Monthly Archives: August 2015

Palliative care

(From BMJ learning module) Palliative Care Adult Network Guidelines Plus are a useful resource. Opiates in renal impairment Some good ones: Oxycodone, which is 90% excreted by the liver and only needs dose reduction in CKD5 Fentanyl – fine down … Continue reading

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(From Pulse learning module) Mild hyponatraemia: 130 – 132 Moderate hyponatraemia: 125 – 129 Severe/profound hyponatraemia: <125 (some experts use ‘profound’ for <110). This category was picked on the basis of patients being increasingly likely to be symptomatic below this … Continue reading

Posted in Clinical biochemistry | 4 Comments

Examination of eyes/vision in young children

(From BMJ learning unit, based on BMJ article BMJ 2015:350:h1716) Have child sitting on parent’s lap, facing you, parent leaning slightly backwards Sing a nursery rhyme for distraction Visual inspection of the eyes Dim lights & use ophthalmoscope from a … Continue reading

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Reactive arthritis

(BMJ module on STIs) My name is (almost) a disease, it seems. Reactive arthritis is a sterile arthritis triggered by an infection elsewhere, typically urogenital or gastrointestinal, and SARA stands for sexually acquired reactive arthritis, most often triggered by chlamydia. … Continue reading

Posted in Infectious Diseases, Joints | Leave a comment


(From Pulse on-line learning module) Mild: <2.88 Moderate: 2.88 – 3.4 Severe: >3.4 If the level is mild or moderate (i.e. 3.4 or less) and the patient is asymptomatic, repeat within the next week. Fasting bloods may be more accurate … Continue reading

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Workplace discrimination law

(From the BMJ Learning module) Legally, there are six types of discrimination: 1. Direct discrimination: Because of a protected characteristic, a person is treated less favourably. 2. Indirect discrimination: A rule is applied across the board, but has more impact … Continue reading

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