dr_amh10
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Tips: Top 50 MRCP
High Yield Facts
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07.24.05 (3 years ago)
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Top 50 MRCP
FACTS:: 
1. Acromegaly Diagnosis: OGTT followed by GH conc.
2. Cushings Diagnosis: 24hr urinary free cortisol. Addisons --> short synacthen
3. Rash on buttocks; Dermatitis herpetiformis (coeliac dx)
4. AF with TIA --> Warfarin
5. Herpes encephalitis --> temporal lobe calicification
6. Obese woman, papilloedema/headache --> Benign Intercanial Hypertention
7. Drug induced pneumonitis --> methotrexate or amiodarone
8. chest discomfort and dysphagia --> achalasia
9. foreign travel, macpap rash/flu like illnes --> HIV acute
10. cause of gout --> dec urinary excretion
11. [bleep] on hands and fragule skin torn by minor trauma --> porphyria cutanea tarda
12. Splenectomy --> need pneumococcal vaccine 2 weeks pre-op and for life
13. primary hrperparathyroidism --> high Ca, normal/low PO4, normal/high PTH (in elderly)
14. middle aged man with KNEE arthritis --> gonococcal sepsis (older people -> Staph)
15. sarcoidosis, erythema nodosum, arthropathy --> Loffgrens syndrome benign, no Rx needed
16. tremor postural,slow progression,titubation, relieved by OH->benign essential tremor AutD
17. electrolytes disturbance causing confusion – low/high Na
18. contraindications lung surgery --> FEV <1.5, MALIGNANT effusion, mets outside lung
19. prevent further renal deterioration/proteinuria--> dec bp 130/90, Ace inhibitors
20. headache with many analgesics at once -> analgesic induced headache
21. 1.5 cm difference btwn kidneys -> Renal artery stenosis --> Magnetic resonance angiogram
22. temporal tenderness--> temporal arteritis -> steroids > 90% ischaemic neuropathy, 10% retinal art occlusion
23. severe retroorbital, daily headache, lacrimation --> cluster headache
24. pemigus – involves mouth (mucus membranes), pemphigoid – less serious NOT mucosa
25. diagnosis of polyuria -> water deprivation test, then DDAVP
26. insulinoma -> 24 hr supervised fasting hypoglycaemia
27. Diabetes Random >7 or if >6 OGTT -> >11.1 also seen in HCT
28. causes of villousd atrophy: coeliac, Whipples, dec Ig, lymphoma, trop sprue (rx tetracycline)
29. diarrhoea, bronchospasm, flushing, tricuspid stenosis -> gut carcinoid c liver mets
30. hepatitis B with general deterioration -> hepaocellular carcinoma
31. albumin normal, total protein high -> myeloma (hypercalcaemia, electrophoresis)
32. HBSag positive, HB DNA not detectable --> chornic carier
33. Inf MI, artery invlived -> Right coronary artert
34. Aut dom conditions: Achondroplasia, Ehler Danlos, FAP, familial hyperchol,Gilbert, Huntington's, Marfans's, NFT I/II, Most porphyrias, tuberous sclerosis, vWD, PeutzJeghers
35. X linked: Beck/Duch musc dyst, alports, Fragile X, G6PD, Haemophilia A/B
36. Loud S1: MS, hyperdynamic, short PR. Soft S1: immobile MS, MR
37. Loud S2: hypertension, AS. Fixed split: ASD. Opening snap: MOBILE MS, severe near S2
38. HOCM/MVP - inc by standing, dec by squating (inc all others). HOCM inc by valsalva, decs all others. Sudden death athlete, FH, Rx. Amiodarone, ICD
39. MVP sudden worsening post MI. Harsh systolic murmur radites to axilla.
40. Dilated Cardiomyopathy: OH, bp, thiamine/selenium deficiency, MD, cocksackie/HIV, preg, doxorubicin, infiltration (HCT, sarcoid), tachycardia
41 Restrictive Cardiomyopathy: sclerodermma, amyloid, sarcoid, HCT, glycogen storage, Gauchers, fibrosis, hypereosinophilia Lofflers, caracinoid, malignancy, radiotherapy, toxins
42. Tumor compressing Respiratory tract --> investigation: flow volume loop
43. Guillan Barre syndrome: check VITAL CAPACITY
Horners – sweating lost in upper face only – lesion proximal to common carotid artery
Internuclear opthalmoplegia: medial longitudinal fasciculus connects CN nucleus 3-4. TRIES TO YANK THE ipsilateral BAD EYE ACROSS THE NOSE. Convergence is normal. Causes: MS, SLE, Miller fisher, overdose(barb, phenytoin, TCA), Wernicke
46.Progressive Supranuclear palsy: Steel Richardson. Absent voluntary downward gaze, normal dolls eye. i.e. Occulomotor nuclei intact, supranuclear Pathology
47 Perinauds syndrome: dorsal midbrain syndrome, damaged midrain and superior colliculus: impaired upgaze (cf PSNP), lid retraction, convergence preserved. Causes: pineal tumor, stroke, hydrocephalus, MS.
48. demetia, gait abnormaily, urinary incontinence. Absent papilloedema-->Normal pressure hydrocephalus.
49. acute red eye -> acute closed angle glaucoma >> less common (ant uveitis, scleritis, episcleritis, subconjuntival haemmorrhage)
50. wheeles, urticaria, drug induced -> aspirin
51. sweats and weight gain -> insulinoma
52. diagnostic test for asthma -> morning dip in PEFR >20%
53. causes of SIADH: Lithium, chlorpropamide, carbamepine
54. bisphosphonates:inhibit osteoclast activity, prevent steroid incduced osteoperosis (vit Dalso)
55. returned from airline flight, TIA-> paradoxical embolus do TOE
55. alcoholic, given glucose develops nystagmus -> B1 deficiency (wernickes). Confabulation->korsakoff
56. mono-artropathy with thiazide -> gout (neg birefringence). NO ALLOPURINOL for acute
High Yield Topics
1. Anorexia Nervosa
2. Reiters Syndrome – arthritis, uveitis, urethritis – Chlymidia, campylobacter, Yersinia, Salmonella, Shigella. Balanisits.
3. PKD – aut dom Chr 16/4 assoc berry aneurysm, mitral/aortic regurg
4. Porphyria – photosensitivity, blisters, scars with millia, hypertrichosis
5. Heart sounds: Aortic Stenosis s2 paradoxical split, length proportional to severity
6. Vitiligo – commonest assoctions pernicious anaemia >>> type 1 DM
, autoimmune addisons, autoimmune thyoid dx
ALMOST Pathognomic for the exam
1.fatiguability -> myasthrnia gravis
2.fasciculations -> Motor neurone diease
3.silvery white scale -> psoriasis
4.hypopigmented -> vitiligo/pityriasis versicolor
Author of this list: Dr Sujit Vasanth, RxPG Nick: sujitvasanth
Edited By: RxPG Team
Edit Reason: List attributed to author
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