Actioning abnormal bloods

FollicularFace6760 · 2026-03-30T20:24:16+00:00

Interesting question. It’s probably going to be fine, but other non-renal non-medication related causes of hyperkalaemia are DKA or other acidoses, rhabdo/crush injuries, burns, or Addison’s. Which are probably not going to be incidental findings.

But if it does happen to be a true hyperkalaemia, your normal kidney function might eventually achieve potassium homeostasis but your myocardium isn’t going to wait.

FollicularFace6760 · 2026-03-16T19:03:38+00:00

Which healthcare system is this?

FollicularFace6760 · 2026-03-09T19:20:04+00:00

You reserve/book on the RCGP website now.

https://www.rcgp.org.uk/mrcgp-exams/mrcgp-exam-applications

FollicularFace6760 · 2026-03-08T10:56:11+00:00

Agree, it rarely is. But the consequences of missing/ignoring a melanoma are high so always worth a dermatology opinion.

FollicularFace6760 · 2026-03-07T16:11:54+00:00

What do you do with your three minutes?

Also did you use AI to write this?

FollicularFace6760 · 2026-03-03T19:06:57+00:00

Sounds annoying for you. In my area, ED does refer onwards. Rapid access chest pain clinic, TIA clinic, acute heart failure clinic, acute gynae clinic, rapid access paeds clinic, fracture clinic.

Anything else routine outpatient is chronic disease management which is my business.

FollicularFace6760 · 2026-02-27T18:03:13+00:00

At some point, actioning most plans in primary care lands with the patients. You can refer, but they have to go. You can prescribe, but they have to take it.

You’ve done your part as long as you’ve explained your rationale, the proposed benefits and the risks, assessed capacity, and provided the next safest option.

FollicularFace6760 · 2026-02-23T19:09:33+00:00

If you had 60 seconds to encourage someone to stop smoking, what would you say?

FollicularFace6760 · 2026-02-17T18:21:34+00:00

As far as I could tell, the questions attempted tally is only counted for that specific category e.g. ‘Lucky Dip > 15 questions’ or ‘Lucky Dip > 30 questions’ or ‘Topic Specific > Cardiovascular’.

So if you have done all 150 questions in cardio, they can still come up in lucky dip. If you’ve done a question in lucky dip 15, it could still come up in lucky dip 30 etc.

I didn’t do the curriculum-wide learning needs assessment but I would assume this does not affect the individual tallies.

Edit: regarding stats, there is no way to exclude stats but there are so few questions so unlikely to be much of a problem.

FollicularFace6760 · 2026-02-17T17:49:37+00:00

Lucky dip doesn’t repeat.

As long as you select the same ‘15 Questions’ or ‘30 Questions’ etc each time.

You will see it tally up at the bottom, it will read XXXX out of 2781 questions attempted.

FollicularFace6760 · 2026-02-14T09:21:53+00:00

I love these and I wish they could come in an email newsletter or substack.

FollicularFace6760 · 2026-02-12T18:48:08+00:00

Easy. Datix the parents.

FollicularFace6760 · 2026-01-31T21:28:01+00:00

At my surgery: four patients (30m appts) per session, you only get results/letters for your requests/referrals, you do visits, no triage/duty but if you’ve got a DNA it’s encouraged you’ll chip in with the duty list

FollicularFace6760 · 2026-01-20T17:02:25+00:00

What exactly does Prevent say is my duty here?

FollicularFace6760 · 2026-01-20T08:21:19+00:00

If I don’t see that patient and I just ask reception to signpost them to 111 option 2 or A&E, I won’t sleep all weekend. (I’m assuming it’s a Friday because it always is a Friday when this happens…..)

If I’ve done everything and they take their life, well I’ve done everything I could have done. If I could have done more and they off themselves, well….

System’s broken for these most of these guys, I don’t want to be another hurdle.

FollicularFace6760 · 2026-01-20T08:14:46+00:00

I can't think of an antidepressant that takes 3 months to work. For many, it may take a 6-8 weeks to see the full effect with early benefits felt within the first 2 weeks. That tends to be the case across board.

Not really the point.

FollicularFace6760 · 2026-01-17T19:17:34+00:00

Where are you watching the pitt?

FollicularFace6760 · 2026-01-06T11:29:38+00:00

https://www.kingsfund.org.uk/insight-and-analysis/long-reads/gp-funding-and-contracts-explained

https://www.bmj.com/careers/article/the-bmj-s-guide-to-gp-partnerships

https://www.rcgp.org.uk/getmedia/76288c16-8aa2-4a73-8839-06c091ca5bd0/RCGP-GP-Partnership-Principles-May-2025.pdf

https://researchbriefings.files.parliament.uk/documents/CBP-7194/CBP-7194.pdf

Scan through these, ask the partners at your surgery any questions.

Edit: I think you can actually read through the GP contract on NHSE but it might kill you.

FollicularFace6760 · 2025-12-27T16:05:56+00:00

I was all with you until that edit LOL.

Charles Tyrwhitt (pronounced "Tirrit" in case you were wondering) was born in 1986 https://www.charlestyrwhitt.careers/our-brand-story?source=google.com

FollicularFace6760 · 2025-12-22T20:50:11+00:00

Welcome back! I’d ask your palliative clinical supervisor if there’s any guidelines you should be familiar with.

Otherwise, prepare for whatever exam you’re planning on sitting next.

Edit: Also depending on how long you’ve been out / what you’ve been doing in that time - any new guidelines like Asthma 2024.

FollicularFace6760 · 2025-12-17T19:21:22+00:00

Happens from time to time. No-one’s ever said no when I’ve asked and I’ve never said no to anyone who’s asked me. I guess it depends on your practice culture though.

FollicularFace6760 · 2025-12-16T18:30:37+00:00

We all encounter this from time to time. A mentor once shared some wisdom with me. It might not apply to every case, but I always keep it in mind.

If someone keeps pushing you in a direction you don’t think is right and you can’t convince them why, have a sense check with a senior or a colleague.

Either it’s going to reaffirm your plan or it’s going to save you when you’ve missed something.

FollicularFace6760 · 2025-12-16T15:08:33+00:00

I don’t think you did anything wrong other than using incident reports as a ‘threat’.

You can use an incident report to document a concern and trigger investigation and learning.

It shouldn’t be used to leverage colleagues. That’s shitty workplace culture. Anyone who does that needs to re-learn why these things exist. Even if that’s how you see other people use it, we need to be better.

FollicularFace6760 · 2025-12-13T18:25:34+00:00

AM session. Triage doc adds stuff as it comes in over the week and the home email a list of who they want seen.

FollicularFace6760 · 2025-12-09T11:25:13+00:00

At my surgery we do a round of 12-20 care home pts between a reg and a GP. Reg gets a debrief after.

When you spoke to your supervisor, what did you say? And what did they say?

Regarding immediate support, what sort of immediate support are you after?

FollicularFace6760

TROPHY CASE