You can upgrade to Monotouch 5.x without any problems. In Monodevelop, change the SDK to 5.x Just make sure your deployment target remains 4.3 if you still want to target this platform. You should pay attention not to calling any methods that are not in 4.3 . If you want to have different / enhanced behavior on iOS 5 devices, you can check the OS version and use a different code branch.
Another small thing that needs to be prepared for: iOS5 behaves differently in some situations. For example, if you have hierarchical UIViewControllers, iOS5 will automatically trigger all UI events, such as ViewWillAppear (), even if you are not using the new hierachy UIViewControllery API. What I want to say: thoroughly test the application on both versions of iOS.
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