Feb 252019
 

Endocrinology is the study of the endocrine system in the human body. This is a system of glands which secrete hormones. Hormones are chemicals which affect the actions of different organ systems in the body. Examples include thyroid hormone, growth hormone, and insulin. Medicos Library has provided high standard Endocrinology Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Dynamic pituitary function tests
A dynamic pituitary function test is used to assess patients with suspected primary pituitary dysfunction Insulin, TRH and LHRH are given to the patient following which the serum glucose, cortisol, growth hormone, TSH, LH and FSH levels are recorded at regular intervals. Prolactin levels are also sometimes measured* A normal dynamic pituitary function test has the following characteristics:

  • GH level rises > 20mu/l
  • cortisol level rises > 550 mmol/l
  • TSH level rises by > 2 mu/l from baseline level
  • LH and FSH should double

*dopamine antagonist tests using metoclopramide may also be used in the investigation of hyperprolactinaemia. A normal response is at least a twofold rise in prolactin. A blunted prolactin response suggests a prolactinoma

Hypopituitarism
Adult growth hormone deficiency
 low peak growth hormone levels in response to insulin-induced hypoglycaemia
Features – mix  low ACTH: tiredness, postural hypotension. (Postural hypotension is related to adrenal failure regardless of cause)
 low gonadotrophins: amenorrhoea
 low TSH: constipated

Antidiuretic hormone

  • Antidiuretic hormone (ADH) is secreted from the posterior pituitary gland.
  • It promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels
  • ADH binds to V2 receptors which are found on the peritubular surface of cells in the distal convoluted tubule and medullary collecting duct. This leads to insertion of aquaporin channels into the luminal membrane, enhancing permeability to water.
  • ADH (vasopressin) is known to increase platelet aggregation, as such it may be considered prothrombotic at high dose.
  • increase factor VIII production, and as such may be of utility in treating some patients with haemophilia A. 
  • It leads to uterine and GI smooth muscle contraction and indirectly leads to a reduction in coronary artery blood flow.

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

Notes Basic Science Biostatistics Notes Basic Science Immunology
Notes Basic Scienses Biochemistry Metabolism Notes Cardiology
Notes Dermatology Notes Endocrinology
Notes Gastroenterology Notes Haematology
Notes Infectious Diseases Notes Neurology
Notes Ophthalmology Notes Pharmacology
Notes Renal System Notes Respiratory Medicine

 

Jan 222019
 

Endocrinology is a essential part of MRCP exam carrying 15 marks in the exam. Most student usual attain low marks in this section. Endocrinology is the study of the endocrine system in the human body. This is a system of glands which secrete hormones. Hormones are chemicals which affect the actions of different organ systems in the body. Examples include thyroid hormone, growth hormone, and insulin. Medicos Library has provided high standard Endocrinology on examination revision materials for medical exams.

  • 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
  • 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

MRCP(UK) develops and delivers postgraduate medical examinations around the world on behalf of the three Royal Colleges of Physicians of the UK.

Part 1 at a glance

  • one-day examination
  • two three-hour papers
  • 200 mutiple-choice (best of five) questions
  • no images
  • sat in an examination hall.

Exam pass marks

MRCP(UK) examinations

Examination Pass mark
Part 1 540
Part 2 Written 454
PACES 130 (see individual skills breakdown below)

The composition of the papers is as follows:

Specialty Number of questions*
Cardiology 15
Clinical haematology and oncology 15
Clinical Pharmacology, Therapeutics and Toxicology 16
Emergency and Critical care
Clinical sciences** 25
Dermatology 8
Endocrinology 15
Geriatric medicine 4
Gastroenterology 15
Infectious diseases and GUM 15
Neurology 15
Nephrology 15
Ophthalmology 4
Psychiatry 8
Respiratory medicine 15
Rheumatology 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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