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.


Wednesday, August 16, 2006

Hansen's Disease


What is your diagnosis if this case appear in skin substation? It is not JVP nor Corrigan's sign! It is a thicken great auricular nerve.
Think of Hansen's disease (Leprosy) in this case. You may see this case in Malaysia PACES center.
The next step is to search for a skin lesion with sensory loss. Ask for contact history

Hypopigmented macules in confluence (patches) of tuberculoid leprosy.

"Leonine facies" of diffuse lepromatous leprosy.

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posted by Dr. David Teoh @ 8/16/2006 10:14:00 PM

6 Comments:

At 8/17/2006 05:53:00 PM, Blogger Neurology4MRCP said...

Thanks to eMRCPian.
Honestly, till now i have not see any leprosy case in the real clinical practice, only in pics and atlases off course.
I wonder if eMRCPian is able to make a video clip (say up to 1MB) of this patient featuring the thickened nerve.
I think that the 3rd pic of a leonine face is not typical of those published in books and atlases.
Regards...
Dr. O Amin
Neurologist and Head of Team Neurology4MRCPGroup

 
At 8/17/2006 06:22:00 PM, Blogger Dr. David Teoh said...

I dont have the video clip of this patient.

 
At 8/18/2006 02:03:00 PM, Anonymous Anonymous said...

This comment has been removed by the author.

 
At 8/19/2006 12:46:00 AM, Blogger Dr. David Teoh said...

Leprosy is not uncommon in Malaysia though we had achieved the WHO standard.

 
At 8/19/2006 10:01:00 PM, Blogger Giant Eagle said...

What does the thickened nerve feel like?

If you want to see leprosy,

can also come to Sarawak. The dermatology unit at Sarawak General Hospital treats a lot of these patients and there actually is a thriving leper colony outside Kuching.

Actually, these ex-lepers have completed their treatment but the stigma remains so they remain in the colony.

 
At 8/19/2006 11:57:00 PM, Blogger Dr. David Teoh said...

The nerve feel like a cord.

So, when is your 1st sharing article?

 

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