Category: Medicine

Understanding the MSRA

The Multiple Specialty Recruitment Assessment (MSRA) is a computer-based exam increasingly being used by many different specialties as part of core training applications. For all specialties, the MSRA score will contribute to or be the sole consideration for shortlisting candidates for limited interview slots for each specialty. Subsequently, the MSRA score will also (often) contribute

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Adrenal Crisis & Hypocortisolism

Cortisol is the body’s natural steroid (glucocorticoid) which helps maintain blood pressure, blood glucose, sodium balance and suppress inflammation. It is a critical hormone which if not replaced when needed could result in life-threatening adrenal crisis. In this article, we discuss diagnosis, emergency management and discuss steroid-induced adrenal suppression.

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Gastroenterology in Primary Care

INTRODUCTION This article covers common gastroenterological presenting complaints seen in primary care. Presentations covered are: dyspepsia, diarrhoea, PR bleeding, constipation and deranged LFTs. DYSPEPSIA Definition Spectrum of upper GI symptoms including epigastric pain and heartburn and acid reflux. Can be categorised into functional causes vs. structural causes (e.g. GORD, PUD, GI malignancies) Overview of causes Management

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Haematological emergencies

In this article, we give an overview of the most important and serious haematological emergencies that junior doctors should know about! Neutropenic sepsis Case 1: 54-year-old woman Recent new diagnosis of a high-grade lymphoma Received R-CHOP chemotherapy 7 days ago Presents to ED with a fever of 38c What could be going on here? What

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Skin Cancer

Skin cancers have one of the highest global incidences of any type of cancer. Early diagnosis and management of melanoma can be life-saving. Junior doctors are in a position to spot such lesions and it is therefore important to be able to recognise them. The different types of skin cancer can usually be identified clinically,

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Bradyarrhythmias

Bradyarrhythmias are abnormal heart rhythms with a pulse rate of <60 beats per minute (bpm). This can be due to a variety of causes, including sinus node disease, atrioventricular disease, or toxins. Although the definition of bradyarrhythmia (brady- = slow, arrhythmia = abnormal rhythm) is defined as a heart rate (HR) <60bpm, many patients remain

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Hypoglycaemia

Management of low blood sugar in conscious & unconscious patients, finding common causes, adjusting medications & when to refer.

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Hypercalcaemia

Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia is a life-threatening electrolyte emergency requiring prompt recognition and urgent treatment.   Classification Mild (2.65 – 3.00 mmol/L): Patient is often asymptomatic Moderate (3.01-3.40 mmol/L): Can be asymptomatic or symptomatic Severe (>3.40 mmol/L): Risk of dysrhythmia and coma Serum calcium is found in 2 forms

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Reporting Adverse Drug Reactions

The World Health Organization (WHO) defines adverse drug reactions (ADR) as “any response to a drug which is noxious and unintended, and which occurs at doses normally used in man”. Importantly, these refer to situations when the drug is used normally and at the recommended dosages. ADRs may be classified into six categories, based on

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PICC Lines and Midlines

You may well be asked to take blood from a PICC line or be called to see a patient because their PICC line is not working. In this article we will take you through the basics of PICC lines, why they are needed, how to use them and some common pitfalls. Please note that procedures

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