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βοΈβοΈ HEARTIEST CONGRATULATIONS βοΈβοΈ
To
Dr Mohammed Ahmed
For passing PACES MRCP ( UK ) from Oman.
We wish him the best for his future.
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*π IMPORTANT 308 π*
*A few investigations for Wilson,s Disease*
Urine: 24h copper excretion is high, eg >100mcg/24h (normal <40mcg).
Raised LFT
Serum copper: typically <11ΞΌmol/L.
Low Serum caeruloplasmin: <200mg/L (<140mg/L is pathognomonic)βbeware of incidental low values in protein-deficiency states (eg nephrotic syndrome, malabsorption)
Molecular genetic testing can confirm the diagnosis.
Slit lamp exam: KF rings: in iris/Descemetβs membrane
Liver biopsy: increased Hepatic copper (copper >250mcg/g dry weight); hepatitis; cirrhosis.
MRI: degeneration in basal ganglia, fronto-temporal, cerebellar, and brainstem
paceUrMRCP.
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*π IMPORTANT 307 π*
Please remember
To rule out *Wilson,s disease* in any young patient getting new onset of
1.CNS signs: ( tremor; dysarthria, dysphagia; dyskinesias; dystonias; dementia; Parkinsonism; ataxia/clumsiness )
and
2.Liver disease ( liver disease (hepatitis, cirrhosis, fulminant liver failure )
paceUrMRCP.
2 523
*π IMPORTANT 306 π*
Please remember
To use the word *PINS AND NEEDLES* to explain *TINGLING* to the patient.
paceUrMRCP.
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π IMPORTANT 305 π
Please remember
To use the word IMAGING for all the SCANS ( CT SCAN, MRI, PET SCAN etc )
Always tell the patient that we will arrange imaging for you to gain more info about your health condition.
paceUrMRCP.
2 523
π IMPORTANT 304 π
Please remember
BIOPSY
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient that we will do your SNIP TEST/WE WILL TAKE SNIP FROM YOUR BODY PART ( eg to send it to lab )
paceUrMRCP.
2 523
π IMPORTANT 303 π
Please remember
FIBROSIS
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient that you have SCARRING
of your body part ( eg lungs )
paceUrMRCP
2 523
*π IMPORTANT 302 π*
Please remember
*ECG*
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient that we will do *TRACING OF YOUR HEART BEAT*
paceUrMRCP.
2 523
*π IMPORTANT 301 π*
Please remember
*LAXATIVES*
might be considered as a Jargon by some examiners so please avoid using it.
Always tell the patient that we will give you *STOOL SOFTNERS*
paceUrMRCP.
2 523
*IMPORTANT 300*
*Few causes of Short stature in PACES*
Turner's
Achondroplasia
Hypothyroidism
Hypopituitarism
paceUrMRCP.
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*IMPORTANT 299* *
*Important points to remember about Charcot Marie Tooth Disease*
A champagne bottle appearance
B same stork legs
C pes cavus with hammer toes
E callosities and ulcer
F wasting of small muscle of hands claw hands Palpable nerves
Distal sensorimotor neuropathy
paceUrMRCP.
2 523
*IMPORTANT 298*
*Few features of Klinfelter Syndrome*
*K* - K(c)ryptochidism
*L* - Long legs / leydig cell hypertrophy
*I* - increased gonadotropins, infertility
*N* - narrow shoulders
*F* - failure of secondary sexual characters
paceUrMRCP.
2 523
*IMPORTANT 297* *
*Some features of Turner's syndrome
cardiac defects ( COA, Bicuspid aortic valve AS)
lymphedema
ovaries streak ( ameboorhea and sterility)
webbed neck
nipples widely spaced
Short stature
paceUrMRCP.
2 523
Cordial greetings to all colleagues
I hope this group has been helpful to you regarding your academics.
This group is meant for MRCP PACES specially however we do have separate groups for MRCP Part 1 and MRCP Part 2 so if any colleague is doing MRCP Part 1 or MRCP Part 2 please let me know by a personal message we can add them in respective groups
Thanks for joining
Good luck
2 523
*IMPORTANT 296*
*Few points for HOMOCYstinuria* ( a very close DD for Marfan Syndrome ) :
βHomocysteine
Osteoporosis
Marfanoid habitus
Ocular changes lens dislocation
Cardiovascular effects ( MVP,AR,MR)
kYphosis
Intellectual disability
paceUrMRCP.
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IMPORTANT 295
Rule of 10's for Pheochromocytomas:
10% malignant
10% bilateral
10% extra-adrenal
10% calcify
10% can affect kids
paceUrMRCP.
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IMPORTANT 294
Few Hs for Pheochromocytomas:
HTN
Hyperglycemia
Hypermetabolism
Hyperhidrosis
Headache
paceUrMRCP.
