MRCP revision battle 56.1: Amyloidosis
MRCP revision battle 56.2: Plasma exchange
MRCP revision battle 56.3: P450 inducers and inhibitors
MRCP revision battle 56.4: Therapeutic drug monitoring
MRCP revision battle 56.5: Vaccines
MRCP revision battle 56.6: Acute lymphoid leukaemia
MRCP revision battle 56.7: Nematodes = roundworms
MRCP revision battle 56.1: Amyloidosis
Amyloidosis is a pathological process characterised by extracellular accumulation of fibrils of insoluble protein.
Inherited forms of amyloidosis are rare but amyloid deposition is central to many diseases including Alzheimers and type 2 diabetes.
Types of amyloid:
1: AL = light chains
- secreted by plasma B cells
- occurs in 15% of myeloma patients
- also occurs in:
- Waldenstroms
- MGUS
- features:
- cardiac deposition = 'sparkling' appearence on echo
- GI
- macroglossia
- peri orbital
- median survival is 12 months
- treatment is to treat the underlying condition, ?prednisolone
2: AA = serum amylase A
- this is secondary amyloidosis, with the amyloid derived from serum amylase A which is an acute phase protein
- seen in:
- RA
- TB
- bronchiectasis
- familial med fever
- IBD
- commonest organ involved = kidney (congo red stain -->red-green birefrigence under polarised light)
- median survival is 24 months
3:
