Pre PACES Podcast

Equal doses education & entertaining. @Dr_SamWilliams helps ease the pain of the MRCP PACES medical exam with expert speakers, key knowledge & bad jokes.

[Pre PACES Podcast @prepacespodcast]

👋🏻Hey listeners!👋🏻

♥️Do you love the pod?

🎉Maybe you've become another PACES success story?

🧠Or you've learned something that helped in your own practice?

⬇️Consider an optional, pay-what-you-can donation over at https://t.co/lddp0ng0Cb

🙏🏻As ever, thanks for listening!

[Pre PACES Podcast @prepacespodcast]

@DrBenLovell @RCPEdin Congratulations to you both! This is such a valuable educational resource!

[Pre PACES Podcast @prepacespodcast]

@timricketts_ @Dr_SamWilliams Thanks Tim, you're too kind! So glad you found the podcast helpful & huge congratulations on your pass!

[DrAshNisbet @drashnisbet]

Returning home after another excellent #EHRA2025 congress. As always, an opportunity to catch up with colleagues, collaborators and friends in a beautiful city! The highlights included the Faculty Dinner and the wonderful choir and our registrar Sam Williams winning the runner up prize in the Clinical Cases Awards for his presentation! Already excited for Paris next year! @EHRAPresident @BHIBristol @uhbwNHS @Dr_SamWilliams

[Pre PACES Podcast @prepacespodcast]

🌟NEW EPISODE KLAXON!🌟

🎊For episode 99 we have welcomed a BIG DOG 🐶 in the world of clinical reasoning and Med Ed: Professor Nicola Cooper!

👨‍⚕️@Dr_SamWilliams & @Cooper00Nicola talk through the pearls & pitfalls of clinical reasoning!

⬇️Listen now!
https://t.co/2ksGlo1wLp

[Pre PACES Podcast @prepacespodcast]

‼️Happy Sunday listeners!

🎧A brilliant episode coming later today on something hugely applicable to both PACES and critical in our day to day clinical practice!

👨‍⚕️A real boon of a guest too!

👀 Keep your eyes on your podcast feeds!

[Pre PACES Podcast @prepacespodcast]

@JoshGahir Best of luck Josh! You got this! 🤝

[Pre PACES Podcast @prepacespodcast]

🌟NEW EPISODE KLAXON 🌟

@Dr_SamWilliams welcomes along Dr Yezen Samaraiee, neurology SpR to discuss....

🧠CEREBELLAR SYNDROME

🎧A brilliant episode with tons of learning points for your PACES!

⬇️Listen now!

https://t.co/J4ECEub4oo

[Luke Austen @lukeausten]

Thanks Sam @prepacespodcast for having Josh and I back to chat about Decision Fatigue, surviving the night shift and medical rules for life!

https://t.co/KT1NWCbWDi

[Pre PACES Podcast @prepacespodcast]

@AmieBurbridge @DrBenLovell We discussed how to look after yourself, as well as your team recently! ⬇️

- Take breaks as a team if possible (especially on night shifts)

- Be approachable & enable your team to work at their peak capability

- Find small pockets of teaching

https://t.co/ow4vXupjeH

[Pre PACES Podcast @prepacespodcast]

‼️Happy Monday listeners!

🎉An exciting milestone to announce!!

🎧300,000 total downloads!

Thank you all for listening!

[Pre PACES Podcast @prepacespodcast]

‼️Another splendid episode coming to your podcast feeds tomorrow listeners!

Here's your clue:

🟡

Yep that's all you're getting!

[Pre PACES Podcast @prepacespodcast]

🎂It's a very special day listeners! 🥳

☕If you didn't know the best day to buy @Dr_SamWilliams a coffee...today is the day!⬇️ https://t.co/LubymQjtSu

🎈🎉Happy birthday Sam!🎂🥳

[Pre PACES Podcast @prepacespodcast]

@NJL_Blancq @mrseleanorohara 🙋‍♂️Guest has been sourced and confirmed willingness!

📌Just need to pin down a record date and it will be out!

[Pre PACES Podcast @prepacespodcast]

🗣️Dysphagia🗣️

Management of suspected oesophageal malignancy:
- Refer to upper GI MDT
- Staging CT
- Confirm histological diagnosis
- Ensure nutrition is addressed - dietetics opinion

[Pre PACES Podcast @prepacespodcast]

🗣️Dysphagia🗣️

Achalasia...gold star stuff here for your examiners

🌟Gold standard diagnostic test is oesophageal manometry

[Pre PACES Podcast @prepacespodcast]

🗣️Dysphagia🗣️

Alternative investigations...for example the patient won't tolerate or are not suitable for an upper GI endoscopy

🌟 Barium / oral contrast swallow offers live action of the oesophageal motion which can be especially helpful for neuromuscular or anatomical causes

[Pre PACES Podcast @prepacespodcast]

🗣️Dysphagia🗣️

☢️Investigations

📷With a history of progressive dysphagia, an upper GI endoscopy should really be your most important diagnostic test 📷

🩸Bloods obviously important:
- Microcytic anaemia (or anaemia of chronic disease)
- Liver function
- Clotting

[Pre PACES Podcast @prepacespodcast]

🗣️Dysphagia🗣️

🩺Examination

- Consider neck examination or palpation of a neck lump
- If suggestion of a neuromuscular causes then may want to focus your examination for a specific diagnosis, e.g. checking for fatiguability in the case of myaesthenia gravis

[Pre PACES Podcast @prepacespodcast]

🗣️Dysphagia🗣️

✋Hands, 😀 Face, 💪 Arms

- Is there clubbing?
- Any conjunctival pallor?
- Palpate for lymph nodes - especially Virchow's node!