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MRCP Part 2 → Gastroenterology and hepatology

Gastroenterology and hepatology for MRCP Part 2

Gastroenterology and hepatology accounts for roughly 9% of the MRCP Part 2 blueprint. This bank has 1 item tagged to it.

How much of MRCP Part 2 is gastroenterology and hepatology?

Around 9% 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 gastroenterology and hepatology questions

A 55-year-old man with known alcohol-related cirrhosis presents with haematemesis. Blood pressure 92/58 mmHg, heart rate 118, haemoglobin 76 g/L. He is resuscitated with fluids and blood. Alongside endoscopy within 24 hours, which drug should be started immediately?

  1. Propranolol Wrong timing. Non-selective beta blockade is secondary prophylaxis once the bleed is controlled; acutely it blunts the compensatory tachycardia maintaining his cardiac output.
  2. Terlipressin correct Correct. In suspected variceal bleeding a splanchnic vasoconstrictor is started before endoscopy: terlipressin reduces portal pressure, improves haemostasis and carries a mortality benefit. Prophylactic antibiotics go in alongside it.
  3. High-dose intravenous proton pump inhibitor Reasonable in non-variceal bleeding but not the answer here. In a cirrhotic patient with a strong suspicion of varices, terlipressin is the agent with the outcome data.
  4. Tranexamic acid Wrong. The HALT-IT trial found no benefit in gastrointestinal bleeding and signalled increased venous thromboembolic events.
  5. Fresh frozen plasma to correct the prolonged INR Wrong. A raised INR in cirrhosis reflects impaired synthesis of both pro- and anticoagulant factors and does not equate to a bleeding tendency. Routine FFP causes volume overload and raises portal pressure.

The point: Suspected variceal bleed: resuscitate, terlipressin, prophylactic antibiotics, endoscopy with band ligation within 24 hours, then a beta blocker plus banding programme. Do not correct the INR reflexively.

Source: NICE CG141 — Acute upper gastrointestinal bleeding NICE · tier 1, national regulator or guidance

The other sections of MRCP Part 2

Cardiology · Respiratory medicine · 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 · Acute and critical care medicine

Back to MRCP Part 2

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