MRCP2 2015 diet 2 recalls

1. Patient with oral and genital ulcer….. behcet’s / SJ syndrome

2. Difference of BP btw 2 arms … takayasu
3. Marathon runner…. Excess water intake
4. Gout with renal insufficiency, intolerant to allopurinol what prophylaxis should be given….
Colchicine
5. Scenario of FHH
6. Sever acute RA… prednisolone
7. RA patient taking NSAIDs for 2years presented with nephrotic syndrome… amyloidosis /
NSAIDs induced nephrotic syndrome
8. Patient with DM previously operated for varicose vein now presented with bilateral
erythematous leg swelling… lipodermatosclerosis / gravitational eczema
9. ECG…. Monomorphic VT / torsades
10. Blurred vision on digoxin + ECG pic …. Digoxin toxicity
11. Intention to treat… double blind studies
12. Tender thyroid swelling, lid lag and lid retraction with hyperthyroidism on TFTs and
anti-peroxidase antibodies absent… viral thyroiditis
13. HIV patient with CD$ count less than 200, what prophylaxis to offer… pneumocystis carani
14. GB syndrome… campylobacter jejuni
15. GB syndrome with low FVC … IVIG / intubation
16. Scenario of miller ficsher syndrome
17. Scenario of wernicek’s… nystagmus + opthalmoplegia+ alcoholic
18. CLL received chemo…. Tumour lysis syndrome
19. Pic of neovascularization
20. Pic of CRA occlusion
21. Pic of herpes encephalitis
22. Pic of extradural hematoma…. Middle meningeal artery
23. Pic of PML
24. Pregnant lady with childhood H/O recurrent UTI presented with small kidneys on US…..
reflux nephropathy
25. Scenario of fedrich’s ataxia
26. Pic of melanoma
27. Wegener’s patient receiving prednisolone what drug to be added…. Cyclophosphamide
28. Patient K/C of asthma treated with antibiotics 2 weeks previously for exacerbation of asthma
presented with bloody diarrhea + raised eosinophil… chrug strauss/ pseudomembranous colitis
29. AFib + slow ventricular rate …. Ventricular pacing
30. SLE patient APLA positive received warfarin for 3 months test repeated showed APLA
again.. lifelong warfarin
31. Drug causing binge eating
32. Drug CT in pregnancy… simvastatin and ramipril
33. CT scan of pancreatitis / perforated viscus
34. Scenario of pancreatitis , how to give nutrition… TPN
35. Scenario of paget’s disease
36. Malignancy with backache… check calcium
37. Patient receiving fluoxetine and carbamazepine presented with SIADH which dru to be
stopped… carbamazepine
38. Normal pregnancy changes
39. Molluscum contigiousum
40. Alzheimer’s disease….. donepezil / memantine
41. Centrally clearing rash… doxycycline
42. Scenario of pneumonia with CRUB65 score of 2…. Amoxicillin and clarithromycin
43. Elderly parient presented with UTI developed confusion, cause…. UTI
44. Scenario of hepatorenal syndrome
45. Scenario of young girl with drowsiness , LFTs shows hepatocellular injury, treatment…
acyetlcystine
46. Scenario of carotid cavernous fistula
47. Malignancy + incidental finding of PE… LMWH
48. Hepatitis A in husband what test is needed for wife… reassurance
49. Pic of larva migran .. albendazole
50. Scenario of SLE rash … hydroxycholoroquine
51. CHF patient, spironolactone stopped because of gynecomastia, what drug should improve
prognosis… epelrenone
52. Ascites in CKD patient on peritoneal dialysis…. Leakage of peritoneal fluid
53. Refeeding syndrome…. Check potassium, phosphate and magnesium
54. CKD patient taking oral iron presented with breathlessness CBC shows low HB, normal
ferritin and increased TIBC… give IV iron
55. Scenario of common variable immunodeficiency
56. Bleeding duodenal ulcer secondary to HPylori…. Urease breath test
57. Dysphagia in young patient … upper GIT endoscopy
58. COPD patient with exacerbation, PH=7.29 on optimal medical therapy … NIV
59. Prolactinoma.. pergolide
60. Prolactinoma… transphenoidal surgery
61. Picture of chromosomes….Androgen insensitivity syndrome
62. Latex glove … irritant contact dermatitis
63. Breakthrough pain… 30mg of intermediate release morphine
64. Patient with heart failure, code is DNR… morphine
65. Azathiopurin… stop allopurinol
66. Patient of MND, presented with spastic muscles… baclofen
67. MND patient unable to eat because of muscle rigidity but swallowing reflux is normal, what
is long term treatment to improve nutritional state of patient… physiotherapy/ assisted feeding/
PEG
68. Pleural thickening and pleural effusion….. CT guided biopsy
69. High triglyceride, treatment… fenofibrate
70. Scenario of adult onset still’s disease
71. Muscle disease with raised CPK…. Muscle biopsy
72. Pheochromocytoma…. Phenoxybenzamine
73. CT of pulmonary fibrosis / lymphangioleiomyomatosis
74. Risk of sucide… depression/ planning
75. Xray of lung… middle lobe
76. Ascities in IVDU with high lymphocytes and muscle wasting… TB/ peritoneal carcinomatosis
77. Sickle cell disease patient has HB=3 and high bilirubin… aplastic crisis
78. Lady K/C of Ca. breast has received radiotherapy, presented with SOB, raised JVP and
echo shows good EF… restrictive pericarditis/ constrictive cardiomyopathy
79. Downbeat nystagmus…syringomyelia
80. Shoulder pain while gardening taking ibuprofen and paracetamo;l presented with blister …..
polymorphic light eruption
81. Post femoral catheterization groin pain and femoral bruit…. AV fistula
82. Vomiting after 6hours of eating reheated pie… staph. Areus
83. COPD patient with spontaneous pneumothorax, chest tube was placed and CXR showed
partial re-expoansion, 4days later lung is still patialy expanded but patient is asymptomatic…
remove chest tube
84. ECG post PCI… reassurance
85. Scenario of patient taking thiazide, ramipril and ???? presented with low potassium and
magnesium… cause????
86. Rash localized on umbilicus… flexural posraisis
87. Lady taking calcium and VitD has family history of osteoporosis, DEXA = -0.3…alendronate
88. Young patient with pansystolic murmur.. rupture of sinus of valsalva
89. Obese patient with raised HBA1c…metformin
90. Male with unilateral gynecomastia… androgen abuse
91. Cat bite.. sporothrix/ pasturella
92. Patient from india received adequate malarial prophylaxis… dengue/malaria/typhoid
93. Mechanical valve endocarditis prophylaxis… vanc, rifampicin, genta
94. Patient received vancomycin developed redness… start at slower rate
95. Patient with decreased visual acuity sees drawfs in her room..charles bonnet
96. Oculogyric reflex… metoclopramide
97. Post renal transplant on tacrolimus received gentamicin… increase level of tacrolimus
98. HTN patient receiving ramipril and thiazide, unable to tolerate amlodipine presented with
raised creatinine and potassium.. doxazocin
99. OSA…polysomnography
100. Detrusor overactivity… oxybutynin
101. Scenario of tropical sprue, biopsy showed partial atrophy of villi… tetracycline
102. Headache on sitting upright and relieved on lying flat.. CSF leakage
103. AFib in young patient… flecanide
104. Febrile neutropenia not responsive to vancomycin… add antifungal
105. Patient with chronic pancreatitis what investigation should be done… CT/fecal fat
106. Scenario of fibromyalgia
107. Prolonged APTT not corrected on adding normal plasma.. lupus antibody
108. Lady with history of gallstones presented with jaundice.. CBD obstruction
109. Ectopic secretion of ACTH
110. Amenorrhea with galactorrhea, labs sowed high TSH, low T3 and high
prolactin…hypothyroidism
111. HTN with normal sodium and low potassium, what investigation should e done… plasma
renin:aldosterone ratio
112. DM patient with reading difficulty.. maculopathy
113. Low C3 with angioedema… hereditary angioedema
114. Seizure+ pregnancy…pseudoseizure
115. Patient with mechanical valve presented with hemolytic anemia… serum haptoglobuin
116. Left sided stroke, right caotid artery 100% stenosed, left carotid artery 75% stenosed.. no
intervention/ rt carotid endartrectomy/ left endarterectomy
117. Picture of distorted circle , resting tremor…propanalol/levodopa
118. Enoxaparin induced hyperkalemia
119. Xray of charcots joint.. cast
120. HIV patient with browinish papule… HHV8
121. Patient hearing neighbours making plans to kill him…schizopherania
122. DM patient with history of recuurent RTI n multiple abcesses presented with fever and
abcess producing greenish pus… klebsellia/pseudomonas
123. UC with left iliac fossa pain… AXR
124. Aortic dissection…labetolol
125. TCA overdose… IV bicarbonate
126. HTN and CKD patient with K=5.5… repeat test after 2 weeks
127. Non-epileptic seizure… close eyes/ post seizure hyperactivity
128. Pregnant lady retrned from Australia presented with SOB has respiratory
alkalosis…PE/Hyperventilation
129. AS…. Dobutamone stress echo/ coronary angio
130. Xray spine, patient has pain on walking and relieved on sitting, SLR=30… spinal stenosis
131. Scenario of VIPoma

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