Recent Posts by Louise Hudman

Nice | Tuberculosis

This is quite a complex, meaty guideline, with lots of flow-charts. Remember to consider if a newly registering patient should be screened and remember BCG in neonates at risk, but otherwise I would suggest referring to the guideline if a specific situation arises. However, the main new things here are: At registration of a new…
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Sign | Management of testicular germ cell tumours

Most of this is not new for us, or is for secondary care. Worthwhile noting is: 2 week wait refer if epididymo-orchitis/orchitis is suspected but is not resolving in 2 to 3 weeks. Patients have an increased risk of cardiovascular disease, because of chemo and radiotherapy, so ensure that they are given appropriate lifestyle advice.…
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Inflammatory Bowel Disease

This is a guideline which seems to be aimed predominantly at specialists. From our point of view there are a few useful bits: Patient Information. It lists some useful sources of information for patients. Faecal calcoprotein can be used in the assessment. (There is a good editorial on this in the BMJ. It has a…
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Alzheimer’s drugs

Some new alzheimers drugs Donepazine, galantamine and rivastigmine can now be used in mild, as well as in moderate disease. Memantine can be used if someone is intolerant to or has contraindications to the other drugs and can also be used in severe disease. Initiation is still by specialists but follow-up can be done by…
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Vulval Skin Disorders

This is a good guideline to have a quick read through as it is a good summary of vulval skin disorders. There is a really useful patient hand out on vulval skin care on page 17. Ask the obvious questions and also about sexual problems, cervical cytology history, immune deficiency, any pads or tampons or…
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Reduced Fetal Movements

A lot of this is what we already do. However there is a good flow chart at page 14. New things for me were: In a pregnancy with 2 or more episodes of reduced fetal movements (RFM), there is a worse outcome, so warn the mother to get checked each time. If a woman hasn’t…
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Food Allergy in Children

This guideline is really quite complex. Unfortunately it basically says that if you or the parents suspect food allergy, test for that food. It gives IgE (immediate) and non IgE mediated (delayed) associated symptoms. For an IgE mediated reaction, a skin-prick test or IgE blood test should be used (aimed at the suspected target, rather…
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Maternal collapse

There is a good algorithm that you can print out on page 22. Remember that in BLS for a pregnant woman, you need a tilt to the left of 15°. This can be achieved by getting someone to put their knees under her right side. Remember that after 20/40, perimortem fetal delivery can save the…
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Anaemia in CKD

Most of this is aimed a specialists, though some of it is useful to know: If GFR ≥ 60, anaemia is unlikely to be due to CKD. In adults you would want to investigate anaemia due to CKD further when their Hb < 11, or if they have symptoms of anaemia.     Louise HudmanI’m…
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