Mrcp part 1 QUESTIONS WITH
COMPLETE SOLUTIONS PASSED
Conns syndrome clinical features - ANS ✔✔Hypertension (aldosterone induced na retention
with increase in ecf volume)
-muscle weakness (due to decreased K)
-muscle paralysis (severe hypokalaemia)
-latent tetany and paraesthesia
-polydypsia, polyuria and nocturia (due to hypokalaemia nephropathy)
Hypokalaemia WITH hypertension - ANS ✔✔Cushings syndrome
Conns syndrome (primary hyperaldostenoism)
Liddles syndrome
11 beta hydroxyl see deficiency
Carbbenoxolone an anti ulcer drug and liquorice excess can potentially cause hypokalaemia
associated hypertension
Hypokalaemia without hypertension - ANS ✔✔Diuretics
GI loss (d and v)
Renal tubular acidosis (type 1 and 2)
Bartters syndrome
Gitelman syndrome
Svt mx - ANS ✔✔Vagal manoeuvres
Iv adenosine 6, 12, 12
, Electrical cardioversion
Prevention of episodes-: beta blockers, radio frequency ablation
Clopidogrel mechanism and interactions - ANS ✔✔Mechanism: antagonist of the p2y12
adenosine diphosphate (adp receptor) inhibiting the activation of platelets
Interactions:concurrent use of PPis may make clopi less effective. However omeprazole no
problem, lansaproxal should be OK
tumour marker for testicular seminoma - ANS ✔✔hCG
Testicular cancer - ANS ✔✔95% germ cell tumours (seminoma, non seminoma-teratoma,
embryonal, yolk sak)
Non germ xerm include leydig cell tumours and sarcoma.
Rfs: infertility, cryptochidism, family hx, klinfelters, mumps orchits
Features testicular cancer - ANS ✔✔Painless lump, some get pain,!hydrocele, gynaecomastia,
AFP elevated in 60% germ cell, LDH elevated in 40% in germ cell, seminoma-hcg elevated in 20%
Cause of loud s2 heart sound in copd - ANS ✔✔Pulmonary hypertension. In patient with bad
copd likely cor pulmonale. This is due to increased vascular resistance in the Pulmonary vessels
which results in right sided heart failure
Heart sound S2( second heart sound) - ANS ✔✔Closure of the aortic valve (A2) closely followed
by that of pulmonary valve (p2)
L s2: hypertension: systemic (loud A2) or pulmonary (loud P2); hyper dynamic states; atrial
septal defect withoutnpulmonary hypertension.
Soft S2: aortic stenosis
Fixed split S2: atrial septal defect
COMPLETE SOLUTIONS PASSED
Conns syndrome clinical features - ANS ✔✔Hypertension (aldosterone induced na retention
with increase in ecf volume)
-muscle weakness (due to decreased K)
-muscle paralysis (severe hypokalaemia)
-latent tetany and paraesthesia
-polydypsia, polyuria and nocturia (due to hypokalaemia nephropathy)
Hypokalaemia WITH hypertension - ANS ✔✔Cushings syndrome
Conns syndrome (primary hyperaldostenoism)
Liddles syndrome
11 beta hydroxyl see deficiency
Carbbenoxolone an anti ulcer drug and liquorice excess can potentially cause hypokalaemia
associated hypertension
Hypokalaemia without hypertension - ANS ✔✔Diuretics
GI loss (d and v)
Renal tubular acidosis (type 1 and 2)
Bartters syndrome
Gitelman syndrome
Svt mx - ANS ✔✔Vagal manoeuvres
Iv adenosine 6, 12, 12
, Electrical cardioversion
Prevention of episodes-: beta blockers, radio frequency ablation
Clopidogrel mechanism and interactions - ANS ✔✔Mechanism: antagonist of the p2y12
adenosine diphosphate (adp receptor) inhibiting the activation of platelets
Interactions:concurrent use of PPis may make clopi less effective. However omeprazole no
problem, lansaproxal should be OK
tumour marker for testicular seminoma - ANS ✔✔hCG
Testicular cancer - ANS ✔✔95% germ cell tumours (seminoma, non seminoma-teratoma,
embryonal, yolk sak)
Non germ xerm include leydig cell tumours and sarcoma.
Rfs: infertility, cryptochidism, family hx, klinfelters, mumps orchits
Features testicular cancer - ANS ✔✔Painless lump, some get pain,!hydrocele, gynaecomastia,
AFP elevated in 60% germ cell, LDH elevated in 40% in germ cell, seminoma-hcg elevated in 20%
Cause of loud s2 heart sound in copd - ANS ✔✔Pulmonary hypertension. In patient with bad
copd likely cor pulmonale. This is due to increased vascular resistance in the Pulmonary vessels
which results in right sided heart failure
Heart sound S2( second heart sound) - ANS ✔✔Closure of the aortic valve (A2) closely followed
by that of pulmonary valve (p2)
L s2: hypertension: systemic (loud A2) or pulmonary (loud P2); hyper dynamic states; atrial
septal defect withoutnpulmonary hypertension.
Soft S2: aortic stenosis
Fixed split S2: atrial septal defect
