Looks easy ? If a case looks easy in MRCP, always think again and do something to impress the examiners.Examination :
Hands - Tremor, onycholysis, Acropashy, Warm sweaty palms
Pulse rate, Irregular to suggest AF ?
Proximal myopathy
Eyes - Exopthalmos, proptosis, Lid lag, lid retraction, Extraocular movements, chemosis
Neck - Scar, Goitre - Inspect, palpate for ? single nodule, multinodular, diffuse(most likely diffuse in Graves), percuss for retrosternal extension, auscultate for bruit
Limb - Pretibial myxedema, tendon reflexes
Well, if you got all those, I guess medical students can do all that.
So, you need to mention whether the disease is active or not.
Signs of activity - tremor, warm&sweaty palms, Thyroid bruit, Tachycardia
So mention the diagnosis as Graves disease and currently the disease is active as evidence by.....
2 comments:
if i present want to end my examination by checking for other autoimmune signs such as vitiligo, any hyperpigmentation with abdominal pain (addison's ds), and check for RBS (type I dM), is it sounds more better? or will i be asked more for these all autoimmune diseases and in case i don't know, then i will dig my own grave already?
A good MRCP teacher once told me that if I could examine whatever I want to mention, go ahead and examine till the examiners stop me. I think that it is not wrong to mention those you mentioned, but most importantly to say it confidently and to sound as though you mean it rather than memorize to present during the exam.
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