MRCP Official Sample Exam 2022/2023 With complete solution

A 65-year-old woman presented with a 12-hour history of the sudden onset of gait unsteadiness, vomiting and headache, followed by increasing drowsiness. What is the most likely diagnosis? A: acute cerebellar hemorrhage B: acute subdural hemorrhage C: frontal subdural empyema D: herpes simplex encephalitis E: pituitary apoplexy - ANSWER A A post-marketing observational study of a new drug was conducted on 5000 patients following clinical trials. What best describes the data generated from this type of study? A: comparative efficacy B: cost-benefit C: cost effectiveness D: potency E: profile of adverse effects - ANSWER E A 79-year-old woman was admitted for elective hip replacement surgery. On examination, she was pale. There was 2-cm splenomegaly and there were small discrete axillary lymph nodes. haemoglobin 107 g/L (115-165) white cell count 34.5 × 109/L (4.0-11.0) platelet count 183 × 109/L (150-400) What is the most likely diagnosis? A: acute myeloid leukaemia B: chronic lymphocytic leukaemia C: chronic myeloid leukaemia D: myelodysplasia E: myelofibrosis - ANSWER B A 17-year-old boy presented with a non-blanching rash over his legs, a swollen knee and painless, visible haematuria. Urinalysis showed blood 3+, protein 1+. serum creatinine 210 µmol/L (60-110) urine culture negative ultrasound scan of kidneys normal What glomerular abnormality is most likely to be present at renal biopsy? A: focal segmental sclerosis B: foot process fusion C: linear deposition of IgG on the basement membrane D: mesangial deposition of IgA E: thickening of basement membranes - ANSWER D A 75-year-old woman developed a spreading cellulitis on her left leg secondary to ulceration. blood cultures MRSA In addition to vancomycin, what is the most appropriate antibiotic? A: amoxicillin B: azithromycin C: flucloxacillin D: metronidazole E: rifampicin - ANSWER E A 45-year-old woman presented with right flank pain. She had a 4-year history of hypertension and progressive cognitive impairment. On examination, she had livedo reticularis and tenderness in the right flank. Her BP was 185/105 mmHg. Urinalysis showed blood 3+, protein 1+. Hb 129 g/L (115-165) WCC 8.7 × 109/L (4.0-11.0) PlTs 83 × 109/L (150-400) serum creatinine 106 µmol/L (60-110) What antibody test is most likely to be positive? A: anticardiolipin B: anticentromere C: anti-glomerular basement membrane D: antimitochondrial E: anti-neutrophil cytoplasmic E: anti-neutrophil cytoplasmic - ANSWER A A 37-year-old woman presented with a history of intermittent lightheadedness. Examination was normal.ECG normal 24-hour ambulatory ECG tracing atrial and ventricular premature beats; nocturnal bradycardia and Mobitz type 1 atrioventricular block, and supraventricular tachycardia Which abnormality on the 24-hour ambulatory ECG is clinically most important? A: atrial premature beats B: profound sleep-associated bradycardia C: supraventricular tachycardia D: transient Mobitz type 1 atrioventricular block E: ventricular premature beats E: ventricular premature beats - ANSWER C A 28-year-old man presented with a 1-month history of weight loss, abdominal distension, flatulence and foul-smelling diarrhoea following a visit to India. anti-tissue transglutaminase antibodies negative stool cultures and microscopy negative What is the most likely diagnosis? A: acute HIV seroconversion illness B: coeliac disease C: giardiasis D: hookworm infection (ancylostomiasis) E: viral gastroenteritis - ANSWER C A 30-year-old woman presented with a 6-month history of tremor and difficulty in speaking. On examination, she was found to have increased muscle tone in all four limbs, bradykinesia and 4-cm hepatomegaly. What laboratory finding would best support a diagnosis of Wilson's disease? A: increased incorporation of radioactive copper into caeruloplasmin B: low hepatic copper content C: low serum caeruloplasmin concentration D: low serum free copper concentration E: low urine copper concentration - ANSWER C Question 10 What dietary substrate is broken down into glucose and galactose by the action of intestinal enzymes? A: fructose B: lactose C: maltose D: mannose E: sucrose - ANSWER B A 16-year-old girl presented with non-scaly, discrete areas of hair loss on the scalp. She had a past history of atopic eczema and had a number of depigmented areas on her hands and around her eyes. What is the most likely diagnosis? A: alopecia areata B: hypothyroidism C: lupus erythematosus D: seborrhoeic dermatitis E: trichotillomania - ANSWER A A 72-year-old man presented following an episode of collapse. There had been two similar episodes recently, each lasting about 1 minute. He had had an anterior myocardial infarction 4 years previously. On examination, he was orientated and symptom-free with a regular pulse of 80 beats per minute. His BP was 140/80 mmHg and the apex beat was displaced to the left. There was an apical systolic murmur. There were no signs of trauma. ECG sinus rhythm; anterior Q waves and anterior ST-segment elevation without reciprocal depression What is the most likely diagnosis? A: acute anterior myocardial infarction B: cerebral embolism C: epilepsy D: pulmonary embolism E: ventricular tachycardia - ANSWER E A 26-year-old woman presented with unequal pupils. On examination, the right pupil was larger than the left and did not react to light, directly or consensually. On conver