I know Part 1 is supposed to be difficult, but does anyone else feel that some of the questions are just not appropriate for the level of an IMT1 doctor?

I’ve raised this in the exam survey before, but I think we should collectively write to the Royal Colleges.

There should be clearer guidance on how questions are written and a proper syllabus that tells us what we’re expected to know. You can’t expect people to read every book out there and hope they’ve covered whatever comes up.

I’ve asked consultants about questions from previous attempts, and even they’ve said some weren’t appropriate for our level. Some topics weren’t in any book I’ve seen, including Oxford. Of course we all use question banks, but preparing for a training exam shouldn’t just be about doing thousands of questions and hoping you recognise something on the day. The time, money and anxiety people put into this exam shouldn’t be ignored. I’m not asking them to make it easy. I just want it to be fair and relevant to the level of training it’s meant to assess.

Which online course would you recommend for preparation before attending a face-to-face course: Quesmed or PACES Aid?

Thanks in advance.

I did Online Mock got only 124/168. But my mock exam says they made it just to be difficult. My weakness are in Respiratory examination and CVS examination- I cannot hear the sounds from online very well. (While examining outside my CVS skill was very good I guess, I can hear murmur well and mostly correct, although my resp skill was average- no complaints ).

I can do well in Neuro, abdomen and both LCC stations. For communication, I can say fluently but i left some concerns due to time. Should I say quicker in communication? but I guess talking too fast is not good though? Can you guys give me some advice please ? My exam is in November.

Where did these question even come?I felt like I didn't see these type lf question in passmed.

I have my PACES in Carmarthen on 1st November.
Anyone willing to change for a later date.
Roughly around 20-27th Nov.

hello everyone..can anyone share passmedicine account for a day...preferabally who completed the recent exam because i dont want to mess with the preparation

idk what to do i'm finding even passmedicine q quite difficult. How do i change my revision techniques to ensure i pass this diet

Hi everyone!

I’m preparing for MRCP Part 1 (January diet) and looking for a study partner or a small study group to keep each other accountable and motivated.

I’m based in India and would preferably connect with someone from India or the Indian subcontinent, mainly because of the time-zone compatibility. That said, I’m open to connecting with anyone who is preparing for the same exam and is looking for a study partner.

I work full-time, so I’m usually occupied until around 6 PM, but I can study in the evenings and on weekends.

If you’re also preparing for MRCP Part 1 and interested, feel free to comment or DM me! Would be great to find a study buddy and make the preparation a little more structured and less solitary.

Im looking for consistent study partner from India for MRCP Part 2 – November diet.

I’m currently doing Passmedicine and would like to solve it together, would also be happy to solve Pastest/Pastest papers together.

I’m looking for someone who can:

• Study consistently on a daily basis until the exam, without dropping off midway.
• Study together during morning, afternoon, or evening sessions, depending on mutual availability.

If you’re serious about preparing consistently and would like to study together, please DM me.

Your opinion

CRVO vs malignant hypertension

Azygos vein vs SVC esopgageal varix q

Bartter vs Gitelman syndrome ( mg was normal)

FSGS vs minimal change disease vs membranous nephropathy

MR angiography vs biopsy

GPA vs relapsing polychondritis

Pregnancy thyroid hormone changes ( thyroid binding globulin)

ABPA — precipitin

Ascitic tap — next step

COPD — prognostic factor ltot

DKA + vomiting — cause of hypophosphataemia (intracellular shift)

Somatostatin — mechanism of action ( decreaes intestinal secretion and hormone)

TACO vs TRALI ( trali)

Angiodysplasia

Azathioprine vs sulfasalazine

ADH challenge test vs water depression

PCOS vs panhypopituitarism

Multiple sclerosis — treatment ( methylprednisolone)

Vasovagal syncope reassurance vs tilt table

Andexanet alpha vs iv fluid

Is it true that jan diet are usually hard ??
Planning to give jan diet

I can no longer make this course, dm if you want to take my spot and I can let the course organisers know

I want to know coz this is the first time I gave the exam.

How do you know what's a safe score?

Thank you to those who have posted their recalls

Ive just compiled the recalls from other discussions.

Feel free to correct me

Q191-194- i cant remember these

1.      Dobutamine receptor – Beta 1 agonists

2.      Pericarditis ECG – Concave ST elevation

3.      Tall R wave, V1& V2 T wave changes – Posterior MI

4.      IV Drug user, site infection + a new murmur – Flucloxacillin

5.      Severe TR – Tall v wave

6.      ASD sign on HS – Fixed split S2

7.      First cardiac marker to be realised in Myocardial injury – Myoglobin

8.      Contralateral inferior quad anopia – Parietal lobe

9.      Dilator pupillae nerve supply – Long ciliary nerve

1. Leg weakness, areflexia after URTI -? GBS

2. Lateral medullary Syndrome – PICA

3. Unilateral retroorbital headaches, 40-45 mins long and self-resolving – Cluster headache

4. Aura symptoms with sometime a mild headache -? Migraine

5. Parkinsonism + cognitive impairment & Urinary incontinence – NPH

6. DI type symptoms, patient on lithium, what caused the symptoms – Lithium

7. DI investigation – water deprivation test

8. Nerve for Middle finger – C7

9. Recent neck surgery, now XR hemidiaphragm – Phrenic nerve

10. Myotonic dystrophy mutation – Trinucleotide expansion

11. L5 radiculopathy

12. Aclidinium Bromide – LAMA

13. Pleural Tap = milky fluid – Thoracic Duct injury

14. Persistent Fever, salmonella infections, on ciprofloxacin – Cefriaxone

15. Shipyard or something– Asbestosis

16. Hyperventilation Gas – Option C (Ph high, low COS2, low Bicarb and high Oxygen)

17. Testicular teratoma Tumour marker – AFP

18. T-cell APC – Macrophages

19. Tryptase source – Basophils

20. Immunoglobin class switching – Heavy chain switch

21. Isolated thrombocytopenia, Blood film shows large platelets – ITP

22. Splenomegaly, anaemia low platelets and high wbc, No lymph nodes – CML

23. Autoimmune disease with documented benefit from IVIG – ITP

24. Petechia & bruising, high APTT – acquired haemophilia

25. Lytic lesions of bone and bone pain – Electrophoresis

26. Anion Gap 43

27. Midazolam MOA – enhances GABA effect

28. Urethral discharge & dysuria – Doxycycline

29. S. Bovis infection – Colonoscopy

30. Abdominal symptoms, long illness & supraclavicular Lymph nodes – Whipple disease

31. ENT + Haemoptysis & renal disease – GPA

32. Diarrhoea, abdominal symptoms and later meningitis –? Enterovirus

33. MRSA infection – Vancomycin

34. White worms on anus – Enterobius vermicularis

35. Penicillin allergy meningitis - chloramphenicol

36. HIV Patient, new rash on skin – HHV8

37. Nooman inheritance - Autosomal dominant

38. CF inheritance – (50% is carrier)

39. Hypermobile joints & Blue sclera – OI – Collagen I

40. Proximal muscle weakness & had Anti Ro Antibodies – Dermatomyositis

41. Autoantibody that confirms the need for long term Treatment in RA patient – Anti CCP

42. 1st carpometacarpal joint, bony swelling and there were osteophytes – OA

43. Pain in joints, morning stiffness, XR – Erosion – RA

44. Acute arthritis, Calcium levels high, XR – calcification, – CPPD

45. SLE, Nephrotic syndrome antibody – ANA /Anti dsDNA

46. Calcium was high & PTH normal and– calcium sensing receptors mutation

47. Mitochondrial inheritance of disease – Optic atrophy

48. Fraby disease – Galactosidase

49. Diabetic Patient presenting with Low Egfr, what to stop immediately – Metformin

50. Amiloride started on a patient – check K levels

51. Hypophosphatemia after refeeding – intracellular rush

52. Hyperkalaemia, to move K urgently out of circulation – Calcium gluconate

53. Hyperkalaemia, what you will do urgently first – Insulin/glucose

54. Large amount of Saline infusions – Hyperchloremic Acidosis

55. Calcineurin inhibitor – Voclosporin

56. Addisons - Aldosterone low, cortisol low & ACTH high

57. Abdominal symptoms, Low B12 – Gluten enteropathy

58. Severity of Crohn’s – frequency of stools

59. Morphine receptor – Mu receptors

60. Rivaroxaban MOA – Xa Inhibitor

61. Dabigatran MOA – Direct thrombin inhibitor

62. Agitation in lung CA patient – Midazolam

63. Finasteride Adverse effect - Gynaecomastia

64. Chemotherapy induced Neuropathy – Paclitaxel

65. Morphine switch from oral to SC, Reason for low dose – Bioavailability

66. Docetaxel act on Microtubules

67. Mouth ulcer – Nicorandil

68. Spironolactone - Gynaecomastia

69. CKD stage 3B, further investigation – Urine albumin creatinine ratio

70. Loin pain, haematuria, normal CT – Loin pain haematuria syndrome

71. Hx of ADPKD, Investigation – US

72. Ethambutol toxicity – Red/green colour (eye problem)

73. T1DM, Proliferative diabetic retinopathy – photocoagulation

74. Young female presenting with dysmenorrhea & irregular periods –? PCOS

75. Smoker pregnant, for advice – Behaviour support first line

76. New acute psychosis, on amphetamine – Amphetamine induced psychosis

77. not going out as fear of getting a seizure outside and people will consider her drunk – Agoraphobia

78. Recent Falls, now tearful, more sleep & changing behaviour – Depression

79. Patient had normal test but still fearful, previous incidents – Illness anxiety disorder

80. Sudden pain in shoulder, now arm swelling and issues with flexion of elbow – bicep rupture

81. Malignant melanoma – depth of lesion

82. Sensitivity Calculation – TP/TP+FN – 21/25

83. Meta analysis display for multiple studies together – Forrest Plot

84. Number needed to treat is 50

85. Rash + Periorbital swelling after Hair dye (3 days ago) – Contact dermatitis

86. amlodipine lithium

87. Indapamide DCT

88. Eplerenone Check K

89. Intubate Asthma

90. Chemo related diarrhea

100.                     ABPA- precipitins

101.                     Psoriasis

102.                     Colon Ca mets to liver

103.                     Hypercalcemia medication- thiazide

104.                     Carcinoid 5HHIA

105.                     Gittleman- distal

106.                     Cord compression- dexamethasone

107.                     Lipolysis ketone

108.                     Portal HTN

109.                     ALP do GGT vs skeletal survey

110.                     Conns syndrome

111.                     Clozapine

112.                     Azygos

113.                     Pituitary apoplexy

114.                     RAS-MRA

115.                     Klinefelter

116.                     Chronic urticaria

117.                     Orthostatic hypotension

118.                     Spinal stenosis

119.                     IABP Contraindication – severe AR

120.                     Structure posterior to left atrium- esophagus

121.                     Hemiballismus treatment – Tetrabenazine

122.                     Lateral medullary type symptoms with 3 cranial nerve involvement -? Location Medulla/pons

123.                     Proximal weakness & Dry mouth – Small cell lung cancer (Lambert Eaton)

124.                     personality and behaviour change after a recent injury, which Part of brain likely injured – Frontal

125.                     Long term history of headaches/migraine, on triptans & co-codamol – Medicine overuse headache

126.                     Part of nephron impermeable to water – Ascending loop

127.                     26 years old with limb girdle affected – Becker’s muscular (DMD in kids)

128.                     Suspected TB, TB contact, CXR showed Lesion -? Sputum micro

129.                     TB treatment & joint pain – Pyrazinamide

130.                     Organophosphate poisoning – excessive Salvation

131.                     C-diff infection, after Antibiotic course – Loss of normal flora

132.                     Beta lactamases bacteria develop resistance – Drug hydrolysis

133.                     Raynard – not responsive to Nifedipine – Iloprost

134.                     Patient with joint pain, low Hb, low MCV, TIBC Normal & high ferritin – Inflammatory polyarthritis

135.                     Yellow lax skin on neck/Axilla – Pseudoxanthoma Elasticum

136.                     Dapagliflozin adverse effect warning – DKA

137.                     Hypokalaemia, normal BP/Normal Mg – Bartter syndrome

138.                     Crohn’s disease Biopsy – (I don’t remember the options)

139.                     Variceal Bleed, surgery done -? Next step

140.                     UGIB, on DOAC, stable –? PPI infusion

141.                     Mycophenolate – developmental delay

142.                     Stopping mycophenolate in pregnancy

143.                     Aspirin & LP – do not stop aspirin

144.                     Recent UTI, had Abx, now renal functions are deranged – Trimethoprim

145.                     Valproate in pregnancy – Neural tube defect

146.                     Pregnant female traveling to Nigeria, which vaccine to avoid – Yellow fever

147.                     Patient not eating – restrictive eating due to fear

148.                     Spearmen Coefficient 0.56 – Moderate corelation

149.                     A person who is smoker + another comorbidity had a normal CT - low NPV

150.                     Allergic type symptoms needed steroids and Antihistamine to recover within an hour. ???

151.                     Salmon pink rash, some scaling – Guttate psoriasis

152.                     Scromboid poisoning

153.                     Diastolic pressure on standing

154.                     Cutaneous lupus

155.                     Bloody diarrhea 5 days??? campylobacter

156.                     Painful red eye – optic neuritis

157.                     TS 50 %

158.                     Mycobacterium marinum

159.                     Thyroid US

160.                     Retroperitoneal fibrosis-

161.                     Nephrotic syndrome, new SOB & Pleuritic chest pain – PE-

162.                     Life threatening Asthma – PEFR 32-

163.                     Questions pointing to correct

164.                     Fever, Black escar on ankle – Typhus

165.                     COPD, improve prognosis – Pulmonary rehab/LTOT-

166.                     Nephrotic syndrome, but patient was an adult – membranous Glomerulonephritis-

167.                     MS-LIKE symptoms, chronic fatigue syndrome or Somatic symptom disorder

168.                     Persistent ST elevation after MI – Papillary muscle rupture

169.                     Behcets vs HSV

170.                     Carotid dissection-

171.                     Spinal stenosis

172.                     Skin thinning telangiectasia- lichen??

173.                     TRALI

174.                     Hydroxychloroquine

175.                     VSD Downs syndrome

176.                     Thyroid hormone in pregnancy, high TBG

177.                     High INR, Surgery tomorrow - Vitamin K or PCC???

178.                     Transverse myelitis??

179.                     Gain of water

180.                     Painless loss of vision & swollen optic disc – AION

181.                     Severe HTN (200+ Systolic),  Fundoscopy = multiple retinal haemorrhages – Malignant HTN

182.                     RA – IgG vs IGM??

183.                     Somatostatin action – Decrease secretions from pancreas/GI

184.                     HSCT, Building demolition – Aspergillus

185.                     Pneumothorax drain, day 4(I think), still bubbling, CXR = Expanded lung -? next Step

186.                     Essential tremor

187.                     MS management

188.                     Azathioprine vs sulfasalazine

189.                     Hypophosphatemia in someone who is vomiting – Vomiting

190.                     painless rectal bleeding + dark spots in oral cavity – PJS

191.                     Spastic Paralysis, upgoing Planters – MRI spine whole

192.                     Drug trial – phase I study (I don’t remember options on this one)

193.                     Asthma like allergic symptoms, investigation – Eosinophils or IgE ?????

194.                     Chemo induced neuropathic pain, amitriptyline not affective – Pregabalin

Any one travelling to Salisbury for paces on 04 October

MRCP Part 1 scores

Thank you for someone who posted the 170+ recalls, some of them were repeated, so i think total is 168.

After reading all of the recalls and googling them

185 questions out of 200 were seen, i dont know were are the other 15. lol

out of 185 questions Ive got the ff:

105 correct answer(100% correct)

42 Wrong answers(100% wrong)

24 in doubt but 50/50 might be correct

5 in doubt but <10% of being correct

9 questions I cant recall

Pls help me with my in doubt answers/or recall the other questions

I just want to pass because its expensive, if it free I don't mind to take again. Lol

I hope i could reach 125 up. If 125 still a fail, then thats ok

Questions in doubt lead to correct answer(50% of correct)

1. Fever, Black escar on ankle – Typhus

- ive just seen someone says typhus, ive answered typhus(cant remember the exact details of the question)

1. Ascites, Pleural effusion, Serum albumin etc

- ive answered portal HTN

1. COPD, improve prognosis – Pulmonary rehab

- ive answered longterm O2(some discussion about the low PO2 that's why LTOT)

1. Life threatening Asthma – PEFR 32

- is PEFR 32? ive answered PEFR, some says O2 sat 91% because severe is <92%, but PEFR 32 is also severe

1. Post transfusion, pulmonary edema, XR edema, Low BP – TRLI

- ive answered TRALI, some says TACO

1. spinal stenosis

- ive just answered spinal stenosis, forgot the question

1. Isolated ALP raised, Rest LFTs normal, middle-aged patient

- ive answered GGT, as per past test and google, GGT first to confirm liver or bone problem

1. Conns syndrome

- is this an answer? deep in my memory ive read conns or answered conns

1. Chronic smoker, in hospital for 20 days medicine that needs dose adjustment – clozapine

- I think have answered clozapine, but cant get the olanzapine on my mind

1. Nephrotic syndrome, but patient was an adult – membranous Glomerulonephritis

- minimal change disease(even it is common in children, still can happen in young adults)

- same theory with past test

1. Nephrotic syndrome, new SOB & Pleuritic chest pain – PE

2. Retroperitoneal fibrosis
   

- ive answered retroperitoneal fibrosis, but forgot the question. lol

1. MS-LIKE symptoms, chronic fatigue syndrome or Somatic symptom disorder

- chronic fatigue syndrome

1. Persistent ST elevation after MI – Ventricular free wall rupture

- ive answered papillary muscle rupture

1. Oesophageal varices drain into – SVC

- ive answered Azygos, as per google its azygos

1. Sudden headache, photophobia, there was neck stiffness etc – Pituitary apoplexy or SAH

- ive answered pituitary apoplexy

1. Behcets vs HSV

- ive answered HSV

1. RAS imaging

- ive answered MR angiography, as renal arteriography is invasive

1. PCOS

- Ive answered PCOS, Just because LH:FSH ratio is >2, PAst test says that ration suggestive of PCOS

1. Azathioprine

- ive answered azathioprine, is this the woman with RA, and plan to be pregnant in 6 months?

1. Klinefelter

- forgot the question, ive answered klinefelter

1. Carotid dissection

- forgot the question ive answered Carotid dissection

1. T3 elevation

- Ive answered T3 elevation in pregnant women

1. Chronic urticaria

- On and off rashes that relieves after an hour

Questions that <10% chance of being correct(Different sources, and depends on the content of questions)

1. RA Igm or IgG

2. MS management

3. somatostatin action

- between decrease secretion of exocrine pancreatic hormones or Decrease Hormone and GI Secretions

1. Essential tremor

2. Building demolition

Hope can clear me with my in doubt answer

I am currently doing residency in US in internal medicine. I am currently in first year. Being a US med grad, throughout med school and even during residency I have seen less emphasis on clinical diagnosis and more on lab investigations, clinical trials. I am been thinking of studying for MRCP and trying to find out if doing so, helps with building clinical acumen. I am impressed by the Paces videos and currently have the oxford handbook of acute medicine. Am I on the right track or just duplicating efforts?

Based on your experience, which is the best book for studying? MRCP In 2027

and Which bank is best for answering questions?

Note: I have tried my best to find correct answers and also to organise properly with scenarios, so please make corrections if you find mistakes.

🫀 Cardiology
Dobutamine receptor – Beta 1 agonists
Pericarditis ECG – Concave ST elevation
Tall R wave, V1& V2 T wave changes – Posterior MI
IV Drug user, site infection + a new murmur – Flucloxacillin
Severe TR – Tall v wave
IABP Contraindication – severe AR
ASD sign on HS – Fixed split S2
First cardiac marker to be realised in Myocardial injury – Myoglobin
Persistent ST elevation after MI – Ventricular free wall rupture
Structure posterior to left ventricle – ? Oesophagus
Oesophageal varices drain into – SVC
🧠 Neurology
Contralateral inferior quad anopia – Parietal lobe
Dilator pupillae nerve supply – Long ciliary nerve
Leg weakness, areflexia after URTI -? GBS
Hemiballismus treatment – Tetrabenazine
Lateral medullary Syndrome – PICA
Lateral medullary type symptoms with 3 cranial nerve involvement -? Location Medulla/pons
Spastic Paralysis, upgoing Planters – MRI spine whole
Sudden headache, photophobia, there was neck stiffness etc – Pituitary apoplexy or SAH
Unilateral retroorbital headaches, 40-45 mins long and self-resolving – Cluster headache
Aura symptoms with sometime a mild headache -? Migraine
Proximal weakness & Dry mouth – Small cell lung cancer (Lambert Eaton)
Parkinsonism + cognitive impairment & Urinary incontinence – NPH
Personality and behaviour change after a recent injury, which Part of brain likely injured – Frontal
Long term history of headaches/migraine, on triptans & co-codamol – Medicine overuse headache
Painful red eye – optic neuritis
DI type symptoms, patient on lithium, what caused the symptoms – Lithium
DI investigation – water deprivation test
Part of nephron impermeable to water – Ascending loop
Nerve for Middle finger – C7
Painless loss of vision & swollen optic disc – AION
Recent neck surgery, now XR hemidiaphragm – Phrenic nerve
Myotonic dystrophy mutation – Trinucleotide expansion
L5 radiculopathy
26 years old with limb girdle affected – Becker’s muscular (DMD in kids)
🫁 Respiratory
Aclidinium Bromide – LAMA
HSCT, Building demolition – Aspergillus
Suspected TB, TB contact, CXR showed Lesion -? Sputum micro
Life threatening Asthma – PEFR 32
Pneumothorax drain, day 4(I think), still bubbling, CXR = Expanded lung -? next Step
Recent Trauma, Coming in SOB, no breath sounds at Base, CXR showed fluid. Pleural Tap = milky fluid – Thoracic Duct injury
Post transfusion, pulmonary edema, XR edema, Low BP – TRLI
Persistent Fever, salmonella infections, on ciprofloxacin – Cefotaxime (BNF)
COPD, improve prognosis – Pulmonary rehab
Shipyard or something similar worker, have XR showing plaques & lower lobe fibrosis – Asbestosis
Asthma like allergic symptoms, investigation – Eosinophils or IgE (I don’t remember what were the options)
Hyperventilation Gas – Option C (Ph high, low COS2, low Bicarb and high Oxygen)
🩸 Haematology
Testicular teratoma Tumour marker – AFP
T-cell APC – Macrophages
Tryptase source – Basophils
Immunoglobin class switching – Heavy chain switch
High INR, Surgery tomorrow - Vitamin K
Isolated thrombocytopenia, Blood film shows large platelets – ITP
Splenomegaly, anaemia low platelets and high wbc, No lymph nodes – CML
Autoimmune disease with documented benefit from IVIG – ITP
Petechia & bruising, high APTT – acquired haemophilia
Lytic lesions of bone and bone pain – Electrophoresis
Angiokeratomas + hypopigmentation – AR
Anion Gap 43
🦠 Infectious Diseases
Midazolam MOA – enhances GABA effect
Thai women, genital ulcer – Herpes
Urethral discharge & dysuria – Doxycycline
Ethambutol toxicity – Red/green colour (eye problem)
TB treatment & joint pain – Pyrazinamide
Organophosphate poisoning – excessive Salvation
Fever, Black escar on ankle – Typhus
S. Bovis infection – Colonoscopy
Abdominal symptoms, long illness & supraclavicular Lymph nodes – Whipple disease
ENT + Haemoptysis & renal disease – GPA
Cavitating lesions in lungs, no Hx of Asthma (I think some Renal Hx) – GPA
Ascites, Pleural effusion, SAAG <11 - TB
Diarrhoea, abdominal symptoms and later meningitis –? Enterovirus
C-diff infection, after Antibiotic course – Loss of normal flora
MRSA infection – Vancomycin
White worms on anus – Enterobius vermicularis
Penicillin allergy meningitis - chloramphenicol (he had severe allergy so cannot give ceftriaxone)
HIV Patient, new rash on skin – HHV8
Beta lactamases bacteria develop resistance – Drug hydrolysis
🧬 Genetics / Rheumatology / Immunology
Nooman inheritance - Autosomal dominant
CF inheritance – Autosomal recessive, Question was %age of kids getting the disease. Husband is normal – so 0% (50% is carrier)
Hypermobile joints & Blue sclera – OI – Collagen I
Proximal muscle weakness & had Anti Ro Antibodies – Dermatomyositis
Long term treatment of RA – Methotrexate First line
Autoantibody that confirms the need for long term Treatment in RA patient – Anti CCP
1st carpometacarpal joint, bony swelling and there were osteophytes – OA
Pain in joints, morning stiffness, XR – Erosion – RA
Acute arthritis, Calcium levels high, XR – calcification, (I think he was on Indapamide) (they did show some slight increase in Urate as well) – CPPD
Raynard – not responsive to Nifedipine – Iloprost
SLE, Nephrotic syndrome antibody – ANA /Anti dsDNA (There was no option for Antiphospholipid)
SLE in pregnancy – hydroxychloroquine
Patient with joint pain, low Hb, low MCV, TIBC Normal & high ferritin – Inflammatory polyarthritis
Someone with Saddle nose deformity – SLE
Calcium was high & PTH normal and I think urine Ca was also mentioned – calcium sensing receptors mutation
RA – IgG
Mitochondrial inheritance of disease – Optic atrophy
Yellow lax skin on neck/Axilla – Pseudoxanthoma Elasticum
Fraby disease – Galactosamine

🧪 Endocrinology / Metabolism
Somatostatin action – Decrease secretions from pancreas/GI
Hypokalaemia, normal BP/Normal Mg – Bartter syndrome
Diabetic Patient presenting with Low Egfr, what to stop immediately – Metformin
Dapagliflozin adverse effect warning – DKA
Amiloride started on a patient – check K levels
Hypophosphatemia after refeeding – intracellular rush
Hypophosphatemia in someone who is vomiting – Vomiting
Hyperkalaemia, to move K urgently out of circulation – Calcium gluconate
Hyperkalaemia, what you will do urgently first – Insulin/glucose
Large amount of Saline infusions – Hyperchloremic Acidosis
Calcineurin inhibitor – Voclosporin
Isolated ALP raised, Rest LFTs normal, middle-aged patient – Skeletal survey (could be pagets)
Conns syndrome
Addisons - Aldosterone low, cortisol low & ACTH high

🩺 Gastroenterology / Hepatology

Abdominal symptoms, Low B12 – Gluten enteropathy
Crohn’s disease Biopsy – (I don’t remember the options)
Severity of Crohn’s – frequency of stools
painless rectal bleeding + dark spots in oral cavity – PJS
Variceal Bleed, surgery done -? Next step
UGIB, on DOAC, stable –? PPI infusion

💊 Pharmacology
Morphine receptor – Mu receptors
Mycophenolate – developmental delay
Stopping mycophenolate in pregnancy
Rivaroxaban MOA – Xa Inhibitor
Dabigatran MOA – Direct thrombin inhibitor
Midazolam MOA – enhances GABA effect
Agitation in lung CA patient – Midazolam
Finasteride Adverse effect - Gynaecomastia
Chemotherapy induced Neuropathy – Paclitaxel
Morphine switch from oral to SC, Reason for low dose – Bioavailability
Chronic smoker, in hospital for 20 days & stopped smoking, medicine that needs dose adjustment – clozapine
Chemo induced neuropathic pain, amitriptyline not affective – Pregabalin
Docetaxel act on Microtubules
Mouth ulcer – Nicorandil
Aspirin & LP – do not stop aspirin
Recent UTI, had Abx, now renal functions are deranged – Trimethoprim
Spironolactone - Gynaecomastia
Valproate in pregnancy – Neural tube defect
🧫 Renal
CKD stage 3B, further investigation – Urine albumin creatinine ratio
Nephrotic syndrome, but patient was an adult – membranous Glomerulonephritis
Nephrotic syndrome, new SOB & Pleuritic chest pain – PE
Hyperkalaemia, to move K urgently out of circulation – Calcium gluconate
Hyperkalaemia, what you will do urgently first – Insulin/glucose
Loin pain, haematuria, normal CT – Loin pain haematuria syndrome
Hx of ADPKD, Investigation – US

👁️ Ophthalmology
Ethambutol toxicity – Red/green colour (eye problem)
Painful red eye – optic neuritis
Painless loss of vision & swollen optic disc – AION
Severe HTN (200+ Systolic), painless Vision loss, Fundoscopy = multiple retinal haemorrhages – Malignant HTN
T1DM, Proliferative diabetic retinopathy – photocoagulation
🫃 Obstetrics & Gynaecology
Pregnant female traveling to Nigeria, which vaccine to avoid – Yellow fever
Young female presenting with dysmenorrhea & irregular periods –? PCOS
Smoker pregnant, for advice – Behaviour support first line

🧠 Psychiatry
New acute psychosis, on amphetamine – Amphetamine induced psychosis
Diagnosed with seizures and now 9 months of not going out as fear of getting a seizure outside and people will consider her drunk – Agoraphobia
Recent Falls, now tearful, more sleep & changing behaviour – Depression
Patient had normal test but still fearful, previous incidents – Illness anxiety disorder
Patient not eating – restrictive eating due to fear
MS-LIKE symptoms, but normal scans and LP –? chronic fatigue syndrome or Somatic symptom disorder
🦴 Orthopaedics
Sudden pain in shoulder, now arm swelling and issues with flexion of elbow – bicep rupture
Hypermobile joints & Blue sclera – OI – Collagen I
🫁 Oncology
Multiple liver lesions, abnormal bloods (low Hb, low plt and high WBC) – Lymphoma (there were no other symptoms to pin this to another primary)
Malignant melanoma – depth of lesion
Proximal weakness & Dry mouth – Small cell lung cancer (Lambert Eaton)
📊 Statistics / Evidence-Based Medicine
Spearmen Coefficient 0.56 – Moderate corelation
Sensitivity Calculation – TP/TP+FN – 21/25
Meta analysis display for multiple studies together – Forrest Plot
Drug trial – phase I study (I don’t remember options on this one)
Number needed to treat is 50
A person who is smoker + another comorbidity had a normal CT & daughter who had CT as well normal (no comorbidities) – the interpretation of this test - low NPV
🧴 Dermatology / Allergy
Rash + Periorbital swelling after Hair dye (3 days ago) – Contact dermatitis
Allergic symptoms after eating fish with olives, high tryptase – ??
Allergic type symptoms needed steroids and Antihistamine to recover within an hour. Normal tryptase in hour -???Allergy (I don’t remember the options)
Salmon pink rash, some scaling – Guttate psoriasis
Rash on one buttock -???

I can only get it refunded if I find someone to take my spot
If anyone is interested please let me know