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Haematology, Infectious Disease & Dermatology Flashcards

6 cards from real MRCP PART 1 practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 45-year-old man presents with polycythaemia vera. His haematocrit is 0.56 and he complains of headaches, facial plethora, and pruritus after bathing. Which mutation is present in >95% of cases?

    Answer: JAK2 V617F mutation

    JAK2 V617F point mutation is found in over 95% of polycythaemia vera cases. The mutation leads to constitutive activation of the JAK-STAT signalling pathway, causing erythroid, myeloid, and megakaryocyte proliferation. Aquagenic pruritus (after bathing) is a classic symptom of PV.

  2. A patient presents with symmetrical proximal muscle weakness, elevated CK, heliotrope rash, and Gottron's papules. What is the diagnosis?

    Answer: Dermatomyositis

    Dermatomyositis is an idiopathic inflammatory myopathy characterised by proximal muscle weakness, elevated CK, and pathognomonic skin changes: heliotrope rash (violet discolouration of eyelids) and Gottron's papules (erythematous papules over knuckles). It is associated with internal malignancy in adults.

  3. Which prophylaxis is recommended for a patient with HIV and a CD4 count below 200 cells/mm³ to prevent Pneumocystis jirovecii pneumonia?

    Answer: Co-trimoxazole (trimethoprim-sulfamethoxazole)

    Co-trimoxazole (trimethoprim-sulfamethoxazole) is the first-line prophylaxis for PCP (Pneumocystis jirovecii pneumonia) in patients with HIV and CD4 count below 200 cells/mm³. Alternatives for those with sulfonamide allergy include dapsone, atovaquone, or aerosolised pentamidine.

  4. A patient develops red man syndrome during vancomycin infusion. What is the mechanism?

    Answer: Direct mast cell degranulation causing histamine release, unrelated to IgE

    Red man syndrome is a non-IgE-mediated reaction caused by direct mast cell degranulation triggered by rapid vancomycin infusion, releasing histamine. It presents with flushing, erythema, and pruritus over the face, neck, and upper torso. It is prevented by slower infusion rates (over at least 60 minutes).

  5. A patient with haemophilia A has a factor VIII level of 3%. What severity does this represent?

    Answer: Moderate haemophilia A (1–5% factor VIII)

    Haemophilia A severity is classified by factor VIII activity: mild (>5–40%), moderate (1–5%), and severe (<1%). A level of 3% places this patient in the moderate category, characterised by bleeding with significant trauma or surgery, but not usually spontaneous bleeding.

  6. Which organism is the most common cause of infective endocarditis in IV drug users?

    Answer: Staphylococcus aureus

    Staphylococcus aureus is the most common cause of infective endocarditis in IV drug users. It typically affects the tricuspid valve (right-sided endocarditis) due to direct injection into venous circulation. It causes an aggressive, destructive infection with high mortality.