PACES MRCP UK - Where MRCPians Meet Since 2006

MRCP is well establised as an entry exam for advanced specialist training in many countries including Malaysia. It consists of 3 paper i.e. Part1, Part2(written tests) and PACES. PACES in full means Practical Assessment of Clinical Examination Skills. It is the third part and the candidate is assessed by fellows of RCP. I passed my PACES in 2005. I am glad that many seniors had guided me throughout my preparation for PACES and I wish to share my experiences with PACES candidates via this blog.

Thursday, February 02, 2006

"Grave's disease"

PACES candidates should know everything about Grave's disease on their fingertips. It is very common. In fact, I got it twice for PACES exam and there was always a drink beside of the patient!

Usual themes:
1. Please examine this lady who presented with palpitation for 2/52
2. This lady presented with neck swelling. Please examine.
3. Please examine this patient's thyroid status.

My advice is to divide the examination into two objectives.
First, assess the thyroid status and signs to support Grave's disease. Second, examine the neck for diffuse goitre. The sequence of examination would depends on the theme given. For theme no. 1 & 3, I would examine the thyroid status then proceed with neck examination.

Thyroid status would include:
1. Hands: pulse, sweaty palms, tremor
2. Arms: proximal myopathy, hyperreflexia
3. Eyes: lig lag, lid retraction

Points that support Grave's disease would include:
1. Diffuse goitre
2. Thyroid acropachy, onycholysis, palmar erythema
3. Exophthalmos, chemosis, ophthalmoplegia
4. Pretibial myxoedema

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At 9/19/2007 01:47:00 PM, Anonymous Anonymous said...

Graves disease can be hyperthyroid,euthyroid or hypothyroid.So, you must include checking the ankle jerk in thyroid status examination.

At 10/15/2010 05:40:00 AM, Anonymous Anonymous said...

how do u treat thyrotoxic AFib


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