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May: 12/5/07 | 21/05/07 | 29/5/07 | July


Questions added


2001 paper one question 39 independent risk factor for stroke

2001 paper one question 9 Diagnosis of MS

2001 paper one question 25 mechanism of Vertigo which occurs with neck extension

2002 paper one question 13 Back pain and spinal cord syndromes

2002 paper one question 47 Presentations of Creutzfeldt-Jakob disease

2002 paper two question 12 acquired (metabolic, structural) causes of seizure

2002 paper two question 50 Treatment of on off symptoms of Parkinson's Disease

2003 paper one question 42 Lesions of C5 and brachial plexus

2003 paper two question 8 Weakness associated with myositis

2003 paper two question 57 blurred vision and fundoscopy

2003 paper two question 75 Differentials for bilateral foot numbness in HIV including drug induced neuropathy

2003 paper two question 76 Neck pain, Xrays in RA, Cervical subluxation and clinical presentation

2003 paper two question 88 Early intervention pharmacology in stroke

2003 paper two question 90 Differential Diagnosis and investigations for profound deafness

2003 paper two question 93 Differentials for hypochromic microcytic anaema

2003 paper two question 97 Differentials for confusion and memory loss

2004 paper two question 95 Critical Illness Myopathy

2004 paper one question 47 Foot drop

2004 paper one question 52 Lung Tumour and stellate ganglion (or cervicothoracic ganglion)

2004 paper one question 58 Spinal cord syndromes

2004 paper two question 21 MRI and masses in the brain : Repeat question 2003 paper two question 44

2004 paper two question 42 spinal canal stenosis

2004 paper two question 39 Genetics of CJD

2004 paper two question 65 Altered concious stroke and crescendo TIAs

2005 paper two question 18 Movement Disorders and drugs

2005 paper two question 30 Radiculopathy and lumbar MRI

2005 paper two question 38 Movement Disorders and psychotropic drugs

2005 paper two question 59 Stroke risk carotid disease and treatment

2005 paper two question 68 Diagnosing stroke syndrome on MRI

2005 paper two question 79 Clinical presentation of spinal canal stenosis



2001 paper one question 7 Graft versus host disease

2001 paper one question 21 T cell development

2001 paper one question 31 laboratory tests in microcytic anaemia

2001 paper two question 6 Differential diagnosis blood film Pancytopenia, with macrocytosis, anisocytosis and hypersegmented neutrophils

2001 paper two question 16 Diagnosis of acquired haemolytic anaemia

2001 paper two question 35 Differentials for anaemia with reticulocytosis / haemolysis

2001 paper two question 52 Causes of prolonged APTT and APTT 1:1 mix, with normal INR

2002 paper one question 57 Blood transfusion reaction Question repeated 2001 paper one question 45

2002 paper one question 70 Leucodepletion

2002 paper two question 2 Genetic counselling for haemoglbinopathies Repeat question2001 paper two question 65

2002 paper two question 20 Diagnosing APML on BMAT and appropriate therapy

2002 paper two question 45 Blood film in myelofibrosis, tear drop cells

2002 paper two question 58 Wafarin reversal and hypercoagulation

2002 paper two question 70 Aplastic Anaemia and Treatment

2002 paper two question 77 Use of FFP during plasma exchange

2002 paper two question 96Waldenstrom’s Macroglobulinaemia (WM)

2003 paper one question 25 Treatment of acquired siderablastic anaemia

2003 paper one question 35 The use of Cryoprecipitate

2003 paper one question 52 Treatment of haemophilia A and a high titre factor VIII inhibitor

2003 paper one question 64 Problems with investigations for an underlying hypercoagulable state in DVT Repeat question 2001 paper one question 19

2003 paper two question 10 Diagnosing Burkkitts Lymphoma on blood smear and karyotypic abnormality

2003 paper two question 25 Diagnosing multiple myeloma on bone marrow aspirate and presentation

2003 paper two question 38Sickle cell crisis: acute presentation, anaemia and blood film

2003 paper two question 51 Distinguishing between primary and secondary causes of polycythaemia

2003 paper two question 82 Diagnosing Pernicious anaemia
question repeated 2005 paper one question 32

2003 paper two question 93 Differentials for hypochromic microcytic anaema repeat question 2001 paper two question 72

2004 paper one question 3 Lymphadenopathy, blood film and CD19 immunophenotype

2004 paper one question 44 Diagnosing CML on blood film (philidelphia chromosome t(9;22))

2004 paper two question 20 CML best treatment for complete cytogenic response

2004 paper two question 33 Distinguishing between primary and secondary causes of polycythaemia

2004 paper two question 46 prevention of recurrent febrile non-haemolytic transfusion reactions

2004 paper two question 66 Diagnosing mechanism of anaemia

2004 paper two question 84 Causes of raised APTT

2004 paper two question 93 Diagnosing aneamia on blood film

2005 paper one question 18 Aneamia post op

2005 paper one question 41 Role of von Willebrand's factor in normal coagulation

2005 paper one question 48 Cancer risk following mantle radiotherapy treatment of hodgkins lymphoma

2005 paper one question 60 Blood components and risk of septic transfusion reaction

2005 paper two question 9 differentials for thrombocytopenia with blood film

2005 paper two question 20 Causes of raised APTT and increased thrombin time

2005 paper two question 36 Management of throbocytopenia in ITP

2005 paper two question 51 Aneamia and ESRD

2005 paper two question 70 Distinguishing between primary and secondary causes of polycythaemia



Questions added


2003 paper one question 63 Use of appropriate Antiemetic in parkinsons disease

2004 paper two question 35 epilepsy and treatment during pregnancy

2004 paper two question 71 treatment of dementia

2004 paper one question 19 neuropathology of MS

2004 paper two question 59 Use of alpha 4 integrins in the treatment of MS

2004 paper two question 100 epilepsy treatment with lamotrigine and interactions

2005 paper one question 26 Mechanism of Trigeminal neuralgia

2005 paper one question 36 Determining peripheral lesion VII facial nerve from clinical signs

2005 paper one question 45 coliform central nervous system (CNS) infections and why not to use gentamicin

2005 paper one question 47 CVD the most common identifiable cause of epilepsy in the elderly

2005 paper one question 66 Stroke syndromes and associated cerebral artery

2002 paper one question 27dysphagia and features for risk of aspiration

2002 paper one question 30 Mechanisms of foot drop

2002 paper two question 98mechansims for incomplete right third nerve palsy with pupil sparing in patient with T2DM


2002 paper one question 52 - Causes of amenorrhoea and Hyperprolactinaemia

2002 paper two question 67 -HRT and Hyperprolactinaemia

2003 paper one question 61 - Interpreting Bone Mineral Density reports

2003 paper two question 99 Hyperprolactinaemia from non functioning macroadenoma

2003 paper two question 34 risk factors for recurrent hypoglycaemic episodes

2003 paper two question 86 mechanism for unawarenes of hypoglycaemic episodes


2001 paper one question 12 use of betablocker in symptomatic HOCM

2001 paper one question 24 abnormal cardiac anatomy on CT - myxoma

2001 paper one question 48 stress exercise ECG test result predictors of angiographically significant multivessel or left main coronary artery disease

2001 paper two question 1 ECG and RBBB

2001 paper two question 20 - thrombolysis in STEMI - contraindications

2001 paper two question 78 - management of inferior MI

2003 paper two question 1 Differentiating Pericardial tamponade from other cardiac emergencies


2003 paper two question 15 - septic sacroilitis

2003 paper two question 36 mechanism of jaundice in acute severe tonsillitis ( also gastro q)

2003 paper two question 67 - Q fever in a dairy farmer presenting with febrile illness / menigism


from the journals

Controversies and Misconceptions in Malaria Chemoprophylaxis for Travelers
Lin H. Chen; Mary E. Wilson; Patricia Schlagenhauf
JAMA. 2007;297:2251-2263.

Treatment of Malaria in the United States: A Systematic Review
Kevin S. Griffith; Linda S. Lewis; Sonja Mali; Monica E. Parise
JAMA. 2007;297:2264-2277.

Ovarian cancer and HRT in the Million Woman Study” Lancet 2007; 369:1703-10

9 years of recurrent dysphagia
The LancetVolume 369, Issue 957526 May 2007-1 June 2007Page 1814
Krishna P Basavaraju, C Roger Hunt and Navneet K Ahluwalia

Repetitive strain injury
The LancetVolume 369, Issue 957526 May 2007-1 June 2007Pages 1815-1822
Maurits van Tulder, Antti Malmivaara and Bart Koes

Acute and chronic complications of type 2 diabetes mellitus in children and adolescents
The LancetVolume 369, Issue 957526 May 2007-1 June 2007Pages 1823-1831
Orit Pinhas-Hamiel and Philip Zeitler

from the lectures

Chapuy MC, Arlot ME, Duboeuf F, Meunier PJ. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992;327:1637-1642

Effects of a Short-Term Vitamin D and Calcium Supplementation on Body Sway and Secondary Hyperparathyroidism in Elderly Women
MICHAEL PFEIFER, 1   BETTINA BEGEROW, 1   HELMUT W. MINNE, 1   CHRISTINE ABRAMS, 2   DETLEF NACHTIGALL, 3   CORINNA HANSEN3   Journal of Bone and Mineral Research, 2000:15:1113-1118 (doi: 10.1359/jbmr.2000.15.6.1113)

Effect of Vitamin D on Falls: A Meta-analysis Bischoff-Ferrari et al.JAMA.2004; 291: 1999-2006.

BMJ 2003;326:469 ( 1 March )
Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial
Daksha P Trivedi, research fellow a, Richard Doll, emeritus professor b, Kay Tee Khaw, professor of clinical gerontology a. 

BMJ  2005;330:1003 (30 April), doi:10.1136/bmj.330.7498.1003
Primary care
Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care
Jill Porthouse et al.

The Lancet 2005 May 7-13;365(9471):1621-8.
Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people (Randomised Evaluation of Calcium Or vitamin D, RECORD): a randomised placebo-controlled trial.

Grant AM, Avenell A, Campbell MK, McDonald AM, MacLennan GS, McPherson GC, Anderson FH, Cooper C, Francis RM, Donaldson C, Gillespie WJ, Robinson CM, Torgerson DJ, Wallace WA; RECORD Trial Group.

Bischoff-Ferrari HA, Willett WC, Wong JB, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005; 293: 2257-2264 Calcium plus Vitamin D Supplementation and the Risk of Fractures
Rebecca D. Jackson
et al
NEJM 354: 669-83, 2006

Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women
Principal Results From the Women's Health Initiative Randomized Controlled Trial

Writing Group for the Women's Health Initiative Investigators
JAMA. 2002;288:321-333.

Effect of Estrogen Plus Progestin on Stroke in Postmenopausal Women
The Women's Health Initiative: A Randomized Trial

Sylvia Wassertheil-Smoller et al
JAMA. 2003;289:2673-2684.


Study Group 21/5/07

Questions added


2005 paper two question 93 - enterococcal UTI and antibiotic resistance

2004 paper two question 99 Management of a needlestick injury


2002 paper two question 6 - Investigations for hypertension in a young person

2002 paper two question 17 - Use of raloxifene

2002 paper two question 30 - Investigating the cause of hypercalcaemia

2002 paper one question 42 cold thyroid nodule, includes thyroid cancer fast facts

2002 paper two question 93 - Use of bone scintigram in the diagnosis of Paget's disease

2003 paper one question 5 lispro insulin analogue

2003 paper two question 6 Thiazolidinedione

2003 paper two question 63 Metformin, Acarbose, Rosiglitazone , Repglinide, Orlistat (Xenical)

2003 paper two question 79 uptake of iodine in thyrotoxicosis

2004 paper one question 36 hot thyroid nodule,and the TSH receptor

2004 paper two question 19 A patient with pituitary apoplexy.

2004 paper two question 38 - OP Vitamin D is first line treatment

2004 paper two question 44 - Management of hypercalcaemia in symptomatic patient with ca - nausea, weakness and constipation

2004 paper two question 69 - investigating hypocalceamia - vitamin D deficiency

2004 paper two question 75autosomal dominant familial hypercholesterolaemia

2005 paper one question 33 Genetic abnormalities in lipid metabolism

2004 paper two question 96 - Hypertension and hypokalaemia

2005 paper two question 33 - hypopituitarism requiring hydrocort Rx

2005 paper two question 3 - Diabetic neurological complications


from the journals
In Respiratory Smoking-related chronic lung disease

A 68-Year-Old Man with COPD Contemplating Colon Cancer Surgery Clinician's Corner JAMA May 26 2007 Vol 297, No 19 pp 2121 - 2130

No sure which topic this belongs to

Narrative Review: The Pathophysiology of Fibromyalgia
Aryeh M. Abeles, MD; Michael H. Pillinger, MD; Bruce M. Solitar, MD; and Micha Abeles, MD
Ann Intern Med. 2007;146:726-734.

In Endocrinology:


Clincial Practice NEJM Volume 356: 2064-2072 May 17,2007 number 20
 The Syndrome of Inappropriate Antidiuresis
David H. Ellison, M.D., and Tomas Berl, M.D.

Adrenal disorders

The Journal of Clinical Endocrinology & Metabolism Vol. 88, No. 12 5593-5602
Copyright © 2003 by The Endocrine Society
Diagnosis and Complications of Cushing’s Syndrome: A Consensus Statement
G. Arnaldi, A. Angeli, A. B. Atkinson, X. Bertagna, F. Cavagnini, G. P. Chrousos, G. A. Fava, J. W. Findling, R. C. Gaillard, A. B. Grossman, B. Kola, A. Lacroix, T. Mancini, F. Mantero, J. Newell-Price, L. K. Nieman, N. Sonino, M. L. Vance, A. Giustina and M. Boscaro

In Infectious Diseases: HIV

Review Article Current Concepts NEJM Volume 356: 2073 - 2081 May 17,2007 number 20
An HIV Vaccine — Evolving Concepts

Margaret I. Johnston, Ph.D., and Anthony S. Fauci, M.D.

In Respiratory: Asthma

Clinical Decisions NEJM Volume 356:2096 - 2100 May 17,2007 number 20
Treatment of Mild Persistent Asthma

In Gastroenterology and Hepatology : GI malignancies

Gastrointestinal stromal tumour
The LancetVolume 369, Issue 957419 May 2007-25 May 2007Pages 1731-1741
Brian P Rubin, Michael C Heinrich and Christopher L Corless

In Medical Oncology: Principles of anticancer therapies

Metastasis: recent discoveries and novel treatment strategies
The LancetVolume 369, Issue 957419 May 2007-25 May 2007Pages 1742-1757
Suzanne A Eccles and Danny R Welch

From the lectures


NEJM Vol 350: 1516-1525 Arpil 8, 2004 No 15

Cinacalcet for Secondary Hyperparathyroidism in Patients Receiving Hemodialysis

Geoffrey A. Block, M.D.et al
Conclusions Cinacalcet lowers parathyroid hormone levels and improves calcium–phosphorus homeostasis in patients receiving hemodialysis who have uncontrolled secondary hyperparathyroidism.

NEJM Vol 350: 1565-1567 Arpil 8, 2004 No 15 - Editorial
Fooling the Parathyroid Gland — Will There Be Health Benefits?
G. Curhan

Dolores M. Shoback, John P. Bilezikian, Stewart A. Turner, Laura C. McCary, Matthew D. Guo, and Munro Peacock
The Calcimimetic Cinacalcet Normalizes Serum Calcium in Subjects with Primary Hyperparathyroidism
J Clin Endocrinol Metab 2003 88: 5644-5649, doi:10.1210/jc.2002-021597
Munro Peacock, John P. Bilezikian, Preston S. Klassen, Matthew D. Guo, Stewart A. Turner, and Dolores Shoback
Cinacalcet Hydrochloride Maintains Long-Term Normocalcemia in Patients with Primary Hyperparathyroidism
J Clin Endocrinol Metab 2005 90: 135-141, doi:10.1210/jc.2004-0842

NEJM Vol 350: 1746-1751 April 22, 2004 No 17
Asymptomatic Primary Hyperparathyroidism

J. P. Bilezikian and S. J. Silverberg
In Endocrinology: Hypercalcaemia


CONSENSUS: Guidelines for Diagnosis and Therapy of MEN Type 1 and Type 2
Maria Luisa Brandi et al
J Clin Endocrinol Metab 2001 86: 5658-5671

Phosphate Homeostasis
NPT2a--the key to phosphate homeostasis.
N Engl J Med. 2002 Sep 26;347(13):1022-4

Disorders of lipid metabolism In Endocrinology: Investigation and management of hyperlipidemia

Mechanisms of Disease: Inflammation, Atherosclerosis, and Coronary Artery Disease
Göran K. Hansson, M.D., Ph.D

NEJM Vol 352: 1685-1695 Arpil 21, 2005 No 16

National Heart Foundation Postion Statement on lipid management

Testosterone Therapy in Men In Endocrinology: adult hypogonadism

Andrology Australia

MJA Practice Essentials — Endocrinology
11: Androgen deficiency and replacement therapy in men
David J Handelsman and Jeffrey D Zajac
MJA 2004; 180 (10): 529-535

Thomas G. Travison, Andre B. Araujo, Varant Kupelian, Amy B. O’Donnell, and John B. McKinlay
The Relative Contributions of Aging, Health, and Lifestyle Factors to Serum Testosterone Decline in Men J Clin Endocrinol Metab 2007 92: 549-555

Androgen Excess: Females In Endocrinology: androgen excess syndromes

Chapter 6 - Randall B. Barnes, M.D., Adrienne B. Neithardt, M.D. and Suleena K. Kalra, M.D.
November 19, 2003

The Evaluation and Management of Hirsutism
Ricardo Azziz
Obstet Gynecol 2003 101: 995-1007


Harbourne L et al. Descriptive review of the evidence for use of metformin in
polycystic ovary syndrome. Lancet 2003; 361: 1894 - 1901

Lord JM et al. Metformin in polycystic ovary syndrome: systematic review and metaanalysis.
BMJ 2003; 327: 951 - 956

DPP Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or
metformin. N Eng J Med 2002; 346: 393 - 403

Ehrmann DA. Polycystic ovary syndrome. N Eng J
Med 2005; 352: 1223 - 36



Study Group 12/5/07

Questions added

2002 paper one question 19 Secondary hypoadrenalism following pituitary adenoma resection

2002 paper one question 60 hypopituitarism and growth hormone, question repeated in 2003 2003 paper one question 41

2002 paper one question 33 aldosterone mechanism

2003 paper two question 49 Adrenal incidentaloma


from the journals
In Endocrinology:

Endocrine causes of hypertension

Review Article: Mechanisms of Disease The New England Journal of Medicine
Volume 356: 1966-1978 May 10 2007 Number 19
Sodium and Potassium in the Pathogenesis of Hypertension
Horacio J. Adrogué, M.D., and Nicolaos E. Madias, M.D.

In Infectious Diseases


Practice Pregnancy Plus: HIV and Pregnancy Glenda E Gray, James A McIntyre
BMJ 2007: 334:950-53

In Gastroenterology:

Inflammatory Bowel disease

Inflammatory bowel disease: cause and immunobiology
The LancetVolume 369, Issue 957312 May 2007-18 May 2007Pages 1627-1640
Daniel C Baumgart and Simon R Carding

Inflammatory bowel disease: clinical aspects and established and evolving therapies
The LancetVolume 369, Issue 957312 May 2007-18 May 2007Pages 1641-1657
Daniel C Baumgart and William J Sandborn

In adolescence

a series from RCH last month in the lancet covering most of the adolescence topics

From the lectures

Endocrinology: Thyroid Disorders