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MRCP Part 2 → Acute and critical care medicine

Acute and critical care medicine for MRCP Part 2

Acute and critical care medicine accounts for roughly 6% of the MRCP Part 2 blueprint. This bank has 1 item tagged to it.

How much of MRCP Part 2 is acute and critical care medicine?

Around 6% of the paper, per MRCP(UK) examination blueprints and regulations. That weighting is why the DocPasser mock builder samples sections in proportion rather than shuffling everything into one pile — practising a flat distribution trains you for a paper that does not exist.

Verification status. All 3 published figures on this page have been read in the source document and dated above. Source of truth: MRCP(UK) examination blueprints and regulations, MRCP(UK) Federation. How we verify.

Sample acute and critical care medicine questions

A 58-year-old man is admitted with pneumonia and hypotension. Despite 30 mL/kg of crystalloid his mean arterial pressure is 58 mmHg, lactate is 4.6 mmol/L and urine output is 10 mL/hour. Echocardiography shows a hyperdynamic left ventricle with a small, underfilled cavity. What is the most appropriate next step?

  1. Start dobutamine Wrong as the first agent. Dobutamine is an inotrope for a failing ventricle. His ventricle is hyperdynamic, and dobutamine's vasodilatory effect would drop his pressure further.
  2. Continue large-volume crystalloid resuscitation Wrong beyond this point. The echo shows a hyperdynamic underfilled ventricle in a vasoplegic state; further indiscriminate fluid causes oedema, worsens oxygenation and increases mortality without fixing the vascular tone.
  3. Start noradrenaline through central access and admit to critical care correct Correct. This is fluid-resistant septic shock with a vasodilated, hyperdynamic circulation. Noradrenaline is the first-line vasopressor, targeting a mean arterial pressure of about 65 mmHg, and the patient needs critical care.
  4. Give intravenous hydrocortisone as the primary intervention Wrong as the primary step. Corticosteroids are considered in septic shock requiring ongoing vasopressors, so they come after noradrenaline is running, not instead of it.
  5. Transfuse red cells to a haemoglobin of 100 g/L Wrong. Restrictive transfusion at a threshold around 70 g/L is standard in critical care; a liberal strategy does not improve outcomes in septic shock.

The point: Septic shock: sepsis with persisting hypotension requiring vasopressors to maintain MAP 65 mmHg plus lactate above 2 despite adequate fluid. Noradrenaline first, vasopressin second, steroids for ongoing vasopressor need, and dobutamine only if there is genuine myocardial depression.

Source: Surviving Sepsis Campaign international guidelines for management of sepsis and septic shock Society of Critical Care Medicine (Surviving Sepsis) · tier 2, specialty society or college

The other sections of MRCP Part 2

Cardiology · Respiratory medicine · Gastroenterology and hepatology · Neurology · Endocrinology and metabolic medicine · Nephrology · Rheumatology · Haematology · Infectious diseases and tropical medicine · Oncology and palliative care · Dermatology · Clinical pharmacology and therapeutics · Clinical sciences and statistics

Back to MRCP Part 2

DocPasser is exam preparation material, not clinical guidance. Nothing here should be used to make a decision about a real patient. Always work from your own local guidelines and seniors.