Coronavirus links - an archive of bookmarks of relevant information

On  Assessing Risk for Employment Reasons
https://alama.org.uk/covid-19-medical-risk-assessment/?fbclid=IwAR2QQxgrxysu2S-Uw69xrnvujYjHNiQl6HI3OawlGKL2DARvIJHdQq70e2Y

COVID TextBook 

https://livingtextbooks.com/pdffiles/covidfinalbinder.pdf

GOV SITES

National restrictions for going to work in light of 2nd lockdown
https://www.gov.uk/guidance/new-national-restrictions-from-5-november?priority-taxon=774cee22-d896-44c1-a611-e3109cce8eae#going-to-work

Reporting nofiable diseases
https://www.gov.uk/guidance/notifiable-diseases-and-causative-organisms-how-to-report?fbclid=IwAR142mIsB40ORhEVhmEZe17fjtLXACXMwo7MAgfz7tGoAukk1ElyW1r2zpM

Covid, isolating and exposed heathcare workers
https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings

On staying at home - for positive results
https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-households-with-possible-coronavirus-covid-19-infection#if-you-live-with-someone-with-covid-19-symptoms-or-a-positive-test-result

Antibody testing - what it can't tell you
https://www.gov.uk/government/publications/coronavirus-covid-19-antibody-tests/coronavirus-covid-19-antibody-tests#what-an-antibody-test-cannot-tell-you

Other Links

Tim Spector + JOIN ZOE blog

https://covid.joinzoe.com/blog

Spanish article on spread through the Air  
https://english.elpais.com/society/2020-10-28/a-room-a-bar-and-a-class-how-the-coronavirus-is-spread-through-the-air.html

NHS UK Self isolation Rx and how long  
https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-and-treatment/how-long-to-self-isolate/

Clinical and Prodromal Ocular Symptoms in Coronavirus Disease: A Systematic Review and Meta-Analysis  https://iovs.arvojournals.org/article.aspx?articleid=2770655

C19 and immunisations - https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/clinical-guidance-for-hcps-on-imms-for-covid-19.pdf

Covid Calculator https://qcovid.org/ 

RCOG pregnancy + covid
https://www.rcog.org.uk/globalassets/documents/guidelines/2020-10-14-coronavirus-covid-19-infection-in-pregnancy-v12.pdf

On common covid symptoms 
 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234765   

summary article https://www.sciencedaily.com/releases/2020/06/200624100047.htm

On Neuropilin-1, neurology and covid symptoms  
https://www.sciencealert.com/a-second-key-used-by-sars-cov-2-to-enter-cells-could-explain-why-it-s-so-infectious

https://science.sciencemag.org/content/early/2020/10/19/science.abd2985

Lancet https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30221-0/fulltext

Understanding the cycle threshold in respect of test results
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/926410/Understanding_Cycle_Threshold__Ct__in_SARS-CoV-2_RT-PCR_.pdf

ONS office of national statistics
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsinvolvingcovid19englandandwales/deathsoccurringinjune2020

A Series of Useful Things for GPs / GP trainees

Is the GP best placed for Mental Capacity Assessments?

The short answer is no.  But sometimes one needs to know why,  and have a polite answer as to why.

Here is useful article from Lawskills.

Covert administration of medications 
(often something that needs to be discussed with relevant teams for patients with mental capacity deficits e.g. due to dementia etc)

From the CQC
NICE guidance.

Advice and support links
BMA GP practice

LMC
Jobs board

On Amending Records

https://www.gponline.com/amending-medical-records-patients-rights/article/1462317?fbclid=IwAR1kiYU4eZTQFq4MuKnGBlmuqiSYy5ruVtQLVwqKI5Ok9KPKzAvLxdw7NOI

On Computer systems used within the GP world. 

https://www.tpp-uk.com/resources
https://youtu.be/s_qVZDfnRhs
https://youtu.be/G5YfmjH_BTg
https://youtu.be/Yms5iV4ceNc Systmone by egplearning.

SystmONE Short CUT keys https://www.youtube.com/watch?v=75-AON7DMSw

https://youtu.be/zR1t0Nk8gkE Emis. deliberately blurred I think to protect patient details. Allows overall gist and look and feel. Very few things that need to be aware of in emis.

Pdf file on EMIS web for clinicians
http://www.primarycaresheffield.org.uk/wp-content/uploads/2020/03/LPUG0019-Emis-Web-Introduction-Admin-Clinical.pdf

Pdf file on  Adastra for clinicians
https://heeoe.hee.nhs.uk/sites/default/files/huc_-_clinicians_adastra_manual.pdf

As a  GP, the most important things one wants to know with a computer system is:
- where to put the consultation
-how to access patient record
-how to save after Consulting
-how to issue and print prescriptions
-how to check patient history
-and how to to see your patient list
-how to call them into the room
-also knowing repeat medications
-how to check lab path results.

Steroids

A very wonderful if not excellent pdf on steroids - their potency and finger tip units. This one has some simple useful tables, easy to print out and pop on one's room wall, and a useful diagram of what a finger tip unit looks like.

https://www.guysandstthomas.nhs.uk/resources/patient-information/dermatology/topical-steroids.pdf


And another one from the Pennine VTS group.
https://www.pennine-gp-training.co.uk/res/steroid%20and%20emoillients%20ladder.docx

This is very lovely one from eczema.org where there is comprehensive table with brand names associated, also with steroid potency information. This is quite helpful as a practicing GP.  Highly recommend downloading and keeping on desktop or file.
https://eczema.org/wp-content/uploads/Topical-steroids-Sep-19.pdf

Here is diagram from their leaflet, for example, useful for physicians and patients alike.

UK immunisation schedule and links 2020

https://www.gov.uk/government/publications/the-complete-routine-immunisation-schedule
This is june 2020
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/899423/PHE_Complete_Immunisation_Schedule_Jun2020_05.pdf

https://patient.info/doctor/immunisation-schedule-uk

This table is  from patient.info

UK 2020 Immunisation Schedule
AGE	Immunisation (Vaccine Given)
8 weeks	DTaP/IPV(polio)/Hib/HepB (diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b and hepatitis B) - 6-in-one injection (Infanrix hexa®); plus: Rotavirus (Rotarix®) - oral route (drops). Meningitis B Bexsero®). PCV (pneumococcal conjugate vaccine) - in a separate injection (Prevenar 13®). Note - for children born from 1st January 2020, this vaccine is offered at 12 weeks and 1 year rather than at 8 weeks, 16 weeks and 1 year.
12 weeks	DTaP/IPV(polio)/Hib/HepB 6-in-one injection, 2nd dose (Infanrix hexa®); plus: PCV (pneumococcal conjugate vaccine) - in a separate injection (Prevenar 13®) for babies born after 1st January 2020. Note - for children born before 1st January 2020, this vaccine is offered at 8 weeks, 16 weeks and 1 year rather than at 12 weeks and 1 year. Rotavirus (Rotarix®) - oral route (drops).
16 weeks	DTaP/IPV(polio)/Hib/HepB 6-in-one injection, 3rd dose (Infanrix hexa®); plus: Meningitis B 2nd dose (Bexsero®). PCV (pneumococcal conjugate vaccine) - in a separate injection (Prevenar 13®). Note - for children born from 1st January 2020, this vaccine is offered at 12 weeks and 1 year rather than at 8 weeks, 16 weeks and 1 year.
Between 12 and 13 months	Hib/MenC (combined as one injection) - 4th dose of Hib and 1st dose of MenC (Menitorix®); plus: MMR (measles, mumps and rubella) - combined as one injection (Priorix® or M-M-RVAXPRO®); plus: PCV 2nd dose (Prevenar 13®) - in a separate injection. Meningitis B 3rd dose (Bexsero®).
2 years- end of primary school	Nasal flu spray annually (Fluenz Tetra®) for all children. For children aged 2, 3 and 4, this is usually given in the GP surgery. Children in primary school should have this at school.
3 years and four months	Preschool booster of DTaP/IPV(polio). 4-in-one injection (Repevax® or Boostrix IPV-IPV®); plus: MMR 2nd dose (Priorix® or M-M-RVAXPRO®) - in a separate injection.
12-13 years (boys and girls)	HPV (human papillomavirus types 16 and 18) - two injections (Gardasil®). The second injection is given 6-24 months after the first one.
14 years	Td/IPV(polio) booster. 3-in-one injection (Revaxis®). Men ACWY: combined protection against meningitis A, C, W and Y (Nimenrix® or Menveo®).
Adults	Influenza (annual) and PPV (pneumococcal polysaccharide vaccine): for those aged over 65 years and also those in high-risk groups. Td/IPV(polio): for those not fully immunised as a child or travelling to high-risk areas (Revaxis®). DTaP/IPV: for pregnant women from 20 weeks of gestation to protect the newborn baby against whooping cough or people travelling to high risk areas (Boostrix-IPV® or Repevax®).  Shingles (Zostavax®) vaccine: for adults aged 70 or 78 years. (Plus catch-up for adults born after 2nd September 1942 who have not previously been immunised if they are under 80 years).

GP and Human

I love this post, and really want to share it.

Could not have written it better.

She speaks of that moment, when we feel like we are trying to draw blood, from stone.
We're just trying our best. And we feel, like the enemy.

https://gpandhuman.com/2017/09/16/theotherside/

AKT & CSA: onwards we struggle, resources, links, revision tips, ideas, a place to put this stuff down in the hope this crappy exam we may sail through

AKT : and we struggle on, and we hope to reach the end, and we search for useful resources, and we put them where we can

This website, is really a gem from someone else who has worked hard to revise some of the more annoying things with respect to AKT in video format. Also other useful GP training related tips. The home page may be relevant for the medical students of you, and for the those who have qualified but need a refresher in mindmap fashion.

http://medimaps.co.uk/akt-revision-videos/  (for those doing AKT)
http://medimaps.co.uk/gp-trainee-resources/  (for GPs - a nice training resource)

http://medimaps.co.uk/about/  (all about the site)
http://medimaps.co.uk/  (for the medstudents)


Then, we have the famous BradfortVTS webpage
http://www.bradfordvts.co.uk/
http://www.bradfordvts.co.uk/online-video/
http://www.bradfordvts.co.uk/mrcgp/akt/  (this is basically the GOLDEN PAGE for more links eg to RCGP etc)

And finally:
http://www.rcgp.org.uk/training-exams/mrcgp-exams-overview/mrcgp-applied-knowledge-test-akt.aspx  [everything else you need to know about it from the horse's mouth, the RCGP]
AKT sample paper with answers
AKT April 2016 Feedback report

The rest of this page, or remainder of this blog may end up having a lot of AKT//CSA related stuff, as part of ongoing revision. Sadly, having failed this twice, I'm pulling my teeth out. Will let you know how things go, and what gems I discover along the way. Please share with me as you feel fit, because together our overall aim, I would hope, is to be better doctors for the benefit of all......

Update:  
I would highly recommend anyone in the UK to access the following -
Dr Nigel Giam's courses - I found personally very helpful, in particular regularly reviewing his videos, and the AKT and CSA courses I did with him. He is dedicated in  what he does and has seen so many students that he can  spot easily the weaknesses with advice to improve.
http://www.docgiam.com/   He is also on  facebook, and can be followed there.

I would also recommend the courses provided by Emedica.
https://www.emedica.co.uk/
There is an online AKT mock test one can try.
They also have a really good 'Life after CCT' course, comprehensive, and a booklet to go with it, useful work and costings.

And finally, if anyone is really struggling to find someone to practice with, I do know someone who has offered his time for a cost via Skype/video learning, in order to help those struggling - as we know, there are those in  some VTS groups where there are such a minimal number of trainees, perhaps one is an international medical graduate and there aren't many people in your peer group to practice with, or there aren't any people willing to give time or make time for you. Drop a comment and will see what we can do. However, I understand that in light of Covid - the exam format may have changed somewhat. Dr Giam has more on this.

There are also other groups of interest too, this eg AroraAman and BeejShah (medlighten)  I don't have personal experience of these but Beej has plenty of useful material on facebook.
https://aroramedicaleducation.co.uk/
https://www.facebook.com/medlighten/

psychiatry links

http://www.trickcyclists.co.uk/pocket_psychiatry.htm

http://psychskills.co.uk/