MRCP Part 1 Mock Examination Latest
2026-2027 Update 100 Professionally
Written Practice Questions • Detailed
Answer Explanations • Scenario-Based
Questions • Covers All Major Exam
Objectives • Ideal For Self-Study And
Final Review
1. A 68-year-old man presents with sudden onset central chest pain radiating
to the left arm. ECG demonstrates ST elevation in leads II, III and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Diagonal artery
Answer: C. Right coronary artery
Inferior ST-elevation myocardial infarction most commonly results from right
coronary artery occlusion. Leads II, III and aVF represent the inferior wall.
2. A patient with chronic kidney disease develops hyperkalaemia. Which ECG
change usually appears first?
A. Wide QRS complexes
,B. Peaked T waves
C. Prolonged QT interval
D. Complete heart block
Answer: B. Peaked T waves
The earliest ECG manifestation of hyperkalaemia is tall, peaked T waves. As
potassium rises further, PR prolongation and QRS widening develop.
3. Which organism is the commonest cause of community-acquired
pneumonia in adults?
A. Mycoplasma pneumoniae
B. Klebsiella pneumoniae
C. Streptococcus pneumoniae
D. Staphylococcus aureus
Answer: C. Streptococcus pneumoniae
The leading cause of community-acquired pneumonia worldwide remains
Streptococcus pneumoniae.
4. A patient has microcytic anaemia with low ferritin. What is the most likely
diagnosis?
A. Anaemia of chronic disease
B. Iron deficiency anaemia
C. Thalassaemia trait
D. Sideroblastic anaemia
Answer: B. Iron deficiency anaemia
Low serum ferritin is highly specific for iron deficiency unless inflammation is
present.
5. Which valve is most commonly affected in infective endocarditis?
,A. Pulmonary valve
B. Tricuspid valve
C. Mitral valve
D. Aortic valve
Answer: C. Mitral valve
The mitral valve is the commonest site overall, although the tricuspid valve
predominates in intravenous drug users.
6. A patient with COPD develops worsening breathlessness and drowsiness.
Which investigation should be performed urgently?
A. Peak expiratory flow
B. Chest X-ray
C. Arterial blood gas
D. Spirometry
Answer: C. Arterial blood gas
An arterial blood gas rapidly identifies hypercapnic respiratory failure requiring
urgent management.
7. Which electrolyte abnormality is classically associated with Addison
disease?
A. Hypernatraemia
B. Hypokalaemia
C. Hyperkalaemia
D. Hypercalcaemia
Answer: C. Hyperkalaemia
Primary adrenal insufficiency causes hyperkalaemia and hyponatraemia due to
aldosterone deficiency.
, 8. A fasting plasma glucose of 8.2 mmol/L confirms which diagnosis?
A. Prediabetes
B. Diabetes mellitus
C. Reactive hypoglycaemia
D. Normal glucose tolerance
Answer: B. Diabetes mellitus
A fasting glucose of 7.0 mmol/L or higher on appropriate testing is diagnostic of
diabetes.
9. Which investigation best confirms pulmonary embolism in a
haemodynamically stable patient?
A. Chest X-ray
B. CT pulmonary angiography
C. Echocardiography
D. D-dimer
Answer: B. CT pulmonary angiography
CTPA is the gold standard first-line imaging in stable patients with suspected
pulmonary embolism.
10.Which cranial nerve is responsible for the corneal reflex afferent limb?
A. Facial nerve
B. Trigeminal nerve
C. Oculomotor nerve
D. Abducens nerve
Answer: B. Trigeminal nerve
2026-2027 Update 100 Professionally
Written Practice Questions • Detailed
Answer Explanations • Scenario-Based
Questions • Covers All Major Exam
Objectives • Ideal For Self-Study And
Final Review
1. A 68-year-old man presents with sudden onset central chest pain radiating
to the left arm. ECG demonstrates ST elevation in leads II, III and aVF. Which
coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Diagonal artery
Answer: C. Right coronary artery
Inferior ST-elevation myocardial infarction most commonly results from right
coronary artery occlusion. Leads II, III and aVF represent the inferior wall.
2. A patient with chronic kidney disease develops hyperkalaemia. Which ECG
change usually appears first?
A. Wide QRS complexes
,B. Peaked T waves
C. Prolonged QT interval
D. Complete heart block
Answer: B. Peaked T waves
The earliest ECG manifestation of hyperkalaemia is tall, peaked T waves. As
potassium rises further, PR prolongation and QRS widening develop.
3. Which organism is the commonest cause of community-acquired
pneumonia in adults?
A. Mycoplasma pneumoniae
B. Klebsiella pneumoniae
C. Streptococcus pneumoniae
D. Staphylococcus aureus
Answer: C. Streptococcus pneumoniae
The leading cause of community-acquired pneumonia worldwide remains
Streptococcus pneumoniae.
4. A patient has microcytic anaemia with low ferritin. What is the most likely
diagnosis?
A. Anaemia of chronic disease
B. Iron deficiency anaemia
C. Thalassaemia trait
D. Sideroblastic anaemia
Answer: B. Iron deficiency anaemia
Low serum ferritin is highly specific for iron deficiency unless inflammation is
present.
5. Which valve is most commonly affected in infective endocarditis?
,A. Pulmonary valve
B. Tricuspid valve
C. Mitral valve
D. Aortic valve
Answer: C. Mitral valve
The mitral valve is the commonest site overall, although the tricuspid valve
predominates in intravenous drug users.
6. A patient with COPD develops worsening breathlessness and drowsiness.
Which investigation should be performed urgently?
A. Peak expiratory flow
B. Chest X-ray
C. Arterial blood gas
D. Spirometry
Answer: C. Arterial blood gas
An arterial blood gas rapidly identifies hypercapnic respiratory failure requiring
urgent management.
7. Which electrolyte abnormality is classically associated with Addison
disease?
A. Hypernatraemia
B. Hypokalaemia
C. Hyperkalaemia
D. Hypercalcaemia
Answer: C. Hyperkalaemia
Primary adrenal insufficiency causes hyperkalaemia and hyponatraemia due to
aldosterone deficiency.
, 8. A fasting plasma glucose of 8.2 mmol/L confirms which diagnosis?
A. Prediabetes
B. Diabetes mellitus
C. Reactive hypoglycaemia
D. Normal glucose tolerance
Answer: B. Diabetes mellitus
A fasting glucose of 7.0 mmol/L or higher on appropriate testing is diagnostic of
diabetes.
9. Which investigation best confirms pulmonary embolism in a
haemodynamically stable patient?
A. Chest X-ray
B. CT pulmonary angiography
C. Echocardiography
D. D-dimer
Answer: B. CT pulmonary angiography
CTPA is the gold standard first-line imaging in stable patients with suspected
pulmonary embolism.
10.Which cranial nerve is responsible for the corneal reflex afferent limb?
A. Facial nerve
B. Trigeminal nerve
C. Oculomotor nerve
D. Abducens nerve
Answer: B. Trigeminal nerve
