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.
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Best wishes, Dr Elmuhtady Said
?mass under the scar. ?bilateral palbable masses of polycystic kidney.
no bilateral masses ,but scar of nephrectomy: ?renal tumor ?polycystic kidney
no bilateral masses and no scar of nephrectomy: ?DM ?high BP
contimue inspecting for: 1.B-C fistula 2.stigmata of cyclosporin/azathioprin/steroids therapy 3.other scars:PD,subclavian line 4.dermopathy of DM,BMS site
in transplant you're expected to comment on: previous modes of replacement Rx current drug therapy is it functioning? original cause of renal failure possible complications: neck scar for hyperparathyroidism, viral warts, native kidney removal scar
so: inspect arms, legs, tremor, gegiva, skin, neck scars
palpate for transplant and native kidney
inspect the back, insulin pump, finger tips
even if you feel liver edge or spleen don't comment on that or else you will put yourself in a big big mess!!!
nice work i think its also worth looking for ptosis and a surgical scar in the forhead i.e repair of post. comm artey anuerysm.. incase the setting was a PCKD .
why not to coment on spleen and liver,i had a pt with cld and liver transplant both,pt has dupuytrens contracture and gynecomastia with all other signs of renal transplant.
let me try,
ReplyDeletepossibilities:
patient with renal transplant.
?mass under the scar.
?bilateral palbable masses of polycystic kidney.
no bilateral masses ,but scar of nephrectomy:
?renal tumor
?polycystic kidney
no bilateral masses and no scar of nephrectomy:
?DM
?high BP
contimue inspecting for:
1.B-C fistula
2.stigmata of cyclosporin/azathioprin/steroids therapy
3.other scars:PD,subclavian line
4.dermopathy of DM,BMS site
any other thoughts?
scar in iliac fossae
ReplyDeleteeither a transplant or crohn's dis.
in transplant you're expected to comment on:
previous modes of replacement Rx
current drug therapy
is it functioning?
original cause of renal failure
possible complications: neck scar for hyperparathyroidism, viral warts, native kidney removal scar
so:
inspect arms, legs, tremor, gegiva, skin, neck scars
palpate for transplant and native kidney
inspect the back, insulin pump, finger tips
even if you feel liver edge or spleen don't comment on that or else you will put yourself in a big big mess!!!
nice work
ReplyDeletei think its also worth looking for ptosis and a surgical scar in the forhead i.e repair of post. comm artey anuerysm.. incase the setting was a PCKD .
why not to coment on spleen and liver,i had a pt with cld and liver transplant both,pt has dupuytrens contracture and gynecomastia with all other signs of renal transplant.
ReplyDeleteoh thats a hard one , CLD with liver transplant and kidney transplant and signs of ???
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ReplyDelete