30/8/2014 ONLY MRCP MCQs

Sani Kay
6 mins

CARDIOLOGY
1. 28 yr old young patient with palpitation, for 4 hours, bp stable, no heart disease , no previous problems,
still having Afib on ecg , which medicine will u give .. Flecanide
2. Patient with wide qrs having ventricular tachycardia.. whatecg featuresdiffertiates it from SVT with
aberration…… - AV dissociation
3. Patient with infective endocarditis, on treatment already having long PR , which of the signs will reflect an
immediate need for surgery……. Prolongation of PR interval
4. Patient with severe Aortic Stenosis , what sign is going to depict the severity of the AS ….Dec intensity of
2nd Heart Sound
5. Patient with A Fib , is to go for Radiofrequency ablation procedure, which part of the heart will give best
result - Pulmonary veins catheter ablation with 85%success rates.
6. Patient with Antero-Lateral MI , with ST elevation went through Cardiac Catheterization and Primary PCI
done , now back to floor, the ecg shows wide complex tachycardia 108, patient with normal BP ,-IV what will
you give the patient, … do nothing- no treatment required as it is idioventricular rhythm
7. Patient with chest pain having Bradycardia and low bp, pulse 60 BP 90/60 high JVP with st elevations
admitted- which coronary artery is affected,…Proximal Right Coronary artey.
8. YoungPatient with breathlessness and systolic murmur at the left sternal border, which increases with
inspiration , what is the possibility..Pulmonary Stenosis
9. Ascites+ early diastolic murmur + x and y descent ? : constrictive pericarditis ..i guess it was Superior
Vena Cava Syndrome as the face was flushed and on chest auscultation right heart was clear no addes
sounds were there jvp was raised …. I went for SVC syndrome instead
10. Patient with complete heart block , what will you find… variable 1st heart sound Other
11. cadiovascular risk assment-which are related to the increased cardiovascular risk… answer is HDL and
TG as Dec HDL and inc TGS are independent risk factors for CardioVascular Diseases
12. Old man with A-fib, started on warfarin therapy , is having dm with following medications-ramipril,
furosimide,etc what are you going to add ? ------- Bisoprolol
13. patient with K 7.9 : IV cagluconate or temporary pace maker ?? one of the cardiologist I discussesd with ,
says we have to give iv first to stabilize the heart then go for pacemaker later
14. levels do not increase in heart failure –nor drenaline,endothelin ? Natriuretic Peptide
15. post PCI with incrasedEosinophils, Creatinine, ,change in color of the foot, …. It was : Cholestrol
embolism
16. patient for long haul flight had a lot of alcohol before flight then had nausea vomitting Blackout in Plane
gained consiousness immediately was being handled by air crew reason - VASOVAGAL SYNCOPE
CLINICAL HEMATOLOGY & ONCOLOGY
17. Young patient with recurrent infections and blood picture showing Howel Jolly bodies,history of Road
Traffic Accident-what is the reason for his blood picture - Asplenism
18. A Patient taking medication for Ischemic Heart Disease including Clopidogrel, ACEI, Bet Blocker is
presented with HUS/ TTP; Which test would be abnormal--- Raised aPTT
19. Irradiated PRBC : ? Patient given irradiated blood .. what is the benefit ... - TO PREVENT VIRAL
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INFECTION CMV
20. HIV pt with Red cell Aplasia : CMV or EBV ?? ERYTHRO VIRUS B-19 =pure red cell aplasia in hiv
21. patient with Renal impairment and neuroSgin : TTP
22. Pokilo cell, with fatigue, : mylofibrosis
23. Patient after Gastric Bypass : which is most common deficiency observed in these patient…..Vitamin B12
Deficiency (most common) followed by Iron etc.
24. Patient with Erythema Nodosum, for investigations?sarcoidosis inves do CXR .. IN THIS QUESTION
PATIENT HAD NO RESP SYMPTOMS , BLOOD TEST COULD HAVE ALSO BEEN OFFERED as next step in
Diagnosis.
25. Patient with Backache, High Creatinine and High Calcium ….what is the most appropriate investigation
for this patient……..serum electrophoresis for myeloma
26. HUS IN adults- female visited a farm and after that had diarrhea with inc creating … so ecoli-0157
27. Young female with menorrhagia (family history present) - Von willibrand disease
28. Patient with Hemochromatosis is being treated with venesection , how will you monitor this ….serum
ferritin level
29. Polycythemia rubravera – which gene mutation will u expect: JAK2 mutation
30. splenomegally and bleeds- with gum hypertrophy, diagnosis……….AML
31. epistaxis stopped,ITP-what is the most appropriate treatment :- predinsolone
32. Female with fatigue and splenomegaly - Myelofibrosis … I guess this is the question in which there
myeloid series cells on peripheral film n myeloblasts..aswell………hmm I went for CML ..
CLINICAL PHARMACOLOGY,THERAPEUTICS & TOXICOLOGY
33. BPH which drug should be given to decrease the size of prostrate gland ?/- Finasteride- 5alfa redictase
inhibitor
34. morphine Toxcicity : Dcrease lean body Mass ..i guess.. Decreased Renal Clearance
35. Time of Elemnation of a drug to 1/8 , half life 2 h , Elimination rate 0.4/h : 6 .. right 6 hours
36. Patient started on Bupropion to stop smoking .. what is the contraindication to the use of this
medication…..h/o seizure disorder ( h/o Epilepsy)
37. patient with nasal blockage , SOB :: Asprin
38. Patient on warfarin for afib, started on antituberculosis treatment lately, having the inr decreasing from
2.5 to 1.3 – which drug might be the reason ….. Rifampicin
39. patient on warfarin and started on metronidazole treatment , now adjusted dose of warfarin is needed to
maintain inr- Reason? …..cyp2c9 gene
40. Mechanism of Action of Allupurinol ….. inhibition of Xanthine oxidase enzyme
41. What’s the mode of action of Calcineurin,Imitanib=Tyrosine Kinase Activity inhibition
42. What is the Mechanism of Action of ..Ciclosporin-IL2 inhibition
43. Patient already taking Ciclosporin post Renal Transplant and stable is diagnosed with fungal infection
and started on Fluconazole .. after 10 days or so the patients creatinine jumps what is the reason
….Ciclosporin toxicity sec to Fluconazole
44. Patient with Facial Hair growth and Acne, side effects of which drug :- Prednisolone… other options were
cyclosporine etc.
45. What is the site of action of the Thiazide Diuretics :- Prox.DistalConvulatedTubles
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46. Paracetamol overdose with hepatic necrosis ,which is the best test for following the prognosis of the
patient ….. s/ creatinine
47. Patient with cholestatic LFT : amoxaclin …I guess Augmentin is the one causes cholestasis with Hepatits
while Flucloxacillin causes cholestatsis with bile duct injury …
48. Metronidazole and Lithim given together leads to .. increased lithium toxicity due to ….. dec renal
excretion of lithium .
49. Patient is started on Aspirin and dipyridamole post stenting … what is the mechanism of action of
Dypyridamole ………. Phosphodieterase Inhibitor
CLINICAL SCIENCES
50. Homocystinuria decreased cystathionine B synthase
51. Analysis : IgE or mast cell Trypase .. its Tryptase from 1hr to 5 hr after reaction
52. Patient with backache, with normal urine control having difficulty dorsifexing the the big toe and sensory
loss on the foot …..where is the lesion.. : L5
53. Patient with weakness of ant.thighmuscles,and weak flexion at the hip with absent knee reflex and having
area of sensory loss in lower leg lateral aspect … where is the lesion ….Femoral N
54. amaurosisfugax :: MCA or Carotid .. ..Internal Carotid Artery
55. Patient with pain at the medial epicondyle having difficulty dorsifelxing wrist against resistance, ..what is
the diagnosis… Medial Epiconylitis
56. Patient with congenital Long QT syndrome, scenario, then question asked which of the ions is
reasonable for REPOLARIZATION,of cardiac action potential…….K+ CHANNELS
57. Patient with weak flexion of the triceps muscle of right arm as compared to left with sensory loss at the
base of the right thumb difficulty extending the wrist ….where is the lesion….RADIAL Nerve
58. Down syndrome 47 XY +21 – aneuploidy
59. Patient with Post.dudenal cap ulcer the artery affected? gastrododenual Artery supplies till mid of 2nd
part and its part of anterior gut .. after that duodenum is supplied by mesenteric Artery …Answer is
…….Gastrodudenal artery…….
60. Nurse with Latex allergy 10 years back and now got the same problem wearing rubber (latex) gloves-
What is the mode of this reaction - TYPE IV HYPERSENSITIVITY
61. Nurse with recurrent hand symptoms of allergy eczema&angio-edema =LATEX Allergy
62. Turner syndrome associated - gonadal malignancy
63. Embryonic stem cell for DM management : protect itself from destruction ?? well I guess I read
somewhere that embryonic cells implanted in Type 1 dm (islet cell ) are put in a membrane to avoid
carcinogenic changes in these cells and not to avoid destruction or apoptosis…or senescence….so I went
for other option .. to avoid carcinogenic change.. I don’t remember the exact wording now .
64. Alkaptanuria...... is it an amino acid metabolic disease or glycogen storage disease or enzyme defect ...
65. Which of the following stimulate the brain chemoreceptor for respiration……H+ions
66. Patient with difficulty opposing the palms of her hand with inability to close hand and the ring and little
fingers flexed ? …..Dupuytren’s contracture..
67. Patient with Hemochromatosis, high ferritin level …. What is the mode of inheritance of
Hemochromatosis……..Autosomal Recessive
68. How To know NPPC :Compare Gene map? Amsterdamcriteria to screen then do GENETIC testing

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69. Patient with dec food intake, now put on NG feeding , how to proceed with diet , the first day …….50% of
the dietery requirements
70. The genetic of DM and sensorineural hearing loss, mother had mild symptoms, sister had mild
symptoms, but the brother had severe symptoms - Mitochondrial disorder Or X-linked Dominant …answer
….MITOCHONDRIAL
71. Patient with cardiac arrest and you are resuscitating him , family including parents and girl friend are
present .. who Is going to decide to stop the Resuscitation ? .. Team leader of Resuscitation team
DERMATOLOGY
72. Patient with a few pearly umblicatedpapular lesion on lower abdomen suprapubic area ..what is the
diagnosis……MOllascumContagiosum
73. IntraepidermalIgG- phemphigus as its IgG deposition , if it was igA then we should think Herpitiformis
74. Patient with long history of a pigmented lesion on face(cheeks), having irregular edges and uneven
pigmentation …. elder man with flat lesion >>>LentigoMaligna .. it’s the carcinoma in situ for Melanoma …..
75. patient with web space lesion itchy rash weeks back was given local steroids and the lesion expanded
further to reach the dorsal aspect of the foot spreading ever since. He was treated with a high-potency
topical steroid cream, .....................answer was TINEA INCOGNITO ........
76. A young girl with history of paracetamol overdose who had rashes at the flexor surface, in linear fashion
previously had self-medicated - Dermatitis Artifacta
77. Acanthoysis nigrcans in obese ass e >> DM? or GI Malignancy ?ans ..Diabetes M.
78. Woman with Papules in vulva and a Macular rash in the Palms( and soles?)with Genital Warts ......what
is the most appropriate next step for Investigating the Conditions the options were :HPV pcr/syphilis
Serology VDRL = Syphilis Serology (Secondary Syphilis
79. Male from Ghana/Gambia .. comes back with multiple areas of skid depigmentation with sensory loss ,
what is the condition…. Tuberculoid Leprosy.
ENDOCRINOLOGY
80. BitemporalHeminopia : Cabergoline or Surgery – as it is non secretory , and causing pressure sx
surgery is the best option
81. A patient asks you about the best indication for the Hormone Replacement Treatment, …..for
Postmenopausal symptoms control
82. pt e HTN DM colon CA and increased sweating ..Dx. .Acromegaly
83. Patient with cough, drowsy, having right upper lobe lesion on cxr , with labs showing Hyponatremia …
115 and urinary Na 65 .. what is going to be the most appropriate management …..Fluid Restrictionthe first
step in SIADH
84. Patient with Recurrent Headaches, high Urinary Cathecholamines =pheochromocytoma: with family
history of Thyroid disease /Nodule … which thyroid Condition can be associated with it …. Mecullary CA …
thinking MEN 2 syndrome
85. Marfan scenario ,eye feature with pesescavatum …. Ectopia lentis
86. 19y Female with facial hair,acne obese( had all features of pcos) but lab results for premature ovarian
failure but clinically not ???premature mature ovarian failure or PCOS ?
87. Patient on long term Hemodialysis having vit D and Calcium with the labs showing high serum calcium,
high phosphates, high PTH .. what is the reason for this ……..Tertiary Hyperparathyroidism
88. Hormone which leads to increased hunger …. Ghrelin

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89. Patient with lid lag, thyroid nodule .. treatment with which modality will worsen the thyroid eye disease -
RADIOIODINE
90. Patient with type T1DM received blood transfusion.. the optimal time for measure of HA1c? 6 months
91. Male with Gynaecomastia, Low testosterone and raised FSH and LH –Klinefelter
92. 16 Y OLD BOY with less height than his class fellows, with lack of secondary sex characteristics and
small testes ..( volume around 4 ml or less), while others in the class had pubic hair , facial hair , labs were
fine and no other abnormality observed.. what is the cause of his delayed puberty......simple constitutional
delayed puberty, kallman, keinfleiter etc... and the answer was Simple Constitutional Delayed puberty..
GERIATRIC MEDICINE
93. Elder female e UTI ,, allergic to pen : TMP/SMX .. I think the empirical treatment is either TMP/SMX or
nitrofurantoin
94. Elderly man, had microscopic hematuria, kidneys were normal- flexible cystoscopy Or CT abdomen ??
well the NEXT step would have been to do an Xray KUB to rule out stone first then to refer to a urologist…
this is what I think .. though it comes under a category of urgent referral to a urologist
95. Old aged woman in garden-goes and gets heat exhaustion… what age related change has made her
more prone to this condition………………dec.Sweating
96. A study done shows that the Pulse pressure tends to increase with increasing age.. what do u think is
the reason for that …...reduce aortic compliance
GASTROENTEROLOGY
97. Lipaemic serum pancreatitis - Chylomicrons
98. Patient with diarrhea blood stained , having itching … labs showing increased bilirubin and alkaline
phosphatase while ALT is within normal range and USG abdomen is normal as well .. what is the most
probable cause-Primary Sclerosing cholangitis.
99. lady for 3 weeks hx of abdo pain and loos stools plain xray normal, with Ulcerative colitis, patient doesn’t
improve in 3 days… what should u do next......X-Ray abdomen ( to rule out Toxic Megacolon)
100. Dumping syndrome 8 yr post Gastric surgery , having symptoms just after eating with nausea, vomiting,
flushing etc .. what to do ??…. It is Dietary Advise ..
101. Patient present e only high bilirubin , other LFTs fine Gilberts Syndrome
102. Patient with history of pyloric ulcer had an operation done 8 years back with suction splash positive
having vomiting and nausea .. what metabolic abnormality will he develop……Hypokalamic Alkalosis
103. Patient on long term Peritoneal Dialysis … comes with abdominal pain, ascites .. the Ascitic tap done…
what will help u with diagnosis of peritonitis: High Neutrophils in Fluid
104. Patient presents with dysphaia of food and drinks both ,Dx..: Achalasia
105. Patient presents with jaundice.. serology given shows IgM for hepatitis A, IgGHep B, and anti-
HBC..whats the Dx…… Hepatitis A
106. Female with itching and right abdominal pain , with sister having the same disease and mother also
affected, no history of hepatitis, drug use … her s/anti mitochondrial antibody is positive .. what is the
diagnosis … Primary Biliary Cirrhosis
107. Patient with malignancy not responding to morphine ,liver capsule pain in metastatic malignancy-
steroid dexamethasone
108. Nutrition for Patient with acute abdominal pain (severe pancreatitis due to gall stone) – NPO
109. Patient with suspected longstanding Chrons Disease having stricture in the small intestine with capsule

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endoscopy and later diagnose as Malignant Stricture.. what is the most common pathology …. LYMPHOMA
110. Diagnosis of Giardia if not seen in stool -wet stool sample or Microscpe with Duodenal Aspirate ??if
stool culture not positive multiple times= RadioImmuoassay (CDC)
111. A girl with negative anti-TTG but presented with coeliac symptoms- Gastroscope with duodenal Biopsy
?
112. gall stones in hereditary sickle cell disease=pigment stones
113. carcinod syndrome intial symptom: facial flushing
114. Female Patient with Chron’s disease smoker, with stable disease.. which association is going to be
most predictive of disease….Cigarette Smoking= 60%
INFECTIOUS DISEASES & GUM
115. A School Teacher is diagnoses with Pneumococcal Meningitis , there is no one else affected in the
school what should we do for the contacts at school ….isolate & observe till one week
116. Patient with history of travel to spain had sex with two , come to you with dry cough , having on blood
dechemoglobin,normalwbc, peripheral blood pic of agglutination, … …Mycoplasma
117. Patient diagnosed with NisseriaMeningitidis Meningitis , what prophylaxis should be given to the
household contacts….Ciprofloxacin
118. Child bit by a cat-it gets swollen and wond on hand get worse-what is the most probalble organism =
BartonellaHenslae
119. African tick bite- ricketsia coronii
120. Strongyloidsstercoralis…- wearing foot wear and avoid bare foot as it enters the skin
121. Epilepsy and malaria prophylaxis- mefloquine , Malarone
122. gonorrhea ttt UTI : ceftriaxone .. as treatment for chalymydia was already given n culture showed gm
negative diplococcic
123. Tonsils weren't coated but had exudates ??? :: diphtheria
124. Patient with Lyme Disease with multiple eschar/ erythema sites 2nd day of treatment with anaphylaxsis
and body reaction - EXPOSURE and INTERACTION WITH DEAD PATHOGENS ? (JerishHerxheimer
reaction)
125. Patient with tuberculosis for diagnosis , what is the most sensitive Pleural test for Tuberculosis……
Pleural Fluid LDH, Pleural Biopsy and culture, Sputum Culture, Pleural aspirate culture, Bronchial lavage
culture ..??? I don’t know the answer ??
126. Patient who is neutropenic on the floor .. with decwbc and dec neutrophil count …. Antibiotics against
which organism would be your first priority…… MRSA, Pseudomonas Aurogenosa,PCPetc ??
127. The hospital experiences multiple cases of MRSA , you are in hospital policy making committee... what
is the best way to decrease the MRSA hospital infection ...........answer was HAND WASHING
NEUROLOGY
128. A typical hx of tuberous sclerosisa 22yr old girl, 4 yrhx of HTN , on Amlodipine,came for r/v gives a
family hx of Nephrectomy to her father following a cystic disease of kidney.O/e- nodules round nose ,
macular patches on trunk Diagnosis?.(TUBEROUSSCLEROSIS) Adult Polycystic kidney/Von HippelLindau
dis
129. Poor Sign of Alzheimer : Poor Identification of Time ? POOR ORIENTATION OF TIME
130. Highest risk for Alzheimer : Family HX ?? Increasing age is the greatest known risk factor for
Alzheimer's

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131. Poor Prognosis after stroke : visual spatial neglect ?? Dysphagia I guess , as neglect responds very
nicely to the Neurorehablitation..
132. Occipital Headache : Bailar Migraine(symptoms of vertebrobasilar insufficiency, which may precede the
headache=Basilar Migrane.)
133. Patient with vision defects lately having accidents .. is having right inferior quadrantopia and unable to
calculate….where is the lesion.. Left Parital Lobe
134. Patient diagnosed with GB syndrome, how will you monitor his respiratory function ….FVC (Forced Vital
Capacity)
135. Patient with Occipital Headache, neck stiffness , 2 weeks with Bilateral 6th nerve Palsy
andpapilledemaand CT scan is normal.. what is the diagnosis.. BIH
136. Pain on walking relieved on sitting - Spinal stenosis
137. Korsakoff syndrome - Short term memory loss
138. Patient with ataxia and nystagmus - Posterior inferior cerebellar artery
139. Tonic clonicseziure , Alcholic and blood sugar 3.1 >>> idiopathic epilpsy or alcohol releated seizure ? it
was a young adult …but all labs were within normal limit and also ecg .. so I went for idiopathic Epilepsy ..
diagnosis of exclusion
140. Prophylaxis for trigeminal neuralgia : Carbamezepin
141. A patient with ant spinal cord syndrome with all limbs paresis, loss of temp/, while fine touch AND
Vibrations are preserved …what is the diagnosis……………Anterior Spinal cord lesion/ Syndrome
142. A female with parkinson's disease having upgaze palsy recurrent fall -------- p.supranuclear palsy
143. Patient with dementia, wide based gait, urinary incontinence diagnosesd with NPH ...what is the
Treatment of Normal Pressure Hydrocephalus - CSF DRAINAGE
144. Patient with NON Hodgkins Lymphoma treated with Vinca Alkaloids 2 years back , presents with Pins
and Needles and impaired vibration and position sense in Big Toe .. Labs showed Lower Levels of B12 in
Serum and also folate in lower Range... No MCV given in details... what is the cause of his symptoms......
well i guess B12 Deficiency was the answer ..
145. pt.parkinson on ropirinole for 3 years and dterurating ,,O/E mild tremor and sever dyskinesa and
regdity what is best RX? benzexol or carpidoa or... ANSWER ….ADD CARBIDOPA
NEPHROLOGY
146. Simvastatin used by a patient having mascular pain and high creatinine, what will u find on urine
examination…… myoglobin
147. Patient with Medullary Sponge Kidney Disease, regarding the complication what is going to be the final
outcome of this patient …NephroCalcinosis
148. A patient with SLE having increased creatinine, with IGa,IGg,IgM deposited in the glomerular membrane
what will u expect ….. Low C3 in Serum
149. Histology from renal biospy, neutrophils, eosinophils with normal renal capsule- AIN
150. Medication in diabetic renal pt-losartan
151. Beer and polyuria – decreased EXPRESSION of aquaporin channels …
152. Young with proteinuria and lower limb oedema with biopsy showing Minimal change disease -what
intervention will decrease the Proteinuria in this patient = Prednisolone
153. A pt with multiple sclerosis , on Baclofen, developed urinary incontinence. Post voided volume 20ml.

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Rx.1. Intra vesicalBotulinum toxin. 2.suprapubic catheter.3.tolterodine

BIOSTATISTICS & EPIDEMIOLOGY
154. why we randomise people on study : ??TO decrese the Type 1 error, To represent the whole
Population etc
155. what is the chance that the Test will be post ice :: Positive predictive value it was some thinglke
380/405 I guess..
156. Chiquard study
157. A study has alot of confounding factors....??? analysis of confouctor ---as much as I could get from
internet search it comes to …….. Spearman Rank correlation
158. question for Drug trial in which two groups were studies one placebo , and the value was nominal .. and
we had to choose the test to compare before and after the treatment ……I rembere answer was UNPAIRED
T test ..
OPTHALMOLOGY
159. Patient with Transit loss of Vision , Carotied 50% what to do?? : Aspirin (endarterectomy from70-99%)
160. Patient with decreased vision in one eye with swollen disc on retinoscopy central scotoma … where is
the lesion….OPTIC nerve
161. Ehler Danlos e angioid present e sudden visual loss the cause---well the Choroidal Neovascularization
may lead to retinal haemmorhage in macula and loss of vision ..i don’t remember the option
162. cotton wool spots and haemorrhage – and vision loss……… .the most common cause would be retinal
vein thrombosis …. .( please confirm that)
PSYCHIATRY
163. Patient Detached from self : Depersonalization disorder
164. Hypochondrosis
165. post natal low mode with tearing—PATIENT HAD DEPRESSIVE SYMPTOMS ,with tendency to cry and
low mood so I guess post natal depression was a better choice .. ??
166. A young male since child hood had grunting, abnormal movement and occationally falls- Tourrete
syndrome
167. Post op patient known parkinson disease old pt wit psychosos: Patient of parkinsonism presented with
Delirium .. what to give .. well haloperidol cant be given as it increases the extrapyramidal symptoms so have
to select from one of the benzodiazepines.. Lorazepam .. i selected this as it is long acting ..other
benzodiazepine was short acting
168. Patient talking on its own and replying " no ididnt do that" , while u never asked such a question ... what
is she experiencing ........auditory hallucinations
169. Patient with chronic alcohol use presents to the ER with tachycardia agitation , abnormal behavior and
Dilated Pupils…What overdose has he taken …. Ecstacy
170. Female patient wth history of multiple suicidal attempts and harsh physical relationship, low mood and
hearing voices off n on ,history of self harm …… Diagnosis…Borderline personality disorder(other options
were , bipolar disorder, .paranoid schizophrenia, )
RESPIRATORY MEDICINE
171. PCP finding :: Normal CXR or Crakles all over the chest ? normal auscultation
172. After internal Jugluar line : Heaomothorax… I guess it was Pneumothorax as the lung was collapsed
and it’s a know complication of central lines

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173. Patient with difficulty breathing, having dec FEV1, FVC and dec TLCO ,dec DLCO what is the most
probable diagnosis….. Pulmonary Fibrosis
174. Female pregnant already taking salbutamol, inhaled steroid 400mcg/day, and recently added long
acting Beta stimulants,still wakes up at night twice a week and has sob-what will u do next= Increase the
dose of Inhaled Steroid 800(beclomethasone)
175. Male Welder who gets sick at work having fever, body aches, running nose, difficulty breathing
immediately but stays well off it .Monday morning SOB FEV!/FVC 71% = Metal Fume Fever
176. COPD patient with reduced Sats 86% on Room air having tachypnea needs to be given oxygen what is
the best mode to deliver the oxygen …..Venturi Mask - Venturi mask ?
177. RA on methotrexate- Bronchiolitis obliterans Or MethotraxateToxicitiy Or Pulmonary vasculitits ?
178. Obese man with BMI of 41, feeling sleepy all day long having high score on epworth sleepless ness
scale 18 and having apnic episodes 4/hr ( normal less than 5)… what is the most important intervention ..
Weight reduction
179. Pneumothorax risk : smoking there are two things which a patient shouldn’t do.. after pneumothorax
correction as per bts guidelines… Smoking .. then to avoid scuba diving and other is Contact sportsfor 6
weeks.
180. Abbreviated mental test score (AMTS) 7/10- Patient with confusion, having hr of 28, bp of 110/70?,
tachypnea, which is the most important prognostic sign =Confusion
181. -Patient with respiratory distress, having high PCO2 and hypoxia ,drowsy , copd exacerbation , what is
the best way to give oxygen ….. Non Invasive PPV
182. Patient with Cystic Fibrosis ,comes to you for vitamin suppliments what will is the most important vitamin
you will prescribe .. Vitamin A
183. Patient with history of childhood pneumonia,recurrent infections , having daily productive cough with
auscultatorycrepts at base……Bronchiectasis
184. Patient with recurrent DVT , with resp distress and leg swollen ..PE e DVT what is the best investigation
: CTPA … CT pul Angiography
RHEUMATOLGOY
185. Patient with new onset prox muscle weakness , with a rash on the backside of hand and
proxinterphalangeal joints.. Dermatomyositis.
186. Female with marginally raised cpk, incesr, with macroglobulin in serum, tired, unable to stand from
chair, no muscle weakness, .. Polymyalgia Rheumatica-PMR
187. Young adult 29y , having back pain and gets better after he walks in morning , improves with his
exercise….Ankylosing Spondylitis
188. Primary biliary cirhosis>>>antimitochondirial
189. Patient with right hand small joint involment and left hand middle finger dactylitis,and having
metatarsophlangeal joint involvement …… Psoriatic Arthritis
190. Old woman with Left wrist swelling- Pseudogout OR Ostomylitits ? people voted for OsteoNecrosis
mostly
191. Patient withHerbendenNodes and bouchards node + dip pain –with normal labs …. Osteoarthritis
192. 45 years old with large joint involvement- RA ?
193. Male with no history of STD but having arthralgias and gastroenteritis 2-3 weeks-which organism can
be involved-Reactive Arthritis= CompylobacterJejuni

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194. Patient with SLE is having ANA positive but forgot to order the Immunoglobin class . which class does
ANA belong to…. IgG
195. RA eye manifestation-episcleritis
196. Pt. e HTN ,raynad , SOB and cough >>> systemic sclrosis
197. A young pt with recurrent DVT with family history of thromboembolism , with antiphospholipd antibodies
positive .. which is the common cause for thrombophelia in this patient ..protein C Def/antithrombin
Def./factor V Leiden mutation /polycythemia/protein S def-----answer=Factor V leiden Mutation
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Sani Kay MAY 2014 RECALL

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