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♕ Badrawy notes for mrcp ➜【basic science】

Sherif Elbadrawy

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25 oct. 2014

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CRUSH the MRCP The ULTIMATE REVISION Basic Science
BY
Dr.Sherif Badrawy
Critical Care Badrawy Notes For MRCP
Basic Sci...

MNEMONIC Type 1 hypersensitivty: "First and Fast"
1a
Badrawy Notes For MRCP
Basic Science
Dr.Sherif
Badrawy
Digitall...

◤ First = first type ◤ Fast = anaphylaxis
◤ Antigen + IgE bound to mast cells ➜ degranulation of mast cells.
1b
Badrawy...

MNEMONIC Type 2 hypersensitivity: "type 2 is cy-2-toxic"
2a
Badrawy Notes For MRCP
Basic Science

◤ cytotoxic (antibody mediated)
◤ IgG or IgM binds to antigen on cell surface
◤ Autoimmune hemolytic anemia, ITP, Goodpa...

MNEMONIC Type 3 hypersensitivity: "imagine an immune complex as 3 things stuck together"
3a
Badrawy Notes For MRCP
Basi...

antigen+AB+complement ➜deposition on the complex on the tissue
➜immunological tissue destruction.
Serum sickness, SLE, p...

MNEMONIC Type 4 hypersensitivity = "4th and last"
4a
Badrawy Notes For MRCP
Basic Science

delayed hypersensitivity
4b
Badrawy Notes For MRCP
Basic Science

MNEMONIC Type 4 hypersensitivity = 4 T's
5a
Badrawy Notes For MRCP
Basic Science

◤ T cell mediated
◤ Transplant rejections ◤ TB skin tests
◤ ConTacT dermaTiTis ◤ scabies
◤ exTrinsic allergic alveoliTi...

MNEMONIC hypersensitivities: ACID
6a
Badrawy Notes For MRCP
Basic Science

◤ A = anaphylactic and atopic (1st) ➜ check by skin prick test.
◤ C = cytotoxic (2nd) ➜ check by Intra dermal injection. ...

Bruton's agammaglobulinemia: Think B's ?
7a
Badrawy Notes For MRCP
Basic Science

◤ Bruton's ◤ Boys
◤ no B cells maturation ➜ recurrent pyogenic infections once maternal antibody levels fall.
7b
Badraw...

Hyper-IgE syndrome (Job's syndrome): FATED
8a
Badrawy Notes For MRCP
Basic Science

◤ F = coarse Facies
◤ A = staphylococcal Abscesses ◤ T = retained primary Teeth ◤ E = increased IgE
◤ D = dermatologic p...

Wiskott-Aldrich syndrome: Triad TIE
9a
Badrawy Notes For MRCP
Basic Science

◤ T = thrombocytopenic purpura ◤ I = infections
◤ E = eczema
9b
Badrawy Notes For MRCP
Basic Science

HLAs are encoded for by genes on which chromosome ?
11a
Badrawy Notes For MRCP
Basic Science

chromosome 6.
11b
Badrawy Notes For MRCP
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class I HLAs antigens ?
12a
Badrawy Notes For MRCP
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HLA A, B and C
12b
Badrawy Notes For MRCP
Basic Science

class II HLAs antigens ?
13a
Badrawy Notes For MRCP
Basic Science

HLA DP, DQ, DR
13b
Badrawy Notes For MRCP
Basic Science

HLA-B27 disease association ?
14a
Badrawy Notes For MRCP
Basic Science

◤ Ankylosing spondylitis ◤ Postgonococcal arthritis ◤ Acute anterior uveitis ◤ Reiter's syndrome (reactive arthritis)
14b...

HLA-DR2 disease association ?
15a
Badrawy Notes For MRCP
Basic Science

◤ Narcolepsy ◤ Goodpasture's
15b
Badrawy Notes For MRCP
Basic Science

HLA-DR3 disease association ?
16a
Badrawy Notes For MRCP
Basic Science

◤ Autoimmune hepatitis
◤ Primary biliary cirrhosis
◤ Diabetes mellitus type 1
◤ Dermatitis herpetiformis
◤ Coeliac dis...

HLA-DR4 disease association ?
17a
Badrawy Notes For MRCP
Basic Science

◤ Rheumatoid arthritis
◤ Diabetes mellitus type 1 (> DR3)
17b
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Basic Science

HLA-DR3 + DR4 combined disease association ?
18a
Badrawy Notes For MRCP
Basic Science

Diabetes mellitus type 1
18b
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Basic Science

HLA-B47 disease association ?
19a
Badrawy Notes For MRCP
Basic Science

21-hydroxylase deficiency
19b
Badrawy Notes For MRCP
Basic Science

HLA-A3 disease association ?
2 a
Badrawy Notes For MRCP
Basic Science

Hemochromatosis
2 b
Badrawy Notes For MRCP
Basic Science

HLA-B5 disease association ?
21a
Badrawy Notes For MRCP
Basic Science

Behcet's disease
21b
Badrawy Notes For MRCP
Basic Science

Felty's syndrome HLA association ?
22a
Badrawy Notes For MRCP
Basic Science

◤ HLA-DRW4 ◤ HLA-DR4
22b
Badrawy Notes For MRCP
Basic Science

CD1 significance ?
23a
Badrawy Notes For MRCP
Basic Science

presents lipid molecules
23b
Badrawy Notes For MRCP
Basic Science

CD2 significance ?
24a
Badrawy Notes For MRCP
Basic Science

Found on thymocytes, T cells, and some natural killer cells signal transduction and cell adhesion
24b
Badrawy Notes For ...

CD3 significance ?
25a
Badrawy Notes For MRCP
Basic Science

The signalling component of the T cell receptor (TCR) complex
25b
Badrawy Notes For MRCP
Basic Science

CD4 significance ?
26a
Badrawy Notes For MRCP
Basic Science

Co-receptor for HLA class II; also a receptor used by HIV to enter T cells
26b
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CD8 significance ?
27a
Badrawy Notes For MRCP
Basic Science

Co-receptor for HLA class I; also found on a subset of myeloid dendritic cells
27b
Badrawy Notes For MRCP
Basic Science

Type 5 hypersensitivty:Stimulated hypersensitivity ?
28a
Badrawy Notes For MRCP
Basic Science

IgG antibodies stimulate cells they are directed against
Graves', myasthenia Gravis
28b
Badrawy Notes For MRCP
Basic S...

Uses of Skin prick test ?
29a
Badrawy Notes For MRCP
Basic Science

◤ food allergies,pollen and wasp/bee venom
◤ histamine (positive) and sterile water (negative) control
◤ Interpret after...

Uses of Radioallergosorbent test (RAST) ?
3 a
Badrawy Notes For MRCP
Basic Science

◤ amount of IgE that reacts specifically with suspected or known allergens
◤ food allergies inhaled allergens (e.g. polle...

Uses of Skin patch testing ?
31a
Badrawy Notes For MRCP
Basic Science

CONTACT DERMATITIS.
31b
Badrawy Notes For MRCP
Basic Science

IgG % of serum Abs ? & half-life ?
32a
Badrawy Notes For MRCP
Basic Science

75% -7-23 days
32b
Badrawy Notes For MRCP
Basic Science

Functions of The Fc portion of IgG ?
33a
Badrawy Notes For MRCP
Basic Science

activate the classical complement pathway. bind to macrophage and
neutrophils ➜phaGocytosis
bind to NK cells ➜ antibody-...

IgA % of serum Abs ? half-life ?
34a
Badrawy Notes For MRCP
Basic Science

15%- ≅ 5 days.
34b
Badrawy Notes For MRCP
Basic Science

Functions of IgA ?
35a
Badrawy Notes For MRCP
Basic Science

◤ secretory IgA (sIgA) (in body secretions) where it protects internal body surfaces exposed to the environment by blockin...

IgM % of serum Abs ? half-life ?
36a
Badrawy Notes For MRCP
Basic Science

10% -5 days.
36b
Badrawy Notes For MRCP
Basic Science

Functions of IgM?
37a
Badrawy Notes For MRCP
Basic Science

first antibody produced during an immune response.
Fc portions of IgM are able to activate
the classical complement path...

IgD % of serum Abs ?
38a
Badrawy Notes For MRCP
Basic Science

1%
38b
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Basic Science

Functions of IgD?
39a
Badrawy Notes For MRCP
Basic Science

on the surface of B-lymphocytes (along
with monomeric IgM) as a B-cell receptor or sIg where it may control of B- lymphoc...

IgE % of serum Abs ? half-life ?
4 a
Badrawy Notes For MRCP
Basic Science

0.002%-2 days
4 b
Badrawy Notes For MRCP
Basic Science

Functions of IgE?
41a
Badrawy Notes For MRCP
Basic Science

✱ made in response to Allergens, parasitic worms
(helminths) and arthropods ➜can bind to eosinophils enabling opsonizatio...

Badrawy Notes For MRCP
Basic Science

Examples of Primary
Immunodeficiency dt Neutrophil disorders ?
42a
Badrawy Notes For MRCP
Basic Science

❃ Chronic granulomatous disease. ❃ Chediak-higashi syndrome. ❃ Leukocyte adhesion deficiency.
42b
Badrawy Notes For MRCP...

Examples of Primary
Immunodeficiency dt B-cell disorders ?
43a
Badrawy Notes For MRCP
Basic Science

❃ IgA deficiency.
❃ Bruton's congenital agammaglobulinemia. ❃ Common variable
immunodeficiency.
43b
Badrawy Notes For ...

Examples of Primary
Immunodeficiency dt T-cell disorders ?
44a
Badrawy Notes For MRCP
Basic Science

❃ DiGeorge syndrome
《microdeletion syndrome 》.
Patients at ↑ risk of viral and fungal infections.
44b
Badrawy Notes Fo...

Examples of Primary
Immunodeficiency dt Combined B- and T-cell disorders ?
45a
Badrawy Notes For MRCP
Basic Science

Severe combined immunodeficiency Ataxic telangiectasia(Autosomal recessive - 10% risk of developing malignancy, lymphoma o...

Definition of Wiskott-Aldrich syndrome ?
46a
Badrawy Notes For MRCP
Basic Science

X-linked recessive.
mutation in the WASP gene. recurrent bacterial infections (e.g.chest)eczema &
thrombocytopenia + ↓ I...

cANCA =?
47a
Badrawy Notes For MRCP
Basic Science

【Wegener's Granulomatosis 】positive in > 90%
Microscopic polyangiitis, positive in 40% 〖Some correlation between cANCA le...

pANCA =?
48a
Badrawy Notes For MRCP
Basic Science

【Churg-Strauss syndrome 】+ others
〖Cannot use level of pANCA to monitor disease activity 〗 Most common target is myeloper...

Etiology of ↑ pANCA ?
49a
Badrawy Notes For MRCP
Basic Science

Churg-Strauss syndrome Wegener's granulomatosis Microscopic polyangiitis
immune crescentic glomerulonephritis
Inflammato...

Disease associated with C1 inhibitor (C1-INH) Complement deficiency ?
5 a
Badrawy Notes For MRCP
Basic Science

hereditary angiedema
it's a serine protease inhibitor
mechanism is uncontrolled release of bradykinin ➜edema of tissues ...

Disease associated with C1q, C1rs, C2, C4 Complement deficiency ?(classical pathway components)
51a
Badrawy Notes For MR...

immune complex disease E.g. SLE, HSP
51b
Badrawy Notes For MRCP
Basic Science

Disease associated with C3 Complement deficiency ?
52a
Badrawy Notes For MRCP
Basic Science

recurrent bacterial infections
52b
Badrawy Notes For MRCP
Basic Science

Disease associated with C5 Complement deficiency ?
53a
Badrawy Notes For MRCP
Basic Science

⌼ Leiner disease ( long lasting
seborrhea dermatitis + ↑ likelihood to infection).
⌼ Recurrent diarrhea, wasting and seb...

Disease associated with C5-9 Complement deficiency ?
54a
Badrawy Notes For MRCP
Basic Science

Neisseria meningitidis infection Encodes the membrane attack complex (MAC)
54b
Badrawy Notes For MRCP
Basic Science

Causes of Normal Anion gap metabolic acidosis ?
55a
Badrawy Notes For MRCP
Basic Science

【U S E D C A R PAR T S 】
✺U ⇨ Ureterosigmoidostomy
✺ S ⇨ saline administration (in the face of renal dysfunction) ✺ E ⇨ ...

Causes of High Anion gap metabolic acidosis ?
56a
Badrawy Notes For MRCP
Basic Science

【MUDPILES 】 ★ M-Methanol
★ U-Uremia (chronic renal failure) ★ D-Diabetic ketoacidosis
★ P-Propylene glycol,Paraldehyde
...

Types of Lactic acidosis ?
57a
Badrawy Notes For MRCP
Basic Science

✵ Lactic acidosis type A: shock, hypoxia, burns
✵ Lactic acidosis type B: metformin Inborn error of metabolism
57b
Badr...

Causes of Metabolic Alkalosis ?
58a
Badrawy Notes For MRCP
Basic Science

loss of hydrogen ions or a gain of bicarbonate 【CLEVER PD 】
✵ Contraction (volume) ✵ Liquorice*
✵ Endo: (Conn's/Cushing'...

Mechanism of metabolic alkalosis ?
59a
Badrawy Notes For MRCP
Basic Science

✪ Activation of (RAAS) is a key factor
✪ Aldosterone ➜ reabsorption of Na+ in exchange for H+ in the DCT
✪ ECF depletion...

What's the 1st test to do after Hyponatremia ?
6 a
Badrawy Notes For MRCP
Basic Science

◆ Check for plasma osmolality:-
✪ Hypertonic ➜ > 290 ➜Hyperglycemia, Mannitol ➜Rx by remove 'cause
✪ Isotonic ➜290-275 ➜...

Etiology of Hypotonic Hyponatremia according to ECF volume?
61a
Badrawy Notes For MRCP
Basic Science

❀ Hypervolemic ➜ 〚Urinary Na < 10 ➜ Prerenal
➜HF,Cirrhosis,Nephrotic 〛, 〚Urinary Na > 20 ➜ Renal Failure 〛
❀ Euvolemic ➜...

Etiology of Hypernatremia ? (DDOH)
62a
Badrawy Notes For MRCP
Basic Science

▶ Dehydration
▶ Diabetes insipidus
▶ Osmotic diuresis ➜ ex. HONK ▶ Hypertonic saline
62b
Badrawy Notes For MRCP
Basic...

Etiology of Hyperkalemia ? (MACHINE )
63a
Badrawy Notes For MRCP
Basic Science

▶M - Medications - ACE inhibitors, NSAIDS,K+ sparing,β-Blockers
▶ A - Acidosis - Metabolic and respiratory
▶ C - Cellula...

Clinical picture of Hyperkalemia ? (MURDER )
64a
Badrawy Notes For MRCP
Basic Science

▶M - Muscle weakness ▶U - ↓ UOP
▶R - Respiratory distress
▶D - Decreased cardiac contractility
▶ E - ECG changes ➜Tall-...

Rx of Hyperkalemia ?
65a
Badrawy Notes For MRCP
Basic Science

『Stabilisation of the cardiac membrane 』 ◔ intravenous calcium gluconate
『K+ shift from extracellular to intracellular 』 ...

Etiology of Hypokalemia with alkalosis ?
66a
Badrawy Notes For MRCP
Basic Science

❂ Vomiting ❂ Diuretics
❂ Cushing's syndrome
❂ Conn's syndrome (primary hyperaldosteronism)
66b
Badrawy Notes For MRCP ...

Etiology of Hypokalemia with acidosis ?
67a
Badrawy Notes For MRCP
Basic Science

❂ Diarrhea ❂ RTA
❂ Acetazolamide
❂ Partially treated DKA
67b
Badrawy Notes For MRCP
Basic Science

ECG features of hypokalemia ?
68a
Badrawy Notes For MRCP
Basic Science

❂ U waves
❂ Prolong PR interval ❂ Long QT
❂ Small or absent T waves (occasionally inversion) ❂ ST depression
68b
Badra...

Etiology of Hypomagnesemia ?
69a
Badrawy Notes For MRCP
Basic Science

❂ DIURETICS ❂ Diarrhea
❂ Hypokalemia, hypocalcemia ❂ TPN
❂ Alcohol
69b
Badrawy Notes For MRCP
Basic Science

Clinical picture of Hypomagnesemia ?
7 a
Badrawy Notes For MRCP
Basic Science

✱ Tetany & convulsions ✱ Paraesthesia
✱ Hypokalemia with ECG changes ✱ Hypocalcemia dt ↓ PTH secretion ✱ Exacerbates digo...

Etiology of Hypophosphatemia ?
71a
Badrawy Notes For MRCP
Basic Science

✱ Refeeding syndrome
✱ Primary hyperparathyroidism ✱ Osteomalacia
✱ DKA
✱ Alcohol
✱ Acute liver failure
71b
Badrawy ...

Complications of Hypophosphatemia ?
72a
Badrawy Notes For MRCP
Basic Science

✱ hemolysis ,WBC and platelet dysfunction
✱ Muscle weakness and rhabdomyolysis
✱ CNS dysfunction
72b
Badrawy Notes For...

Vitamin D effect on Calcium & phosphate Metabolism ?
73a
Badrawy Notes For MRCP
Basic Science

↑ plasma calcium and plasma
phosphate ➜ dt ↑ renal tubular
absorption and ↑ gut absorption of calcium and ↑ renal phosph...

hormones control calcium metabolism ?
74a
Badrawy Notes For MRCP
Basic Science

✸ PRIMARY CONTROL:-
✾ parathyroid hormone (PTH) ✾ vitamin D
✸ OTHERS:- ✾ Calcitonin ✾ Thyroxine
✾ Growth hormone
74b
...

Actions of parathyroid hormone ?
75a
Badrawy Notes For MRCP
Basic Science

【↑ plasma calcium, ↓ plasma phosphate 】 □ ↑ plasma calcium dt ➜
□ ↑ renal reabsorption of calcium □ ↑ osteoclastic activi...

Actions of vitamin D ?
76a
Badrawy Notes For MRCP
Basic Science

【↑ plasma calcium, ↑ plasma phosphate 】
□ ↑ plasma calcium dt ➜
□ ↑ renal reabsorption of calcium □ ↑ osteoclastic activ...

Corrected Ca+ = ?
77a
Badrawy Notes For MRCP
Basic Science

serum Ca level (mmol/l) + [40 - S.Albumin (g/dl)] x 0.027
77b
Badrawy Notes For MRCP
Basic Science

Etiology of Hypocalcemia ?
78a
Badrawy Notes For MRCP
Basic Science

◊ Vitamin D deficiency (osteomalacia) ➜ ↓ Ca++ & ↓ Mg ++ ◊ Hypoparathyroidism (e.g. Post thyroid/parathyroid surgery)
◊ P...

Why Cisplatin ( Rx of non-small cell lung cancer) usually associated with Hypocalcemia ?
79a
Badrawy Notes For MRCP
Bas...

Cisplatin is a well known cause of
magnesium deficiency. Without first correcting magnesium levels it is difficult to rev...

Badrawy Notes For MRCP
Basic Science

Clinical picture of Hypocalcemia ?
8 a
Badrawy Notes For MRCP
Basic Science

extracellular calcium is important for muscle and nerve function ➜hypocalcemia ➜【neuromuscular excitability. 】
✰ Tetany: ...

Rx of Hypocalcemia ?
81a
Badrawy Notes For MRCP
Basic Science

◕ IV calcium gluconate, 10ml of 10% solution over 10 minutes (IV calcium chloride) ➜local irritation
◕ ECG monitoring
◕ ...

Most common causes of Hypercalcemia ?
82a
Badrawy Notes For MRCP
Basic Science

【primary hyperparathyroidism 】( MCC of silent hypercalcemia) 【malignancy 】(bone metastases, myeloma, PTHrP from
squamous ...

DD between monoclonal gammopathy of uncertain
significance (MGUS) and myeloma ?
83a
Badrawy Notes For MRCP
Basic Scien...

absence of complications such as immune paresis, hypercalcemia and bone pain.
83b
Badrawy Notes For MRCP
Basic Science

Etiology of Hypercalcemia ? (VITAMINS TRAP)
84a
Badrawy Notes For MRCP
Basic Science

V - Vitamins A & D
I - Immobilization
T - Thyrotoxicosis
A - Addison's disease
M - Milk-alkali syndrome I - Inflammato...

Rx of Hypercalcemia ?
85a
Badrawy Notes For MRCP
Basic Science

✬ hypercalcemic crises:-
✫ IV fluids ➜normal saline (usu. 3-4 litres/day). ✫ bisphosphonates.
✫ furosemide has a limited...

Conditions associated with Hyperuricemia ?
86a
Badrawy Notes For MRCP
Basic Science

hyperlipidemia and hypertension & metabolic syndrome
86b
Badrawy Notes For MRCP
Basic Science

Etiology of Hyperuricemia dt ↑ Synthesis ?
87a
Badrawy Notes For MRCP
Basic Science

★ Lesch-Nyhan disease ★ Myeloproliferative
disorders ➜Cytotoxics ➜ tumer lysis syndrome
★ Diet rich in purines ★ Exercis...

Etiology of Hyperuricemia dt ↓ Excretion ?
88a
Badrawy Notes For MRCP
Basic Science

★ Renal failure
★ Drugs: low-dose aspirin, diuretics, pyrazinamide
★ Pre-eclampsia ★ Alcohol
★ Lead
88b
Badrawy Notes...

Acute Phase Proteins that ↑ during inflammation ?
89a
Badrawy Notes For MRCP
Basic Science

✰ CRP
✰ Ferritin
✰ Caeruloplasmin ✰ Complement ✰ Haptoglobin ✰ Fibrinogen ✰ α-1 antitrypsin
✰ Serum amyloid A & P
89b ...

Acute Phase Proteins that ↓ during inflammation ?
9 a
Badrawy Notes For MRCP
Basic Science

✰ albumin ✰ prealbumin ✰ transferrin
✰ retinol binding protein ✰ cortisol binding protein
9 b
Badrawy Notes For MRCP
B...

Other name of Nitric Oxide ?
91a
Badrawy Notes For MRCP
Basic Science

endothelium derived relaxation factor
It is formed from L-arginine and oxygen by nitric oxide synthetase (NOS).
91b
Bad...

Mechanism of Nitric Oxide ?
92a
Badrawy Notes For MRCP
Basic Science

✪ Vasodilation, mainly venodilation ✪ Inhibits platelet aggregation ✪ dt Action on guanylate cyclase ➜ ↑ intracellular cGM...

Clinical relevance of Nitric Oxide ?
93a
Badrawy Notes For MRCP
Basic Science

✪ ↓ NO ➜ hypertrophic pyloric stenosis ✪ ↓ NO ➜ promote atherosclerosis
✪ In sepsis ↑ levels of NO ➜ contribute to septic...

Mechanism of Atrial Natriuretic Peptide (ANP) ?
94a
Badrawy Notes For MRCP
Basic Science

✪ secreted by heart muscle cells ➜.right atrium and ventricle in response to ↑ blood volume ➜ +
cGMP
94b
Badrawy Notes ...

Effects of Atrial Natriuretic Peptide (ANP) ?
95a
Badrawy Notes For MRCP
Basic Science

✫ ↓ water, sodium and adipose loads on the circulatory system, ✫ Antagonises actions of angiotensin II, aldosterone ➜ ↓ BP...

Clinical uses of B-type Natriuretic Peptide (BNP) ?
96a
Badrawy Notes For MRCP
Basic Science

✾ hormone produced mainly by the left
ventricular myocardium in response to strain.
✾ Diagnosing patients with acute dys...

Etiology of ↑BNP ?
97a
Badrawy Notes For MRCP
Basic Science

✼ heart failure
✼ LV dysfunction dt myocardial ischemia or valvular disease ✼ Renal failure
97b
Badrawy Notes For MRCP ...

Etiology of ↓BNP ?
98a
Badrawy Notes For MRCP
Basic Science

✼ ACE I ✼ ARBs
✼ diuretics.
98b
Badrawy Notes For MRCP
Basic Science

Mechanism of Endothelin I action ?
99a
Badrawy Notes For MRCP
Basic Science

secreted as a PROHORMONE by the vascular endothelium ➜ converted to ET-1 by endothelin converting enzyme. ➜ calcium releas...

Factors Promote the release of Endothelin I ?
1
a Badrawy Notes For MRCP
Basic Science

⌘ Angiotensin II ⌘ ADH
⌘ Hypoxia
⌘ Mechanical shearing forces
1
b Badrawy Notes For MRCP
Basic Science

Factors inhibit the release of Endothelin I ?
1 1a
Badrawy Notes For MRCP
Basic Science

⌘ Nitric oxide ⌘ Prostacyclin
1 1b
Badrawy Notes For MRCP
Basic Science

Endothelin I Raised levels in ?
1 2a
Badrawy Notes For MRCP
Basic Science

⌘ MI
⌘ Heart failure ⌘ ARF
⌘ Asthma
⌘ Primary pulmonary hypertension
1 2b
Badrawy Notes For MRCP
Basic Science

TNF is secreted mainly by ?
1 3a
Badrawy Notes For MRCP
Basic Science

macrophages.
key mediator of body response to
gram NEGATIVE septicemia and it is a costimulator of T cell.
1 3b
Badraw...

Definition of Interferons (IFN) ?
1 4a
Badrawy Notes For MRCP
Basic Science

⌘ CYTOKINES released by the body in response to viral infections and neoplasia.
⌘ IFN-α and IFN-β bind to type-1 receptor...

Functions of IFN-α (a"L"pha) ?
1 5a
Badrawy Notes For MRCP
Basic Science

⌘ Produced by "L"eucocytes
⌘ Antiviral action ➜hepatitis B & C, kaposi's sarcoma, metastatic renal cell cancer, hairy cel...

Functions of IFN-"β" ?
1 6a
Badrawy Notes For MRCP
Basic Science

⌘ Produced by fibro"B"lasts
⌘ Antiviral action ➜ ↓ frequency of exacerbations in patients with
relapsing-remitting MS
1...

Functions of IFN-gamma ?
1 7a
Badrawy Notes For MRCP
Basic Science

⌘ Produced by T lymphocytes & NK cells ⌘ weaker antiviral action (inhibit viral duplication), > in immunomodulation esp. m...

Definition of Leukotrienes ?
1 8a
Badrawy Notes For MRCP
Basic Science

FATTY MOLECULES (arachidonic acid derivatives) of the immune system ➜contribute to inflammation
in asthma and bronchitis....

Functions of Leukotrienes ?
1 9a
Badrawy Notes For MRCP
Basic Science

✫ Mediators of inflammation and allergy
✫ Cause bronchoconstriction, mucous production ✫ ↑ vascular permeability, attract...

Definition of Interleukin 1 (IL-1) ?
11 a
Badrawy Notes For MRCP
Basic Science

✫ key mediator of the immune response.
✫ secreted by ➜ macrophages and monocytes
✫ Action ➜costimulator of T cell and B ...

Functions of Interleukin 1 (IL-1) ?
111a
Badrawy Notes For MRCP
Basic Science

✫ expression of ADHESION MOLECULES on the endothelium
✫ VASODILATION and ↑ vascular
permeability dt (+) release vasoacti...

Functions of T-Helper Cells 1 ?
112a
Badrawy Notes For MRCP
Basic Science

✫ Cell mediated response and delayed (type IV) hypersensitivity ✫ Secrete IFN-gamma, IL-2, IL-3
112b
Badrawy Notes For M...

Functions of T-Helper Cells 2 ?
113a
Badrawy Notes For MRCP
Basic Science

✫ mediating humoral (antibody) immunity ➜(+) IgE production in asthma
✫ Secrete IL-4, IL-5, IL-6, IL-10, IL- 13
113b
Ba...

first Cardiac marker to rise in MI ?
114a
Badrawy Notes For MRCP
Basic Science

Myoglobin (rise éin 1-2 h,Peak 6-8 h,Back to normal 1-2 d)
114b
Badrawy Notes For MRCP
Basic Science

Cardiac marker useful to look for reinfarction ?
115a
Badrawy Notes For MRCP
Basic Science

CK-MB (rise éin 2-6 h,Peak 16-20 h,Back to normal 2-3 d)
as it returns to normal after 2-3 days (troponin T remains eleva...

Most useful Cardiac marker for MI ?
116a
Badrawy Notes For MRCP
Basic Science

TROPONIN (rise éin 4-6 h,Peak12-24 h,Back to normal 7-10 d)
116b
Badrawy Notes For MRCP
Basic Science

Causes of ↑ alkaline phosphatase (ALP) ?
117a
Badrawy Notes For MRCP
Basic Science

✫ PAGET'S DISEASE 《1,2 & 3 é ↑ Ca 》 ✫ Bone metastases
✫ Hyperparathyroidism
✫ Osteomalacia 《4 & 5 é ↓ Ca 》 ✫ Renal failu...

Definition of ESR ?
118a
Badrawy Notes For MRCP
Basic Science

non-specific marker of inflammation and depends on both the size, shape and number of RBCs & the
concentration of plasma ...

Etiology of ↑ ESR ?
119a
Badrawy Notes For MRCP
Basic Science

★ Temporal arteritis ★ Multiple Myeloma ★ CT Diseases
★ Malignancies ★ Infection
★ Others ➜anemia,Elderly, ♀
119b
Badr...

Etiology of ↓ ESR ?
12 a
Badrawy Notes For MRCP
Basic Science

★ Polycythemia
★ Afibrinogenemia/hypofibrinogenemia
12 b
Badrawy Notes For MRCP
Basic Science

Etiology of ↑ Leukocyte alkaline phosphatase ?
121a
Badrawy Notes For MRCP
Basic Science

★ Myelofibrosis
★ Leukemoid reactions ★ PRV
★ Infections
★ Corticosteroids, Cushing's syndrome
★ Pregnancy, oral contr...

Etiology of ↓ Leukocyte alkaline phosphatase ?
122a
Badrawy Notes For MRCP
Basic Science

★ CML
★ IMN (EBV) ★ PNH
★ Pernicious anemia
122b
Badrawy Notes For MRCP
Basic Science

Definition of Gene ? = PROTEIN
123a
Badrawy Notes For MRCP
Basic Science

a region of DNA that encodes protein.
123b
Badrawy Notes For MRCP
Basic Science

Definition of Genome ?= Group gene
124a
Badrawy Notes For MRCP
Basic Science

Group gene ➜ intervening DNA sequence
124b
Badrawy Notes For MRCP
Basic Science

Definition of Locus ? = SITE
125a
Badrawy Notes For MRCP
Basic Science

site of gene on a chromosome
125b
Badrawy Notes For MRCP
Basic Science

Definition of Chromosome ?
126a
Badrawy Notes For MRCP
Basic Science

Self-replicating genetic structure ➜ nucleotide sequence
126b
Badrawy Notes For MRCP
Basic Science

Definition of Alleles ?
127a
Badrawy Notes For MRCP
Basic Science

【Alternative form of a gene 】found at the same locus on a chromosome ; a single allele for each locus is inherited separat...

Definition of Haploid ?
128a
Badrawy Notes For MRCP
Basic Science

a single set of chromosomes (half the full set of genetic material), present in the gamete (egg or sperm) = (23).
128b
B...

Definition of Codon ?
129a
Badrawy Notes For MRCP
Basic Science

sequence of AMINO ACID
129b
Badrawy Notes For MRCP
Basic Science

Definition of Karyotype ?
13 a
Badrawy Notes For MRCP
Basic Science

number and appearance of
chromosomes in the nucleus, in
human there are 44 autosome + 2 sex chromosomes
13 b
Badrawy N...

Definition of Autosome ?
131a
Badrawy Notes For MRCP
Basic Science

any chromosome other than sex chromosome (22 pairs)
131b
Badrawy Notes For MRCP
Basic Science

Etiology of Autosomal Recessive Conditions ?
132a
Badrawy Notes For MRCP
Basic Science

Autosomal 【RECESSIVE 】conditions are 【'METABOLIC' 】except 〚inherited ataxias. 〛
132b
Badrawy Notes For MRCP
Basic Scien...

Etiology of Autosomal Dominant Conditions ?
133a
Badrawy Notes For MRCP
Basic Science

Autosomal 【DOMINANT 】conditions are 【'STRUCTURAL' 】except 〚hyperlipidemia type II, hypokalaemic
periodic paralysis 〛
133...

General Criteria of Autosomal Recessive Conditions ?
134a
Badrawy Notes For MRCP
Basic Science

✯ Autosomal recessive are more life- threatening compared to autosomal dominant condition
✯ ♀ = ♂
✯ Only homozygotes are...

If two heterozygote parents (Carrier Parents),what's the propability in the children ? (review the pic page 31)
135a
Bad...

✯ 25% chance of having an affected (homozygote) child (get the diseased gene from each parent)
✯ 50% chance of having a c...

If one affected parent (i.e.
homozygote for gene) and one
unaffected (i.e. not a carrier or
affected),what's the propab...

✯ All the children will be carriers
136b
Badrawy Notes For MRCP
Basic Science

Specific Clues to Autosomal Dominant or recessive ?
137a
Badrawy Notes For MRCP
Basic Science

✯【most of Cs and Gs are recessive. 】C - G - re ✯ ALL the Hs are Dominant except
Hemochromatosis & Homocystinuria are rece...

Other mnemonic for Autosomal Dominant Conditions ?
138a
Badrawy Notes For MRCP
Basic Science

Dominant Job Hunting
✯ D= Dystrophicas Myotonic.
✯ O= Ostogenesis Imperfecta. ➜Type 1 collagen defect. ✯ M= Marfans synd...

General Criteria of Autosomal Dominant Conditions ?
139a
Badrawy Notes For MRCP
Basic Science

✯ Both homozygotes and heterozygotes manifest disease (THERE IS NO CARRIER STATE) ✯ Only affected individuals can pass on ...

General Criteria of X-linked Recessive Conditions ?
14 a
Badrawy Notes For MRCP
Basic Science

✯ 【only ♂s are affected 】.(an exception is Turner's syndrome ➜ affected dt only having one X-chromosome).
✯ 【NO ♂ -to- ♂ ...

Father is affected and mother is carrier of X-linked Recessive Conditions ?
141a
Badrawy Notes For MRCP
Basic Science

✯ 【all kids have 50% chance of being affected. 】 ✯ ♂s will be affected if they got the diseased X from the mother + Y ➜ 50...

X-linked recessive conditions ?
142a
Badrawy Notes For MRCP
Basic Science

➜ Kallman Syndrome ➜ Fabry's disease ➜ Hunter's disease
➜ Becker muscular dystrophy
➜ G6PD deficiency
➜ Lesch-Nyhan syn...

Clinical picture of Wiskott-Aldrich syndrome ?
143a
Badrawy Notes For MRCP
Basic Science

X-linked recessive ➜ Combined B+T
primary immunodeficiency dt mutation in the WASP gene ➜ recurrent bacterial infection c...

Diseases have varying patterns of inheritance with the majority being X-linked recessive ?
144a
Badrawy Notes For MRCP
...

Chronic granulomatous disease (in > 70%)
(Primary
Immunodeficiency,Neutrophil disorder)
144b
Badrawy Notes For MRCP
B...

General Criteria of X-linked Dominant Conditions ?
145a
Badrawy Notes For MRCP
Basic Science

❐ If a child has inherited the mutation from the X
chromosome of one of their parents they will have the condition.
❐ 【N...

X-linked Dominant conditions ?
146a
Badrawy Notes For MRCP
Basic Science

❐ Vit D resistant Rickets ❐ Rett syndrome
❐ Alport syndrome (85% XLD)
146b
Badrawy Notes For MRCP
Basic Science

Definition of anticipation ?
147a
Badrawy Notes For MRCP
Basic Science

earlier onset of genetic disease in successive generations.
In most cases also ↑in the severity of symptoms is also noted...

Definition of Trinucleotide Repeat Disorders ?
148a
Badrawy Notes For MRCP
Basic Science

genetic conditions caused by an abnormal number of repeats
(expansions) of a repetitive sequence of three nucleotides
Th...

Examples of Trinucleotide Repeat Disorders (anticipation)?
149a
Badrawy Notes For MRCP
Basic Science

Fragile X (CGG) ➜ ►►►►►► FHM=GAT (C...G) Huntington's (CAG)
Myotonic dystrophy (CTG)
Friedreich's ataxia (GAA) ➜ no anti...

Which one of the following
intracellular organelles is associated with the metabolism of oligopeptides? A Golgi apparatus...

Lysosomes
15 b
Badrawy Notes For MRCP
Basic Science

Criteria of Mitochondrial Disease inheritance ?
151a
Badrawy Notes For MRCP
Basic Science

❊ rare neurological diseases (ex. Leber's OA
,MELAS .MERRF ,Pearson syndrome)
❊ Inheritance is only via the maternal lin...

Dx of Mitochondrial Diseases ?
152a
Badrawy Notes For MRCP
Basic Science

Muscle biopsy classically shows 'red, ragged fibres' due to ↑ number of mitochondria
152b
Badrawy Notes For MRCP
Basic ...

Definition of Tumour Suppressor Genes ?
153a
Badrawy Notes For MRCP
Basic Science

Genes which normally control the cell cycle
Exhibit a recessive effect - both copies must be mutated before cancer occurs...

Examples of Tumour Suppressor Genes ?
154a
Badrawy Notes For MRCP
Basic Science

❊ P53
❊ APC: colorectal cancer ❊ NF-1: neurofibromatosis ❊ RB: retinoblastoma
154b
Badrawy Notes For MRCP
Basic Scienc...

Definition of Proto-Oncogenes ?
155a
Badrawy Notes For MRCP
Basic Science

A normal gene which, when altered by mutation ➜ ACTIVE FORM of proto-oncogene-->leads to cancers
【RETired MEN RAShed MY E...

Significance of P53 Gene ?
156a
Badrawy Notes For MRCP
Basic Science

✾ tumour suppressor gene located on chromosome 17p. It is the most commonly mutated gene in BREAST, COLON AND LUNG CANCER ...

Li-Fraumeni Syndrome ?
157a
Badrawy Notes For MRCP
Basic Science

AD disease ➜ cancers (sarcomas, breast cancer).dt mutation in the p53 gene.
157b
Badrawy Notes For MRCP
Basic Science

Etiology of Down Syndrome ?
158a
Badrawy Notes For MRCP
Basic Science

trisomy 21, a chromosomal disorder dt the presence of all or
part of an extra 21 chromosome.
158b
Badrawy Notes For MRC...

Dx of Down syndrome in utero ?
159a
Badrawy Notes For MRCP
Basic Science

amniocentesis during pregnancy or in a baby at birth.
159b
Badrawy Notes For MRCP
Basic Science

Clinical picture of Down Syndrome ?
16 a
Badrawy Notes For MRCP
Basic Science

❂ Face: epicanthic folds,protruding tongue, upslanting palpebral fissures, Brushfield spots in iris,small ears round/flat ...

Cardiac complications of Down Syndrome ?
161a
Badrawy Notes For MRCP
Basic Science

◊ 【Endocardial cushion defect 】 (40%, aka AV septal canal defects)
〚Most common cardiac congenital anomaly with Down synd...

Other complications of Down Syndrome ?
162a
Badrawy Notes For MRCP
Basic Science

☆ Learning difficulties ☆ Short stature
☆ Repeated respiratory infections ( ↓hearing dt glue ear)
☆ 【Acute lymphoblastic...

Risk of Down's syndrome with increasing maternal age ?
163a
Badrawy Notes For MRCP
Basic Science

Risk at 30 years = 1/1000
35 years = 1/350
40 years = 1/100
45 years = 1/30
One way of remembering this is by starting...

Etiology of Turner Syndrome ?
164a
Badrawy Notes For MRCP
Basic Science

◤ dt either the presence of only one sex
chromosome (X) or a deletion of the short arm of one of the X chromosomes. Turne...

Clinical picture of Turner Syndrome ?
165a
Badrawy Notes For MRCP
Basic Science

◤ BICUSPID AORTIC VALVE (15%)
◤ COARCTATION OF THE AORTA (5-10%) ◤ Short stature
◤ Shield chest, widely spaced nipples ◤...

Etiology of Klinefelter Syndrome ?
166a
Badrawy Notes For MRCP
Basic Science

【Hypergonadotropic hypogonadism 】 ➜karyotype 47, XXY
166b
Badrawy Notes For MRCP
Basic Science

Clinical picture of Klinefelter Syndrome ?
167a
Badrawy Notes For MRCP
Basic Science

◥ 【Elevated gonadotrophin levels ➜ ↑ LH & FSH 】
◥ Small, firm testes (hypogonadism)
◥ Tall , Infertile
◥ Lack of second...

Dx of Klinefelter Syndrome ?
168a
Badrawy Notes For MRCP
Basic Science

by chromosomal analysis ➜
(K)aryotyping = (K)linefelter
168b
Badrawy Notes For MRCP
Basic Science

Etiology of Kallman Syndrome ?
169a
Badrawy Notes For MRCP
Basic Science

◥ hypogonadotrophic hypogonadism ➜ X- linked recessive
◥ 【Decreased gonadotrophin levels ➜ ↓ LH & FSH 】
◥ dt failure of ...

Clinical picture of Kallman Syndrome ?
17 a
Badrawy Notes For MRCP
Basic Science

◥ Anosmia
◥ Delayed puberty
◥ Hypogonadism, cryptorchidism (including undescended tests)
◥ Sex hormone levels are low
...

Etiology of Marfan Syndrome ?
171a
Badrawy Notes For MRCP
Basic Science

a defect in the fibrillin-1 gene on chromosome 15
autosomal dominant CT disease (fibrillin protein).
171b
Badrawy Notes...

Clinical picture of Marfan Syndrome ?
172a
Badrawy Notes For MRCP
Basic Science

◢ Tall stature with arm span > height ratio > 1.05 ◢ High-arched palate
◢ Eyes: upwards lens dislocation (ectopia lentis)...

Etiology of Noonan Syndrome ?
173a
Badrawy Notes For MRCP
Basic Science

' ♂ Turner's' ,autosomal dominant ,normal karyotype.
dt a defect in a gene on chromosome
12.
173b
Badrawy Notes For MR...

Clinical picture of Noonan Syndrome ?
174a
Badrawy Notes For MRCP
Basic Science

✱ Cardiac: pulmonary stenosis ✱ Ptosis
✱ ▲ shaped face ✱ Low-set ears
✱ Coagulation problems: factor XI deficiency
✱ + ...

Etiology of Fragile X ?
175a
Badrawy Notes For MRCP
Basic Science

trinucleotide repeat disorder, complex X-linked inheritance.
175b
Badrawy Notes For MRCP
Basic Science

Clinical picture of Fragile X ?
176a
Badrawy Notes For MRCP
Basic Science

❂ ♂ pt.
✼ MVP,MR
✼ LARGE low set ears, LONG thin face, HIGH arched palate ✼ MACROorchidism (Large testes)
✼ Hypotonia
...

Dx of Fragile X ?
177a
Badrawy Notes For MRCP
Basic Science

▨ In utero ➜ chorionic villus
sampling or amniocentesis
▨ Analysis of the number of CGG repeats using restriction
endon...

Etiology of Patau Syndrome ?
178a
Badrawy Notes For MRCP
Basic Science

trisomy 13 (extra chromosome 13) . death within 1 year.
Like all non-disjunction conditions (Down syndrome, Edwards syndr...

Clinical picture of Patau Syndrome ? = Petit = 【MICROCEPHALY 】
179a
Badrawy Notes For MRCP
Basic Science

【MICROCePHALY 】
✺M ➜ mental retardation ✺ I ➜ 13
✺ C ➜ Cleft lip , Cleft palate
✺ R ➜ Renal , Rocker bottom feet. ✺O ➜ ...

Etiology of Edwards Syndrome ?
18 a
Badrawy Notes For MRCP
Basic Science

dt the presence of all or part of an extra 18th chromosome.
It is the second most common
autosomal trisomy, after Down's...

Clinical picture of Edwards Syndrome ?
181a
Badrawy Notes For MRCP
Basic Science

【MICRO EDWARDS 】 ▼M ➜ mental retardation ▼ I ➜ 18
▼ C ➜ Cleft lip , Cleft palate ,Cardiac ➜ severe MR ▼R ➜ Renal
▼O ➜ Om...

Etiology of Prader-Willi Syndrome ?
182a
Badrawy Notes For MRCP
Basic Science

GENETIC IMPRINTING where the phenotype
depends on whether the deletion occurs on a gene inherited from the mother or fath...

Clinical picture of Prader Willi Syndrome ?
183a
Badrawy Notes For MRCP
Basic Science

【"SOM 'eats too much' Though He Has small hands , small feet & fish shaped mouth. 】
✾ S= short stature
✾ O= obese
✾ M= ...

Clinical picture of vitamin A 〔Retinoids 〕deficiency ?
184a
Badrawy Notes For MRCP
Basic Science

【Night-blindness 】(nyctalopia)
184b
Badrawy Notes For MRCP
Basic Science

Clinical picture of vitamin B1 〔Thiamine 〕deficiency ?
185a
Badrawy Notes For MRCP
Basic Science

【Beriberi 】
Polyneuropathy, Wernicke-Korsakoff syndrome
Heart failure
185b
Badrawy Notes For MRCP
Basic Science

Clinical picture of vitamin B3
〔Niacin 〕(Nicotinic Acid) deficiency ? B3 = 3D
186a
Badrawy Notes For MRCP
Basic Scienc...

【Pellagra 】
✪ Dermatitis (brown scaly rash on sunexposed sites - termed Casal's necklace if around neck)
✪ Diarrhea
✪ D...

Clinical picture of vitamin B6 〔 Pyridoxine 〕deficiency ?
187a
Badrawy Notes For MRCP
Basic Science

Anemia, irritability, seizures
187b
Badrawy Notes For MRCP
Basic Science

Clinical picture of vitamin B7 〔Biotin 〕deficiency ?
188a
Badrawy Notes For MRCP
Basic Science

Dermatitis, seborrhoea
188b
Badrawy Notes For MRCP
Basic Science

Clinical picture of vitamin B9 〔Folic acid 〕deficiency ?
189a
Badrawy Notes For MRCP
Basic Science

【Megaloblastic anemia 】, deficiency during pregnancy - neural
tube defects
189b
Badrawy Notes For MRCP
Basic Science

Etiology of vitamin B12 deficiency ?
19 a
Badrawy Notes For MRCP
Basic Science

✩ It is absorbed after binding to INTRINSIC
FACTOR (secreted from parietal cells in the stomach) & actively absorbed in t...

Clinical picture of vitamin B12 〔Cyanocobalamin 〕deficiency ?
191a
Badrawy Notes For MRCP
Basic Science

【Megaloblastic anemia 】 ▶Sore tongue and mouth
▶Neurological symptoms: e.g. Ataxia
,Subacute combined degeneration of sp...

Rx of vitamin B12
〔Cyanocobalamin 〕deficiency ?
192a
Badrawy Notes For MRCP
Basic Science

If no neurological involvement ➜ IM Hydroxocobalamin
If a patient is also deficient in folic acid then it is important to...

Clinical picture of vitamin C 〔Ascorbic acid 〕deficiency ?
193a
Badrawy Notes For MRCP
Basic Science

↓Vitamin C ➜ defective synthesis of
collagen ➜ capillary fragility (bleeding tendency) & poor wound healing 【Scurvy 】
▶▶...

Clinical picture of vitamin D 〔cholecalciferol 〕deficiency ?
194a
Badrawy Notes For MRCP
Basic Science

Rickets, osteomalacia (good source is cod liver oil)
194b
Badrawy Notes For MRCP
Basic Science

Etiology of Vitamin D-Resistant Rickets ?
195a
Badrawy Notes For MRCP
Basic Science

X-linked dominant (like Rett and Alport syndrome) ➜ presents in infancy with FTT.dt impaired phosphate reabsorption in the...

Clinical picture of Vitamin D- Resistant Rickets ?
196a
Badrawy Notes For MRCP
Basic Science

Failure to thrive
Normal serum calcium, low phosphate,
↑ alkaline phosphotase
X-ray changes: cupped metaphyses with wid...

Rx of Vitamin D-Resistant Rickets ?
197a
Badrawy Notes For MRCP
Basic Science

High-dose vitamin D supplements Oral phosphate supplements
197b
Badrawy Notes For MRCP
Basic Science

Clinical picture of Vitamin E 〔Tocopherol 〕deficiency ?
198a
Badrawy Notes For MRCP
Basic Science

Mild hemolytic anemia in newborn infants, ataxia, peripheral
neuropathy
198b
Badrawy Notes For MRCP
Basic Science

Clinical picture of Vitamin K
〔Naphthoquinone 〕deficiency ?
199a
Badrawy Notes For MRCP
Basic Science

Hemorrhagic disease of the newborn, bleeding diathesis
199b
Badrawy Notes For MRCP
Basic Science

Drugs which interfere with Folate metabolism ?
2
a Badrawy Notes For MRCP
Basic Science

✰ Trimethoprim ✰ Methotrexate ✰ Pyrimethamine
✰ Phenytoin ➜ can ↓ absorption
2
b Badrawy Notes For MRCP
Basic Science

Iron Absorption ?
2 1a
Badrawy Notes For MRCP
Basic Science

✰ Upper small intestine (only 10% of dietary iron absorbed)
✰ Fe++ (ferrous iron) ⋙ absorbed than Fe+++ (ferric iron)
✰ ...

Iron Distribution in body ?
2 2a
Badrawy Notes For MRCP
Basic Science

✰ Total body iron = 4g ✰ Hemoglobin = 70%
✰ Ferritin and hemosiderin = 25% ✰ Myoglobin = 4%
✰ Plasma iron = 0.1%
✿ Carr...

Clinical picture of Zinc Deficiency ?
2 3a
Badrawy Notes For MRCP
Basic Science

✿ Short stature
✿ Hypogonadism
✿ Hepatosplenomegaly
✿ Geophagia (ingesting clay/soil)
✿ Perioral dermatitis: red, crus...

Function of Endoplasmic reticulum ?
2 4a
Badrawy Notes For MRCP
Basic Science

★ (rough endoplasmic reticulum) ➜ Translation and folding of new proteins
★ (smooth endoplasmic reticulum) ➜ expression o...

Function of Golgi apparatus ?
2 5a
Badrawy Notes For MRCP
Basic Science

SORTING and MODIFICATION of proteins
2 5b
Badrawy Notes For MRCP
Basic Science

Function of Mitochondria ?
2 6a
Badrawy Notes For MRCP
Basic Science

Energy production. Contains
mitochondrial genome as circular double stranded DNA
2 6b
Badrawy Notes For MRCP
Basic Sci...

Function of Nucleus ?
2 7a
Badrawy Notes For MRCP
Basic Science

DNA maintenance and RNA transcription
2 7b
Badrawy Notes For MRCP
Basic Science

Function of Lysosome ?
2 8a
Badrawy Notes For MRCP
Basic Science

= LYSE ➜ Breakdown of large
molecules such as PROTEINS and POLYSACCHARIDES
2 8b
Badrawy Notes For MRCP
Basic Science

Function of PROTEAsome ?
2 9a
Badrawy Notes For MRCP
Basic Science

large PROTEIN molecules
Breakdown (together with Lysosome)
2 9b
Badrawy Notes For MRCP
Basic Science

Function of Nucleolus ?
21 a
Badrawy Notes For MRCP
Basic Science

Ribosome production
21 b
Badrawy Notes For MRCP
Basic Science

Function of (R)ibosome ?
211a
Badrawy Notes For MRCP
Basic Science

(R)NA Translation into proteins
211b
Badrawy Notes For MRCP
Basic Science

Function of PEROxisome ?
212a
Badrawy Notes For MRCP
Basic Science

hydrogen PEROxide Breakdown
212b
Badrawy Notes For MRCP
Basic Science

G1 - Gap phase 1 - determines length of cell cycle - under influence of ?
213a
Badrawy Notes For MRCP
Basic Science

p53
213b
Badrawy Notes For MRCP
Basic Science

Types of Membrane Receptors ?
214a
Badrawy Notes For MRCP
Basic Science

4 types :-
⌘ Ligand-gated ion channel
▶(fast responses) nicotinic acetylcholine, ▶GABA-A & GABA-C, glutamate receptors⌘ ...

α ₁ Adrenoreceptor ➜ Agonist & function ?
215a
Badrawy Notes For MRCP
Basic Science

❁ (Agonist ➜ phenylephrine) ❐ Vasoconstriction
❐ Relaxation of GI smooth muscle ❐ Salivary secretion
❐ Hepatic glycogeno...

α ₂ Adrenoreceptor ➜ Agonist & function ?
216a
Badrawy Notes For MRCP
Basic Science

❁ (Agonist ➜ clonidine)
❐ Mainly presynaptic:(-) transmitter release (NA, Ach from autonomic nerves)
❐ Inhibits insulin ...

β ₁ Adrenoreceptor ➜ Agonist & function ?
217a
Badrawy Notes For MRCP
Basic Science

❁ (Agonist ➜ dobutamine) ❐ Mainly located in the heart ❐ ↑ heart rate + force
217b
Badrawy Notes For MRCP
Basic Science

β ₂ Adrenoreceptor ➜ Agonist & function ?
218a
Badrawy Notes For MRCP
Basic Science

❁ (Agonist ➜ salbutamol) ❐ Vasodilation
❐ Bronchodilation
❐ Relaxation of GI smooth muscle
218b
Badrawy Notes For MRCP...

β ₃ Adrenoreceptor ➜ Agonist & function ? ₃
219a
Badrawy Notes For MRCP
Basic Science

( ❁ Agonist ➜ being developed, may have a role in preventing obesity) ❐ Lipolysis
219b
Badrawy Notes For MRCP
Basic Sci...

General Criteria of Adrenoceptors ?
22 a
Badrawy Notes For MRCP
Basic Science

All are G-protein coupled
α ₁:(+) phospholipase C ⇨ IP3 ⇨ DAG α ₂: (-) adenylate cyclase
β ₁: (+) adenylate cyclase β ₂:...

Function of Second Messengers ?
221a
Badrawy Notes For MRCP
Basic Science

amplification of external stimulus
221b
Badrawy Notes For MRCP
Basic Science

Types of Second Messengers ?
222a
Badrawy Notes For MRCP
Basic Science

□Cyclic AMP
E.g. Adrenaline, noradrenaline, glucagon, LH, FSH, TSH, calcitonin, parathyroid hormone □Protein kinase activ...

Molecular biology techniques 〖Snow Drop 〗?
223a
Badrawy Notes For MRCP
Basic Science

(South - NOrth - West) (BLOTTING) (DNA - RNA - Protein)
223b
Badrawy Notes For MRCP
Basic Science

Uses of Polymerase Chain Reaction (PCR) ?
224a
Badrawy Notes For MRCP
Basic Science

Prenatal diagnosis.
Detection of mutated oncogenes Dx of infections.
Forensics.
only one strand of sample DNA is needed...

Uses of Reverse transcriptase PCR ?
225a
Badrawy Notes For MRCP
Basic Science

▤ Used to amplify RNA
▤ RNA is converted to DNA by reverse transcriptase
▤ Gene expression in the form of
mRNA (rather ...

Strucures passing through Optic canal ?
226a
Badrawy Notes For MRCP
Basic Science

Ophthalmic A. Optic nerve (II)
226b
Badrawy Notes For MRCP
Basic Science

Strucures passing through Superior orbital fissure ?
227a
Badrawy Notes For MRCP
Basic Science

Superior ophthalmic V. Inferior ophthalmic V. Oculomotor nerve (III) Trochlear nerve (IV) Abducent nerve (VI)
lacrimal, f...

Strucures passing through Inferior orbital fissure ?
228a
Badrawy Notes For MRCP
Basic Science

Inferior ophthalmic V. Infraorbital artery
Infraorbital vein Zygomatic nerve and infraorbital nerve of
maxillary nerve (...

Strucures passing through Foramen Rotundum ?
229a
Badrawy Notes For MRCP
Basic Science

Maxillary nerve (V2)
229b
Badrawy Notes For MRCP
Basic Science

Strucures passing through Foramen Ovale ?
23 a
Badrawy Notes For MRCP
Basic Science

Accessory meningeal A. Mandibular nerve (V3)
23 b
Badrawy Notes For MRCP
Basic Science

Strucures passing through Jugular Foramen ?
231a
Badrawy Notes For MRCP
Basic Science

Posterior meningeal A. Ascending pharyngeal A. Inferior petrosal sinus Sigmoid sinus
Internal jugular V.
Glossopharyngea...

anatomical relations of the Rt kidneys ?
232a
Badrawy Notes For MRCP
Basic Science

Direct contact
Right suprarenal gland Duodenum
Colon
Layer of peritoneum in-between Liver
Distal part of small intesti...

anatomical relations of the Lt kidneys ?
233a
Badrawy Notes For MRCP
Basic Science

Direct contact
Left suprarenal gland Pancreas
Colon
Layer of peritoneum in-between Stomach
Spleen
Distal part of smal...

five layers of the Epidermis ?
234a
Badrawy Notes For MRCP
Basic Science

★ Stratum Corneum
★ Stratum Lucidum
★ Stratum Granulosum
★ Stratum Spinosum ➜Squamous
cells,Thickest layer of epidermi...

Phase 0 Myocardial Action Potential ?
235a
Badrawy Notes For MRCP
Basic Science

Rapid depolarisation dt Rapid sodium influx
These channels automatically deactivate after a few ms
235b
Badrawy Notes F...

Phase 1 Myocardial Action Potential ?
236a
Badrawy Notes For MRCP
Basic Science

Early repolarisation dt Efflux of potassium
236b
Badrawy Notes For MRCP
Basic Science

Phase 2 Myocardial Action Potential ?
237a
Badrawy Notes For MRCP
Basic Science

Plateau dt Slow influx of calcium
237b
Badrawy Notes For MRCP
Basic Science

Phase 3 Myocardial Action Potential ?
238a
Badrawy Notes For MRCP
Basic Science

Final repolarisation dt Efflux of potassium
238b
Badrawy Notes For MRCP
Basic Science

Phase 4 Myocardial Action Potential ?
239a
Badrawy Notes For MRCP
Basic Science

Restoration of ionic concentrations dt Na+/K+ ATPase mediated slow entry of Na+ into the cell ➜ ↓the potential difference ...

Atrial Conduction velocity ?
24 a
Badrawy Notes For MRCP
Basic Science

1 m/sec
24 b
Badrawy Notes For MRCP
Basic Science

AV node Conduction velocity ?
241a
Badrawy Notes For MRCP
Basic Science

0.05 m/sec
241b
Badrawy Notes For MRCP
Basic Science

Ventricular Conduction velocity ?
242a
Badrawy Notes For MRCP
Basic Science

Purkinje fibres are of large diameter and achieve velocities of 2-4 m/sec (this allows a rapid and coordinated contraction...

Mechanism of action of Antidiuretic hormone ?
243a
Badrawy Notes For MRCP
Basic Science

ADH is secreted from the posterior pituitary ➜ water reabsorption in the collecting ducts dt insertion of AQUAPORIN-2 CHAN...

The adrenal medulla resembles what ?
244a
Badrawy Notes For MRCP
Basic Science

a specialised sympathetic ganglion secretes adrenaline + small amounts of noradrenaline
244b
Badrawy Notes For MRCP
Bas...

Wegner's causes glomerulonephritis by crescent formation. Distinguished from other types by ?
245a
Badrawy Notes For MRC...

absence of immune deposits on immune -histochemical analysis.
245b
Badrawy Notes For MRCP
Basic Science

Most reliable features of D.M-1 presentation ?
246a
Badrawy Notes For MRCP
Basic Science

weight loss
246b
Badrawy Notes For MRCP
Basic Science

rate limiting enzyme in glycolysis and gluconeogenesis ?
247a
Badrawy Notes For MRCP
Basic Science

Pyruvate kinase
Its deficiency results in hereditary hemolytic anemia.
247b
Badrawy Notes For MRCP
Basic Science

Pyramidal Tract lesion (UMN lesion) in the upper & lower limbs ?
248a
Badrawy Notes For MRCP
Basic Science

affects extensors in U- limbs and flexors in lower limbs (knee flexion).
248b
Badrawy Notes For MRCP
Basic Science

Increased TG, Decreased HDL, Normal LDL.
249b
Badrawy Notes For MRCP
Basic Science

Sensation of Fecal control ?
25 a
Badrawy Notes For MRCP
Basic Science

Involuntary Fecal control is by
internal anal sphincter and voluntary by external ones.
Ultrasound used to study structu...

Hb- Electrophoresis of sickle patients show ?
251a
Badrawy Notes For MRCP
Basic Science

No Hb-A, 2-20 % Hb-F, 80-96% Hb-
S.
251b
Badrawy Notes For MRCP
Basic Science

Isotope suppression (Decreased other immune globulins) and light chains in urine only seen in ?
252a
Badrawy Notes For M...

Myeloma.
252b
Badrawy Notes For MRCP
Basic Science

Most early biochemical change to occurs in primary Hypothyroidism ?
253a
Badrawy Notes For MRCP
Basic Science

Increased TSH.
253b
Badrawy Notes For MRCP
Basic Science

Immunity against bacteria is mainly provided by ?
254a
Badrawy Notes For MRCP
Basic Science

Beta - cells (Humoral immunity)
254b
Badrawy Notes For MRCP
Basic Science

Immunity against intracellular organisms (Mycobacterium) by ?
255a
Badrawy Notes For MRCP
Basic Science

T-cells (cellular immunity).
255b
Badrawy Notes For MRCP
Basic Science

Knee extension mediated by ?
256a
Badrawy Notes For MRCP
Basic Science

L2, L3, L4.
256b
Badrawy Notes For MRCP
Basic Science

Ankle dorsiflexion mediated by ?
257a
Badrawy Notes For MRCP
Basic Science

L4, L5.
257b
Badrawy Notes For MRCP
Basic Science

Ankle plantar flexion & Great toe extension mediated by ?
258a
Badrawy Notes For MRCP
Basic Science

S1, S2.
258b
Badrawy Notes For MRCP
Basic Science

Eversion of foot mediated by ?
259a
Badrawy Notes For MRCP
Basic Science

S1.
259b
Badrawy Notes For MRCP
Basic Science

Inversion of foot mediated by ?
26 a
Badrawy Notes For MRCP
Basic Science

L4.
26 b
Badrawy Notes For MRCP
Basic Science

Lumbar disk prolapse mostly affects which roots ?
261a
Badrawy Notes For MRCP
Basic Science

L4/L5 and L5/S (Sudden weight lifting).
261b
Badrawy Notes For MRCP
Basic Science

Genital itching after condom use, itching perioral region after blowing up balloons ?
262a
Badrawy Notes For MRCP
Basic...

Latex allergy/ Rubber allergy
(Bananas, Avocados, Kiwi fruits also cause rubber allergy).
262b
Badrawy Notes For MRCP
...

motor supply to the intrinsic muscles of the hand which dermatome ?
263a
Badrawy Notes For MRCP
Basic Science

(C8, T1) , if affected ➜ weakness of the hand muscles ➜ Klumpke's paralysis.
263b
Badrawy Notes For MRCP
Basic Science

movements of the shoulder and
elbow supplied by which dermatome ?
264a
Badrawy Notes For MRCP
Basic Science

C6 and C7
264b
Badrawy Notes For MRCP
Basic Science

The[[[[[[ is required for normal positioning of the arm ?
265a
Badrawy Notes For MRCP
Basic Science

radial nerve
265b
Badrawy Notes For MRCP
Basic Science

[[[[[lesion affects the small
muscles of the hand and wrist flexion but not the positioning of the arm ?
266a
Badrawy N...

proximal ulnar nerve
266b
Badrawy Notes For MRCP
Basic Science

Dx Ab in primary biliary cirrhosis ?
267a
Badrawy Notes For MRCP
Basic Science

【Antimitochondrial antibodies 】95% of patients with primary biliary cirrhosis ➜ especially against E2/E3 component of pyru...

Factors affecting expression of aquaporin 2 proteins ?
268a
Badrawy Notes For MRCP
Basic Science

✯ Extreme temperature conditions (Deserts) ➜increased expression of aquaporin 2 proteins ➜ increased water reabsorption an...

Lab value most suggestive of CRF (not for ARF) ?
269a
Badrawy Notes For MRCP
Basic Science

Hypocalcemia.
269b
Badrawy Notes For MRCP
Basic Science

Tail of pancreas lies interiorly in direct contact with[[[[[ without separation by visceral peritoneum ?
27 a
Badrawy No...

left kidney
27 b
Badrawy Notes For MRCP
Basic Science

Botulinum Toxin A and E
cleaves[[1[[ and Botulinum Toxin C cleaves [[[2[[[
271a
Badrawy Notes For MRCP
Basic Science

1- SNAP-25 2- syntaxin.
271b
Badrawy Notes For MRCP
Basic Science

[[1[[activates classical complement pathway. [[2[[ activates Alternative complement pathway.
272a
Badrawy Notes For MRCP...

1- IgG/IgM 2- IgA
272b
Badrawy Notes For MRCP
Basic Science

Most specific finding that indicates metabolic alkalosis ?
273a
Badrawy Notes For MRCP
Basic Science

Raised plasma bicarbonate
concentration (Not high Arterial pH).
273b
Badrawy Notes For MRCP
Basic Science

monoclonal antibodies against IL-2 (prevent T-cell
proliferation) ?
274a
Badrawy Notes For MRCP
Basic Science

Basiliximab and Daclizumab
274b
Badrawy Notes For MRCP
Basic Science

Infection with hemophilus influenza and strep pneumonia (not strep. Pyogenes) ?
275a
Badrawy Notes For MRCP
Basic Scien...

indicates
hypogammaglobulinemia.
275b
Badrawy Notes For MRCP
Basic Science

T-cell deficiencies is associated with which infections ?
276a
Badrawy Notes For MRCP
Basic Science

Pneumocystis jiroveci, viral and candida infections, HIV
276b
Badrawy Notes For MRCP
Basic Science

Respiratory central chemoreceptors are located in[[1[[ and responds directly to CSF [[2[[ion
concentration ?
277a
Badra...

1- medulla 2-hydrogen
277b
Badrawy Notes For MRCP
Basic Science

Respiratory peripheral
chemoreceptors are located in[[1[[ responds to decreased [[2[[
concentration ?
278a
Badrawy Not...

1-(Aortic body in wall of arch of aorta, carotid body in right / left common carotid arteries)
2- O2
278b
Badrawy Notes...

Inspiration controlled by
[[1[[medulla and expiration by [[2[[medulla ?
279a
Badrawy Notes For MRCP
Basic Science

1-dorsal 2-ventral
279b
Badrawy Notes For MRCP
Basic Science

DiGeorge syndrome mnemonic ?
28 a
Badrawy Notes For MRCP
Basic Science

☆ Cardiac Abnormality (especially tetralogy of Fallot)
☆ Abnormal facies
☆ Thymic aplasia /T cell deficiency ☆ Cleft pal...

[[[%[loss of Dopamine occurs prior to emergence of Parkinsonism
symptoms ?
281a
Badrawy Notes For MRCP
Basic Science

60-70%
281b
Badrawy Notes For MRCP
Basic Science

Recurrent infections with pneumocystis carinii causes ?
282a
Badrawy Notes For MRCP
Basic Science

Hyper IgM Syndrome. (Increased IgM, Decreased IgA and IgG - Decreased Beta cell activation due to T-cell defect).
282b
B...

A patient is found to have unilateral pheochromocytoma and severe HTN. His father died of Renal cancer carcinoma. He also ...

Von Hippel Lindau Syndrome. DNA analysis will detect VHL gene
mutation in 90% of cases.
283b
Badrawy Notes For MRCP
Ba...

Most serious complication of NF-1 is ?
284a
Badrawy Notes For MRCP
Basic Science

hypertension due to Renal Artery Stenosis, pheochromocytoma or malignant transformation of
neurofibromas.
284b
Badrawy ...

confirmatory test for contact dermatitis is [[[[ ?
285a
Badrawy Notes For MRCP
Basic Science

patch test (Type 4 Hypersensitivity)
285b
Badrawy Notes For MRCP
Basic Science

TPN patient suddenly gets drowsy in emergency with abnormal electrolytes ?
286a
Badrawy Notes For MRCP
Basic Science

Hypophosphatemia (Refeeding Syndrome). Administration of
carbs/glucose ➜ insulin release ➜shifts
phosphate into cell res...

Random cortisol levels should be measured in cushing syndrome at what time ?
287a
Badrawy Notes For MRCP
Basic Science

2400 hour (midnight).
287b
Badrawy Notes For MRCP
Basic Science

Anticipation is due to ?
288a
Badrawy Notes For MRCP
Basic Science

expansion of Triplet repeats.
288b
Badrawy Notes For MRCP
Basic Science

Bradycardia in patients with B/L ptosis ?
289a
Badrawy Notes For MRCP
Basic Science

Myotonic dystrophy
289b
Badrawy Notes For MRCP
Basic Science

Redox process (hydrogen, transfer chain in mitochondria) and production of ATP requires[[[[ ?
29 a
Badrawy Notes For MRC...

Riboflavin.
29 b
Badrawy Notes For MRCP
Basic Science

V/Q Ratio high (PaO2 high and PaCO2 low) at ?
291a
Badrawy Notes For MRCP
Basic Science

Apex of Lung
291b
Badrawy Notes For MRCP
Basic Science

Rx of Metabolic alkalosis Secondary to NG aspiration /Vomiting ?
292a
Badrawy Notes For MRCP
Basic Science

normal saline is best choice. Ringer lactate exacerbates the alkalosis.
292b
Badrawy Notes For MRCP
Basic Science

Ehler's Danlos Syndrome Type [[ collagen defect ?
293a
Badrawy Notes For MRCP
Basic Science

collagen type 3 Autosomal recessive Ehlers-Danlos, Collagen, Bowel rupture and Bleeding into skin, Aortic dissection.
Hyp...

Hereditary angioedema patient presents with [[1[[ They don't get[[2[[ They are resistant to [[3[[.
Immediate management w...

1-abdominal pain / resp. distress. 2-urticarial or pruritus.
3-steroids /Anti histamines / Epinephrine.
4-C1 inhibitor c...

Finding suggestive of CRF (Not present in ARF) ?
295a
Badrawy Notes For MRCP
Basic Science

Small kidney's on ultrasound.
295b
Badrawy Notes For MRCP
Basic Science

During normal inspiration
Diaphragm drops by [[1[[, and
negative pressure of [[2[[is created.
296a
Badrawy Notes For M...

1- 1cm
2- 1-3 mm Hg
296b
Badrawy Notes For MRCP
Basic Science

During strenuous exercise Diaphragm drops by
[[[[(inspiration).
297a
Badrawy Notes For MRCP
Basic Science

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