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.


Friday, March 03, 2006

"Abdomen"

MRCP-PACES 30th November 2005

Station 1:
Abdomen:
During periphery examination, I noted an AVF. So, that gave me a clue this was a renal patient and the case probably a APCKD or transplanted kidney. There was no stigmata of CLD. Abdominal examination reviewed a RIF mass with an overlying mass, a RHC mass with bilateral balottable kidneys. So, confidently, I said, "This patient has a right transplanted kidney. He has ESRF secondary to APCKD". Examiner asked me, "What do you think the RHC mass is?". I wasn't sure. I "hentam", most probably a right polycystic kidney. Examiner wasn't satisfy and asked "what else?". I said, it could be a liver. Why? Because, this patient was hemodialysis-dependent previously, so he could have contracted infective hepatitis due to Hep B or C. "What else?". By that time, the bell rang. Didn't get into the management part.

Comment:
In retrospectively, I thought, that could be a polycystic liver!!

Outcome: 4/2

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2 Comments:

At 6/25/2007 07:44:00 AM, Blogger Muhammad Arif said...

I got very similar case in Dec 2006 at UK centre. Patient had APKD with AVF, right renal transplant and a liver transplant. Examiners asked me to put my findings into one diagnosis. I said APKD with Renal and, liver transplant for cysts in liver, but examiners were asking me about other differentials which I couldnt think of... I got 3/4

 
At 6/30/2007 07:07:00 AM, Blogger Dr Sujit Vasanth said...

I think they werw looking for lopcystic kidney disease with liver involvement which is more common in childhood AR-PKD but can be seen in adult AD-PKD.

 

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