MRCP revision on the go...: Answers to 'Wars'

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:

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:

spontaneous and recurrent nosebleeds
telangiectasia
AVMs
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

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 revision on the go...

Pages

Answers to 'Wars'

MRCP questions: War 1

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.

MRCP questions: War 3

MRCP questions: War 4

MRCP questions: War 5

MRCP questions: War 6

MRCP questions: War 7

MRCP questions: War 8

MRCP questions: War 9

MRCP questions: War 10

MRCP questions: War 11

MRCP questions: War 12

MRCP questions: War 13

MRCP questions: War 14

MRCP questions: War 15

MRCP questions: War 16

MRCP questions: War 17

MRCP questions: War 18

MRCP questions: War 19

MRCP questions: War 20

MRCP questions: War 21

MRCP questions: War 22

MRCP questions: War 23

MRCP questions: War 24

MRCP questions: War 25

MRCP questions: War 26

MRCP questions: War 27

MRCP questions: War 28

MRCP questions: War 29

MRCP questions: War 30

Pages

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 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.