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MRCP Past Papers > Past papers > Flashcards

Past papers Flashcards

1
Q

What is the most useful way to differentiate toxoplasma infection?

A

CSF PCR
(IgG antibody titre is less reliable given high chance of previous exposure)

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2
Q

Which enzyme transports fatty acids within the cell?

A

Carnitine acyltransferase

Carnitine deficiency in kids can lead to cardiomyopathy

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3
Q

Initial intervention for toxoplasma?

A

Pyrimethamine

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4
Q

What is Charles Bonnet syndrome?

A

syndrome of visual hallucinations with preserved consciousness associated with visual impairment

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5
Q

Latex fruit syndrome

A

Bananas, kiwis, avocados

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6
Q

Ragweed allergy

A

Food allergies to banana and melon

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7
Q

Avoidant vs schizoid personality disorder vs schizotypal

A

Avoidant - has a need for human contact and feels lonely, anxiety is limiting socialisation

Schizoid - emotional aloofness, indifference to praise or criticism

Schizotypal - schizoid + abnormalities of thought

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8
Q

Medical management of bowel ischaemia

A

Fluids and analgesia

no role for steroids

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9
Q

Common peroneal nerve palsy vs L5 lesion

A

Preserved foot inversion and plantar flexion = common peroneal nerve palsy

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10
Q

Medication causing acute pancreatitis

A

furosemide

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11
Q

Carbamazepine MoA

A

Voltage dependent sodium channel inhibition

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12
Q

Somatostatinoma symptoms

A

Pentad of DM, cholelithiasis, weight loss, steatorrhoea and diarrhoea and hypochlorhydria

10% assoc. with NF-1
45% assoc. with MEN-1

Can secrete VIP, insulin, gastrin, ACTH calcitonin and pancreatic polypeptide

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13
Q

Engorged episcleral vessels, gritty feeling, watery eyes- diagnosis?

A

Episcleritis

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14
Q

Medication that worsens psoriasis symptoms?

A

beta blockers

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15
Q

Poor prognostic factors in infective endocarditis

A

S. aureus infection
Prosthetic valve
Culture negative infection
Depletion of complement levels

Strep. infection = better prognosis

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16
Q

Alpha-1 antitrypsin deficiency genetics

A

SERPINA1 gene mutation
Autosomal codominant
PiMM = normal
PiZZ = severest homozygous form

A1 antitrypsin = alpha 1 proteinase inhibitor made in liver
Mutations -> abnormal protein accumulation in liver causing scarring -> cirrhosis

Deficiency -> accumulation of neutrophil elastase in lungs -> emphysema

17
Q

Tertiary syphilis vs Yaws

A

Tertiary syphilis - confusion, dorsal column involvement, nodular rash, West Africa

Yaws- ulceration of palate and nasopharynx, subcutaneous nodules, osteoperiostitis

18
Q

Hypopigmented macular lesions with decreased sensation in the centre?

A

Tuberculoid leprosy

19
Q

Which cytokine production is reduced by ciclosporin?

A

IL-2 (aka T cell growth factor)

20
Q

Which cytokine production is reduced by tacrolimus?

A

IL-2

21
Q

Treatment of prolactinoma

A

Dopamine agonists - cabergoline, ropinirole, bromocriptine

22
Q

Medications that worsens myasthenia gravis

A

Calcium channel blockers
Beta blockers

23
Q

Treatment of cat scratch disease (Bartonella henselae)

A

If not immunocompromised - reassurance as likely to self resolve

If immunocompromised - ciprofloxacin or azithromycin

24
Q

Metabolic acidosis + QRS >100 in overdose

A

Sodium bicarbonate due to risk of ventricular arrhythmia

25
Q

Gynaecomastia, tall stature, microochidism, hypergonadotrophic hypogonadism

A

Klinefelter syndrome

26
Q

Most concerning complication of recurrent gonorrhoea infection

A

Infertility

27
Q

Fitz Hugh Curtis syndrome

A

Peri hepatitis secondary to chlamydia or gonorrhoea

28
Q

Jarisch-Herxheimer reaction

A

transient reaction secondary to antibiotic administration for sphirocyte infection (syphilis, lyme disease, leptospirosis)

29
Q

Autoimmune hepatitis vs PBC vs PSC antibodies

A

AH - anti-smooth muscle
PBC - anti-mitochondrial
PSC - assoc. w/ IBD

30
Q

Pleural fluid pH < 7.3

A

malignant effusion

31
Q

Indications for surgery in IE

A

-cardiac failure
- haemodynamic instability
-large vegetations
-septic emboli
-septal abscess (prolonged PR interval)
-fungal infection
- failure to respon to abx after 5 days

32
Q

Normal bladder emptying occurs because of…

A

increased parasympathetic activity of S2-S4

hyperactivity treated with muscarinic antagonists

33
Q

Hyponatraemia in lung Ca

A

SCC
can also occur in mesothelioma

34
Q

Necrotic changes around stoma site?

A

Pyoderma gangrenosum

35
Q

Hepatitis with mixed cryoglobulinaemia and consequent renal impairment

A

Hep C > hep B

36
Q

Best antidepressant while breastfeeding

A

Sertraline

Fluoxetine and citalopram accumulate

37
Q

Diagnostic test for Wilson’s disease

A

liver biopsy

MRCP Past Papers (2 decks)

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