Author Archives: Dr Sarah

About Dr Sarah

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

NNTs/ARRs for secondary prevention of cardiovascular events

The other day, I had one of those “Do I really need all these pills, Doctor?” questions that requires a grey-area conversation about risk reduction. Anyway, in medical terms the information needed is “What is the NNT for each of … Continue reading

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

Temporal arteritis

Some notes: Not everyone gets headache. 4% of sufferers have a normal ESR. Biopsy can show false negatives. Constitutional symptoms (fever, sweats, weight loss/anorexia, fatigue) are common; but do consider other causes (infection, malignancy). Visual symptoms can affect part of … Continue reading

Posted in Credits 2019, Don't miss, Rheumatology | Leave a comment

Avascular necrosis of the femoral head

Pathogenesis of AVNFH isn’t known, but it occurs when the microcirculation of the femoral head is disrupted, leading to necrosis and eventual subchondral collapse of the femoral head (with consequent secondary arthritis). Incidence is around 1 in 50 000. It … Continue reading

Posted in Credits 2019, Don't miss, Joints, Orthopaedics | Leave a comment

Mouth ulcers

History and examination The three main points to inquire about when evaluating ulcers are site; number (single or multiple); and onset/behaviour (acute, persistent, or recurrent). Ulcers lasting >3/52 are of concern as they may be malignant; alternatively, they may be … Continue reading

Posted in Oral | Leave a comment


Had to see someone yesterday about a lowish phosphate level, and, since I know nothing about hypophosphatemia, it was learning time. I found a couple of useful articles for quick reference – this one in the BMJ and this one … Continue reading

Posted in Credits 2019, DENs, Lab results | Leave a comment

Red flags in low back pain

I noticed I have someone booked into an upcoming session to see me about back pain, so I decided it was time I checked the list of red flags for back pain to be sure I don’t miss anything. This … Continue reading

Posted in Back pain, Credits 2019, Don't miss, Musculoskeletal | Leave a comment

Axial spondyloarthritis

The spondyloarthritides are a group of inflammatory conditions which can affect axial or peripheral joints. Axial spondyloarthritis Radiographic axial spondyloarthritis* Non-radiographic axial spondyloarthritis** *This is the entity that used to be known as ankylosing spondyloarthritis. However, the criteria for diagnosing … Continue reading

Posted in Back pain, Musculoskeletal, Rheumatology | 1 Comment