MRCP Part 1 - Mock Exam (1)

I have prepared 20 questions for you to answer in 25 minutes, you can find the answers after you complete the questions below,

1)A 55 year old female undergoes a DEXA scan which reveals a bone mineral density T score of -2.5 at the hip and lumbar spine.
Which of the following may contribute to such a result?
1 ) Acromegaly 2 ) Delayed menopause 3 ) Hypothyroidism 4 ) Myeloma 5 ) Obesity

2)In a normal heart, the oxygen saturation of a sample of blood taken from a catheter in the pulmonary capillary wedge position should be equal to a sample from which of the following?

1 ) coronary sinus 2 ) femoral artery 3 ) pulmonary artery 4 ) right atrium 5 ) right ventricle

3)Elevation of the jugular venous pressure during inspiration is most likely to be found in which of the following situations?

1 ) a normal physical exam 2 ) cardiac tamponade 3 ) constrictive pericarditis 4 ) dilated cardiomyopathy 5 ) myocarditis

4)A 50-year-old plumber presented with a dry nocturnal cough and increasing exertional breathlessness.

On examination he had early finger clubbing, cyanosis and bilateral basal crackles. A chest X-ray showed bilateral lower zone shadowing.

Investigations revealed:
PaO2 (breathing air) 8.0 kPa (11.3-12.6) FEV1/FVC ratio 90%
Which of the following investigations is most likely to establish the diagnosis

1 ) Echocardiography. 2 ) High resolution CT scan of the lung 3 ) Measurement of diffusion capacity
4 ) Serun calcium level 5 ) Transbronchial lung biopsy

5)A 40 year old woman presents with an acute attack of asthma. She is able to speak in short sentences.
Her respiratory rate is 20 breaths per minute and the peak expiratory flow rate 320L/min (predicted 480 L/min.
What is the most appropriate treatment for this patient?

1 ) Intravenous aminophylline. 2 ) Intravenous salbutamol 3 ) Nebulized salbutamol
4 ) Oral salbutamol 5 ) Oral theophylline

6)A new diagnostic test for malabsorption has been analysed and the results have yielded the following 2x2 contingency table.
Disease present
test result yes no
+ve 0.9 0.1
-ve 0.2 0.8

Applying this test to a case of chronic diarrhoea from a patient group where the prevalence of malabsorption is known to be 20% (probability = 0.2)
what is the probability of a patient having malabsorption if they have a positive test?

1 ) 0.16 2 ) 0.24 3 ) 0.48 4 ) 0.64 5 ) 0.8

7)A 53-year-old man presented with hypertension of 150/110 mmHg. He is generally asymptomatic and has no previous medical history of note. He is a smoker of 5 cigarettes daily and drinks modest quantities of alcohol. He takes no prescribed medications. Examination reveals a BMI of 33.5 kg/2 but nil else.
The following detail his investigations:
Serum sodium 146 mmol/l (NR 133-145)
Serum potassium 3.2 mmol/l (NR 3.5 - 5)
Urinary potassium excretion 42 mmol/l (NR less than 30)
What is the likely diagnosis?
1 ) Adrenocortical adenoma 2 ) Bartter's syndrome 3 ) Liddle's syndrome 4 ) Liquorice ingestion 5 ) Pheochromocytoma

8)A 74-year-old man presented with acute pain, pallor and absent pulses in his right leg. Investigations revealed an embolus in his femoral artery.

What is the most likely source of this embolus?

1 ) marantic endocarditis 2 ) paradoxical emboli 3 ) rheumatic endocardial vegetations
4 ) right ventricular thrombi 5 ) thrombi from an atheromatous aorta

9)When acclimatised to life at high altitudes

1) the mean corpuscular haemoglobin concentration is increased 2) respiration becomes periodic
3) cardiac output is increased 4) pulmonary diffusion capacity is increased 5) airway resistance is decreased

10)Recognised features of acromegaly include EXCEPT

1) hypocalciuria 2) intestinal polyposis 3) splenomegaly 4) palpable peripheral nerves 5) proximal myopathy

11)Which ONE of the following statements is true of autoimmune hepatitis:
1 ) It usually presents as an acute hepatitis 2 ) It rarely presents before 20 years of age
3 ) It may be associated with keratoconjunctivitis sicca 4 ) It is associated with hypogammaglobulinaemia
5 ) It rarely interferes with menstruation except in later stages

12)A 38 year old female presents with red target lesions confined to the hands and is diagnosed with erythema multiforme.
Which of the following could be the cause? 1 ) Cytomegalovirus infection 2 ) Ureaplasma urealyticum
3 ) Group B Streptococci 4 ) Langerhan's cells histiocytosis 5 ) Penicillin V

13)A 50-year-old man presented in the summer complaining of itching and blistering of his hands and forehead. On examination there were small areas of excoriation on the backs of his hands.
What is the most likely diagnosis?
1 ) dermatitis herpetiformis 2 ) lupus erythematosus 3 ) pemphigoid 4 ) pemphigus 5 ) porphyria cutanea tarda

14)Which of the following statements concerning the thymus is true?

1 ) The majority of cortical thymocytes express either CD4 or CD8.
2 ) CD4/CD8 double positive cells are eliminated by a process of negative selection.
3 ) A proportion of alpha/beta+ thymocytes undergo isotype switching to produce gamma/delta+ T cells.
4 ) Thymocytes whose TcR bind with high affinity to self Ag/MHC complexes are clonally deleted.
5 ) Mature thymocytes express surface IgM and IgD.

15)Which of the following conditions is most likely to be associated with thrombocytopenia?
1 ) haemophilia A 2 ) hereditary haemorrhagic telangiectasia 3 ) pernicious anaemia 4 ) porphyria 5 ) uraemia

16)Concerning Neurofibromatosis Type 1 (NF1),
which one of the following statements is true?

1 ) Bilateral acoustic neuromas are common 2 ) Clinical severity in individuals is similar in a given family
3 ) New mutations occur rarely 4 ) Lisch nodule is a characteristic feature
5 ) The diagnosis is likely if one café-au-lait patches are present

17)A 73 year old female is diagnosed with Cushing's disease. Which of the following is correct?

1 ) Adrenalectomy would be the treatment of choice. 2 ) op-DDD is a treatment if unfit for surgery 3 ) Ketoconazole may be used as a treatment if unfit for surgery 4 ) Recurrence of Cushing's disease after transphenoidal surgery is less than 5%
5 ) yttrium implantation is an effective treatment

18)A 19-year-old male student attends casualty complaining of an urethral discharge. Gram stain shows numerous neutrophils, some of which contain gram-negative intracellular diplococci. The patient is treated with Ceftriaxone, 250 mg as an im injection. Five days later, the patient re-attends with persisting discharge.
Which of the following is the most likely cause of this discharge?
1 ) Chlamydia trachomatis 2 ) Penicillin-resistant Neisseria gonorrhoeae 3 ) Re-infection with Neisseria gonorrhoeae
4 ) Ureaplasma urealyticum 5 ) Urethral stricture

19)A randomised double-blind placebo controlled study of a cholesterol-lowering drug for the primary prevention of coronary heart disease was conducted. It had a five-year follow up period.
The results showed an absolute risk of myocardial infarction in the group-receiving placebo during was 10 per cent. The relative risk of those given the cholesterol lowering medication was 0.8
What number of patients will need to be treated with the drug for five years to prevent one myocardial infarction?
1 ) 20 2 ) 40 3 ) 50 4 ) 80 5 ) 100

20) This gentleman presents with recurrent per-rectal bleeding.What is the risk of his children to have the similiar problem?
1) 25%
2) 50%
3) 100%
4) Depending on the children's gender
5) variable

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