Last-2-Weeks Strategy for Nephrology (MRCP Part 1)

TL;DR:

In your final 14 days before the exam you need a laser-focused last-2-weeks strategy for nephrology (MRCP Part 1) to maximise recall and accuracy. Prioritise the five highest-yield renal sub-topics, watch out for common traps, lock in performance with timed QBank and mock exams, and follow a structured revision checklist to stay calm and sharp.

Why this matters

The renal section in the MRCP Part 1 demands strong recall of physiology, pathophysiology, investigations and management of kidney disease, often under time pressure. With just two weeks left, broad reading won’t cut it — you must adopt a refined revision strategy to sharpen your exam performance. At Crack Medicine we’ve distilled this into a practical, high-yield blueprint to get you through this final run-in. By linking to major resources and focusing your time effectively you’ll move from overwhelmed to confident.

Scope of nephrology for MRCP Part 1

Whilst the depth of a renal sub-specialty exam may exceed what MRCP Part 1 demands, you’ll benefit from familiarising yourself with major themes. The renal specialty blueprint laid out by the The Federation of the Royal Colleges of Physicians UK shows high proportions of questions on glomerular disease, AKI/renal replacement, CKD and electrolyte disorders. Royal Colleges UK+1 For MRCP Part 1, your focus should be: physiology foundations, core kidney-clinical syndromes, investigations & decision-making — rather than rare syndromes. Solidify the high-yield rather than chase fringe topics.

High-Yield Nephrology Sub-topics

Here are five topic-areas you must prioritise in these final two weeks:

1. Acute Kidney Injury (AKI) & Fluid/Electrolyte/Acid-Base Disorders

   • Quickly recall definitions (e.g. KDIGO AKI stages) and differential of pre-renal vs intrinsic vs post-renal.

   • Practice urine indices (FENa, Uosm) and common electrolyte patterns (hyperkalaemia, metabolic acidosis) from reliable sources. Oxford Medical Education

   • Do timed MCQs on mixed electrolyte/acid-base cases.

2. Chronic Kidney Disease (CKD) & Complications

   • Focus on CKD staging, when to refer for renal replacement, and common complications (renal anaemia, bone-mineral disorder).

   • Create a one-pager summarising CKD complications and link to management pathways.

3. Glomerular Diseases (Nephritic & Nephrotic Syndromes)

   • Ensure you can contrast nephritic vs nephrotic presentation, key investigations (immunology, biopsy indications), and first-line treatments.

   • Use flow-charts to track “presentation → diagnosis → management”.

4. Hypertension, Renal & Renovascular Disease

   • Recall secondary hypertension causes (renal artery stenosis, fibromuscular dysplasia), management in renal context (ACE/ARB in CKD).

   • Practice questions that link hypertension, CKD progression & cardiovascular risk.

5. Renal Replacement Therapy (RRT) & Transplantation Basics

   • Know indications for dialysis initiation, compare haemodialysis vs peritoneal dialysis, common complications (e.g. peritonitis, access thrombosis).

   • Brush up transplant basics: contraindications, immunosuppression, post-transplant complications.

Quick study tips for each sub-topic

• AKI/fluids: Use flashcards of definitions (e.g. oliguria <0.5 mL/kg/h), draw fluid-balance diagrams, practise 20 timed QBank questions.

• CKD: Create a summary table of CKD stages, memorise key complications by category (bone, anaemia, cardiovascular).

• Glomerular: Make a table comparing nephrotic vs nephritic (proteinuria, haematuria, oedema, immunology).

• Hypertension/renal: Write a decision-tree: “Resistant HTN → suspect renovascular → investigation (renal Doppler/angiography) → management”.

• RRT/transplant: Sketch a flow-chart: “When to initiate dialysis → modality selection → complications → transplant evaluation”.

  
  

Your 2-Week Nephrology Revision Plan

Week	Day	Focus	Activity
Week 1	Day 1	AKI & fluid/electrolytes	Review key definitions + 30 timed QBank questions
	Day 2	CKD complications	One-page summary + 20 QBank questions
	Day 3	Glomerular disease	Compare nephrotic vs nephritic, draw table, 25 QBank questions
	Day 4	Hypertension & renal vascular	Concept map + 20 QBank questions
	Day 5	RRT & transplantation	Flow-chart + 20 QBank questions
	Day 6	Mixed revision	Timed mock (40 questions) on all renal topics
	Day 7	Error review & consolidation	Review all incorrect answers, revisit flashcards
Week 2	Day 8	AKI & fluid/electrolytes	Rapid 15-question timed set + key trap review
	Day 9	CKD & glomerular overlap	Mixed 25 questions + high-yield comparison
	Day 10	Hypertension/renal + transplant	20 questions + complication mind-map
	Day 11	Full renal timed mock	50 questions in one block under timed conditions
	Day 12	Error review & weak-area blitz	Identify weakest 10 topics and rapid review
	Day 13	Final mixed revision	30 questions + summary sheet, light reading only
	Day 14	Rest & light review	Quick flashcards in morning, early sleep, prepare mindset

How to use a QBank & Mock Tests Effectively

• Always use timed mode in your question bank to simulate exam conditions — pacing is key.

• After each session, thoroughly review every error: ask yourself why you picked the wrong answer and verbalise the correct rationale.

• Maintain an error-log (e.g. spreadsheet or flashcard deck) of weak topics — revisit next morning.

• Use full-length mock exams in the final week to build stamina and reduce exam anxiety.

• Map your performance analytics (percentage correct per sub-topic) to your revision plan: if electrolyte questions are weak, allocate an extra session accordingly.

• Note: In the Crack Medicine app you’ll find subject-wise QBank for nephrology, over 10 mock tests per system, monthly new mock releases, detailed performance analytics and explanation videos coming soon.

• After each mock, spend at least as long reviewing errors as you spent answering questions — learning from mistakes is what improves performance.

  
  

Practical Example / Mini-Case

MCQ: A 56-year-old man with known hypertension and type 2 diabetes presents with a rise in creatinine from 120 µmol/L to 240 µmol/L in 48 hours. Urine output is 450 mL in 24 hours. Urine microscopy shows granular casts; fractional excretion of sodium (FENa) is 2.8 %.Which is the most likely cause of his acute kidney injury?A. Pre-renal azotaemia due to dehydrationB. Acute tubular necrosis (ATN)C. Obstructive uropathyD. Vasculitis with glomerular injuryE. Acute interstitial nephritis

Answer: B. Acute tubular necrosis Explanation: The FENa >2 % and presence of granular casts point to intrinsic tubular injury rather than pre-renal azotaemia (which typically has FENa <1 % and bland casts). Here the rapid creatinine rise, low urine output and granular casts are classic for ATN — a high-yield pattern in the AKI/fluids section of MRCP Part 1.Exam flashpoint: Recognise the triad: acute rise, granular casts, FENa >2 % → intrinsic AKI.

Common Pitfalls & Fixes

• Pitfall: Spending time on rare renal syndromes at the expense of core material. Fix: Stick strictly to the five core sub-topics above in the last two weeks.

• Pitfall: Doing question sets without error review. Fix: After each session allocate separate time purely for reviewing mistakes and converting them into flash-cards.

• Pitfall: Memorising lists without understanding flow of decision-making. Fix: Use flow-charts and verbalise pathways aloud (“if this, then this, then that”).

• Pitfall: Ignoring exam stamina and timing until too late. Fix: Build in full timed mocks no later than day 10 of your schedule.

• Pitfall: Over-cramming in the final day and exhausting yourself. Fix: Use the last day primarily for light review, flash-cards, and early sleep.

  
  

FAQs

Q: How many questions on nephrology can I expect in MRCP Part 1?

A: There is no precise breakdown publicly released for MRCP Part 1, but the renal specialty blueprint suggests significant weighting for AKI/fluid-electrolytes and glomerular disease. Royal Colleges UK+1

Q: Should I cover rare renal diseases like Alport syndrome at this stage?

A: Only if you already have strong foundations; in the last two weeks your time is better spent consolidating high-yield topics.

Q: When should I schedule mock exams in my final 14-day window?

A: Ideally one full mock in week 1 (Day 6) and another in week 2 (Day 11) as per the table above — use the intervening days for error review and sub-topic blitzing.

Q: Can online free resources replace structured lectures for nephrology revision?

A: Yes, provided you commit to disciplined timed practice and error review; but structured lectures (such as those in the lectures section) add value for conceptual clarity.

Q: What’s the top mindset tip for the renal section of MRCP Part 1?

A: Approach each question with the mindset: “Diagnosis → Investigations → Management” and actively ask yourself “what’s the next best step?” in each stem.

Ready to start?

You now have a comprehensive last-2-weeks strategy for nephrology (MRCP Part 1) — high-yield topics, trap watch, structured revision schedule, and QBank tactics. Next, go and work through the Free MRCP MCQs to sharpen your timing, use the Start a mock test section under timed conditions, and if you prefer guided teaching check out our lectures for structured renal modules. Stay consistent, rest well, and walk into the exam hall calm, prepared and confident.

Sources

• The Federation of the Royal Colleges of Physicians of the UK: Nephrology sample questions. Royal Colleges UK+1

• The Federation: Specialty Certificate Examination in Nephrology Blueprint. Royal Colleges UK+1

• Oxford Medical Education – Questions about acute kidney injury. Oxford Medical Education

• GMC/UK Kidney Association: Renal Medicine Curriculum 2022. gmc-uk.org