MRCP-1 RECALL- JAN-2014 CARDIOLOGY Join us here: 1. https://www.facebook.com/Medicalvideosfordoctor s 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/
1. Drug that decreases mortality post-MI= Valsartan 2. Malignant HTN that is not controlled by oral
verapamil and bisoprolol, what next= i/v labetalol 3. Long apical diastolic murmur with pansystolic
murmur, atria dilated with permanent AF and crackles in lungs, Dx= mitral stenosis?
4. 75 years man with high B.P has AF, Rx= warfarin
5. Patient with stroke alredy taking aspirin ,what next= add dipyridamole
6. Cardiac anomaly with pulmonary HTN, contraindication for surgery= pulmonary HTN
8. Canon waves= complete heart block
9. 25-30% carotid artery stenosis in a patient taking aspirin, what next= continue aspirin?
10. VF, shock at 200, then 360..no improvement , what next=amidarone
11. Diference between cardiogenic edema and ARDS= increase protein in fluid in ARDS
12. Cardiac effusion contain blood, characteristic finding= increase JVP on inspiration
13. Patient taking warfarin presented with DVT, what next= increase INR to 3.5+/-0.5?
14. Test of choice in HOCM= TTE
15. Most common finding in ECG of P.Emboli= Tachycardia Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/
HEAM/ONC
1. spherocytes in peripheral blood film, what test to do next= DAT
2. bite cells in peripheral blood film after treatment of UTI with ciprofloxacin, cause= G6PD Deficiency 3. menorrhagia with bruises, small rise in apt and
small fall in platelets, Dx=Von-willebrands 4. 70 years old with lymphocytosis, Dx=CLL
5. 10cm splenomegaly with neutrophilia, Dx= Myelofibrosis/CML?
6. 56 years active blood donor has now been refused as blood donor, he is assymptomatic and systemically well, blood film shows iron deficiency , likely cause= small intestine dysplasia/colon cancer?
7. Recurrent abortions with Dvt, ECHO findings= normal
8. Patient with a Episode of Haemetemesis presented, now hb=100(130-150) , what
intervention next= terlipressin/transfuse blood/endoscopy?
9. Patient being transfused twice weekly , now develops anaphylactic reaction , cause=GVHD
10. Increase cret, anaemia, thrombocytopenia, fever and confusion, Dx=TTP
11. CD20= Rituximab 12. Non-Hodgkins= EBV
13. Waldenstorms=Hyperviscosity syndrome
14. Factor 5 leiden= activated protein C resistance 15. Dx of Hypercalcemia of Malignancy Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ PHARMACOLOGY
1. Digoxin prescribed to old age patient= volume of distribution increases
2. INH acts on liver enzyme= Cyp3A4-p450
3. Patient on lithium treatment , Tfts are normal, when to repeat test= 6 months
4. Clinical presentation of steven-johnsons syndrome was given, and the patient has known epilepsy, cause= limotrigine
5. Contact prophlaxis of meningococcal meningitis= single dose of ciprofloxacin/ 2 days on rifampicin? 6. SIADH cause = bendroflumethiazide
7. Diazepam and dosulpin overdosed, Rx= sodium bicarb
8. Paracetamol overdosed, cause= alcoholic
9. Obese with T2DM, cret is 150, drug of choice= pioglitazone
10. Patient taking morphine 75mg b.d, what to prescribe for breakthrough pains= morphine elixir 11. Patient prescribed allupurinol 1 week ago
presented with pain in multiple joints now , cause= allupurinol
12. Patient presented with red eye was started on cholaramphenicol eyedrops, now presents with swelling of lid and erythema, cause= allergy to chloramphenicol
13. Cocaine intoxication presentation= persistant chest pain
14. Dx of amphetamine induced psychosis
15. Patient with rheumatoid arthritis being treated with MTX and Sulfasalazine with no improvemt, what next= etanercept/rituximab?
Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ CLINICAL/BASIC SCIENCES
1. Cause of increased anion gap= methanol poisoning
2. Respiratory alkalosis with po2=32, dx= psychological hyperventilation
3. CVID association with infections= meningococcal?
4. SIADH feature from scenario= urinary sodium of 60
5. Cystic fibrosis carrier rate?, mother had it and also one other family member had it = 1 in 25? 6. X-linked disease in a child, cause? = maternal
grandfather
7. Breast adenoma, size 3cm, not movable!, which stage of cell cycle is this= G1?
8. Centromere covene at the centre in = metaphase 9. Refeeding syndrome= hypophosphatemia
10. Protein=western blot 11. Dx of L4 radiculopathy
12. Negative result when not diseased= specificity
13. Calculate specificity=40%
14. Compare proportions= chi-square test
15. Swaping and cross over in a study , = paired t-test
16. Rheumatoid arthritis= TNF-alpha 17. NF-1= chr.17
18. Use of PCR= cytogenetics/ protein conformation?
20. Rheumatoid arthritis= b-lymphocytes
21. Gastric adenocarcinoma= signet ring cells 22. Index finger flexion= flexor carpi
23. Surfactant= type-2 pneumocytes
24. Forearm pain, worse on extention , can not use the pen= lateral epicondylitis
25. Cd20= rituximab Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ DERMATOLOGY
1. Acne with scars, Rx= oral isotrtinoin
2. HIV +ve patient with pink patch on chest= Kaposi`s
3. Velvety lesions on flexures and neck ( dx=acanthosis nigricans), asosiation= gastinoma
4. Ileostomy site ulceration, dx= Pyoderma Gangrenosum
5. There was a question relating recurrent cellulites. 6. Extensive psoriasis, dry scaly skin , ist line
treatment= emoliants
7. Dx of hand, foot and mouth disease
8. Dermatitis herpetiformis , test to diagnose= direct immunoflorescence of skin
Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ ENDOCRINOLOGY
1. characteristic of MODY= Family Hx
2. interpretiton of thyroid hormones, Dx= adequate dosing
3. hypothyroid patient presented with acute flare, Rx= Steroids
4. Cushings , test to Dx= Oral DST
5. Early morn sweating, with one such episode , blood glucose was 4, gets well with sugar diet, Dx= Insulinoma
6. Pancreatic insufficiency, how to control diarrhea= octreotide/pancreatin?
7. Patient taking quitepine has amenorrhea but not galactorhea, cause?
8. Dx of Kallmans ( both FSH AND LH were low) 9. PKD, test ?= U/S abdomen
10. Adrenal mass, it was either pheocromocytoma or primary hyperaldosteronism? They have asked for Test to diagnose= urinary metanephrines/ ald-renin ratio! ( I opted for primary hyperaldosteronism, which may be wrong )
11. True about thyroxine= increase gluconeogenesis 12. Retoncogene asosiation= medullary throid
cancer
Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ GASTROENTEROLOGY
1. Bilirubin got raised after 1 week of starting co-amoxiclav, cause= co-amoxiclave/ gilberts?
2. Dx a case of Achalasia ,and they asked for test of choice= oesophageal manometry
3. Dx a case of Hepato-renal syndrome 4. Hepatitis C complication= PCT
5. Hepatitis C case= check for antibody
6. Anti-Tb meds caused hepatitis, now they are stopped , how to monitor response= liver enzymes
7. Best antiviral response to interferons if it shows = HbeAg ( Infective particle)
9. Best test to Dx Giardiasis= Small bowel biopsy 10. Hx of bloody diarrhea after 1 week return from
travel= entameaba histolytica
11. Dx of Celiac disease ( vit-b12 was normal, Rbc folate was low)
12. Contraindication of liver biopsy= dilatation of bile ducts
13. Damage to liver= prothrombin time
14. Question relating MRCP ( Magnetic Resonance Cholangi-Pancreatography)
15. Dx of pernicious anaema ( there was autoimmune hepatitis, vitiligo and hemolysis).
Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ INFECTIOUS DISEASES
1. LGV Rx= doxycycline
2. Lyme disease rash in pregnant, previous hx of allergic rash to penicillin, Rx=Cephalosporin
3. Migratory arthritis scenario, Dx= Lyme disease 4. Dx of leishmaniasis
5. Case of Reiters, asosiated eye findings=conjunctivitis
6. Ring enhancing lesion in parietal area , Dx= Toxoplasmosis
7. Black spot on thigh after return from Africa= Tick typhus
8. Immunocompromised old age patient comes in contact with a child having chickenpox= give VZIG 9. Meningococcal meningitis Dx=Culture (
antibiotics have not been given yet)
10. Scenario of PCP, what is suggestive of Dx= exercise desaturation
11. Patient with subarachnoid heamorrhage presented 12 hrs later, what test appropriate= LP 12. Best test to diagnose Mycoplasma= cold
agglutinins/ throat swab for serology?
13. Community acquired pneumonia= strept-pneumonie
Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ NEPHROLOGY
1. Nsaid induced ATN 2. Penicillin induced AIN
3. Prevent contrast induced kidney damage in a patient known diabetic= normal saline
4. Colon cancer has been surgically removed in patient, his kidney functions have markedly improved, dx= membranous GN
5. PAN= MPO
6. IgA nephropathy poor prognosis= HTN 7. Comon with type-1 RTA= nephrocalcinosis 8. Recurrent UTI`s= Reflux nephropathy
9. PKD= Ultrasound 10. C4 decreased= SLE
11. Dx of glomerolunephritis= renal biopsy
12. Long standing kidney disease , one kidney has size of 7cm now= amyloidosis?
13. Scenario of pyelonephritis Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/
NEUROLOGY AND OPHTHALMOLOGY
1. Essential tremor with head titubation Rx= propanolol
2. Dx of multiple system atrophy
3. Parkinsonism characteristic= asymmetry of tremor
5. Status epilepticus Rx= Lorazepam
6. Memory loss, personality and speech affected, area involved= frontal lobe
7. Weber syndrome , site involved=midbrain
8. Possible Dx of perinauds, site of lesion= dorsal midbrain
9. Hemi sensory loss from head to toe, area involved= thalamus
10. Sub acute combined degeneration involves= dorsal column
11. Syringomylia= prick sensation lost in arm 12. Dx of conus-medullaris syndrome
13. Dx of Fascio-scapulo-humeral dystrophy 14. GBS, respiratory monitoring = Vital capacity 15. Schwanoma= corneal reflex lost on same side 16. Dx of poliomyelitis
17. Bulbar palsy= small arteries hyalinosis
18. What is underlying cause of CRVO from the given scenario= Glaucoma ( increased IOP )
19. Immediate referral= neovascularization on retina
Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ RESPIRATORY MEDICINE
1. Dx of idiopathic pulmonary fibrosis
2. Upper lobe fibrosis with skin findings= sarcoidosis? 3. 3cm mass, suspected small cell cancer, Rx=
chemo/surgery?
4. OSA Characteristic feature= excessive daytime sleep 5. Dx of chronic occupational asthma
6. Dx of psychological Hyperventilation
7. PCP scenario, O2 sat was less than 9, Rx= steroids 8. Increased survival in COPD= LTOT
10. Pleural effusion and thickened pleura (mesothelioma), best test to diagnose= pleural biopsy
11. Pulmonary emboli , most common ecg finding= tachycardia
12. Possible Dx of Emphysema( alpha anti-trypsin deficiency 13. Dx of Ext.Allergic Alveolitis Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ PSYCHIATRY 1. Dx of global amnesia 2. Dx of Somatisation syndrome 3. Dx of Panic disorder 4. Dx of Depressive disorder
5. Dx of acute schizophrenia 6. Dx of anorexia bulimia
7. Dx of wernekes encephalopathy
8. Dx of amphetamine induced psychosis
Join us here: 1. https://www.facebook.com/Medicalvideosfordoct ors 2. http://www.medicalbook.org/f53-mrcp 3. http://medicalvideofree.blogspot.com/ RHEUMATOLOGY 1. chondrocalcinosis= pseudogout
2. distal joint involved, mild morning stiffness, Dx= osteoarthritis
3. case of osteoarthritis, now same joint inflamed , swollen, Dx= septic arthritis
4. knee joint swollen,temp of 37.5, patellar tap absent, Dx= prepatelar bursitis
6. Dx of Limited systemic sclerosis
7. Pain in right hip joint , gets better with analgesia , now pain in left hip joint, Dx= Bilateral Hip dysplasia/ reflex neuropathy?
8. Scenario of eosinophillic fasciitis 9. Migratory arthritis= lyme disease 10. Dx of Ankylosing spondylitis Join us here: 4. https://www.facebook.com/Medicalvideosfordoct ors 5. http://www.medicalbook.org/f53-mrcp 6. http://medicalvideofree.blogspot.com/
