january 2009 mrcp part 1 questions

[dr A]

im just after the exam
it was really hard for me..

some stuf i remebr,
1.cholesterol embolisation
2.dicrotic notch
3.cipro to avoid in pregnancy
4.ALL poor prognostic factor ..age 20 yrs
5.HOCM best diagnosis -TOE?
6. diarrhoea, gastric ulcer--do gastrin leverls
7. de quarvains thyroiditis (painful)
8. firm thyroid- hashimotos
9.NsaidS causing ARF mechanism- ATN
10. post splenectomy overwhelming infection -pneumococcus
11- anti ro-heartblock in child
12. dermatomyositis-heliotrope rash

[salboy]

Thnis was my 4 th attempt
It was the worst paper of all
Please every one post their recalled questions so that we could know where we stand
I am recalling the themes and will post them shortly

[rasha27]

what was the commnest maligancy assoicated with non hodgkin lymphoma

[rasha27]

-tonic puiple unreactive to light and slowly reactive to accomodation unilateral
-alzhimer disease uninary incontiance , grasp reflex, mood disorder
-concrete thinking
- basilar artery infaction - crossed hemiplegia 3rd nerve on one side and hemiplegia on the other side

[rasha27]

-multiple sclerosis unsteadiness of the gait and sensory loss spastic paraplegia

[rasha27]

porasis of the saclp due to hairline affaction which is hyperkeratotic plaque

[rasha27]

i cant remmeber more

[rasha27]

bullous pemphgoid ----no mucsal affection
pytriasis versicolor
phenytoin
antiglidan antibody-- typical sites of dermatitis herptiform
indication of surgrey in aortic valve stenois is the symptomatology of the patient not sure about this
amlodpine ---- causes gingival hyperplesia
staph discutis----- backpain and following pacemaker insertion

[rasha27]

antinuclear antibody to confrim the diagnosis of ANA

[rasha27]

antimyleperoxidas----- cresent GN

[rasha27]

what about the pt who had mild anemia (112 hb) and lymphcytosis
observation _ chlorambcil_ fludrabine_ ( both could treat CLL)

[rasha27]

pt with heavy peroid and have mild vwd------- desmopressin
achlaesia of the cardia
vipoma ----- hypkalemia secretory diarrhea
depressive illness ----- loss of interest
acute global amnesia
aysmetrical tremor---- idiopathtic parkinsomism
progressive supranular palsy---- upgaze paralysis, congitive impairment,falls
osteoarthtritis---- pain and swelling in base of the thumb
surface antibody------- effect of b vaccination
acute hepatitis A----- after 4 weeks jaudice dark urine
paget disease------- normal ca and p high ALP usually there is no ostelytic lesion in prostatic cancer

[burningice]

ALL-philadelphia poor prognosis...i think.
lithium tixicity.heamodyalisis
HOCM;transesophageal
HIV diarrhoea not responding to cryptospodimium
implantable pacemaker sugery...diarrhoea-cl.defficile
von vilibrand-DDVAP/or tranxemic acid???
tricyclic toxicity:bicarbonate
MALT..eradication therapy???oral PPI
Cl.Defficile..cause cipro
Long standing RA-impaired renal function--Do rectal biopsy
SLE;membrnous GN
Huntingoton..Penetrance
peutz jehger...ASD
BNP--Decreases renine-aldosteron
QT-sodium blockade
VT-verapamil contra or adenosin
solid liquid-achalasia
megaloblastic anemia after gastric surgery...small bowl bact.overgrowth
pt for cholecystectomy-small percardial effusion..reasurance i ans????
assessment for aortic valve replacemnt---symptomatic pt
pain in the base of the thimb..osteoarthrits
spetic arthritis..joint aspiration..
joint aspiration__WBC-no organism,..intraaurticular steroid
left hip pain after chemotherapy;avascular necrosis????
which thyroid cancer-worst prognosis????papilary with lymh node mets or madulary with bones mets or anplastic?????????really tough
heamophilia:mother carier..father heamophilic...in theor daughter..0% or 25% ?????
thas wt i remmber at the moment

[burningice]

nefedipin causes gingival hyperplasia

[burningice]

heamophilia----50%

[dr A]

1)nifedipine coz gingival hyperplasia .
2)ALL poor porgnosis .. with philelphia chromosome .
chemo and pts having joint pain ? this one was very tough ...
3)HOCM ...TOE
4)young gal with headache n raised csf protein with normal glucose ? Viral/cryptococcal ? wbc 200 ..and lymph 60%????
5)heamophilia father n mother is carried ... one of the daughter wud be carrier and one will have the disease ... 25 or 35% ??? they asked percentage duaghter have heamophilia ... if the other duaghter has a bar X chromosome .. then she cud have disease too rather than being a carrier ... so why not 35 % ???
6)back pain with N ca and Phosphate .. and raised alk PO...pagets
a man with left arm pain ... with lost bicep,tricep n flexor reflexes but preserved touch n propioception ??? myelitis ?syringomylia ? cant recall wat were other options ...
brainstem is the place effected if internuclear opthalmoplegia occurs ..as the man with poor right gaze and loss of right eye addaction ...???
7)thumb pain ... ostearthritis
8)pain in the joint and no organism ... give analgesics first then go for intra articular steroids ?? plz give ur veiws on this one
8)cipro to be avoided in pregnancy
9)side effects of valproate ... pt on OCPs ... wat alternative anti epileptic to choose ?? carbamazepine ??lamotrigene is used as a second line or as an adjuvant?? no ?? plz comment
10) gal with polyuria of one week ... Na is NOrmal ... osmolality of plasma 300 something and that of urine is 200 something ... psychogenic polyuria ..cant recal the full question ??
11) a man with transient gluteal itchy rash from africa ... shistosomiasis ??? or dranuclosis ?
12) itchy hyper keratotic leasion on the hair line .. tinea capitis(psoraisis is not itcy)
13)dermatitis herpitiformis ... IgA
14)MALT... H pylori erradication
15)maxalliray N...foraman ovale
16)one sided dilated pupil non responsive to direct n concensual light reflex... 3rd N palsy
there was a ques abt gonoccocus infection and immunoglobins likely to be deficient ... IgA 1 /IaA 2/IgG 1 /IgG2/IgM??? which one isnt ?i guessed IgG1??
17)diarrhea with blunted atrphic villi in small intestine .easinophilic inclusion .. giardiasis?
18)HiV diarrhea not responding to treatment ... crypococal
19)aneamia ... sperocytosis ... osmotic fragility ? or G6PD def ??

[dr A]

hungtington ..is a trinucleatide disorder .. so anticipation is the answer ... more severity with ease suscessive generations
1)pts with asthma .. on beclomethason 800microgm and salbutamole inhalar ..use it twice in a day and wakes up one a wk with dyspnea ... continue same treatment ?
2)normal anion gap in pts with urerterosigmoidostomy...
pts with FEV1 1.2 and FVC 2.6 and transfer factor 55 %
improment after bronchodilartor .... FEV1 1.9 and FVC 3.8(somewat this much improvement ..not real values cant recall em )
what is the condition ? asthma ..emphsema .. pul fibrosis .. embolism ? one more ... i calculated the ratio was less than 58 percent .. ???transfer factor is very low...so i wrote pul fibrosis...cud it be emphysema ?

[Dr A]

1)pt have CCF ..on thizide but edema is still not decreasing... natirutric peptide is deficient ?
2)SIADH....and collapsed bronchus
3)pts has senile atrphy of the brain ... wat to give to improve dementia and agrresive behaviour...denozipil ?
4)pt with urinary incontinence .. ,..anti cholinergic?
5)hypertensive pt... with side effect of ankle swelling etc (calcium channel blocker ) which drug to be given ..i think thiazide was already being given or it was not in the list ...b blocker or losartan ... he is 70 plus of age
6)cannabis related schizopherina

[burningice]

chest x rays were noraml....i think it was emphysema
a-1 antitrypsin..smokers.PiSZ(pastest)
non-smoker--PiZZ
anorexic:refeeding:hypophosaphat
acromegaly:IGf

[burningice]

erythropoetin????dec red cell aplasia??