The Lotus @ Marina Bay
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PACES 2011/1
I started in Station 3.It went well. Cranial Nv Examination: Lt sided LMN VII Palsy was obvious.Then I looked for cause:auricles,mouth,parotid and neck.Then I asked for smell,Vision and EoM.There was Nystagmas on Lt LGaze.He said Double Vision on Lt Lateral Gaze.Outer image disappeared on covering Rt eye(a bit confused to interpret at that time).Then noted [...]
2010 in review
The stats helper monkeys at WordPress.com mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health: The Blog-Health-o-Meter™ reads This blog is on fire!. Crunchy numbers A Boeing 747-400 passenger jet can hold 416 passengers. This blog was viewed about 4,100 times in 2010. That’s about [...]
PACES 2010/3_survey1
from a candidate Resp: ?bronchiectasis with R mastectomy and bilateral thoracotomy scars, CVS: young lady with small L thoracotomy scar in the back, and asked “why SOB in pregnancy?” Hx: longstanding SOB+ suddenly worse, FH of CVA, MI and PE, Abdo: PKD NEURO: peripheral sensory neuropathy in diabetic Ethics: explain to a patient recently diagnosed [...]
Station 2-Diarrhoea
Action Plan: Follow standard history taking format sensibly. You are …… tell me more about the symptoms how frequent?any blood? still much the same or getting worse? any medication?help Cigarette Caffeine Alcohol Any change in period Any SoB etc. Diet SOCRATES is useful mnemonics for associated PAIN. Site Onset: ? following infective episodes or travel Character? how [...]
Sarcoid : RCP’s favorite in Station 1-2-4-5
Try practice Sarcoidosis in term of Seven core clinical skills assessed in the PACES examination. Here is a sample from 2010/2 diet: station 2- jt pain , dry cough and bilateral gld + in CXR, two candidates sat apart 2 weeks in a UK centre got the same scenario. (PS. in station 4,don’t bother skill D, ie.Differential Dx;but [...]
Kyphosis in Station 5
Scan as a whole: enlarged head with hearing aid,bow legs. tall,thin man with pectus excavatum,arachnodactily and flat feet. extended neck,kyphoscoliosis with loss of lumbar lordosis. feel the pulse: high volume look at the eyes: reduced acuity,afferent pupillary defect,optic atrophy and angioid streak. thick spectacle,tremor of iris and dislocated len, small pupil,sluggish pupillary response,circumcorneal injection Listen [...]
