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Thursday, October 15, 2009

MRCP Part 1 MCQ question #23


A 24 year old in-patient has chronic diarrhea as well as a large draining fistula. She complains of nausea and anorexia and of marked weakness. On physical examination her blood pressures is 120/80 mmHg. When she stands up, she feels very dizzy and her blood pressure is 110/70. Her heart rate is 100. She weighs 50 kg. When the intern pinches her forehead skin, it stands up like a tent. Her eyes are sunken. Her laboratory tests are pending. The intern suspects that she has extracellular fluid volume depletion. What volume of water would be expected in the extracellular compartment of a healthy 50 kg female?

a) 30 liters
b) 2.5 liters
c) 10 liters
d) 20 liters
e) 7.5 liters

Answer:

MRCP Part 1 MCQ question #22

what is the main mode of action of beta-blockers in controlling hypertension ?

a) decrease cardiac input
b) slow the heart rate
c) increase the cardiac force of contraction
d) increase cardiac output
e) decrease plasma volume

Answer:

MRCP Part 1 MCQ question #21

Elderly woman develops sudden onset of a right sided partial ptosis and a divergent squint , there is no pupil asymmetry. When asked to raise both arms and she has weakness of the left arm in comparison with the right arm. The likely cause is :

a) pontine lesion
b) lesion at cerebellpontine angle
c) Weber's syndrome
d) mid-brain vascular lesion
e) diabetic third nerve palsy

Answer:

MRCP Part 1 MCQ question #24

A selective, reversible alpha-1 blocker which may be used in the pre-operative preparation of patients with phaeochromocytoma

a) phenylephrine
b) prazosin
c) clonidine
d) yohimbine
e) idazoxan

Answer:

MRCP Part 1 MCQ question #20

A 28 patient with a 10 year history of bronchial asthma presents with footdrop, he is noted to have purpura and painful skin nodules, the chest radiograph shows several peripheral nodules, these features are characteristic of:

a) Leoffler's syndrome
b) Idiopathic Hypereosinophilic Syndrome
c) chronic eosinophilic pneumonia
d) Churg-Strauss syndrome
e) Allergic bronchopulmonary aspergillosis

Answer:

MRCP Part 1 MCQ question #19

Muscarinic Acetylcholine receptors are selectively blocked by :

a) atropine
b) C5
c) muscarine
d) curare and C6
e) nicotine

Answer:

MRCP Part 1 MCQ question #18

An infarct involving the middle cerebellar peduncle is likely to be secondary to occlusion in the territory of the :

a) the Posterior Cerebral Artery
b) the Basilar Artery
c) The superior cerebellar artery
d) The anterior inferior cerebellar artery
e) The posterior inferior cerebellar artery

Answer:

MRCP Part 1 MCQ question #17

Aspirin inhibits platelet function by acetylating :

a) prostaglandin reductase
b) thromboxane synthetase
c) cyclooxygenase
d) succinic dehydrogenase
e) NADH-cytochrome-c-reductase

Answer:

MRCP Part 1 MCQ question #16

A carcinogen known to cause hepatocellular carcinoma

a) aniline dyes
b) Aflatoxins
c) Tamoxifen
d) Hydroquinone
e) asbestos

Answer:

MRCP Part 1 MCQ question #15

A sexually active patient presents with a pharyngitis , diarrhea and lymphadenopathy three weeks following exposure to an individual infected with HIV.
What is the test of choice for HIV in acutely infected individuals during the short period between infection and seroconversion?

a) viral lysate EIA
b) Fluoxetine
c) p24 antigen
d) Radioimmunoprecipitation assay
e) Polymerase chain reaction

Answer:

MRCP Part 1 MCQ question #14

A fifty-five year old with chronic cardiac failure is on treatment with digoxin and the a loop diuretic.
This combination is likely to cause digoxin toxicity by the following reason:

a) this combination increases the half-life of digoxin
b) diuretics decrease potassium levels
c) frusemide and digoxin interact to form a poisonous compound
d) digoxin is a competitive inhibitor of frusemide
e) the above statement is wrong, loop diuretics are not a recognised cause of increased digoxin toxicity

Answer:

MRCP Part 1 MCQ question #13

Marfan syndrome is associated with defective encoding of

a) collagen
b) elastin
c) fibrillin
d) elastin
e) laminin

Answer:

MRCP Part 1 MCQ question #12

A 40 yrs old man was diagnosed to have a pheochromocytoma tumor. Staging investigations showed the tumour to be operable. What definite therapy will the patient most likely be started on a few weeks before the surgery:

a) verapamil
b) sodium nitroprusside
c) phenoxybenzamine
d) nitroglycerine
e) none of the above

Answer:

MRCP Part 1 MCQ question #11

An 18-year-old girl has dull retrosternal pain and shortness of breath. On examination she has a heaving apical pulse, an apical systolic thrill and a short mid-diastolic rumbling murmur. The most likely diagnosis is
a) mitral insufficiency
b) aortic stenosis
c) pericarditis
d) tricuspid incompetence
e) costochondritic pain

Answer:

FCPS and MRCP Part 1 MCQ question #10

A patient with symptomatic WPW syndrome undergoes an intracardiac electrophysiological Study and is found to have a reciprocating tachycardia using the accessory pathway for the anterograde conduction and the normal AV conduction system for retrograde conduction. This is best described as :

a) Orthodromic tachycardia
b) atrial fibrillation
c) supraventricular tachycardia
d) atrial flutter
e) Ventricular tachyarrhythmias

Answer:

FCPS and MRCP Part 1 MCQ question #9

A patient suffering from hemochromatosis classically presents with the following triad:

a) micro-nodular liver cirrhosis, iron deficiency anemia & diabetes mellitus
b) micro-nodular liver cirrhosis, diabetes mellitus & bronze pigmentation of skin
c) diabetes mellitus, sickle cell anemia, bronze pigmentation of skin
d) micro-nodular liver cirrhosis, diabetes mellitus & sickle cell anemia
e) micro-nodular liver cirrhosis, Kayser-Fleischer rings & diabetes mellitus

Answer:

FCPS and MRCP Part 1 MCQ question #8

A 52 year old white male is found to have some abnormalities in his peripheral blood smear. He has anti-intrinsic factor antibodies in his serum. He has a positive Schilling test. He is given a diagnosis of pernicious anemia. He is told that on his differential count, the abnormality was a shift to the right. What is a 'shift to the right'?

a) increased number of white blood cells in the peripheral blood
b) decreased number of white blood cells in the peripheral blood
c) hypersegmented granulocytes present in the peripheral blood
d) increased number of immature white blood cells in the peripheral blood
e) increased number of immature red blood cells in the peripheral blood

Answer:

MRCP Part 1 MCQ question #8

Progression to colonic carcinoma has been associated with

a) mutations of MSH2, MSH6, and MLH1
b) mutation of DPC4 gene
c) Mutation of p21 gene
d) Mutation of Rb gene
e) Mutation of p53 gene

Answer:

MRCP Part 1 MCQ question #7

Captopril is a commonly used anti-hypertensive drug. the most common side effect observed with its prolonged use is the development of a dry cough sometimes accompanied by wheezing. The cause for the cough is likely to be:

a) increase in the plasma levels of bradykinin
b) idiosyncratic reaction to the drug
c) due to decrease in the blood pressure.
d) decrease in the angiotensin levels in the plasma
e) none of the above

Answer:

MRCP Part 1 MCQ question #6

The most common type of nontraumatic acute monoarthritis in young, sexually active persons


a) Lyme disease
b) Nongonococcal septic arthritis
c) Gonococcal arthritis
d) gout
e) Spontaneous osteonecrosis

Answer:

Wednesday, October 14, 2009

MRCOG Part 1 MTF #1

The antiphosphopholipid syndrome is associated with:

True / False

1. myocardial infarction

2. venous thrombosis

3. left ventricular thrombus

4. pulmonary hypertension

5. recurrent abortion

Answer:

MRCS Part A Paper 1 and 2 MCQ #2

A 21-year-old professional footballer presents to the Accident and Emergency unit with severe, stabbing pain just above his right knee joint. He states that the pain was of sudden onset and happened whilst he was sprinting during a match. On examination, he walks with a limp and is unable to extend the leg. There is a swelling over the supra-patellar region and is identified to have a low-lying patella. Knee jerk is absent.
(Please select 1 option)

0. Fracture of patella

0. Injury to the posterior cruciate ligament

0. Tear of adductor magnus muscle

0. Tear of biceps femoris tendon

0. Tear of quadriceps tendon

Answer:

MRCS Part A Paper 1 and 2 MTF Question #1

Utilising the posterior approach to a surgical procedure on the kidney, the surgeon will find that


True / False

1. The perirenal fat is exterior to the renal fascia (of Gerota)

2. The peritoneum needs to be opened

3. The pleura reaches below the level of the 12th rib

4. The renal artery is posterior to the renal vein

5. The subcostal nerve is anterior to the kidney

Answer:

MRCPCH Part 1 and DCH MCQ question #2

A 3-month-old boy presents with a 3cm cavernous haemangioma behind the right ear.
Which is the best advice to give the parents?
(Please select 1 option)

He should be referred to the plastic surgeons for surgical removal
He should receive 2 mg/kg of prednisolone for 4 months to shrink it down
He should receive alpha interferon injections
He should receive intralesional triamcinolone injections
It is likely to enlarge to about a year of age, then disappear over the next 5-8 years
Answer:

MRCPCH Part 1 and DCH MTF question #1

In a 2-year-old boy, which of the following conditions are likely to require surgery?

True / False


Bow legs


In-toeing


Knock knees


Metatarsus varus


Tibial torsion

Answer:

Tuesday, October 13, 2009

MRCP Part 2 question #2

A 47-year-old man with HIV disease presents to hospital with a tonic-clonic seizure. He had initially presented six months previously with Pneumocystis carinii pneumonia with a CD4 T-lymphocyte count of 10 cells/mm3 and had subsequently started on highly active antiretroviral therapy. His most recent CD4 count, taken one month prior to his new presentation, was 50 cells/mm3. On examination he has no focal weakness, but both plantar responses are extensor. Fundoscopy is normal.

A CT scan of his brain is shown.


What is the diagnosis?


(Please select 1 option)


0. AIDS-related dementia
0. Brain abscess
0. Cerebral toxoplasmosis
0. Primary CNS lymphoma
0. Progressive multifocal leukoencephalopathy

Answer:

Monday, October 12, 2009

MRCP Part 2 question #1


This patient with advanced HIV disease noted the appearance of these lesions on her face over several weeks.


What is the causative agent?


(Please select 1 option)


0. Bartonella henselae
0. Cryptococcus neoformans
0. Human herpes virus 8
0. Human papilloma virus
0. Pox virus

Answer:

MRCP Part 1 MCQ question #4

A nurse presents with severe swelling around the mouth following her lunch.

She was treated for suspected anaphylaxis and on further questioning she says that previously she has had an itchy rash on her hands after wearing latex gloves.

Which of the following fruit is the most likely to have been in her lunch to explain this reaction?


(Please select 1 option)


0. Apple
0. Banana
0. Gooseberry
0. Pineapple
0. Star fruit

Answer:

Saturday, October 10, 2009

Anatomy MCQ Thorax #2

A 72-year-old woman dies after a strock. At autopsy, a large embolus is found in the brain. this embolus mostlikely formed in which of the following blood vessels?

A) Right coronary artery

B) Right hepatic vein

C) Right renal vein

D) Superior vena cava

E) Right pulmonary vein

Answer:

Anatomy MCQ Thorax #1

An 18-year-old man, in shock and bleeding profusely is brought to the emergency department after being stabbed in the chest. An examination shows a knife wound to the right first intercostal space,immediately lateral to the manubrium. The knife entered parallel to the ground and penetrated to a depth of 6.5 cm. which of the following structures is most likely injured?



A) Left common carotid artery

B) Ascending aorta

C) Superior vena cava

D) Right ventricle

E) Right subclavian artery

Answer:

Friday, October 9, 2009

MRCP Part 1 MCQ question #3

A 16-year-old girl developed pulmonary haemorrhage and acute renal failure requiring dialysis.

Investigations revealed:

Renal biopsy - Crescentic glomerulonephritis

Which one of the following antibodies is most likely to be found in the blood?


(Please select 1 option)


0. Anticardiolipin
0. Anticentromere
0. Antimitochondrial
0. Antimyeloperoxidase
0. Antinuclear

Answer :

Wednesday, October 7, 2009

MRCP Part 1 MCQ question #1

A 79-year-old woman presents with mild dyspnoea and confusion. Of note in her past medical history was a one year history of Raynaud's phenomenon.
On examination her pulse was 118 beats per minute, she had a blood pressure of 122/88 mmHg and she had a small ulcer on her right big toe.
Auscultation of her chest revealed bibasal crackles and she had mild ankle oedema.

Her investigations show:
Haemoglobin: 9.5 g/dl (11.5-16.5)
White cell count: 3.5 x 109/l (4-11)
Platelet count: 110 x 109/l (150-400)
Serum total protein: 120 g/l (61-76)
Serum immunoglobulins:
IgA: 0.8 g/l (0.8-3.0)
IgG: 15 g/l (6.0-13.0)
IgM: 70 g/l (0.4-2.5)
Which of the following complications is she likely to develop?

(Please select 1 option)

0. Acute renal failure
0. Atypical pneumonia
o. Erythema repens gyratum
o. Hyperviscosity syndrome
o. Pathological bone fracture

Answer: