Category Archives: Credits 2013

Wheezing in pre-school children

I never quite understood why wheezing in pre-school children is not meant to be called asthma when it looks like asthma, sounds like asthma and behaves like asthma, but apparently the reason is the absence of eosinophilic airways inflammation. Some … Continue reading

Posted in BMJ, Credits 2013, Paediatrics, Respiratory | Leave a comment

Flashes and floaters

Flashes and floaters typically indicate posterior vitreous detachment; flashes are caused by the shrinking vitreous tugging on the retina, and floaters can be due to blood, inflammatory debris, or condensations (thickened strands) of the vitreous humour. Risk factors for posterior … Continue reading

Posted in Credits 2013, Ophthalmology | Leave a comment

Neck lumps

I typically request plasma viscosity as part of investigating suspicious neck lumps, but it seems this actually isn’t useful. For persistent posterior node enlargement, an FBC and IM screen can be worthwhile, and obviously any lump in the thyroid should … Continue reading

Posted in Credits 2013, Lumps and Bumps | Leave a comment


Allopurinol should be started at a dose of 100 mg od and titrated upwards in 100 mg increments on a monthly basis, with the aim of getting the urate <0.36 – some experts say to aim for <0.3 for the … Continue reading

Posted in Credits 2013, Gout, Rheumatology | Leave a comment

Thrombosis risk with different COCs

A very useful review and meta-analysis in the BMJ has grouped COCs with regard to their relative risk of thromboembolism. Highest risk, unsurprisingly, is Ovran, which I can’t recall ever actually using. Of the ones in more common use, the … Continue reading

Posted in Contraception, Credits 2013 | Leave a comment

Varicose veins – NICE guidance

Compression stockings, which always sounded like such a nice harmless intervention to suggest in minor cases, are now no longer recommended as a first-line intervention unless other interventions are not suitable (pregnancy being a good example). First-line treatment, where treatment … Continue reading

Posted in Credits 2013, Vascular | Leave a comment

Acute leg ischaemia – don’t miss

This BMJ article reminded us of the importance of considering acute ischaemia as a differential diagnosis when a patient presents with acute-onset leg pain plus or minus sensory loss. It’s easy to convince yourself you can feel a weak pulse … Continue reading

Posted in Credits 2013, Urgent problems, Vascular | Leave a comment