Refeeding Syndrome
Defined as a collection of electrolyte abnormalities associated with a massive intracellular shift of electrolytes. Associated with aggressive nutritional rehabilitation
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Bradyarrhythmias
Bradyarrhythmias are abnormal heart rhythms with a pulse rate of <60 beats per minute (bpm). This can be due to
Arthralgia
There are three joint pain calls you might receive whilst you’re on call or on the wards. We have split
Notifiable Diseases
As a junior doctor, it is your statutory duty as a medical professional to alert the local public health team
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
Chronic Pancreatitis
Chronic pancreatitis is characterised by repeated pancreatic inflammation. This leads to the destruction of pancreatic tissue leading to irreversible loss
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.
Interpreting CSF Results
Understanding how to do an LP and interpret the results is an essential skill for most doctors, particularly those planning
Superior Vena Cava Syndrome
SVC syndrome is an oncological emergency. There is obstruction of the superior vena cava resulting in stagnating blood and a
Sudden Visual Loss
Loss of vision can be a scary symptom for patients to experience, and a scary presentation for doctors to manage!
Acutely Swollen Joint
There are three joint pain calls you might receive whilst you’re on call or on the wards. We have split
Managing patients with CKD
In whichever specialty you work, you will encounter large numbers of patients with chronic kidney disease and this will impact
CNS Infections
A CNS infection is one that involves the central nervous system in some way. This includes the meninges, cerebellum, ventricular
Diarrhoea
Diarrhoea is a very common complaint and may be the reason for a patient’s admission, or develop as a new
HIV
Human Immunodeficiency Virus (HIV) is a species of lentivirus that can infect humans and subsequently causes Acquired Immunodeficiency Syndrome (AIDS).
Suturing
Sutures are placed to aid with wound healing following a traumatic laceration or surgical incision and to promote haemostasis. In
Sickle Cell Disease
Sickle cell diseases are a disorder of haemoglobin affecting red blood cells. This autosomal recessive, single gene defect results in
Hypocalcaemia
Acute hypocalcaemia that is severe (<1.9 mmol/L) or symptomatic can be life-threatening and necessitates urgent treatment. It is often initially
Dialysis Patients
There is an increasing prevalence of end-stage kidney disease and it is therefore likely that you will be involved in
Urinary Tract Infections
Urinary tract infections (UTIs) in adults are extremely common in both primary and secondary care and it is inevitable that
Headache
Acute headache is a common complaint that you’ll see whilst on the wards or in the acute take. Although most
Hypophosphataemia
The UK Medicines Information group have provided excellent guidance on how to replace phosphate.
Nutrition
Nutrition is an important aspect of a patient’s health and is overlooked during medical school as you are learning exciting
Infective Endocarditis
Infective endocarditis (IE) is relatively rare in the UK. However, delays in diagnosis and treatment can lead to serious complications,
Thyroid Disease
As a junior, you will frequently see patients who potentially have thyroid dysfunction. The problem is these patients often present
Lumbar Puncture
A lumbar puncture uses a fine needle inserted between the vertebrae in the lower back to take samples of CSF
Deep Vein Thrombosis
A deep vein thrombosis (DVT) is a condition in which a blood clot (thrombosis) forms within a deep vein and
Performing Arterial Blood Gases (ABGs)
Thanks to Geeky Medics for an excellent video demonstration Equipment Gloves Alcohol wipe Cotton wool/ gauze ABG syringe (ensure it
Metastatic Spinal Cord Compression
Spinal cord compression occurs when there is compression of the spinal cord or cauda equina at any level secondary to
Abdominal Pain
When you are on call, you will often get a bleep about a patient with abdominal pain. Abdominal pain can
Diabetic Foot Ulcers
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)
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
Neutropenic Sepsis
Please read an overview of the management of sepsis before reading this article. Neutropenic sepsis is defined as a temperature
Pancreatitis
Pancreatitis is a condition characterised by the inflammation of the pancreas. These patients are usually managed conservatively. Your aim is
Hypernatraemia
Hypernatraemia is defined as a sodium above 145 mmol/L with severe being more than 150 mmol/L.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) refers to a relapsing and remitting inflammatory disorder of the gastrointestinal (GI) tract, which may be
Parkinson’s Disease
In this article, we will present several common scenarios involving Parkinson’s disease (PD) that you might face on the ward
Opiate overdose & toxicity
You will likely encounter an opiate overdose due to the prevalence of opiates for recreational use, in those who have
Alcohol Withdrawal
Suddenly stopping alcohol intake in patients who have been drinking heavily for prolonged periods is dangerous and can lead to
Describing Skin Lesions
It is quite common for you to need to describe rashes for documentation purposes, to senior colleagues or to refer
Back Pain
In this article, we cover the assessment and management of back pain. This article forms part of a series on
Stomas
The word stoma comes from Greek to mean “an opening”. There are many types which are formed for a variety
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…
Frailty Syndromes
What is frailty? In simple terms, frail patients lack physiological reserves, and it takes more for them to bounce back
Common Skin Issues
Dermatology is a vast topic that junior doctors often find daunting. Do read our article on describing skin lesions. Fortunately,
Transfusion
In this article, we will go through the three most common scenarios you will encounter. These are: (1) Does this
Microbiology Discussions
A lot of your time as an FY1 will be spent on the phone to various other specialities. You’ll come
Haematuria
You will regularly see patients with blood in their urine, most often picked up incidentally on a urine drip. Your
Anaemia
Perhaps the most common blood test you will review daily will be the FBC (full blood count). You will commonly
Acute Asthma
You are unlikely to be expected to make decisions about long term asthma management, therefore focus your efforts on learning
Pneumothorax
A pneumothorax is defined as the abnormal collection of air between the visceral and parietal space of the lung i.e.
Pneumonia
In this article, we will focus on more practical concerns when managing a patient with pneumonia for junior doctors. Covid-19
Acute Stroke
Whilst on call or in A&E you may be asked to assess somebody who is suspected to have had a
Acute COPD exacerbation
As an FY1, you are unlikely to be expected to make decisions about long term COPD management therefore focus your
Heart Failure
Heart Failure is not a diagnosis in itself, rather a collection of symptoms that require investigation to find the underlying
Palpitations
Palpitations can be described as the sensation of an abnormally received heartbeat. It can be rapid, irregular, forceful or just
Pulmonary Oedema
RCEM has published some clear and comprehensive information which is well worth a read. Below we include a very quick summary
Pulmonary embolism
A pulmonary embolism (PE) is a blocked blood vessel in your lungs, most often due to a blood clot. It
Orthogeriatrics
Fragility fractures in the elderly As a junior doctor on call, in geriatrics or in orthopaedics – you will frequently
Understanding Types of Homes
Patients may live or be discharged to a wide variety of social care settings and understanding these is important for
Dementia
As an FY1 in hospital, you will come across lots of patients with dementia. They often have multiple problems requiring
PICC Lines and Midlines
You may well be asked to take blood from a PICC line or be called to see a patient because
Paracetamol Overdose
As an FY1, you will encounter these either during clerking shifts or you may look after them on the ward.
Nasogastric Tubes
NG tubes are passed from the nose to the stomach. Depending on the material, they can stay between 2 to
ECG Basics
The electrocardiogram (ECG) is one of the most common, and important, investigations interpreted by doctors. In order to help the
Nausea & Vomiting
You will frequently get calls regarding nausea & vomiting: many patients present with it or develop it because of their
Palliative Care
Dying is a natural process and unfortunately, something that we all come across in our daily jobs, including whilst on
Discussing Treatment Escalation & DNAR
As an FY1 you should not be expected to make decisions regarding treatment escalation and DNAR, but you may need
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
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
Interpreting Blood Films
A blood film looks at our three cell types (erythrocytes, leukocytes & platelets) under a microscope to identify any abnormalities
Upper GI bleed
These patients have the potential to become haemodynamically unstable extremely quickly; try to avoid delays in reviewing them. In-hospital mortality
Skin Cancer
Skin cancers have one of the highest global incidences of any type of cancer. Early diagnosis and management of melanoma
Constipation
Constipation is one of the most common complaints in hospital, especially on the geriatric wards.Failure to treat constipation can lead
Jaundice & Deranged LFTs
As the FY1, you will see patients with liver dysfunction either on the take or deranged LFTs when you are
Discharge Planning
It is important for junior doctors to understand what the discharge planning process involves so you can have an active
Sepsis
Sepsis is an infection with evidence of organ dysfunction. Septic shock is when a patient with sepsis is hypotensive despite
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
Atrial Fibrillation
AF is the most common sustained cardiac arrhythmia you will encounter. In this article, we focus on the management of
Non-Invasive Ventilation
Non-invasive ventilation is a way of providing ventilatory support to patients in respiratory failure without using an invasive airway device
Chest Pain
As a junior doctor, you will also often assess patients complaining of chest pain in the acute admissions setting and
Ascitic Tap and Drain
Ascitic aspiration (tap) is routinely performed for every patient admitted with ascites to identify the underlying cause. The most urgent
Seizures
Scenario: You are bleeped by one of the staff nurses to review a patient on the orthopaedic ward who is
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
Hypertension in Hospital
As a junior doctor, you will often be called about patients with raised blood pressure (BP) in secondary care. This
Delirium
Acute confusion, otherwise known as delirium, is very common in hospitals: 20-30% on medical wards, and between 10-50% of those
Anticoagulation
For new doctors, prescribing anticoagulants can be daunting. A few simple rules can make this easier. Ensure you use your
Abdominal X-rays
The advantages of AXRs are far less radiation to patients & that they’re logistically easy to organise out of hours.
Hypoglycaemia
Management of low blood sugar in conscious & unconscious patients, finding common causes, adjusting medications & when to refer.
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
Reduced GCS
As a doctor, you will frequently be called for a drowsy patient. They can vary from confused to completely unconscious.
Hypoxia
As an FY1, you will be called to review hypoxic ward patients. Here we discuss common causes of generalised hypoxia
Hyperglycaemia
Hyperglycaemia is something you will encounter frequently. In this article, we focus on how to approach hyperglycaemia and identify diabetic
Fluid Balance
Almost every patient admitted to hospital receives IV fluids at some point in their journey. However, the body manages this,
Reporting Adverse Drug Reactions
The World Health Organization (WHO) defines adverse drug reactions (ADR) as “any response to a drug which is noxious and