MRCP2 2015 diet 2 recalls
1. Patient with oral and genital ulcer….. behcet’s / SJ syndrome 
2. Difference of BP btw 2 arms … takayasu 
3. Marathon runner…. Excess water intake 
4. Gout with renal insufficiency, intolerant to allopurinol what prophylaxis should be given…. Colchicine 
5. Scenario of FHH 
6. Sever acute RA… prednisolone 
7. RA patient taking NSAIDs for 2years presented with nephrotic syndrome… amyloidosis / NSAIDs induced nephrotic syndrome 
8. Patient with DM previously operated for varicose vein now presented with bilateral erythematous leg swelling… lipodermatosclerosis / gravitational eczema 
9. ECG…. Monomorphic VT / torsades 
10. Blurred vision on digoxin + ECG pic …. Digoxin toxicity 
11. Intention to treat… double blind studies 
12. Tender thyroid swelling, lid lag and lid retraction with hyperthyroidism on TFTs and anti-peroxidase antibodies absent… viral thyroiditis 
13. HIV patient with CD$ count less than 200, what prophylaxis to offer… pneumocystis carani 
14. GB syndrome… campylobacter jejuni 
15. GB syndrome with low FVC … IVIG / intubation 
16. Scenario of miller ficsher syndrome 
17. Scenario of wernicek’s… nystagmus + opthalmoplegia+ alcoholic 
18. CLL received chemo…. Tumour lysis syndrome 
19. Pic of neovascularization 
20. Pic of CRA occlusion 
21. Pic of herpes encephalitis 
22. Pic of extradural hematoma…. Middle meningeal artery 
23. Pic of PML 
24. Pregnant lady with childhood H/O recurrent UTI presented with small kidneys on US….. reflux nephropathy 
25. Scenario of fedrich’s ataxia 
26. Pic of melanoma 
27. Wegener’s patient receiving prednisolone what drug to be added…. Cyclophosphamide 
28. Patient K/C of asthma treated with antibiotics 2 weeks previously for exacerbation of asthma presented with bloody diarrhea + raised eosinophil… chrug strauss/ pseudomembranous colitis 
29. AFib + slow ventricular rate …. Ventricular pacing 
30. SLE patient APLA positive received warfarin for 3 months test repeated showed APLA again.. lifelong warfarin 
31. Drug causing binge eating 
32. Drug CT in pregnancy… simvastatin and ramipril 
33. CT scan of pancreatitis / perforated viscus 
34. Scenario of pancreatitis , how to give nutrition… TPN 
35. Scenario of paget’s disease 
36. Malignancy with backache… check calcium 
37. Patient receiving fluoxetine and carbamazepine presented with SIADH which dru to be stopped… carbamazepine 
38. Normal pregnancy changes 
39. Molluscum contigiousum 
40. Alzheimer’s disease….. donepezil / memantine 
41. Centrally clearing rash… doxycycline 
42. Scenario of pneumonia with CRUB65 score of 2…. Amoxicillin and clarithromycin 
43. Elderly parient presented with UTI developed confusion, cause…. UTI 
44. Scenario of hepatorenal syndrome 
45. Scenario of young girl with drowsiness , LFTs shows hepatocellular injury, treatment… acyetlcystine 
46. Scenario of carotid cavernous fistula 
47. Malignancy + incidental finding of PE… LMWH 
48. Hepatitis A in husband what test is needed for wife… reassurance 
49. Pic of larva migran .. albendazole 
50. Scenario of SLE rash … hydroxycholoroquine 
51. CHF patient, spironolactone stopped because of gynecomastia, what drug should improve prognosis… epelrenone 
52. Ascites in CKD patient on peritoneal dialysis…. Leakage of peritoneal fluid 
53. Refeeding syndrome…. Check potassium, phosphate and magnesium 
54. CKD patient taking oral iron presented with breathlessness CBC shows low HB, normal ferritin and increased TIBC… give IV iron 
55. Scenario of common variable immunodeficiency 
56. Bleeding duodenal ulcer secondary to HPylori…. Urease breath test 
57. Dysphagia in young patient … upper GIT endoscopy 
58. COPD patient with exacerbation, PH=7.29 on optimal medical therapy … NIV 
59. Prolactinoma.. pergolide 
60. Prolactinoma… transphenoidal surgery 
61. Picture of chromosomes….Androgen insensitivity syndrome 
62. Latex glove … irritant contact dermatitis 
63. Breakthrough pain… 30mg of intermediate release morphine 
64. Patient with heart failure, code is DNR… morphine 
65. Azathiopurin… stop allopurinol 
66. Patient of MND, presented with spastic muscles… baclofen 
67. MND patient unable to eat because of muscle rigidity but swallowing reflux is normal, what is long term treatment to improve nutritional state of patient… physiotherapy/ assisted feeding/ PEG 
68. Pleural thickening and pleural effusion….. CT guided biopsy 
69. High triglyceride, treatment… fenofibrate 
70. Scenario of adult onset still’s disease 
71. Muscle disease with raised CPK…. Muscle biopsy 
72. Pheochromocytoma…. Phenoxybenzamine 
73. CT of pulmonary fibrosis / lymphangioleiomyomatosis 
74. Risk of sucide… depression/ planning 
75. Xray of lung… middle lobe 
76. Ascities in IVDU with high lymphocytes and muscle wasting… TB/ peritoneal carcinomatosis 
77. Sickle cell disease patient has HB=3 and high bilirubin… aplastic crisis 
78. Lady K/C of Ca. breast has received radiotherapy, presented with SOB, raised JVP and echo shows good EF… restrictive pericarditis/ constrictive cardiomyopathy 
79. Downbeat nystagmus…syringomyelia 
80. Shoulder pain while gardening taking ibuprofen and paracetamo;l presented with blister ….. polymorphic light eruption 
81. Post femoral catheterization groin pain and femoral bruit…. AV fistula 
82. Vomiting after 6hours of eating reheated pie… staph. Areus 
83. COPD patient with spontaneous pneumothorax, chest tube was placed and CXR showed partial re-expoansion, 4days later lung is still patialy expanded but patient is asymptomatic… remove chest tube 
84. ECG post PCI… reassurance 
85. Scenario of patient taking thiazide, ramipril and ???? presented with low potassium and magnesium… cause???? 
86. Rash localized on umbilicus… flexural posraisis 
87. Lady taking calcium and VitD has family history of osteoporosis, DEXA = -0.3…alendronate 
88. Young patient with pansystolic murmur.. rupture of sinus of valsalva 
89. Obese patient with raised HBA1c…metformin 
90. Male with unilateral gynecomastia… androgen abuse 
91. Cat bite.. sporothrix/ pasturella 
92. Patient from india received adequate malarial prophylaxis… dengue/malaria/typhoid 
93. Mechanical valve endocarditis prophylaxis… vanc, rifampicin, genta 
94. Patient received vancomycin developed redness… start at slower rate 
95. Patient with decreased visual acuity sees drawfs in her room..charles bonnet 
96. Oculogyric reflex… metoclopramide 
97. Post renal transplant on tacrolimus received gentamicin… increase level of tacrolimus 
98. HTN patient receiving ramipril and thiazide, unable to tolerate amlodipine presented with raised creatinine and potassium.. doxazocin 
99. OSA…polysomnography 
100. Detrusor overactivity… oxybutynin 
101. Scenario of tropical sprue, biopsy showed partial atrophy of villi… tetracycline 
102. Headache on sitting upright and relieved on lying flat.. CSF leakage 
103. AFib in young patient… flecanide 
104. Febrile neutropenia not responsive to vancomycin… add antifungal 
105. Patient with chronic pancreatitis what investigation should be done… CT/fecal fat 
106. Scenario of fibromyalgia 
107. Prolonged APTT not corrected on adding normal plasma.. lupus antibody 
108. Lady with history of gallstones presented with jaundice.. CBD obstruction 
109. Ectopic secretion of ACTH 
110. Amenorrhea with galactorrhea, labs sowed high TSH, low T3 and high prolactin…hypothyroidism 
111. HTN with normal sodium and low potassium, what investigation should e done… plasma renin:aldosterone ratio 
112. DM patient with reading difficulty.. maculopathy 
113. Low C3 with angioedema… hereditary angioedema 
114. Seizure+ pregnancy…pseudoseizure 
115. Patient with mechanical valve presented with hemolytic anemia… serum haptoglobuin 
116. Left sided stroke, right caotid artery 100% stenosed, left carotid artery 75% stenosed.. no intervention/ rt carotid endartrectomy/ left endarterectomy 
117. Picture of distorted circle , resting tremor…propanalol/levodopa 
118. Enoxaparin induced hyperkalemia 
119. Xray of charcots joint.. cast 
120. HIV patient with browinish papule… HHV8 
121. Patient hearing neighbours making plans to kill him…schizopherania 
122. DM patient with history of recuurent RTI n multiple abcesses presented with fever and abcess producing greenish pus… klebsellia/pseudomonas 
123. UC with left iliac fossa pain… AXR 
124. Aortic dissection…labetolol 
125. TCA overdose… IV bicarbonate 
126. HTN and CKD patient with K=5.5… repeat test after 2 weeks 
127. Non-epileptic seizure… close eyes/ post seizure hyperactivity 
128. Pregnant lady retrned from Australia presented with SOB has respiratory alkalosis…PE/Hyperventilation 
129. AS…. Dobutamone stress echo/ coronary angio 
130. Xray spine, patient has pain on walking and relieved on sitting, SLR=30… spinal stenosis 
131. Scenario of VIPoma

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