Doctor

☛ J - joules

☛ JVP - jugular venous pressure

☛ LBBB - left bundle branch block

☛ LDH - lactate dehydrogenase

☛ LDL - low-density lipoprotein

☛ LFT - liver function test

☛ LTOT - long-term oxygen therapy

☛ MCV - mean cell volume

☛ MHC - major histocompatibility complex

☛ MMSE - mini mental state examination

☛ MRI - magnetic resonance imaging

☛ MRSA - methicillin-resistant Staphylococcus aureus

☛ MSH - melanocyte-stimulating hormone

☛ NAC - N-acetylcysteine

☛ NG - nasogastric

☛ NICE

1) Formerly: National Institute for Clinical Excellence

2) Currently: National Institute for Health and Clinical Excellence

☛ NMDA - N-methyl-D-aspartate

☛ NSAIDs - non-steroidal anti-inflammatory drugs

☛ NSTEMI - non-ST-elevation myocardial infarction

☛ PaCO2 - partial pressure of carbon dioxide

☛ PaO2 - partial pressure of oxygen

☛ PCA - patient-controlled analgesia

☛ PCI - primary coronary intervention

☛ PCP - Pneumocystis carinii pneumonia

☛ PCR - polymerase chain reaction

☛ p.r.n. - pro re nata

☛ PSA - prostate-specific antigen

☛ PSC - primary sclerosing cholangitis

☛ PSGN - post-streptococcal glomerulonephritis

☛ RAS - renal artery stenosis

☛ RBBB - right bundle branch block

☛ SIADH - syndrome of inappropriate ADH secretion

☛ SLE - systemic lupus erythematosus

☛ STEMI - ST-elevation myocardial infarction

☛ STD - sexually transmitted disease

☛ TFTs - thyroid function tests

☛ U - units

☛ UC - ulcerative colitis

☛ V/Q - ventilation/perfusion

☛ WCC - white cell count

In the management of asthma, patients should be sitting upright in bed and receiving 100% oxygen. Salbutamol is given at a dose of 5 mg nebulised, not 500 micrograms. Ipratropium bromide and steroids should then be considered.

☛ Peak expiratory flow rate of between 30% and 50% of expected

☛ Respiratory rate greater than 25 breaths/minute

☛ Tachycardia: heart rate > 100 beats per minute

☛ Inability to complete sentences with one breath

☛ Peak expiratory flow rate of < 33% of best or predicted

☛ Silent chest

☛ Exhaustion

☛ Hypotension

☛ Bradycardia

☛ Coma

☛ Rising PaCO2

In SLE the erythrocyte sedimentation rate is classically raised while C-reactive protein levels can stay normal and therefore CRP is also not as useful as the other investigations to monitor disease activity and progression.

In drug-induced SLE anti-histone antibody is present in 90% of patients, although this is not specific for the condition. Anti-nuclear antibody is positive in 50% of patients as opposed to 95% of patients with idiopathic SLE.

A cephalosporin such as ceftriaxone is first-line treatment in patients with streptococcal meningitis. Benzylpenicillin would be more appropriate if Neisseria meningitidis was suspected.

Treatment of hypercalcaemia can include fluid rehydration, loop diuretics, bisphosphonates, steroids, salmon calcitonin and chemotherapy.

In clinical practice intravenous fluids are the first-line agent used to treat hypercalcaemia, both rehydrating the patient and helping to lower the calcium levels. This is combined with the co-administration of bisphosphonates such as pamidronate, which exert their maximal effect 5-7 days after administration.

Azathioprine takes a number of months to exert its anti-inflammatory effect and therefore has a limited role in the acute management of Crohn's disease, though it can be started at the time of an acute flare of Crohn's.

There are numerous extra-gastrointestinal manifestations of inflammatory bowel disease that occur in both ulcerative colitis and Crohn's disease, such as uveitis, conjunctivitis, arthritis, pyoderma gangrenosum and erythema nodosum. Some occur primarily in Crohn's, such as gallstones and renal stones due to the area of bowel affected, while patients with ulcerative colitis are more likely to develop primary sclerosing cholangitis and venous thromboses.

Communication skills play a major role in developing patient-doctor relationship. And miscommunication could lead to clashes with relatives/friends of patients over care given to the latter.

Once a patient begins developing trust in a doctor, the chances of him/her recovering increases as his/her confidence in the doctor goes up and s/he begins to believe that s/he can recover.

Some doctors specialise in a certain kind of medicine. These physicians are called specialists. They may only treat injuries to a certain part of the body, or only treat patients who have certain diseases. For example, there are physicians who specialise in diseases of the stomach or intestines. Other physicians are "general practitioners" or "family practitioners". This means that they do a little bit of everything. They try to deal with as much of a patient's health problems as they can without sending them to a specialist. A doctor who performs surgery is called a surgeon.