Answers to 'Wars'

Click on the links below to get to the answers of the various 'wars'


Answers to MRCP questions War 1
Answers to MRCP questions War 2
Answers to MRCP questions War 3
Answers to MRCP questions War 4
Answers to MRCP questions War 5
Answers to MRCP questions War 6
Answers to MRCP questions War 7
Answers to MRCP questions War 8
Answers to MRCP questions War 9
Answers to MRCP questions War 10
Answers to MRCP questions War 11
Answers to MRCP questions War 12
Answers to MRCP questions War 13
Answers to MRCP questions War 14
Answers to MRCP questions War 15
Answers to MRCP questions War 16
Answers to MRCP questions War 17
Answers to MRCP questions War 18
Answers to MRCP questions War 19
Answers to MRCP questions War 20
Answers to MRCP questions War 21
Answers to MRCP questions War 22
Answers to MRCP questions War 23
Answers to MRCP questions War 24
Answers to MRCP questions War 25
Answers to MRCP questions War 26
Answers to MRCP questions War 27
Answers to MRCP questions War 28
Answers to MRCP questions War 29
Answers to MRCP questions War 30



MRCP questions: War 1

Not yet written!






MRCP questions: War 2


Question 1: 
procainamide, chlorpromazine, minocycline, hydralazine, isoniazid, phenytoin.


Question 2: 
anti DS antibody titre, ESR, c3/c4 levels


Question 3:
a non-bacterial endocarditis associated with SLE, commonly affecting the MV.

Question 4:
SLE, rheumatic fever, parkinsons disease
 

Question 5:
- ataxia
-torsades de pointes
- alveolitis
- pulmonary fibrosis
- corneal microdeposits
- hepatitis
- metallic taste
- photosensitivity







MRCP questions: War 3

Question 1: 
Cancer, sarcoid and TB, lymphoma, HIV, CF, churg strauss, EAA, phenytoin, pneumoconiosis


Question 2: 
Malignancy and hyperparathyroidism


Question 3:
thiazide diuretics, lithium


Question 4:
Vit A and vit D


Question 5:
Breast, thyroid, bronchus, prostate, kidney


Question 6:
Increases calcium by increasing GI absorption and renal reabsorption
Increases phosphate by the same mechanism


Question 7:
Raised PTH, low calcium, raised phosphate


Question 8: 
A single adenoma


Question 9:
Cholesterol


Question 10:
It increases calcium by osteoclast stimulation and increased renal reabsorption.  It also increases vit D hydroxylation so indirectly increases GI calcium absorption.
It decreases phosphate levels as although it increases phosphate by stimulating osteoclasts its effect on encouraging renal excreation of phosphate is greater.






MRCP questions: War 4

Question 1:
Obstructive


Question 2:
Farmers lung

Question 3:
Upper lobes


Question 4:
Cryptogenic fibrosing alveolitis, bleomycin, amiodarone, rheumatological disease (RA/SLE), radiation, TB, asbestotis, paraquat, pigeon fanciers lung, silicosis, sarcoid


Question 5:
atrial myoxoma, cyanotic congenital heart disease, endocarditis, malabsorption, inflammatory bowel disease, lymphoma, cirrhosis, mesothilioma, cystic fibrosis, cancer, fibrosis, abscess, bronchiectasis


 

MRCP questions: War 5

Question 1:
Proteinuria >3g, hypoalbuminaemia <25, oedema


Question 2:
B12 defeciency, osteomalacia, budd chiari, immunodeficiency, hyponatraemia, infections, thrombosis, hyperlipidaemia, iron deficiency, malnutrition


Question 3:
Renal vein thrombosis


Question 4:

IgA nephropathy


Question 5:
Good


Question 6:
HLA DQw7 or HLA B35


Question 7:
3rd generation cephalosporin


Question 8:
Glomerulonephritis


Question 9:
C3


Question 10:
Males






MRCP questions: War 6

Question 1:
B27


Question 2:
Red eye(circumcorneal injection), lacrimation, pain, blurred vision, small pupil, photophobia


Question 3:
hypopyon


Question 4:
yersinia, salmonella, shigella, campylobacter, gonorrhoea, chlamydia, ureaplasma


Question 5:
keratoderma blenorrhagica, which is brown raised plaques on the hands and feet


Question 6:
Triad of conjunctivits/uveitis, urethritis and arthritis


Question 7:
  • pleural:serum protein > 0.5 or
  • pleural:serum LDH > 0.6 or
  • pleural LDH >2/3 upper limit of serum LDH
Question 8:
Transudates: heart failure, renal failure, liver failure, peritoneal dialysis, hypothyroidism, Meigs, constrictive pericarditis
Exudates: TB, pneumonia, subphrenic abscess, Dresslers, pancreatitis, SLE, RA, mesothelioma, local cancer, lymphoma, PE, uraemia, yellow nail syndrome


Question 9:
TB, empyema, RA, cancer, SLE


Question 10:
COPD, brochiectasis, recurrent pleural effusions, hypothyroidism, nephrotic syndrome, D penicillamine




MRCP questions: War 7


Question 1:
Potassium

Question 2:
block potassium channels


Question 3: 

verapamil and diltiazem


Question 4:
QT decreases as heart rate increases


Question 5:
QT corrected = QT divided by square root of heart rate


Question 6:
450ms for men, 470ms for women


Question 7: 
Any class I or class III antiarrhythmic, TCA, haloperidol, SSRI, erythromycin, some antihistamines, cocaine, organophosphates, lots of others - check BNF if your answer isn't here


Question 8:
Low magnesium, calcium or potassium, hypothermia or hypothyroidism


Question 9:
Increase: dipyridamol and carbamazepine.  Decrease: aminophylline


Question 10:
More likely




MRCP questions: War 8


Question 1:
100% oxygen, ?s/c sumitriptan ?nasal lidocaine

Question 2:

Unilateral pain around eye, redness of eye, swelling of lid, lacrimation, nasal stuffiness, possibly ptosis

Question 3:

Garlic

Question 4:

renal failure, heavy metal poisoning, arsenic poisoning, thalium poisoning.

Question 5:

Hypoxia, hypothermia, hypovolaemia, hypoglycaemia/kalaemia/hyperkalaemia
Thrombus, tension pneumothorax, toxins, cardiac tamponade.

Question 6:

Bitemporal hemianopia

Question 7:
Chromophobe
 

Question 8:
Condition in which after adrenalectomy for pituitary-controlled cushings the pituitary gland produces lots of ACTH (due to loss of feedback) resulting in hyperpigmentation and possibly an invasive pituitary tumour.

Question 9:

Both are congenital causes of long QT thought to be due to potassium ion channel mutations.
Romano ward is aut dom while JLN is aut recessive.  JLN is associated with bilateral deafness while Romano ward isn't.

Question 10:
Prolactin






MRCP questions: War 9

Question 1:
erythema chronicum migrans

Question 2:

Doxycycline

Question 3:

Pseudogout

Question 4:

large punched-out erosions distant from the joint margins

Question 5:

knee

Question 6:

A benign tumour that arises from the remnants of rathkes pouch

Question 7:

Pneumothorax that occurs during menstruation secondary to endometriosis of the lung.

Question 8:

A crunching sound in the lungs which suggests a pneumomediastinum.

Question 9:

Aspirate the air.  If this improves the situation consider ?discharge ?observation.  If it does not improve try once more, then try a chest drain.

Question 10:
Pseudogout.


 

 MRCP questions: War 10

Question 1:
  1. spontaneous and recurrent nosebleeds
  2. telangiectasia
  3. AVMs
  4. positive family history - a first degree relative
Question 2:
AVM of lung, left atrial thrombus, left atrial tumour

Question 3:

Progressive muscular atrophy

Question 4:

riluzole

Question 5:

  • MND
  • syringobulbia (more about this condition tomorrow!)
  • GBS (also lined up for battle tomorrow)
  • polio
  • Lyme disease
  • brain-stem tumours
Question 6:
Psuedobulbar palsy

Question 7:

Lesch-Nyhan Syndrome

Question 8:

  • emphysema/COPD
  • pericardial effusion
  • severe obesity
  • pleural effusion
  • amyloid
  • haemochromatosis
  • cardiomyopathies
  • global ischaemia
Question 9:

Pericardial effusion/cardiac tamponade

Question 10:
IVIG







MRCP questions: War 11

Question 1
older age, fast onset, preceded by campylobacter infection, axonal neuropathies

Question 2

85%

Question 3

FVC

Question 4

Areflexia, ataxia, opthalmoplegia

Question 5

Anti-ganglioside antibodies, especially to GQ1b

Question 6

a cyst/cavity forming in or close to the central canal of the spinal cord

Question 7

  • wasting and weakness of muscles of the hands (possibly 'claw hand')
  • loss of pain and temperature sensation in hands
Question 8
x linked recessive

Question 9

flushing, hypotension, bronchoconstriction, diarrhoea, pellegra

Question 10
Surgery/ocreotide.



 

MRCP questions: War 12

Question 1:
left

Question 2:

diastolic - aortic regurgitation

Question 3:

15%

Question 4:

Type A = ascending

Question 5:

IV labetalol and surgery

Question 6:

smear/smudge cell

Question 7:

being male, age >70, lymphocytes >50, prolymphocytes >10%, doubling rate <12 months, raised LDH, CD 38 positive, ZAP 70 + 

Question 8:

hairy cell leukaemia

Question 9:

The transformation of CLL to invasive B cell lymphoma

Question 10:
70%



MRCP questions: War 13

Not yet written!


MRCP questions: War 14

Not yet written!




MRCP questions: War 15

Question 1:
Bone, lung, liver

Question 2:
Polycythaemia, raised calcium

Question 3:
a rare autosomal dominal condition that results in haemangioblastomas in various locations, including the kidneys, cerebellum, spinal cord and retina.

Question 4:
Neuralgic amyotrophy

Question 5:
Acute intermittent porphyria

Question 6:
alcohol, benzos, rifampicin, tetracycline, phenytoin, OCP, halothane, sulphonamides and probably others

Question 7:
Porphyria cutanea tarda

Question 8:
muscle biopsy looking for ragged red fibres

Question 9:
Dermatitis, depression, diarrhoea, dementia, ataxia, insomnia

Question 10:
dantrolene


MRCP questions: War 16

Question 1:
bowing of tibia, bossing of skull, bone pain, secondary arthritis, deafness/cranial nerve compression signs, pathological fractures, 1% osteosarcoma, high output cardiac failure

Question 2:

alendronic acid

Question 3:

Co trimexazole

Question 4:

pyridostigmine

Question 5:

eaton-lambert syndrome

Question 6:

contralateral lesion in subthalmic nuclei

Question 7:

bromocriptine

Question 8:

erbs





MRCP questions: War 17

Question 1:
Prolonged aPTT/PT, low platelets, low fibrinogen, raised d-dimer

Question 2:
loss of taste to posterior third of tongue, dysphagia, paralysis of sternocleidomastoid and trapezius muscles.

Question 3:
follicular

Question 4:
previous TB, previous haemothorax, previous empyema

Question 5:
pseudoxanthoma elasticum

Question 6:
false

Question 7:
low sodium



MRCP questions: War 18

Question 1:
II, VII, IX, X

Question 2:

stop the warfarin, restart when INR<5

Question 3:

Guttate psoriasis

Question 4:

extertional dyspnoea, angina and dizziness

Question 5:

severe

Question 6:

15mg prednisolone PO OD

Question 7:

mebendazole 100mg

Question 8:

normal





MRCP questions: War 19



MRCP questions: War 20

 

 

 


MRCP questions: War 21

 


MRCP questions: War 22

 


MRCP questions: War 23

 


MRCP questions: War 24

 Question 1:
Xanthelasma, Hepatosplenomegaly, Clubbing, Jaundice
Also acceptable – signs of portal hypertension

Question 2:
Antimitochondrial antibody M2 (SMA is only 30% specific, therefore not the best answer)

Question 3:
Acute promyelocytic myeloid leukemia,  t (15;17)

Question 4:
Cytosine, arabinoside, daunorubicin


Question 5:
Sickle cell disease, lead poisoning, acromegaly, pagets disease, pseuodxanthoma elasticum, ehlers-danlos, raised calcium/phosphate, short people

Question 6:
SSRIs Opiates Carbamazepine Tricyclics

Question 7:
Urine sodium and osmolality

Question 8:
Confusion, seizures, hypertension, oedema, nausea, anorexia, muscle weakness, signs of cardiac failure

Question 9:
SIADH

Question 10:
1.    insertion of aquaporin channels resulting in water reabsorption
2.    increased vascular resistance


MRCP questions: War 25

 


MRCP questions: War 26

 


MRCP questions: War 27

 


MRCP questions: War 28

 


MRCP questions: War 29

 


MRCP questions: War 30