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.


Sunday, July 30, 2006

IE signs

OK, enough neurology cases for July. I will show you some classical signs of infective endocarditis.

SPLINCTER HAEMORRHAGE

subungual linear “vasculitic” lesions


OSLER’S NODES

red, raised tender nodules on the pulp of the fingers (or toes), or on the thenar or hypothenar eminences


ROTH’S SPOT

intraretinal haemorrhages with white centers representing fibrin thrombus occluding a rupture blood vessel


JANEWAY’S LESION

Non-tender, erythematous maculopapular lesions, containing bacteria, which occur very rarely on the palms and pulps of the fingers


CLUBBING

Labels:

2 Comments:

At 8/06/2006 07:22:00 PM, Blogger Giant Eagle said...

I would also advice a candidate to look in the conjuctivae carefully as splinter hemorrhages can be found there too. In fact I'm told this is the best place as splinter hemorrhages on fingers can actually be due to manual labour.

We are generally told that Janeway lesions are just septic emboli from the heart

Osler's nodes are said to be caused by immunologic reaction of host towards presence of immune mediated complexs deposited in the skin. However some researchers don't think so.

Check out this article for more information.

http://www.ecu.edu/intmedresidency/CurrentResidents/Clinical%20Signs/Peripheral%20Signs%20of%20Endocarditis.pdf

PS as to which one is the one that hurts, remember Osler=Ow! Ouch! is the one that hurts

 
At 8/06/2006 10:00:00 PM, Blogger eMRCPian said...

Thx, Giant Eagle. It's a good article that describes the IE signs in detail.

 

Post a Comment

<< Home