pace your MRCP-PACES

👉 *IMPORTANT 509* 👈 *Few pearls about urine microscopy* *Crystals:* Crystals are common in old or cold urine and may not signify pathology. They are important in stone formers. • Uric acid—uric acid stones, tumour lysis syndrome. • Calcium oxalate—stones, high oxalate diet, ethylene glycol poisoning. • Cystine—seen in cystinuria. Good Luck

👉 *IMPORTANT 508* 👈 *Few pearls about urine microscopy* *Casts:* Casts are cylindrical bodies formed in the lumen of distal tubules. They are formed of Tamm-Horsfall protein combined with cells. • Hyaline cast —seen in normal urine. • Red cell cast —signify an inflammatory process in the glomerulus, eg glomerulonephritis. • White cell cast —pyelonephritis, interstitial nephritis , glomerulonephritis. • Granular cast —formed from degenerated tubular cells, seen in any chronic kidney disease. Good Luck

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr. Jerry John* For passing *PACES MRCP ( UK )* from India. He was with us in our batch of June-July 22 online course for PACES. We wish him the best for his future.

👉 *IMPORTANT 507* 👈 *Few pearls about urine microscopy* *Cells:* *Squamous epithelial cells:* Often seen, not pathological. Good Luck

👉 *IMPORTANT 506* 👈 *Few pearls about urine microscopy* *Cells:* *White blood cells:* >10 white cells/mm³ in an unspun specimen is abnormal. Causes include UTI, glomerulonephritis, tubulointerstitial nephritis, renal transplant rejection, and malignancy. Good Luck

👉 *IMPORTANT 505* 👈 *Few pearls about urine microscopy* *Cells:* *Red blood cells:* >2 red cells/mm³ is abnormal. Can come from anywhere in the urinary tract. Isomorphic red cells are similar to circulating red cells and may suggest bleeding from a genitourinary or external source. Dysmorphic red cells are abnormal in size/shape. Although they may in dicate bleeding from the glomerulus (especially in exam questions!), assessment is subjective and dysmorphism also occurs due to changes in pH, osmolality, protein, and due to tubular passage. Good Luck

ANNOUNCEMENT Hello n salam everyone Regarding our *Sep 2022 online course for PACES MRCP (UK) ( duration 15 days ).* starting from *12 Sep* till *28 Sep* All slots for active participants are fully occupied however *Listener slots still available* Interested candidates may send a personal message for details. WhatsApp No: 00923346036496. Email: drtanzeelbukhari@gmail.com GOOD LUCK.

Dear coalleagues I regret to inform you that our tomorrow,s weekly session has to be cancelled due to some unexpected travelling. I regret the inconvenience indeed. Our next session will be on 10 Sep, next Sunday Good Luck

👉 *IMPORTANT 504* 👈 *Famous CAGE Questionaire for Alcholism* C: Have you ever felt you should Cut down on your drinking? A: Have people Annoyed you by criticizing your drinking? G: Have you ever felt bad or Guilty about your drinking? E: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)? Two "yes" responses indicate that the possibility of alcoholism should be investigated further. In that situation, it would be nice to offer help as referring to (Alcohol cessation clinic/ Rehabilitation for alcoholism). Good Luck

👉 *IMPORTANT 503* 👈 *Few General Symptoms Symptoms for history taking* Rise in body temperature Tiredness Lumps or Bumps Weight loss/Gain Pallor Hair Loss, Excessive Hair GrowthRash Sleep Sweating Mood Appetite Good Luck

👉 *IMPORTANT 502* 👈 *Few Genito-Urinary Symptoms for history taking* Hesitancy, straining, poor flow, dribbling and sense of incomplete evacuation (Males) Passing less/more urine than usual (Polyuria/Oliguria) Burning pains with your water works (Dysuria) Change in color or smell of your water works Abnormal discharge from private areas What about your periods? Regular? Any problems? Problems with amounts or timings? When did you first start to have periods? Using any methods of contraception? Are you using the pill? (Females) Good Luck

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr. Majid Iqbal* For passing *PACES MRCP ( UK )* from UK. He had online personal coaching for PACES in July 22. We wish him the best for his future.

ANNOUNCEMENT Hello n salam everyone We are pleased to announce admissions for our *Sep 2022 online course ( 15 days ) for PACES MRCP (UK).* We will start from *12 Sep and finish on 28 September.* *Active slots available on first come--first served basis.* Listener slot available too. *60 Important exam cases ( including recent diets cases ) will be practiced and discussed as we do in our weekly general 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 501* 👈 *Few Rheumatological Symptoms for history taking* Joint pains; Analyze Joint Pains Number: No. Of Joint affected Deformity: present or absent Stiffness: Present or absent, if present for how long & when Swelling Symmetry Skin rash, Bruising, Acne Oral sores Morning stiffness of joints Skin tightness Muscle pains Muscle weakness Good Luck

👉 *IMPORTANT 500* 👈 *Few Endocrinology Symptoms for history taking* Intolerance to hot or cold weather Shoes size does it still fit, ring size does it still fit Weight gain/loss Bowel motions Abnormal pigmentations on your skin Any problems with sexual drive/intercourse Drinking more water than usual/passing more urine (water works) than usual Eating more than usual Good Luck

👉 *IMPORTANT 499* 👈 *Few Neurological Symptoms for history taking* Headaches, neck stiffness Dizziness Weakness of arms or legs Abnormal sensation in hands or feet like pins & needles. Handshakes Abnormal movements of arms or legs Gait disturbances/unsteadiness on your feet Fits, seizures Speech Visual disturbance Double vision Hearing problems Memory problems Confusion Autonomic Dysfuntion o Urinary Retention / Incontinence Constipation Impotence Good Luck

☝️ *IMPORTANT 35* ☝️ Please remember *RHEUMATOLOGIST* might be considered as a Jargon by some of the examiners so be careful while using it in exam and always say *JOINT DOCTOR / SPECIALIST* to your patient  Good luck.

☝️ *IMPORTANT 34* ☝️ Please remember For station 2 n 5 In a case of *antiphospholipid antibody syndrome conventional anticoagulants ( heparin and warfarin ) are still preferred for anticoagulation* otherwise now a days NOACS are preferred for anticoagulation whenever required. Good luck.

☝️ *IMPORTANT 33* ☝️ Please remember *CONTRACEPTIVE PILLS* ( ANY TYPE ) might be considered as a Jargon by some of the examiners so be careful while using it in exam and always say *BIRTH CONTROL PILLS* to your patient  Good luck.

☝️ *IMPORTANT 32* ☝️ Please remember For station 2 n 5 *Medicine history* is very important in all cases but it becomes more important when you have *calcium disorders* So always keep in mind that *THIAZIDE DIURETICS* can cause *HYPERCALCEMIA* If you find your patient is having high calcium levels and he is taking thiazide diuretics then you have to adress it, otherwise you loose marks in clinical judgement. Good luck.