Pre PACES Podcast
@prepacespodcastEqual doses education & entertaining. @Dr_SamWilliams helps ease the pain of the MRCP PACES medical exam with expert speakers, key knowledge & bad jokes.
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👋🏻Hey listeners!👋🏻 ♥️Do you love the pod? 🎉Maybe you've become another PACES success story? 🧠Or you've learned something that helped in your own practice? ⬇️Consider an optional, pay-what-you-can donation over at buymeacoffee.com/prepacespodcast 🙏🏻As ever, thanks for listening!
🌟NEW EPISODE KLAXON!🌟 🎊For episode 99 we have welcomed a BIG DOG 🐶 in the world of clinical reasoning and Med Ed: Professor Nicola Cooper! 👨⚕️@Dr_SamWilliams & @Cooper00Nicola talk through the pearls & pitfalls of clinical reasoning! ⬇️Listen now! open.spotify.com/show/5i7o1ENPU…
‼️Happy Sunday listeners! 🎧A brilliant episode coming later today on something hugely applicable to both PACES and critical in our day to day clinical practice! 👨⚕️A real boon of a guest too! 👀 Keep your eyes on your podcast feeds!
🌟NEW EPISODE KLAXON 🌟 @Dr_SamWilliams welcomes along Dr Yezen Samaraiee, neurology SpR to discuss.... 🧠CEREBELLAR SYNDROME 🎧A brilliant episode with tons of learning points for your PACES! ⬇️Listen now! open.spotify.com/episode/5JHdSx…
Thanks Sam @prepacespodcast for having Josh and I back to chat about Decision Fatigue, surviving the night shift and medical rules for life! shows.acast.com/the-pre-paces-…
‼️Happy Monday listeners! 🎉An exciting milestone to announce!! 🎧300,000 total downloads! Thank you all for listening!
‼️Another splendid episode coming to your podcast feeds tomorrow listeners! Here's your clue: 🟡 Yep that's all you're getting!
🎂It's a very special day listeners! 🥳 ☕If you didn't know the best day to buy @Dr_SamWilliams a coffee...today is the day!⬇️ buymeacoffee.com/prepacespodcast 🎈🎉Happy birthday Sam!🎂🥳
🗣️Dysphagia🗣️ Management of suspected oesophageal malignancy: - Refer to upper GI MDT - Staging CT - Confirm histological diagnosis - Ensure nutrition is addressed - dietetics opinion
🗣️Dysphagia🗣️ Achalasia...gold star stuff here for your examiners 🌟Gold standard diagnostic test is oesophageal manometry
🗣️Dysphagia🗣️ Alternative investigations...for example the patient won't tolerate or are not suitable for an upper GI endoscopy 🌟 Barium / oral contrast swallow offers live action of the oesophageal motion which can be especially helpful for neuromuscular or anatomical causes
🗣️Dysphagia🗣️ ☢️Investigations 📷With a history of progressive dysphagia, an upper GI endoscopy should really be your most important diagnostic test 📷 🩸Bloods obviously important: - Microcytic anaemia (or anaemia of chronic disease) - Liver function - Clotting
🗣️Dysphagia🗣️ 🩺Examination - Consider neck examination or palpation of a neck lump - If suggestion of a neuromuscular causes then may want to focus your examination for a specific diagnosis, e.g. checking for fatiguability in the case of myaesthenia gravis
🗣️Dysphagia🗣️ ✋Hands, 😀 Face, 💪 Arms - Is there clubbing? - Any conjunctival pallor? - Palpate for lymph nodes - especially Virchow's node!
🗣️Dysphagia🗣️ 🩺Examination 🛏️End of the bed - Are they cachectic or pale? - Any obvious lymphadenopathy? - Is there obvious abdominal distension? - Is there an obvious neck lump?
🎉Happy weekend listeners!🎉 😌Take some time to rest and relax, we hope at this point you've settled nicely into your IMT rotations & learning plenty!
🗣️Dysphagia🗣️ 🏠Social history Predominantly comprises 🚬Smoking 🍺Alcohol consumpton
🗣️Dysphagia🗣️ ⬇️Drugs associated oesophagitis that may contribute to reflux-related strictures: 💊Bisphosphonates (alendronic acid) 💊Nicorandil (an anti-anginal) 💊Systemic steroid treatment (prednisolone) 💊NSAIDs (though more often gastritis) ❓Can you name any others?
🗣️Dysphagia 🗣️ 🧠Neuromuscular causes of dysphagia: Motor neurone disease Myaesthenia Gravis Multiple sclerosis Parkinsonism Bulbar palsies Stroke
🗣️Dysphagia 🗣️ 🍔Ask about what food they are able to tolerate 🚧Typically, mechanical or obstructive causes of dysphagia tend to cause problems with solid food first, before affecting liquids. ⚡️Neuromuscular causes would tend to causes problems with both from the outset
🗣️Dysphagia 🗣️ 🤮If there is a strong background of dyspepsia or reflux symptoms, consider reflux oesophagitis as a possible cause of dysphagia 🫁Eosinophilic oesophagitis may be associated with atopic conditions such as eczema, hay fever and asthma
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