Bowel Obstruction

Gastro: 10. Harry and Sally discuss small and large bowel obstruction. They discuss the different underlying causes of the two, their symptoms, signs on examination, potential investigations and management plans. They also discuss ileus and pseudo-obstruction and some subtypes of Stomas. This episode was vetted by Miss Alexandra Cope, Consultant General & Colorectal Surgeon at Wexham Park Hospital, Berkshire. *Also, Harry would like to apologise for any noticable audio issues with his microphone during this episode, will be fixed for next time. Links: Picture from Netter's Anatomy showing a Volvulus. https://www.netterimages.com/volvulus-labeled-hansen-ca-2e-gastroenterology-frank-h-netter-40090.html

Cardio: 6. Harry and Dan talk about SVTs, recognising them clinically and their management. This episode also covers Wolff-Parkinson-White syndrome. This episode was vetted by a Consultant Cardiologist (who wishes to remain anonymous) at the Royal Brompton & Harefield NHS Trust, London.  Links: An example of an ECG showing SVT SVT example 1a https://litfl.com/supraventricular-tachycardia-svt-ecg-library/ An example of an ECG showing WPW pattern Example 2 https://litfl.com/pre-excitation-syndromes-ecg-library/    Modified Valsava technique from the REVERT Trial link https://www.youtube.com/watch?v=8DIRiOA_OsA  Resus council adult tachycardia algorithim (2021) https://www.resus.org.uk/sites/default/files/2021-04/Tachycardia%20Algorithm%202021.pdf Key resource used (but frankly, this provides detail far beyond what is expected for medical school): Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia: The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020;41(5):655-720. doi:10.1093/eurheartj/ehz467

PRN: 5. Sally talks about making an assessment of a fallen patient and generating a management plan. This is part of a subseries looking at key concepts for foundation year doctors. This episode was written by Dr Sally Barker. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode  suggestions - pleae email [email protected] Links: NICE CT head guidance for adults https://www.nice.org.uk/guidance/cg176/resources/imaging-algorithm-pdf-498950893  

PRN: 4. How to interpret basic pathology on abdominal radiographs for an undergraduate clinical exam. Harry talks about bowel-related pathology including large and small bowel obstruction, volvulus, perforation and complications of inflammatory bowel disease.  This is part of a subseries looking at key concepts for foundation year doctors that are not common conditions. This episode was written by Dr Harry Kingsley-Smith. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - please email [email protected] Links: Recommended radiology website (in no way affiliated with the podcast): https://www.radiologymasterclass.co.uk/gallery/abdo/abdominal_xray/normal Further reading about Abdominal radiograph interpretation: https://geekymedics.com/abdominal-x-ray-interpretation/ Other resource used for fact checking (this resource is peer reviewed) Closed loop bowel obstruction: https://www.ncbi.nlm.nih.gov/books/NBK441888/

PRN: 3. Tips for ePortfolio (in particular, Horus, used in England) during foundation training. Sally talks to Jess Caterson, another doctor who has recently completed her foundation training - to offer insights into to hopefully make Horus and ARCP easier for you.  Links: General ePortofolio guidance for doctors training in England: https://foundationprogramme.nhs.uk/curriculum/e-portfolio/ Sumarry narratives examples: https://www.scotlanddeanery.nhs.scot/media/547182/topic-8-example-summary-narrative-for-hlo-1.pdf This part of a subseries looking at key concepts for foundation year that are not common conditions. The episode was written by Dr Sally Barker in conjunction with Dr Jess Caterson. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - please email:  [email protected]

Season 3. Neuro: 3 (ID). Harry and Sally talk through the types of meningitis, their presenting features, how to investigate for them and the principles of their acute management. This episode was vetted by Dr. Gabriel Wallis, Consultant in Infectious Disease at London North West University Healthcare NHS Trust. Links: Video demonstrating Brudzinski's Sign: https://www.youtube.com/watch?v=ke5EsXMXPHo Video demonstrating Kernig's Sign: https://www.youtube.com/watch?v=euNPB3OjrdM Note: parts of the episode reference the UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults

Gastro: 9. Harry and Yvonne talk about the clinical presentation of GI bleeding, cover the classic 'upper' GI causes and the general blueprint for their management. Please note there is an addendum mentioning oesophagitis at the end of the episode. This episode was vetted by Dr Jonathan Hoare, Consultant Gastroenterologist and Head of Endoscopy at St. Mary's Hospital, London.  Links (these links are from consultant led presentations on bleeding and should link to a google image) Example of Coffee-ground vomiting: https://www.google.com/imgres?imgurl=x-raw-image%3A%2F%2F%2F01ece6a1f0316a0247f50c38e19018db2694d83024d1b7c096c7a8d066fd5784&imgrefurl=https%3A%2F%2Fwww.transfusionguidelines.org%2Fdocument-library%2Fdocuments%2Fgi-bleed-sishaq-may-16%2Fdownload-file%2FGI%2520Bleed%2520SIshaq%2520May%252016.pdf&tbnid=Amox8KHm7AF_fM&vet=12ahUKEwjajITng5H4AhUVw4UKHVzRCxgQMygOegUIARDPAQ..i&docid=b6lwT2-n3UWsBM&w=640&h=480&q=coffee%20ground%20vomit&ved=2ahUKEwjajITng5H4AhUVw4UKHVzRCxgQMygOegUIARDPAQ Example of Melaena: https://www.google.com/search?q=melaena&rlz=1C1CHBF_en-GBGB755GB755&sxsrf=ALiCzsZ3MpEeQoP4uii30fnEX8wcfstWkA:1654250952558&source=lnms&tbm=isch&sa=X&ved=2ahUKEwiK35WDhZH4AhVqSUEAHT6-APwQ_AUoAXoECAEQAw&biw=1600&bih=700&dpr=2#imgrc=Ak2UeTV_OQCbSM

Gastro 8: Harry and Dan talk about diverticulosis, diverticulitis and diverticular disease. They also talk about true and false diverticula - including a Meckel's diverticulum of the small bowel. They discuss the epidemiology, clinical presentation, investigations and management of diverticula pathology. Dan also makes an awful star wars reference. This episode was vetted by Miss Alexandra Cope, Consultant General & Colorectal surgeon at Wexham Park Hospital, Berkshire.  Links: Picture showing the difference between false and true diverticula (although I wouldn't really call the appendix a diverticulum): https://www.pinterest.co.uk/pin/522839837983243297/ Endoscopy images of diverticula (looking from inside the bowel): https://www.nejm.org/doi/10.1056/NEJMcp1800468

PRN: 2. How to use a Bleep. Sally talks about standard bleep etiquette and shares some tips about how to accept a job - including what to ask about the scenario and what to ask them to do next.  This is part of a new subseries looking at key concepts for foundation year doctors that are not common conditions . This episode was written by Dr Sally Barker. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - please email [email protected]

PRN: 1. Patient Flow & the Take. Harry talks about the a typical patient journey into an NHS hospital, via ED, clerking and the post take ward round. This is part of a new subseries looking at key concepts for foundation year doctor that are not common conditions. This episode was written by Dr Harry Kingsley-Smith. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give any feedback or episode suggestions – please email [email protected].