MRCP PART 1 PRACTICE EXAMINATION 2026–2027 —
STUDY GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS | ALREADY GRADED A+
This original practice examination is designed for physicians preparing
for the MRCP(UK) Part 1 examination and for medical professionals
seeking to strengthen their knowledge of clinical medicine and applied
basic sciences. The 100-question test evaluates mastery of cardiology,
respiratory medicine, gastroenterology, neurology, endocrinology,
nephrology, hematology, infectious diseases, rheumatology, and clinical
pharmacology. Questions are written in MRCP single-best-answer
format at the application and analysis level to mirror the cognitive
complexity of the MRCP Part 1 written examination. The 2026–2027
edition incorporates current UK guidelines, NICE recommendations, and
evidence-based clinical practice. Use this comprehensive review to
assess readiness, identify knowledge gaps, and strengthen your clinical
reasoning for the MRCP Part 1. This is an independent educational
resource, not affiliated with or endorsed by the Royal Colleges of
Physicians.
Table of Contents
I. Cardiology and Vascular Medicine
II. Respiratory Medicine
III. Gastroenterology and Hepatology
IV. Neurology and Stroke Medicine
V. Endocrinology and Metabolic Medicine
VI. Nephrology and Electrolytes
,VII. Hematology and Oncology
VIII. Infectious Diseases and HIV
IX. Rheumatology and Immunology
X. Clinical Pharmacology and Toxicology
1. A 55-year-old man presents with chest pain radiating to the left
arm. ECG shows ST elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A) Left anterior descending
B) Left circumflex
C) Right coronary artery
D) Left main stem
Correct Answer: C
ST elevation in leads II, III, and aVF indicates an inferior wall myocardial
infarction, most commonly due to occlusion of the right coronary artery.
The left anterior descending causes anterior changes in V1–V4, the
circumflex causes lateral changes in I, aVL, V5–V6, and the left main
causes widespread ST depression with ST elevation in aVR.
2. A 68-year-old man with heart failure is started on ramipril. Which
electrolyte disturbance is most likely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypomagnesemia
Correct Answer: B
ACE inhibitors such as ramipril reduce aldosterone secretion, leading to
potassium retention and hyperkalemia. Hypokalemia is more common
,with loop/thiazide diuretics. Hyponatremia and hypomagnesemia are
less typical with ACE inhibitor monotherapy.
3. A 45-year-old woman presents with palpitations and shortness of
breath. ECG shows absent P waves and an irregularly irregular
rhythm. What is the diagnosis?
A) Atrial flutter
B) Atrial fibrillation
C) Ventricular tachycardia
D) Supraventricular tachycardia
Correct Answer: B
Atrial fibrillation is characterized by absent P waves and an irregularly
irregular ventricular rhythm. Atrial flutter has saw-tooth flutter waves
and often a regular rhythm. Ventricular tachycardia has broad QRS
complexes. SVT typically has a regular narrow-complex tachycardia with
P waves buried or visible.
4. A 60-year-old man with hypertension is prescribed amlodipine.
Which adverse effect is most common?
A) Bradycardia
B) Peripheral edema
C) Dry cough
D) Constipation
Correct Answer: B
Amlodipine, a dihydropyridine calcium channel blocker, commonly
causes peripheral edema due to vasodilation. Bradycardia and
constipation are more typical of non-dihydropyridines (verapamil,
diltiazem). Dry cough is an ACE inhibitor effect.
, 5. A patient with a pulmonary embolism is hemodynamically
unstable. What is the definitive treatment?
A) Warfarin alone
B) Low molecular weight heparin alone
C) Thrombolysis
D) Aspirin only
Correct Answer: C
Hemodynamically unstable pulmonary embolism requires thrombolysis
(e.g., alteplase) unless contraindicated. Anticoagulation with heparin or
warfarin is for stable PE. Aspirin is not the treatment for PE.
6. A 70-year-old woman with atrial fibrillation is started on warfarin.
Which dietary advice is most important?
A) Avoid all green vegetables
B) Maintain a consistent intake of vitamin K-rich foods
C) Increase green leafy vegetables
D) Take vitamin K supplements
Correct Answer: B
Warfarin efficacy is affected by vitamin K intake. Consistent vitamin K
consumption is essential to maintain a stable INR. Avoiding all vitamin K
is unnecessary and impractical. Increasing or supplementing vitamin K
can reduce anticoagulation effect.
7. A 50-year-old man with a history of myocardial infarction is
prescribed atorvastatin. Which adverse effect requires urgent
medical attention?
A) Mild headache
B) Muscle pain with dark urine
STUDY GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS | EXAM
REVIEW | 100% CORRECT ANSWERS | VERIFIED
SOLUTIONS | ALREADY GRADED A+
This original practice examination is designed for physicians preparing
for the MRCP(UK) Part 1 examination and for medical professionals
seeking to strengthen their knowledge of clinical medicine and applied
basic sciences. The 100-question test evaluates mastery of cardiology,
respiratory medicine, gastroenterology, neurology, endocrinology,
nephrology, hematology, infectious diseases, rheumatology, and clinical
pharmacology. Questions are written in MRCP single-best-answer
format at the application and analysis level to mirror the cognitive
complexity of the MRCP Part 1 written examination. The 2026–2027
edition incorporates current UK guidelines, NICE recommendations, and
evidence-based clinical practice. Use this comprehensive review to
assess readiness, identify knowledge gaps, and strengthen your clinical
reasoning for the MRCP Part 1. This is an independent educational
resource, not affiliated with or endorsed by the Royal Colleges of
Physicians.
Table of Contents
I. Cardiology and Vascular Medicine
II. Respiratory Medicine
III. Gastroenterology and Hepatology
IV. Neurology and Stroke Medicine
V. Endocrinology and Metabolic Medicine
VI. Nephrology and Electrolytes
,VII. Hematology and Oncology
VIII. Infectious Diseases and HIV
IX. Rheumatology and Immunology
X. Clinical Pharmacology and Toxicology
1. A 55-year-old man presents with chest pain radiating to the left
arm. ECG shows ST elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A) Left anterior descending
B) Left circumflex
C) Right coronary artery
D) Left main stem
Correct Answer: C
ST elevation in leads II, III, and aVF indicates an inferior wall myocardial
infarction, most commonly due to occlusion of the right coronary artery.
The left anterior descending causes anterior changes in V1–V4, the
circumflex causes lateral changes in I, aVL, V5–V6, and the left main
causes widespread ST depression with ST elevation in aVR.
2. A 68-year-old man with heart failure is started on ramipril. Which
electrolyte disturbance is most likely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypomagnesemia
Correct Answer: B
ACE inhibitors such as ramipril reduce aldosterone secretion, leading to
potassium retention and hyperkalemia. Hypokalemia is more common
,with loop/thiazide diuretics. Hyponatremia and hypomagnesemia are
less typical with ACE inhibitor monotherapy.
3. A 45-year-old woman presents with palpitations and shortness of
breath. ECG shows absent P waves and an irregularly irregular
rhythm. What is the diagnosis?
A) Atrial flutter
B) Atrial fibrillation
C) Ventricular tachycardia
D) Supraventricular tachycardia
Correct Answer: B
Atrial fibrillation is characterized by absent P waves and an irregularly
irregular ventricular rhythm. Atrial flutter has saw-tooth flutter waves
and often a regular rhythm. Ventricular tachycardia has broad QRS
complexes. SVT typically has a regular narrow-complex tachycardia with
P waves buried or visible.
4. A 60-year-old man with hypertension is prescribed amlodipine.
Which adverse effect is most common?
A) Bradycardia
B) Peripheral edema
C) Dry cough
D) Constipation
Correct Answer: B
Amlodipine, a dihydropyridine calcium channel blocker, commonly
causes peripheral edema due to vasodilation. Bradycardia and
constipation are more typical of non-dihydropyridines (verapamil,
diltiazem). Dry cough is an ACE inhibitor effect.
, 5. A patient with a pulmonary embolism is hemodynamically
unstable. What is the definitive treatment?
A) Warfarin alone
B) Low molecular weight heparin alone
C) Thrombolysis
D) Aspirin only
Correct Answer: C
Hemodynamically unstable pulmonary embolism requires thrombolysis
(e.g., alteplase) unless contraindicated. Anticoagulation with heparin or
warfarin is for stable PE. Aspirin is not the treatment for PE.
6. A 70-year-old woman with atrial fibrillation is started on warfarin.
Which dietary advice is most important?
A) Avoid all green vegetables
B) Maintain a consistent intake of vitamin K-rich foods
C) Increase green leafy vegetables
D) Take vitamin K supplements
Correct Answer: B
Warfarin efficacy is affected by vitamin K intake. Consistent vitamin K
consumption is essential to maintain a stable INR. Avoiding all vitamin K
is unnecessary and impractical. Increasing or supplementing vitamin K
can reduce anticoagulation effect.
7. A 50-year-old man with a history of myocardial infarction is
prescribed atorvastatin. Which adverse effect requires urgent
medical attention?
A) Mild headache
B) Muscle pain with dark urine
