MRCP part 1 self-assessment: medical masterclass questions and explanatory answers PDF
Preview MRCP part 1 self-assessment: medical masterclass questions and explanatory answers
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 MRCP(01)_part1_Prelim.fm Page ii Wednesday, October 24, 2007 6:48 PM 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 ii MRCP(01)_part1_Prelim.fm Page iii Wednesday, October 24, 2007 6:48 PM 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 iii MRCP(01)_part1_Prelim.fm Page iv Wednesday, October 31, 2007 6:29 PM 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 iv MRCP(01)_part1_Prelim.fm Page v Wednesday, October 24, 2007 6:48 PM 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 v MRCP(01)_part1_Prelim.fm Page vi Wednesday, October 24, 2007 6:48 PM 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 vi MRCP(01)_part1_Prelim.fm Page vii Wednesday, October 24, 2007 6:48 PM 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 vii MRCP(01)_part1_Prelim.fm Page viii Wednesday, October 24, 2007 6:48 PM 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 viii MRCP(01)_part1_Prelim.fm Page ix Wednesday, October 24, 2007 6:48 PM 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 ix
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