Wardround 8vi7

The two minute talks this week were stimulated by a recent case of tetanus. We heard about the toxin effects of Tetanus (J Wallace); C. diff (G Bell); Botulism (N Mohan); Staph Toxin (L Frame). Very interesting topics. I was not aware of the neuromuscular effects of aminoglycosides. My prize goes to NM. You can find out more trivia about botulism at Naveen’s blog.

For next week’s talks we will address the four giants of geriatrics. Our mental search for the fifth giant reminded me of Terry Pratchett’s fifth horseman of the apocalypse. I once did a podcast on the subject and remain taken by the thought of that fifth horseman, Ronnie, who left before they became famous. The assignments for next Friday are:

Falls (MJM’s SHO)
Delirium (KL)
Incontinence (JW)
Immobility (NM)

Two minutes please. Keep it precise and concise, quote your sources and make a one page handout that is so perfect people will want to keep a copy to show their grandchildren. Given the subject matter I would prefer that you avoided practical demonstrations, especially JW.

The paper discussed this week was The dogged physical examination in the era of the C.A.T. Riegelman K. Primary Care 1980 Dec;7(4):625-35. I hope this has stimulated each of you to think about those parts of the exam that are particularly useful, yet easily and often omitted. You might want to read the last paragraph of the previous paper as well.

For next week I would like you to read and think about: Aunt Sophie’s Choice: the perils of paternalism. Schafer A.

PS beware Pratchett's four minor horsemen of the apocralypse: panic, bewilderment, ignorance and shouting.

MJM