The FCP Podcast

Send us a textRichard is joined on the podcast by consultant hepatologist Dr Sophia Than.  During the episode we introduce liver function tests.  We discuss what is included in a liver function test, who needs a liver function test, any guidance for clinicians in interpreting liver function tests and some common reasons for abnormal liver function test.  We then discuss a case of a raised alanine transaminase,  including history, red flags, further investigations and referral. As always big thank you to Scott for your support.Richard Tennant - richard.tennant@nhs.netBritish Society of Gastroenterology - Management of abnormal liver function testshttps://www.bsg.org.uk/clinical-resource/guidelines-on-abnormal-liver-blood-testsFIB-4 https://www.mdcalc.com/calc/2200/fibrosis-4-fib-4-index-liver-fibrosisNAFLD scorehttps://www.mdcalc.com/calc/3081/nafld-non-alcoholic-fatty-liver-disease-fibrosis-scoreKings college acute liver injuryhttps://www.mdapp.co/kings-college-criteria-calculator-527/Change Grow Live https://www.changegrowlive.org/Coventry and Warwickshire Training Hubhttps://www.cwtraininghub.co.uk/British Society of Gastroenterologyhttps://www.bsg.org.uk/

Send us a textRichard is joined on the podcast by Advanced Clinical Practitioner (Nurse) and ReSPECT fellow Debbie White.  During the episode we discuss the 'Recommended Summary Plan for Emergency Care and Treatment' (ReSPECT).  We discuss the relevant background to the ReSPECT process, including why it was started, who the process is for, when should the process start and what are the legal implications for clinicians.  We then discuss two cases including an acutely unwell patient refusing further care and a new cancer diagnosis.  We us Debbie's expertise for the appropriate use of ReSPECT process in these situations. Hope you Enjoy the episodeAs always big thank you to Scott for your support.Richard Tennant - richard.tennant@nhs.netResuscitation Council https://www.resus.org.uk/respectWarwick University Respect Toolshttps://warwick.ac.uk/fac/sci/med/research/hscience/sssh/research/respect/resourcesE Learning for Healthhttps://portal.e-lfh.org.uk/Component/Details/626543GMC CPR Professional Standardshttps://www.gmc-uk.org/professional-standards/the-professional-standards/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cprAdvanced Care Planning Guidance CCGhttps://www.cqc.org.uk/sites/default/files/20210318_dnacpr_printer-version.pdfMENCAP Reasonable Adjustments https://www.mencap.org.uk/easyread/about-reasonable-adjustmentsDNACPR Guidance https://www.turning-point.co.uk/_themesdelivery/content-delivery/assets/dnacpr-content/dnacpr-information-pack/content/index.html#/Coventry and Warwickshire Training Hubhttps://www.cwtraininghub.co.uk/College of Paramedicshttps://collegeofparamedics.co.uk/

Send us a textRichard and Sophie are join by palliative care doctor Alistair Duncan and Nurse specialist Angela Wilson to discuss palliative care assessment. During the episode we then utilise their skills and knowledge to discuss a case of a palliative care patient with low mood/depression and nausea/vomiting. Including pertinent history, red flags and when to refer.Thank you Scott for all your help as always!West Midlands Palliative Care Guidance  https://www.westmidspallcare.co.uk/wmpcp/guide/Scottish Palliative Care Guidancehttps://www.palliativecarescotland.org.uk/news/news/new-guidelines-on-palliative-care-in-scotland-published/#:~:text=The%20guidelines%20provide%20practical%2C%20evidence-based%20or%20best-practice%20guidance,end%20of%20life%20care%20and%20use%20of%20medicines.Macmillanhttps://www.macmillan.org.uk/?gclid=f45758439b8e10e75a253f9ad779540a&gclsrc=3p.ds&msclkid=f45758439b8e10e75a253f9ad779540aNICE Prescribing in Palliative Care https://bnf.nice.org.uk/medicines-guidance/prescribing-in-palliative-care/Coventry and Warwickshire Training Hubhttps://www.cwtraininghub.co.uk/College of Paramedicshttps://collegeofparamedics.co.uk/

Send us a textRichard and Sophie are join by palliative care doctor Alistair Duncan and Nurse specialist Angela Wilson to discuss palliative care assessment. During the episode they define palliative care, what the journey may look like for patients, who is involved and when should specialist team get involved.  We then utilise their skills and knowledge to discuss a case of a palliative care patient with pain. Including pertinent history, red flags and when to refer. Thank you Scott for all your help as always!West Midlands Palliative Care Guidance  https://www.westmidspallcare.co.uk/wmpcp/guide/Scottish Palliative Care Guidance https://www.palliativecarescotland.org.uk/news/news/new-guidelines-on-palliative-care-in-scotland-published/#:~:text=The%20guidelines%20provide%20practical%2C%20evidence-based%20or%20best-practice%20guidance,end%20of%20life%20care%20and%20use%20of%20medicines.Kathryn Mannixhttps://www.kathrynmannix.com/Coventry and Warwickshire Training Hubhttps://www.cwtraininghub.co.uk/College of Paramedicshttps://collegeofparamedics.co.uk/

Send us a textWe welcome Dr Graham Dunthorn to the podcast who is a GPwSI in Pain management.  During the podcast we define chronic pain, symptoms and types of pain.  We discuss assessment of a patient with fibromyalgia including history taking, diagnosis , investigations , red flags and referral. As always thank you for your help with the podcast Scott and thank you to our guest Graham for giving us his time on the podcast.NICE Guidelines Chronic Painhttps://www.nice.org.uk/guidance/ng193Royal College of Physicians  https://www.rcp.ac.uk/improving-care/resources/the-diagnosis-of-fibromyalgia-syndrome/Diagnosis of FibromyalgiaTo make a diagnosis using the ACR 2016 criteria the following need to be present  1 - Widespread pain index (WPI) ≥7 and symptom severity scale (SSS) score ≥5 OR WPI 4–6 and SSS score ≥9. 2 - Generalised pain, defined as pain in at least 4 of the 5 body regions, is present 3 - Symptoms have been present at a similar level for at least 3 months. Symptoms Severity Score (SSS) and Widespread Pain Index (WPI) calculator https://rheumcalc.com/fibromyalgia/Live Well With Painhttps://livewellwithpain.co.uk/Flippin Painhttps://www.flippinpain.co.uk/Pain Toolkithttps://www.paintoolkit.org/Rethink Pain https://rethinkingpain.org/Fibromyalgia UKhttps://www.fmauk.org/

Send us a textWe welcome Dr Graham Dunthorn to the podcast who is a GPwSI in Pain management.  During the podcast we define chronic pain, symptoms and types of pain.  We discuss assessment of pain including ; onset, reviewing medications, investigations and referral.  We then utilise Graham's knowledge to discuss a patient with chronic lower back pain.As always thank you for your help with the podcast Scott and thank you to our guest Graham for giving us his time on the podcast.Reviewing patient medicationis the medication recommended?is it effective? is it safe? is it wanted ? Low back pain and sciatica in over 16s: assessment and managementhttps://www.nice.org.uk/guidance/ng59Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary painhttps://www.nice.org.uk/guidance/NG193Osteoarthritis in over 16s: diagnosis and managementhttps://www.nice.org.uk/guidance/ng226Neuropathic pain in adults: pharmacological management in non-specialist settingshttps://www.nice.org.uk/Guidance/CG173Pain Concernhttps://painconcern.org.uk/Live Well With Painhttps://livewellwithpain.co.uk/Pain Consortiumhttps://www.painconsortium.nih.gov/Coventry and Warwickshire Training Hubhttps://www.cwtraininghub.co.uk/

Send us a textWe welcome Dr Jeff Forster who is a GP with a specialism in men's health to the podcast. We use Dr Jeff Forster's knowledge to discuss a 2 cases including testicular swelling and testosterone deficiency.  We discuss pertinent history, investigations , red flags and referrals.  Hope you enjoy the episode. Thank you as always Scott for you help!The British Society for Sexual Medicine Guidelines on Male Adult Testosterone Deficiencyhttps://pubmed.ncbi.nlm.nih.gov/36876744/NICE - Scrotal Pain and Swelling https://cks.nice.org.uk/topics/scrotal-pain-swelling/Testosterone Calculator https://www.pctag.uk/testosterone-calculator/The TIMES2 studyTestosterone Replacement in Hypogonadal Men With Type 2 Diabetes and/or Metabolic Syndrome (the TIMES2 Study) | Diabetes Care | American Diabetes Association (diabetesjournals.org)H3 Healthhttps://www.h3health.co.uk/Coventry and Warwickshire Training HubHome - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk)College of Paramedic https://collegeofparamedics.co.uk/

Send us a textWe welcome Dr Jeff Forster who is a GP with a specialism in men's health to the podcast.  During the episode we discuss what men's health is and why it is important in general practice.  We then use Dr Jeff Forster knowledge to discuss a case of a patient with Lower Urinary Tract Symptoms, including pertinent history, investigation , red flags and referrals.  Thank you as always Scott for you help!NICE guidelines LUTShttps://cks.nice.org.uk/topics/luts-in-men/Patient UKhttps://patient.info/mens-health/prostate-and-urethra-problems/lower-urinary-tract-symptoms-in-menProstate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysishttps://www.bmj.com/content/362/bmj.k3519.abstractH3 Health https://www.h3health.co.uk/Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk)College of Paramedic https://collegeofparamedics.co.uk/

Send us a textWe are joined on the podcast by Dr Caroline Wrigley who is a GPwSI and personal interest in ADHD.  During the episode we discuss ADHD, the importance of recognition, assessment and referral.  We discuss pertinent history, referral and red flags.  Caroline also gives some methods to help parents and patients with possible ADHD following her own experience and research.As always thank you Scott for your help and support.Please contact us if you wishCaroline Wrigley - c.wrigley@nhs.netRichard Tennant - richard.tennant@nhs.netNICE Guidelines https://cks.nice.org.uk/topics/attention-deficit-hyperactivity-disorder/ Screening toolsASRS v1.1 for ADHD (score 4+ is significant)  - https://www.mdcalc.com/calc/1730/adult-self-report-scale-asrs-adhdPatient-generated document detailing ADHD symptoms according to diagnostic criteria, includes ASRS - https://thinkadhd.co.uk Screening questionnaires for parents/teachers of children aged 6-18:SNAP-IV 26 for ADHD (see results for significance of scores) - https://www.mdapp.co/snap-iv-teacher-and-parent-rating-scale-18-and-26-items-calculator-491/ Information ·         Driven to Distraction by Ed Hallowell MD and John Ratey MD – Book/Audiobook·         Taking charge of adult ADHD by Russell Barkley – Book/Audiobook·         ADHD Aha! by Understood – Podcast ·         The Disruptors – Documentary film·         ADDitude magazine - https://www.additudemag.com  ADHD in women and girls:·         ADHD As Females – Podcast·         ADHD for smart ass women by Tracy Otsuka – Podcast·         Unmasked by Ellie Middleton – Book/Audiobook ·         Earthed by Rebecca Schiller – Book/Audiobook·         Moodswings, Meds and Mared – Documentary (Welsh with subtitles) https://m.youtube.com/watch?v=Y4aDWG-AXCo  

Send us a textWe are joined on the podcast by Dr Caroline Wrigley who is a GPwSI and personal interest in autism.  During the episode we discuss autism, the importance of recognition, assessment and referral.  We discuss pertinent history, referral and red flags.  Caroline also given some methods to help parents and patients with possible autism follow her own experience and research.As always thank you Scott for your help and support.Please contact us if you wish Caroline Wrigley - c.wrigley@nhs.net Richard Tennant - richard.tennant@nhs.netNICE guidelines Autism in children https://cks.nice.org.uk/topics/autism-in-children/NICE guidelines Autism in Adults https://cks.nice.org.uk/topics/autism-in-adults/The Explosive Child (book)https://www.amazon.co.uk/Explosive-Child-Sixth-Understanding-Chronically/dp/0063092468/ref=asc_df_0063092468?tag=bingshoppinga-21&linkCode=df0&hvadid=80470608947562&hvnetw=o&hvqmt=e&hvbmt=be&hvdev=c&hvlocint=&hvlocphy=&hvtargid=pla-4584070152008036&psc=1Autism West MidlandsAutism West Midlands | Supporting the Autistic CommunitySIGN patient information bookletshttps://www.sign.ac.uk/patient-and-public-involvement/patient-publications/autism/Neurotribes by Steve Silberman – Book/AudiobookWhat I want to talk about: How autistic special interests shape a life & Untypical by Pete Wharmby – Book/AudiobookChris Packham’s Inside our autistic minds - BBC documentary Autism in women and girlsAutism, girls and keeping it all inside white paper by the Autistic Girls Networkhttps://autisticgirlsnetwork.org/wp-content/uploads/2022/03/Keeping-it-all-inside.pdfOdd Girl Out: An autistic woman in a neurotypical world by Laura James – Book/AudiobookStrong female character by Fern Brady – Book/AudiobookUnmasked by Ellie Middleton – Book/Audiobook Christine McGuinness: Unmasking my autism – BBC documentary Screening questionnaires for adults age 16+ without intellectual disabilityASQ-10 for autism (score of 6+ meets NICE criteria for referral) - https://embrace-autism.com/aq-10/ ASQ-50 for autism (score of 26+ significant) - https://embrace-autism.com/autism-spectrum-quotient/