MRCP Part 1 SBAs

Question 1

What is GAD antibody associated with?

Answer 1

stiff person’s syndrome or diffuse hypertonia

associated with breast ca, colorectal ca and sclc

Question 2

what is the preferred diagnostic test for chronic pancreatitis

Answer 2

ct abdomen

Question 3

pemphigoid gestationalis vs polymorphic eruption of pregnancy

Answer 3

polymorphic eruption
- itchy condition last trimester
- often appear in abdominal striae

pemphigoid
- pruritic blistering lesions
2nd or 3rd trimester
usually requires steroids
develops in peri umbilical region and then spreads

Question 4

what receptor does herceptin (Trastuzumab) act on

Answer 4

HER 2 - monoclonal antibody

Question 5

which cancers overexpress HER2

Answer 5

breast and gastric

Question 6

what neurological finding is polyarteritis nodosa associted with

Answer 6

mononeuritis multiplex, and sensorimotor polyneuropathy

Question 7

management of genital warts if keratinised

Answer 7

solitary keratinised warts respond well to cryotherapy

Question 8

management of genital warts if non keratinised

Answer 8

multiple non-keratinised warts are generally best treated with topical agents

Question 9

neurofibromatosis features and which chromosome is it on

Answer 9

cafe au lait >6
axillary/groin freckles
peripheral neurofibromas
iris haematoma
scoilosis
phaeochromocytoma

in nf2 - bl vestibular schwannomas

chromosome 17
autosomal dominant

Question 10

associations of myotonic dystophy DDD

Answer 10

Distal weakness initially
Autosomal Dominant
Diabetes
Dysarthria

Question 11

anterior cerebral artery stroke

Answer 11

CL weakness and sensory loss
legs > arms and face

Question 12

middle cerebral artery stroke

Answer 12

CL weakness and sensory loss
upper extremety
CLL HH
Aphasia

Question 13

posterior cerebral artery stroke

Answer 13

Contralateral homonymous hemianopia with macular sparing
Visual agnosia

Question 14

webers syndrome (midbrain stroke)

Answer 14

ipsilateal CN III palsy
CL weakness upper and lower

Question 15

wallenburg syndrome (lateral medullary) - posterior inferior cerebellar artery

Answer 15

ipsilateral loss of facial temp and paib
CL limb/torso pain and temperature loss
ataxia and nystagmus

Question 16

Anterior inferior cerebellar artery stroke (lateral pontine syndrome)

Answer 16

Ipsilateral: facial paralysis and deafness
cl limb/torso pain a
ataxia
nystagmus

Question 17

retinal/opthalmic arytery stroke

Answer 17

amaurosis fugax

Question 18

basilar artery stroke

Answer 18

locked in syndrome

Question 19

lacunar stroke common sites and presentation

Answer 19

basal ganglia thalamus and internal capsule
isolated hemiparesis, hemisensory loss or hemiparesis with limb ataxia
strong association with hypertension

Question 20

cranial nerve 3 palsy

Answer 20

oculomotor nerve palsy
down and out appearance
affects all extraocular muscles except SO and LR
also causes ptosis and a dilated fixed pupil

Question 21

horners syndrome - sympathetic fibres affected

Answer 21

miosis (small pupils)
anhydrosis
ptosis
and sunken eye

can be tested with apraclonidine drops (an alpha-adrenergic agonist)

Question 22

lesion location in horners syndrome

central lesion

Answer 22

anhidrosis of the face arms and trunk

stroke, syringomyelia and MS (+ tumour and encephalitis)

Question 23

lesion location in horners syndrome

pre-ganglionic lesion

Answer 23

Anhidrosis of the face

Pancoast’s tumour
Thyroidectomy
Trauma
Cervical rib

remember as Ts

Question 24

horners syndrome

post ganglionic lesion

Answer 24

no anhydrosis
Carotid artery dissection
Carotid aneurysm
Cavernous sinus thrombosis
Cluster headache

remember as Cs

Question 25

mneumonic / way to remember cause/lesion location of horners syndrome central / preganglionic/ post ganglionic

Answer 25

S T and C central S pre T post C

Question 26

cavernous sinus thrombosis

Answer 26

contains CN III, IV and V1 and V2 CST is the formation of clot in the cavernous sinus - most commonly caused by infection. headache unilateral periorbital oedema proptosis, photophobia CN palsy most commonly CN 4

Question 27

focal seizure treatment

Answer 27

lamotrigine or levetiracetam first line second line - carbamazepine

Question 28

generalised tonic clonic seizures

Answer 28

lamotrigine or levetiracetam

Question 29

absence seizures tx

Answer 29

ethosuximide second line - L or L

Question 30

what exacerbates absenses more

Answer 30

carbamazepine

Question 31

myoclonic seizures tx

Answer 31

levetiracetam

Question 32

tonic or atonic seizures

Answer 32

lamotrigine second line clobazam

Question 33

what type of seizure experiences aura, automatisms

Answer 33

temporal lobe

Question 34

what type of seizure experiences Head/leg movements, posturing, post-ictal weakness, Jacksonian march

Answer 34

frontal lobe

Question 35

what type of seizures experience paraesthesia

Answer 35

parietal lobe

Question 36

what type of seizure experiences floaters/flashers

Answer 36

occipital lobe

Question 37

first line tx for essential tremor

Answer 37

propranolol

Question 38

second line for essential tremor

Answer 38

primidone

Question 39

what is downbeat nystagmus associated with

Answer 39

Arnold-chiari syndrome

Question 40

what is upbeat nystagmus associated with

Answer 40

cerebellar vermis lesion

Question 41

brocas area location and function

Answer 41

inferior left frontal lobe lesion usually left mca function is formation of speech comprehension impaired

Question 42

wernickes area lcoation and function

Answer 42

superior temporal gyrus function is comprehension lesion left mca

Question 43

what tracts are affected in subacute degeneration of the cord

Answer 43

it causes loss of vibration sense and proprioception - so dorsal column it also affects the st tract so causes a spastic paresis