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 Diagnosis: OGTT followed by GH conc.
2. Cushings Diagnosis: 24hr urinary free cortisol. Addisons --> short synacthen.
3. Rash on buttocks Dermatitis herpetiformis (coeliac dx).
4. AF with TIA --> Warfarin. Just TIA's with no AF --> Aspirin
5. Herpes encephalitis --> temporal lobe calicification OR temporoparietal atten
tuation subacute onset i.e. Several days.
6. Obese woman, papilloedema/headache --> Benign Intercanial Hypertention.
7. Drug induced pneumonitis --> methotrexate or amiodarone.
8. chest discomfort and dysphagia --> achalasia.
9. foreign travel, macpap rash/flu like illnes --> HIV acute.
10. cause of gout --> dec urinary excretion.
11. bullae on hands and fragule SKIN torn by minor trauma --> porphyria cutanea
tarda.
12. Splenectomy --> need pneumococcal vaccine AT LEAST 2 weeks pre-op and for li
fe.
13. primary hrperparathyroidism --> high Ca, normal/low PO4, normal/high PTH (in
elderly).
14. middle aged man with KNEE arthritis --> gonococcal sepsis (older people -> S
taph).
15. sarcoidosis, erythema nodosum, arthropathy --> Loffgrens syndrome benign, no
Rx needed.
16. TREMOR postural,slow progression,titubation, relieved by OH->benign essentia
l TREMOR AutDom. (MS titbation, PD no titubation)
17. electrolytes disturbance causing confusion low/high Na.
18. contraindications lung Surgery --> FEV dec bp 130/90, Ace inhibitors (if pro
teinuria analgesic induced headache.
21. 1.5 cm difference btwn kidneys -> Renal artery stenosis --> Magnetic resonan
ce angiogram.
22. temporal tenderness--> temporal arteritis -> steroids > 90% ischaemic neurop
athy, 10% retinal art occlusion.
23. severe retroorbital, daily headache, lacrimation --> cluster headache.
24. pemphigus involves mouth (mucus membranes), pemphigoid less serious NOT muco
sa.
25. diagnosis of polyuria -> water deprivation test, then DDAVP.
26. insulinoma -> 24 hr supervised fasting hypoglycaemia.
27. Diabetes Random >7 or if >6 OGTT (75g) -> >11.1 also seen in HCT.
28. causes of villous atrophy: coeliac (lymphocytic infiltrate), Whipples , dec
Ig, lymphoma, trop sprue (rx tetracycline).
29. diarrhoea, bronchospasm, flushing, tricuspid stenosis -> gut carcinoid c liv
er mets.
30. hepatitis B with general deterioration -> hepaocellular carcinoma.
31. albumin normal, total protein high -> myeloma (hypercalcaemia, electrophores
is).
32. HBSag positive, HB DNA not detectable --> chornic carier.
33. Inf MI, artery invlived -> Right coronary artert.
34. Aut dom conditions: Achondroplasia, Ehler Danlos, FAP, FAMILIAL hyperchol,Gi
lberts, Huntington's, Marfans's, NFT I/II, Most porphyrias, tuberous sclerosis,
vWD, PeutzJeghers.
35. X linked: Beck/Duch musc dyst, alports, Fragile X, G6PD, Haemophilia A/B.
36. Loud S1: MS, hyperdynamic, short PR. Soft S1: immobile MS, MR.
37. Loud S2: hypertension, AS. Fixed split: ASD. Opening snap: MOBILE MS, severe
near S2.
38. HOCM/MVP - inc by standing, dec by squating (inc all others). HOCM inc by va
lsalva, decs all others. Sudden death athlete, FH, Rx. Amiodarone, ICD.
39. MVP sudden worsening post MI. Harsh systolic murmur radites to axilla.
40. Dilated Cardiomyopathy: OH, bp, thiamine/selenium deficiency, MD, cocksackie
/HIV, preg, doxorubicin, infiltration (HCT, sarcoid), tachycardia.
41. Restrictive Cardiomyopathy: sclerodermma, amyloid, sarcoid, HCT, glycogen st
orage, Gauchers, fibrosis, hypereosinophilia Lofflers, caracinoid, malignancy, r
adiotherapy, toxins.
42. Tumor compressing Respiratory tract --> investigation: flow volume loop.
43. Guillan Barre syndrome: check VITAL CAPACITY.
44. Horners sweating lost in upper face only lesion proximal to common carotid a
rtery.
45. Internuclear opthalmoplegia: medial longitudinal fasciculus connects CN nucl
eus 3-4. Ipsilateral adduction palsy, contralateral nystagmus. Aide memoire (TRI
ES TO YANK THE ipsilateral BAD eye ACROSS THE nose ). Convergence retraction nys
tagmus, but convergence reflex is normal. Causes: MS, SLE, Miller fisher, overdo
se(barb, phenytoin, TCA), Wernicke.
46. Progressive Supranuclear palsy: Steel Richardson. Absent voluntary downward
gaze, normal dolls eye . i.e. Occulomotor nuclei intact, supranuclear Pathology
.
47. Perinauds syndrome: dorsal midbrain syndrome, damaged midrain and superior c
olliculus: impaired upgaze (cf PSNP), lid retraction, convergence preserved. Cau
ses: pineal tumor, stroke, hydrocephalus, MS.
48. demetia, gait abnormaily, urinary incontinence. Absent papilloedema-->Normal
pressure hydrocephalus.
49. acute red eye -> acute closed angle glaucoma >> less common (ant uveitis, sc
leritis, episcleritis, subconjuntival haemmorrhage).
50. wheeles, URTICARIA , drug induced -> aspirin.
51. sweats and weight gain -> insulinoma.
52. diagnostic test for asthma -> morning dip in PEFR >20%.
53. Causes of SIADH : chest/cerebral/pancreas Pathology , porphyria, malignancy,
Drugs (carbamazepine, chlorpropamide, clofibrate, atipsychotics, NSAIDs, rifamp
icin, opiates)
54. Causes of Diabetes Insipidus: Cranial: tumor, infiltration, trauma Nephrogen
ic: Lithium, amphoteracin, domeclocycline, prologed hypercalcaemia/hypornatraemi
a, FAMILIAL X linked type
55. bisphosphonates:inhibit osteoclast activity, prevent steroid incduced osteop
erosis (vitamin D also).
56.returned from airline flight, TIA-> paradoxical embolus do TOE.
57. alcoholic, given glucose develops nystagmus -> B1 deficiency (wernickes). Co
nfabulation->korsakoff.
58. mono-artropathy with thiazide -> gout (neg birefringence). NO ALLOPURINOL fo
r acute.
59. painful 3rd nerve palsy -> posterior communicating artery aneurysm till prov
en otherwise
60 late complication of scleroderma --> pumonaryhypertention plus/minus fibrosis
.
61. causes of erythema mutliforme: lamotrigine
62. vomiting, abdominal pain, hypothyroidism -> Addisonian crisis (TFT typically
abnormal in this setting DO NOT give thyroxine).
63. mouth/genital ulcers and oligarthritis -> behcets (also eye /SKIN lesions, D
VT)
64. mixed drug overdose most important step -> Nacetylcysteine (time dependent p
rognosis)
65. cavernous sinus syndrome - 3rd nerve palsy, proptosis, periorbital swlling,
conj injectn
66. asymetric parkinsons -> likely to be idiopathic
67. Obese, NIDDM female with abnormal LFT's -> NASH (non-alcoholic steatotic hep
atitis)
68. fluctuating level of conciousness in elderly plus/minus deterioration --> ch
ronic subdural. Can last even longer than 6 months
69. Sensitivity --> TP/(TP plus FN) e.g. For SLE - ANA highly sens, dsDNA:highly
specific
70. RR is 8%. NNT is ----> 100/8 --> 50/4 --> 25/2 --> 13.5
71. ipsilateral ataxia, Horners, contralateral loss pain/temp --> PICA stroke (l
ateral medulary syndrome of Wallenburg)
72. renal stones (80% calcium, 10% uric acid, 5% ammonium (proteus), 3% other).
Uric acid and cyteine stone are radioluscent.
73. hyperprolactinaemia (allactorrohea, amenorrohea, low FSH/LH) -> Da antags (m
etoclopramide, chlorpromazine, cimetidine NOT TCA's), pregnancy, PCOS, pit tumor
/microadenoma, stress.
74. Distal, asymetric arthropathy -> PSORIASIS
75. episodic headache with tachycardia -> phaeochromocytoma
76. very raised WCC -> ALWAYS think of leukaemia.
77. Diagnosis of CLL --> immunophenotyping NOT cytogenetics, NOT bone marrow
78. Prognostic factors for AML -> bm karyotype (good/poor/standard) >> WCC at di
agnosis.
79. pancytopenia with raised MCV --> check B12/folate first (other causes possbl
e, but do this FIRST). Often associayed with phenytoin use --> decreased folate
80. miscariage, DVT, stroke --> LUPUS anticoagulant --> lifelong anticoagulation
81. Hb elevated, dec ESR -> polycythaemua (2ndry if paO2 low)
82. anosmia, delayed puberty -> Kallmans syndrome (hypogonadotrophic hypogonadis
m)
83. diag of PKD -> renal US even if think anorexia nervosa
85. commonest finding in G6PD hamolysis -> haumoglobinuria
86. mitral stenosis: loud S1 (soft s1 if severe), opening snap.. Immobile valve
-> no snap.
87. Flank pain, urinalysis:blood, protein -> renal vein thrombosis. Causes: neph
rotic syndrome, RCC, amyloid, acute pyelonephritis, SLE (atiphospholipid syndrom
e which is recurrent thrombosis, fetal loss, dec plt. Usual cause of cns manifes
tations assoc with LUPUS ancoagulant, anticardiolipin ab)
88. anaemia in the elderly assume GI malignancy
89. hypothermia, acute renal failure -> rhabdomyolysis (collapse assumed)
90. pain, numbness lateral upper thigh --> meralgia paraesthesia (lat cutaneous
nerve compression usally by by ing ligament)
91. diagnosis of haemochromatosis: screen with Ferritin, confirm by tranferrin s
aturation, genotyping. If nondiagnostic do liver biopsy 0.3% mortality
92. 40 mg hidrocortisone divided doses (bd) --> 10 mg prednisolone (ie. Prednisl
one is x4 stronger)
93. BTS: TB guidlines close contacts -> Heaf test -> positive CXR, negative -->
repeat Heaf in 6 weeks. Isolation not required.
94. Diptheria -> exudative pharyngitis, lymphadenopathy, cardio and neuro toxici
ty.
95. Indurated plaques on cheeks, scarring alopecia, hyperkeratosis over hair fol
licles ->>Discoid LUPUS
96. wt loss, malabsoption, inc ALP -> pancreatic cancer
97. foreign travel, tender RUQ, raised ALP --> liver abscess do U/S
98. wt loss, anaemia (macro/micro), no obvious cause -> coeliac (diarrhoea does
NOT have to be present)
99. haematuria, proteinuria, best investigation --> if glomerulonephritis suspec
ted --> renal biopsy
100. venous ulcer treatment --> exclude arteriopathy (eg ABPI), control oedema,
prevent infection, compression bandaging.
101. Malaria, incubation within 3/12. can be relapsing /remitting. Vivax and Ova
le (West Africa) longer imcubation.
102. Fever, lymphadenopathy, lymphocytosis, pharygitis --->EBV ---> heterophile
antibodies
103. GI bleed after endovascular AAA Surgery --> aortoenteric fistula