Monthly Archives: October 2012

Assessment of pain in dementia

There are now scales for assessing pain in patients too demented to communicate. They rely on observation of behaviour over at least 5 minutes. PAINAD (Pain Assessment in Advanced Dementia) OPBAI (Observational Pain Behaviour Assessment Instrument) PADE (Pain Assessment in … Continue reading

Posted in Credits 2012, Elderly Medicine, Pain control, Psychiatry | Leave a comment

Whooping cough

Can be diagnosed if: cough >2/52 coughing paroxysms present no other cause identified In young infants, adolescents, and adults, it can present as a single prolonged cough (references here and here). That complicates diagnosis considerably. Note that it starts with … Continue reading

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Carbon monoxide poisoning

Useful screening mnemonic from a letter in the BJGP (Aug 2012) – think COMA. Cohabitees – is anyone else in the building (including pets) affected? Out of the building – are your symptoms better when out of the building? Maintenance … Continue reading

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BJGP September 2012

Two for the ‘easily missed’ category: Eagle Syndrome. This has nothing to do with being bald or growing feathers, but refers to symptoms caused by elongation of the styloid bone/ossification of the stylohyoid ligament, with consequent impingement on local structures. … Continue reading

Posted in Credits 2012, ENT, Gastroenterology | Leave a comment

Chronic pain control

Useful tips: You’re probably not going to get the patient to a pain-free state. Be realistic and upfront about expectations, and aim for pain reduction to a manageable level, rather than elimination of pain. Tramadol works mainly through noradrenergic and … Continue reading

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Investigations for weight faltering in children

Following history and physical examination (including neurodevelopmental), the recommended list is FBC, ferritin, U&Es, TSH, coeliac screen and MSU. Check Vitamin D in children at risk of deficiency (dark skin colour, limited diet) and consider CXR/sweat test in children with … Continue reading

Posted in BMJ, Credits 2012, Paediatrics | Leave a comment

Breastfeeding – useful snippets

Recommended dose of Fluconazole for ductal candidiasis (if it even exists, but that’s another story) is 200 – 400 mg loading dose, then 100 – 2oo mg od for 2 – 3 weeks. (Merewood A and Philipp B, Breastfeeding: conditions … Continue reading

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