pace your MRCP-PACES

*👉 IMPORTANT 308 👈* *A few investigations for Wilson,s Disease* Urine: 24h copper excretion is high, eg >100mcg/24h (normal <40mcg). Raised LFT Serum copper: typically <11μmol/L. Low Serum caeruloplasmin: <200mg/L (<140mg/L is pathognomonic)—beware 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/Descemet’s membrane Liver biopsy: increased Hepatic copper (copper >250mcg/g dry weight); hepatitis; cirrhosis. MRI: degeneration in basal ganglia, fronto-temporal, cerebellar, and brainstem paceUrMRCP.

*👉 IMPORTANT 307 👈* 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.

*👉 IMPORTANT 306 👈* Please remember To use the word *PINS AND NEEDLES* to explain *TINGLING* to the patient. paceUrMRCP.

👉 IMPORTANT 305 👈 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.

👉 IMPORTANT 304 👈 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.

👉 IMPORTANT 303 👈 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

*👉 IMPORTANT 302 👈* 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.

*👉 IMPORTANT 301 👈* 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.

*IMPORTANT 300* *Few causes of Short stature in PACES* Turner's Achondroplasia Hypothyroidism Hypopituitarism paceUrMRCP.

*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.

*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.

*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.

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

*IMPORTANT 296* *Few points for HOMOCYstinuria* ( a very close DD for Marfan Syndrome ) : ↑Homocysteine Osteoporosis Marfanoid habitus Ocular changes lens dislocation Cardiovascular effects ( MVP,AR,MR) kYphosis Intellectual disability paceUrMRCP.

IMPORTANT 295 Rule of 10's for Pheochromocytomas: 10% malignant 10% bilateral 10% extra-adrenal 10% calcify 10% can affect kids paceUrMRCP.

IMPORTANT 294 Few Hs for Pheochromocytomas: HTN Hyperglycemia Hypermetabolism Hyperhidrosis Headache paceUrMRCP.

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Announcement for Online Session No 108 31 Dec 2023 WE WILL NOT RECORD THIS SESSION DEAR DOCTORS : MAY I HAVE YOUR ATTENTION PLEASE : Todahy we will have an online session on Zoom discussing 1 Clinical Consultation Station regarding our preparation for MRCP PACES ( UK ) and MRCPI ( Ireland ) 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 : 3 00 pm Libya : 3 00 pm Bahrain : 4 00 pm Burma ( Myanmar ) :7 30 pm Sudan : 3 00 pm UAE : 5 00 pm UK : 1 00 pm Ireland ( Dublin ) : 1 00 pm Afghanistan : 5 30 pm Kenya : 4 00 pm Germany ( Berlin ) : 2 00 pm Nigeria : 2 00 pm Japan ( Tokyo ) : 10 00 pm Denmark : 2 00 pm Qatar : 4 00 pm Oman : 5 00 pm Italy : 2 00 pm Indonesia : 8 00 pm Mauritius : 5 00 pm Iraq : 4 00 pm Texas Usa : 8 00 am Kuwait : 4 00 pm Sri Lanka : 6 30 pm Somalia : 4 00 pm Zimbabwe : 3 00 pm China ( Beijing ) : 9 00 pm Australia ( Sydney) : 12 00 am ( 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.