MedicsQuestions

Nitrite negative UTI- why?

Your patient presents and has pain in the hypogastrium with dysuria and haematuria. As a brilliant diagnostician, you get them to do a urine dip which come back positive for leucocytes but not nitrite and you think, what might have caused this? ~~Just to refresh your memories, nitrates (produced in the kidney) are converted to nitrites by various gram negative bacteria (classically E.coli).…

Löfgren vs Löffler’s syndrome

Löffler’s syndromeLöfgren syndromeAlso known asSimple pulmonary eosinophiliaSymptomsTransient respiratory symptoms (cough, dyspnée, slight fever)Erythema nodosumBilateral hilar lymphadenopthyArthritis (usually bilaterla anckles)Fever EtiologyParasites (Ascaris, Strongyloides, Ancylostoma)Medication (aspirin, penicillin)No cause found in 1/3rd of patientsSarcoidosis RadiologicallyPeripheral…

Revision resources etc (Medicine undergrad)

As a med student, I was always lurking around looking for extra resources to study on, add more details etc. I thought some of you might like to have some of these resources accessible! Revision websites: General * Oxford handbooks *Almost a doctor (it’s Australian but has good advice and their random blog posts are also nice for an educational break!)*Speaking clinically (this one, your uni…

Jones vs Duke criteria for diagnosis

So, nothing ground breaking but I keep confusing the two, in the hope it helps someone! JonesDukeMedical condition Rheumatic feverEndocarditisMajor criteriaPolyrthritis Carditis Sydehm’s chore Erythema marginatum Subcutenous nodules Positive blood culture (typical for endocarditis or repeatedly positive)Positive echo (mass, abscess, valve dehiscence)Minor criteriaPolyarthralgiaProlonged…

Ursodeoxycholic acid vs Cholestyramine

Ursodeoxycholic acidCholestyramineIndication Dissolution of gallstones, primary billiary cirrhosis, gall reflux gastritis, intrahepatic cholestasis of pregnancyHyperlipidaemia, pruritus (in patients with cholestatic disease and incomplete biliary obstruction), diarrhea associated with Chron’s,  ileal resection, vagotomy, diabetic vagal neuropathy, and radiationMechanism of actionDecreased…

Hyoscine butylbromide vs Hyoscine hydrobromide

Want any more content? Visit medicsquestions! Have a look through our menu and if you can’t find something you’d like me to produce, contact me on here! Sources:BNFPatient.infohttps://medicines.necsu.nhs.uk/misuse-of-hyoscine-butylbromide-buscopan/ => drug misuse statementhttps://www.tandfonline.com/doi/abs/10.1080/15563650500357560?journalCode=ictx20 =>…

Otitis and associated ear pathologies: summary table

 Otitis externaNecrotizing/malignant otitis externa Otitis mediaGlue earChronic suppurative otitis mediaCholesteatomaMastoiditisRisk factorsSwimming Cotton buds Heat Immunocompromised DM Eczema Previous mastoidectomyDM ImmunocompromiseLess than 7 yo Male Down’s, Kartagener Cleft palate Tobacco No breastfeeding URTI FH Nursery PollutionCraniofacial malformations Make Daycare Having older siblings…

Functional neurological disorder: Rise, take up thy bed, and walk:

There are two aspects to this post, first a kind of “message from a patient” and then a personal “food for thought”. I will divide those clearly below for those of you who just want to know about patients.

I met a young girl who had one day stopped being able to walk. This was after a strong argument with a relative. But she went to a rehab center and after seeing a psychologist she was able…

Charcot’s join: Case study

I just attended a fantastic talk about Charcot’s joint in diabetes and I thought I would share with you my findings!

Suprising fact: Acute charcot’s joint is REVERSIBLE and VERY POORLY recognized by doctors.

The presentation of the patient is the following:

A 30 yo patient who is type I diabetic, who has a renal transplant and is HIV positive. He has an injury to his foot which is…

Treatment timings MI & stroke (UK)

To be very brief but clear as these get confusing (at least for me)

Timings of urgent treatmentsMIIschemic strokeThrombolysisWithin 12h of symptom onsetWithin 4.5-6h of symptom onset (4.5 ideally but might still have benefit up to 6h after)PCIWithin 12h of symptom onsetN/AThrombectomyN/AWithin 6h of symptom onsetAdjunct treatment given Morphine + metoclopramide + glyceryl trinitrate + aspirin +…

STI BASH guideline summary

PathogenInvestigationInvestigation findingsTest partner ?AbstinenceContact tracingTest of cureTreatmentCandidaClinical Culture second line NoNoNoNoFluconazole single doseTrichomonousVaginal swab + Wet mounts (saline + KOH)Loads of WBC and epithelial cells Parasite of motile oval or fusiform shaped 15 µm die after 10 minutes outside bodyNo1 week from diagnosisYes, treat partners empirically if…

Rinne’s an Weber’s explained and tested

Rinne’s: If it’s sensorineural loss, the ear bad will hear louder in front because the other good ear will be helping out and doing the hearing. If it’s conductive, the bad ear will hear louder at the back because all of a sudden, the mastoid is vibrating (ie: it’s kinda doing the job of the ossicles). If it’s a normal ear, both ears will hear better at the front. Hearing better at the front =…

In geriatrics there’s a few little extras to think about EVERY TIME you do a history, examination, treatment plan etc for each geriatric patient. This is based on the comprehensive geriatric assessment (GCA). So if you can’t do a full GCA as you’re just doing a quick history, I’ve decided to make a list of things not to forget:

Medications review

Nutrition review

Falls assessment and…

Mental health act summary (UK)!

Let’s be honest, it gets quite confusing, but it’s slightly better when put one next to another!

Section: mental health act 19832345Why?AssessmentTreatmentEmergencyKeep in hospital Patient must be suffering from a “mental disorder of a nature or degree” warranting admission for assessment and this must be in the “interests of his own health or safety or the protection of others”Patient must be…

Palliative pain relief prescription quizz

In this quizz, we will review the main ratios to know for pain prescription. This is kinda off by heart learning so hopefully this quizz will help you remember it! Usually this is done relative to oral morphine potency, so this will be the case for this quizz unless specified otherwise. There are 11 questions in total, all the answers are given at the end of the quizz and you don’t have to answer…

Colourful HLA (or why they are relevent)

What am I on about? HLAs, Human leucocyte antigen. Said simply, this is part of what the body uses to determine whether cells are foreign or not. It is the name of a polymorphic gene cluster region that codes for the MHC (major histocompatibility complex) surface proteins on the cells of the body. It lies on chromsome 6. Two siblings have a 1/4 chance of having the same HLA genes.

MHC class…