Feb 252019
 

Renal/Nephrology is the study of normal kidney function and kidney disease, the preservation of kidney health, and the treatment of kidney disease. Medicos Library has provided high standard Renal/Nephrology Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Renal blood flow (RBF)

  • Renal blood flow is 20-25% of cardiac output
  • The ‘Fick principle’ can be used to estimate RBF through clearance.
  • Sympathetic stimuli produce vasoconstriction and RBF should be increased in response to hypoxia.
  • Renal cortical blood flow > medullary blood flow (i.e. tubular cells more prone to ischaemia)

Renin

  • Released by JGA cells in kidney in response to ↓ renal perfusion, low sodium
  • Hydrolyses angiotensinogen to form angiotensin I

Factors stimulating renin secretion

  • ↓ BP → ↓ renal prefusion
  • Hyponatremia
  • Sympathetic nerve stimulation
  • Catecholamines
  • Erect posture

Factors reducing renin secretion

  • β-blockers
  • NSAIDS

Angiotensin

  • ACE in lung converts angiotensin I → angiotensin II
  • Vasoconstriction leads to raised BP
  • Stimulates thirst
  • Stimulates aldosterone and ADH release

Aldosterone

  • Released by the zona glomerulosa in response to raised angiotensin II, potassium, and ACTH levels
  • Causes retention of Na+ in exchange for K+/H+ in distal tubule

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
 

Renal/Nephrology is a essential part of MRCP exam carrying 15 marks in the exam. Most student usual attain low marks in this section. Renal/Nephrology is the study of normal kidney function and kidney disease, the preservation of kidney health, and the treatment of kidney disease. Medicos Library has provided high standard Renal/Nephrology on examination revision materials for medical exams.

  • 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 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

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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