Pastest MRCP Part 2 PACES Station 2: Achalasia

This MRCP Part 2 PACES video is an example of one of Pastest's PACES station 2 history taking videos. This is the first of three Achalasia videos available in the full resource including: an examination, discussion and case critique.

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[emilyb]

FYI ocular melanoma can spread to the liver. My aunty died because medics didnt know this - 20 yrs after successful treatment of iculat melanoma liver disease started & took over. Mentioning as i didn't know this either.

[rivakhan]

Dysphagia+ weight loss + asthma history + heartburn+ background melanoma
Possible DD: 1) esophageal Carcinoma (considering the age, and the presenting S/S, although the melanoma was excised completely)
2) Achalasia cardia
3) Long standing Steroid induced candidiasis (unlikely in the absence of sore throat/ oral ulcer/ odynophagia)

I think to rule out carcinoma completely, history of feeling tired/ generalized weakness, getting paler day by day or anemic symptoms and fever as a part of constitutional symptom should have been explored.
Nonetheless, good wrap up of the history.
A barium meal xray, a chest xray PA view, FBC, and an upper GIT endoscopy is needed anyway.
From the investigation clues, an esophageal manometry or biopsy can be planned accordingly.
Smoking cessation advice and advice regarding steroid use for asthma should be counselled.

[cosmoholicscafeteria]

Hello i subscribed to pass test n its nt showin my subscription omly message so many times to customer care what kind of service is this???

[Anood]

You better but the discussion similar to that in the exam for better yield.

[محمدحسين-ذذع]

Too much talk exusting and overwhelming for both Doc and patient what an exaggerated prequiset of us on tests! That is not needed in real life!!😐

[Zoe-drps]

Jeez I wonder what could be wrong with this lady.