MRCP Part 1 Gastroenterology & Neurology

Question 1

A 45-year-old woman presents with jaundice, pruritus, elevated ALP, and positive anti-mitochondrial antibodies (AMA). What is the diagnosis?

Accepted Answer

Primary biliary cholangitis

Answer

Primary sclerosing cholangitis

Answer

Autoimmune hepatitis

Answer

Wilson's disease

Question 2

Which score is used to assess severity and 30-day mortality in acute upper GI bleeding?

Accepted Answer

Glasgow-Blatchford score

Answer

Child-Pugh score

Answer

Maddrey's discriminant function

Answer

MELD score

Question 3

A 30-year-old man presents with profuse watery diarrhoea, terminal ileum disease on colonoscopy, and perianal fistulae. What is the most likely diagnosis?

Accepted Answer

Crohn's disease

Answer

Ulcerative colitis

Answer

Coeliac disease

Answer

Microscopic colitis

Question 4

In a patient with oesophageal varices and acute variceal haemorrhage, which pharmacological agent should be given immediately alongside resuscitation?

Accepted Answer

IV terlipressin

Answer

IV ranitidine

Answer

IV omeprazole

Answer

IV metoclopramide

Question 5

A patient with long-standing ulcerative colitis undergoes surveillance colonoscopy. Dysplasia is found in a flat non-polypoid area. What is the recommended management?

Accepted Answer

Colectomy

Answer

Repeat colonoscopy in 6 months

Answer

Argon plasma coagulation of the dysplastic area

Answer

Enhanced surveillance with narrow-band imaging annually

Question 6

What is the mechanism of action of rifaximin in hepatic encephalopathy?

Accepted Answer

Minimally absorbed antibiotic that alters gut flora to reduce ammonia production

Answer

Reduces gut motility

Answer

Increases renal ammonia clearance

Answer

Acts as a GABA receptor antagonist