Feb 252019

Biochemistry is the study of the chemical substances and vital processes occurring in living organisms. Biochemists focus heavily on the role, function, and structure of biomolecules and Metabolism is the set of life-sustaining chemical reactions in organisms. Medicos Library has provided high standard Basic Science Biochemistry Metabolism Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Anion gap
The anion gap is calculated by: (sodium + potassium) – (bicarbonate + chloride) A normal anion gap is 8-14 mmol/L It is useful to consider in patients with a metabolic acidosis: Causes of a normal anion gap or hyperchloraemic metabolic acidosis

  • gastrointestinal bicarbonate loss: diarrhoea, ureterosigmoidostomy, fistula
  • renal tubular acidosis
  •  drugs: e.g. acetazolamide
  •  ammonium chloride injection
  •  Addison’s disease

Causes of a raised anion gap metabolic acidosis

  • lactate: shock, hypoxia
  • ketones: diabetic ketoacidosis, alcohol
  •  urate: renal failure
  •  acid poisoning: salicylates, methanol

Metabolic alkalosis
Metabolic alkalosis may be caused by a loss of hydrogen ions or a gain of bicarbonate. It is due mainly to problems of the kidney or gastrointestinal tract Causes

  • vomiting / aspiration (e.g. peptic ulcer leading to pyloric stenos, nasogastric suction)
  •  diuretics
  •  liquorice, carbenoxolone
  •  hypokalaemia
  •  primary hyperaldosteronism
  • Cushing’s syndrome
  • Bartter’s syndrome
  • congenital adrenal hyperplasia

Mechanism of metabolic alkalosis

  • activation of renin-angiotensin II-aldosterone (RAA) system is a key factor

Advice form Dr. Yousif Abdallah Hamad

How to use the notes to study for MRCP:

  • Initially, you need to skim through the notes at least twice to build up an idea about the syllabus of MRCP. Highlight any portion that is difficult so that you can concentrate on that during your revision.
  • Next proceed to the question banks. You can choose to do Passmedicine, onexamination or Pastest. I usually recommend students to do Passmedicine and the Pastest.
  • As you go through the questions make a super-revised notes of your own. Write down in one sentence what you learned from the question you just attempted.
  • If you get any question wrong or you get confused then return to the notes and re-read one more time before attempting the question again. And write down the point in red in you revision notes so that you can skim through it easily during your revision.
  • I have highlighted some points in yellow and green to help you concentrate on those points. As you go through passmedicine and pastest, you can highlight the points further to help in your revision.
  • During your revision before the main exam, only read the highlighted portions including those that you highlighted when practicing the question bank. And also read your super-revised notes that you made from the question banks.

I believe these method has worked for many students and will help you in your journey to be successful in MRCP part 1 and as well as build your basics for Part 2.

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Find more Notes By Dr. Yousif Abdallah Hamad

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