MRCP PART 01 : Q 1-3 :

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Question Number 1

Question:
A 40 year old woman is complaining of finding it increasingly more difficult to swallow food. She also complains that whenever washes his hands with cold water,the middle finger on the left becomes very painful and pale . On examination she is seen to have telengiectasia The physician suspects a connective tissue disorder. She also complains of shortness of breath. Which of the following is the most likely cause of her respiratory syntoms?

a) pulmonary abscess
b) pulmonary fibrosis
c) bilateral hilar adenopathy
d) bilateral pleural effusions
e) pneumothorax

 

Question Number 2

Question:
diffuse interstitial pneumonitis with interstitial edema, varying degrees of fibrosis, lymphoid cell infiltration, and alveolar-cell hyperplasia are pathological features typical of :

a) CMV
b) Influenza virus
c) RSV
d) Parainfluenza virus
e) Paramyxovirus

 

Question Number 3

Question:
A 24 year old in-patient has chronic diarrhea as well as a large draining fistula. She complains of nausea and anorexia and of marked weakness. On physical examination her blood pressures is 120/80 mmHg. When she stands up, she feels very dizzy and her blood pressure is 110/70. Her heart rate is 100. She weighs 50 kg. When the intern pinches her forehead skin, it stands up like a tent. Her eyes are sunken. Her laboratory tests are pending. The intern suspects that she has extracellular fluid volume depletion. What volume of water would be expected in the extracellular compartment of a healthy 50 kg female?

a) 30 liters
b) 2.5 liters
c) 10 liters
d) 20 liters
e) 7.5 liters

 

CORRECT ANSWERS

Question Number 1


Correct Answer: B

Explanation:
Telangiectasis are a diagnostic sign of the CRST syndrome C (Calcinosis of subcutaneous tissues, R(Raynaud's phenomenon) S( sclerodactyly) T (telengiactasia) CRST syndrome- variant of systemic scleroderma. In association with Raynaud's phenomenon, the presence of telengiectasis in one or more of the locations described above is sufficient to make the diagnosis of scleroderma (the RT of CRST). Sclerosis of the skin does not have to be present to make this diagnosis in the early stages of the CRST syndrome. The distribution of the telangiectasia in CRST is identical to that found in hereditary hemorrhagic telangiectasia (also known as Rendu-Osler-Weber disease) . The progression of the systemic sclerosis becomes generalised affecting the lungs with fibrosis, the kidneys with severe hypertension and the GI tract.

 

Question Number 2

Correct Answer: A

Explanation:
The two patterns of CMV involvement include (1) a multifocal or miliary pattern characterized by discrete spherical lesions as large as 4 mm in diameter, with alveolar hemorrhage, fibrin deposition, and a moderate neutrophilic response, and (2) a diffuse interstitial pneumonitis with interstitial edema, varying degrees of fibrosis, lymphoid cell infiltration, and alveolar-cell hyperplasia

 

Question Number 3
Correct Answer: C

Explanation:
Body water distribution can be calculated using the rule of thirds. 60% of an average persons weight is water. Of this, 2/3 is intracellular and 1/3 is extracellular. Of the extracellular water, 2/3 is interstitial and 1/3 is plasma. In a 50 kg person, there will be 30 kg of water (60%). This will be approximately 30 liters. Of this 1/3 is extracellular or 10 liters.


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