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, July 13, 2006

Proximal myopathy

The clinical diagnosis of proximal myopathy is usually straightforward. Proximal muscle wasting and weakness is easily demonstratable.

**The weakness is bilateral and usually symmetrical.
**The sensory is always INTACT!

The causes that you need to consider are:
1. Muscular dystrophy
**Duchenne/ Becker muscular dystrophy (look for pseudohypertrophy of calf muscle
** Fascioscapulohumeral dystrophy (look for facial muscle weakness)
**Limb girdle muscular dystrophy

2. Inflammatory muscle disease

** Polymyositis (muscle may be tender)
** Dermatomyositis (Facial heliotrope rash and Gottron's sign)

3. Endocrinopathy
** Cushing's syndrome
** Thyrotoxicosis
** Acromegaly
**ALL will have obvious external features

4. Metabolic myopathies
** Hypo/hyperkalemia, Hypo/hypercalcemia

Wasting of deltoid muscle

Difficulty in standing up from squatting

This patient was referred to neurology clinic for an investigation. He was then planned for an elective procedure.

What is the respective investigation and procedure?



At 7/14/2006 01:25:00 PM, Blogger Samrat Bose said...

Is the investigation a muscle biopsy?

At 7/14/2006 06:51:00 PM, Blogger eMRCPian said...

Investigation: EMG
Procedure: muscle biopsy

At 7/16/2006 12:04:00 AM, Blogger yunn said...

Blood tests: CBP, TFT, CPK, RFT, glucose, cortisol
muscle biopsy


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