Author Archives: Dr Sarah

About Dr Sarah

I'm a GP with a husband and two young children.

Multiple sclerosis

(Notes on the BMJ module regarding NICE guidelines) Presentation There wasn’t much on this, but common presentations include: Optic neuritis (loss of/reduction of vision in one eye, associated with aching) Double vision Ascending sensory disturbance (e.g. from feet to abdomen), … Continue reading

Posted in Neurology | Leave a comment

Glucose control in Type II diabetes

(As per BMJ module ‘Clinical pointers: Blood glucose control in Type 2 diabetes’) I’ve used sulfonylureas as second-line diabetic drugs for years on a ‘devil you know’ basis, but it now seems that’s out of date; one meta-analysis showed them … Continue reading

Posted in Diabetes, Medication | Leave a comment

Assessment of purpuric/petechial rashes

This was a BMJ module, based on this article. Steps in assessing purpuric/petechial rashes: Assess for acute illness and consider the possibility of meningococcal sepsis. If suspected, administer parenteral antibiotics and admit urgently. If meningococcus is not the suspected diagnosis, … Continue reading

Posted in Dermatology, Don't miss, Haematology | Leave a comment

Indications for urgent referral of childhood eczema

Same day: Eczema herpeticum (widespread HHV infection of eczema). Will need same-day dermatology opinion and, if it affects periorbital skin, same-day ophthalmology opinion as well. Give systemic aciclovir in the meantime (not sure of practicalities of this). Within two weeks: … Continue reading

Posted in Dermatology, Paediatrics | Leave a comment

Managing menopause

(Notes from BMJ module) From 45 yrs onwards, menopause/perimenopause can be diagnosed on history only. FSH or other blood tests are not actually helpful in diagnosis in the >40s because of the wide fluctuation in levels in the perimenopause. FSH … Continue reading

Posted in Gynaecology, HRT | Leave a comment

Antidepressants/NOACs and bleeding risk

A DEN came up while I was sorting out repeat prescriptions: While it’s well known that patients taking an SSRI with NSAIDs or antiplatelet agents should strongly consider GI prophylaxis, does that apply to people taking SSRIs with NOACs? I … Continue reading

Posted in Medication | Leave a comment

Aspirin + clopidogrel short-term after TIA/ischaemic stroke

I belatedly got round to reading a January BMJ that contained this article, an analysis of previous work on DAPT (dual antiplatelet therapy) after TIA/stroke. The recommendations are: After either a high-risk TIA or a minor ischaemic stroke, use both … Continue reading

Posted in Cardiovascular, Credits 2019, Medication | Leave a comment