pace your MRCP-PACES

IMPORTANT 18 Please remember ENZYME/ENZYMES is considered as Jargons by most of the examiners so always say PROBLEM IN LEVEL OF SOME SALT/SALTS IN YOUR BODY to your patient pace your MRCP-PACES.

IMPORTANT 17 Please remember: HOW TO ASK SYMPTOM OF PENILE DISCHARGE IN GENITOURINARY SYSTEM.. Always take permission before these questions ( like if you don't mind may I ask you some personal questions ) Then ask your patient: DO YOU HAVE ANY DISCHARGE FROM YOUR PRIVATE PARTS. please remember that GENETELIA are called as PRIVATE PARTS ( atleaast in exam) pace your MRCP-PACES.

IMPORTANT 16 Please remember: HOW TO ASK SYMPTOM OF REGURGITATION IN GIT SYSTEM.. Always ask your patient: DO YOU HAVE ANY BAD TASTE OR FOUL SMELLING TASTE IN YOUR MOUTH. pace your MRCP-PACES.

*🩺 Symptom Snapshot 21 – Visual Loss* *(by pace your MRCP – Dr Tanzeel Bukhari)* *1️⃣ Retinal / Optic Nerve Ischaemia (Amaurosis Fugax / Optic Neuritis)* Sudden, painless visual loss (often monocular) Amaurosis fugax: transient “curtain coming down” → vascular cause Optic neuritis: painful eye movements, reduced colour vision *2️⃣ Stroke (Occipital Lobe)* Sudden visual field loss (homonymous hemianopia) Vision loss is often bilateral but symmetric May have other focal neurological signs *3️⃣ Giant Cell Arteritis* Visual loss in patients >50 years Associated with headache, jaw claudication, scalp tenderness Medical emergency → start steroids immediately

*🧠 Mnemonic 2 – Causes of Chest Pain* *(by pace your MRCP – Dr Tanzeel Bukhari)* 🔑 *Mnemonic: CARDIAC-P* C – Coronary artery disease (ACS / Angina) → Central, pressure-like pain ± radiation, associated with exertion or risk factors. A – Aortic pathology (Dissection) → Sudden severe “tearing” pain radiating to the back, BP differential. R – Reflux / Oesophageal spasm → Burning retrosternal pain, post-prandial, worse lying flat. D – Diseases of lung (PE, Pneumothorax, Pneumonia) → Pleuritic pain, breathlessness, hypoxia. I – Inflammation (Pericarditis) → Sharp pain, worse on inspiration, relieved by sitting forward. A – Anxiety / Panic attack → Chest tightness with palpitations, normal investigations. C – Chest wall / Musculoskeletal → Localised, reproducible pain on palpation or movement. P – Pleural causes → Sharp pain with respiration, often unilateral.

Photo from Dr Tanzeel Bukhari

*🩺 Symptom Snapshot 19 – Numbness / Paraesthesia* *(by pace your MRCP – Dr Tanzeel Bukhari)* *1️⃣ Peripheral Neuropathy* Stocking–glove distribution numbness or tingling Common in diabetes, alcohol excess, B12 deficiency Often bilateral and distal *2️⃣ Radiculopathy (Cervical / Lumbar Disc Disease)* Dermatomal sensory symptoms May be associated with neck or back pain Worsens with movement or posture *3️⃣ Central Cause (Stroke / Multiple Sclerosis)* Sudden or progressive unilateral sensory loss Often associated with weakness or visual symptoms Requires urgent neuroimaging

*🧠 Mnemonic 1 – Causes of Syncope* *(by pace your MRCP – Dr Tanzeel Bukhari)* *🔑 Mnemonic: V-PASS* *V – Vasovagal* → Reflex hypotension/bradycardia triggered by pain, fear, prolonged standing. *P – Postural (Orthostatic hypotension)* → Drop in BP on standing due to dehydration, autonomic failure, or drugs. *A – Arrhythmia / Aortic stenosis* → Sudden reduction in cardiac output causing transient cerebral hypoperfusion. *S – Situational syncope* → Coughing, micturition, defecation, swallowing (vagal reflex). *S – Seizure / Subclavian steal (mimics)* → Important differentials that can present like syncope but need exclusion.

👉 IMPORTANT 3 👈 Please remember that all infective agents ( bacteria viruses, parasites and Fungus) are BUGS . The word INFECTION is tolerable ( not considered as a Jargon by most of the examiners) so u will say to your patient that you have bug infection ( in your lungs, tummy whatever etc) pace your MRCP-PACES..

👉 IMPORTANT 2 👈 FATIGUE is considered as a Jargon by some examiners , so avoid it and say do you feel TIRED or TIREDNESS. pace your MRCP-PACES..

👉 IMPORTANT 1 👈 FEVER is considered as a Jargon by most of the examiners , so avoid it and say HIGH BODY TEMPERATURE. pace your MRCP-PACES..

Photo from Dr Tanzeel Bukhari

Photo from Dr Tanzeel Bukhari

Photo from Dr Tanzeel Bukhari

Photo from Dr Tanzeel Bukhari

Photo from Dr Tanzeel Bukhari

Photo from Dr Tanzeel Bukhari

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Photo from Dr Tanzeel Bukhari