Our two minute talks this week were about malaria. I have put in links for the HPA malaria page and CDC malaria page as well as the UK guidelines: HPA Advisory Committee on Malaria Prevention in UK Travellers, UK malaria treatment guidelines. Journal of Infection 2007; 54(2):111-21

KG’s handout for malaria prophylaxis has been voted into the permanent collection.

Please remember that the talks need to be precise and the source of information quoted so that its authenticity can be weighed. Non-UK guidance may not be appropriate to management of a condition in the UK.

For next week there will be a lighter topic choice. Two minutes on a film or book which has influenced your practice of medicine, and why.

The paper for discussion on Tuesday will be Time, Now, to Recover the Fun in the Physical Examination Rather Than Abandon It. ARCH INTERN MED 166, 603-604, MAR 27, 2006

You can get it via the elibrary.

Interesting topics

Malaria – see above.

Dr Gilchrist, welcome to the fold. Please look at the 'training' link on the right.

MJM

Wardround 7xii7

The two minute tutorials this week were acute endocrine emergencies. I will upload the Addisonoan Crisis sheet to the summary sheet section. Remember, think about hypoadrenalism in any patient with shock, especially if they have a history of steroid use.

For next week the talks are themed around Malaria:

Epidemiology HJ
Falciparum JR
Vivax (Kaur)
Malariae/Ovale NS
Acute malaria SS
Travel prophylaxis KG

Two minutes please. Concise yet precise and quote your sources. The aim is not ‘to give a talk’ but to educate by giving a talk. Those handouts deemed up to scratch will be added to the permanent collection. We know this is a difficult task, that is why we challenge you with it.

The paper for discussion on Tuesday is

Clinical decision-making: Coping with uncertainty. A F West; R R West
Postgraduate Medical Journal; Jun 2002; 78, 920.

Interesting topics

Pericardial effusions

Yohimbine



MJM

Wardround 30xi7

This week’s intellectual task, if it can be so called, was the three minute test. The score you achieved is far less important than what you learned from the exercise. When one looks up the treatment of “an emergency”, in this case (life threatening) hyperkalaemia, it is essential to see how you would enact it in real life. For example, drugs must get from the cupboard/trolley into the patient’s bloodstream and do not just magically do so as they might in your mind. When reading the book ask yourself how you would get each step done. And don't forget to get and use help efficiently.

The case began with “Doctor, the lab have rung with his results. The creatinine is 491”. Elevated creatinine levels must always be qualified with a potassium result. Your response should have been a reflex “and the potassium?” Get into the habit of feeling incomplete if you are aware of SC but not K results, and always offer both when further disseminating the information.


The reading for Tuesday is Truth, stardust and comfort blankies by “ Aphra Behn”, presumably a nom de plume.

We are failing the great moral test of our times and retreating into the comfort of a new mediaevalism, surrounding ourselves with ideology... and warm and righteous certainties .... Discuss.


The two minute talks for Friday will be endocrine emergencies: recognition and management.

Thyroid crisis RR
Acute hypoadrenalism MJM
DKA SS
Acute hypopit HJ
Carcinoid KG
Vipoma JB
SIADH NS

Only two minutes, keep it concise and precise. Concentrate on th emergency aspect. And remember that the goal is to educate the group. Education achieved is not proportional to the number of words spoken. A one page visual aid is allowed.

Interesting topics
Thunderclap headache, uptodate has a good article

MJM