MRCOG PART 1 IMPORTANT TOPICS AND ADVICES
[ We Must Agree That Notes That Will Be Mentioned Is About The Most Important And Frequent Questions And Topics. That Doesn’t Mean To Leave The Rest Of The Subject Without Studying. It Is Right That Common Is Common And A Lot Of Sbas Are Repeated In The Exam But Also They Tend To Introduce New Sbas In Each Exam Of Course. You Still Have A Very Long And Enough Time To Study Well And Carefully. You Must Believe That Any Effort You Do Will Never Go In Vain.]
(1.) GENETICS :
It is one of the most important subjects
[Paper 1- About 12 SBAs in the Exam (Number of SBAs is nearly not exactly and of course variable from exam to exam)].
It is written well in Oxford Revision Notes:
1- Structure of DNA and RNA (SBA about nitrogenous bases usually comes).
2- Steps of protein synthesis and enzymes involved with the function of each enzyme.
3- Blotting.
4- Stages of cell cycle and what happens in each stage (Very important – SBA is a must in this topic).
5- Chromosomal abnormalities:
- A. Down, Edward, Patau, Turner and Klinefelter’s syndromes.
- B. Chromosomes undergo Robertsonian translocation.
- C. Types of structural abnormalities (Translocation, deletion, inversion … etc.) SBA with an image asking about the type of abnormality can come.
6- Types of genetic disorders (Autosomal and sex-linked) must be memorized by heart (SBA is also a must in this item).
7- Cystic fibrosis.
8- Sickle cell disease and thalassemia.
9- Screening tests for congenital abnormalities (1st and 2nd trimesters).
10- Nuchal Translucency.
11- Pedigrees. (Diagrams of Mode of Inheritance).
12- Pictures of Karyotyping (Usually Trisomies 21, 18, 13, Turner and Klinefelter’s syndrome).
[13- I Recommend You To Read From Page 109 To Page 116 In Oxford Handbook Of Obstetrics And Gynecology 2013 © .]
[ I Hope I Covered The Subject Well, Don’t Panic From Those Items, They Are Too Easy To Cover. ]
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(2.) ANATOMY :
(Paper 1 and We are talking about 20-22 SBAs).
[ Honestly, This subject must be covered very well and I can’t recommend ignoring any topic within it, but let’s have a general overview: Your main source is Oxford Revision Notes, get some help from any available Atlas of anatomy you have. ]
MAIN TOPICS :
1- Truncal Surface Anatomy (Vertebral levels and Corresponding Structures), very important but you may find some controversies between books (For me I went with what was written in Oxford Revision Notes).
2- Muscles of Abdominal Wall (Anterior and posterior), Rectus sheath, Inguinal ligament and Canal, Femoral Sheath and Triangle, Structure of spermatic cord.
3- Ligaments within peritoneal cavity (and their embryological origins).
4- Pelvis (I think I don’t need to say anything about it of course every single word is important).
a. Bones and diameters.
b. Muscles.
c. Fascia and ligaments.
d. Pelvic floor (Memorize the levator ani muscle by heart).
e. Perineal pouches and perineal body.
f. Ischio-rectal fossa (Very important).
5- Rectum and anal canal + (External Anal Sphincter).
6- Blood supply of Colon.
7-Branches of Celiac trunk.
8- Kidney, Bladder and ureter and urethra.
9-Male and female genital systems.
10- Branches of Aorta (and their levels).
11- Blood Vessels of Pelvis and Anterior Abdominal Wall.
12- Lymphatic drainage (internal and external genital organs – other pelvic organs – anterior abdominal wall).
13- Peripheral Nerves in Pelvis.
14- Pituitary Gland.
15- Fetal Skull.
16- Breast (You can read that topic from Essential Revision Guide).
[So, Those are the main topics actually they are nearly all topics in the book but again don’t panic, you have enough time, anatomy is important not only to that exam but to all levels you will pass through and for sure your practice and don’t forget the general rules while studying.]
Learn: PLAB Guide for Overseas doctors in the world
(3.) EMBRYOLOGY :
(Paper 1, About 13 to 14 SBAs).
I think Oxford Revision Notes is an enough source, All you need is a source for some illustrating images or pictures to make studying easier.(You Can Buy Them Easily)
MAIN TOPICS :
1- General embryology (This includes early embryogenesis, placental and fetal membranes)”Very important 10 pages in Oxf. notes”.
2- Musculo-skeletal system (Just go through the time appearance of ossification centers and when ossification occurs).
3- Stages of the development of the alveoli + Surfactant development.
4- Development of CVS, fetal circulation and changes that occur in fetal circulation after birth.
5- GIT focus on Mid-gut herniation during fetal development (physiological and abnormal).
5- Development of urinary system (very important).
6- Development of reproductive system “plus reproductive system abnormalities””Very important”.
7- Nervous system (Times and stages of formation of neural plate, fold and tube, neural crest derivatives, NTD and pituitary gland development).
8- Pharyngeal arches, pouches and clefts.
9- Development of thyroid gland.
[Trust me they are very easy topics, just make some collective notes about days or Gestational age and corresponding events of development “for example day 18: neural plate formation, …… and so on”.]
(4.) PHYSIOLOGY:
(The main source is Oxford revision notes)(19 – 20 SBAs).
MAIN TOPICS :
1- Acid-Base Balance (Very Important): Must be well understood as many SBAs can be given in this topic especially interpretation of ABG (You can also refer to Essential Revision Guide in that topic and we will share separate notes about how to read and interpret ABG).
2- Calcium Homeostasis (Of extreme importance): Must be well covered from A to Z.
3- Cardiovascular System (Physiology, ECG “Usually there is a SBA about ECG in data Interpretation” and Cardiovascular Changes During Pregnancy).
4- Respiratory system (Respiratory function “Lung Volumes And Spirometry”, Respiratory changes during pregnancy, O2 dissociation curve “Of Critical Importance”).
5- GIT (Nutritional Requirements during Pregnancy, Changes in Pregnancy and Vitamin Deficiencies).
6- Urinary system (Very important): (General functional measurements, Urodynamic chart “We had a SBA in march 2017” and Normal Urodynamic values, Changes in Pregnancy, Parts of Nephron “In each part what Hormones act and what element are Reabsorbed”).
7- Female Reproductive System (Folliculogenesis, Oogenesis, Reproductive “Menstrual Cycle” and Hormonal changes during it “Diagram of Hormonal Changes is Very Important”, Menarche and Menopause).
8- Male Reproductive System (Spermatogenesis and interpretation of Semen analysis).
9- Fetal and Placental Tissues.
10- “ Hematological, Hormonal, Musculoskeletal, Skin, Metabolic and Liver ” Changes During Pregnancy.
[ Don’t Forget Practice SBAs As Much As You Can While Studying. ]
(5.) ENDOCRINOLOGY :
(15-17 SBAs) “Very Important Subject To Be Covered From A to Z”
Main source is oxford revision notes.
MAIN TOPICS :
1- Hypothalamic Hormones.
2- Pituitary Hormones.
3- Sex Hormones.
4- Thyroid Hormones.
5- Adrenal Hormones.
6- Pancreatic Hormones.
7- Renin-Angiotensin System.
8- Endocrine Disorders (SIADH, Diabetes insipidus, Hypo/Hyper thyroidism, Addison’s Disease, Cushing’s Syndrome, Conn’s Disease, Pheochromocytoma, and Prolactinoma).
9- Puberty.
10- Placental Hormones.
11- Endocrine Changes During Pregnancy, Labor, Puerperium and Lactation.
12- Fetal Endocrine System.
(6.) PHARMACOLOGY :
( 20-21 SBAs).
I will list now the important topics but fine details within each topic you are going to find and discover by answering SBAs.
MAIN TOPICS :
1- Antibiotics.
2- Anti-retroviral Therapy.
3- Anti-Malarial Drugs.
4- Uterotonics.
5-Tocolytics.
6- Anti-hypertensive agents.
7- Anti-epileptic drugs.
8- Anti-coagulants.
9- Drugs for GERD and anti-emetics.
10- Mifepristone.
11- SERMs.
12- Contraception.
13- Dopamine agonists and antagonists.
14- Treatment of urinary incontinence and over-active bladder.
[ Don’t forget answering SBAs in pharmacology is more useful than wasting a lot of time reading theory so practice a lot with an overall view on theory topics. ]
(7.) PATHOLOGY :
A major and Very important subject in Paper 2 (23-24 SBAs)
The Main Source Is Oxford Revision Notes.
MAIN TOPICS :
1- Inflammation (Quick Reading, Vascular And Cellular Response During Inflammation).
2- Definitions (Atrophy, Hypertrophy, Dysplasia, Metaplasia, Hyperplasia).
3- Cell injury (The Most Important Part Is “Types of Necrosis”).
4- Phases of Wound Healing.
5- Neoplasia (Including: Cancer Genes, Carcinogenic Agents and Related Cancers, Tu not Markers, Para-Neoplastic Syndromes).
6- Coagulation Abnormalities.
7- Types of Shock and Blood Transfusion.
8- Disorders of Female Genital Tract : “Benign and malignant conditions” ( The most important topic for sure and to be covered from A to Z)(Don’t forget GTD, Endometriosis and PCO).
9- Disorders in Pregnancy; (Pre-Eclampsia, HELLP Syndrome, Acute Fatty Liver, Cholestatsis and Peri-Partum Cardiomyopathy).
(8.) BIOSTATISTICS :
(About 9-10 SBAs)
The main source for studying biostatistics is KAPLAN BOOK for USMLE (All Books Are Available) and Most importantly to practice a lot of SBAs.
MAIN TOPICS :
1- Measures of Morbidity And Mortality (Incidence and Prevalence Rates).
2- Causes Of Maternal Deaths (Direct and Indirect).
3- Screening Tests (Sensitivity, Specificity, Accuracy, Predictive Value (+/-) And Likelihood Ratio (+/-).
4- WHO Screening Criteria.
5- Types of study designs.
6- Analysis of studies (Relative Risk, Attributable Risk and Odds Ratio).
7- Bias in Research.
8- Normal Distribution Curve.
9- Measures of Central Tendency and Dispersion of Data.
10- Types of Data (scales).
11- Inferential Statistics (Confidence Interval, Hypothesis Testing, Significance Testing, Types of Errors, Types of Statistical Tests and Correlation).
12- Meta-analysis.
13- Levels of Evidence Based Medicine.
(9.) MICROBIOLOGY AND IMMUNOLOGY :
( About 10 SBAs in Paper 2 for MICROBIOLOGY, Our main source is Oxford Revision Notes )
( 6-7 SBAs for IMMUNOLOGY, Main source is Oxford Revision Notes. )
A- IMMUNOLOGY :
MAIN TOPICS :
O1- Types of Immunity.
2- Types of Hypersensitivity (Very Important).
3- Different Types of Vaccines (And Vaccination During Pregnancy).
4- Complement System.
5- Immune Cells.
6- Classes of Immunoglobulins.
7- Immuno-Histo-Chemistry (IHC) markers.
8- Immunology and Pregnancy.
9- Immunological Disorders (SLE, Multiple Sclerosis and Myasthenia Gravis).
B- MICROBIOLOGY :
MAIN TOPICS :
1- Classifications of Bacteria.
2- Types of Bacterial Toxins.
3- Mechanisms of Bacterial Anti-Microbial Resistance.
4- Streptococci (All Types).
5- Gonorrhea.
6- Bacterial Vaginosis.
7- Syphilis + Different Types of Treponema Pallidum.
8- Chlamydia.
9- PID.
10- Trichomonas Vaginalis.
11- Toxoplasma.
12- Malaria.
13- Types of Viruses (DNA & RNA).
14- Herpes Family.
15- Rubella.
16- Parvo-Virus.
17- HPV.
18- HIV (Very Important) (Refer Also To Essential Revision Guide Book In This Topic).
19- Hepatitis Viruses (Especially HBV: Serology and Managemet During Pregnancy).
We will go through essential revision guide book in the following topics:
1- Skin and Soft Tissue Infection.
2- Staphylococci.
3- Listeria.
4- Actinomycosis.
5- Candida.
6- UTI.
7- Puerperal Sepsis.
[ N.B. Chapter 22 in Essential Revision Guide Book First Edition “Infections in Obstetrics And Gynecology”. (20 Pages) ].
I Recommend You to Read this Chapter “Quick Reading” Especially for Fresh Graduates.
[ I Hope You Did Well With Pharma I Really Hope So. Don’t Panic, Pharma Is A Tough Subject And Needs To Be Revised More Than Once. ]
(10.) BIOCHEMISTRY :
It Is A Light Subject (4 To 5 SBAs In Paper 1).
My Opinion Is To Read It Quickly And Depend On Answering A Lot Of SBAs Because As I Said Just 4 To 5 SBAs In The Exam And Usually Repeated.
But – As We Used To – Let’s Have A Look On Important Topics:
MAIN TOPICS :
1- Functions of each organelle within Eukaryotic cell.
2- Cell receptors (Quick Reading).
3- CHO metabolism (Glycolysis, Kreb’s Cycle, Cori Cycle) (Diagrams are very important to know because you may face a question asking about what is this diagram showing or asking about something missing in the diagram).
4- Interpretation of Blood Glucose Levels (Normal and Diabetic).
5- Essential/Unsaturated Fatty Acids.
6- Ketone Bodies.
7- Essential Amino-Acids.
8- Urea Cycle.
9- Hemoglobin Sub-Types.
10- Steroid synthesis (Diagram of Steroidogenesis is very important – A question in our exam March 2017).
11- Congenital Adrenal Hyperplasia.
12- PGs Synthesis Pathway.
13- Metabolic Response to Starvation.
[ It is a light subject about 20 pages in Oxford Revision Notes read it quickly and answer a lot of SBAs. ]
(11.) BIOPHYSICS : (6-7 SBAs).
Main source is Oxford Revision notes (Practicing a lot of SBAs will allow you to know most frequent SBAs in this subject).
MAIN TOPICS :
1- Ultrasound.
2- All Units of Measurements.
3- Radiation Poisoning.
4- RadioTherapy.
5- MRI.
6- Laser.
7- Electro-Surgery.
(12.) DATA INTERPRETATION AND CLINICAL MANAGEMENT :
(About 20 to 22 SBAs in Paper 2)
INTRA-PARTUM SCIENCE : Small chapter “Just 7 pages” to be covered from Oxford Revision notes, and It is not a separate subject. Its questions are given within Clinical Management subject and we already covered it during studying data interpretation and Clinical Management subject.
This round will be a mixture of topics from different subjects plus some clinical topics to cover.
{THEY HAVE NO SPECIFIC SOURCE}
(You Will Need To Buy These Topics From Different books, Guidelines and Even From The Different Websites.)
(A.) DATA INTERPRETATION :
1- Interpretation of Pedigrees (Genetics).
2- Interpretation of Karyotyping (Genetics).
3- ABG And Electrolyte Imbalance.
4- ECG.
5- O2 Dissociation Curve.
6- CTG and Fetal Blood Sampling.
7- Semen Analysis.
8- Urodynamics.
9- Normal and Abnormal blood sugar levels in pregnancy.
10- Risk of malignancy index (RMI) of ovarian tumors.
11- Interpretation of HBV serology.
12- Age related risk of Down’s syndrome.
13- Fetal Biophysical Profile.
14- APGAR Score.
15- Bishop score.
(B.) CLINICAL MANAGEMENT:
1- Abnormal Uterine Bleeding (Causes, Diagnostic Work Up and Management).
2- HIV and Pregnancy.
3- Diabetes and Pregnancy.
4- Genital Infections and PID.
5- Immunization During Pregnancy.
6- Bleeding In Early Pregnancy and Antepartum Hemorrhage.
7- Contraception.
8- Shoulder Dystocia.
9- Clinical Scenarios of Management During Labor.
10- Hypertensive Disorders With Pregnancy (NICE guidelines 107).
11- Tumor Markers.
12- Management of CIN.
13- Classes or Degrees of Perineal Tears.
14- Diagnostic Work-up of Infertile Woman.
15- Utero-Vaginal Prolapse
16- Hypo and Hyper Thyrodism.
17- Genital Cancers (Risk Factors, Cassifications and Staging).
[ I know they are too many topics to cover, but they are extremely important. Please do your maximum effort especially those who have not taken any training or residency in OB/GYN.
Any comments or additions from other seniors will be very welcome. ]
Courtesy :
Regards ,
Dr. Perry Jones
MRCOG,UK
Tareque Kamal
smmc
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