Author Archives: Dr Sarah

About Dr Sarah

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

Ear conditions

Exostoses: overgrowths of bone in the external ear canal; they present as whitish lumps narrowing the canal. They are particularly common in people who spend a lot of time swimming in cold water. They can obstruct wax or cause hearing … Continue reading

Posted in ENT | Leave a comment

BP control before surgery

A reference in the latest BJGP has just answered a question I’ve been meaning to look into; how good a blood pressure control do we need to aim for in patients we’re referring for surgery? Not as strict as I’d … Continue reading

Posted in BJGP, Credits 2017, Hypertension, Surgery | Leave a comment

Steroids for sore throats

An update on this problem: a systematic review and meta-analysis in the BMJ. This found that there is, in fact, moderate quality evidence that a one-off dose of steroid can improve pain in sore throat. Not the speed with which … Continue reading

Posted in Credits 2017, Medication, Minor but annoying | Leave a comment

Shingles infectivity

After having a case of shingles and two more suspected cases (which turned out not to be) at the care home where I work, I thought it might be useful to put together a protocol for staff. I posted this … Continue reading

Posted in Credits 2017, DENs, Infectious Diseases | Leave a comment

Secondary post-partum haemorrhage

Blood loss of >500 ml for a vaginal birth or >1000 ml for a CS, between 24 hours and 12 weeks postpartum. Causes: Retained products or endometritis. Examination: Note that the uterus should not be palpable abdominally by day 14; … Continue reading

Posted in Credits 2017, Pregnancy and Childbirth | Leave a comment

Contraception in the perimenopause

DMPA and Sayana Press do cause decrease in bone density, but this is reversible and thus not considered an absolute contradiction to contraception over 45. Review every two years for other risk factors is advised. The FSRH do advise against … Continue reading

Posted in Gynaecology, Sexual health | Leave a comment

HRT and heart disease

Well, we have an update on the days of the Million Women Study (though it’s still a cool trial name). Much of the data available then were from women starting HRT in their mid-sixties, and this skewed the data. It … Continue reading

Posted in Gynaecology, HRT | Leave a comment