Category: Palliative

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

Read More »

Superior Vena Cava Syndrome

SVC syndrome is an oncological emergency. There is obstruction of the superior vena cava resulting in stagnating blood and a high risk of thrombosis. Due to this obstruction, collaterals develop to drain the head, neck & upper extremities which dilate over several weeks. Cardiac output is usually not severely diminished as the quick rise in

Read More »

Seizures

Scenario: You are bleeped by one of the staff nurses to review a patient on the orthopaedic ward who is “jerking in her bed”. She tells you the patient is a 74-year-old female who is 2 days post knee replacement. She is a known epileptic who takes sodium valproate daily but has not taken any

Read More »

Metastatic Spinal Cord Compression

Spinal cord compression occurs when there is compression of the spinal cord or cauda equina at any level secondary to the effects of a malignancy. This can include metastatic infiltration to the vertebral column causing instability or pathological fractures as well as direct pressure from malignancy to the spinal cord. This condition affects around 5-10%

Read More »

Neutropenic Sepsis

Please read an overview of the management of sepsis before reading this article. Neutropenic sepsis is defined as a temperature of greater than 38°C or any symptoms and/or signs of sepsis, in a person with an absolute neutrophil count of 0.5 x 109/L or lower. It is a common and potentially life-threatening complication of neutropenia.

Read More »

Nausea & Vomiting

You will frequently get calls regarding nausea & vomiting: many patients present with it or develop it because of their diagnosis or treatment. You must consider anything concerning that could be causing it and give appropriate treatment for the underlying cause, correct any electrolyte disturbances & dehydration due to it in addition to antiemetics. Certain

Read More »

Palliative Care

Dying is a natural process and unfortunately, something that we all come across in our daily jobs, including whilst on call. Despite this, very little time is dedicated during our training towards managing the dying patient. Instead, all the focus is upon saving and resuscitating the patient. The question is though, what do we do

Read More »

Discussing Treatment Escalation & DNAR

As an FY1 you should not be expected to make decisions regarding treatment escalation and DNAR, but you may need to prompt seniors to consider them & explain these decisions to your patients and/or relatives. Definitions and abbreviations Do Not Attempt Resuscitation (DNAR/ DNA CPR) – this is a medical decision that states if a

Read More »

Prescribing analgesia

When assessing pain, ensure you begin by taking a history to characterise the pain as neuropathic pain, inflammatory pain and oncological pain all respond to different analgesia. SOCRATES is a helpful way to systematically take this history as it will help identify any serious underlying disease that is causing the pain and whether any further

Read More »

Sepsis

Sepsis is an infection with evidence of organ dysfunction. Septic shock is when a patient with sepsis is hypotensive despite appropriate fluid resuscitation. Introduction One study has shown that for every hour delay in receiving treatment mortality increases by 7.4%. There is NO diagnostic test for sepsis. Your Trust will likely have a Sepsis Screening

Read More »

Follow us

Our Newsletter

Trending Now

How to take a psychiatric history
Psychiatry, as a specialty is unique in that diagnostic methods, rely very heavily on symptomatology,...
Preparing for the Situational Judgement Test
Preparing for the Situational Judgement Test (SJT) exam can be quite daunting. It makes up 50% of your...
Applying to Core Surgical Training (CST)
Surgical training has a variety of work to get involved in as well as having many sub-specialties within...
Audits & Quality Improvement Projects (QIPs)
Audits & QIPs are a way to identify issues, drive changes and assess the effects they have. It is...
Passing the Prescribing Safety Assessment (PSA)
The PSA is aimed at final year medical students and those graduating overseas to assess their competency...
Describing Skin Lesions
It is quite common for you to need to describe rashes for documentation purposes, to senior colleagues...
ABG Interpretation
In this article, we will look at more practical aspects of how to read an ABG and treatment following...

Sign up for our awesome resources

Join over 25,000 users who have signed up for our free weekly webinars, referral cheat sheet & other amazing content!