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MRCP 1: Recalled Questions of January 2012

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Thread: MRCP 1: Recalled Questions of January 2012

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#1

01-18-2012, 06:23 PM

MMR
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MRCP 1: Recalled Questions of January 2012

1st time appeared & it was a horrible experience. can not concentrate
on 2nd paper, so lengthy exam.
some recalled questions...
1. Tirofiban M/A - GP IIb/IIIa inhibitor (mine wrong put direct thrombin
inhibitor)
2. Rheumatoid Arthritis - HLA DR4 (mine wrong put DR3)

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3. Bitemporal Upper Quandrantopia - Pituitary Macroadenoma (mine

wrong put Craniopharyngioma)
4. Ciclosporin M/A - IL2 inhibitor
5. Squamous cell Ca of Lung Surgery Contraindication - SVC Obstruction
6. after Chemotherapy recurrent URTI, which one reduced - Tcell/IgG/macrophage/Complement
7. Stemcell Therapy in Type 1 DM, prevent Glycation/mutagenesis/oxidative stress/senescence
8. Acoustic Neuroma - Absent Corneal Jerk
9. GBS Respiratory Function Monitor - Vital Capacity
10. in Colon Cancer advantage of Capecitabine over 5FU - Oral form
11. Pre-Pregnancy Checkup soft ejection systolic murmur - Bicuspid
Aortic valve
12. cANCA +ve Renal biopsy finding - Crecentic GN
13. Paracetamol poisoning, monitor - Prothrombin Time
14. JAK2 Mutation Polycythemia Treatment - Hydroxycarbamide
15. Panton-Valentine Leukocidin +ve Staphylo aureus treatment Clindamycin + Nasal Mupirocin
16. Teratoma Pt. planned to give 6 cycle Chemo, which one should
given before starting chemo - Allupurinol/Dexamethasone
17. Travelled from India now jaundice, high LFT - Hepatitis A/ Leptospira
18. Rheumatoid Arthritis Pt. with red eye, irritation - Episcleritis
19. Meningococcal meningitis prophylactic drug - Rifampicin
20. Herpes zoster Neuralgia not relieved by NSAID, give Carbamazepine
21. anti-Parietal antibody detection Biopsy from - Proximal
Stomach/Distal stomach/Terminal ileum
22. Repolarization in cardiac Muscle due to - Pottasium Current/L type
Calcium Current
23. after drinking Huge beer,polyurea occurs due to - decrease
Aquaporin channel in collecting duct
24. Ejection Systolic murmur best heard on expiration in left sternum ASD/AS/PS
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25. CMV +ve HIV pt.(<100 CD4) besides HAART Treatment needed - iv
Ganciclovir/Valaciclovir/Aciclovir
24. 23 yrs man bloody diarrhoea 3 month, Colonoscopy continous
inflammation in sigmoid with scattered Diverticula - Ulcerative
Colitis/Diverticolitis/inflamatory Colitis/Ischemic Colitis/Crohns colitis
25. Bisphosphonate therapy problem if GFR<30/Ca+<2.5/BMI<19
26. penicillin allergy pt. but Methicillin sensitive strain, give Clarithromycin/Vancomycin/Linezolid/Ceftazidime
27. pt. gaining weight 6 kg last 3 month with sweating at night insulinoma
28. method to study 3D structure of Protein - X-ray Crystallography/Gel
Electrophoresis/Western Blot(mine wrong Western Blot)
29. Aortic Stenosis poor prognosis - Aortic Regurgitation/severe valve
calcification
30. Rheumatoid Arthritis Poor Prognosis - pt age 30 yrs/bony
erosion/sudden onset
31. Temporary Single Chamber pacing, pacemaker wire should be placed
- Right Atrium/RV apex/LV apex/coronary sinus/Bundle of His (mine
wrong LV apex)
32. Demyelinating Neuropathy - Decrease Motor nerve Conduction
33. Reading problem after Parietal Lobe infarction, due to Hemianopia/amnesia/
34. Anti Thyroid Peroxidase +ve - Hashimoto Thyroiditis/Graves
35. Ret oncogene +ve in - Medullary Ca/papillary Ca/Follicular Ca
Thyroid
36. 65 year man regular narrow complex tachycardia with 150 bpm Pulse
- Atrial fibrillation/Atrial flutter/AVRT/AVNRT
37. 65 yr man 3 yrs back MI contd. drug ACEi+Bendrothiazide, now
Haemoglobin<9.5, PBF-polychromasia,poikiloSpherocyte, RBC finding fragmented RBC/Target Cell/Howell Jollie
38. previously not immunised recent contact with TB pt. - do
MT/BCG/Isoniazide
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Last edited by MMR; 01-20-2012 at 09:58 PM.

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#2

01-20-2012, 02:45 PM

DrShaheen
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here some of questions trying to remember :

-pt. drink 4 litres of Alcohol after that he became diuresis what is the
cause : BNP may be iam not sure
-there is question about Thoracic outlet syndrome
-blood film in HUS ; fragmented red cell
-scleroderma with abdominal bloating and vit b12 def treatment:
tetracycline
-case of scleroderma with esophageal dysmotality
-case of conns disease how to confirm: renin:aldosterone ratio may be
true may be wrong
-in dehydrated pt. compenstatory water retention, which part of
nephron still impermeable for water:
-IDA in elderly what how to establish diagnosis : ???fecal occult blood
or colonoscopy
-case of refeeding syndrome: hypophosphatemia
-case of optic neuritis with pale disc and loss colour vision
-case of RA eye complication painless eye injection : ?episcleritis
-case of acute painfull eye injection, blurred vision, dialated pupil with
hypopyon : ? Acute closed angle glaucoma
-case of horner syndrome in heavy smoker how to establish diagnosis :
chest x ray
-case of cutaneous leishmania
- case of UC with sclerosing cholangitis: MRCP best diagnostic
-case of traveller diarrhea in egypt: shegilla
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there is alot in my mind when i recall i will post it here

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#3

01-20-2012, 04:23 PM

it is a very hard rated MRCP exam

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#4

01-21-2012, 11:08 PM

That's good but i dont know where is my post!

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#5

02-10-2012, 09:01 PM

MMR
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Alhamdulillah. passed MRCP part 1.

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#6

02-14-2012, 05:25 PM

MMR
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I have collected some questions from another forum.

1) Stats- greatest risk reduction (27%, 54%)
2) Drug causing low sodium, low potassium- bendroflumethiazide
3) metformin in PCOS- increases peripheral glucose uptake
4) stats tables death/survival- chi sq test
5) Negative predictive value (cannot remember figures)
6) Uncertainty of mean- Standard error of mean
7) action of ciclosporin- IL-2 inhibitor
8) polyuria in alchol intoxication- decreased aquaporins
9) cholesterol embolism association- eosinophilia
10) drug causing haematuria- cyclophosphamide
11) tuberculin skin reaction- interferon gamma (t helper was not there)
12) allergic reaction- type 1 hypersensitivity
13) Anaphylaxis, how to diagnose- serum tryptase
14) anaphylaxis, what route of epinephrine- IM
15) Paracetamol OD, useful test for management- PH
16) illicit drug causing mydriasis- cocaine
17) confusion with visual problems- methyl alcohol poisoning
18) lithium toxicity, 6.5mmol, management- dialysis
19) action of tirofiban- glycoprotein 11b/111a inhibitor
20) early diastolic murmur- aortic regurgitation
21) Right heart failure, pansystolic murmur ? TR, feature- left
parasternal heave
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22) AntiCCP +ve- Rheumatoid arthritis

23) rheumatoid arthritis HLA- DR4
24) rheumatoid, factor -ve, joint erosions. worse prognosis- joint
erosions
25) features on x ray of ank spond- osteosclerosis
26) raised CK on bloods- myoglobinuria
27) hypokalaemic alkalosis on bloods (bicarb-33) - hyperaldosteronism
28) hypertension, hypokalaemia- renin:aldosterone concentration (?
Conn's)
29) fasting glucose 6.0-6.9 on 2 occasions- impaired fasting glycaemia
30) weight gain, hypo ? insulinoma- prolonged fast
31) MEN 1 association- insulinoma
32) painless ulcer + rash + lymphadenopathy- syphilis
33) bronchiectasis on CT, low IgA and IgD- Common variable ID
34) asthma, ominous blood result- raised PCO2
35) COPD acidotic, low PO2, ?Rx- NIV
36) anaemia, dysphagia, Ix- gastroscopy
37) 55 year old fe def anaemia, Ix- colonoscopy
38) commonest organism in bronchiectasis- H. Influenzae
39) fever, haemolysis (cold agglutinins), rash ? erythema multiformemycoplasma pneumoniae
40) preceding cold, then SOB, CXR b/l infiltrates- staph pneumonia
41) hill walker with concentric rash- lyme disease
42) recurrent bilateral red eye with watering in rheumatoid- episcleritis
43) lesion increasing in size, dark pigmentation- lentigo maligna
44) acoustic neuroma, sign- loss of corneal reflex
45) lower back pain, loss of ankle reflex- L5/S1 prolapse
46) thigh weakness, sensory level to medial lower leg- L4 radiculopathy
47) loss of facial hair, normal FSH/LH, low testosterone- klinefelters
48) difficulty swallowing solids and liquids- achalasia
49) man with wilsons, wife 1/100 chance of carrier, kids chance- 1/200
50) haemochromatosis, best test to diagnosis- transferrin saturation
51) learning difficulties and ectopia lentis- homocysteinuria
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52) absent brachial pulse on raising arm- thoracic outlet syndrome

53) diarrhoea, weight loss, high anion gap acidosis, normal Cl- villous
adenoma
54) Reversed splitting of 2nd heart sound- LBBB
55) Rx mycoplasma, allergic to erythromycin- doxycycline
56) prophylaxis of meningits- rifampicin
57) loss of colour vision, visual loss after 3 days- optic neuritis
58) urinary incontinence in MS, Rx- anticholinergics
59) superior bitemporal quadrantanopia- pituitary tumour
60) parietal lobe stroke, problems reading, why?- inattention
61) weakness in grip, loss of two point discrimination in hand- parietal
lobe
62) multiple investigations for symptoms. All normal- somatization
disorder
63) Manic, unable to stop talking- pressure of speech
64) suspicious individual, withdrawn- paranoid schizophrenia
65) Similar case to 64- schizophrenia
66) worried about rat infestations, checks floorboards- OCD
67) weakness during waking from sleep, hallucinations- sleep paralysis
68) woman with itching, xerostomia, obstructive LFTs ?PBCantimitochondrial antibodies
69) Return from Egypt, blood diarrhoea- Shigella dysenteriae
70) traveller, raised LFTs jaundice- Hep A
71) +ve Anti-HBc, +ve AntiHbs, -ve HBs antigen, previous infection,
now immune
72) Ulcerative colitis, obstructive LFTs ? PSC- MR cholangiogram
73) colonoscopy- inflammation to sigmoid, diverticula- ulcerative colitis
74) eczema, fever, widespread ? eczema herpeticum- IV aciclovir
75) weakness areflexia (Guillain barre), monitoring- Forced vital capacity
76) Guillain barre, feature- low conduction velocity
77) third nerve palsy, pupillary involvement, diagnosis- Post Comm
Artery aneurysm
78) confusion, multiple ring enhancing lesions- cerebral toxoplasmosis
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79) minimal change gn, treatment- prednisolone

80) haemolytic uraemic syndrome on bloods, blood film- fragmented cells
81) raised platelets, jak 2 +ve (? PRV, but normal Hb!), Rxhydroxycarbide
82) treatment for CML- imatinib
83) heart rate 150, likely ECG finding- atrial flutter
84) treatment for torsades de pointes- IV magnesium
85) Long QT syndrome, responsible for ventricular repolarisationpotassium
86) Feature of hypothermia on ECG- Long QT (J wave not a feature)
87) pregnant asthmatic, stopped taking steroid inhaler and salmeterol,
management- restart inhalers
88) renal failure, high calcium, high protein, low albumin- myeloma
89) sinusitis, C-ANCA +ve, finding on renal biopsy- crescentic gn
90) arthritis, rash on soles of feet (?keratoderma blenorrhagica)reactive arthritis
91) steroid injection to knee, later fixed flexion to 20 degrees, effusion ?
septic arthritis
92) before chemotherapy, uric acid 0.65- allopurinol
93) Fast AF, dizzy, BP<90- DC cardioversion
94) occupational asthma, spirometry- reduced FEV1/FVC ratio
95) smoker, suspicious CXR, hyponatraemia- Small cell lung ca
96) Contraindication to lung cancer surgery- Superior vena cava obs
97) temporal lobe attenuation on CT- herpes simplex encephalitisaciclovir
[snip]) hypertension in young adult resistant to 4 drugs, bilateral
shrunken kidneys- fibromuscular dysplasia
99) indwelling line, likely cause of infection- staph epidermidis
100) ST elevation, had aspirin, clopidogrel, next treatment- Angioplasty
101) pancytopenia, likely drug- azathioprine
102) wernicke's with low glucose, immediate Rx- 50%, 50ml glucose
103) purpuric rash on buttocks- henoch-schonlein purpura
104) Most likely feature of acute tubular necrosis- UrineOs<300
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105) DEXA scan, osteopenia vertebrae, osteoporosis hip

106) low K+, Low Ca, ? cause- Low Mg
107) starting Total parental nutrition, likely abnormalityhypophosphataemia
108) CXR findings most likely in PE- normal
109) visualising 3d structure of protein- western blotting
110) widespread eruption after throat infection- guttate psoriasis
111) porphyria cutanea tarda, treatment- venesection
112) on phenytoin, unwell in skin separation, fever- toxic epidermal
necrolysis
113) primaquine in malaria- kills liver stage
114) 9 months hallucations post event- post traumatic stress disorder
115) vomiting, altered body image, normal BMI- bulimia nervosa
116) abnomal lymphocytes on blood film- glandular fever
117) Feature of bell's palsy- hyperacusis
118) Boils treated, now MRSA carrier (+ve PCR)- mupirocin and
chlorhexidine
119) spirometry- obstructive, high TLCO- emphysema
120) small bowel overgrowth, tx- tetracycline
121) blood film- basophilic stippling, raised HbA2- thalassaemia
122) erythema nodosum, likely outcome- full recovery
123) goitre, anti TPO +ve- hashimoto's
124) post herpetic neuralgia, rx- amitryptilline
125) strongest indicator for type 1 DM- ketones
126) grave's disease, most associated- pretibial myxoedema
127) 2l O2 nasal cannula, domicillary o2- 28%
128) advantage of capecitabane over fluorouracil- oral
129) Anticipation- presents at younger age in successive generations
130) RET oncogene- medullary thyroid cancer
131) renal failure, high phosphate, management- Phosphate binders
132) Cystic fibrosis, malabsorption, test- faecal elastase
133) Turner's syndrome, commonest defect- bicuspid valve.
134) Ecstacy, feature- hyponatraemia
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135) Physiological change on standing from lying- increased salt and

water excretion
136) patient drops out of trial before starting chemo- discard (no
intention to treat option)
137) From Brazil, hypopigmented face, tingling sensations, loss of
eyebrow- leprosy
138) Russian sailor, toxic, exudative tonsillar features- diphtheria
139) patient in LVF, echo aortic stenosis with calcifications, LVH on ECG
and echo, worst prognosis- LVF
140) 25 year old woman, scalp rash, and over face and nasolabial fold ?
seborrhoeic dermatitis- topical ketoconazole
141) Collapse, BMs-45, treated. Now cannot see, reason?- lens
refractive changes
142) bloods- anaemic, cold agglutinins, ? test- cryoglobulins
143) neonatal lupus- anti-ro
144) 30s, progressive SOB, problems climbing chair, rash around MCP
and PIP (gouttrons papules)- dermatomyositis
145) 15 days post bone marrow transplant, jaundice, diarrhoea- graft
versus host disease
146) lethargic lady, low sodium, high k+ (adrenal insuff) + high TSH (?
hashimoto's), Ix- short synacthen test
147) Bisphosphonates, blood check before starting- renal function
148) facial pain with ptosis, miosis, multiple episodes overnight- atypical
facial pain
149) smoker, features of horners. Ix (? pancoast's tumour)- CXR
150) testing cholesterol levels in two groups- unpaired t test

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#7

02-14-2012, 05:25 PM

MMR
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150) testing cholesterol levels in two groups- unpaired t test

151) left hemiparesis, hypertensive, brachial ischaemia- aortic
dissection
152) limb weakness, loss of temperature and sensation- anterior cord
syndrome
153) man with haematuria. Father and uncle same problem- thin
membrane disease
154) treatment of CMV, mouth ulcers- IV ganciclovir
155) amyloidosis, +ve bence jones- AL amyloid
156) 24 year old cyanosis, clubbing, ESM- tetralogy of fallot
157) cause of bilateral shrunken kidneys in diabetic for 9 yrs,
Rheumatoid 18 years, recurrent UTIs- reflux nephropathy
158) Low Na 121, high urinary sodium ?SIADH. Na now 119 after fluid
restriction. Rx- demeclocycline
159) Insulin, site of action- cytoplasmic membrane
160) rash on arm, exfoliation around it- dermatitis artefacta
161) Heparin induced thrombocytopenia, which factor?- factor 4
162) nephron, which part is impermeable to water?- ascending limb
163) single pacemaker, anatomical site to place- atrioventricular node
164) discitis, organism MSSA. Rx- vancomycin
165) seminoma, platelets 17 prior to chemo. management- platelet
transfusion
166) started risperidone, raised prolactin, multiple abnormalitiesrisperidon effect
167) contact lenses, stratching, hypopyon- infective keratitis
168) depressive male patient attempts suicide. Feature of likeliness to
succeed- planning of event
169) hip pain laterally. Normal ROM hips- trochanteric bursitis
170) patient on CCU, witnessed to lose responsiveness, VF on monitor,
immediate treatment- chest thump
171) patient with HIV develops pleural effusion. Unable to tap, next
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investigation- ultrasound chest.

172) patient with features of right heart failure, has reduced ejection
fraction on echo. Next investigation- right and left heart catheter
173) most likely feature of parkinson's disease- asymmetrical
bradykinesia
174) penicillin allergic (rash) patient develops meningitis. Abxchloramphenicol
175) recent return from spending time with known sputum +ve TB
person. Next step- quantiferon
176) pre-op, lymphocytosis. 1.5cm lymph node on examination. Next Ix
(? CLL)- immunophenotyping
177) NSAIDs- interstitial nephritis
178) primary hyperparathyroid, Ca-2.88. Managementparathryoidectomy
179) Drug most likely to cause confusion that patient is taking- digoxin
180) Worsening asthma, on aspirin and atenolol, and oters ? causeatenolol
181) elderly patient with triad of nephrotic syndrome. Like causemembranous gn
182) stroke, unilateral neglect, dysphagia, heminaopia, most likely to
hinder recovery- homonymous hemianopia
183) Why is verapamil used in a smaller dose IV than oral?bioavailability
184) cause of lipaemia in pancreatitis- hyperchilomicronaemia
185) pernicious anaemia, biopsy most likely to be abnormal? distal
stomach
186) osteoarthritic patient with swelling of hands including MCPs. Rxprednisolone
187) phenytoin dose increased. When should a level be checked?- 1
week
188) lethargic woman post partum. What test should be done?- Tissue
transglutaminase
189) What are stem cells protected against- mutations
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190) active SLE. Blood test to assess activity- C3/C4

191) 20 something year old chap with ? tunnel vision. Appearance on
fundoscopy- black bone spicules
192) Patient with HIV and drowsy, unable to answer questions, next
appropriate action- Test for HIV
193) Patient with CLL on chemo, having recurrent infections. cause?Immunoglobulin G deficiency
194) Post partum lady with a white leg, poor palpable pulses, and gross
oedema upto groin- puerperal lymphoedema
195) Lady with shoulder and pelvic aches. raised ESR- polymyalgia
rheumatica
196) Patient with suspected gout, best test to confirm- synovial fluid
aspirate
197) reverse split heart sound= left bundle branch block
198) A female patient with oligomennorrhea and occasional galactorrhea
prolactin level 700 whats the diagnosis? PCOD , HYPOTHYROIDISM,
PROLACTINOMA , CUSHINGS???
199) a young patient having burkitt lymphoma treated with whole body
irradiation and then 3 month combination chemo including cyclosporin
presents with red rashes whole bode fever and neutropenia whats the
cause ?
cyclosporin toxicity
radiation toxicity ?????
199) loss of two point discrimination and gripping affected .but all other
sensations intact (not affected) where is the lesion?
periphral nerve
Brain
spinal cord
brachial plexus
200) A known cystic fibrosis patient had a travel history to thiland 6
month back ?? present with chronic Non bloody offensive diarrohea
what is the diagnostic test? parasite and ova in stool, colonoscopy,,
gastroscopy ,, duodenoscopy ,, fecal elastase??
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Last edited by MMR; 02-15-2012 at 02:12 PM.

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#8

02-14-2012, 05:27 PM

MMR
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The passmedicine site has added a batch of questions supposedly from

Jan 2012. The questions appear similar to the actual ones asked, and
the answers given are as follows:
1) COPD, SOB, clubbed, hyponatraemic ? diagnosis- small cell lung
cancer.
2) Old man confused, renal failure, hypercalcaemia, raised total proteinmultiple myeloma.
3) Man with central line, pyrexial, likely organism- staph epidermidis
4) Man with recent contact of TB, test for latent TB- mantoux test
5) Patchy haemorrhagic lesions in temporal lobe on MRI - IV aciclovir
(herpes simplex encephalitis)
6) High platelets, Jak2+ve, treatment- hydroxycarbamide
7) Man, flu like illness then signs of pneumonia- staphylococcal
pneumonia
8) Prior to start of chemotherapy, what treatment to start- allopurinol
9) palpitations, heart rate 150- atrial flutter
10) Pregnant lady on inhalers, has stopped them. management- restart
as usual
11) treatment for small bowel overgrowth- rifaximin (cant remember this
being an option, I put tetracycline)
12) man with right heart failure signs, ?TR, sign- left parasternal heave

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13) Treatment for torsades de pointes- IV magnesium

14) non tender goitre + anti TPO+ high TSH- hashimotos
15) Russian sailor, lymphadenopathy, tonsillar swelling- diphtheria
16) Skin lesions ? erythema nodosum, most likely outcome- full recovery
17) DEXA scan, osteopenia vertebrae (-1.4), osteoporosis femoral neck
(-2.7)
18) feature most consistent with Bell's palsy- hyperacusis
19) Shingles, painful, treatment- amitryptilline
20) action of tirofiban- glycoprotein 11b/111a inhibitor
21)Suspected cholesterol embolus, feature- eosinophilia
22) meningitis prophylaxis- rifampicin
23) alcohol, polyuria, mechanism- inhibits adh secretion (reduced
aquaporin)
24) mantoux test, induration on forearm, ?due to- interferon gamma
25)SOB, early diastolic murmur- aortic regurgitation
26) history of hypertension, angina, low na and k+, muscle weaknessbendroflumethiazide
27) young person, tachycardic, dilated pupils, cause- cocaine
28) ?meningitis, penicillin allergic- chloramphenicol
29) route of adrenaline in anaphylaxis- IM.
The questions seem modified from our real exam, and the options are
different. I am just adding for interest what the site suggests are the
correct answers

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