Author Archives: Dr Sarah

About Dr Sarah

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

Dyspareunia

Note that this may present indirectly; repeated failure to attend cervical screening, persistent dissatisfaction with contraception, describing disgust with her genitals, dissociating during examination. History Open questions, kept to a minimum; encourage description. ‘When do you get the pain?’ ‘Show … Continue reading

Posted in Credits 2019, Gynaecology, Sexual health | Leave a comment

Mirtazapine + SSRIs

I’ve occasionally seen Mirtazapine used as an add-on to SSRIs in resistant depression. An RCT recently showed that adding Mirtazapine to an SSRI or SNRI in resistant depression works no better than adding placebo. That said, the definition of ‘resistant’ … Continue reading

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

Deprivation of liberty

(Notes from Bluestream Academy learning module) Note that there are plans to replace the DOLS. The proposed plan is called Liberty Protection Safeguards (LiPS) and should be through shortly. The ‘acid test’ for whether a deprivation of liberty has occurred … Continue reading

Posted in Medicolegal | Leave a comment

Talking to people about their diabetes

Judith Handley, a health policy geek with Type I diabetes, has written an article for the ‘What your patient is thinking’ section of the BMJ, on alternatives to asking people with diabetes whether they’re well-controlled (to which she always feels … Continue reading

Posted in Communication, Credits 2018, Diabetes | Leave a comment

When not to use HbA1c for maintenance

We’re hopefully all familiar with the list of situations in which HbA1c might give a false reading when used to diagnose diabetes (short version; any situation in which the glucose might have undergone rapid recent change), but it’s also important … Continue reading

Posted in Credits 2018, Diabetes | Leave a comment

STOPP (Screening Tool of Older People’s Prescriptions)

I’ve just been reading through this, having decided to check it out after reading a mention of it in the latest BMJ. (Deprescribing is a particular interest of mine; it has the satisfying feel of clearing out a bunch of … Continue reading

Posted in Credits 2018, Elderly Medicine, Medication | Leave a comment

Flozins and COPD inhalers

That’s two separate subjects, not one, whose link here is that they were both the topics of useful papers in this week’s BMJ. The first was on possible adverse effects of flozins (sodium-glucose cotransporter-2 inhibitors). The paper was a very … Continue reading

Posted in BMJ, COPD, Credits 2018, Diabetes, Endocrinology, Medication, Respiratory | Leave a comment