Archives: MRCP Part 2

MRCP2-2656

A 30-year-old female returned from Tanzania 2 weeks ago and presents to the medical take with symptoms of fever, headache and generalised arthralgia. She had taken doxycycline as an antimalarial and had been fully vaccinated prior to her travel. However, she admits to getting mosquito bites regularly whilst away and had a severe reaction to one of them, leaving a mark on her shoulder. On examination, she appears drowsy, has mild hepatosplenomegaly and a well circumscribed, rubbery, painful, red lesion approximately 5 cm in diameter above her left shoulder. What is the likely diagnosis?

MRCP2-2641

A 30-year-old man is referred to a tuberculosis (TB) clinic following his wife’s confirmed diagnosis of fully sensitive pulmonary TB. He denies any symptoms of cough, fevers, or weight loss and has no significant medical history. He is not a regular smoker or drinker and does not take any medications. Laboratory results reveal a negative HIV antibody test, negative hepatitis B surface antigen test, positive hepatitis B surface antibody test, negative hepatitis C antibody test, and positive interferon-gamma release antibody. What is the most appropriate initial treatment to offer?

MRCP2-2642

A 54-year-old female patient complains of recurring dysuria accompanied by tingling sensations and shooting pains in the genital area. What is a fact about genital herpes?

MRCP2-2643

A 32-year-old female patient complains of painful lesions on her labia and upper thigh. The lesions appeared three days ago and she has no significant medical history. She tested negative for HIV a month ago but had unprotected sex during her recent trip to Rwanda. Upon examination, the patient has multiple erythematous pustules on her labia and upper thighs, with two of them appearing ulcerated. She also experiences painful inguinal lymphadenopathy. What is the probable diagnosis?

MRCP2-2645

A 20-year-old student on a gap year has just returned from a three-week camping trip in the USA. He is experiencing foul-smelling watery diarrhoea, abdominal pain, and nausea. During the examination, he shows mild general abdominal tenderness. What is the most probable cause of his diarrhoea?

MRCP2-2646

A 28-year-old man presents with joint pains one week after returning from a vacation in Corfu. He reports experiencing intermittent arthralgia in both knees and wrists, with more severe pain in his left knee. Upon examination, he is febrile and has a swollen, warm, and tender left knee, as well as pustular lesions on three digits of his right hand. Laboratory tests reveal elevated white blood cell and platelet counts, as well as increased plasma creatinine levels. Knee aspiration shows yellow turbid fluid with numerous polymorphs, but cultures are negative. Given these findings, what is the likely result of the Gram stain of the synovial fluid?

MRCP2-2647

A 21-year-old male presents to the Emergency department with a complaint of urethral discharge one week after engaging in unprotected casual sex. Upon examination, Gram stain reveals the presence of numerous neutrophils, some of which contain Gram negative intracellular Diplococci. The patient is administered ceftriaxone, 250 mg via intramuscular injection. However, five days later, the patient returns with persistent discharge. What is the most probable cause of this discharge?

MRCP2-2648

A 35-year-old man with HIV disease visits the clinic with complaints of fatigue and weakness. His lab results, taken eight weeks apart, are shown below.

Results 1:
Hb – 145 g/L
WBC – 4.0 ×109/L
Platelets – 70 ×109/L
CD4 – 120 cells/mm3

Results 2:
Hb – 76 g/L
WBC – 4.3 ×109/L
Platelets – 200 ×109/L
CD4 – 250 cells/mm3

The normal ranges for these values are:
Hb – 130-180 g/L
WBC – 4-11 ×109/L
Platelets – 150-400 ×109/L

What is the most likely explanation for these results?

MRCP2-2649

A 42-year-old male patient complains of jaundice. Upon liver screening, it is found that he does not have HBs antigen or anti-HBs antibody. What other test can be done to confirm that his hepatitis is caused by hepatitis B virus?