Free MRCP(UK) Part 2 written exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the MRCP(UK) Part 2 written exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A patient with heart failure has increasing ankle oedema from fluid retention. Which medicine directly increases urinary fluid loss?

   1. A.Enalapril
   2. B.Candesartan
   3. C.Bisoprolol
   4. D.FurosemideCorrect answer: D

   Explanation: The NHS states: "make you pee more to reduce fluid build-up in your body (diuretics), such as furosemide". Furosemide is a diuretic and targets the fluid accumulation; the other medicines act principally through vascular or heart-rate effects.

   Reference: NHS: Heart failure — Medicines

2. 2A 22-year-old has recurrent scaly plaques on the elbows and knees, with pits in several fingernails. Which diagnosis is most likely?

   1. A.PsoriasisCorrect answer: A
   2. B.Atopic eczema
   3. C.Lichen planus
   4. D.Pityriasis versicolor

   Explanation: The NHS states: "The surface of your nails can have dents and pits.". The plaque distribution and nail pitting favour psoriasis.

   Reference: NHS: psoriasis — Symptoms of psoriasis

3. 3A patient has weight loss, heat intolerance and tremor. Which thyroid test pattern most strongly supports hyperthyroidism?

   1. A.High TSH with low free T4
   2. B.High TSH with normal free T4
   3. C.Low TSH with low free T4
   4. D.Low TSH with high free T4Correct answer: D

   Explanation: The NHS states: "A low level of TSH and high levels of T3 and/or T4 usually means you have an overactive thyroid.". The suppressed TSH and raised thyroid hormone pattern supports thyroid hormone excess.

   Reference: NHS: thyroid-d — Thyroid function blood test

4. 4An older patient with dementia develops confusion abruptly over a few hours rather than a gradual decline. Which syndrome requires urgent assessment for an underlying cause?

   1. A.Mild cognitive impairment
   2. B.Alzheimer's disease
   3. C.Frontotemporal dementia
   4. D.DeliriumCorrect answer: D

   Explanation: The NHS states: "Get medical help immediately if someone suddenly becomes confused (delirious).". An acute change from baseline raises delirium rather than a slowly progressive neurodegenerative disorder.

   Reference: NHS: delirium — Sudden confusion (delirium)

5. 5An adult has tuberculosis infection identified on testing, but no symptoms or evidence of active disease. Which term describes this state?

   1. A.Tuberculous meningitis
   2. B.Latent tuberculosisCorrect answer: B
   3. C.Active pulmonary tuberculosis
   4. D.Miliary tuberculosis

   Explanation: The NHS states: "Sometimes you can have TB in your body but have no symptoms. This is called latent TB.". Latent infection is distinguished from active symptomatic disease.

   Reference: NHS: tb — Symptoms of tuberculosis (TB)

6. 6A patient with glaucoma asks which nerve is damaged by the condition. Which structure is affected?

   1. A.Oculomotor nerve
   2. B.Trochlear nerve
   3. C.Abducens nerve
   4. D.Optic nerveCorrect answer: D

   Explanation: The NHS states: "the main nerve, which connects the eye to the brain, becomes damaged.". Glaucoma injures the optic nerve, rather than a nerve controlling eye movement.

   Reference: NHS: glaucoma — Glaucoma

7. 7A patient about to receive chemotherapy that may impair fertility wants to preserve the chance of having a biological child later. Which option should be discussed?

   1. A.Induction of ovulation
   2. B.Intrauterine insemination
   3. C.Cryopreservation of eggs or spermCorrect answer: C
   4. D.Embryo transfer

   Explanation: The NHS states: "you may want to ask about options for storing your eggs or sperm.". Potential gonadotoxicity warrants fertility preservation discussion before exposure.

   Reference: NHS: chemo — Before you have chemotherapy

8. 8A person with bipolar disorder has several days of markedly elevated mood, little need for sleep, rapid speech and extravagant spending. Which mood state best explains this pattern?

   1. A.Generalised anxiety disorder
   2. B.Obsessive-compulsive disorder
   3. C.Manic or hypomanic episodeCorrect answer: C
   4. D.Major depressive episode

   Explanation: The NHS states: "having a lot of energy, feeling restless or not needing much sleep". The elevated energy, reduced need for sleep and disinhibition fit an elevated mood episode.

   Reference: NHS: bipolar — High mood (mania and hypomania) symptoms

9. 9A patient's renal function deteriorates acutely. Which blood measurement is used to identify the reduced kidney clearance?

   1. A.Amylase
   2. B.CreatinineCorrect answer: B
   3. C.Alanine aminotransferase
   4. D.Troponin

   Explanation: The NHS states: "Your blood will be checked for levels of creatinine". Creatinine rises when renal clearance deteriorates.

   Reference: NHS: aki — How acute kidney injury is diagnosed

10. 10A patient with newly diagnosed rheumatoid arthritis asks why a DMARD is prescribed rather than analgesia alone. Which benefit is the principal additional aim?

    1. A.Reduce pain through opioid receptor activation
    2. B.Reduce pain through cyclo-oxygenase inhibition
    3. C.Reduce pain through central analgesic effects
    4. D.Suppress immune-driven joint injury and progressionCorrect answer: D

    Explanation: The NHS states: "These medicines ease the symptoms of the condition and slow down its progression.". DMARDs modify inflammatory disease activity; analgesia alone does not achieve that purpose.

    Reference: NHS: ra — Disease-modifying anti-rheumatic drugs (DMARDs)