Monthly Archives: November 2012


Good link for normal values here. Remember: FEV1/FVC ratio is 70% or higher in restrictive disease and <70% in obstructive. Restrictive disease will show reduction in both FEV1 and FVC, proportionately (FEV1 <80% but FEV1/FVC ratio 70% or higher) Reversibility … Continue reading

Posted in Respiratory | Leave a comment

Migraine treatment

According to latest NICE guidelines, it’s now worth trying combination treatment (triptan + NSAID or paracetamol) as first-line, as found to be effective. For prophylaxis, as per NICE: First-line: Propranolol or topiramate Second-line: Gabapentin (up to 1200 mg/day) or acupuncture … Continue reading

Posted in Alternative medicine, Migraine, Neurology | Leave a comment

Random paediatric points

A selection of fairly random points from the Pulse on-line learning module in child health: A fever over 38 degrees in a baby less than 3 months or over 39 degrees in a 3 – 6-month-old is a red flag … Continue reading

Posted in Dermatology, Paediatrics, Rheumatology | Leave a comment


Should be a differential diagnosis of abdominal pain in under-5s Typically presents with attacks of severe colicky pain 10 – 20 minutes apart – parents report children drawing up legs to abdomen/kicking legs Onset usually acute but may be insidious … Continue reading

Posted in Paediatrics | Leave a comment

Chronic cough in children

❤ weeks counts as acute, >8 weeks as chronic. 3 – 8 weeks is called ‘subacute’ and may be pertussis, but may also be post-viral. Post-viral cough presents as a persistent dry cough and, if history and examination do not … Continue reading

Posted in Paediatrics, Respiratory | 1 Comment

Community acquired pneumonia in children

Definitions of tachypnoea in children: <2 months: >60/min 2 – 12 months: >50/min >12 months: >40/min. Triad of symptoms suggesting CAP in children: Tachypnoea Chest recession Persistent fever >38.5 No definitive scoring systems for CAP severity exist. However, the following … Continue reading

Posted in Infectious Diseases, Paediatrics, Respiratory | Leave a comment

About this blog: information for appraisers

I use this blog to record my learning points/reflections arising from my CPD. It’s a very handy way of doing it, as it lets me refer back to it easily and use the search function and category menu to find … Continue reading

Posted in About this blog, Credits 2016, Credits 2018 | 2 Comments

HbA1c to diagnose diabetes

48 mmol/mol is the cut-off for diagnosis of diabetes but, as with fasting glucose, should be rechecked unless clear clinical symptoms exist. 42 – 47 equates to ‘high risk of diabetes’ – intensive lifestyle management, recheck annually. <42 – may … Continue reading

Posted in Credits 2012, Diabetes, Endocrinology | Leave a comment

Fitness for work

Guidelines on time off work after surgery are available at Working Fit. Patients may need much less time off work than previously thought – belief plays a large part. New surgical techniques also help – the mesh used in hernia … Continue reading

Posted in Uncategorized | Leave a comment


Differential diagnosis Stress fracture Morton’s neuroma Plantar fasciitis at the metatarsal insert (less common than at the calcaneal insert) Rheumatoid arthritis Osteoarthritis Gout Peripheral neuropathy Stress fracture: may be relatively minor trauma which has been forgotten. A tender callus may … Continue reading

Posted in Orthopaedics | Leave a comment