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*๐ Two Conditions That Look Similar โ Bellโs Palsy vs Stroke*
(by pace your MRCP โ Dr Tanzeel Bukhari)
*1๏ธโฃ Bellโs 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
*2๏ธโฃ 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
*โญ๏ธ PACES Key Distinction:*
Forehead involvement = Bellโs palsy
Forehead sparing + other deficits = Stroke
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*๐ Data Interpretation Pearl 3 โ Interpreting a Low Haemoglobin with Normal MCV*
(by pace your MRCP โ Dr Tanzeel Bukhari)
*๐ What a NORMAL MCV should make you think of:*
*1๏ธโฃ Acute blood loss*
โ HB falls quickly but MCV remains normal initially.
โ Look for tachycardia, postural drop, GI symptoms.
*2๏ธโฃ Anaemia of chronic disease (ACD)*
โ Chronic inflammation โ impaired iron utilisation.
โ Ferritin normal or high, transferrin low.
*3๏ธโฃ Chronic kidney disease*
โ Low erythropoietin production.
โ Check creatinine, eGFR.
*4๏ธโฃ Mixed deficiencies*
โ Iron deficiency + B12/folate deficiency may normalise MCV.
โ Always look at RDW for variability.
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๐ IMPORTANT 797๐
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
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๐ IMPORTANT 796๐
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
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๐ IMPORTANT 795๐
Pneumocystis jirovecii ( PCP ) is the most common pneumocystis species affecting the humans
pace your MRCP-PACES
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๐ IMPORTANT 794๐
All patients with NAFLD should be screened and tested for CVS risk factors.
pace your MRCP-PACES
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๐ IMPORTANT 793๐
Perisinusidal fibrosis is a characteristic of NAFLD.
pace your MRCP-PACES
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๐ IMPORTANT 792๐
In NASH the histological findings are steotosis, hepatocellular injury and inflammation mainly in centrilobular acinar zone 3 distribution.
pace your MRCP-PACES
Available now! Telegram Research 2025 โ the year's key insights 
