MRCP part 1 self-assessment: medical masterclass questions and explanatory answers

184 Pages·2008·8.69 MB·English

by  Firth

MRCP(01)_part1_Prelim.fm Page i Wednesday, October 31, 2007 6:29 PM
MRCP Part 1
Self-Assessment
Medical Masterclass questions
and explanatory answers
EDITED BY
John D Firth
DM FRCP
Consultant Physician and Nephrologist
Addenbrooke’s Hospital
Cambridge
FOREWORD BY
Professor Ian Gilmore
MD PRCP
President
Royal College of Physicians
Radcliffe Publishing
Oxford • New York
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Radcliffe Publishing Ltd
18 Marcham Road
Abingdon
Oxon OX14 1AA
United Kingdom
www.radcliffe-oxford.com
Electronic catalogue and worldwide online ordering facility.
© 2008 Royal College of Physicians of London
The Royal College of Physicians of London have asserted their right under the Copyright, Designs and Patents Act
1998 to be identified as the author of this work.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted,
in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior
permission of the copyright owner.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
ISBN-13: 978 1 84619 227 2
Set and printed by Graphicraft Limited, Hong Kong
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Contents
Foreword iv
Preface v
List of contributors vi
Questions Answers
Genetics and molecular medicine 3 Genetics and molecular medicine 125
Biochemistry and metabolism 7 Biochemistry and metabolism 126
Cell biology 11 Cell biology 128
Immunology and immunosuppression 15 Immunology and immunosuppression 130
Anatomy 19 Anatomy 131
Physiology 23 Physiology 132
Clinical pharmacology 29 Clinical pharmacology 135
Statistics, epidemiology, clinical trials, Statistics, epidemiology, clinical trials,
meta-analyses and evidence-based medicine 35 meta-analyses and evidence-based medicine 137
Pain relief and palliative care 41 Pain relief and palliative care 141
Emergency medicine 45 Emergency medicine 142
Infectious diseases 51 Infectious diseases 143
Dermatology 57 Dermatology 145
Haematology 61 Haematology 146
Oncology 67 Oncology 148
Cardiology 73 Cardiology 149
Respiratory medicine 79 Respiratory medicine 150
Gastroenterology and hepatology 85 Gastroenterology and hepatology 152
Neurology 91 Neurology 154
Ophthalmology 97 Ophthalmology 155
Psychiatry 101 Psychiatry 156
Endocrinology 105 Endocrinology 157
Nephrology 111 Nephrology 160
Rheumatology and clinical immunology 117 Rheumatology and clinical immunology 162
Index 165
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Foreword
Since its initial publication in 2001, Medical Masterclass pass rate at each sitting of the written papers is about 40%.
has been regarded as a key learning and teaching resource Even the most prominent consultants have had to sit each
for physicians around the world. The resource was pro- part of the examination more than once in order to pass.
duced in part to meet the Royal College of Physicians’ With this challenge in mind, the College and Radcliffe
vision: ‘Doctors of the highest quality, serving patients well’. Publishing have produced this compilation of self-
This vision continues and has led to the compilation of assessment questions that were written as part of Medical
two volumes of self-assessment questions – one of which Masterclass, the aim being to help as many doctors as possible
you now hold in your hands. in the revision process for the MRCP(UK) examination. I
The MRCP(UK) is an examination of high interna- hope you find them to be as beneficial to your studies as
tional standing and reputation that seeks to advance the thousands of other doctors have; and that you enjoy the
learning of, and enhance the training process for, physi- challenges they present to your medical knowledge!
cians worldwide. On passing the examination physicians
are recognised as having attained the required knowledge, Professor Ian Gilmore MD PRCP
skills and manner appropriate for training at a specialist President of the Royal College of Physicians
level. However, passing the examination is a challenge. The September 2007
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Preface
This collection of self-assessment questions and explan- fare will give them a good indication of where to focus the
atory answers has been drawn from Medical Masterclass, remainder of their revision if they want to be successful in
which is produced and published by the Education their upcoming examinations.
Department of the Royal College of Physicians of I hope that you enjoy using these Medical Masterclass
London. The questions have been specifically written self-assessment questions to test your knowledge of
to help doctors in their first few years of training to test medicine, which – whatever is happening politically to
and revise their medical knowledge and skills; and in primary care, hospitals and medical career structures –
particular to pass postgraduate examinations, such as the remains a wonderful occupation. It is sometimes intel-
MRCP(UK). lectually and/or emotionally very challenging, and also
These questions come in the format that is found in sometimes extremely rewarding, particularly when reduced
both the MRCP(UK) Part 1 or Part 2 examinations. They to the essential of a doctor trying to provide best care for
cover the scientific background to medicine, general clinical a patient.
skills, acute medicine and the range of medical specialties;
all of which candidates will be tested on when they sit Dr John Firth DM FRCP
their MRCP(UK). The questions collected in this volume Editor-in-Chief
will provide a stern test for any such doctor, and how they September 2007
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List of contributors
Genetics and molecular medicine Immunology and immunosuppression
Professor Timothy J Vyse Professor Kevin A Davies
MA MRCP(UK) PhD BA MBBS MA MD FRCP
Honorary Consultant in Rheumatology/Medicine and Chair of Medicine
Wellcome Trust Senior Fellow Brighton and Sussex Medical School
Imperial College London, Faculty of Medicine and Brighton
Hammersmith Hospital
Dr Michael G Robson
London BA PhD MRCP(UK)
Senior Lecturer and Honorary Consultant Nephrologist
King’s College London
Biochemistry and metabolism
London
Dr Fiona M Gribble
MA DPhil MRCPath
Wellcome Senior Research Fellow and Anatomy
Honorary Consultant in Clinical Biochemistry
Dr Samuel Jacob
Cambridge Institute for Medical Research and Department of MBBS MS (Anatomy)
Clinical Biochemistry, Addenbrooke’s Hospital Formerly Senior Lecturer
Cambridge Department of Biomedical Science
University of Sheffield
Sheffield
Cell biology
Dr Emma H Baker Physiology
PhD FRCP
Reader and Consultant in Clinical Pharmacology
Dr Jane D Collier
Division of Basic Medical Sciences MB ChB MD FRCP
St George’s, University of London Consultant Hepatologist
London John Radcliffe Hospital
Oxford
Dr Kristian M Bowles
MB BS PhD MRCP(UK) MRCPath
Dr Anna Crown
Consultant Haematologist MA MB BChir MRCP(UK) PhD
Norfolk and Norwich University Hospital NHS Trust Consultant Endocrinologist and Honorary Senior Lecturer
Norwich Bristol and Sussex University Hospitals NHS Trust
Royal Sussex County Hospital
Dr Graham G Dark
MBBS PhD FRCP East Sussex
Clinical Senior Lecturer
Dr John D Firth
Northern Centre for Cancer Treatment DM FRCP
Newcastle General Hospital Consultant Physician and Nephrologist
Newcastle-upon-Tyne Addenbrooke’s Hospital
Cambridge
Dr Aroon D Hingorani
MA PhD FRCP
Senior Lecturer Dr Peter E Glennon MB ChB Hons MD FRCP
Centre for Clinical Pharmacology and Therapeutics Consultant Cardiologist
University College London University Hospital
London Coventry
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List of contributors
................................................................................................................................................................
Dr Mark Gurnell Clinical pharmacology
BSc Hons MBBS FRCP PhD
University Lecturer and
Dr Emma H Baker
Honorary Consultant Physician PhD FRCP
University of Cambridge, Department of Medicine Reader and Consultant in Clinical Pharmacology
and Addenbrooke’s Hospital Division of Basic Medical Sciences
Cambridge St George’s, University of London
London
Dr Paul R Roberts
MB ChB FRCP MD
Dr Stephen F Haydock
Consultant Cardiologist MA MB BChir PhD FRCP
Southampton General Hospital Consultant Physician and Director of Acute Medical Services
Southampton Addenbrooke’s Hospital
Cambridge
Dr Catherine EG Head
MA MRCP(UK) PhD
Dr Aroon D Hingorani
Consultant Cardiologist MA FRCP PhD
Guy’s and St Thomas’ NHS Foundation Trust Senior Lecturer
London Centre for Clinical Pharmacology and Therapeutics
University College London
Dr John M Hebden MBBS BSc MD FRCP London
Consultant Physician and Gastroenterologist
Dr D John M Reynolds
Northern General Hospital MA BM BCh DPhil FRCP
Sheffield Consultant Physician and Clinical Pharmacologist
John Radcliffe Hospital
Dr Michael I Polkey MRCP(UK) PhD Oxford
Consultant Physician
Royal Brompton Hospital and
Statistics, epidemiology, clinical trials,
National Heart & Lung Institute
meta-analyses and evidence-based
London
medicine
Dr Jeremy Shearman
DPhil FRCP
Clinical trials and meta-analyses:
Consultant Gastroenterologist
Warwick Hospital
Professor John Danesh
MB ChB MSc DPhil FRCP
Warwick
Head, Department of Public Health and Primary Care
University of Cambridge
Dr Mohammed Z Qureshi
MBBS MRCP(UK)
Cambridge
Consultant Physician
Mid Cheshire Hospitals NHS Trust Evidence-based medicine:
Crewe, Cheshire
Professor William Rosenberg
MA MBBS DPhil FRCP
Dr Hamish A Walker
BA Hons MBBS MRCP(UK) Professor of Hepatology
Western Infirmary, Glasgow Southampton General Hospital
North Glasgow University Hospitals NHS Trust Southampton
Dr Nick S Ward BSc MBBS MRCP(UK) Statistics and epidemiology:
Consultant Neurologist
National Hospital for Neurology and Professor Christopher JM Whitty MA MSc FRCP DTM&H
Neurosurgery and Institute of Neurology Clinical Research Unit
University College London London School of Hygiene and Tropical Medicine
London London
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List of contributors
................................................................................................................................................................
Pain relief and palliative care Dr Paul Klenerman
MRCP(UK) DPhil
Wellcome Trust Research Fellow
Dr G Nicola Rudd
MB ChB FRCP Nuffield Department of Medicine
Consultant in Palliative Medicine University of Oxford
Palliative Care Team Oxford
Leicester Royal Infirmary
Leicester Dr William Lynn
MBBS MD FRCP
Consultant in Infectious Diseases and Medical Director
Emergency medicine Ealing Hospital NHS Trust
London
Dr C Andrew Eynon
BSc MBBS FRCP FFAEM
Director of Neurosciences Intensive Care
Dermatology
Wessex Neurological Centre
Southampton General Hospital
Dr Karen Harman
Southampton DM MA MB BChir FRCP
Consultant Dermatologist
Professor Paul F Jenkins MA MB BChir FRCP FRCPE University Hospitals of Leicester
Professor of Acute Medicine Leicester
Joondalup Health Campus
Western Australia Dr Graham Ogg BM BCh FRCP DPhil
MRC Senior Clinical Fellow and
Dr Carole M Gavin (nee Libetta)
MB ChB MRCP(UK) Honorary Consultant Dermatologist
FRCS(Ed) FCEM MD Oxford Radcliffe NHS Trust
Consultant in Emergency Medicine Oxford
Salford Royal Hospitals Foundation Trust
Salford Dr Natalie M Stone BA Hons FRCP
Dermatology Consultant
Royal Gwent NHS Trust
Infectious diseases
Newport, Gwent
Dr Alec Bonington
BSc MB ChB FRCP DTMH MD
Clinical Director and
Haematology
Consultant in Infectious Diseases
Monsall Unit
Dr Kristian M Bowles
Department of Infectious Diseases MB BS PhD MRCP(UK) MRCPath
North Manchester General Hospital Consultant Haematologist
Manchester Norfolk and Norwich University Hospital NHS Trust
Norwich
Dr Carolyn Hemsley
MRCP(UK) MRCPath BM BCh MA PhD
Dr David W Galvani
Consultant in Infectious Diseases and Microbiology MD MEd FRCP FRCPath
St Thomas’ Hospital Consultant Haematologist
London Haematology Department
Arrowe Park Hospital
Dr Michael Jacobs MA PhD FRCP DTMH Wirral
Senior Lecturer and
Honorary Consultant in Infectious Diseases Dr Bronwen E Shaw MB ChB MRCP(UK)
University College London Medical School and Haematology Consultant
Royal Free Hampstead NHS Trust Royal Marsden Hospital
London London
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List of contributors
................................................................................................................................................................
Oncology Dr Michael I Polkey
MRCP(UK) PhD
Consultant Physician
Dr Mark Bower FRCP FRCPath PhD Royal Brompton Hospital and
Consultant Medical Oncologist National Heart & Lung Institute
Department of Oncology London
Chelsea & Westminster Hospital
Dr Veronica LC White
London BSc MSc MBBS FRCP MD
Vascular Physiologist and Clinical Scientist
Dr Graham G Dark MBBS PhD FRCP Barts and the London NHS Trust
Clinical Senior Lecturer London
Northern Centre for Cancer Treatment
Newcastle General Hospital
Gastroenterology and hepatology
Newcastle-upon-Tyne
Dr Jane D Collier
MB ChB MD FRCP
Cardiology Consultant Hepatologist
John Radcliffe Hospital
Dr Peter E Glennon MB ChB Hons MD FRCP Oxford
Consultant Cardiologist
Dr John M Hebden
University Hospital MBBS BSc MD FRCP
Coventry Consultant Physician and Gastroenterologist
Northern General Hospital
Dr Catherine EG Head MA MRCP(UK) PhD Sheffield
Consultant Cardiologist
Dr Satish Keshav
Guy’s and St Thomas’ NHS Foundation Trust MB BCh DPhil FRCP
London Consultant Gastroenterologist
Department of Gastroenterology
Dr Paul R Roberts MB ChB FRCP MD John Radcliffe Hospital
Consultant Cardiologist Oxford
Southampton General Hospital
Dr Jeremy Shearman
Southampton DPhil FRCP
Consultant Gastroenterologist
Dr Hamish A Walker BA Hons MBBS MRCP(UK) Warwick Hospital
Western Infirmary, Glasgow Warwick
North Glasgow University Hospitals NHS Trust
Neurology
Respiratory medicine
Dr Gillian L Hall
BSc BM BCh MRCP(UK) PhD
Dr Praveen Bhatia MBBS MRCP(Ireland) Consultant Neurologist
Consultant Physician, Respiratory and Internal Medicine Aberdeen Royal Infirmary
Tameside General Hospital Aberdeen
Ashton-under-Lyme
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