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Case ID: 1
Created: 11 October 2017

View Dr Goh Heong Keong Site HERE!!

Station Short Case:

Subject Ms Roki- 45 years old

Ms Roki is having discomfort over her upper limbs. Please inspect and proceed.



You might not pick up at the first look but this is a common MRCP PACES question. What you notice here is the patient left upper limb is more swollen than the right. So, obvious causes are either central stenosis or lymphatic obstruction.

Therefore,always look for presence of dialyis fistula or catheter. Central stenosis usually happens after prolonged usage of neck catheter, make sure you look at the neck for scar.Lymphatic obstruction is either due to breast cancer or previous radiation, look for masectomy scar or radiation mark,

You should proceed to do the following,

arrow1) Suggest to examiners you would like to check femoral catheter if you can't one in the neck

arrow2) History of neck catheter insertion

arrow3) Suggest to examiners you would like to ask about history of breast cancer


Common Questions in MRCP PACES,

1) What are the treatment for this?

2) What are the complications?

Extra points:

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Case ID:2
Created: 11 October 2017

Breaking trial in Clinical Medicine/Nephrology



Background History:

    Ig A Nephropathy is always bread and butter for nephrologists. However, in view there is a wide range of spectrum of this glomerular disease, treatment is contraversial.Dr Thomas Rauen looks at treatment option for this illness.

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