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# Causes of Chest Discomfort:
8. Neuromusculoskeletal Conditions
Part 1
🌷🍃@HarrisonsClinicalPoints
Chest Discomfort
🌷🍃@HarrisonsClinicalPoints
Cervical disk disease can cause chest pain by compression of nerve roots.
Pain in a dermatomal distribution can also be caused by intercostal muscle cramps or by herpes zoster.
Chest pain symptoms due to herpes zoster may occur before skin lesions are apparent.
🌷🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
3. Diseases of the Aorta
Part 1
Causes and pathophysiology…
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Aortic dissection is a potentially catastrophic condition that is due to spread of a subintimal hematoma within the wall of the aorta.
The hematoma may begin with a tear in the intima of the aorta or with rupture of the vasa vasorum within the aortic media.
This syndrome can occur with trauma to the aorta, including motor vehicle accidents or medical procedures in which catheters or intraaortic balloon pumps damage the intima of the aorta.
Nontraumatic aortic dissections are rare in the absence of hypertension and/or conditions associated with deterioration of the elastic or muscular components of the media within the aorta's wall.
Cystic medial degeneration is a feature of several inherited connective tissue diseases, including Marfan and Ehlers-Danlos syndromes.
About half of all aortic dissections in women under 40 years of age occur during pregnancy.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
3. Diseases of the Aorta
Part 2
Aortic dissection: important points of history…
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Unlike the pain of ischemic heart disease, symptoms of aortic dissection tend to reach peak severity immediately, often causing the patient to collapse from its intensity.
The classic teaching is that the adjectives used to describe the pain reflect the process occurring within the wall of the aorta—"ripping" and "tearing"—but more recent data suggest that the most common presenting complaint is sudden onset of severe, sharp pain.
The location often correlates with the site and extent of the dissection.
Thus, dissections that begin in the ascending aorta and extend to the descending aorta tend to cause pain in the front of the chest that extends into the back, between the shoulder blades.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
3. Diseases of the Aorta
Part 3
Aortic dissection: physical findings…
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Physical findings may also reflect extension of the aortic dissection that compromises flow into arteries branching off the aorta.
Thus, loss of a pulse in one or both arms, cerebrovascular accident, or paraplegia can all be catastrophic consequences of aortic dissection.
Hematomas that extend proximally and undermine the coronary arteries or aortic valve apparatus may lead to acute myocardial infarction or acute aortic insufficiency.
Rupture of the hematoma into the pericardial space leads to pericardial tamponade.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
4. Pulmonary Embolism
Symptoms…
🌼🍃@HarrisonsClinicalPoints
Chest Discomfort
🌼🍃@HarrisonsClinicalPoints
Chest pain due to pulmonary embolism is believed to be due to distention of the pulmonary artery or infarction of a segment of the lung adjacent to the pleura.
Massive pulmonary emboli may lead to substernal pain that is suggestive of acute myocardial infarction.
More commonly, smaller emboli lead to focal pulmonary infarctions that cause pain that is lateral and pleuritic.
Associated symptoms include dyspnea and, occasionally, hemoptysis.
Tachycardia is usually present.
Although not always present, certain characteristic ECG changes can support the diagnosis.
🌼🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
4. Pulmonary Embolism
Summery…
🌻🍃@HarrisonsClinicalPoints
Chest Discomfort
🌻🍃@HarrisonsClinicalPoints
Condition:
Pulmonary embolism
Duration:
Abrupt onset; several minutes to a few hours
Quality:
Pleuritic
Location:
Often lateral, on the side of the embolism
Associated Features:
Dyspnea, tachypnea, tachycardia, and hypotension
🌻 🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 103.
# Causes of Chest Discomfort:
🌺🍃@HarrisonsClinicalPoints
Chest Discomfort
🌺🍃@HarrisonsClinicalPoints
5. Pneumothorax
Sudden onset of pleuritic chest pain and respiratory distress should lead to consideration of spontaneous pneumothorax, as well as pulmonary embolism.
Such events may occur without a precipitating event in persons without lung disease, or as a consequence of underlying lung disorders.
6. Pneumonia or Pleuritis
Lung diseases that damage and cause inflammation of the pleura of the lung usually cause a sharp, knifelike pain that is aggravated by inspiration or coughing.
🌺🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
7. Gastrointestinal Conditions
Part 1
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Acid reflux typically causes a deep burning discomfort that may be exacerbated by alcohol, aspirin, or some foods; this discomfort is often relieved by antacid or other acid-reducing therapies.
Esophageal spasm may occur in the presence or absence of acid reflux and leads to a squeezing pain indistinguishable from angina.
Prompt relief of esophageal spasm is often provided by antianginal therapies such as sublingual nifedipine, further promoting confusion between these syndromes.
Chest pain can also result from injury to the esophagus, such as a Mallory-Weiss tear caused by severe vomiting.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
7. Gastrointestinal Conditions
Part 2
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Chest pain can result from diseases of the gastrointestinal tract below the diaphragm, including peptic ulcer disease, biliary disease, and pancreatitis.
These conditions usually cause abdominal pain as well as chest discomfort; symptoms are not likely to be associated with exertion.
The pain of ulcer disease typically occurs 60 to 90 min after meals, when postprandial acid production is no longer neutralized by food in the stomach.
Cholecystitis usually causes a pain that is described as aching, occurring an hour or more after meals.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
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The October 2017 Fellowship Examinations of the West African College of Surgeons (WACS), in the Faculties of Anaesthesia, Dental Surgery, Obstetrics and Gynaecology, Ophthalmology, Otorhinolaryngology, Radiology and Surgery, will hold from 11th October to 24th October, 2017.
All candidate application for primary should log on to www.wacscoac.org and follow the step to step proceedure for online application.
THE PRIMARY EXAMINATIONS WILL HOLD ON FRIDAY 13TH OCTOBER, 2017 IN SEVEN CENTRES AS FOLLOWS:
1. University College Hospital (UCH), Ibadan, Nigeria
2. National Centre for Women Development (NCWD), Abuja, Nigeria
3. Korle-Bu Teaching Hospital (KBTH), Accra, Ghana
4. National Orthopaedic Hospital (NOH) Main Hall, Enugu, Nigeria
5. Komfo Anokye Teaching hospital kumasi
6. Connaught Hospital, Freetown, Sierra leonae
Online Registration for Primary Examination applicants Only.
The Parts I&II Examinations will hold from 191th October, 2017 (Obstetrics & Gynaecology) and 26th October, 2017 (Anaesthesia, Diploma in Anaesthesia (DA). Dental Surgery, Ophthalmology, ORL, Radiology and Surgery) in Two Centres namely:
* University College Hospital (UCH) Ibadan, Nigeria
* Korle-Bu Teaching Hospital (KBTH) Accra, Ghana
REQUIREMENTS
* Candidates applying for the Primary Fellowship Examinations must be Medical Practitioners who are fully registered in member countries, have acquired at least one year-post-registration experience.
* Candidates must register and pay ONLINE by logging on to www.wacscoac.org where candidates passport phtotgraph, Degree Certificate and Evidence of FULL registration with Medical & Dental Council of their countries will be unploaded. Provisional Registration Certificate or Annual practicing License is NOT Acceptable.
* As part of primary registration requirement, candidates are to print the CERTIFICATION page from the website to be endorsed by the supervising Consultant or HOD and UPLOAD the signed Certification page along with other required documents ONLINE. NO DOCUMENT SHOULD BE SUBMITTED TO THE COLLEGE SECRETARIAT.
* Candidates are advised to carefully populate appropriate fields meant for surname and other names, any confusion that arises from this will not be entertained.
* Candidates should ensure that the same name is used when making offline payment and registration for primary Examination, any disparty between name for off line payment and the one for online registration would lead to candidates disqualification.
* Relebant documents such as evidence for change of Name should be uploaded where applicable.
* Candidates applying to sit for diploma in anaesthesia examination must have completed the requiste 12months training in anaesthesia in an accredited institution. Applicaiton must be submitted with approved log book/ portfolio and copies of appropriate relevant documents to the College Secretariat.
* Candidates applying to sit the Part I Fellowship Examinatiopns must have passed the Primary Examination of the West African College of Surgeons or its equivalent and satisfactorily completed appropriate years of Post graduate training as prescribed by the relevant Faculty in the institutions accrdited for the purpose by the college, Candidates are required to submit their original Certificants of Training (COT) form with dates of commencement and completion of training clearly stated, Altered or defaced COT will not be accepted,www.medicalworldnigeria.com. submission of photocopies of logbooks duly certified by their training consultants is commpulsory. Surgeon in training registration evidence and attendance certificate of relevant update courses are required.
* Candidates applying to sit the Part I examination in the faculty of radiology must indicate the specialty of interest ie (radiodiagnosis or radiotherapy) as it appears on item no.6 on the application form.
* Candidates applying to sit for part II (final) Fellowship Examinations must have passed the Part I Fellowship Examinations of the West Adrican College of Surgeons and satisfactorily completed appropriate years of Postgraduat
e training and worked in their specialty for at least Two (2) Years in an Institutions(s) accredited for the purpose by WACS as prescribed by the relevant Faculty. Candidates are to submit their original Certificates of Training (COT) form with dates of commencement, completion of training and various postings/appointments, clearly stated, Altered or defaced COT will not be accepted.
* Specialty as it appears on item no.6 in the application form should be completed (this is applicable to part 11 dental surgery, radiology and surgery)
* Candidates applying to sit surgery part II must submit 3 copies of their dessertations and 3 copies of approved proposals seperately bound in spiral format and a copy of their resident log book at the time of submission of applicaiton for the examination. They should in addition bring their files of the raw result of dissertation with them to the venue of the oral examination. it is the candidates responsiblity to retreive both his or her log book and dissertation at the end of the examination. A copy of the dissertation shall be kept by the college.
* All first time applicants for Part I & II in the Faculty of Srgery should submit the original of their log books along with the photocopies od the Logbooks and their application forms for the examinations. Fresh Candidates who submit only the photocopies of their logbooks will be disqualified from the examinations. Each Candidates should collect his/her original logbooks from the College Secretariat one month before examinations and should arrive at the venue of the examinations with the original of their logbooks.
* Candidates who wish to sit April 2018 part II examinations in O&G must submit Case Books and dissertations latest by friday 29th September, 2017.
* Candidates applying to sit for dental Surgery must submit Two Copies of their log books while part 11 candidates for anaesthesia, ORL and radiology are to submit a photocopy of their log books, three copies of approved proposals and three copies of dissertations before the closing day of applications. original copies of log books should be brought to the examination venues.
* All Part II candidates must submit an evidence of attendance of Manuscript Writing Workshop and the Health Management and Ethics Workshop.
* Further details are available in the Prospectus of the College
EXAMINATION FEES
1. Primary Examination - N110,000.00
2. Diploma in Anaesthesia (DA) - N110,000.00
3. Part I Examination - N160,000.00
4. Part II (Final) Examination - N200,000.00
MODE OF PAYMENT
Payment for all aspects of the examinations should be made online. No payment Teller shall be accepted by the College. Any candidate who refuses to follow this directive shall be disqualified and his/her money forfeited.
DEFERMENT OF EXAMINATION AFTER SUBMISSION OF APPLICATION OR REFUND OF EXAMINATION FEES AFTER PAYMENT IS NOT ACCEPTABLE
CLOSING DATE:
The closing date for the online application is July 7th, 2017. Candidates for the Part II (Final) Examinations in Anaesthesia, Dental Surgery, Ophthalmology, ORL, Radiology and Surgery must submit their dissertations by the closing date.
NO LATE SUBMISSION OR REGISTRATION
NB: All Application should be submitted online by logging on www.wacscoac.org
Documents to be submitted online
• For Primary Applicants - All documents to be submitted online.
• For DA - All Documents except Logbook that will be sent to the College Secretariat
• For Parts I/Membership & Part II - All documents except Original Certificate of Training (COT) and photocopy of logbook but 1st time applicants for surgery are to submit Original and photocopy of logbooks
Other Documents:
• Copies of Dissertations and approved Proposals - Part II to be submitted to the college.
• Photocopy o f Log Books in spiral bound format (DA, Parts I/Membership & Part II)
• All first time applicants for Parts I/Membership & II Surgery are to submit Original and photocopies of logbooks
• Evidence of attendance at Manuscript Writing workshop (Part II to
he submitted online
• Evidence of attendance at Health Management and Ethics WOrkshop (Part II) to be submitted online
• Evidence of training since passing Primary (Part I/Membership) to be submitted online
• Evidence of training since passing Part I Membership (Part II) to be submitted online
• Evidence of registration as a Surgeon in Training (S.I.T) Part I/Membership candidates only (to be submitted online)
• Exemption Certificate front Primary (Where applicable for Part I/Membership candidates) to be submitted online
• Relevant documents for Change of Name (where applicable) to be ssainnitted online
• Candidates should provide an address which can easily be accvssed by courier.
Signed
Dr.J.Olutola Olatosi, FWACS[truncated by WhatsApp]
The October 2017 Fellowship Examinations of the West African College of Surgeons (WACS), in the Faculties of Anaesthesia, Dental Surgery, Obstetrics and Gynaecology, Ophthalmology, Otorhinolaryngology, Radiology and Surgery, will hold from 11th October to 24th October, 2017.
All candidate application for primary should log on to www.wacscoac.org and follow the step to step proceedure for online application.
THE PRIMARY EXAMINATIONS WILL HOLD ON FRIDAY 13TH OCTOBER, 2017 IN SEVEN CENTRES AS FOLLOWS:
1. University College Hospital (UCH), Ibadan, Nigeria
2. National Centre for Women Development (NCWD), Abuja, Nigeria
3. Korle-Bu Teaching Hospital (KBTH), Accra, Ghana
4. National Orthopaedic Hospital (NOH) Main Hall, Enugu, Nigeria
5. Komfo Anokye Teaching hospital kumasi
6. Connaught Hospital, Freetown, Sierra leonae
Online Registration for Primary Examination applicants Only.
The Parts I&II Examinations will hold from 191th October, 2017 (Obstetrics & Gynaecology) and 26th October, 2017 (Anaesthesia, Diploma in Anaesthesia (DA). Dental Surgery, Ophthalmology, ORL, Radiology and Surgery) in Two Centres namely:
* University College Hospital (UCH) Ibadan, Nigeria
* Korle-Bu Teaching Hospital (KBTH) Accra, Ghana
REQUIREMENTS
* Candidates applying for the Primary Fellowship Examinations must be Medical Practitioners who are fully registered in member countries, have acquired at least one year-post-registration experience.
* Candidates must register and pay ONLINE by logging on to www.wacscoac.org where candidates passport phtotgraph, Degree Certificate and Evidence of FULL registration with Medical & Dental Council of their countries will be unploaded. Provisional Registration Certificate or Annual practicing License is NOT Acceptable.
* As part of primary registration requirement, candidates are to print the CERTIFICATION page from the website to be endorsed by the supervising Consultant or HOD and UPLOAD the signed Certification page along with other required documents ONLINE. NO DOCUMENT SHOULD BE SUBMITTED TO THE COLLEGE SECRETARIAT.
* Candidates are advised to carefully populate appropriate fields meant for surname and other names, any confusion that arises from this will not be entertained.
* Candidates should ensure that the same name is used when making offline payment and registration for primary Examination, any disparty between name for off line payment and the one for online registration would lead to candidates disqualification.
* Relebant documents such as evidence for change of Name should be uploaded where applicable.
* Candidates applying to sit for diploma in anaesthesia examination must have completed the requiste 12months training in anaesthesia in an accredited institution. Applicaiton must be submitted with approved log book/ portfolio and copies of appropriate relevant documents to the College Secretariat.
* Candidates applying to sit the Part I Fellowship Examinatiopns must have passed the Primary Examination of the West African College of Surgeons or its equivalent and satisfactorily completed appropriate years of Post graduate training as prescribed by the relevant Faculty in the institutions accrdited for the purpose by the college, Candidates are required to submit their original Certificants of Training (COT) form with dates of commencement and completion of training clearly stated, Altered or defaced COT will not be accepted,www.medicalworldnigeria.com. submission of photocopies of logbooks duly certified by their training consultants is commpulsory. Surgeon in training registration evidence and attendance certificate of relevant update courses are required.
* Candidates applying to sit the Part I examination in the faculty of radiology must indicate the specialty of interest ie (radiodiagnosis or radiotherapy) as it appears on item no.6 on the application form.
* Candidates applying to sit for part II (final) Fellowship Examinations must have passed the Part I Fellowship Examinations of the West Adrican College of Surgeons and satisfactorily completed appropriate years of PostgraduatAkpobome Biakolo:
A post NYSC Dr needed for cover in a PH along Lekki-Epe Expressway tomorrow & next (9am ,27/05/17 -5pm, 28/05/17). Call:08069138667,by that u will be able to negotiate with the MD.
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Essential (Wiley-Blackwell)
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# Causes of Chest Discomfort:
8. Neuromusculoskeletal Conditions
Part 1
🌷🍃@HarrisonsClinicalPoints
Chest Discomfort
🌷🍃@HarrisonsClinicalPoints
Cervical disk disease can cause chest pain by compression of nerve roots.
Pain in a dermatomal distribution can also be caused by intercostal muscle cramps or by herpes zoster.
Chest pain symptoms due to herpes zoster may occur before skin lesions are apparent.
🌷🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
3. Diseases of the Aorta
Part 1
Causes and pathophysiology…
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Aortic dissection is a potentially catastrophic condition that is due to spread of a subintimal hematoma within the wall of the aorta.
The hematoma may begin with a tear in the intima of the aorta or with rupture of the vasa vasorum within the aortic media.
This syndrome can occur with trauma to the aorta, including motor vehicle accidents or medical procedures in which catheters or intraaortic balloon pumps damage the intima of the aorta.
Nontraumatic aortic dissections are rare in the absence of hypertension and/or conditions associated with deterioration of the elastic or muscular components of the media within the aorta's wall.
Cystic medial degeneration is a feature of several inherited connective tissue diseases, including Marfan and Ehlers-Danlos syndromes.
About half of all aortic dissections in women under 40 years of age occur during pregnancy.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
3. Diseases of the Aorta
Part 2
Aortic dissection: important points of history…
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Unlike the pain of ischemic heart disease, symptoms of aortic dissection tend to reach peak severity immediately, often causing the patient to collapse from its intensity.
The classic teaching is that the adjectives used to describe the pain reflect the process occurring within the wall of the aorta—"ripping" and "tearing"—but more recent data suggest that the most common presenting complaint is sudden onset of severe, sharp pain.
The location often correlates with the site and extent of the dissection.
Thus, dissections that begin in the ascending aorta and extend to the descending aorta tend to cause pain in the front of the chest that extends into the back, between the shoulder blades.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
3. Diseases of the Aorta
Part 3
Aortic dissection: physical findings…
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Physical findings may also reflect extension of the aortic dissection that compromises flow into arteries branching off the aorta.
Thus, loss of a pulse in one or both arms, cerebrovascular accident, or paraplegia can all be catastrophic consequences of aortic dissection.
Hematomas that extend proximally and undermine the coronary arteries or aortic valve apparatus may lead to acute myocardial infarction or acute aortic insufficiency.
Rupture of the hematoma into the pericardial space leads to pericardial tamponade.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
4. Pulmonary Embolism
Symptoms…
🌼🍃@HarrisonsClinicalPoints
Chest Discomfort
🌼🍃@HarrisonsClinicalPoints
Chest pain due to pulmonary embolism is believed to be due to distention of the pulmonary artery or infarction of a segment of the lung adjacent to the pleura.
Massive pulmonary emboli may lead to substernal pain that is suggestive of acute myocardial infarction.
More commonly, smaller emboli lead to focal pulmonary infarctions that cause pain that is lateral and pleuritic.
Associated symptoms include dyspnea and, occasionally, hemoptysis.
Tachycardia is usually present.
Although not always present, certain characteristic ECG changes can support the diagnosis.
🌼🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
4. Pulmonary Embolism
Summery…
🌻🍃@HarrisonsClinicalPoints
Chest Discomfort
🌻🍃@HarrisonsClinicalPoints
Condition:
Pulmonary embolism
Duration:
Abrupt onset; several minutes to a few hours
Quality:
Pleuritic
Location:
Often lateral, on the side of the embolism
Associated Features:
Dyspnea, tachypnea, tachycardia, and hypotension
🌻 🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 103.
# Causes of Chest Discomfort:
🌺🍃@HarrisonsClinicalPoints
Chest Discomfort
🌺🍃@HarrisonsClinicalPoints
5. Pneumothorax
Sudden onset of pleuritic chest pain and respiratory distress should lead to consideration of spontaneous pneumothorax, as well as pulmonary embolism.
Such events may occur without a precipitating event in persons without lung disease, or as a consequence of underlying lung disorders.
6. Pneumonia or Pleuritis
Lung diseases that damage and cause inflammation of the pleura of the lung usually cause a sharp, knifelike pain that is aggravated by inspiration or coughing.
🌺🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
7. Gastrointestinal Conditions
Part 1
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Acid reflux typically causes a deep burning discomfort that may be exacerbated by alcohol, aspirin, or some foods; this discomfort is often relieved by antacid or other acid-reducing therapies.
Esophageal spasm may occur in the presence or absence of acid reflux and leads to a squeezing pain indistinguishable from angina.
Prompt relief of esophageal spasm is often provided by antianginal therapies such as sublingual nifedipine, further promoting confusion between these syndromes.
Chest pain can also result from injury to the esophagus, such as a Mallory-Weiss tear caused by severe vomiting.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
# Causes of Chest Discomfort:
7. Gastrointestinal Conditions
Part 2
🌸🍃@HarrisonsClinicalPoints
Chest Discomfort
🌸🍃@HarrisonsClinicalPoints
Chest pain can result from diseases of the gastrointestinal tract below the diaphragm, including peptic ulcer disease, biliary disease, and pancreatitis.
These conditions usually cause abdominal pain as well as chest discomfort; symptoms are not likely to be associated with exertion.
The pain of ulcer disease typically occurs 60 to 90 min after meals, when postprandial acid production is no longer neutralized by food in the stomach.
Cholecystitis usually causes a pain that is described as aching, occurring an hour or more after meals.
🌸🍃@HarrisonsClinicalPoints
Reference: Harrison's Principles of Internal Medicine, chapter 12, Chest Discomfort, page 104.
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The October 2017 Fellowship Examinations of the West African College of Surgeons (WACS), in the Faculties of Anaesthesia, Dental Surgery, Obstetrics and Gynaecology, Ophthalmology, Otorhinolaryngology, Radiology and Surgery, will hold from 11th October to 24th October, 2017.
All candidate application for primary should log on to www.wacscoac.org and follow the step to step proceedure for online application.
THE PRIMARY EXAMINATIONS WILL HOLD ON FRIDAY 13TH OCTOBER, 2017 IN SEVEN CENTRES AS FOLLOWS:
1. University College Hospital (UCH), Ibadan, Nigeria
2. National Centre for Women Development (NCWD), Abuja, Nigeria
3. Korle-Bu Teaching Hospital (KBTH), Accra, Ghana
4. National Orthopaedic Hospital (NOH) Main Hall, Enugu, Nigeria
5. Komfo Anokye Teaching hospital kumasi
6. Connaught Hospital, Freetown, Sierra leonae
Online Registration for Primary Examination applicants Only.
The Parts I&II Examinations will hold from 191th October, 2017 (Obstetrics & Gynaecology) and 26th October, 2017 (Anaesthesia, Diploma in Anaesthesia (DA). Dental Surgery, Ophthalmology, ORL, Radiology and Surgery) in Two Centres namely:
* University College Hospital (UCH) Ibadan, Nigeria
* Korle-Bu Teaching Hospital (KBTH) Accra, Ghana
REQUIREMENTS
* Candidates applying for the Primary Fellowship Examinations must be Medical Practitioners who are fully registered in member countries, have acquired at least one year-post-registration experience.
* Candidates must register and pay ONLINE by logging on to www.wacscoac.org where candidates passport phtotgraph, Degree Certificate and Evidence of FULL registration with Medical & Dental Council of their countries will be unploaded. Provisional Registration Certificate or Annual practicing License is NOT Acceptable.
* As part of primary registration requirement, candidates are to print the CERTIFICATION page from the website to be endorsed by the supervising Consultant or HOD and UPLOAD the signed Certification page along with other required documents ONLINE. NO DOCUMENT SHOULD BE SUBMITTED TO THE COLLEGE SECRETARIAT.
* Candidates are advised to carefully populate appropriate fields meant for surname and other names, any confusion that arises from this will not be entertained.
* Candidates should ensure that the same name is used when making offline payment and registration for primary Examination, any disparty between name for off line payment and the one for online registration would lead to candidates disqualification.
* Relebant documents such as evidence for change of Name should be uploaded where applicable.
* Candidates applying to sit for diploma in anaesthesia examination must have completed the requiste 12months training in anaesthesia in an accredited institution. Applicaiton must be submitted with approved log book/ portfolio and copies of appropriate relevant documents to the College Secretariat.
* Candidates applying to sit the Part I Fellowship Examinatiopns must have passed the Primary Examination of the West African College of Surgeons or its equivalent and satisfactorily completed appropriate years of Post graduate training as prescribed by the relevant Faculty in the institutions accrdited for the purpose by the college, Candidates are required to submit their original Certificants of Training (COT) form with dates of commencement and completion of training clearly stated, Altered or defaced COT will not be accepted,www.medicalworldnigeria.com. submission of photocopies of logbooks duly certified by their training consultants is commpulsory. Surgeon in training registration evidence and attendance certificate of relevant update courses are required.
* Candidates applying to sit the Part I examination in the faculty of radiology must indicate the specialty of interest ie (radiodiagnosis or radiotherapy) as it appears on item no.6 on the application form.
* Candidates applying to sit for part II (final) Fellowship Examinations must have passed the Part I Fellowship Examinations of the West Adrican College of Surgeons and satisfactorily completed appropriate years of Postgraduat
e training and worked in their specialty for at least Two (2) Years in an Institutions(s) accredited for the purpose by WACS as prescribed by the relevant Faculty. Candidates are to submit their original Certificates of Training (COT) form with dates of commencement, completion of training and various postings/appointments, clearly stated, Altered or defaced COT will not be accepted.
* Specialty as it appears on item no.6 in the application form should be completed (this is applicable to part 11 dental surgery, radiology and surgery)
* Candidates applying to sit surgery part II must submit 3 copies of their dessertations and 3 copies of approved proposals seperately bound in spiral format and a copy of their resident log book at the time of submission of applicaiton for the examination. They should in addition bring their files of the raw result of dissertation with them to the venue of the oral examination. it is the candidates responsiblity to retreive both his or her log book and dissertation at the end of the examination. A copy of the dissertation shall be kept by the college.
* All first time applicants for Part I & II in the Faculty of Srgery should submit the original of their log books along with the photocopies od the Logbooks and their application forms for the examinations. Fresh Candidates who submit only the photocopies of their logbooks will be disqualified from the examinations. Each Candidates should collect his/her original logbooks from the College Secretariat one month before examinations and should arrive at the venue of the examinations with the original of their logbooks.
* Candidates who wish to sit April 2018 part II examinations in O&G must submit Case Books and dissertations latest by friday 29th September, 2017.
* Candidates applying to sit for dental Surgery must submit Two Copies of their log books while part 11 candidates for anaesthesia, ORL and radiology are to submit a photocopy of their log books, three copies of approved proposals and three copies of dissertations before the closing day of applications. original copies of log books should be brought to the examination venues.
* All Part II candidates must submit an evidence of attendance of Manuscript Writing Workshop and the Health Management and Ethics Workshop.
* Further details are available in the Prospectus of the College
EXAMINATION FEES
1. Primary Examination - N110,000.00
2. Diploma in Anaesthesia (DA) - N110,000.00
3. Part I Examination - N160,000.00
4. Part II (Final) Examination - N200,000.00
MODE OF PAYMENT
Payment for all aspects of the examinations should be made online. No payment Teller shall be accepted by the College. Any candidate who refuses to follow this directive shall be disqualified and his/her money forfeited.
DEFERMENT OF EXAMINATION AFTER SUBMISSION OF APPLICATION OR REFUND OF EXAMINATION FEES AFTER PAYMENT IS NOT ACCEPTABLE
CLOSING DATE:
The closing date for the online application is July 7th, 2017. Candidates for the Part II (Final) Examinations in Anaesthesia, Dental Surgery, Ophthalmology, ORL, Radiology and Surgery must submit their dissertations by the closing date.
NO LATE SUBMISSION OR REGISTRATION
NB: All Application should be submitted online by logging on www.wacscoac.org
Documents to be submitted online
• For Primary Applicants - All documents to be submitted online.
• For DA - All Documents except Logbook that will be sent to the College Secretariat
• For Parts I/Membership & Part II - All documents except Original Certificate of Training (COT) and photocopy of logbook but 1st time applicants for surgery are to submit Original and photocopy of logbooks
Other Documents:
• Copies of Dissertations and approved Proposals - Part II to be submitted to the college.
• Photocopy o f Log Books in spiral bound format (DA, Parts I/Membership & Part II)
• All first time applicants for Parts I/Membership & II Surgery are to submit Original and photocopies of logbooks
• Evidence of attendance at Manuscript Writing workshop (Part II to
he submitted online
• Evidence of attendance at Health Management and Ethics WOrkshop (Part II) to be submitted online
• Evidence of training since passing Primary (Part I/Membership) to be submitted online
• Evidence of training since passing Part I Membership (Part II) to be submitted online
• Evidence of registration as a Surgeon in Training (S.I.T) Part I/Membership candidates only (to be submitted online)
• Exemption Certificate front Primary (Where applicable for Part I/Membership candidates) to be submitted online
• Relevant documents for Change of Name (where applicable) to be ssainnitted online
• Candidates should provide an address which can easily be accvssed by courier.
Signed
Dr.J.Olutola Olatosi, FWACS[truncated by WhatsApp]
The October 2017 Fellowship Examinations of the West African College of Surgeons (WACS), in the Faculties of Anaesthesia, Dental Surgery, Obstetrics and Gynaecology, Ophthalmology, Otorhinolaryngology, Radiology and Surgery, will hold from 11th October to 24th October, 2017.
All candidate application for primary should log on to www.wacscoac.org and follow the step to step proceedure for online application.
THE PRIMARY EXAMINATIONS WILL HOLD ON FRIDAY 13TH OCTOBER, 2017 IN SEVEN CENTRES AS FOLLOWS:
1. University College Hospital (UCH), Ibadan, Nigeria
2. National Centre for Women Development (NCWD), Abuja, Nigeria
3. Korle-Bu Teaching Hospital (KBTH), Accra, Ghana
4. National Orthopaedic Hospital (NOH) Main Hall, Enugu, Nigeria
5. Komfo Anokye Teaching hospital kumasi
6. Connaught Hospital, Freetown, Sierra leonae
Online Registration for Primary Examination applicants Only.
The Parts I&II Examinations will hold from 191th October, 2017 (Obstetrics & Gynaecology) and 26th October, 2017 (Anaesthesia, Diploma in Anaesthesia (DA). Dental Surgery, Ophthalmology, ORL, Radiology and Surgery) in Two Centres namely:
* University College Hospital (UCH) Ibadan, Nigeria
* Korle-Bu Teaching Hospital (KBTH) Accra, Ghana
REQUIREMENTS
* Candidates applying for the Primary Fellowship Examinations must be Medical Practitioners who are fully registered in member countries, have acquired at least one year-post-registration experience.
* Candidates must register and pay ONLINE by logging on to www.wacscoac.org where candidates passport phtotgraph, Degree Certificate and Evidence of FULL registration with Medical & Dental Council of their countries will be unploaded. Provisional Registration Certificate or Annual practicing License is NOT Acceptable.
* As part of primary registration requirement, candidates are to print the CERTIFICATION page from the website to be endorsed by the supervising Consultant or HOD and UPLOAD the signed Certification page along with other required documents ONLINE. NO DOCUMENT SHOULD BE SUBMITTED TO THE COLLEGE SECRETARIAT.
* Candidates are advised to carefully populate appropriate fields meant for surname and other names, any confusion that arises from this will not be entertained.
* Candidates should ensure that the same name is used when making offline payment and registration for primary Examination, any disparty between name for off line payment and the one for online registration would lead to candidates disqualification.
* Relebant documents such as evidence for change of Name should be uploaded where applicable.
* Candidates applying to sit for diploma in anaesthesia examination must have completed the requiste 12months training in anaesthesia in an accredited institution. Applicaiton must be submitted with approved log book/ portfolio and copies of appropriate relevant documents to the College Secretariat.
* Candidates applying to sit the Part I Fellowship Examinatiopns must have passed the Primary Examination of the West African College of Surgeons or its equivalent and satisfactorily completed appropriate years of Post graduate training as prescribed by the relevant Faculty in the institutions accrdited for the purpose by the college, Candidates are required to submit their original Certificants of Training (COT) form with dates of commencement and completion of training clearly stated, Altered or defaced COT will not be accepted,www.medicalworldnigeria.com. submission of photocopies of logbooks duly certified by their training consultants is commpulsory. Surgeon in training registration evidence and attendance certificate of relevant update courses are required.
* Candidates applying to sit the Part I examination in the faculty of radiology must indicate the specialty of interest ie (radiodiagnosis or radiotherapy) as it appears on item no.6 on the application form.
* Candidates applying to sit for part II (final) Fellowship Examinations must have passed the Part I Fellowship Examinations of the West Adrican College of Surgeons and satisfactorily completed appropriate years of Postgraduat
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