Varicose veins

Background dilated, palpable, often tortuous subcutaneous veins >3mm in diameter usually involve saphenous veins, saphenous tributaries, and/or non-saphenous superficial leg veins Causes Primary most common cause, usually due to intrinsic biochemical or morphological abnormality in vein wall, may occur in setting of valvular incompetence Secondary previous DVT AV fistula deep vein obstruction superficial thrombophlebitis Congenital … Continue reading Varicose veins


Winged scapula

Uncommon cause of MSK pain of shoulder and posterior chest wall caused by paralysis of serratus anterior muscle begins as painless weakness of the muscle, eventual finding is pathognomonic winged scapula dysfunction secondary to paralysis of the muscle usually occurs after heavy exertion i.e. carrying heavy backpacks trauma to the long thoracic nerve of Bell … Continue reading Winged scapula

Joanna Moncrieff: The Bitterest Pills

The Bitterest Pills: The Troubling Story of Antipsychotic Drugs Antipsychotic (neuroleptic) drugs have become some of the biggest blockbusters of the early 21st century, increasingly prescribed not just to people with ‘schizophrenia’ or other severe forms of mental disturbance but for a range of more common psychological complaints. This book challenges the accepted account that … Continue reading Joanna Moncrieff: The Bitterest Pills

Dementia: An Introduction

Description neurodegenerative syndrome → progressive decline in several cognitive domains over months/years, usually signalled by memory loss Cognition: the mental processes by which knowledge is acquired i.e. perception, reasoning, acts of creativity, problem-solving and possibly intuition Subtypes Alzheimer's Disease Vascular Dementia (25%) cumulative effect of many small strokes sudden onset and stepwise deterioration Identify signs of … Continue reading Dementia: An Introduction

Safe Alcohol Consumption Guidelines

Healthy Adults No more than 2 standard drinks (20 grams) at any given time to reduce life time risk of alcohol related harm or disease No more than 4 standard drinks (40 grams) at any given time to reduce risk of alcohol related harm or injury from that occasion Pregnant and Breastfeeding Women Not drinking … Continue reading Safe Alcohol Consumption Guidelines

Opioid Substitution Therapy

Opioid intoxication Opioid withdrawal slow sleepy hypotensive bradycardic hypopnoeic constricted pupils constipation "on the nod" agitated dilated pupils tachycardia hypertension piloerection (goosebumps) "orange peel" skin nausea, vomiting diarrhea wet signs: clammy/sweaty, tears, runny nose yawning headache and body cramps Choice of withdrawal Methadone Buprenorphine  Pure μ opioid receptor agonist Partial μ opioid receptor agonist,  ↑ efficacy ↓ … Continue reading Opioid Substitution Therapy

Alcohol dependence

Features Drink driving (2 or more significant for dependence) Rescue drink (i.e. midnight, lunch) Perceptual changes (hallucinations) when alcohol is stopped, i.e. due to illness can be as subtle as shapes/colours appearing to change Seizures (in withdrawal) Concurrent use of benzodiazepines i.e. valium (diazepam) Hiding alcohol supply and drinking behaviour Frequent blackouts This refers to … Continue reading Alcohol dependence