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Dialysis Patients

There is an increasing prevalence of end-stage kidney disease and it is therefore likely that you will be involved in

Deep Vein Thrombosis

A deep vein thrombosis (DVT) is a condition in which a blood clot (thrombosis) forms within a deep vein and

Infective Endocarditis

Infective endocarditis (IE) is relatively rare in the UK. However, delays in diagnosis and treatment can lead to serious complications,

Lumbar Puncture

A lumbar puncture uses a fine needle inserted between the vertebrae in the lower back to take samples of CSF

HIV

Human Immunodeficiency Virus (HIV) is a species of lentivirus that can infect humans and subsequently causes Acquired Immunodeficiency Syndrome (AIDS).

Thyroid Disease

As a junior, you will frequently see patients who potentially have thyroid dysfunction. The problem is these patients often present

Nutrition

Nutrition is an important aspect of a patient’s health and is overlooked during medical school as you are learning exciting

Fever in the Returning Traveller

COVID-19 aside, international travel is easier and more prevalent than ever before, and illness associated with travel is common. Although

Acutely Swollen Joint

There are three joint pain calls you might receive whilst you’re on call or on the wards. We have split

Sudden Visual Loss

Loss of vision can be a scary symptom for patients to experience, and a scary presentation for doctors to manage!

Managing patients with CKD

In whichever specialty you work, you will encounter large numbers of patients with chronic kidney disease and this will impact

Metastatic Spinal Cord Compression

Spinal cord compression occurs when there is compression of the spinal cord or cauda equina at any level secondary to

Pancreatitis

Pancreatitis is a condition characterised by the inflammation of the pancreas. These patients are usually managed conservatively. Your aim is

Abdominal Pain

When you are on call, you will often get a bleep about a patient with abdominal pain. Abdominal pain can

Sickle Cell Disease

Sickle cell diseases are a disorder of haemoglobin affecting red blood cells. This autosomal recessive, single gene defect results in

Hypernatraemia

Hypernatraemia is defined as a sodium above 145 mmol/L with severe being more than 150 mmol/L.

Headache

Acute headache is a common complaint that you’ll see whilst on the wards or in the acute take. Although most

Opiate overdose & toxicity

You will likely encounter an opiate overdose due to the prevalence of opiates for recreational use, in those who have

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) refers to a relapsing and remitting inflammatory disorder of the gastrointestinal (GI) tract, which may be

Neutropenic Sepsis

Please read an overview of the management of sepsis before reading this article. Neutropenic sepsis is defined as a temperature

Acute Asthma

You are unlikely to be expected to make decisions about long term asthma management, therefore focus your efforts on learning

Frailty Syndromes

What is frailty? In simple terms, frail patients lack physiological reserves, and it takes more for them to bounce back

Back Pain

In this article, we cover the assessment and management of back pain. This article forms part of a series on

Parkinson’s Disease

In this article, we will present several common scenarios involving Parkinson’s disease (PD) that you might face on the ward

Microbiology Discussions

A lot of your time as an FY1 will be spent on the phone to various other specialities. You’ll come

Dementia

As an FY1 in hospital, you will come across lots of patients with dementia. They often have multiple problems requiring

Alcohol Withdrawal

Suddenly stopping alcohol intake in patients who have been drinking heavily for prolonged periods is dangerous and can lead to

Introduction: Diabetic foot ulcerations are a significant complication of diabetes and often precede minor (below the ankle) or major (above or below the knee) amputation. At least 2% of people with diabetes experience new foot ulcers annually, and of these, one in 400 undergoes amputation (Kerr, M. 2019)

Stomas

The word stoma comes from Greek to mean “an opening”. There are many types which are formed for a variety

Describing Skin Lesions

It is quite common for you to need to describe rashes for documentation purposes, to senior colleagues or to refer

Transfusion

In this article, we will go through the three most common scenarios you will encounter. These are: (1) Does this

Pulmonary Oedema

RCEM has published some clear and comprehensive information which is well worth a read. Below we include a very quick summary

Common Skin Issues

Dermatology is a vast topic that junior doctors often find daunting. Do read our article on describing skin lesions. Fortunately,

Palpitations

Palpitations can be described as the sensation of an abnormally received heartbeat. It can be rapid, irregular, forceful or just

Haematuria

You will regularly see patients with blood in their urine, most often picked up incidentally on a urine drip. Your

Syncope

From the Greek: Syn: together & kopein: to cut – referring to a block in blood supply from the body to the brain, most often due a drop in systemic blood pressure. It is defined as (1) temporary and transient (2) a form of loss of consciousness…

Acute Stroke

Whilst on call or in A&E you may be asked to assess somebody who is suspected to have had a

Orthogeriatrics

Fragility fractures in the elderly As a junior doctor on call, in geriatrics or in orthopaedics – you will frequently

Acute COPD exacerbation

As an FY1, you are unlikely to be expected to make decisions about long term COPD management therefore focus your

Discussing Treatment Escalation & DNAR

As an FY1 you should not be expected to make decisions regarding treatment escalation and DNAR, but you may need

Heart Failure

Heart Failure is not a diagnosis in itself, rather a collection of symptoms that require investigation to find the underlying

Nasogastric Tubes

NG tubes are passed from the nose to the stomach. Depending on the material, they can stay between 2 to

Pneumonia

In this article, we will focus on more practical concerns when managing a patient with pneumonia for junior doctors. Covid-19

Hypercalcaemia

Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia is a life-threatening electrolyte emergency requiring prompt recognition and urgent

Nausea & Vomiting

You will frequently get calls regarding nausea & vomiting: many patients present with it or develop it because of their

Pulmonary embolism

A pulmonary embolism (PE) is a blocked blood vessel in your lungs, most often due to a blood clot. It

Anaemia

Perhaps the most common blood test you will review daily will be the FBC (full blood count). You will commonly

DKA and HHS

You’ve found a patient is hyperglycaemic & either they are ketotic or have significant hyperglycaemia (>30mmol/L) and so you suspect DKA or

PICC Lines and Midlines

You may well be asked to take blood from a PICC line or be called to see a patient because

Pneumothorax

A pneumothorax is defined as the abnormal collection of air between the visceral and parietal space of the lung i.e.

Palliative Care

Dying is a natural process and unfortunately, something that we all come across in our daily jobs, including whilst on

Understanding Types of Homes

Patients may live or be discharged to a wide variety of social care settings and understanding these is important for

Paracetamol Overdose

As an FY1, you will encounter these either during clerking shifts or you may look after them on the ward.

Upper GI bleed

These patients have the potential to become haemodynamically unstable extremely quickly; try to avoid delays in reviewing them. In-hospital mortality

Sepsis

Sepsis is an infection with evidence of organ dysfunction. Septic shock is when a patient with sepsis is hypotensive despite

Constipation

Constipation is one of the most common complaints in hospital, especially on the geriatric wards.Failure to treat constipation can lead

Hypoglycaemia

Management of low blood sugar in conscious & unconscious patients, finding common causes, adjusting medications & when to refer.

ECG Basics

The electrocardiogram (ECG) is one of the most common, and important, investigations interpreted by doctors. In order to help the

Discharge Planning

It is important for junior doctors to understand what the discharge planning process involves so you can have an active

Seizures

Scenario: You are bleeped by one of the staff nurses to review a patient on the orthopaedic ward who is

Jaundice & Deranged LFTs

As the FY1, you will see patients with liver dysfunction either on the take or deranged LFTs when you are

Anticoagulation

For new doctors, prescribing anticoagulants can be daunting. A few simple rules can make this easier. Ensure you use your

Interpreting Blood Films

A blood film looks at our three cell types (erythrocytes, leukocytes & platelets) under a microscope to identify any abnormalities

Ascitic Tap and Drain

Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites to identify the underlying cause. The most urgent

Hypertension in Hospital

As a junior doctor, you will often be called about patients with raised blood pressure (BP) in secondary care. This

Atrial Fibrillation

AF is the most common sustained cardiac arrhythmia you will encounter. In this article, we focus on the management of

Delirium

Acute confusion, otherwise known as delirium, is very common in hospitals: 20-30% on medical wards, and between 10-50% of those

Chest Pain

As a junior doctor, you will also often assess patients complaining of chest pain in the acute admissions setting and

Non-Invasive Ventilation

Non-invasive ventilation is a way of providing ventilatory support to patients in respiratory failure without using an invasive airway device

Acute Kidney Injury

AKI is very common affecting around 20% of inpatients & it is important to recognise promptly and correctly to avoid

Hyponatraemia

Hyponatraemia (serum Sodium <135 mmol/L) is one of the most common electrolyte abnormalities you will see and so a systematic

Medications in Diabetes

In this article, we’ll cover the treatments used in Diabetes Mellitus. We’ll look at key things you need to know

Prescribing analgesia

When assessing pain, ensure you begin by taking a history to characterise the pain as neuropathic pain, inflammatory pain and

Falls

As an F1, you will quite frequently get bleeped to review a patient who has had a fall on the

Hyperglycaemia

Hyperglycaemia is something you will encounter frequently. In this article, we focus on how to approach hyperglycaemia and identify diabetic

Hypoxia

As an FY1, you will be called to review hypoxic ward patients. Here we discuss common causes of generalised hypoxia

Abdominal X-rays

The advantages of AXRs are far less radiation to patients & that they’re logistically easy to organise out of hours.

Reduced GCS

As a doctor, you will frequently be called for a drowsy patient. They can vary from confused to completely unconscious.

Fluid Balance

Almost every patient admitted to hospital receives IV fluids at some point in their journey. However, the body manages this,

Bradyarrhythmias

Bradyarrhythmias are abnormal heart rhythms with a pulse rate of <60 beats per minute (bpm). This can be due to

Reporting Adverse Drug Reactions

The World Health Organization (WHO) defines adverse drug reactions (ADR) as “any response to a drug which is noxious and

Refeeding Syndrome

Defined as a collection of electrolyte abnormalities associated with a massive intracellular shift of electrolytes. Associated with aggressive nutritional rehabilitation

Chronic Pancreatitis

Chronic pancreatitis is characterised by repeated pancreatic inflammation. This leads to the destruction of pancreatic tissue leading to irreversible loss

Superior Vena Cava Syndrome

SVC syndrome is an oncological emergency. There is obstruction of the superior vena cava resulting in stagnating blood and a

Vertigo

Vertigo is described as an “abnormal sensation of motion. It can occur in the absence of motion or when motion

PEG Tubes

PEG tubes are used as long term feeding options (and medication administration) for those in whom NG tubes are unsuitable

Arthralgia

There are three joint pain calls you might receive whilst you’re on call or on the wards. We have split

Suturing

Sutures are placed to aid with wound healing following a traumatic laceration or surgical incision and to promote haemostasis. In

CNS Infections

A CNS infection is one that involves the central nervous system in some way. This includes the meninges, cerebellum, ventricular

Interpreting CSF Results

Understanding how to do an LP and interpret the results is an essential skill for most doctors, particularly those planning

Applying to Geriatric Medicine

Within Geriatric Medicine you are always working as part of a multidisciplinary team and have lots of close interactions with other allied health professionals. In my experience, this means plenty of opportunity for discussion and shared decision making with colleagues, as well as being able to gain knowledge and learn from others’ expertise. This also creates a very supportive environment to work in.

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