Category Archives: Credits 2020

Post-traumatic headache

Paradoxically, this occurs more commonly with mild or moderate cases of traumatic brain injury (TBI) than with severe cases. It seems to be due to complex pathophysiological changes triggered by the inflammatory reaction to axonal damage. 90% of cases resolve … Continue reading

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Recurrent vulvovaginal candidiasis

History, examination, and swabs to a) make sure the diagnosis isn’t something completely different and b) check type of candidiasis; non-albicans responds better to nystatin. Risk factors include: Antibiotics Oestrogen (however, evidence contradictory on whether COC is a risk) Daily … Continue reading

Posted in Credits 2020, Gynaecology, Sexual health | Leave a comment

Hydrochlorothiazide and skin cancer

According to MIMS Learning, two studies have now shown a link between hydrochlorothiazide and non-melanoma skin cancer, which is dose-dependent and cumulative. Try to avoid this drug in patients with a skin cancer history, and advise patients who do take … Continue reading

Posted in Credits 2020, Dermatology, Medication | Leave a comment

Fungal nail disease

There are five types of fungal nail infection: Distal and lateral subungual onychomycosis Superficial white onychomycosis Proximal subungual onychomycosis Endonyx onychomycosis Candidal onychomycosis The main type is distal and lateral subungual onychomycosis, which is the kind I’m used to seeing, with … Continue reading

Posted in Credits 2020, Dermatology, Fungal infections, Nails | Leave a comment

Assessment of dizziness or vertigo

From the recent BGJP article. Examinations for investigation of dizziness: Otoscopy Cranial nerve examination HINTS examination (see below) if currently symptomatic Romberg’s test Unterberger’s test (high-stepping on the spot for 30s with eyes closed; vestibular lesions can cause rotation to that … Continue reading

Posted in Credits 2020, ENT, Vertigo | Leave a comment

Scaphoid fractures

I know, of course, about checking for anatomical snuffbox tenderness. However, since the sensitivity is <100%, the latest BMJ article advises that a combination of three tests should actually be used: Tenderness in the anatomical snuffbox Tenderness over the scaphoid … Continue reading

Posted in Credits 2020, Fractures, Orthopaedics | Leave a comment

DVT/PE

Couple of points from this BMJ article on NICE guidance: Interim treatment if scan is going to be a while is now apixaban or rivaroxaban. No more faffing around with injections… but do remember to get baseline blood tests, of … Continue reading

Posted in Credits 2020, DVT, Haematology, Vascular, VTE | Leave a comment

ANCA-associated vasculitides

This is an umbrella term for a group of autoimmune small-vessel vasculitides, affecting multiple organ systems via granuloma formation and inflammation of arterioles/venules/capillaries. They include the syndromes that used to be called Wegener’s granulomatosis and Churg-Strauss syndrome, which both seem … Continue reading

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Kidney stones

Management Arrange urgent imaging within 24 hrs: non-contrast CT is first choice, but ultrasound should be used for pregnant people or children. Arrange analgesia. Rectal analgesia doesn’t work any better unless N&V present. NSAIDs are first choice, paracetamol or opioids … Continue reading

Posted in Credits 2020, Urology | Leave a comment

General practice in the time of COVID

(I’m going to use this post to update any day-to-day information I need, and keep it on the front page. Some of it might be specific to my area, so none of it should be taken as official information, except … Continue reading

Posted in COVID-19, Credits 2020, Infectious Diseases | Leave a comment