MRCP 1 Basics

MRCP 1 BASIC GUIDE http://www.facebook.com/pages/Mrcp1prep/503168116374168 INCLUDES EXAM PATTERN AND BASIC SYLLABUS MATERIAL. PLEASE NOTE THIS IS THE BASIC OUTLINE PROVIDED.ITS VALIDITY CANNOT BE FULLY GUARANTEED OR RELIED ON. Compiled/Edited by MRCP 1 Prep – Facebook Page ADMINS

2 | P a g e - M R C P 1 P R E P – B A S I C S f o r M R C P 1

-EXAM FORMAT-

The MRCP(UK) Part 1 Examination is designed to assess a candidate's knowledge and

understanding of the clinical sciences relevant to medical practice and of common or

important disorders to a level appropriate for entry to specialist training.

The MRCP(UK) Part 1 Examination has a two-paper format. Each paper is 3 hours in

duration and contains 100 multiple choice questions in one from five (best of five) format,

where a candidate chooses the best answer from five possible answers. Candidates will be

tested on a wide range of common and important disorders in General Medicine as set out

in the published syllabus.

The composition of the Papers is as follows:

Specialty Number of

questions*

Cardiology 15

Clinical pharmacology, therapeutics and toxicology 20

Clinical sciences** 25

Dermatology 8

Endocrinology 15

Gastroenterology 15

Haemotology and oncology 15

Neurology 15

Ophthalmology 4

Psychiatry 8

Renal medicine 15

Respiratory medicine 15

Rheumatology 15

Tropical medicine, infectious and sexually transmitted

diseases 15

200

* This should be taken as an indication of the likely number of questions - the actual

number may vary slightly.

** Clinical sciences comprise:

Cell, molecular and membrane biology 2

Clinical anatomy 3

Clinical biochemistry and metabolism 4

Clinical physiology 4

Genetics 3

Immunology 4

Statistics, epidemiology and evidence-

based medicine 5

.

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Cardiology

Anatomy and physiology

- Basic anatomy and physiology of the heart in health and disease including: --- Clinical relevant normal anatomy of the heart, coronary arteries and great vessels --- Determinants of the heart rate and rhythm

--- Cardiac conduction --- Cardiac output ---Vascular tone --- Blood pressure --- Coronary blood flow --- Genesis of heart sound

Pathophysiology and pathology - Mechanism underlying the main pathological processes Ex: --- Thrombosis --- Infarction --- Atherogenesis --- Hypertrophy ---Heart failure --- Cardiomyopathies --- Dysrhythmias --- Hypertension

Cell biology - Topics of proven clinical relevance such as: --- Excitation-contraction process

--- Molecular and cellular aspects of hypertrophy of the myocardium of vascular smooth muscle

Clinical pharmacology - Indications of drug therapy in cardiac disease - Actions, interactions, and side effects of the drugs used, with emphasis on new drugs and newly observed side effects.

Clinical cardiology - Clinical features and management of the cardiac disorders encountered in hospital practice by the general physician - Risk factors Ex: --- Clinical features of constrictive pericarditis, cardiac tamponade, endocarditis, valvular disease

--- Management of acute coronary syndromes --- Management of cardiac failure ---Management issues in atrial fibrillation --- Indications for, and types of, permanent pacemaker - Important changes in clinical practice, following the publication of major clinical trials

Ex:

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--- Use of ACE inhibitors after myocardial infarction --- Use of HMG CoA reductase inhibitors in primary and secondary prevention of coronary morbidity and mortality --- Use of beta-adrenoceptor blocking drugs in left ventricular

dysfunction - Indications for invasive and non-invasive cardiac investigation - Principle of these investigative methods, their limitations and the clinical relevance Ex: --- Common ECG abnormalities ---Basic echocardiographic abnormalities such as hypertrophic

obstructive cardiomyopathy or pericardial effusion --- Indication for coronary angiography

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Clinical pharmacology, therapeutics and clinical toxicology

Pharmacology - Mechanisms by which drugs produce their pharmacological effects - Basic principles of agonism and antagonism - Clinical implication of drugs that act at different receptor sites - Links between the pharmacological effects of drugs at the molecular level, the cellular level, and the tissue / organ level, and

how these are affected by disease processes and other drugs - Principles by which both therapeutic and adverse effects occur

Clinical pharmacokinetics - Processes of drug absorption and distribution - Bio-transformation and excretion - Concepts of drug half-life and clearance

- First order and zero order kinetics

Monitoring drug therapy - Direct measurement of therapeutic response - Measurement of plasma drug concentrations - Scientific basis for the measurement of drug concentration and its link to the principles of pharmacokinetics

Adverse drug reactions - Epidemiology of adverse drug reactions: recognition and avoidance - Important adverse effects of commonly used drugs - Importance of adverse drug reaction reporting schemes

Drug interactions - Adverse drug interactions and mechanisms by which interaction

may occur - Common drug interactions and their clinical consequences

Pharmacogenetics - Principles of pharmacogenetics and its importance in determining variations in response to drugs in man, both in term of efficacy and toxicity - Clinical consequences of the common pharmacogenetic variations relevant to clinical practice

Therapeutics for specific patient groups - Principles of therapeutics as they apply in the following circumstances: --- The elderly --- Pregnancy and breast feeding

--- Patients with renal disease --- Patients with hepatic disease ----- Effects of these altered physiology on the pharmacokinetics and pharmacodynamics of drugs ----- Principle underlying drug choice, in pregnancy and breast feeding ----- Teratogenic effects of drugs that may be used in pregnancy -

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Drugs that may produce toxicity in the case of renal and hepatic disease

Clinical toxicology - Principle of management of patients poisoned by drugs or other

toxic substances - Assessment, recognition of common symptom patterns - Principles of removal of toxic substances - Antidotes where these approaches may be appropriate

Criteria for selecting drugs in a therapeutic class - Criteria used to select a drug from among drugs in a popular

therapeutic class including: --- Differences in pharmacokinetics and pharmacodynamics --- The approved indications of the drug --- Possible adverse effects or drug inteactions --- Cost effectiveness ----- Nomenclature ----- Used to describing studies that may be used to underpin drug selection

Drug formulations and routes of administration - Various formulations of medicines available - Routes by which medicines may be administered - Advantages and disadvantages of various routes and preparation - Most appropriate formulation selection and drug administration in common clinical scenarios

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Cell, molecular and membrane biology

Structure and function of the components of the cell and its membrane

How cells communicate internally and with each other by means of chemical substances and membrane receptors.

Ex: - Function of intracellular organelles - Cellular communication

Anatomy Clinical relevant anatomy including neuroanatomy

Ex: - Peripheral nerve lesions - Cranial nerve abnormalities - Dermatomes, myotomes and reflexes

Physiology, biochemistry and metabolism

Structure and function of the different organs and their interaction

(such as hormonal and neural influences)

Broad principle of metabolism such as the production of energy and pathways of carbohydrate, protein, and lipid metabolism

Principle of nutrition, water, electrolyte and acid base balance.

Physiology and biochemistry of each organ system

Ex: - The mechanism of blood pressure control - Acid-base balance

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Gastroenterology Clinical science

- Structure and function of the gastrointestinal and hepatobilary tract - Neurohormonal control of gut motility - Secretory and absorptive functions of the gastro-intestinal tract and liver - Symptoms and signs of gastrointestinal, hepatobiliary and

pancreatic diseases - Genetics of the more common gastrointestinal and liver disorders - Clinical pharmacology of drugs used in gastrointestinal disorders including their actions, interactions and adverse effects

Clinical nutrition - Nutritional requirements in health

- Assessment of nutritional status - Nutritional deficiency states - Primary nutritional disorders

Disorders of the mouth, tongue and salivary glands - Mouth ulcers, periodontal and salivary disorders - Oral manifestations of systemic and dermatological disorders

Disorders of the oesophagus and stomach - Alchalasia - Carcinomas - Peptic ulceration - Gastritis - Gastrointestinal haemorrhage

Functional disorders

- Functional chest pain and functional dyspepsia - Irritable bowel syndrome and functional abdominal pain - Functional constipation and diarrhoea

Disorders of the small intestine - Malabsoption syndromes and gluten enteropathy - Hormone-secreting tumours of the gut

Disorders of the liver, biliary tree and pancreas - Bilirubin metabolism and the enterohepatic circulation of bile acids - Causes of jaundice and cholestasis - Common pancreatic disorders including carcinoma - Fulminant liver failure - Acute and chronic hepatitis

- Drugs, toxins, alcohol and the liver

The acute abdomen - Perforated viscus and peritonitis - Intestinal obstruction - Ischaemic disease of the small and large bowel

Inflammatory bowel diseases

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- Crohn's disease - Ulcerative colitis - Infective gastroenteritis - Parasitic and protozoal gut infections

Colorectal disorders - Polyps - Carcinomas - Diverticular disease - Anorectal disorders

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Clinical haematology

Physiology, control and function of formed blood elements

Bone marrow structure and function

Applications of biochemistry, genetics, immunology and

virology to blood disorders

Effects of age and pregnancy on blood diseases

Splenomegaly, lymphadenopathy and their causes

Principles and hazards of blood and blood product replacement therapy

Principles, but not detail, of anti-tumour chemotherapy

Principles of marrow transplantation

Adverse effects of drugs on the blood

Iron metabolism - Physiology of iron, including its absorption - Iron overload - Iron deficiency states including diagnostic, causes and treatment - Iron metabolism, including anaemias of chronic disorders and sideroblastic anaemias

Megaloblastic anaemias - Physiology of vitamin B12 and folic acid - Mechanisms and investigation of deficiencies and their management

Haemolytic anaemias - Mechanisms of shortened red cell survival - Feature and management of congenital and acquired haemolytic states - Molecular pathology of thalassaemia and common haemoglobinopathies Ex: - Causes of haemolysis - Diagnostic of haemolytic anaemia

Other anaemias - Anaemias complicating systemic disease - Aplastic anaemia - Myelodysplastic syndromes

Polycythaemia and myeloproliferative disorders - Causes, investigation and management of polycythaemia - Causes, investigation and management of myeloproliferative disorders

White cells disorders - Physiology of leucocytes - Leucocytosis and leucopenia

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- Acute and chronic leukaemias, including diagnosis, management and prognosis - Lymphoproliferative diseases including Hodgkin's disease, non-Hodgkin's lymphomas and plasma cell dyscrasias.

Disorders of haemostasis - Platelet function and coagulation - Thrombocytopenia and impaired platelet function - Thrombocytosis - Common congenital and acquired disorders of coagulation (especially anticoagulant therapy and disseminated intravascular coagulation)

Neurology Neuroanatomy

- Detailed Neuroanatomy to appreciate the localisation of a

particular neurological problem Ex: --- Clinical features of a lesion within the cavernous sinus --- Manifestations o a particular nerve root or peripheral nerve disorder --- Organisation of pathways within the spinal cord

Neurophysiology - Aspects of Neurophysiology relevant to the understanding of neurological disease Ex: - Formation, circulation, absorption and content of the cerebrospinal fluid - Aspect of cerebral blood flow - Principles of nerve conduction and its modification by disease processes

Neurogenetics - Recent advances in the understanding of the genetic basis for various neurological disorders

Cell biology

- Advances in the cellular mechanisms of certain neurological disease processes which have provided better understanding of disease mechanisms and which might, in the future, lead to more rational therapy

Neuropharmacology - New drug developments in neurology - Established drug therapies Ex: --- Role of some recently introduced anticonvulsants --- Present status of immunosuppressant therapy in multiple sclerosis

Neuropathology - Pathological aspects of some common diseases such as multiple

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sclerosis, Parkinson's disease and Alzheimer's disease

Clinical neurology

- Common disorders - Clinical features which have been shown to be of diagnostic value

- Areas of recent advance, particularly those which have either led to better definition of disease entities, or have led to their improved management Ex: --- Epidemiological aspects, in particular the risk factors for stroke --- The evidence for the role of anti-platelet agents in transient ischaemic attacks - The role of carotid endarterectomy in the management of stroke patients

Psychiatry Mental state

- Conduct and scope of a mental state examination - Features of abnormal mental states and particularly those

present commonly to physicians and to Accident and Emergency Departments

Aetiological factors in psychiatric illness - Primary aetiological factors in psychiatric areas including: ---Genetic factors ---Environmental factors ---Life events

Investigations - Potential value of, and indications for, common investigations used in psychiatric illness including: ---Psychometric testing ---EEG ---Brain imaging

Syndromes of psychiatric disorder and their treatment - Organic brain syndromes (delirium, dementia, focal brain syndromes, head injury) - Schizophrenia and related syndromes - Paranoid disorders and related syndromes - Affective disorders (anxiety states, phobic disorders, bipolar

affective disorders) - Grief and bereavement - Self-harm, attempted suicide, suicide - Substance misuse (including alcohol dependence) - Eating disorders - Obsessive compulsive disorder - Abnormal illness behaviour - Syndromes associated with medically explained physical

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symptoms (including somatization and somatoform syndrome)

Psychiatric aspects of physical disease

- Psychiatric presentation of physical disease including: ---Endocrine and metabolic disorders

---Toxic states ---AIDS ---Neurological disease ---Epilepsy ---Pain

Mental retardation

- Features of the commoner syndromes

Respiratory medicine

Anatomy and physiology - Clinical relevant anatomy of the upper and lower respiratory tract and thorax including radiological anatomy - Principles of respiratory physiology including: How respiration is controlled --- Principles of gas exchange and oxygen transport --- Ventilation-perfusion relationships --- Lung volumes and transfer factor ---Respiratory aspects of sleep and exercise physiology - Physical, humoral and cellular aspects of respiratory defence mechanisms - Physiology of the proteinase inhibitors and pulmonary surfactant

Pathophysiology and pathology - Effects of disease on pulmonary physiology and anatomy including: --- The pulmonary and bronchial circulations as gas exchange --- Adaptations to chronic hypoxaemia --- Pleural fluid production and reabsorption - Application of the basic immunological processes to pulmonary

pathology including: --- Asthma ---Alveolitis --- Tuberculosis - Humoral and cellular immunodeficiency states and sequelae - Microbiology of acute and chronic respiratory infections

Cell biology and genetics - Lung inflammation and repair - Vasculitis - Cystic fibrosis - Anti-protease deficiency

Clinical pharmacology - Indications for, and mechanisms of action of, drugs used in

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respiratory disease together with their interactions and side effects. - Important respiratory complications of other drugs (NSAIDs and beta blockers)

Clinical conditions - Clinical features, investigation and management of respiratory disease likely to be encountered by a general physician Ex: --- Pleural effusion --- Chest pain ---Haemoptysis --- Breathlessness - Impact of systemic disease on the respiratory system Ex: --- Vasculitis --- Neuromuscular disease ---HIV infection

- Occupational lung disease, particularly asthma, pneumoconiosis and asbestos related disease - Assessment of respiratory malignant condition - General principles of oncological management including indication of surgery Indications for specialised investigations including bronchoscopy, CT scanning, lung biopsy, lung volumes and exercise testing

- Investigation of sleep related disorders and of the radiological aspects of respiratory diseases - Indications for, and problems of, lung transplantation - Control of Mycobacterium tuberculosis infection· ---Exclusion - Knowledge of detailed pulmonary mechanics, oncology drug regimens, drug therapy of environmental mycobacterial infection,

inhalation drug kinetics, and detailed histological descriptions is not required.

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Rheumatology

Basic principles of the common musculoskeletal conditions

Clinical science

- Basic physiology, biochemistry, anatomy and pathology relating to musculoskeletal diseases - Pathology of the common rheumatic conditions

Clinical conditions - Relative prevalence and major associations of the common rheumatological conditions

- Symptoms and signs of the rheumatic diseases - Arthritis associated with other medical conditions

Investigations - Investigations relevant to the diagnosis and assessment of rheumatic diseases including - Acute phase proteins - Immunological tests relating to the connective tissue diseases

- Contemporary imaging techniques

Management - Management of acute rheumatological emergencies including Septic arthritis, Osteomyelitis, temporal arteritis and acute spinal cord compression - Management of rheumatic diseases

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Statistics, Epidemiology and Evidence-based medicine

Descriptive statistics

- Mean, median, mode, standard deviation, standard error, confidence interval, variance - Range, quartile, inter-quartile range, percentile - Skewness - Contingency table, population - Missing values

- Outliers

Graphical techniques - Histogram - Box-plot - Scattergram

Inferential techniques

- Null hypothesis, alternative hypothesis - Parametric and non-parametric tests - Normal distribution - Type 1 and type 2 errors - False positive and false negative - Statistical power - One and two tailed tests

- Statistical significance, P value - T-test - Mann-Whitney and Wilcoxon test - Chi-square test for 2 x 2 contingency table - Correlation (Pearson's and Spearman's) - Linear regression - Study design

Evidence based medicine - General understanding of evidence-based management and applications to management of patients

Clinical trials - Interpretation of simple clinical trial data - Randomisation

- Placebo-controlled trial - Open trial - Single-blind trial - Double-blind trial - Intention-to-treat - Bias

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Infectious diseases and tropical

medicine

Microbiology - Taxonomy of bacteria in terms of Gram-straining and aerobic

/anaerobic metabolism - Virus classification for members of the herpes group - Virus replication with reference to the retroviruses - Major pathogenic protozoa and helminths Ex: -Aerobic or anaerobic bacteria -Gram-staining characteristics of bacteria

Immunology of infectious diseases - Immune deficiency states linked with types of opportunistic infections - Principle of immunisation and vaccines currently used Ex: - Opportunistic infections

- Immunisation policy

Pathophysiology - Septic shock - ARDS - Role of cytokines in infection

Epidemiology

- Principles relevant to infectious diseases Ex: - Mechanisms of transmission of pathogens - How epidemics happen - Knowledge of carrier states, reservoirs, vectors and zoonoses - Elementary concepts of the control of communicable diseases (including immunisation, isolation, contact tracing, chemoprophylaxis of close contacts) - Geographical variation in diseases including TB, HIV, Hepatitis B, malaria

Treatment - Broad indications for commonly employed antimicrobial agents - Major adverse effects for commonly employed antimicrobial agents

Ex: - B-lactams - Tetracyclines - Macrolides - Aminoglycosides - Quinolines

- Trimethoprim

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- Metronidazole - Antituberculous drugs - Antimalarial drugs - Antiviral agents

Specific infections - Characteristics, recognition, prevention, eradication, and pathological effects of all commonly encountered bacteria, viruses, rickettsia, fungi, protozoa, parasites and toxins. - Principle of infection control - Differential diagnostic and appropriate investigations - Presumptive therapies indications Ex: - Septicaemia - Meningitis and encephalitis - Endocarditis - Pneumonia (community-acquired, hospital-acquired, lung abscess, empyema)

- Tuberculosis - PUO (appropriate investigations, when empirical therapy might be indicated) - Soft-tissue infection and Osteomyelitis - Streptococcal infection, rheumatic fever, nephritis - Intra-abdominal sepsis - Food-poisoning

- Tropical Infections (especially malaria, bilharzias, amoebiasis, filariasis, leishmaniasis, hookworm and viral haemorrhagic fevers) - Viral hepatitis - HIV/AIDS (course of typical infection, CD4 count and HIV viral load as markers of progression; main opportunistic infections including Pneumocytis pneumonia, CNS toxoplasmosis, cryptococcal meningitis, tuberculosis)

- Glandular fever syndrome and its differentiation from HIV seroconversion illness - Spirochaetosis - syphilis, leptospirosis, borrelia - Toxic shock syndrome and staphylococcal infections

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Immunology

Principles of immuno-mechanisms Ex: - Humoral and cell-mediated immunity - Immunodeficiency syndromes - Phagocytic dysfunction diseases

- Complement deficiencies - Hypersensitivities including allergies and autoimmune diseases

Immunological tests: - Immune system in health and disease Ex: - Common immunological laboratory tests - Evaluation of patients with immune disease - Intercellular communication and signal transduction - Lymphocyte and phagocytic cell biology - Antigen presentation - Humoral, cellular and mucosal immunity including Th2 and TH2 responses - Inflammation - Complement system and cytokines

- Hypersensitivity and autoimmunity

Clinical condition - Various immunodeficiency syndromes Ex: - Mechanisms of immunodeficiency - Antibody immunodeficiency disorders

- T-cell immunodeficiency disorders - Combined antibody and cellular immunodeficiency disorders - Phagocytic dysfunction diseases - Complement deficiencies - Clinical characteristics and immediate management of acute allergic emergencies Ex: - Anaphylaxis - Angio-oedema - Urticaria - Immunology as applied with other medical diseases (ex: Rheumatic diseases - connective tissue diseases)

Ex: - Rheumatic diseases (connective tissue disease) - Endocrine diseases (thyroid autoimmune diseases, diabetes mellitus, Addison's disease) - Haematological diseases (pernicious anaemia, autoimmune haemolytic anaemia, idiopathic thrombocytopenic purpura) - Gastrointestinal diseases (Coleiac disease, inflammatory bowel

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disease, hepatobiliary diseases) - Renal diseases (Goodpasture's syndrome, immune-complex glomerulonephritis) - Dermatological diseases (demyelinating diseases, myasthenic

syndromes)

Management - Principles of immunosuppressive therapy including major indications and side-effects Ex: - Immunosupressive drug therapy - Intravenous immunoglobulin - Monoclonal antibodies - Cytokine therapy - Bone marrow transplantation - Principle of immunisation - Vaccines currently in use

Genetics

Structure and function of chromosomes and genes Principle of inheritance of chromosomal and genetic disorders Ex:

- Inherited diseases - Chromosome structure - Common chromosome abnormalities

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Endocrinology

Mechanisms of hormone action and importance of Receptors and substances involved in control of intracellular metabolism

Clinically relevant anatomical aspects of the speciality Thyroid

- Mechanisms of thyroid disease - Clinical presentation and treatment Ex: ---Thyroid hormone biosynthesis and its control ---Important drugs interfering with thyroid function ---Indications for use of various types of thyroid function test ---Autoimmunity and the thyroid

---Clinical features of thyrotoxicosis and hypothyroidism ---Goitre and its management ---Thyroid neoplasia

Hypothalamus/Pituitary - Physiology and testing of the control mechanisms of the endocrine system Ex:

---The physiology and Pathophysiology of control of pituitary hormone secretion ---The mechanisms of maintaining plasma osmolality ---Tests of pituitary diseases such as acromegaly, prolactinoma and Cushing's syndrome ---Drugs used in the treatment of pituitary disease ---Pituitary replacement therapy

Adrenal - Clinically relevant mechanisms of steroid biosynthesis Ex: ---Build-up of precursor compounds when there is defective cortisol biosynthesis in adrenocortical hyperplasia ---Tests for adrenocortical function ---Endocrine causes of hypertension and their differential diagnosis

---Clinical features and management of adrenal hyper- and hypofunction ---Complications of steroid therapy

Ovary - Physiology of ovarian functions - Conditions presenting to a physician

Ex: ---Hormonal changes across the menstrual cycle ---Physiological changes in pregnancy ---The differential diagnosis of hirsutism and virilism ---Causes of amenorrhoea and anovulation ---Endocrine causes of infertility

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Testis - Relevant investigations of urological infertility - Endocrine aspects of testicular functions

Growth

- Factors controlling growth hormone secretion - Normal growth patterns - General medical and endocrine causes of short stature - Control of excessive growth - Growth hormone therapy and its complications

Parathyroid/bone - Control of bone turnover and disorders which can result of its

failure Ex: ---Control of calcium metabolism ---Laboratory tests of parathyroid function ---The causes of hypercalcaemia ---Mechanisms of oesteomalacia ---Hyperparathyroidism, both primary and secondary ---The differentiation of primary, secondary and pseudo-hypoparathyroidism ---The differentiation of primary, secondary and pseudo-hypoparathyroidism ---The prophylaxis and treatment of osteoporosis ---Calcitonin and its role in metabolism

Diabetes mellitus

- Detailed knowledge is required. Ex: ---Control of carbohydrate metabolism ---Genetics of diabetes ---Aetiology of type I diabetes and type 2 diabetes ---Long-term complications of diabetes ---Management of diabetic emergencies ---Differential diagnosis and treatment of hypoglycaemia

Disorders of lipid metabolism - Importance of this group disorder Ex: ---Control of cholesterol metabolism ---Aetiology of different types of hyperlipidaemia including both cholesterol and triglyceride disorders

---Indications for lipid lowering agents and their complications ---Types of secondary hyperlipidaemia

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Nephrology

Physiology - Discrete functions of Glomerular ultrafiltration and tubular function - Proximal and distal parts of the nephron, with particular

reference to control of water and electrolyte balance - Renal tubular acidosis - Cystinuria - Fluid, electrolyte, and acid-balance disturbances

Molecular biology and genetics - Genetic defects of common disorders including: ---Polycystic kidney ---Alport's syndrome ---Hypophosphataemic rickets - Inflammatory injury of the kidney mediated by various cytokines factors

Glomerular and tubular disorders - Glomerular ultra structure based upon techniques of light microscopy, electron microscopy and immunofluorescence as applied to renal biopsy - Primary Glomerular disorders as in idiopathic glomerulonephritis, and nephropathies of systemic diseases Ex: ---Diabetes mellitus ---SLE

---Hypertensive nephrosclerosis ---Vasculitis ---Amyloidosis - Interstitial nephritis, in particular vase s with reversible aetiology such as drug, heavy metals and analgesics - Metabolic sequelae of acute nephrotic and nephritic syndromes - Investigation and assessment of Glomerular and tubular disorders, including ultrasonic studies and nuclear medicine - Disturbed renal and metabolic functions in nephritic syndrome from a variety of causes

Infections of the kidney - Management of urinary tract infections including their detention, predisposing factors, prevention, and treatment - Anatomical abnormalities leading to repeated urinary tract

infection Ex: ---Reflux nephropathy ---Prostatic hypertrophy - Other infections that might affect the kidney by direct invasion or by immune-complex deposition

Calculus formation within the urinary tract - Metabolic disorders predisposing to stone formation, their

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investigation, prevention and treatment Ex: ---Idiopathic hypercalciuria ---Primary Hyperparathyroidism

---Cystinuria ---Hyperoxaluria · Acute and chronic renal failure - Management of acute and chronic renal failure and of disturbed physiology involved - Pathophysiological changes and non-dialytic treatment in different stages of progressive renal failure - Principle of nutritional requirements and diatery intervention for

patients with chronic renal failure - Other therapeutic means to slow down the progression of renal failure

Hypertension and renal problems in pregnancy - Renal adaptation to pregnancy - Management and profylaxis of renal disease and hypertension in pregnancy

Drug and the kidney - Role of the kidney in the normal elimination of drugs - Mechanisms by which drugs cause nephrotoxic damage - Principle of dose adjustment according to residual renal function

Renal replacement therapy - Different dialysis modalities and their complications - Complications related to immunosuppressive therapy following

renal transplantation

Dermatology

Basic science - Structure and function of the epidermis and dermis

Clinical dermatology - Recognition of cutaneous symptoms and signs of systemic diseases (diseases affecting internal organs and presenting skin

signs or symptoms) Ex: ---Collagen vascular disease such as SLE, systemic sclerosis ---Metabolic and endocrine disorders ---Infectious diseases ---Cancers ---Leukaemias

---Respiratory and cardiovascular diseases ---Common inherited diseases such as neurofibromatosis - Main dermatological complications of therapeutic immunosuppression (ex: systemic corticosteroid therapy, cyclosporin…) or of diseases such as HIV which cause immunosuppression - Differential diagnosis and plan of investigation of patients whom,

present with the following cutaneous signs or symptoms which

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may indicate internal diseases: ---Itch ---Hyperpigmentation ---Generalised erythema

---Loss of hair ---Increased hair growth ---Common patterns of nail dystrophy such as clubbing ---Erythema nodosum ---Erythema multiform ---Purpura ---Ulceration

---Vasculitis - Clinical features of the following skin diseases: ---Psoriasis ---Eczema ---Urticaria ---Superficial fungal infections (dermatophytosis, pityriasis versicolor) ---Common skin cancers such as melanoma ---Vitiligo and alopecia areata ---Pemphigus and pemphigold ---Cutaneous herpes virus infections (herpes simplex, varicella zoster) ---Cutaneous staphylococcal and streptococcal infections ---Leprosy · Investigation

- Principles of dermatological investigation such as patch testing Drugs and therapy

- Drugs which cause life-threatening skin conditions such as ---Erythroderma ---Stevens-Johnson syndrome, ---Angio-oedema ---Toxic epidermal necrolysis

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Documents

MRCP 1 Basics