mrcp classical presentations.pdf
TRANSCRIPT
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This is a collecion for some of the
common presentations for the MRCP exam (useful for part 1 & 2) Useful for revision after studying
the only note &/or passmedicine.1a
BADRAWY MRCP revision
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HOPE THIS WILL BEBENIFICIAL FOR EVERYONENB I may add some morepresentations to this set, yourcomments are highlyappreciated.
1b
BADRAWY MRCP revision
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A 17-y girl cardiac arrest asystoleresuscitate unsuccessfulcollapsed in a 1.500m race atcollegeno relevant family history causeof death?
2a
BADRAWY MRCP revision
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HOCMMCC of SCD in the young
2b
BADRAWY MRCP revision
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2 day baby cyanotic withfeeding & crying ?
3a
BADRAWY MRCP revision
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TGAcyanotic: TGA most
common at birth. Fallot'smoss common overall
3b
BADRAWY MRCP revision
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A 17-y girl recurrent attacks atcollapse occur without warning,occurred whilst she wasrunning for a bus,family history father diedsuddenly when he was 38-s, Dx ?
4a
BADRAWY MRCP revision
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HOCMMCC of SCD in the young
4b
BADRAWY MRCP revision
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A 30-y F, central chestpain,severe, non-radiating
and eases onexpiration,ECG,widespread
ST elevation,Dx ?5a
BADRAWY MRCP revision
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Acute pericarditis
5b
BADRAWY MRCP revision
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50 -ys M, SOB since themorning,inferior MI 1 y ago,echo following the MI normal LVfunction,still a smoker bibasal crackles,perihilarshadowing,ECG and cardiac enzymesare normal,Dx ?
6a
BADRAWY MRCP revision
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Penal artery stenosis Renal artery stenosis may causesudden onset or 'flash'pulmonary oedema. A MI isunlikely given the normal ECGand cardiac enzymes
6b
BADRAWY MRCP revision
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18-y Turner's syndromehas a murmur
soft ejection systolicmurmur,Dx ?
7a
BADRAWY MRCP revision
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Bicuspid aortic valve MC heart disease with
Turner7b
BADRAWY MRCP revision
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70 y F, palpitation + chesttightness,ECG atrial
activity 300, ventricularactivity 150 ,Dx ?
8a
BADRAWY MRCP revision
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Atrial FlutterTachycardia with HR 150
think flutter8b
BADRAWY MRCP revision
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A 60-y M, SOB onexertion,third heart sound
, respiratory system isunremarkable,Dx ?
9a
BADRAWY MRCP revision
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Dilated cardiomyopathyA 3rd heart sound is only
considered a normalvariant in patients < 40 s
9b
BADRAWY MRCP revision
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A 36-y F routine antenatal review,15weeks pregnantBP 154/94 confirmed withambulatory BP monitoringher BP 4 weeks ago was 140/88,urinedipstick protein + and nothingelse,no significant past Hx, Dx ?
10a
BADRAWY MRCP revision
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Pre-existing hypertension Pregnancy related BPproblems (pre-eclampsia orpregnancy induced HTN)don't occur before 20 weeks.
10b
BADRAWY MRCP revision
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A 35-y F,DVT in the thirdtrimester of pregnancy,sudden left hemiparesis,
Dx ?11a
BADRAWY MRCP revision
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Patent foramen ovalepresent in about 20% of
population11b
BADRAWY MRCP revision
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A 1-y-old girl, a continuousmurmur,loudest at the leftsternal edge,not cyanosed,
Dx ?12a
BADRAWY MRCP revision
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PDA
12b
BADRAWY MRCP revision
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A 40-y old F,refractoryhypertension,non-specific chestpains,coronary angiogram,Rightfemoral artery 122/68Left ventricle 202/104,Aorta194/84,left arm BP 188/74, Dx ?
13a
BADRAWY MRCP revision
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Coarctation of the aorta
13b
BADRAWY MRCP revision
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An 82-y M, increasingdyspnoea or exertion,
systolicmurmur,BP 100/80,slow
rising pulse,Dx ?14a
BADRAWY MRCP revision
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AS dt Calcification of theaortic valve
14b
BADRAWY MRCP revision
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A 56-y M, ED with headaches,chest pain and confusion, BP250/140,equal in botharms,Blurring of the opticdiscs,no significant medicalhistory,Dx ?
15a
BADRAWY MRCP revision
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Malignant hypertension Rx with Intravenous
nitroprusside15b
BADRAWY MRCP revision
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A 62-y M,two episodes of 'passingout' for around 15 seconds lastmonths associated with effort,feeling'groggy' for only a few seconds afterthe episode,systolic murmur radiates to the carotid area,Dx ?
16a
BADRAWY MRCP revision
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ASNext best step isEchocardiogram
16b
BADRAWY MRCP revision
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A 44-y M, Hx of palpitations +pre-syncopal symptomsECGT wave inversion in leadsV1-3 +notch at the end of theQRS complex,FH of SCD, Dx ?
17a
BADRAWY MRCP revision
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Arrhythmogenic rightventricular
cardiomyopathy17b
BADRAWY MRCP revision
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A 76-y, palpitationsirregular cannon 'a'
waves,Dx18a
BADRAWY MRCP revision
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Complete heart block
18b
BADRAWY MRCP revision
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an elderly Hx of chronicglaucoma & HTN a suddenpainless loss of vision in one eye.Fundoscopy reveals multipleflame-shaped haemorrhages andoptic disc oedema
19a
BADRAWY MRCP revision
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Central retinal veinocclusion
19b
BADRAWY MRCP revision
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an elderly short-sightedman presents with a floater
on the temporal field ofvision. Visual acuity is
normal20a
BADRAWY MRCP revision
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Posterior vitreousdetachment
20b
BADRAWY MRCP revision
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An elderly mancomplains of dysphagia,halitosis, regurgitation
and cough21a
BADRAWY MRCP revision
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pharyngeal pouch
21b
BADRAWY MRCP revision
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an elderly patient presentswith bone pain,
depression, renal stonesand recurrent peptic ulcer
22a
BADRAWY MRCP revision
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Primaryhyperparathyroidism
22b
BADRAWY MRCP revision
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a teenage girl primaryamenorrhoea, well developedsecondary sexual characteristics& breasts. scanty pubic hair andblind-ending vagina
23a
BADRAWY MRCP revision
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Androgen insensitivitysyndrome
23b
BADRAWY MRCP revision
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An elderly women developsitchy, tense blisters around
the flexures. There is nomucosal involvement -
24a
BADRAWY MRCP revision
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bullous pemphigoid
24b
BADRAWY MRCP revision
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A 30-year-old manhaemoptysis and renal
failure. A renal biopsy linearIgG deposits along thebasement membrane
25a
BADRAWY MRCP revision
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Goodpasture's syndrome
25b
BADRAWY MRCP revision
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A 45-year-old womanpresents with fatigue and
pruritus. Blood tests show araised bilirubin, ALP and
IgM level26a
BADRAWY MRCP revision
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primary biliary cirrhosis
26b
BADRAWY MRCP revision
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A 55-year-old presents withfever, headache, confusionand aphasia. A CT showspetechial haemorrhages inthe temporal lobe
27a
BADRAWY MRCP revision
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herpes simplexencephalitis
27b
BADRAWY MRCP revision
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A 30-year-old man presentswith recurrent palpitationsand syncope. A resting ECGshows T wave inversion inV1-3 and epsilon waves
28a
BADRAWY MRCP revision
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arrhythmogenic rightventricular
cardiomyopathy28b
BADRAWY MRCP revision
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A teenager with tear droppapules on the trunk andlimbs 3 weeks after a sore
throat29a
BADRAWY MRCP revision
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Guttate psoriasis
29b
BADRAWY MRCP revision
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a young child with a history ofatopic eczema develops a suddeneruption of painful, oedematousvesicles and pustules. They haveare systemically unwell and havea fever
30a
BADRAWY MRCP revision
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Eczema herpeticum
30b
BADRAWY MRCP revision
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A 60-Hx of TB dyspnoeaand fatigue. JVP is
elevated, loud S3 andKussmaul's sign is positive.
Hepatomegaly31a
BADRAWY MRCP revision
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constrictive pericarditis
31b
BADRAWY MRCP revision
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bitemporal hemianopia(upper quadrant defect >
lower quadrant defect)32a
BADRAWY MRCP revision
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Pituitary tumour
32b
BADRAWY MRCP revision
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A tall, slim man presentswith infertility. He is notedto have small, firm testes.Gonadotrophin levels are
elevated33a
BADRAWY MRCP revision
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Klinefelter's syndrome
33b
BADRAWY MRCP revision
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a tall, slim 18-year-old manpresents with hypogonadism.
He also complains ofanosmia. Gonadotrophin
levels are reduced34a
BADRAWY MRCP revision
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Kallman's syndrome
34b
BADRAWY MRCP revision
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An elderly gradualworsening dementia and
bradyphrenia , a slow,shuffling gait. urinary
incontinence35a
BADRAWY MRCP revision
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normal pressurehydrocephalus
35b
BADRAWY MRCP revision
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An elderly Jewish womandevelops painful, flaccid, easilyruptured vesicles and bullae onthe skin.not itchy and werepreceded by mouth lesions
36a
BADRAWY MRCP revision
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pemphigus vulgaris
36b
BADRAWY MRCP revision
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A woman rheumatoid arthritisred right eye.no pain,discharge or photophobiaalthough the eye is tearing.Visual acuity is normal
37a
BADRAWY MRCP revision
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episcleritis
37b
BADRAWY MRCP revision
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A patient develops footdrop following a fibular
neck fracture38a
BADRAWY MRCP revision
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common peroneal nerve
38b
BADRAWY MRCP revision
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middle aged womanthyrotoxicosis and a goitre.exophthalmos and pretibialmyxoedema. Anti-TSH receptorstimulating antibodies arepositive -
39a
BADRAWY MRCP revision
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Graves' disease
39b
BADRAWY MRCP revision
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persistent foul-smellingwatery diarrhoea and
weight loss after travellingto India.symptoms for two
weeks40a
BADRAWY MRCP revision
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giardiasis
40b
BADRAWY MRCP revision
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a patient speak fluently butmakes little sense with mulitpleword substitutions andneologisms. + difficultyunderstanding what people aresaying to him
41a
BADRAWY MRCP revision
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Wernicke's aphasia
41b
BADRAWY MRCP revision
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a patient have laboured,non-fluent, halting speech.He does however retain hisability to understand whatpeople are saying to him
42a
BADRAWY MRCP revision
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Broca's aphasia
42b
BADRAWY MRCP revision
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A 40-year-old womanpresents with fever,
fluctuating neurologicalsigns, thrombocytopenia
and renal failure43a
BADRAWY MRCP revision
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TTP
43b
BADRAWY MRCP revision
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An elderly acute onsetataxia, nystagmus and
sensory loss.sensory lossaffecting the left side of the
face and right arm44a
BADRAWY MRCP revision
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posterior inferiorcerebellar arteryocclusion (lateral
medullary syndrome)44b
BADRAWY MRCP revision
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A man presents withsevere vomiting. Earlier inthe day he reheated some
rice from a takeaway45a
BADRAWY MRCP revision
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Bacillus cereus
45b
BADRAWY MRCP revision
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unilateral spastic paresis andloss of proprioception /vibrationsensation with loss of pain andtemperature sensation on theopposite side.
46a
BADRAWY MRCP revision
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Brown-Sequardsyndrome
46b
BADRAWY MRCP revision
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A 20-y presents in summerwith gradually worsening
flu-like symptoms and a drycough. + erythema
multiforme47a
BADRAWY MRCP revision
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mycoplasma pneumonia
47b
BADRAWY MRCP revision
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bilateral spastic paresisand loss of pain and
temperature sensation48a
BADRAWY MRCP revision
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Anterior spinal arteryocclusion
48b
BADRAWY MRCP revision
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A 6-yboy passing darkurine 10 days after having
had a sorethroat.periorbital oedema
49a
BADRAWY MRCP revision
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Post-streptococcalglomerulonephritis
49b
BADRAWY MRCP revision
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a 5-year-old child develops acuterenal failure shortly after beingadmitted with bloody diarrhoeaand fever. Bloods show renalfailure, thrombocytopaenia andanaemia
50a
BADRAWY MRCP revision
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Haemolytic uraemicsyndrome
50b
BADRAWY MRCP revision
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A 30-y Turkish manrecurrent oral and genitalulceration. anterior uveitis
and thombophlebitis -51a
BADRAWY MRCP revision
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Behcet's syndrome
51b
BADRAWY MRCP revision
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A 30-y woman with ahistory of recurrent peptic
ulcer disease,hypercalcaemia on routine
bloods. -52a
BADRAWY MRCP revision
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multiple endocrineneoplasia (type 1)
52b
BADRAWY MRCP revision
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40-y man with a history ofulcerative colitis fatigue,
jaundice and pruritus andright upper quadrant pain
53a
BADRAWY MRCP revision
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primary sclerosingcholangitis
53b
BADRAWY MRCP revision
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Young adult with anabdominal herald patch,erythematous, oval, scaly
patches in a 'fir-tree'distribution
54a
BADRAWY MRCP revision
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pityriasis rosea
54b
BADRAWY MRCP revision
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A patient with a long historyof 'migraines' presents withregular headaches despiteusing sumatriptan on a dailybasis -
55a
BADRAWY MRCP revision
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medication overuseheadache
55b
BADRAWY MRCP revision
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A young man an acuteheadache + unilateralperiorbital edema. Onexamination there is a
lateral gaze palsy56a
BADRAWY MRCP revision
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cavernous sinusthrombosis
56b
BADRAWY MRCP revision
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A 45-y man diarrhoea,weight loss and arthralgia.
Jejunal biopsy deposition ofmacrophages PAS-positive
granules57a
BADRAWY MRCP revision
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Whipple's disease
57b
BADRAWY MRCP revision
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An elderly alcoholic manpersistent headache afterfalling over the previousday.fluctuating level of
consciousness58a
BADRAWY MRCP revision
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subdural haemorrhage
58b
BADRAWY MRCP revision
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A 65-y man chronichepatitis b infection
symptoms and signs of livercirrhosis. Alpha-fetoprotein
is elevated. -59a
BADRAWY MRCP revision
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hepatocellular carcinoma
59b
BADRAWY MRCP revision
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A young athlete paralysis ofhis right leg before an
athletics meet. Neurologicalexamination is inconsistent
-60a
BADRAWY MRCP revision
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conversion disorder
60b
BADRAWY MRCP revision
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Flacid paresis of theintrinsic hand muscleswith loss of pain and
temperature sensation -61a
BADRAWY MRCP revision
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syringomyelia
61b
BADRAWY MRCP revision
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A 50-y man history ofsinusitis presents withhaemoptysis and renal
impairment.renal biopsycrescentic GN
62a
BADRAWY MRCP revision
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Wegener'sgranulomatosis
62b
BADRAWY MRCP revision
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Elderly 2 week history ofunilateral headache +pain on chewing and
brushing her hair63a
BADRAWY MRCP revision
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temporal arteritis
63b
BADRAWY MRCP revision
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A man itchy, purple,papular rash on the palms
and flexor surfaces of arms.polygonal and covered in a
'white-lace' -64a
BADRAWY MRCP revision
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lichen planus
64b
BADRAWY MRCP revision
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A 15-year-old presents withnephrotic syndrome. Theirblood pressure and renalblood tests are normal -
65a
BADRAWY MRCP revision
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minimal change disease
65b
BADRAWY MRCP revision
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A 30-y woman foul smelling oilydiarrhoea, abdominal bloating,fatigue and weight loss.papulovesicular lesions on theextensor aspects of her arms
66a
BADRAWY MRCP revision
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coeliac disease
66b
BADRAWY MRCP revision
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A 60-y muscle fasciculation+ wasting of the small ms ofthe hand. MN signs in the
arms and UMN signs in thelegs
67a
BADRAWY MRCP revision
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motor neuron disease
67b
BADRAWY MRCP revision
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A teenage boyclumsywalking. gait ataxia, an
intention tremor and lossof lower limb reflexes -
68a
BADRAWY MRCP revision
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Friedreich's ataxia
68b
BADRAWY MRCP revision
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A 15-y midline neck lumppainless and cystic in
nature. It moves upwardson protrusion of the tongue
69a
BADRAWY MRCP revision
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thyroglossal cyst
69b
BADRAWY MRCP revision
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60-y man lung cancer dyspnoea. tachycardic,
hypotensive,JVP absent Ydescent pulsus paradoxus
70a
BADRAWY MRCP revision
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cardiac tamponade
70b
BADRAWY MRCP revision
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Intense pain around one eye.Attacks occurs once/day, eachepisode 1 hour for the past 8weeks. + red and watery eyeand a constricted pupil -
71a
BADRAWY MRCP revision
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cluster headache
71b
BADRAWY MRCP revision
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A 60-y man flu-likesymptoms & dry cough.relative bradycardia +
confused. + low sodium -72a
BADRAWY MRCP revision
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Legionnaires' disease
72b
BADRAWY MRCP revision
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Bilateral spastic paresis,loss of proprioception
and vibration sensationand limb ataxia -
73a
BADRAWY MRCP revision
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subacute combineddegeneration of the
spinal cord73b
BADRAWY MRCP revision
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bitemporal hemianopia(lower quadrant defect >upper quadrant defect)
74a
BADRAWY MRCP revision
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Craniopharyngioma -
74b
BADRAWY MRCP revision
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Young child withmultiple small, pearly,
umbilicated lesions75a
BADRAWY MRCP revision
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molluscum contagiosum
75b
BADRAWY MRCP revision
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A young man acute, painfulred eye + photophobia &
blurred vision.pupil issmall and irregular -
76a
BADRAWY MRCP revision
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anterior uveitis
76b
BADRAWY MRCP revision
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A patient persistent STelevation 4 weeks aftermyocardial infarction.
bibasal crackles +third andfourth heart sound
77a
BADRAWY MRCP revision
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left ventricular aneurysm
77b
BADRAWY MRCP revision
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an elderly short-sighted manflashing lights worse on eyemovement located in thetemporal visual field.uppervisual field loss 'like a curtaincoming down'
78a
BADRAWY MRCP revision
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Retinal detachment
78b
BADRAWY MRCP revision
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an elderly man with a longhistory of diabetes sudden visualloss in one eye. For the past fewdays floaters and 'cobwebs'.Visual acuity is reduced tosensing light
79a
BADRAWY MRCP revision
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Vitreous haemorrhage
79b
BADRAWY MRCP revision
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A woman complains oflethargy, diplopia anddysphagia. a ptosis on
examination -80a
BADRAWY MRCP revision
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myasthenia gravis
80b
BADRAWY MRCP revision
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a 30-y M visual problems. Hisvision is much worse in the dark +started to lose peripheral vision.He has a family history of similarproblems
81a
BADRAWY MRCP revision
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Retinitis pigmentosa
81b
BADRAWY MRCP revision
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an elderly female smokerreduced visual acuity, +'blurred' vision. central
scotoma and fundoscopymultiple drusen
82a
BADRAWY MRCP revision
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Macular degeneration
82b
BADRAWY MRCP revision
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a patient develops acuteheart failure 5 days after a
MI. A new pan-systolicmurmur is noted on
examination83a
BADRAWY MRCP revision
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Ventricular septal defect
83b
BADRAWY MRCP revision
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a patient is noted to have anew early-to-mid systolic
murmur 10 days afterbeing admitted for a MI
84a
BADRAWY MRCP revision
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Ischaemia of thepapillary muscle
84b
BADRAWY MRCP revision
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A 30-y man productivecough, fever and chestpain.herpes labialis +
consolidation in the rightlower zone -
85a
BADRAWY MRCP revision
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pneumococcalpneumonia
85b
BADRAWY MRCP revision
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A 25-y woman irregularperiods hirsutism.elevatedLH:FSH ratio and raised
testosterone level -86a
BADRAWY MRCP revision
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polycystic ovariansyndrome
86b
BADRAWY MRCP revision
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A 20-y painless swellingon the lateral aspect of theneck. smooth, non-tender
and fluctuant -87a
BADRAWY MRCP revision
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branchial cyst
87b
BADRAWY MRCP revision
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A 30-y man progressiveweakness of his hands. wasting ofthe small muscles of the hand.pain and temperature sensationis reduced but light touch ispreserved. -
88a
BADRAWY MRCP revision
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syringomyelia
88b
BADRAWY MRCP revision
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combination of bothupper and lower motor
neuron signs89a
BADRAWY MRCP revision
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Amyotrophic lateralsclerosis
89b
BADRAWY MRCP revision
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A man developshaematuria and
frequency after visitingMalawi -
90a
BADRAWY MRCP revision
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Schistosomahaematobium
90b
BADRAWY MRCP revision
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Sudden onset vertigo andvomiting, dysphagia, ipsilateralfacial pain and temperatureloss, contralateral limb pain andtemperature loss and ataxia -
91a
BADRAWY MRCP revision
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posterior inferiorcerebellar artery
91b
BADRAWY MRCP revision
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a 45-year-old woman withnephrotic syndrome is noted
to have marked loss ofsubcutaneous tissue from
the face92a
BADRAWY MRCP revision
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Membranoproliferativeglomerulonephritis (type
II)92b
BADRAWY MRCP revision
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A 2-year-old childdevelops perianal itching,which is particularly bad
at night -93a
BADRAWY MRCP revision
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Enterobius vermicularis
93b
BADRAWY MRCP revision
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a patient Hx of heartburnpresents with odynophagia.
There no weight loss,vomiting or anorexia
94a
BADRAWY MRCP revision
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Oesophagitis
94b
BADRAWY MRCP revision
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A middle-aged womensymptoms of
hypothyroidism. a diffuse,non-tender goitre .TSH
,T4 , anti-TPO +ve95a
BADRAWY MRCP revision
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Hashimoto's thyroiditis
95b
BADRAWY MRCP revision
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An elderly man restingtremor in right hand.
shuffling gait and a generalslowness of movement -
96a
BADRAWY MRCP revision
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Parkinson's disease
96b
BADRAWY MRCP revision
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A 50-year-old alcoholicpresents with fever. He is
found to have an rightupper lobe pneumonia -
97a
BADRAWY MRCP revision
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Klebsiella pneumonia
97b
BADRAWY MRCP revision
-
a patient develops waterydiarrhoea one week after
arriving in Mexico98a
BADRAWY MRCP revision
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Escherichia coli(enterotoxigenic)
98b
BADRAWY MRCP revision
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A young man from north-east of the USA
fever,arthralgia. + rash 5 cmerythematous oval area with
central clearing99a
BADRAWY MRCP revision
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Borrelia burgdorferi
99b
BADRAWY MRCP revision
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A young man weakness oflegs shortly after severegastroenteritis. normal
Sensation in legs+ loss ofDTR
100a
BADRAWY MRCP revision
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Guillain-Barre syndrome
100b
BADRAWY MRCP revision
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A 75-yewoman colickypain typically in the LLQ+ diarrhoea and fever -
101a
BADRAWY MRCP revision
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diverticulitis
101b
BADRAWY MRCP revision
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A 40-y woman tremor ofboth hands.worse when sheis stressed and relieved by
alcohol. FH of similarproblems
102a
BADRAWY MRCP revision
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essential tremor
102b
BADRAWY MRCP revision
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A patient has difficultabducting their arm
following a humeral neckfracture
103a
BADRAWY MRCP revision
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Axillary nerve
103b
BADRAWY MRCP revision
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wrist drop following ahumeral midshaft
fracture104a
BADRAWY MRCP revision
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Radial nerve
104b
BADRAWY MRCP revision
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An elderly man acute,painful red eye + decreasedvisual acuity. worse in the
dark. semi-dilated non-reacting pupil
105a
BADRAWY MRCP revision
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acute angle closureglaucoma
105b
BADRAWY MRCP revision
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gradual onset bloodydiarrhoea after travelling to
Egypt. lasted four weeks.occasional abdominal pain
and tenesmus106a
BADRAWY MRCP revision
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Amoebiasis
106b
BADRAWY MRCP revision
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profuse 'rice water' diarrhoeaafter visiting a disaster reliefzone.vomiting but has noabdominal pain. Onexamination he is severelydehydrated
107a
BADRAWY MRCP revision
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Cholera
107b
BADRAWY MRCP revision
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sudden onset severeoccipital headache, like
being 'kicked in the backof the head'
108a
BADRAWY MRCP revision
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Subarachnoidhaemorrhage
108b
BADRAWY MRCP revision
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constant headacheassociated with nausea. Theheadache is present at nightand worse when coughing
109a
BADRAWY MRCP revision
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Raised intracranialpressure
109b
BADRAWY MRCP revision
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frontal headachefollowing URTI,worse on
leaning forward110a
BADRAWY MRCP revision
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Sinusitis
110b
BADRAWY MRCP revision
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A 30-y woman weight gainand irregular menstruation.BP is elevated at 170/100mmHg + evidence ofproximal muscle weakness
111a
BADRAWY MRCP revision
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Cushing's syndrome
111b
BADRAWY MRCP revision
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A 35-y woman BP180/110 mmHg. tired
and weak. Routine bloodsshow hypokalaemia
112a
BADRAWY MRCP revision
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primaryhyperaldosteronism
112b
BADRAWY MRCP revision
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a 15-year-old boy developsfever and tachypnoea one
week after recoveringfrom influenza
113a
BADRAWY MRCP revision
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Staphylococcus aureuspneumonia
113b
BADRAWY MRCP revision
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a 60-y Pt Hx of COPD infective exacerbation+productive cough and
consolidation on the chestx-ray
114a
BADRAWY MRCP revision
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Haemophilus influenzaepneumonia
114b
BADRAWY MRCP revision
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Recurrent, severe headacheunilateral and throbbing in
nature. Associated withnausea and
photosensitivity115a
BADRAWY MRCP revision
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migraine
115b
BADRAWY MRCP revision
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a patient with Huntington'sdisease speech which is
difficult to comprehend. canunderstand what is being
said to him116a
BADRAWY MRCP revision
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Dysarthria
116b
BADRAWY MRCP revision
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young adult noticeshypopigmented patches on hertrunk after coming gettingsuntan. Patches are mildlypruritic with some scale
117a
BADRAWY MRCP revision
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Pityriasis versicolor
117b
BADRAWY MRCP revision
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a 35-y man severe, episodicloin pain radiates round to
the front. blood+++,leucocytes ++ on the urine
dipstick118a
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Renal colic
118b
BADRAWY MRCP revision
-
an elderly man severecentral abdominal pain
radiating to the backassociated with
hypotension119a
BADRAWY MRCP revision
-
Ruptured abdominalaortic aneurysm
119b
BADRAWY MRCP revision
-
a 60-y with a history oftuberculosis dyspnoea &fatigue. JVP , loud S3 and
Kussmaul's sign +ve,Hepatomegaly
120a
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Constrictive pericarditis
120b
BADRAWY MRCP revision
-
a 25-y man is investigatedfor recurrent syncope anddyspnoea. ejection systolic
murmur121a
BADRAWY MRCP revision
-
Hypertrophic obstructivecardiomyopathy
121b
BADRAWY MRCP revision
-
a 60-y alcoholic man severechest pain after repeated
episodes of vomiting. + SCemphysema
122a
BADRAWY MRCP revision
-
Boerhaave syndrome
122b
BADRAWY MRCP revision
-
a patient who is known tohave HIV presents with
odynophagia123a
BADRAWY MRCP revision
-
Oesophageal candidiasis
123b
BADRAWY MRCP revision
-
a 55-yman fever andmalaise past few weeks
common peroneal nervepalsy. hepatitis B surface
antigen +ve124a
BADRAWY MRCP revision
-
Polyarteritis nodosa
124b
BADRAWY MRCP revision
-
a 30-y woman from Singaporeheadache, malaise & myalgia.BP 160/100 mmHg, the rightradial pulse is difficult topalpate and a carotid bruit isnoted
125a
BADRAWY MRCP revision
-
Takayasu's arteritis
125b
BADRAWY MRCP revision
-
a 65-y Male IgGparaprotein band +
asymptomatic + calciumand renal function are
normal126a
BADRAWY MRCP revision
-
Monoclonal gammopathyof undetermined
significance126b
BADRAWY MRCP revision
-
a 70-y DVT. monoclonalIgM paraprotein band . lost
weight and feels unwell.calcium and renal function
normal127a
BADRAWY MRCP revision
-
Waldenstrom'smacroglobulinaemia
127b
BADRAWY MRCP revision
-
an obese 55-y pain in theRUQ associated with fever.
Palpation of the RUQcauses arrest of respiration
128a
BADRAWY MRCP revision
-
Acute cholecystitis
128b
BADRAWY MRCP revision
-
a patient Hx of Barrett'soesophagus presents with
dysphagia and weightloss
129a
BADRAWY MRCP revision
-
Oesophageal cancer
129b
BADRAWY MRCP revision
-
a middle-aged patientdysphagia of both liquidsand solids from the start.
regurgitation and apersistent cough
130a
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-
Achalasia
130b
BADRAWY MRCP revision
-
an elderly man severe painaround his right eye,
nausea, redness of the eye,'misty vision' and a semi-
dilated pupil131a
BADRAWY MRCP revision
-
Acute narrow-angleglaucoma
131b
BADRAWY MRCP revision
-
a patient feigns chroniclower back pain to allow
him to claim governmentbenefits
132a
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-
Malingering
132b
BADRAWY MRCP revision
-
a car crash survivor feelslike he is 'watching a movie'when trying to recall details
of the episode133a
BADRAWY MRCP revision
-
Dissociative disorder
133b
BADRAWY MRCP revision
-
a 75-y man large amountsof a mucous-like diarrhoea.
Bloods demonstratehypokalaemia
134a
BADRAWY MRCP revision
-
Villous adenoma
134b
BADRAWY MRCP revision
-
a man who presents withintussusception is noticed to havemultiple polyps on colonoscopy.These are later shown to behamartomatous. He also haspigmented lesions on his lips andpalms
135a
BADRAWY MRCP revision
-
Peutz-Jeghers syndrome
135b
BADRAWY MRCP revision
-
A woman develops awinged scapula after
mastectomy136a
BADRAWY MRCP revision
-
long thoracic nerve
136b
BADRAWY MRCP revision
-
An elderly womanitchylesion on her vulva. It
started as a red patch buthas now turned into a white
plaque137a
BADRAWY MRCP revision
-
lichen sclerosus
137b
BADRAWY MRCP revision
-
a 65-y man back pain andlethargy.raised calcium,renal dysfunction and a
raised ESR138a
BADRAWY MRCP revision
-
Multiple myeloma
138b
BADRAWY MRCP revision
-
a 20-y woman recurrent episodesof abdominal pain +bloating.pain is relieved ondefecation. She normal passes 3loose stools with mucous in themornings
139a
BADRAWY MRCP revision
-
Irritable bowel syndrome
139b
BADRAWY MRCP revision
-
A man diarrhoea andabdominal pain,
papulovesicular lesions onthe soles & urticarial rash
140a
BADRAWY MRCP revision
-
Strongyloides stercoralis
140b
BADRAWY MRCP revision
-
a child sore throat and low-grade fever.vesicles in themouth and on the palms
and soles of the feet141a
BADRAWY MRCP revision
-
Hand, foot and mouthdisease
141b
BADRAWY MRCP revision
-
a child pink maculopapularrash, initially on the face beforespreading to the whole body.Suboccipital & postauricularlymphadenopathy is present
142a
BADRAWY MRCP revision
-
Rubella
142b
BADRAWY MRCP revision
-
a middle-aged womandevelops painful,
erythematous, nodularlesions over both shins
143a
BADRAWY MRCP revision
-
Erythema nodosum
143b
BADRAWY MRCP revision
-
a young child history of atopiceczema a sudden eruption ofpainful, oedematous vesiclesand pustules. systemicallyunwell and have a fever
144a
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-
Eczema herpeticum
144b
BADRAWY MRCP revision
-
a middle aged woman tendergoitre + hyperthyroidism.
TSH & T4. globallyuptakeon iodine-131 scan
145a
BADRAWY MRCP revision
-
Subacute thyroiditis
145b
BADRAWY MRCP revision
-
A patient presents with a'droopy eyelid'. unilateralmiosis, ptosis and narrowpalpebral aperture giving theappearance of enophthalmos
146a
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-
Horner's syndrome
146b
BADRAWY MRCP revision
-
A 50-y man Marfan syndromepalpitations &dyspnoea.collapsing pulse, the BP160/60 mmHg and a high-pitched diastolic murmur
147a
BADRAWY MRCP revision
-
aortic regurgitation
147b
BADRAWY MRCP revision
-
An elderly woman developsa reticulated,
hyperpigmented rash afterusing a hot water bottle
excessively -148a
BADRAWY MRCP revision
-
erythema ab igne
148b
BADRAWY MRCP revision
-
a 35-y woman loin pain +fever. She has blood+++,
leucocytes +++ on theurine dipstick
149a
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-
Pyelonephritis
149b
BADRAWY MRCP revision
-
a 50-year-old manpresents with epigastricpain relieved by eating
150a
BADRAWY MRCP revision
-
Duodenal ulcer
150b
BADRAWY MRCP revision
-
an ECG shows progressiveprolongation of the PRinterval until a dropped
beat occurs151a
BADRAWY MRCP revision
-
Second degree heartblock (Mobitz I)
151b
BADRAWY MRCP revision
-
a man develops a cardiacarrest shortly after MI. TheECG monitor shows rapid,
irregular waveforms152a
BADRAWY MRCP revision
-
Ventricular fibrillation
152b
BADRAWY MRCP revision
-
a 2-y abdominal mass andpallor. raised urinary
(VMA) and homovanillicacid (HVA) levels
153a
BADRAWY MRCP revision
-
Neuroblastoma
153b
BADRAWY MRCP revision
-
A man history of syphilisbilateral small, irregularpupils which respond toaccomodation but not to
light154a
BADRAWY MRCP revision
-
Argyll-Robertson pupil
154b
BADRAWY MRCP revision
-
an elderly Hx of HTN andglaucoma visual acuity &peripheral visual field loss.
Fundoscopy optic disccupping
155a
BADRAWY MRCP revision
-
Primary open-angleglaucoma
155b
BADRAWY MRCP revision
-
a baby is born withmicrocephaly, small eyes,low-set ears, cleft lip and
polydactyly156a
BADRAWY MRCP revision
-
Patau syndrome
156b
BADRAWY MRCP revision
-
a young boy is noted tohave learning difficulties,macrocephaly, large ears
and macro-orchidism157a
BADRAWY MRCP revision
-
Fragile X
157b
BADRAWY MRCP revision
-
a 55-y woman recurrent episodesof vertigo often triggered by achange in head position. Eachepisode lasts around 10-20seconds and is associated withnausea
158a
BADRAWY MRCP revision
-
Benign paroxysmalpositional vertigo
158b
BADRAWY MRCP revision
-
a 45-y man unilateralhearing loss. tinnitus andsome problems with hisbalance. absent corneal
reflex159a
BADRAWY MRCP revision
-
Acoustic neuroma
159b
BADRAWY MRCP revision
-
a 6-week-old baby with 1*1.5cmswelling in the left axilla. Theywere given the BCG vaccine at
birth160a
BADRAWY MRCP revision
-
Reactivelymphadenopathy
160b
BADRAWY MRCP revision
-
a 20-y man tender, swollen 2cmmass in the right submandibularregion. His temperature is38.2degC and he is noted to havepoor dental hygiene
161a
BADRAWY MRCP revision
-
Reactivelymphadenopathy
161b
BADRAWY MRCP revision
-
a 40-y alcoholichaematemesis after
repeated vomiting. Anendoscopy two months ago
no evidence of varices162a
BADRAWY MRCP revision
-
Mallory-Weiss syndrome
162b
BADRAWY MRCP revision
-
a middle-aged woman Hxof Raynaud's phenomenonc/o dysphagia + multiple
telangectasia163a
BADRAWY MRCP revision
-
Systemic sclerosis
163b
BADRAWY MRCP revision
-
a 40-year-old womandysphagia. Oesophageal
manometry oesophagealperistalsis & lower
oesophageal sphincter tone164a
BADRAWY MRCP revision
-
Systemic sclerosis
164b
BADRAWY MRCP revision
-
an elderly patient waterydiarrhoea after being treatedfor pneumonia. Blood tests
show a new, markedneutrophilia
165a
BADRAWY MRCP revision
-
Clostridium difficile
165b
BADRAWY MRCP revision
-
a 20-y man bloodydiarrhoea. abdominal pain
and tenesmus. Yesterday hehad flu-like symptoms
166a
BADRAWY MRCP revision
-
Campylobacter
166b
BADRAWY MRCP revision
-
a 60-y woman dysphagiaand lethargy. smooth,
swollen tongue and paleconjunctivae
167a
BADRAWY MRCP revision
-
Plummer-Vinsonsyndrome
167b
BADRAWY MRCP revision
-
a patien Hx of anxietyc/o having a 'lump' in her
throat168a
BADRAWY MRCP revision
-
Globus hystericus
168b
BADRAWY MRCP revision
-
a 30-y woman with a historyof recurrent peptic ulcerdisease is found to have
hypercalcaemia on routinebloods
169a
BADRAWY MRCP revision
-
Multiple endocrineneoplasia (type 1)
.169b
BADRAWY MRCP revision
-
A teenage girl anterior kneepain worse when going
down stairs and rising fromprolonged sitting
170a
BADRAWY MRCP revision
-
chondromalacia patellae
170b
BADRAWY MRCP revision
-
A 70-y womanpan-systolicmurmur after presentingwith dyspnoea. A soft S1
and split S2171a
BADRAWY MRCP revision
-
mitral regurgitation
171b
BADRAWY MRCP revision
-
a 1-y is swelling on theleft side of the neck. Themass is soft, non-tender
and transilluminates172a
BADRAWY MRCP revision
-
Cystic hygroma
172b
BADRAWY MRCP revision
-
ipsilateral oculomotorpalsy and contralateral
weakness173a
BADRAWY MRCP revision
-
Branches of the posteriorcerebral artery that
supply the midbrain173b
BADRAWY MRCP revision
-
contralateral hemiparesis andsensory loss with the upperextremity being more affectedthan the lower, contralateralhomonymous hemianopia andaphasia
174a
BADRAWY MRCP revision
-
Middle cerebral artery
174b
BADRAWY MRCP revision
-
a young woman takes aparacetamol overdose aftersplitting with her boyfriend. Twodays later she is in a newrelationship which is troubled byher repeated outbursts of anger
175a
BADRAWY MRCP revision
-
Borderline personalitydisorder
175b
BADRAWY MRCP revision
-
a woman presents to her male familydoctor wearing a low-cut top and ashort skirt. She tries to flirt with thedoctor. The consultation is filled withdrama and she becomes annoyedwith the centre of attention shiftsfrom her
176a
BADRAWY MRCP revision
-
Histrionic personalitydisorder
176b
BADRAWY MRCP revision
-
a boy is noted to havereduced tone,
hypogonadism andobesity
177a
BADRAWY MRCP revision
-
Prader-Willi syndrome
177b
BADRAWY MRCP revision
-
a baby micrognathia and a cleftpalate. He is placed prone dueto upper airway obstruction.There is no family history ofsimilar problems
178a
BADRAWY MRCP revision
-
Pierre-Robin syndrome
178b
BADRAWY MRCP revision
-
an overweight 50-y manlethargy and excessive
thirst. Fundoscopy blothaemorrhages
179a
BADRAWY MRCP revision
-
Type 2 diabetes mellitus
179b
BADRAWY MRCP revision
-
a 40-y patient Hxhypertension presents with
episodic palpitations,excessive sweating,
headaches and tremor180a
BADRAWY MRCP revision
-
Phaeochromocytoma
180b
BADRAWY MRCP revision
-
a boy arm problems after fallingfrom a tree, caught a branch tosave himself. On examination hehas a claw hand with ahyperextended wrist
181a
BADRAWY MRCP revision
-
Lower trunk of thebrachial plexus (C8, T1)
181b
BADRAWY MRCP revision
-
Loss of proprioceptionand vibration . No motor
deficit182a
BADRAWY MRCP revision
-
neurosyphilis
182b
BADRAWY MRCP revision
-
A 35-y jerky, random anduncontrollable movements of hisarms. getting progressively worsefor the past few months. His wifealso says he is increasinglyirritable and moody
183a
BADRAWY MRCP revision
-
Huntington's disease
183b
BADRAWY MRCP revision
-
a patient with acute HF 10days after MI. JVP, pulsusparadoxus and diminished
heart sounds184a
BADRAWY MRCP revision
-
Left ventricular free wallrupture
184b
BADRAWY MRCP revision
-
A woman Hx of rheumatoidarthritis severe, constant pain inher right eye. right eye is red andthere is a degree of photophobia.Visual acuity is normal
185a
BADRAWY MRCP revision
-
scleritis
185b
BADRAWY MRCP revision
-
a patient speak fluently but havedifficulty repeating phrases. Heis aware of the errors he ismaking and comprehensionremains normal
186a
BADRAWY MRCP revision
-
Conduction aphasia
186b
BADRAWY MRCP revision
-
A patient presents withsevere vomiting 4 hours
after eating at arestuarant -
187a
BADRAWY MRCP revision
-
Staphylococcus aureus
187b
BADRAWY MRCP revision
-
A 2-year-old child isadmitted with watery
diarrhoea, vomiting anddehydration -
188a
BADRAWY MRCP revision
-
rotavirus
188b
BADRAWY MRCP revision
-
a sporty teenage boypresents with pain,
tenderness and swellingover the tibial tubercle
189a
BADRAWY MRCP revision
-
Osgood-Schlatter disease
189b
BADRAWY MRCP revision
-
a sporty teenager presentswith knee pain after
exercise associated withintermittent swelling and
locking190a
BADRAWY MRCP revision
-
Osteochondritisdissecans
190b
BADRAWY MRCP revision
-
An elderly patient with a historyof atrial fibrillation presents witha sudden painless loss of vision inone eye. Fundoscopy reveals a'cherry red' spot on a pale retina-
191a
BADRAWY MRCP revision
-
central retinal arteryocclusion
191b
BADRAWY MRCP revision
-
transient unilateral lossof vision described as a
'curtain descending'192a
BADRAWY MRCP revision
-
Ophthalmic artery
192b
BADRAWY MRCP revision
-
locked-in syndrome
193a
BADRAWY MRCP revision
-
Basilar artery
193b
BADRAWY MRCP revision
-
A man episodic angioedemawhilst in west Africa. Onone occasion he noticed a'worm moving across the
left eye'194a
BADRAWY MRCP revision
-
Loa loa
194b
BADRAWY MRCP revision
-
a patient is suspected ofinjecting her mothers
insulin to cause repeatedepisodes of hypoglycaemia
195a
BADRAWY MRCP revision
-
Factitious disorder
195b
BADRAWY MRCP revision
-
Flaccid paralysis of upper+ lower face -
196a
BADRAWY MRCP revision
-
CN VII
196b
BADRAWY MRCP revision
-
A patient complains ofpins/needles and pain on
the lateral aspect of thehand -
197a
BADRAWY MRCP revision
-
median nerve
197b
BADRAWY MRCP revision
-
A 25-y man presents withvisible haematuria. He alsocomplains of having a badsore throat at the current
time198a
BADRAWY MRCP revision
-
IgA nephropathy
198b
BADRAWY MRCP revision
-
A man presents withcentral, pleuritic chest painand fever 4 weeks following
MI. The ESR is elevated -199a
BADRAWY MRCP revision
-
Dressler's syndrome
199b
BADRAWY MRCP revision
-
recurrent, non-disabling,bilateral headache,
described as a 'tight-band'
200a
BADRAWY MRCP revision
-
Tension headache
200b
BADRAWY MRCP revision
-
a man with raised, red,spherical lesion on his neck.It initially was a red spot but
rapidly grew over 4 weeks201a
BADRAWY MRCP revision
-
Pyogenic granuloma
201b
BADRAWY MRCP revision
-
a man with HIV presents with apainful, vesicular rash on theright side of his face around theeye. Fluorescein staining revealsmultiple small defects on theright cornea
202a
BADRAWY MRCP revision
-
Herpes zosterophthalmicus
202b
BADRAWY MRCP revision
-
a patient with an acute,painful red eye +
photophobia and epiphora.Fluorescein staining ragged
area on the cornea203a
BADRAWY MRCP revision
-
Herpes simplex keratitis
203b
BADRAWY MRCP revision
-
an elderly man withparkinsonism atonic
bladder, posturalhypotension and cerebellar
signs204a
BADRAWY MRCP revision
-
Multiple system atrophy
204b
BADRAWY MRCP revision
-
a 40-y man with headachesand coarsening of his facialfeatures.his wedding ring
and shoes no longer fit him205a
BADRAWY MRCP revision
-
Acromegaly
205b
BADRAWY MRCP revision
-
a newborn's arm is noted to behanging loosely following adifficult forceps delivery. Thearm is adducted and internallyrotated, elbow extended
206a
BADRAWY MRCP revision
-
Upper trunk of thebrachial plexus (C5,C6)
206b
BADRAWY MRCP revision
-
A child presents with fever,malaise and tonsillitisassociated with a 'strawberry'tongue and a fine punctateerythematous rash sparing theface -
207a
BADRAWY MRCP revision
-
scarlet fever
207b
BADRAWY MRCP revision
-
a 35-y man Hx of HTNand SAH presents with
recurrent UTIs andepisodic haematuria
208a
BADRAWY MRCP revision
-
Autosomal dominantpolycystic kidney disease
208b
BADRAWY MRCP revision
-
an elderly male smokervisible haematuria + loinpain. a loin mass can befound on the same side
209a
BADRAWY MRCP revision
-
Renal cell carcinoma
209b
BADRAWY MRCP revision
-
a 25-y man develops a painlesspustule that later erodes to forman ulcer. By the time he presentshe has painful inguinallymphadenopathy andproctocolitis
210a
BADRAWY MRCP revision
-
Lymphogranulomavenereum
210b
BADRAWY MRCP revision
-
middle-aged man head injury fallingdown some stairs. After losingconsciousness he quickly recoversc/o of a headache. Over the next fewhours he becomes more confusedand has one seizure -
211a
BADRAWY MRCP revision
-
extradural (epidural)haematoma
211b
BADRAWY MRCP revision
-
A patient develops abradycardia of 36/min followinga myocardial infarction. TheECG shows no associationbetween the P waves and QRScomplexes -
212a
BADRAWY MRCP revision
-
complete heart block
212b
BADRAWY MRCP revision
-
Plz don't hesitate to sharecomments & suggestions
for this set ..144a
BADRAWY MRCP revision
-
Thank You
144b
BADRAWY MRCP revision
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