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, October 14, 2007

Station 5: Fundus

What is the diagnosis?

What else to look for?



At 10/14/2007 08:50:00 AM, Anonymous Anonymous said...


not very sure, but i put my bet on angiod streak... here goes my presentation...

The fundus examination showed angiod streak, I say this because of the presence of irregular red brown lines seen radiating from the optic disc. The lines end abruptly, and are larger in diameter compared to the vessels.

i will proceed to examine the right fundus. assess the visual acuity as the acuity can be affected in some cases, although this is usually asymptomatic.

Examine further for associated conditions.
1. Pseudoxanthoma Elasticum
- chicken plucked skin, mitral valve prolapse, young IHD/ Stroke.
2. Ehler Danlos Syndrome.
- lax skin, thin cigarette paper, hypermobile joints, GI bleed, Heart valve.
3. Paget's Ds
- large deformed skull, long bones bowing, Heart failure, nerve entrapment (facial nerve, 8th nerve, spinal cord) sarcoma, urinary stones.
4. Acromegaly - typical features in head, hands, skin tags, acanthosis nigricans, gynaecomastia, spine/ skeletal deformity, HPT, DM, Visual field

5. Lead Txicity - motor peripheral neuropathy, X-rays, Dental, history

6. Sickle cell anaemia - African, pain, haemolysis

At 10/14/2007 02:21:00 PM, Blogger Wuchereria said...

Yes ! well done! This pt came out in MRCP paces in Feb 02 in UK - he has pseudoxanthoma elasticum.

At 10/14/2007 02:46:00 PM, Blogger Axonopathic said...

Anonymous: You have just demonstrated a clear pass (4/4) in this particular case. Well Done!


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