Additional Information
Book Details
Abstract
This new book is written by authors experienced in training candidates to pass MRCP PACES from across the UK. They have put together Pass PACES based on their own teaching experiences to fill the gap in preparation aids for this high-stakes examination. As well as covering the curriculum, this book is designed to help candidates marshal their knowledge most effectively in order to maximize candidate’s performance. The book provides a pragmatic guide to the presentation of cases and gives great tips for how to achieve full marks at each station in the exam.
Gives the candidate a stepwise approach in how to present the clinical cases that appear in the exam, with the aim of achieving full marks in the clinical stations.
Highlights the extra knowledge and information sought by examiners in order to award full marks at the discussion phase of each station.
Gives advice on time management and organization before and during the exam.
Uses smart memory techniques in order to create brain images for candidates to be able to recruit knowledge under the stress of the exam.
Presents unique hidden curriculum knowledge and non-technical skills tips, customised for this exam.
Accompanying videos that walk candidates through key examinations for each station, and podcasts giving instructional tips and guidance.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Inside Front Cover | ES2 | ||
| Pass PACES: essential study guide | iii | ||
| Copyright | iv | ||
| Contributors | v | ||
| Contents | vii | ||
| Video Contents | ix | ||
| Preface | xi | ||
| Acknowledgements | xv | ||
| Station 1: | 1 | ||
| Chapter 1: Respiratory | 1 | ||
| Pulmonary fibrosis | 1 | ||
| Presenting a case of pulmonary fibrosis | 1 | ||
| Positive clinical findings | 1 | ||
| General examination | 1 | ||
| Chest examination | 1 | ||
| Presence of complications | 2 | ||
| Differential diagnosis | 2 | ||
| Workup | 2 | ||
| Model presentation | 3 | ||
| Discussion with the examiners | 3 | ||
| What investigations would you request for this patient? | 3 | ||
| How would you manage this patient? | 4 | ||
| What do you know about IPF? | 5 | ||
| Name some drugs causing pulmonary fibrosis | 5 | ||
| Do you know any other respiratory causes of finger clubbing? | 5 | ||
| Where to find respiratory cases for practise | 5 | ||
| Pleural effusion | 5 | ||
| Presenting a case of a pleural effusion | 5 | ||
| Positive clinical findings | 6 | ||
| General examination | 6 | ||
| Chest examination | 6 | ||
| Workup | 7 | ||
| Treatment | 7 | ||
| Model presentation | 7 | ||
| Discussion with the examiners | 8 | ||
| What are the possible causes of pleural effusion? | 8 | ||
| Would you perform a diagnostic aspiration? | 9 | ||
| What tests would you send the pleural fluid for? | 9 | ||
| What are the Light’s criteria of an exudate? | 10 | ||
| What other investigations would you request for this patient? | 10 | ||
| How would you manage this patient? | 10 | ||
| What are the indications for chest drain in parapneumonic effusions? | 11 | ||
| Bronchiectasis | 11 | ||
| Presenting a case of bronchiectasis | 12 | ||
| Positive clinical findings | 12 | ||
| General examination | 12 | ||
| Chest examination | 12 | ||
| Presence of complications | 13 | ||
| Differential diagnosis | 13 | ||
| Workup | 13 | ||
| Model presentation | 13 | ||
| Discussion with the examiners | 14 | ||
| What are the causes of bronchiectasis? | 14 | ||
| What investigations would you like to perform for this patient? | 15 | ||
| What is the treatment for bronchiectasis? | 15 | ||
| How is CF diagnosed? | 16 | ||
| What are the systems that are affected by CF? | 16 | ||
| What is yellow nail syndrome? | 16 | ||
| What is Kartagener’s syndrome? | 16 | ||
| Lobectomy/pneumonectomy | 16 | ||
| Presenting a case of a lobectomy/pneumonectomy | 16 | ||
| Positive clinical findings | 17 | ||
| General examination | 17 | ||
| Chest examination | 17 | ||
| Workup | 17 | ||
| Model presentation | 18 | ||
| Discussion with the examiners | 18 | ||
| What are the indications for pneumonectomy? | 18 | ||
| What are the reasons for lobectomy? | 18 | ||
| Chronic obstructive pulmonary disease | 19 | ||
| Presenting a case of chronic obstructive pulmonary disease ( COPD) | 19 | ||
| Positive clinical findings | 19 | ||
| General examination | 19 | ||
| Chest examination | 19 | ||
| Presence of complications | 20 | ||
| Differential diagnosis | 20 | ||
| Workup | 20 | ||
| Model presentation | 20 | ||
| Discussion with the examiners | 21 | ||
| What investigations would you want for this patient? | 21 | ||
| What are the most common pathogens to cause infective exacerbations in COPD patients? | 21 | ||
| How do you classify the severity of COPD? | 22 | ||
| How do you treat stable COPD? | 22 | ||
| Other treatments | 22 | ||
| When is LTOT indicated? | 22 | ||
| Chapter 2: Abdomen | 25 | ||
| Chronic liver disease | 25 | ||
| Presenting a case of chronic liver disease | 25 | ||
| Positive clinical findings | 25 | ||
| Workup | 26 | ||
| Model presentation | 26 | ||
| Discussion with the examiners | 27 | ||
| What are the consequences of CLD? | 27 | ||
| What are the causes of decompensation? | 27 | ||
| What are the causes of CLD? | 28 | ||
| How do you interpret the caput medusa finding? | 28 | ||
| Investigations | 28 | ||
| What investigations would you request for this patient? | 28 | ||
| What are the complications of CLD? | 29 | ||
| How would you manage this patient? | 29 | ||
| Variceal bleed | 30 | ||
| Chronic liver disease | 30 | ||
| What predictive models do you know for determining the prognosis in CLD? | 31 | ||
| Where to find abdominal cases to practise | 31 | ||
| Hepatomegaly | 31 | ||
| Presenting a case of hepatomegaly | 31 | ||
| Positive clinical findings | 32 | ||
| Workup | 33 | ||
| Model presentation | 33 | ||
| Discussion with the examiners | 33 | ||
| Splenomegaly | 34 | ||
| Presenting a case of splenomegaly without hepatomegaly | 34 | ||
| Positive clinical findings | 34 | ||
| Workup | 35 | ||
| Model presentation | 36 | ||
| Discussion with the examiners | 36 | ||
| How would you proceed investigating this patient? | 36 | ||
| How would you manage this patient? | 36 | ||
| Haematological malignancy | 37 | ||
| Haemolytic anaemia | 37 | ||
| When would you consider splenectomy for a patient? | 38 | ||
| Chapter 3: Renal | 39 | ||
| Renal transplant | 39 | ||
| Presenting a case of a renal transplant | 39 | ||
| Part 1. Describe the presence of the renal graft | 39 | ||
| Part 2. Present important positive and negative findings | 39 | ||
| Model presentation | 40 | ||
| Discussion with the examiners | 40 | ||
| What investigations would you request for this patient? | 40 | ||
| What are the complications of renal transplant? | 41 | ||
| Name some common immunosuppressant medications in renal transplant | 41 | ||
| How would you manage this patient? | 41 | ||
| Adult polycystic kidney disease | 42 | ||
| Presenting a case of APKD | 42 | ||
| Workup | 43 | ||
| Model presentation | 44 | ||
| Discussion with the examiners | 44 | ||
| What are other possible differentials for bilateral palpable kidneys? | 44 | ||
| How is APKD inherited? | 44 | ||
| What are the ultrasound diagnostic criteria in people with positive family history of ADPKD? | 44 | ||
| What is the management of ADPKD? | 45 | ||
| Where to find renal cases for practise | 45 | ||
| Station 2: | 47 | ||
| Chapter 4: History taking | 47 | ||
| Introduction | 47 | ||
| Single presenting complaint: Shortness of breath | 50 | ||
| Preparation before entering the examination room | 50 | ||
| In the examination room | 50 | ||
| Presenting complaint | 50 | ||
| History of presenting complaint/associated symptoms | 51 | ||
| Past medical history/family history/drug history/social history | 52 | ||
| Chronic condition: Known rheumatoid arthritis, uncontrolled symptoms | 53 | ||
| Before entering the examination room | 54 | ||
| In the examination room | 54 | ||
| Presenting complaint/history of presenting complaint | 54 | ||
| Past medical history/progression of the disease from diagnosis to present | 54 | ||
| Other past medical history/social history/family history | 55 | ||
| Patient’s concerns | 55 | ||
| Mixture of different symptoms: Weight loss and tiredness | 56 | ||
| Preparation before entering the examination room | 56 | ||
| In the examination room | 56 | ||
| Presenting complaint | 56 | ||
| History of presenting complaint | 57 | ||
| Associated symptoms | 57 | ||
| Past medical/family/social history/drug history and allergies | 58 | ||
| Explore the patient’s concerns | 58 | ||
| Investigation finding: Hypercalcaemia | 59 | ||
| Preparation before entering the examination room | 59 | ||
| In the examination room | 59 | ||
| History of presenting complaint | 60 | ||
| Past medical history/family history/social history | 61 | ||
| Drug history and allergies | 61 | ||
| Patient’s concerns | 61 | ||
| Explain the plan | 61 | ||
| Exercise 1 | 62 | ||
| Information for the candidate | 62 | ||
| Information for the patient | 62 | ||
| Your questions to the doctor | 63 | ||
| Exercise 2 | 63 | ||
| Information for the candidate | 63 | ||
| Information for the patient | 64 | ||
| Your questions to the doctor | 65 | ||
| Exercise 3 | 65 | ||
| Information for the candidate | 65 | ||
| Information for the patient | 66 | ||
| Your medications are | 66 | ||
| You have these questions for the doctor | 67 | ||
| Exercise 4 | 67 | ||
| Information for the candidate | 67 | ||
| Information for the patient | 67 | ||
| You have some questions for the doctor | 68 | ||
| Station 3: | 69 | ||
| Chapter 5: Cardiovascular | 69 | ||
| Aortic stenosis | 69 | ||
| Presenting a case of aortic stenosis | 69 | ||
| Positive clinical findings | 69 | ||
| Workup | 69 | ||
| Model presentation | 70 | ||
| Discussions with the examiners | 70 | ||
| What investigations are indicated for this patient? | 70 | ||
| How would you manage this patient? | 71 | ||
| What are the complications of aortic stenosis? | 72 | ||
| Aortic regurgitation | 72 | ||
| Presenting a case of aortic regurgitation | 72 | ||
| Positive clinical findings | 73 | ||
| Workup | 73 | ||
| Model presentation | 74 | ||
| Model presentation if spot diagnosis of a specific phenotype is made | 75 | ||
| Discussion with the examiners | 75 | ||
| What are the causes of aortic regurgitation? | 75 | ||
| How would you proceed with this patient? | 76 | ||
| Mitral regurgitation | 76 | ||
| How to present a case of mitral regurgitation | 76 | ||
| Positive clinical findings | 77 | ||
| Model presentation | 78 | ||
| Workup | 78 | ||
| Discussion with the examiners | 78 | ||
| What other lesions can give rise to a pansystolic murmur? | 78 | ||
| What are the causes of mitral regurgitation? | 78 | ||
| How would you advise this patient regarding dental treatment? | 79 | ||
| How would you investigate this patient further? | 79 | ||
| How would you manage this patient? | 80 | ||
| What are the possible causes of mitral regurgitation? | 80 | ||
| Mitral stenosis | 81 | ||
| Presenting a case of mitral stenosis | 81 | ||
| Positive clinical findings | 81 | ||
| Workup | 82 | ||
| Model presentation | 82 | ||
| Workup | 83 | ||
| Discussion with the examiners | 83 | ||
| What are other differentials of a mid-diastolic murmur with the above characteristics? | 83 | ||
| What are the causes of mitral stenosis? | 83 | ||
| How would you investigate this patient? | 83 | ||
| How would you manage this patient? | 84 | ||
| How can you explain the different symptoms and complication of mitral stenosis? | 84 | ||
| What is the medical treatment for this patient? | 85 | ||
| Prosthetic valve replacements | 85 | ||
| Presenting a case of a prosthetic valve | 85 | ||
| Positive clinical findings | 85 | ||
| Presence of complications | 86 | ||
| Workup | 86 | ||
| Model presentation | 87 | ||
| Discussion with the examiners | 87 | ||
| What investigations would you request for this patient? | 87 | ||
| How would you manage this patient? | 88 | ||
| What are the pros and cons of different types of valves? | 89 | ||
| Who would you refer this patient to following initial investigations? | 89 | ||
| If this patient is listed to have an elective total hip replacement, what advice would you give to the orthopaedic team reg ... | 90 | ||
| Where to find patients for practise | 90 | ||
| Chapter 6: Central nervous system | 91 | ||
| Presenting and diagnosing neurology cases | 91 | ||
| Multiple sclerosis | 92 | ||
| Positive clinical findings | 92 | ||
| Model presentation | 93 | ||
| Lower limbs | 93 | ||
| Upper limbs | 93 | ||
| Cranial nerves | 94 | ||
| Discussion with the examiners | 94 | ||
| How would you confirm your diagnosis on this patient? | 94 | ||
| How would you treat this patient? | 94 | ||
| Hereditary sensory and motor neuropathy | 95 | ||
| Positive clinical findings | 95 | ||
| Model presentation | 95 | ||
| Discussion with the examiners | 96 | ||
| How would you confirm your diagnosis? | 96 | ||
| What is the pattern of inheritance? | 96 | ||
| What are other possible differentials of peripheral sensorimotor neuropathy if it is not hereditary? | 96 | ||
| How would you manage this patient? | 97 | ||
| Motor neurone disease | 97 | ||
| Positive clinical findings | 97 | ||
| Model presentation | 98 | ||
| Discussion with the examiners | 98 | ||
| What types of MND are you aware of? | 98 | ||
| How would you investigate this patient? | 98 | ||
| How would you manage this patient? | 99 | ||
| Myotonic dystrophy | 99 | ||
| Face | 99 | ||
| Upper limbs | 99 | ||
| Positive clinical findings | 100 | ||
| Face | 100 | ||
| Upper limbs | 100 | ||
| Model presentation | 100 | ||
| Discussion with the examiners | 100 | ||
| What are the possible complications of MD? | 100 | ||
| How would you diagnose MD? | 101 | ||
| What is the pattern of inheritance? | 101 | ||
| Parkinson’s disease | 101 | ||
| Positive clinical findings | 102 | ||
| Model presentation | 102 | ||
| Discussion with the examiners | 103 | ||
| What medications are used in the treatment of PD? | 103 | ||
| How would you investigate this patient? | 103 | ||
| Pattern recognition cases | 103 | ||
| Cerebellar syndrome | 104 | ||
| Positive clinical findings | 104 | ||
| Model presentation | 105 | ||
| Discussion with the examiners | 105 | ||
| How would you investigate this patient? | 105 | ||
| How would you treat this patient? | 106 | ||
| Peripheral neuropathy | 106 | ||
| Positive clinical findings | 106 | ||
| Sensory neuropathy | 106 | ||
| Motor neuropathy | 107 | ||
| Sensorimotor | 107 | ||
| Model presentation | 107 | ||
| Discussion with the examiners | 107 | ||
| How would you investigate this patient? | 107 | ||
| Spastic paraparesis | 108 | ||
| Positive clinical findings | 108 | ||
| Model presentation | 109 | ||
| Discussion with the examiners | 109 | ||
| How would you treat this patient? | 109 | ||
| How would you start investigating this patient? | 109 | ||
| Hemiparesis | 109 | ||
| Positive clinical findings | 109 | ||
| Model presentation | 110 | ||
| Discussion with the examiners | 110 | ||
| What are the possible causes of hemiparesis? | 110 | ||
| How would you manage this patient? | 111 | ||
| Distal weakness of the upper limbs | 111 | ||
| Positive clinical findings | 111 | ||
| Bilateral findings | 111 | ||
| Unilateral findings | 111 | ||
| Model presentation | 112 | ||
| Discussion with the examiners | 112 | ||
| Where to find neurology cases to practise | 112 | ||
| Station 4: | xv | ||
| Chapter 7: Communication and ethics | 113 | ||
| Introduction | 113 | ||
| Example scenario 1: DVLA regulations | 114 | ||
| Background | 115 | ||
| Points to cover in the consultation | 115 | ||
| Discussion with the examiners | 116 | ||
| Other conditions to be aware of | 117 | ||
| Further tips for this type of scenario | 118 | ||
| Example scenario 2: Breaking bad news | 118 | ||
| Background | 118 | ||
| Points to cover | 118 | ||
| Discussion with the examiners | 121 | ||
| Other scenarios to be aware of | 121 | ||
| Further tips for this type of scenario | 122 | ||
| Example scenario 3: Confidentiality case | 122 | ||
| Background | 123 | ||
| Points to cover | 123 | ||
| Discussion with the examiners | 124 | ||
| Other scenarios to be aware of | 125 | ||
| Further tips for this type of scenario | 125 | ||
| Example scenario 4: Communicating a medical error to patients | 126 | ||
| Background | 126 | ||
| Points to cover | 126 | ||
| Discussion with the examiners | 127 | ||
| Other scenarios to be aware of | 128 | ||
| Further tips for this type of scenario | 129 | ||
| Example scenario 5: Capacity and action against medical advice | 129 | ||
| Background | 130 | ||
| Points to cover | 130 | ||
| Discussion with the examiners | 131 | ||
| Other scenarios to be aware of | 132 | ||
| Further tips for this type of scenario | 132 | ||
| Station 5 | viii | ||
| Chapter 8: Brief clinical consultations | 135 | ||
| Introduction to Station 5 | 135 | ||
| Passing Station 5 | 135 | ||
| Presentation technique | 136 | ||
| Proposed strategy | 136 | ||
| Station 5 scenario example | 137 | ||
| Case 1: Practical example of above strategy | 139 | ||
| Hyperthyroidism | 141 | ||
| Focused questions to ask if hyperthyroidism is suspected | 141 | ||
| Signs of hyperthyroidism on focused examination | 141 | ||
| Hyperthyroidism biochemically | 141 | ||
| Causes of hyperthyroidism | 142 | ||
| Treatment of Graves | 142 | ||
| Treatment of toxic multinodular goitre | 142 | ||
| Radio-iodine therapy | 142 | ||
| In a nutshell | 142 | ||
| Practical example cases | 143 | ||
| Index | 151 |