MRCP Endpoints

Pastest Handwritten Notes by Dr. Ahmad Ismail Pages 1-10 https://t.me/c/2051269839/41696 Pages 11-20 https://t.me/c/2051269839/41706 Pages 21-25 https://t.me/c/2051269839/41724

11)60y male undergone transphenoidal pituitary surgery-10 days after that developed polyuria and increased thirst Lab values Na-167 K-normal Raised urea and creatinine Which is the next investigation to establish diagnosis? -paired plasma and urine osmolality - urinary sodium - short synacthen test - water deprivation test - serum ADH ANSWERS paired plasma and urine osmolality

10 )35 yrs female with early breast cancer Sister had ovarian cancer at 39. Grandmother had colon cancer Grandfather had prostate cancer. What is the inheritance? BRCA 1 HER 1 CHROMOSOME 22 DELETION ANSWERS: BRCA 1

9)65 yr man with DM2 On Empagliflozin M.O.A of Empagliflozin? A. Act on PPAR gamma receptor B. Open potassium dependent ATP channel C. GLP 1 analog D. Inhibit reabsorption of glucose from proximal tubules ANSWERS: Inhibit reabsorption of glucose from proximal tubules

8)A 58-year-old woman presents with 3 weeks progressive history of pain weakness and clumsiness of right hand (dominant) On examination there is weakness of abductor pollicis brevis and opponens pollicis and decreased sensation on the palm and 3 1/2 fingers. What is the most likely site of lesion? A. Median nerve B. Radial nerve C. Posterior interasseous nerve D. Ulnar nerve E. T1 lesion ANSWERS: Median nerve

7)A 46 years old man presents with 3 weeks history of progressive weakness and headache and 6 years history of uncontrollable hypertension. He is taking ramipril 10 mg, bisoprolol 10 mg Amlodipine 10 mg doxazosin 4 mg and atorvastatin 20 mg On examination his pulse is 55 bpm and blood pressure is 190/110 mmHg Labs Na-138 K-2.8 HCO3-38 Urea is normal Creatinine is normal USG shows normal sized kidney without any obstruction Urine-1 plus proteinuria What is the likely diagnosis? A. Gitelman Syndrome B. Hyperaldosteronism C. Renal artery stenosis D. Pheachromocytoma E. Kidney disease ANSWERS Hyperaldosteronism

6)A woman presented with a painful ulcer on lateral midcalf. Deep ulcer indurated margins and erythema. H/O trauma, undermining of edge, rapidly growing ulcer Dx? Pyoderma gangrenosum Venous ulcer Arterial ulcer Necrobiosis lipoidica Traumatic ulcer ANSWERS: Pyoderma gangrenosum

5) A 30-year-old man presented with a 2-year history of deafness, cardiomyopathy, DM and ischemic stroke 5 years back. What metabolic outcome will be present in this mitochondrial disease? Hyperammonemia Homocysteinemia Lactic acidemia ANSWERS: Lactic acidemia

4) Headache Diplopia Papilledema Tinnitus Adductor palsy Dx? Idiopathic intracranial hypertension Vestibular schwannoma ANSWERS: Idiopathic intracranial hypertension

3) Itching and jaundice No alcohol hx Bilirubin up Dx? Options Cholestatic jaundice Acute hepatitis Hep E ANSWERS: Cholestatic jaundice