MRCP Part 1 EXAM QUESTIONS AND
ANSWERS 100% SOLVED (Newest 2025)
Pregnancy and Thyroid Hormone - Correct Answers
✅Pregnancy increases the amount of TBG (thyroid binding
globulin) so increases the total thyroxin levels but not free
thyroxine
Hyperthyroid in pregnancy - Correct Answers ✅Untreated -
fetal loss, premature labour, maternal heart failure
Graves disease most common
HCG can activate TSH receptors - transient gestational
hyperthyroid - these fall in trimester 2 & 3
treatment - propylthiouracil in first trimester
this can cause hepatic injury
carbimazole in 2nd trimester once lower risk of congenital
abnormalities
Monitoring - free thyroxine levels should be kept upper third
normal so to avoid fetal hypothyroid
- thyrotrophin receptor stimulating antibodies should be
checked weeks 30-36
DO NOT - block and replace or use radioiodine.
Hypothyroid in pregnancy - Correct Answers ✅Thyroxine
replacement is safe in pregnancy and breastfeeding
TSH measured each trimester and 6-8 weeks post partum
Women often require an increased dose - up to 50% by weeks
4-6
untreated - developmental abnormalities, miscarriage, still
birth, low birth weight, pre-eclampsia, anaemia
,MRCP Part 1 EXAM QUESTIONS AND
ANSWERS 100% SOLVED (Newest 2025)
Gentamicin - Correct Answers ✅Aminoglycoside antibioitic
Given IV or topically
Ototoxic - irreversible due to auditory or vestibular nerve
damage
Nephrotoxic - causes tubular necrosis, accumulates in renal
failure requiring increased monitoring, furosemide increases
this risk
CI - Myasthenia Gravis
Dosed via height and weight and renal function. Peak and
trough levels monitored with dose adjustments based on
trough levels
CSF: Protein levels - Correct Answers ✅normal = 0.2-0.4
g/L
Causes of raised CSF protein
GBS
Froin's syndrome - a spinal canal blockage characterised by
xanthochromia, raised protein and CSF hypercoagulability
TB, bacterial or fungal meningitis
viral encephalitis
Vigabatrin - Correct Answers ✅Irreversibly inhibits GABA
transaminase-->increased GABA levels in synapse
,MRCP Part 1 EXAM QUESTIONS AND
ANSWERS 100% SOLVED (Newest 2025)
Uses = tx infantile spasms (Viga"Baby"trin)
Or used as adjunct therapy for adults with refractory complex
partial seizures
SE = visual field constriction and even visual loss in 40% of
patients- visual fields must be checked every 6 months as
visual loss can be irreversible
Tricuspid regurgitation - Correct Answers ✅Signs:
pansystolic murmer, parasternal heave, giant V waves,
pulsatile hepatomegaly
causes: IVDU endocarditis, rheumatic heart disease, right
ventricle infarction, pulmonary hypertension, carcinoid
syndrome, epsteins anamoly (rare heart defect that causes
tricuspid regurg)
Corticosteroid side effects - Correct Answers ✅COME IN
PIGG
Cushings
opthalmic - glaucoma, catterachts
M - musculoskeletal - OP, proximal myopathy, avascular
necrosis
Endocrine- hyperglycaemia, weight gain, hirsuitism, high
lipids
Immunosupression
, MRCP Part 1 EXAM QUESTIONS AND
ANSWERS 100% SOLVED (Newest 2025)
Neutrophilia
Psychiatric - mania, psychosis, insomnia, depression
Intracranial hypertension
Gastric - pancreatitis, ulcers,
Growth suppression in kids
Acne - Systemic glucocorticoids can cause drug-induced
acne. This is characterised as monomorphic papular rash
without comedones or cysts. This does not respond to acne
treatment but improves on drug discontinuation
Therapeutic Steroids - Correct Answers ✅Fludocortisone -
mostly mineralocorticoid
hydrocortisone - some glucocorticoid, some mineralocoticoid
Dexamethsone - high glucocorticoid
Medication overuse headache - Correct Answers
✅Headache for over 15 days a month, whilst taking regular
analgesia
triptans and opioids are highest risk
very common, can affect 1/50 people
management - stop simple analgesia and triptans, wean
down any opioids
ANSWERS 100% SOLVED (Newest 2025)
Pregnancy and Thyroid Hormone - Correct Answers
✅Pregnancy increases the amount of TBG (thyroid binding
globulin) so increases the total thyroxin levels but not free
thyroxine
Hyperthyroid in pregnancy - Correct Answers ✅Untreated -
fetal loss, premature labour, maternal heart failure
Graves disease most common
HCG can activate TSH receptors - transient gestational
hyperthyroid - these fall in trimester 2 & 3
treatment - propylthiouracil in first trimester
this can cause hepatic injury
carbimazole in 2nd trimester once lower risk of congenital
abnormalities
Monitoring - free thyroxine levels should be kept upper third
normal so to avoid fetal hypothyroid
- thyrotrophin receptor stimulating antibodies should be
checked weeks 30-36
DO NOT - block and replace or use radioiodine.
Hypothyroid in pregnancy - Correct Answers ✅Thyroxine
replacement is safe in pregnancy and breastfeeding
TSH measured each trimester and 6-8 weeks post partum
Women often require an increased dose - up to 50% by weeks
4-6
untreated - developmental abnormalities, miscarriage, still
birth, low birth weight, pre-eclampsia, anaemia
,MRCP Part 1 EXAM QUESTIONS AND
ANSWERS 100% SOLVED (Newest 2025)
Gentamicin - Correct Answers ✅Aminoglycoside antibioitic
Given IV or topically
Ototoxic - irreversible due to auditory or vestibular nerve
damage
Nephrotoxic - causes tubular necrosis, accumulates in renal
failure requiring increased monitoring, furosemide increases
this risk
CI - Myasthenia Gravis
Dosed via height and weight and renal function. Peak and
trough levels monitored with dose adjustments based on
trough levels
CSF: Protein levels - Correct Answers ✅normal = 0.2-0.4
g/L
Causes of raised CSF protein
GBS
Froin's syndrome - a spinal canal blockage characterised by
xanthochromia, raised protein and CSF hypercoagulability
TB, bacterial or fungal meningitis
viral encephalitis
Vigabatrin - Correct Answers ✅Irreversibly inhibits GABA
transaminase-->increased GABA levels in synapse
,MRCP Part 1 EXAM QUESTIONS AND
ANSWERS 100% SOLVED (Newest 2025)
Uses = tx infantile spasms (Viga"Baby"trin)
Or used as adjunct therapy for adults with refractory complex
partial seizures
SE = visual field constriction and even visual loss in 40% of
patients- visual fields must be checked every 6 months as
visual loss can be irreversible
Tricuspid regurgitation - Correct Answers ✅Signs:
pansystolic murmer, parasternal heave, giant V waves,
pulsatile hepatomegaly
causes: IVDU endocarditis, rheumatic heart disease, right
ventricle infarction, pulmonary hypertension, carcinoid
syndrome, epsteins anamoly (rare heart defect that causes
tricuspid regurg)
Corticosteroid side effects - Correct Answers ✅COME IN
PIGG
Cushings
opthalmic - glaucoma, catterachts
M - musculoskeletal - OP, proximal myopathy, avascular
necrosis
Endocrine- hyperglycaemia, weight gain, hirsuitism, high
lipids
Immunosupression
, MRCP Part 1 EXAM QUESTIONS AND
ANSWERS 100% SOLVED (Newest 2025)
Neutrophilia
Psychiatric - mania, psychosis, insomnia, depression
Intracranial hypertension
Gastric - pancreatitis, ulcers,
Growth suppression in kids
Acne - Systemic glucocorticoids can cause drug-induced
acne. This is characterised as monomorphic papular rash
without comedones or cysts. This does not respond to acne
treatment but improves on drug discontinuation
Therapeutic Steroids - Correct Answers ✅Fludocortisone -
mostly mineralocorticoid
hydrocortisone - some glucocorticoid, some mineralocoticoid
Dexamethsone - high glucocorticoid
Medication overuse headache - Correct Answers
✅Headache for over 15 days a month, whilst taking regular
analgesia
triptans and opioids are highest risk
very common, can affect 1/50 people
management - stop simple analgesia and triptans, wean
down any opioids
