Table Of ContentAl-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
6
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
9
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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