An Aid to The MRCP PACES Volume 2, Stations 2 and 4 (Download PDF)

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An Aid to The MRCP PACES Volume 2, Stations 2 and 4 Table of Content: 

Station 2, History-Taking Skills, 7
1 Abdominal swelling, 8
2 Ankle swelling, 10
3 Asymptomatic hypertension, 13
4 Back pain, 16
5 Breathlessness, 19
6 Burning of the feet, 23
7 Chest pain, 26
8 Cold and painful fingers, 28
9 Collapse? cause, 30
10 Confusion, 32
11 Cough, 35
12 Diabetic feet, 37
13 Difficulty in walking, 40
14 Dizziness and feeling faint, 43
15 Double vision, 45
16 Dysphagia, 48
17 Epigastric pain and nausea, 50
18 Facial swelling, 52
19 Funny turns, 55
20 Haemoptysis, 58
21 Headache, 60
22 Hoarse voice, 63
23 Hypercalcaemia, 65
24 Hyperlipidaemia, 67
25 Jaundice, 70
26 Joint pains, 73
27 Loin pain, 76
28 Loss of weight, 78
29 Lower gastrointestinal haemorrhage, 80
30 Macrocytic anaemia, 82
31 Neck lump, 85
32 Painful shins, 87
33 Painful shoulders, 89
34 Palpitations, 91
35 Personality change, 93
36 Pins and needles, 96
37 Polyuria, 98
38 Pruritus, 100
39 Purpuric rash, 102
40 Pyrexia, 104
41 Renal colic and haematuria, 107
42 Tiredness, 109
43 Tremor, 112
44 Visual disturbances, 114
45 Vomiting, 117
46 Vomiting and forgetfulness, 120
47 Weakness of the right arm, 123
48 Weight gain, 126
49 Weight loss and chronic diarrhoea, 129
50 Wheeze, 131
Section E: Communication Skills
and Ethics, 135

Station 4, Communication Skills and
Ethics, 145

Category 1: Informed Consent
1 Consent for a lumbar puncture, 147
2 Consent for oesophagogastroduodenoscopy
(OGD), 150
3 Emergency surgery under principles of ‘best
interests’, 154
4 A competent patient’s refusal of treatment, 157

Category 2: Diagnoses and Management
Advice
5 Obesity management, 160
6 Side-effects of cardiac medication, 163
7 Presentation of a first seizure, 166
8 Rheumatoid arthritis, 169
9 Valvular heart disease in a young woman, 172
10 Air travel with chronic obstructive pulmonary
disease, 175
11 Polypharmacy, 178
12 Blood transfusion, 181
13 Hormone replacement therapy, 183
14 Lifestyle adjustments after a myocardial
infarction, 186
15 Smoking cessation, 189
16 Starting insulin therapy, 192
17 Refusal of analgesia, 194

Category 3: General Clinical Issues
18 Human immunodeficiency virus testing, 196
19 Communication of a human immunodeficiency
virus-positive result, 200
20 New diagnosis of tuberculosis, 204
21 Non-compliance with anti-tuberculous
treatment, 208
22 Multidrug-resistant tuberculosis, 211
23 ‘Hospital superbug’ 1 (Clostridium difficile), 215
24 ‘Hospital superbug’ 2 (methicillin-resistant
Staphylococcus aureus), 219
25 Assessing suicide risk, 223
26 Genetic counselling, 226
27 Fitness for anaesthesia/surgery, 230
28 Screening for prostate cancer, 232

Category 4: Breaking Bad News
29 Malignancy in a young patient, 235
30 A chronic illness, 238

Category 5: Ethical and Legal Issues
31 A patient with a functional illness, 240
32 Brainstem death testing and organ
transplantation, 243
33 Hospital postmortem, 248
34 Coroner’s postmortem, 253
35 Do not attempt resuscitation decisions, 257
36 Withholding information from patients, 262
37 Maintaining patient confidentiality, 266
38 Advance care decisions, 270
39 Healthcare decisions for a patient who lacks
mental capacity, 274
40 Care of the vulnerable adult, 278
41 Blood transfusion for a Jehovah’s
Witness, 282
42 Eligibility for major surgery, 285
43 Postponement of an investigation, 287
44 Clinical error in drug administration, 289
45 Fitness to drive, 292
46 Limits of treatment in end-stage
disease, 295
47 Withdrawing treatment, 298
48 Enrolling a patient in a clinical trial, 301
49 Industrial Injuries Disablement Benefit, 304
50 Internet therapy, 306
51 Unrelated live donor transplant, 309

Category 6: Dealing with Difficult Patients/
Relatives
52 A patient desperate for a diagnosis, 311
53 A missed tumour, 315
54 An unhappy inpatient, 319
55 Delay in investigation, 322
56 A patient wanting to self-discharge, 324

Category 7: Professional Issues and
Communication with Colleagues
57 Major incident exercise, 327
58 A struggling team of doctors, 330
59 A colleague with hepatitis B infection, 334
60 A colleague with a needlestick injury, 337
61 The improper doctor, 340
62 The incompetent doctor, 343
63 The sick doctor, 345
64 Consent for medical examination, 347
65 Submitting an audit project, 350
66 Treating a prisoner, 353
67 A violent and abusive patient, 355
68 Withdrawing treatment in intensive care,
357

Section F: Experiences, Anecdotes,
Tips, Quotations, 359 Full PACES experiences in the first person (since
2009), 367
Full PACES experiences in the first person (before
2009), 389
Additional Station 2 experiences, 427
Additional Station 4 experiences, 431
Invigilators’ diaries – Stations 2 and 4, 435
Some anecdotes from our most recent surveys,
435
Experiences, 437
The power and range of the candidate’s
observations, 439
The candidate’s examination technique, 441
The clinical competence of the candidate, 443
Common errors, 444
Look first, 444
Double pathology, 445
Tell them of the expert that told you, 445
Apologies accepted, 445
‘Even though I didn’t mean to say it – I did’, 446
Invigilator’s diaries, 446
Fly on the wall – complete accounts, 448
Ungentlemanly clinical methods, 452
Miscellaneous ‘pass’ experiences, 452
You never know you’ve failed until the list is
published, 464
Survivors of the storm, 466
Some ‘fail’ experiences, 470
Downward spirals, 475
Anecdotes, 477
Some anecdotes in the first person, 480
Miscellaneous, 483
Useful tips, 483
Quotations, 484
Adopt good bedside manners, 485
Practise clinical examination and presentation,
485
Get it right, 486
Listen, obey and do not stray, 486
One wrong does not make one fail, 487
If you say less they want more, 487
Humility is more persuasive than
self-righteousness, 487
Keep cool: agitation generates aggression,
488
Simple explanations raise simple questions, 488
Think straight, look smart and speak
convincingly, 488
You have seen it all before, 489
Use your eyes first and most, 489
Doing and forgetting, 489
Examiners are different, 489
Additional comments and quotes from
candidates, 490

 

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