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100 commonly tested facts for MRCP Part 1 Here is a list of commonly tested facts in hte MRCP Part

1 exam. They are listed in order of importance - highest first. 1. Acromegaly iagnosis! "#TT follo$ed %y #H conc. &. C'shings iagnosis! &(hr 'rinary free cortisol. Addisons --) short synacthen. *. Rash on %'ttoc+s ermatitis herpetiformis ,coeliac dx-. (. A. $ith T/A --) 0arfarin. 1'st T/A2s $ith no A. --) Aspirin 3. Herpes encephalitis --) temporal lo%e calicification "R temporoparietal attent'ation s'%ac'te onset i.e. 4e5eral days. 6. "%ese $oman7 papilloedema8headache --) 9enign /ntercanial Hypertention. :. r'g ind'ced pne'monitis --) methotrexate or amiodarone. ;. chest discomfort and dysphagia --) achalasia. <. foreign tra5el7 macpap rash8fl' li+e illnes --) H/= ac'te. 10. ca'se of go't --) dec 'rinary excretion. 11. >%leep? on hands and frag'le s+in torn %y minor tra'ma --) porphyria c'tanea tarda. 1&. 4plenectomy --) need pne'mococcal 5accine AT @AA4T & $ee+s pre-op and for life. 1*. primary hrperparathyroidism --) high Ca7 normal8lo$ P"(7 normal8high PTH ,in elderly-. 1(. middle aged man $ith BCAA arthritis --) gonococcal sepsis ,older people -) 4taph-. 13. sarcoidosis7 erythema nodos'm7 arthropathy --) @offgrens syndrome %enign7 no Rx needed. 16. tremor post'ral7slo$ progression7tit'%ation7 relie5ed %y "H-)%enign essential tremor A't om. ,M4 tit%ation7 P no tit'%ation1:. electrolytes dist'r%ance ca'sing conf'sion lo$8high Ca. 1;. contraindications l'ng s'rgery --) .A= D1.37 MA@/#CACT eff'sion7 mets o'tside l'ng. 1<. pre5ent f'rther renal deterioration8protein'ria--) dec %p 1*08<07 Ace inhi%itors ,if protein'ria D*g8&(hrs&0. headache $ith many analgesics at once -) analgesic ind'ced headache. &1. 1.3 cm difference %t$n +idneys -) Renal artery stenosis --) Magnetic resonance angiogram. &&. temporal tenderness--) temporal arteritis -) steroids ) <0E ischaemic ne'ropathy7 10E retinal art occl'sion. &*. se5ere retroor%ital7 daily headache7 lacrimation --) cl'ster headache. &(. pemphig's in5ol5es mo'th ,m'c's mem%ranes-7 pemphigoid less serio's C"T m'cosa. &3. diagnosis of poly'ria -) $ater depri5ation test7 then A=P. &6. ins'linoma -) &( hr s'per5ised fasting hypoglycaemia. &:. ia%etes Random ): or if )6 "#TT ,:3g- -) )11.1 also seen in HCT. &;. ca'ses of 5illo's atrophy! coeliac ,lymphocytic infiltrate-7 0hipples 7 dec /g7 lymphoma7 trop spr'e ,rx tetracycline-. &<. diarrhoea7 %ronchospasm7 fl'shing7 tric'spid stenosis -) g't carcinoid c li5er mets. *0. hepatitis 9 $ith general deterioration -) hepaocell'lar carcinoma.

*1. al%'min normal7 total protein high -) myeloma ,hypercalcaemia7 electrophoresis-. *&. H94ag positi5e7 H9 CA not detecta%le --) chornic carier. **. /nf M/7 artery in5li5ed -) Right coronary artert. *(. A't dom conditions! Achondroplasia7 Ahler anlos7 .AP7 familial hyperchol7#il%erts7 H'ntington2s7 Marfans2s7 C.T /8//7 Most porphyrias7 t'%ero's sclerosis7 50 7 Pe'tF1eghers. *3. G lin+ed! 9ec+8 'ch m'sc dyst7 alports7 .ragile G7 #6P 7 Haemophilia A89. *6. @o'd 41! M47 hyperdynamic7 short PR. 4oft 41! immo%ile M47 MR. *:. @o'd 4&! hypertension7 A4. .ixed split! A4 . "pening snap! M"9/@A M47 se5ere near 4&. *;. H"CM8M=P - inc %y standing7 dec %y sH'ating ,inc all others-. H"CM inc %y 5alsal5a7 decs all others. 4'dden death athlete7 .H7 Rx. Amiodarone7 /C . *<. M=P s'dden $orsening post M/. Harsh systolic m'rm'r radites to axilla. (0. ilated Cardiomyopathy! "H7 %p7 thiamine8seleni'm deficiency7 M 7 coc+sac+ie8H/=7 preg7 doxor'%icin7 infiltration ,HCT7 sarcoid-7 tachycardia. (1. Restricti5e Cardiomyopathy! sclerodermma7 amyloid7 sarcoid7 HCT7 glycogen storage7 #a'chers7 fi%rosis7 hypereosinophilia @offlers7 caracinoid7 malignancy7 radiotherapy7 toxins. (&. T'mor compressing Respiratory tract --) in5estigation! flo$ 5ol'me loop. (*. #'illan 9arre syndrome! chec+ =/TA@ CAPAC/TI. ((. Horners s$eating lost in 'pper face only lesion proximal to common carotid artery. (3. /ntern'clear opthalmoplegia! medial longit'dinal fascic'l's connects CC n'cle's *-(. /psilateral add'ction palsy7 contralateral nystagm's. Aide memoire ,TR/A4 T" IACB THA ipsilateral 9A AIA ACR"44 THA C"4A-. Con5ergence retraction nystagm's7 %'t con5ergence reflex is normal. Ca'ses! M47 4@A7 Miller fisher7 o5erdose,%ar%7 phenytoin7 TCA-7 0ernic+e. (6. Progressi5e 4'pran'clear palsy! 4teel Richardson. A%sent 5ol'ntary do$n$ard gaFe7 normal dolls eye. i.e. "cc'lomotor n'clei intact7 s'pran'clear Pathology . (:. Perina'ds syndrome! dorsal mid%rain syndrome7 damaged midrain and s'perior collic'l's! impaired 'pgaFe ,cf P4CP-7 lid retraction7 con5ergence preser5ed. Ca'ses! pineal t'mor7 stro+e7 hydrocephal's7 M4. (;. demetia7 gait a%normaily7 'rinary incontinence. A%sent papilloedema--)Cormal press're hydrocephal's. (<. ac'te red eye -) ac'te closed angle gla'coma )) less common ,ant '5eitis7 scleritis7 episcleritis7 s'%conJ'nti5al haemmorrhage-. 30. $heeles7 'rticaria7 dr'g ind'ced -) aspirin. 31. s$eats and $eight gain -) ins'linoma. 3&. diagnostic test for asthma -) morning dip in PA.R )&0E. 3*. Ca'ses of 4/A H ! chest8cere%ral8pancreas Pathology 7 porphyria7 malignancy7 r'gs ,car%amaFepine7 chlorpropamide7 clofi%rate7 atipsychotics7 C4A/ s7 rifampicin7 opiates3(. Ca'ses of ia%etes /nsipid's! Cranial! t'mor7 infiltration7 tra'ma Cephrogenic! @ithi'm7 amphoteracin7 domeclocycline7 prologed hypercalcaemia8hypornatraemia7 familial G lin+ed type 33. %isphosphonates!inhi%it osteoclast acti5ity7 pre5ent steroid incd'ced osteoperosis ,5itamin also-.

36.ret'rned from airline flight7 T/A-) paradoxical em%ol's do T"A. 3:. alcoholic7 gi5en gl'cose de5elops nystagm's -) 91 deficiency ,$ernic+es-. Confa%'lation-)+orsa+off. 3;. mono-artropathy $ith thiaFide -) go't ,neg %irefringence-. C" A@@"PKR/C"@ for ac'te. 3<. painf'l *rd ner5e palsy -) posterior comm'nicating artery ane'rysm till pro5en other$ise 60 late complication of scleroderma --) p'monaryhypertention pl's8min's fi%rosis. 61. ca'ses of erythema m'tliforme! lamotrigine 6&. 5omiting7 a%dominal pain7 hypothyroidism -) Addisonian crisis ,T.T typically a%normal in this setting " C"T gi5e thyroxine-. 6*. mo'th8genital 'lcers and oligarthritis -) %ehcets ,also eye8s+in lesions7 =T6(. mixed dr'g o5erdose most important step -) Cacetylcysteine ,time dependent prognosis63. ca5erno's sin's syndrome - *rd ner5e palsy7 proptosis7 perior%ital s$lling7 conJ inJectn 66. asymetric par+insons -) li+ely to %e idiopathic 6:. "%ese7 C/ M female $ith a%normal @.T2s -) CA4H ,non-alcoholic steatotic hepatitis6;. fl'ct'ating le5el of concio'sness in elderly pl's8min's deterioration --) chronic s'%d'ral. Can last e5en longer than 6 months 6<. 4ensiti5ity --) TP8,TP pl's .C- e.g. .or 4@A - ACA highly sens7 ds CA!highly specific :0. RR is ;E. CCT is ----) 1008; --) 308( --) &38& --) 1*.3 :1. ipsilateral ataxia7 Horners7 contralateral loss pain8temp --) P/CA stro+e ,lateral med'lary syndrome of 0allen%'rg:&. renal stones ,;0E calci'm7 10E 'ric acid7 3E ammoni'm ,prote's-7 *E other-. Kric acid and cyteine stone are radiol'scent. :*. hyperprolactinaemia ,allactorrohea7 amenorrohea7 lo$ .4H8@H- -) a antags ,metoclopramide7 chlorpromaFine7 cimetidine C"T TCA2s-7 pregnancy7 PC"47 pit t'mor8microadenoma7 stress. :(. istal7 asymetric arthropathy -) psoriasis :3. episodic headache $ith tachycardia -) phaeochromocytoma :6. 5ery raised 0CC -) A@0AI4 thin+ of le'+aemia. ::. iagnosis of C@@ --) imm'nophenotyping C"T cytogenetics7 C"T %one marro$ :;. Prognostic factors for AM@ -) %m +aryotype ,good8poor8standard- )) 0CC at diagnosis. :<. pancytopenia $ith raised MC= --) chec+ 91&8folate first ,other ca'ses poss%le7 %'t do this ./R4T-. "ften associayed $ith phenytoin 'se --) decreased folate ;0. miscariage7 =T7 stro+e --) l'p's anticoag'lant --) lifelong anticoag'lation ;1. H% ele5ated7 dec A4R -) polycythaem'a ,&ndry if pa"& lo$;&. anosmia7 delayed p'%erty -) Ballmans syndrome ,hypogonadotrophic hypogonadism;*. diag of PB -) renal K4 e5en if D*07 lin+age analysis 9KT reH'ires ser'm from & relati5es $ith dx ;(. Io'ng female -) thin+ anorexia ner5osa

;3. commonest finding in #6P hamolysis -) ha'moglo%in'ria ;6. mitral stenosis! lo'd 41 ,soft s1 if se5ere-7 opening snap.. /mmo%ile 5al5e -) no snap. ;:. .lan+ pain7 'rinalysis!%lood7 protein -) renal 5ein throm%osis. Ca'ses! nephrotic syndrome7 RCC7 amyloid7 ac'te pyelonephritis7 4@A ,atiphospholipid syndrome $hich is rec'rrent throm%osis7 fetal loss7 dec plt. Ks'al ca'se of cns manifestations assoc $ith l'p's ancoag'lant7 anticardiolipin a%;;. anaemia in the elderly ass'me #/ malignancy ;<. hypothermia7 ac'te renal fail're -) rha%domyolysis ,collapse ass'med<0. pain7 n'm%ness lateral 'pper thigh --) meralgia paraesthesia ,lat c'taneo's ner5e compression 'sally %y %y ing ligament<1. diagnosis of haemochromatosis! screen $ith .erritin7 confirm %y tranferrin sat'ration7 genotyping. /f nondiagnostic do li5er %iopsy 0.*E mortality <&. (0 mg hidrocortisone di5ided doses ,%d- --) 10 mg prednisolone ,ie. Prednislone is x( stronger<*. 9T4! T9 g'idlines close contacts -) Heaf test -) positi5e CGR7 negati5e --) repeat Heaf in 6 $ee+s. /solation not reH'ired. <(. iptheria -) ex'dati5e pharyngitis7 lymphadenopathy7 cardio and ne'ro toxicity. <3. /nd'rated plaH'es on chee+s7 scarring alopecia7 hyper+eratosis o5er hair follicles -)) iscoid l'p's <6. $t loss7 mala%soption7 inc A@P -) pancreatic cancer <:. foreign tra5el7 tender RKL7 raised A@P --) li5er a%scess do K84 >snip?. $t loss7 anaemia ,macro8micro-7 no o%5io's ca'se -) coeliac ,diarrhoea does C"T ha5e to %e present<<. haemat'ria7 protein'ria7 %est in5estigation --) if glomer'lonephritis s'spected --) renal %iopsy 100. 5eno's 'lcer treatment --) excl'de arteriopathy ,eg A9P/-7 control oedema7 pre5ent infection7 compression %andaging. 101. Malaria7 inc'%ation $ithin *81&. can %e relapsing 8remitting. =i5ax and "5ale ,0est Africa- longer imc'%ation. 10&. .e5er7 lymphadenopathy7 lymphocytosis7 pharygitis ---)A9= ---) heterophile anti%odies 10*. #/ %leed after endo5asc'lar AAA s'rgery --) aortoenteric fist'la High Iield Topics 1. Io'ng girl s'spect Anorexia Cer5osa lin'go hair7 finctional hypogonadotrophic hypogonadism -) amennorhea. @H and .4H %oth lo$. All other hormones are 's'ally normal. .erritin lo$. &. Reiters 4yndrome arthritis7 '5eitis7 'rethritis Chlymidia7 campylo%acter7 Iersinia7 4almonella7 4higella. 9alanisits. *. PB a't dom Chr 168( assoc %erry ane'rysm7 mitral8aortic reg'rg (. Porphyria photosensiti5ity7 %listers7 scars $ith millia7 hypertrichosis 3. Heart so'nds! Aortic 4tenosis s& paradoxical split7 length proportional to se5erity 6. =itiligo commonest assoctions pernicio's anaemia ))) type 1 M 7 a'toimm'ne addisons7 a'toimm'ne thyoid dx :. #o't %lood 'rate high8lo$8normal7 Joint aspirate pos %irif7 ppt thiaFides7 C" allop'rinol8aspirin in ac'te phase

;. Peripheral ne'ropathy a- 91& rapid7 dorsal col'mns ,Joint pos7 5i%ration-7 sensory ataxia7 pse'doathetosis of 'pperlim%s %- dia%etic slo$7 spinothalamic ,pain7 tempMc-alcohol slo$ progressi5e7 spinothalamic d- P% motor 'pper lim%s <. CC4 a%normalities in H/=! toxoplaasmosis ,ring enhancing-7 lymphoma ,solitary lesion-. H/= encephalopathy7 progressi5e m'ltifocal le'coencephalopathy ,PM@ demylination in ad5anced H/=7 lo$ atten'ation lesions10. Tra5ellers diarrohea! chronic ,)& 0AAB4- giardia ,incidio's onset rx. MetronidaFole-7 salmonella ,serio's systemic illness-7 A.coli ,rx. Ciprofloxacin- 7 4higella 11. Renal syndrome minimal change disease7 mem%ano's7 /gA nephropathy7 poststreptococcal. 1&. /f yo' see %lood on 'rinalysis forget a%o't RA4 1*. Thyroid Malignancy tend to %e non-f'nctional7 anaplastic has $orse prognosis7 local infiltration -) dysphagia7 5ocal cord paralysis A@M"4T Pathognomic for the exam fatig'a%ility -) myasthenia gra5is fascic'lations -) Motor ne'rone diease sil5ery $hite scale -) psoriasis hypopigmented -) 5itiligo8pityriasis 5ersicolor preti%ial myxoedema --) #ra5es ,C"T lid lag7 C"T exopthalm'sP@AA4A #/=A C"RRACT/"C4 AC A /T/"C4

"C@I /CC@K A .ACT4 THAT HA=A .RALKACT@I APPAARA "C "../C/A@ PA4T MRCP LKA4T/"C4 /f yo' 'se or copy this list7 please gi5e me credit7 as / $as the one that p't this list together. %est $ishes r 4'Jit =asanth
hormones are usually normal. Ferritin low. 2. Reiters Syndrome arthritis, uveitis, urethritis Chlymidia, campylobacter, Yersinia, SAL !"#LLA , Shi$ella. %alanisits. &. '() aut dom Chr *+,- assoc berry aneurysm, mitral,aortic re$ur$ -. 'orphyria photosensitivity, blisters, scars with millia, hypertrichosis .. heart sounds/ Aortic Stenosis s2 parado0ical split, len$th proportional to severity +. 1itili$o commonest assoctions pernicious anaemia 222 type * ) autoimmune addisons, autoimmune thyoid d0 ,

3. 4out blood urate hi$h,low,normal, 5oint aspirate pos biri6, ppt thia7ides, "! allopurinol,aspirin in acute phase 8. 'eripheral neuropathy a9 %*2 rapid, dorsal columns :5oint pos, vibration9, sensory ata0ia, pseudoathetosis o6 upperlimbs b9 diabetic slow, spinothalamic :pain, temp;9 c9alcohol slow pro$ressive, spinothalamic d9 'b motor upper limbs <. C"S abnormalities in =>1/ to0oplaasmosis :rin$ enhancin$9, lymphoma :solitary lesion9. =>1 encephalopathy, pro$ressive multi6ocal leucoencephalopathy :' L demylination in advanced =>1, low attenuation lesions9 *?. @ravellers diarrohea/ chronic :22 A##(S9 $iardia :incidious onset r0. etronida7ole9, SAL !"#LLA :serious systemic illness9, #.coli :r0. Cipro6lo0acin9 , Shi$ella **. Renal syndrome minimal chan$e disease, membanous, >$A nephropathy, postBstreptococcal. *2. >6 you see blood on urinalysis 6or$et about RAS *&. @hyroid ali$nancy tend to be nonB6unctional, anaplastic has worse pro$nosis, local in6iltration B2 dyspha$ia, vocal cord paralysis AL !S@ 'atho$nomic 6or the e0am 6ati$uability B2 myasthenia $ravis 6asciculations B2 otor neurone diease

silvery white scale B2 'S!R>AS>S hypopi$mented B2 vitili$o,pityriasis versicolor pretibial my0oedema BB2 4raves :"!@ lid la$, "!@ e0opthalmus9

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