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MRCP PART 1 > PAST YEAR PAPER > Flashcards

PAST YEAR PAPER Flashcards

1
Q

Squamous cell carcinoma secretes?

A

Parathyroid hormone related peptide PTHrP.

TSH

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2
Q

Which cancer causes increase calcitonin?

A

Medullary Thyroid Cancer.

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3
Q

Where is gastrin produced?

A

G cells in pyloric antrum and duodenum. Gastrin stimulates parietal cells to produce HCL.

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4
Q

Initial cause of osmotic demyelination in hyponatraemia?

A

Astrocyte apoptosis.

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5
Q

Antibody for PBC?

A

Anti mitochondrial antibody

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6
Q

Common bacterial causes for indwelling line infection?

A

Staph aureus and staph epidermidis.

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7
Q

Treatment for Chlamydia?

A

Doxycycline.

2nd line Azithromycin.

Tetracycline should not be used in pregnant or breastfeeding women.

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8
Q

Hereditary haemochromatosis is associated with which kind of joint arhtropathy?

A

Pyrophosphate arhtropathy.
Psuedogout

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9
Q

Mode of action of digoxin?

A

Inhibits sodium-potassium exchange pump.

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10
Q

Why is irradiated blood used?

A

prevent graft vs host disease.

  • hodgkins lymphoma
  • stem cell transplant
  • haem malignancies treated with alemtuzumab
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11
Q

Tx for idiopathic intracranial hypertension?

A

Headache in young obese women.
Blurring of vision on straining.

Acetazolamide (carbonic anhydrase inhibitor)

Weight loss

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12
Q

Serious complication from marfans syndrome?

A

Aortic dissection.

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13
Q

Most likely site of gastrinoma?

A

Pancreas.

  1. first part of duodenum

(different answer at different website??)

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14
Q

Which NSAID associated with worsening of heart failure?

A

Celecoxib is a COX2 inhibitor - lower risk of GI haemorrhage vs non selective NSAIDs although carries risk of exacerbating cardiac failure.

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15
Q

What does passing a magnet do to a combined cardioverter difibrillator-pacemaker?

A

Turns off defibirillator portion of device and switch pacemaker to asynchronous pacing mode.

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16
Q

Which TB med is an enzyme inducer?

A

Rifampicin.

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17
Q

Acute interstitial nephritis is asscociated with use of which drugs?

A

Acute interstitial nephritis (AIN) is an immunologically mediated renal disorder characterized by inflammation of the renal interstitium.Mmedications being the most common etiological factor. Drugs implicated in AIN include antibiotics (notably beta-lactams and sulfonamides), nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), and diuretics.

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18
Q

Tumour lysis syndrome leads to rise in uric acid. Which medication is given to help with this?

A

Rasburicase.

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19
Q

Murmur for mitral stenosis?

A

Rumbling diastolic murmur. Best heard at apex.

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20
Q

Murmur for mitral prolapse?

A

Late systolic murmur. Loudest a apex.

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21
Q

Medication to treat delirium in the elderly at risk to others or themselves?

A

Halopreridol.

Lorazepam used instead if features of parkinsonism.

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22
Q

Most useful investigation for suspected carcinoid syndrome?

A

Flushing, diarrhoea, palpitations.

Urinary 5-hydroxyindoleactic acid (5-HIAA)

23
Q

score for pressure ulcers?

A

Waterlow score.

24
Q

Score for independence following a stroke?

A

Barthel Index.

25
Q

HPV 16 associated with which cancers?

A
  • Cervical cancer.
  • Oropharyngeal cancer
  • Anal cancer
26
Q

Medication used for oculogyric crisis?

A
  • Benztropine
  • Procyclidine
  • Diphenhydramine
27
Q

Investigation for adrenal insufficiency?

A

Short synacthen test.

28
Q

which conditions associated with HLA B27?

A
  • Psoriatic arthritis
  • Ankylosing spondylitis
  • Reactive arthritis
  • IBD arthritis
29
Q

Cancers associated with BRCA2?

A

Breast cancer
Ovarian cancer
Prostate cancer
Pancreatic cancer

Stomach
Bile duct
gallbladder

30
Q

How to calculate SAAG and what result is indicative of portal hypertension?

A

Serum Ascites Albumin Gradient (SAAG)

Serum albumin subtracted by ascitic fluid albumin.
Above 11 is predictive of portal hypertension.

31
Q

Beck’s triad?

A
  • Hypotension
  • Distended neck veins
  • Muffled heart sounds
32
Q

Which morphine metabolite accumulates in renal impairment leading to respiratory depression?

A

Morphine 6 glucuronide.

33
Q

Main site of damage related to gentamicin toxicity?

A

Proximal tubule.

Gentamicin leads to necrosis of tubular cells predominantly in the proximal tubule.

34
Q

Initial intervention for OCD?

A

Individualised cognitive behavioural therapy.

If does not respond to CBT for SSRI.

35
Q

prophylaxis for bleeding in patient’s with von willebrand disease?

A

Tranexamic acid
Desmopressin (intranasally or parenterally) - used before tooth extractions.

36
Q

Features of minimal change disease?

A

Minimal change disease nearly always presents as nephrotic syndrome.

  • Facial oedema
  • Proteinuria

Majority of patients respond to steroids.

37
Q

Pityriasis versicolor treatment?

A

Topical ketoconazole.

Topical selenium shampoo used when ketoconazole is inappropriate.

38
Q

Gene associated with increased risk of Alzheimer’s disease?

A

APOE e4 Allele carriage is associated with late onset Alzheimer’s disease.

39
Q

Mode of inheritance for hereditary haemorrhagic telangiectasia (HHT)?

A

Autosommal dominant

Respiratory tract bleed (haemoptysis)
GI tract bleed.

40
Q

Mode of action of gliclazide?

A

Increase glucose independent insulin release.

41
Q

Management of Raynaud’s disease?

A
  1. Nifedipine (promotes vasodilation)
  2. Alpha blockers (Prazosin/ doxazosin)
  3. Phosphodiesterase inhibtors (Sildenafil)
42
Q

MODY HNF-1 alpha mutation positive treatment?

A

Sulfonylureas (Gliclazide)

43
Q

Inferior MI affected artery?

A

Right coronary artery.

44
Q

HLA in Behcet disease?

A

HLA-B51

45
Q

Non caseating granulomas seen in which condition?

A

Crohn’s disease

46
Q

Features of type 1 renal tubular acidosis?

A

Type 1 = Distal renal tubular acidosis

  • Hypokalaemia
  • Metabolic acidosis
  • Renal stones
  • Sjogren’s, SLE,
47
Q

Virus for kaposi’s sarcoma?

A

Kaposi’s sarcoma is associated with human herpes virus 8.

48
Q

Drug choice for hirsutism in PCOS?

A

Topical Eflornithine.

49
Q

Hormone affected in patients causing hypothalamic amenorrhea (from weight loss, heavy physical traning)?

A

Lutenising hormone.

50
Q

Patient with allergy to latex commonly allergic to which fruits as well?

Latex fruit syndrome

A

Banana
Pineapple
Avocado
Chestnut
Kiwi
Peach
Fig
Tomato

51
Q

Clotting test for initial investigation of factor V Leiden mutation.

A

Dilute Russell’s viper venom time.

52
Q

Area of nephron most responsible for sodium reabsorption?

A

Proximal convoluted tubule and ascending loop of Henle.

53
Q

Lewy body dementia features?

A
  • Dementia/cognitive impairment
  • Hallucination
  • Parkinsonism

MRCP PART 1 (20 decks)

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