Dear friends and colleagues, Passing the MRCP UK is an important step in the medical career. PACES is the practical clinical exam and require a wide breadth of knowledge. This blog is a space to share materials, information and knowledge and I hope you find it useful. Am open for any ideas or suggestion and would value your contributions and comments. please visit my related pages on facebook and youtube. Best wishes, Dr Elmuhtady Said
PACES Stations
- General
- PACES station 1 abdomen
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- PACES station 5 (new station 5)
- PACES station 5 endocrinology
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Monday, 2 June 2008
Addison's disease
there is generalized pegmentation,most marked in scars,skin crease and buccal mucosa.
examin the abdomen for adrenal scar(Nelson syndrome)
check the BP lying and standing
how would you confirm the diagnosis?
Random cortisol
Short synacthin test (normal cortisol rise above 600 nmol/l or increase by 300 nmol/l)
ACTH level or long synacthin test
what is the most common cause?
mention other caues of hyperpegmentaion.
what is Schmidt's syndrome?
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PACES station 5 endocrinology
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causes of Addison's disease:
ReplyDelete1-80% idiopathic(autoimmune)
2-TB
3-metastasis
4-HIV infection
Short synacthin test:
ReplyDeleteAdrenal glucocorticoid secretion is controlled by ACTH released by the anterior pituitary.
This test evaluates the ability of the adrenal cortex to produce cortisol after stimulation by synthetic ACTH (tetracosactide; Synacthen ®).
Adrenal insufficiency is excluded by an incremental rise in cortisol of > 200nmol/L and a 30 min value > 600 nmol/L.
Autoimmune
ReplyDeleteSchidmt syndrome- Addison disease together with hypothyroidism
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