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MRCP 1 > Past Papers > Flashcards

Past Papers Flashcards

1
Q

Womanly man, small balls, libido lacking?
Any mention of male with sparse pubic hair, gynaecomastia and small testes also

A

Kleinfelters

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2
Q

Acute MI after stenting and stopping clopidogrel? Re-stenosis or in-stent thrombosis?

A

In-stent thrombosis
Re-stenosis takes much longer

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3
Q

Sounds like cauda equina with lower limb weakness but INCREASED tone?

A

Conus medularis syndrome

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4
Q

Concurrent single genital ulcer with lymphadenopathy?

A

LV
(Shyphilis lymphadenopathy presents later)

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5
Q

Antibiotic preference in legionella

A

Modern quinolone e.g. levofloxacin
Macrolides are an alternative

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6
Q

Side effects of retinal photocoagulation?

A

Tunnel vision, colour loss

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7
Q

Acute onset AF, no heart disease?

A

Flecanaide

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8
Q

Earliest helpful investigation in RA (imaging)

A

Colour doppler

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9
Q

Where is phosphate reabsorbed?

A

Proximal tubule

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10
Q

PPH poor prognostic factors

A

Raised BNP
Arrhythmia
RHF/hypertrophy

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11
Q

Largest component of bile?

A

Bile salts

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12
Q

Which part of the kidney is impermeable to water?

A

Ascending loop of henle

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13
Q

Long term bronchiectasis/chronic inflammatory condition and then develops kidney failure?

A

Think amyloid

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14
Q

Blistering skin condition in the sun in an alcoholic, often with raised AST/ALT and ferritin?

A

PCT

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15
Q

Thyroid cancer much higher risk in hashimotos patients?

A

Lymphoma

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16
Q

First line for schitstosomiasis?

A

Praziquentel

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17
Q

Best treatment of worsening lupus nephritis?

A

MFM

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18
Q

TB drug most commonly assoc with eye disease?

A

Ethambutol

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19
Q

Mild genotype in A1AT?

A

MZ

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20
Q

Therapy of choice in anti-GMB renal disease?

A

Cyclophosphamide

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21
Q

Where is the ostium of the coronary sinus?

A

RA

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22
Q

Small bowel angiodysplasia and heart murmur?

A

Heyde’s disease - AS

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23
Q

Frontal lobe stroke symptoms?

A

Distal anterior cerebral artery

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24
Q

Fluconazole and verapamil together and constipation

A

FLuconazole may have increased serum verapamil and caused it

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25
Q

Vomiting 7-8hrs post rice?

A

Bacillus ceres

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26
Q

Occular tumour in VHL?

A

Hemangioblastoma

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27
Q

Ciclosporin action?

A

Anti-IL-2

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28
Q

Hormone under constant feedback?

A

Prolactin

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29
Q

Schistosoma mansoni and haematobium, which assoc with bladder Ca and which with hepatic fibrosis?

A

Haematobium bladder Ca - (bladder Ca bleeds (haem))

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30
Q

Pupil in syphilis?

A

Argyll Robertson
usually bilateral

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31
Q

Mention of shawl-like distribution of sensory loss?

A

Syringomyelia

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32
Q

What time is cortisol lowest?

A

0000

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33
Q

First line treatment for WPW (non-acutely)

A

Ablation

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34
Q

Massive uric acid levels despite either allopurinol or fexobustat?

A

Add benzbromarone

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35
Q

Cyclophosphamide action

A

Anti-Tcell

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36
Q

Ambrisentan mechanism?

A

Endothelin B antagonist

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37
Q

What can be added in psoriatic arthritis after MTX and another DMARD?

A

ANti-TNF e.g. golimumab/infliximab/adalimumab/etanercept

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38
Q

Renal biopsy in GPA?

A

Pauci immune!

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39
Q

Hasnt tried continuous HRT, or is within 2 years of last period?

A

Sequential HRT

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40
Q

Hyperkalaemic metabolic acidosis with worsening of potassium on ACEi?

A

RTA type 4

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41
Q

Gonorrhoea and penicillin allergy?

A

High dose azithromycin once off

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42
Q

Neglect mentioned? Which lobe affected and which side

A

Contralateral parietal lobe

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43
Q

How do you prevent stones in someone with medullary sponge kidney?

A

Large fluid intake

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44
Q

What is a 7th nerve palsy? Treatment?

A

Bells
Steroids

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45
Q

Single thyroid nodule (symptomatic) in woman with completed family and older children?

A

Radioiodine

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46
Q

Paget’s treatment

A

IV!!! bisphosphonates

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47
Q

Soil contamination wound?

A

Clindamycin

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48
Q

Eye changes in NFM?

A

Lisch nodules

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49
Q

What do microRNAs do?

A

Silence mRNA

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50
Q

What often drops with IV quinine treatment for malaria?

A

Glucose

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51
Q

Schistosomiasis treatment?

A

Praziquantel

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52
Q

Short fourth and fifth metacarpals?

A

Pseudohypoparathyroidism

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53
Q

Herceptin (trastuzumab) major adverse effect?

A

Cardiac failure

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54
Q

Deletions assoc with poor prognosis in CLL?

A

17q
p53

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55
Q

Genetic features assoc with better prognosis in CLL?

A

13q
Trisomy 12

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56
Q

Treatment for Waldenstrom’s?

A

Rituximab-containing chemo regime
(if you see a chemo plus rituximab it’s that)

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57
Q

Most sensitive area in response to hypoxia?

A

Carotid body

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58
Q

Earliest detectable test for HIV infection?

A

RNA

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59
Q

Osmolality equation?

A

(2 x Na) + (2 x K) + urea + glucose

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60
Q

Bacteria often found in dog bites

A

Pasturella

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61
Q

Endovascular coil or neurosurgical clipping preferred in intracranial aneurysm?

A

Coil

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62
Q

Live vaccines?

A

Yellow fever
BCG
MMR
Influenza
VZV

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63
Q

Long term prevention for cluster headaches?

A

Verapamil

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64
Q

Thinking pathway for AV replacement?

A

If fit, either mechanical or bioprosthetic valve. If a contraindication to anticoagulation - bioprosthetic.
If not fit for surgery - TAVI.

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65
Q

Treatment for cyclosporidium?

A

Co-trim

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66
Q

Antibiotic treatment in culture negative peritonitis?

A

Intraperitoneal vanc plus oral cipro

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67
Q

What can you give to protect the bones in a Turners patient?

A

HRT

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68
Q

First line preventative measure in congenital long QT?

A

BB

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69
Q

First and second line for reactive arthritis?

A

NSAIDs
Then steroids

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70
Q

What to add to SU in MODY if needs further intervention?

A

Insulin, usually long acting in first instance

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71
Q

Aspirin mechanism?

A

COX 1 AND COX 2

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72
Q

Immunotherapy in Grave’s eye disease?

A

Tocilizumab

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73
Q

APML gene?

A

15:17

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74
Q

MODY with renal cysts?

A

MODY-5

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75
Q

First line in JME?
When might you want to use something else and what would you use?

A

Valproate

Older girls - risk to a foetus. Leviteracitam istead

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76
Q

Prominent x and y descents?

A

Restrictive disease

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77
Q

Most prone side of the heart for healthy individuals?

A

Left side (high pressure)

Right side in IVDU

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78
Q

Young man with progressive unilateral optic neuropathy, eventually other eye involvement, +/- proximal muscle features and increased tone?

A

Leber’s hereditary optic myopathy

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79
Q

How long off driving after ICD shock?

A

6 months

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80
Q

When to check lithium level after starting?

A

5-7 days

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81
Q

Where most affected in Wilson’s?

A

Basal ganglia

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82
Q

von Willebrand chromosome?

A

12

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83
Q

Depression with significant somnolence?

A

Venlafaxine

84
Q

Main treatment for ank spon?

A

Adalibumab

85
Q

Antifreeze antidote?

A

Fomepizole

86
Q

Most common GI cause of GBS?

A

Campylobacter

87
Q

Vaginal flora mostly made up of?

A

Lactobacilli

88
Q

Crossed neurological signs after stroke? Lesion must be in the …

A

Brainstem

89
Q

Best test of respiratory muscle weakness in GBS?

A

FVC

90
Q

Dense fibrous tissue replacing the thyroid?

A

Riedel’s

91
Q

HIV nephropathy type

A

COLLAPSING (like the immune system)

92
Q

Gallop rhythm an early sign of?

A

LVH

93
Q

SGLT2 location of action?

A

Early proximal tubule

94
Q

Most specific finding in pericarditis?

A

PR depression

95
Q

AML good prognosis genetic finding?

A

t15:17 (APML)

96
Q

Negative predictive value equation?

A

TN / (TN + FN)
(think all the negatives, comparing the actual negatives with all the negative results)

97
Q

Most common endocarditis organism? What if within 2 months of replacement?

A

Staph aureus

Staph epidermis

98
Q

Goodspastures and ANCA GNs, which type?

A

Rapidly progressive

99
Q

First line treatment for ABPA?

A

Steroids

100
Q

What inhibits prolactin?

A

Dopamine

101
Q

What is contralateral in Brown-Sequard?

A

pain and temperature loss

102
Q

What’s high in PCT?

What about AIP?

A

Urine UROporphyrinogen

Urine PORphobilinogen

103
Q

What produces IL-1?

A

Macrophages

104
Q

What does troponin I bind to?

A

Actin

105
Q

Phenytoin mode of metabolism? What else uses this?

A

Zero-order
Alcohol, salicylates

106
Q

Most common photosensitivity drug cause?

A

Thiazides

107
Q

What is inserted in response to ADH?

A

Aquaporin-2 channels

108
Q

Chancroid microbial

A

H. ducreyi

109
Q

Cryptosporidium test?

A

ZN stain on stool

110
Q

TR change in JVP waveform?

A

Prominent V waves

111
Q

Anti-NMDA cancer assoc?

A

Ovarian teratoma

112
Q

Type 1 and 2 cryo, assoc with what?

A

Type 1 - Monoclonal IgG/IgM diseases, lymphoproliferative syndromes

Type 2 - AI disease/ IDs. Polyclonal IgGs/IgM

113
Q

Good stuff for cancer oral pain?

A

Benzydamine mouthwash

114
Q

Toxin in paracetamol overdose?

A

NAPQI

115
Q

First line for rosacea?

A

Topical metronidazole

116
Q

Sensitivity equation?

A

TP / TP+FN

117
Q

Most commonly affected gene in congenital nephrogenic DI?

A

Vasopressin

Second most Aquaporin 2

118
Q

Burkitts gene

A

8:14

119
Q

Tear drop cells?

A

Myelofibrosis - think of marrow trying to squeeze cells out of dry marrow

120
Q

Earliest XR change in RA?

A

Juxta-articular osteoporosis/osteopenia

121
Q

Renal transplant + infection, think…

A

CMV

122
Q

S4 coincides with?

A

P wave

123
Q

Thinking toxoplasmosis but only one lesion and homogenously enhancing?

A

CNS lymphoma

124
Q

Barters vs Liddles vs Gitelmans

A

All hypokalaemic

Liddles causes

Barters HIGH calcium (Big C)

Gitelmans causes LOW calcium (Gone C) and LOW magnesium

125
Q

Alports inheritance?

A

X-linked dominant

126
Q

Itchy white spots on the vulva of old woman?

A

Lichen sclerosus

127
Q

Idiopathic MG antibody?

A

APLA2

128
Q

TB drug induced lupus?

A

Isoniazid

129
Q

Goodpastures collagen type?

A

4

130
Q

Dermatitis herpetiformis HLA association?

A

HLA - DR3

131
Q

CD on Reed-Sternberg cells?

A

CD15

132
Q

What should you give in cocaine induced MI alongside ACS Rx?

A

IV benzos

133
Q

Drug causing corneal opacities?

A

Amiodarone

134
Q

Somatostatin produced where?

A

D cells

135
Q

Which stage of cell cycle dictates the length? (p53 acts on this part)

A

G1

136
Q

Most common cause of CAH?

A

21-hydroxylase def

137
Q

Pityriasis rosea implicated virus?

A

Herpes 7

138
Q

Whats wrong in Fanconi syndrome?

A

Global lack of resorptive defect in PROXIMAL tubule

139
Q

Triangle of safety borders?

A

Lateral pec major
5th intercostal space in axilla
Anterior border of latissimus dorsi

140
Q

Brugada gene?

A

SCN5A

141
Q

Widening of the wrist joints?

A

Rickets

142
Q

Microtubule function?

A

Help guide movement during intracellular transport and also help bind internal organelles

143
Q

Hyperthyroid and patchy gland uptake?

A

Toxic multinodular goitre

144
Q

Mucopigmentation and polyps/GI cancer?

A

Peutz-Jeghers

145
Q

Where does RNA splicing happen?

A

Nucleus

146
Q

ADAMTS13?

A

TTP

147
Q

Inf STEMI?

A

RCA

148
Q

Range of inherited heart diseases but the deaths appear while sleeping/overnight?

A

Brugada

149
Q

Furosemide primarily reduces preload or afterload?

A

Preload

150
Q

Achondroplasia inheritance?

A

AD

151
Q

3 steps of haemoglobin metabolism

A

Haem -> biliverdin -> bilirubin

152
Q

IV therapy in serotonin syndrome?

A

Cyproheptadine

153
Q

Young woman, perhaps sportsperson, pain swelling of forefoot?

A

AVN of 2nd metatarsal head (Freibergs)

154
Q

If duchenne and becker both options in the question, how to separate?

A

DMD far more severe, similar features

155
Q

Impetigo first line?

A

Topical mupirocin/fucidin

156
Q

Alports what is abnormal?

A

T4 collagen

157
Q

Bad antibiotic in AIP?

A

Erythromycin

158
Q

What can you not drink with a statin?

A

Grapefruit juice

159
Q

Threadworn treatment

A

Mebendazole

160
Q

Drug-induced lupus autoantibody?

A

Anti-histone

161
Q

Initial PD therapy if trying to avoid dopamine-agonist SEs e.g. gambling?

A

Procyclidine

162
Q

Anti-LKM2?

A

AI hepatitis
Drug-induced hepatitis

163
Q

Calcineurin inhibitors target?

A

IL-2

164
Q

Chronic psoriasis HLA?

A

CW6

165
Q

RA treatment and pancytopenia and terrible renal impairment?

A

d-penicillamine

166
Q

Purely a winging of the scapula, what is injured?

A

Long thoracic nerve

167
Q

Young person with bad sounding presentation/B symptoms and nephrotic syndrome?

A

Minimal change

168
Q

Ondansetron mechanism?

A

5-HT3 antagonist

169
Q

Percentage of patients whose renal function will recover after dialysis for ATN?

A

95%

170
Q

Biggest type of bias problem in meta-analysis?

A

Publication

171
Q

Psychotic features in PD? Try

A

Olanzapine

172
Q

Itching in liver failure?

A

Cholestyramine

173
Q

HNPCC mutation?

A

MSH2 (no polyps, just cancer)

174
Q

First line treatment of acute hep B in a well person?

A

Observe and repeat testing

175
Q

Upper GI ulcers in HIV?

A

Think CMV - valganciclovir

176
Q

Want to compare outcomes from two groups of decent size and with normal distribution?

A

Students t-test

177
Q

Ipsilateral CNIII palsy and contralateral hemiplegia? Which artery

A

Weber syndrome (middle medullary sydrome)
Posterior cerebral artery (leads to midbrain infarcation)

178
Q

Very useful endocrine blood test to differentiate between acute and chronic renal failure?

A

PTH
Normal implies acute disease with 90% confidence

179
Q

What first before surgery for macroprolactinoma?

A

Cabergoline

180
Q

What is the resistance in factor V leiden?

A

Protein C

181
Q

First test for MND?

A

EMG

182
Q

Rasburicase mechanism?

A

Recombinant urate oxidase

183
Q

Guideline for contact sports post EBV?

A

4 weeks

184
Q

Comparing two proportions? Which two tests? Which is more accurate?

A

Fisher - very complex but significantly more accurate

Chi-squared

185
Q

Comparing two large groups with skewed distribution?

A

Mann-Whitney

186
Q

ARVT causing anaemia?

A

Zidovudine

187
Q

Why can ETOH cause hypoglycaemia?

A

Increased insulin generation

188
Q

Most common SBP organism?

A

E coli

189
Q

Nasty sounding lesion described at the margin of a chronic venous ulcer?

A

SCC

190
Q

Description of mixed depressive and schizophrenic-like periods?

A

Schizoaffective disorder

191
Q

BRCA1 & 2 cancers?

A

Breast
Ovarian
Pancreas
Prostate

192
Q

Autoimmune disease, triggered bleeding and massively prolonged APTT?

A

Think acquired haemophilia A

193
Q

AED safe in heart block?

A

Primidone

194
Q

Travel, unwell, salmon-pink rash?

A

Typhoid

195
Q

Travel, appalling muscle/bone pains, very high fever?

A

Dengue

196
Q

Which subunit in most common long QT?

A

Alpha

197
Q

Testicular teratoma marker?

A

AFP

198
Q

Anti TB peripheral neuropathy?

A

Isoniazid

199
Q

Evanicumab

A

ANGPTL3

200
Q

Good initial intervention for mania?

A

Risperidone

201
Q

Crossed neurological signs so thinking brainstem lesion, describes lateral rectus (abducens) palsy?

A

Medial pontine syndrome (medial pons)

202
Q

First line DMARD in eczema/psoriasis?

A

Ciclosporin

203
Q

What do we like to give for cardioprotection in marfans?

A

Beta blocker, if not ARB e.g. valsartan

204
Q

Where do foam cells originate?

A

Neutrophils

205
Q

Haloperidol location of action?

A

D2-receptor antagonist. It has a central antiemetic action, binding to receptors in the area postrema

206
Q

ISMN actioon?

A

Cyclic GMP

MRCP 1 (24 decks)

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