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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

MRCP part 1 - Recall May 2013


1. Patient is unable to take his arm beyond or pain wen rising above 140-180 degree. ( Supraspinatus tendinitis). 2.Sensory loss of middle finger and some other features. (C7 involvement). 3. Pt having diarrhea for last one month following passing holidays somewhere and stool microscopy shows Strongolides. (Albendazole). 4. Protien 3D view. (western method) 5.Patient having recurrent chest infection. (Complement levels).. 6. Mechanism of Action of meglitinides. (DPP-4 inhibitor) 7. Mechanism of action of Flecanide. (sodium channel blocker). 8. Herpetic lesion on wrist then after few days macular rash over the body. (Erythema Multiforme). 9. Pt having low calcium, low phosphate, low Vit-D, ALP raised, parathyroid hormone raised. How to manage. (Oral vit-D). 10. Pt having Ankylosing spondilitis. chose feature. (Global Axial decrease mobility) 11. Pt having itchy scales on sternum, eyelids, face, nasal bridge. (Sebohric dermatitis). 12. Pt having lesion on toes, microscopy shows Trychophytum rubrum. (terbinafine) 13. Pt having sever photosensitivity, malar rash and some other findings. (SLE). 14. Piercing pain in the eye. (trigeminal neuroglia) not sure on this. 15. Pt having ischemic colitis, which part of colon is involved. (Spleenic flexure). 16. Continuous bleeding from pt after vena puncture. PT-raised, APPT-raised, Fibronogen-low, D-dimers-raised. (DIC) 17. Poor prognostic factor in leukemia.
Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

18. Question from statistics about positive predictive value. answer 10% 19. Vit- D Resistant rickets. (X-link Dominant). 20. Hereditary telangictasia (Autosomal Dominant) 21.Pt having dizziness, vertigo and eye examination was normal. (Mieniers disease) 22. Specify the site of lesion that pt is unable to abduct his eye and some other features. (PONS) not sure, 23. There was a question in which a pt is having lower motor neuron lesion in upper limb and upper neuron lesion in lower limbs. (Amytropic lateral sclerosis) 24. PCR...(fromation od DNA from RNA) 25. Where RNA splicing take place. 26. Pat had mastoid surgery for deafness and there was renal involvement showing blood+, Protien+ in urine. (Alport syndrome). 27. PT diabetic and HTN having painless decrease vision in one of the eye. fundoscopy shows cotton wools, haemorrhage. (Not sure) 28. CSF examination. glucose normal, protein normal, Lymphos raised, neutros normal. (Viral infection) 29. Diagnosis of pt on basis of investigation , Von Willbrand antigen low, Von Willbrand activity low, factor VIII low. (Von willbrand disease). 30. Pt having plasmodium Vivax infection. wt is the benefit of giving chloroquine+primaquine. (Decrease resistant) 31. 1 cm rim of pneumothorax. (Discharge and repeat X-ray after 7 days). 32. Pt having small lung carcinoma, having SOB. Increase cortisol level due to ectopic production of ACTH. 33. Pregnant lady increase frequency of SOB and wheeze. she is on salbutamol inhaler. (Add steriods)

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

34. Pt on long term tx for rheumatoid arthritis. some other features. (Rectal biopsy for amyloidosis). 35. Pt having barret oesophagus on proven following endoscopy. (Acid suppression and repeat biopsy). 36. Pt having dyspepsia for long time. (endoscopy) 37. Pt having sever chest infection and was admitted in the hospital. IV antibiotics are given. 10 days after that pt feel SOB and x-ray shows large plural Effusion. (Empyema) not sure. 38. Pt had chemotherapy and presented SOB and muffled heart sounds. (Cardiac temponade) 39. MOA of Bivalirudin. ( direct thrombin inhibitor) 40. Pt having numbness on the lateral boarder of foot. (S1 lesion) 41. CREST complication. (Malabsorption) 42. Pt having lytic lesion on radio graphy. (Protien electrophoresis) 43. Rt sided apical lung cancer involving brachial plexus. Mode of tx. Not sure. 44. Which of the following causing upper lobe fibrosis. (Allergic Fibrosing alvelitis) 45. Which of the following cell is raised in Aspergiollus infection. (Eosinophill) 46. Pt having painlees or red urine and SOB. TX not sure 47. Pt going for chemoptherapy which of the measures should taken prior to tx. (Red pack cell transfusion) 48. Pt taking DEMARDS drugs and having oral ulcer. (candidiasis) 49. Tricyclic overdose. (IV NaHCO3) 50. Methnol Over dose. (Dialysis) 51. Pt collapse not breathig, no pulse, next step. ( Call for Help)

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

52. patient with abdomina lpain and vomitting and acidosis nothing about ketonemia mentioned given insulin in infusion waht nest step. ( Normal Saline) 53. Hypertention and palpitaion thyroin cancer removed in the hx( carcenoma) what is the diagnosis: pheochromocytoma. 54. Which drug will u give wen pt with pheochromocytomo going for surgery. (phenoxybenzamine) 55. ECG show st depression in V5 and V6. (Circumflex artery) 56. Pt with obstructive sleep apnea. CPAP, BIPAP, some instruments use. not sure in this senario.

1.Adenosine mech of action - G-couple receptors 2.Strongloides tx - albendazole 3. Rupturing blisters - bullous pemphigoid 4.Boy with down syndrome and murmur and parasternal heave - Ebstein Abn 5.Pregnant lady with worsening asthma - beclomethasone 6.Lady known diabetic with postural drop - hypopitutarism 7. ischaemic colitis - splenic flexure 8. what rhematoid factor target - ? citrulline 9. Boy with hypercalcemia and xray changes - sarcoidosis 10. positive predictive value statistics - 1% 11. Man U whitney for the question about blood pressures 12. another statistics - sensivity 9 is the answer) 13. Question about pernicious anemia - anti parietal cell antibodies 14. What causes repolarization - pottasium channels

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

15. What causes prolongation of QT - pottasium channel blockage 16. CNS- patient with ipsilateral and contralateral sisns - where is the lesion lateral medulla 17 Patient with mark-gunn pupils - lesion in occipital lobe 18 patient with a non secreting pituitary tumor - what could it cause a few yrs down the line - bitemp hemianopia 19. Lady with bleeders on colonoscopy Hb 9.2 - i said to transfuse(?) 20. Young man with haematuria and past history of deafness plus proteinuria - ??? Alports, IgA nephropathy 21. lady with rash and signs of - ITP 22. 9:22 translocation - CML 23 patient with bloating with all those haematological signs - Myelodysplastic syn 24. Tear drops poikilocytes - myelofibrosis 25. line infection - s epidermis 26. Lady with increased ALP, what further test - Anti mitochondrail 27. Patient with IBS with non specific signs of - Bacterial overgrowth 28. Lady with altered bowel habit, past hx of depression - Irritable bowel synd 29. Young man with dyspepsia, no other signs - Urea breadth test 30. Young lady, pneumothorax 1.5 cm no SOB - outpatient xray 31. old man with pagets disease, no fractures - ? residronate 32. 19 year old with neck tremors and snoring in class - ? Wilson's dx 33. Barretts oesophagus - Endoscopy surveillance 34. Man with polyuria, loss of libido and back pain - Do transferrin sat. 35.Villous adenoma - can remember question

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

36. Patient with diarhoea, chest infection etc - X-linked agammaglobulinemia ( Wiskott Aldrich - i think) 37. Loss of sensation dorsum of foot etc - S1 root compression 38. Question about - frozen shoulder 39. Another one with answer as - ulnar neuropathy 40. Lady with recurrent bacterial pneumonia - check immunoglobulins 41. Ramipril induced angioedema, what cause - Bradykinin 42. Hereditary Haemorrhagic telangiectasia - Autosomal dominant 43. What does primaquine do in vivax plasmodium - destroy gametes- i think 44. Man with insect bite from south africa ( no lymes !! ) - Rickettsia 45. Anorexia on NG feeding - hypophosphatemia 46. DM - Action of Sitalgliptin - DDP-4 inhibitor 47. Before starting on warfarin - P450 48. which cell organelle splices RNA to protein - Ribosome 49. reverse transcriptase - amplifies DNA 50. CT scan multiple enhancing lesion , what to start after dexa - sulp + pyremerhamine 51. cANCA + symptoms - I chose Wegners - did anybody choose Microscopic polyangitis? 52. Marfan's syndrome - Aut dominant 53. ST changes in V5-V6, what are you likely to see on coronary angio Circumflex lesion 54. SVT , you gave adenosine 6 mg, nothing happens, what next - repeat adenosine 55. Vit D resistant ricketts - X linked dominant

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

56. Young man , bipolar, with polyuria - Lithium 57.Patient on clarithromycin, dont give - simvastatin 58. Bivarudin , mech of action - direct thrombin inhibitor 59. Amitriptylline overdose, low GCS - IV bicarb 60. Methanol overdose, GCS 5 - Haemodyalysis 61. Man who had viral infection, now comes with rash - erythema multiforme 62. Red eye pain - scleritis 63. Intermittent blurred vision - normal on corrected - cataract ? 64. First order kinetics - bioavailability 65. LVF, what med to add - Digoxin 66. patchy hair loss - alopecia areata 67. Dementia, loss of inhibition - Lewy body 68. Dementia recurrent falls - stop haloperidol 69. Patient with worsening renal fxn - I will stop metformin 70. Severe acne - isotretinoin 71. Lorazepam - increases GABA activity 72. 70 yr old man with LVF, which antiHTN - I chose ramipril 73. Ashtmatic - severely acute, not responding - IV Mg sulphate 74. Patient on pergolidine - organise ECHO 75. Anti HBc positive, HBsAG negative - Do Hep E serology 76. man with signs of MG etc - Thymoma 77. Man with neck stiffness, headache - AV malformation

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

78. Girl with reduced consiousness and seizures when disturbed - ? complex partial ? primary generalised 79. Headache piercing the eyes - Cluster headache 80. MND - with LMN and UMN signs - Amyotropic lateral sclerosis 81. Girl with menorrhagia - Activated protein C resistance 82. Man with tumour of apex, which condition will you not operate - FVC 1.8 ?? 83. Which intervention decreases colon cancer - etoricoxib ??? 84. Which intervention decreases risk of pre-ecclampsia - ?? aspirin... LMWH ( patient is 12 wks) 85. leukaemia good prognosis - t(15:17) 86. Woman with sudden onst SOB, just started chemo for BRCA - Anthracycline Cardiomyopathy ? 87. Uncomplicated clamydia treatment - Doxycycline 88. Man presented with urethral discharge - swab - neisseria gonococcus, but blood cultures negative, why - co-existence of Chlamydia 89. Man with painful genital ulcers - chanchroid 90. Woman whose husband died, but she still sees him talking to her - ? PTSD ??? 91. Man with low mood, no eye contact, 2nd person auditory hallucination, drinker, suicidal - ? psychotic depression ? 92. man convinced he had cancer despite all negative tests - hypochondriac 93. Man presenting with symptoms, despite tests he believed there still there Somatisation 94. man with parkinsons, agitated, abusive - haloperidol 95. Joint sepsis - staph aureus

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

96. man with bloody diarrhoea, children's school mates recently had diarrhoea - ? rotavirus 97. lady admitted with sweating and palpitations - Phaeochromocytoma 98. Complete heart block - variable intensity S1 99. Dermatomyositis, initial mgt - prednisolone 100. African lady, symptoms suggestive of leprosy - biopsy a skin lesion. 101. ETT, strongest indicator to stop - angina **102. Heart murmur in 2nd and 3rd ic space - PS **103. mitral stenosis, indicator of severity - Degree of Pulmonary capillary wedge pressure (pulmonary HTN) 104. infective endocarditis risk highest with previous IE 105. Patient with cardiogenic syncope - SA dysfunction 106. physiologic change after one minute of standing - increased cardiac output **107. maximum absorption of Na in salt and water depleted patient - still proximal tubule and TAL ? **108. pulmonary hypertension diagnosis - 2Decho 109.alcholic, camunity acuired pnemonia, treated in icu, again fever, ?empyema **110. idiopathic pulmonary fibrosis, finding on xr - lower zone heart border blurring ***111. extertringic allergic alviolitis, investigation, CXR shows upper zone involvement ***112 Allergic bronchopulmonary aspergilosis, investigation - precipitins - most specific 113 Small cell carcinoma, one of its paraneoplastic syndromes was given 114. lambert eton syndrome, antibodies to VGCC

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

115. pain in fore arm on resistance of extension of wrist, lateral epicondolyitis *116. Multiple sclesosis, patient with past histery of arm problem, now vision 117. hopital acquired pnemonia... tazosin 118. patient with fever and jaundice, picture of asending cholangitis, - CBD stone 119. patient with ingestion of 20 paracetamol pills, PT ** 120.feature of anemia of chronic disease 121. patient wid ulcerative collitis and now joint pains - enteropathic arthritis 122. dka, iv insulin was given, iv n saline 123. Test of Acromegaly, insulin with oral glucose toleance test ** 124. feature most strongly associated with tb recurrence - ?CXR granulomas indicate previous infection 125. treament startd with acylovir, csf feature most strongly associated wid diagnosis - lymphocytosis ** 126 . man with 3 yrs h/o lesion on shin - Bowens disease ** 127. diabetic patient, poorly controlled, type of diabetes 128. Patient with pheochoromsytoma, started..?phenoxybenzamine what treatment shoud be

129. flash pulmonary edema.... renal artery stenosis 130. resistant hypertension, hypokalemic alkalosis - renin/aldo ratio 131. patient with early mornign stiffness and uper arms tenderness,, polymylgia rheumatica 132. patient with father with psoriasis, now with inflammatory oligoarthritis but no other systemic features - spondyloarthropathy 133. ankylising spondolyits, clinical feature reduced joint excursion in all directions

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

134. patient with picture of RA, on nsaid, next treatment option - MTX 135. patient in hospital, got gout, treatment with colchicine 136. patient with hearing loss, tinnitus and vertigo.. ?meniere's disease **137. sudden onset visual loss, retinal hemrges and cotton wool spots - CRVO 138. thyroid swelling, investigation.... FNAC 139. collapsed patient....call for help first - early access as per ACLS/BCLS 140. 3d image of protein - electron microscopy. Xray crystallography is for 3d visualisation of crystals 141. seborrhic dermatitis.. scaly lesion on face, nose scalp sternum i think 142. xray osteosclerosis ---osteoarthritis old lady with varus deformity 3 months pain 143. PCOD--- test... high LH/FSH ratio 144. boy with abnormal movements tourette syndrome ** 145. pt on chemotherapy was given ondansatron but vomiting not controlled nabilone 146. Ciclosporin in post renal transplant - Tcell function suppressed 147. A subject with urethritis, gram neg intracellular diplococci, VDRL +ve False positive VDRL 148.Creatinine increased after Trimethoprim - decreased tubular secretion (trimethoprim decreases tubular secretion of creat) 149. things move or spin with head position change = BPV = Dix Halpik maneuver. **150 circular lesion on dorsum of the hand = granuloma annulare (thoguht not mentioned diabetic). ?BCC **151. on lithium & hypertensive = give amlodipine (SHOULD BE alpha blocker)

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

152. a young man diagnosed with IBD (crohns) and started treatment what is the advice = stop smoking 153. Mechanism of action of Flecanide. (sodium channel blocker). 154. Pt having low calcium, low phosphate, low Vit-D, ALP raised, parathyroid hormone raised. How to manage. (Oral vit-D). 155. Pt having lesion on toes, microscopy shows Trychophytum rubrum. (terbinafine) 156. Continuous bleeding from pt after vena puncture. PT-raised, APPT-raised, Fibronogen-low, D-dimers-raised. (DIC) 157.Pt having dizziness, vertigo and eye examination was normal. (Mieniers disease) 158. Pt having lytic lesion on radio graphy. (Protien electrophoresis for myeloma) 159. Patient hiking in west scotland, has a bite on thigh but no other symptoms observe 160. Tricyclic overdose. (IV NaHCO3) **161. Pt with obstructive sleep apnea. CPAP 162.normal aonion gap metabolic acidosis- type II RTA **163. ?Addison's disease 164. location of mechanism of action of spirinolactone 165. Occupational asthma - monitor PEFR on weekdays and weekends **166. Diplopia and proximal myopathy - MG 167. Unequal blood pressures in both arms in asian lady - Takayasu's arteritis **168. which anti depressant to use in young type I DM patient? mirtazapine? others were SSRI/venlafaxine 169. Rash and renal impairment - HSP ** 170. mechanism of inactivation of cortisol - ?free excretion
Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

171. klienfilter syndrome - small testes, primary testicular failure ** 172. Patient with hypocalcemic hyper calciuria. How to treat? **173. Red urine, facial swelling amongst symptoms - likely PNH over PCH 174. bilirubin mild elevated and other LFT normal next test - reticulocytes 175. Organism causing epiglottitis - Hib 176. Lung fibrosis finding? - Reduced TLCO ** 177. Patient with newly diagnosed Chron's disase, started on prednisolone, which is next best treatment advice - mesalazine vs quit smoking 178. Type I DM not well controlled on OHGAs, looks like will be insulin requiring - LADA

Mixed respiratory and metabolic acidosis ETT, strongest indicator to stop Heart murmur in 2nd and 3rd ic space, mitral stensis, indicator of severity infective endocarditis risk cardiogenic, ?vasogenic syncope in patient wid 1st degree heart block physiologic change after one minute of standing maximum absorption of Na in salt and water depleted patient pulmonary hypertension diagnosis treatment option for mild heart failiur with no edema ?cardiac temponade, patient with markedly elevated jvp treatment of hypertension in patient wid peripheral vascular disease

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

alcholic, camunity acuired pnemonia, treated in icu, again fever, ?empyema idiopathic pulmonary fibrosis, finding on xr extertringic allergic alviolitis, investigation, ?esoinophilia Allergic bronchopulmonary aspergilosis, investigation Small cell carcinoma, one of its paraneoplastic syndromes was given lambert eton syndrome, antibodies Systemic sclerosis, wot next can be affcted pain in fore arm on resistance of extension of wrist, ?epicondolyitis osteoarthritis of hip, treatmnet option patient with problem of speech, carotid artery diseciton etc were options Multiple sclesosis, patient with pst histery of arm problem, now vision ? hopital acquired pnemonia... tazosin patient wid fever and juandice, picture of asending cholangitis, where is the promblem? cbd etc were options spontaneous becteriia peritonitis, organism patient wid ingestion of 20 paracetamol pills, PT ? VOn wilibrand disease, patient with menoragia feature of anemia of chronic disease patient wid ulcerative collitis and now joint pains dka, iv insulin was given, iv n saline patient wid low TSH, cortisol etc, hypopiturism Test of Acromegally, insulin toleance test? feature most strongly associated wid tb

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

treament startd wid acylovir, csf feature most strongly associated wid diagnosis man wid 3 yrs h/o lesion on shin diabetic patient wid episodic loss of conciousness ?automic neuropathi diabetic patient, poorly controlled, type of diabetes Patient wid pheochoromsytoma, phenoxybenzamine wot treatment shoud be started..?

flash pulmonary edema.... renal artery stenosis resistand hypertension, wot inx should be done patient wid early mornign stiffness and uper arms tenderness,, polymylgia? patient wid fater has soriasis, now joint pains ankylising spondolyits, clinical feature patient wid picture of RA, on nsaid, next treatment option patient in hospital, got gout, treatment? patient wid hearing loss, tinnitus and vertigo.. ?meniere's disease sudden onset visual loss, retinal hemrges and cotton wool spots thyroid swelling, investigation.... ?FNA colon cancer-- aspirin

more qs... =collapsed patient.... compression first =reactivation of TB test...gamma interferon =case of ketoacidosis dehydrated what next after insulin.... normal saline =3d image of ? protien test?

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

=case of pulmonary stenosis =hep c with cryoglobulin disorder somthing like that =pulmonary hypertension ...confirmatory test?? patient with dyspnea...echo or V/Q perfusion to confirm sec to emboli =seborrhic dermatitis.. scaly lesion on face, nose scalp sternum i think =xray osteosclerosis ---osteoarthritis old lady with varus deformity 3 months pain =PCOD--- test... high LH/FSH ratio .. increased androgen =boy with abnormal movements ? tourette syndrome =recurrent uri ---- to check for complement def =weak extension at elbow and wrist with some sensory loss--? post interosseos nerve another q was on cervical radiculomylelopathy =one patient with heart failure ...was on ramipril, furosemide aspirin ? need to ad bisoprolol -collpased pt-i think u give rescue breaths first -diabetic pt 15 yrs-collapsed,no postural drop , prolonged pr interval-SA Node. -pt on chemo,vomiting-i went for steroids,as this chemo is highly ematoigenic and we give steroids for another few days to help with same -colon ca-aspirin -pt on lithium and started frusemide,polyuria.only low urine osmolality,i went for frusemide as it does not fit with DI secondary to lithium ? -cluster headaches -carotid dissection CCF-add B.Blockers -loss of sensation dorsum foot/ankle reflex ? i think L5

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

-methanol OD with low GCS,I think that methanol levels were very high,in that case i went for Haemodialysis,ethanol infusion will be an answer if the levels were not high enough,now i dont know 500 is mildly/or highly raised - 70 yr old LVF - Bendroflu -man with tumour at apex lung-i think he had metastatic disease ,i did not went for FEV's -pregnant lady,known pre eclampsia,i went for salt restriction?do we give aspirin in pregnancy -diarrhoea,recently children had it in school-rota virus -pt had acute gout with ccf-steroids to start with -worsening renal fuction-continoue.creatinine still < 150 -girl with syncope,but normal after the episode-vasovagal. Pergolide - echo (causes valvular heart disease and cardiac fibrosis) 3D structure of protein - Xray crystallography Ciclosporin in post renal transplant - Tcell function suppressed A subject with urethritis, gram neg intracellular diplococci, VDRL +ve - False positive VDRL Ischemic colitis - Splenic flexure commonest site Creatinine increased after Trimethoprim - decreased (trimethoprim decreases tubular secretion of creat) Down's syndrome valvular HD - VSD Myelofibrosis - fatigue commonest symptom The question on ABG - mixed metabolic and respiratory acidosis Relative afferent pupillary defect - Optic nerve is site of lesion Lesion in pituitary (0.9 cm) not increasing in size over one year - a probable incidentaloma...no effect
Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

tubular

secretion

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

* things move or spin with head position change = BPV = Dix Halpik maneuver. * false positive VDRL = thinks about yaws (trponemal species) * collapsed patient with no breath or pulse: chest compression ? (before AHA guidelines 2010 PP argues abt asking for help). *someone with Howel-Jowel = Coealiac (a known casue of hyposplenism). * circular lesion on dorsum of the hand = granuloma annulare (thoguht not mentioned diabetic). * multiple enhance ring in CT = crebral toxoplasmoisi = give pyrimeth+ sulfazianize (Co tir.) * resistant hypertension with the investigations are consistent with Conn's syndrome = check Rennin-Aldo ration. * on lithium & hypertensive = give amlodipine * contraindication to samll cell caner = infliltration of brachial plexus (or volue < 1.5 not 1.8 in options) *lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels * pain in the forearm worst by wrist extension = radial tunnel syndrome ( more distal than tenis elbow). * malingering man asking fir sick report and he drinks alcohol = alcohol dependence. * woman who sees her dead husband = readjustment. * a young man diagnosed with IBD (crohns) and started treatment what is the advice = stop smoking *recurren vertigo = BPV = Dix Halpik maneuver. * false +ve VDRL = yaws (trponemal species). * collapsed pt & breath or pulse: chest compression ? (before AHA 2010 PPl argued abt asking for help). * Howel-Jowel =hyposplenism = Coealiac.
Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

* circular lesion on dorsum of the hand = granuloma annulare. * multiple enhance ring in CT = c.toxoplasmoisi =pyrimeth+ sulfazianize. * resistant hypertension =Conn's syndrome=Rennin-Aldo ration. * on lithium & hypertensive = give amlodipine * contraindication to samll cell caner = infliltration of brachial plexus (or volue < 1.5 not 1.8 in options) *lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels. * pain in the forearm worst by wrist extension = radial tunnel syndrome ( more distal than tenis elbow). * malingering man asking fir sick report and he drinks alcohol = alcohol dependence. * woman who sees her dead husband = ?readjustment. * a young man diagnosed as crohn and started treatment =advice = stop smoking. * ibsilateral facial loss + ibsl horner + con.lt weaknes = posterior inferoir cerebellar *red eye with mild tenderness = epislcleritis * digested into glucose and galactose = lactose. * penumia in ICU improved then high fever with p effusions = empyema * gout in CVS problem = cholcicine (others have risk of fluids retention). * weird movements in class = tourret syndome.

*which is correct---cluster or analgesia induced headache *which is correct ---to prevent colon cancer--w3 or vit -3 or etoricoxib *in preclamsia--treament--salt restriction or nifedipine

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

*occupational asthma---is it correct --do pefr to do work and away from work *following uti with red urine ,mastoid surgery-iga or alport *in plasmodium vivax -primaquine used due to reduce gamate or liver stage *diabetic retinopathy---stop smoking correct or no* *sciatic or s1 nrve compressio* *red urine with howell jolly body-pnh or pch *severe dyspepsia after treatment-do endoscopy or others *in ra ---ig or citrulline ***arnold chiarri or ms *optic nerve or occiptal lobe-maccunn *in severity of ms --which one correct i la size or pul artery pressure *in ulner nerve anatomy-1 st or 2nd lumbrical *psudomona-tazobactam or cefotaxime *esbl -impenem or other *bowens or granloma annulare *gilbert ----iv nicotinamide or fasting 48 hours *in eyes---osmolality change or cataract *in youge age af ---flecainide or digixoin *recurren vertigo = BPV = Dix Halpik maneuver. * false +ve VDRL = yaws (trponemal species). * collapsed pt & breath or pulse: chest compression ? (before AHA 2010 PPl argued abt asking for help). * Howel-Jowel =hyposplenism = Coealiac.

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

* circular lesion on dorsum of the hand = granuloma annulare. * multiple enhance ring in CT = c.toxoplasmoisi =pyrimeth+ sulfazianize. * resistant hypertension =Conn's syndrome=Rennin-Aldo ration. * on lithium & hypertensive = give amlodipine * contraindication to samll cell caner = infliltration of brachial plexus (or volue < 1.5 not 1.8 in options) *lambert eaton syndrome = antibodies to post synaptic Ca voltage gated channels. * pain in the forearm worst by wrist extension = radial tunnel syndrome ( more distal than tenis elbow). * malingering man asking fir sick report and he drinks alcohol = alcohol dependence. * woman who sees her dead husband = ?readjustment. * a young man diagnosed as crohn and started treatment =advice = stop smoking. * ibsilateral facial loss + ibsl horner + con.lt weaknes = posterior inferoir cerebellar *red eye with mild tenderness = epislcleritis * digested into glucose and galactose = lactose. * penumia in ICU improved then high fever with p effusions = empyema * gout in CVS problem = cholcicine (others have risk of fluids retention). * weird movements in class = tourret syndome. * asian woman with unequal blood pressur = Takayasu * pt wheneve has flu urine turn dark = IgA nephropathy *cholangitis with 4-fold rise in S.amylase = stone as pancreatic duct? * discritpiton of sata disribution around mean = SD?

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

*pituitary incidentalom prognosis = no progress * insulinoma = supervised 72h hrs fasting.

topics asked were: 1. lateral epicondyitis 2. ischaemia mesenteric 3.ra 4.sle 5.htn treatement in more than55 6.malignant htn 7.hf 8.vsd 9.ps or aortic valve bicuspid ? 10.normal aonion gap metabolic acidosis 11.ppv 12.ppv 13.nonparametric test 14.exercise tolerance test 15.ihd location of artey 16.men 2 pheochromocytoma 17.treatment of pheochromocytoma 18.infective endocarditis

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

19. rf 20.ankylosing spondylosis 21.gout 22. oa 23.septic arthrits 24.septic arthritis 25 psoritic arthritis 26 enteric arthritis 27.metronidazole -ileic involvement in chrons 28.dka 29.addisons disease 30 hypertension with low potasium. 31.mechanism of action of spirinolactone 32 direct thrombin agonist 33.eea 34.iaa 35.telangestasia
36 marfans

37,complement 38.arnold chiari 39. catract 40.retinal vien obstruction

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

41, carotid artery dissection 42. alzehmars disease 43. clear airways / call for help 44.peritoneal dialyses 45. occupational asthma 46.copd 47 . mg sulphate 48.scleritis 49.mgravis/ 50.s1 lesion 51.radial nerves branch lesion. 52.frozen shoulder 53.bph 54.ceolic disease 55. systemic sclerosis 56.osteomalacia 58.pagets disease. 59 cushings 60. graves 61. subacute thyrotoxicosis 62.unequal blood pressures 63.psedomonas.

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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MRCP part 1 Recall May 2013

( Note: some answers are not correct )

64.hypochondriasis. 65.schizophrenia, 66.seizures 67. head tremor 68 .motor neuron disease. 69.pons 70.intrasellar piytutary 71.hypopitutarism 72.smivastativ+clarithromycin 73.meiners disease. 74.tertiray hyperparathriodism 75.acromegaly 76 insulinoma 77.di lithium. 78. siadh.fluxetine 79. fluoxitine in young patient 80.alcohol piosing 81.wegeners 82 alport 83.hsp 84 iga nephropathy. 85.erythrema multiforme

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

25

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

86.bullous pempigoid 87.seboric dermatits 88.psoriasis 89. granuloma annulare 90.ulnar nerve leision 91.dyspepsia. 92.uc 93.ibs 94.yersinia 95.mechanism of inactivity of cortisol. 96.pcos 97.klienfilter 98.hypothriodism 99.myeloma 100.primary hyperparathyriodism 101.diuretic used in calcium stones 102.cml 103.cll 104. 15.17 translocation 105.mylofibrosis 1o6.dic 107.myelofroliferative disorder

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

26

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

108.pnh 109.anaemia of chronic disease 110.vonwilbrand 111.bilirubin mild elevated next test 112. chronic hepatitis c -cryoglobinemia 113.paracetamol poising- pt 114.mitral valve severity. 115.heriditary angieoedema -c4 level 116.alopecia 117.small cell ca. 118. bpaspergilosis. 119.aspiration pneumonia 120.pregnanat treat asthma 121.prophylaxis in previous preeclampsia 122.iv bypass the first order kinectics 123.epiglotitis 124.oral painful ulcers. 125 treatement of toxoplasmosis 126.xlinked dominant rickets 127.tlco reduced in lung fibrosis 128.plural effusion 129.cluster headache

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

27

MRCP part 1 Recall May 2013

( Note: some answers are not correct )

130.tricyclic overdose' bicarbonate 131.adenosine first in svt then give again 132.adenosine mechanism 133.inflixanib 134.risk factor crohons smoking 135-omega 3 use

Dr. Khalid Yusuf El-Zohry Sohag Teaching Hospital (01118391123)

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