THese are some Qs from some cadidates who attended mrcp part 1 sept 2009

1. a nurse has latex allergy ; develops anaphylaxis after lunch ; which fruit.... banana , orange , apple , pear, grape ? (banana). I selected orange
2. trastuzumab started for a pt. for breast cancer; which factor predisposes to heart failure..... ? don't remember the options; one was ...past anthracycline Rx ;
3. another question for trastuzumab and heart failure;
4. a pt. with ischemic stroke and AF with 150/min rate presented after 6 hours ; initial Rx ? ... alteplase , aspirin , clopidogrel , dipyridimole, warfarin?
5. 18 yrs old male had excessive bleeding after dental extraction , APTT =86 , PT= normal ; deficiency of which clotting factor? II , VII , V , X , XII or XI

& these some of items that have been asked :

Aspirin for AF
echo for tarzmib!! and duboxtine!!
Factor V
Pneumo carinii pneumonia
Prolonged diarrhoea
Acute Hep A infection
Anti TB adjovant = CSF
Prognosis of Rh A Acute onset
Macrocytic aneamia in Gastrectomy pt= U endosopy
tear drop= myelofibrosis
Wagner`s s =Pul hge+renal imp
Thrombocytopenia= ? Churg straus
A promylo leukemia
Transudae Pl eff= ? TB vs SLE not sure wt
Commonest Thrompophilia
splitting of second heart sound: LBBB
SVC: immediate management, I think stenting as radiotherapy requires 2 weeks
amlodipine for the elderly on lethium
ciclosporin nephrotoxicity for the patient with increasing creatinine and on fluconazole
there was a question about someone with both hypokalemia and hypercalcemia, I picked hypomagnesemia
the boy with teratoma, follow up by alpha-fetoprotein and hCG
the female with secondary amenorrhea, i think it was premature ovarian failure
regular narrow complex tachycardia: AV re-entry tachycardia with accessory pathway
High levels of IgM: Walendstrom macroglobulinemia
The patient with SAH are likely to develop hydrocephalus

another tough question patient with paracetamol od investigations shows
INR 2.1
Cewatinine 200 plus
ph 7.1
alt 1348
fasting BM 2.2

which indicate for possible liver transplant

-The stroke Pt should be given ASPIRIN.. Warfarin is never started b4 2 weeks even in Ischaemic soke for hear of haemorrage into an infarct
-The strongest indicator for Liver transp in Paracet o/dose is pH!
- The described pl effusion was an Exudate, specifically EMPYEMA (bcoz low pH)
- SVC immediate ttt is Radiotherapy!
- Cyclosporin (and Tacrolimus too) axn inhibits IL2
- Both female sex and anti CCP are bad prognostics for Rh arthritis. I don't know which 1 they want but probably female (I wish i chose it )!!!
question asking for treatment of atopic dermatitis


patient collapse 5 min after tetanus injection , local erythema and hypotensive which type of hypersensitive reaction
Type 1 , Type 2 , type 3 ........ type 5

10 weeks pregnant lady with pleuritic chest pain and left calf pain
what investigation

venogram
CTPA
dopplers leg
V/Q scan
patient develops lesion o to his left hand 4 yr after renal transplant
? cut lymphoma


lady with severe right forearm pain during weekdays , extension of wrist cause severe pain , unable to hold pain or cup

? radial tunnel syndrome
lat or medial condyle
pronator sydrome


question about T1 dermatome problem


95 yr old gentleman 4 admission with confusion 1 time chest infection 3 times UTI
next investigation
?cystoscopy


preg lady with uti which abx
? cephalosorin


mycoplasma pneumonia , patient not toleratind clarithrymycin what to give alternate , no other macrolide was in option


bronchiectais what abx to prescribe
? cipro

what investigation for bronchiectasis
HRCT

young lady with recently diagnosed PHT which will make her condition severe
fatigue
wheeze
syncope

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