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# Mind the Bleep: Medical Education Platform for Doctors and Medical Students

## Sitemaps
[XML Sitemap](https://mindthebleep.com/sitemap_index.xml): Includes all crawlable and indexable pages.

## Posts
- [Surgical scrubbing](https://mindthebleep.com/surgical-scrubbing-2/): Surgical scrubbing can be a daunting task when it is your first few times or if you are rusty, especially if you are bieng watched by other staff or in a rush! Here is a re-fresher to make going to theatre more pleasant!
- [Breaking Bad News](https://mindthebleep.com/breaking-bad-news-2/): This is a UKMLA-centred article about breaking bad news.
- [Contraception Counselling](https://mindthebleep.com/contraception-counselling/): This is a UKMLA-centred article about contraceptive counselling.
- [Difficulties in Breastfeeding](https://mindthebleep.com/difficulties-in-breastfeeding/): This is a UKMLA-centred article about difficulties in breastfeeding.
- [In-Flight Medical Emergencies: A practical guide for healthcare staff](https://mindthebleep.com/in-flight-medical-emergencies-a-practical-guide-for-healthcare-staff/): You’re cruising at 35,000 feet, the seatbelt sign is on, and suddenly… 
- [Pre-Hospital Management of Hypothermia](https://mindthebleep.com/pre-hospital-management-of-hypothermia/): Hypothermia is defined as a core body temperature below 35°C. It may sound like a condition reserved for mountaineers or explorers stranded in Antarctica, but in the wrong circumstances, even the British climate can be life-threatening. Consider a student in Aberdeen who passes out drunk in a garden after a night out, or an elderly neighbour left without heating during a winter cold snap. When the body loses heat faster than it can produce it, core temperature begins to fall, triggering a cascade of physiological changes that can rapidly become fatal if left untreated. Understanding how hypothermia develops, how the body responds, and how to recognise its signs is essential for anyone working in pre-hospital medicine.
- [Explaining Endoscopy Procedures](https://mindthebleep.com/explaining-endoscopy-procedures/): This is a UKMLA-centred article about explaining endoscopy procedures.
- [Fraser Guidelines](https://mindthebleep.com/fraser-guidelines/): This is a UKMLA-centred article about the Fraser guidelines.
- [HIV Counselling](https://mindthebleep.com/hiv-counselling/): This is a UKMLA-centred article about HIV counselling.
- [Consent](https://mindthebleep.com/consent/): This is a UKMLA-centred article on consent.
- [Explaining Cervical Smear Results](https://mindthebleep.com/explaining-cervical-smear-results/): This is a UKMLA-centred article about explaining cervical smear results.
- [Management of Hypertension in Pregnancy](https://mindthebleep.com/management-of-hypertension-in-pregnancy/): This is a UKMLA-centred article about the management of hypertension in pregnancy.
- [Explaining Gestational Diabetes](https://mindthebleep.com/explaining-gestational-diabetes/): This is a UKMLA-centred article about explaining gestational diabetes.
- [Explaining HRT](https://mindthebleep.com/explaining-hrt/): This is a UIKMLA-centred article about explaining HRT.
- [Intravenous Cannulation](https://mindthebleep.com/intravenous-cannulation/): This is a UKMLA-centred article about intravenous cannulation.
- [Nasogastric Tube Insertion](https://mindthebleep.com/nasogastric-tube-insertion/): This is a UKMLA-centred article about nasogastric tube insertion.
- [Prescribing and Adminstering Oxygen](https://mindthebleep.com/prescribing-and-adminstering-oxygen/): This is a UKMLA-centred article about prescribing and administering oxygen.
- [Venupuncture](https://mindthebleep.com/venupuncture/): This is a UKMLA-centred article about venupuncture.
- [Surgical Scrubbing](https://mindthebleep.com/surgical-scrubbing/): This is a UKMLA-centred article about surgical scrubbing.
- [Inhaler Technique](https://mindthebleep.com/inhaler-technique/): This is an article about how to assess inhaler technique.
- [Red Eye History Guide](https://mindthebleep.com/red-eye-history-guide/): This is a UKMLA-centred history guide about red eye.
- [Headache History Guide](https://mindthebleep.com/headache-history-guide/): This is a UKMLA-centred history guide about headache.
- [Abdominal Pain In Children History Guide](https://mindthebleep.com/abdominal-pain-in-children-history-guide/): This is a UKMLA-centred history guide about abdominal pain in children.
- [Painful Swollen Leg History Guide](https://mindthebleep.com/painful-swollen-leg-history-guide/): This is a UKMLA-centred history guide about painful swollen leg.
- [Abdominal Pain History Guide](https://mindthebleep.com/abdominal-pain-history-guide/): This is a UKMLA-centred history guide about abdominal pain.
- [Palpitations History Guide](https://mindthebleep.com/palpitations-history-guide/): This is a UKMLA-centred history guide about palpitations.
- [Rash History Guide](https://mindthebleep.com/rash-history-guide/): This is a UKMLA-centred history guide about rashes.
- [Fever History (Child Health)](https://mindthebleep.com/fever-history-child-health/): This is a UKMLA-centred history guide about fever in children.
- [Limb Weakness History Guide](https://mindthebleep.com/limb-weakness-history-guide/): This is a UKMLA-centred history guide about limb weakness.
- [Basics of ICU: Airway](https://mindthebleep.com/basics-of-icu-airway/): Starting in intensive care can feel overwhelming, especially when it comes to managing airways. This guide will walk you through the basics in simple terms, so you feel more confident when you encounter these situations.
- [Psychiatric Emergencies: Recognition and Initial Management](https://mindthebleep.com/psychiatric-emergencies-recognition-and-initial-management/): Written by: Dr Varun Kamath and Dr Alexia Caramitsos-Tziras
- [Personality Disorders: A Practical Guide for Residents Doctors](https://mindthebleep.com/personality-disorders-a-practical-guide-for-residents-doctors/): Written for Mind the Bleep by Dr Mamoor Waheed CT1
- [Fixed Rate Ending? How Doctor Mortgages Can Help When Your Deal Expires](https://mindthebleep.com/fixed-rate-ending-how-doctor-mortgages-can-help-when-your-deal-expires/): Through its partnership with Doctors Mortgages, Mind The Bleep connects doctors with specialist mortgage advisers who understand NHS career structures and medical income.
- [Hand Washing](https://mindthebleep.com/hand-washing/): Hand washing is a fundamental and frequent procedure that is practiced in healthcare. Correct technique reduces the transmission of infectious diseases thereby protecting patients, colleagues and yourself. This article will explain when you should clean your hands, the correct technique and use of alcohol gels.
- [Top Tips for Exploring HealthTech Careers](https://mindthebleep.com/top-tips-for-exploring-healthtech-careers/): HealthTech is becoming an increasingly popular area of interest for doctors looking to diversify their careers, develop portfolio roles, or explore opportunities beyond traditional clinical work. With the wide range of possible roles and unclear entry routes, knowing where to start can feel overwhelming.
- [Digital Nerve Block](https://mindthebleep.com/digital-nerve-block/): Digital nerve block is a quick and effective method to provide anaesthesia for injuries and procedures to the digits. This is a useful skill for any doctor working in the emergency department. This article will cover the relevant anatomy, indications, complications and technique to perform this procedure.
- [Performing an ECG](https://mindthebleep.com/performing-an-ecg/): An electrocardiogram (ECG) is a very useful investigation for cardiac symptoms. It is important doctors are able to perform an ECG as it is not uncommon to be in a situation where no available staff can do it (especially in community settings). This article aims to serve as a quick guide or refresher on how to perform an ECG.
- [Ultrasound Scan Guided Cannulation](https://mindthebleep.com/ultrasound-scan-guided-cannulation/): Ultrasound scan (USS) guided cannulation is a technique to obtain peripheral vascular access under ultrasound visual guidance. It is particularly useful when peripheral venous access is difficult. It is essential you are confident with cannulation before attempting USS guided cannulation.
- [Radiology Into Action Case 2 – How to Recognise and Manage Pleural Effusion on a Chest X-Ray](https://mindthebleep.com/radiology-into-action-case-2-how-to-recognise-and-manage-pleural-effusion-on-a-chest-x-ray/): Learn how to recognise pleural effusions on chest X-ray with this practical case-based guide for medical students and junior doctors.
- [Managing Fainters During Blood Tests](https://mindthebleep.com/managing-fainters-during-blood-tests/): Although these episodes are usually brief and self-limiting, they can be distressing for both patients and healthcare staff. Poor recognition of early warning signs may lead to falls, injuries, failed procedures, and increased patient anxiety surrounding future blood tests. 
- [Venepuncture in Children](https://mindthebleep.com/venepuncture-in-children/): Venepuncture in children can be challenging for both healthcare professionals and families. Anxiety, movement, small veins, and previous negative experiences may all make blood sampling more difficult. 
- [Basics of Venepuncture](https://mindthebleep.com/basics-of-venepuncture/): Venepuncture is one of the most commonly performed clinical procedures in healthcare. It is used to obtain blood samples for diagnostic testing, monitoring chronic conditions, guiding treatment decisions, and investigating acute illness. 
- [Blood Bottles Explained](https://mindthebleep.com/blood-bottles-explained/): This article is the first in our series on phlebotomy and venepuncture. It provides a practical overview of the common blood bottles used in UK hospitals, including their additives, common investigations, and important practical considerations encountered during everyday venepuncture.
- [Paediatric ED – Poisoning and Toxic Exposures](https://mindthebleep.com/paediatric-ed-poisoning-and-toxic-exposures/): A practical guide for resident doctors in the emergency department, focusing on the assessment and management of paediatric poisoning and toxic exposures — where early recognition and decision-making are crucial.
- [Paediatric ED – Foreign Body Inhalation and Ingestion](https://mindthebleep.com/paediatric-ed-foreign-body-inhalation-and-ingestion/): A practical guide for resident doctors in the emergency department, focusing on recognising and managing paediatric foreign body inhalation and ingestion — where early decision-making really matters.
- [A Child is not just a Small Adult](https://mindthebleep.com/a-child-is-not-just-a-small-adult/): Children can appear stable until they suddenly deteriorate. Unlike adults, they compensate effectively through physiological mechanisms before rapidly decompensating. This makes early recognition of subtle clinical signs essential in paediatric practice. This article outlines the key anatomical and physiological differences in children and, importantly, how these differences should change your clinical approach in acute settings.
- [Clinical Radiology ST1 Portfolio 2026: How to Maximise Your Score](https://mindthebleep.com/clinical-radiology-st1-portfolio-2026/): Master the 2026 Radiology ST1 application with our expert guide. Learn how to optimise your portfolio, score maximum points, and plan for long-term success.
- [Clinical Radiology ST1 Application Guide 2026 – MSRA, Portfolio & Interview](https://mindthebleep.com/clinical-radiology-st1-application-guide-2026/): A comprehensive Clinical Radiology ST1 Application Guide 2026 for entry in the UK, including MSRA, portfolio scoring, interview format, timeline, and top preparation tips.
- [AI Analysis of Prostate MRI: What Every Doctor Should Know About AI-Assisted Radiology](https://mindthebleep.com/how-artificial-intelligence-reviews-your-prostate-mri-what-is-ai-assisted-imaging/): Whether or not you've noticed it yet, artificial intelligence (AI) is beginning to appear in medical imaging processes in trusts around the UK. Depending on where you work, you may already have access to such systems, such as AI-interpretation directly integrated into PACS (Akbar, 2025; Calderdale and Huddersfield NHS Foundation Trust, 2025; Naz, 2024). For most doctors, this raises an immediate and practical question: what does that actually mean for the report I'm reading?
- [Radiology into Action Case 1 – How to Recognise and Manage Pneumothorax on Chest X-Ray](https://mindthebleep.com/radiology-into-action-how-to-recognise-and-manage-pneumothorax-on-chest-x-ray/): Learn how to recognise pneumothorax and tension pneumothorax on chest X-ray, assess acute patients, and manage according to BTS 2023 guidelines
- [Corneal Dystrophies](https://mindthebleep.com/corneal-dystrophies/): Corneal dystrophies are inherited, bilateral, slowly progressive, non-inflammatory disorders characterised by abnormal material deposition within the cornea. They are classified anatomically by the corneal layer affected a framework that directly informs clinical presentation and management. This article covers the four dystrophies most relevant to medical students and junior doctors.
- [Confusion Station](https://mindthebleep.com/confusion-station/): This is a practice OSCE station for UKMLA content.
- [Malnutrition Risk Assessment (MUST Score)](https://mindthebleep.com/malnutrition-risk-assessment-must-score/): Malnutrition is a common and often under-recognised problem in hospitalised patients. It is associated with increased risk of infection, poor wound healing, prolonged hospital stay, and higher mortality.
- [Falls Risk Assessment](https://mindthebleep.com/falls-risk-assessment/): Falls risk assessment is a core component of patient safety in hospital practice. While prevention strategies are essential, they rely on accurate and repeated identification of risk factors.
- [4AT: Delirium Assessment](https://mindthebleep.com/4at-delirium-assessment/): Delirium is an acute disturbance in attention, awareness, and cognition, commonly seen in hospitalised patients, particularly older adults. It is associated with increased morbidity, mortality, length of stay, and long-term cognitive decline.
- [Venous Thromboembolism (VTE) Risk Assessment](https://mindthebleep.com/venous-thromboembolism-vte-risk-assessment/): Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common and preventable cause of hospital-associated morbidity and mortality. Hospitalised patients are at increased risk due to immobility, acute illness, and comorbidities.
- [Preventing Prescribing Errors on the Ward](https://mindthebleep.com/preventing-prescribing-errors-on-the-ward/): Medication errors are one of the most common and preventable causes of patient harm in healthcare. They can occur at any stage of the medication process, from prescribing to administration, and are associated with increased morbidity, mortality, and length of hospital stay.
- [Preventing Deconditioning on the Ward](https://mindthebleep.com/preventing-deconditioning-on-the-ward/): Deconditioning refers to the loss of physical, functional, and cognitive abilities that can occur during hospital admission, particularly in older patients with frailty. It can begin within hours of bed rest and is associated with longer hospital stays, increased dependency, and higher rates of discharge to care homes.
- [Preventing Pressure Ulcers on the Ward](https://mindthebleep.com/preventing-pressure-ulcers-on-the-ward/): Pressure ulcers (also known as pressure sores) are localised injuries to the skin and underlying tissue, usually occurring over bony prominences due to prolonged pressure. They are a significant cause of patient harm, leading to pain, infection, delayed recovery, and increased length of stay.
- [Preventing Falls on the Ward](https://mindthebleep.com/preventing-falls-on-the-ward/): Falls are one of the most common causes of harm to hospitalised patients, particularly in older adults. They can lead to significant morbidity, including fractures, head injury, prolonged admission, and loss of independence. Preventing falls is therefore a key patient safety priority.
- [Anxiety disorder: Post-Traumatic Stress Disorder](https://mindthebleep.com/anxiety-disorder-post-traumatic-stress-disorder/): This is a UKMLA-centred history guide about Post-Traumatic Stress Disorder.
- [Diagnostic Radiographer](https://mindthebleep.com/diagnostic-radiographer/): Hospitals rely on a wide range of clinical and non-clinical staff to provide safe, effective care. One key clinical role in this process is the radiographer, who produces medical images that are essential for diagnosis and treatment. This article is the fourth part of our series exploring allied health professional roles in the NHS.
- [Psychologist](https://mindthebleep.com/psychologist/): Hospitals and healthcare services rely on a diverse team of clinical professionals to support patients’ physical and mental health. One key role is that of the psychologist, who works with patients to assess, treat, and manage psychological and emotional difficulties associated with illness, injury, or life changes.
- [Speech and Language Therapist](https://mindthebleep.com/speech-and-language-therapist/): Hospitals rely on a wide range of clinical and non-clinical staff to deliver safe and effective care. One of the key allied health professional roles is the Speech and Language Therapist (SLT), who assesses and treats problems with speech, language, communication, and swallowing.
- [Dietician](https://mindthebleep.com/dietician/): Hospitals rely on a range of clinical and non-clinical staff to deliver care and improve patient outcomes. One of the key allied health professional roles involved in patient care is the dietitian, who assesses, plans, and manages nutrition for patients across hospital, outpatient, and community settings.
- [Patient Pathway Coordinator](https://mindthebleep.com/patient-pathway-coordinator/): Hospitals rely on a range of clinical and non-clinical staff to coordinate how patients move through services. One of the key non-clinical roles involved in this process is the patient pathway coordinator, who manages administrative aspects of a patient’s journey through outpatient clinics and elective care from the pathway from referral through to treatment.
- [Bed Manager](https://mindthebleep.com/bed-manager/): Hospitals rely on a range of clinical and non-clinical staff to manage the movement of patients through the organisation. One of the key non-clinical roles involved in this process is the bed manager, who oversees bed allocation and patient flow across the hospital.
- [Ward Clerk](https://mindthebleep.com/ward-clerk/): Hospital wards rely on a range of clinical and non-clinical staff to function effectively. One of the key non-clinical roles is the ward clerk, who provides administrative support within the ward environment. This article is the second instalment in our series exploring non-clinical roles within the multidisciplinary team.
- [Optic Neuritis](https://mindthebleep.com/optic-neuritis/): Optic neuritis is an inflammatory disorder of the optic nerve (CN II), disrupting its ability to transfer information from the retina to the brain. It leads to acute, central vision loss with ocular pain made worse on eye movement. 
- [Eating Disorders – History Guide](https://mindthebleep.com/eating-disorders-history-guide/): This is a UKMLA-centred history guide about eating disorders.
- [A step-by-step guide on passing the FRCOphth part 1 as a foundation year 1 doctor](https://mindthebleep.com/a-step-by-step-guide-on-passing-the-frcophth-part-1-as-a-foundation-year-1-doctor/): The FRCOphth Part 1 is the first written examination set by the Royal College of Ophthalmologists. It is required for progression to ST3 ophthalmology training. However, many doctors now choose to sit it much earlier, including during foundation training, because of the advantages it offers when applying for ST1.
- [AI – Should I Use Artificial Intelligence as a Doctor?](https://mindthebleep.com/am-i-allowed-to-use-artificial-intelligence-as-a-doctor/): You may have used artificial intelligence (AI) tools yourself already, or observed colleagues doing so.  Adoption of AI systems is rising amongst doctors, but it's largely ad-hoc: clinicians are discovering and using third-party platforms independently of institutional oversight (1,2).
- [Contrast Media: A Practical Guide](https://mindthebleep.com/contrast-media-a-practical-guide/): Contrast agents are an essential part of modern medical imaging. This guide highlights essential principles any doctor should know about contrast – how it works, when to use it, and how to manage risks – so you can make safe clinical decisions and answer patients’ questions with confidence. 
- [Melaena – History Guide](https://mindthebleep.com/melaena-history-guide/): This is a UKMLA-centred history guide about melaena.
- [Abnormal Involuntary Movements – History Guide](https://mindthebleep.com/abnormal-involuntary-movements-history-guide/): This is a UKMLA-centred history guide about abnormal involuntary movements.
- [Anosmia – History Guide](https://mindthebleep.com/anosmia-history-guide/): This is a UKMLA-centred history guide about anosmia.
- [Peripheral Oedema and Ankle Swelling – History Guide](https://mindthebleep.com/peripheral-oedema-and-ankle-swelling-history-guide/): This is a UKMLA-centred history guide about peripheral oedema and ankle swelling.
- [Swallowing Problems – History Guide](https://mindthebleep.com/swallowing-problems-history-guide/): This is a UKMLA-centred history guide about swallowing problems.
- [Behaviour/Personality Change – History Guide](https://mindthebleep.com/behaviour-personality-change-history-guide/): This is a UKMLA-centred history guide about behaviour/personality change.
- [Facial Weakness – History Guide](https://mindthebleep.com/facial-weakness-history-guide/): This is a UKMLA-centred history guide on facial weakness.
- [Dizziness and Vertigo – History Guide](https://mindthebleep.com/dizziness-and-vertigo-history-guide/): This is a UKMLA-centred history guide for dizziness and vertigo.
- [Non-Blanching Rash in Children – History Guide](https://mindthebleep.com/non-blanching-rash-in-children-history-guide/): This is a UKMLA-centred history guide for non-blanching rash in children.
- [Newborn Examination Guide](https://mindthebleep.com/newborn-examination-guide/): This is a UKMLA-centred guide to the Newborn Examination.
- [Polydipsia Station](https://mindthebleep.com/polydipsia-station/): This is a practice OSCE station for UKMLA content.
- [Urinalysis](https://mindthebleep.com/urinalysis/): Urinalysis is the physical and chemical examination of a urine sample. It is a common procedure that can be done quickly and yields important clinical information. This article will teach you the three key steps to perform this procedure and interpret the results.
- [Eye Pain – History Guide](https://mindthebleep.com/eye-pain-history-guide/): Eye pain is a common presentation with a broad differential. A structured history is essential to identify sight-threatening and systemic causes. It is important to ask about eye pain when taking an ophthalmic history, even if it is not the presenting complaint.
- [Your Guide to a Low-Income Country Ophthalmology Elective: Lessons from Rural Southern Africa](https://mindthebleep.com/your-guide-to-a-low-income-country-ophthalmology-elective-lessons-from-rural-southern-africa/): My medical school ophthalmology elective to Southern Africa was cancelled during COVID. Three years later, as an F3 doctor, I decided to make it happen anyway, volunteering at the rural eye clinic where I had originally planned my elective. This article is a guide on how to arrange and make the most of an elective in a low-income country. The challenges are greater, but the rewards are often profound.
- [Head Injury – History Guide](https://mindthebleep.com/head-injury-history-guide/): Head injury remains a common reason for presentations to the emergency department in the UK and, akin to trauma as a whole, represents a significant cause of death and morbidity in those aged 1 to 40 years of age. Whilst over 1 million patients will present each year, head injury is by no means a uniform diagnosis, instead incorporating numerous specific pathologies with significant differences in severity across patients.   
- [Acute Joint Pain/Swelling – History Guide](https://mindthebleep.com/acute-joint-pain-swelling-history-guide/): This guide is designed to help you take a safe, structured, and clinically relevant history when assessing a patient with acute joint pain or swelling. It focusses on gathering the key information needed to identify red flags (such as septic arthritis), build a differential diagnosis, and guide appropriate investigations. 
- [Loss of Vision – History Guide](https://mindthebleep.com/loss-of-vision-history-guide/): When taking a history from a patient presenting with ophthalmic symptoms, it is important to ask about any vision loss. 
- [Bone Pain Station](https://mindthebleep.com/bone-pain-station/): This is a practice OSCE station for UKMLA content.
- [Altered Sensation, Numbness and Tingling Station](https://mindthebleep.com/altered-sensation-numbness-and-tingling-station-2/): This is a practice OSCE station for UKMLA content.
- [Diarrhoea Station](https://mindthebleep.com/diarrhoea-station-2/): This is a practice OSCE station for UKMLA content.
- [Infant Feeding Problems Station](https://mindthebleep.com/infant-feeding-problems-station/): This is a practice OSCE station for UKMLA content.
- [Vomiting Station](https://mindthebleep.com/vomiting-station/): This is a practice OSCE station for UKMLA content.
- [Breathlessness Station (A-E)](https://mindthebleep.com/breathlessness-station-a-e-2/): This is a practice OSCE station for UKMLA content.
- [Acute Abdominal Pain Station](https://mindthebleep.com/acute-abdominal-pain-station-5/): This is a practice OSCE station for UKMLA content.
- [Flashes and Floaters in Visual Fields Station](https://mindthebleep.com/flashes-and-floaters-in-visual-fields-station/): This is a practice OSCE station for UKMLA content.
- [Red Eye Station](https://mindthebleep.com/red-eye-station/): This is a practice OSCE station for UKMLA content.
- [Gradual Change in or Loss of Vision Station](https://mindthebleep.com/gradual-change-in-or-loss-of-vision-station/): This is a practice OSCE station for UKMLA content.

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- [Neonatology](https://mindthebleep.com/neonatology/): Medicine Surgery Emergencies Final Year FY1 SHO Career IMG Radiology eLearning In Person Courses Paediatrics Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now on Neonatology Prematurity Prematurity (or Pre-term) describes infants delivered before 37 weeks of gestation. Pre-term birth is a leading cause of morbidity and mortality in children under 5 years globally,... A Cheat Sheet for Neonatal Invasive Ventilation Neonatal ventilation is a complex topic but one you may need to get your head around as an FY2 if you cover a NICU as part of your paeds rotation. You should read our article about... Neonatal Respiratory Physiology This may seem like a very subspecialist topic but as part of a paeds job as a junior trainee or FY2 you may be expected to cover a neonatal unit and this may involve looking after ventilated... Assessing the floppy baby A "floppy" baby may present in many different ways and there is a long list of differentials for a baby with reduced tone. This article will you refine your diagnostic skills when it... Bilious Vomiting in the Neonate “Bilious vomiting” is a common problem you will be asked to review babies for on the postnatal ward or in the neonatal unit. True bilious vomiting can be an emergency and this article... Neonatal Jaundice Jaundice in the newborn is a relatively common presentation, typically seen on postnatal wards and presenting to paediatric units in the first couple of weeks of life. It is often managed... Latest Content on Neonatology Prematurity Prematurity (or Pre-term) describes infants delivered before 37 weeks of gestation. Pre-term birth is a leading cause of morbidity and mortality in children under 5 years globally,... NIPE The Newborn and Infant Physical Examination (NIPE) or Examination of the Newborn (EON) is performed on every newborn baby within the first 72 hours of life by doctors and midwives.... Neonatal hypoglycaemia Neonatal hypoglycaemia is defined as blood glucose levels < 2.6mmol/L. It’s a common problem in the first days of life, affecting up to 15% of neonates. It can be due to a variety... Neonatal Respiratory Physiology This may seem like a very subspecialist topic but as part of a paeds job as a junior trainee or FY2 you may be expected to cover a neonatal unit and this may involve looking after ventilated... A Cheat Sheet for Neonatal Invasive Ventilation Neonatal ventilation is a complex topic but one you may need to get your head around as an FY2 if you cover a NICU as part of your paeds rotation. You should read our article about... Assessing the floppy baby A "floppy" baby may present in many different ways and there is a long list of differentials for a baby with reduced tone. This article will you refine your diagnostic skills when it... Necrotising Enterocolitis Necrotising enterocolitis is one of the most common neonatal surgical emergencies and is a potentially life-threatening condition. This article talks through the risks for developing... Bilious Vomiting in the Neonate “Bilious vomiting” is a common problem you will be asked to review babies for on the postnatal ward or in the neonatal unit. True bilious vomiting can be an emergency and this article... Neonatal Jaundice Jaundice in the newborn is a relatively common presentation, typically seen on postnatal wards and presenting to paediatric units in the first couple of weeks of life. It is often managed... Paediatrics: Clerking & Discharge tips As an FY1 it is likely that you will manage paediatric patients during their admission, often in other specialties like general surgery. Having a few paediatric skills under your belt... Previous
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- [Research](https://mindthebleep.com/research/): Medicine Surgery Emergencies Final Year FY1 SHO Career IMG Radiology eLearning In Person Courses Paediatrics Psychiatry Finance Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Research Match 2025 Register now for our Research Match Programme, designed to connect medical students and foundation trainees eager to get involved in research with supervisors leading exciting projects. Sign up! Research Courses Introduction to Python and a simple Image Classifier with Deep Learning (TensorFlow) In this two part course, we will introduce the basics of using Python and its package TensorFlow to demonstrate the key components... Check it out » Audit and QI Course Welcome to the Mind the Bleep course on Audit and QI. From this course you should achieve the following: A working understanding... Check it out » Trending Now on Research An Introduction to Artificial Intelligence in Healthcare Introduction to AI Artificial Intelligence (AI) has changed almost every aspect of modern technology, and it is inevitable that we will soon witness its impact on healthcare. It is... Randomised Control Trials - The Basics Introduction Randomised Control Trials (RCTs) play a vital role in evidence-based medicine, providing valuable insights into the effectiveness of medical interventions. As medical students,... Introduction to AI in Healthcare - Types of AI and replacing Healthcare Professionals (HCPs) Welcome back to our series on AI in Healthcare. Article 2 will cover the main types of AI and try to answer the question “Will AI replace human healthcare professionals in the future?”.... Writing a Letter to the Editor of a Medical Journal  What is a Letter to the Editor?  A letter to the editor in a medical journal serves as a concise written communication where readers, including healthcare professionals, researchers,... How to Critique Randomised Control Trials Introduction Randomised Control Trials (RCTs) play a vital role in evidence-based medicine, providing valuable insights into the effectiveness of medical interventions. As medical students,... Unveiling the World of Research: My Medical Student Journey and Tips for Getting Involved  Introduction   Starting my research journey as a medical student has been an incredible and transformative experience. In this article, I wholeheartedly share my personal... Latest Content on Research Introduction to AI in Healthcare - Types of AI and replacing Healthcare Professionals (HCPs) Welcome back to our series on AI in Healthcare. Article 2 will cover the main types of AI and try to answer the question “Will AI replace human healthcare professionals in the future?”.... An Introduction to Artificial Intelligence in Healthcare Introduction to AI Artificial Intelligence (AI) has changed almost every aspect of modern technology, and it is inevitable that we will soon witness its impact on healthcare. It is... Writing a Letter to the Editor of a Medical Journal  What is a Letter to the Editor?  A letter to the editor in a medical journal serves as a concise written communication where readers, including healthcare professionals, researchers,... Unveiling the World of Research: My Medical Student Journey and Tips for Getting Involved  Introduction   Starting my research journey as a medical student has been an incredible and transformative experience. In this article, I wholeheartedly share my personal... How to Critique Randomised Control Trials Introduction Randomised Control Trials (RCTs) play a vital role in evidence-based medicine, providing valuable insights into the effectiveness of medical interventions. As medical students,... Randomised Control Trials - The Basics Introduction Randomised Control Trials (RCTs) play a vital role in evidence-based medicine, providing valuable insights into the effectiveness of medical interventions. As medical students,... Previous
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- [Wellbeing](https://mindthebleep.com/wellbeing/): Medicine Surgery Emergencies Final Year FY1 SHO Career IMG Radiology eLearning In Person Courses Paediatrics Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now on Wellbeing The Holistic Approach to Wellbeing There’s a myriad of resources out there to help with maintaining your mental well-being, but it can be overwhelming to understand where to start or what to focus on. This article will... Starting in the NHS as an International Medical Graduate: A Guide to Wellbeing and Adaptation Moving into a new healthcare system can be overwhelming. Many international medical graduates face this reality when joining the NHS. Whether you’re starting as a Junior or Senior... Understanding Resident Doctors Pay and How to Spot Errors We’ve partnered with Doctors Paycheck to provide a comprehensive webinar on Understanding Resident Doctors’ Pay. The session aims to equip doctors with essential knowledge... Coronavirus and your wellbeing Covid-19 is taking a huge emotional toll on everyone. The usual work-life balance tips don’t work as well when you can’t go out and everyone’s emotions are... Wellbeing for FY1's As you transition from medical school to your first year as an FY1 doctor, it’s important to recognise the challenges you’ll face and prioritize your well-being. The shift from student... Mind The Bleep: The Podcast Mental health and well-being are taboo subjects for medical students and doctors, and something which is often not talked about enough. This is surprising, considering there is a higher... Latest Content on Wellbeing Compassion Fatigue and Preventing Empathy Burnout: A Guide for New Doctors Starting your career as a doctor is a mix of emotions, split between excitement and worry of the challenges ahead. Every day, you are tasked with making critical decisions, connecting... Understanding Resident Doctors Pay and How to Spot Errors We’ve partnered with Doctors Paycheck to provide a comprehensive webinar on Understanding Resident Doctors’ Pay. The session aims to equip doctors with essential knowledge... Dealing with difficult colleagues This is a tricky area to cover as it can be challenging to us both personally and professionally when things don’t go well with a colleague, particularly when we know that this might... Self-care and Wellness Tools We have compiled a list of wellbeing resources designed to support healthcare professionals in improving their mental health: WELLBEING RESOURCES BMA Wellbeing Support Services Covers... Starting in the NHS as an International Medical Graduate: A Guide to Wellbeing and Adaptation Moving into a new healthcare system can be overwhelming. Many international medical graduates face this reality when joining the NHS. Whether you’re starting as a Junior or Senior... The Holistic Approach to Wellbeing There’s a myriad of resources out there to help with maintaining your mental well-being, but it can be overwhelming to understand where to start or what to focus on. This article will... Where to go for foundation training? This article has been written with final year medical students in mind, deciding where to go for foundation training. As an FY2, it is one of the questions I get asked most by medical... Wellbeing for FY1's As you transition from medical school to your first year as an FY1 doctor, it’s important to recognise the challenges you’ll face and prioritize your well-being. The shift from student... Healthy meal prep Right, we’ve all been there. You’re starving after finished a long day, have forgotten the shops close at 4pm on Sunday, or simply can’t find the energy to chop onions and garlic in... How to be happy by practicing Gratitude Journalling! Gratitude – a strong feeling of appreciation to someone or something for what the person has done to help you. What is gratitude journalling? Gratitude journalling is keeping a record... Mind The Bleep: The Podcast Mental health and well-being are taboo subjects for medical students and doctors, and something which is often not talked about enough. This is surprising, considering there is a higher... Financial Tips for IMGs This article will go over the costs for international medical graduates associated with applying for a Health and Care Worker Visa and what kind of issues to be aware of once you’ve... Coronavirus and your wellbeing Covid-19 is taking a huge emotional toll on everyone. The usual work-life balance tips don’t work as well when you can’t go out and everyone’s emotions are... Breaks and Burnout When I left medical school, I thought my only difficulty would be the actual medicine, which most resident doctors will tell you flies out your head as soon as you walk out of finals... Work-Life Balance Work-life balance is a topic that has become increasingly prevalent over the past decade with positive changes being made to the resident doctor contract and several initiatives being... Working Less Than Full Time Working LTFT in FY1/FY2 Working LTFT can be a great way to improve your work-life balance and applies to individuals in many situations. Obviously, training takes a little longer and... Coping with illness Important things to remember You will get sick. That is life. You’re surrounded by germ-exuding things (otherwise known as your patients and colleagues), and may well be in a new place,... Leave As an FY1 doctor, there are different types of leave you will come across during the year and the rest of your career. This article will talk about annual leave, study leave and sick... Previous
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- [Final Year Medical Student](https://mindthebleep.com/finalyear/): Medicine Surgery Emergencies Career Radiology eLearning In Person Courses Paediatrics Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now for Final Year Medical Students Passing the Prescribing Safety Assessment (PSA) The PSA is aimed at final year medical students and those graduating overseas to assess their competency at prescribing as Foundation Year 1 Doctors. It can also be taken by FY1s if... e-Portfolio Your e-Portfolio is an online tool to gather and store evidence of progression throughout your time as a Foundation Doctor (FD). You can store clinical competencies, reflections on... Prepare for FY1 Guide by Specialty This amazing guide was created by so many amazing doctors like yourself helping each other. It is a snapshot of the freely editable guide that can be found here. As you use this resource,... Maximise Points for Specialty Applications With the recent removal of additional degrees counting for points towards all specialty applications for 2023 recruitment, it’s now even more important to build one’s portfolio... Clerking Patients: A few tips Here we assume you know the basics, and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Not all FY1s have the opportunity to clerk patients... Discharge letters: hints & tips Writing a discharge summary is a task you are likely to carry out every day, and despite the sense of monotony, it plays a critical part in the patient journey. Contents of a good discharge... Latest Content for Final Year Students Death Verification As a new F1 in August, it can feel like quite a daunting task to verify a death, particularly if you have never seen this done before. This step by step guide will take you through... Clerking Patients: A few tips Here we assume you know the basics, and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Not all FY1s have the opportunity to clerk patients... Writing a Letter to the Editor of a Medical Journal  What is a Letter to the Editor?  A letter to the editor in a medical journal serves as a concise written communication where readers, including healthcare professionals, researchers,... Prepare for FY1 Guide by Specialty This amazing guide was created by so many amazing doctors like yourself helping each other. It is a snapshot of the freely editable guide that can be found here. As you use this resource,... How much do resident doctors earn? Overview of how much resident doctors earn with a broad range of salaries depending on grade and hours worked Ophthalmology Applications: How To Get Ahead While Still at Medical School Ophthalmology is a hugely popular career. Having the skills and ability to improve a patient’s quality of life by restoring their eyesight is undeniably a rewarding vocation. Other... Specialised Foundation Programme - Introduction to interview The Specialised Foundation Programme (SFP – formerly known as the AFP or academic foundation programme) is a highly competitive application process for final-year medical students.... Specialised Foundation Programme - Clinical Station You will have a total of 10 minutes of interactive time. Prior to the station, you will be provided with a clinical vignette or series of clinical vignettes involving a number of medical... Specialised Foundation Programme - Academic Station The academic station generally begins with a personal question and is your opportunity to demonstrate why you are applying for a specialised foundation programme. Whether that be medical... Maximise Points for Specialty Applications With the recent removal of additional degrees counting for points towards all specialty applications for 2023 recruitment, it’s now even more important to build one’s portfolio... Resident Doctor Contract explained In the UK, there are different contracts for each region: Northern Ireland, Scotland, England & Wales. For England, the latest update is in 2018 & it is worth making sure you’re... ECG Basics The electrocardiogram (ECG) is one of the most common, and important, investigations interpreted by doctors. In order to help the interpretation process, it is necessary to understand... Preparing for the Situational Judgement Test Preparing for the Situational Judgement Test (SJT) exam can be quite daunting. It makes up 50% of your Foundation Programme application and thus has the largest weight of any one exam... Passing the Prescribing Safety Assessment (PSA) The PSA is aimed at final year medical students and those graduating overseas to assess their competency at prescribing as Foundation Year 1 Doctors. It can also be taken by FY1s if... 10 Gifts for your Colleagues As we all rotate so frequently between departments, many of us like to get our seniors or juniors something nice to say thank you. Personally, I’m a massive gift giver because... Ranking Foundation Jobs If you’re worried about not getting your top choice, you shouldn’t worry. It doesn’t affect your future career and wherever you will go, given everyone is in the same... Medical Podcasts that are worth a listen! We asked on social media what your favourite podcasts were & these were rated the most popular. Comment below if you have any other favourite podcasts we’ve missed! RCP Medicine... Preparing for FY1 It is common for FY1s to feel anxious & feel like they’re not ready to start. We expect you to feel like this & hence are ready to support you. You will have SHOs who... Common Prescribing Errors When I supervise and teach FY1s, prescribing is among the top three things they are most concerned about. Usually, they’re worried that they won’t know what to prescribe... How to teach medical students Balancing your workload as a resident doctor whilst teaching medical students effectively is difficult so here are some tips! Portfolio requirements As a resident doctor, it is a requirement... ABG Interpretation In this article, we will look at more practical aspects of how to read an ABG and treatment following your interpretation. If you’re looking on how to perform an ABG, read this... Bullying and Undermining - Changing Culture Welcome to FY1. In your first few months, you will find your learning curve is steep and you may feel out of your depth and lost. This is normal-you will develop skills in your first... e-Portfolio Your e-Portfolio is an online tool to gather and store evidence of progression throughout your time as a Foundation Doctor (FD). You can store clinical competencies, reflections on... Documentation Medical documentation should authentically represent every consultation and is primarily intended to support patient care. Good record-keeping means you or a colleague can reconstruct... Careers Advice FY1 is a great opportunity to explore new specialties and start to gain an idea of what working in them is actually like. A few things to bear in mind though: As an FY1 your job will... Discharge letters: hints & tips Writing a discharge summary is a task you are likely to carry out every day, and despite the sense of monotony, it plays a critical part in the patient journey. Contents of a good discharge... Performing Arterial Blood Gases (ABGs) An arterial blood gas (ABG) test is performed to measure the oxygen and carbon dioxide levels in the blood, as well as the pH. The sample is taken from an artery. Equipment Gloves Alcohol... Venepuncture Venepuncture is the term used to describe the procedure of withdrawing blood from a vein using a needle. Consider the requirement for the procedure and establish appropriate levels... Cannulation Cannulation is a procedure regularly undertaken which involves threading a plastic tube into a vein, allowing access for fluid & drug administration. Blood samples can be taken... Essential Apps Here’s a list of apps that are in order of how essential we find them. There’s probably more out there so drop us a comment if you have any suggestions to add! Induction... Previous
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- [FY2](https://mindthebleep.com/fy2/): Medicine Surgery Emergencies Career Radiology eLearning In Person Courses Paediatrics Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now for FY2s & SHOs Clinical Radiology ST1 Application Guide 2025 Radiology is an exciting and fast-evolving specialty, with radiologists playing a crucial role in diagnosing patients and guiding management across all specialties. This article takes... Gynaecological Examination If the thought of conducting an intimate examination or attempting to wield (without any embarrassing pitfalls) the contraption that is the speculum is enough to fill you with apprehension-... Claiming Tax Relief This article is about claiming tax relief on essential things for your job – such as your GMC registration, BMA subscription, indemnity insurance and exams. Understanding exactly... Referral Cheat Sheet Our referral cheat sheet is our most popular resource with over 50,000 downloads! It has key information to provide when referring to every specialty. Special thanks to Drs Ben Turner... 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... Maximise Points for Specialty Applications With the recent removal of additional degrees counting for points towards all specialty applications for 2023 recruitment, it’s now even more important to build one’s portfolio... Latest Content for FY2s & SHOs Clinical Radiology ST1 Application Guide 2025 Radiology is an exciting and fast-evolving specialty, with radiologists playing a crucial role in diagnosing patients and guiding management across all specialties. This article takes... Lumbar Puncture A lumbar puncture involves the insertion of a needle between the lumbar vertebrae, at a level below the termination of the spinal cord, allowing for CSF collection from the... Clerking Patients: A few tips Here we assume you know the basics, and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Not all FY1s have the opportunity to clerk patients... Thinking about Australia? Resident Doctors in the UK are increasingly moving to Australia after FY1, for FY3 or other years in between training. You can even join an exchange programme as part of your training... Getting Started in General Practice Many FY2 doctors spend time in General Practice as part of the Foundation Programme. It is a valuable experience even for those who do not intend to pursue GP as a career. This article... How to set up a teaching programme In this guide, we’ll walk you through how to set up local, regional and national teaching programmes with top tips we’ve learnt over the last several years of running programmes... Gastroenterology in Primary Care INTRODUCTION This article covers common gastroenterological presenting complaints seen in primary care. Presentations covered are: dyspepsia, diarrhoea, PR bleeding, constipation... How much do resident doctors earn? Overview of how much resident doctors earn with a broad range of salaries depending on grade and hours worked How to plan your FY3 FY3 refers to time spent out of training after completing the foundation programme i.e. the year after FY2. In this article, we hope to give you an overview of the process of planning... Maximise Points for Specialty Applications With the recent removal of additional degrees counting for points towards all specialty applications for 2023 recruitment, it’s now even more important to build one’s portfolio... 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.... Resident Doctor's Pay Calculator 2025 We’ve created a pay calculator to help you better understand your salary, how much tax you’ll pay, student loans & contributions to NHS pensions. Top Finance Tips Ensure... 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... NHS Pension Scheme (2015) This article is supplementary to the webinar on the same subject, which you might find extremely useful as we were joined by Andrew, a pensions expert from Wesleyan. We also address... Applying to Psychiatry Training Do you have an interest in human behaviour? Did you go into medicine to speak to patients? Are you looking for variety in your work? Do you want to make a difference in people’s lives?... Introduction to Dental Traumatology for A&E This article aims to give basic information on the assessment of dental trauma to enable the reader to both recognise and communicate injuries correctly with the appropriate speciality.... Pneumothorax A pneumothorax is defined as the abnormal collection of air between the visceral and parietal space of the lung i.e. the pleural space. It typically presents with acute shortness of... Referral Cheat Sheet Our referral cheat sheet is our most popular resource with over 50,000 downloads! It has key information to provide when referring to every specialty. Special thanks to Drs Ben Turner... Suturing Sutures are placed to aid with wound healing following a traumatic laceration or surgical incision and to promote haemostasis. In this article, we will look at the different types of... Applying to Paediatrics On the one hand, you wear a Disney lanyard, with a pocket stuffed with stickers, on the other, you are dealing with what is internationally referred to as the most precious of lives.... 10 Gifts for your Colleagues As we all rotate so frequently between departments, many of us like to get our seniors or juniors something nice to say thank you. Personally, I’m a massive gift giver because... 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 it. The field is constantly advancing with the use of robotic surgery etc. and... Gynaecological Examination If the thought of conducting an intimate examination or attempting to wield (without any embarrassing pitfalls) the contraption that is the speculum is enough to fill you with apprehension-... Payslips & Income Tax Each month, your pay and any deductions will be summarised to you in the form of a payslip. You should check your payslip every month to ensure you’re not being overtaxed or underpaid.... Applying to Anaesthetics Anaesthetics is a very hands-on specialty. Day-to-day work will have a mix of practical procedures and other clinical work such as pre-operative assessment. You will have a lot of supervision... Applying to General Practice GP training is one of the most popular pathways. In this article, we discuss how to build your portfolio, the different roles a GP can have & we detail the application process.... Choosing your Future Career What does your future hold? Have you thought of a specialty that you want to pursue? This article discusses the different factors that you may want to consider and will hopefully help... Applying to Obstetrics and Gynaecology In this article, we discuss why you should apply to O&G training, how to build your portfolio & we detail the application process. O&G is a 7 year run-through programme, incorporating... Applying to Ophthalmology Ophthalmology provides a great deal of variety by combining medicine, surgery & A&E. It is predominantly an outpatient specialty with plenty of opportunities to subspecialise.... Medical Podcasts that are worth a listen! We asked on social media what your favourite podcasts were & these were rated the most popular. Comment below if you have any other favourite podcasts we’ve missed! RCP Medicine... Femoral Stab Femoral puncture is typically used to acquire blood from a patient in an emergency setting as both the veins and arteries are large vessels. In profound hypotension, unlike the radial,... Ascitic Tap and Drain Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites to identify the underlying cause. The most urgent reason to do it would be to consider the diagnosis... Claiming Tax Relief This article is about claiming tax relief on essential things for your job – such as your GMC registration, BMA subscription, indemnity insurance and exams. Understanding exactly... Leadership The impact you have on yourself and the impact you have on people around you Although it can be scary to take on a leadership role, it is an essential role of resident doctors and a... ENT Emergencies In this article, we cover the main ENT situations you are likely to encounter either in A&E, during an ENT on call job or occasionally as a ward emergency. ENT cases can be exciting... Managing patients with CKD In whichever specialty you work, you will encounter large numbers of patients with chronic kidney disease and this will impact many components of their care. Your role as a junior is... DKA and HHS You’ve found an unwell dehydrated, diabetic patient who is hyperglycaemic. They are ketotic or have significant hyperglycaemia alone (>30mmol/L) at a first glance, and so you... How to teach medical students Balancing your workload as a resident doctor whilst teaching medical students effectively is difficult so here are some tips! Portfolio requirements As a resident doctor, it is a requirement... Hyperglycaemia Hyperglycaemia is something you will encounter frequently. In this article, we focus on how to approach hyperglycaemia and identify diabetic emergencies. If your patient is ketotic... ABG Interpretation In this article, we will look at more practical aspects of how to read an ABG and treatment following your interpretation. If you’re looking on how to perform an ABG, read this... Hypertension in Hospital As a resident doctor, you will often be called about patients with raised blood pressure (BP) in secondary care. This differs from chronic hypertension in primary care for which the... Pre & Post Operative Care As a resident doctor, you will frequently look after patients prior to and after their operation. You may be asked to clerk patients who are admitted to hospital the night before their... Gynaecology Assessment & Common Disorders As gynaecology issues uncommonly present on the ward, many doctors have difficulties with the standard framework for addressing these issues. The classic referrals to gynaecology are:... 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... Paediatrics: Clerking & Discharge tips As an FY1 it is likely that you will manage paediatric patients during their admission, often in other specialties like general surgery. Having a few paediatric skills under your belt... Pancreatitis Pancreatitis is a condition characterised by the inflammation of the pancreas. These patients are usually managed conservatively. Your aim is to try to find out the underlying cause,... Difficult Airway Patients As a doctor, you may come across patients with complex airways. They should be found on dedicated wards such as respiratory, ENT, ITU or HDU – however, bed pressures might lead... Reduced GCS As a doctor, you will frequently be called for a drowsy patient. They can vary from confused to completely unconscious. The Glasgow Coma Scale can help reliably quantify and track the... Atrial Fibrillation AF is the most common sustained cardiac arrhythmia you will encounter. In this article, we focus on the management of it. Identification of atrial fibrillation is usually fairly easy... Hypotension Expect many bleeps about hypotension from concerned nursing staff. It is a useful way to flag up which patients might be unwell. Although defined as below 90 systolic or 60 diastolic,... Hypoxia As an FY1, you will be called to review patients who are hypoxic. Here we will discuss common causes of generalised hypoxia rather than focal hypoxia/ischaemia, such as in strokes or... On Call Tips FY1s are usually most apprehensive about being on call, but it is also the shift you will usually learn the most. Predominantly as an FY1 you will be doing ward cover shifts and so... Hyponatraemia Hyponatraemia (serum Sodium <135 mmol/L) is one of the most common electrolyte abnormalities you will see and so a systematic approach to identifying the underlying cause and management... Non-Invasive Ventilation Non-invasive ventilation (NIV) is a way of providing ventilatory support to patients in respiratory failure without using an invasive airway device (e.g. endotracheal, naso-tracheal... Bullying and Undermining - Changing Culture Welcome to FY1. In your first few months, you will find your learning curve is steep and you may feel out of your depth and lost. This is normal-you will develop skills in your first... Jaundice & Deranged LFTs As the FY1, you will see patients with liver dysfunction either on the take or deranged LFTs when you are reviewing bloods. A focused approach can save you time & help you find... Upper GI bleed These patients have the potential to become haemodynamically unstable extremely quickly; try to avoid delays in reviewing them. In-hospital mortality is around 10%. If they are unwell... Common Dental Issues A very quick guide to common issues prompting referrals to maxillofacial surgery (aka MaxFax and OMFS) This is a surgical speciality relating to the hard and soft tissues of the head... Acute Stroke Whilst on call or in A&E you may be asked to assess somebody who is suspected to have had a stroke. This is a very brief overview that gives you an approach to managing a patient... 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... Deteriorating Patient The deteriorating patient is often the worst nightmare for new FY1s.  I remember when I started FY1, I was terrified of coming across a deteriorating patient whilst on call and... 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... Essential Apps Here’s a list of apps that are in order of how essential we find them. There’s probably more out there so drop us a comment if you have any suggestions to add! Induction... Previous
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Renal Replacement Therapy In 2024 there were more than 44,900 people living in the UK with a kidney transplant. 2,868 renal transplants were performed in the UK in 2021/2022 with the projected estimate for renal... ECG Basics The electrocardiogram (ECG) is one of the most common, and important, investigations interpreted by doctors. In order to help the interpretation process, it is necessary to understand... Requesting Scans Requesting scans can be a scary daily occurrence for new doctors. It is one of few times where you liaise directly with a consultant. Introduction When requesting scans, there are two... Polymyalgia Rheumatica You’re the resident doctor working in primary care; a patient comes in with symptoms such as neck ache and fatigue – what are the differentials you are going to consider? It is common... Latest Content When to Refer to Clinical Genetics: A Practical Guide for Junior Doctors Recognising when to refer a patient to the Clinical Genetics Service (CGS) is important but not always well understood. This article provides guidance for junior doctors on when and... A Quick Framework: Taking a Genetic Family History in 5 Minutes As a junior doctor, it can be difficult to find time for a detailed family history — especially during a busy clinic or on-call shift. Here’s a quick framework to help you efficiently... What is Clinical Genetics? Introduction Clinical genetics is a rapidly evolving medical specialty at the forefront of modern healthcare. With the growing impact of personalised medicine, genomic diagnostics,... Polymyalgia Rheumatica You’re the resident doctor working in primary care; a patient comes in with symptoms such as neck ache and fatigue – what are the differentials you are going to consider? It is common... Renal Replacement Therapy In 2024 there were more than 44,900 people living in the UK with a kidney transplant. 2,868 renal transplants were performed in the UK in 2021/2022 with the projected estimate for renal... Sexual and Reproductive Health in the Media Sexual Health covers some fascinating topics and has featured in some of the most prominent parts of recent history. For anyone who wants to learn more about Sexual Health with a cultural... Microscopy in Sexual Health Microscopy is an interesting, straightforward and fast point-of-care method of diagnosis in Sexual Health clinics. In this article, we’ll go through the process of collecting a sample,... Sexual Health Consultations- navigating challenges and building a strong Doctor-Patient relationship  As a medical student, Sexual Health can seem daunting at first. You need to ask a series of personal questions in quick succession, often followed by an intimate examination. But with... Lumbar Puncture A lumbar puncture involves the insertion of a needle between the lumbar vertebrae, at a level below the termination of the spinal cord, allowing for CSF collection from the... Top Tips for the IMT Clinical Station With IMT interviews fast approaching, we have partnered with Optimise Interviews to publish free resources for anyone who has interviews upcoming! They have provided the below video... Top Tips for IMT Interviews With IMT interviews fast approaching, we have partnered with Optimise Interviews to publish free resources for anyone who has interviews upcoming! They have provided the below videos... How to Assess a Chest Drain Although as an FY1/2 you wouldn’t be expected to insert a chest drain yourself but you will often be called out of hours to review a drain for a variety of reasons: Not swinging/bubbling... Writing a Letter to the Editor of a Medical Journal  What is a Letter to the Editor?  A letter to the editor in a medical journal serves as a concise written communication where readers, including healthcare professionals, researchers,... Skin Cancer Skin cancer is usually categorised as melanoma or nonmelanoma skin cancer, the latter including squamous cell (SCC) and basal cell carcinoma (BCC). Risk factors Basal cell carcinoma... Referring to the Intensive Care Unit As a foundation doctor, caring for patients who deteriorate rapidly and/or are critically unwell can be daunting.Intensive care units provide the highest-level care for patients within... Mind the (renal) Bleep: Preparing for your First Renal SHO On-Call So you’ve finally got your rota for your hotly anticipated renal rotation… and your first shift is out of hours. But worry not, for this guide will help you to prepare for that dreaded... Malaria Overview Malaria is a tropical protozoal infection caused by the Plasmodium parasite, and is transmitted via the female Anopheles mosquito in endemic areas. It is the most commonly... Cardiomyopathy The word cardiomyopathy is used as a general term referring to the abnormal structure or function of the heart.  Strictly speaking, the definition of cardiomyopathy excludes myocardial... Internal Medical Training (IMT) IMT is an exciting and challenging training programme which will certainly make you a better clinician but you will need perseverance, dedication and resilience to complete it. In this... A guide to passing MRCP Part 2 written The MRCP part 2 exam is a multiple choice, best-of-five written exam with 2, 3 hour papers. You’ll be familiar with the vague format of the exam if you’ve sat the part 1 exam, but part... Pleural effusion As a foundation doctor, shortness of breath is one of the commonest symptoms you can encounter on the acute take. Causes of shortness of breath are very broad but in this session, we... Managing a patient with decompensated liver cirrhosis Introduction Patients with liver disease are common in the UK. Since 1970, mortality from liver disease has quadrupled. It has become the greatest cause of death in people aged between... Tachyarrhythmias Tachyarrhythmias are abnormal heart rhythms with a pulse rate of >100 beats per minute (bpm). This can be due to a variety of causes, including physiological and pathological, and... Bronchiectasis Bronchiectasis is a chronic respiratory condition characterised by the irreversible widening and scarring of the bronchi, leading to recurrent infections and a decline in lung function.... Myocarditis Myocarditis (derived from ‘myocardium’ = cardiac muscle, and -itis = inflammation) describes the inflammation of the muscular layer of the heart, the ‘myocardium’. The myocardium forms... How to set up a teaching programme In this guide, we’ll walk you through how to set up local, regional and national teaching programmes with top tips we’ve learnt over the last several years of running programmes... Gastroenterology in Primary Care INTRODUCTION This article covers common gastroenterological presenting complaints seen in primary care. Presentations covered are: dyspepsia, diarrhoea, PR bleeding, constipation... Haematological emergencies In this article, we give an overview of the most important and serious haematological emergencies that resident doctors should know about! Neutropenic sepsis Case 1: 54-year-old woman... 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. Resident doctors are in a position to spot... 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... ECG Basics The electrocardiogram (ECG) is one of the most common, and important, investigations interpreted by doctors. In order to help the interpretation process, it is necessary to understand... Requesting Scans Requesting scans can be a scary daily occurrence for new doctors. It is one of few times where you liaise directly with a consultant. Introduction When requesting scans, there are two... Previous
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- [Free Medical Education Platform](https://mindthebleep.com/): Medicine Surgery Emergencies Final Year FY1 SHO Career IMG Radiology eLearning In Person Courses Paediatrics Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now Salivary Gland Pathology Problems with salivary glands are often seen at GPs and in emergency departments. It is important to be able to differentiate between different causes of facial pain and swelling. Anatomy ... Chemical Eye Injuries What is it? Chemical injuries of the eye are ocular emergencies that necessitate urgent clinical attention.  Alkali injuries are in general more common and destructive than acidic... Pupil abnormalities Pupillary reflex pathway: Light reaches the retina, travels via ganglion cells to the optic nerve, which then forms the optic chiasm before diverging into the left and right optic tracts... Eyelid Disease Introduction and Anatomy The eyelid is important for ensuring physical protection of the eye and maintaining lubrication over the surface of the eyeball. It is composed of five main... Digital Health: A Guide for Future Clinicians What is digital? To a Victorian doctor, the term digital would have referred to the anatomy of our fingers or toes and the nerves and vasculature contained within. This term came from... Autism Spectrum Disorder Background Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects around 1.76% of school-age children in the UK. Multiple factors have been proposed in the aetiology... Latest Content When to Refer to Clinical Genetics: A Practical Guide for Junior Doctors Recognising when to refer a patient to the Clinical Genetics Service (CGS) is important but not always well understood. This article provides guidance for junior doctors on when and... A Quick Framework: Taking a Genetic Family History in 5 Minutes As a junior doctor, it can be difficult to find time for a detailed family history — especially during a busy clinic or on-call shift. Here’s a quick framework to help you efficiently... Getting to Grips with Genetic Terminology With the relevance of genomics in clinical practice increasing, here are simple explanations of some key genetic terms: Penetrance:The proportion of individuals with a gene variant... What is Clinical Genetics? Introduction Clinical genetics is a rapidly evolving medical specialty at the forefront of modern healthcare. With the growing impact of personalised medicine, genomic diagnostics,... Mobility Aids Have you ever glanced at the ward board and wondered what “ZF + A02” actually means? Or when a patient is marked as MFFD (medically fit for discharge), have you thought about... Polymyalgia Rheumatica You’re the resident doctor working in primary care; a patient comes in with symptoms such as neck ache and fatigue – what are the differentials you are going to consider? It is common... Renal Replacement Therapy In 2024 there were more than 44,900 people living in the UK with a kidney transplant. 2,868 renal transplants were performed in the UK in 2021/2022 with the projected estimate for renal... Guide To Radiology Posts In Foundation Training Throughout medical school, students often receive little to no exposure to radiology as a specialty. Even during foundation training, most doctors only encounter radiology through brief... Prematurity Prematurity (or Pre-term) describes infants delivered before 37 weeks of gestation. Pre-term birth is a leading cause of morbidity and mortality in children under 5 years globally,... Idiopathic Intracranial Hypertension Introduction Idiopathic intracranial hypertension (IIH), also known as pseudotumour cerebri, is a disorder of raised intracranial pressure with normal cerebrospinal fluid (CSF) constituents... Previous
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- [International Medical Graduates](https://mindthebleep.com/img/): Medicine Surgery Emergencies Career Radiology eLearning In Person Courses Paediatrics Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp 11 Jul FY1 Course (London) - 11th July July 11, 2026     9:00 am - 6:00 pm £15.00 London fy1course Our top-rated & free simulation-based course condenses real-life scenarios you will frequently encounter into various stations allowing you to practice them in small groups within More Info Book Now! 12 Jul FY1 Course (London) - 12th July July 12, 2026     9:00 am - 6:00 pm £15.00 London fy1course Our top-rated & free simulation-based course condenses real-life scenarios you will frequently encounter into various stations allowing you to practice them in small groups within More Info Book Now! Trending Now for IMGs Microbiology Discussions A lot of your time as an FY1 will be spent on the phone to various other specialities. You’ll come across patients with infections in all your rotations, and – if they don’t present... e-Portfolio Your e-Portfolio is an online tool to gather and store evidence of progression throughout your time as a Foundation Doctor (FD). You can store clinical competencies, reflections on... 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,... Audits & Quality Improvement Projects (QIPs) Audits & QIPs are a way to identify issues, drive changes and assess the effects they have. It is your way of making improvements in your workplace, where you can assess the impact... Claiming Tax Relief This article is about claiming tax relief on essential things for your job – such as your GMC registration, BMA subscription, indemnity insurance and exams. Understanding exactly... Surviving Ward Rounds It takes time to get used to the ward round. Particularly, when patients are being seen so fast it seems impossible to document properly. The most important tip is to ask your colleagues... Latest Content for IMGs Death Verification As a new F1 in August, it can feel like quite a daunting task to verify a death, particularly if you have never seen this done before. This step by step guide will take you through... Clerking Patients: A few tips Here we assume you know the basics, and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Not all FY1s have the opportunity to clerk patients... Discharge Planning It is important for resident doctors to understand what the discharge planning process involves so you can have an active role in multidisciplinary team meetings. This article focuses... Referrals Often one of the scariest things you can do as you will most likely be speaking to a more senior colleague in an unfamiliar speciality. However, as an F1, you may well know the patient... Breaking Bad News As a resident doctor, you will have face situations where you have to convey potentially distressing information, whether it is explaining a diagnosis or blood results to a patient... Dealing with difficult colleagues This is a tricky area to cover as it can be challenging to us both personally and professionally when things don’t go well with a colleague, particularly when we know that this might... Microbiology Discussions A lot of your time as an FY1 will be spent on the phone to various other specialities. You’ll come across patients with infections in all your rotations, and – if they don’t present... Guide to the Skilled Worker Visa Application for Incoming IMG FY1s Congratulations on securing your FY1 position! This is an exciting milestone in your medical career. As you prepare for this new journey, one of your key tasks will be navigating the... IELTs vs OET: The Essentials Choosing between IELTS and OET is an intense conundrum for many Medical students and qualified Healthcare Professionals who plan to practice in the UK. This article aims to shed light... Clinical Attachments                  and everything else you need to know about them! What is a clinical attachment? A clinical... Medicolegal Essentials A medico-legal quick-start guide by Dr Udvitha Nandasoma (MDU Head of advisory services) Overseas doctors and other healthcare professionals have made tremendous contribution to the... GMC Registration after PLAB 2 Congratulations, if you’ve made it this far, that means you have either passed your exam or are on your way to achieving your goal. Anyway, we’re here to assist you in completing... Financial Tips for IMGs This article will go over the costs for international medical graduates associated with applying for a Health and Care Worker Visa and what kind of issues to be aware of once you’ve... 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,... How much do resident doctors earn? Overview of how much resident doctors earn with a broad range of salaries depending on grade and hours worked Maximise Points for Specialty Applications With the recent removal of additional degrees counting for points towards all specialty applications for 2023 recruitment, it’s now even more important to build one’s portfolio... Resident Doctor's Pay Calculator 2025 We’ve created a pay calculator to help you better understand your salary, how much tax you’ll pay, student loans & contributions to NHS pensions. Top Finance Tips Ensure... Safeguarding History – The Basics Children are vulnerable. Unfortunately, child abuse does happen, and it has a significant and lifelong impact. You may be one of the only professionals to have sufficient access to... NHS Pension Scheme (2015) This article is supplementary to the webinar on the same subject, which you might find extremely useful as we were joined by Andrew, a pensions expert from Wesleyan. We also address... Resident Doctor Contract explained In the UK, there are different contracts for each region: Northern Ireland, Scotland, England & Wales. For England, the latest update is in 2018 & it is worth making sure you’re... Appraisal Many of us have only heard of appraisals happening in the corporate or in the IT sectors. Here in the NHS, appraisals are done annually for all doctors. What is an appraisal? It is... PLAB 2 Guidance We believe you have been through a lot of stress and anxiety while waiting for your PLAB 1 result. Once you receive an email from the GMC saying that you have passed your PLAB 1, it... GMC Registration after PLAB 2 Congratulations, if you’ve made it this far, that means you have either passed your exam or are on your way to achieving your goal. Anyway, we’re here to assist you in completing... Preparations for IELTS As an IMG, English is the only language you would use to communicate with people in the UK. GMC requires candidates to undertake an English requirement exam before they can book you... Payslips & Income Tax Each month, your pay and any deductions will be summarised to you in the form of a payslip. You should check your payslip every month to ensure you’re not being overtaxed or underpaid.... Claiming Tax Relief This article is about claiming tax relief on essential things for your job – such as your GMC registration, BMA subscription, indemnity insurance and exams. Understanding exactly... Understanding Types of Homes Patients may live or be discharged to a wide variety of social care settings and understanding these is important for any foundation doctor. This can help you have conversations with... Reviewing and Requesting Bloods Here we focus on blood tests requests for a variety of common scenarios you might see in practice and also common further tests you may do as a result of the first abnormality. When... Requesting Scans Requesting scans can be a scary daily occurrence for new doctors. It is one of few times where you liaise directly with a consultant. Introduction When requesting scans, there are two... Surviving Ward Rounds It takes time to get used to the ward round. Particularly, when patients are being seen so fast it seems impossible to document properly. The most important tip is to ask your colleagues... On Call Tips FY1s are usually most apprehensive about being on call, but it is also the shift you will usually learn the most. Predominantly as an FY1 you will be doing ward cover shifts and so... Audits & Quality Improvement Projects (QIPs) Audits & QIPs are a way to identify issues, drive changes and assess the effects they have. It is your way of making improvements in your workplace, where you can assess the impact... e-Portfolio Your e-Portfolio is an online tool to gather and store evidence of progression throughout your time as a Foundation Doctor (FD). You can store clinical competencies, reflections on... Documentation Medical documentation should authentically represent every consultation and is primarily intended to support patient care. Good record-keeping means you or a colleague can reconstruct... Death Certification After a patient has died you may be asked to complete the death certificate. It may be issued by a doctor who has provided care during the last illness and who has seen the deceased... Deteriorating Patient The deteriorating patient is often the worst nightmare for new FY1s.  I remember when I started FY1, I was terrified of coming across a deteriorating patient whilst on call and... 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... Leave As an FY1 doctor, there are different types of leave you will come across during the year and the rest of your career. This article will talk about annual leave, study leave and sick... Venepuncture Venepuncture is the term used to describe the procedure of withdrawing blood from a vein using a needle. Consider the requirement for the procedure and establish appropriate levels... Cannulation Cannulation is a procedure regularly undertaken which involves threading a plastic tube into a vein, allowing access for fluid & drug administration. Blood samples can be taken... Essential Apps Here’s a list of apps that are in order of how essential we find them. There’s probably more out there so drop us a comment if you have any suggestions to add! Induction... Handover Handover occurs between shifts to ensure everyone is up to speed with patients. The exact nature of how it occurs varies greatly by hospital & specialty. E.g. in paediatrics or... Previous
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- [Oncology](https://mindthebleep.com/oncology/): Oncology Prescribing analgesia When assessing pain, ensure you begin by taking a history to characterise the pain... Read More » Hypercalcaemia Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia... Read More » Sepsis Sepsis is an infection with evidence of organ dysfunction. Septic shock is when a... Read More » Discussing Treatment Escalation & DNAR As an FY1 you should not be expected to make decisions regarding treatment escalation... Read More » Nausea & Vomiting You will frequently get calls regarding nausea & vomiting: many patients present... Read More » Palliative Care Dying is a natural process and unfortunately, something that we all come across in... Read More » Transfusion In this article, we will go through the three most common scenarios you will encounter.... Read More » Neutropenic Sepsis Please read an overview of the management of sepsis before reading this article.... Read More » Deep Vein Thrombosis A deep vein thrombosis (DVT) is a condition in which a blood clot (thrombosis) forms... Read More » Metastatic Spinal Cord Compression Spinal cord compression occurs when there is compression of the spinal cord or cauda... Read More » Superior Vena Cava Syndrome SVC syndrome is an oncological emergency. There is obstruction of the superior vena... Read More »
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- [Vascular](https://mindthebleep.com/vascular/): Vascular Pulmonary embolism A pulmonary embolism (PE) is a blocked blood vessel in your lungs, most often due... Read More » Diabetic Foot Ulcers Introduction: Diabetic foot ulcerations are a significant complication of diabetes... Read More » Deep Vein Thrombosis A deep vein thrombosis (DVT) is a condition in which a blood clot (thrombosis) forms... Read More » Superior Vena Cava Syndrome SVC syndrome is an oncological emergency. There is obstruction of the superior vena... Read More »
- [Surgery](https://mindthebleep.com/surgery/): Surgical Specialties ENT General Gynaecology Maxillofacial Obstetrics Ophthalmology Orthopaedics Urology Vascular Trending Now Chemical Eye Injuries What is it? Chemical injuries of the eye are ocular emergencies that necessitate urgent clinical attention.  Alkali injuries are in general more common and destructive than acidic... Pupil abnormalities Pupillary reflex pathway: Light reaches the retina, travels via ganglion cells to the optic nerve, which then forms the optic chiasm before diverging into the left and right optic tracts... Eyelid Disease Introduction and Anatomy The eyelid is important for ensuring physical protection of the eye and maintaining lubrication over the surface of the eyeball. It is composed of five main... Peri-Orbital Cellulitis and Orbital Cellulitis: Diagnosis and Management Introduction: This exploration of peri-orbital cellulitis and orbital cellulitis is designed to aid in the diagnosis and management of two distinct but closely related ophthalmological... Hypertensive Retinopathy Poorly controlled hypertension results in target-organ damage. In the eye, it results in choroidopathy, retinopathy and optic neuropathy. This article will focus on hypertensive retinopathy,... Infective Flexor Tensosynovitis (Flexor Sheath Infection) Introduction Flexor sheath infection is an infection of the synovial sheath surrounding flexor tendon in the hand . This is a surgical emergency that can result in significant morbidity.... Latest Content Posterior Vitreous Detachment: What Every Medical student and Resident Doctors should Know Posterior Vitreous Detachment (PVD) is a relatively common ophthalmic condition that most doctors will encounter in general practice, the emergency department, or ophthalmology... Subconjunctival Haemorrhage: Reassurances vs. Red Flags A subconjunctival haemorrhage (SCH) can appear alarming to patients: the sudden, bright red bleeding on the white of the eye can often raise fears of a serious problem. However, for... Conjunctivitis: Differentiating Between Viral, Bacterial, and Allergic Causes Conjunctivitis, which is often termed “pink eye”, is one of the most frequent causes of red eye presentations within primary care and the emergency department. In most cases, the condition... A Comprehensive Guide to Surgical Clerking This guide is designed to help you identify the key areas you need to focus on when clerking a surgical patient. There are several differences when compared to clerking a medical patient,... Thyroid Eye Disease Introduction Thyroid Eye Disease (TED) is an autoimmune disease characterised by extraocular muscle swelling and orbital fat expansion1.  It affects approximately 50,000 people... Acute Scrotum Introduction The acute scrotum is a ‘constellation of new-onset pain, swelling and/or tenderness of intra-scrotal contents’ (1). In this article, we will review the limited number of... Chemical Burns Chemical burns are a unique subset of burns that require specialised management due to the nature of the substances involved. Proper initial management is critical to prevent further... Infective Flexor Tensosynovitis (Flexor Sheath Infection) Introduction Flexor sheath infection is an infection of the synovial sheath surrounding flexor tendon in the hand . This is a surgical emergency that can result in significant morbidity.... Dry Eye Disease Introduction Dry eye disease, also known as keratoconjunctivitis sicca, is a common eye disorder characterised by insufficient lubrication and moisture on the surface of the eye. This... Ptosis Introduction Ptosis is a condition characterized by the drooping of the upper eyelid, which partially obstructs the eye1. It can occur in one or both eyes and has the potential to cause... Retinal Detachment Basic anatomy In this article, we will be discussing retinal detachments and will therefore focus only on the back of the eye. The eye is full of a jelly called the vitreous which plays... Basics of Slit Lamp Examination Anatomy of a Slit Lamp Biomicroscope The slit lamp consists of: An illumination arm which offers a range of settings to facilitate examining the eye. This swivels on a pivot to allow... Basic Fracture Management Whether you’re interested in orthopaedics or not, knowledge of basic fracture management can be useful in any ED. Start at the beginning… As with any other patient, take a focused history. ... Orofacial Infections Orofacial infections are a common A&E presentation and are often due to a dental source. Due to the proximity of the airway and the potential for compromise, it is essential to... Hand Infections Hand infections are a common presentation, they can spread rapidly and cause damage to local structures and therefore require prompt identification and treatment. Causes Hand infections... Pupil Disorders Pupil size results from the activity of sympathetic and parasympathetic stimulation to the muscles of the iris. Under normal circumstances, bright light causes pupil constriction (miosis)... Papilloedema Introduction Papilloedema is optic disc swelling which is specifically secondary to raised intracranial pressure (ICP). It is nearly always bilateral and can be asymmetrical. The... Amblyopia Amblyopia is a childhood cause of visual impairment. It occurs due to abnormal visual development in early life, particularly the cortical visual pathway. It is often described as a... Anterior uveitis Introduction – epidemiology and causes/risk factors: Uveitis is a condition that describes the inflammation of the iris, ciliary body, and choroid. Anterior uveitis, more specifically,... Visual Field Defects: A Summary The visual field is the entire area a patient can see with their eyes fixes and without moving their head up, down, left or right. The image is inverted upside down and flipped left... Central retinal artery/vein occlusion Definition Sudden onset painless loss of vision is usually due to vascular occlusion. There are two types of vascular occlusions discussed in this article. Central Retinal Vein Occlusion... Pupil abnormalities Pupillary reflex pathway: Light reaches the retina, travels via ganglion cells to the optic nerve, which then forms the optic chiasm before diverging into the left and right optic tracts... Chronic open angle glaucoma Glaucoma can be divided into open-angle or closed-angle glaucoma. Closed-angle glaucoma has been described in a separate article. Open-angle glaucoma accounts for the majority (74%)... An Introduction To Retinal Tears Most common presenting symptoms: Flashing lights or new floaters Introduction A retinal tear is described as a full thickness defect in the retina, normally in the periphery of the... Hypertensive Retinopathy Poorly controlled hypertension results in target-organ damage. In the eye, it results in choroidopathy, retinopathy and optic neuropathy. This article will focus on hypertensive retinopathy,... How to spend a Foundation Year 3 for an Ophthalmology application (and other things you can do in Foundation training) Ophthalmology training is becoming increasingly competitive every year and is one of the most competitive specialty training programmes in the UK, boasting a competition ratio of  9.91... How to make a (good) referral to Ophthalmology – tips and tricks Ophthalmology has long been the specialty with the most referrals and patient appointments in an outpatient environment, having had over 8.7 million clinic appointments scheduled in... Diabetic Retinopathy Overview Diabetes mellitus can cause both macrovascular (e.g., myocardial infarction, peripheral vascular disease, stroke) and microvascular (e.g., nephropathy, neuropathy, retinopathy)... Periorbital and Orbital Cellulitis Introduction The orbital septum is a fibrous connective tissue layer which divides orbital tissue from the eyelid, thus serving as a barrier against the spread of infection into the... Peri-Orbital Cellulitis and Orbital Cellulitis: Diagnosis and Management Introduction: This exploration of peri-orbital cellulitis and orbital cellulitis is designed to aid in the diagnosis and management of two distinct but closely related ophthalmological... Foreign Bodies in the Ear, Nose and Throat Introduction ENT Foreign bodies can be intimidating to the SHO tasked with first seeing the patient and attempting removal. This quick guide will give you some useful tips and make... Eyelid Disease Introduction and Anatomy The eyelid is important for ensuring physical protection of the eye and maintaining lubrication over the surface of the eyeball. It is composed of five main... Basics of eye trauma with emergency pathologies This article is the first of two articles about traumatic eye injuries. This article covers the relevant anatomy, history, examination and emergency sight-threatening pathologies to... Common Eye Trauma This article is the second of two articles about traumatic eye injuries.  The first is called Basics of Eye Trauma with Emergency Pathologies and covers the relevant anatomy, history,... Keratitis Introduction Keratitis is inflammation of the cornea. It may result from infective or non-infective causes Infectious keratitis can be classified as microbial keratitis (bacterial,... Open Fractures Introduction Clinical Definition An open fracture is when the broken bone breaks through the skin or any other body cavity that is open to the outside, including those through the rectum... Chemical Eye Injuries What is it? Chemical injuries of the eye are ocular emergencies that necessitate urgent clinical attention.  Alkali injuries are in general more common and destructive than acidic... Acute Angle Closure Glaucoma What is it? A sudden increase in intraocular pressure, which can present as an ophthalmic emergency. It usually occurs when the angle between the cornea and iris suddenly becomes closed.... Orbital Compartment Syndrome No matter what time of the day it is, this is an ophthalmic emergency and requires urgent management to save vision! Orbital compartment syndrome occurs as a result of a raised intra-orbital... How to set up a teaching programme In this guide, we’ll walk you through how to set up local, regional and national teaching programmes with top tips we’ve learnt over the last several years of running programmes... 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,... Post Operative Cataract Complications Cataract Surgery: A Brief Introduction Cataracts are the leading cause of reversible blindness in the world. Cataract surgery involves removal of the cataract and replacement with an... A Career in Plastic Surgery If you ask most people (medics included!) what they think of when you say plastic surgery, most people will say it’s about nose jobs, boob jobs and making people look like a Kardashian!... Giant Cell Arteritis What is it? GCA (Giant cell arteritis) or temporal arteritis is a well known Ophthalmology emergency. GCA is a type of vasculitis that affects medium to larger sized vessels Who gets... Introduction to Cataracts A cataract is “a clouding of the lens of the eye or of its surrounding transparent membrane that obstructs the passage of light”. Cataracts cause 50% of blindness and 33% of visual... Ophthalmology Applications: How To Get Ahead While Still at Medical School Ophthalmology is a hugely popular career. Having the skills and ability to improve a patient’s quality of life by restoring their eyesight is undeniably a rewarding vocation. Other... Dry and Wet Age-Related Macular Degeneration (ARMD) Introduction With an increase in the ageing population globally, we will be seeing more diseases that typically affect elderly patients. One such condition is age-related macular degeneration... Removal of foreign body from eye Foreign body in eye is a very common presentation seen in the emergency department. Patients often complain of a foreign body sensation in the eye and pain on eye movement or on blinking.... Tinnitus Tinnitus is a common and debilitating medical symptom encountered in the field of Otolaryngology. It is the conscious perception of auditory stimulus without the presence of external... Study Tips for the Duke-Elder Undergraduate Prize Exam The Duke-Elder Undergraduate Prize Exam is an optional competitive exam run by the Royal College of Ophthalmologists, designed for undergraduate medical students who have an interest... Applying to Oral and Maxillofacial Surgery (OMFS) Oral and Maxillofacial Surgery is a mouthful (no pun intended), but you may have heard of it referred to as OMFS or, more affectionately, Maxfacs. A speciality of the head and neck,... Groin Lumps The groin, also known as the inguinal region, extends from the anterior superior iliac spine (ASIS) anterolaterally, the thigh inferiorly and the pubic tubercle medially. It is an anatomical... Colorectal Cancer and Polyps Colorectal cancer is one of the most common cancer types seen in the western world. They are adenocarcinomas arising from adenomatous polyps in the colon and rectum, with a majority... Benign Anorectal Pathology In this article, we cover common benign anorectal pathologies including haemorrhoids, fissures & fistulas with a quick overview of their assessment & management. Basic anatomy... Compartment Syndrome Acute Compartment Syndrome is one of the few orthopaedic emergencies. If missed, it can lead to severe and life-changing consequences for the patient. This article will focus on acute... Suturing Sutures are placed to aid with wound healing following a traumatic laceration or surgical incision and to promote haemostasis. In this article, we will look at the different types of... Chronic Pancreatitis Chronic pancreatitis is characterised by repeated pancreatic inflammation. This leads to the destruction of pancreatic tissue leading to irreversible loss of both endocrine and exocrine... 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 it. The field is constantly advancing with the use of robotic surgery etc. and... Requesting Scans Requesting scans can be a scary daily occurrence for new doctors. It is one of few times where you liaise directly with a consultant. Introduction When requesting scans, there are two... Postnatal Patients The management and review of postnatal women are usually straightforward. There are a few points specific to postnatal women that are important to consider, which will be covered below.... Pre & Post Operative Care As a resident doctor, you will frequently look after patients prior to and after their operation. You may be asked to clerk patients who are admitted to hospital the night before their... Gynaecology Assessment & Common Disorders As gynaecology issues uncommonly present on the ward, many doctors have difficulties with the standard framework for addressing these issues. The classic referrals to gynaecology are:... Gallstone Disease Patients regularly present under the acute take with gallstone disease. The aim of this article is to supplement the surgical webinar series session on gallstone disease that can be... Pancreatitis Pancreatitis is a condition characterised by the inflammation of the pancreas. These patients are usually managed conservatively. Your aim is to try to find out the underlying cause,... PR Bleeding The first thing when called is to identify whether the bleeding is truly a lower GI bleed or whether it is an Upper GI Bleed as the management differs. Both can quickly become... Bowel Obstruction Bowel obstruction is a common reason for admission or complication of patients under the surgical team, but doctors don’t frequently get that much exposure to it in medical school.... 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... Urinary Catheterisation In this article, we discuss when a catheter might be needed and top tips on male & female catheterisation. Before attempting catheterisation, always review the following Is the... Kidney Stones Given how frequently patients present with renal colic, it is helpful for FY1s to understand the basic management. Specifically, this article will help ensure you do the relevant investigations... Urinary Retention Urinary retention can be acute or chronic. When acute it occurs within a number of hours causing significant pain. In contrast, chronic retention is painless and accumulates over weeks... 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... Epistaxis Epistaxis is a common presentation, especially amongst the young and elderly population. Knowing the basic management, red flags, and when to escalate is important particularly in acute... Common Dental Issues A very quick guide to common issues prompting referrals to maxillofacial surgery (aka MaxFax and OMFS) This is a surgical speciality relating to the hard and soft tissues of the head... Abdominal Pain When you are on call, you will often get a bleep about a patient with abdominal pain. Abdominal pain can be a bit of a minefield and it is easy to get bogged down with all the possibilities.... Constipation Constipation is one of the most common complaints in hospital, especially on the geriatric wards.Failure to treat constipation can lead to longer hospital stays and increased morbidity.... 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... Prescribing IV Fluids There are certain situations where you need to prescribe IV fluids which vary from fluid resuscitation to maintenance fluids if a patient is nil-by-mouth (NBM) (e.g. pre-operatively,... Previous
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- [Urology](https://mindthebleep.com/urology/): Urology Understanding the MSRA The Multiple Specialty Recruitment Assessment (MSRA) is a computer-based exam increasingly... Read More » Urinary Retention Urinary retention can be acute or chronic. When acute it occurs within a number of... Read More » Haematuria You will regularly see patients with blood in their urine, most often picked up incidentally... Read More » Urinary Catheterisation In this article, we discuss when a catheter might be needed and top tips on male... Read More » A Comprehensive Guide to Surgical Clerking This guide is designed to help you identify the key areas you need to focus on when... Read More » Urinary Tract Infections Urinary tract infections (UTIs) in adults are extremely common in both primary and... Read More » CT Abdomen & Pelvis Interpretation In the webinar below, Dr Henry de Boer (radiology registrar) provides a structured... Read More » Kidney Stones Given how frequently patients present with renal colic, it is helpful for FY1s to... Read More » Acute Scrotum Introduction The acute scrotum is a ‘constellation of new-onset pain, swelling and/or... Read More »
- [Orthopaedics](https://mindthebleep.com/orthopaedics/): Orthopaedics Orthogeriatrics Fragility fractures in the elderly As a resident doctor on call, in geriatrics or in... Read More » Compartment Syndrome Acute Compartment Syndrome is one of the few orthopaedic emergencies. If missed,... Read More »
- [Ophthalmology](https://mindthebleep.com/ophthalmology/): Ophthalmology Applying to Ophthalmology Ophthalmology provides a great deal of variety by combining medicine, surgery &... Read More » How to use an Ophthalmoscope Being able to use an ophthalmoscope confidently is very important to resident doctors,... Read More » Red Eye Red eye is one of the most common eye presentations you will encounter. Whilst many... Read More » Eye History & Exam This is intended for resident doctors on the ward or in ED, covering how to approach... Read More » Study Tips for the Duke-Elder Undergraduate Prize Exam The Duke-Elder Undergraduate Prize Exam is an optional competitive exam run by the... Read More » Overview of eye drops Medicines reconciliation is the process of accurately listing a person’s medicines.... Read More » Sudden Visual Loss Loss of vision can be a scary symptom for patients to experience, and a scary presentation... Read More » Diplopia Diplopia, also known as double vision, happens when there is a mismatch in images... Read More »
- [Obstetrics](https://mindthebleep.com/obstetrics/): Obstetrics Applying to Obstetrics and Gynaecology In this article, we discuss why you should apply to O&G training, how to build your... Read More » Gynaecological Examination If the thought of conducting an intimate examination or attempting to wield (without... Read More » Vaginal Bleeding One of the most common obstetric/gynaecological presentations in a hospital/GP setting... Read More » Urinary Tract Infections Urinary tract infections (UTIs) in adults are extremely common in both primary and... Read More » Postnatal Patients The management and review of postnatal women are usually straightforward. There are... Read More »
- [Maxillofacial Surgery](https://mindthebleep.com/maxillofacial-surgery/): Maxillofacial Surgery Applying to Oral and Maxillofacial Surgery (OMFS) Oral and Maxillofacial Surgery is a mouthful (no pun intended), but you may have... Read More » Common Dental Issues A very quick guide to common issues prompting referrals to maxillofacial surgery... Read More » Introduction to Dental Traumatology for A&E This article aims to give basic information on the assessment of dental trauma to... Read More »
- [Gynaecology](https://mindthebleep.com/gynaecology/): Gynaecology Applying to Obstetrics and Gynaecology In this article, we discuss why you should apply to O&G training, how to build your... Read More » Gynaecological Examination If the thought of conducting an intimate examination or attempting to wield (without... Read More » Abdominal Pain When you are on call, you will often get a bleep about a patient with abdominal pain.... Read More » Vaginal Bleeding One of the most common obstetric/gynaecological presentations in a hospital/GP setting... Read More » Gynaecology Assessment & Common Disorders As gynaecology issues uncommonly present on the ward, many doctors have difficulties... Read More » Postnatal Patients The management and review of postnatal women are usually straightforward. There are... Read More »
- [General Surgery](https://mindthebleep.com/general-surgery/): General Surgery Prescribing IV Fluids There are certain situations where you need to prescribe IV fluids which vary from... Read More » Abdominal X-rays The advantages of AXRs are far less radiation to patients & that they’re... Read More » Prescribing analgesia When assessing pain, ensure you begin by taking a history to characterise the pain... Read More » Pre & Post Operative Care As a resident doctor, you will frequently look after patients prior to and after their... Read More » Constipation Constipation is one of the most common complaints in hospital, especially on the... Read More » PR Bleeding The first thing when called is to identify whether the bleeding is truly a lower... Read More » Nasogastric Tubes NG tubes are passed from the nose to the stomach. Depending on the material, they... Read More » Nausea & Vomiting You will frequently get calls regarding nausea & vomiting: many patients present... Read More » Gallstone Disease Patients regularly present under the surgical take with gall stone disease. The aim... Read More » Stomas The word stoma comes from Greek to mean “an opening”. There are many... Read More » Bowel Obstruction Bowel obstruction is a common reason for admission or complication of patients under... Read More » Inflammatory Bowel Disease Inflammatory bowel disease (IBD) refers to a relapsing and remitting inflammatory... Read More » Pancreatitis Pancreatitis is a condition characterised by the inflammation of the pancreas. These... Read More » Abdominal Pain When you are on call, you will often get a bleep about a patient with abdominal pain.... Read More » Groin Lumps The groin, also known as the inguinal region, extends from the anterior superior... Read More » Diarrhoea Diarrhoea is a very common complaint and may be the reason for a patient’s admission,... Read More » Appendicitis Appendicitis is a one of the most common abdominal emergencies worldwide. Your aim... Read More » Chronic Pancreatitis Chronic pancreatitis is characterised by repeated pancreatic inflammation. This leads... Read More » Diverticular Disease Diverticulae can occur throughout the gastrointestinal tract but are more common... Read More » Colorectal Cancer and Polyps Colorectal cancer is one of the most common cancer types seen in the western world.... Read More » Benign Anorectal Pathology In this article, we cover common benign anorectal pathologies including haemorrhoids,... Read More »
- [ENT](https://mindthebleep.com/ent/): Webinars & articles covering the assessment & management of ENT conditions
- [Respiratory](https://mindthebleep.com/respiratory/): Respiratory Hypoxia As an FY1, you will be called to review hypoxic ward patients. Here we discuss common... Read More » Non-Invasive Ventilation Non-invasive ventilation is a way of providing ventilatory support to patients in... Read More » Pulmonary embolism A pulmonary embolism (PE) is a blocked blood vessel in your lungs, most often due... Read More » Acute COPD exacerbation As an FY1, you are unlikely to be expected to make decisions about long term COPD... Read More » Pneumothorax A pneumothorax is defined as the abnormal collection of air between the visceral... Read More » Acute Asthma You are unlikely to be expected to make decisions about long term asthma management,... Read More » Pneumonia In this article, we will focus on more practical concerns when managing a patient... Read More » Performing Arterial Blood Gases (ABGs) Thanks to Geeky Medics for an excellent video demonstration Equipment Gloves Alcohol... Read More »
- [Renal](https://mindthebleep.com/renal/): Renal Fluid Balance Almost every patient admitted to hospital receives IV fluids at some point in their... Read More » Acute Kidney Injury AKI is very common affecting around 20% of inpatients & it is important to recognise... Read More » Haematuria You will regularly see patients with blood in their urine, most often picked up incidentally... Read More » Dialysis Patients There is an increasing prevalence of end-stage kidney disease and it is therefore... Read More » Managing patients with CKD In whichever specialty you work, you will encounter large numbers of patients with... Read More »
- [Neurology](https://mindthebleep.com/neurology/): Neurology Reduced GCS As a doctor, you will frequently be called for a drowsy patient. They can vary from... Read More » Seizures Scenario: You are bleeped by one of the staff nurses to review a patient on the orthopaedic... Read More » Behavioural and Psychological Symptoms of Dementia (BPSD) In people over the age of 65 years, 1 in 11 will have a diagnosis of dementia. Dementia... Read More » Delirium Acute confusion, otherwise known as delirium, is very common in hospitals: 20-30%... Read More » Acute Stroke Whilst on call or in A&E you may be asked to assess somebody who is suspected... Read More » CNS Infections A CNS infection is one that involves the central nervous system in some way. This... Read More » Functional Neurological Disorders (FND) Introduction Functional neurological disorders are some of the most common neurological... Read More » Lumbar Puncture A lumbar puncture involves the insertion of a needle between the lumbar vertebrae,... Read More » Parkinson’s Disease In this article, we will present several common scenarios involving Parkinson’s disease... Read More » Syncope From the Greek: Syn: together & kopein: to cut - referring to a block in blood supply... Read More » Interpreting CSF Results Understanding how to do an LP and interpret the results is an essential skill for... Read More » Sudden Visual Loss Loss of vision can be a scary symptom for patients to experience, and a scary presentation... Read More » Metastatic Spinal Cord Compression Spinal cord compression occurs when there is compression of the spinal cord or cauda... Read More » Vertigo Vertigo is described as an “abnormal sensation of motion. It can occur in the absence... Read More » Headache Acute headache is a common complaint that you’ll see whilst on the wards or... Read More » Frontotemporal Dementia (FTD) Frontotemporal dementia (FTD) is the third most common dementia across all age groups... Read More » CT Head Interpretation In the webinar below, Dr Sam Kular (interventional radiology fellow) provides a structured... Read More »
- [Microbiology](https://mindthebleep.com/microbiology/): Microbiology Sepsis Sepsis is an infection with evidence of organ dysfunction. Septic shock is when a... Read More » Pneumonia In this article, we will focus on more practical concerns when managing a patient... Read More » Microbiology Discussions A lot of your time as an FY1 will be spent on the phone to various other specialities.... Read More » Neutropenic Sepsis Please read an overview of the management of sepsis before reading this article.... Read More » Fever in the Returning Traveller COVID-19 aside, international travel is easier and more prevalent than ever before,... Read More » Diarrhoea Diarrhoea is a very common complaint and may be the reason for a patient’s admission,... Read More » CNS Infections A CNS infection is one that involves the central nervous system in some way. This... Read More » Urinary Tract Infections Urinary tract infections (UTIs) in adults are extremely common in both primary and... Read More » HIV Human Immunodeficiency Virus (HIV) is a species of lentivirus that can infect humans... Read More » Notifiable Diseases As a resident doctor, it is your statutory duty as a medical professional to alert... Read More »
- [Haematology](https://mindthebleep.com/haematology/): Haematology Interpreting Blood Films A blood film looks at our three cell types (erythrocytes, leukocytes & platelets)... Read More » Haematological emergencies In this article, we give an overview of the most important and serious haematological... Read More » Anticoagulation For new doctors, prescribing anticoagulants can be daunting. A few simple rules can... Read More » Transfusion In this article, we will go through the three most common scenarios you will encounter.... Read More » Neutropenic Sepsis Please read an overview of the management of sepsis before reading this article.... Read More » Anaemia Perhaps the most common blood test you will review daily will be the FBC (full blood... Read More » Deep Vein Thrombosis A deep vein thrombosis (DVT) is a condition in which a blood clot (thrombosis) forms... Read More » Sickle Cell Disease Sickle cell diseases are a disorder of haemoglobin affecting red blood cells. This... Read More »
- [Geriatrics](https://mindthebleep.com/geriatrics/): Geriatrics Falls As an F1, you will quite frequently get bleeped to review a patient who has had a... Read More » Delirium Acute confusion, otherwise known as delirium, is very common in hospitals: 20-30%... Read More » Discharge Planning It is important for resident doctors to understand what the discharge planning process... Read More » Constipation Constipation is one of the most common complaints in hospital, especially on the... Read More » Palliative Care Dying is a natural process and unfortunately, something that we all come across in... Read More » Syncope From the Greek: Syn: together & kopein: to cut - referring to a block in blood supply... Read More » Orthogeriatrics Fragility fractures in the elderly As a resident doctor on call, in geriatrics or in... Read More » Dementia As an FY1 in hospital, you will come across lots of patients with dementia. They... Read More » Understanding Types of Homes Patients may live or be discharged to a wide variety of social care settings and... Read More » Frailty Syndromes What is frailty? A state of increased vulnerability to poor resolution of homeostasis... Read More » Parkinson’s Disease In this article, we will present several common scenarios involving Parkinson’s disease... Read More » Applying to Geriatric Medicine Within Geriatric Medicine you are always working as part of a multidisciplinary team... Read More »
- [Gastroenterology](https://mindthebleep.com/gastroenterology/): Gastroenterology Nasogastric Tubes NG tubes are passed from the nose to the stomach. Depending on the material, they... Read More » Anaemia Perhaps the most common blood test you will review daily will be the FBC (full blood... Read More » Alcohol Withdrawal Suddenly stopping alcohol intake in patients who have been drinking heavily for prolonged... Read More » Upper GI bleed These patients have the potential to become haemodynamically unstable extremely quickly;... Read More » Diarrhoea Diarrhoea is a very common complaint and may be the reason for a patient’s admission,... Read More » Pancreatitis Pancreatitis is a condition characterised by the inflammation of the pancreas. These... Read More » Inflammatory Bowel Disease Inflammatory bowel disease (IBD) refers to a relapsing and remitting inflammatory... Read More » Abdominal Pain When you are on call, you will often get a bleep about a patient with abdominal pain.... Read More » Nutrition Nutrition is an important aspect of a patient’s health and is overlooked during medical... Read More » Refeeding Syndrome Defined as a collection of electrolyte abnormalities associated with a massive intracellular... Read More » Chronic Pancreatitis Chronic pancreatitis is characterised by repeated pancreatic inflammation. This leads... Read More » PEG Tubes PEG tubes are used as long term feeding options (and medication administration) for... Read More » Managing a patient with decompensated liver cirrhosis Introduction Patients with liver disease are common in the UK. Since 1970, mortality... Read More » Gastroenterology in Primary Care INTRODUCTION
This article covers common gastroenterological presenting complaints... Read More » CT Abdomen & Pelvis Interpretation In the webinar below, Dr Henry de Boer (radiology registrar) provides a structured... Read More » Paracetamol Overdose Paracetamol overdose is a common presentation in A&E and so you may often find... Read More » Abdominal X-rays The advantages of AXRs are far less radiation to patients & that they’re... Read More » Jaundice & Deranged LFTs As the FY1, you will see patients with liver dysfunction either on the take or deranged... Read More » Ascitic Tap and Drain Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites... Read More » Stomas The word stoma comes from Greek to mean “an opening”. There are many... Read More »
- [Endocrinology](https://mindthebleep.com/endocrinology/): Webinars & articles covering the assessment & management of diabtes & endocrine conditions
- [Dermatology](https://mindthebleep.com/dermatology/): Webinars & articles covering the assessment & management of dermatological conditions
- [Cardiology](https://mindthebleep.com/cardiology/): Webinars & articles covering the assessment & management of Cardiovascular diseases
- [Toxicology](https://mindthebleep.com/toxicology/): Toxicology Paracetamol Overdose As an FY1, you will encounter these either during clerking shifts or you may look... Read More » Opiate overdose & toxicity You will likely encounter an opiate overdose due to the prevalence of opiates for... Read More » Reporting Adverse Drug Reactions The World Health Organization (WHO) defines adverse drug reactions (ADR) as “any... Read More »
- [Rheumatology](https://mindthebleep.com/rheumatology/): Rheumatology Back Pain In this article, we cover the assessment and management of back pain. This article... Read More » Acutely Swollen Joint There are three joint pain calls you might receive whilst you’re on call or... Read More » Arthralgia There are three joint pain calls you might receive whilst you’re on call or... Read More »
- [Career](https://mindthebleep.com/career/): Webinars & articles covering applications to various careers
- [Procedures](https://mindthebleep.com/procedures/): Procedures Ascitic Tap and Drain Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites... Read More » Femoral Stab Femoral puncture is typically used to acquire blood from a patient in an emergency... Read More » Non-Invasive Ventilation Non-invasive ventilation is a way of providing ventilatory support to patients in... Read More » How to use an Ophthalmoscope Being able to use an ophthalmoscope confidently is very important to resident doctors,... Read More » Gynaecological Examination If the thought of conducting an intimate examination or attempting to wield (without... Read More » Nasogastric Tubes NG tubes are passed from the nose to the stomach. Depending on the material, they... Read More » Urinary Catheterisation In this article, we discuss when a catheter might be needed and top tips on male... Read More » Cannulation Demonstration video thanks to Geeky Medics Equipment Gloves Hand sanitiser Tourniquet... Read More » Venepuncture Equipment Gloves Hand sanitiser Alcohol wipe Tourniquet Cotton wool/ gauze Needle... Read More » Paediatrics: Venepuncture & Cannulation This article will discuss how to take blood and cannulate patients in the paediatric... Read More » Performing Arterial Blood Gases (ABGs) Thanks to Geeky Medics for an excellent video demonstration Equipment Gloves Alcohol... Read More » Suturing Sutures are placed to aid with wound healing following a traumatic laceration or... Read More » Lumbar Puncture A lumbar puncture uses a fine needle inserted between the vertebrae in the lower... Read More »
- [Prescribing](https://mindthebleep.com/prescribing/): Prescribing Prescribing IV Fluids There are certain situations where you need to prescribe IV fluids which vary from... Read More » Passing the Prescribing Safety Assessment (PSA) The PSA is aimed at final year medical students and those graduating overseas to... Read More » Common Prescribing Errors When I supervise and teach FY1s, prescribing is in the top three things they are... Read More » Prescribing analgesia When assessing pain, ensure you begin by taking a history to characterise the pain... Read More » Anticoagulation For new doctors, prescribing anticoagulants can be daunting. A few simple rules can... Read More » Hypercalcaemia Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia... Read More » Hypokalaemia As an FY1 you will frequently see hypokalaemia and most trusts have guidelines that... Read More » Medications in Diabetes In this article, we’ll cover the treatments used in Diabetes Mellitus. We’ll... Read More » Paracetamol Overdose As an FY1, you will encounter these either during clerking shifts or you may look... Read More » Constipation Constipation is one of the most common complaints in hospital, especially on the... Read More » Nausea & Vomiting You will frequently get calls regarding nausea & vomiting: many patients present... Read More » Palliative Care Dying is a natural process and unfortunately, something that we all come across in... Read More » Transfusion In this article, we will go through the three most common scenarios you will encounter.... Read More » Parkinson’s Disease In this article, we will present several common scenarios involving Parkinson’s disease... Read More » Bowel Obstruction Bowel obstruction is a common reason for admission or complication of patients under... Read More » Opiate overdose & toxicity You will likely encounter an opiate overdose due to the prevalence of opiates for... Read More » Alcohol Withdrawal Suddenly stopping alcohol intake in patients who have been drinking heavily for prolonged... Read More » Opiate Withdrawal As doctors, you will frequently see patients with opiate dependence. It isn’t... Read More » Paediatrics: Prescribing As an FY1 it is likely that you will manage paediatric patients during their admission,... Read More » Overview of eye drops Medicines reconciliation is the process of accurately listing a person’s medicines.... Read More » Hypomagnesaemia The UK Medicines Information group have provided excellent guidance on... Read More » Reporting Adverse Drug Reactions The World Health Organization (WHO) defines adverse drug reactions (ADR) as “any... Read More » Hypophosphataemia The UK Medicines Information group have provided excellent guidance on how to replace... Read More » Hypocalcaemia Alongside strengthening bone, calcium is used in the clotting cascade, in muscle... Read More »
- [Electrolytes](https://mindthebleep.com/electrolytes/): List of articles covering the assessment & management of electrolyte disorders
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- [Radiology](https://mindthebleep.com/radiology/): Medicine Surgery Emergencies Final Year FY1 SHO Career IMG eLearning In Person Courses Paediatrics Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now on Radiology Guide To Radiology Posts In Foundation Training Throughout medical school, students often receive little to no exposure to radiology as a specialty. Even during foundation training, most doctors only encounter radiology through brief... Introduction to AI in Healthcare - Types of AI and replacing Healthcare Professionals (HCPs) Welcome back to our series on AI in Healthcare. Article 2 will cover the main types of AI and try to answer the question “Will AI replace human healthcare professionals in the future?”.... Clinical Radiology ST1 Application Guide 2025 Radiology is an exciting and fast-evolving specialty, with radiologists playing a crucial role in diagnosing patients and guiding management across all specialties. This article takes... 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,... Requesting Scans Requesting scans can be a scary daily occurrence for new doctors. It is one of few times where you liaise directly with a consultant. Introduction When requesting scans, there are two... Abdominal X-rays The advantages of AXRs are far less radiation to patients & that they’re logistically easy to organise out of hours. Unlike CTs they do not need to be discussed with the on-call... Latest Content on Radiology Guide To Radiology Posts In Foundation Training Throughout medical school, students often receive little to no exposure to radiology as a specialty. Even during foundation training, most doctors only encounter radiology through brief... Clinical Radiology ST1 Application Guide 2025 Radiology is an exciting and fast-evolving specialty, with radiologists playing a crucial role in diagnosing patients and guiding management across all specialties. This article takes... Introduction to AI in Healthcare - Types of AI and replacing Healthcare Professionals (HCPs) Welcome back to our series on AI in Healthcare. Article 2 will cover the main types of AI and try to answer the question “Will AI replace human healthcare professionals in the future?”.... CT Abdomen & Pelvis Interpretation In the webinar below, Dr Henry de Boer (radiology registrar) provides a structured approach to CT abdomen & pelvis interpretation, with an overview of common cases & pitfal... Upper Limb X-ray Interpretation In the webinars below, Dr June Lau & Dr Henry de Boer (radiology registrars) provides a structured approach to interpreting shoulder, elbow, forearm, wrist & hand x-rays, with... Lower Limb X-Ray Interpretation In the webinar below, Dr Joe Kang (radiology registrar) provides a structured approach to interpreting knee, ankle & foot x-rays, with an overview of common cases & pitfalls.... CT Chest Interpretation In the webinar below, Dr Dexter Valencia (interventional radiology registrar) provides a structured approach to CT chest/thorax interpretation, with an overview of common cases &... CT Head Interpretation In the webinar below, Dr Sam Kular (interventional radiology fellow) provides a structured approach to CT head interpretation, with an overview of common cases & pitfalls. 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,... Pneumothorax A pneumothorax is defined as the abnormal collection of air between the visceral and parietal space of the lung i.e. the pleural space. It typically presents with acute shortness of... Abdominal X-rays The advantages of AXRs are far less radiation to patients & that they’re logistically easy to organise out of hours. Unlike CTs they do not need to be discussed with the on-call... Requesting Scans Requesting scans can be a scary daily occurrence for new doctors. It is one of few times where you liaise directly with a consultant. Introduction When requesting scans, there are two... Chest X-Rays In this article, we focus on the interpretation of a CXR. Have a low threshold to request one as they provide a lot of information with minimal radiation. Typically, if the patient... Previous
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Next Follow us Facebook Twitter Youtube Instagram Comments Discord Whatsapp Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Locum Finder eLearning Radiology Newsletter Upcoming Webinars
- [Psychiatry](https://mindthebleep.com/psychiatry/): Medicine Surgery Emergencies Final Year FY1 SHO Career IMG Radiology eLearning In Person Courses Paediatrics Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now on Psychiatry Autism Spectrum Disorder Background Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects around 1.76% of school-age children in the UK. Multiple factors have been proposed in the aetiology... Lived Experience: Autism The following article has been written by David Birch. David is a paramedic aiming to increase awareness of managing Autism amongst healthcare professionals, particularly paramedics... Obsessive Compulsive disorder The psychiatric condition obsessive-compulsive disorder (OCD) is estimated to be present in 1.2% of the UK population. This condition has been oversimplified in the past and present... ADHD in children Background ADHD is a neurodevelopmental disorder that begins in childhood, and is formed of the following core features: 1. Inattention: difficulty finishing tasks difficulty focussing... Paracetamol Overdose Paracetamol overdose is a common presentation in A&E and so you may often find yourself looking after them. The information below is to help give you an overview. This article (like... 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,... Latest Content on Psychiatry ADHD in children Background ADHD is a neurodevelopmental disorder that begins in childhood, and is formed of the following core features: 1. Inattention: difficulty finishing tasks difficulty focussing... Lived Experience: Autism The following article has been written by David Birch. David is a paramedic aiming to increase awareness of managing Autism amongst healthcare professionals, particularly paramedics... Autism Spectrum Disorder Background Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects around 1.76% of school-age children in the UK. Multiple factors have been proposed in the aetiology... Functional Neurological Disorders (FND) Introduction Functional neurological disorders are some of the most common neurological problems and are conceptualised as disorders of the functioning of the nervous system (rather... Frontotemporal Dementia (FTD) Frontotemporal dementia (FTD) is the third most common dementia across all age groups and the leading type of early-onset dementia. This type affects primarily the frontal and temporal... Behavioural and Psychological Symptoms of Dementia (BPSD) In people over the age of 65 years, 1 in 11 will have a diagnosis of dementia. Dementia is a chronic, irreversible and progressive condition, not only affecting memory but also an individual’s... Electroconvulsive therapy (ECT) Electroconvulsive therapy (ECT) is a treatment that has been used in psychiatry since the 1930s. The procedure involves passing an electric current between two electrodes placed on... Prescribing in Old Age Psychiatry The general prescribing principles from both Old Age Psychiatrists and Geriatricians is to start at a low dose for a drug, and then titrate up slowly. A small dose for a general adult... Obsessive Compulsive disorder The psychiatric condition obsessive-compulsive disorder (OCD) is estimated to be present in 1.2% of the UK population. This condition has been oversimplified in the past and present... 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,... Psychosis Psychosis refers to patients suffering a loss of contact with reality. It affects 3 out of 100 people in their lifetime. Psychosis is a constellation of symptoms and signs rather than... Psychotropic medication Psychotropic medication includes some of the most commonly prescribed medication in the the world. This article will cover the types of medication you will tend to encounter, important... Risk assessment Determining the risk of harm to the patient, and sometimes to others, is an essential part of a psychiatric assessment. It is useful to know what questions to ask whether you’re... Anxiety disorders Anxiety is a commonly experienced symptom as part of the body’s reaction to stress. It becomes a mental health disorder if exaggerated, lasts >3 weeks and interferes with daily... Mood (affective) disorders In this article, we cover depressive disorders, bipolar affective disorder and schizoaffective disorder with an overview of the epidemiology, diagnostic criteria, assessment and management... How to take a psychiatric history Psychiatry, as a specialty is unique in that diagnostic methods, rely very heavily on symptomatology, therefore assessment has to be thorough. Components of psychiatric assessment Full... Applying to Psychiatry Training Do you have an interest in human behaviour? Did you go into medicine to speak to patients? Are you looking for variety in your work? Do you want to make a difference in people’s lives?... Mental State Examination The mental state examination (MSE) is an observational assessment of a patient’s appearance, behaviours and cognitive state. It has seven domains that need to be assessed in order to... Management of the Aggressive Patient At times as a resident doctor, you will be faced with the management of patients displaying aggression. There are many causes for aggressive behaviour, from pain to frustration at delays... Sections of the Mental Health Act 1983/2007 What is the MHA? It is legislation that governs patients’ Compulsory detention Treatment Discharge Aftercare It can be used to hospitalise patients that have a mental illness which:... Self-discharge Frequently patients wish to self-discharge from hospitals. This article pertains to adult patients only (18y+) and these patients can be broadly split into three groups: Those that... Paracetamol Overdose Paracetamol overdose is a common presentation in A&E and so you may often find yourself looking after them. The information below is to help give you an overview. This article (like... Delirium Acute confusion, otherwise known as delirium, is very common in hospitals: 20-30% on medical wards, and between 10-50% of those that have surgery develop delirium. Types of Delirium... Self Harm The most common place you will see a patient who has self-harmed is in ED, where they have been referred to the psychiatry team but need to be medically cleared. Rarely this could occur... Previous
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- [Paediatrics](https://mindthebleep.com/paediatrics/): Medicine Surgery Emergencies Final Year FY1 SHO Career IMG Radiology eLearning In Person Courses Psychiatry Finance Research Wellbeing Favourites Weekly Webinars YouTube Videos Discount Codes Doctor's Pay Calculator Referral Cheat Sheet Contribute Prize Locum Finder Follow Us Facebook Twitter Youtube Instagram Envelope Comments Discord Whatsapp Trending Now in Paediatrics Autism Spectrum Disorder Background Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects around 1.76% of school-age children in the UK. Multiple factors have been proposed in the aetiology... Infantile Haemangioma Infantile Haemangiomas are common skin lesions seen in paediatrics. This article explains how to identify these lesions and when medical management would be indicated Cystic Fibrosis in Paediatrics Cystic Fibrosis has a high incidence in the UK and Europe and 1 in 25 people are carriers. Whilst it is screened for on day 5 of life this does not always detect CF and so it is important... ADHD in children Background ADHD is a neurodevelopmental disorder that begins in childhood, and is formed of the following core features: 1. Inattention: difficulty finishing tasks difficulty focussing... Faltering Growth in Infants Faltering growth (also known as failure to thrive) describes when a child is not growing as expected. This may reflect underlying poor health or nutrition. By routinely assessing a... Delayed puberty Delayed puberty may seem like a very specialist area of paediatrics, but it’s actually a relatively common reason for presentation to the GP, and a lot of children are referred onwards... Latest Content on Paediatrics Delayed puberty Delayed puberty may seem like a very specialist area of paediatrics, but it’s actually a relatively common reason for presentation to the GP, and a lot of children are referred onwards... Paediatric Cardiovascular Examination It is very common that we perform a cardiovascular examination in paediatrics, particularly in babies, but we will often leave out key steps which would be expected in a clinical exam... Paediatric Eye Examination It is unusual that you would need to do more than examine cranial nerves in a child in day to day practice, but this is for the purpose of clinical exams. It is a step by step guide... Faltering Growth in Children Faltering growth (also known as failure to thrive) describes when a child is not growing as expected. This may reflect underlying poor health or nutrition. By routinely assessing a... Faltering Growth in Infants Faltering growth (also known as failure to thrive) describes when a child is not growing as expected. This may reflect underlying poor health or nutrition. By routinely assessing a... NIPE The Newborn and Infant Physical Examination (NIPE) or Examination of the Newborn (EON) is performed on every newborn baby within the first 72 hours of life by doctors and midwives.... ADHD in children Background ADHD is a neurodevelopmental disorder that begins in childhood, and is formed of the following core features: 1. Inattention: difficulty finishing tasks difficulty focussing... Cow’s Milk Protein Allergy CMPA is a very common presentation to GP and paediatric assessment units and can cause a lot of parental anxiety. This article talks through different types of CMPA, and how to man... Paediatric Respiratory Examination This article gives a run down of how to perform a thorough paediatric respiratory examination and what signs and symptoms to look for. It will be helpful for anyone on a paeds placement... Paediatric IV Fluid Prescribing Prescribing IV fluids in paediatrics is different to adult medicine and requires a bit more thinking and some maths. This article breaks down prescribing fluid boluses, maintenance... Diabetic Ketoacidosis in Paediatrics Paediatric DKA is a common but life threatening paediatric emergency and it is important to be able to recognise the signs and symptoms early to initiate the correct treatment . The... Autism Spectrum Disorder Background Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects around 1.76% of school-age children in the UK. Multiple factors have been proposed in the aetiology... Cystic Fibrosis in Paediatrics Cystic Fibrosis has a high incidence in the UK and Europe and 1 in 25 people are carriers. Whilst it is screened for on day 5 of life this does not always detect CF and so it is important... Necrotising Enterocolitis Necrotising enterocolitis is one of the most common neonatal surgical emergencies and is a potentially life-threatening condition. This article talks through the risks for developing... Nephrotic Syndrome in Paediatrics Nephrotic syndrome is rare but is often misdiagnosed resulting in delayed diagnosis and increased morbidity. This article will help you to accurately diagnose and manage nephrotic... Henoch Schonlein Purpura Henochn Schonlein Purpura (HSP) is a common vasculitis in paediatrics that presents with a non-blanching rash and can often cause a migrating arthritis, abdominal pain and renal problems.... Abdominal Pain in Children Abdominal pain in paediatrics can have a wide range of causes, some being innocent and some needing urgent intervention. This article gives you an idea of how to narrow down your list... Paediatric Constipation Constipation is a very common cause of abdominal pain and recurrent presentations to paediatric services. It can be difficult to manage and it is important to rule out underlying causes.... Common Viral Infections (exanthem) in Paediatrics Viral infections are extremely common in paediatrics and a common presentation to paediatric A&E is a worried parent with a child with a rash. This article will help you to identify... Kawasaki Disease Kawasaki disease is a rare but serious condition in children which should always be considered in children with 5 or more days of fever without an identifiable source. This article... Infantile Haemangioma Infantile Haemangiomas are common skin lesions seen in paediatrics. This article explains how to identify these lesions and when medical management would be indicated Brief Resolved Unexplained Event (BRUE) BRUE's are a common presentation for young babies and can be a huge concern for parents. It is important to be able to distinguish between those that are low risk and do not need any... Croup Croup is one of the most common winter illnesses we see in paediatrics and rarely these children can become very unwell. This article will help you understand the management options... Febrile Convulsions Febrile convulsions are a common presentation in paediatrics. This article will you help differentiate between the concerning presentations that need further investigation and management,... Hand, Foot and Mouth Disease Hand foot and mouth disease is a very common illness in children which commonly causes children to present to A&E and GP. This article tells you all you need to know about hand foot... Pre-School Wheeze Introduction Affects children under the age of 5 years old There tends to be two patterns of recurrent wheezing in this age group: Episodic and viral induced wheezing which occurs as... Group A Strep - What you need to know Introduction Group A streptococcus (GAS) is a gram positive cocci usually found in normal skin and upper respiratory tract flora  Infections caused by GAS vary and include tonsillitis,... Bronchiolitis Introduction Viral infection in children 0-2 years of age (but most commonly < 1yo) Inflammation of the bronchioles, neutrophilic response Infection of bronchiolar and cilia cells... Respiratory Distress Written by Dr Rebecca Evans, ST3 Paediatrics One of the most common presentations to paediatric A&E is “SOB” “DIB” or “increased WOB”. There are many different causes of respiratory... Safeguarding History – The Basics Children are vulnerable. Unfortunately, child abuse does happen, and it has a significant and lifelong impact. You may be one of the only professionals to have sufficient access to... Paediatric Chest Pain Most of the time, chest pain in children originates from a benign cause. However, paediatric chest pain can be a sign of serious pathology, particularly cardiac. It is important that,... Consenting Children and Adolescents The rules on consenting children and adolescents can seem a complex business. Putting the theory learned in medical school into practice can be challenging. This article aims to describe... Applying to Paediatrics On the one hand, you wear a Disney lanyard, with a pocket stuffed with stickers, on the other, you are dealing with what is internationally referred to as the most precious of lives.... Describing Skin Lesions It is quite common for you to need to describe rashes for documentation purposes, to senior colleagues or to refer to various specialties including dermatology. Here is a refresher... Paediatrics: Communication & Consent As an FY1 you will likely manage paediatric patients during their admission, often in other specialties like general surgery. Difficult communication scenarios can occur & being... Paediatrics: Prescribing As an FY1 it is likely that you will manage paediatric patients during their admission, often in other specialties like general surgery. Having a few prescribing skills under your belt... Paediatrics: Venepuncture & Cannulation This article will discuss how to take blood and cannulate patients in the paediatric setting. Preparation If you think you will need to take blood from a paediatric patient, it is kinder... Paediatrics: Clerking & Discharge tips As an FY1 it is likely that you will manage paediatric patients during their admission, often in other specialties like general surgery. Having a few paediatric skills under your belt... Previous
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- [FY1 Course (London) – 12th July](https://mindthebleep.com/events/fy1-course-london-12th-july-2/): Our top-rated & free simulation-based course condenses real-life scenarios you will frequently encounter into various stations allowing you to practice them in small groups within a safe learning environment before having to do them for real. You can find more information on this here.
- [FY1 Course (London) – 11th July](https://mindthebleep.com/events/fy1-course-london-11th-july/): Our top-rated & free simulation-based course condenses real-life scenarios you will frequently encounter into various stations allowing you to practice them in small groups within a safe learning environment before having to do them for real. You can find more information on this here.
- [FY1 Course (London) – 5th July](https://mindthebleep.com/events/fy1-course-london-5th-july/): Our top-rated & free simulation-based course condenses real-life scenarios you will frequently encounter into various stations allowing you to practice them in small groups within a safe learning environment before having to do them for real. You can find more information on this here.
- [FY1 Course (London) – 4th July](https://mindthebleep.com/events/fy1-course-london-4th-july/): Our top-rated & free simulation-based course condenses real-life scenarios you will frequently encounter into various stations allowing you to practice them in small groups within a safe learning environment before having to do them for real. You can find more information on this here.
- [F1 Cardiology Crash Course: Hypertension](https://mindthebleep.com/events/f1-cardiology-crash-course-hypertension-6/)
- [F1 Cardiology Crash Course: Cardiotoxicity](https://mindthebleep.com/events/f1-cardiology-crash-course-cardiotoxicity-6/)
- [UKMLA: HPV](https://mindthebleep.com/events/ukmla-hpv/)
- [UKMLA: Pyschiatry, personality and substance use disorders](https://mindthebleep.com/events/ukmla-pyschiatry-personality-and-substance-use-disorders/)
- [F1 Cardiology Crash Course: Infective Endocarditis](https://mindthebleep.com/events/f1-cardiology-crash-course-hypertension-5/)
- [F1 Cardiology Crash Course: Syncope](https://mindthebleep.com/events/f1-cardiology-crash-course-cardiotoxicity-5/)
- [Portfolio Building for Specialty Applications](https://mindthebleep.com/events/f1-cardiology-crash-course-cardiotoxicity-4/)
- [FY3 in Australia](https://mindthebleep.com/events/f1-cardiology-crash-course-hypertension-4/)
- [F1 Cardiology Crash Course: Cardiotoxicity](https://mindthebleep.com/events/f1-cardiology-crash-course-cardiotoxicity-3/)
- [F1 Cardiology Crash Course: Hypertension](https://mindthebleep.com/events/gastroenterology-exam-consolidation-and-practical-advice/)
- [F1 Cardiology Crash Course: Valvular disease](https://mindthebleep.com/events/f1-cardiology-crash-course-hypertension-3/)
- [UKMLA Paediatrics: OSCE revision](https://mindthebleep.com/events/f1-cardiology-crash-course-cardiotoxicity-2/)
- [Gastroenterology Exam Consolidation and Practical Advice](https://mindthebleep.com/events/f1-cardiology-crash-course-infective-endocarditis-2/)
- [Coronary Artery Disease and Hypertension](https://mindthebleep.com/events/f1-cardiology-crash-course-syncope-2/)
- [UKMLA Paediatrics: Neuro, Rheum and T&O](https://mindthebleep.com/events/fy3-in-australia-understanding-taxes-exams-and-working-in-australia/)
- [Preparing for ARCP](https://mindthebleep.com/events/alternative-careers-series-working-in-healthtech-as-a-doctor-2/)
- [The Weight of the Bleep: A talk on Mental Health for Resident Doctors](https://mindthebleep.com/events/professional-dilemmas-teaching-series-week-5-effective-communication-and-teamworking-2/)
- [F1 Cardiology Crash Course: Hypertension](https://mindthebleep.com/events/f1-cardiology-crash-course-hypertension-2/)
- [F1 Cardiology Crash Course: Hypertension](https://mindthebleep.com/events/f1-cardiology-crash-course-hypertension/)
- [F1 Cardiology Crash Course: Cardiotoxicity](https://mindthebleep.com/events/f1-cardiology-crash-course-cardiotoxicity/)
- [F1 Cardiology Crash Course: Infective Endocarditis](https://mindthebleep.com/events/f1-cardiology-crash-course-infective-endocarditis/)
- [Acute Chest X-Rays](https://mindthebleep.com/events/f1-cardiology-crash-course-syncope/)
- [F1 Cardiology Crash Course: Valvular disease](https://mindthebleep.com/events/f1-cardiology-crash-course-valvular-disease/)
- [F1 Cardiology Crash Course: ECGs and arrhythmias](https://mindthebleep.com/events/f1-cardiology-crash-course-ecgs-and-arrhythmias/)
- [F1 Cardiology Crash Course: ACS](https://mindthebleep.com/events/f1-cardiology-crash-course-acs/)
- [CST Applications, MSRA, Interview Preparation](https://mindthebleep.com/events/portfolio-building-for-specialty-applications/)
- [Transition to FY2: Practical Tips](https://mindthebleep.com/events/ukmla-paediatrics-osce-revision/)
- [F1 Cardiology Crash Course: ECGs and arrhythmias](https://mindthebleep.com/events/transition-to-fy2-practical-tips/)
- [UKMLA: HPV](https://mindthebleep.com/events/ukmla-paediatrics-neuro-rheum-and-to/)
- [UKMLA: Pyschiatry, personality and substance use disorders](https://mindthebleep.com/events/alternative-careers-series-working-in-healthtech-as-a-doctor/)
- [Prostate Conditions](https://mindthebleep.com/events/preparing-for-arcp/)
- [Alternative Careers Series: Working in HealthTech as a doctor](https://mindthebleep.com/events/professional-dilemmas-teaching-series-week-5-effective-communication-and-teamworking/)
- [Final Year Series: T&O – Foot, Ankle, Hand and Wrist](https://mindthebleep.com/events/final-year-series-to-foot-ankle-hand-and-wrist/)
- [Final year Series: ED/ICU/Anaesthetics – Introduction to Anaesthesia](https://mindthebleep.com/events/final-year-series-ed-icu-anaesthetics-introduction-to-anaesthesia/)
- [Professional Dilemmas Teaching Series: Week 4 Patient Focus](https://mindthebleep.com/events/professional-dilemmas-teaching-series-week-4-patient-focus/)
- [Final Year Series Ophthalmology](https://mindthebleep.com/events/final-year-series-ophthalmology-5/)
- [UKMLA Series: Paediatric Surgery and Gastroenterology](https://mindthebleep.com/events/ukmla-series-paediatric-surgery-and-gastroenterology-2/)
- [Final Year Series – Psychiatry](https://mindthebleep.com/events/final-year-series-psychiatry-2/)
- [Final Year Series – Endocrinology](https://mindthebleep.com/events/final-year-series-endocrinology-2/)
- [Professional Dilemmas Series – Professional Integrity](https://mindthebleep.com/events/final-year-series-ophthalmology-4/)
- [UKMLA Series: Paediatric Surgery and Gastroenterology](https://mindthebleep.com/events/ukmla-series-paediatric-surgery-and-gastroenterology/)
- [FY1 Series: Oncology and Orthopaedics](https://mindthebleep.com/events/fy1-series-oncology-and-orthopaedics/)
- [UKMLA Series: ED/ICU/Anaesthetics](https://mindthebleep.com/events/ukmla-series-ed-icu-anaesthetics/)
- [Building a career for HealthTech](https://mindthebleep.com/events/building-a-career-for-healthtech/)
- [Trauma and Orthopaedics: Lower Limb Fractures](https://mindthebleep.com/events/trauma-and-orthopaedics-lower-limb-fractures/)
- [Final Year Series: Rheumatology](https://mindthebleep.com/events/final-year-series-rheumatology-3/)
- [Final Year Series: OSCE Teaching for Trauma & Orthopaedics](https://mindthebleep.com/events/final-year-series-osce-teaching-for-trauma-orthopaedics/)
- [Neonates and Cardiology](https://mindthebleep.com/events/neonates-and-cardiology/)
- [Acute Abdomen and ENT Emergencies](https://mindthebleep.com/events/acute-abdomen-and-ent-emergencies/)
- [Psychiatry Core Training: applications, training pathway and competencies](https://mindthebleep.com/events/psychiatry-core-training-applications-training-pathway-and-competencies-5/)
- [UKMLA Series Dermatology: A from B and When to Worry](https://mindthebleep.com/events/ukmla-series-dermatology-a-from-b-and-when-to-worry/)
- [Specialty Recruitment Interview Preparation Series – ACCS Emergency Medicine CT1](https://mindthebleep.com/events/psychiatry-core-training-applications-training-pathway-and-competencies-4/)
- [The Breathless Patient](https://mindthebleep.com/events/specialty-recruitment-interview-preparation-series-accs-emergency-medicine-ct1-3/)
- [Obstetrics & Gynaecology Emergencies](https://mindthebleep.com/events/psychiatry-core-training-applications-training-pathway-and-competencies-3/)
- [UKMLA Finals Series: Common ED Emergencies](https://mindthebleep.com/events/specialty-recruitment-interview-preparation-series-accs-emergency-medicine-ct1-2/)
- [Final Year Series: Orthopaedics – Upper limb fractures and dislocations](https://mindthebleep.com/events/final-year-series-orthopaedics-upper-limb-fractures-and-dislocations-2/)
- [Final Year Series: Orthopaedics – Upper limb fractures and dislocations](https://mindthebleep.com/events/final-year-series-orthopaedics-upper-limb-fractures-and-dislocations/)
- [Final Year Series: ortho – upper limb fractures and dislocations](https://mindthebleep.com/events/final-year-series-ortho-upper-limb-fractures-and-dislocations/)
- [Specialty Recruitment Interview Preparation Series – Core Surgical CT1](https://mindthebleep.com/events/psychiatry-core-training-applications-training-pathway-and-competencies-2/)
- [Specialty Recruitment Interview Preparation Series – ACCS Emergency Medicine CT1](https://mindthebleep.com/events/specialty-recruitment-interview-preparation-series-accs-emergency-medicine-ct1/)
- [UKMLA Series: Lymphoma and myeloma](https://mindthebleep.com/events/final-year-series-ophthalmology-3/)
- [Specialty Recruitment Interview Preparation Series – ACCS Anaesthetics CT1](https://mindthebleep.com/events/psychiatry-core-training-applications-training-pathway-and-competencies/)
- [UKMLA Series: Testicular Conditions](https://mindthebleep.com/events/the-breathless-patient-3/)
- [Specialty Recruitment Interview Preparation Series – ACCS Anaesthetics CT1](https://mindthebleep.com/events/obstetrics-gynaecology-emergencies-6/)
- [The Breathless Patient](https://mindthebleep.com/events/the-breathless-patient-2/)
- [Paediatric Emergencies](https://mindthebleep.com/events/paediatric-emergencies-6/)
- [Obstetrics & Gynaecology Emergencies](https://mindthebleep.com/events/obstetrics-gynaecology-emergencies-5/)
- [Mental Health Act](https://mindthebleep.com/events/mental-health-act-4/)
- [Paediatric Emergencies](https://mindthebleep.com/events/paediatric-emergencies-5/)
- [Final Year Series : OSCE Sunday Gastroenterology](https://mindthebleep.com/events/final-year-series-osce-sunday-gastroenterology-2/)
- [Mental Health Act](https://mindthebleep.com/events/mental-health-act-3/)

## Courses
- [UKMLA Ophthalmology: High-Yield Finals Course](https://mindthebleep.com/courses/ukmla-ophthalmology-high-yield-finals-course/): A UKMLA-aligned ophthalmology course for final-year medical students covering red eye, cornea and external eye disease, retinal conditions, neuro-ophthalmology, uveitis and thyroid eye disease, cataract and glaucoma. The course focuses on clinical recognition, red flags, initial management, referral urgency and exam-style SBA practice.
- [Situational Judgement Test](https://mindthebleep.com/courses/situational-judgement-test/): Preparing for a Situational Judgement Test (SJT) for speciality application? We’re here to help you understand the exam, refine your judgement, and maximise your score.
- [Clinics to Communities: A Leadership and Social Entrepreneurship Teaching Programme for Medics](https://mindthebleep.com/courses/clinics-to-communities-a-leadership-and-social-entrepreneurship-teaching-programme-for-medics/): This course is designed to build your knowledge and understanding of leadership and social entrepreneurship as a medic. It introduces practical models and frameworks that can be applied to clinical leadership, quality improvement, service development, advocacy, and wider system change. The course can be taken for general interest or to support your ongoing leadership learning.
- [Conducting a Systematic Review](https://mindthebleep.com/courses/systematic-review-course/): Created by Dr Jonathan James and Dr Suraya Yusuf.
- [Preparing for the MSRA](https://mindthebleep.com/courses/preparing-for-the-msra/): Applying for specialty training? Need to sit the MSRA exam? We're here to streamline your revision process, boost your score and secure your choice of specialty training program!
- [Ultrasound Guided Cannulation Course](https://mindthebleep.com/courses/ultrasound-guided-cannulation/): Welcome to the Mind the Bleep Ultrasound Guided Cannulation eLearning.
- [Wellbeing Course](https://mindthebleep.com/courses/wellbeing/): Welcome to our eLearning course for your wellbeing! We are here to develop tools for doctors and medical students you can actually use.Can't wait to see you on the course!
- [Introduction to Python and a simple Image Classifier with Deep Learning (TensorFlow)](https://mindthebleep.com/courses/python/): In this two part course, we will introduce the basics of using Python and its package TensorFlow to demonstrate the key components of a contemporary image classifier using deep learning (i.e. Artificial Intelligence). 
- [Prescribing Safety Assessment Course](https://mindthebleep.com/courses/prescribing-safety-assessment/): We believe strongly that the best Prescribing Safety Assessment course should be provided completely free. This outstanding PSA preparation series has been put together by Dr Sona Petrosyan who is dually qualified in Pharmacy & Medicine.
- [Urology Course](https://mindthebleep.com/courses/urology/): Our course covers assessing & managing common urological issues
- [Surgery Course](https://mindthebleep.com/courses/surgery/): Our course covers assessing & managing common surgical issues
- [Radiology Course](https://mindthebleep.com/courses/radiology/): Our course covers a structured approach to interpreting scans with common cases & pitfalls
- [Finance Course](https://mindthebleep.com/courses/finance/): Our course covers basic financial topics
- [Neurology Course](https://mindthebleep.com/courses/neurology/): Our course covers assessing & managing common neurological issues
- [Audit and QI Course](https://mindthebleep.com/courses/audit-and-qi/): Welcome to the Mind the Bleep course on Audit and QI. From this course you should achieve the following:
- [Surviving FY1](https://mindthebleep.com/courses/surviving-fy1/): Our course covers all the key tips & tricks to surviving FY1
- [Sweet & Salty](https://mindthebleep.com/courses/sweet-salty/): Hi! I'm Dr Akash Doshi - a registrar in Endocrinology & Diabetes. I've put this course together to help you understand how to manage common disorders you'll see on the ward. Treat this as a learning experience with video tutorials & quizzes to improve your confidence.
- [Employment Essentials Course](https://mindthebleep.com/courses/employment/): In this course, we go through the following topics:

## Lessons
- [Uveitis and Ocular Manifestations of Systemic Disease](https://mindthebleep.com/lessons/uveitis-and-ocular-manifestations-of-systemic-disease/)
- [Lesson](https://mindthebleep.com/lessons/lesson-22/)
- [Red Eye, Cornea and External Eye](https://mindthebleep.com/lessons/orbit-and-external-eye/)
- [Neuro-ophthalmology](https://mindthebleep.com/lessons/neuro-ophthalmology/)
- [Cataract and Glaucoma](https://mindthebleep.com/lessons/cataract-and-glaucoma/)
- [Retinal conditions](https://mindthebleep.com/lessons/retinal-conditions/)
- [Professional Integrity](https://mindthebleep.com/lessons/professional-integrity/): One of the four key domains in the General Medical Council (GMC) Good Medical Practice Domains is Trust and Professionalism which forms a key section of assessment in a medical situational judgement test.
- [What is a Situational Judgement Test (SJT)?](https://mindthebleep.com/lessons/what-is-a-situational-judgement-test-sjt/): A Situational Judgement Test (SJT) is an assessment method which measures how a candidate believes they should behave when posted with a challenging professional dilemma. It is used in variety of fields including Medicine, most notably as the 'Professional Dilemmas Paper' part of the Multi- Speciality Recruitment Assessment (MSRA) for entering training at CT1/ST1 level in a host of specialities.
- [Coping with Pressure](https://mindthebleep.com/lessons/lesson-26/): Coping with pressure in medicine does not simply mean working harder during busy or stressful situations. Instead, it involves recognising when support is needed, prioritising patient safety, communicating effectively with colleagues, and managing competing demands in a professional and responsible way.
- [Effective Communication and Teamwork](https://mindthebleep.com/lessons/lesson-25/): Effective communication and team working are key attributes assessed in the Situational Judgement Test (SJT) and are central to safe and professional medical practice.
- [Empathy and Sensitivity](https://mindthebleep.com/lessons/lesson-23/): Empathy and sensitivity are essential qualities assessed in the Situational Judgement Test (SJT) and reflect the standards expected of doctors in their interactions with patients, families, and colleagues.
- [Course Conclusion and Feedback](https://mindthebleep.com/lessons/course-conclusion-and-feedback/): Congratulations on completing the course! You’ve now explored the key principles assessed in the Situational Judgement Test (SJT), including professionalism, coping with pressure, empathy and sensitivity, patient focus, and effective communication and team working.
- [Patient Focus](https://mindthebleep.com/lessons/lesson-21/): In the context of the SJT, this domain assesses how candidates prioritise patient welfare when faced with competing demands. The most appropriate responses are those that consistently place patient safety and wellbeing first, while demonstrating professionalism, clear communication, and respect for patient autonomy.
- [Post-Programme Survey](https://mindthebleep.com/lessons/post-programme-survey/): Please complete the post  - programme survey here. This is a mandatory step.
- [Module 1 Insight Notes](https://mindthebleep.com/lessons/module-1-insight-notes/): The Module 1 Insight Notes are brought to you by Cleyson Bonfim, 4th Year Medical Student at the Hull York Medical School. 
- [Pre Programme Survey](https://mindthebleep.com/lessons/pre-programme-survey/): Before commencing the course, please complete the pre-programme survey here. This is a mandatory step.
- [Module 6 Growth Moment](https://mindthebleep.com/lessons/module-6-growth-moment/): Take time to engage with this reflective task. Growth Moments are designed to help you consolidate your learning and begin building a personal log of insights. This reflective record can be returned to in the future — whether you’re developing your own initiative or contributing to other projects and teams.
- [Module 6 Insight Notes](https://mindthebleep.com/lessons/module-6-insight-notes/): The Module 6 Insight Notes are brought to you by Tiffany Agbobu, a 4th year medical student at the Hull York Medical School. 
- [Module 5 Growth Moment](https://mindthebleep.com/lessons/module-5-growth-moment/): Take time to engage with this reflective task. Growth Moments are designed to help you consolidate your learning and begin building a personal log of insights. This reflective record can be returned to in the future — whether you’re developing your own initiative or contributing to other projects and teams.
- [Module 5 Insight Notes](https://mindthebleep.com/lessons/module-5-insight-notes/): The Module 5 Insight Notes are brought to you by Miriam Solomon, a 4th year medical student at the Hull York Medical School. 
- [Module 5 On Demand Webinar with Dr Olamide Oguntimehin](https://mindthebleep.com/lessons/module-5-on-demand-webinar-with-dr-olamide-oguntimehin/): Dr Olamide Oguntimehin is a GP trainee, social justice advocate, and Founder and CEO of Melanin Medics, a national charity advancing racial equity in medicine. She led a landmark NHS Race & Health Observatory rapid review on racial bias in pulse oximetry during COVID-19, informing national policy and a subsequent government review of medical devices.
- [About Module 5](https://mindthebleep.com/lessons/about-module-5/): 🎯 Goal: Help participants build teams, find support, and position their work for reach and sustainability
- [Module 4 Growth Moment](https://mindthebleep.com/lessons/module-4-growth-moment/): Take time to engage with this reflective task. Growth Moments are designed to help you consolidate your learning and begin building a personal log of insights. This reflective record can be returned to in the future — whether you’re developing your own initiative or contributing to other projects and teams.
- [Module 4 Insight Notes](https://mindthebleep.com/lessons/module-4-insight-notes/): The Module 4 Insight Notes are brought to you by Dr Oyinda Adeniyi, a SFP Foundation Year Doctor. 
- [Module 4 On Demand Webinar with Dr Natasha Binnie](https://mindthebleep.com/lessons/module-4-on-demand-webinar-with-dr-natasha-binnie/): Natasha Binnie is a doctor and Clinical Fellow at NHS England, currently undertaking the National Medical Director’s Clinical Fellowship with the Faculty of Medical Leadership and Management in the National Public Health team. She is the Chair of the Young Fabians Health Network and a former Policy Research Fellow, with a focus on reducing health inequalities and improving outcomes for people with severe mental illness.
- [About Module 4](https://mindthebleep.com/lessons/about-module-4/): 🎯 Goal: Teach participants to move from idea → action with practical tools and methods
- [Module 3 Insight Notes](https://mindthebleep.com/lessons/module-3-insight-notes/): The Module 3 Insight Notes are brought to you by Shadie Esteki, 4th Year Medical Student at the Hull York Medical School.
- [Module 3 Growth Moment](https://mindthebleep.com/lessons/module-3-growth-moments/): Take time to engage with this reflective task. Growth Moments are designed to help you consolidate your learning and begin building a personal log of insights. This reflective record can be returned to in the future — whether you’re developing your own initiative or contributing to other projects and teams.
- [Module 3 On Demand Webinar with Dr Oyinda Adeniyi](https://mindthebleep.com/lessons/module-3-on-demand-webinar-with-dr-oyinda-adeniyi/): Dr Oyinda Adeniyi is an award-winning social entrepreneur, SFP junior doctor, mentor, and speaker. She is the Co-Founder of the award-winning CIC Black Excellence Network, Director of Communications at Melanin Medics, and Co-Founder of the Project 2% Conference. Passionate about mentorship, leadership, and addressing health inequalities, Oyinda uses her platform to empower students and professionals. Her work has been widely recognised, including being a 2023 Diana Award Winner, Outstanding Contribution to the Community Award recipient (2022), Top 5 in the Powerlist 150 Black Future Leaders (2021), and Student Orator at the University of York (2024).
- [About Module 3](https://mindthebleep.com/lessons/about-module-3/): 🎯 Goal: Build understanding of what social entrepreneurship is and how to use innovation for social good
- [Module 6 On Demand Webinar Session with Dr George Obolo](https://mindthebleep.com/lessons/module-6-on-demand-webinar-session-with-dr-george-obolo/):  
- [About Module 6](https://mindthebleep.com/lessons/about-module-6/): 🎯 Goal: Equip students to balance their work and sustain long-term momentum
- [Module 2 Growth Moment](https://mindthebleep.com/lessons/module-2-growth-moment/): Take time to engage with this reflective task. Growth Moments are designed to help you consolidate your learning and begin building a personal log of insights. This reflective record can be returned to in the future — whether you’re developing your own initiative or contributing to other projects and teams.
- [Module 2 Insight Notes](https://mindthebleep.com/lessons/module-2-insight-notes/): The Module 2 Insight Notes are brought to you by Michelle Igiehon, 4th Year Medical Student at the Hull York Medical School.
- [Module 2 On Demand Webinar with Dr Lara Akinnawonu](https://mindthebleep.com/lessons/module-2-on-demand-webinar-with-dr-lara-akinnawonu/): Dr Lara Akinnawonu is a medical graduate from Cardiff University with a strong background in leadership and community-focused work. She is an experienced Team Lead with a demonstrated history of working within the non-profit and charity sector, particularly in roles supporting young people and driving social impact. Lara is skilled in charity work, public speaking, leadership, and team leadership, and is passionate about empowering others through service and advocacy. Her medical interests include general practice, paediatrics, and leadership and management within healthcare.
- [About Module 1](https://mindthebleep.com/lessons/about-module-1/): 🎯 Goal: Ground students in self-awareness, motivation, and leadership for change
- [An Important Note on How to Engage With This Course](https://mindthebleep.com/lessons/an-important-note-on-how-to-engage-with-this-course/): This course is made up of six modules, each designed to be completed flexibly and at your own pace.
- [Module 1 Growth Moment](https://mindthebleep.com/lessons/module-1-growth-moment/): Take time to engage with this reflective task. Growth Moments are designed to help you consolidate your learning and begin building a personal log of insights. This reflective record can be returned to in the future — whether you’re developing your own initiative or contributing to other projects and teams.
- [Module 1 On-Demand Webinar with Dr Ellen Nelson Rowe](https://mindthebleep.com/lessons/module-1-on-demand-webinar-with-dr-ellen-nelson-rowe/): Dr Ellen Nelson-Rowe is currently a core surgical trainee in Yorkshire and previously completed the specialised foundation programme in Medical Education. She has frequently engaged in leadership roles throughout her tenure at university where she received recognition in Top 150 Future Leaders Magazine. Her leadership journey continued alongside postgraduate training where she held directorships with The Healthcare Leadership Academy and Melanin Medics. She intends to pursue a portfolio career encompassing leadership, medical education and surgery. 
- [Welcome to the Clinics to Communities Teaching Programme!](https://mindthebleep.com/lessons/welcome-to-the-clinics-to-communities-teaching-programme/): Lead change beyond the bedside. Build solutions for systems improvement, and social impact.
- [Learning styles](https://mindthebleep.com/lessons/learning-styles/)
- [Techniques and models](https://mindthebleep.com/lessons/techniques-and-models/)
- [Tips and tricks for teaching in a busy workplace](https://mindthebleep.com/lessons/tips-and-tricks-for-teaching-in-a-busy-workplace/)
- [How students learn in the workplace](https://mindthebleep.com/lessons/how-students-learn-in-the-workplace/)
- [Lesson](https://mindthebleep.com/lessons/lesson-20/)
- [Lesson](https://mindthebleep.com/lessons/lesson-19/)
- [Introduction to teaching in the workplace](https://mindthebleep.com/lessons/introduction-to-teaching-in-the-workplace/)
- [Lesson](https://mindthebleep.com/lessons/lesson-18/)
- [Discharge Letters](https://mindthebleep.com/lessons/discharge-letters/): https://mindthebleep.com/discharge-letters/ Click here to return to Clerical Tasks in the Ward
- [Ward Round Documentation](https://mindthebleep.com/lessons/ward-round-documentation/): https://mindthebleep.com/surviving-ward-rounds/ Click here to return to Clerical Tasks in the Ward
- [Clerical Tasks in the Ward](https://mindthebleep.com/lessons/clerical-tasks-in-the-ward/): Click on any of the topics below for more information
- [Colonoscopy](https://mindthebleep.com/lessons/colonoscopy/)
- [Endoscopy](https://mindthebleep.com/lessons/endoscopy/)
- [A-E 2 Quiz](https://mindthebleep.com/lessons/a-e-2-quiz/)
- [A-E 1 Quiz](https://mindthebleep.com/lessons/a-e-1-quiz/)
- [Ascitic Tap/Drain](https://mindthebleep.com/lessons/ascitic-tap-drain/): Positioning and Site Identification:
- [A-E Scenario 2](https://mindthebleep.com/lessons/a-e-scenario-2-2/)
- [A-E Scenario 1](https://mindthebleep.com/lessons/a-e-scenario-1-2/)
- [How to perform an A-E](https://mindthebleep.com/lessons/how-to-perform-an-a-e-2/): Click here to find more information on how to approach a deteriorating patient
- [Ascitic fluid analysis](https://mindthebleep.com/lessons/ascitic-fluid-analysis-2/): Click here to go back to the quiz
- [Research](https://mindthebleep.com/lessons/research-2/): https://youtube.com/playlist?list=PLRr_Z-f8Y1U_i29IDvTsrPLtXb8JyHGxb&si=hUd7PtHNoG_gPEGV https://www.youtube.com/watch?v=FG-MvgUPFL4&list=PLRr_Z-f8Y1U_i29IDvTsrPLtXb8JyHGxb&index=10 https://www.youtube.com/watch?v=BiKAS9Wv0sU&list=PLRr_Z-f8Y1U_i29IDvTsrPLtXb8JyHGxb&index=11 https://mindthebleep.com/research/
- [Teaching](https://mindthebleep.com/lessons/teaching-2/): https://mindthebleep.com/how-to-teach-medical-students/
- [QIP/Audit](https://mindthebleep.com/lessons/qip-audit-2/): https://mindthebleep.com/courses/audit-and-qi/
- [Mental Capacity Act and DOLS](https://mindthebleep.com/lessons/mental-capacity-act-and-dols-2/): https://www.youtube.com/watch?v=_ZqD2nVvOSo https://mindthebleep.com/mental-capacity/ https://mindthebleep.com/self-discharge/
- [DNACPR](https://mindthebleep.com/lessons/dnacpr-2/): https://www.youtube.com/watch?v=SUOVZ2tc56A https://mindthebleep.com/discussing-treatment-escalation-dnar/
- [Death Verification](https://mindthebleep.com/lessons/death-verification-2/): https://www.youtube.com/watch?v=SUOVZ2tc56A https://mindthebleep.com/death-verification/
- [PR examination](https://mindthebleep.com/lessons/pr-examination-2/)
- [Abdominal Examination](https://mindthebleep.com/lessons/abdominal-examination-2-2/)
- [Explaining Colonoscopy](https://mindthebleep.com/lessons/explaining-colonoscopy-2/)
- [Explaining Endoscopy](https://mindthebleep.com/lessons/explaining-endoscopy-2/)
- [NG Tube](https://mindthebleep.com/lessons/ng-tube-2/)
- [A-E Scenarios](https://mindthebleep.com/lessons/a-e-scenarios-2-2/): How to perform an A-E
- [Academic](https://mindthebleep.com/lessons/academic-2-2/): QIP/Audit
- [Ethics](https://mindthebleep.com/lessons/ethics-2/): Death Verification
- [Clinical Examination](https://mindthebleep.com/lessons/clinical-examination-2-2/): Abdominal Examination
- [Information Giving](https://mindthebleep.com/lessons/information-giving-2-2/): Explaining Endoscopy
- [Clinical Skills](https://mindthebleep.com/lessons/clinical-skills-2/): Ascitic Tap and Drain
- [Jobs list 2](https://mindthebleep.com/lessons/jobs-list-2-2/): Patient needs an NG tube
- [Jobs list 1](https://mindthebleep.com/lessons/jobs-list-1-2/): After the ward round, you have compiled the following list of tasks to complete:
- [Ascitic fluid analysis](https://mindthebleep.com/lessons/ascitic-fluid-analysis/): ParameterKey FindingsCommon CausesAppearanceClear/Straw-ColouredCirrhosisCloudy/TurbidSpontaneous bacterial peritonitis (SBP)Milky (Chylous)Lymphatic obstruction (e.g., lymphoma, malignancy, TuberculosisBloodyTraumatic tap, malignancy, ruptured vesselSAAG (>1.1 g/dL)Portal hypertensionCirrhosis, Budd-Chiari syndromeSAAG (<1.1 g/dL)No portal hypertensionPeritoneal carcinomas, TB, pancreatic ascitesTotal Protein (>4 g/dL)High proteinTB, SBPGlucose (<50 mg/dL)Low glucoseTB, malignancyAmylaseElevated amylasePancreatic ascitesWCC (>250/dL)High WCCSBP (predominantly neutrophils), TB (predominantly lymphocytes)CulturePositiveSBP, secondary peritonitis Click here to go back to results
- [Lesson](https://mindthebleep.com/lessons/lesson-17/)
- [Lesson](https://mindthebleep.com/lessons/lesson-16/)
- [Lesson](https://mindthebleep.com/lessons/lesson-15/)
- [Lesson](https://mindthebleep.com/lessons/lesson-14/)
- [Lesson](https://mindthebleep.com/lessons/lesson-13/)
- [Lesson](https://mindthebleep.com/lessons/lesson-12/)
- [Lesson](https://mindthebleep.com/lessons/lesson-11/)
- [Lesson](https://mindthebleep.com/lessons/lesson-10/)
- [Lesson](https://mindthebleep.com/lessons/lesson-9/)
- [Lesson](https://mindthebleep.com/lessons/lesson-8/)
- [Lesson](https://mindthebleep.com/lessons/lesson-8/)
- [Lesson](https://mindthebleep.com/lessons/lesson-7/)
- [Academic](https://mindthebleep.com/lessons/academic-2/): Click on any of the topics below for more information!
- [A-E Scenarios](https://mindthebleep.com/lessons/a-e-scenarios-2/): Click on any of the options below to get started.
- [Clinical Examination](https://mindthebleep.com/lessons/clinical-examination-2/): Click on any of the examinations below to get started!
- [Information Giving](https://mindthebleep.com/lessons/information-giving-2/): Click on any of the scenarios below to get started!
- [Academic](https://mindthebleep.com/lessons/academic/): QIP/Audit
- [A-E Scenarios](https://mindthebleep.com/lessons/a-e-scenarios/): How to perform an A-E
- [Ethics](https://mindthebleep.com/lessons/ethics/): Click on any of the topics below for more information!
- [Clinical Examination](https://mindthebleep.com/lessons/clinical-examination/): Abdominal Examination

## Topics
- [Topic](https://mindthebleep.com/topic/topic-28/)
- [How students learn in the workplace](https://mindthebleep.com/topic/how-students-learn-in-the-workplace/)
- [Topic](https://mindthebleep.com/topic/topic-27/)
- [Topic](https://mindthebleep.com/topic/topic-26/)
- [Topic](https://mindthebleep.com/topic/topic-26/)
- [Discharge Letters](https://mindthebleep.com/topic/discharge-letters/)
- [Ward round documentation](https://mindthebleep.com/topic/ward-round-documentation/)
- [How to perform an A-E](https://mindthebleep.com/topic/how-to-perform-an-a-e-4/): Click here to find more information on how to approach a deteriorating patient
- [Topic](https://mindthebleep.com/topic/topic-25/)
- [How to perform an A-E](https://mindthebleep.com/topic/how-to-perform-an-a-e-3/): Click here to find more information on how to approach a deteriorating patient
- [Management](https://mindthebleep.com/topic/a-e-interventions-2/): Risk Stratification: Glasgow-Blatchford Score (pre-endoscopy): To assess the urgency for endoscopy. Rockall Score (post-endoscopy): To assess the risk of morbidity and mortality following the procedure. Management: Resuscitation: Administer IV fluids to maintain circulation and ensure proper hydration. If the patient's Hb drops below 7 g/dL (or 8 g/dL in patients with cardiovascular disease), consult with senior colleagues about blood transfusion. Follow local protocols for managing bleeding and coagulopathy, including potential use of blood products. If Suspected Variceal Bleed: Start terlipressin with senior approval (monitor closely for side effects like ischaemia). Administer prophylactic antibiotics (IV ceftriaxone) to reduce the risk of infections. Prepare for early endoscopy for potential variceal band ligation. If Suspected Non-Variceal Bleed: Arrange for urgent endoscopy to identify the bleeding source and control it (e.g., variceal banding, adrenaline injection, ulcer clipping). Administer PPI therapy as per local guidelines (usually to reduce gastric acid and help control bleeding). Endoscopic Techniques: Endoscopy may involve variceal banding, adrenaline injection, or ulcer clipping to control the bleeding. If variceal bleeding is severe, further measures like a Sengstaken-Blakemore tube or TIPS (Transjugular Intrahepatic Portosystemic Shunt) may be required.
- [Case Background](https://mindthebleep.com/topic/case-background-12-2/): You are an FY1 on the gastroenterology ward, and a nurse calls you to urgently review Mr. John Smith, a 68-year-old male with alcohol-related cirrhosis, who has just been seen vomiting a large amount of blood. The nurse mentions the patient is feeling lightheaded and weak especially upon standing. The nurse recalled Mr Smith denied any recent trauma, but mentions a long-standing history of alcohol use (10-15 units daily) and NSAID use (ibuprofen for chronic joint pain).
- [A-E Interventions](https://mindthebleep.com/topic/a-e-management-2/): Click here to start the quiz
- [Case Background](https://mindthebleep.com/topic/case-background-10-2/): You are the FY1 doctor on the gastroenterology ward. The nurse has alerted you about a 56-year-old man with alcohol-related liver cirrhosis who has become febrile, developed altered mental status and is complaining of abdominal pain .
- [Investigations and Management](https://mindthebleep.com/topic/investigations-2-2/): Conservative Management:
- [Findings](https://mindthebleep.com/topic/findings-2-2/): On performing the per rectum (PR) examination, the following were noted:
- [PR Examination](https://mindthebleep.com/topic/pr-examination-2-2/): Equipment: Non-sterile gloves Water-based lubricating jelly Tissues or wipes Protective apron Examination: Preparation: Ensure patient privacy and comfort. Explain the procedure and obtain consent. Position the patient in the left lateral position with knees drawn up toward the chest. Inspection: Inspect the perianal area for any signs of external hemorrhoids, fissures, skin tags, or lesions. Palpation: Insert a lubricated, gloved finger gently into the rectum. Assess for the tone of the anal sphincter, noting any abnormal tightness or laxity. Assess for any masses, tenderness, or abnormal structures within the rectum. Cough Test: While the finger is in place, ask the patient to cough. A positive test (pain or discomfort during coughing) may suggest peritoneal irritation, which could indicate conditions such as peritonitis or abdominal pathology. Squeeze Test: Ask the patient to squeeze the anal sphincter around your finger. Normal tone involves a tight, voluntary contraction. Weak or absent contraction may indicate nerve damage or muscle dysfunction, suggesting conditions like incontinence or spinal cord injury. Completion: Remove the finger gently, clean the area, and thank the patient. Document the findings and any relevant concerns.
- [Case Background](https://mindthebleep.com/topic/case-background-6-2/): You are an FY1 doctor on the gastroenterology ward. Mr. John Smith, a 67-year-old man, was admitted with decompensated liver cirrhosis secondary to chronic alcohol use. He has a history of variceal bleeding and esophageal varices. Mr. Smith now presents with a new onset of bright red rectal bleeding. He denies any recent trauma or changes in bowel habits. The bleeding occurs after passing stool, and he has not reported any pain or abdominal discomfort. He also has a history of portal hypertension and is on beta-blockers to prevent variceal bleeding. His vital signs are stable, and his abdominal examination reveals mild hepatomegaly. You are asked to perform a per rectum (PR) examination.
- [Task completed!](https://mindthebleep.com/topic/task-completed-2/): Click here if you want to go to your job’s list
- [Investigation and Management](https://mindthebleep.com/topic/investigations-3/): Document Findings: Record physical examination results and clinical impression in her medical notes.
- [Findings](https://mindthebleep.com/topic/findings-3/): General Appearance:
- [Abdominal Examination](https://mindthebleep.com/topic/abdominal-examination-2-2/): Click here to move on to patient findings
- [Case background](https://mindthebleep.com/topic/case-background-15/): Nurse: "Hello Doctor. Mrs. Margaret Brown is a 72-year-old female complaining of abdominal distension and constipation. She has a history of hypertension, osteoarthritis, and diverticular disease, and is on ACE inhibitors and intermittent NSAIDs and codeine. Her vital signs are stable, but she hasn’t had a bowel movement for 2 days, and she’s reporting ongoing abdominal discomfort. Could you review her when you’re available?"
- [Procedure](https://mindthebleep.com/topic/procedure-4-2/): Introduce Yourself and Build Rapport
- [Case Background](https://mindthebleep.com/topic/case-background-5-2/): You are the FY1 on the gastroenterology ward, and the nursing staff asks you to review Mr. Smith because he is confused about his bowel preparation for the colonoscopy. When you see him, he tells you he isn’t sure when he should stop eating. He also complains of feeling dizzy after taking the first dose of the bowel prep.
- [Procedure](https://mindthebleep.com/topic/procedure-3-2/): Purpose:
- [Case Background](https://mindthebleep.com/topic/case-3-2/): Mrs. Patel, a 45-year-old woman, is admitted to the gastroenterology ward with complaints of upper abdominal pain, nausea, and occasional vomiting. After initial investigations, the consultant recommends an upper gastrointestinal endoscopy (OGD) to evaluate the cause of her symptoms, possibly related to peptic ulcer disease.
- [Useful Resources](https://mindthebleep.com/topic/summary-2-2/): https://mindthebleep.com/nasogastric-tubes/
- [Procedure](https://mindthebleep.com/topic/procedure-2-2/): Click here to view additional resources
- [Case Background](https://mindthebleep.com/topic/case-background-4-2/): You are an FY1 doctor on the gastroenterology ward. Mrs. Smith, a 72-year-old woman with a history of Parkinson’s disease and recurrent aspiration pneumonia, has been admitted with significant weight loss and poor oral intake. The multidisciplinary team has decided that an NG tube is required to provide nutritional support. Your registrar asks you to explain the procedure, obtain consent, and insert the tube under supervision.
- [Task completed!](https://mindthebleep.com/topic/task-completed/): Click here if you want to go to your job’s list
- [Task completed!](https://mindthebleep.com/topic/back-to-jobs-list/): Click here to go back to your job's list
- [Jobs List 2](https://mindthebleep.com/topic/jobs-list-2/)
- [Jobs List 1](https://mindthebleep.com/topic/jobs-list-1/): Complete an ascitic tap/drain
- [A-E Interventions and Management](https://mindthebleep.com/topic/a-e-interventions/): Airway Suction – Clear blood/vomit to prevent aspiration. Airway adjuncts – Oropharyngeal or nasopharyngeal airway if needed. Jaw thrust/head tilt-chin lift – If airway obstruction suspected. Anaesthetic review – If airway protection is required (e.g., reduced GCS). Breathing High-flow oxygen (15L via non-rebreathe mask) – if sPO2 <94% Positioning – Sit patient upright if conscious to aid breathing. Monitor oxygen saturations – Adjust oxygen delivery accordingly. Circulation Two large-bore cannulas (14-16G) – Ensure rapid IV access. IV fluid resuscitation: 500ml bolus of Hartmann’s/0.9% NaCl (warmed if possible). Blood transfusion (if indicated): Massive transfusion protocol – If haemorrhagic shock. Red cell transfusion – If Hb <70 g/L (target 70-100 g/L). Platelets & Fresh Frozen Plasma (FFP) – As per transfusion protocol. As bleeding is severe and the patient is haemodynamically unstable, escalate to Medical Registrar and activate the major haemorrhage protocol. Tranexamic acid (TXA) – Consider if major haemorrhage. Reversal of anticoagulation: Warfarin: PCC + Vitamin K. DOACs: Idarucizumab (dabigatran), Andexanet alfa (apixaban/rivaroxaban), PCC if unavailable. Discuss with haematology. Catheterisation – To monitor urine output (>30ml/hr target). Disability Assess GCS/ACVPU – Escalate if GCS ≤8 (consider airway protection). Review drug chart – Stop anticoagulants, NSAIDs, and medications affecting consciousness. Exposure and everything else Keep the patient NBM (nil by mouth) to prepare for endoscopy. Risk stratification: Glasgow-Blatchford Score (GBS) – Identify low-risk patients for outpatient care. Rockall Score – Assess rebleeding risk and mortality post-endoscopy. Escalation & Ongoing Management SBAR handover – Escalate to seniors, critical care, and endoscopy team. Pharmacological therapy: Terlipressin – For suspected variceal bleeding (Consultant-led decision). Prophylactic antibiotics – For variceal bleeding (e.g., Ciprofloxacin 1g OD for 7 days). Proton Pump Inhibitors (PPIs) – IV PPI post-endoscopy for non-variceal UGIB. Urgent endoscopy – Immediately if unstable; within 24 hours for all UGIB. Variceal bleeding: Band ligation or sclerotherapy. If variceal bleeding is severe, further measures like a Sengstaken-Blakemore tube or TIPS (Transjugular Intrahepatic Portosystemic Shunt) may be required. Non-variceal bleeding: Adrenaline injection, thermal coagulation, or haemostatic clips. Monitor for rebleeding – Repeat Hb checks and reassess haemodynamic status. Follow-up & secondary prophylaxis: PPI therapy – Continue for high-risk peptic ulcer disease. Hepatology input for variceal bleeding – Consider beta-blockers for prophylaxis. Click here to start the A-E Quiz
- [Ascitic Tap results](https://mindthebleep.com/topic/ascitic-tap-results/)
- [How to perform an A-E](https://mindthebleep.com/topic/how-to-perform-an-a-e-2/)
- [How to perform an A-E](https://mindthebleep.com/topic/how-to-perform-an-a-e/)
- [A-E Interventions](https://mindthebleep.com/topic/a-e-management/): 🫁 A – Airway Ensure the airway is clear: No immediate concerns as the patient is breathing comfortably. 🌬️ B – Breathing Administer oxygen if SpO₂ falls below 94%. If any signs of distress are noted (tachypnea, accessory muscle use, hypoxia), escalate for further review. Chest X-ray (CXR): Order if signs of pneumonia or other respiratory infections are noted (e.g., fever, cough, crackles on auscultation). ❤️ C – Circulation If the patient becomes hypotensive, consider IV Colloids (e.g., Human Albumin Solution) instead of IV crystalloids (e.g., 0.9% saline). Monitor response and adjust fluid therapy as needed. Take bloods: FBC, U&Es, LFTs, coagulation profile, lactate, and blood cultures (aerobic and anaerobic) as part of the sepsis screen to rule out bacteremia. Start empirical antibiotics (e.g., IV cefotaxime or piperacillin-tazobactam) for suspected SBP/Sepsis while awaiting culture results. Always check local trust guidelines! Monitor lactate: Elevated lactate can indicate sepsis and poor perfusion. 🧠 D – Disability Assess GCS and mental status frequently: The patient is confused. If GCS worsens, escalate for further review. Give IV thiamine (especially due to alcohol-related liver disease) to prevent Wernicke's encephalopathy. 🩺 E – Exposure & Everything Else Perform a thorough abdominal examination: The patient has tense ascites, tenderness, and signs of peritonitis, raising suspicion for SBP. Perform a repeat ascitic tap to obtain fluid for: White cell count (neutrophil count to confirm SBP), Culture (to identify the causative organism), Albumin (to calculate SAAG and assess for portal hypertension). Urine culture: If there’s suspicion of UTI as a secondary infection. 🔄 Monitoring and Escalation Escalate to the medical registrar to discuss management plan. Monitor NEWS score regularly to assess patient stability. Check for improvement in vital signs, urine output, and mental status. Ensure consultant review as early as possible for further management decisions. Click here to continue
- [A-E Examination](https://mindthebleep.com/topic/a-e-examination/): You recall this patient from the ward round:
- [Resus 27](https://mindthebleep.com/topic/resus-27/): That would not be the correct change to make for Callum at this point. These guidelines for DKA management from BMJ Best Practice and NICE will be helpful to review.
- [Resus 26](https://mindthebleep.com/topic/resus-26/): To avoid an iatrogenic hypoglycaemia, you adjust the rate of the infusion. Even though the glucose has normalised, the ketoacidosis is still ongoing and the insulin will be key in inhibiting further lipolysis and ketone formation, allowing the ketone bodies to be broken down by other pathways and the acidosis to correct. At this point, your consultant appears from the adjacent bay to check on your progress."Sounds like you've got him on the right track to sorting out his DKA- I'll talk to the medical team and we can get him transferred out of here and into an acute medical bed. Can you make a start on the next one while I sort this out?" they say to you. With never a minute too long to rest in healthcare, you take a deep breathe and move to the adjacent free bay. Who is being brought in to you next?
- [Resus 25](https://mindthebleep.com/topic/resus-25/): That's not the correct answer for this question - these pages from the BMJ and NICE may help you here.
- [Resus 24](https://mindthebleep.com/topic/resus-24/): Callum is experiencing his metabolic alkalosis due to the build up of ketone bodies in his blood, and his raised glucose along with this informs you that he's experiencing Diabetic Ketoacidosis - this needs urgent rehydration as a first stage, before going on to prescribe a Fixed Rate Insulin Infusion (FRII). Following your hospital's protocol, after giving a fluid bolus you prescribe an FRII and begin the process of correcting Callum's DKA. After half an hour you repeat a blood gas to assess how Callum is progressing with his treatment. He is still in 15L of oxygen at present.
- [Topic](https://mindthebleep.com/topic/topic-24/)
- [Resus 23](https://mindthebleep.com/topic/resus-23/): That's not quite right - consider reviewing this Mind The Bleep page on ABG Interpretation and try again.
- [Resus 22](https://mindthebleep.com/topic/resus-22/): The pH of this gas is acidotic (7.25) The pO2 is raised because Callum is on oxygen. Importantly, his pCO2 is low (2.8) - so we can say that this acidosis is not respiratory.Looking at the metabolic components, there is a low Bicarbonate (18) mildly raised lactate (3.0) and the ketones are also raised (4.3) and contribute acidity - so we can say this is a metabolic acidosis.
- [Topic](https://mindthebleep.com/topic/topic-23/)
- [Resus 21](https://mindthebleep.com/topic/resus-21/): That's not quite right- this page from Resus UK may be helpful to review. See if there's any information in the question that we already have that we can make an assessment from.When you're ready, return to the question using the link below.
- [Topic](https://mindthebleep.com/topic/topic-22/)
- [Resus 20](https://mindthebleep.com/topic/resus-20/): Having already heard Callum speaking clearly, telling you that his airway is patent, you need to assess his breathing."We can sort you out with some good pain relief, Callum, but I need to check you over first," you explain, putting your stethoscope on. Listening at the front and back, Callum's chest sounds clear and his heart sounds are normal. While the nursing staff take bloods and insert a cannula, you feel his abdomen and it's soft, with no peritonism, but generally tender. The nursing staff bring you his blood gas to assess, and you catch an eye on his observations prior to looking at it:
- [Resus 19](https://mindthebleep.com/topic/resus-19/): That's not quite the right answer. The Sepsis UK Manual can provide some information to guide you on this.
- [Resus 18](https://mindthebleep.com/topic/resus-18/): Lactate levels and trend are an important prognostic factor in the management of Sepsis. After the swift introduction of your Septic bundle- administered just within the 60 minute target- your consultant prescribes a second bolus for Deborah."Her blood pressure isn't coming up very much from the last round of fluids- let's keep pushing to see if we get a response. Otherwise it might be a trip to ITU for this lady" they explain to you, scribbling onto a prescription sheet while the Resus nurse puts another 500ml bag of fluids up. "I'll keep an eye on her- would you be able to get started with the next patient and I'll check in when I can?" They ask you. You're slightly reluctant to leave, as you're hoping the consultant might do some teaching with you, but you understand that the department is busy right now. You move along to the next empty bay and await the patient being brought in to you.Who is being brought to you?
- [Resus 17](https://mindthebleep.com/topic/resus-17/): That answer is not correct.This page on ABG Interpretation can give you some support at working through this question. When you're ready, return to the question using the button below.
- [Resus 16](https://mindthebleep.com/topic/resus-16/): The pH of this sample is acidotic at 7.31 - this means that this gas is not compensated. The pCO2 is within normal limits, meaning that this is not a respiratory acidosis (nor is there respiratory compensation).The bicarbonate is within normal limits, which is our usual culprit for metabolic acidosis, but two other sources should be considered: Ketone bodies (e.g. in DKA) and Lactic Acid (lactate).In Deborah's case, her Lactate is raised at 3.5, providing the source of her acidosis.
- [Topic](https://mindthebleep.com/topic/topic-21/)
- [Resus 15](https://mindthebleep.com/topic/resus-15/): That's not quite the correct answer in this situation.This page on Prescribing IV Fluids and Acute Assessment may be helpful. When you're ready, return to the question using the button below.
- [Resus 14](https://mindthebleep.com/topic/resus-14/): The 500ml bolus runs through the cannula and you continue to assess Deborah.Her abdomen is soft but she winces as you feel along her left flank, and there is no tenderness or swelling in her legs. The nursing staff took an arterial blood gas while you were assessing and ask you to review it:
- [Resus 13](https://mindthebleep.com/topic/resus-13/): That's not the first step you would take in your acute assessment. This page may point you towards the correct answer.
- [Resus 12](https://mindthebleep.com/topic/resus-12/): Correct - Assessing someone's airway is the first step in any acute assessment. You approach the trolley and speak loudly and clearly,"Deborah - this is one of the A&E Doctors- can you hear me?" and Deborah responds to you, without opening her eyes,"Oh is that you doctor? I kept telling Angela I was fine- George has been doing a grand job checking in on me, I'm feeling much better now," she mumbles back to you. Angela, from behind you, whispers "That's her husband- he passed away 6 years ago now, she's been all over the place and talking nonsense for most of this week," and you nod in acknowledgment. "I'm just going to have a quick listen to your chest Deborah, is that alright?" you ask her. She nods her head slowly, and you proceed to assess her breathing and listen to her chest, which is clear in all zones, and she is still maintaining saturations of 96% on 2L O2. Looking at the rest of her observations, you see the following:HR 120bpmBP 87/64mmHgTemp. 39.4 CelsiusThe nursing staff have inserted a cannula while you were listening to the chest- what would you like to do next?
- [Resus 11](https://mindthebleep.com/topic/resus-11/): You show the chest x-ray to your consultant, who is conveniently sitting at the Resus workdesk, and they spring into action - Barry has likely had some emphysematous bullae that have ruptured from the positive pressure of the NIV. A chest drain is sited and the position is confirmed on the x-ray below.
- [Resus 10](https://mindthebleep.com/topic/resus-10/): That chest x ray doesn't quite match Barry's symptoms and clinical signs. This chest x-ray article may help you out- return to the question using the button below when you're ready.
- [Resus 9](https://mindthebleep.com/topic/resus-9/): That would probably not be the next step that you attempt for Barry - this page will shed some light on how to identify and manage different respiratory failures, if you need it. Return to the question when you're ready using the button below.
- [Resus 8](https://mindthebleep.com/topic/resus-8/): You titrate Barry's oxygen requirements down from his 15L O2, aiming for saturations between 88-92%. Barry needs to go under the care of the medical team for his admission, but he can't move from Resus until he's in a more stable position- inevitably, this means that you are with him for some time. After half an hour, the consultant has finished with the case in the next bay and pops their head in to see how you're doing. "That was a good catch- Barry doesn't look so well. I've just looked at the repeat blood gas that you've done and titrating his oxygen doesn't seem to be shifting this acidosis. I think we need to step him up to NIV" they confidently inform you, gesturing at Barry's repeat gas with a pH of 7.26 and PCO2 of 9.5 kPa. Subsequently, Barry is fitted with an NIV mask set up to deliver CPAP (Continuous Positive Airway Pressure) at 10cmH20 and you continue to observe him in Resus, hoping his gases will begin to improve. When you go to take another blood gas half an hour later, Barry's breathing seems more laboured and he tells you that he's struggling for breath. Listening to his chest, you can hear reduced sounds on the right hand sides, and his chest is now hyperresonant to percussion.
- [Resus 7](https://mindthebleep.com/topic/resus-7/): Unfortunately that is not the correct answer- ABGs can be tricky to work through, but this is something you'll get plenty of practise with!This page on ABG Interpretation may give you some support to go through this question again when you're ready.
- [Resus 6](https://mindthebleep.com/topic/resus-6/): ABGs can be tricky: The overall pH is acidotic (7.28) in this acute setting.This acidosis must be coming from the raised pCO2 (9.0) as the lactate is normal (2.0), and (in context) we have a patient with respiratory distress on a background of likely COPD (coarse crackles, tar stained fingers).Note the raised Bicarbonate (31) as a sign that this patient likely has some longstanding metabolic compensation on his background of COPD - from this we can infer that, at his baseline, he is a CO2 retainer. However, when we think back to the overall acidotic pH (7.28) we are now no longer compensated in this acute setting. Therefore, this is: Respiratory Acidosis with partial metabolic compensation.
- [Resus 5](https://mindthebleep.com/topic/resus-5/): That's not the first step you would take in your acute assessment. This page may point you towards the correct answer.
- [Resus 4](https://mindthebleep.com/topic/resus-4/): "Sir- can you tell me your name?" you calmly ask the man in front of you."Buh...Barry Cluh-Clarke" he responds between gasps, intonating clearly. Satisfied that his airway is clear, you immediately apply 15L Oxygen (~80% FiO2) via a Non-Rebreathe mask. You pause and watch the monitor for a second."I don't think we have time to watch, Doc, let me get a cannula in while you listen to his chest," advises your nursing colleague, who is already prepared with the equipment. In nonverbal agreement, you move to Barry's back and listen to his chest. You can hear coarse breath sounds and a global wheeze, with some very prominent crackles all along Barry's left side. "Are you a smoker, Barry?" you ask, and he nods at you. He says something, but you can't hear him through the mask, although you do notice now that the fingers on his left hand are dark yellow. You relax internally, slightly, when you see that his saturations are now sitting at 100% and his respiratory rate is 17.At that moment, your nursing colleague returns to you with a piece of paper."After the cannula, I did a quick arterial gas while you were assessing Mr Clarke- do you want to take a look at it?"What do you make of the gas?
- [Majors 27](https://mindthebleep.com/topic/majors-27/): You turn the flashcard over- Correct. You smile to yourself. As you bring yourself out of your thoughts, the surgical SHO has finished seeing the patient and gratefully takes the flashcards from your hands. "Mr Yaxley will be going next on the CEPOD list", they inform you, "I'll sort out his meds, and the anaesthetist will be along next to preassess," and they disappear almost as soon as they appeared. Satisfied with your work, you sit yourself down at the central hub. "We've got plenty more for you, Doc, don't get too comfortable" the charge nurse calls over at you from their own computer. Sheepishly, you grab a few Cas cards from the top of the pile. Who will you see next?
- [Majors 26](https://mindthebleep.com/topic/majors-26/): You flip the flashcard over- Wrong...In your head you can visualise the page you revised appendix anatomy for.
- [Majors 25](https://mindthebleep.com/topic/majors-25/): Correct- 6 hours with no food and 2 hours without clear fluids is the UK fasting standard. Mr Yaxley has a radiologically proved diagnosis and is fasted, ready for theatre. The surgical registrar hangs up, without saying thank you, and their SHO materialises by the patient bedside almost immediately with a consent form in their hand, keen and eager to get the patient ready in the hopes that they may get to do the case this time. As they brush past you, a pack of flashcards fall out of their pocket and you pick them up to pass to the SHO when they're finished with the patient. Out of curiosity, you take a peak."I wonder what you need to know for surgical exams" you think, taking a card out of the pack."What artery does the blood supply of the appendix come from?" it reads. "I did that at medschool!" you think, "Obviously it's..."
- [Majors 24](https://mindthebleep.com/topic/majors-24/): The surgical reg was unimpressed with your answer - this guideline might help you.When you're ready, return to the question and try again.
- [Majors 23](https://mindthebleep.com/topic/majors-23/): Time to hit the clinical surgery books again- that's not the right name for that sign. These two pages may help:TeachMeSurgeryGeekyMedics
- [Majors 22](https://mindthebleep.com/topic/majors-22/): "Rosvig's sign!" You exclaim, finishing the radiology request and submitting it. Within the hour, the CT scan is performed and reported, confirming what you suspected all along: Acute Appendicitis. You call the registrar on call for general surgery and refer the case to them. Well, you attempt to. After a light grilling about why you thought this particular abdominal pain was surgical, they ask for the patient number and review the CT themselves to be sure that they believe the radiologist. After an awkwardly long silence, peppered with the sounds of mouse clicks and muttered swear words, they ask you,"And how long has the patient been fasting for?""Oh- well, they haven't been formally fasting- they weren't expecting a surgery" you blurt out. The registrar sighs,"We can't operate if they're not properly fasted- when was the last time they had anything to eat or drink? Do you know how long they need to be fasted for?" You can recall Mr Yaxley telling you that he hadn't had anything to eat since he vomitted up some toast at breakfast, and that was about 10 hours ago. He hadn't had any water since he first attended the department 4 hours ago. You think hard- how long did someone need to be fasted before they were fit for surgery?
- [Majors 19](https://mindthebleep.com/topic/majors-19/): That is not the action that you would want to undertake first in the management of hyperkaelamia. Review this article and return to the question when you're ready.
- [Majors 21](https://mindthebleep.com/topic/majors-21/): Correct- Creatinine is irrelevant in making the decision for haemodialysis, although Margaret's is very raised indeed!Your Registrar furrows their brow and purses their lips, deep in thought,"She's not very well at all. It seems like she has an AKI secondary to some kind of gastroenteritis- but her kidneys are struggling. Great job managing so far, but I should probably pick up from here and make sure she's stable before we get the medical team involved," they say to you. Gratefully, you hand the notes over to the registrar and feel the weight lift from your shoulders."I was just about to see one of these patients," they say to you, as they start to get up and walk towards Bay 2, "Would you be able to get started seeing one of them while I take over with Bay 2?". The relief from work is always short lived in the NHS. Looking at the Cas cards left behind by the registrar, which one would you like to see next?
- [Majors 20](https://mindthebleep.com/topic/majors-20/): The indications for haemodialysis are quite strict, as it requires intensive care support and a lot of resources to support someone. This page may be helpful in guiding you towards the right answer. When you're ready, return to the question and try again.
- [Majors 18](https://mindthebleep.com/topic/majors-18/): Correct - the first step in hyperkaelamia management is to stabilise the myocardial membranes with calcium gluconate. You follow your departmental protocol, helpfully stapled onto a nearby support column along with 24 other common guidelines, and ask the staff nurse looking after to repeat a blood gas in one hour to see how the potassium has responded.An A&E registrar overhears you relaying this to the staff nurse and stops to ask if you feel comfortable managing this patient, as they sound quite unwell. "I would probably prefer to discuss it with you, if I'm honest, because she is quite unwell. I can see that she has quite a bad AKI and, looking at her results again, I'm worried she might need haemodialysis," you explain to the registrar. They bring you along to one of the computers and you look through the results together. Which of the following would not be an indicator for initiating haemodialysis?
- [Topic](https://mindthebleep.com/topic/topic-20/)
- [Majors 17](https://mindthebleep.com/topic/majors-17/): That's not quite right- ECGs can be tricky, consider reviewing this article and having another look.
- [Majors 16](https://mindthebleep.com/topic/majors-16/): Correct- this ECG shows some of the classical features of Hyperkalaemia: Tall tented T-waves, reduced/absent p waves. Thankfully, Margaret's QRS complexes have not become broad. With the concerns raised by your ECG assessment, you repeat Margaret's biochemistry sample and also take a venous blood gas to gain a quick assessment of her potassium, which comes back at 6.8 mmol/L (3.5-5.3 mmol/L) . What action should you take next to address this?
- [Topic](https://mindthebleep.com/topic/topic-16/)
- [Majors 15](https://mindthebleep.com/topic/majors-15/): That action would not address the other abnormalities on Margaret's blood results.These articles may help you work through the question:Reviewing & Requesting Blood ResultsAcute Kidney Injury
- [Majors 14](https://mindthebleep.com/topic/majors-14/): Correct! Margaret's raised urea and creatinine reflect an acute kidney injury (AKI) and, in the context of her history of diarrhoea, dry mucous membranes, tachycardia and hypotension, this is most likely a pre-renal AKI. Intravenous fluids will be key in helping to resolve this.As a result of the dehydration, other values in Margaret's blood will appear more concentrated and higher than they truly are. With this in mind, you begin a bolus of 0.9% Sodium Chloride. While you were reviewing those investigations, one of the staff nurses undertook an ECG on Margaret due to her level of tachycardia, and asks if you would review it. What abnormality is happening in this ECG?
- [Majors 13](https://mindthebleep.com/topic/majors-13/): Correct- this patient was on a Long Acting Muscarinic Antagonist (LAMA) as well as a steroid inhaler and reliever inhaler, but was missing a Long Acting Beta Agonist (LABA). Double checking the GP record, you can see that Helen is prescribed Formoterol and add this to the clerking. The charge nurse circles away from the bay where they have just left the A&E registrar and paces towards you, clipboard in hand."What's happening with Bay 7 then?" they enquire. You catch a glimpse of the paper on their clipboard and see quite a lot of circled names, aggressively scribbled out areas, and more colours than you thought could exist for pen ink. "I've just referred them to medics- she seems stable enough to wait for them now," you respond, quite satisfied with yourself and smiling. The charge nurse does not return your smile, and instead attacks their clipboard viciously with one of those many coloured pens,"That's great- thanks. Can you see one of these two next, they've been waiting ages and they weren't looking too great when we last did obs on them," they say to you, sliding two Cas Cards across to you.
- [Majors 12](https://mindthebleep.com/topic/majors-12/): That's not quite right. This joint guideline and infographic by NICE, BTS and SIGN may help, as well as this primary care guideline on inhaler types and names.When you're ready, return to the question with the button below.
- [Majors 11](https://mindthebleep.com/topic/majors-11/): "Absolutely- well done!" your registrar responds, a smile across their face. Just at that moment, the charge nurse accosts the registrar to come and review a patient for discharge. Apologising that they can't continue your conversation, but promising to fill in a work-based assessment for you, they take their leave.You bleep the medical registrar to refer the patient to the medical take and, during your handover on the phone, they stop you,"Are you sure that Ms Birch isn't taking anything else for her asthma? That medication list doesn't quite make sense to me. It sounds like we need to take her- but can you just recheck her meds or cross-check it against her GP record?" Looking at Helen's medication list, she told you that she takes the following:Salbutamol INH PRNTiotropium INH BDBudesonide INH BD
- [Majors 10](https://mindthebleep.com/topic/majors-10/): Your registrar sighs gently, but patiently,"Not quite- have another think."The gears in your brain continue to turn.
- [Majors 9](https://mindthebleep.com/topic/majors-9/): Correct- Amoxicillin and Clarithromycin are the first-line empirical treatment for a community acquired pneumonia, which can be adjusted based on microbiology and response.After the fluids, nebulisers and antibiotics, Helen is now resting with stable observations, yielding only a NEWS of 2 for supplementary oxygen.The registrar that has been keeping an eye on you is impressed with your initiative and management and wants to take this opportunity to do some adhoc teaching. Sitting down at the computer hub with two plastic cups of the finest NHS orange squash, they begin:"So can you tell me what spectrum of coverage those two antibiotics will provide for this patient?" You can feel your brain draw a blank and your head shaking on autopilot. Undeterred, they continue,"That's okay. Do you know what the most common causative organism is for CAPs?" Like a lightbulb, you feel the neurones firing up in your brain- you remember this from sitting in the back of a respiratory clinic in third year."I know this one! It's:"
- [Majors 8](https://mindthebleep.com/topic/majors-8/): That would not be the best empirical treatment for what is going on in this image.Consider reviewing these pages on Chest X Ray Interpretation and NICE Guidelines for antimicrobials.
- [Majors 7](https://mindthebleep.com/topic/majors-7/): Correct - Although Helen is maintaining her saturations, her high respiratory rate and oxygen requirement put her at risk of tiring and going into respiratory arrest. You prescribe 5mg of a Salbutamol nebuliser and, on the advice of a passing registrar, also add in 500 micrograms of nebulised Ipratropium.After a few minutes, Helen's breathing has settled to 18 breaths per minute and you have been able to titrate her oxygen down to 2L/min. Recognising this as a primarily respiratory pathology, you arrange a chest x ray for Helen while you await her bloods from triage to return. Based on the chest x-ray below, what treatment will you initiate?
- [Majors 6](https://mindthebleep.com/topic/majors-6/): Unfortunately that's not the correct answer. Review these guidelines from RCEM and NICE before trying again by pressing the button below.
- [Case 2 Q3X](https://mindthebleep.com/topic/case-2-q3x/): Your registrar sighs gently, but patiently."Hmm, that's not quite right- have another think."
- [Case 2 Q3O – QF](https://mindthebleep.com/topic/case-2-q3o-qf/): Correct - Streptococcus pneumonia is the most common cause of community acquired pneumonias. With your patient stabilised and appropriate antimicrobials administered, you decide to call the medical registrar to refer the patient. During the call with the medical registrar, they ask you what your patient's current inhaler prescriptions are. Helen tells you that she takes the following:
- [Case 2 Q2X](https://mindthebleep.com/topic/case-2-q2x/): That answer is not correct, unfortunately.Consider looking over these pages on Chest X Rays and Pneumonia Antimicrobials and return to the question when you're ready.
- [Case 2 Q2O – Q3](https://mindthebleep.com/topic/case-2-q2o-q3/): Correct - This chest x-ray demonstrates a lobar pneumonia on the right hand side. First line therapy for a suspected community acquired pneumonia is Amoxicillin with Clarithromycin. The registrar that has been floating around in Majors has been keeping an eye on you from afar with this patient, and has been impressed with your initiative and decision making. Keen to teach you further, the registrar asks you if you know about what spectrum of bacteria are covered by the antibiotics you've prescribed. There's an awkward silence, and you can feel your brain sending down the signal to shake your head slowly. Undeterred, your reg changes tactic and asks you:" Okay then, so what's the most common causative organism in this case?"A lightbulb goes off in your head- you can just about remember this from when you were a medical student sitting in the back of the respiratory clinic- and it was:
- [Case 2 Q1X](https://mindthebleep.com/topic/case-2-q1x/): That would not be beneficial for the patient in this scenario.Consider reading the following for some information that may guide you:RCEM Guidelines - AsthmaRCEM Guidelines - Community Acquired Pneumonia
- [Case 2 Q1O – Q2](https://mindthebleep.com/topic/case-2-q1o-q2/): Correct - Helen has asthma with a wheeze and a high respiratory rate. Her oxygen saturations are maintained at 4L, however we do not want her to tire and for this requirement to increase.You commence 5mg Salbutamol and, on the advice of a passing registrar who corrects your dosage, decide to commence 500 micrograms of Ipratropium alongside this.Very soon into the nebuliser, Helen's respiratory rate calms down to 18 and her saturations improve enough to titrate the oxygen down to 2L. While awaiting the bloods from triage to return, you decide to arrange a chest x ray to guide your next decisions. Based on the chest x-ray below, what will your next course of action be?
- [?DOLS](https://mindthebleep.com/topic/dols-2/)
- [Useful Resources](https://mindthebleep.com/topic/useful-resources/): https://www.youtube.com/watch?v=SUOVZ2tc56A https://mindthebleep.com/discussing-treatment-escalation-dnar/

## Quizzes
- [Pre-Learning Quiz – https://forms.gle/dV4eKXMVf1MZwjHHA](https://mindthebleep.com/quizzes/pre-learning-quiz-https-forms-gle-dv4ekxmvf1mzwjhha/)
- [Final Quiz – https://forms.gle/hC1922Ar8HpbM7886](https://mindthebleep.com/quizzes/final-quiz-https-forms-gle-hc1922ar8hpbm7886/)
- [Enrolment Sign Up](https://mindthebleep.com/quizzes/enrolment-sign-up/)
- [Pre Programme Survey](https://mindthebleep.com/quizzes/pre-programme-survey/)
- [Quiz](https://mindthebleep.com/quizzes/quiz-7/)
- [Quiz](https://mindthebleep.com/quizzes/quiz-5/)
- [A-E Interventions](https://mindthebleep.com/quizzes/a-e-interventions-2/): Airway: Ensure the airway is patent, especially if the patient is vomiting or drowsy. Breathing: Monitor SpO₂, keep O2 Sats >94% Circulation: Obtain two wide-bore IV cannulas (ideally in the upper limbs). Send bloods: FBC, U&E, LFTs, clotting, G&S, and lactate. Treat hypotension with a 500 mL IV bolus of crystalloids (e.g., 0.9% saline). Continue monitoring vitals and adjust fluids as necessary. If the patient's Hb drops below 7 g/dL (or 8 g/dL in patients with cardiovascular disease), consult with senior colleagues about blood transfusion. As bleeding is severe and the patient is haemodynamically unstable, escalate to Medical Registrar and activate the major haemorrhage protocol. Disability: If the patient is on anticoagulants (e.g., warfarin), check INR and reverse with Vitamin K or prothrombin complex concentrates (PCC) as directed by senior colleagues. Exposure: Keep the patient nil by mouth to prepare for possible endoscopy.
- [A-E Examination](https://mindthebleep.com/quizzes/a-e-examination-4/): Airway:
- [Results](https://mindthebleep.com/quizzes/results/): Click here to review ascitic fluid analysis
- [A-E Examination](https://mindthebleep.com/quizzes/a-e-examination-3/): You recall this patient from the ward round:
- [PR Examination Quiz](https://mindthebleep.com/quizzes/pr-examination-quiz-2/)
- [Abdominal Examination Quiz](https://mindthebleep.com/quizzes/abdominal-examination-quiz-2/)
- [Colonoscopy Quiz](https://mindthebleep.com/quizzes/colonoscopy-quiz-2/)
- [Endoscopy Quiz](https://mindthebleep.com/quizzes/endoscopy-quiz-2/)
- [NG Tube Quiz](https://mindthebleep.com/quizzes/ng-tube-quiz-2/)
- [A-E Quiz](https://mindthebleep.com/quizzes/a-e-quiz/)
- [A-E Findings](https://mindthebleep.com/quizzes/a-e-examination-2/): Airway: 🫁 Clear, no signs of obstruction or compromise. Breathing: 🌬️ Normal respiratory effort, no signs of distress. RR: 21 Circulation: ❤️ BP: 90/60 mmHg (hypotension). HR: 110 bpm (tachycardia). Peripheral pulses: Radial and femoral pulses present but weak. Capillary refill: Delayed (4 seconds) in both hands and feet. Disability: 🧠 Consciousness: Alert, oriented. GCS: 15/15. No neurological deficits noted. Exposure: 🩺 Fresh blood observed on patient's gown and vomit bowl Abdomen: Hepatomegaly, soft, non-tender, no peritonism. No signs of active rectal bleeding.
- [A-E Findings](https://mindthebleep.com/quizzes/a-e-examination/): You recall this patient from the ward round:
- [Results](https://mindthebleep.com/quizzes/ascitic-tap-results/): Click here to review ascitic fluid analysis
- [PR Examination Quiz](https://mindthebleep.com/quizzes/pr-examination-quiz/)
- [Death Verification Quiz](https://mindthebleep.com/quizzes/death-verification-quiz/)
- [Abdominal Examination Quiz](https://mindthebleep.com/quizzes/abdominal-examination-quiz/)
- [Colonoscopy Quiz](https://mindthebleep.com/quizzes/colonoscopy-quiz/)
- [Case 1](https://mindthebleep.com/quizzes/case-1/)
- [Ascitic Tap/Drain Scenario and Quiz](https://mindthebleep.com/quizzes/ascitic-tap-drain-scenario-and-quiz/): Test your knowledge
- [Endoscopy Quiz](https://mindthebleep.com/quizzes/endoscopy-quiz/)
- [Quiz](https://mindthebleep.com/quizzes/quiz-6/)
- [NG Tube Quiz](https://mindthebleep.com/quizzes/ng-tube-quiz/)
- [Quiz](https://mindthebleep.com/quizzes/quiz-4/)
- [Quiz](https://mindthebleep.com/quizzes/quiz-3/)
- [Quiz](https://mindthebleep.com/quizzes/quiz-2/)
- [Title and Abstract Screening Quiz](https://mindthebleep.com/quizzes/title-and-abstract-screening-quiz/)
- [Course Feedback](https://mindthebleep.com/quizzes/feedback/): Complete the feedback questions below to receive your course certificate.
- [Quiz](https://mindthebleep.com/quizzes/quiz/)
- [Test Quiz](https://mindthebleep.com/quizzes/test-quiz/)
- [How confident do you feel about sitting the MSRA?](https://mindthebleep.com/quizzes/__trashed/): We would greatly appreciate it if you could complete these pre e-learning course questions. Your ongoing feedback will help us continuously improve the content we provide. Thank you!
- [Anatomy and sonoanatomy of the forearm](https://mindthebleep.com/quizzes/anatomy-and-sonoanatomy-of-the-forearm/)
- [Needle technique & visualisation](https://mindthebleep.com/quizzes/needle-technique-visualisation/)
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- [Introduction to ultrasound](https://mindthebleep.com/quizzes/introduction-to-ultrasound/)
- [Wellbeing post-course quiz](https://mindthebleep.com/quizzes/wellbeing-post-course-quiz/): Congratulations for completing EVERY module of
- [Defining the Research Question Quiz](https://mindthebleep.com/quizzes/defining-the-research-question-quiz/)
- [Wellbeing pre-course quiz](https://mindthebleep.com/quizzes/wellbeing-pre-course-quiz-2/): Please consider taking our pre-course quiz to help us gather more information about how to improve our resources!
- [CNN basics Quiz](https://mindthebleep.com/quizzes/cnn-basics/)
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- [Where to do QI/Audit projects](https://mindthebleep.com/quizzes/where-to-do-qi-audit-projects/): Answer the below questions to complete the module
- [When to do a clinical audit or QIP](https://mindthebleep.com/quizzes/when-to-do-a-clinical-audit-or-qip/): Answer the below questions to complete the module
- [For the following statements please decide whether it describes an audit, QIP or other](https://mindthebleep.com/quizzes/for-the-following-statements-please-decide-whether-it-describes-an-audit-qip-or-other/): Answer the questions below to complete the "What" module
- [How to complete an Audit/QIP](https://mindthebleep.com/quizzes/how-to-complete-an-audit-qip/): Complete the questions below to complete the module and course! In this quiz you will attempt to create your own Clinical audit or QIP
- [Why QIP/Audit quiz](https://mindthebleep.com/quizzes/why-qip-audit-quiz/): Answer the following questions to complete this module of the course. Answers may be used once, more than once, or not at all and have multiple correct answers. Make sure you select all the correct answers relevant to a question!
- [Building your Audit project](https://mindthebleep.com/quizzes/building-your-qi-audit-research-project/): Answer the questions below to build your audit project!
- [Surviving F1 Post course Quiz](https://mindthebleep.com/quizzes/surviving-f1-post-course-quiz/)
- [Surviving F1 Pre course Quiz](https://mindthebleep.com/quizzes/surviving-f1-pre-course-quiz/)
- [Hypercalcaemia](https://mindthebleep.com/quizzes/hypercalcaemia/)
- [Hyponatraemia](https://mindthebleep.com/quizzes/hyponatraemia/): Pseudohyponatraemia is most commonly seen in hyperglycaemia where it tends to be quite mild. You can work out a corrected sodium to see if the patient has true hyponatraemia using MdCalc.
- [Hyperkalaemia](https://mindthebleep.com/quizzes/hyperkalaemia/): Below is a case for you to work through. The questions will indicate when you need to reveal the content below.
- [DKA & HHS](https://mindthebleep.com/quizzes/dka-hhs/)
- [Hyperglycaemia](https://mindthebleep.com/quizzes/hyperglycaemia-2/)
- [Hypoglycaemia](https://mindthebleep.com/quizzes/hypoglycaemia/)

## Certificates
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