Things I learnt today from MRCP Part 2 revision (Day 1)
From the ESC and some other places: Peripartum cardiomyopathy needs heparin (prophylactic dose if ejection faction > 30%, treatment dose if less than 30% or if AF or previous clot)….
Category: Medical Education
Treating insomnia naturally without medication
A lady in her early 50s had come for a repeat of her zopiclone. She had been on it for years. When I suggested a trial of cutting down, she…
Mildy deranged LFTs in the GP setting
A man in his mid 30s was invited to make a routine appointment to discuss his LFTs. 6 months ago Now Reference range Alanine Transferase 67 132 < 40 IU/L…
Antibiotic associated diarrhoea: My new primary care strategy
A woman in her mid 50s had been prescribed doxycycline 5 days ago for persistent upper respiratory symptoms. She returned to us because of watery diarrhoea since yesterday. There was…
A suggested strategy for ‘Could be a PE but probs not’
A super simplified yet evidence-based approach to using the d-dimer in PE Q1. Is PE your top differential? If yes, do a V/Q or CTPA. Wells et al suggested that…
Pitfalls of using amylase to confirm pancreatitis
A 30 year old man presented intoxicated to A&E. He didn’t speak much English, and was triaged as ‘abdominal pain and vomiting’. With the help of a multilingual colleague, we…
KUB xray vs CT KUB for renal and ureteric colic
A 21 year old woman presented with vomiting and right flank pain. The pain started at 9am that morning, and had waves of 10/10 severity on a background of 8/10…
NICE Guidelines for Cervical Spine Imaging 2014
There I was reading “Accident and Emergency Radiology” by Harvey and finding out how to interpret a cervical spine xrays when I discovered that the NICE guidelines on CT Imaging…
Myoclonus vs chorea
“Anyone can moonwalk. It’s making it smooth that matters” Michael Jackson never once said. It’s all about smoothness when trying to decide between the dance like “there’s a snake trapped…
GCS: Causing more harm than good since 1974
Triage notes: 61 yo man, reducing GCS. PMH myelofibrosis Reduced GCS? Uh oh. What could be going on in that tortured skull? Is the first thing I would normally think…