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Gastro: 10. Harry and Sally discuss small and large bowel obstruction. They discuss the different underlying causes of the two, their symptoms, signs on examination, potential investigations and management plans. They also discuss ileus and pseudo-obstruction and some subtypes of Stomas. This episode was vetted by Miss Alexandra Cope, Consultant General & Colorectal Surgeon at Wexham Park Hospital, Berkshire.
*Also, Harry would like to apologise for any noticable audio issues with his microphone during this episode, will be fixed for next time.
Links:
Picture from Netter's Anatomy showing a Volvulus.
https://www.netterimages.com/volvulus-labeled-hansen-ca-2e-gastroenterology-frank-h-netter-40090.html
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Cardio: 6. Harry and Dan talk about SVTs, recognising them clinically and their management. This episode also covers Wolff-Parkinson-White syndrome. This episode was vetted by a Consultant Cardiologist (who wishes to remain anonymous) at the Royal Brompton & Harefield NHS Trust, London.
Links:
An example of an ECG showing SVT
SVT example 1a https://litfl.com/supraventricular-tachycardia-svt-ecg-library/
An example of an ECG showing WPW pattern
Example 2 https://litfl.com/pre-excitation-syndromes-ecg-library/
Modified Valsava technique from the REVERT Trial link
https://www.youtube.com/watch?v=8DIRiOA_OsA
Resus council adult tachycardia algorithim (2021)
https://www.resus.org.uk/sites/default/files/2021-04/Tachycardia%20Algorithm%202021.pdf
Key resource used (but frankly, this provides detail far beyond what is expected for medical school):
Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia: The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(5):655-720. doi:10.1093/eurheartj/ehz467
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PRN: 5. Sally talks about making an assessment of a fallen patient and generating a management plan.
This is part of a subseries looking at key concepts for foundation year doctors. This episode was written by Dr Sally Barker. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - pleae email [email protected]
Links:
NICE CT head guidance for adults
https://www.nice.org.uk/guidance/cg176/resources/imaging-algorithm-pdf-498950893
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PRN: 4. How to interpret basic pathology on abdominal radiographs for an undergraduate clinical exam. Harry talks about bowel-related pathology including large and small bowel obstruction, volvulus, perforation and complications of inflammatory bowel disease.
This is part of a subseries looking at key concepts for foundation year doctors that are not common conditions. This episode was written by Dr Harry Kingsley-Smith. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - please email [email protected]
Links:
Recommended radiology website (in no way affiliated with the podcast):
https://www.radiologymasterclass.co.uk/gallery/abdo/abdominal_xray/normal
Further reading about Abdominal radiograph interpretation:
https://geekymedics.com/abdominal-x-ray-interpretation/
Other resource used for fact checking (this resource is peer reviewed)
Closed loop bowel obstruction: https://www.ncbi.nlm.nih.gov/books/NBK441888/
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PRN: 3. Tips for ePortfolio (in particular, Horus, used in England) during foundation training. Sally talks to Jess Caterson, another doctor who has recently completed her foundation training - to offer insights into to hopefully make Horus and ARCP easier for you.
Links:
General ePortofolio guidance for doctors training in England:
https://foundationprogramme.nhs.uk/curriculum/e-portfolio/
Sumarry narratives examples:
https://www.scotlanddeanery.nhs.scot/media/547182/topic-8-example-summary-narrative-for-hlo-1.pdf
This part of a subseries looking at key concepts for foundation year that are not common conditions. The episode was written by Dr Sally Barker in conjunction with Dr Jess Caterson. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - please email:
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Season 3. Neuro: 3 (ID). Harry and Sally talk through the types of meningitis, their presenting features, how to investigate for them and the principles of their acute management. This episode was vetted by Dr. Gabriel Wallis, Consultant in Infectious Disease at London North West University Healthcare NHS Trust.
Links:
Video demonstrating Brudzinski's Sign:
https://www.youtube.com/watch?v=ke5EsXMXPHo
Video demonstrating Kernig's Sign:
https://www.youtube.com/watch?v=euNPB3OjrdM
Note: parts of the episode reference the UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults
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Gastro: 9. Harry and Yvonne talk about the clinical presentation of GI bleeding, cover the classic 'upper' GI causes and the general blueprint for their management. Please note there is an addendum mentioning oesophagitis at the end of the episode. This episode was vetted by Dr Jonathan Hoare, Consultant Gastroenterologist and Head of Endoscopy at St. Mary's Hospital, London.
Links (these links are from consultant led presentations on bleeding and should link to a google image)
Example of Coffee-ground vomiting:
https://www.google.com/imgres?imgurl=x-raw-image%3A%2F%2F%2F01ece6a1f0316a0247f50c38e19018db2694d83024d1b7c096c7a8d066fd5784&imgrefurl=https%3A%2F%2Fwww.transfusionguidelines.org%2Fdocument-library%2Fdocuments%2Fgi-bleed-sishaq-may-16%2Fdownload-file%2FGI%2520Bleed%2520SIshaq%2520May%252016.pdf&tbnid=Amox8KHm7AF_fM&vet=12ahUKEwjajITng5H4AhUVw4UKHVzRCxgQMygOegUIARDPAQ..i&docid=b6lwT2-n3UWsBM&w=640&h=480&q=coffee%20ground%20vomit&ved=2ahUKEwjajITng5H4AhUVw4UKHVzRCxgQMygOegUIARDPAQ
Example of Melaena:
https://www.google.com/search?q=melaena&rlz=1C1CHBF_en-GBGB755GB755&sxsrf=ALiCzsZ3MpEeQoP4uii30fnEX8wcfstWkA:1654250952558&source=lnms&tbm=isch&sa=X&ved=2ahUKEwiK35WDhZH4AhVqSUEAHT6-APwQ_AUoAXoECAEQAw&biw=1600&bih=700&dpr=2#imgrc=Ak2UeTV_OQCbSM
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Gastro 8: Harry and Dan talk about diverticulosis, diverticulitis and diverticular disease. They also talk about true and false diverticula - including a Meckel's diverticulum of the small bowel. They discuss the epidemiology, clinical presentation, investigations and management of diverticula pathology. Dan also makes an awful star wars reference. This episode was vetted by Miss Alexandra Cope, Consultant General & Colorectal surgeon at Wexham Park Hospital, Berkshire.
Links:
Picture showing the difference between false and true diverticula (although I wouldn't really call the appendix a diverticulum):
https://www.pinterest.co.uk/pin/522839837983243297/
Endoscopy images of diverticula (looking from inside the bowel):
https://www.nejm.org/doi/10.1056/NEJMcp1800468
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PRN: 2. How to use a Bleep. Sally talks about standard bleep etiquette and shares some tips about how to accept a job - including what to ask about the scenario and what to ask them to do next.
This is part of a new subseries looking at key concepts for foundation year doctors that are not common conditions . This episode was written by Dr Sally Barker. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - please email [email protected]
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PRN: 1. Patient Flow & the Take. Harry talks about the a typical patient journey into an NHS hospital, via ED, clerking and the post take ward round. This is part of a new subseries looking at key concepts for foundation year doctor that are not common conditions. This episode was written by Dr Harry Kingsley-Smith. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give any feedback or episode suggestions – please email [email protected].
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Haem: 1. Yvonne talks dan through the causes of microcytic anaemia and the basics of RBC transfusion. This episode was vetted by Dr Nina Salooja, Consultant Haematologist at Imperial College Healthcare NHS Trust, London.
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Cardio: 5. Dan talks Yvonne through the assessment and management of pulmonary oedema and Light's Criteria. This episode was vetted by a Consultant Cardiologist (who wishes to remain anonymous) at the Royal Brompton & Harefield NHS Trust, London.
Links:
X-ray changes in pulmonary oedema (this website is very useful in general!)
https://www.radiologymasterclass.co.uk/gallery/chest/cardiac_disease/pulmonary_oedema
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Nephrology/Urology: 2. Harry and Yvonne talk through the common causes of AKI as well as how to classify, investigate and treat it. aThis episode was vetted by Dr Peter Hill, Consultant Nephrologist and clinical lead for Interventional Nephrology at Hammersmith Hospital, London.
Links:
https://www.thinkkidneys.nhs.uk/
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Gastro: 7. Harry and Dan talk through the causes, investigations and management of acute pancreatitis - alongside how to present such information in a clinical exam setting. This episode was vetted by Miss Alexandra Cope, Consultant General & Colorectal surgeon at Wexham Park Hospital, Berkshire.
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Cardio: 4. Dan talks Harry through the Chronic side of Heart Failure - including the diagnosis and management of so called "HFrEF" and "HFpEF". Disclaimer: this episode is likely suitable for finals as well as first clinical year students. This episode was vetted by a Consultant Cardiologist (who wished to remain anonymous) at the Royal Brompton & Harefield NHS trust, London.
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Gastro: 6. Yvonne and Harry talk about gastric duodenal ulcers, their common causes and how to treat them. This episode was vetted by Dr. Jonathan Hoare, Consultant Gastroenterologist and Head of Endoscopy at St. Mary's Hospital, London.
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Season 2. Resp 4: Harry and Yvonne talk about COPD, its presentation and management in both primary and secondary care. This episode was vetted by Dr. Georgina Russell, Consultant Respiratory physician at Imperial College Healthcare NHS Trust, London.
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Neuro: 2. Sally and Harry talk through Dementia and its main subtypes: Alzheimer's, Dementia with Lewy Bodies, Vascular and Frontotemporal. This episode was vetted by Prof. Steve Gentleman, Professor of Neuropathology at Imperial College London.
AMTS Mnemnonic: ABC (10 questions)
Age.
Birthday.
Count backwards from 20 to 1.
Date - current year.
Estimated time of day/day of week.
First/Second world war date.
Geography - current location.
Home Address (check recall at end of test).
Identify two people in area by name (or profession).
Jingoism - Who is Prime Minister or on Throne.
Links:
AMTS: https://www.mdcalc.com/abbreviated-mental-test-amt-10
Histopathology of the Substantia Nigra in Parkinson's Disease: https://www.researchgate.net/profile/Liviu-Aron/publication/45314202/figure/fig1/AS:669388923482114@1536606164215/Loss-of-substantia-nigra-SN-neurons-causes-Parkinsons-disease-Pathological.jpg
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Gasto: 5. Harry and Sally talk through Appendicitis, why it causes centralised to RIF pain and its key complications. This episode was vetted by Miss Alexandra Cope, Consultant General & Colorectal Surgeon at Wexham Park Hospital, Berkshire.
Links:
Demonstration of Rovsing's, Psoas and Obturator Signs: https://www.youtube.com/watch?v=6LrL4ysi_AE
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Nephrology/Urology: 1. Yvonne and Harry talk through renal stones, their types, underlying causes and the initial investigations and management. This episode was vetted by Mr Ranan Das Gupta, Consultant Urologist at Charing Cross Hospital, Imperial College Healthcare NHS Trust, London.
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