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30/7/2014
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MRCP notes
10 March
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MRCP notes
10 March
Space Occypying Lesions
MRCP notes
10 March
Hereditary angioedema (HAE)

Epidemiology: Autosomal dominant. 1 in 10,000 to 1 in 50,000 people. 20%
may result from spontaneous mutation.
Age: 1/3 - 7yo, 2/3 - 13yo increasing in adolescent
Aetiology: low level C1 inhibitor.
Pathology: low level of C1 inhibitor causing improper response to disease
fighting, coagulation, and inflammatory process.
Clinical features: episodes of edema (swelling) in various body parts
including the hands, feet, face and airway.
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MRCP notes
including the hands, feet, face and airway.
Diagnosis: genetic testing, C1 inhibitor quantitative (type II), C1 inhibitor
functional (type II)
Management: avoid ACE Inhibitors and estrogen-derived medications which
can worsen the HAE attack and frequency.
Treatment: Cinryze & Berinert (C1-inhibitors), Kalbitor (plasma kallikrein
inhibitors), Firazyr (bradykinins receptor antagonist), Ruconest (research
ongoing..)
Reference: http://www.haea.org/
MRCP notes
27 September 2013
I would like to invite anybody to share anything necessary for incoming

exam..
MRCP notes
31 August 2013
Causes of Villous Atrophy

- Giardiasis
- Collagenous sprue
- Common-variable immunodeficiency
- Autoimmune enteropathy
- Radiation enteritis
- Whipples disease
- Tuberculosis
- Tropical sprue
- Eosinophilic gastroenteritis
- Human immunodeficiency virus enteropathy
- Intestinal lymphoma
- ZollingerEllison syndrome
- Crohns disease
- Intolerance of foods other than gluten
MRCP notes
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MRCP notes
MRCP notes
14 August 2013 near Kampong Tabuan, Malaysia
WHAT IS MALARIA?
Malaria is an infectious disease cause by protozoa name Plasmodium sp.
Mosquito which act as a vector in Malaria disease is called Anopheles.
Vector is a carrier that transfer an infective agent from one host to another.
Host is an organism that harbor & nourish another organism.
Organism is an individual living thing.
Life is an aggregate of vital phenomena, the quality and principle in which the
living things are distinguished from inorganic matter, such as metabolism,
growth, etc.
Protozoa is an organism which has a characteristic of unicellular, eukaryotic,
motile & some shows animal and plant-like behavior.
Eukaryotic is a cell with nucleus.
Nucleus is a central core within a body/ object.
Cell nucleus is a central core within the cell which have proper DNA
compartment.
Malaria cause disease in human by invading the RBC & cause it to rupture &
release of merozoites into the bloodstream.
Disease is a condition that cause harmful, depraved, or morbid condition.
Infection is an invasion & multiplication of micro-organisms in body tissues.
MRCP notes
14 August 2013 near Kampong Semariang, Malaysia
CLINICAL FEATURES OF VIRUS INFECTION:

Smurf Has Headache..
Sun (fever)
Myalgia + arthralgia
URti symptoms
Fatigue/malaise
Has Headache
MRCP notes
13 August 2013
LIFE CYCLE OF MALARIA
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MRCP notes
MRCP notes
13 August 2013
CLINICAL FEATURES OF MALARIA

Become symptomatic a few weeks after infection, although the host's
previous exposure or immunity to malaria affects the symptomatology and
incubation period.
Importantly, virtually all patients with malaria present with headache. Other
symptoms: cough, fatigue, malaise, shaking chills, arthralgia, & myalgia.
They shows paroxysm of fever, shaking chills, and sweats... See More
MRCP notes
13 August 2013 near Kampong Semariang, Malaysia
Malaria
MRCP notes
5 August 2013
Dermatitis herpetiformis..
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MRCP notes
MRCP notes
4 August 2013
ACROMEGALY
diagnosis: measuring GH during OGTT.
- normal: GH suppressed to < 2mU/l
- acromegaly: doesn't suppressed (50% rises)
In insulin deficiency (Type I or long standing Type II DM), there is a failure of
IGF-1 stimulation from the liver during OGTT, hence GH is failed to be
suppressed.
So, IGF-1 measurement are low in DM without acromegaly, while in
acromegalic patient, IGF-1 are high.
Management:
- 1st line: Trans-sphenoidal surgey
- 2nd line: Radiotherapy (risk of hypopituitarism)
- Medical treatment
MRCP notes
3 August 2013
Normal sleep has two distinct states:

- non-rapid eye movement (NREM)
- rapid eye movement (REM)
During REM sleep...
-
rapid eye movements occur

breathing becomes irregular
blood pressure rises
loss of muscle tone
The brain is highly active, and the electrical activity recorded in the brain by
EEG during REM sleep is similar to that recorded during wakefulness.
REM sleep is usually associated with dreaming. REM sleep accounts for
20%-25% of the sleep period.
In a person with REM sleep behavior disorder (RBD), the paralysis that
normally occurs during REM sleep is incomplete or absent, allowing the
person to "act out" his or her dreams.
RBD is characterized by the acting out of dreams that are vivid, intense, and
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MRCP notes
RBD is characterized by the acting out of dreams that are vivid, intense, and
violent.
Dream-enacting behaviors include talking, yelling, punching, kicking, sitting,
jumping from bed, arm flailing, and grabbing.
An acute form may occur during withdrawal from alcohol or sedative-hypnotic
drugs.
REM sleep behavior disorder (RBD) may occur in association with:
-
Parkinson's disease
multisystem atrophy
diffuse Lewy body dementia
Shy-Drager syndrome
alcohol or sedative-hypnotic withdrawal
drugs: tricyclic antidepressant, SRI, antidepressants
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MRCP notes
3 August 2013
Clinical features of carcinoid tumours:

-
Small bowel obstruction due to the tumour mass

Intestinal ischemia (due to mesenteric infiltration/vasospasm)
Hepatic metastasis causing pain, hepatomegaly & jaundice
Flushing & wheezing
Diarrhoea
Cardiac involvement leading to heart failure
Facial telangiectasia
MRCP notes
1 August 2013
Hyponatraemia..
urine Na: low (<30 mmol/L)
urine osmolality: low (<100 mmol/kg)
Cause: primary polydipsia, beer excess, malnutrition
urine Na: low
urine osmolality: high
Cause: salt depletion, hypovolaemia
urine Na: high
urine osmolality: low
Cause: diuretic (acute phase)
urine Na: high (>40 mmol/L)
urine osmolality: high (>150mmol/kg)
Cause: SIADH, adrenal insufficiency, cerebral salt-wasting
MRCP notes
1 August 2013
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MRCP notes
1 August 2013
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MRCP notes
1 August 2013
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Just a collection of my own notes.

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Normally, the C-peptide levels increase when pancreatic secretion of insulin

increases.
Conversely, the C-peptide levels decrease when pancreatic secretion of
insulin is low.
Exogenous administration of insulin results in an increase in insulin levels
without a concomitant increase in the C-peptide level.
PHOTOS
MRCP notes
1 August 2013
The diagnostic criteria for exogenous insulin administration include high

serum insulin levels and the absence of serum C-peptide levels in the
presence of hypoglycemia.
During the purification of commercial insulin preparations, the C-peptide is
removed.
As a result, C-peptide cannot be detected by means of radioimmunoassay.
By contrast, both insulin and C-peptide levels are elevated and detectable in
patients with insulinoma.
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30/7/2014

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Space Occypying Lesions

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Hereditary angioedema (HAE)

I would like to invite anybody to share anything necessary for incoming

Causes of Villous Atrophy

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CLINICAL FEATURES OF VIRUS INFECTION:

LIFE CYCLE OF MALARIA

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CLINICAL FEATURES OF MALARIA

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Normal sleep has two distinct states:

rapid eye movements occur

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You like this.

Clinical features of carcinoid tumours:

Small bowel obstruction due to the tumour mass

Like Comment Share Highlight

Invite your friends to like this Page

Just a collection of my own notes.

Normally, the C-peptide levels increase when pancreatic secretion of insulin

Like Comment Share Highlight

The diagnostic criteria for exogenous insulin administration include high

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