PACES review on your computer??

While scouring for good information and books on Amazon, I came across a Kindle version of the PACES book we featured in this blog. Well, it more of 'an aid' to the existing books, but sometimes that's just what you need for last minute revision. Did you know you can access Kindle books on your computer, though its great own a Kindle and revise on the go! Here it is my friends -

Carrying heavy books around can be frustrating. This book on your Kindle or on your computer is brilliant to revise when travelling about. I am assuming that you all possess a Kindle - if you don't have it, get one! Its great - why do you think it remains the number one seller on Amazon!! :-)




Best wishes y'all!

Answer to clinical scenario 27.03.2012

Hey everyone,

You may remember the clinical scenario that was posted on the 27th of last month. Well, for those of you who were wondering what the actor was asked to do - if the candidate apologised for the accident with the lignocaine and stated that it was contraindicated in her father, the actor would stand up and shout 'you killed my father' and leave the room! Imagine that.

The correct way to handle that situation is to explain the situation in its totality, and explain that at the local anaesthetic concentration, lignocaine pretty much has no effect on the heart, so would play no role in contributing toward the patient's death. Of course, you would also get a senior to discuss the situation with you and the family together.

MRCP clinical scenarios only appear scary on paper. They are no more than regular scenarios encountered in clinical practice. Keep a cool head, and they are all a walk in the park.

More scenarios soon!

Cardio4mrcp team.

Case 1 - How will you handle this?

You are called to casualty to see an 81 year old man who has a background history of ischemic heart disease and hypertension. He is admitted with acute shortness of breath and is in atrial fibrillation with a ventricular rate of 162 bpm. His blood pressure is only 80/60 mmHg. He is in heart failure. He is being given oxygen, but the staff are having a lot of difficulty obtaining peripheral access. You insert a central line in, flush it to ensure it's patency, and give him some frusemide to help shift the fluid. Unfortunately a short while later, he arrests, and despite the best resuscitation efforts, he dies. While cleaning up the area, the staff mentions to you that the patient's daughter is in the waiting area and has no idea what is going on. While preparing yourself to go and speak to her, you notice that you injected lignocaine (used to anaesthetise the skin) into central line while flushing it instead of saline. Knowing fully what the effects of intravenous lignocaine can be in such a situation, you have to now speak to the daughter, who is anxious to know what is going on, as she is his main carer.

How will you go about handling this scenario? Submit your answers in the comments box and I will tell you what the daughter was instructed to do!

By the way, this was an actual scenario that I wrote for the exams. Good luck!

Vik

Passing the PACES

Right, once you have passed the written exam, then comes the toughest part of the MRCP - (drumroll!) the PACES. 5 stations, tough clinical cases and some moody examiners! But go in with the right preparation, and you will absolutely wing it! Its really not that hard; just think of it as a ward round  or an on-call shift where you are asked to see complicated and sick patients. Beware however, sometimes you could get a normal case, like I did in my exam 6 years ago. I remember it well - abdominal station, normal abdomen but she was pseudocushingoid. Don't know how, but I got it! Phew!

Well, actually I do know how. Like many of us who passed, we had the right tutors and the right books to prepare. While you may get some old books handed down by registrars to you, just remember that newer editions and new books that emerge have new cases and sometimes provide you with valuable tips on picking up ceratin things. Of course, the whole inspection-palpation-percussion-auscultation rule always applies, but its the little things that these books will help you with.

I have listed a few books below that will no doubt be useful. Once you have these, ensure you have a study partner who will critique you every time you examine a patient. I tell you, it helps.

I have organised the MRCP PACES exam in the past, and I have seen first hand what the examiners can mark you down on, and what you can score full on. Remember the steps in examination and be cool and calm. No patient wants to see a nervous doctor!!

Books to read :

I would strongly recommend these.  Study well and you can score full marks. In my next post, I will be placing a tough clinical scenario that was in the MRCP communication station a few years ago. I look forward to hearing how you will handle it!

Happy reading!

Vik