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, November 01, 2006

Marfan Syndrome

A popular spot diagnosis in MRCP station 5 or may be in CVS station. You notice this man has long fingers ( arachnodactyly).Demonstrate to examiners and convince them that the patient's fingers are long and joints are hypermobile by demonstrating thumb sign ( ask patient to clench her thumb in her fist, the thumb should not exceed the ulnar side of the hand in normal subjects)

Then, look for other signs to suggest Marfan syndrome such as high arched palate ( in this patient), upwards subluxation of the lens, kyphoscoliosis, and chest wall deformity i.e. pectus excavatum.

For the heart, remember you are likely to find either aortic regurgitation or mitral regurgitation.

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