Monthly Archives: October 2016


In patients who are on an anticoagulant, there is no evidence to support adding an antiplatelet agent, and SIGN and NICE guidelines now say that this is not recommended. We don’t have data on whether this applies to patients who … Continue reading

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Requests from social care for information

Some interesting information in the Pulse Learning child safeguarding module: If social care request information about a patient, we are not actually obliged to give it, and can refuse to do so if we feel that would put us or … Continue reading

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Influenza vaccination

Time to effect About 10 – 14 days. Note that if someone in a high-risk group comes into contact with flu after the vaccine but before it’s likely to have taken effect, then they may be eligible for oseltamivir/zanamivir (check … Continue reading

Posted in Credits 2016, Vaccines | Leave a comment

Tight foreskin

Uncomplicated phimosis Treat with 4/52 of a moderate to strong steroid cream (e.g. 0.1% Betamethasone), applied to the foreskin but avoiding the glans, and review 1 – 2 weeks later. If symptoms are still troublesome, refer for consideration of circumcision. … Continue reading

Posted in Credits 2016, Urology | Leave a comment

FSRH guidance – intrauterine contraception

Both the IUS & the Cu-IUD are thought to work primarily through prevention of fertilisation, but the IUS seems to have more of an anti-implantation effect as part of its effectiveness than the Cu-IUD does. Both are extremely effective, with … Continue reading

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Exercise-induced laryngeal obstruction

The cause of EILO is unclear, but it may be due to laryngeal hypersensitivity. It’s most common in athletic females under 20. Symptoms include shortness of breath, throat discomfort, chest tightness, and wheeze developing during intense exercise. EILO, for obvious … Continue reading

Posted in Credits 2016, ENT, Respiratory | Leave a comment


BPPV Some new info on the Dix-Hallpike manoeuvre: Stand in front of the patient (not behind as I’ve been doing) Look at them for 30s first. (Why? Must ask DNUK.) After the patient is lain down, the nystagmus usually appears … Continue reading

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