Feb 252019
 

Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. Medicos Library has provided high standard Gastroenterology Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Blood supply Bleeding from Posterior duodenal ulcers are due to erosion of the gastroduodenal artery 

  • The right and left gastroepiploic arteries (gastro-omental arteries) supply the greater curvature of the stomach.
  • The source of ulcer bleeding in the greater curvature of the stomach
  • Left gastroepiploic artery
  • The right gastric artery arises from the hepatic artery or the left hepatic artery, supplies the pylorus and travels along the lesser curvature of the stomach, supplying it, and anastomosing with the left gastric artery.
  • The cause of ulcer bleeding in the lesser curvature of the stomach
  • right gastric artery
  • The pancreaticoduodenal artery (a branch of the gastroduodenal artery) supplies mainly the upper and lower duodenum and the head of the pancreas.
  • The right hepatic artery supplies the right lobe of the liver and part of the caudate lobe.

Acid secretion
Principle mediators of acid secretion
 gastrin
 vagal stimulation
 histamine
Factors increasing acid secretion
 gastrinoma
 small bowel resection (removal of inhibition)
 systemic mastocytosis (elevated histamine levels)
 basophilia
Factors decreasing acid secretion
 drugs: H2-antagonists, PPIs
 hormones: secretin, VIP, GIP, CCK  Prostaglandins.

Intrinsic factor

  • Intrinsic factor is a glucoprotein secreted from the parietal cells of the stomach in response to gastrin, food or histamine.
  • intrinsic factor transport vitamin B12 across the mucosal wall.
  • When the vitamin B12 bound to intrinsic factor reaches the terminal ileum, it binds to receptors on the surface of the mucosal cells and is able to cross the membrane and enter the cytoplasm.
  • The intrinsic factor is then replaced by transcobalamin II which transports the B12 out of the cell and into the bloodstream.

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 282019
 

Gastroenterology is a essential part of MRCP exam carrying 15 marks in the exam. Most student usual attain low marks in this section. Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. Medicos Library has provided high standard Gastroenterology on examination revision materials for medical exams.

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

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

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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