Faraz Ahmed guide to MRCP

Causes of villous atrophy (other than coeliacs): tropical sprue, Whipple's, lymphoma, hypogammaglobulinaemia Central retinal vein occlusion - sudden painless loss of vision, severe retinal haemorrhages on fundoscopy Cephalosporins are now the treatment of choice for Gonorrhoea Cephalosporins, not just clindamycin, are strongly linked to Clostridium difficile Cetuximab - monoclonal antibody against the epidermal growth factor receptor Chickenpox exposure in pregnancy - first step is to check antibodies Chickenpox exposure when pregnant - if not immune give VZIG Chronic myeloid leukaemia - imatinib = tyrosine kinase inhibitor Ciclosporin + tacrolimus - MOA: inhibit calcineurin thus decreasing IL-2 Ciclosporin - decreases IL-2 release by inhibiting calcineurin Ciclosporin side-effects: everything is increased - fluid, BP, K + , hair, gums, glucose Ciprofloxacin – tendinopathy Cisplatin is associated with hypomagnesaemia Cisplatin may cause peripheral neuropathy Clopidogrel inhibits A

CLL - treatment: Fludarabine, Cyclophosphamide and Rituximab (FCR) CLL is caused by a monoclonal proliferation of B-cell lymphocytes CML - Philadelphia chromosome - t(9:22) COPD - LTOT if 2 measurements of pO2 < 7.3 kPa COPD - reason for using inhaled corticosteroids - reduced exacerbations COPD - still breathless despite using inhalers as required? FEV1 > 50%: LABA or LAMA FEV1 < 50%: LABA + ICS or LAMA CT head showing temporal lobe changes - think herpes simplex encephalitis CTPA is the first line investigation for PE according to current BTS guidelines CYP3A4 is the most common and important cause of P450 drug interactions Calcium channel blockers - side-effects: headache, flushing, ankle oedema Calcium channel blockers are now preferred to thiazides in the treatment of hypertension Cancer patients with VTE - 6 months of LMWH Carbon monoxide poisoning - most common feature = headache Case-control studies - odds ratio Cat scratch disease - caused by Bartonella henselae Caus

Blood pressure target (based on clinic readings) for patients < 80 years - 140/90 mmHg Bosentan - endothelin-1 receptor antagonist Breakthrough dose = 1/6th of daily morphine dose Breast feeding is acceptable with nearly all anti-epileptic drugs Bronchiectasis: most common organism = Haemophilus influenzae Brush border enzymes: maltase: glucose + glucose sucrase: glucose + fructose lactase: glucose + galactose Bupropion: contraindicated in epilepsy Burkitt's lymphoma - c-myc gene translocation Burkitt's lymphoma is a common cause of tumour lysis syndrome Burning thigh pain - ? meralgia paraesthetica - lateral cutaneous nerve of thigh compression CKD on haemodialysis - most likely cause of death is IHD CKD: only diagnose stages 1 & 2 if supporting evidence to accompany Egfr CLL - immunophenotyping is investigation of choice Blisters/bullae:- no mucosal involvement (in exams at least*): bullous Pemphigoid mucosal involvement: pemphigus vulgaris

Asymmetrical symptoms suggests idiopathic Parkinson's Atrial fibrillation - cardioversion: amiodarone + Flecainide Atrial fibrillation: rate control - beta blockers preferable to digoxin Atrial myxoma - commonest site = left atrium Atrial natriuretic peptide - powerful vasodilator Atypical antipsychotics commonly cause weight gain Atypical lymphocytes - ?glandular fever Autosomal recessive conditions are 'metabolic' - exceptions: inherited ataxias Autosomal dominant conditions are 'structural' - exceptions: hyperlipidaemia type II, hypokalaemic periodic paralysis Avoid aspirin in children < 16 years as risk of Reye's syndrome Azathioprine - check thiopurine methyltransferase deficiency (TPMT) before treatment B-type natriuretic peptide is mainly secreted by the ventricular myocardium BNP - actions: Vasodilator diuretic and natriuretic suppresses both sympathetic tone and the renin-angiotensin-aldosterone system Bacterial vaginosis - overgrowth of predominate

Ankylosing spondylitis - x-ray findings: subchondral erosions, sclerosis and squaring of lumbar vertebrae Ankylosing spondylitis features - the 'A's Apical fibrosis Anterior uveitis  Aortic regurgitation Achilles tendonitis AV node block Amyloidosis  Anorexia features:- most things low G's and C's raised: growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia Anti-Jo-1 antibodies are more common in polymyositis than dermatomyositis Anti-cyclic citrullinated peptide antibodies are associated with rheumatoid arthritis Anti-ribonuclear protein (anti-RNP) = mixed connective tissue disease Antibiotic prophylaxis reduces mortality in cirrhotic patients with gastrointestinal bleeding Anticipation in trinucleotide repeat disorders = earlier onset in successive generations Antidiuretic hormone (ADH) - site of action = collecting ducts Antiphospholipid syndrome in pregnancy: aspirin + LMWH Antiphospholipid syndrome: (paradoxically) prolonged APTT +

H. pylori eradication: PPI + amoxicillin + clarithromycin, or PPI + metronidazole + clarithromycin  Saccharopolyspora rectivirgula causes farmer's lung, a type of EAA  ACE inhibitors have reduced efficacy in black patients and are therefore not used first-line  ADPKD type 1 = chromosome 16 = 85% of cases  ADPKD type 2 = chromosome 4 = 15% of cases  ATN or prerenal uraemia? In prerenal uraemia think of the kidneys holding on to sodium to preserve volume  Absence seizures - good prognosis: 90-95% become seizure free in adolescence  Absolute risk reduction = (Control event rate) - (Experimental event rate)  Acne rosacea treatment: mild/moderate: topical metronidazole severe/resistant: oral tetracycline Acromegaly: increased sweating is caused by sweat gland hypertrophy Activated protein C resistance (Factor V Leiden) is the most common inherited thrombophilia Acute angle closure glaucoma is associated with hypermetropia, where as primary open-angle glaucoma is associated wit