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pace your MRCP-PACES

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Photo from Dr Tanzeel Bukhari
Photo from Dr Tanzeel Bukhari

Photo from Dr Tanzeel Bukhari
Photo from Dr Tanzeel Bukhari

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*🔍 Two Conditions That Look Similar – Bell’s Palsy vs Stroke* (by pace your MRCP – Dr Tanzeel Bukhari) *1️⃣ Bell’s Palsy (LMN Facial Weakness)* Sudden onset unilateral facial paralysis Forehead is affected (cannot raise eyebrow) No limb weakness May have hyperacusis, taste disturbance Often idiopathic or post-viral Recovery usually good with steroids *2️⃣ Stroke (UMN Facial Weakness)* Facial weakness + other neurological deficits (limb weakness, speech issues) Forehead spared (patient can wrinkle the forehead) Onset usually abrupt Requires urgent CT head Treat according to stroke protocol *⭐️ PACES Key Distinction:* Forehead involvement = Bell’s palsy Forehead sparing + other deficits = Stroke

*📊 Data Interpretation Pearl 3 – Interpreting a Low Haemoglobin with Normal MCV* (by pace your MRCP – Dr Tanzeel Bukhari) *🔍 What a NORMAL MCV should make you think of:* *1️⃣ Acute blood loss* — HB falls quickly but MCV remains normal initially. — Look for tachycardia, postural drop, GI symptoms. *2️⃣ Anaemia of chronic disease (ACD)* — Chronic inflammation → impaired iron utilisation. — Ferritin normal or high, transferrin low. *3️⃣ Chronic kidney disease* — Low erythropoietin production. — Check creatinine, eGFR. *4️⃣ Mixed deficiencies* — Iron deficiency + B12/folate deficiency may normalise MCV. — Always look at RDW for variability.

👉 IMPORTANT 797👈 The PCP organism can not be cultured so the definitive diagnosis depends upon the demonstration of the organism in respiratory specimen using specific strains eg immunofluorescence or silver staining pace your MRCP-PACES

👉 IMPORTANT 796👈 In HIV patients the risk of pneumocystis Jiroveci increases with the fall in CD 4 count and most cases occur when the CD4 count is less than 200/mcL pace your MRCP-PACES

👉 IMPORTANT 795👈 Pneumocystis jirovecii ( PCP ) is the most common pneumocystis species affecting the humans pace your MRCP-PACES

👉 IMPORTANT 794👈 All patients with NAFLD should be screened and tested for CVS risk factors. pace your MRCP-PACES

👉 IMPORTANT 793👈 Perisinusidal fibrosis is a characteristic of NAFLD. pace your MRCP-PACES

👉 IMPORTANT 792👈 In NASH the histological findings are steotosis, hepatocellular injury and inflammation mainly in centrilobular acinar zone 3 distribution. pace your MRCP-PACES

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