Here is a list of commonly tested facts in Part 1 exam.

They are listed in

order of importance - highest first.

1. Acromegaly – Diagnosis: OGTT followed by GH conc.

2. Cushings – Diagnosis: 24hr urinary free cortisol. Addisons --> short
synacthen.
3. Rash on buttocks – Dermatitis herpetiformis (coeliac dx).
4. AF with TIA --> Warfarin. Just TIA's with no AF --> Aspirin
5. Herpes encephalitis --> temporal lobe calicification OR
temporoparietal attentuation – subacute onset i.e. Several days.
6. Obese woman, papilloedema/headache --> Benign Intercanial
Hypertention.
7. Drug induced pneumonitis --> methotrexate or amiodarone.
8. chest discomfort and dysphagia --> achalasia.
9. foreign travel, macpap rash/flu like illnes --> HIV acute.
10. cause of gout --> dec urinary excretion.
11. bullae on hands and fragule SKIN torn by minor trauma -->
porphyria cutanea tarda.
12. Splenectomy --> need pneumococcal vaccine AT LEAST 2 weeks pre-
op and for life.
13. primary hrperparathyroidism --> high Ca, normal/low PO4,
normal/high PTH (in elderly).
14. middle aged man with KNEE arthritis --> gonococcal sepsis (older
people -> Staph).
15. sarcoidosis, erythema nodosum, arthropathy --> Loffgrens
syndrome benign, no Rx needed.
16. TREMOR postural,slow progression,titubation, relieved by OH-
>benign essential TREMOR AutDom. (MS – titbation, PD – no titubation)
17. electrolytes disturbance causing confusion – low/high Na.
18. contraindications lung Surgery --> FEV dec bp 130/90, Ace
inhibitors (if proteinuria analgesic induced headache.
21. 1.5 cm difference btwn kidneys -> Renal artery stenosis -->
Magnetic resonance angiogram.
22. temporal tenderness--> temporal arteritis -> steroids > 90%
ischaemic neuropathy, 10% retinal art occlusion.
23. severe retroorbital, daily headache, lacrimation --> cluster
headache.
24. pemphigus – involves mouth (mucus membranes), pemphigoid – less
serious NOT mucosa.
25. diagnosis of polyuria -> water deprivation test, then DDAVP.
26. insulinoma -> 24 hr supervised fasting hypoglycaemia.
27. Diabetes Random >7 or if >6 OGTT (75g) -> >11.1 also seen in HCT.
28. causes of villous atrophy: coeliac (lymphocytic infiltrate), Whipples
, dec Ig, lymphoma, trop sprue (rx tetracycline).
29. diarrhoea, bronchospasm, flushing, tricuspid stenosis -> gut
carcinoid c liver mets.
30. hepatitis B with general deterioration -> hepaocellular carcinoma.
31. albumin normal, total protein high -> myeloma (hypercalcaemia,
electrophoresis).
32. HBSag positive, HB DNA not detectable --> chornic carier.
33. Inf MI, artery invlived -> Right coronary artert.
34. Autosomal dominant conditions: Achondroplasia, Ehler Danlos, FAP,
FAMILIAL hyperchol,Gilberts, Huntington's, Marfans's, NFT I/II, Most
porphyrias, tuberous sclerosis, vWD, PeutzJeghers.
35. X linked: Beck/Duch musc dyst, alports, Fragile X, G6PD,
Haemophilia A/B.
36. Loud S1: MS, hyperdynamic, short PR. Soft S1: immobile MS, MR.
37. Loud S2: hypertension, AS. Fixed split: ASD. Opening snap: MOBILE
MS, severe near S2.
38. HOCM/MVP - inc by standing, dec by squating (inc all others). HOCM
inc by valsalva, decs all others. Sudden death athlete, FH, Rx.
Amiodarone, ICD.
39. MVP sudden worsening post MI. Harsh systolic murmur radites to
axilla.
40. Dilated Cardiomyopathy: OH, bp, thiamine/selenium deficiency,
MD, cocksackie/HIV, preg, doxorubicin, infiltration (HCT, sarcoid),
tachycardia.
41. Restrictive Cardiomyopathy: sclerodermma, amyloid, sarcoid, HCT,
glycogen storage, Gauchers, fibrosis, hypereosinophilia Lofflers,
caracinoid, malignancy, radiotherapy, toxins.
42. Tumor compressing Respiratory tract --> investigation: flow volume
loop.
43. Guillan Barre syndrome: check VITAL CAPACITY.
44. Horners – sweating lost in upper face only – lesion proximal to
common carotid artery.
45. Internuclear opthalmoplegia: medial longitudinal fasciculus
connects CN nucleus 3-4. Ipsilateral adduction palsy, contralateral
nystagmus. Aide memoire (TRIES TO YANK THE ipsilateral BAD eye
ACROSS THE nose ). Convergence retraction nystagmus, but convergence
reflex is normal. Causes: MS, SLE, Miller fisher, overdose(barb,
phenytoin, TCA), Wernicke.
46. Progressive Supranuclear palsy: Steel Richardson. Absent voluntary
downward gaze, normal dolls eye . i.e. Occulomotor nuclei intact,
supranuclear Pathology .
47. Perinauds syndrome: dorsal midbrain syndrome, damaged midrain
and superior colliculus: impaired upgaze (cf PSNP), lid retraction,
convergence preserved. Causes: pineal tumor, stroke, hydrocephalus,
MS.
48. demetia, gait abnormaily, urinary incontinence. Absent
papilloedema-->Normal pressure hydrocephalus.
49. acute red eye -> acute closed angle glaucoma >> less common (ant
uveitis, scleritis, episcleritis, subconjuntival haemmorrhage).
50. wheeles, URTICARIA , drug induced -> aspirin.
51. sweats and weight gain -> insulinoma.
52. diagnostic test for asthma -> morning dip in PEFR >20%.
53. Causes of SIADH : chest/cerebral/pancreas Pathology , porphyria,
malignancy, Drugs (carbamazepine, chlorpropamide, clofibrate,
atipsychotics, NSAIDs, rifampicin, opiates)
54. Causes of Diabetes Insipidus: Cranial: tumor, infiltration, trauma
Nephrogenic: Lithium, amphoteracin, domeclocycline, prologed
hypercalcaemia/hypornatraemia, FAMILIAL X linked type
55. bisphosphonates:inhibit osteoclast activity, prevent steroid
incduced osteoperosis (vitamin D also).
56.returned from airline flight, TIA-> paradoxical embolus do TOE.
57. alcoholic, given glucose develops nystagmus -> B1 deficiency
(wernickes). Confabulation->korsakoff.
58. mono-artropathy with thiazide -> gout (neg birefringence). NO
ALLOPURINOL for acute.
59. painful 3rd nerve palsy -> posterior communicating artery aneurysm
till proven otherwise
60 late complication of scleroderma --> pumonaryhypertention
plus/minus fibrosis.
61. causes of erythema mutliforme: lamotrigine
62. vomiting, abdominal pain, hypothyroidism -> Addisonian crisis (TFT
typically abnormal in this setting DO NOT give thyroxine).
63. mouth/genital ulcers and oligarthritis -> behcets (also eye /SKIN
lesions, DVT)
64. mixed drug overdose most important step -> Nacetylcysteine (time
dependent prognosis)
65. cavernous sinus syndrome - 3rd nerve palsy, proptosis, periorbital
swlling, conj injectn
66. asymetric parkinsons -> likely to be idiopathic
67. Obese, NIDDM female with abnormal LFT's -> NASH (non-alcoholic
steatotic hepatitis)
68. fluctuating level of conciousness in elderly plus/minus
deterioration --> chronic subdural. Can last even longer than 6 months
69. Sensitivity --> TP/(TP plus FN) e.g. For SLE - ANA highly sens,
dsDNA:highly specific
70. RR is 8%. NNT is ----> 100/8 --> 50/4 --> 25/2 --> 13.5
71. ipsilateral ataxia, Horners, contralateral loss pain/temp --> PICA
stroke (lateral medulary syndrome of Wallenburg)
72. renal stones (80% calcium, 10% uric acid, 5% ammonium (proteus),
3% other). Uric acid and cyteine stone are radioluscent.
73. hyperprolactinaemia (allactorrohea, amenorrohea, low FSH/LH) ->
Da antags (metoclopramide, chlorpromazine, cimetidine NOT TCA's),
pregnancy, PCOS, pit tumor/microadenoma, stress.
74. Distal, asymetric arthropathy -> PSORIASIS
75. episodic headache with tachycardia -> phaeochromocytoma
76. very raised WCC -> ALWAYS think of leukaemia.
77. Diagnosis of CLL --> immunophenotyping NOT cytogenetics, NOT
bone marrow
78. Prognostic factors for AML -> bm karyotype (good/poor/standard)
>> WCC at diagnosis.
79. pancytopenia with raised MCV --> check B12/folate first (other
causes possble, but do this FIRST). Often associayed with phenytoin use -
-> decreased folate
80. miscariage, DVT, stroke --> LUPUS anticoagulant --> lifelong
anticoagulation
81. Hb elevated, dec ESR -> polycythaemua (2ndry if paO2 low)
82. anosmia, delayed puberty -> Kallmans syndrome
(hypogonadotrophic hypogonadism)
83. diagnosis of PKD -> renal US even if think anorexia nervosa
85. commonest finding in G6PD hamolysis -> haumoglobinuria
86. mitral stenosis: loud S1 (soft s1 if severe), opening snap.. Immobile
valve -> no snap.
87. Flank pain, urinalysis:blood, protein -> renal vein thrombosis.
Causes: nephrotic syndrome, RCC, amyloid, acute pyelonephritis, SLE
(atiphospholipid syndrome which is recurrent thrombosis, fetal loss, dec
plt. Usual cause of cns manifestations assoc with LUPUS ancoagulant,
anticardiolipin ab)
88. anaemia in the elderly assume GI malignancy
89. hypothermia, acute renal failure -> rhabdomyolysis (collapse
assumed)
90. pain, numbness lateral upper thigh --> meralgia paraesthesia (lat
cutaneous nerve compression usally by by ing ligament)
91. diagnosis of haemochromatosis: screen with Ferritin, confirm by
tranferrin saturation, genotyping. If nondiagnostic do liver biopsy 0.3%
mortality
92. 40 mg hidrocortisone divided doses (bd) --> 10 mg prednisolone (ie.
Prednislone is x4 stronger)
93. BTS: TB guidlines – close contacts -> Heaf test -> positive CXR,
negative --> repeat Heaf in 6 weeks. Isolation not required.
94. Diptheria -> exudative pharyngitis, lymphadenopathy, cardio and
neuro toxicity.
95. Indurated plaques on cheeks, scarring alopecia, hyperkeratosis over
hair follicles ->>Discoid LUPUS
96. wt loss, malabsoption, inc ALP -> pancreatic cancer
97. foreign travel, tender RUQ, raised ALP --> liver abscess do U/S
98. wt loss, anaemia (macro/micro), no obvious cause -> coeliac
(diarrhoea does NOT have to be present)
99. haematuria, proteinuria, best investigation --> if
glomerulonephritis suspected --> renal biopsy
100. venous ulcer treatment --> exclude arteriopathy (eg ABPI), control
oedema, prevent infection, compression bandaging.
101. Malaria, incubation within 3/12. can be relapsing /remitting. Vivax
and Ovale (West Africa) longer imcubation.
102. Fever, lymphadenopathy, lymphocytosis, pharygitis --->EBV --->
heterophile antibodies
103. GI bleed after endovascular AAA Surgery --> aortoenteric fistula

104. Young girl – suspect Anorexia Nervosa – linugo hair, finctional

hypogonadotrophic hypogonadism -> amennorhea. LH and FSH both
low. All other hormones are usually normal. Ferritin low.

105. Reiters Syndrome – arthritis, uveitis, urethritis – Chlymidia,

campylobacter, Yersinia, SALMONELLA , Shigella. Balanisits.
106. PKD – aut dom Chr 16/4 assoc berry aneurysm, mitral/aortic regurg
107. Porphyria – photosensitivity, blisters, scars with millia,
hypertrichosis
108. heart sounds: Aortic Stenosis s2 paradoxical split, length
 proportional to severity
109. Vitiligo – commonest assoctions pernicious anaemia >>> type 1 DM ,
autoimmune addisons, autoimmune thyoid dx
110. Gout – blood urate high/low/normal, joint aspirate pos birif, ppt
thiazides, NO allopurinol/aspirin in acute phase
111. Peripheral neuropathy – a) B12 – rapid, dorsal columns (joint pos,
vibration), sensory ataxia, pseudoathetosis of upperlimbs b) diabetic –
slow, spinothalamic (pain, temp?) c)alcohol – slow progressive,
spinothalamic d) Pb – motor upper limbs
112. CNS abnormalities in HIV: toxoplaasmosis (ring enhancing),
lymphoma (solitary lesion). HIV encephalopathy, progressive multifocal
leucoencephalopathy (PML – demylination in advanced HIV, low
attenuation lesions)
113. Travellers diarrohea: chronic (>2 WEEKS) giardia (incidious onset
rx. Metronidazole), SALMONELLA (serious systemic illness), E.coli (rx.
Ciprofloxacin) , Shigella
114. Renal syndrome – minimal change disease, membanous, IgA
nephropathy, post-streptococcal.
115. If you see blood on urinalysis forget about RAS
116. Thyroid Malignancy – tend to be non-functional, anaplastic has
worse prognosis, local infiltration -> dysphagia, vocal cord paralysis
117.ALMOST Pathognomic for the exam
fatiguability -> myasthenia gravis
fasciculations -> Motor neurone diease
silvery white scale -> PSORIASIS
hypopigmented -> vitiligo/pityriasis versicolor
pretibial myxoedema --> Graves (NOT lid lag, NOT exopthalmus)

IMPORTANT POINTS TO REMEMBER FOR FCPS-1

IMPORTANT POINTS TO REMEMBER FOR FCPS-1

COMMONLY TESTED FACTS

I) ONLY TWO Cranial Nerves Decussate:

Optic & Trochlear.
2 & 4 Decussate.
2 & 4 Decussate.
2 & 4 Decussate.

II) Almost all the questions of leukemias can be correctly answered just by knowing the age
range of these cancers:
0-14: ALL
14-39: AML
40-59: CML
60+: CLL

III) Rhabdomyolysis causes HYPERkalemia.

HYPOkalemia causes Rhabdomyolysis
IV) ALL causes of hypopituitarism result in deficiency of MORE than ONE hormone EXCEPT
Kallmann Syndrome

V) Clostridium:
Tetani - causes SPASTIC paralysis.
Botulinum - causes FLACCID paralysis.
Perfringes - causes NO paralysis

VI) IN Nephron:
Maximum reabsorption of H2O take place in Proximal Convoluted Tubules, REGARDLESS to
ADH status (present or absent).

VII) Offspring of Older Women: Inc incidence of Trisomy 21 (DOWN Syndrome).

Offspring of Older Men: Inc incidence of Achondroplasia & Marfan Syndrome.

VIII) Know the difference:

Cisplatin is NEPHrotoxic.
Cyclophosphamide is CYStotoxic (Hemorrahagic CYSitis)

IX) Try to Understand that:

History of Smoking = Bronchogenic Cancer.
Exposure to Asbestos = Mesothelioma.
Smoking Hx + Asbestos exposure = Bronchogenic Cancer.

X) Until proven Otherwise:

Post-coital vaginal bleeding is Cervical cancer.
Post-menopausal vaginal bleeding is Endometrial cancer.

Most important component of shock

Q: Most important component of shock is??

a) Hypotension
b) Tachycardia
c) Tissue hypoxia
d) Temperature

Answer: C

Explanation: By definition shock is inadequate tissue perfusion, which is just ANOTHER way
of saying "Tissue Hypoxia".

Q: Young female with low MCV and MCH but normal Fe and TIBC, most likely test to make
Diagnosis?

A. bone marrow aspiration

B. Hb A2
C. Retic count

Answer: B

Explanation: Microcytic Anemia With NORMAL Iron studies (Serum Iron, TIBC, Ferritin etc)
= Thalassemia.

Hb electropheresis is the Next best Investigation.

Question: One of the following is not an oncogenic virus?

a.EBV
b. Hep B
c.Hep D
d.herpes virus
e. HPV

Answer: C

Remember:

If Hep D and Herpes are in options SELECT Hep D.

If Hep D and HSV in options SELECT HSV.

Herpes --> family of 8 viruses (Including HHV8 and EBV - BOTH are carcinogenic)

1) Microcytic Anemia with Low Ferritin & High TIBC = Iron deficiency Anemia.

2) Microcytic Anemia with High Ferritin & Low TIBC = Anemia of Chronic Disease.

3) Microcytic Anemia with High Serum Iron = Sideroblastic Anemia.

4) Microcytic Anemia with NORMAL Iron studies = Thalassemia.

________
TIBC = Total Iron Binding Capacity
Ferritin = Stored Iron

A young female with pregnancy developed nausea vomiting and jaundice suddenly she died
which is most unlikely in this patient?

A. HAV
B. Hep B
C. Hep C
D. Hep D
E. . Hep E

Answer: C (Hepatitis C)

Explanation: ALL Hepatitis viruses can cause Acute fulminant hepatitis EXCEPT Hepatitis C.
The given presentations are HIGHLY suggestive of Fulminant hepatitis and the Least likely or
most Unlikely cause will be Hepatitis C.

Coagulative Necrosis is seen in...

A.TB
B. Pyogenic infections
C.all infractions
D.gangrene
E.brain

Answer: A
Explanation: Yes! I know I know, T.B & Caseous Necrosis thing. Actually Caseous is variant of
Coagulative Necrosis that's why here the correct answer is T.B (a)
Why NOT Gangrene?
We have TWO types of Gangrenes (a) Gas (b) Wet
Gas Gangrene is related to Coagulative while Wet Gangrene is related with Liquifective
Necrosis.
Here in question we have generalized term "Gangrene" which can be BOTH - either Gas or Wet.

1)
Oral Cavity:
Premalignant CONDITIONS = Submucous Fibrosis & Lichen planus.
Premalignant LESIONS = Erythroplakia & Leukoplakia.

2)
Isolated 6th cranial nerve palsy causes HORIZONTAL diplopia.
Isolated 4th cranial nerve palsy causes VERTICAL diplopia.

3)
Fluent aphasia: Cerebral lesion is POSTERIOR to the central sulcus.
Nonfluent aphasia: Cerebral lesion is ANTERIOR to the central sulcus.

Tamoxifen is an estrogen receptor AGONIST in the uterus.

Raloxifene is an estrogen receptor ANTAGONIST in the uterus.

Tamoxifen for PREmenopausal women with high risk for breast cancer.
Raloxifene for POSTmenopausal women with high risk for breast cancer.

ALL steroid hormones are protein bound EXCEPT DHEA.

ALL protein hormones are not bound to plasma proteins EXCEPT IGF-1.

ALL hormones are secreted in pulsatile fashion EXCEPT Thyroxin.

Regarding TB:
- T.B.
- T.B.
Calcification, Positive PPD, Caseating granuloma - in BOTH.

The MOST COMMON thyroid Carcinoma is Papillary (P-opular).

It also has P-sammoma bodies on histology.
It causes P-alpable lymph nodes (lymphatic spread)

n. MeninGitidis ferments Maltose & Glucose.

n. Gonorrhoeae ferments ONLY Glucose.

LYMPHATIC DRAINAGE OF MAJOR ORGANS

GIT: all lymph of GIT is drained into CYSTERNA CHYLI, THORACIC DUCT & then finally
drains into LEFT SUBCLAVIAN VEIN

CERVICAL ESOPHAGUS drains into Deep cervical nodes

THORACIC ESOPHAGUS drains into posterior mediastinal nodes

ABDOMINAL ESOPHAGUS drains into Preaortic & celiac nodes

STOMACH is drained to Aortic nodes

SMALL INTESTINE drains into Superior Mesentric nodes

LARGE INTESTINE drains into Central nodes through Epicolic, Paracolic & Intermediate
nodes

RECTUM: Upper half drains into Inferior mesentric nodes

Lower half drains into internal iliaac nodes

ANAL CANAL: Upper half into internal iliac nodes

Lower half into Superficial inguinal nodes

MALE GENITAL TRACT

SCROTUM drains into Superficial inguinal nodes
TESTIS drains into Paraaortic nodes
PROSTATE drains into Internal & external Iliac nodes
PENIS.. Skin.. Superficial Inguinal nodes
Deep structure.. Internal Iliac nodes

FEMALE GENITAL TRACT

OVARY, FALLOPIAN TUBES, UPPER UTERINE CORPUS drains into Aortic & paraaortic
nodes.
UPPER VAGINA, CERVIX drains into External & Internal Iliac nodes.
LOWER VAGINA & VULVA drains into Inguinal nodes.

GoodLuck 

-Dr Waleed