If a patient has diplopia, it is the outermost image that is the abnormal image Cover each eye in turn If the inner image disappears, you have covered the good eye If the same image disappears covering each eye or changes on reexamination consider psychogenic #FOAMed #MedEd

Wegener = C-ANCA = pR3 Churg & MPA = P-ANCA = MPO PAN = ANCA -'ve Wegener's new name GPA (Granulomatosis with polyangiitis) Churg Strauss new name eGPA (Eosinophilic Granulomatosis with polyangiitis) Ulcerative colitis = p-ANCA Crohn's = ASCA #FOAMed #MedEd

Finding on blood film (exams) Pencil cells = iron deficiency Tear drops = Myelofibrosis Heinz bodies = G6PD Smear (smudge) cells = CLL Howell Jolly bodies = missing spleen Helmet / fragmented cells = MAHA Burr cells = Uraemia Basophilic stippling = Lead poisoning #FOAMed #MedEd

Summary of abnormalities on EMG Increased amplitude with repeated stimulation = LEMS Decreased amplitude with repeated stimulation = Myasthenia Divebomber = Myotonic dystrophy Reduced amplitude and duration with fibrillation = Myositis #FOAMed #MedEd

Factors 10 9 7 2 are reduced by Warfarin Factors 10a 9a 2a are inhibited by IV Heparin The only numerical difference in their site of action is factor 7 which is why Heparin doesn't affect the extrinsic clotting cascade #FOAMed #MedEd

Type 1 RTA = Loss of ability to secrete H+ ions in DCT Type 2 RTA = Loss of ability to resorb HCO3- in PCT Type 4 RTA = Same as spironolactone Your blood is acidic and your urine alkaline. Simple (Type 3 doesn't exist anymore)

Booking open for March 25th - 26th MRCP written, weekend revision course. Free to Wessex trainees Book on Concisemrcp.co.uk See you there!

Free for Wessex trainees. A few places left for this weekends course (14th & 15th Jan). Book via webpage

Causes of lung fibrosis - upper lobe predominant TB Tuberculosis EAA Extrinsic allergic alveolitis ABPA Allergic bronchopulmonary aspergillosis Silicosis Sarcoidosis Histiocytosis x

Free sitting of conciseMRCP part 1 revision course Aug 11th 12th. All course fees will be refunded on attendance. In celebration of 10th Anniversary Visit ConciseMRCP.co.uk to book a place

Westermark sign A dark section of lung due to a PE (Oligaemic section due to lack of perfusion)

Remember to practice 10 questions at a time before looking at whether you got the answers right. You need to learn to maintain your confidence going forward, one question at a time, despite not knowing how you are performing.