Pre PACES Podcast

Dermatology registrar, Dr Naomi Jones, joins Sam to discuss everything dermatological related to PACES. Naomi is also our next guinea-pig on Reg Against the Machine!

DermnetNZ and BAD patient leaflets

Music:

Chase & Superepic by Alexander Nakarada | https://www.serpentsoundstudios.com Music promoted by https://www.free-stock-music.com Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

Cinematic Epic Motivational Music | FILM by Alex-Productions | https://www.youtube.com/channel/UCx0_M61F81Nfb-BRXE-SeVA

Music promoted by https://www.free-stock-music.com

Creative Commons Attribution 3.0 Unported License

https://creativecommons.org/licenses/by/3.0/deed.en_US

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Sam's going solo this week discussing his process for consenting patients for invasive procedures with three examples of lumbar puncture, chest drain and ascitic drain.

Lumber puncture sources:

https://www.hey.nhs.uk/patient-leaflet/lumbar-puncture/

https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/Neurology/5561-1Lumberpunctureandconsent.pdf

https://www.nhs.uk/conditions/lumbar-puncture/

https://www.esht.nhs.uk/wp-content/uploads/2022/02/0957.pdf

Chest drain sources:

https://www.health.qld.gov.au/__data/assets/pdf_file/0016/150028/thoracics_04.pdf

https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Chest%20Drain%20Insertion%20Consent%20Form.pdf

https://www.jpaget.nhs.uk/media/279437/CT-5-Insertion-of-a-Chest-Drain-llt-v1-print.pdf

https://www.guysandstthomas.nhs.uk/health-information/chest-drain

Ascitic drain sources:

https://patientinfo.nhshighland.scot.nhs.uk/Liver/Abdominal%20Paracentesis%20%28drainage%20of%20ascites%29.pdf

https://hgs.uhb.nhs.uk/wp-content/uploads/Tapping-Ascites-guidelines-03.05.19.pdf

https://www.cddft.nhs.uk/media/659993/ascitic%20tap-drain.pdf

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Dr Sarah Verhemel, structural heart disease fellow at Erasmus Medical Centre in Rotterdam, joins Sam to discuss aortic regurgitation in PACES.

Music:

Chase & Superepic by Alexander Nakarada | https://www.serpentsoundstudios.com Music promoted by https://www.free-stock-music.com Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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This episode's PACES classic topic is Systemic sclerosis, brought to you with a smile by Dr Sam Williams (as usual) and Dr John Pauling, consultant rheumatologist at North Bristol NHS Trust. This episode covers all the key elements of Systemic sclerosis as it might be presented in a PACES style scenario and is surely essential listening for your PACES preparation.

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Sam welcomes Dr Alex Carpenter, cardiology registrar with a specialist interest in electrophysiology to tackle the topic of palpitations. This is such a common topic with tons of clinical crossover and we discuss the common causes of palpitations, how they typically present and how you can tease this out in your history. We also talk through how to strategise the investigation of your patients and the various types of ambulatory ECG monitoring.

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In this second episode of Sam's chat with Dr Phil Berry, consultant hepatologist at Guy's & St Thomas's hospital in London, we cover the investigations, management, common examiner questions of chronic liver disease. Phil also tackles his all important Quiz the Consultant topic of STAR WARS - one NOT to be missed!

Music:

Chase & Superepic by Alexander Nakarada | https://www.serpentsoundstudios.com Music promoted by https://www.free-stock-music.com Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

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Dr Phil Berry, consultant hepatologist at Guy's & St Thomas's is Sam's next expert guest on the podcast to discuss another HUGE PACES station that comes up time and time again - chronic liver disease. This is absolutely essential for your PACES preparation. In this episode, Sam and Phil cover the examination of your patient, the presentation to the examiner and the differential diagnosis!

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The second part of Sam's chat with Dr Paul Sellors covers thrombectomy, hyperacute stroke theory and then ANOTHER up to date chat on the updated National Clinical Guideline for Stroke. We cover the important updates in the guidelines published in 2023 on thrombectomy, posterior strokes and wake-up strokes. Essential listening for anyone expected to cover the thrombolysis calls whether in-hours or out-of-hours!

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We welcome another fantastic returning guest in the form of Dr Paul Sellors, consultant in stroke medicine at North Bristol Hospital NHS Trust. Sam and Paul discuss tricky cases in Stroke medicine including stroke mimics, the modified Rankin score, the NIHSS, thrombolysis and thrombectomy! Plenty to unpack in this episode so sit back and enjoy!

03:00 Basic stroke nomenclature and physiology

11:00 Thrombolysis and stroke assessment

22:20 Seizure activity and stroke

28:00 Contraindications to thrombolysis

38:00 Calling the Stroke Consultant

42:00 Digression: BP control in stroke

47:30 Digression: Glucose control in stroke

50:00 Wake-up strokes

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Dr Tom Minton, neurology registrar in the Severn deanery joins Sam again in this episode of the podcast to discuss Bell's palsy including the important differentials and the critical management steps to take.

09:00 Presentation

14:30 Examination

19:20 Differential diagnosis

27:45 Management

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