MRCP Part 2 Self-Assessment

Medical Masterclass Questions and Explanatory Answers

John D Firth, Barbara Nichols

• Publisher: CRC Press
• Year: 2018
• Print ISBN:
  9781846192289
• eBook ISBN:
  9781315346953
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

"MRCP Part 2 Self-Assessment" is the perfect revision aid. Drawn from the highly successful Medical Masterclass material from the Royal College of Physicians of London, this concise volume is specifically designed to cover the topics and format found in the Membership to the Royal College of Physicians (MRCP) Part 1 examination. The large scale, lavishly illustrated, full-colour format makes it easy to comprehend complex topics.With contributions from an extensive list of prestigious and authoritative professionals, the questions cover all areas of assessment, including the scientific background the medicine, general clinical skills, acute medicine and a range of specialties. It is ideal for examination MRCP candidates, doctors preparing for the European Diploma in internal medicine and junior doctors wanting to revise their knowledge and skills.'This collection of self-assessment questions and explanatory answers has been drawn from Medical Masterclass, which is produced and published by the Royal College of Physicians of London. The questions have been specifically written to help doctors in their first few years of training to test and revise their medical knowledge and skills; and in particular to pass postgraduate examinations, such as the MRCP(UK)' - John D Firth, in the Introduction.

Questions

Clinical pharmacology

Emma H Baker, Stephen F Haydock, Aroon D Hingorani and D John M Reynolds(Editor)

Clinical pharmacology

Answers are on pp. 113–115.

Question 1
A 48-year-old woman with a renal transplant is established on ciclosporin, azathioprine and prednisolone to prevent transplant rejection, and enalapril and bendrofluazide for hypertension. After a 14-day course of ketoconazole for oesophageal candidiasis her creatinine is found to have increased from 100 μmol/L to 180 μmol/L. Her deterioration in renal function is most likely attributable to:

A hypertension poorly controlled on enalapril and bendrofluazide

B nephrotoxic effects of ketoconazole

C ciclosporin toxicity due to inhibition of ciclosporin metabolism by ketoconazole

D transplant rejection due to induction of ciclosporin metabolism by ketoconazole

E effect of enalapril on background of stenosis of artery supplying renal transplant

Question 2
Clozapine is an atypical antipsychotic drug that appears to have fewer problems with adverse effects than older antipsychotics. The relative safety of clozapine stems from which one of the following properties:

A low affinity for dopamine D2 receptors

B low affinity for 5HT receptors

C increase in prolactin levels

D does not cause tachycardia

E no effect on white cell counts

Question 3
A 39-year-old woman with a past history of treated hypertension is in her 3rd trimester of pregnancy and requires on-going anti-hypertensive treatment. Which anti-hypertensive would you definitely NOT prescribe?

A hydralazine

B labetalol

C lisinopril

D methyldopa

E nifedipine

Question 4
A 70-year-old woman has severe Parkinson’s disease and is on co-careldopa and apomorphine. She complains of nausea and vomiting due to her medication. Which one of the following drugs would you prescribe for these symptoms?

A domperidone

B metoclopramide

C prochlorperazine

D entacapone

E betahistine

Question 5
A 26-year-old woman presents in the 12th week of pregnancy with fever and dysuria. There is no other significant history, but direct questioning reveals a self-limiting rash in the past after taking penicillin. Urine culture reveals a significant growth of Gram negative bacilli. The organism is sensitive to the antibiotics listed below. Which of the following would be the best choice of drug in this situation?

A ciprofloxacin

B gentamicin

C cefaclor

D trimethoprim

E co-amoxiclav

Question 6
You see a woman in late pregnancy who has just been diagnosed with thyrotoxicosis. She is planning to breastfeed her baby after delivery. Which treatment would you recommend for her?

A carbimazole

B blocking dose of carbimazole with added thyroxine

C potassium perchlorate

D propylthiouracil

E Lugol’s iodine

Question 7
A 28-year-old man presents following an overdose. Anticholinergic syndrome is suspected. Which one of the following is true of this syndrome?

A tricyclic antidepressants are not a cause

B bradycardia is common

C physostigmine is the treatment of choice

D mydriasis occurs

E urinary incontinence is common

Question 8
A 73-year-old man presents to the Accident and Emergency department with drowsiness and confusion. He is noted to be tachycardic and tachypnoeic. He is not cyanosed, and his pulse oximeter reading is 96% on room air. His wife had been admitted with similar symptoms earlier in the week. Which one of the following is most likely?

A paracetamol overdose

B salicylate overdose

C carbon monoxide poisoning

D cerebrovascular accident

E pneumonia

Question 9
A 79-year-old woman presents to the Accident and Emergency department with confusion, headache and tinnitus. She has recently started on an analgesic for back pain and you are worried she may have taken too much. Which of the following would most likely explain her symptoms?

A paracetamol

B aspirin

C diclofenac sodium

D co-codamol

E codeine phosphate

Question 10
A 35-year-woman presents 6 hours after a deliberate overdose of paracetamol. The paracetamol level is above the treatment line. Thirty minutes after starting an infusion of N-acetyl cysteine (NAC) she becomes flushed and hypotensive with a blood pressure of 80/55 mmHg. The infusion is stopped ...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• Foreword
• Preface
• Contributor
• Questions
• Answers
• Index