Last Min MRCP part -2 Revision (part A)
🔐 the last revision :
❤ in MRCP 2 :
ECG :
♠Lead Reversal : changes mostly in P & T wave : inversion
Lt arm / Lt leg 👉 changes in lead 111
Lt arm / Rt arm 👉 lead 1
avL /avR 👉 both lead 1& 2
♠ PE :
S1 Q3 T3
♠ Brugada Syndrome :
Pseudo RBBB + downsloping ST elevation
♠ Acute pericarditis 👉Coxsackie group B virus
♠ CHB post stenining do temporal pacemaker
🔍🔎 One Modern anticholinergic for Rx of urge urine incontinence is Solifenacin , traditional Rx such as Oxybutynin S/E affect in cognition .... If Rx failure ▶ sacral nerve stimulation
🔍🔎 modern RX FOR HCV :Sofosbuvir MOA NS5B RNA polymerase inhibitor,
Alendronate is contraindicated if GFR less than 35
Teriparatide is a synthetic PTH analogue, use in severe cases of osteoporotic, with caution as it associated moderate to worse renal impairment
BTX reaction related to immunoglobulins deficiencies think in selective IgA def
IgM associated with increase risk of G-ve pul infection
IgG associated with recurrent sinusitis and chronic bronchiectasis
Rx of isolated distal
Ulcerative colitis is Mesalazine enemas
Lyme disease can lead to heart block
Rx of Solar Keratosis:
topical 5 FU cream bid for 3-4 weeks as 1st line.
2nd line Diclofenac gel for 12 weeks .
it can progress to Squamous cell skin cancer
Heart failure in young pt can be due to Coxsackie B virus myocarditis
Rx of lead poisoning by DMSA . In severe case of lead poisoning use Calcium disodium EDTA I.m or I.V .
Pencillamine and Tridentine use as Copper chelation
Rx of ethylene glycol overdose by Fomepizole , Harmodialysis for severe cases.
Rx of B blocker overdose Glucagon
Rx Paracetamol overdose not responded to N-AC , is Methionine.
Rx of genital ulcer :
Painless Chancre > if not allergic to penicillin by I.M penicillin followed by Doxycycline 100 mg Bid for 2 weeks . Otherwise Azithromycine 2 g single dose . Or 3 days ciprofloxacin 500 mg bid.
Seborrheic dermatitis >> facial rash around upper lips 👄, nose 👃 and hair line
Febuoxostate is xanthine oxidase inhibitor use in Rx acute gout
Echo
- atrial myxoma >> well organized mass in the atrium abutting the mitral valve.
- HOCM : ASH asymmetrical ventricular septal hypertrophy.
- Mitral stenosis : thickening and reduce movement of M leaflets
- atrial myxoma >> well organized mass in the atrium abutting the mitral valve.
- HOCM : ASH asymmetrical ventricular septal hypertrophy.
- Mitral stenosis : thickening and reduce movement of M leaflets
Glucagonoma associated with necrolytic migratory erythema .
Gastric Ca : acanthosis nigricans
Barium Swallow:
Achalasia: distal esophagus narrowing like bird’s beak.
Ca esophagus similar to achalasia but irregular constriction
Pharyngeal pouch out pouching in upper esophagus
pt with flash pul edema :
1st step control BP
2nd step do renal artery stent
Hypokalaemia :
- Bartter syndrome: N BP + metabolic alkalosis + high urinary Ca excretion (during childhood)
- Gitelman like Bartter but the difference in low urinary Ca ( mostly in adulthood)
❤ in MRCP 2 :
ECG :
♠Lead Reversal : changes mostly in P & T wave : inversion
Lt arm / Lt leg 👉 changes in lead 111
Lt arm / Rt arm 👉 lead 1
avL /avR 👉 both lead 1& 2
♠ PE :
S1 Q3 T3
♠ Brugada Syndrome :
Pseudo RBBB + downsloping ST elevation
♠ Acute pericarditis 👉Coxsackie group B virus
♠ CHB post stenining do temporal pacemaker
🔍🔎 One Modern anticholinergic for Rx of urge urine incontinence is Solifenacin , traditional Rx such as Oxybutynin S/E affect in cognition .... If Rx failure ▶ sacral nerve stimulation
🔍🔎 modern RX FOR HCV :Sofosbuvir MOA NS5B RNA polymerase inhibitor,
Alendronate is contraindicated if GFR less than 35
Teriparatide is a synthetic PTH analogue, use in severe cases of osteoporotic, with caution as it associated moderate to worse renal impairment
BTX reaction related to immunoglobulins deficiencies think in selective IgA def
IgM associated with increase risk of G-ve pul infection
IgG associated with recurrent sinusitis and chronic bronchiectasis
Rx of isolated distal
Ulcerative colitis is Mesalazine enemas
Lyme disease can lead to heart block
Rx of Solar Keratosis:
topical 5 FU cream bid for 3-4 weeks as 1st line.
2nd line Diclofenac gel for 12 weeks .
it can progress to Squamous cell skin cancer
Heart failure in young pt can be due to Coxsackie B virus myocarditis
Rx of lead poisoning by DMSA . In severe case of lead poisoning use Calcium disodium EDTA I.m or I.V .
Pencillamine and Tridentine use as Copper chelation
Rx of ethylene glycol overdose by Fomepizole , Harmodialysis for severe cases.
Rx of B blocker overdose Glucagon
Rx Paracetamol overdose not responded to N-AC , is Methionine.
Rx of genital ulcer :
Painless Chancre > if not allergic to penicillin by I.M penicillin followed by Doxycycline 100 mg Bid for 2 weeks . Otherwise Azithromycine 2 g single dose . Or 3 days ciprofloxacin 500 mg bid.
Seborrheic dermatitis >> facial rash around upper lips 👄, nose 👃 and hair line
Febuoxostate is xanthine oxidase inhibitor use in Rx acute gout
Echo
- atrial myxoma >> well organized mass in the atrium abutting the mitral valve.
- HOCM : ASH asymmetrical ventricular septal hypertrophy.
- Mitral stenosis : thickening and reduce movement of M leaflets
- atrial myxoma >> well organized mass in the atrium abutting the mitral valve.
- HOCM : ASH asymmetrical ventricular septal hypertrophy.
- Mitral stenosis : thickening and reduce movement of M leaflets
Glucagonoma associated with necrolytic migratory erythema .
Gastric Ca : acanthosis nigricans
Barium Swallow:
Achalasia: distal esophagus narrowing like bird’s beak.
Ca esophagus similar to achalasia but irregular constriction
Pharyngeal pouch out pouching in upper esophagus
pt with flash pul edema :
1st step control BP
2nd step do renal artery stent
Hypokalaemia :
- Bartter syndrome: N BP + metabolic alkalosis + high urinary Ca excretion (during childhood)
- Gitelman like Bartter but the difference in low urinary Ca ( mostly in adulthood)
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