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.
Tuesday, August 28, 2007
Quiz Fundus
What is the diagnosis ? What are the causes ? How to treat ?
Acute retinal arterial ischaemia due to thrombembolic disease first to start ,we have to detect primary source of embolus by echocardiogram ,internal carotid doppler ultrasound.... then investigate for throbophilia.
Yes, the fundus is pale with cherry red spot at the macula, the arterioles are thin and scanty. Diagnosis of CRAO. Clinically look for carotid bruit, AF, heart murmurs. What is the diagnosis if this patient complaints of headache ? What are the 2 investigations you would offer ?
The patient must be having Giant Cell Arteritis, so I will proceed to check ESR and temporal artery biopsy. At the same time I would start high dose steroids to prevent visual loss in the other eye.
well headach can be caused by *CTD like SLE,RA *vasculitis like WG,CSS,PAN..TA *TIA with amourosis fugax so we need to look for relevant clinical features,then send for the following investigations: CBC,ESR,cANCA ,ANF,DsDNA,S.chol,FBS,GUE,LFT,RFT ..
Acute retinal arterial ischaemia
ReplyDeletedue to thrombembolic disease
first to start ,we have to detect primary source of embolus by echocardiogram ,internal carotid doppler ultrasound....
then investigate for throbophilia.
Yes, the fundus is pale with cherry red spot at the macula, the arterioles are thin and scanty. Diagnosis of CRAO.
ReplyDeleteClinically look for carotid bruit, AF, heart murmurs.
What is the diagnosis if this patient complaints of headache ? What are the
2 investigations you would offer ?
The patient must be having Giant Cell Arteritis, so I will proceed to check ESR and temporal artery biopsy. At the same time I would start high dose steroids to prevent visual loss in the other eye.
ReplyDeletewell headach can be caused by
ReplyDelete*CTD like SLE,RA
*vasculitis like WG,CSS,PAN..TA
*TIA with amourosis fugax
so we need to look for relevant clinical features,then send for the following investigations:
CBC,ESR,cANCA ,ANF,DsDNA,S.chol,FBS,GUE,LFT,RFT
..
Well done medtoddler. straight to the point !
ReplyDelete