RECALL MRCGP EXAM HOLDED AT 2 JUNE 2021

1 GYN female taking HPV vaccine is it 1ry or 2ry prevention 2ry prevention or 1ry
2 GYN Female 20 ys want to married & her mother died from CX cervix Give HPV vaccine/ we will screen you When you sexual active
3 GYN 60 Ys bleeding twice/month US unremarkable (atrophied vaginitis) Make endometrial biopsy / CA125 /
4 GYN female having genital infection Gonorrhea
5 GYN female coming with dysparunea & pelvic pain& excessive bleeding
6 GYN female coming with Severe dysmenorrhea and menorrhagia Fibroid / adenomyosis / Endometriosis / endometritis / PID
7 GYN subfertile female with pain & distension & IVF Overstimulation
8 GYN female with mastitis & penicillin allergy Azithromycin
9 GYN Gestational dm high refuse insulin & random 146 Metformin
10 GYN female coming with urgent incontinence Oxbytonin
11 GYN young female coming after normal delivery with prolapse from anterior 1/3 of vagina Cystocele / urogenital Prolapse/ Urocele /Rectocele
12 GYN Female vaginal discharge with pelvic pain cx tenderness on touch Neisseria gonorrhoeae / chlamydia
13 GYN Chlamydia test done & it is negative what the organism causing PID
14 GYN Pregnant with trichomonas ttt with azithromycin
15 OBS 32 weeks pregnant & bleeding
16 OBS 28 weeks pregnant with painless bleeding Placenta previa
17 OBS 20 year unprotected sex since 8 months no pregnancy what nice guidline Reasuurance & come after 12 months
18 OBS postnatal depression breast feeding Take Sertraline
19 CONTRA She make intercourse since 4 days, she wants an emergency contraceptive IUCD /pop/merina/ cocp
20 CONTRA Previous cancer breast ask what contraceptive safe for her IUCD
21 CONTRA Women stopping OCP & she want to take Toprimate She must make BHCG
22 CONTRA Man take Toprimate & loss 5 kg Decreasing wt gain
23 CONTRA Women on OCP Intracranial HTN
24 PSCHYC Pain social fear from mall & open place Agarophobia /clasutrophobia
25 PSCHYC Blumia nervosa bmi 21 Fluxotene
26 PSCHYC Schizophrenia extrapyramidal manifestations Lithium / olanzapem / chlorpromazine / Haloperidol
27 PSCHYC Visual halucination see his died wife Depression
28 PSCHYC 65 ys with dementia / shuffling gait / Lewy body dementia
29 PSCHYC Progressive cognitive impairment Fronto temporal dementia
30 PSCHYC Personality disorder Paranoid
31 PSCHYC wife depend on her husband in every thing dependant
32 PSCHYC frequently washing hand & closing doors coming complaint that he is tired from that Obsessive-compulsive
33 PSCHYC Elongation QT Amytriptilline
34 PSCHYC Haloperidol ?
35 PSCHYC tirdness +LBP+ sore thoat + headache + joint pain Somatization
36 PSCHYC 28 ys chest pain palpitation ,numbness & tingling in fingers Panic attack
37 PEDIA Child 9 ys with abd pain = git upset & migraine Taking pizotifen
38 PEDIA 10 months inability to sit or inability to speech
39 PEDIA pregnant 16 weeks with family history of down syndrome amniocentesis/nuchal line /alpha feto prorein
40 PEDIA hypertonia cerebral palsy
41 PEDIA take vaccination then coming cry with agitation & tendeness at site of injection DTP / hepatitis B / PVC / Hib / pneumococcal
42 PEDIA 10 ms take vaccination then his mother coming complain of his abd pain hepatitis B / PVC / Hib / pneumococcal
43 PEDIA boy 14 ys fatty slipped upper femoral / perth's disease
44 PEDIA boy wake night & crying then sleep & blinking with next day not remember any thing night terror or temporal lobe epilepsy
normal hight of both parents & 10 ys boy 142 cm ,high FSH&LH but low Testosterone he is hereditary hight/ testosterone / hypopituitary /
PEDIA
45 the most shortness in his class what the cause of his shortness ?? hypogonadism / reasuure
46 PEDIA Child with Rt abd pain Lymphodenitis / appendicitis / pyelonephritis
47 PEDIA 3 ys no eye contact autism
48 PEDIA 7 ms baby when changing diaper found blood Red gell stool intersusseption / diverticulitis
49 PEDIA splenectomy which vaccine must take meningococcal conjugate / pneumococcal / polio
50 PEDIA baby born on 32 week with hypertonia ?? CP
51 PEDIA 9 ys child having diarrhea then hematuria hemolytic uremic syndrome
52 PEDIA boy passed out or syncope from HOCM hypertrophic cardiomyopathy
53 PEDIA child syncope, Systole murmer ,Dyspnoea aortic stenosis
54 ENT Allergic rhinitis with nasal disharge & frontal headache Intranasal steroids / phenoxybenzylpenicillin
55 ENT sinusitis ttt phenoxybenzylpenicillin /
56 ENT sinusitis + systemic upset ttt Co-amoxiclav
57 ENT Female 30 ys conductive hearing loss Otosclerosis or acoustic neuroma or presbycusis
58 ENT Covid 19 PCR
59 ENT Statin + clarithromycin Causing myositis
60 ENT Overdose of ASA Tinnitis & liver failure
61 ENT Refractory HTN high BP/fatigue & K is normal Sleep apnea /Pheochromocytoma or Conn's disease
62 ENT Adenohypertrophy Snoring & recurrent OM
coming with his mother complain of fatigue & mild excertion low HB having ant & leukemia / Epstein-barr virus (EBV)
63 ENT post cervical LN splenomegally
64 ENT high grade fever 39 bilateral tonsillitis exudate & lympadenopathy infectious mononucliosis / lymphoma
65 ENT Mastoiditis
66 ENT Otitis externa
67 ENT Oral acyclovir for vesicles
68 ENT Case of Vertigo take about 20 sec with nausea what the management ? Dix-Hallpike manoeuvre / Epley manoeuvre / Betahistine
Pt taking alderonate because she having fracture then stopping it because GIT
alendronate +PPI / zoledronic acid / remaking DEXA
69 RHEUM upset then having another fracture what she must take
70 RHEUM Knee Osteoarthritis what the 1st line ttt paracetamol
71 RHEUM hand Osteoarthritis IN 2 fingers & taking paracetmol what adding drug Topical NSAIDS
72 RHEUM Case ESR 70 & if ttt with prednisolone you can exclude diagnosis of Polymyalgia rheumatica / fibromyalgia
73 RHEUM Female weakness with ms stifness & high CK Polymyositis
74 RHEUM Shoulder frozen (external rotation most affected) Adhesive capsulitis
75 RHEUM Polymyalagia which ttt for this patient prednisolone
76 RHEUM Asthma on 2 years on prednisolone Induced cushing
30 ys female awaking morning on Knee & elbow joint pain & stifness ,the stifness duration of pain / duration of stiffness / small joint involvement
77 RHEUM long 20-30 min ,the diagnosis depend on which?
78 RHEUM septic arthritis what done for him ? AB / X-ray / diagnostic joint aspiration
79 RHEUM Raynaud phenomenon Nifidipine
80 ORTH Pain in knee movement Posterior cruciate ligament / anterior cruciate ligament /
81 SURGEY Testicular vein & when rising scrotum pain is relieve Epididimitis / epididymo-orchitis / testicular torsion
82 SURGEY Renal colic or flank pain radiating to groin IM diclfenac
83 SURGEY 1 year boy & has hydrocele with transillumination Observation or surgery
84 SURGEY Man above 50 ys painless hematuria Urinary bladder cancer / urolithiasis / BPH
85 SURGEY Either old man DM & HTN or child ??? Mesentric ischemia mesenteric vascular occlusion
86 SURGEY Non-seminoma or teratoma marker BHCG
87 SURGEY Elderly with backpain & dysuria lumber spine degnerative changes Cancer prostate ask about marker
88 CVS Old women high BP CCB amlodipine
89 CVS Man > 55 ys 2 occasional bp 160/100 & decrease salts CCB / ACE / follow up 2 weeks
90 CVS pt with pulmonary empolism with tachycardia & palpitation put Holter for palpitation
91 RESP Lung with restrictive symptoms Idiopathic pulmonary fibrosis
92 RESP Boy tired with exertion Salbutamol
93 RESP latent TB Pt ttt then having hemoptysis & still cough with cavity with x ray Ct scan / Mantoux / sputum acid-fast bacillus (AFB) tests/or restart ttt
94 RESP pt with COPD on SABA & LAMA still having SOB with excersice ? What the ttt LABA & ICS / oral thyophylline
95 RESP Copd with pneumonia Cefixime ??
96 RESP Copd & exacerbation bronchitis & fever Doxycycline
97 RESP bronchgenic carcinoma reduced appetite what you give him ? betaheptadine / morphine / vitamins
98 RESP Heavy smokers &just stopping ??
99 GIT Man eating at night & the pain increase with eating GERD
100 GIT Tender lesion in erythema nodosum with flaring Bloody diarrhea in UC
101 GIT DM + gastroparesis what ttt he must took ? domperidone
102 GIT what drug causing Galactorrea or nipple disharge domperidone
103 GIT female 30 ys having dyspepsia & fullness sensation also taking 2 courses of Functional dyspepsia / reflux esophagitis / chronic pancreatitis
104 GIT yong man came with Severe epigastric pain Pancreatitis /peptic ulcer
105 GIT Gastroparesis Domperidone
106 GIT High triglycerides what causing? Pancreatitis / MI / aortic dissection
107 GIT Infective hepatitis B Hepatitis c antigen / hepatitis s antigen
108 GIT 36ys obese male Non-alcoholic steatohepatitis AST & ALT double normal& bilirubin is 2 with BMI 29
109 GIT Flexible Esophagitis
110 GIT case of Gilbert syndrome
111 ENDO Women want wt loss & her thyroid TSH 3.5 Start ttt now or after 3 ms
112 ENDO Thyroid nodule & high TSH Hashimoto
113 ENDO DM will do CT Scan With Barium what drug must stopping ? Must stopping metformin
114 ENDO DM with high glucose want to keep his wt don’t want to take insulin Sitagliptin
Gynecomastia increased breast tissue & loss of hair body& adenopathy past
ENDO Liver disease /CKD/ breast adenoma / BT cancer/ PIT adenoma
115 history of mums
116 ENDO Man with hyperprolactinemia with nipple discharge Take domperidone or metoclopramide
117 ENDO Hyperparathyroidism
118 NEUR Old man cannto speak but he want to speak dysarthria & having dysphagia & weakness doing MRI / CPA
119 NEUR Case of spinal stenosis Cervical MRI
120 NEUR lacrimation & nasal congestion cluster headache
121 NEUR 60y unilateral pain with touching & jaw jawing with problem in artery & taking prednisolone temporal arteritis
122 NEUR acute stapping pain trigeminal neuralgia with electric pain in touch give carbamazepine
123 NEUR man after traffic accident having back & neck pain not respond to NSAIDS & all lab normal SSRI
124 NEUR pt after resp infection having Gullian Barre
125 NEUR meningitis give penicillin
126 NEUR pregnant migraine propranolol
127 NEUR upper fasiculation /hypertonia motor neuron
128 NEUR Neuropathic pain & facial herpes Amytriptilline
129 NEUR Subarachnoid hemorrhage & thickness neck
130 NEPHRO nephrotic syndrome frothy urine with HTN
131 NEPHRO he then after 10 days coming with frothy urine & high BP & high creatinine poststreptococcal glomerulonephritis
132 NEPHRO High creatinine 300 after taking ARBS losartan Renal artery stenosis
133 NEPHRO Renal artery stenosis Give arbs or indapamide
134 INFECT Admitted patient after discharge having diarrhea Clostridium difficile
135 INFECT Old man & curb criteria 3 or 4 Must admission
136 INFECT 2ry syphilis Penicillin or ceftriaxone
137 INFECT Angioedema or periorbital edema Adrenaline
138 INFECT Man with ED & ask for the cause Autonomic neuropathy or DM neuropathy or Serum testosterone
139 INFECT Man complain of forget & agitated & don’t know the doctor & confused Thiamine right // Niacin wrong
140 INFECT Boy having G6PD due to Nitrofurantoin
141 INFECT Pregnant 10 weeks with UTI Nitrofurantoin 7 days & repeat urine culture
142 INFECT Pregnant 28 weeks with UTI co-amoxiclav
143 INFECT Drug causing tendonitis Ciprofloxacin
144 INFECT Man take frusemide or HCT & it causing toxicity to Digoxin or ARBS or ACE
145 INFECT Retinopathy or problem with vision Hydroxychloroquine
146 INFECT Low Backpain Urinary Incontince Normal Pressure Hydrocephalus
147 INFECT female eating infected rice ttt of bacillus cereus dehydration & observation / ciprofloxacin / metronidazole
148 INFECT ttt of gonorrhea IM Ceftriaxone
149 HEMA 30 ys thalassemia
150 HEMA 64 old male with Fe def anemia & fatigue what do for him? upper & lower GIT endoscopy
151 EYE Pt when driving having visual disturbance not see the sides of Streat Without pain it is bitemporal hemianopia=pit adenoma///
152 derm Malignancy & jaundice need ttt to decrease itching prednisolone / Cholestyramine / Antihistaminics
153 Claudication plus DM & HTN tired with walking Peripherl artery disease & doing ABI ankle brachial index
154 Female making x ray discovering asymptomatic gall bladder 1 cm Observe
155 Man go to hire 1st time having protein 2nd time no protein Orthostatic proteinuria / UTI
156 55y women with persistent non visible hematuria cystoscopy
157 women coming from travel after 4 days with high fever & joint pain abd pain & frothy stool malaria
158 man coming with decreased sensation in saddle area transverse myelitis
159 man coming from travelling & have low Na legionella
160 palliative case what you give him for vomiting ? metoclopramide
161 Ask for US or biopsy or anti thyroid peroxidase enzyme
162 case of salmilosis CIPROFLXACIN /
163 case of genital herpes type 2 oral acyclovir
164 Progressive hearing loss
165 history of TB coming by cough& fever how to ensure diagnosis of TB after starting imprical ttt ?
166 10 weeks pregnant with UTI
167 28 weeks pregnant with UTI
168 Cohort study
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169 CVS Atrial flutter
170 CVS Anterior MI
171 CVS DM & HTN change his ttt & having nausea & drowsiness Losartan
172 resp 2ys boy with 2 ms recurrent chest infections & decreased air entry & Ronchi & FB or cystic fibrosis
173 resp X ray of Cyst in upper lt lung & pt having TB Aspergilloma
174 resp Dry cough rash like EN & EM with low Na 128 Mycoplasma pneumonia
175 resp Asthmatic on hydrocortisone not well withdrawl for cortisol
176 resp Old man with sudden chest pain Pneumothorax
177 derm Child with sebaceous cyst Dermatofibroma or BCC
178 derm around 40ys women with forehead rash (rosacea) increasing with sun & spicy food Metronidazole or retinoids
179 derm Foot with pus since one year Mycetoma or bacterial osteomylitis
180 derm Man with psoriasis in inner thigh need ttt Steroid
181 derm T. Versicolor Ketoconazole shampoo
182 derm Polymorphic eruption of pregnant = papular & urticarial rash of pregnancy Spare umbilicus
183 derm Pyogenic granuloma Excision
184 derm Pregnant with scabies Permethrin or malathione
185 derm Infective scabies
186 derm Atopic dermatitis & need diagnosis
187 derm sole of the foot management (mosaic wart) salysilic acid / cryotherapy /
188 eye case of Cinjunctivitis & all attendants in the school same case for ttt Hygiene / AB / histamine / steroids
189 eye Infective stye ttt Drinage or saline drops
190 eye Pterygium ttt Excision
191 eye Fundoscopy -- papilledema Intracranial hypertension
192 neur Bells palsy coming to you within 24 h ? Give acyclovir & prednisolone
193 neur Elderly women with herpes & need ttt for neuropathic pain Amytriptiline or dantrolene
194 neur What test done before giving sumatriptan BHCG
195 ortho Swelling over the posterior aspect of the elbow Gouty tophi / olecranion bursitis
196 ortho ttt of Osgood–Schlatter disease ICE rest/ physiotherapy / injection steroids /surgey
197 surg ingrowing Infected nail with abscess Incision & drainage or excision the nail
198 surg 1 year boy & has hydrocele with transillumination Observation or surgery
199 surg X ray intestinal obstruction CT scan abdomen or nasogatric tube & barium
200 surg Air under diaphragm Rupture viscus
201 pedia Baby with umbilical granuloma for diagnosis only
202 nephro Pt having confusion lethargy & weakness low Na 125 SIADA or adrenal insufficiency
‫اﻟﻠﮭم ان ﻛﺎن ھذا اﻟﻌﻣل ﻟوﺟﮭك اﻟﻛرﯾم ﻓﻧﺟﺣﻧﻲ وﻧﺟﺢ ﻛل ﻣن ﺷﺎرك ﻓﯾﮫ ﯾﺎذا اﻟﺟﻼل واﻻﻛرام‬
0553197594 ‫ ﻣﺣﻣد اﻟﺷﺑراوي ﻟﻠﺗواﺻل ﻟﻠﺗﻌدﯾل ﻋﻠﻲ اﻟﻣﻠف واﺗـــــــس‬/‫د‬