Sarcoid: frequently tested

Sarcoid : RCP’s favorite in Station 1-2-4-5

Try practice Sarcoidosis in term of Seven core clinical skills assessed in the PACES examination.

Here is a sample from 2010/2 diet:

station 2: jt pain , dry cough and bilateral gld + in CXR,

two candidates sat apart 2 weeks in a UK centre got the same scenario.

(PS. in station 4,don’t bother skill D, ie.Differential Dx;but it is assessed in all other stations!)

Clinical Skill/Skill Descriptor

A

Physical Examination

Demonstrate correct, thorough, systematic (or focused in Station 5 encounters), appropriate, fluent and professional technique of physical examination.

B

Identifying Physical Signs

Identify physical signs correctly, and not find physical signs that are not present.

C

Clinical Communication

Elicit a clinical history relevant to the patient’s complaints, in a systematic, thorough (or focused in Station 5 encounters), fluent and professional manner.

Explain relevant clinical information in an accurate, clear, structured, comprehensive, fluent and professional manner.

D

Differential Diagnosis

Create a sensible differential diagnosis for a patient that the candidate has personally clinically assessed.

E

Clinical Judgement

Select or negotiate a sensible and appropriate management plan for a patient, relative or clinical situation.

Select appropriate investigations or treatments for a patient that the candidate has personally clinically assessed.

Apply clinical knowledge, including knowledge of law and ethics, to the case.

F

Managing Patients’ Concerns

Seek, detect, acknowledge and address patients’ or relatives’ concerns.

Listen to a patient or relative, confirm their understanding of the matter under discussion and demonstrate empathy.

G

Maintaining Patient Welfare

Treat a patient or relative respectfully and sensitively and in a manner that ensures their comfort, safety and dignity.

Station1:Chest Percussion

Clinical Method_Respiratory

A colleague who sit for the paces diet 1 in 2009 was criticized by an examiner that he made percussion of the chest far below the boundaries of the lungs.

How far should we percuss downward on back of the chest in Respiration Station?

• In quiet respiration, the lungs’ inferior
  margin travels around the thoracic wall
  following a VI, VIII, X contour

  (i.e. rib VI in the midclavicular line, rib VIII in the
  midaxillary line, and vertebra TX posteriorly).