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, January 31, 2008

Quiz time again!


You see this patient in Station 5: skin.

Describe the skin finding. Then, outline the other system involvements that are relevant to this condition.

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7 Comments:

At 1/31/2008 06:36:00 PM, Anonymous Anonymous said...

plucked chicken skin of psudoxanthoma elasticum; check BP, fundus for angiod streaks, CVS for MVP murmur, peripheral pulses and rule out UGI bleed.

 
At 2/01/2008 07:41:00 AM, Anonymous Anonymous said...

Plucked chicken appearance with yellowish hue suggestive of Pseudo xanthoma elasticum.

I would like to proceed to inspect other areas like; axilla, ante cubital fossa and groin for similar appearance and demonstrate hyperflexibility of joints.

Tell the examiner that I would like to examine CVS for MVP/MR/AR, Fundus for angioid streaks.

Would like to rule out GI bleed

 
At 2/01/2008 07:41:00 AM, Anonymous Anonymous said...

I would like to proceed to inspect other areas like; axilla, ante cubital fossa and groin for similar appearance and demonstrate hyperextensibility of joints.

Tell the examiner that I would like to examine CVS for MVP/MR/AR, Fundus for angioid streaks.

Would like to rule out GI bleed

 
At 2/01/2008 11:04:00 AM, Anonymous Anonymous said...

I will discribe this lesion as erythematous wheal like lesions with defined border around the neck of a person wearing a neck lace.I will first think that this is probably contact dermatitis due to the component of the neck lace most likely nickle.I will examine her flexural areas, the nails for ridging, ,the chest for signs of astham.AsI will consider the pluckled skin lesion of pseudoxathoma elasticum.I will examine for joint and skin hypermobility and hyperextensibility.I will look for angiod streak on the fundus,murmur of mitral valve prolap,asked for history of melena and probably request for ECG as ischemic heart dis is common at ealy age.

 
At 2/01/2008 04:34:00 PM, Blogger David Teoh said...

Bingo, it is Pseudoxanthoma elasticum (PXE).

To be more precise, what is the pattern of inheritance? What gene is affected in PXA?

 
At 2/02/2008 04:55:00 PM, Anonymous Anonymous said...

inheritance can be both aut recessive or aut dominant, though the former is common.
gene affected is mapped to
chromosome 16

 
At 2/02/2008 07:11:00 PM, Blogger David Teoh said...

It is AR in inheritance. The gene is ABCC6.

 

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