Feb 252019

Respiratory Medicine is the study of that deals with the causes, diagnosis, prevention and treatment of diseases affecting the lungs. Medicos Library has provided high standard Respiratory Medicine Notes by Dr. Yousif Abdallah Hamad.

Summary of Notes:

Lung development

  • Complete development of the alveoli and the pores of Kohn only occurs around the age of 7 years.
  • Distension in the fluid-filled lungs, tonic negative pressure of diaphragmatic tone and fetal breathing all cause lung growth.
  • Absence of liquor, which is produced by the fetal kidneys, causes poor lung growth and a low phospholipid content. Renal agenesis is therefore a cause of hypoplastic lungs.
  • Lamellar bodies in type II pneumocytes that produce surfactant are seen by 22 weeks’ gestation.

Phrenic nerve

  • The diaphragm is innervated by the phrenic nerve (C3,4,5).
  • Diagnosis is suspected when on the chest radiograph the diaphragmatic leaflet is elevated and is confirmed fluoroscopically by observing paradoxical diaphragmatic motion on sniff and cough.
  • In patients with normal lungs unilateral paralysis is usually asymptomatic and rarely requires treatment.
  • The diagnosis of unilateral paralysis, suggested by asymmetric elevation of the affected hemidiaphragm on X-ray, can be confirmed by fluoroscopy.
  • During a forced inspiratory manoeuvre (the ‘sniff test), the unaffected hemidiaphragm descends forcefully, increasing intra-abdominal pressure and pushing the paralysed hemidiaphragm cephalad (paradoxical motion).
  • Fluoroscopy is inaccurate for the diagnosis of bilateral paralysis.
  • While MRI may demonstrate a structural defect, it isn’t a dynamic investigation.

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

Respiratory is a essential part of MRCP exam carrying 15 marks in the exam. Most student usual attain low marks in this section. Respiratory is the study of that deals with the causes, diagnosis, prevention and treatment of diseases affecting the lungs. Medicos Library has provided high standard Respiratory on examination revision materials for medical exams.

  • 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:
    - 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 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
 Pleural effusion
 Chest pain
- Impact of systemic disease on the respiratory system
 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·
- Knowledge of detailed pulmonary mechanics, oncology drug regimens, drug therapy of environmental mycobacterial infection, inhalation drug kinetics, and detailed histological descriptions is not required.

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

* 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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