pace your MRCP-PACES

👉 *IMPORTANT 190* 👈 Please remember that all patients of Addison,s should be followed up yearly with BP and U&E Good luck.

👉 *IMPORTANT 189* 👈 Always think of Addison's in all with unexplained abdominal pain or vomiting. Good luck.

👉 *IMPORTANT 188* 👈 *Some causes of primary adrenocortical insufficiency:* 80% are due to autoimmunity in the UK. TB (commonest cause worldwide), Adrenal metastases (eg from lung, breast, renal cancer) Lymphoma Opportunistic infections in HIV (eg CMV, Mycobacterium avium ) Adrenal haemorrhage (Waterhouse-Friderichsen syndrome antiphospholipid syndrome;SLE), Congenital (late-onset congenital adrenal hyperplasia). Good luck.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Amarnath duraikannan* For passing *PACES MRCP UK* from UK. He was with us in our batch for online prepration for PACES in Aug, Sep and Oct 22. We wish him the best for his future.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Maha Shaikh* For passing *PACES MRCP UK* from Pakistan. She was with us in our batch for online prepration for PACES in Aug 22 and Sep 22 We wish her the best for her future.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Samar* For passing *PACES MRCP UK* from Pakistan. She was with us in our batch for online prepration for PACES in Sep 22 We wish her the best for her future.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Sidra German* For passing *PACES MRCP UK* from Pakistan. She was with us in our batch for online prepration for PACES in Feb 22 and Sep 22 We wish her the best for her future.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Mahmood Akhtar* For passing *PACES MRCP UK* from Pakistan. He was with us in our batch for online prepration for PACES in Sep 22. We wish him the best for his future.

👉 *IMPORTANT 187* 👈 *Nelson's syndrome:* It resembles too much with the Cushing but there will be scars on the back of the patient and increased skin pigmentation due to increased ACTH from an enlarging pituitary tumour, as adrenalectomy removes -ve feedback. It responds well to pituitary radiation. Good luck.

👉 *IMPORTANT 186* 👈 Please remember to ask about steroids intake specifically in medicine history of any case of Cushing Syndrome. Good luck.

👉 *IMPORTANT 185* 👈 Please remember that in Cushing Syndrome Myopathy, obesity, menstrual irregularity, osteoporosis, subtle mood changes, HTN and DM often remain after the treatment but their control may become better. Good luck.

Let's start again

👉 ANNOUNCEMENT 👈 Dear all I will be travelling out of city for a couple of days so our academic activities will remain suspended from tomorrow 8th Dec ( Thursday ) till 11th Dec ( Sunday ) We will resume our activities from 12th of Dec. Meanwhile I regret to inform that our weekly Sunday session will not happen and our next session will be on 18th Dec if all goes well. I am sorry for any inconvenience. Regards

👉 *IMPORTANT 184* 👈 *Autoimmune polyendocrine syndrome 2* Features: Addison's disease. Type 1 diabetes mellitus. Autoimmune thyroid disease-hypothyroidism or Graves' disease. Also associated with primary hypogonadism, vitiligo, alopecia, pernicious anaemia, chronic atrophic gastritis, coeliac disease, dermatitis herpetiformis. Good luck.

👉 *IMPORTANT 183* 👈 *Autoimmune polyendocrine syndrome 1* Autosomal recessive Features: Addison's disease. Chronic mucocutaneous candidiasis. Hypoparathyroidism. Also associated with hypogonadism, pernicious anaemia, autoimmune primary hypothyroidism, chronic active hepatitis, vitiligo, alopecia. Good luck.

👉 *IMPORTANT 182* 👈 *MEN-2b:* Has similar features to MEN-2a plus mucosal neuromas and Marfanoid appearance, but no hyperparathyroidism. Mucosal neuromas consist of 'bumps' on: lips, cheeks, tongue, glottis, eyelids. Good luck.

👉 *IMPORTANT 181* 👈 *MEN-2a:* • Thyroid: medullary thyroid carcinoma (seen in ~100%). Adrenal: phaeochromocytoma ( usually benign and bilateral). Parathyroid hyperplasia. Good luck.

👉 *IMPORTANT 180* 👈 *MEN-1:* • Parathyroid hyperplasia/adenoma • Pancreas endocrine tumours—gastrinoma or insulinoma, or, rarely, somatostatinoma (DM + steatorrhoea + gallstones/cholangitis), VIPoma or glucagonomas ( migrating rash; glossitis; cheilitis, anaemia; reduced weight; increased plasma glucagon; increased glucose). • Pituitary prolactinoma or GH secreting tumour (acromegaly ); also, adrenal and carcinoid tumours may be associated. Good luck.

👉 *IMPORTANT 179* 👈 *Hypothyroidism and pregnancy* Pregnancy problems in hypothyroidism may include Eclampsia, anaemia, prematurity, birthweight, stillbirth, PPH. Good luck.

✌️✌️ *HEARTIEST CONGRATULATIONS* ✌️✌️ To *Dr Muhammad Hashim* For passing *PACES MRCP UK* from India. He was with us in our batch for online prepration for PACES in Aug-Sep 22 We wish him the best for his future.