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An Aid to the MRCP PACES: Volume 1: Stations 1 and 3, 4th Edition

ISBN: 978-0-470-65509-2
350 pages
October 2012, Wiley-Blackwell
An Aid to the MRCP PACES: Volume 1: Stations 1 and 3, 4th Edition (0470655097) cover image

Description

This new edition of An Aid to the MRCP Paces Volume 1: Stations 1 and 3 has been fully revised and updated, and reflects feedback from PACES candidates as to which cases frequently appear in each station.

The hundreds of cases have been written in accordance with the latest examining and marking schemes used for the exam and, together with exam hints, tips, routines and clinical checklists, provide an invaluable training and revision aid for all MRCP PACES candidates.

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Table of Contents

Preface vii

Preface to the third edition xi

Preface to the second edition xiii

Preface to the first edition xv

Introduction xvii

Section A: Preparation 1

Section B: Examination Routines 7

1 Pulse 11

2 Heart 12

3 Chest 17

4 Abdomen 21

5 Visual fields 26

6 Cranial nerves 27

7 Arms 30

8 Legs 34

9 Legs and arms 38

10 Gait 39

11 Ask some questions 40

12 Fundi 43

13 Eyes 47

14 Face 49

15 Hands 51

16 Skin 55

17 Rash 57

18 Neck 58

19 Thyroid status 60

20 Knee 62

21 Hip 64

22 What is the diagnosis? 65

Section C: Short Case Records 69

Station 1 Respiratory 73

1 Interstitial lung disease (fibrosing alveolitis) 74

2 Pneumonectomy/lobectomy 77

3 Chronic bronchitis and emphysema 79

4 Bronchiectasis 81

5 Dullness at the lung base 83

6 Rheumatoid lung 85

7 Old tuberculosis 86

8 Chest infection/consolidation/pneumonia 87

9 Yellow nail syndrome 89

10 Kyphoscoliosis 90

11 Stridor 92

12 Marfan’s syndrome 93

13 Carcinoma of the bronchus 94

14 Klippel–Feil syndrome 97

15 Kartagener’s syndrome 98

16 Lung transplant 99

17 Cystic fi brosis 101

18 Obesity/Pickwickian syndrome 103

19 Pneumothorax 107

20 Corpulmonale 109

21 Collapsed lung/atelectasis 110

22 Superior vena cava obstruction 112

23 Tuberculosis/apical consolidation 113

24 Normal chest 115

Station 1 Abdominal 117

1 Transplanted kidney 118

2 Polycystic kidneys 120

3 Chronic liver disease 121

4 Hepatosplenomegaly 124

5 Hepatomegaly (without splenomegaly) 126

6 Splenomegaly (without hepatomegaly) 127

7 Ascites 129

8 Abdominal mass 131

9 Crohn’s disease 133

10 Polycythaemia rubra vera 135

11 Normal abdomen 136

12 PEG tube 138

13 Single palpable kidney 139

14 Generalized lymphadenopathy 140

15 Hereditary spherocytosis 142

16 Idiopathic haemochromatosis 143

17 Primary biliary cirrhosis 145

18 Carcinoid syndrome 147

19 Motor neurone disease 149

20 Nephrotic syndrome 150

21 Pernicious anaemia 152

22 Pyoderma gangrenosum 153

23 Felty’s syndrome 154

Station 3 Cardiovascular 155

1 Prosthetic valves (mechanical) 156

2 Mitral incompetence (lone) 157

3 Mixed mitral valve disease 159

4 Aortic incompetence (lone) 161

5 Aortic stenosis (lone) 163

6 Mixed aortic valve disease 165

7 Mitral stenosis (lone) 167

8 Irregular pulse 169

9 Other combinations of mitral and aortic valve disease 171

10 Mitral valve prolapse 172

11 Tricuspid incompetence 174

12 Ventricular septal defect 175

13 Marfan’s syndrome 176

14 Pulmonary stenosis 177

15 Ankylosing spondylitis 178

16 Atrial septal defect 179

17 Ebstein’s anomaly 181

18 Raised jugular venous pressure 183

19 Down’s syndrome 184

20 Hypertrophic cardiomyopathy 185

21 Dextrocardia 186

22 Rheumatoid arthritis 187

23 Fallot’s tetralogy with a Blalock shunt 188

24 Normal heart 189

25 Cannon waves 190

26 Coarctation of the aorta 191

27 Eisenmenger’s syndrome 193

28 Infective endocarditis 195

29 Patent ductus arteriosus 198

30 Pulmonary incompetence 199

31 Slow pulse 201

Station 3 Central Nervous System 203

1 Peripheral neuropathy 205

2 Myotonic dystrophy (dystrophia myotonica) 207

3 Parkinson’s disease 209

4 Charcot–Marie–Tooth disease (hereditary motor and sensory neuropathy) 212

5 Abnormal gait 214

6 Spastic paraparesis 217

7 Cerebellar syndrome 218

8 Hemiplegia 220

9 Muscular dystrophy 222

10 Multiple sclerosis 224

11 Motor neurone disease 226

12 Friedreich’s ataxia 229

13 Visual fi eld defect 231

14 Ulnar nerve palsy 233

15 Old polio 235

16 Ocular palsy 236

17 Spinal cord compression 240

18 Ptosis 243

19 Guillain–Barré syndrome (acute inflammatory demyelinating polyradiculopathy) 247

20 Choreoathetosis 249

21 Bulbar palsy 251

22 Lateral popliteal (common peroneal) nerve palsy 252

23 Proximal myopathy 254

24 Absent ankle jerks and extensor plantars 255

25 Cerebellopontine angle lesion 256

26 Cervical myelopathy 257

27 Myasthenia gravis 259

28 Normal central nervous system 263

29 Syringomyelia 264

30 Diabetic foot/Charcot’s joint 266

31 Holmes–Adie–Moore syndrome 267

32 Nystagmus 269

33 Carpal tunnel syndrome 272

34 Drug-induced extrapyramidal syndrome 274

35 Lower motor neurone VIIth nerve palsy 275

36 Dysarthria 279

37 Subacute combined degeneration of the cord 280

38 Argyll Robertson pupils 281

39 Congenital syphilis 282

40 Dysphasia 284

41 Horner’s syndrome 286

42 Infantile hemiplegia 288

43 Jugular foramen syndrome 290

44 Lateral medullary syndrome (Wallenberg’s syndrome) 292

45 Polymyositis 294

46 Pseudobulbar palsy 295

47 Psychogenic/factitious 296

48 Radial nerve palsy 298

49 Subclavian-steal syndrome 299

50 Tabes 301

51 Thalamic syndrome 303

52 Wasting of the small muscles of the hand 304

Appendices 307

1 Checklists 309

2 Examination frequency of MRCP PACES short cases 313

3 Texidor’s twinge and related matters 317

4 Abbreviations 319

Index 321

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Author Information

Robert E.J. Ryder is Consultant Physician and Clinical IT Lead at City Hospital NHS Trust, Birmingham, and Honorary Senior Lecturer in Medicine at the University of Birmingham.

Dr M. Afzal Mir is Senior Lecturer and Consultant Physician at University Hospital of Wales, Cardiff

Dr Anne Freeman is Consultant Physician at Royal Gwent Hospital, Newport, and Clinical Adviser and Chairwoman of the Welsh Stroke Alliance

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