Clinical Sciences
Cell/molecular and membrane
(72)
biology
Clinical anatomy (67)
Clinical biochemistry and metabolism (118)
Clinical physiology (92)
Genetics (107)
Immunology (118)
Statistics (158)
Passing mark range between 63-66%
Year No. of Q
MRCP 1 May 19 100
MRCP 1 Jan 19 100
MRCP 1 Sept 18 100
MRCP 1 May 18 100
MRCP 1 Jan 18 100
MRCP 1 Sept 17 100
MRCP 1 May 17 100
MRCP 1 Jan 17 100
MRCP 1 Sept 16 100
MRCP 1 May 16 100
MRCP 1 Jan 2016 100
MRCP 1 Sept 2015 100
MRCP 1 May 2015 100
MRCP 1 Jan 2015 100
A. H. Murad
ﻻ ﺗﻨﺴﻮﻧﺎ ﻣﻦ ﺻﺎﻟﺢ دﻋﺎﺋﻜﻢ
ﺗﻢ ﺑﺤﻤﺪ ﷲ وﺗﻮﻓﯿﻘﮫ وﻣﻨﮫ
ﺟﻌﻞ ﷲ ﻋﻤﻠﻨﺎ ﻣﺘﻘﺒﻼ ﺧﺎﻟﺼﺎ ﻟﻮﺟﮭﮫ اﻟﻜﺮﯾﻢ
,A 42-year-old woman who has been taking phenytoin for the past month for epilepsy comes
to the surgery for review. She is complaining of a severe skin reaction. On examination she is
pyrexial at 37.9 oC, and has a BP of 110/70 mmHg. She tells you that she feels awful.
Apparently the rash began on her face and quickly spread over the rest of the body; they
begin as large, painful, burning macules, and eventually the epidermis sheds to reveal a moist
dermis layer underneath. Her mucous membranes seem to be affected, and she has crusted
bleeding around her lips.
Investigations:
Hb 12.9 g/dl
WCC 9.2 x 10 9/l (raised eosinophils)
PLT 203 x 10 9/l
Na + 140 mmol/l
K+ 5.2 mmol/l
Cr 140 µmol/l
A Necrotising fasciitis
B Pemphigoid
C Pemphigus
D SLE
E Toxic epidermal necrolysis
48973
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Normal Values
, A 62-year-old man who has recently been diagnosed with bronchial carcinoma comes to the
Dermatology Clinic for review. Over the past few weeks he has begun to suffer from a
number of painful mouth ulcers and a generalised blistering, itchy skin rash. On examination,
his BP is 132/82 mmHg, pulse is 82/min and regular and there are decreased breath sounds
on the left hand side consistent with the known carcinoma. In addition, examination reveals
widespread tense blisters in various skin and mucosal sites.
A cANCA
B Anti-envoplakin
C Anti-Hu
D Anti-Ro
E Anti-tissue transglutamase
Explanation
B Anti-envoplakin
A number of antibodies are demonstrated in paraneoplastic pemphigus; these include
envoplakin, periplakin, bullous pemphigoid antigen I, desmoplakin, desmoplakin II, plectin and
alpha2-macroglobulin-like-1. They can also exhibit antibodies to antigens associated with
pemphigus vulgaris (desmoglein 3) and pemphigus foliaceus (desmoglein 1).
A cANCA
cANCA is incorrect. This man has cancer-associated pemphigus, a recognised paraneoplastic
syndrome. cANCA is associated with the development of Wegener’s granulomatosis but is
not associated with the development of bullous diseases.
C Anti-Hu
Cell/molecular and membrane
(72)
biology
Clinical anatomy (67)
Clinical biochemistry and metabolism (118)
Clinical physiology (92)
Genetics (107)
Immunology (118)
Statistics (158)
Passing mark range between 63-66%
Year No. of Q
MRCP 1 May 19 100
MRCP 1 Jan 19 100
MRCP 1 Sept 18 100
MRCP 1 May 18 100
MRCP 1 Jan 18 100
MRCP 1 Sept 17 100
MRCP 1 May 17 100
MRCP 1 Jan 17 100
MRCP 1 Sept 16 100
MRCP 1 May 16 100
MRCP 1 Jan 2016 100
MRCP 1 Sept 2015 100
MRCP 1 May 2015 100
MRCP 1 Jan 2015 100
A. H. Murad
ﻻ ﺗﻨﺴﻮﻧﺎ ﻣﻦ ﺻﺎﻟﺢ دﻋﺎﺋﻜﻢ
ﺗﻢ ﺑﺤﻤﺪ ﷲ وﺗﻮﻓﯿﻘﮫ وﻣﻨﮫ
ﺟﻌﻞ ﷲ ﻋﻤﻠﻨﺎ ﻣﺘﻘﺒﻼ ﺧﺎﻟﺼﺎ ﻟﻮﺟﮭﮫ اﻟﻜﺮﯾﻢ
,A 42-year-old woman who has been taking phenytoin for the past month for epilepsy comes
to the surgery for review. She is complaining of a severe skin reaction. On examination she is
pyrexial at 37.9 oC, and has a BP of 110/70 mmHg. She tells you that she feels awful.
Apparently the rash began on her face and quickly spread over the rest of the body; they
begin as large, painful, burning macules, and eventually the epidermis sheds to reveal a moist
dermis layer underneath. Her mucous membranes seem to be affected, and she has crusted
bleeding around her lips.
Investigations:
Hb 12.9 g/dl
WCC 9.2 x 10 9/l (raised eosinophils)
PLT 203 x 10 9/l
Na + 140 mmol/l
K+ 5.2 mmol/l
Cr 140 µmol/l
A Necrotising fasciitis
B Pemphigoid
C Pemphigus
D SLE
E Toxic epidermal necrolysis
48973
Submit
Skip Question
, Calculator
Normal Values
, A 62-year-old man who has recently been diagnosed with bronchial carcinoma comes to the
Dermatology Clinic for review. Over the past few weeks he has begun to suffer from a
number of painful mouth ulcers and a generalised blistering, itchy skin rash. On examination,
his BP is 132/82 mmHg, pulse is 82/min and regular and there are decreased breath sounds
on the left hand side consistent with the known carcinoma. In addition, examination reveals
widespread tense blisters in various skin and mucosal sites.
A cANCA
B Anti-envoplakin
C Anti-Hu
D Anti-Ro
E Anti-tissue transglutamase
Explanation
B Anti-envoplakin
A number of antibodies are demonstrated in paraneoplastic pemphigus; these include
envoplakin, periplakin, bullous pemphigoid antigen I, desmoplakin, desmoplakin II, plectin and
alpha2-macroglobulin-like-1. They can also exhibit antibodies to antigens associated with
pemphigus vulgaris (desmoglein 3) and pemphigus foliaceus (desmoglein 1).
A cANCA
cANCA is incorrect. This man has cancer-associated pemphigus, a recognised paraneoplastic
syndrome. cANCA is associated with the development of Wegener’s granulomatosis but is
not associated with the development of bullous diseases.
C Anti-Hu
