PACES station 3

Cardiovascular System: Murmurs

PACES station 3 CVS (systolic murmur)

1-Systolic murmur in the aortic area
(a) Aortic stenosis: low volume pulse/difficult to feel, radiation to carotid (check both side)
(b) Aortic sclerosis: normal pulse volume, no carotid radiation (say mild AS and flow murmur as your differentials)
(c) HOCM: associated MR may be present (dynamic auscultation)
(d) Flow murmur: associated aortic valve replacement (AVR)

2-Systolic murmur in pulmonary area
(a) ASD: thrill, pulmonary hypertension, fixed splitting of S2, atrial fibrillation
(b) Pulmonary stenosis (PS): thrill, rare
(c) Pulmonary flow murmur: associated cyanosis, clubbing & polycythemia in Tetralogy of Fallot (TOF)
(d) HOCM: associated MR may be present (dynamic auscultation)

3-Systolic murmur in tricuspid/lower left sternal area
(a) VSD: younger age, pulmonary hypertension
(b) Tricuspid regurgitation: secondary to MS/pulmonary HTN, Ebstein anomaly (cyanosis, clubbing), pulsatile liver or epigastrium
(c) Mitral regurgitation: axilla radiation, apical thrill, more prominent in apex, atrial fibrillation

4-Systolic murmur in apical area
(a) MR including mitral valve prolapse (MVP) and HOCM
(b) TR
(c) VSD
(d) AS (radiation, also present in aortic area with carotid radiation)

Nephrology for MRCP written

Nephrology for MRCP written

1-Hydration versus N-acetylcysteine in contrast nephrotoxicity

2-Renal biopsy in childhood nephrotic syndrome versus adult-onset nephrotic syndrome

3-Transabdominal renal biopsy versus transjugular renal biopsy

4-Glomerular haematuria versus lower urinary tract haematuria

5-Haematuria versus myoglobinuria

6-Thin GBM disease versus Alport’s syndrome

7-Microalbuminuria

8-Cystitis versus pyelonephritis

9-Nitrofurantoin in UTI

10-Micturating cystourethrogram versus DMSA isotope renogram in VUR (reflux nephropathy)

11-Acute kidney injury (AKI) versus chronic kidney disease (CKD)

12-Pre-renal azotemia versus acute tubular necrosis (ATN)

13-Seven steps of CKD management

14-Role of ACE inhibitors in CKD

15-Role of calcium carbonate in CKD

16-Hyperparathyroid bone disease versus adynamic bone disease in CKD

17-Cinacalcet

18-Erythropoietin deficiency versus iron deficiency anemia in CKD

19-Side effects of erythropoietin therapy

20-Monitoring during erythropoietin therapy

Common Question appearing in SLE Exam- Saudi Licensing Exam

Here are the Common Question appearing in SLE Exam- Saudi Licensing Exam

Thanks to Dr. SOSo for sharing this qbank with us

This licensing exam is necessary for all doctors who want to practice medicine as a general practitioner or as a specialist in Saudi Arabia. The exams are different for different specialities and for general practice.

One can appear in this exam anywhere in the world, while for appearing in saudi arabia you need an eligibility number.

The exam is SINGLE BEST TYPE MCQs. and as the questions are repeated so it is better to take a look at past papers of SLE.


This QBANK CAN BE READ HERE

Saudi License Exam for General Dentist-Updated

Today I am sharing important q bank for General Dentist Exam for SCHS- Saudi Licensing Exam

Hope it helps. Remember in prayers

We present here  'A Comprehensive Review for Saudi Licence Exam for General Dentist'

Saudi Licensing Exam (SLE) for Dentist is a ‘Saudi Commission for Health Specialties’ (SCHS) exam forDental speciality.

This licensing exam is necessary for all dentists who want to practice dentistry as a general practitioner inSaudi Arabia. The exams are different for different specialities and for general practice.

It can either be taken inside Saudi Arabia (where you need an eligibility number from the SaudiCommission for Health Specialties, which is a hassle) or in several countries of the world (where noeligibility requirement applies, which is great).

The quickest and easiest way to make yourregistration on-line.

This exam counts when you apply for jobs in Saudi Arabia. An organization calledPrometricarranges thisexam inside as well as outside of Saudi Arabia.

Passing this exam is one of the requirements for license to work in Kingdom of Saudi Arabia. Moreover, Iyou pass the test, you did not get practice license, it just means that you have reached the standard asrequired by the SCFHS to practice in your chosen speciality

Result of examination is valid for three years.

You have to answer 70 MCQs and the time is 2 hours

Passing Score is 60 %

Thanks to Dr Younis for sharing his book with us..

This book can be read HERE

Jobs for dental nurse at CANADIAN SPECIALIST HOSPITAL

Jobs for dental nurse at CANADIAN SPECIALIST HOSPITAL

Completion of a formal program of professional nursing education and current licensure as a professional registered nurse.

Experience
Two years clinical nursing experience following licensure/registration in the country of origin with DHA license to practice Dubai, U.A.E.

No of Positions
1

Closing Date
31 December 2016
These responsibilities include placement and removal of the rubber dam, placement of temporary dressings, taking alginate impressions for study models, removal of surgical sutures, and removal of excess cement following crown and/or bridge cementation.

The clinical functions performed include;

preparing and dismissing patients;

point of use cleaning of instrumentation and disinfecting equipment;

providing post-operative instructions prescribed by the dentist;

maintaining supply order;

maintaining applicable records, and others as requested by the dentist.

Participates with the dentist in the examination and treatment of patients by retracting cheeks and tissues and by irrigating and aspirating mouth fluids without harm or discomfort to the patient.

Anticipates the dentist’s needs and practices four-handed dentistry to provide efficient operative procedures for the patient or as assigned to a dental surgical operating team.

Performs expanded duty procedures under the supervision of the dentist as required.


TO APPLY TO THIS JOB

CLICK HERE

Family Medicine Consultant jobs in Riyadh & Qassim, Saudi Arabia

Family Medicine Consultant jobs in Riyadh & Qassim, Saudi Arabia

The Medical Group is One of the largest providers of comprehensive healthcare services in the Middle East. Currently operating 9 Medical Facilities including General Hospitals, Specialized Hospitals and Medical Centers. The Hospitals are JCIA & ISO Accredited. The Medical Group is proud to have 900+ doctors, 2800+ nurses. Highly Attractive 2 Year Family or Single contract packages available for international candidates. Benefits such as Free Fully furnished accommodation, Free Flight tickets, educational allowance for children, medical insurance etc. If you feel your qualifications, skills and experience is a good match for this position we encourage you to contact us using the +APPLY BUTTON (on your right). Not suitable for you? Why not pass this position on to a friend or colleague? Note: Global Medical Recruiting will not charge you, the applicant any placement fees.

To APPLY THIS JOB CLICK HERE

MRCP PACES COURSE Preparation

PACES COURSE preparation

Download MRCP Past test part 1 2016

Download past test Free download part 1

Latest 2016 @ The Online Medicals FOAMed#


Follow the link

HIGHEST Yield Pearls for MRCP 1 2 & PACES

HIGHEST Yield Pearls for MRCP 1 2 & PACES

1) Hepatitis "D" Virus has HIGHEST mortality in ALL people EXCEPT#Pregnancy.
In Pregnant women: MOST LETHAL is Hepatitis E virus.
2) "While calculating Serum Osmolality the serum Na is multiplied by 2 to account for the accompanying ANIONS (mostly Cl- & HCO3-)."
3) Most Common cause of Metastasis to LIVER is primary cancers of Lung.
LLLLLungs send metastasis to LLLLLLiver.
4) Ketamine is the ONLY induction agent that causes Bronchodilation.
Again:
Ketamine is the ONLY induction agent that causes Bronchodilation.
5) AANNencephaly: failure of AANNterior neuropore to close.(at day 25)
SSSpinda bifida: failure of poSSSterior neuropore to close.(at day 27)
6) Muscle Spindles: Innervated by 1a fibers - cause skeletal muscle to CONTRACT.
GTOs: innervated by 1b - cause contracting muscle to RELAX
7) In SSSpontaneous pneumothorax: trachea shifts to ipSSSilateral side.
In TTTension pneumothorax: trachea deviates to conTTTralateral side.
8) Antibiotics SAFE in pregnancy:
All Penicillins.
All Cephalosporins.
All Carbapenems.
Aztreonam.
Azithromycin.
Nitrofurantoin (Avoid in last trimester bcoz can cause hemolysis in G6PD deficient fetus).
Metronidazole (SAFE in ALL trimesters).

Free Exam Resources for doctors

Following are free resources for exam Practice
Specefically MRCP, PLAB, MRCGP and clinical revision

MRCPass

• Notes on topics covered in MRCP Part 1
• 130 MCQ questions
• Bookmark questions
• Choose questions by topic
• Track statistics
• Look back over wrong answers

Revise MRCP

• Covers MRCP Parts 1 and 2
• Over 5,000 MCQs arranged by topic
• Free to sign up
• Past papers going back to September 2010

Medexam.net 

• Over 1,800 MCQs with detailed answers

The Only MRCP Notes you will ever need 5th Edition: 2015 Edition

The Only MRCP Notes you will ever need 5th Edition

This is a solid book for consolidating your knowledge before the exam, Most of the data is updated than the 4th edition, But still few topics you should see through Passmedicine.com like ACS, STROKE, ARRHYTHMIA management. 

Also latest Treatment for diabetes according to NICE December 2015 guidelines 

Terminology of Acid-Base Disorders

Definitions

The definitions of the terms used here to describe acid-base disorders are those suggested by the Ad-Hoc Committee of the New York Academy of Sciences in 1965. Though this is over 35 years ago, the definitions and discussion remain valid today.

Basic Definitions

• Acidosis - an abnormal process or condition which would lower arterial pH if there were no secondary changes in response to the primary aetiological factor.
• Alkalosis - an abnormal process or condition which would raise arterial pH if there were no secondary changes in response to the primary aetiological factor.
• Simple (Acid-Base) Disorders ¹ are those in which there is a single primary aetiological acid-base disorder.
• Mixed (acid-Base) Disorders ^2,3 are those in which two or more primary aetiological disorders are present simultaneously.
• Acidaemia - Arterial pH < 7.36 (ie [H⁺] > 44 nM )
• Alkalaemia - Arterial pH > 7.44 (ie [H⁺] < 36 nM )

Regulation of Intracellular Hydrogen Ion Concentration

Importance of Intracellular [H⁺]

The most important [H⁺] for the body is the intracellular [H⁺]

Why? Because of its profound effects on metabolism and other cell processes which occur due to the effects of [H⁺] on the degree of ionisation of intracellular compounds. Specifically:

• Small molecule effect: Intracellular trapping function -due to the ionisation of metabolic intermediates.
• Large molecule effect: Effects on protein function: The function of many intracellular proteins (esp the activities of enzymes) is altered by effects on the ionisation of amino acid residues (esp histidine residues)

Renal Regulation of Acid-Base Balance

The organs involved in regulation of external acid-base balance are the lungs are the kidneys.

The lungs are important for excretion of carbon dioxide (the respiratory acid) and there is a huge amount of this to be excreted: at least 12,000 to 13,000 mmols/day.

In contrast the kidneys are responsible for excretion of the fixed acids and this is also a critical role even though the amounts involved (70-100 mmols/day) are much smaller. The main reason for this renal importance is because there is no other way to excrete these acids and it should be appreciated that the amounts involved are still very large when compared to the plasma [H⁺] of only 40 nanomoles/litre.

There is a second extremely important role that the kidneys play in acid-base balance, namely the reabsorption of the filtered bicarbonate. Bicarbonate is the predominant extracellular buffer against the fixed acids and it important that its plasma concentration should be defended against renal loss.

In acid-base balance, the kidney is responsible for 2 major activities:

• Reabsorption of filtered bicarbonate: 4,000 to 5,000 mmol/day
• Excretion of the fixed acids (acid anion and associated H⁺): about 1 mmol/kg/day.

Both these processes involve secretion of H⁺ into the lumen by the renal tubule cells but only the second leads to excretion of H⁺ from the body.

The renal mechanisms involved in acid-base balance can be difficult to understand so as a simplification we will consider the processes occurring in the kidney as involving 2 aspects:

• Proximal tubular mechanism
• Distal tubular mechanism

Respiratory Regulation of Acid-Base Balance: Acid Base Learner Series

How is the Respiratory System Linked to Acid-base Changes?

‘Respiratory regulation’ refers to changes in pH due to pCO2 changes from alterations in ventilation. This change in ventilation can occur rapidly with significant effects on pH. Carbon dioxide is lipid soluble and crosses cell membranes rapidly, so changes in pCO2 result in rapid changes in [H+] in all body fluid compartments.

A quantitative appreciation of respiratory regulation requires knowledge of two relationships which provide the connection between alveolar ventilation and pH via pCO₂. These 2 relationships are:

• First equation - relates alveolar ventilation (V_A) and pCO₂
• Second equation - relates pCO₂ and pH.