Faraz Ahmed guide to MRCP

Neurology 'Fasciculations' - think motor neuron disease Chorea is caused by damage to the basal ganglia, in particular the Caudate nucleus Dystrophia myotonica - DM1  distal weakness initially  autosomal dominant  diabetes  dysarthria Absence seizures - good prognosis: 90-95% become seizure free in adolescence Antiplatelets  TIA: clopidogrel  ischaemic stroke: clopidogrel Asymmetrical symptoms suggests idiopathic Parkinson's Bitemporal hemianopia  lesion of optic chiasm  upper quadrant defect > lower quadrant defect = inferior chiasmal compression, commonly a pituitary tumour  lower quadrant defect > upper quadrant defect = superior chiasmal compression, commonly a craniopharyngioma Burning thigh pain - ? meralgia paraesthetica - lateral cutaneous nerve of thigh compression CT head showing temporal lobe changes - think herpes simplex encephalitis Cluster headache - acute treatment: subcutaneous sumatriptan + 100% O2 DVLA advice post CVA:...

Dermatology Acne rosacea treatment:  mild/moderate: topical metronidazole  severe/resistant: oral tetracycline Blisters/bullae  no mucosal involvement (in exams at least*): bullous pemphigoid  mucosal involvement: pemphigus vulgaris Blisters/bullae  no mucosal involvement: bullous pemphigoid  mucosal involvement: pemphigus vulgaris Dermatitis herpetiformis - caused by IgA deposition in the dermis Dermatophyte nail infections - use oral terbinafine Discoid lupus erythematous - topical steroids → oral hydroxychloroquine Dry skin is the most common side-effect of isotretinoin Flexural psoriasis - topical steroid Impetigo - topical fusidic acid → oral flucloxacillin / topical retapamulin Keloid scars - more common in young, black, male adults Keloid scars are most common on the sternum Lichen  planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham's striae over surface. Oral involvement common  sclerosus: itchy white spots typically s...

TOP TEN REASONS WHY YOU DO NOT PASS MRCP part -,I 1.Reading lengthy sources like divisdson Harrison etc reading big books will never train ur brain to memorize infct u can't swallow much info... 2.solving only one qbank =solving only one qbank will never expose you to enough information 3.ignoring theory books like notes and notes and Khalid mugharbi 4.not memorizing bullets (my 3500bullets is diamond for u ppl only single source that can help u to pass this exam ) 5.giving less time like if u are traniee u are setting 4 Mon to pass this exam or if u are nontrainee and setting 4 Mon to pass this exam 6.not discussing with friends in whatsaap group 7.reading to much deep and ignoring bullets points 8.ignoring clincal science part completely 9.not solving sample paper 10.not revising  main topics in the end By Faraz Ahmed Mrcp part-I and part-II cleared Author of 3500Mrcp bullets and MRCP Visuals

Gastroenterology Wilson's disease - serum caeruloplasmin is decreased 24hr oesophageal pH monitoring is gold standard investigation in GORD E. coli is the most common cause of travellers' diarrhoea H. pylori eradication:  PPI + amoxicillin + clarithromycin, or  PPI + metronidazole + clarithromycin Causes of villous atrophy (other than coeliacs): tropical sprue, Whipple's, lymphoma, hypogammaglobulinaemia Coeliac disease - tissue transglutaminase antibodies first-line test Deterioration in patient with hepatitis B - ? hepatocellular carcinoma Dysphagia affecting both solids and liquids from the start - think achalasia Flucloxacillin + co-amoxiclav are well recognised causes of cholestasis Gastric MALT lymphoma - eradicate H. pylori Give 50% of normal energy intake in starved patients (> 5 days) to avoid refeeding syndrome Hepatocellular carcinoma  hepatitis B most common cause worldwide  hepatitis C most common cause in Europe Obese T2DM with abnorma...

Patients with Sjogren's syndrome have an increased risk of lymphoid malignancies Philadelphia translocation, t(9;22) - good prognosis in CML, poor prognosis in AML + ALL Polycythaemia rubra vera - JAK2 mutation Polycythaemia rubra vera - around 5-15% progress to myelofibrosis or AML Polycythaemia rubra vera is associated with a low ESR Rasburicase - a recombinant version of urate oxidase, an enzyme that metabolizes uric acid to allantoin Screening for haemochromatosis  general population: transferrin saturation > ferritin  family members: HFE genetic testing TTP - plasma exchange is first-line Taxanes (e.g. Docetaxel) prevent microtubule disassembly Tear-drop poikilocytes = myelofibrosis Trastuzumab (Herceptin) - cardiac toxicity is common Trimethoprim may cause pantcytopaenia Venous thromoboembolism - length of warfarin treatment  provoked (e.g. recent surgery): 3 months  unprovoked: 6 months Vincristine - peripheral neuropathy Blood film abnormalities T...

Clinical Hematology and Oncology Activated protein C resistance (Factor V Leiden) is the most common inherited thrombophilia Acute myeloid leukaemia - good prognosis: t(15;17) Acute myeloid leukaemia - poor prognosis: deletion of chromosome 5 or 7 Acute promyelocytic leukaemia - t(15;17) Anaplastic thyroid cancer - aggressive, difficult to treat and often causes pressure symptoms Antiphospholipid syndrome in pregnancy: aspirin + LMWH Antiphospholipid syndrome: (paradoxically) prolonged APTT + low platelets Burkitt's lymphoma - c-myc gene translocation Burkitt's lymphoma is a common cause of tumour lysis syndrome CLL - immunophenotyping is investigation of choice CLL - treatment: Fludarabine, Cyclophosphamide and Rituximab (FCR) CML - Philadelphia chromosome - t(9:22) Cancer patients with VTE - 6 months of LMWH Cetuximab - monoclonal antibody against the epidermal growth factor receptor Chronic myeloid leukaemia - imatinib = tyrosine kinase inhibitor Cisplatin is...