mrcp recalls may 2014

8/10/2019 Mrcp Recalls May 2014

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Cardiology

1. 28 yr old young patient with palpitation, for 4 hours, bp stable, no heart disease , no

previous problems, still having Afib on ecg , which medicine will u give .. Flecanide

2. Patient with wide qrs having ventricular tachycardia.. whatecg featuresdiffertiates it fromSVT with aberration…… - AV dissociation

3. Patient with infective endocarditis, on treatment already having long PR , which of the

signs will reflect an immediate need for surgery……. Prolongation of PR interval

4. Patient with severe Aortic Stenosis , what sign is going to depict the severity of the AS

….Dec intensity of 2nd Heart Sound

5. Patient with A Fib , is to go for Radiofrequency ablation procedure, which part of the heart

will give best result - Pulmonary veins catheter ablation with 85%success rates.

6. Patient with Antero-Lateral MI , with ST elevation went through Cardiac Catheterization

and Primary PCI done , now back to floor, the ecg shows wide complex tachycardia 108,

patient with normal BP ,-IV what will you give the patient, … do nothing- no treatment

required as it is idioventricular rhythm

7. Patient with chest pain having Bradycardia and low bp, pulse 60 BP 90/60 high JVP with st

elevations admitted- which coronary artery is affected,…Proximal Right Coronary artey.

8. YoungPatient with breathlessness and systolic murmur at the left sternal border, which

increases with inspiration , what is the possibility..Pulmonary Stenosis

9. Ascites+ early diastolic murmur + x and y descent ? : constrictive pericarditis ..i guess it

was Superior Vena Cava Syndrome as the face was flushed and on chest auscultation right

heart was clear no addes sounds were there jvp was raised …. I went for SVC syndrome

instead

10. Patient with complete heart block , what will you find… variable 1st heart sound Other

11. cadiovascular risk assment-which are related to the increased cardiovascular risk… answer

is HDL and TG as Dec HDL and inc TGS are independent risk factors for CardioVascularDiseases

12. Old man with A-fib, started on warfarin therapy , is having dm with following

medications-ramipril, furosimide,etc what are you going to add ? ------- Bisoprolol

13. patient with K 7.9 : IV cagluconate or temporary pace maker ?? one of the cardiologist I

discussesd with , says we have to give iv first then go for pacemaker later



14. levels do not increase in heart failure –nor drenaline,endothelin ? Natriuretic Peptide ..

15. post PCI with incrasedEosinophils, Creatinine, ,change in color of the foot …. It was :

Cholestrol embolism

16. patient for long haul flight had a lot of alcohol before flight then had nausea vomitting

Blackout in Plane gained consiousness immediately was being handled by air crew reason -

VASOVAGAL SYNCOPE

Clinical haematology and oncology

17. Young patient with recurrent infections and blood picture showing Howel Jolly

bodies,history of Road Traffic Accident-what is the reason for his blood picture - Asplenism

18. A Patient taking medication for Ischemic Heart Disease including Clopidogrel, ACEI, Bet

Blocker is presented with HUS/ TTP; Which test would be abnormal--- Raised aPTT

19. Irradiated PRBC : ? Patient given irradiated blood .. what is the benefit ... - TO PREVENT

VIRAL INFECTION CMV

20. HIV pt with Red cell Aplasia : CMV or EBV ?? ERYTHRO VIRUS B-19 =pure red cell aplasia in

hiv

21. patient with Renal impairment and neuroSgin : TTP

22. Pokilo cell : mylofibrosis

23. Patient after Gastric Bypass : which is most common deficiency observed in these

patient…..Vitamin B12 Deficiency (most common) followed by Iron etc.

24. Patient with Erythema Nodosum, for investigations?sarcoidosis inves do CXR .. IN THIS

QUESTION PATIENT HAD NO RESP SYMPTOMS , BLOOD TEST COULD HAVE ALSO BEEN OFFERED

as next step in Diagnosis.

25. Patient with Backache, High Creatinine and High Calcium ….what is the most appropriate

investigation for this patient……..serum electrophoresis for myeloma

26. HUS IN adults- female visited a farm and after that had diarrhea with inc creating … so

ecoli-0157

27. Young female with menorrhagia (family history present) - Von willibrand disease

28. Patient with Hemochromatosis is being treated with venesection , how will you monitor



this ….serum ferritin level

29. Polycythemia rubravera - JAK2 mutation

30. splenomegally and bleeds- with gum hypertrophy, ……….AML

31. epistaxis stopped,ITP- predinsolone

32. Female with fatigue and splenomegaly - Myelofibrosis … I guess this is the question in

which there myeloid series cells on peripheral film n myeloblasts..aswell………hmm I went for

CML ..

Clinical Pharmacology, Therapeutics and Toxicology

33. morphine Toxcicity : Dcrease lean body Mass ..i guess.. Decreased Renal Clearance

34. Time of Elemnation of a drug to 1/8 , half life 2 h , Elimination rate 0.4/h : 6 .. right 6

hours

35. Patient started on Bupropion to stop smoking .. what is the contraindication to the use of

this medication…..h/o seizure disorder ( h/o Epilepsy)

36. patient with nasal blockage , SOB :: Asprin

37. Patient on warfarin for afib, started on antituberculosis treatment lately, having the inrdecreasing from 2.5 to 1.3 – which drug might be the reason ….. Rifampicin

38. patient on warfarin and started on metronidazole treatment , now adjusted dose of

warfarin is needed to maintain inr- Reason? …..cyp2c9 gene

39. Mechanism of Action of Allupurinol ….. inhibition of Xanthine oxidase enzyme

40. What’s the mode of action of Calcineurin,Imitanib=Tyrosine Kinase Activity inhibition

41. What is the Mechanism of Action of ..Ciclosporin-IL2 inhibition

42. Patient already taking Ciclosporin post Renal Transplant and stable is diagnosed with

fungal infection and started on Fluconazole .. after 10 days or so the patients creatinine

jumps what is the reason ….Ciclosporin toxicity sec to Fluconazole

43. Patient with Facial Hair growth and Acne, side effects of which drug … Prednisolone…..

other options were cyclosporine etc.



44. What is the site of action of the Thiazide Diuretics .Prox.DistalConvulatedTubles

45. paracetamol overdose with hepatic necrosis ,which is the best test for following the

prognosis of the patient ….. s/ creatinine

46. Patient with cholestatic LFT : amoxaclin …I guess Augmentin is the one causes cholestasis

with Hepatits while Flucloxacillin causes cholestatsis with bile duct injury …

47. metronidazole and lithim given together leads to .. increased lithium toxicity due to …..

dec renal excretion of lithium .

48. Patient is started on Aspirin and dipyridamole post stenting … what is the mechanism of

action of Dypyridamole ………. Phosphodieterase Inhibitor

Clinical sciences

49. Homocystinuria decreased cystathionine B synthase

50. Analysis : IgE or mast cell Trypase .. its Tryptase from 1hr to 5 hr after reaction

51. Patient with backache, with normal urine control having difficulty dorsifexing the the big

toe and sensory loss on the foot …..where is the lesion.. : L5

52. Patient with weakness of ant.thighmuscles,and weak flexion at the hip with absent knee

reflex and having area of sensory loss in lower leg lateral aspect … where is the lesion

….Femoral N

53. amaurosisfugax :: MCA or Carotid .. ..Internal Carotid Artery

54. Patient with pain at the medial epicondyle having difficulty dorsifelxing wrist against

resistance, ..what is the diagnosis… Medial Epiconylitis

55. Patient with congenital Long QT syndrome, scenario, then question asked which of the

ions is reasonable for REPOLARIZATION,of cardiac action potential…….K+ CHANNELS

56. Patient with weak flexion of the triceps muscle of right arm as compared to left with

sensory loss at the base of the right thumb difficulty extending the wrist ….where is thelesion….RADIAL Nerve

57. Down syndrome 47 XY +21 – aneuploidy

58. Patient with Post.dudenal cap ulcer the artery affected? gastrododenual Artery supplies

till mid of 2nd part and its part of anterior gut .. after that duodenum is supplied by

mesenteric Artery …Answer is …….Gastrodudenal artery…….



59. Nurse with Latex allergy 10 years back and now got the same problem wearing rubber

(latex) gloves- What is the mode of this reaction - TYPE IV HYPERSENSITIVITY

60. Nurse with recurrent hand symptoms of allergy eczema&angio-edema =LATEX Allergy

61. Turner syndrome associated - gonadal malignancy

62. Embryonic stem cell for DM management : protect itself from destruction ?? well I guess I

read somewhere that embryonic cells implanted in Type 1 dm (islet cell ) are put in a

membrane to avoid carcinogenic changes in these cells and not to avoid destruction or

apoptosis…or senescence….so I went for other option .. to avoid carcinogenic change.. I don’t

remember the exact wording now .

63. Alkaptanuria...... is it an amino acid metabolic disease or glycogen storage disease or

enzyme defect ...

64. Which of the following stimulate the brain chemoreceptor for respiration……H+ions

65. Patient with difficulty opposing the palms of her hand with inability to close hand and the

ring and little fingers flexed ? …..Dupuytren’s contracture..

66. Patient with Hemochromatosis, high ferritin level …. What is the mode of inheritance of

Hemochromatosis……..Autosomal Recessive

67. How To know NPPC :Compare Gene map? Amsterdamcriteria to screen then do GENETICtesting

68. Patient with dec food intake, now put on NG feeding , how to proceed with diet , the first

day …….50% of the dietery requirements

69. The genetic of DM and sensorineural hearing loss, mother had mild symptoms, sister had

mild

symptoms, but the brother had severe symptoms - Mitochondrial disorder Or X-linked

Dominant …answer ….MITOCHONDRIAL

70. Patient with cardiac arrest and you are resuscitating him , family including parents and

girl friend are present .. who Is going to decide to stop the Resuscitation ? .. Team leader of

Resuscitation team

Dermatology

71. Patient with a few pearly umblicatedpapular lesion on lower abdomen suprapubic area



..what is the diagnosis……MOllascumContagiosum

72. IntraepidermalIgG- phemphigus as its IgG deposition , if it was igA then we should think

Herpitiformis

73. Patient with long history of a pigmented lesion on face(cheeks), having irregular edgesand uneven pigmentation …. elder man with flat lesion >>>LentigoMaligna .. it’s the

carcinoma in situ for Melanoma …..

74. patient with web space lesion itchy rash weeks back was given local steroids and the

lesion expanded further to reach the dorsal aspect of the foot spreading ever since. He was

treated with a high-potency topical steroid cream, .....................answer was TINEA

INCOGNITO ........

75. A young girl with history of paracetamol overdose who had rashes at the flexor surface, in

linear fashion previously had self-medicated - Dermatitis Artifacta

76. Acanthoysis nigrcans in obese ass e >> DM? or GI Malignancy ?ans ..Diabetes M.

77. Woman with Papules in vulva and a Macular rash in the Palms( and soles?)with Genital

Warts ......what is the most appropriate next step for Investigating the Conditions the options

were :HPV pcr/syphilis Serology VDRL = Syphilis Serology (Secondary Syphilis

78. Male from Ghana/Gambia .. comes back with multiple areas of skid depigmentation with

sensory loss , what is the condition…. Tuberculoid Leprosy.

Endocrinology

79. BitemporalHeminopia : Cabergoline or Surgery – as it is non secretory , and causing

pressure sx surgery is the best option

80. A patient asks you about the best indication for the Hormone Replacement Treatment,

…..for Postmenopausal symptoms control

81. pt e HTN DM colon CA and increased sweating ..Dx. .Acromegaly

82. Patient with cough, drowsy, having right upper lobe lesion on cxr , with labs showing

Hyponatremia …115 and urinary Na 65 .. what is going to be the most appropriate

management …..Fluid Restrictionthe first step in SIADH

83. Patient with Recurrent Headaches, high Urinary Cathecholamines =pheochromocytoma:

with family history of Thyroid disease /Nodule … which thyroid Condition can be associated

with it …. Mecullary CA …thinking MEN 2 syndrome



84. Marfan scenario ,eye feature with pesescavatum …. Ectopia lentis

85. 19y Female with facial hair,acne obese( had all features of pcos) but lab results for

premature ovarian failure but clinically not ???premature mature ovarian failure or PCOS ?

86. Patient on long term Hemodialysis having vit D and Calcium with the labs showing high

serum calcium, high phosphates, high PTH .. what is the reason for this ……..Tertiary

Hyperparathyroidism

87. Hormone which leads to increased hunger …. Ghrelin

88. Patient with lid lag, thyroid nodule .. treatment with which modality will worsen the

thyroid eye disease - RADIOIODINE

89. Patient with type T1DM received blood transfusion.. the optimal time for measure of

HA1c? 6 months

90. Male with Gynaecomastia, Low testosterone and raised FSH and LH –Klinefelter

91. 16 Y OLD BOY with less height than his class fellows, with lack of secondary sex

characteristics and small testes ..( volume around 4 ml or less), while others in the class had

pubic hair , facial hair , labs were fine and no other abnormality observed.. what is the cause

of his delayed puberty......simple constitutional delayed puberty, kallman, keinfleiter etc...

and the answer was Simple Constitutional Delayed puberty..

Geriatric medicine

92. Elder female e UTI ,, allergic to pen : TMP/SMX .. I think the empirical treatment is either

TMP/SMX or nitrofurantoin

93. Elderly man, had microscopic hematuria, kidneys were normal- flexible cystoscopy Or CT

abdomen ?? well the NEXT step would have been to do an Xray KUB to rule out stone first then

to refer to a urologist… this is what I think .. though it comes under a category of urgent

referral to a urologist

94. Old aged woman in garden-goes and gets heat exhaustion… what age related change hasmade her more prone to this condition………………dec.Sweating

95. A study done shows that the Pulse pressure tends to increase with increasing age.. what

do u think is the reason for that …...reduce aortic compliance

Gastroenterology



96. Lipaemic serum pancreatitis - Chylomicrons

97. Patient with diarrhea blood stained , having itching … labs showing increased bilirubin and

alkaline phosphatase while ALT is within normal range and USG abdomen is normal as well ..

what is the most probable cause-Primary Sclerosing cholangitis.

98. lady for 3 weeks hx of abdo pain and loos stools plain xray normal, with Ulcerative colitis,

patient doesn’t improve in 3 days… what should u do next......X-Ray abdomen ( to rule out

Toxic Megacolon)

99. Dumping syndrome 8 yr post Gastric surgery , having symptoms just after eating with

nausea, vomiting, flushing etc .. what to do ??…. It is Dietary Advise ..

100. Patient present e only high bilirubin , other LFTs fine Gilberts Syndrome

101. Patient with history of pyloric ulcer had an operation done 8 years back with suction

splash positive having vomiting and nausea .. what metabolic abnormality will he

develop……Hypokalamic Alkalosis

102. Patient on long term Peritoneal Dialysis … comes with abdominal pain, ascites .. the

Ascitic tap done… what will help u with diagnosis of peritonitis: High Neutrophils in Fluid

103. Patient presents with dysphaia of food and drinks both ,Dx..: Achalasia

104. Patient presents with jaundice.. serology given shows IgM for hepatitis A, IgGHep B, and

anti-HBC..whats the Dx…… Hepatitis A

105. Female with itching and right abdominal pain , with sister having the same disease and

mother also affected, no history of hepatitis, drug use … her s/anti mitochondrial antibody is

positive .. what is the diagnosis … Primary Biliary Cirrhosis

106. Patient with malignancy not responding to morphine ,liver capsule pain in metastatic

malignancy- steroid dexamethasone

107. Nutrition for Patient with acute abdominal pain (severe pancreatitis due to gall stone) –

NPO

108. Patient with suspected longstanding Chrons Disease having stricture in the small

intestine with capsule endoscopy and later diagnose as Malignant Stricture.. what is the most

common pathology …. LYMPHOMA

109. Diagnosis of Giardia if not seen in stool -wet stool sample or Microscpe with Duodenal

Aspirate ??if stool culture not positive multiple times=RadioImmuoassay(CDC)



110. A girl with negative anti-TTG but presented with coeliac symptoms- Gastroscope with

duodenal Biopsy ?

111. gall stones in hereditary sickle cell disease=pigment stones

112. carcinod syndrome intial symptom: facial flushing

113. Female Patient with Chron’s disease smoker, with stable disease.. which association is

going to be most predictive of disease….Cigarette Smoking= 60%

Infectious diseases and GUM

114. A School Teacher is diagnoses with Pneumococcal Meningitis , there is no one else

affected in the school what should we do for the contacts at school….isolate & observe till

one week

115. Patient with history of travel to spain had sex with two , come to you with dry cough ,

having on blood dechemoglobin,normalwbc, peripheral blood pic of agglutination,

……Mycoplasma

116. Patient diagnosed with NisseriaMeningitidis Meningitis , what prophylaxis should be given

to the household contacts….Ciprofloxacin

117. Child bit by a cat-it gets swollen and wond on hand get worse-what is the most probalble

organism = BartonellaHenslae

118. African tick bite- ricketsia coronii

119. Strongyloidsstercoralis…- wearing foot wear and avoid bare foot as it enters the skin

120. Epilepsy and malaria prophylaxis- mefloquine , Malarone

121. gonorrhea ttt UTI : ceftriaxone .. as treatment for chalymydia was already given n

culture showed gm negative diplococci

122. Tonsils weren't coated but had exudates ??? :: diphtheria

123. Patient with Lyme Disease with multiple eschar/ erythema sites 2nd day of treatment

with anaphylaxsis and body reaction - EXPOSURE and INTERACTION WITH DEAD PATHOGENS ?

(JerishHerxheimer reaction)

124. Patient with tuberculosis for diagnosis , what is the most sensitive Pleural test for

Tuberculosis…… Pleural Fluid LDH, Pleural Biopsy and culture, Sputum Culture, Pleural



aspirate culture, Bronchial lavage culture ..??? I don’t know the answer ??

125. Patient who is neutropenic on the floor .. with decwbc and dec neutrophil count ….

Antibiotics against which organism would be your first priority…… MRSA, Pseudomonas

Aurogenosa,PCPetc ??

126. The hospital experiences multiple cases of MRSA , you are in hospital policy making

committee... what is the best way to decrease the MRSA hospital infection... ...........answer

was HAND WASHING

Neurology

127. A typical hx of tuberous sclerosisa 22yr old girl, 4 yrhx of HTN , on Amlodipine,came for

r/v gives a family hx of Nephrectomy to her father following a cystic disease of kidney.O/e-

nodules round nose , macular patches on trunk Diagnosis?.(TUBEROUSSCLEROSIS) Adult

Polycystic kidney/Von HippelLindau dis

128. Poor Sign of Alzheimer : Poor Identification of Time ? POOR ORIENTATION OF TIME

129. Highest risk for Alzheimer : Family HX ?? Increasing age is the greatest known risk factor

for Alzheimer's

130. Poor Prognosis after stroke : visual spatial neglect ?? Dysphagia I guess , as neglect

responds very nicely to the Neurorehablitation..

131. Occipital Headache : Bailar Migraine(symptoms of vertebrobasilar insufficiency, which

may precede the headache=Basilar Migrane.)

132. Patient with vision defects lately having accidents .. is having right inferior quadrantopia

and unable to calculate….where is the lesion.. Left Parital Lobe

133. Patient diagnosed with GB syndrome, how will you monitor his respiratory function

….FVC (Forced Vital Capacity)

134. Patient with Occipital Headache, neck stiffness , 2 weeks with Bilateral 6th nerve Palsy

andpapilledemaand CT scan is normal.. what is the diagnosis.. BIH

135. Pain on walking relieved on sitting - Spinal stenosis

136. Korsakoff syndrome - Short term memory loss

137. Patient with ataxia and nystagmus - Posterior inferior cerebellar artery

138. Tonic clonicseziure , Alcholic and blood sugar 3.1 >>> idiopathic epilpsy or alcohol



152. A pt with multiple sclerosis , on Baclofen, developed urinary incontinence. Post voided

volume 20ml. Rx.1. Intra vesicalBotulinum toxin. 2.suprapubic catheter.3.tolterodine

Bio Statistics and Epidemiology

153. why we randomise people on study : ??

154. what is the chance that the Test will be post ice :: Positive predictive value it was some

thinglke 380/405 I guess..

155. Chiquard study

156. A study has alot of confounding factors....??? analysis of confouctor ---as much as I could

get from internet search it comes to …….. Spearman Rank correlation

157. question for Drug trial in which two groups were studies one placebo , and the value was

nominal .. and we had to choose the test to compare before and after the treatment ……I

rembere answer was UNPAIRED T test ..

Ophthalmology

158. Patient with Transit loss of Vision , Carotied 50% what to do?? : Aspirin (endarterectomy

from70-99%)

159. Patient with decreased vision in one eye with swollen disc on retinoscopy central

scotoma … where is the lesion….OPTIC nerve

160. Ehler Danlos e angioid present e sudden visual loss the cause---well the Choroidal

Neovascularization may lead to retinal haemmorhage in macula and loss of vision ..i don’t

remember the option

161. cotton wool spots and haemorrhage – and vision loss……… .the most common cause would

be retinal vein thrombosis …. .( please confirm that)

Psychiatry

162. Patient Detached from self : Depersonalization disorder

163. Hypochondrosis

164. post natal low mode with tearing—PATIENT HAD DEPRESSIVE SYMPTOMS ,with tendency

to cry and low mood so I guess post natal depression was a better choice .. ??



165. A young male since child hood had grunting, abnormal movement and occationally falls-

Tourrete syndrome

166. Post op patient known parkinson disease old pt wit psychosos: Patient of parkinsonism

presented with Delirium .. what to give .. well haloperidol cant be given as it increases the

extrapyramidal symptoms so have to select from one of the benzodiazepines.. Lorazepam .. iselected this as it is long acting ..other benzodiazepine was short acting

167. Patient talking on its own and replying " no ididnt do that" , while u never asked such a

question ... what is she experiencing ...................auditory hallucinations

168. Patient with chronic alcohol use presents to the ER with tachycardia agitation , abnormal

behavior and Dilated Pupils…What overdose has he taken …. Ecstacy

169. Female patient wth history of multiple suicidal attempts and harsh physical relationship,

low mood and hearing voices off n on ,history of self harm …… Diagnosis…Borderline

personality disorder(other options were , bipolar disorder, .paranoid schizophrenia, )

Respiratory medicine

170. PCP finding :: Normal CXR or Crakles all over the chest ? normal auscultation

171. After internal Jugluar line : Heaomothorax… I guess it was Pneumothorax as the lung was

collapsed and it’s a know complication of central lines

172. Patient with difficulty breathing, having dec FEV1, FVC and dec TLCO ,dec DLCO what is

the most probable diagnosis….. Pulmonary Fibrosis

173. Female pregnant already taking salbutamol, inhaled steroid 400mcg/day, and recently

added long acting Beta stimulants,still wakes up at night twice a week and has sob-what will

u do next= Increase the dose of Inhaled Steroid 800(beclomethasone)

174. Male Welder who gets sick at work having fever, body aches, running nose, difficulty

breathing immediately but stays well off it .Monday morning SOB FEV!/FVC 71% = Metal Fume

Fever

175. COPD patient with reduced Sats 86% on Room air having tachypnea needs to be givenoxygen what is the best mode to deliver the oxygen …..Venturi Mask - Venturi mask ?

176. RA on methotrexate- Bronchiolitis obliterans Or MethotraxateToxicitiy Or Pulmonary

vasculitits ?

177. Obese man with BMI of 41, feeling sleepy all day long having high score on epworth

sleepless ness scale 18 and having apnic episodes 4/hr ( normal less than 5)… what is the most



important intervention .. Weight reduction

178. Pneumothorax risk : smoking there are two things which a patient shouldn’t do.. after

pneumothorax correction as per bts guidelines… Smoking .. then to avoid scuba diving and

other is Contact sportsfor 6 weeks.

179. Abbreviated mental test score (AMTS) 7/10- Patient with confusion, having hr of 28, bp

of 110/70?, tachypnea, which is the most important prognostic sign =Confusion

180. -Patient with respiratory distress, having high PCO2 and hypoxia ,drowsy , copd

exacerbation , what is the best way to give oxygen ….. Non Invasive PPV

181. Patient with Cystic Fibrosis ,comes to you for vitamin suppliments what will is the most

important vitamin you will prescribe .. Vitamin A

182. Patient with history of childhood pneumonia,recurrent infections , having daily

productive cough with auscultatorycrepts at base……Bronchiectasis

183. Patient with recurrent DVT , with resp distress and leg swollen ..PE e DVT what is the

best investigation : CTPA … CT pul Angiography

Rheumatology

184. Patient with new onset prox muscle weakness , with a rash on the backside of hand and

proxinterphalangeal joints.. Dermatomyositis.

185. Female with marginally raised cpk, incesr, with macroglobulin in serum, tired, unable to

stand from chair, no muscle weakness, .. Polymyalgia Rheumatica-PMR

186. Young adult 29y , having back pain and gets better after he walks in morning , improves

with his exercise….Ankylosing Spondylitis

187. Primary biliary cirhosis>>>antimitochondirial

188. Patient with right hand small joint involment and left hand middle finger dactylitis,and

having metatarsophlangeal joint involvement …… Psoriatic Arthritis

189. Old woman with Left wrist swelling- Pseudogout OR Ostomylitits ? people voted for

OsteoNecrosis mostly

190. Patient withHerbendenNodes and bouchards node + dip pain –with normal labs ….

Osteoarthritis



191. 45 years old with large joint involvement- RA ?

192. Male with no history of STD but having arthralgias and gastroenteritis 2-3 weeks-which

organism can be involved-Reactive Arthritis= CompylobacterJejuni

193. Patient with SLE is having ANA positive but forgot to order the Immunoglobin class .which class does ANA belong to…. IgG

194. RA eye manifestation-episcleritis

195. Pt. e HTN ,raynad , SOB and cough >>> systemic sclrosi s

196. A young pt with recurrent DVT with family history of thromboembolism , with

antiphospholipd antibodies positive .. which is the common cause for thrombophelia in this

patient ..protein C Def/antithrombin Def./factor V Leiden mutation /polycythemia/protein S

def-----answer=Factor V leiden Mutation

mrcp recalls may 2014

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