pace your MRCP-PACES

*👉 IMPORTANT 320 👈* *LFTs in cholestasis predominant liver injury* ALP and GGT are markedly raised While AST and ALT are mildly raised paceUrMRCP.

*👉 IMPORTANT 319 👈* *LFTS in Alcoholic liver disease:* AST/ALT ratio is typically 2:1 or more. When the history is not reliable, normal ALP, raised GGT, and macrocytosis suggest this condition. paceUrMRCP.

*👉 IMPORTANT 318 👈* *Tests of hepatic function* Serum albumin Serum bilirubin PT (INR). paceUrMRCP.

✌️✌️ HEARTIEST CONGRATULATIONS ✌️✌️ To Dr Daphnie For passing PACES MRCP ( UK ) from Malaysia. She is our 200th candidate to pass PACES. We wish her the best for her future.

✌️✌️ HEARTIEST CONGRATULATIONS ✌️✌️ To Dr Stephen Ponnampalam For passing PACES MRCP ( UK ) from Malaysia. We wish him the best for his future.

*👉 IMPORTANT 317 👈* *Tests of hepatocellular injury or cholestasis* *Aminotransferases:* (AST, ALT) Released in the bloodstream after hepatocellular injury. ALT is more specific for hepatocellular injury (but also expressed in kidney and muscle). AST is also expressed in the heart, skeletal muscle, and RBCS. *Alkaline phosphatase:* May originate from liver, bone (so raised in growing children) or placenta. *Gamma-glutamyltransferase* (GGT): Present in liver, pancreas, renal tubules, and intestine—but not bone, so it helps tell if a raised ALP is from bone (GGT = normal) or liver (GGT = increased). It is not specific to alcohol damage to the liver. paceUrMRCP.

*👉 IMPORTANT 316 👈* Combined symptoms from Respiratory system and Liver in a young adult should prompt your brain towards alpha 1 antitrypsin defeciency which has appeared in PACES paceUrMRCP.

*👉 IMPORTANT 315 👈* Hereditary Haemochromatosis if cirrhotic then screen for HCC with ultrasound ± AFP twice-yearly. paceUrMRCP.

*👉 IMPORTANT 314 👈* In Hereditary Haemochromatosis joints, liver, heart, pancreas, pituitary, adrenals, and skin are most commonly affected so focus on symptoms associated with these organs in your history taking. paceUrMRCP.

*👉 IMPORTANT 313 👈* *Hidden agenda in a case of Haemochromatosis.* Please notice that patients with haemochromatosis should avoid uncooked seafood as it may contain bacteria that thrive on increased plasma iron concentrations, eg Listeria monocytogenes, Vibrio vulnificus so there is an increased risk of infection from these bacteria. paceUrMRCP.

*👉 IMPORTANT 312 👈* *Hidden agenda in a case of Haemochromatosis.* Please notice that patient with haemochromatosis may be taking over the counter multivitamins. You must stop these as they may contain Iron. Failure in doing so will result in less score in Clinical Judgement. paceUrMRCP.

*👉 IMPORTANT 311 👈* Newly diagnosed Diabetes in a young male with sexual dysfunction should prompt your mind to think about Haemochromatosis. paceUrMRCP.

*👉 IMPORTANT 310 👈* *Treatment options for Wilson,s disease* 1. Life long pencillamine 2. Liver transplant ( if required ) paceUrMRCP.

*👉 IMPORTANT 310 👈* *Treatment options for Wilson,s disease* 1. Life long pencillamine 2. Liver transplant ( if required ) paceUrMRCP.

*👉 IMPORTANT 309 👈* *Few general measures to be mentioned in the anagement of Wislon,s disease* Avoid foods with high copper content (eg liver, chocolate, nuts, mushrooms, legumes, and shellfish). Check water sources (eg wells, pipes) for copper. paceUrMRCP.

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Announcement for Online Session No 109 07 Jan 2024 DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : Today we will have an online session on Zoom discussing 1 Communication Station regarding our preparation for MRCP PACES ( UK ) and MRCPI ( Ireland ) The candidate for this session has been selected. TIMINGS : Saudia Arabia: 4 00 pm Pakistan : 6 00 pm Bangladesh : 7 00 pm India : 6 30 pm Singapore : 9 00 pm Hong Kong : 9 00 pm Malaysia : 9 00 pm Egypt : 3 00 pm Libya : 3 00 pm Bahrain : 4 00 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 00 pm UAE : 5 00 pm UK : 1 00 pm Ireland ( Dublin ) : 1 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 2 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 2 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 2 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am Kuwait : 4 00 pm Sri Lanka : 6 30 pm Somalia : 4 00 pm Zimbabwe : 3 00 pm China ( Beijing ) : 9 00 pm Australia ( Sydney) : 12 00 am ( please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. GOOD LUCK.

Announcement for Online Session No 109 07 Jan 2024 DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : Tomorrow we will have an online session on Zoom discussing 1 Clommunication Station regarding our preparation for MRCP PACES ( UK ) and MRCPI ( Ireland ) Interested candidate may send a personal message to take the case. TIMINGS : Saudia Arabia: 4 00 pm Pakistan : 6 00 pm Bangladesh : 7 00 pm India : 6 30 pm Singapore : 9 00 pm Hong Kong : 9 00 pm Malaysia : 9 00 pm Egypt : 3 00 pm Libya : 3 00 pm Bahrain : 4 00 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 00 pm UAE : 5 00 pm UK : 1 00 pm Ireland ( Dublin ) : 1 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 2 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 2 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 2 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am Kuwait : 4 00 pm Sri Lanka : 6 30 pm Somalia : 4 00 pm Zimbabwe : 3 00 pm China ( Beijing ) : 9 00 pm Australia ( Sydney) : 12 00 am ( please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. GOOD LUCK.