Al-Rokh’s Pacemaker of Paces

312 Pages·2017·7.438 MB·English

by  Al-Rokh

Al-Rokh’s
Pacemaker of Paces

A simplified approach For MRCP (UK) Paces

Communication - History - Brief consultation

First Edition
By/ Dr. Sadek Al-Rokh
MBBS Mansoura University
MRCP United kingdom
International Medical Center (Jeddah)

ME
MIDDLE EAST LIBRARIES
01110150022-01001485817-01221570154

1
Pacemaker of Paces
A simplified approach - for MRCP Paces
Edited by Dr. Sadek Al-Rokh
MRCP (UK)
International Medical Center (Jeddah)

Copyright© 2017

ISBN 978-977-6551-04-6 :
2016/20959
All rights reserved

No part of thispublication may be reproduced, printed or
transmitted in any from or by any means, electronic of
mechanical, including photocopying, recording or any
information storage or retrieval system without penmission in
writing from the publisher.

Arabic

Publisher: Middle East Libraries
01110150022 - 01065351200 - 010014S5317 - 01221570154
E-mail: [email protected]
ME
MIDDLE EAST LIBRARIES
01110150022-01001485817-01221570154

2
Arabic

And of knowledge, you (mankind) have been given only a little.

DEDICATION

This book is dedicated to ray great mother who always taught me to love giving
and helping others.

And to my wonderful wife for her patience and encouragement.

And to my dear colleagues, wishing that this book could help and ease their
approach in the exam and real medical practice.

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Contents

Station 4 Communication...1

About Communication (Station 4)…..2
Communication Scheme…..5
Counseling for chronic disease
(Pheochromocytoma) …..7
Counseling for chronic disease
(Multiple Sclerosis) …..10
Counseling for chronic disease (Adult polycystic kidney
disease) …..13
Counseling for chronic disease
(Addisoo disease)…..16
Counseling for chronic illness
(Celiac Disease)…..19
Counseling for chronic illness (Epilepsy) …..22
Active TB Asking for discharge…..25
Breaking bad news (Advanced cancer for palliative care)…..29
A Nurse with a needle stick injury from a patient with HIV…..32

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Contents

(Medical error) Angry son - Father developed Allergy for codeine…..35
Complication of a procedure Angry son - Father
died after a procedure (PCI) …..38
Counseling for DNR decision…..41
Counseling for Steroid therapy Side effects…..44
Counseling for Warfarin side effects…..47
Counseling for Genetic test…..50
Counseling for a procedure (SLE for Renal biopsy) …..53
Breaking bad news Counseling for hickman line
(Hodgkin Lymphoma for hickman line) …..56
Drug incompliance…..59
Patient with Suicidal Attempt Asking For Discharge…..62
Somatization Somatoform Disorders…..66

Station 2 History...73
About station 2 (History taking) …..74
History Approach…..75

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Microcytic Anemia in Young Female.....78

Chronic Diarrhea.....83

Jaundice.....88

Chronic Cough and Wheezy chest.....94

Chronic cough and hyponatremia.....100

Both Lower limb weakness.....105

Periodic paralysis.....110

Abnormal sensation in both Lower limbs.....115

Ataxia.....121

Tremors.....126

Low Back pain.....131

Monoarthritis.....136

Osteoporosis.....141

Hematurea in young Femate.....146

Recurrent chest pain in young mate.....151

Recurrent Sweating and Gtycosurea.....157

Skin rash and SOB.....162

Syncope.....169

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Station 5 Cases … 175

About station 5 (Brief consuitation)….176

Vitiligo….179

Psoraisis….183

Hereditary Hemorrhagic Telangectesia (HHT) ….186

Pemphigus….190

Neurofibromatosis….195

Chronic Mouth Ulcer….199

Tuberous Sclerosis….202

Acromegaly….206

Addison Disease (Hyperpigmentation)....212

Cushing Syndrome (Weight gain) ….216

Neck lump (Graves' disease) ….220

Obstructive sleep Apnea (Hypothyroidism) ….225

Ankylosing Spondilitis….228

Psoraitic Arthropathy….233

Rheumtoid Arthritis….236

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Systemic Lupus Erythematosus….241

Systemic scterosis ….245

Monoarthritis….251

Retinitis Pigmentosa….254

Papiiioedema….258

Optic Atrophy….262

Diabetic& hypertensive Retinopathy….266

Limb weakness in young femaie….271

Sudden paintess loss of vision….275

Both lower limb swelling….278

Chest pain (Pulmonary embolism) ….281

Hematemsis and Metena….285

Lymphadenopathy ….289

Tall Stature (Marfan Syndrome) ….292

Pruritus….297

Miscellaneous Notes….300

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Communication

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About Communication (Station 4)

 Communications is 20 minutes, 14 minutes with the surrogate, 1 minutes to review your ideas and 5 minutes
with the examiner.
 You are given 5 minutes before the station in which you have to read he scenario and prepare yourself. Focus on
every word in the scenario to know the patient name, your task and your position.
 These 5 minutes prior to the station are very precious to prepare yourself, organize your ideas , structure your
case and write scheme of the headlines you are going to discuss with the surrogate in a white paper to cover all
the important points in the scenario.

Golden points in communication

1. Make a good scheme in your mind and write it on your white paper in headlines to cover all the important points
in the station.
2. But a good structure and be organized in your thoughts and information during your discussion with the
surrogate.
3. Avoid jargons absolutely, try to be fluent in your discussion.
4. You have to be a good actor, with empathic body language and eye contact.
5. Don't push a lot of detailed complicated information to the surrogate.
6. Don't interrupt the surrogate when he is talking and let him to express his thoughts, feelings or queries.
7. Be interactive with the surrogate, don't talk a lot without checking his understanding and absorption saying are
you with me Mr (x)?.. Does it makes any sense for you.. Please don't hesitate to interrupt me any time for any
query.
8. If the Surrogate showed any variant emotions like anger, denial or crying, don't interrupt him and try to
understand and appreciate his feeling.
9. Show empathy and sympathy from time to the other in breaking bad news and counseling for chronic illness in

empathic body language and eye contact.

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