MRCPI GM Part I study guide
MRCPI GM Part I · Work through your exam, one topic at a time.
The MRCPI General Medicine Part I - formally Membership of the Royal College of Physicians of Ireland, General Medicine, Part I - is the first written component of RCPI's membership pathway in adult internal medicine. It is intended for doctors in basic specialist training, or equivalent hospital posts, who already have practical ward experience and are now consolidating the knowledge base they will need for higher specialist training. The MRCPI GM Part I study guide has 12 sections and about 3,449 words.
01Cardiology
Distinguish STEMI (ST elevation in contiguous leads, or posterior MI shown by V1–V3 depression) from NSTEMI/unstable angina, where troponin and risk scores drive the timing of angiography. Learn territory-to-artery mapping: II/III/aVF inferior (RCA), V1–V4 anterior (LAD), I/aVL/V5–V6 lateral (circumflex).
321 words, about 2 min02Respiratory Medicine
Spirometry defines disease: asthma shows reversibility (FEV1 rise 12% and 200 mL), while COPD shows a post-bronchodilator FEV1/FVC below 0.70. Recognise life-threatening asthma: silent chest, exhaustion, cyanosis, PEF under 33%, normal or rising PaCO2 in a breathless patient.
296 words, about 1 min03Gastroenterology and Hepatology
Separate hepatocellular injury (ALT/AST predominant, over 1000 IU/L in paracetamol toxicity, viral hepatitis or ischaemia) from cholestatic injury (ALP and GGT predominant: obstruction, PBC, PSC, drugs). Remember that ALT is not a liver function test - synthetic function is judged by bilirubin, INR and albumin.
288 words, about 1 min04Endocrinology and Diabetes Mellitus
Diabetic ketoacidosis shows hyperglycaemia, ketonaemia and acidosis (pH <7.3, bicarbonate <15); hyperosmolar hyperglycaemic state shows glucose above 30 mmol/L, osmolality above 320 mOsm/kg and minimal ketosis, with higher mortality. Give fluids first, check potassium before insulin, and replace potassium once below 5.5 mmol/L; do not give routine bicarbonate.
298 words, about 1 min05Nephrology and Fluid/Electrolyte Disorders
KDIGO defines AKI as a creatinine rise of at least 26 µmol/L within 48 hours, or 1.5 times baseline within 7 days, or urine output below 0.5 mL/kg/hour for 6 hours. Distinguish prerenal, intrinsic and post-renal causes; a bladder scan and catheter relieve obstruction, while urine sodium below 20 mmol/L, fractional excretion of sodium below 1% and urine osmolality above 500 suggest a prerenal state - but these indices mislead in sepsis, CKD, diuretic use and contrast nephropathy.
307 words, about 2 min06Neurology
Intravenous thrombolysis is licensed within 4.5 hours of onset and mechanical thrombectomy for large vessel occlusion within 6 hours (selected patients up to 24 hours). Immediate CT excludes haemorrhage; check glucose before thrombolysis.
286 words, about 1 min07Rheumatology and Musculoskeletal Medicine
Rheumatoid arthritis is symmetrical, affects small joints and causes morning stiffness over an hour; anti-CCP is more specific than rheumatoid factor. Start methotrexate early with folic acid cover, checking baseline bloods, renal and liver function, and hepatitis serology.
285 words, about 1 min08Haematology
Classify by MCV and use the reticulocyte count to separate underproduction from loss or haemolysis. Iron deficiency gives low ferritin, low MCV, high TIBC and high RDW; anaemia of chronic disease gives normal or high ferritin with low TIBC and low transferrin saturation.
272 words, about 1 min09Infectious Diseases and Clinical Microbiology
Recognise sepsis early, take cultures, measure lactate and give broad-spectrum antibiotics within one hour, with 30 mL/kg crystalloid for hypotension or high lactate, and vasopressors to keep mean arterial pressure at 65 mmHg or above. Do not delay antibiotics for lumbar puncture when there are signs of raised intracranial pressure or focal neurology - image first, and give dexamethasone with or just before the first antibiotic dose in suspected bacterial meningitis.
283 words, about 1 min10Clinical Pharmacology and Therapeutics
For first-order drugs a constant fraction is eliminated per unit time, so half-life determines time to steady state (about 4–5 half-lives), and loading dose = volume of distribution × target concentration while maintenance dose = clearance × target concentration. Zero-order kinetics (phenytoin, ethanol, high-dose salicylate) means a small dose increase produces a disproportionate rise in level.
278 words, about 1 min11Geriatric and General Internal Medicine
The comprehensive geriatric assessment - medical, functional, cognitive, psychological and social domains - improves outcomes more than any single intervention. Assess falls with a multifactorial review: medications (sedatives, antihypertensives, anticholinergics), vision, footwear, gait, arrhythmia and postural blood pressure.
263 words, about 1 min12Clinical Sciences (pathophysiology, biochemistry, genetics, immunology, statistics)
Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP). Positive predictive value = TP/(TP+FP) and is heavily dependent on prevalence, whereas sensitivity and specificity are not.
272 words, about 1 min