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MIMS Learning Annual Membership
£ 154.80

Start learning now with all 550+ clinical education modules. Full MIMS Learning membership for £129+VAT gives you instant access to all education on the site for one year, plus priority booking for live events, a CPD organiser integrated with the Clarity & RCGP Appraisal Toolkit for GPs, the MIMS Learning Compendium in print and clinical guidance updates.

Courses Included in this Subscription:

Guidance update: latest NICE guidelines on asthma diagnosis and management

Dr Toni Hazell discusses the latest guidance from NICE on asthma diagnosis, monitoring and chronic asthma management.

 

Guidance update: latest NICE guidance on child abuse and neglect

Dr Toni Hazell explains what GPs need to know about NICE guidance on child abuse. This module focuses on what’s new, what to do differently in your practice and how to advise young patients about confidentiality.

 

Guidance update: latest NICE guidelines on tuberculosis

Dr Steve Holmes, Jane Scullion and Dr Gerrit Woltmann describe the latest NICE guidance on tuberculosis.

 

Training resource: slide sets on latest guidelines in 15 topic areas

Update your colleagues and refresh your own knowledge using our ready-prepared slide sets on 15 key guidelines.

 

Guidance update: latest NOGG guidelines on osteoporosis

Dr Jessica Garner describes the latest guidance from the National Osteoporosis Guideline Group (NOGG).

 

Guidance update: latest NICE guidelines on eating disorders

Dr Sally Higginbottom describes the latest NICE guidance on eating disorders.

 

Guidance update: latest GMC guidance on confidentiality

Dr Toni Hazell describes the latest GMC guidance on confidentiality.

 

Guidance update: latest guidelines on food allergy

Dr Elizabeth Angier describes the latest NICE guidance on food allergy.

 

Guidance update: latest NICE guidelines on rheumatoid arthritis

Dr Katrina Davies describes the latest guidance on rheumatoid arthritis (RA).

 

Guidance update: latest NICE guidelines on spondyloarthritis in over 16s

Dr Rob Hampton describes how to implement the latest NICE guidance on spondyloarthritis.

 

Guidance update: latest NICE guidelines on anaphylaxis

Dr Elizabeth Angier describes the latest guidance on anaphylaxis.

 

Guidance update: latest NICE guidelines on dementia

Dr Elizabeth Kendrick describes the latest NICE guidance on supporting people with dementia and their carers.

 

Guidance update: Latest NICE guidelines on lower urinary tract symptoms in men

Dr Mike Thurgood describes an update to NICE guidance on lower urinary tract symptoms (LUTS) in men.

 

Guidance update: latest SACN/PHE guidelines on vitamin D

Dr Mark Jopling outlines the recommendations of the SACN and PHE guidance on vitamin D

 

Guidance update: latest NICE guidelines on low back pain and sciatica in over 16s

Dr Rob Hampton describes the NICE guidance on low back pain and sciatica.

 

Guidance update: latest NICE guidelines on mental health problems in people with learning disabilities

Dr Tillmann Jacobi describes the NICE guidance on mental health problems in people with learning disabilities.

 

Guidance update: latest guidance on HIV

Dr Toni Hazell rounds up the latest guidance relating to the diagnosis of HIV and the aspects of treating patients with HIV that are relevant to primary care.

 

Guidance update: latest NICE guidelines on end of life care in children

Dr Jennifer Kelly describes the NICE guidance on end of life care in children.

 

Guidance update: latest NICE guidelines on irritable bowel syndrome

Dr Jamie Dalrymple describes the NICE guidance on irritable bowel syndrome.

 

Guidance update: latest BTS/SIGN guidelines on asthma

Jane Scullion and Steve Holmes outline the recommendations of the BTS/SIGN guidance on asthma.

 

Guidance update: latest NICE guidelines on challenging behaviour and learning disabilities

Dr Tom Howseman explains how to implement the first NICE guidance on challenging behaviour and learning disabilities in primary care

 

Guidance update: latest NICE guidelines on sepsis

Dr Jessica Garner describes the NICE guidance on recognising and managing sepsis.

 

Latest guidance: latest RCOG guidelines on ovarian cysts in postmenopausal women

Dr Toni Hazell describes how to implement the RCOG guidance on ovarian cysts in postmenopausal women in primary care.

 

Guidance update: latest NICE guidelines on multimorbidity

Professor David Haslam, Chair of NICE, describes how to implement the NICE guidance on multimorbidity.

 

Guidance update: latest NICE guidelines on motor neurone disease

Dr Mark Rickenbach outlines what GPs need to know about the diagnosis and management of motor neurone disease.

 

Guidance update: latest ESHRE guidelines on premature ovarian insufficiency

Dr Louise Newson explains how to implement the ESHRE guidance on premature ovarian insufficiency in primary care

 

Guidance update: latest NICE guidelines on heavy menstrual bleeding

Dr Jessica Garner describes the August 2016 update to existing NICE guidance on heavy menstrual bleeding.

 

Guidance update: latest FSRH guidelines on contraceptive use (UKMEC)

Dr Toni Hazell describes the changes to the latest FSRH guidance: UK Medical Eligibility Criteria for Contraceptive Use.

 

Guidance update: latest NICE guidelines on non-alcoholic fatty liver disease

Dr Rachel Pryke describes how to implement the latest NICE guidance on non-alcoholic fatty liver disease in primary care.

 

Guidance update: latest NICE guidance on assessment and management of cirrhosis

Dr Iain Brew summarises the latest NICE guidelines on cirrhosis.

 

Guidance update: latest NICE guidelines on antenatal and postnatal mental health

Dr Carrie Ladd describes how to implement the latest NICE quality standard on antenatal and postnatal mental health in primary care.

 

Guidance update: latest NICE guidelines on diabetes in children and young people

Dr Suneeta Kochhar describes how to implement the August 2015 NICE guidance on the diagnosis and management of type 1 and type 2 diabetes in children and young people.

 

Guidance update: NICE guidance on type 1 diabetes in adults

Professor Roger Gadsby describes how to implement the updated NICE guidance on type 1 diabetes in adults in primary care.

 

Guidance update: latest NICE and Home Office guidelines on domestic abuse

Dr Toni Hazell explains how to implement the NICE quality standard on domestic violence and abuse in primary care.

 

Guidance update: NICE guidance on cardiovascular risk assessment and lipid modification

Dr Farooq Ahmad describes how to implement the latest NICE guidance on cardiovascular disease risk assessment and lipid modification in primary care.

 

Guidance update: NICE guidelines on bronchiolitis in children

Dr Suneeta Kochhar describes how to implement the NICE guidance on bronchiolitis in primary care.

 

Guidance update: latest NICE guidelines on coeliac disease

Dr Suneeta Kochhar describes how to implement the NICE guidance on coeliac disease in primary care.

 

Guidance update: latest NICE guidelines on melanoma

Dr Nigel Stollery describes how to implement the latest NICE guidance on assessment and management of melanoma.

 

Guidance update: latest NICE guidelines on familial hypercholesterolaemia

In this module, Dr Martin Duerden reviews the current guidance on familial hypercholesterolaemia (FH), which is due to be updated soon.

 

Guidance update: latest NICE guidelines on venous thromboembolic diseases

Dr Suneeta Kochhar explains the updates to NICE guidance on diagnosing and managing venous thromboembolic diseases.

 

Guidance update: latest NICE guidelines on prostate cancer

Dr Tillmann Jacobi describes how to implement the NICE quality standard on the care of men with suspected or diagnosed prostate cancer in primary care.

 

Guidance update: latest NICE guidelines on hypertension

Dr Raj Thakkar describes how to implement the latest NICE guidance relating to hypertension in primary care. The module outlines the latest evidence and what to do differently in your practice.

 

Guidance update: latest NICE guidelines on headache in adults and teenagers

Dr Tilllmann Jacobi looks at how best to implement 2015 NICE guidance on headache in primary care in this educational module.

 

Guidance update: latest NICE guidelines on menopause

Dr Louise Newson describes how to implement the first NICE guidance on menopause in primary care.

 

Guidance update: latest NICE guidelines on type 2 diabetes in adults

Dr Richard Brice describes how to implement the NICE guidance on management of type 2 diabetes in adults in primary care. The module outlines what’s new in the guidance and what to do differently in your practice.

 

Guidance update: latest NICE guidelines on recognition and referral of suspected cancer

Dr Toni Hazell outlines how to implement the latest NICE guidance on the recognition and referral of suspected cancer in primary care.

 

Guidance update: latest NICE guidelines on care of the dying adult

Dr Toni Hazell describes how to implement the NICE guidance on care of dying adults in the last days of life in primary care.

 

Guidance update: latest NICE guidelines on osteoarthritis

Dr Louise Warburton describes how to implement the NICE quality standard on osteoarthritis in primary care.

 

Guidance update: latest NICE guidelines on chronic heart failure in adults

Dr Ivan Benett describes how to implement the updated NICE quality standard on chronic heart failure in adults in primary care.

 

Guidance update: latest NICE guidelines on gastro-oesophageal reflux disease in children

Dr Jessica Garner describes how to implement the latest NICE guidance and quality standard on gastro-oesophageal reflux disease in children and young people in primary care.

 

Guidance update: latest NICE guidelines on optimising medication

Dr Ian Hill-Smith describes how to implement the latest NICE guidance on medicines optimisation to get the best possible outcome for patients in primary care while being cost-efficient for the NHS.

 

Guidance update: latest DH and RCOG guidelines on female genital mutilation

Dr Louise Clarke and Dr Mais Al-Hity discuss the implications of updated guidance on female genital mutilation including guidance from the Department of Health in September 2015 and March 2015 and the Royal College of Obstetricians and Gynaecologists in July 2015 .

 

Guidance update: latest NICE guidelines on atrial fibrillation

Dr Pipin Singh describes how to implement the NICE quality standard on atrial fibrillation in primary care. The module outlines what’s new in the guidance and what to do differently in your practice.

 

Guidance update: latest NICE guidelines on chronic kidney disease: managing anaemia

Dr Neil Iosson describes the changes to NICE guidance on managing anaemia in patients with CKD and explains how to implement them.

 

Guidance update: latest NICE guidelines on bipolar disorder, psychosis and schizophrenia in children

Dr Toni Hazell describes how to implement the NICE quality standard on bipolar disorder, psychosis and schizophrenia in children and young people in primary care.

 

Guidance update: latest NICE guidelines on diabetic foot disease

Dr Colin Kenny describes how to implement the updated NICE guidance on diabetic foot problems in primary care.

 

Uterine fibroids: clinical review

 

Fibromyalgia: patient case study

Fibromyalgia often presents in primary care with non-specific symptoms and so can be difficult to diagnose and treat.

 

Early diagnosis of pancreatic cancer

In this article Dr Lucy Thompson and Dr Anthony Cunliffe advise on symptoms and signs of pancreatic cancer that may present in primary care.

 

Hyperemesis gravidarum: clinical review

Dr Abdelmageed Abdelrahman gives an overview of nausea and vomiting of pregnancy, outlines the definition of hyperemesis gravidarum and explains when to consider inpatient management.

 

Malignant disease: illustrated

Carcinoma of the pancreas, glioblastoma, renal cancer, breast cancer and lymphoma, among other malignant disease, are covered in this activity. Each is illustrated with photographs and key education points for GPs by Dr Phil Marazzi.

 

Eye pain - red flag symptoms

Dr Pipin Singh discusses the red flag symptoms to be aware of in patients presenting with eye pain.

 

Management of contact dermatitis

Dr Graham Johnston gives an overview of evidence-based recommendations for the management of contact dermatitis.

 

Scalp necrosis secondary to giant cell arteritis

Dr Elizabeth Roberts describes the case of an 87-year-old woman who presented with headache, lethargy, weight loss, jaw claudication and significant pain and tenderness in her scalp.

 

Diagnosis of common hair loss conditions

Hair loss can severely affect patients. Dr Anton Alexandroff describes the most common types of alopecia, including non-scarring alopecia, telogen effluvium and alopecia areata.

 

Skin problems in haematological disease

Dr Ekaterina Burova and colleagues describe dermatological signs and symptoms that may indicate a blood disorder, and common cutaneous side effects of medications used to treat haematological conditions.

 

Basal cell carcinoma: clinical review

In this article, Dr David Brass and Dr Neil Rajan discuss the risk factors for BCC, making the diagnosis and management.

 

Psychosocial problems in a patient with vitiligo

This case study describes the diagnosis and management of a vitiligo in a patient with pigmented skin.

 

Diagnosis and management of tricky dermatological cases

Dr Brian Malcolm discusses the presentation, diagnosis and management of four cases.

 

Bullous pemphigoid: clinical review

Consultant dermatologist Dr James Powell explains the diagnosis and management of bullous pemphigoid.

 

New treatments for psoriasis

Dr Elizabeth Roberts and Dr Shanti Ayob give an update on new treatment options for patients with psoriasis, including topical therapies, phototherapy and biologics.

 

Acute skin problems in children

Dr Catriona Maybury and Dr Alya Abdul-Wahab review the diagnosis and management of common paediatric dermatology presentations needing urgent treatment.

 

First treatment for IBS with diarrhoea

This news article from MIMS explains the use of a new agent, eluxadoline, that has been approved by NICE as a treatment for IBS with diarrhoea. Test your knowledge by answering questions after reading.

 

Anxiety and depression in young people, fructose intake in diabetes, and probiotics: journals update September 2017

Anxiety and depression, glucose replacement in diabetes, probiotic supplements and gallstone disease are covered by Dr Tillmann Jacobi in this MIMS Learning journals update for GPs and other healthcare professionals.

 

Valproate risks in pregnancy

This news article from MIMS explains the GP's role in making women aware of the risks associated with the use of valproate in pregnancy.

 

HIV: clinical review

This article, updated in 2017 by Dr Laura Waters, considers the role of rapid HIV tests, referring newly diagnosed patients and useful baseline assessments.

 

Autism spectrum disorder: clinical review

This article discusses common presentations, core features and behaviours that may suggest a diagnosis of ASD, and evidence-based interventions.

 

Primary care genetics Q&A

GPwSI in genetics Dr Jude Hayward advises on taking an effective family history and the developing role of genomics in primary care.

 

MIMS Learning Live 2017 - Diabetes & Cardiovascular Disease, London Slides

Presentation slides from the MIMS Learning Live 2017 London event, Diabetes & Cardiovascular Disease stream – for attendees only.

 

MIMS Learning Live 2017 - Dermatology London Slides

Presentation slides from the MIMS Learning Live 2017 London event, Dermatology stream – for attendees only.

 

MIMS Learning Live 2017 - Women's Health, London Slides

Presentation slides from the MIMS Learning Live 2017 London event, Gastroenterology stream – for attendees only.

 

MIMS Learning Live 2017 - Gastroenterology, London Slides

Presentation slides from the MIMS Learning Live 2017 London event, Gastroenterology stream – for attendees only.

 

Asthma in children

Respiratory nurse Jane Scullion and GP Dr Steve Holmes outline common symptoms of paediatric asthma, how to get the medication right and lifestyle modifications.

 

Obesity treatment, IBS and rosacea: prescribing update July/August 2017

Obesity treatment, IBS and rosacea are covered in an update on prescribing developments from MIMS.

 

Atrial fibrillation: clinical review

This review by Dr Andrew Money-Kyrle, updated in 2017, examines the diagnosis and management of atrial fibrillation.

 

Postnatal checks, bleeding risk with aspirin and antibiotic resistance: update clinical July/August 2017

Postnatal checks, antibiotic prescribing and diabetes awareness are all covered in this news update from the July/August 2017 edition of MIMS Learning in print. All articles originate from GPonline.

 

Trauma: Illustrated

Trauma, including dog bite, corneal abrasion and burns, are highlighted in this activity.

 

Antiphospholipid syndrome: diagnosis and management

Dr Anisur Rahman and Dr Salma Ahmed discuss the diagnosis and management of antiphospholipid syndrome (APS).

 

Comorbidities in older people

This article by Dr Richard Day considers comorbidities in older people, including the likelihood of having multiple conditions, primary prevention and prescribing in older people.

 

Menopause and migraine

Dr Louise Newson describes a case of migraine linked with menopause.

 

First drug approved for diabetes prevention

This news article from MIMS explains the use of sustained-release metformin in prevention of diabetes. Test your knowledge by answering questions after reading.

 

Early diagnosis of Lyme disease

Dr Sara Ritchie explains how recognition of the erythema migrans rash and other symptoms can aid prompt identification of Lyme disease.

 

Insomnia: clinical review

This article, updated in 2017 by Dr Annemarie Luik, Dr Rachel Sharman and Professor Colin Espie, explains the criteria for diagnosis of insomnia and how to help patients to manage the factors that cause it.

 

Weight loss, sexual health and listening skills: update clinical June 2017

Weight loss programmes, sexual health for young people and GP listening skills are all covered in this news update from the June 2017 edition of MIMS Learning in print. All articles originate from GPonline.

 

Diabetes prevention, asthma treatment, long-term quinine: prescribing update June 2017

Diabetes prevention, therapeutics in rheumatoid arthritis and long-term use of quinine are covered in an update on prescribing developments from MIMS.

 

Lifestyle change and obesity Q&A

GP and chair of GPs Interested in Nutrition Group, Dr Rachel Pryke advises on the GP’s role in talking to patients and signposting, and offers useful resources on weight management.

 

MIMS Learning Live 2017 - Birmingham Slides

Presentation slides from the MIMS Learning Live 2017 Birmingham event – for attendees only.

 

Rheumatoid arthritis, rapid-acting insulin and chemoprevention of breast cancer: prescribing update May 2017

The new treatment class for rheumatoid arthritis, rapid-acting insulin aspart and chemoprevention of breast cancer are covered in an update on prescribing developments from MIMS.

 

Abdominal swellings: differential diagnosis

Dr Nigel Stollery outlines differential diagnoses of abdominal swellings including paraumbilical hernias, umbilical hernias, ovarian cysts and umbilical granulomas.

 

Urgent care clinical Q&A

Dr Philip Brown, GP and clinical adviser in urgent care discusses his role and how GPs can develop an interest in urgent care.

 

Hypertension and CVD clinical Q&A

Dr Terry McCormack, GP and research lead, describes his role in primary care cardiovascular research and advises on an upcoming rewrite of NICE hypertension guidelines.

 

Pelvic organ prolapse: clinical review

This article by Dr Abdelmageed Abdelrahman discusses diagnosis and management of pelvic organ prolapse. Key learning points for healthcare professionals include risk factors, assessment and conducting a vaginal examination.

 

Identifying oral cancer

Dental nurse and adviser at the Oral Health Foundation, Karen Coates, discusses how to recognise the main signs, symptoms and risk factors of oral cancer in primary care.

 

Oesophageal cancer, prescribing rules and women's health: update clinical April 2017

Oesophageal cancer, prescribing rules and women’s health are all covered in this article from the April 2017 edition of MIMS Learning in print.

 

Weight management, type 2 diabetes and asthma: prescribing update April 2017

Liraglutide as a weight loss option, a combination tablet for type 2 diabetes and a dry powder inhaler for asthma and COPD are covered in an update on prescribing developments from MIMS.

 

Diagnosis of cutaneous vasculitis

Dr James Miller and Dr Anton Alexandroff consider classification, clinical features and suitable investigations.

 

Guidelines for the management of TEN and SJS

Professor Chris Bunker discusses new guidance on the recognition and management of SJS/TEN.

 

Skin reaction after progestogen implant case study

Dr Rajiv Ghurye, Dr Suma Sreeshyla and Dr Simon Giles describe an unusual cause of Koebner’s phenomenon.

 

Pitted keratolysis resulting from hyperhidrosis case study

Dr Maria-Angeliki Gkini and Dr Anshoo Sahota discuss clinical diagnosis and treatment options for pitted keratolysis.

 

Medical tattooing for lasting skin camouflage

Medical tattooing has distinct cosmetic and psychological advantages for patients, writes Dawn Cragg.

 

Management of cutaneous viral warts

Dr Anton Alexandroff discusses clinical presentations and the latest advice on therapeutics for cutaneous viral warts.

 

Developments in melanoma treatment

Dr Stamatina Verykiou reviews established and novel therapeutic approaches for malignant melanoma.

 

Diagnosing dermatitis artefacta

Dr Padma Mohandas and Dr Anthony Bewley consider clinical features and offer consultation strategies for dermatitis artefacta.

 

Dermatological conditions in pigmented skin

Dr Emily Rudd and Dr Claire Fuller discuss conditions specific to pigmented skin.

 

Contraceptive choices in primary care

Dr Anne Connolly presents a case-based update on contraception including risks and benefits of different contraception methods.

 

Osteoporosis prevention and management

Dr Sally Hope discusses prevention and treatment of osteoporosis.

 

The ECG in ischaemia

In part four of a series on ECG interpretation, Dr Sayan Sen and Dr Ravi Assomull discuss the ECG in ischaemia.

 

Learning disabilities clinical Q&A

Dr Tom Howseman, GP and clinical lead for learning disability commissioning, describes his role and answers questions on primary care management of patients with learning disabilities.

 

Breast cancer, HRT and cholesterol: update clinical March 2017

Tamoxifen prescribing, HRT, and cholesterol targets and postnatal mental health are all covered in this article from the March 2017 edition of MIMS Learning in print.

 

Testosterone treatment, consultation length and IUD fitting: journals update March 2017

Potential VTE risks of testosterone treatment, the impact of consultation length on patient experience and tolerance of IUD fitting are covered by Dr Jessica Garner.

 

Uncontrolled asthma, psoriasis treatment, and antibiotics: prescribing update March 2017

LTRA tablets in uncontrolled asthma, psoriasis treatment with apremilast, and antibiotics for bacterial skin infections are covered in an update on prescribing developments from MIMS.

 

Asthma exacerbation with heroin use

Dr Matthew Johnson outlines the case of an asthma death associated with heroin use. Learning points for GPs include the role of heroin use in triggering or exacerbating asthma.

 

Fever of unknown origin in children - red flag symptoms

Dr Pipin Singh outlines the red flag symptoms to look out for in a child presenting with pyrexia of unknown origin.

 

A discoloured nail - what's the diagnosis?

Dr Ravi Ramanathan describes the case of man who presented to his GP with a darkened line along one of his fingernails. Identify the likely diagnosis in this picture quiz.

 

A lesion on the nose - what's the diagnosis?

Dr Ravi Ramanathan describes the case of an older man with a non-painful lesion on his nose. Identify the likely diagnosis in this picture quiz.

 

A swollen elbow - what's the diagnosis?

Dr Ravi Ramanathan describes the case of a man who presented with a swollen elbow that felt hot and inflamed. Identify the likely diagnosis in this picture quiz.

 

Painful and swollen fingers - what's the diagnosis?

Dr Ravi Ramanathan describes the case of a woman with pain and swelling in her fingers. Identify the likely diagnosis in this picture quiz.

 

A nasal blockage - what's the diagnosis?

Dr Ravi Ramanathan describes the case of a man presenting to the GP with a nasal blockage and discharge from his nostril. Identify the likely diagnosis in this picture quiz.

 

A ring in the cornea - what's the diagnosis?

Dr Ravi Ramanathan describes the case of an older woman who noticed a ring in the corneal margin of her eye. Identify the likely diagnosis in this picture quiz.

 

Women's health clinical Q&A

Dr Anne Connolly, GPSI in gynaecology and chair of the Primary Care Women’s Health Forum discusses opportunities to provide better care for women and recommends useful resources for GPs and nurses.

 

End of life care scenario: managing hepatic failure

As GPs become more and more involved with palliative care, they are having to deal with more complex cases.

 

Fever in adults - red flag symptoms

Fever in adults can have potentially serious causes, ranging from sepsis to malignancy.

 

Turner syndrome: clinical review

In this article Dr Amish Chinoy and Dr Raja Padidela discuss this condition caused by loss of the X chromosome. Key learning points for healthcare professionals include clinical features of Turner syndrome, comorbidities, management and early referral.

 

Vulval pain: clinical review

Vulval pain is a relatively common condition. Dr Abdelmageed Abdelrahman discusses causes, the distinction between provoked and unprovoked vulval pain, and the evidence base for available treatments.

 

Mental health clinical Q&A

Lecturer in primary care mental health and GP Dr Ian Walton, describes his role and answers questions on management of mental health conditions in primary care, including assessment and prescribing.

 

Flu vaccination, inhaled steroids and diabetes education: update clinical January 2017

Flu vaccination, inhaled steroids, diabetes education, pharmacist prescribers and HIV testing are all covered in this article from the January 2017 edition of MIMS Learning in print.

 

Hepatitis C, refractory psoriasis and COPD: prescribing update January 2017

Hepatitis C, refractory psoriasis, COPD and breast cancer are covered in an update on prescribing developments from MIMS.

 

Neck swellings: differential diagnosis

Dr Nigel Stollery outlines differential diagnoses of neck swellings including thyroglossal cysts, cervical lymphadenopathy, a goitre and an abcess.

 

Analysing ECGs in primary care

In the third of a series, Dr Ravi Assomull and Dr Sayan Sen present steps 6 to 10 of a 10-step system for successful ECG interpretation in primary care.

 

Back pain - red flag symptoms

This red flags article explains the signs and symptoms of potentially serious pathology in patients presenting with back pain.

 

Minimising health risks in prescribing contraception

Dr Zara Aziz offers an update on contraception taking into account new guidance on health risks.

 

Answering patients' questions on intrauterine contraception

Dr Anita Sharma and Dr Farzana Siddiqui discuss questions that GPs may need to answer from women considering having an IUS or IUD fitted.

 

How to become a resilient leader

In the last of five articles, Fiona Dalziel discusses the benefits of resilient leadership and looks at how GPs and practice managers can develop as leaders.

 

Resilience when under pressure

In the fourth of five articles, Fiona Dalziel looks at how being resilient can help GPs, other practice team members, and practices to succeed in times of pressure.

 

Steps to personal resilience

In the third of five articles, Fiona Dalziel discusses how GPs and practice staff can develop emotional resilience.

 

Building a resilient practice team

In the second of five articles, Fiona Dalziel explains how building a resilient practice team can enable practices to cope with challenges and move forward successfully.

 

Creating a resilient practice to cope with change

In the first of five articles, Fiona Dalziel explains the first steps to developing a resilient practice that can thrive in times of change.

 

Vascular conditions: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of vascular conditions including strawberry naevus, spider naevus, cherry haemangioma and telangiectasia.

 

Drug spending, COPD and conjunctivitis: update clinical December 2016

Hospital drug costs, COPD, conjunctivitis self-care and targeted cardiovascular screening are all covered in this article from the December 2016 edition of MIMS Learning in print.

 

Gathering CPD for your appraisal Q&A

Dr Ravi Ramanathan, GP appraiser, offers his tips on gathering CPD for your appraisal.

 

Weight faltering and failure to thrive

Dr Kathryn Deakin and Professor Mary Rudolf look at a common cause for concern in young children.

 

Acquiring ECGs: lead placement, axis, rate and rhythm

Dr Sayan Sen and Dr Ravi Assomull, in the second of a series on ECG interpretation, discuss key steps including practicalities of ECG acquisition.

 

Depression prevalence, weight loss advice and drug dependence: update clinical November 2016

QOF figures on depression prevalence, effectiveness of GPs’ weight loss advice and prescribed drug dependence are all covered in this article from the November 2016 edition of MIMS Learning in print.

 

Parkinson's, asthma and advanced renal cancer: prescribing update November 2016

Parkinson’s treatment, antibody therapy for asthma, advanced renal cancer and etoricoxib for rheumatoid arthritis and ankylosing spondylitis are covered in an update on prescribing developments from MIMS.

 

Food allergy in infants, NSAIDs and Bell's palsy: journals update November 2016

Food allergy in infants, heart failure risk with NSAIDs, antivirals for Bell’s palsy and weight loss advice are covered by Dr Roopa Jaiswal.

 

Laparoscopy: illustrated

Injuries and conditions requiring keyhole surgery are are highlighted in this activity, including shoulder surgery, nasal surgery and laparoscopic hysterectomy.

 

Pigmentation: differential diagnosis

Dr Nigel Stollery outlines the differential diagnosis of conditions presenting with pigmentation including melasma and Naevus of Ota.

 

Sexual health clinical Q&A

Dr Richard Ma, GP with an interest in sexual and reproductive health, describes his role and answers questions on improving sexual history taking, STI testing and contraceptive advice in primary care.

 

Subfertility in women: clinical review

Dr Abdelmageed Abdelrahman discusses possible causes and management of subfertility in women.

 

Cardiovascular complications of renal disease

Dr Neil Iosson outlines the aetiology and management of risk factors for cardiovascular disease in patients with chronic kidney disease.

 

Arrhythmias - red flag symptoms

Dr Pipin Singh provides an overview into the red flags of arrhythmias. Key learning points for healthcare professionals include primary care investigations and when to refer.

 

Issuing fit notes and referring to Fit for Work

Dr Emma Lackey explains when a fit note is needed, who can issue fit notes and how long they can last for.

 

Asthma guidance, narcolepsy drug and HIV prophylaxis: prescribing update October 2016

BTS/SIGN asthma guidance, a new drug for narcolepsy, HIV prophylaxis and contraception in those taking enzyme inducers are covered in an update on prescribing developments from MIMS.

 

Statins, antidepressants and end-of-life care: journals update October 2016

Statin therapy, stopping antidepressants, smoking cessation and end-of-life care are covered by Dr Jessica Garner in the MIMS Learning journals update for GPs and other healthcare professionals.

 

Multimorbidity, Zika virus and emergency contraception: update clinical October 2016

Managing multimorbidity, a rise in cases of Zika virus, emergency contraception and a GP cancer audit are all covered in this article from the October 2016 edition of MIMS Learning in print.

 

Painful nails: differential diagnosis

Dr Nigel Stollery presents four common types of nail problems including pincer nails, subungual haematoma, subungual viral warts and paronychia.

 

ECG acquisition and interpretation in primary care: introduction

ECG interpretation can be undertaken in primary care. In the first of a series, Dr Ravi Assomull and Dr Sayan Sen provide a guide to the infrastructure needed, a 10-step system for interpreting ECGs

 

Managing urticaria: current guidelines

Dr Tabi Leslie reviews the current guidelines for chronic spontaneous urticaria, including the EAACI, BAD, BSACI and AAAAI guidelines, and recent NICE guidance on use of omalizumab in previously treated chronic spontaneous urticaria.

 

Trichotillomania: diagnosis and management

Dr Satwinderjit Shinhmar and Dr Anthony Bewley describe trichotillomania, explaining its pathogenesis and possible aetiology.

 

Skin changes and complaints in pregnancy

Dr Ekaterina Burova-Mills and colleagues outline the diagnosis and management of the main skin conditions affecting pregnant women. Key learning points for healthcare professionals include diagnosis, treatment and complications.

 

Nicotine addiction: clinical review

Tobacco use remains the leading cause of preventable death and disease in England. Jennifer Percival outlines the key elements of smoking cessation and how these can be applied in primary care.

 

Hidradenitis suppurativa: diagnosis and management

Hidradenitis suppurativa causes significant physical and psychosocial morbidity and a holistic approach is important for management.

 

Recognition of frontal fibrosing alopecia

Dr Yusur Al-Nuaimi and Dr Matthew Harries summarise the epidemiology, diagnosis and management of frontal fibrosing alopecia and highlights research findings about the possible role of sunscreen and facial cosmetics in the aetiology of this disorder.

 

How to discharge patients appropriately

GPs and consultants make decisions every day as to whether a patient needs to be seen again. However, there are virtually no studies exploring how to discharge a patient in a safe and timely manner.

 

Case study: a new, solitary lesion on pigmented skin

A male patient of Asian origin presented with a new, solitary pigmented lesion on his back.

 

Dermatology: five pictorial cases and outcomes

Dr Brian Malcolm presents five illustrated cases of skin conditions, with case histories and outcomes. Presented cases include pityriasis/tinea amiantacea, morphea (localised scleroderma), nicorandil-induced ulceration and two cases showing the effectiveness of topical chemotherapy agents in skin dysplasia.

 

Atopic eczema: clinical review

In this article Dr Rufaro Gamanya considers the causes of atopic eczema and advises on managing the condition.

 

Acne vulgaris: clinical review

Acne is the most common skin condition seen in the developed world and can have huge psychological impact on patients. James Leveson and Dr Karolina Gholam explain the importance of identifying triggering factors, treating promptly and appreciating the psychological impact on the patient.

 

Seborrhoeic dermatitis: clinical review

In this article, updated in 2016, Dr James Powell covers the diagnosis and management of seborrhoeic dermatitis. Key learning points for healthcare professionals include infantile and adult seborrhoea dermatitis, distribution and morphology of lesions, common symptoms and prognosis.

 

Type 1 diabetes: clinical review

This article by Professor Rayaz Malik and colleagues give an overview of the pathogenesis of type 1 diabetes, how to make the diagnosis, preventing complications and reducing mortality.

 

Management of chronic cough in children

Dr Atul Gupta offers advice on managing chronic cough in children.

 

Bronchiectasis: clinical review

This article, updated in 2016 by Dr Anthony De Soyza, advises on causes, investigations and managing exacerbations.

 

Steroid-induced hyperglycaemia

This article by Dr Pipin Singh discusses the risk of steroid-induced hyperglycaemia in patients with or without diabetes.

 

Contraceptives, flu and shingles immunisation, and cystic fibrosis medication: prescribing update September 2016

Contraceptive eligibility criteria, flu and shingles immunisation and gene-specific medication for cystic fibrosis are covered.

 

Alopecia, bariatric surgery and muscle relaxants for low back pain: journals update September 2016

Alopecia and cardiovascular risk, bariatric surgery, hypertension and cognitive impairment, and muscle relaxants for low back pain are covered by Dr Tillmann Jacobi.

 

Paediatric problems: illustrated

Presentations of haemangioma, atopic eczema, rhabdomyosarcoma and precocious puberty are highlighted in this activity.

 

Warts: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of warts including filiform warts, seborrhoeic warts and molluscum contagiosum.

 

Zika virus, syphilis, anticoagulation and alcohol guidelines: update clinical September 2016

Zika virus, syphilis, GP health checks, alcohol guidelines and anticoagulation for patients who have had an MI or stroke are all covered in this article from the September 2016 edition of MIMS Learning in print.

 

Endometrial cancer: clinical review

This article by Dr Abdelmageed Abdelrahman considers risk factors for endometrial cancer and management options.

 

Premature ovarian insufficiency: clinical review

Dr Louise R Newson describes the diagnosis and management of premature ovarian insufficiency (POI).

 

Cardioversion and ablation strategies for atrial fibrillation

Dr Rajiv Sankaranarayanan describes how a rhythm control approach is used to manage atrial fibrillation.

 

Vitamin D deficiency

Around 50% of adults have low vitamin D levels. Dr Louise R Newson discusses investigation and prevention of vitamin D deficiency in primary care.

 

New menopause treatment, anticoagulants and interaction alert for citalopram: prescribing update August 2016

Calciphylaxis risk with warfarin, a new menopause treatment and potential interaction between cocaine and citalopram are covered in an update on prescribing developments from MIMS.

 

Psoriasis: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of psoriasis including plaque psoriasis, guttate psoriasis, palmoplantar psoriasis and flexural psoriasis.

 

Sepsis, diabetes in children and diagnosing lung problems: update clinical August 2016

Managing suspected sepsis, referring children with potential diabetes, diagnosing lung problems, and prescribing antibiotics.

 

End-of-life care clinical Q&A

Dr Catherine Millington-Sanders, GP and national clinical end-of-life care champion explains her role and offers tips for improving your end-of-life care services.

 

Ectopic pregnancy: clinical review

Dr Polly Weston outlines the incidence, diagnosis and management of ectopic pregnancy.

 

Postcoital bleeding - red flag symptoms

Postcoital bleeding may have a serious cause. Dr Pipin Singh explores questions to ask, investigations to conduct and red flag symptoms to look out for.

 

Cyclical vomiting syndrome: diagnosis and management

Cyclical vomiting syndrome is characterised by episodes of sudden onset nausea and vomiting in an otherwise healthy child.

 

Sepsis case study

Dr Sean Brink describes the case of a 39-year-old man who presented with swelling and pain in his scrotum and penis.

 

Cardiac rehabilitation: impact and uptake

Professor Patrick Doherty and Professor Gill Furze summarise the evidence for cardiac rehabilitation.

 

Night sweats - red flag symptoms

This ‘red flags’ article by Dr Pipin Singh provides an overview of the possible causes of night sweats and a multiple choice post-test with case vignettes.

 

Mitral valve disease: clinical review

Dr Wern Yew Ding and Dr Robert Cooper review mitral valve disease.

 

Myasthenia gravis: clinical review

In this article Dr Fiona Norwood considers the characteristics of myasthenia gravis, key diagnostic features and how to manage this condition, as well as giving a round up of the current evidence base. Key learning points for healthcare professionals include what do to for a patient in myasthenic crisis, prognosis ...

 

Ambulatory blood pressure monitoring

Dr Raj Thakkar outlines the benefits of in-house ambulatory blood pressure monitoring.

 

Total knee replacement

Orthopaedic surgeon Mr Steven Cutts describes total knee replacement.

 

Pulse oximetry in primary care

Dr Anita Sharma provides an overview of the use of pulse oximetry in general practice.

 

Cerebral palsy

Dr Pinki Munot and Dr Sophia Varadkar summarise how to diagnose and manage cerebral palsy.

 

Plaque psoriasis, Nexplanon implants and lipid-lowering drugs: prescribing update July 2016

Treating plaque psoriasis, new treatment for multiple myeloma, migration of Nexplanon implants and therapy for patients with SLE.

 

Aspirin after TIA, probiotics, and yoga for asthma: journals update July 2016

Aspirin to reduce stroke risk after TIA, antibiotics for dental problems, and yoga for patients with asthma are covered by Dr Rupesh Amin.

 

Shoulder problems: illustrated

Presentations of shoulder problems are highlighted in this activity by Dr Phil Marazzi.

 

Reversing obesity: hot topic July 2016

In light of a National Obesity Forum report on reversing obesity, Professor David Haslam and Dr Rachel Pryke discuss how to advise your patients on eating a healthy diet.

 

Lower leg eczema: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of lower leg eczema including varicose eczema, atopic eczema, emollient contact dermatitis, asteatotic eczema.

 

Physical activity advice, antibiotics, and cervical screening: update clinical July 2016

Advice on behaviour change, meningitis vaccination for school pupils, diabetes prevention and HPV vaccination for boys are all covered in this article from the July 2016 edition of MIMS Learning in print.

 

Travel medicine clinical Q&A

Jane Chiodini, travel health specialist nurse, describes her role and answers questions on travel health services in primary care, effective travel consultations and advising patients who are going away.

 

Thalassaemia: diagnosis and treatment

Dr Banu Kaya and Dr Paul Telfer outline the aetiology and prevalence of thalassaemia, its diagnosis and treatment, and the role of the GP in its management.

 

Vulvovaginal atrophy

Dr Louise Newson highlights vulvovaginal atrophy, a common condition in postmenopausal women for which effective treatments are available.

 

Being effective: effective consulting part 5

In the fifth of a series of video modules, Dr Peter Tate discusses effective consulting skills in primary care, using common scenarios. This video and accompanying text explores being effective and making best use of consultation time – the fourth of five key tasks that need to be tackled ...

 

Management and responsibility: effective consulting part 4

In the fourth of a series of video modules, Dr Peter Tate discusses effective consulting skills in primary care, using common scenarios. This video and accompanying text explores management and sharing of decision making and responsibility – the fourth of five key tasks that need to be tackled in ...

 

Sharing an understanding: effective consulting part 3

In the third of a series of video modules, Dr Peter Tate discusses effective consulting skills in primary care, using common scenarios. This video and accompanying text explores the extent to which the patient and doctor share an understanding of the problem or condition – the third of five key ...

 

Understanding the problem: effective consulting part 2

In the second of a series of video and text modules, Dr Peter Tate discusses effective consulting skills in primary care, using common scenarios. This video and accompanying text explores understanding the nature of the patient’s problem – the second of five key tasks that need to be tackled in ...

 

Understanding the patient: effective consulting part 1

In the first of a series of video modules, Dr Peter Tate discusses effective consulting skills in primary care, using common scenarios. This video and accompanying text explores understanding the reasons why the patient has come – the first of five key tasks that need to be tackled in order ...

 

Cushing's syndrome: clinical review

Dr Krystallenia Alexandraki and Professor Ashley Grossman discuss the epidemiology and causes of Cushing’s syndrome.

 

Management of common photodermatoses

Dr Adam Fityan discusses skin disorders caused or aggravated by light. Key learning points for GPs and nurses include differential diagnosis and the principles of photoprotection.

 

Infective endocarditis: clinical review

In this article Dr Kyriacos Mouyis, Dr Sofia Metaxa and Dr Constantinos Missouris provide an overview of the diagnosis and management of infective endocarditis, including how to make the diagnosis, investigations such as blood cultures and echocardiography, and European Society of Cardiology guidelines for managing the condition.

 

Advising couples on subfertility

Dr Abdelmageed Abdelrahman provides a refresher on the definition of subfertility and the likelihood that it is caused by male factors, female factors or a combination of these.

 

Brugada syndrome: clinical review

Dr Keith Barnard discusses the aetiology and symptoms of Brugada syndrome.

 

Influenza: clinical review

Dr Steve Holmes and respiratory nurse consultant Jane Scullion review the clinical features of influenza, and the risk groups for serious illness.

 

Dermatological emergencies in primary care

Dr Stela Ziaj and Dr Anshoo Sahota provide an overview of dermatological emergencies for primary care physicians.

 

Pre-hospital trauma care

Dr Andrew Webster and Dr Arvind Byka explain what to do when faced with an emergency trauma situation.

 

Bone pain - red flag symptoms

In this article Dr Pipin Singh advises on how to identify red flags in patients presenting with bone pain. Key learning points for healthcare professionals include how to ask patients to describe the pain, conducting a clinical examination and useful investigations.

 

Non-infective skin disorders in HIV patients

Skin disorders are common in patients with HIV and may be related to the infection or treatment. Dr Sara Ritchie discusses conditions such as alopecia, erythroderma, granuloma annulare, ichthyosis, lupus, malignancies, photosensitivity, pruritus and psoriasis.

 

Skin reactions to wound dressings

Professor Richard White explains the importance of careful selection of wound dressings in order to minimise allergic reactions.

 

Gastroenteritis in children, GP cancer care and pre-eclampsia risk: journals update June 2016

Gastroenteritis in children, GP cancer care, pre-eclampsia risk and hypoglycaemia risk are covered by Dr Roopa Jaiswal in the MIMS Learning journals update for GPs and other healthcare professionals.

 

New Parkinson's drug, SGLT2s as monotherapy: prescribing update June 2016

A new Parkinson’s drug, SGLT2s as monotherapy and a MIMS guide to diabetes devices are covered in an update on prescribing developments from MIMS. This article is from the June 2016 edition of MIMS Learning in print.

 

Skin conditions in young children

Dr Helen Goodyear describes the diagnosis and management of four common skin conditions affecting young children.

 

Management of diabetes during Ramadan

Professor Rayaz Malik and colleagues explain how to advise Muslim patients with diabetes on fasting safely during Ramadan.

 

End-of-life care, cancer diagnostics and antibiotic use: update clinical June 2016

End-of-life care, cancer diagnostics, hormone therapy for transgender patients and targets for cutting antibiotic use are all covered in this article from the June 2016 edition of MIMS Learning in print.

 

Nose problems: illustrated

Nose problems including epistaxis, polyps, carcinoma and septal perforation are highlighted in this activity.

 

HRT: hot topic June 2016

Dr Louise Newson discusses the background of HRT `scares’ and outlines advice to give women regarding safety and benefits.

 

Urology clinical Q&A

Dr Catherine Briggs, GP with an interest in urology, describes role and answers questions on diagnosis and management of urological conditions in primary care.

 

Daytime wetting in children

Mr Prasad Godbole explains why daytime wetting occurs in children and how it can be managed.

 

Restricted finger movement - what's the diagnosis?

An older man presented with difficulty in gripping and restricted movement in his ring and little fingers. Identify the likely diagnosis in this pictorial quiz by Dr Ravi Ramanathan.

 

Lip swellings: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of lip swellings including granulomatous cheilitis, venous lake, milk blisters, and oral mucocele.

 

Common bile duct stones: clinical review

Dr Ghassan El Sayed and Dr Earl Williams outline the diagnosis and management of common bile duct stones, estimated to be present in 10-20% of patients with symptomatic gallstones.

 

Gastrointestinal bleeding: emergency presentations

Kathryn Oakland provides an overview of the causes and management of acute gastrointestinal bleeding.

 

Choking in adults and children

Dr Anthony Handley provides a quick guide to recognition and management of choking in adults and children.

 

Alcohol misuse: clinical review

In this article Dr Steve Brinksman discusses the morbidity caused by excessive alcohol consumption, effective screening tools, brief interventions and when to refer.

 

Allergic rhinitis: diagnosis and management

Dr Suneeta Kochhar explains the impact of allergic rhinitis, how to take a careful symptom history, investigations to confirm diagnosis and when to refer.

 

Managing psoriasis in children

Sue Ann Chan and Helen Goodyear provide an overview of the management of childhood psoriasis.

 

Atypical presentation of diabetes

Dr Pipin Singh describes a 45 year old man with apparent type 2 diabetes who was unintentionally losing weight. Key learning points for healthcare professionals include assessing patients, which investigations are suitable, and tips for managing patients with an unclear diabetes diagnosis

 

Managing nocturnal enuresis

Mr Prasad Godbole outlines the prevalence of nocturnal enuresis and the factors that contribute to its development. Key learning points for GPs and nurses include how to investigate enuresis, and useful interventions in primary care.

 

Strabismus in childhood

Dr Gill Adams provides an overview of the diagnosis and management of strabismus in childhood. Key learning points for GPs and nurses include how to screen children who are at-risk, and when to refer to ophthalmology services.

 

Loss of appetite - red flag symptoms

Dr Pipin Singh discusses red flag symptoms in patients with loss of appetite and considers the importance of taking a detailed history. Key learning points for GPs and nurses include possible causes and further investigations to consider.

 

Unintentional weight gain - red flag symptoms

Dr Rupesh Amin considers red flag symptoms in unintentional weight gain and explores possible serious causes such as Cushing’s syndrome or hypothyroidism.

 

Peripheral vascular disease: clinical review

Mr Vish Bhattacharaya reviews the diagnosis and management of peripheral vascular disease in primary care. Key learning points for GPs and nurses include methods to manage cardiovascular risk for these patients, and optimal therapies to reduce side-effects.

 

Abnormal vaginal discharge - red flag symptoms

Dr Pipin Singh advises on red flag symptoms in patients with vaginal discharge, including what examinations and investigations are needed. Key learning points for GPs and nurses include possible causes and how to identify these.

 

Facial ulcers in children

Dr Helen Goodyear summarises the most common causes of facial ulcers in children. Key learning points for GPs and nurses include how to distinguish between bacterial and viral aetiology, and the correct management.

 

Rheumatoid arthritis: clinical review

Dr Rod Hughes outlines the epidemiology, aetiology, diagnosis, monitoring and treatment of rheumatoid arthritis. This review includes the latest advice on investigations and the role of early referral and treatment in halting disease progression.

 

Diabetic emergencies and complications in primary care

Dr Pipin Singh outlines the presentation and management of emergencies and complications arising from diabetes in primary care. Key learning points include the management of hypoglycaemia, implementing sick day rules and identifying acute hyperglycaemia.

 

Protecting patients and staff from the risks of legionella bacteria: CQC briefing

In the eighth article in our CQC briefing series, Dr Devin Gray provides an overview of legionella and its risks, what is expected of GP practices, and guidance on controlling the risks of exposure to legionella.

 

Schizophrenia: clinical review

Dr Jonathan Mitchell discusses the incidence of psychosis and schizophrenia, recognition of signs and symptoms, the role of medication and cognitive behaviour therapy, and positive outcomes to work towards. This review includes references and signposts to national guidance useful for primary care professionals.

 

Pityriasis: differential diagnoses

Dr Nigel Stollery outlines differential diagnosis of pityriasis, including pityriasis rosea, pityriasis versicolor, pityriasis alba and pityriasis capitis. Key learning points for healthcare professionals include the presentation and management of these conditions.

 

Eye disorders: illustrated

Presentations of eye disorders including adenoviral conjunctivitis, senile scleral translucency and pterygium are highlighted in this activity. Each is illustrated with photographs and key education points for GPs by Dr Phil Marazzi.

 

Substance misuse clinical Q&A

Dr Iain Brew, GP with a special interest in substance misuse, describes his role and answers questions on prevention and management of addiction to alcohol, illegal drugs and prescription medications in primary care. Key learning points include use of brief intervention for harmful drinking, strategies for use of potentially addictive ...

 

Fracture risk, BP monitoring and screening for COPD: journals update May 2016

Fracture risk among Asian women taking bisphosphonate therapy, screening for patients with COPD and BP monitoring for adults with dementia are covered by Dr Tillmann Jacobi in the MIMS Learning journals update for GPs and other healthcare professionals. This article is from the May 2016 edition of MIMS Learning in ...

 

Multimorbidity, scarlet fever and controlled drugs: update clinical May 2016

NICE guidance on multimorbidity, rising scarlet fever cases and advice on prescribing controlled drugs are all covered in this article from the May 2016 edition of MIMS Learning in print.

 

Vaccination updates, antiplatelet therapy and new bacterial vaginosis treatment: prescribing update May 2016

Latest advice on immunisation schedules and safety, long-term antiplatelet therapy and a new treatment for bacterial vaginosis are covered in an update on prescribing developments from MIMS.

 

Acute epigastric pain

Dr Louise Newson describes a presentation of acute epigastric pain in a 44-year old female patient, leading to a diagnosis of pancreatitis. Key learning points for healthcare professionals include prevalence, investigation and treatment of acute pancreatitis.

 

Developmental speech impairment

Dr Yvonne Wren and Dr Debbie Sell provide a practical overview of developmental speech impairment. Key learning points for GPs and nurses include how to recognise children at risk of developmental speech impairment, and when to refer to speech and language therapy services.

 

Self-harm in children and young people

Faiben Yemane and Dr Vibhav Shetty summarise how to recognise the signs and symptoms of self-harm in young people. Key learning points for GPs and nurses include the importance of early recognition of self-harm, and the common psychiatric disorders associated with it.

 

Innocent cardiac murmurs in children

Professor Michael Burch explains the importance of identifying innocent cardiac murmurs in children, and its role in successful management. Key learning points for nurses and GPs include the characteristics of different types of murmurs, and how to recognise warning signs for serious cardiac pathology.

 

Valvular heart disease: clinical review

Dr Rajiv Sankaranarayanan summarises the four most common disorders of valvular heart disease – aortic stenosis and regurgitation, and mitral stenosis and regurgitation.

 

Genital swelling following caesarean delivery

Dr Anita Sharma and Dr Sapna Tandon describe a presentation of clitoral swelling and vaginal discharge at three weeks post caesarean section, leading to a diagnosis of infection with group A streptococci. Key learning points for GPs and other healthcare professionals include when to suspect puerperal infection and what action ...

 

Asthma comorbidity, antibiotic prescribing and peanut allergy: journals update April 2016

Comorbidity in asthma patients, antibiotic prescribing for RTIs and peanut allergy are all covered in this article by Dr Louise Newson from the April 2016 edition of MIMS Learning in print.

 

Mouth conditions: illustrated

Presentations of conditions affecting the mouth including herpes zoster, angioedema and candidiasis are highlighted in this activity. Each is illustrated with photographs and key education points for GPs and nurses by Dr Phil Marazzi.

 

Musculoskeletal Q&A

Dr Louise Warburton, GP with a special interest in musculoskeletal medicine, describes her role and answers questions on back pain management, clinical assessment tools and rheumatoid arthritis.

 

Hand rashes: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of hand rashes including atopic dermatitis, contact dermatitis and pompholyx. Key learning points for healthcare professionals include understanding the presentation and management of these conditions.

 

Dyspepsia - red flag symptoms

Dr Suneeta Kochhar outlines the red flag symptoms and possible causes of dyspepsia, including advice on management. Key learning points for healthcare professionals include assessing the timing, frequency and re-occurrence of symptoms, when urgent referral for endoscopy is needed, and lifestyle advice.

 

Weakness and hypotension

Dr Tillmann Jacobi describes a case of weakness and hypotension leading to a diagnosis of Addison’s disease. Key learning points for GPs and nurses include the role of postural hypotension in Addison’s disease, and the investigations required in its diagnosis.

 

Parkinson's disease: clinical review

Dr Benjamin Simpson provides an in-depth overview of Parkinson’s disease, including information on risk factors and prognosis as well as advice on diagnosis and treatment. Key learning points for healthcare professionals include genetic susceptibility, motor and non-motor features, and the role of structural imaging.

 

Management of the poisoned patient

Dr James Dear and Dr Peter Gallacher outline how to deal with a patient who has ingested a poisonous substance. Key learning points for GPs and nurses include the investigation and identification of the poison, and how to manage the patient’s condition.

 

Acute erythematous rashes in children

Dr Dharshini Sathishkumar and Dr Helen Goodyear focus on infectious causes of erythematous rashes in children and important differential diagnoses.

 

Leg ulcers - red flag symptoms

Dr Pipin Singh discusses the causes of leg ulcers, examination and initial investigations, and highlights red flag symptoms warranting further investigation. Key learning points for healthcare professionals include taking a good vascular history, and advice for patients with diabetes.

 

Down's syndrome: clinical review

Dr Esther Corker and colleagues outline the cause of Down’s syndrome, the screening process and the role of the GP in the management of comorbidities both in childhood and adulthood. Key learning points for healthcare professionals include when to conduct assessments for cardiac, thyroid and gastrointestinal disease.

 

Management of acute cough in children

Dr Atul Gupta provides a practical guide to the common causes of childhood cough and management of symptoms. Key learning points for GPs and nurses include investigation of the treatment options, and how to recognise serious underlying pathology.

 

Tiredness, thirst and feeling unwell

Dr Simon Gowda explains how a drug safety alert helped to identify the cause of a presentation of tiredness, thirst and feeling unwell in a patient with type 2 diabetes and other conditions. Learning points for GPs and nurses include signs and symptoms of diabetic ketoacidosis (DKA) and advice to ...

 

Facial pain - red flag symptoms

Dr Rupesh Amin discusses red flag symptoms in facial pain and explores possible causes. Key learning points for GPs and nurses include questions to ask, investigations to conduct and when to refer.

 

Use of newer oral anticoagulants in AF

Dr Mehul Dhinoja provides a practical guide to using novel oral anticoagulants (NOACs) for stroke prevention in non-valvular atrial fibrillation (AF). Key learning points for GPs and nurses include the safety and efficacy profiles of newer anticoagulants compared with warfarin, and how to switch patients from warfarin to NOACs.

 

Medication reviews in nursing homes

Dr Pipin Singh provides a practical guide to conducting medication reviews in nursing homes with the aim of improving quality of life for residents. Learning points for GPs, nurses and pharmacists include how to go about conducting reviews and what they should cover.

 

Barrett's oesophagus

Dr Neel Sharma and Professor Khek Yu Ho outline diagnosis, management and follow-up of Barrett’s oesophagus, a premalignant condition associated with the development of oesophageal adenocarcinoma. Key learning points include lifestyle advice to give patients.

 

Emotional distress in children and young people

Dr Suzy O'Connor, Dr Emma House, and Dr Terri Carney outline how to recognise emotional distress in children and young people, and the screening tool available to aid diagnosis. Key learning points include how to distinguish between physical symptoms and signs of emotional distress, and when to refer to mental ...

 

Updated RCGP guidance on revalidation

Dr Ravi Ramanathan highlights new Royal College of General Practitioners (RCGP) guidance on supporting information for appraisal and revalidation. The guidance, effective from 1 April 2016, aims to simplify the process for GPs and clarify how they can claim CPD credits.

 

Lesions on the trunk and neck - what's the diagnosis?

A 59-year old woman presented with lesions on her trunk and neck. Identify the likely diagnosis in this pictorial quiz by Dr Ravi Ramanathan.

 

A painful lump on a child's knee - what's the diagnosis?

A young teenager presented with a painful prominence on his knee. Identify the likely diagnosis in this pictorial quiz by Dr Ravi Ramanathan.

 

Rash on the trunk and limbs - what's the diagnosis?

A 28-year old man presented with a rash affecting his limbs and trunk. Identify the likely diagnosis in this pictorial quiz prepared by Dr Ravi Ramanathan.

 

Measles: clinical review

Dr Kirsty Le Doare and Dr Nuria Martinez-Alier describe the signs and symptoms of measles and outline its treatment and prognosis.

 

Tuberculosis: hot topic March 2016

Respiratory nurse Jane Scullion and GP Dr Steve Holmes outline the key recommendations relevant to primary care in the latest NICE guidance on tuberculosis (TB). This article is from the March 2016 edition of MIMS Learning in print. Key learning points for healthcare professionals include TB prevention, symptoms and specialist ...

 

Cardiology clinical Q&A

Dr Matt Fay, GP with a special interest in cardiology, describes his role and answers questions on risk assessment, management of atrial fibrillation and stroke prevention.

 

Depression in adolescents, renal agents in diabetes and skin cancer in RA: journals update March 2016

Diagnosis of depression in adolescents, safety of renal agents in diabetes and risk of skin cancer in rheumatoid arthritis are covered by Dr Katie Collier in the MIMS Learning journals update for GPs and other healthcare professionals. This article is from the March 2016 edition of MIMS Learning in print.

 

Prescribing hormone replacement therapy

Dr Sarah Gray outlines the factors to consider when prescribing hormone replacement therapy to treat symptoms of menopause. This article contains six questions to ask, a treatment pathway and simple formulary, and three case studies with which you can test your awareness of appropriate prescribing options.

 

Scrotal lesions: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of scrotal lesions including inguinal scrotal hernia, hydrocoele, angiokeratomas of Fordyce, and steatocystoma multiplex. Key learning points for healthcare professionals include presentation and management in primary and secondary care.

 

Foot conditions: illustrated

Presentations of conditions affecting the feet including oedema, hammer toe, and hallux valgus are highlighted in this activity. Each is illustrated with photographs and key education points for GPs and nurses by Dr Phil Marazzi.

 

Diagnostic imaging and cancer risk

Dr Rajiv Ghurye and colleagues explain the radiation delivered by X-rays and CT scans to help GPs and other healthcare professionals to counsel patients about cancer risks. Learning points include a comparison of X-rays, scans and normal background radiation.

 

Cystic fibrosis: clinical review

Dr Ranjan Suri discusses diagnosis and management of cystic fibrosis and potential complications including lung infections. This educational module for primary healthcare professionals offers learning points on pancreatic insufficiency, cystic fibrosis-related diabetes, dietary advice and dietary supplements.

 

Peripheral arterial disease: identification and management

Dr Anita Sharma discusses diagnosis and management of peripheral arterial disease. Learning points for healthcare professionals include risk factors, symptoms, and how to manage PAD in primary care.

 

Significant event analysis: CQC briefing

In the sixth article of our CQC briefing series, Dr Rishi Duggal explores how CQC inspectors approach the use of significant event analysis (SEA) in GP practices. The article highlights structured approaches to SEA and what constitutes good practice in its use.

 

Coronary heart disease in women

Dr Carolyn Webb and Professor Peter Collins highlight common presenting symptoms in women with coronary heart disease (CHD) and reflects on the need to take a careful gynaecological history. Key learning points for healthcare professionals include the influence of female-specific factors on the development of CHD, and conditions that raise ...

 

Sickle cell anaemia

Dr Amit Patel reviews the diagnosis, features and management of sickle cell anaemia. Key learning points for clinicians include identifying and dealing with sickle cell anaemia crises.

 

Perinatal mental illness in primary care

In this presentation, psychiatrist Dr Trudi Seneviratne outlines the important points for GPs to consider when faced with a new mother with mental health problems such as postnatal depression, PTSD, anxiety and postpartum psychosis.

£ 9.99
 

Management of heavy menstrual bleeding

Dr Anne Connolly discusses current thinking on heavy menstrual bleeding. She explains the need for a risk assessment, and presents the investigations and management that can be done in primary care, as well as clarifying when women might need to be referred to secondary care.

£ 9.99
 

Consent in children, Gillick competence and Fraser guidelines: CQC briefing

Children’s consent to medical treatment or contraceptive advice is the focus of the fifth article in our CQC briefing series. Dr Devin Gray explains how inspectors assess the way that GP practices seek consent to care and treatment, with regard to Gillick competence and the Fraser guidelines.

 

Advising patients on the Zika virus

Dr Jessica Garner focuses on the latest advice for GPs and nurses regarding the management of patients who may have been exposed to the Zika virus. Key learning points include advice to give pregnant women and when to refer for an ultrasound scan. Article last updated September 2016.

 

Pregnancy - red flag symptoms

Dr Matthew West covers the red flags to look out for in pregnancy, including back pain, bleeding, headaches, This activity highlights symptoms that warrant urgent referral to the obstetric department.

 

Deprivation of Liberty Safeguards: CQC briefing

In the fourth article of our CQC briefing series, Dr Devin Gray highlights how inspectors assess the way that GP practices seek consent to care and treatment. This article focuses on the Deprivation of Liberty Safeguards (DoLS), which form part of the Mental Capacity Act.

 

Tonsillitis in children and adults

Mr Maurice Hawthorne highlights the causes of tonsillitis, symptoms and management, and differential diagnoses to consider in children and adults. Key learning points for healthcare professionals include the evidence base for antibiotic prescribing, the effectiveness of tonsillectomy, and red flags indicating a need for urgent referral.

 

Attention deficit hyperactivity disorder: clinical review

Dr Sabina Dosani outlines the diagnosis and management of attention deficit hyperactivity disorder.

 

Childhood food allergy and intolerance

Paediatric dietitian Dr Kate Maslin provides guidance on food allergy and intolerance, and explains the latest advances in food allergy research. Educational points for GPs and nurses include symptoms and signs of food allergy, and when to consider excluding foods from a child’s diet.

 

Managing epistaxis in children

Mr Samuel Leong describes the causes, assessment and management of nasal bleeding (epistaxis) in children. Learning points for GPs and other primary healthcare professionals include management of nosebleeds, and when outpatient or emergency referral may be required.

 

Benign skin lesions: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of benign skin lesions including epidermoid cyst, ganglion, dermatofibroma, and lipoma. Each lesion is illustrated with a photograph and concise learning points about presentation, management and prognosis.

 

Head and neck tumours: illustrated

Presentations of head and neck tumours including basal cell carcinoma and squamous cell carcinoma are highlighted in this educational guide by Dr Phil Marazzi. Each is illustrated with photographs and key education points for GPs and nurses.

 

Chronic pain clinical Q&A

Dr Martin Johnson, RCGP clinical lead for chronic pain, describes his role and answers questions on diagnosis and management of chronic pain in primary care. Key learning points for healthcare professionals include effective assessment, the need for medication review and the limitations to use of the WHO pain ladder.

 

Alcohol misuse: hot topic February 2016

Dr Anna Cumisky outlines new Government proposals for recommended limits for alcohol consumption. The guidelines aim to reduce the harm caused by excessive drinking, including a raised risk of cancer. This article is from the February 2016 print edition of MIMS Learning.

 

Nasal flu vaccination, women's cardiovascular risk and drug interactions: journals update February 2016

Safety of nasal flu vaccination in severe egg allergy, raised cardiovascular risk in women with atrial fibrillation, and potential interactions between sulfonylureas and warfarin are covered by Dr Roopa Jaiswal in the MIMS Learning journals update for GPs and other healthcare professionals. This article is from the February 2016 edition ...

 

Social phobia in children and young people

Faiben Yemane and Dr Vibhav Shetty outline the diagnostic criteria for social phobia in children and young people. Key learning points for healthcare professionals include symptoms, causes, assessment and management.

 

Carpal tunnel syndrome

Orthopaedic surgeon Mr Steven Cutts discusses symptoms and management of carpal tunnel syndrome. Learning points for healthcare professionals include medical and surgical treatment options and prognosis.

 

Heavy menstrual bleeding - red flag symptoms

Dr Anita Somalanka provides a refresher on red flag symptoms associated with heavy menstrual bleeding (menorrhagia). Key learning points for healthcare professionals include identifying when urgent referral is required.

 

Acute otitis media in children

Professor Kim Ah See and Louise McMurran discuss management of acute otitis media. Educational points for healthcare professionals include when to avoid antibiotic prescriptions and when to offer delayed prescriptions.

 

Endometriosis: clinical review

Mr Ertan Saridogan, consultant in reproductive medicine, discusses the diagnosis and management of endometriosis. Key educational points for GPs, nurses and other healthcare professionals include the symptoms of endometriosis, its impact on patients, and the medical and surgical treatments available.

 

Primary biliary cirrhosis

Dr Pipin Singh describes a case of primary biliary cirrhosis discovered during routine liver function tests. Learning points for GPs and other healthcare professionals include signs and symptoms.

 

Frey's syndrome

Dr Pipin Singh describes a case of Frey’s syndrome. Learning points for GPs and other healthcare professionals include aetiology and treatment options.

 

Headache in pregnancy

Dr Pipin Singh describes a case of pre-eclampsia presenting as headache in pregnancy. Learning points for GPs and other healthcare professionals include risk factors and symptoms of pre-eclampsia.

 

A mouth sore - what's the diagnosis?

A woman presented with a painful, sore area on her lower lip. Identify the likely diagnosis in this picture quiz by Dr Ravi Ramanathan.

 

Dry and blistered feet - what's the diagnosis?

A 41-year old postman presented with dry, blistered feet. Identify the likely diagnosis in this pictorial quiz prepared by Dr Ravi Ramanathan.

 

Rash on the legs - what's the diagnosis?

A young man with coeliac disease presented with a rash on his legs. Identify the likely diagnosis in this picture quiz by Dr Ravi Ramanathan.

 

Attention deficit hyperactivity disorder: diagnosis and management

Professor Amanda Kirby describes the symptoms and key elements of attention deficit hyperactivity disorder (ADHD), and provides an update on NICE guidelines. Key learning points for healthcare professionals include criteria for a diagnosis of ADHD, and successful management.

 

Tennis elbow (lateral epicondylitis)

Orthopaedic surgeon Mr Steven Cutts discusses lateral epicondylitis, also known as tennis elbow, with learning points for GPs and healthcare professionals on management options, including pharmacological treatments, physiotherapy and surgery.

 

Menopause - NICE and FSRH guidance

Based on guidance from NICE and the Faculty of Sexual and Reproductive Healthcare’s Clinical Effectiveness Unit (FSRH) Dr Suneeta Kochhar describes the symptoms, diagnosis and management of the menopause. Key education points for GPs and other healthcare professionals include diagnostic tests, use of HRT and dealing with the contraceptive requirements ...

 

What happens after an inspection visit: CQC briefing

Following an inspection visit from the Care Quality Commission, your GP surgery will receive a report. Dr Devin Gray explains the content of the report, in the third of three articles about preparing for CQC inspections. This article focuses on ratings, publication of the report, enforcement, and responding to the ...

 

Hodgkin's lymphoma - haematology

Prompt diagnosis and treatment of Hodgkin’s lymphoma is important, says consultant haematologist Dr Lisa Lowry. This module provides key learning points for GPs, nurses and other healthcare professionals around diagnosis and staging of this type of cancer, along with management and prognosis.

 

What to expect on the day of an inspection: CQC briefing

What should you expect on the day of a CQC inspection? Dr Devin Gray outlines what will happen in an announced inspection of general practice. This activity, the second in a series, focuses on the practice’s presentation of performance, speaking to practice staff and patients, key lines of enquiry and ...

 

Pancreatic glucagonoma

Dr Rupesh Amin describes a rare case of pancreatic glucagonoma, which initially presented with symptoms of an intractable eczematous rash. Key learning points for GPs and other healthcare professionals include discussion of the important differential diagnoses, and an outline of cutaneous manifestations of internal malignancies.

 

Lipid modification: NICE guideline

Dr Suneeta Kochhar reviews the latest NICE guideline on risk assessment and reduction of cardiovascular disease. Key educational messages for GPs and other healthcare professionals include use of QRISK2 for assessment of CVD risk, appropriate prescribing of statins for primary and secondary prevention of CVD, and advice on when to ...

 

Top tips on menopause: hot topic January 2016

Dr Sarah Gray presents 10 top tips for GPs and other healthcare professionals on diagnosing and managing menopause, developed by the Primary Care Women’s Health Forum in the wake of NICE guidance on menopause. This article is from the January 2016 edition of MIMS Learning in print.

 

Fracture risk, asthma management and effect of statins: journals update January 2016

Fracture risk in depression, asthma provision for pregnant women and the effect of statins on gallstones are covered by Dr Tillmann Jacobi in the MIMS Learning journals update for GPs and other healthcare professionals. This article is from the January 2016 edition of MIMS Learning in print.

 

Diabetes clinical Q&A

Beverley Bostock, nurse practitioner with an interest in diabetes care, describes her role and answers questions on diagnosis and management of diabetes in primary care. Key learning points include assessing risk of diabetes and prescribing for diabetes.

 

Limb pain in children

Dr Nathan Hasson describes causes of `growing pains’ or limb pain in children, including juvenile idiopathic arthritis and benign joint hypermobility syndrome. Key learning points for GPs include presenting symptoms that may suggest a serious cause for limb pain, including Ewing’s sarcoma.

 

Skin complications of diabetes: pictorial guide

Dr Jean Watkins uses photos to illustrate diagnosis and management of skin conditions that are frequently seen in patients with diabetes. Conditions covered include infection, gangrene, atherosclerosis, necrobiosis lipoidica, generalised granuloma annulare and diabetic dermopathy.

 

Scans and X-rays: illustrated

Dr Phil Marazzi presents scans and X-rays of non-malignant conditions. Each image is accompanied by commentary and key education points on conditions including hallux valgus, rheumatoid disease and osteoarthritis of the shoulder.

 

How to prepare for a CQC inspection: CQC briefing

Dr Devin Gray outlines what GP practices should do to prepare for an announced visit from Care Quality Commission inspectors. This activity, the first in a series, explains the CQC’s five key questions, outlines population groups for which inspectors will assess the quality of care, and highlights how how to ...

 

Vomiting in adults - red flag symptoms

Dr Suchita Shah highlights the red flag symptoms associated with vomiting in adults that may indicate a serious cause. Key learning points for healthcare professionals include appropriate investigations to undertake in primary care and important questions to ask during history-taking.

 

Alopecia: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of alopecia including male pattern baldness, alopecia areata, pseudopelade and lichen planopilaris. Key learning points for healthcare professionals include the presentation and management of these conditions.

 

Assessment of older people

Dr Pipin Singh provides insight into the pitfalls of assessing older patients and presents case studies of good multidisciplinary care. Educational points for GPs and other primary healthcare professionals include common drug side-effects and assessing mental capacity.

 

Chlamydia: clinical review

Dr Jackie Sherrard reviews the pathological and clinical manifestations of chlamydial disease.

 

Upper extremity DVT

Dr Nonye Agomo describes a case of upper extremity DVT, providing learning points for GPs on presenting symptoms, risk factors including IV infusions, treatment, complications and follow-up.

 

Primary care's role in cancer diagnosis and management

Dr Richard Roope outlines the expanding role of primary healthcare professionals in diagnosis and management of cancer. Key learning points include current trends in cancer referrals and diagnosis.

 

Cancer mortality, diabetes complications and risks of working long hours: journals update December 2015

Improved cancer mortality, risk of blindness and amputation in diabetes, safer prescribing and cardiovascular risk of working long hours are covered by Dr Katie Collier in the MIMS Learning journals update for GPs and other healthcare professionals. This article is from the December 2015 edition of MIMS Learning in print.

 

Dermatology clinical Q&A December 2015

Dr Brian Malcolm, GP with a special interest in dermatology, describes his role and answers questions on diagnosis and management of key conditions in primary care including potentially malignant lesions, eczema, acne, and psoriasis.

 

Facial Raynaud's disease

Dr Penny Edrich describes an unusual rash on a patient’s face, which upon specialist examination proved to be linked to Raynaud’s phenomenon. Tips for treatment of Raynaud’s disease are listed in this activity, along with learning points regarding specialist investigation to exclude autoimmune disease.

 

Tourette's syndrome

Professor Amanda Kirby describes the symptoms, diagnosis and management of Tourette’s syndrome. Key education points for GPs and other healthcare professionals include an overview of differential diagnoses and the treatment options available to patients.

 

Developmental coordination disorder (dyspraxia)

Professor Amanda Kirby describes the symptoms, diagnosis and management of developmental coordination disorder (dyspraxia). Key education points for GPs and other healthcare professionals include how to distinguish the condition, and how to help patients find areas of strength they may develop in order to maintain self-esteem.

 

Huntington's disease: clinical review

Rachel Taylor explains the diagnosis and management of Huntington’s disease, providing key learning points for GPs on symptom reduction and quality of life.

 

Pharyngitis - red flag symptoms

Significant pathologies that need to be considered when patients present with sore throat is the subject of this activity by Dr Pipin Singh. Key learning points include symptoms that may indicate significant pathology, questions to ask, investigations to conduct and when to refer.

 

Cellulitis: clinical review

Dr Ava Lee and Dr Nick Levell review the causes, diagnosis and management of cellulitis, along with associated complications and recommended strategies for prevention. Key learning points for clinicians include appropriate use of antibiotics.

 

Atopic eczema in children

Dr Andre Khoo and colleagues review atopic eczema in children. This activity provides an educational update for healthcare professionals on diagnosis and management, with learning points on patient education, traditional treatments such as coal tar and the role of biological agents.

 

Child protection in dermatology

Dr Helen Goodyear provides an overview of child abuse in relation to dermatology. Learning points for healthcare professionals include awareness of dermatological signs of abuse.

 

Urgent referrals in dermatology

Dr Beebee Meeajun and Professor Rino Cerio provide an overview of dermatological conditions requiring urgent referral including skin cancer, toxic epidermal necrolysis, and acute generalised pustular psoriasis. Tips for healthcare professionals include red flag signs for early referral for skin cancer and common instigators of drug eruptions.

 

Multiple myeloma

Dr Charlotte Attwood and Dr Shirley D’Sa outline the diagnosis and management of multiple myeloma. Tips for healthcare professionals include symptoms such as fatigue, bone pain and recurrent infections, the GPs role, and red flag triage for acute back pain.

 

Reversing the effects of warfarin

Dr Shruthi Patel and Dr John Hanley explain how to reverse the anticoagulant effects of warfarin should a patient develop bleeding. Key education points for GPs and other healthcare professionals include recognising signs of bleeding and prescribing vitamin K appropriately.

 

Cocaine use and its effects

Dr Iain Brew provides an overview of the use and effects of cocaine and how GPs can manage patients experiencing adverse effects. Tips for healthcare professionals include a framework for discussion of illicit drug use and possible sources of treatment for patients with problematic cocaine use.

 

Respiratory care clinical Q&A November 2015

Dr Steve Holmes, GP with an interest in respiratory care, describes his role and answers questions on diagnosis and management of key conditions in primary care including cough, COPD, pneumonia and asthma in children.

 

Coeliac disease: hot topic November 2015

Dr Suneeta Kochhar highlights NICE guidance on the diagnosis, management and follow-up of coeliac disease, providing key learning points for GPs and other healthcare professionals. This article is from the November 2015 edition of MIMS Learning in print.

 

Research, back pain, ADHD and coeliac disease: journals update November 2015

Reanalysis of research findings, physiotherapy for low back pain, treating prisoners for ADHD and exploring the risk of dementia in people with coeliac disease are covered by Dr Tillmann Jacobi in the MIMS Learning journals update for GPs and other healthcare professionals. This article is from the November 2015 edition ...

 

Facial conditions: illustrated

Presentations of conditions affecting the face, including chickenpox, anaemia, jaundice, trauma, Bell’s palsy, and frostbite, are highlighted in this activity. Each is illustrated with photographs and key education points for GPs by Dr Phil Marazzi.

 

Patchy lesions: differential diagnosis

Dr Nigel Stollery outlines differential diagnosis of lesions including fixed drug eruption, tinea and basal cell carcinoma. Key learning points for healthcare professionals include presentation and management of these conditions.

 

Total hip replacement

Mr Steven Cutts describes the surgery involved in total hip replacement. Key learning points for healthcare professionals include risks associated with this surgery such as infection, dislocation and sciatic nerve palsy, and new technologies.

 

Feeding problems in infants

Dr Jessica Garner provides an update for GPs and other healthcare professionals on infant feeding problems. Key learning points include symptoms of cows’ milk allergy, managing gastro-oesophageal reflux, and identifying lactose intolerance.

 

A swollen jaw - what's the diagnosis?

Dr Nigel Stollery describes the case of a young man who attended the GP surgery with a jaw swelling that was increasing in size. Identify the likely diagnosis in this picture quiz.

 

Male breast cancer case study

Dr Rupesh Amin describes a case of male breast cancer. Key learning points for healthcare professionals include presenting symptoms, risk factors, and NICE guidance on suspected cancer.

 

Pelvic inflammatory disease: clinical review

Dr Suneeta Kochhar provides an educational update for healthcare professionals on diagnosis and management of pelvic inflammatory disease. PID is relatively common and carries a substantial risk of subfertility and chronic pelvic pain. Key learning points for healthcare professionals include antibiotic treatment, when to consider hospitalisation, and prognosis.

 

`I've had this cough': lung cancer diagnosis

Dr Jaishree Bhosle presents key learning points for GPs on diagnosis of lung cancer. This 35-minute activity is comprised of audio and presentation slides from MIMS Clinical Update 2014, with the kind permission of the Royal Marsden NHS Foundation Trust.

 

Differential diagnosis: blistering rashes

Dr Nigel Stollery compares shingles, bullous pemphigoid, bullous pemphigus, and insect bites. Key learning points for healthcare professionals include typical presentation and management of these conditions.

 

Hot topic: flu vaccination, October 2015

Dr Anita Sharma outlines how to maximise the clinical value of this year’s flu vaccination programme. Key learning points for healthcare professionals include identifying at-risk groups, usual side-effects, and the role of community pharmacists.

 

Illustrated: allergy and immunology

Dr Phil Marazzi presents eight cases of allergic or immune reaction. Key learning points for healthcare professionals include identifying and managing urticaria, varicose eczema, contact dermatitis and periorbital eczema.

 

Type 1 diabetes mellitus and NICE guidance

Professor Rayaz Malik and colleagues outline the latest NICE guidance on diagnosis and management of type 1 diabetes. Key learning points for healthcare professionals include when to measure C-peptide and diabetes-specific autoantibodies, DAFNE (dose-adjustment for normal eating) education programme, carbohydrate-counting training, and management options.

 

Clinical Q&A on men's health

Men’s health specialist and GP Professor Mike Kirby outlines the rewards of becoming more involved in men’s health and answers questions on prostate cancer risk and ED.

 

Substance misuse: benzodiazepines

Dr Iain Brew provides practical advice on prescribing benzodiazepines. Key learning points for healthcare professionals include equivalence and pharmacokinetics of benzodiazepines, risks associated with long-term use, current guidance and consultation techniques.

 

Pneumonia: clinical review

Dr Sinan Eccles and Dr Simon Barry review the assessment and management of pneumonia in primary care. Key learning points for healthcare professionals include community-acquired pneumonia (CAP) in adults, making a clinical diagnosis, rationalising the use of antibiotics and when to refer the patient for hospital assessment.

 

A child with a sore throat - what's the diagnosis?

This quiz by Dr Ravi Ramanathan challenges you to diagnose the likely cause of a child’s symptoms.

 

Foot problems in diabetes

Dr Suneeta Kochhar describes the steps recommended by NICE for preventing and managing foot problems in people with diabetes. Key learning points for healthcare professionals include clinical examination to assess for neuropathy, limb ischaemia, ulceration etc, management of diabetic foot ulcers, and when to refer.

 

Medical management of depression

Dr Raj Thakkar reviews the medical management of depression in primary care. Key learning points for healthcare professionals include indications for drug treatment, choice of antidepressant, and managing refractory depression.

 

Type 1 diabetes in a child

Dr Tillman Jacobi presents the case of a five-year old discovered to have type 1 diabetes. Key learning points for healthcare professionals include the presentation of type 1 diabetes, genetic likelihood of developing type 1 diabetes, and diagnosis with a positive dipstick test.

 

A scalp lesion - what's the diagnosis?

In this article Dr Ravi Ramanathan asks you to diagnose the likely cause of a patient’s symptoms.

 

Red cheeks - what's the diagnosis?

This article by Dr Ravi Ramanathan challenges you to diagnose the likely cause of a patient’s symptoms.

 

Differential diagnosis: facial lumps and bumps

Dr Nigel Stollery compares presentations of milia, keratosis pilaris, comedones and molluscum contagiosum.

 

Clinical Q&A on women's health September 2015

GP with a special interest in women’s health, Dr Sarah Gray, outlines her role and answers questions on women’s health.

 

Falls in older people

This article by Dr Mark Jopling covers the causes and contributing factors to falls in the elderly, plus how to assess a frequent faller and prevent falls. Key learning points for healthcare professionals include identifying the cause of a fall such as tripping or syncope, the link between polypharmacy and ...

 

Post-traumatic stress disorder: clinical review

The article by Dr Tony Downes reviews the diagnosis and management of post-traumatic stress disorder. Key learning points for healthcare professionals include diagnostic criteria for PTSD, taking a structured core symptom history, mindfulness-based techniques and trauma-focused psychological therapies as first-line management.

 

A recurrent macule - what's the diagnosis?

In this picture quiz Dr Nigel Stollery asks you to identify a condition you may come across in your work as a GP.

 

A painful toenail - what's the diagnosis?

This picture quiz by Dr Nigel Stollery asks you to identify a condition you may come across in your work as a GP.

 

A wounded leg - what's the diagnosis?

In this article Dr Ravi Ramanathan asks you to diagnose the likely cause of a patient’s symptoms.

 

A swollen knee - what's the diagnosis?

In this article Dr Ravi Ramanathan asks you to diagnose the likely cause of a patient’s symptoms.

 

Choices in emergency contraception

This article by Dr Gill Jenkins provides an update on emergency contraception with case studies for GPs and nurses to work through. Key learning points for healthcare professionals include efficacy and cost of levonorgestrel, UPA and IUD, effective timing after UPSI, and contraindications.

 

Hypertension: clinical review

The article by Dr Klaus Witte and colleagues reviews the management of hypertension in primary care. Key learning points for healthcare professionals include causes of secondary hypertension, suitable investigations such as urine dipstick and ECG, the role of ambulatory blood pressure monitoring, lifestyle advice and medication.

 

A persistent rash

This article by Dr Louise Newson examines the clinical manifestations, diagnosis, complications and management of patients with dermatitis herpetiformis. Key learning points for healthcare professionals include symptoms and distribution, and management of patients with coeliac disease and dermatitis herpetiformis.

 

Breathlessness on exertion

The article by Dr Raj Thakkar examines the clinical approach to a patient with breathlessness caused by aortic valve disease and concomitant heart failure. Key learning points for healthcare professionals include acute and on-going management of patients with this condition.

 

Managing urinary tract infections

Dr Sally Hope examines the diagnosis and management of both men and women with UTI. Key learning points for healthcare professionals include interpretation of urine dipsticks in patients with UTI, differential diagnoses and management of patients with UTI who are pregnant.

 

Managing chronic pruritus

This article reviews the causes and management of chronic pruritus.

 

End-of-life care

This article by Dr Trisha Macnair outlines GPs’ responsibilities in care of the dying. Key learning points for healthcare professionals include GMC guidance on treatment and care towards the end of life, five priorities for individual, holistic care planning, and drugs and dosages for anticipatory prescribing.

 

Scarlet fever

This article by Dr Nigel Stollery reviews the bacterial infection scarlet fever, including the presentation and prognosis and how to investigate and manage. Key learning points for healthcare professionals include mechanisms of transmission such as by respiratory droplets, when to take a throat swab and culture, differential diagnosis and complications.

 

Managing PPI resistant GORD

This case study by Dr Neel Sharma and colleagues looks at the management of gastro-oesophageal reflux disease that is resistant to proton pump inhibitors. Key learning points for healthcare professionals include lifestyle advice, when upper GI endoscopy should be undertaken, changing medications and surgical interventions.

 

Lung disease in patients with rheumatoid arthritis

This article by Dr Clive Kelly examines the lung manifestations of rheumatoid arthritis. Key learning points for healthcare professionals include increased frequency of interstitial lung disease in patients with RA, risk of pneumonia, and the effects of RA drugs on the lungs.

 

Assessing pain in palliative care patients

This article by Dr Patricia Macnair, updated in 2017, examines the assessment of pain in palliative care patients.

 

Recognising dengue fever

In this article Dr Mike Townend covers the clinical features, diagnosis and treatment of dengue fever. Key learning points for healthcare professionals include common symptoms such as severe arthralgia and myalgia, bite avoidance advice, and complications of dengue.

 

Referral and management of renal colic

This activity covers the clinical assessment and referral of renal colic, along with treatments available in secondary care.

 

Recognising domestic violence

Dr Fiona Duxbury covers the recognition of domestic violence and abusive relationships in general practice. Key learning points for healthcare professionals include characteristics of abusive relationships such as undue possessiveness and isolation, questions to ask, explaining available resources, and how to refer.

 

Testing procalcitonin in bacterial infection

The article examines the use of testing for raised procalcitonin in response to infection by bacteria, fungi and malaria parasites.

 

Assessing fever in children

This article discusses the assessment and management of fever in children, including the traffic light system for assessing the child’s symptoms.

 

A painful leg - what's the diagnosis?

In this article Dr Ravi Ramanathan asks you to diagnose the likely cause of a patient’s symptoms.

 

A wrist swelling - what's the diagnosis?

This article by Dr Nigel Stollery challenges you to diagnose the likely cause of a patient’s symptoms.

 

A sore tongue - what's the diagnosis?

This article by Dr Nigel Stollery challenges you to diagnose the likely cause of a patient’s symptoms.

 

Acute coronary syndromes

This article by Professor Tom Quinn covers the diagnosis and management of acute coronary syndromes in primary care.

 

A hacking cough - what's the diagnosis?

In this article Dr Ravi Ramanathan asks you to diagnose the likely cause of a patient’s symptoms.

 

Facial rash - what's the diagnosis?

This article by Dr Ravi Ramanathan asks you to diagnose the likely cause of a patient's symptoms.

 

Hirsutism - red flag symptoms

This article examines the possible causes of hirsutism and how to manage the presentation of this symptom.

 

Psoriasis: clinical review

This article by Dr Claire Marshall and Dr Anshoo Sahota examines the classification, diagnosis and management of patients with psoriasis. Key learning points for healthcare professionals include exacerbating factors and NICE quality standards.

 

Familial breast cancer

Dr Helen Hanson provides an update on familial risk of breast cancer, and BRCA testing. Key learning points for healthcare professionals include appropriate breast surveillance, who is eligible for a genetic test, and management of BRCA carriers.

 

Assessing anxiety in palliative care patients

This article by Dr Trisha Macnair, updated in 2017, covers how assessing anxiety in palliative care patients can better help to develop a treatment plan.

 

What to recommend for travel vaccinations

This article by Dr Mike Townend covers the most important vaccinations travellers should consider, including tetanus, poliomyelitis and diphtheria. Key learning points for healthcare professionals include carrying out a full risk assessment, vaccines for diseases of close physical contact, and vaccines for travel to countries with poor food and water ...

 

Long-stay and remote travel vaccinations

In this article Dr Mike Townend covers the vaccinations that may be needed for travellers who are at higher risk of infectious disease because they are travelling for longer or to remote destinations. Key learning points for healthcare professionals include vaccination schedule and side-effects of hepatitis B, rabies, yellow fever, ...

 

Abdominal pain - red flag symptoms

Dr Pipin Singh provides an update on identifying potentially serious causes of abdominal pain.

 

Erectile dysfunction - red flag symptoms

This activity covers the possible red flag symptoms to consider when a patient presents with erectile dysfunction.

 

Delirium - red flag symptoms

This article by Dr Anna Cumisky covers the possible red flag symptoms associated with acute confusion. Key learning points for healthcare professionals include how to assess an acutely confused patient, differential diagnoses such as psychosis, depression and dementia. and when to refer.

 

Persistent cough - red flag symptoms

This activity covers the possible red flag symptoms of persistent cough.

 

Managing anaphylaxis during an emergency

Dr Adam Fox and Dr Sian Ludman outlines the steps that need to be taken to manage anaphylaxis successfully.

 

Pitting oedema - red flag symptoms

This activity covers the possible red flag symptoms to be aware of when a patient presents with pitting oedema in primary care.

 

Hallucinations - red flag symptoms

Dr Suneeta Kochhar explores the red flag symptoms of hallucinations, their possible causes how to assess patients.

 

Systemic lupus erythematosus: clinical review

Dr Natasha Jordan and Professor David D’Cruz review the epidemiology and classification of SLE, as well as the pharmacological management options.

 

Tremor - red flag symptoms

The article by Dr Suneeta Kochhar examines the causes of tremor and how to assess and manage this symptom.

 

OCD in children and adolescents: clinical review

This article by Dr Eloise Donaghay-Spire and Dr Vibhav Shetty reviews the diagnosis and the pharmacological and non-pharmacological management of OCD in children and adolescents.

 

Diagnosing actinic keratoses

This article by Dr Nigel Stollery provides an overview of the diagnosis of actinic keratoses.

 

Atrial fibrillation: clinical review

This review by Dr Andrew Money-Kyrle, updated in 2017, examines the diagnosis and management of atrial fibrillation.

 

Insomnia - red flag symptoms

The article by Dr Suneeta Kochhar describes the symptoms associated with insomnia that will indicate when further investigation is needed and explores the possible causes of insomnia.

 

Delirium: clinical review

This article by Dr Reshad Malik and Dr Muffazal Rawala defines delirium and explains how to manage the condition according to its cause.

 

Loss of consciousness - red flag symptoms

In this article Dr Pipin Singh explains how to elucidate if there is a sinister cause to loss of consciousness. Key learning points for healthcare professionals include red flags, appropriate investigations and when to refer.

 

Jaundice - red flag symptoms

In this article Dr Suneeta Kochhar reviews the red flag symptoms associated with serious causes of jaundice

 

Cervical cancer: clinical review

This article reviews the diagnosis and management of cervical cancer, including an overview on common surgical management techniques and factors affecting prognosis.

 

Headaches in children - red flag symptoms

This article explores the causes of headache in children and how to assess them to make decisions about urgent referrals.

 

Absent peripheral pulses - red flag symptoms

This activity covers the possible red flags of patients presenting with absent peripheral pulses.

 

Haematuria - red flag symptoms

This article explores the red flag symptoms that may indicate a serious cause of haematuria.

 

Haemoptysis - red flag symptoms

This article by Dr Suneeta Kochhar, updated in September 2016, explores the red flag symptoms that may indicate a more serious cause of haemoptysis. Key learning points for healthcare professionals include identifying possible causes such as COPD, TB, malignancy or heart failure, and when to refer.

 

Premature ejaculation: clinical review

This article by Mr Paul Anderson and Mr Zubair Cheema covers the assessment and management of premature ejaculation in primary care. Key learning points for healthcare professionals include classifying premature ejaculation as lifelong or acquired, identifying risk factors and prognosis.

 

Dizziness - red flag symptoms

The article highlights the red flag symptoms in patients presenting with dizziness.

 

Heart failure: clinical review

Dr Rajiv Sankaranarayanan provides an overview of the diagnosis and management of heart failure.

 

Headache - red flag symptoms

Dr Suneeta Kochhar provides an overview of red flag symptoms in patients presenting with headaches.

 

Alopecia: clinical review

This activity reviews the common causes and different types of alopecia, with recommended investigations and management strategy.

 

Rectal bleeding - red flag symptoms

Dr Suneeta Kochhar provides an overview into the red flags of rectal bleeding. Key learning points for healthcare professionals include ruling out malignancy and inflammatory bowel disease, and when to refer.