MRCP Part 1 Questions (1)

Hope you find the following questions useful,

1)A 50-year-old male presented with acute respiratory failure during an episode of fulminant sepsis and was thought to have developed adult respiratory distress syndrome (ARDS). Which of the following would support a diagnosis of ARDS?

1 ) High pulmonary capillary wedge pressure
2 ) High protein pulmonary oedema
3 ) Hypercapnia
4 ) Increased lung compliance
5 ) Normal chest X-ray

ANSWER: 2

2)In malignant hyperpyrexia:

1 ) A mortality rate of 10-20% may be expected
2 ) Elevation of serum creatine kinase and myoglobinuria is diagnostic
3 ) Muscle biopsy may be histologically normal
4 ) The only available specific treatment is sodium dantrolene, which has a neutral pH
5 ) The predisposing gene is thought to be on chromosome 9

ANSWER: 3

3)A 25-year-old female presented with 6 months history of depression, irritability and painful sensory symptoms in her legs. Over the last 4 weeks she presents a broad base ataxic gait. An MRI brain showed bilateral posterior thalamic nuclei high signals.
The most likely diagnosis is:

1 ) Sporadic CJD
2 ) New variant CJD
3 ) Wilson disease
4 ) Multiple system atrophy
5 ) Herpes simplex encephalitis

ANSWER: 2

4)A 25-year-old man presents with a two years history of intermittent tingling sensation involving his left side. It starts in his fingers and spreads in 10-20 seconds to affect the whole arm and leg on the same side. The attacks only last for one minute. The most likely diagnosis is:
1 ) Migraine with aura
2 ) Transient ischaemic attacks
3 ) Somatosensory seizures
4 ) Hyperventilation
5 ) Multiple sclerosis

ANSWER: 3

5)Causes of dilated pupils include:

1 ) Argyll Robertson pupil
2 ) Ethylene glycol poisoning
3 ) Myotonic dystrophy
4 ) Organophosphate poisoning
5 ) Pontine haemorrhage

ANSWER: 2

6)Diabetic Microalbuminuria:EXCEPT

A Occurs within 10 years of the diagnosis of diabetes mellitus
B Is most accurately assessed through a timed urine collection during the day.
C Predicts premature cardiovascular mortality in type 2 diabetes
D Correlates with hypertension
E Is reduced by ACE inhibitor therapy

ANSWER: A

7)A 35-year-old man on regular haemodialysis complained of weakness and exertional fatigue. On examination, his blood pressure was 177/105 mmHg (pre-dialysis) and 150/95 mmHg (post-dialysis). Investigations pre-dialysis revealed:

Haemoglobin 9.0g/dl
serum potassium 6.9
serum creatinine 1250 serum
corrected calcium 2.1 mmol/l

Which intervention is most likely to improve his symptonis:

1 ) increase haemoglobin with epoetin
2 ) increase the length of each dialysis session
3 ) lower the potassium in the dialysate
4 ) improve blood pressure control with ramipril
5 ) correct hypocalcaemia with alfacalcidol

ANSWER: 1

8)A 50-year-old woman on treatment for long-standing rheumatoid arthritis has recently become dyspnoeic on mild exertion and developed a dry cough. The oxygen saturation was found to be 89% on air. The chest x-ray showed a diffuse bilateral interstitial infiltrate. An extensive infection screen was negative and her symptoms were felt to be drug-induced.

Which drug is most likely to have caused this adverse effect?
1 ) azathioprine 2 ) cyclosporin 3 ) hydroxychloroquine
4 ) methotrexate 5 ) sulphasalazine

ANSWER: 4

9)A 70 year old female is admitted 12 hours after taking an overdose of aspirin. Investigations revealed: Serum sodium 138 mmol/L (137-144), Serum potassium 5.9 mmol/L (3.5-4.9), Serum bicarbonate 14 mmol/L (20-28), Serum urea 18.1 mmol/L (2.5-7.5), Serum creatinine 238 umol/L (60-110), Serum salicylate 1120 mg/L (8 mmol/L). What is the most appropriate treatment of this patient?

1 ) Haemodialysis 2 ) Haemofiltration
3 ) Intravenous sodium bicarbonate. 4 ) Peritoneal dialysis. 5 ) Urine alkalinization.

ANSWER: 1

10)A 62 year old male is noted to have a broad-based ataxic gait.This is characteristic of which of the following?
1 ) A basal ganglia lesion 2 ) Cerebellar vermis lesion 3 ) Osteomalacia
4 ) phenytoin toxicity 5 ) Right-sided cerebral infarction

ANSWER: 4