Medical Trainees

Your tricky questions answered on dermatological infections
A 65 year old woman presents to you with excruciating pain in her right foot. She says it started with a small blister a couple of days ago, but is now much worse. She describes the pain as the worst pain imaginable. On examination the entire foot is dusky grey with bullae and areas of necrosis. There are crepitations on palpation. 
What should you do next?
Find out the answer to this and other practical questions posed by BMJ Learning users in Ask the consultant: Dermatological infections. It’s been getting great reviews:
"Helpful review of some common and thankfully not so common (necrotising fasciitis) dermatological conditions."
“Very useful module on topics of dermatology that I did not know too much about. Nice detailed explanations of answers to a range of interesting topics”

How would you manage a patient admitted with accidental hypothermia?

A 70 year old homeless man is brought in by ambulance in cardiac arrest with resuscitation in progress. A tympanic temperature is taken and found to be 29°C.

What would you do next?

Check your answer to this and other management scenarios in our case-based module Hospital presentations: hypothermia. It will give you the knowledge and confidence to manage the rewarming of patients and understand how hypothermia can alter the management of advanced life support.

It’s getting great reviews from other users:

“Excellent scenarios with real life situations. Good questions, great and concise tips and learning points. Genuinely enjoyed doing this module. Thank you authors!”

Dysuria: what treatment would you start?

A 35 year old man attends the emergency department with a one day history of worsening dysuria, frequency, low back pain, and myalgia. On examination, he is febrile and tachycardic. A per rectal examination reveals a swollen and very tender prostate. Urine dipstick: leucocytes 3+, nitrites 3+

What is your diagnosis and initial management?

Check your answer in our latest hospital presentations module on dysuria. It follows the investigation and management of two patients presenting with painful urination, and covers topics such as risk factors for urinary tract infection (UTI), when to treat asymptomatic bacteriuria, preventing recurrent UTI, and the pathophysiology and management of infective urethritis.

Other modules in the same series on related topics include:

Genital discharge and ulceration

Delirium

Acute headache: can you identify a potentially life-threatening cause?

Can you recognise and relate different presentations of acute new headache to the underlying pathology? Do you know when to arrange urgent imaging? Can you spot the features of raised intracranial pressure and other red flags? Do you know how and when to start prompt drug treatment for a patient presenting acutely with headache?

Get up to speed on these and other clinical issues with our case-based module Hospital presentations: Headache. It follows the assessment and initial management of four patients with different presentations of severe headache, testing your knowledge and clinical skills along the way.  Throughout the module you’ll see “I want to know more” links, giving you the option to go into more depth on specific aspects of the topic. Just click on the link to see additional information.

It’s already proving popular with other users:

"Fantastic review of primary and secondary headaches"

"This was such a good review of the material we have covered so far in class. Although we haven't done management side of headaches it was easy to follow and really helpful summaries. Thanks!"

Your tricky questions answered on dermatological infections

A 65 year old woman presents to you with excruciating pain in her right foot. She says it started with a small blister a couple of days ago, but is now much worse. She describes the pain as the worst pain imaginable. On examination the entire foot is dusky grey with bullae and areas of necrosis. There are crepitations on palpation.

What should you do next?

Find out the answer to this and other practical questions posed by BMJ Learning users in Ask the consultant: Dermatological infections. It’s been getting great reviews:

"Helpful review of some common and thankfully not so common (necrotising fasciitis) dermatological conditions."

“Very useful module on topics of dermatology that I did not know too much about. Nice detailed explanations of answers to a range of interesting topics”

What grade is this pressure ulcer?

pressure ulcerA 62 year old man with poorly controlled type 2 diabetes mellitus is admitted to hospital with hyperosmotic hyperglycaemic state. While examining him you note this ulcer on his left ischial tuberosity.

What’s your assessment of the grade of his ulcer?

Check your answer in Challenges in hospital care: pressure ulcers. This highly practical module walks you through three case histories, giving you the option to delve deeper if you want. Covering prevention, assessment, complications and management, this is an important challenge for clinicians at all levels. It’s getting great feedback from other users:

Detailed module giving important information about an easily neglected subject despite its prevalence. The cases help to give it relevance and interest while learning

Memory loss: can you distinguish reversible from irreversible causes?

Would you feel confident to identify a patient whose progressive memory loss is caused by a reversible cause such as pseudo-dementia? In patients with true dementia, what features in the history and presentation can help you to distinguish between different forms, including Alzheimer's disease, vascular dementia, frontotemporal dementia and dementia with Lewy bodies?

Build your confidence with our new Hospital Presentations module on Memory loss, in which you'll work through a patient case that might arise in your daily work on the wards or in the emergency department. It covers assessment and immediate management of patients who present with progressive memory loss, the range of potential causes and practical tips on using bedside cognitive assessment tools. Other junior doctors are already finding it really helpful:

“Great module. Has essential information in managing and understanding patients with cognitive impairment. Also I liked how the screening tools were presented.”

What sign can be seen on this x ray?

A 25 year old man presents with a one week history of crampy abdominal pain and frequent passage of bloody stools. His radiograph is shown below. What sign can be seen?

Check your answer in our new module on Interpretation of abdominal radiographs, which will help you to differentiate normal from abnormal features and reach the right diagnosis for a range of common and rarer conditions.

In the module, consultant radiologist Dr Vikas Shah takes you through the ABDO X system for analysing abdominal x rays and offers invaluable practical tips on how to assess bowel gas patterns, soft tissue structures and bones. Other users are loving the module:

"Magnificent module, very highly recommended."

"An absolute highlight. A dedicated teacher with an extraordinary didactic skill has delivered a perfect introduction into a not-so-easy topic."

Join our audience panel

If you’d like to help BMJ Learning ensure we deliver the content that you need as a medical trainee, join our audience panel to provide feedback and ideas. Email clinical editor Jo Haynes.

Animated practical skills modules to support you in your first years on the ward

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