CSA Cases Workbook for the MRCGP, second edition

** Please scroll down for the clickable weblinks **

CSA Cases Workbook 2e is a unique workbook designed to be used by GP revision groups practising for the CSA examination –  it is written by three GPs who recently passed the CSA.

Building on the success of the first edition, this new edition includes over 20 new cases aligned to the RCGP curriculum areas and latest guidelines. The ringbound design makes the practice consultations as exam-like as possible – allowing each member of the revision group to act as ‘doctor’, ‘patient’ or ‘observer’ and to take out just the pages they need ahead of the next revision session.

Along with easy to use marking schemes for every case, the cases also now include smartphone links to guide readers to useful resources.

To help further with revision, each curriculum area is split up into:
• possible cases – lists the cases most likely to come up in the CSA (including emergency and ‘special’ cases)
• revision notes – fully updated to provide the latest NICE and SIGN guidelines, along with other helpful references and websites, to help direct your revision
• material for the patient – a list of resources that you could usefully guide the patient towards in the consultation (including after you have passed the CSA!)
• practice explanations – topics, tests and procedures that you should be able to describe to the patient in a couple of minutes
• practice examinations – procedures you should be able to undertake confidently

Furthermore, the authors suggest a combination of 13 cases which could be used to run your own mock exam in preparation for the real thing.

Your revision group needs just a single copy of CSA Cases Workbook rather than multiple copies of any other book, and no photocopying needed either!

- WINNER OF THE BMA YOUNG AUTHORS AWARD -

Clickable weblinks:

PART 1: THE CSA

Chapter 1

RCGP information on MRCGP (www.rcgp.org.uk/...)

Marking scheme (www.rcgp.org.uk/...)

The daily pass mark (www.rcgp.org.uk/...)

Information on iPads in the CSA (www.rcgp.org.uk/...)

Pennine GP Training Scheme Cases (www.pennine-gp-training.co.uk/...)

Bradford VTS Cases (www.bradfordvts.co.uk/...)

My MRCGP (www.mymrcgp.com)

How to help your GP specialty registrar pass the CSA (www.rcgp.org.uk/...)

 

 

Chapter 2

‘Information for the doctor’ pages for the mock cases listed on page 18 of the Workbook: www.scionpublishing.com/CSAworkbook2, Resources tab

[2] GP curriculum statements (www.rcgp.org.uk/...)

[3] MRCGP Statistics 2014–2015 (www.rcgp.org.uk/...)

 [4] Independent review of the Membership of the Royal College of General Practitioners (MRCGP) examination (www.gmc-uk.org/...)

[5] Academic performance of ethnic minority candidates and discrimination in the MRCGP examination between 2010 and 2012: analysis of data. BMJ, 347: f5662 (www.bmj.com/...)

[6] RCGP CSA elearning course (http://elearning.rcgp.org.uk/...)

[7] MRCGP Statistics 2015–2016: Annual report on the AKT and CSA examination (www.rcgp.org.uk/...)

[8] The independent review of the Membership of the Royal College of General Practitioners examination (MRCGP) by Professor Aneez Esmail (www.gmc-uk.org/...)
[9] Joint RCGP and COGPED Guidance on CSA preparation (www.rcgp.org.uk/...)

 

PART II: CASE SCENARIOS

Patient.info provides detailed information on a wide range of conditions and is suitable for both patients and professionals (patient.info)

GPnotebook is a popular encyclopaedia of medical knowledge (www.gpnotebook.co.uk)

The RCGP online learning environment provides courses and modules across a range of subject areas (elearning.rcgp.org.uk) as does the BMJ Learning site (learning.bmj.com/…)

Clinical Knowledge Summaries provides a good source of evidence-based information on common primary care conditions (cks.nice.org.uk)

The GP Update Handbook compiles the latest research and evidence relevant to GPs

(gpcpd.com) and now includes separate handbooks on women's heath, cancer and GP leadership (the handbook and 12 months of access to the website is free to delegates of the GP Update course, or you can subscribe)

www.gp-training.net is a valuable educational resource for trainees, providing clinical guidelines, educational theory and consultation models.

E-learning for health is available to all NHS doctors in the UK, and provides access to

e-learning topics across the curriculum (www.e-lfh.org.uk/)

Doctors.net provides educational resources for doctors including textbooks and

e-learning modules (www.doctors.net.uk/)

The RCGP Curriculum statements (www.rcgp.org.uk/...)

 Patients’ unmet needs, doctors’ educational needs (gpcpd.walesdeanery.org/...)

The website www.choosingwisely.org aims to start a discussion to avoid wasteful

and unnecessary medical tests

The GP consultation in practice (www.rcgp.org.uk/...)

CSA feedback for candidates (2014–15) (www.rcgp.org.uk/...)

 

1       Healthy people: promoting health and preventing disease

Applicable guidelines

NICE guidelines and pathways:

Physical activity (pathways.nice.org.uk/...)

Behaviour change (pathways.nice.org.uk/...)

Diet, nutrition and obesity (www.nice.org.uk/guidance/...)

Sunlight exposure (www.nice.org.uk/guidance/...)

 

NHS screening programmes:

·         www.screening.nhs.uk

·         Recommendations (legacyscreening.phe.org.uk/...)

The UK immunisation schedule from autumn 2017 (www.gov.uk/...)

Public Health England (www.gov.uk/...)

Society of Occupational Medicine (www.som.org.uk)

Options grid (optiongrid.org)

E-learning for Healthcare (www.e-lfh.org.uk)

Motivate2Move – a comprehensive resource for GPs encouraging patients to exercise (gpcpd.walesdeanery.org/...)

A site for public and professionals to reduce unnecessary or wasteful medical tests,

treatments and procedures (www.choosingwisely.org)

 

Material for patient

NHS Cancer screening website (www.cancerscreening.nhs.uk)

Bandolier (www.bandolier.org.uk)

National Obesity Forum (www.nationalobesityforum.org.uk)

 

Geeky Medics cervical screening video (www.youtube.com/...)

 

Case 1.1

Obesity in adults (patient.info/...)

Bariatric surgery (patient.info/...)

Case 1.2

HPV vaccination (patient.info/...)

Case 1.3

PSA (patient.info/...)

Case 1.4

A short video on how to administer a vaccination safely (www.pharmacist.com/...)

Influenza vaccination (patient.info/...)

The National flu immunisation programme 2017/2018 – includes links to the Green Book and other useful resources (nhs-digital.citizenspace.com/...)

Case 1.5

Zika virus (patient.info/...)

Delaying a period (patient.co.uk/…)

National Travel Health Network and Centre (http://nathnac.net/)

Travel health advice (travelhealthpro.org.uk)

Zika virus guidance (www.gov.uk/...)

 

2       Genetics in primary care

Applicable guidelines

NICE guidelines:

Genetic conditions (www.nice.org.uk/guidance/...)

RCOG information about prenatal testing (www.rcog.org.uk)

NHS sickle cell and thalassaemia screening programme (www.gov.uk/...)

Primary Care Genetics Society (www.pcgs.org.uk)

Information on antenatal and newborn screening programmes:

·         NHS fetal anomaly screening programme (www.gov.uk/...)

·         NHS newborn blood spot screening programme (www.gov.uk/...)

·         Non-invasive prenatal diagnosis information (www.rapid.nhs.uk/...)

British Society for Genetic Medicine (www.bsgm.org.uk)

The NHS Genomics Education Programme (www.genomicseducation.hee.nhs.uk)

 

Material for patient

National Hereditary Breast Cancer Helpline (www.breastcancergenetics.co.uk)

Genetic Alliance UK (www.geneticalliance.org.uk)

Contact a Family (contact.org.uk)

UK Genetic Testing Network (ukgtn.nhs.uk)

Down's Syndrome Association (www.downs-syndrome.org.uk/..)

 

Case 2.1

·         Pre-pregnancy counselling (patient.info/...)

·         Prenatal diagnosis (patient.info/...)

·         Bleeding disorders (patient.info/...)

Case 2.2

·         Prenatal screening for Down’s syndrome (patient.info/...)

·         Down’s syndrome (patient.info/...)

Case 2.3

·         Genetic counselling – a guide for GPs (patient.info/...)

·         Huntington’s Disease Association (www.hda.org.uk)

 

 

3       Care of acutely ill people

Applicable guidelines

NICE guidelines and pathways:

Injuries, accidents and wounds (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

148 Acute coronary syndrome

 

The College of Emergency Medicine (www.rcem.ac.uk/...)

The British Thoracic Society guidelines on the management of respiratory conditions (www.brit-thoracic.org.uk/...)

RCOG guidelines on the management of pregnancy-related emergencies (www.rcog.org.uk/guidelines)

Anaphylaxis guidelines for healthcare providers (www.resus.org.uk/...)

Cardiac arrest management guidelines (www.resus.org.uk/...)

Surviving Sepsis campaign (www.survivingsepsis.org/...)

 

Material for patient

British Heart Foundation (www.bhf.org.uk)

 

Case 3.1

·         Ectopic pregnancy (patient.info/...)

Case 3.2

·         Raised intracranial pressure (patient.info/...)

·         Telephone consultations (patient.info/...)

Case 3.3

·         Pulmonary embolism (patient.info/...)

Case 3.4

·         Bradycardia (patient.info/...)

·         Bradyarrhythmia guidance from the Resuscitation Council (www.resus.org.uk/...)

·         Useful ECG articles (patient/info/...)

 

 

4       Care of children and young people

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Children and young people (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

·         117 Management of sore throat and indications for tonsillectomy

·         145 Assessment, diagnosis and interventions for autism spectrum disorders

·         153 British guideline on the management of asthma

RCGP autistic spectrum disorders toolkit (www.rcgp.org.uk/...)

Royal College of Paediatrics and Child Health (www.rcpch.ac.uk) has a collection of clinical guidelines and elearning.

Great Ormond Street Hospital has comprehensive guidelines on many childhood conditions: (www.gosh.nhs.uk/...)

Health for all Children (www.healthforallchildren.com)

International Children’s Palliative Care Network (www.icpcn.org.uk)

 

Safeguarding resources

RCGP safeguarding children toolkit for general practice (www.rcgp.org.uk/...)

The Victoria Climbié inquiry (www.victoria-climbie-inquiry.org.uk)

Safeguarding guidance for GP and other primary medical services (www.safechilduk.info/...)

BYTSYZ e-learning resources (fees apply) Award in Safeguarding Children and Young People

Level 3 required for appraisals post-qualification (www.bytsyz.co.uk/...)

The National Working Group for Sexually Exploited Children (www.nwgnetwork.org)

 

Material for patient

Action for Sick Children (www.actionforsickchildren.org)

Autism Society (www.autism-society.org)

Jumo – medical information written in a child-friendly fashion (www.jumohealth.com)

Meningitis Research Foundation (www.meningitis.org)

Down’s Syndrome Association (www.downs-syndrome.org.uk)

Teenage Health Freak – health information written specifically for teenagers (www.teenagehealthfreak.org)

Cow’s milk protein allergy advice (www.allergy.org.au/...)

 

Case 4.1

·         Constipation in children (patient.info/...)

·         Telephone consultations (patient.info/...)

Case 4.2

·         Urinary tract infection in children (patient.info/...)

·         Telephone consultations (patient.info/...)

Case 4.3

Safeguarding children

·         How to recognise abuse or a child at risk (patient.info/...)

·         Referral and management of an abused or at-risk child (patient.info/...)

Case 4.4

Male genital examination – OSCE guide (geekymedics.com/...)

Undescended and maldescended testes (patient.info/...)

Case 4.5

NICE flowchart: Fever in under 5s (pathways.nice.org.uk/...)

 

5       Care of older adults

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Older people (www.nice.org.uk/guidance/...)

·         Multiple long-term conditions (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

·         111 Management of hip fracture in older people

·         113 Diagnosis and pharmacological management of Parkinson’s disease

·         118/119 Management of patients with stroke: Rehabilitation, prevention and management of complications, and discharge planning and Identification and management of dysphagia

·         142 Management of osteoporosis and the prevention of fragility fractures

British Geriatric Society guidelines (www.bgs.org.uk/...)

RCP National Clinical guidelines for Stroke: (www.rcplondon.ac.uk/...)

RCP Diploma in Geriatric Medicine (www.rcplondon.ac.uk/...)

National Osteoporosis Society resources for primary care (www.nos.org.uk/...)

 

Material for patient

Age UK (www.ageuk.org.uk)

Alzheimer’s Society (www.alzheimers.org.uk)

Parkinson’s UK (www.parkinsons.org.uk)

National Osteoporosis Society (www.nos.org.uk)

 

Case 5.1

·         Community care (patient.info/...)

·         Mental Capacity Act (patient.info/...)

·         Telephone consultations (patient.info/...)

Case 5.2

·         Osteoporosis (patient.info/...)

·         Bisphosphonates (patient.info/...)

·         NICE CG146: Osteoporosis: assessing the risk of fragility fracture (www.nice.org.uk/guidance/cg146/...)

·         FRAX calculation tool (www.shef.ac.uk/FRAX/tool.jsp)

·         Alendronic acid for osteoporosis (www.patient.info/...)

Case 5.3

·         Iron-deficiency anaemia (patient.info/...)

·         NICE NG12: Suspected cancer: recognition and referral (www.nice.org.uk/guidance/...)

·         Guidelines for the management of iron deficiency anaemia (www.bsg.org.uk/...)

·         Rapid Referral Guidelines by Macmillan Cancer Support (July 2015) (www.macmillan.org.uk/...)

Case 5.4

·         Dementia (patient.info/...)

 

6       Women’s health

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Fertility, pregnancy and childbirth (www.nice.org.uk/guidance/...)

·         Gynaecological conditions (www.nice.org.uk/guidance/...)

·         Breast cancer (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

·         99 Management of cervical cancer

·         127 Management of perinatal mood disorders

·         134 Treatment of primary breast cancer

·         135 Management of epithelial ovarian cancer

RCGP Perinatal mental health toolkit (www.rcgp.org.uk/...)

Medication use during pregnancy (www.uktis.org/...)

RCOG Green-top guidelines (www.rcog.org.uk/guidelines)

The British Menopause Society (thebms.org.uk)

Diploma of the Royal College of Obstetricians and Gynaecologists (www.rcog.org.uk/...)

 

Material for patient

FertilityUK (www.fertilityuk.org)

Menopause Matters (www.menopausematters.co.uk)

www.managemymenopause.co.uk

Miscarriage Association (www.miscarriageassociation.org.uk)

Women’s Health Concern (www.womens-health-concern.org)

Women’s Health (www.womens-health.co.uk)

The Daisy Network (www.daisynetwork.org.uk)

Endometriosis UK (https://endometriosis-uk.org)

 

Geeky medics breast examination video (www.youtube.com/...)

Geeky medics vaginal examination video (www.youtube.com/...)

 

Case 6.1

·         Contraception and young people (patient.info/...)

·         Combined oral contraceptive pill (patient.info/...)

Case 6.2

·         Contraception and special groups (patient.info/...)

·         UKMEC 2016 (http://ukmec.pagelizard.com/2016#)

Case 6.3

·         BMS Tools for clinicians (thebms.org.uk/...)

·         HRT – topical (patient.info/...)

Case 6.4

·         Recurrent miscarriage (patient.info/...)

·         Green-top Guideline No.17: Recurrent miscarriage, investigation and treatment of couples (www.rcog.org.uk/...)

Case 6.5

·         Atrophic vaginitis (patient.info/...)

 

7       Men’s health

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Urological conditions (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

·         124 Management of adult testicular germ cell tumours

 

College of Sexual and Relationship Therapists (www.cosrt.org.uk)

Trends in Urology and Men’s Health (www.trendsinurology.com)

The International Society of Men’s Health (www.ismh.org/en)

Updated Guidance for GPs on PSA testing (phescreening.blog.gov.uk/...)

Material for patient

The Men’s Health Forum (www.menshealthforum.org.uk)

Prostate Cancer UK (www.prostatecanceruk.org)

Sexual Advice Association (www.sexualadviceassociation.co.uk)

 

Case 7.1

·         Erectile dysfunction (patient.info/...)

Case 7.2

·         Sterilisation (patient.info/...)

Case 7.3

·         Haematuria (patient.info/...)

 

 

8       Sexual health

Applicable guidelines

The British Association for Sexual Health and HIV (www.bashh.org/guidelines)

 

The Faculty of Sexual and Reproductive Healthcare (FSRH) (www.fsrh.org) provides useful guidelines, including the UK Medical Eligibility criteria for contraceptive use (www.fsrh.org/news/ukmec-2016--guidance-for-nurses/) and e-learning modules for trainees interested in gaining their diploma (www.e-lfh.org.uk/...)

 

RCOG clinical guidelines on topics such as pelvic inflammatory disease (www.rcog.org.uk)

 

Relevant NICE guidelines and pathways:

·         Sexual health (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

·         109 Management of genital Chlamydia trachomatis infection

·         133 Management of hepatitis C

 

A directory of hormonal contraceptives from around the world (www.ippf.org/...)

A useful directory of drugs that interact with antiretroviral therapy (www.hiv-druginteractions.org)

 

Material for patient

British Pregnancy Advisory Service (www.bpas.org)

Brook clinics (www.brook.org.uk)

56 Dean Street (dean.st/56deanstreet)

Marie Stopes UK (www.mariestopes.org.uk)

The Family Planning Association (FPA) (www.fpa.org.uk)

Relate (www.relate.org.uk)

The Terrence Higgins Trust (www.tht.org.uk)

Other support:

·         www.aidsmap.com

·         www.myhiv.org.uk

·         www.i-base.info

·         www.positivelyuk.org/Project-100

 

Case 8.1

·         Urethritis in men (patient.info/...)

·         Epididymo-orchitis (patient.info/...)

Case 8.2

·         Termination of pregnancy (patient.info/...)

·         GMC Confidentiality guidance (www.gmc-uk.org/...)

Case 8.3

·         Breakthrough bleeding with combined hormonal contraception (patient.info/...)

Further reading

[1] Public Health England cervical cancer consultation Q&A (legacy.screening.phe.org.uk/...)

[2] Cervical screening: professional guidance (www.gov.uk/...)

[3] www.bmj.com/content/348/bmj.g3334.full.pdf+html

[4] Pulse article www.pulsetoday.co.uk/...

[5] Manchester Cytology Centre (www.cmft.nhs.uk/...)

[6] RCOG Query bank: postcoital bleeding (www.rcog.org.uk/...)

 

·         Cervical cancer incidence statistics from Cancer Research UK (www.cancerresearchuk.org/...)

·         Lab Tests Online: cervical cytology (www.labtestsonline.org.uk/...)

·         Explanation of smears and HPV for patients (www.jostrust.org.uk)

Case 8.4

·         CDC PrEP (www.cdc.gov/hiv/basics/prep.html)

·         PrEPWatch guidelines (www.prepwatch.org/...)

 

9       End of life care

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Cancer (www.nice.org.uk/guidance/...)

·         End of life care (www.nice.org.uk/guidance/...)

 

End of life care training to professionals (www.goldstandardsframework.org.uk)

Scottish Palliative Care Guidelines (www.palliativecareguidelines.scot.nhs.uk)

RCGP end of life care resources and toolkits (www.rcgp.org.uk/...)

Palliative care resources (book.pallcare.info)

International Children’s Palliative Care Network (www.icpcn.org.uk)

End of life care for adults in the Emergency department (www.rcem.ac.uk/...)

Emergency care and CPR decision-making (www.resus.org.uk/...)

Decisions relating to CPR guidance from the BMA, Resuscitation Council (UK) and the

Royal College of Nursing (www.resus.org.uk/...)

 

Material for patient

Dying Matters Coalition resources (www.dyingmatters.org/...)

Compassion in Dying (www.compassionindying.org.uk)

Cancer support groups:

·         Cancer Research UK (www.cancerresearchuk.org)

·         Macmillan Cancer Support (www.macmillan.org.uk)

·         Marie Curie (www.mariecurie.org.uk)

 

Case 9.1

·         Oncological emergencies (patient.info/...)

·         Telephone consultations (patient.info/...)

Case 9.2

·         Advance care planning (patient.info/...)

Case 9.3

·         Algorithm for calculating prescription for syringe driver (www.johntaylorhospice.org.uk/...)

·         Syringe drivers (patient.info/...)

 

 

10 & 11    Care of people with mental health problems and intellectual disability

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Mental health and wellbeing (www.nice.org.uk/guidance/...)

·         Mental health and behavioural conditions (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

·         114 Non-pharmaceutical management of depression

·         127 Management of perinatal mood disorders

·         131 Management of schizophrenia

·         145 Assessment, diagnosis and interventions for autism spectrum disorders

 

Royal College of Psychiatrists (www.rcpsych.ac.uk/...)

RCGP toolkit on autistic spectrum disorders (www.rcgp.org.uk/...)

RCGP toolkit on mental health (www.rcgp.org.uk/...)

RCGP toolkit on perinatal mental health (www.rcgp.org.uk/...)

 

Material for patient

The National Attention Deficit Disorder Information and Support Service (www.addiss.co.uk)

Mencap (www.mencap.org.uk)

Scope (www.scope.org.uk)

Moodgym (moodgym.com.au)

 

Case 10.1

·         Suicide risk assessment and threats of suicide (patient.info/...)

Case 10.2

·         Contraception and special groups (patient.info/...)

·         General learning disability (patient.info/...)

Case 10.3

·         Subdural haematoma (patient.info/...)

·         Rapid tranquilisation (patient.info/...)

·         Telephone consultations (patient.info/...)

Case 10.4

·         Cannabis use and abuse (patient.info/...)

·         Depression (patient.info/...)

Case 10.5

·         General learning disability (patient.info/...)

·         Subclinical hypothyroidism (patient.info/...)

·         Telephone consultations (patient.info/...)

 

 

12     Cardiovascular health

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Cardiovascular conditions (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

·         94 Cardiac arrhythmias in coronary heart disease

·         96 Management of stable angina

·         129 Antithrombotics: indications and management

·         147 Management of chronic heart failure

·         148 Acute coronary syndrome

·         149 Risk estimation and the prevention of cardiovascular disease

British Society for Heart Failure guidelines (www.bsh.org.uk/...)

British Hypertension Society (www.bhsoc.org)

The King’s Thrombosis Centre guidelines on anticoagulation (www.kingsthrombosiscentre.org.uk/...)

Life in the Fast Lane is an emergency medicine site which provides a useful collection of

ECGs as well as many explanations of common emergency conditions (lifeinthefastlane.com/ecg-library)

Resus UK ALS guidance (www.resus.org.uk/...)

Guidelines in Cardiovascular Medicine (www.bcs.com/...)

 

Material for patient

British Heart Foundation (www.bhf.org.uk)

Geeky Medics cardiovascular examination video (www.youtube.com/...)

Geeky Medics peripheral vascular examination video (www.youtube.com/...)

 

Case 12.1

·         Atrial fibrillation (patient.info/...)

Case 12.2

·         Palpitations (patient.info/...)

Case 12.3

·         Heart failure diagnosis and investigation (patient.info/...)

·         Heart failure management (patient.info/...)

Case 12.4

Wells score calculator (www.mdcalc.com/wells-criteria-for-dvt)

Deep vein thrombosis (patient.info/...)

FSRH guidance on POPs (www.fsrh.org/...)

FSRH statement on VTE and hormonal contraception November 2014 (www.fsrh.org/...)

Case 12.5

Lipid-regulating drugs (patient.info/...)

Cardiovascular risk assessment (patient.info/...)

NICE guidelines and pathways on lipid disorders (www.nice.org.uk/guidance/...)

 

13     Digestive health

Applicable guidelines                                                                                                                                                           

Relevant NICE guidance and pathways:

·         Digestive tract conditions (www.nice.org.uk/...)

·         NICE pathways for digestive conditions (pathways.nice.org.uk/...)

 

SIGN guidelines (www.sign.ac.uk):

133 Management of hepatitis C

 

The Primary Care Society for Gastroenterology (www.pcsg.org.uk)

British Society of Gastroenterology (www.bsg.org.uk)

Rome Foundation criteria for functional bowel disorders (https://irritablebowelsyndrome.net/...)

 

Material for patient

Gluten Free Foods Ltd (www.glutenfree-foods.co.uk)

Coeliac UK (www.coeliac.org.uk)

Crohn’s and Colitis UK – incorporating the National Association for Colitis and Crohn’s Disease (www.crohnsandcolitis.org.uk)

IBS network (www.theibsnetwork.org)

Colostomy UK (www.colostomyuk.org)

Help with IBS (ww5.theguttrust.org)

British Liver Trust (www.britishlivertrust.org.uk)

 

FODMAP diet (http://fodmapliving.com/...)

 

Geeky medics abdominal examination video (www.youtube.com/...)

Geeky medics rectal examination video (www.youtube.com/...)

 

Case 13.1

·         Irritable bowel syndrome (patient.info/...)

Case 13.2

·         Anal fissure (patient.info/...)

Case 13.3

·         Gastro-oesophageal reflux disease (patient.info/...)

·         Helicobacter pylori (patient.info/...)

Case 13.4

·         Gallstones and cholecystitis (patient.info/...)

 

 

14     Care of people who misuse drugs and alcohol

Applicable guidelines

NICE guidelines for drug and alcohol-related problems:

Alcohol-use disorders overview (pathways.nice.org.uk/...)

Drug misuse management in over 16s overview (pathways.nice.org.uk/...)

 

SIGN guidelines (www.sign.ac.uk):

133 Management of hepatitis C

 

NHS guidelines on management of drug misuse and dependence (www.nta.nhs.uk/...)

Chemsex resources for professionals (dean.st/...)

RCGP resources (www.rcgp.org.uk/...)

 

Material for patient

FRANK – friendly, confidential drugs advice (www.talktofrank.com)

Alcoholics Anonymous GB (www.alcoholics-anonymous.org.uk)

Addaction, a charity providing support for people with addictions (www.addaction.org.uk)

Narcotics Anonymous UK (ukna.org)

Chemsex explanation (www.changegrowlive.org/...)

 

Case 14.1

Alcoholism and alcohol misuse:

·         Recognition and assessment (patient.info/...)

·         Management (patient.info/...)

Case 14.2

·         Insomnia (patient.info/...)

Case 14.3

·         Opioid abuse and dependence (patient.info/...)

·         Assessment of drug dependence (patient.info/...)

 

15     Care of people with ENT, oral and facial problems

Applicable guidelines

Useful guidelines from the ENT team at the North Cumbria University Hospitals Trust (www.ncuh.nhs.uk/...)

The RCGP TARGET Antibiotic toolkit (www.rcgp.org.uk/TARGETantibiotics)

NICE pathways for head and neck cancers (pathways.nice.org.uk/...)

 

Material for patient

ENT UK (entuk.org)

British Association of Oral and Maxillofacial Surgeons – BAOMS (www.baoms.org.uk)

British Snoring and Sleep Apnoea Association (www.britishsnoring.co.uk)

British Tinnitus Association (www.tinnitus.org.uk)

Action on Hearing Loss (www.actiononhearingloss.org.uk)

Geeky medics neck lump examination video (www.youtube.com/...)

 

Case 15.1

·         Snoring (patient.info/...)

·         Epworth Score (www.britishsnoring.co.uk/...)

Case 15.2

·         Hoarseness (patient.info/...)

Case 15.3

·         Tinnitus (patient.info/...)

 

16     Care of people with eye problems

Applicable guidelines

NICE pathways for eye conditions (pathways.nice.org.uk/...)

Moorfield Eye Hospital (www.moorfields.nhs.uk/...)

British Undergraduate Ophthalmology Society (www.buos.co.uk/...)

 

Material for patient

RNIB (www.rnib.org.uk)

Vision Express (www.visionexpress.com/...)

Geeky medics examination of eyes and vision video (www.youtube.com/...)

 

Case 16.1

·         Blepharitis image (en.wikipedia.org/...)

·         Blepharitis (patient.info/...)

Case 16.2

·         Cataracts and cataract surgery (patient.info/...)

Case 16.3

·         Fundoscopy image (en.wikipedia.org/...)

·         Some colour images (and a quiz) are available at lifeinthefastlane.com/...

·         Angle-closure glaucoma (patient.info/...)

Case 16.4

·         Infective conjunctivitis (patient.info/...)

 

Public Health England advice on conjunctivitis (www.gov.uk/...)

 

 

17     Care of people with metabolic problems

Applicable guidelines

NICE pathways and guidelines

Endocrine, nutritional and metabolic conditions (pathways.nice.org.uk/...)

Diabetes (pathways.nice.org.uk/...)

Osteoporosis (pathways.nice.org.uk/...)

Obesity (pathways.nice.org.uk/...)

Familial hypercholesterolaemia (pathways.nice.org.uk/...)

 

SIGN guidelines (www.sign.ac.uk):

115 Management of obesity

116 Management of diabetes

 

Material for the patient

Diabetes UK (www.diabetes.org.uk)

British Thyroid Foundation (www.btf-thyroid.org)

Pituitary Foundation (www.pituitary.org.uk)

Addison’s Disease Self-Help Group (www.addisons.org.uk)

UK National Kidney Federation (www.kidney.org.uk)

The Daisy Network – support for women diagnosed with premature ovarian

insufficiency / premature menopause (www.daisynetwork.org.uk)

 

Geeky medics thyroid status examination video (www.youtube.com/...)

Geeky medics diabetic foot examination video (www.youtube.com/...)

 

Case 17.1

Subclinical hypothyroidism (patient.info/...)

Telephone consultations (patient.info/...)

Case 17.2

Chronic kidney disease (patient.info/...)

Case 17.3

GP-Update – Ramadan and diabetes management (www.gp-update.co.uk/...)

Case 17.4

Vitamin D deficiency including osteomalacia and rickets (patient.info/...)

The GP Update group summary on vitamin D – subscription necessary (https://gpcpd.com/...)

 

18     Care of people with neurological problems

Applicable guidelines

Relevant NICE guidance and pathways:

Neurological conditions (www.nice.org.uk/...)

Head injury overview (pathways.nice.org.uk/...)

Stroke overview (pathways.nice.org.uk/...)

Bacterial meningitis and meningococcal septicaemia overview (pathways.nice.org.uk/...)

 

SIGN guidelines (www.sign.ac.uk):

113 Diagnosis and pharmacological management of Parkinson’s disease

143 Diagnosis and management of epilepsy in adults

 

TIA: Prognosis and key management considerations. National Stroke Association (www.stroke.org/...)

DVLA fitness to drive guidelines (www.gov.uk/...)

 

Material for patient

Epilepsy Society (www.epilepsysociety.org.uk)

Meningitis Research Foundation (www.meningitis.org)

Migraine Action (www.migraine.org.uk)

Motor Neurone Disease Association (www.mndassociation.org)

Multiple Sclerosis Society (www.mssociety.org.uk)

Parkinson’s UK (www.parkinsons.org.uk)

Stroke Association (www.stroke.org.uk)

Geeky Medics upper limb neurological examination video (www.youtube.com/...)

Geeky Medics lower limb neurological examination video (www.youtube.com/...)

Geeky Medics cranial nerve examination video (www.youtube.com/...)

 

Case 18.1

·         Transient ischaemic attacks (patient.info/...)

Case 18.2

·         Multiple sclerosis (patient.info/...)

Case 18.3

·         Medication-overuse headache and headache triggers (patient.info/...)

Case 18.4

·         Bell’s palsy image (commons.wikimedia.org/...)

Case 18.5

·         Tremor (patient.info/...)

 

19     Respiratory health

Applicable guidelines

BTS guidelines relevant to primary care (www.brit-thoracic.org.uk/...)

Relevant NICE guidelines and pathways:

Respiratory conditions (www.nice.org.uk/...)

 

SIGN guidelines (www.sign.ac.uk):

137 Management of lung cancer

153 British guideline on the management of asthma

 

RCGP TARGET antibiotic toolkit (www.rcgp.org.uk/targetantibiotics)

International Primary Care Respiratory Group (www.theipcrg.org)

Primary Care Respiratory Society (www.pcrs-uk.org)

National Centre for Smoking Cessation and Training (www.ncsct.co.uk)

British Society of Allergy and Clinical Immunology (www.bsaci.org)

 

Material for patient

Asthma UK (www.asthma.org.uk)

The British Lung Foundation (www.blf.org.uk)

Cystic Fibrosis Trust (www.cysticfibrosis.org.uk)

Thrombosis UK (www.thrombosisuk.org)

Smoking cessation help (smokefreeaction.org.uk)

 

BTS has a useful document on spirometry (www.brit-thoracic.org.uk/...)

Geeky Medics respiratory examination video (www.youtube.com/...)

Geeky Medics peak expiratory flow rate (PEFR) demonstration video (www.youtube.com/...)

 

Case 19.1

·         Chronic persistent cough in adults (patient.info/...)

·         Gastro-oesophageal reflux disease (patient.info/...)

Case 19.2

·         Common cold (patient.info/...)

Case 19.3

·         Management of adult asthma (patient.info/...)

 

20     Care of people with musculoskeletal problems

Applicable guidelines

Relevant NICE guidelines and pathways:

Musculoskeletal conditions (www.nice.org.uk/...)

Injuries, accidents and wounds (www.nice.org.uk/...)

Chronic fatigue syndrome ME overview (pathways.nice.org.uk/...)

 

SIGN guidelines (www.sign.ac.uk):

136 Management of chronic pain

 

British Institute of Musculoskeletal Medicine (www.bimm.org.uk)

Primary Care Rheumatology Society (www.pcrsociety.org.uk)

Arthritis Research UK (www.arthritisresearchuk.org)

British Association of Sport and Exercise Medicine (www.basem.co.uk)

UK Anti-Doping website (ukad.org.uk/...)

National Osteoporosis Society (www.nos.org.uk)

Disabled Living Foundation (www.dlf.org.uk)

Resource to help GPs assess fitness for work (www.gov.uk/...)

 

Material for patient

Arthritis Research UK PILs (www.arthritisresearchuk.org)

The BackCare charity (www.backcare.org.uk)

Children’s Chronic Arthritis Association (www.ccaa.org.uk)

British Sjögren’s Syndrome Association (www.bssa.uk.net)

Lupus UK (www.lupusuk.org.uk)

National Ankylosing Spondylitis Society (nass.co.uk)

National Rheumatoid Arthritis Society (www.nras.org.uk)

Polymyalgia Rheumatica and Giant Cell Arteritis Scotland (pmrandgca.org.uk)

Scleroderma and Reynaud's UK (www.sruk.co.uk)

National repetitive strain injury charity (www.rsiaction.org.uk)

Online physio resources for common injuries (www.physioroom.com)

Help for patients to manage musculoskeletal pain (www.sheffieldachesandpains.com)

 

Geeky Medics shoulder examination (www.youtube.com/...)

Geeky Medics hip joint examination (www.youtube.com/...)

Geeky Medics knee examination (www.youtube.com/...)

Geeky Medics spine examination (www.youtube.com/...)

Geeky Medics hand examination (www.youtube.com/...)

Geeky Medics GALS (gait/arms/legs/spine) examination (www.youtube.com/...)

 

Case 20.1

·         Gout (patient.info/...)

Case 20.2

Plantar fasciitis

·         patient.info/...

·         www.arthritisresearchuk.org/...

Case 20.3

·         Ankylosing spondylitis (patient.info/...)

·         Low back pain and sciatica (patient.info/...)

Case 20.4

·         www.racgp.org.au/afp/2012/april/meniscal-tear/

·         Knee exam video (www.youtube.com/...)

·         Thessaly test (www.youtube.com/...)

·         Meniscal tears and other knee cartilage injuries (patient.info/...)

Case 20.5

·         Impingement tests (www.physio-pedia.com/...)

·         BJSM shoulder examination (www.youtube.com/...)

·         Shoulder pain (patient.info/...)

·         Resources for performing a focused shoulder exam can be found at:

o   www.youtube.com/...

o   www.shoulderdoc.co.uk

 

21     Care of people with skin problems

 

Applicable guidelines

Relevant NICE guidelines and pathways:

Skin conditions (www.nice.org.uk/guidance/...)

 

SIGN guidelines (www.sign.ac.uk):

120 Management of chronic venous leg ulcers

125 Management of atopic eczema in primary care

 

British Association of Dermatologists (www.bad.org.uk)

Primary Care Dermatology Society (www.pcds.org.uk)

DermNet NZ (www.dermnetnz.org)

Dermatology Information System (www.dermis.net)

 

Material for patient

The British Association of Dermatologists PILs (www.bad.org.uk/...)

National Psoriasis Foundation (www.psoriasis.org)

National Rosacea Society (www.rosacea.org)

The Skin Cancer Foundation (www.skincancer.org/melanoma)

Allergy UK (www.allergyuk.org)

Anaphylaxis Campaign (www.anaphylaxis.org.uk)

Alopecia UK (www.alopecia.org.uk)

Lupus UK (www.lupus.org.uk)

National Eczema Society (www.eczema.org)

 

Case 21.1

·         Malignant melanoma image (web.med.unsw.edu.au/...)

·         Malignant melanoma of skin (patient.info/...)

Case 21.2

·         Dermatitis image (www.danderm-pdv.is.kkh.dk/...)

·         Contact and occupational dermatitis (patient.info/...)

Case 21.3

·         Alopecia (patient.info/...)

Case 21.4

·         Eczema image (cdn1.bigcommerce.com/...)

·         Atopic dermatitis and eczema (patient.info/...)

Case 21.5

·         Acne images available at www.dermnetnz.org/topics/acne

·         Acne vulgaris (patient.info/...)

Case 21.6

·         Food allergy and food intolerance (patient.info/...)

·         Atopic dermatitis and eczema (patient.info/...)

 

22     Special cases

Applicable guidelines

GMC Standards and ethical guidance for doctors (www.gmc-uk.org/...)

GMC Raising and acting on concerns about patient safety (www.gmc-uk.org/...)

BMA ethics toolkits (www.bma.org.uk/...)

 

NICE pathways

Domestic violence and abuse (pathways.nice.org.uk/...)

Child abuse and neglect (pathways.nice.org.uk/...)

Harmful sexual behaviour among children and young people (pathways.nice.org.uk/...)

Violence and aggression (pathways.nice.org.uk/...)

Long-term sickness and incapacity for work (pathways.nice.org.uk/...)

Workplace health (pathways.nice.org.uk/...)

RCGP Patient safety toolkit (www.rcgp.org.uk/...)

Agenda setting (www.pennine-gp-training.co.uk/...)

Breaking bad news (patient.info/...)

Dealing with an angry patient (www.bradfordvts.co.uk/...)

MPS guide to complaint resolution (www.medicalprotection.org/...)

Balint groups (www.balint.co.uk)

 

Material for patient

Choosing wisely (www.choosingwisely.org)

How to complain in the NHS (www.nhs.uk/...)

Citizens Advice (www.citizensadvice.org.uk)

 

Case 22.1

·         MDU complaints guidance (www.themdu.com/...)

·         RCGP e-learning resource on dealing with complaints (elearning.rcgp.org.uk/...)

Case 22.2

·         Sickness certification in primary care (patient.info/...)

·         Long-term sickness and incapacity (patient.info/...)

·         Fitness for work guidance (www.gov.uk/...)

Case 22.3

·         Data security and Caldicott guardianship (patient.info/...)

·         Medico-legal – alterations to medical records (www.gponline.com/...)

·         Requesting amendments to health and social care records (webarchive.nationalarchives.gov.uk/...)

·         MDU significant event analysis (www.themdu.com/...)

Case 22.4

·         Urinary incontinence (patient.info/...)

·         Dealing with complaints (MPS) (www.medicalprotection.org/...)

·         RCGP elearning resource on dealing with complaints (elearning.rcgp.org.uk/...)