEMODYNAMIC LOW----DC
BELLS PALSY---- LACRIMATION OR SALIVATION OR HYPERACUSIS OR HYPERATHESIA
CSF WITH HIGH LYMPOCYTE AND PROTEIN AND GLUCOSE 3.3 ---GUILLAN BARRE OR POLIO
mrcp jan 2010
1 signs of anterior spinal artery occlusion with flaccid paralysis and loss of pain and temp
2symptoms of unwell diarrohea post terminal illeum removal ? bile salt irritation
3 lower quadrant visual symptoms what next investigation
4 dilated pupil slowly reacting to light irregular ?adie pupil
5 raised cholestrol ,ldl,triglycerides tx atrorva /simvas
6 hypokalemia ecg shows U waves
8 smalll ca with siadh
9jaw stiffness with multiple injected sites with discharging sinus tx? metronidazole /vac
10 presenting with bleeding pr and abdominal pain post recent surgery ?mesenteric artery occlusion
Paper one was average, but 2 was a bit tough. Alhamdullilah I have done better than before. Following are the remembered questions, please note that these are my answers and can be wrong, so please discuss to make them right. Thanks
1.JAK 2 mutation --- PRV
2.Mother upset by her son's disobedience, presented mute but movement ok-- Depression ???
3.HOCM risk -- septal wall thickness 3.3 cm
4. ITP 2 questions
5. Tuberous Sclerosis (periungual fibroma)
6. Pt seeing Dog lying in next bed--Alcohol withdrawal
7. Pt claiming to be dean of medical faculty, after his girl friend left him--Mania
8. Boy behaving schezophrenic, Urine shows mild canabiniod--Dont remember the answer exactly but i marked something related to schizophrenia.
9. Lady with hip pain but all movements normal--Osteoarthritis
10. Positive predicted value---I screwed that up
11. Standard deviation
12. Lady with hypertension, hursutism and weight gain---PCOS or CAH ?
14. HIV seroconversion in African boy
15. Carbamazepine autoinduction
16. Respiratory depression in an overdose--Diazepam ??
17.Ring Enhacing Lesion-Toxoplasmosis
18.Pneumocystis Jiroveci treatment--Co-trimoxazole
19. Glucose Tolerance test with Plasma growth hormone measurement
20. Man from india with jaunced picture--Hep A
21. Bloating, pain, long standing diarrhoea--Giardiasis
22. Typpical picture of Multiple Myeloma with unmeasured extra Immunoglobulins in blood + Bence John's Protein
23. Central Scotoma----Optic Neuritis
24. Anti-Ro ----Heart block
26. FEV1/FVC low -- Emphysema
27. ABGs given -- Mixed Metabolic acidosis and respiratory acidosis
29. Difference between 5FU and new drug Capecitabine---Used Orally
30. Inflamatory infiltrates in lamina propria+Granuloma --- Crohn's
31. Asymptomatic with low Hb but more markedly low MCV and Raised HbA2 --- Beta Thalasaemia Trait
32. Mild haematuria, father and brother also had haematuria---Exercise related haematuria (I tried to figure out if it can be hereditary but the option given was Alport's synd which is X-Linked dominant so no male to male transfer)
33.Widespread ST elevation in anterior leads -- Constrictive Pericarditis
34.Another question with constrictive pericarditis picture and asked what else is found --- widespread ST elevation
35. Rate control in AF in a heart failure patient already on Digoxin---Amiodarone (other options were beta blocker but cant be used in heart failure)
36.Thyroid Nodule in a totally asymptomatic patient---Fine Needle Biopsy ??
37. Minimial Change disease
38. Henoch Schonlien Purpura
39. Lorry driver with chest x-ray having calcification--TB
40.Hypokalaemia, what else is found----U wave on ECG
41.Pleural effusion patient---Do bronchoscopy (It was the 1st question in paper 1 I think)
42. Pt with history of influenza, now pneumonic picture-- Organism responsible ---Staph Aureus ??
43.Cholesterol Embolisation with Levido Reticularis, what else is found -- Eosinophilia
44. Hypertension in Pregnancy -- Methyldopa
45. Pt with low BP, Hickman Line insterted presents with various electrolyte abnormalities, what else can be expected -- Hypophosphataemia
46. Pt with low BP and AF -- DC cardioversion
47. Footballer suddenly collapsed while playing and died on way to hospital -- HOCM
48. Latex Allergy -- IgE mediated hypersensitivity ??
49.Hyperventilation due to panic, what will be immediate blood abnormality -- answer was either low HCO3 or low H+ ion....?? I marked H+ because HCO3 takes time.
50.Short Synacthen test
51. Pt on haemodialysis for 5 years 3 times per week. Cause of death -- Dilated cardiomyopathy ???
52.Beta Blocker Toxicity with very low blood sugar and bradycardia non-responsive to atropine -- Give Glucagon
53. Pt took cocaine, what else can be found -- Ischaemic Cardiac pain
54. Coronary Vasospam--give Calcium Channel Blocker
55.Drug in the marketr for 2 years and now a study claimed to have found a serious side effect, what test will be used to check--- i wrote Case Control study (Because Rand Cont Trial cannot be used for side effect measuremenst, but I can totally wrong, please discuss)
56. Pt with typical DLE -- give HydroxyCholoquine
57. Pt seemed to have Seborrhoea or Dandruff (Not sure) -- But I marked Ketoconazol cream, other options were totally irrelevent except Metronidazole cream.....so i was in doubt and marked Keto.
58.Pt with alcohol abuse presents with ataxia. Wats the reason? Options were various but I marked Vit E Deficiency....Please correct me.
59. Lady after a fall, pain in neck with weakness but joint position sense and vibration sense and light touch preserved--- Anterior spinal compression/Syndrone...???
60. Patient presents with functional symptoms but he also had a history of thinking he had a cancer 1 year ago, but now presents with some functional symptoms--Somatoform disroder and not Hypochondriac disorder.
60.Lady with persistent diarrhoea for 2 years without any cause, some other functional symptoms were also given -- Somatoform disroder
61. Patient with SIADH -- Fluoxetine
62. Prophylaxis for Trigeminal Neuralgia-- I just marked Phenytoin. Please correct me.
63.Lithium toxicity ---Concomittant use of ACE-Inhibitor
64. Rheumatooid Arthritis patient alread on Diclofenac Sodium,what should be started next-- Methotrexate
This is all I can recall by now.
Please share more to make a complete list. Thanks and good luck to all.
May Allah pass us all...Ameen
alopecia is casued by valproate
treatment of neuralgia is carbamazepine
pt on digoxin /warfarin still af uncontrolled i wrote bioprolol ??
pt on dialysis i wrote ischeamic heart disease something related
alcoholic patient with ataxia had blurring of vision 2 years ago therefore i wrote MS
respiratory depression i wrote codiene as its a morphine derivative and can cause resp depression and low gcs
thyroid nodule i agree it can only be FNA
lady with previous hx of investigation for cancer i wrote hypochondriasis as it was major illness for which she got investigated for dont know could be wrong
atn sec to 10 day use of diclofenac
i agree with most of ur choices , those i recall
1-28 y with DM why type 1 age, bicarb, acetone i chose age
3-18 y f eczema and recent small pustule at face and UL topical steroid
4- single nucleotide polymorphism i chose predict protein
5-Huntington chance of sun to be carrier 50%???
however, let us discus these
7. Pt claiming to be dean of medical faculty, after his girl friend left him--Mania i thinnk its paranoid schizophrania
9. Lady with hip pain but all movements normal--Osteoarthritis i think bursitis arthritis would have limitation of active move
10. Positive predicted value---I screwed that up---------50%
11. Standard deviation----------------SEM
12. Lady with hypertension, hursutism and weight gain---PCOS or CAH ? -------PCO there was high LH:FSH ratio
14. HIV seroconversion in African boy--- glandular fever atypical lymphocytes
16. Respiratory depression in an overdose--Diazepam ?? ------i chose dihydrocodien PLS discus
36.Thyroid Nodule in a totally asymptomatic patient---Fine Needle Biopsy ?? i chose scan discus
37. Minimial Change disease--- MGN sicus
41.Pleural effusion patient---Do bronchoscopy (It was the 1st question in paper 1 I think) ---------thoracoscopy pleural biopsy
51. Pt on haemodialysis for 5 years 3 times per week. Cause of death -- Dilated cardiomyopathy ??? -----------septicaemia
55.Drug in the marketr for 2 years and now a study claimed to have found a serious side effect, what test will be used to check--- i wrote Case Control study (Because Rand Cont Trial cannot be used for side effect measuremenst, but I can totally wrong, please discuss) - I agree
57. Pt seemed to have Seborrhoea or Dandruff (Not sure) -- But I marked Ketoconazol cream, other options were totally irrelevent except Metronidazole cream.....so i was in doubt and marked Keto.---------metronidazol pls discus
59. Lady after a fall, pain in neck with weakness but joint position sense and vibration sense and light touch preserved--- Anterior spinal compression/Syndrone...??? ---------------SYRNX dissociated sens loss
62. Prophylaxis for Trigeminal Neuralgia-- I just marked Phenytoin. Please correct me. - carbamazepine
63.Lithium toxicity ---Concomittant use of ACE-Inhibitor ----------Ca channel ??//increas toxicity
1. Heart block after inferior MI. ?RCA occlusion
2. Guillain-Barre ?monitor respiratory function ?FVC
3. 13y after valve replacement. anaemic ? haemolysis
4. PCP treatment. ?Co-trimoxazole
5. Haemochromatosis screening: transferrin saturation
6. Lady with excessive hair --> SE of: ciclosporin
7. Acoustic neuroma --? absent corneal reflex
8. Betablocker overdose with bradycardia not respond to atropine. Next managment --> glucagon (repeat question Jan 2006)
9. Hypopigmentated areas round the eyes in pt with thyrotoxcitosis ? vititligo
10. Male with severe pain behind eye worse in the morning --? ?trigeminal neuralagia
11. Unwell young pt with lymphoadenopathy --> grandular fever (EBV)
12. JAK2 mutation --> Polycythaemia ruba vera
13. Idiopathic parkinson --> ?tremor
14. Tear-drop poikilocytes --> myelofibrosis
15. Pt with polyarthritis and anti-CCP --> ?RA
16. Northern blotting to detect RNA
17. Weight loss for obstructive sleep apnoea
18. Prophylaxis in trigeminal pain --> carbamezipine
19. New AF in compromised pt --> DC shock
20. AF with CCF not respond to digoxin --> give bisoprolol as per NICE
21. Lady with tenderness + pain lateral R hip --> I wrote bruisitis
22. A question on sensitivity
23. Positive predicted value TP/FP+TP
24. Respiratory depression due to overdose --> dihydrocodeine
25. Ring enhancing lesion --> Toxoplasmosis
26. Obese lady with deranged LFTs and USS prognostic --> Nonalcoholic steatahepatits
27. Hypokalemia --> flattened P wave
28. Refeeding syndrome --> low phosphate
29. Risk Sudden death in HOCM --> ?enlarged L atrium
30. Serious SE (fluminant hepatitis) of a new drug as per a journal article. Best course of action is to do metaanalysis of related clinical trials as this would give the strongest evidence.
31. DLE --> hydroxychloroquine
32. Dandruf --> ketoconazole
33. Fall and loss of pain and temperature and joint sensation preserved --> ?cervical disc prolapse
few more that i can barely remember
plz help give answers
testicular feminization ? male with female gentalia
mitochondrial disease shows ?optic atrophy
polypeptide degradation occurs in ?? endoplasmic reticulum
nurse presents with a rash she has palmar rash and papules 0.4cm around gentalia
renal failure /loss of left knee and right ankle reflex with loss of power /urine positive for hematuria ? PAN/ SLE
cause of pnuemonia in a 50 year old ?mycoplasm/h influenza
a patients cxr showing 2-5mm calcified lesion ???
recent colonic operation now severe chest pain management ? nitrates
dx with cholecystitis 6months ago had stent insertion on aspirin and clopidogrel tx ?? delay for 6 months plz tell
patient tx for meningitis but after 4 days again confused and restless ? investigation ?urea/elec or MR scan brain
dx of parkinsonism i wrote repeated falls ( signifies ridigidty )
recently had chemotherapy now has neuropathy ? cause cyclophosphamide /vincristine
shin lesion with ankle swelling ?resolves
cause of raised urinary sodium
treatment of immune thrombocytopenia
Hi all of you
Just back from exam Happy after paper 1 , devastated after paper 2
I think same topics but with variety of questions may be I need more practice
Here are some questions which i remember , answers might be wrong but please discuss and add if remember more
1 . Alcoholic , weight loss , chest signs and symptoms , CXR shows pleural effusion aspiration attmepted but failed whats the NEXT investigation
its clearly mention next not best investigation
2. carbamazemine autoinduction
3. valporate hair loss
4. cyclosporin excessive hair
5.patient suffered peripheral neuropathy , had chemo whic medication to stop ? vincristine
6. mismatch blood transfusion what test to confirm ? direct coombs test
7. Ring enhancing lesion on CT aids patient ( toxo )
8. 10 days after chemo patient neutrophil 1.2 ( Neutropenic sepsis )? prophylactic cipro
9. patient with variety of symptoms and sign anaemia . renal failure . neuropathy ? Polyarteritis nodosa
10. Mild headache in elderly which investigation ? ESR
11. Patient having unequal pupil and Ptosis ( Horner) which investigation to confirm ? cxr
12. CSF showing 100 lympho plus high protien ? TB
13. Ankylosing spondylosis what will present in Lumbar xray ? sclerosis / osteophyste / sydem/ wedge shape
14. patient with hip pain and lateral tenderness ? Osteoarthritis
15. 2/52 renal transplant dont remember the exact question but indicating cyclosporin toxicity
16 . patient on cyclosporin LFT become derange what investigation next to find the cause renal ultrasound / urea creatinine / cyclosporin levels
17. Alcoholic with deranged LFT pointing towards NASH
18. Contraindication to liver biopsy PT / obesity / platelets / ultrasound appearance of intra dilation of biliary tree
19 . patient on 5 HTN medications develops ankle edema amlodipine/ doxazocin / monoxidine
20 . Preg HTN methyldopa
21. 19 yr old patient having heavy protien urea but no heamturia most common cause membranous / minimal /FG / Ig A
22. routine medcial check showing iron deficiency with basophilic stripling , patient asymptomatic lead poisonng / sideroblastic dont remember other options
23. elderly feeling lethatgic investigation showing Iron defeciency but no altered bowel symptoms which investigation first ( gaasto / colonoscopy )
24. patient having blood diarrhoea / recent antibiotics for chest infection history of MI / diabetes ( c .diff / ischaemic colitis / diverticulits )
25. patient having blood diarrhoea not respond to 5 days of metro ? campylo
26. IV drug abuser sign and symtoms of tetanus which antibiotcs ? metro ? doxy
27 . Endocarditis blood culture alpha hemolytic which combination ? ben + rifa / benpen + genta
28 . GB syndrome patient asking for Vital capacity i think
29 . 37 yr old patient with Upper and lower motor sign father had similar problem at 78 yr of age ? amyotrophic lat sclerosis
30 . Bronchiectasis whic organism common ? Kleb / Moraxella / H influenza
31. Pulmonary HTN best investigation ? Echo / ctpa / vq scan
32 . caviating lesion with RF ? Wegners
33. weight loss / hemoptysis / hyponatremia which lung ca ? small cell
34 . patient heavy smoker and asbestos exposure diagnose lung cancer which account more i think smoking mainly
35 . testicular feminisation how will patient look like male with female genitals / male with inguinal testis / femal with clitromegaly etc
36 . Type 2 dm obese which medication first metformin
37. thyroid mass with normal TFT which investigation next ? FNAC ? radioisotope scan
38 . Man 30s pain behind eye and problem with colours examination showis central scotoma ? optic neutris
39 . question asking about absent ciliary reflex
40 . cocaine abuser ischaemic chest pain
41 . elder with fast AF but unstable hypotensive sys less then 80 ? cardiovert ? iv amiodarone / iv betablocker
42 . VSD want to become pregant which will be make it difficult ? Pulmonary HTN / aortic regurg cant remember all
43 . patient why playing dead HOCM
44. RTA which will be present renal stones
45 . Cushing meatbolic alkalosis
46 . Patient investigated for palpitation all normal last yr think he had cancer ? Hypochondriasis
47 . Mother stressed with disobeyed child suddenly unable to speak ? akinetic mutism ? dpreseeion
48 . pastient with left hemiplegia and h/o of CABG 15 yrs , unable to find right brachial and radial pulse . having head neck and back pain
? brachia site stenosis / dissection / GCA
49 . Nurse from southern india experiencing wight loss and diarrhea facal elastase less then normal ? tropical sprue ? coeliac
50 . lady with linear erythema and exfoliative margins on the shoulder prv h/o of overdose ? factitious / psoraisis
51 . lady taking carbimazole develops hypopig around eyes ? vitiligo
52 . Discoid lupus not responding to normal treatment what next
53 . MMSE 18 medication donezepil
54 . qusetion about drug induced Diabetes inspidus
55 . idiopathic PD ? symmetrical bradykinesia
56 . Acromegaly invest OGGT and growth harmone
57 . copd with PE which invetigation ? CTPA ? V/Q scan
58 . patient blood gas showing mixed metabolic and resp acidosis
59 . patient blood gas showing type 2 resp failure diagnosis copd / Asthma
60 . RA anti ccp positve
61 . RA treatment metho / pred
62 . patient ABPA admitted with exacerbation what to give first ? steroids ? itraconazole / neb saline / neb steroids
63 . patient with Hypokalemia what will ECG shows
64 . patient with Pericardial rub What will ECG shows ? small complex
65 . Ramipiril most common side effect cough
66 . pateint with facial edema ? which medication ramipirl
67 . Patient on lithium HTN medication made levels high ? ACE
68 . Cholestrol emboli what will in the blood ? eosinophilia ? thrombopcytopia
69 Patient with features of DIC what investigation ? coagultion ? d dimers
70. ITP treatment prednisolone
71.another question with neutropnia what to give GCFactor
72 . question about reactive arthirtis affectiong knees ankle and sole rash
73 . 2 questions of Herpes patient ? iv acyclovir
74 . myxoma where left atra / right atria / ventricles
75 . clusture headache question
76 , Perxisome straight forward question
77 . Hypercalcemia patient recieving fluids 4 hrs qhat next pamidranate
78 . Hypercalemia but low PO which is increasing ca reabsorbtion ? PTH / 1 , 25 / Hypophostemia
79 . 2 questions of Primary Hyperparathyroid
80 . Question about prolactinoma
81 . patient with renal failure and high total protien ? Multiple myeloma
82. Recent major surgery now 3 days later major MI after aspirin and clopidogrel what next ? primary angio / thrmobolysis / LMWH / unfrac heaprin
83 . patient on clopidogrel and aspirin awaiting surgery ? stop clopi and start LMWH
84 . SLE want to ask about developing neonatal Lupus which antibody present ? Anti Double Ds ? Anti Ro ? Anti sm
85 . question about PBC
86 question of Autoimmune Hepatis
87 cystic fibosis what chance of sister being carrier or effected cant remember the exact qyuestion ? 1:4 ? 2:3
88 . tubeorus scleosis two question asking association polycystic kidney
89 . diabetic patient with B/L small kidneys and protienuria and mild renal derangement ? Amylodosis ? diabetic nehropathy ? renavascular both kidneys
90 . ALL poor prognosis Ph chromosome
91 . CML treatment Imatinib
92 . question of grave disease
93 . megaobastic anaemia ileal resection
94 . another question with high MCV cause ? b12 def ? folate def
95 . parietal lobe infarction patient unable to read ? agraphia
96. patient with glucose in urine fasting and 2 hr normal feeling tired and lethargic ? Renal glucosuria
97 . medical student think he is dean of the university
98 . hemibalissmus wher is lesion ? subthalamic ? substania nigra ? caudate nucleus
99 . separate RNA from DNA ? northern blotting ? hybri
100 . whome to isolate patient with MRSA septicaemia / pneumonia and MRSA in sputum / perotenal TB 1 day treatment / pulm TB 16 day treatment
These are some , if some one has good memory fill the rest of the parts
Stridor, dysphagia (Flow volume loop)
alot of stastitcs ...MANN whitney U or chie sequard ??
hey guys the question about the infective endocardits in prothetic valve we should give vancomycin+gentamicin+rifampcin
Ring Enhacing Lesion-Toxoplasmosis
I thought the question said single Ring Enhacing Lesion, which should be CNS lymphoma
-Site of action of bendrofluthiazide
- low hb . low MCV ? cause ? ascaris and others
-Alcohol withdrawl with seeing dog next to bed
-X-ray changes in AS
-pregnant lady with raised amylase
-Duch Ms Dystrophy with grand children inheritance
-girl with FH of 2 brothers with ?> weakness . mum negative..mode of inheritance?
- SE of drug being compared on both sides of face, best statistical rest ?
which patient can be left in multibed area - Legionell, Varicella etc etc
The following are most likely TEST questions,(cos I donâ€™t recollect seen them in the exam); so donâ€™t worry if youâ€™ve got them wrong
1.Which patient can be left in multi-bed area
2.Pregnant lady with raised amylase
3.Causative organism for infected peritoneal dialysis patient
4.Intermittent painful defecation with fresh blood in young lad
5.Blue vision is seen in?
6.Huntington chance of son to be carrier
7.Whom to isolate patient with MRSA septicaemia / pneumonia and MRSA in sputum / peritoneal TB 1 day treatment / pulm TB 16 day treatment
8.Hemiballismus where is lesion ?
Also, thought Iâ€™ll give my explanations for some questions with controversial answers
â€¢Site of polypeptide degradation â€“ Proteosome /wwwproteasomescom/
â€¢ Man with Back ache, multiple joint pains (father â€“ vague joint pain history) RF negative, Anti CCP positive â€“ Answer should be Psoriatic arthritis - Explanation is â€œAnti-CCP positivity was a frequent finding in PsA and associated with symmetrical polyarthritisâ€ /wwwspringerlinkcom/content/m24q5784428h2m3n/
â€¢ Neutropenia on Post-chemo day 10 â€“ I think needs only careful monitoring â€“ Reason because the period of maximum cytopenia is over(day8) and the cytopenias can only improve from now on.
Thanks for posting all these questions.
I forgot to answer a few questions as I wanted to go back to them at the end to think better but later had no time as latter questions in Part 2 were lengthier and tougher. I don't remeber seeing many of the questions posted here. I gave the exam from Thiruvanathapuram, India. Please tell me, is it possible that the College asks different questions in different regions? If I have missed so many questions, it will be a disaster for me. Please help.
1. Causative organism for infected peritoneal dialysis patient??
2. Anti TB with decreased visual acity??
3. person has hematuria father and brother had same
4. Cons pericarditis ECG??
5. ANATOMY: SCIATICA AND LONG THORACIC NERVE AND ABDUCTOR POLLICES PREVIS
6. intermittent painful defecation with fresh blood in young lad (?polyp ? haemorrhoids ?anal fissure)
7. BLUE VISION----SILDENFIL
8. Mild haematuria, father and brother also had haematuria---Exercise related haematuria (I tried to figure out if it can be hereditary but the option given was Alport's synd which is X-Linked dominant so no male to male transfer)
9. Another question with constrictive pericarditis picture and asked what else is found --- widespread ST elevation
10. Lorry driver with chest x-ray having calcificationâ€”TB
11. Huntington chance of sun to be carrier 50%???
12. Male with severe pain behind eye worse in the morning --? ?trigeminal neuralagia
13. Weight loss for obstructive sleep apnoea
14. a patients cxr showing 2-5mm calcified lesion ???
15. patient tx for meningitis but after 4 days again confused and restless ? investigation ?urea/elec or MR scan brain
16. renal transplant dont remember the exact question but indicating cyclosporin toxicity
17. patient on cyclosporin LFT become derange what investigation next to find the cause renal ultrasound / urea creatinine / cyclosporin levels
18. caviating lesion with RF ? Wegners
19. question asking about absent ciliary reflex
20. Ramipiril most common side effect cough
21. pateint with facial edema ? which medication ramipirl
22. another question with neutropnia what to give GCFactor
23. clusture headache question
24. Perxisome straight forward question
25. Hypercalcemia patient recieving fluids 4 hrs qhat next pamidranate
26. Hypercalemia but low PO which is increasing ca reabsorbtion ? PTH / 1 , 25 / Hypophostemia
27. hemibalissmus wher is lesion ? subthalamic ? substania nigra ? caudate nucleus
28. whome to isolate patient with MRSA septicaemia / pneumonia and MRSA in sputum / perotenal TB 1 day treatment / pulm TB 16 day treatment
29. MANN whitney U or chie sequard ??
30. Duch Ms Dystrophy with grand children inheritance
31. girl with FH of 2 brothers with ?> weakness . mum negative..mode of inheritance?
- SE of drug being compared on both sides of face, best statistical rest ?
32. which patient can be left in multibed area - Legionell, Varicella etc etc
33. Pregnant lady with raised amylase
I definitely did not see these questions in the papers. Are you sure they were there? Could anyone who gave the exam from India verify?
* Mediator for Hereditary angioedema - Bradykinin
REF - Clinical Immunology,Volume 114, Issue 1, January 2005, Pages 3-9
Posted: Wed Jan 20, 2010 6:06 pm Post subject: More Indian questions
1. Diarrhoea, jaundice etc. in post-bone marrow transplant patient. Investigation? CMV PCR
2. Which patient to isolate-sputum positive tuberculosis, sputum cultured tubuerculosis, CSF cultured tuberculosis. Sputum positive tuberculosis.
3. Post-trnasplant patient with skin lesion, diarrhea etc. What is the diagnosis? GVHD
I gave the exam in INDIA....i have listed the questions not seen in the indian MRCP paper in a previous post!!
The papers are uniform in one centre...but not sure if they are uniform over countries or not!!
suspected active TB which needs isolation how to diagnose ? spitting acid fast bacilli in sputum
Man with Back ache, multiple joint pains (father â€“ vague joint pain history) RF negative, Anti CCP positive
Answer is rheumatoid arthritis
can check at google search Anti-citrullinated protein antibody
I am aware that in the diagnosis of RhA, anti-CCP is preferred now as it is more specific.
However, its unlikely for a young 'male' with "backache" and symmetrical arthritis,with ?positive family history to have RhA, more over anti-CCP can be falsely positive in PsA
(ref: quoted earlier) /wwwspringerlinkcom/content/m24q5784428h2m3n/.
I feel the anti-CCP was mentioned to misguide us(at least when i gave the exam). Anyway I could be wrong.
mrcp part one
this forum had been very helpful for giving part one , so i am back to post the questions.
the ones that are not mentioned are-
1 . earliest sign of acoustic neuroma- absent corneal reflex.
2. cystic fibrosis : it was a patient with disease. what is the chance that his 17 year old sister is a carrier.? 2:3
3. in a population males and females bp were compared ,which test used to comparebp in both groups
4. mesothioloma related question accurate statement- prob biopsy would cause involvement of tract
5.case of hameturia in pt, his borother and father- Ig A nephropathy
6. clopidigrel question was that pt had cabg 6 months backon aspirin and clopidogrel. diagnosed as cholelithiasis. surgeon worried about bleeding-
stop clop and start lmwh
stop clop and increase asprin
delay surgery by 6 months
7. seborrheic dermatitis - treatment ?ketoconazole
8. 25 year old with hematuria- normal usg, creat- investigation ? cystoscopy
9. 19 year old with edema and massive proteinuria: ? minimal change ? membranous
10. drug induced diabetes insipidus was fluoxetine
11. young girl with tooth erosion and decreased na, K , ca, ? bullemia nervosa
12. pneumothorax in prev healthy young < 1cm in x ray. stable-
discharge and advise follow up
13.decreased tlco, fev1, increased tlc-
14. decreased tlco and kco 150% of predicted? in pt of systemic sclerosis with prog breathlessness : ? effusion or diaphgrammatic weakness
15. tubercular pt who needs isolation- one who is sputum positive
16. bloody diarrhea not responded to metro 5 days
17. elderly with inferior quadrantonopia swelling in disc at upper pole with 3 week h/o headaches- first invegn
18. young pt with 8 days fever, 2 red spots at junc of soft and hard palate, splenomegaly, gen lymphadenpathy
ps atypical cells
ALL,or infectious mononucleosis
19. test to confirm anaphylaxis- serum tryptase level
20.alcoholic with ataxia and opthalmoplegia comes with hypoglycemia -fist drug: thiamine
can anyone say dm type 1 diagnosis best by age or ketone bodies
21. poisoning with loss of vision after 24 hrs- ? methanol
22. pt with chest pain ,hemoptysis- PE like pcitre commonest x ray finding-
normal xray or wedge shaped infarct
23. ds caused by hhv 8 -kaposi sarcoma
24. b/l basal cylindircal bronciectasis - likely organism ? staphy
25. operated 2 days back for colorectal ca, develos AMI- after apsirin clop, best t/t
: primary angioplasty
26. chest pain suggested of pericarditis
diifuse st elevation
glucose tolerance with gh measurement
28. young lady with hypogly- what to measure next- insulin and c peptide or sulphonylurea level
will get back with more as i recollect.
but my sure advise to all those appearing is PASSMEDICINE is must.....
i think type 1 is best by ketosis, as MODY can occur at young age
thanx relaxed i did it ketosis too
about PULMONARY EMBOLISM NORMAL CHEST X RAY IT IS WRITTEN AND IN MANY SITES THAT WE ARE NOT DEPEND ON CHEST X RAY AS IT IS OFTEN NORMAL
INSULIN AND C PEPTIDE SURE
PRIMANRY ANGIOPLASTY SURE IT IS SUPERIOR TO THROMBLYTICS WHENEVER AVAILABLE WE SHOULD DO IT
BRONCHIECTASIS---H INFLUNZA SEARCH FOR IT BESIDE THE COMMONEST IN COPD IS H INFLUNZA TOO
the question about ??insulinoma was quite tricky. As far as I remember the question was: there was h/O dizziness and once her rbs was 2 mmols and if this pt came back with complains of dizziness what would be appropriate first investigation? and the answer is blood glucose. because you are dealing with a patient who comes symptomatic with a previous history of hypoglycemia. why to wait for a patient to come back dizzy for insulin and c peptide level?
For unexplained Hypoglydemia you do prolong fasting 72 hrs under supervision check BM ever hr and as soon you record hypo take insulin and c peptide to confirm the diagnosis
paper 2 was really tough
site of action of acetazolamide
many pharmacology questions....
treatment of the lady with multiple ST infections isolated candida, gonococci and vaginosis?
crp and insulin testing whilst having symptoms to differentiate from endogenous source or if she was mis-using insulin so do it whilst having symptoms.
man with history of acute MI
in standard deviation which value doesnt come under 2sd???
ECG changes in Hypokalaemia
prominent U wave
Test to diagnose Pulmonary hypertension
commonet site for Myxoma??/
Not able to abduct arm Nerve involved??
Man with slight rise in Urinary proten 2+???
Does anyone remember the liver biopsy question ? I answered obesity as contraindication, any other ideas ?
Those are the contraindications from emedicine :
Inability to identify a suitable biopsy site by either percussion or ultrasonographic guidance
Prolonged (>1.5) international normalized ratio (INR)6
Decreased platelet count (<60,000/mm3)
Bleeding diathesis (eg, hemophilia)
Recent use (within the last 7 days) of aspirin or nonsteroidal anti-inflammatory drugs (NSAID) or antiplatelet class of medications
Unavailability of blood products for transfusion
Morbid obesity of patient
No backup support available from surgery or interventional radiology in case of a complication
Suspected hemangioma or hepatic echinococcal cysts
Abdominal wall infection over the identified biopsy site
Infection in the right pleural cavity or below the right hemidiaphragm
Bowel overlying biopsy site (on ultrasound or other abdominal imaging)
It was Obesity.
Liver biopsy is contraindicated when bile duct obstruction is suspected (hence dilated), so from options given bile ducts dilatation is the more convincing answer ..
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