Our Medical Articles

When you are on call you will often get a bleep about a patient in abdominal pain. Abdominal pain can be a bit of a...

The advantages of AXRs are far less radiation to patients & that they’re logistically easy to organise out of hours. Unlike CTs they do not...

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

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

AKI is very common affecting around 20% of inpatients & it is important to recognise promptly and correctly to avoid complications. In this article, we...

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

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

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

Perhaps the most common blood test you will review daily will be the FBC (full blood count). You will commonly see a low haemoglobin &...

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

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...

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

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

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

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

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

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

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

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

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

A deep vein thrombosis (DVT) is a condition in which a blood clot (thrombosis) forms within a deep vein and can be provoked or unprovoked...

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

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

It is quite common for you to need to describe rashes for documentation purposes, to senior colleagues or to refer to various specialties including dermatology....

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....

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

Diarrhoea is a very common complaint and may be the reason for a patient’s admission, or develop as a new problem during an inpatient stay....

It is important for junior doctors to understand what the discharge planning process involves so you can have an active role in multidisciplinary team meetings....

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

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

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

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

Almost every patient admitted to hospital receives IV fluids at some point in their journey. However, the body manages this, without the need for careful...

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

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

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

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

Human Immunodeficiency Virus (HIV) is a species of lentivirus that can infect humans and subsequently causes Acquired Immunodeficiency Syndrome (AIDS). At the end of 2018,...

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 treatment.  Do check out our...

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

Hypernatraemia is defined as a sodium above 145 mmol/L with severe being more than 150 mmol/L. Usually, hypernatraemia is a “not enough water” problem –...

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

Acute hypocalcaemia that is severe (<1.9 mmol/L) or symptomatic can be life-threatening and necessitates urgent treatment. It is often initially picked up when a patient...

In this article, we provide a quick overview of how to treat and investigate the cause of patients with hypoglycaemia. Definition In diabetics, <4 mmol/L...

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

The UK Medicines Information group have provided excellent guidance on how to replace phosphate. Clinical features Generally asymptomatic if mild Can cause many systemic features...

As an FY1, you will be called to review hypoxic ward patients. Here we discuss common causes of generalised hypoxia and not focal hypoxia/ischaemia such...

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

Inflammatory bowel disease (IBD) refers to a relapsing and remitting inflammatory disorder of the gastrointestinal (GI) tract, which may be accompanied by extra-GI manifestations. ContentsWhat...

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

Understanding how to do an LP and interpret the results is an essential skill for most doctors, particularly those planning on a hospital-based specialty. You...

As the FY1, you will see patients with liver dysfunction either on the take or deranged LFTs when you are reviewing bloods. A focused approach...

A lumbar puncture uses a fine needle inserted between the vertebrae in the lower back to take samples of CSF from the subarachnoid space. The...

In whichever specialty you work, you will encounter large numbers of patients with chronic kidney disease and this will impact many components of their care....

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

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

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

NG tubes are passed from the nose to the stomach. Depending on the material, they can stay between 2 to 6 weeks. However, they quite...

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

Please read an overview of the management of sepsis before reading this article. ContentsDefinitionHigh-risk patientsSigns and symptomsInvestigations and ManagementConfirming the diagnosisScoring systemsFollow upReferences Definition Neutropenic...

Non-invasive ventilation is a way of providing ventilatory support to patients in respiratory failure without using an invasive airway device (e.g. ET tube or tracheostomy...

As a junior doctor, it is your statutory duty as a medical professional to alert the local public health team to a new or suspected...

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

You will likely encounter an opiate overdose due to the prevalence of opiates for recreational use, in those who have chronic pain or mental health...

Fragility fractures in the elderly As a junior doctor on call, in geriatrics or in orthopaedics – you will frequently look after frail and elderly...

Dying is a natural process and unfortunately, something that we all come across in our daily jobs, including whilst on call. Despite this, very little...

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

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

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

In this article, we will present several common scenarios involving Parkinson’s disease (PD) that F1 doctors might face on the ward or on call. We...

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

Thanks to Geeky Medics for an excellent video demonstration Equipment Gloves Alcohol wipe Cotton wool/ gauze ABG syringe (ensure it is pre-heparinised) and blue needle...

In this article, we will focus on more practical concerns when managing a patient with pneumonia for junior doctors. Covid-19 is not discussed here.  History...

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

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

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

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

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

Defined as a collection of electrolyte abnormalities associated with a massive intracellular shift of electrolytes. Associated with aggressive nutritional rehabilitation of malnourished patients in e.g....

Scenario: You are bleeped by one of the staff nurses to review a patient on the orthopaedic ward who is “jerking in her bed”. She...

Sepsis is an infection with evidence of organ dysfunction. Septic shock is when a patient with sepsis is hypotensive despite appropriate fluid resuscitation. ContentsIntroductionHigh-risk criteriaSepsis...

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

The word stoma comes from Greek to mean “an opening”. There are many types which are formed for a variety of reasons, but here we...

Loss of vision can be a scary symptom for patients to experience, and a scary presentation for doctors to manage! You will not be expected...

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

Sutures are placed to aid with wound healing following a traumatic laceration or surgical incision and to promote haemostasis. In this article, we will look...

From the Greek: Syn: together & kopein: to cut - referring to a block in blood supply from the body to the brain, most often...

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

In this article, we will go through the three most common scenarios you will encounter. These are: (1) Does this patient need a transfusion? (2)...

Patients may live or be discharged to a wide variety of social care settings and understanding these is important for any foundation doctor. This can...

These patients have the potential to become haemodynamically unstable extremely quickly; try to avoid delays in reviewing them. In-hospital mortality is around 10%. If they...

Urinary tract infections (UTIs) in adults are extremely common in both primary and secondary care and it is inevitable that you will be diagnosing and...

Vertigo is described as an “abnormal sensation of motion. It can occur in the absence of motion or when motion is sensed inaccurately”1 Assessing a...