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.

Monday, May 22, 2006

5 minutes Transplanted kidney

Transplanted kidney is the main focus of a short case in 9% of attempts at PACES station 1. It is not difficult to diagnose this condition. Just remember, iliac fossa scar with a mass equivalent to transplanted kidney until proven otherwise! However, the story does not end here for MRCPian. As a MRCPian, you need to search for the causes, complications and the functional capacity of the patient (4Cs rule).

1. Causes

* Most of the cases shown are polycystic kidney disease
* Other causes include DM (check for dermopathy and diabetic ulcers), GN and etc

2. Complications
a. Side effects of medications
** Azathioprine - myelosuppression with bruises, pallor, jaundice
** Cyclosporin - hand tremor, hypertrichosis, gum hyperplasia, high BP
** Prednisolone - Cushing's syndrome, pallor secondary to UGIB
b. Hepatitis B/C with CLD signs

3. Functional capacity

* Signs of graft rejection - tender transplanted kidney
* Signs of infections - they have 1001 reasons to get infections
* Uremic/hepatic encephalopathy - unlikely to appear in PACES!



At 5/22/2006 11:28:00 PM, Blogger Axonopathic said...

Dear emrcpian, thanks for the tips.

Bilateral nephrectomy scars with a transplanted kidney -> APKD with ESRF until proven otherwise!

At 5/23/2006 12:19:00 AM, Blogger eMRCPian said...

Ya, scar is always a gift for MRCPian!


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