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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National insurance for sessional GPs.

A salaried GP, who is an NHS pension scheme member, will pay Class 1 contributions at the contracted out rate – 9.4% (and the employer will also pay a contribution). If the employment is not pensioned, then the rate increases to 11%. In both cases the contribution rate on the slice of income over £844…
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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.    
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BASHH | Pelvic inflammatory disease

Little of this new guideline is new. Take home messages for me were: Only 25% cases are caused by gonorrhoea/chlamydia. The rest are other STDs and non STDs. Any young, sexually active female (ie <25 yrs) should have PID considered and empiric treatment offered if they present with recent onset bilateral lower abdominal pain and…
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Alcohol use disorder (part 2)

A lot of this alcohol use disorder guideline is aimed at specialists. Basically, anyone with dependence (AUDIT > 15) needs specialist referral. Under 18s should be referred to CAMHS. There are specific tools which are listed for use with under 16s instead of the AUDIT screen. If someone has harmful drinking, but isn’t dependent, a ‘brief intervention’…
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Why doctors should write poems

Hilton Koppe is a genial Australian GP whose talent for engaging an audience can be judged by the fact that he can cajole Aussie orthopods to write poetry. His thesis is that we spend our lives writing down patients’ stories, but are not encouraged to reflect on them or allowed to admit our emotional involvement.…
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BASHH | Chlamydia testing

Most of the information is these guidelines is stuff we know. Learning points for me were: Endocervical swabs and HVS swabs have a similar sensitivity (before, the advice was that endocervical swabs were essential for testing where there are symptoms). FCU is not as sensitive in women. To take an HVS, you should rotate the…
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Nice | Anxiety quick reference guide

This guideline from Nice puts psychological interventions first. The following stepwise interventions should be considered. Start at any step, depending on severity: 1st line: Explain the disorder and explore their worries. Suggest self-help: NHS choices RCPysch has a good leaflet (These are my suggestions – NICE gives no specifics) 2nd line – Choose one of the…
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BASHH | Use of androgens

Guidelines on the management of sexual problems in men and women – the use of androgens These are short and worth a read – there are useful summaries on the back pages. They encourage screening men and women at risk of sexual problems and advise when checking testosterone is useful (which is our job). It…
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