Sunday, September 16, 2012

For SALE !!!

Brand new Litmann II SE blue for sale for only RM200.
Email me if interested :

Thursday, March 15, 2012


Please look at this patient's tongue and proceed with the examination.

What would you do next and what are your differential diagnosis ?

Friday, February 17, 2012

MCQ for medical students and MRCP Part 1 or 2a

A 35 years old Malay lady presented with weakness of the legs when climbing stairs over the past 2 weeks. She has had no previous illness and are not on any medications. When she came to the outpatient clinic, you noted the above findings. Which of the following is true regarding the patient.

A. A DMARDs should be started immediately
B. The patient need to be counseled regarding risk of similar illness in her siblings and future offsprings
C. The lesions in the picture is a violaceous rash which would be very itchy
D. Intralesional triamcinolone would be part of the treatment
E. This patient would need steroids

Thursday, February 16, 2012

Experience from a recent candidate in Singapore MRCP PACES exam

As he enters the room of the Neurology station in the Singapore exam in TTSH, he was given a patient who has resting tremors, bradykinesia and rigidity......the diagnosis was obvious- Parkinson disease.
However, he was asked by the examiner.....what do you think is this on the patient ?

How would you answer the examiner ?

Tuesday, February 14, 2012

MCQ for medical students and MRCP Part 1 or 2a

A 73 years old Chinese lady came to you in the outpatient complaining of chronic pain over the joints of the hands. All the following are true except :

A. the knees and the cervical region may have similar problem
B. the first line of pain relief medication is paracetamol
C. Leflunamide is one of the treatment as a DMARDs
D. The PIP involvement is called Bouchard's nodes
E. The DIP involvement is called Herberden's nodes

Monday, February 6, 2012

MCQ for Medical Student

The following are causes of the above except :
a. Cyclosporin
b. Phenytoin
c. Thiazide diuretic
d. Vit C deficiency
e. acute myeloid leukemia

Sunday, February 5, 2012

MCQ for MRCP part 1 and 2a

This gentleman arrived in the ER with shortness of breath and difficulty in swallowing.

Question 1 :

What is the pathophysiology of his problem ?
a. Antibodies to presynaptic P/Q type voltage gated Ca channel
b. Antibodies to voltage gated K+ channel
c. Antibodies to postsynaptic Ach receptor
d. Antibodies to voltage gated Na channel
e. Antibodies to presynaptic Ach receptor

After assessment of airway, breathing and circulation, the patient was intubated/stabilized and was admitted to the ICU.

What is the treatment of choice for this patient ?
a. IV immunoglobulin
b. IV cyclophosphamide
c. 3,4-aminopyridine
d. conservative management
e. I don't know the answer, refer to the neurology experts !

Friday, January 20, 2012


Hospital Batu Pahat will be organising an MRCP PACES MOCK EXAM 2012 on 10/3/2012. Examiners include Dr Christopher Lee, Dato Dr Sree Raman, Prof Dato Raymond Azman Ali, Datuk Aziah(IPR), Dr Hooi Lai Siong, Dr Lee Man Pin, Dr Paras Doshi, Dr Kauthamon as our distinguished examiners.

For more information, please email:

Sunday, January 15, 2012

This 18 years old boy has complaints of releasing his grip when intending to throw a ball.
What is the diagnosis ?