pace your MRCP-PACES

👉 *IMPORTANT 169* 👈 *ECG and Brugada Syndrome ( Autosomal Dominant ) :* You may find • convex ST elevation in V1–V3 • partial RBBB • ECG changes are absent at rest may be unmasked by sodium channel blockers, e.g. Flecainidine Good luck.

👉 *IMPORTANT 168* 👈 *ECG and hypothermia* You may find in ECG during hypothermia • LQTS. • Bradycardia. • First degree heart block. • Atrial and ventricular arrhythmia. • J wave at end of QRS complex. Good luck.

👉 *IMPORTANT 167* 👈 *Some causes of prolonged PR interval* • Idiopathic. • Hypokalaemia. • Digoxin toxicity. • Myotonic dystrophy. • Aortic root abscess. • Sarcoidosis. • Lyme disease. Good luck.

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👉 *IMPORTANT 166* 👈 Some causes of Long QT : • congenital – which are: – Jervell-Lange-Nielsen ( Autosomal recessive, associated with deafness) – Romano-Ward ( Autosomal dominant ) • drugs – Amiodarone, Sotalol, TCA, Chloroquine, Erythromycin, Antipsychotics, Antihistamine (if given with cP450 inhibitors) • electrolytes – hypokalaemia, hypocalcaemia, hypomagnesaemia • others – Subarchnoid Haemorrhage, hypothermia, Myicardial Infarction, myocarditis. Good luck.

👉 *IMPORTANT 165* 👈 *The causes of hypoglycemia in non diabetics* *EXPLAIN* *E* *x* ogenous drugs, eg insulin, oral hypoglycaemics, alcohol, eg a binge with no food; aspirin poisoning; ACE-i; B-blockers; pentamidine; quinine sulfate; aminoglutethamide; insulin-like growth factor. *P* ituitary insufficiency. *L* iver failure *A* ddison’s disease *I* slet cell tumours (insulinoma) and immune hypoglycaemia (eg anti-insulin receptor antibodies in Hodgkin’s disease). *N* on-pancreatic neoplasms, eg fibrosarcomas and haemangiopericytomas. Good luck.

👉 *IMPORTANT 164* 👈 Please remember that all forms of diabetes carry an increased risk to mother and fetus Like : Miscarriage, pre-term labour, pre-eclampsia, congenital malformations, macrosomia, and a worsening of diabetic complications, eg retinopathy, nephropathy. Good luck.

👉 *IMPORTANT 163* 👈 Please remember that typical symptoms of polydipsia, polyuria and weight loss are more common with Type 1 DM. Good luck.

👉 *IMPORTANT 162* 👈 *Some causes of Diabetes Mellitus* Steroids Anti-HIV drugs Newer antipsychotics Pancreatitis; surgery (where >90% pancreas is removed) Haemochromatosis Cystic fibrosis Pancreatic cancer Cushing’s disease Acromegaly Phaeochromocytoma Hyperthyroidism Pregnancy. Good luck.

👉 *IMPORTANT 161* 👈 *Thyrotoxicosis in a glimpse* : Hair loss pretibial myxoedema Acropachy bulging eyes (exophthalmos/proptosis) Tachycardia Sweating Palmer erythema Tremers Proximal myopathy Diarrhea Good luck.

👉 *IMPORTANT 160* 👈 *Some causes of bilateral hilar lymphadenopathy* Sarcoidosis Infection, eg TB, mycoplasma Malignancy, eg lymphoma, carcinoma,mediastinal tumours Organic dust disease, eg silicosis, berylliosis Hypersensitivity pneumonitis Histocytosis X (Langerhan’s cell histiocytosis). Good luck.

👉 *IMPORTANT 159* 👈 Be careful in Steroid use in Scleroderma as it is known to precipitate scleroderma renal crisis Good luck.

👉 *IMPORTANT 158* 👈 *Few steps in the mangement of obstructive sleep apnoea* : Weight loss CPAP is first line for moderate and severe OSA Intraoral devices ( Mandibular advancement ) If CPAP is not tolerated Uvulopalatophrngraphy Tracheostomy is last resort Good luck.

ANNOUNCEMENT Hello n salam everyone We are pleased to announce admissions for our *Dec 2022 online course ( 15 days ) for PACES MRCP (UK).* We will start from *5 Dec and finish on 24 Dec.* *Active slots available on first come--first served basis.* Listener slot available too. *Atleast 90 Important exam cases ( including recent diets cases ) will be practiced and discussed as we do in our weekly Sunday sessions.* After the performance a detailed feedback will be given to elaborate the weak skills. It is equally beneficial for those who are beginners or have exam in coming diet. Interested candidates may send a personal message for details. WhatsApp No: 00923346036496. Email: drtanzeelbukhari@gmail.com GOOD LUCK.

Dear all I regret to inform you that our session for tomorrow is cancelled due to some family commitments and travelling. Our next session will be on 4 Dec 22 if all goes well. I am sorry for any inconvenience. Good luck

👉 *IMPORTANT 157* 👈 Never miss to mention monitoring of Forced Vital Capacity in GBS what ever is the station. Good luck.

👉 *IMPORTANT 156* 👈 Please remember Ideally the patient should avoid smoking,caffeine, or exercise for 30 minutes prior to measurement of blood pressure. Good luck.

👉 *IMPORTANT 155* 👈 *Some drugs associated with weight gain* : Tricyclic antidepressants Insulin and sulfonylurea Contraceptives Glucocorticoids Progestational steroids Mirtazapine and paroxetine Gabapentin and valproate Propranolol Good luck.

ANNOUNCEMENT Hello n salam everyone We are pleased to announce admissions for our *Dec 2022 online course ( 15 days ) for PACES MRCP (UK).* We will start from *5 Dec and finish on 24 Dec.* *Active slots available on first come--first served basis.* Listener slot available too. *Atleast 90 Important exam cases ( including recent diets cases ) will be practiced and discussed as we do in our weekly Sunday sessions.* After the performance a detailed feedback will be given to elaborate the weak skills. It is equally beneficial for those who are beginners or have exam in coming diet. Interested candidates may send a personal message for details. WhatsApp No: 00923346036496. Email: drtanzeelbukhari@gmail.com GOOD LUCK.

👉 *IMPORTANT 151* 👈 *Symptoms indicating lower probability of asthma* Prominent dizziness, lightheadedness, tingling Chronic productive cough with no wheeze Normal examination when symptomatic Change in voice Symptoms with colds only Cardiac diseaae Significant smoking history (>20 pack year) Normal PEF when symptomatic Good luck.