Monthly Archives: September 2018

High-dose B12 therapy

The standard maintenance course of injectable B12 (after the two week loading period) is 1 mg every three months. Occasionally, I’ve come across a patient who finds that the effects of the injection wear off, and the symptoms of deficiency … Continue reading

Posted in Credits 2018, Haematology, Medication | Leave a comment

Thyrotoxicosis – initial treatment

An article from the BMJ, with some useful tips on starting anti-thyroid drugs if necessary. Causes: Medication-related (see below) Thyroiditis (subacute, de Quervain’s, initial phase Hashimoto’s, postpartum) Grave’s Toxic multinodular goitre Solitary toxic adenoma Very rarely, functional thyroid carcinoma Medication-related … Continue reading

Posted in Credits 2018, Endocrinology, Thyroid | Leave a comment

Signs of Kawasaki’s disease

Kawasaki’s disease is an arteritis (primarily affecting the coronary arteries). Signs: high fever for 5 or more days and: Polymorphous erythematous rash (can be urticarial, scarlatiniform or morbilliform and can contain small aseptic pustules) Cervical lymphadenopathy Bilateral conjunctival injection Changes … Continue reading

Posted in Dermatology, Paediatrics | Leave a comment

Indications for referring children with eczema

Immediately Eczema herpeticum where child is systemically unwell   Within two weeks Severe eczema not responding to optimal therapy within a week Bacterially infected eczema not responding to treatment   (Quick Quiz BMJ module)

Posted in Dermatology, Paediatrics, Uncategorized | Leave a comment


Permethrin 5% cream is first-line treatment; aqueous malathion is 2nd-line. If the first course doesn’t work, try the other one. Everyone in the family needs to be treated simultaneously, and all clothing (including clothes which have been worn but are … Continue reading

Posted in Dermatology, Uncategorized | Leave a comment

Changes in the Mental Health Act

The MHA covers the legal aspects of when and how you can detain a person for assessment or treatment of a mental health disorder without their consent. It is primarily for ensuring that people with a serious mental disorder threatening … Continue reading

Posted in Medicolegal | Leave a comment

Acute red eye

Acute angle-closure glaucoma: Intermittent haloes around lights.  Nausea and sometimes vomiting. Photophobia. Severe visual impairment. Red eye with hazy cornea and fixed mid-dilated pupil. Eye feels firmer than other side to palpation through closed lid. (Do not palpate an eyeball with a possible … Continue reading

Posted in Ophthalmology | Leave a comment