pace your MRCP-PACES

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Arooj* For passing *PACES MRCP ( UK )* from Pakistan. She has been a keen member of our PACES group. We wish her the best for her future.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr. Esraa Soliman* For passing *PACES MRCP ( UK )* from Egypt. She was with us in our batches of Oct 21 and April 22 online course for PACES. We wish her the best for her future.

*👉 IMPORTANT 444👈* *Few signs of decompensation of CLD: (and how to check for them)* Jaundice (skin and sclera) Ascites (abdominal distension, fluid wave,shifting dullness) Splenomegaly/caput medusa Encephalopathy (make sure you check for hepatic flap) Good Luck.

*👉 IMPORTANT 443👈* In every case of chronic liver disease , please try to comment • whether the disease is compensated or decompensated Good Luck.

*👉 IMPORTANT 442👈* *most common pathogens causing infective exacerbations in COPD patients* • Haemophilus influenza • Streptococcus pneumonia • Moraxella catarrhalis. Good Luck.

*👉 IMPORTANT 441👈* *Scar for lung transplant* If the trachea is not deviated to the scar site, and the breath sounds are normal on the scar side, whereas you can identify abnormal breathing sounds on the other side, consider single lung transplant. Good Luck.

*👉 IMPORTANT 440👈* *Signs suggestive of pulmonary hypertension and cor pulmonale:* • Raised JVP with tall V waves • Left parasternal heave • Loud P2 component of second heart sound • Peripheral oedema (pedal oedema/sacral oedema). Good Luck.

*👉 IMPORTANT 439👈* *Tip for respiratory case* Before examining a patient in the respiratory station, spend a few seconds looking around the room for clues to the diagnosis (oxygen, inhalers, sputum pots). In a case of bronchiectasis, the clue would be a sputum pot. If you see a sputum pot, ask the patient to cough. In bronchiectasis, the cough will probably be productive. Good Luck.

*👉 IMPORTANT 438👈* *Tip for inspection of respiratory case* After scanning the room, check the patient’s breathing. Stand at the end of the bed and observe the patient at rest to assess their respiratory rate and breathing pattern. Observe both inspiratory and expiratory phases (patients with airflow obstruction may have prolonged expiration). Then ask the patient to take a deep breath to emphasize any asymmetry in chest expansion. Good Luck.

*👉 IMPORTANT 437👈* Please consider Lung transplant in younger patients with IPF. Good Luck.

*👉 IMPORTANT 436👈* Please remember Every IPF patients should be offered pulmonary rehabilitation. Good Luck.

*👉 IMPORTANT 435👈* Nintedanib is a tyrosine kinase inhibitor that slows the rate of lung function decline in IPF patients. It is licenced in the United States, but not yet available in the United Kingdom for general use. Good Luck.

*👉 IMPORTANT 434👈* Pirfenidone is a novel antifibrotic drug that slows the rate of lung function decline in idiopathic pulmonary fibrosis patients. It is licenced in the United Kingdom for patients with a forced vital capacity (FVC) of 50–80%. Good Luck.

*👉 IMPORTANT 433👈* *Face and Neck in Abdominal station* Tattoes = CLD Good Luck.

*👉 IMPORTANT 432👈* *Face and Neck in Abdominal station* Spider Nevi = CLD Good Luck.

*👉 IMPORTANT 431👈* *Face and Neck in Abdominal station* Jaundice = CLD , Chronic Hemolytic Anemia Good Luck.

*👉 IMPORTANT 430👈* *Face and Neck in Abdominal station* SLE Rash = Autoimmune hepatitis, Renal Failure Good Luck.

*👉 IMPORTANT 429👈* *Face and Neck in Abdominal station* Cushingoid Face = Steroids Use = Auto-Immune Hepatitis , Sarcoidosis , Renal Transplant Cushing`s Syndrome Good Luck.

*👉 IMPORTANT 428👈* *Face and Neck in Abdominal station* Temporalis Wasting = CLD Good Luck.

*👉 IMPORTANT 427👈* *Face and Neck in Abdominal station* Parotid Enlargement = CLD, Sarcoidosis Good Luck.