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, September 10, 2006

Turner's Syndrome

Case record by Wucheceria

Short stature

Webbed neck and low set hairline

Wide carrying angle


Approach

Short stature

Hands
*Short 4th metacarpal
*Wide carrying angle (cubitus valgus)

Face
*Hypertelorism
*Epicanthic fold
*High arched palate

Neck
*Webbed neck
*Low hairline

Chest
*ASD scar
*Shield like chest
*Wide spaced nipple

Lymphoedema
Mental retardation is rare
Left sided heart lesions i.e. aortic stenosis , coarctation of aorta

Questions:
What renal abnormalities are associated with Turner’s
Horseshoe kidney and hydronephrosis

Is pregnancy possible ?
Yes in the mosaic individuals with normal 46 XX cell line

How would you manage such patients ?
Tretment is supportive and includes hormone replacement therapy on attaining puberty, primarily to prevent osteoporosis and induce sexual maturation or menses

Differential diagnosis
Noonan’s syndrome

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