Cases for PACES

Synopsis

Cases for PACES is concise, ideal for quick reference, and the perfect study aid to Part II of the MRCP examination. Including all the essential information for the exam in colour-coded sections for each station, it lets you quickly understand the most common cases.

Now in full colour, it features new case material, updated content on ethics and law, and revised brief clinical consultations that better reflect the current exam. Cases for PACES also includes hints and tips for preparing for the exam, and what to expect on the day.

The authors have condensed their own experiences in learning and teaching PACES to provide you with exactly what you need to pass. With its informal style it is ideal for self-directed learning in groups, and will help you hone your clinical skills and boost your confidence throughout your revision.

Summary

Chapter 1: Cardiovascular System

* History: A 38-year-old male presents with chest pain on exertion, shortness of breath, and ankle swelling. Exam reveals a regular pulse, blood pressure of 160/90 mmHg, and elevated jugular venous pressure. Auscultation reveals an S3 gallop.
* Investigations: ECG shows sinus tachycardia, left ventricular hypertrophy, and ischemic changes. Chest X-ray shows cardiomegaly and pulmonary edema. Echocardiogram reveals LV enlargement, reduced ejection fraction, and mitral regurgitation.
* Diagnosis: Ischemic cardiomyopathy with congestive heart failure

Chapter 2: Respiratory System

* History: A 65-year-old female with a history of COPD presents with increased shortness of breath, productive cough, and wheezing. Exam reveals tachypnea, cyanosis, and wheezing throughout the lungs.
* Investigations: Spirometry shows severe airflow obstruction. Chest X-ray shows hyperinflation and emphysema. Arterial blood gas analysis reveals hypoxemia and hypercapnia.
* Diagnosis: Acute exacerbation of COPD

Chapter 3: Abdominal and Gastrointestinal System

* History: A 23-year-old male presents with recurrent episodes of abdominal pain, nausea, vomiting, and diarrhea. Exam reveals tenderness in the right lower quadrant.
* Investigations: Blood tests show elevated white cell count and C-reactive protein. Abdominal ultrasound reveals appendicitis.
* Diagnosis: Appendicitis

Chapter 4: Genitourinary System

* History: A 35-year-old female presents with urinary frequency, urgency, and dysuria. Exam reveals tenderness over the suprapubic area. Urine dipstick shows pyuria and bacteriuria.
* Investigations: Urine culture grows Escherichia coli.
* Diagnosis: Urinary tract infection

Chapter 5: Neurological System

* History: A 55-year-old male presents with sudden onset of right-sided weakness and numbness. Exam reveals a right-sided hemiparesis and positive Babinski sign.
* Investigations: CT scan of the head reveals a left middle cerebral artery infarct.
* Diagnosis: Ischemic stroke

Chapter 6: Endocrine System

* History: A 30-year-old female presents with thirst, polyuria, and weight loss. Exam reveals dry skin and mucus membranes.
* Investigations: Blood tests show hyperglycemia, elevated HbA1c, and a positive anti-GAD antibody.
* Diagnosis: Type 1 diabetes mellitus

Chapter 7: Musculoskeletal System

* History: A 45-year-old male presents with pain and swelling in his left knee. Exam reveals an effusion, tenderness, and reduced range of motion.
* Investigations: Knee X-ray shows osteoarthritis.
* Diagnosis: Osteoarthritis

Chapter 8: ENT and Oral Surgery

* History: A 25-year-old female presents with a painful swelling in her left ear. Exam reveals a red, tender lump in the ear canal.
* Investigations: Otoscopy confirms a furuncle.
* Diagnosis: Otitis externa