Qs RECALL / MRCP PART 1- MAY 2019 ---------DR.
SAIFEE
-----------------------------------------------------------------------------
1-Pregnant lady with early diastolic murmur increased on expiration? Pulmonary HTN as
there is loud S2,
2-Painful inguinal lymph nodes - ? LGV
3-Painful vaginal ulcers, girl not drinking anything due to painful micturition - ? Herpes
simplex virus
4-Confusion, temporal changes on CT - ? Herpes simplex encephalitis
5-Hemophilia A , odds to fetus being effected - ? i guessed in 4 , what was the answer ? X
linked reccecive1:4
6-Old lady with uti , how to reduce risk of fall - ? Physical restraint-- I think the question
asked for treatment of her confusion.. So I think it will be haloperidol as first line of
treatment,
7-Definition of sensitivity - something like "those with the disease ..."
8-Lady with small joint arthritis of the hands with the options being anti Citrulline, anti sm
- I Chose anti CCP antibodies
9-Chances of kid being affected in a genetic condition, answers in percentage given , I put
50 percent
10-Fragile x male with few symptoms with fsmily history of the disease
His sons wud b affected how much %
11-Dementia = MSME <24 in q. was 25 , Not Lewy body / Alzheimer
Man driving behind horses – schizrophrenia
student thinks professor evil ,hears voices - paranoid schizophrenia
Drugs that's cause long Qt:dilatizim.. Or that uses for alzhaimer??
Prosthetic metallic valve replacement with endocarditis ..asking antibiotics ? vancomycin
Long QT mechanism - blockage of K channels
A lady with ck 3000 and difficulty in raising from chair.... anti ach antibodies.. or ct chest ?
Muscle biopsy *Ck is NL in MG
Inc creatinine .... trimethoprim
Restless leg syndrome ... ropinirole
RA case.. addedd adlimumab .. moa ..anti tnf
pt treated for pnemonia , has LTC with suspision of uti , what do u do with the amoxicillin ,
- ? Change to co amox, pt have resistance to amoxicillin, so Cipro
Meningitis case..Allergic to amoxicillin.. give chloramafenicol
Meningitis-- prophylaxis for family -- Cipro
uy with uti with E Coli of 100,000- was was the investigation
Case of chalamydia trichomatics .. rx doxy
Case of pnemonia .. lab shows low Na.. i did legionella
Case of otitis media with discharge then half face paralysis (bells)?... where is lesion .. trunk
of facial nerve
Female with tenderness on lat side of thigh, no problem in movement in any direction ...
tronchentor bursitis?
Case of low back pain tenderness ..on upper back too .. multiple tender points
...fibromyalgia?
Case of late diastolic murmur ... MS ?
Female treated with anythrcyline now developed sob ..cardioxicity? she has kaussamul sign
so malignant pericardial effusion…Cardiac tamponade.....sudden onset Kaussam. Sign
Case of thyroid cancer.. treated.. now check thyroglobulin to followup.?
Female with thyrotoxicosis. pt has increase uptake in rt upper lobe, .propranolol given..one
nodule radio uptake .. Rx.. carbimazole.. PTU..radioiodine therapy .near total thyroidectomy
?
psychiatry qs.. i did ..
Cannabis induced psychisis?
..
Psychotropic drugs usage ?
..
Drug induced psychosis?
Qs asking tacrolimus toixcity. Pt on fluconazole too...i did dec renal clearance nt sure
Fluconazole = p450 inh. =toxicity
Female with urine incontinence memory loss.. with falls ..NPH
Female with Bitemporal hamianopia ..bp 80/50..i did pituitary adenoma?
lady with upper limb symptoms and loss over sensation over the thumb and index finder -
C6
One qs of simvastatin drug interaction.. it was clarithromycin
Rash on legs after throat infection.. guttate psoriasis?
Iv drug abuser. Site abscess.. and endocarditis? Rx fluclox
Forearm pain on wrist extension? Lateral epicondylitis? Radial tunnel syndrome?
A case of LFT deranged.. Gamma gt raised.. i did alcoholic hepatitis?
There was a q on deranged LFTs with hep A , B , C as the options , what was the answer
A case of surgery. On warfarin already.. what to give.. i did prothrombin complex?
Qs of severe diarrhea ..chinese restaurant .. i did b.cerus
Qs of liver cirrhosis .. peritonitis,(SBP) peritoneal dialysis...Staph Epidermis , E.coli
Qs of one month diarrhea .. multiple joint pain .. i did Whipple's
Qs of gastric cancer .. eradicate h.pylori , Family history as the most imp factor,
Qs of foot injury.. got tetanus infection.. moa of tetanospamin ?? Endocytosis..exocytosis..
inc dna protein synthesis etc
Qs about NG tube placement in Parkinson pt.. first thing to confirn.. ask to speak..auscultate
air on steth .. cxr..?
man with lung functions tests , had changed 3 jobs , - was the answer hypersensitivity
pneumonitis
Drug implicated in c diff infection - ? Omeprazole, simvastatin, aspirin
Qs with Hb A2 was 4... i did beta thalesemia trait ?
pt with SVT settled with vagal massage - ?now on ECG there is preexcitation vt… reassure
and discharge
Most common finding in PE - ? Tachycardia, S1Q1T3 on ecg
Anaemia with sidroblasts on film , splenomegaly, mom had spleen removed - Sidroblastic
anaemia
Pancytopenia with mention of teardrop cells - answer something like mylodysplasia or
myelofibrosis
target of imatinib - tyrosine kinase
CML as the anser to one of the questions , i think the pt has spleemomegaly , is this the
same question where there is raised WCC ..
heart block in the baby - anti Ro
migraine prophtylaxis – propranolol
pt with diplopia, ptosis , poximal limb weakness- myesthenia gravis
nephritic picture , ACR normal , ? investigation - ? biopsy
80 yr old lady with painless visual derterioration from last 4 days , hypertensive, cotton
wool spots , options being hypertensive something , CRAO , CRVO - what was the answer ?
hyperthyroid patent , very low tsh , raised t4 , thyrotoxic nodule picute , iodine uptake on
scan asking for MX with the options being carbimazole, radiodine - what was the answer ? (
i put radio ioidine )
acts on a membrane channel – furosemide
highest glycemic index ? choclate
pt with toxoplasmosis - pyrimethamine ( i got it wrong :( )
t1dm pt claiming he had ingested something , anion gap was normal - diabetic ketoacidosis
pt vomitting with gatric something , what would u expect -hypokalmic alkolasis
anorexia female .. which drug she is taking ..frucimide..thiazide ..?
apkd most likely association - spleemomagaly , MVP
One case of electrolyte imbalance ..u gave calcium.. why .. i did membrane stability
One case of SAH ..did clipping.. now what to do initial investigation .. CT..MR brain..
venogram brain
pagets disease rx a bisphosphonate
One case female got HRT.. main indication .. menopausal symptoms
papillary carcimona , monitor with Thyroglobulin
squamous cell carcinoma with confusion and polyuria --primary hyperthyroidism
Oral n genital ulcers .. which HLA ? I did HLA B51
sorethroat and multiple oral ulcers of hard palate and tongue , options being some king of
fungus , HSV, - I chose HSV
FFP given .. what’s risk . Anaphylaxis. Ascetic meningitis? Other options were too
angioedema .. what will b increase .. bradykinin ..histamine ..?
how u transfer the stuff.. keep on ice..keep at 37c.. keep in freezer ..??
gastro question old man with micro anemia picture , asking for inv , - colonoscopy,
endoscopy with duodenal biopsy.
Female with skin rash papules on face chin around nose cheeks.. what u give
..isoterntoin..doxy ..amox.
pt takes cocaine .. bloody diarrhea ... i did ischaemic colitis
wt loss ..rt lower quadrant palpable mass .. i thought it could b cecal tb ..?
pt having lympadenopathy .. night swts .. etc.. i did lymph node biopsy
Teratoma cancer .. afp raised .. what to do followup.. b.hcg.. LDH.. ?
Short girl with prob with sexual characteristics primary amenorrhea - I put turner
syndrome
vomiting ..suction splash. Pyloric stenosis.. what electrlyte imbalance .. hypokalemic
alkalosis
Diarrhea for one month.. hx of travel .. Now bloody diarrhea .. rt upper quadrant pain.. dx..
ameobiasis.. salmonella entritis ?
Cryoglubinemia sample handing, send to lab in 10 min -- keep on ice , keep in 37.c, keep in
freezer, keep under sunshine
Young guy with asymptomatic hyperbilirubinemia.... gilbert syndrome
Medullary sponge kidney .. What will have pt in the end .. large kidneys.. HTN.. end stage
renal disease.. acute kidney injury ?, nephrolithiasis.
Most sensitive investigation for pleural tb - ? pleural biopsy with fluid something, pleural
fluid microscopy n culture,
Pt on Dialysis .wrist pain.. what will be deposition.. beta 2 microglobulin ?
Myoclonic seizures..... rx.. Sodium valproate
Thrombocytopenia.... i did autoimmunity
Function of C3 , - --- t lymphocytes, opsonisation,
Black spots in mouth ..peutz jeghers ? Asking colon ca ?
Stroke, hypertensive patient, site of lesion..
Bone pain... taking morphine.. Now buprenorphine added .. why .. Relieve pain.. Add
anesthesia. Respiratory depression.
CCBs mode of action.. on arterioles ..on venules.. on capillaries . elastic arteries .?
Anaphylaxis.. Angioedema.. rx .. --- IM adrenaline
Young diabetic , strong family hx of diabetes = sulphonylureas, young with a positive family
hx pointing towards MODY, for which Gliclazide is first choice
MOA Gliflazolin ====== glycosuriac
Resistance to penicillins ....asking mechanism.. beta lactamase enzyme, efflux pump, influx
Drug-Ambreastein MOA = Endothelin receptor antagonist
Hx of exposure to tobacco, upper lobe changes = ext allergic alveolitis
Guy have fast driving on narrow road.. said i cant have any accident as some angles guiding
me .. he had ecstsy taken previously too.. ? I did drug induced psychosis
pt had worsened creatine , asking for cause - limb chopped off
advantage of humanisation of monoclonal antibodies -Reduce immunogenicity, reduce
antigenicity
lady cant concentrate , feels low , asking for diagnosis - ? generalised anxiety disorder
patient on some parkinsons meds , cant tolerate co caroldopa , what would you add
,options being MOA , selegeline , - amantadine, selegiline ,
Gastric bypass surgery bariatric surgery, ? most common deficiency—zinc, folate, iron
Lady with prev breast cancer , now hypercalcemia , bone scan normal , ? next investigaion -
? electrophoresis
pt goes flacid , kind of falls down , options being epilepsy , cataplexy --- ? cataplexy
.female having pubic hair louse ...permethrin, hair cutting cleaning option
Hpeatitis A ---for guy came from India or something like that
Fast acetylator took Inh = hepatitis ( exam Q )
Slow acetylator took Inh = peripheral neuropathy
Ptyriasis rosae = HHV7 homonis bovis
Separate proteins by which Molecular technology---elisa, western, southern
Paget's--zoledronic acid and aldronate sodium
Dissociation curve: o2 more released to tissue always to right ie, ans: raised pco2.
Acromegaly.cause of sweating?ans: BMR,Sympathetic activity?? hypertrophy of sweet
glands
Squamous cell ca of lung- surgery contraindicated when with vocal cord paralysis*
Duloxetin ----GABA , SSRI, SNRI,
Hyponatremia + bilateral basal consolidation is mycoplasa , legionella
Recent bleed in the brain , now presents with stroke like symptoms , NEXT inv -- ? CT head
iron over load , ? rx, deferixamine..
pt on SABA + Inh steroid, asthma add on drug = monteleukast
The anorexic female significant hypokalemia and hyponatremia, more of a feature of loop
and thiazide
