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, April 20, 2006

Fibrosing Alveolitis

The respiratory case that I had in UK was rheumatoid lung disease. I got no problem in detecting the clubbing and fine inspiratory crepitations bibasally. But, the outcome was 2/2!

Pitfall: I failed to identify the underlying cause for fibrosing alveolitis. I missed out the obvious sign i.e. Rheumatoid hand changes!

The moral of the story to learn is ALWAYS look for the underlying cause for fibroising alveolitis as cryptogenic fibrosing alveolitis is RARE for PACES!

Face: malar rash (SLE)
telangiectasia, beak nose, microstomia (scleroderma)
facial pigmentation (amiodarone)
heliotrope rash (dermatomyositis)
Hand: RA, sclerodactyly

Never miss RA hands in respiratory station!



At 11/06/2007 09:29:00 PM, Anonymous Anonymous said...

wah like that oso can fail one
ah?so unfair
was there perhaps another reason why they score 2/2
the dx can't be the end all and be all !!!

At 11/06/2007 11:10:00 PM, Blogger Axonopathic said...

Fortunately or unfortunately, the diagnosis DOES play a central role in determining your final score in most instances, but not all.

After all, we physicians are supposed to be observant enough to tie all the physical findings together and form a sensible diagnosis, aren't we?

At 11/09/2007 05:34:00 PM, Anonymous Anonymous said...

thanks for the prompt reply!
if that is the case very scary
all the month of work to waste
just because of well if you're not ON that day and you miss the dx its bye bye?

my problem is i'm not very observant
i miss things when under stress and when there is a time limit
how do i over come this?


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