Monday, 27 September 2010

MRCP revision battle 22.1: Goodpasture's Syndrome

Today's battles cover a lot of the random conditions that frequently appear as differentials in MRCP questions but rarely feature in your day-to-day life.  As well as being random, or possibly as a consequence of them being random, their exact causes are often unknown, their treatments are debated and they are just downright complex.  Can you tell from this opening gambit how much fun I've had preparing today's battles?!  Hopefully I've whittled them down to digestible forms and have tried to give links if I've whittled away too much.  I've also thrown in aortic regurgitation for some light relief... when aortic regurgitation is light relief you know its going to be a bad day....

So here goes, and good luck!!

MRCP revision battle 22.1: Goodpasture's Syndrome
MRCP revision battle 22.2: Neurofibromatosis
MRCP revision battle 22.3: Tuberous sclerosis
MRCP revision battle 22.4: Fanconi anaemia
MRCP revision battle 22.5: Fanconi syndrome
MRCP revision battle 22.6: Aortic regurgitation
MRCP revision battle 22.7: Argyll Robertson Pupil

MRCP revision battle 22.1: Goodpasture's Syndrome 

Goodpasture's syndrome is a rare condition caused by anti GBM antibodies and is characterised by pulmonary haemorrhage and renal failure.

There is less than 1 case per million people per year.
Cases may be triggered by inhaled hydrocarbons, paraquat or viral infections.

Pulmonary haemorrhage is treated by plasma exchange
Renal involvement is treated by steroids, cyclophosphamide and plasma exchange.

Renal biopsy would show:
  • IgG on basement membrane
  • crescent formation

For the really keen:

1 random battle down, several more to go...