pace your MRCP-PACES

*👉 IMPORTANT 704 👈* *WEIGHT LOSS 2* *Causes* 1) MALIGNANCY --- malignancy is one of the important cause of clinically significant unintentional weight loss... Lung Cancer, oesophageal cancer, gastric cancer, pancreatic cancer, ovarian cancer, colorectal cancer , breast cancer,renal cancer are associated with weight loss.. cancer patients with weight loss not only just have weight loss but they have associated symptoms that should be sought out.. dysphagia, odynophagia, early satiety ( due to hepatosplenomegaly) ,abdominal distention, nausea vomiting, hypercalcemia etc 2) NON MALIGNANT GI DISEASES... non malignant GI diseases like Peptic ulcer disease, malabsorption diseases like celiac diseease, inflammatory boel diseases these too can cause weight loss.. 3) Psychiatric Disorders--- Depression can cause weight loss, patients with bipolar disorder they loose weight in manic phase of illness , anorexia nervosa and bulimia nervosa lead to weight loss. 4) ENDOCRINE ISSUES--- Hyperthyroidism increases the basal metabolic rate and weight loss happens in old patient with hyperthyroidism... while many young patients with hyperthyroidism acctually compensate with eating more and may gain some weight paradoxically Diabetes mellitus--- newly diagnosed TYPE 1 diabetic patient loose weight , due to hyperglycaemia polyuria,and catabolism, Type2 diabetic with high levels of sugars too can go in catabolism and come with loosing weight .. Pheochromocytoma--- patient loose weight Adrenal insufficiency ---- Chronic adrenal insufficieny can lead to weight loss 5) Chronic infections.. chronic HIV infection causes episodic weight loss in opportunistic infection or secondary infection period Tuberculosis-- TB is associated with weight loss... reactivation of latent TB too can lead to unexplained weight loss HCV -- chronic HCV infection is associated with weight loss Helminthic infections can cause nutritional deficiencies and weight loss 6) CHRONIC DISEASES-- Chronic heart failure, CKD, chronic Lung disease, chronic liver disease all can lead to weight losss.. but many patients with above condition are actually fluid overloaded so they are taught to have falsely gain weight... but its not true weight gain but its weight of extra fluid retained in body.. so patients of above diseases should be started on recommended medical therapy and once optimized their weight status should be checked regularly . 7) NEUROLOGICAL CONDITIONS --- Stroke motor neuron disease etc can cause weight loss DRUGS-- several drugs are associated with weight loss Anticonvulsants, antidiabetic ( Metformin, SGLT2i, GLP1 analogues ) stopping of typical antipsychotics , can lead to weight loss 9) recreational drugs and addictions.. smoking alcoholism cocaine marijuana( withdrwal) , heavy tobacco use they cause weight loss. 10) RHEAMATOLOGICAL CONDITIONS--- Rheumatoid arthritis GIANT cell arteritis they cause systemic symptoms and weight losss 11) SOCIAL CAUSES-- elderly neglected people, poor excess to food too can lead to weight loss *paceUrMRCP.*

*👉 IMPORTANT 703 👈* *WEIGHT LOSS 1* weight loss is common symptom with which patient comes to OPD.. Clinically significant weight loss is > 5% weight loss in 6 to 12 months ( unintentional) clinically significant unintentional weight loss happens due to medical or psychiatric condition. weight loss is associated with mortality... *paceUrMRCP.*

*👉 IMPORTANT 702 👈* *Common Stroke Symptoms by Vessel Territory 8* *Carotid artery dissection :-* Distinguishing Symptoms :- Sudden headache, neck pain, Horner syndrome Caused by oropharyngeal injury *paceUrMRCP.*

*👉 IMPORTANT 701 👈* *Common Stroke Symptoms by Vessel Territory 7* *PICA SYNDROME* Distinguishing Symptoms:- Loss of pain and temperature sensation on ipsilateral face and contralateral body Ipsilateral bulbar weakness Ipsilateral Horner syndrome Vertigo, nystagmus *paceUrMRCP.*

*👉 IMPORTANT 700 👈* *Common Stroke Symptoms by Vessel Territory 6* *Transient ischemic attack :-* Distinguishing Symptoms :- Any of the symptoms above, depending on location of vascular lesion Neurologic deficit lasts < 24 hours (most last < 1 hour) Often without findings on MRI *paceUrMRCP.*

*👉 IMPORTANT 699 👈* *Common Stroke Symptoms by Vessel Territory 5* *Small penetrating arteries of basal ganglia and internal capsule :-* Distinguishing Symptoms :- Eye deviation toward lesion (putamen injury), contralateral hemiparesis and sensory loss *paceUrMRCP.*

*👉 IMPORTANT 698 👈* *Common Stroke Symptoms by Vessel Territory 4* *Lacunar :-* Distinguishing Symptoms :- Symptoms are pure motor, pure sensory, ataxic hemiparesis, dysarthria, or clumsy hand Strokes affecting the thalamus may cause thalamic pain syndrome several weeks after the event, with hypersensitive pain response over the affected area of the body *paceUrMRCP.*

*👉 IMPORTANT 697 👈* *Common Stroke Symptoms by Vessel Territory 3* *Posterior cerebral artery :-* Distinguishing Symptoms :- Vertigo;homonymous hemianopsia ; ipsilateral sensory loss of face, CN IX and CN X; contralateral sensory loss of limbs; limb ataxia *paceUrMRCP.*

*👉 IMPORTANT 696 👈* *Common Stroke Symptoms by Vessel Territory 2* *Anterior cerebral artery :-* Distinguishing Symptoms :- Contralateral paresis and sensory loss in the leg; cognitive or personality changes; urinary incontinence *paceUrMRCP.*

*👉 IMPORTANT 695 👈* *Common Stroke Symptoms by Vessel Territory 1* *Middle cerebral artery :-* Distinguishing Symptoms :- Contralateral paresis and sensory loss in the face and arm; gaze; homonymous hemianopsia preference toward the side of the lesion Nondominant hemisphere—neglect Dominant hemisphere (90% left side)—aphasia *paceUrMRCP.*

*👉 IMPORTANT 694 👈* In case of pitutary adenoma with optic chiasma compression there will be bitemporal (( upper quadrant hemianopia)) with decreased vision in lower quadrant While in craniopharyngeoma there will be bitemporal (( lower quadrant hemianopia)) with decreased vision in upper quadrant. *paceUrMRCP.*

*👉 IMPORTANT 693 👈* *Info about Medialert bracelets* Please mention bracelets in the management of these cases ( whatever the station is ) Epilepsy Steroids Splenectomy anticoagulant Angioedema Renal transplant *paceUrMRCP.*

*👉 IMPORTANT 692 👈* *Markers of disease activity of Acromegaly.* Headache Progressive vision loss Uncontrolled hypertension Uncontrolled dm Skin tags Sweating. *paceUrMRCP.*

This is the recording of our todays session, please try to listen it within 24 hours, as zoom allows limited space and after 24 hours it will auto delete this one to free space for others

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*Announcement for Online Session No 90* *11 June 2023* DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : *Today we will have an online session on Zoom discussing 1 station 2 ( History taking )* regarding our preparation for MRCP PACES ( UK ) 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 : 4 00 pm Libya : 3 00 pm Bahrain : 4 00 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 00 pm UAE : 5 00 pm UK : 2 00 pm Ireland ( Dublin ) : 2 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 3 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 3 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 3 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am Kuwait : 4 00 pm ( please Google for your local time zones to avoid any inconvenience ) Zoom meeting link will be shared 5 minutes before start time. The candidate for today's session has been selected. GOOD LUCK.