The Only MRCP Notes You Will Ever Need

546 Pages·019.165 MB·English

by  Hani Abuelgasim M

Hani Abuelgasim M.
The Only MRCP Notes You’ll Ever Need 1H / 54u6 ssamw wAw.s.u dAameldbicaa.conm na
MRCP, The Only Notes You Will Ever Need, 4th edition © January 2012
3rd edition © October 2010
2nd edition © January 2010
1st edition © September 2009

Copyright © 2012 SudaMediCa Publications

ISBN: pending issuance

All rights reserved. No part of this publication may be reproduced or distributed in any form or by any
means, or stored in a database or retrieval system, without the prior written permission of the publisher.

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PREFACE

These notes intended to target those who are appearing in MRCP exam. The idea behind it was
collecting the most commonly tested topics and facts in the exam for my personal revision. The data
has been collected from many sources.

This book was not prepared to be the primary studying source but it can help you after finishing your
primary reading by arranging the thoughts in your mind and making every topic as short as possible by
highlighting the most important points about it. You may use it just before going through your favorite
MCQs book or internet site.

A friend of mine appeared in part one for couple of times, he reached to a conclusion and gave me a
valuable advice that said ‘when preparing for MRCP, study MRCP! Don’t study medicine!’ this book
helps you to study MRCP rather than studying medicine. But at the end, you have to be a good
physician otherwise MRCP will be a less valuable recognition, this is why I would advise to study
medicine before you study MRCP and for sure before you say that you are a member of the Royal
College you have to be upto the expectations.

This edition contains the latest guidelines including 2011 guidelines and recommendations. It is more
organized than ever.

In the 4th edition we have added topics that matters for part two, we have added many pictures, we
claim that it’s just enough to get you through the second part comfortably.

The study pattern we recommend is:
1. Study one chapter of your choice from this book
2. Solve the same chapter’s questions either on www.passmedicine.com, www.onexamination.com
or www.pastest.co.uk
3. Study another chapter and go online to solve its question, continue until you finish all the
chapters in the book and questions on your website of choice.
4. Revise the whole book.
5. Start solving questions randomly from another website (other than the website you have chosen
to solve chapter by chapter)
6. Now you have probably solved at least 4000 BOF questions, you have seen all the question
patterns in MRCP, now you need to stabilize the information you have gained through your
journey
7. The most important step is to revise this book again just before the exam, this should be the
last thing you do just before going to the exam. Solving question till the last moment is not
recommended, you have probably gathered enough amount of information in your study, try to
fix the information by reading this book.

All candidates who followed this pattern have passed comfortably and no single one gave us a negative
feedback in both parts.

Hani Abuelgasim M., MD
Author

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DEDICATION

To Mehiara, my late daughter who stole my heart and left
To my lovely Ahlam, who kept being patient and kind while I was studying
To my parents who always supported me
Hani Abuelgasim M.

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CONTRIBUTORS
Dr.Hussam Albanna
Cardiology Registrar
MBBS, MRCP UK

Dr.Ahmed Ali Abuzaid
Medicine Specialist
MBBS, MRCP UK, MRCP Ireland

Dr.Salma Othman
Senior Cardiology Resident
MBBS, MRCP Part 1

Dr.Ahmed Elmotaz Mahgoub
Nephrology Specialist
MBBS, MRCP, Nephrology Diploma (Sheffield, UK)

To contribute to the next edition, please send your contributions to
[email protected]

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ALL BOXES WITH THIS COLOR
ARE FOR
MRCP PART II WRITTEN EXAM

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Contents

Basic Medical Science ……………...……………………………. 9
Biostatistics & EBM ……………...……………………………. 53
Miscellaneous ……………...……………………………. 65
Neurology ……………...……………………………. 83
Hematology ……………...……………………………. 131
Endocrinology ……………...……………………………. 167
GIT ……………...……………………………. 203
Nephrology ……………...……………………………. 245
Locomotor System ……………...……………………………. 269
Rhematology ……………...……………………………. 287
Cardiovascular System ……………...……………………………. 309
Respiratory Sytem ……………...……………………………. 357
Infectious & STD Diseases ……………...……………………………. 389
Gyne & Obs ……………...……………………………. 425
Dermatology ……………...……………………………. 437
Psychiatry ……………...……………………………. 459
Ophthalmology ……………...……………………………. 475
Pharmacology 491
• General Pharma ……………...……………………………. 492
• Nervous Pharma ……………...……………………………. 509
• Cardiac Pharma ……………...……………………………. 515
• Other Medications ……………...……………………………. 523
• Antibiotics ……………...……………………………. 535

Commonly tested facts in MRCP ……………...……………………………. 541

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BASIC SCIENCES

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HLAs:
are encoded for by genes on chromosome 6. HLA A, B and C are class I antigens whilst DP,
DQ, DR are class II antigens. Questions are often based around which diseases have strong HLA
associations. The most important associations are listed below

HLA and autoimmune diseases
Ankylosing spondylitis
Postgonococcal arthritis
HLA-B27
Acute anterior uveitis
Reiter's syndrome (reactive arthritis)
Narcolepsy
HLA-DR2
Goodpasture's
Autoimmune hepatitis
Primary biliary cirrhosis
Diabetes mellitus type 1
HLA-DR3
Dermatitis herpetiformis
Coeliac disease (95% associated with HLA-DQ2)
Primary Sjögren syndrome
Rheumatoid arthritis
HLA-DR4
Diabetes mellitus type 1 (> DR3)
HLA-DR3 + DR4 combined Diabetes mellitus type 1
HLA-B47 21-hydroxylase deficiency
HLA-A3 Hemochromatosis
HLA-B5 Behcet's disease HLA B51 is a split of B5

Around 70% of patients with rheumatoid arthritis are HLA-DR4. Patients with Felty's syndrome
(a triad of rheumatoid arthritis, splenomegaly and neutropaenia) are even more strongly
associated with 90% being HLA-DR4

Clusters of Differentiation (CD):
The table below lists the major clusters of differentiation
(CD) molecules
CD1 HLA molecule that presents lipid molecules
Found on thymocytes, T cells, and some natural killer cells that acts as a ligand for CD58 and
CD2
CD59 and is involved in signal transduction and cell adhesion
CD3 The signalling component of the T cell receptor (TCR) complex
CD4 Co-receptor for HLA class II; also a receptor used by HIV to enter T cells
CD8 Co-receptor for HLA class I; also found on a subset of myeloid dendritic cells

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