12. pancytopenia despite a
hypercellular bone marrow
Pelger-Huet cells
↑ MCV, nucleated red cells, &
a small number of blasts
6a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
16. ★ ↑WBCs +【BLASTS 】± ↓RBCs
,↓Platlets or even ↓WBCs
★ AUER ROD ➜ an esoinophilic
neede like inclusion bodies in
cytoplasm of blast cells
★ Myeloperoxidase
8a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
49. Sweat test: 2 reliable +Ve
results on 2 separate days is
Dx for CF. it is +Ve when
chloride is > 60
24b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
50. best test to Dx Cushing's
syndrome ?
25a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
51. ✯ overnight dexamethasone
suppression test (failure to
suppress cortisol < 50 is highly
suggestive for cushing)
✯ 24 hour urinary free cortisol is
the next best answer
25b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
52. best test to Dx Conn's
Syndrome ?
26a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
106. Monoclonal proteins in the
serum & urine
↑plasma cells in the BM
Bone lesions on the skeletal
survey
Hypercalcemia
53a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
119. ✯ CT: Diagnostic, may be -Ve
in 5%.
✯ LP: done after 12 Hrs
(allowing time for
xanthochromia to develop)
59b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
169. ✯ Traditional cell culture is
no longer widely used
✯ Nuclear Acid Amplification
Tests (NAATs) Ix of choice
84b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
173. ✯ Pelvic ultrasound Ix of choice
✯ ↑LH:FSH ratio is a 'classical' feature but
is no longer thought to be useful is Dx
✯ Prolactin may be normal or mildly
elevated.
✯ Testosterone may be normal or mildly
elevated
86b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
179. ✯ General population: transferrin
saturation > ferritin
✯ transferrin saturation < 45% excludes
the diagnosis
✯ ferritin > 1000 a liver biopsy should be
performed and Rx initiated.
✯ Family members: HFE genetic testing
89b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
180. screening test for Acromegaly
90a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
181. ✯ Serum IGF-1
✯ & is sometimes used to
monitor disease
90b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
182. screening test for Colorectal
cancer
91a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
183. ✯ Fecal occult blood testing is the
only method to have been
proven to ↓ mortality (about
20%)
✯ sigmoidoscopy & colonoscopy
91b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
184. HNPCC screening for ↑risk
group
92a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
185. ✯ Colonoscopy every 2 years
from 20 to 40 years age ➜
annually
✯ Check mutation in DNA or
mismatched repair gene
92b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
187. ✯ ↑risk of developing colonic
cancer, & it is recommended to be
screened annually é colonoscopy
✯ Pts post-liver transplant for PSC
still should have yearly screening
93b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
211. ✯ measure left ventricular
ejection fraction. Typically
used before & after
cardiotoxic drugs are used
105b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
233. ✯ Current evidence ➜ NO screening
for hematuria.incidence of non-
visible hematuria = Pts taking
aspirin/warfarin to the general
population ➜ should be Ix for
bladder cancer if there's hematuria
116b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
260. diagnosis of haemochronnatosis
as suggested by the presentation
and laboratory investigations
including elevated ferritin.
The next investigation would be
measurement of
130a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
261. transferrin saturation, if elevated
(above 45%),then
genotyping (homozygosity for C282y
mutations) would be expected to
clinch the diagnosis.
In rarer mutations confirmation with
liver biopsy may be required.
130b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
262. unprovoked VTE event ➜ Ix for
an underlying malignancy in all
patient groups. This should be
done with
131a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
263. ◒ Hx & examination.
◒ chest x-ray
◒ calcium levels and liver function,
◒ a urinalysis
Thrombophilia screen isn't the 1st Ix.
131b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
265. ✼ a 25% increase in serum creatinine
within 48-72 hours of contrast injection.
✼ Cholesterol atheroemboli may present
in a similar way, but associated with
multiorgan and skin involvement, and the
renal impairment is progressive.
132b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
266. multiple sclerosis pt, MRI of
the brain is inconclusive (NO
demyelination plaques of
MS), next step ?
133a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
267. ✼ MRI spinal cord ➜ look for
demyelination plaquesquite
specific for MS
✼ NOT CSF examination for
oligoclonal bands ➜ less specific
than MRI spinal cord
133b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
269. Cholesterol embolization had
been reported to occur FOR
SEVERAL MONTHS following
coronary angiography.
134b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
272. How to DD bw pleural thickening,
organised empyema or
mesothelioma, and also to
obtain tissue to DD
mesothelioma from other
primary or metastatic cancers ?
136a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
278. alarm bells in this history
which should make you think
about Viral Haemorrhagic
Fever:
139a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
279. ✺ Travel to endemic region
✺ Onset of symptoms within 21
days of return
✺ Attendance at funeral
✺ Other deaths and hospital
closures
139b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
281. ✱ occurs within 6 months
✱ typically presents with S &
S of infection
✱ Chronic rejection is after 6
months from transplant.
140b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
283. RUQ pain, vomiting, ±fever. It is unlikely
to have any features of portal
hypertension and the LFTs are only mildly
deranged.
141b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
284. If there is a 'white-out' of a hemithorax
it is useful to assess the position of
the
trachea - is it central, pulled or pushed
from the side of opacification ?
142a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
287. dt a small-vessel vasculitis
sensorimotor, or purely
sensory.
143b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
288. causes of Type 4 RTA
(hyperkalaemic) ?
144a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
289. DM, hypoaldosteronism (a
deficiency of aldosterone, or
to a resistance to its effects)
144b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
290. Councilman bodies in the
liver, Think ?
145a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
294. In the Ix of amenorrhoea, LH
and FSH may be reduced in ?
147a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
295. young ♀ with excessive weight
loss ➜ can cause decreased
levels of gonadotrophins. This is
often the case with athletes or
patients with anorexia
147b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
297. ❀ Both cause weakness, wasting, and
fasciculation + preserved reflexes, and normal
sensation.
❀ bulbar weakness in MND but not in MMN
❀ MND may have upper motor neuron signs but
MMN is a purely lower motor neuron
❀ MND fatal within 5 years, MMN is slowly
progressive over decades and no respiratory
failure
148b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
299. 1) Monoclonal plasma cells in
BM: at least 10%, OR monoclonal
protein at least 30 g/L
2) Absence of myeloma related
organ/tissue dysfunction
149b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
300. diagnosis of symptomatic
myeloma ?
All three of the following are
needed
150a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
301. 1) Monoclonal plasma cells in BM: at least
10%
2) Monoclonal protein in serum or urine
(but if non-secretory at least 30%
monoclonal plasma cells in BM)
3) Myeloma-related organ impairment
(hypercalcaemia, anaemia and lytic bone
lesions)
150b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
494. antibodies directed against
pre-synaptic voltage gated
calcium channel in the
peripheral nervous system
247a
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy
663. ★ Thumb + index finger
★ Make a 6 with your left
hand by touching the tip of
the thumb & index finger
together - C6
331b
MRCP Classical Diagnostics & Keywords
Dr.Sherif Badrawy