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*Announcement for Online Session No 75* *18 Dec 2022* DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : *Today we will have an online session on Zoom discussing 1 station 2 ( History taking )* regarding our preparation for MRCP PACES ( UK ) TIMINGS : Saudia Arabia: 4 pm Pakistan : 6 pm Bangladesh : 7 pm India : 6 30 pm Singapore : 9 pm Hong Kong : 9 pm Malaysia : 9 pm Egypt : 3 pm Libya : 3 pm Bahrain : 4 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 pm UAE : 5 pm UK : 1 00 pm Ireland ( Dublin ) : 1 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 3 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 3 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 3 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am ( please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. The candidate for this session has been selected. GOOD LUCK.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Umar Iftikhar* For passing *PACES MRCP UK* from UK. He was with us in our batches for online prepration for PACES in Oct and Nov 22. We wish him the best for his future.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Sohail* For passing *CLINICAL EXAM MRCP IRELAND* from KSA. He took personal sessions for online prepration for CLINICAL EXAM MRCP IRELAND in Feb 22. We wish him the best for his future.

The slot for tomorrow's session is occupied now Good luck

*Announcement for Online Session No 75* *18 Dec 2022* DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : *Tomorrow we will have an online session on Zoom discussing 1 station 2 ( History taking )* regarding our preparation for MRCP PACES ( UK ) TIMINGS : Saudia Arabia: 4 pm Pakistan : 6 pm Bangladesh : 7 pm India : 6 30 pm Singapore : 9 pm Hong Kong : 9 pm Malaysia : 9 pm Egypt : 3 pm Libya : 3 pm Bahrain : 4 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 pm UAE : 5 pm UK : 1 00 pm Ireland ( Dublin ) : 1 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 3 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 3 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 3 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am ( please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. Interested candidate may send a personal message to take the slot GOOD LUCK.

👉 *IMPORTANT 202* 👈 Always suspect pituitary apoplexy if there is an acute onset of headache, meningism, decreased GCS, ophthalmoplegia/visual field defect, especially in a known case of pituitary tumour (it may present like subarachnoid haemorrhage). Good luck.

👉 *IMPORTANT 201* 👈 Please remember that in any case involving pituitary gland try to rule out 3 types of symptoms 1.the symptoms caused by local pressure, 2. The symtoms caused by oversecretion of hormones (eg galactorrhoea) 3. The symtoms caused by hypopituitarism Good luck.

👉 *IMPORTANT 200* 👈 *Some features of local pressure from pituitary tumors* Headache visual field defects (bilateral temporal hemianopia, due to compression of the optic chiasm) Palsy of cranial nerves III, IV, VI (pressure or invasion of the cavernous sinus ) Diabetes insipidus (DI) (more likely from hypothalamic disease) Disturbance of hypothalamic centres of sleep, and appetite Erosion through floor of sella leading to CSF rhinorrhoea. Good luck.

👉 *IMPORTANT 199* 👈 *Some medicines which may cause impotence* digoxin, B-blockers, diuretics, antipsychotics, antidepressants, oestrogens, finasteride, narcotics. Good luck.

👉 *IMPORTANT 198* 👈 In any case of Impotence always remember the big three ( along with other causes ) 1.Smoking 2.Alcohol 3.Diabetes Good luck.

👉 *IMPORTANT 197* 👈 *Some causes of gynaecomastia* Causes: Hypogonadism Liver cirrhosis (toestrogens) Hyperthyroidism Tumours (oestrogen-producing, eg testicular, adrenal; HCG-producing, eg testicular, bronchial); Drugs: oestrogens, spironolactone, digoxin, marijuana. Good luck.

👉 *IMPORTANT 196* 👈 *Some factors that can trigger attack of phaeochromocytoma* straining, exercise, stress, abdominal pressure, surgery, or agents such as p-blockers, IV contrast agents, or the tricyclics. Good luck.

👉 *IMPORTANT 195* 👈 *Always think of Conn's in these contexts:* • Hypertension associated with hypokalaemia. • Refractory hypertension, eg despite more than 3 antihypertensive drugs. • Hypertension occurring before 40yrs of age (especially in women). Good luck.

👉 *IMPORTANT 194* 👈 *Classic triad of phaeochromocytoma* Episodic headache sweating tachycardia With increased BP. Good luck.