# data[].attributes.body
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002408/#!po=31.0811

# data[].attributes.body
https://sepsistrust.org/wp-content/uploads/2018/06/Sepsis_Manual_2017_web_download.pdf

# data[].attributes.body
https://sites.google.com/exeter.ac.uk/pbl13y2unit3/home?authuser=1

# data[].attributes.body
https://ebookcentral.proquest.com/lib/exeter/reader.action?docID=5787851#ppg=64

# data[].attributes.body
https://geekymedics.com/how-to-read-an-ecg/

# data[].attributes.body
Paraesthesia -  Numbness/tingling.
https://termbrowser.nhs.uk/?perspective=full&conceptId1=91019004&edition=uk-edition&release=v20190601&server=https://termbrowser.nhs.uk/sct-browser-api/snomed&langRefset=999001261000000100,999000691000001104#home-fh-cd1_canvas

# data[].attributes.body
SNOMED. https://termbrowser.nhs.uk/?perspective=full&conceptId1=20262006&edition=uk-edition&release=v20190601&server=https://termbrowser.nhs.uk/sct-browser-api/snomed&langRefset=999001261000000100,999000691000001104#home-fh-cd1_canvas

# data[].attributes.body
https://www.researchgate.net/figure/Normal-walk-Turning-and-Tandem-The-three-walking-conditions-including-five-gait_fig4_311930609

# data[].attributes.body
https://aclandanatomy.com/MultimediaPlayer.aspx?multimediaId=10528475

https://www.cureus.com/articles/13852-the-tentorium-cerebelli-a-comprehensive-review-including-its-anatomy-embryology-and-surgical-techniques

# data[].attributes.body
https://www.youtube.com/watch?v=gLZoYLxdXCQ

# data[].attributes.headline
Fluid-attenuated inversion recovery (FLAIR) 

# data[].attributes.subject
Fluid-attenuated inversion recovery (FLAIR) 

# data[].attributes.body
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504317/

# data[].attributes.body
https://eyewiki.aao.org/Relative_Afferent_Pupillary_Defect#targetText=Relative%20Afferent%20Pupillary%20Defect%20(RAPD,the%20retina%20or%20optic%20nerve.

https://www.youtube.com/watch?v=HSYo7LhfV3A

# data[].attributes.body
Dawson fingers are a radiographic feature of demyelination characterised by periventricular demyelinating plaques distributed along the axis of medullary veins, perpendicular to the body of the lateral ventricles and/or callosal junction. This is thought to reflect perivenular inflammation. They are a relatively specific sign for multiple sclerosis.
https://radiopaedia.org/articles/dawson-fingers?lang=gb

# data[].attributes.body
http://www.neuroexam.com/neuroexam/content38.html#targetText=Test%20tandem%20gait%20by%20asking,the%20other%20with%20each%20step.

# data[].attributes.body
https://www.sciencedirect.com/topics/neuroscience/qrs-complex

# data[].attributes.headline
Movement and Control Wk 1 Questions - Google Doc 

# data[].attributes.subject
Movement and Control Wk 1 Questions - Google Doc 

# data[].attributes.body
As previously shared by email.

https://docs.google.com/document/d/1AriG38AkU_bSvdCOuR4FbcBvu0Iq3oNAviqPFVrp_6o/edit

# data[].attributes.body
https://www.healio.com/cardiology/learn-the-heart/ecg-review/ecg-interpretation-tutorial

# data[].attributes.body
https://images.app.goo.gl/kqnSqA4bye5Vj28MA

# data[].attributes.body
In ischemic myocytes, the electrical properties are altered so that the resting membrane potential in phase 4 becomes less negative, the duration of the action potential is shortened to less than 200 milliseconds, and the morphology of phase 2 is altered.¹ As a result, a voltage gradient forms between the normal myocytes and the ischemic myocytes. These changes are recorded by the electrocardiogram as deviations of the ST segment from the isoelectric point.

The change in resting membrane potential causes a depression of the ST segment during the diastolic stage and contributes to the appearance of the ST segment elevation on the ECG. Likewise, in transmural ischemia, a shortened action potential occurs which causes an abnormal current flow during the systolic stage of the cardiac cycle. The ST vector is shifted towards the outer positive epicardial zones, producing ST elevations and tall T waves (see Figure 2).

# data[].attributes.body
https://www.mstrust.org.uk/news/views-and-comments/epidemiology-and-natural-history-ms

Myth buster #1: Men do worse than women

A commonly held perception in MS has been that men fair worse than women, at least in terms of their disease progression. Our study showed that this is not necessarily true. We found that on average men and women with MS required a stick to walk at around the same age: 59 years old for men and 60 for women.

Myth buster #2: An older age at onset is worse than a younger age

Another commonly held belief was that the outcome for those older at MS onset was gloomy. We challenged this and found that it was not always true. We found that those who were older at onset of MS were on average still older when they required a stick to walk compared to their younger counterparts. When you combine this with the fact that these people have enjoyed a longer disease free period, then it seems that an older age at MS onset is not so bad after all.

Myth buster #3: Relapses drive the long-term disability progression

It has often been thought (or assumed) that relapses drive the long-term irreversible disability progression. So much so that many of the disease modifying 🤬 for MS primarily work by reducing relapses rates with the belief that this will automatically result in a beneficial effect on long-term disability outcomes. However, a number of different studies are showing that relapses might not be the main factor influencing long-term progression in MS.

In our study, we were able to look at over 11,700 relapses that occurred in 2,477 people with relapsing-onset MS (ie relapsing remitting or secondary progressive MS) over a mean follow-up of 20.6 years from onset of MS. It was quite challenging to analyze so much information spanning such a long period of time. However, by teaming up with some talented statisticians, we found that relapses tended to pose a transitory short-term risk rather than having substantial longterm consequences. However we did find that relapses occurring in the first five years from disease onset or in people under 25 seemed to have more of an impact than those occurring ten or more years after onset or in people over 35 years at MS onset.

# data[].attributes.headline
Treatment of MS - Functional Electrical Stimulation for Foot Drop

# data[].attributes.subject
Treatment of MS - Functional Electrical Stimulation for Foot Drop

# data[].attributes.body
https://www.mstrust.org.uk/a-z/functional-electrical-stimulation-fes

# data[].attributes.body
https://www.mdcalc.com/wells-criteria-pulmonary-embolism

# data[].attributes.body
Case 1 (Venous circulation)

1. Chest anatomy (Anatomy of heart in relation to ECG’s)

2. Review normal coagulation cascade

3. What precipitates abnormal/pathological coagulation (e.g.vessel wall damage)

4. What is the difference between anticoagulants and antiplatelets and give examples of procoagulants

5. Describe the process of VTE?-epidemiology, pathophysiology, signs and symptoms, treatment, diagnosis(d-dimer)

6. Describe the VTE risk factors- smoker, post-op, hormones (oral contraceptive pill), long distance travel, bed bound

7. How does the Well score work

# data[].attributes.body
Case 2 (Arterial circulation)

1. Describe common rhythm disturbances identifiable by ECG (VF, VT,SVT, AF, Ectopic beat, Tachy/Bradycardia)

2. What are the common structural changes to the heart identifiable by and ECG(LVH, Valvular dysfunction, Congenital heart disease- don’t spend too much time on this)

3. What are the main effects of ischemia and infarction on an ECG?- What can be inferred about sites of infarction from and ECG (i.e. what leads to what artery)

4. Differential diagnosis of oedema? And the common sites of oedema?

5. Compare right and left sided heart failure

6. Describe the pathophysiology of arterial degeneration (i.e. athersclerosis, atheroma etc) and how does it leads to angina, claudication, renal failure, cerebrovascular disease, vascular dementia.

7. What are the types of angina?How is it distinguished from a MI (troponin and CK)

8. Describe the disease profile of abdominal aortic aneurysm (include screening for AAA)

9. What are the common and clinically important aneurysms out there

10. How to thrombolytics work and when are they indicated

11. What causes and what are the effects of  aortic dissection (Marfan’s and sex differences)

# data[].attributes.body
https://docs.google.com/document/d/1d_AnXLWcb8rY1v44fxb3NGAczJ24Rav79KWZSUooK98/edit?usp=drivesdk

# data[].attributes.body
https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.nice.org.uk/Media/Default/About/what-we-do/NICE-guidance/antimicrobial%20guidance/summary-antimicrobial-prescribing-guidance.pdf&ved=2ahUKEwjbwo3MlZfmAhXDmFwKHbuwAIwQFjAAegQIAhAB&usg=AOvVaw3WRkBla9_Gn0fijt1TrqPR

# data[].attributes.headline
MSD manuals - Movement and Cerebellar disorders - Nice anatomical descriptions and 3D models

# data[].attributes.subject
MSD manuals - Movement and Cerebellar disorders - Nice anatomical descriptions and 3D models

# data[].attributes.body
https://www.msdmanuals.com/en-gb/professional/neurologic-disorders/movement-and-cerebellar-disorders/overview-of-movement-and-cerebellar-disorders

# data[].attributes.body
From Oxford book

# data[].attributes.body
https://youtu.be/DGOmN6rnsNk

# data[].attributes.body
https://www.news-medical.net/news/20190605/Chronic-inflammation-removes-motivation-by-reducing-dopamine-in-the-brain.aspx?fbclid=IwAR2IhZLBXLFVx9YaBrVSVE1TVBWWG0855tmL50IKr20A1ilaW2xNM_Z3Mv4#commentblock

# data[].attributes.body
Paraesthesia
Unilateral vision loss
Spastic catch
Dysmetria
Spastic paraperesis
Preservation of power
Ataxia- heel shin
Tandem walk
Gait abnormalities
Supratentorial
T1 and T2 weighted images
FLAIR sequence
Dawson fingers
Relative afferent pupillary defect

# data[].attributes.body
https://www.racgp.org.au/afp/2013/januaryfebruary/sudden-loss-of-vision/#targetText=The%20differential%20diagnosis%20for%20sudden%2C%20painless%2C%20unilateral%20vision%20loss%20in,nonarteritic%20ischaemic%20optic%20neuropathy

# data[].attributes.body
http://www.ncbi.nlm.nih.gov/books/NBK1119/

Diagnosis/testing.

The diagnosis of a dystrophinopathy is established in a proband with the characteristic clinical findings and elevated CK concentration and/or by identification of a hemizygous pathogenic variant in DMD on molecular genetic testing in a male and of a heterozygous pathogenic variant in DMD on molecular genetic testing in a female. Females may present with a classic dystrophinopathy or may be asymptomatic carriers.

Management.

Treatment of manifestations: ACE inhibitors are used with or without beta blockers for cardiomyopathy in both DMD and BMD phenotypes. Congestive heart failure is treated with diuretics and oxygen as needed; cardiac transplantation is offered to persons with severe dilated cardiomyopathy and BMD with limited or no clinical evidence of skeletal muscle disease. Scoliosis is treated with bracing and surgery. Corticosteroid therapy improves muscle strength and function for individuals with DMD between ages five and 15 years; the same treatment is used in BMD, although the efficacy is less clear.

# data[].attributes.headline
Compulsory Vaccination? BBC Briefing Room

# data[].attributes.subject
Compulsory Vaccination? BBC Briefing Room

# data[].attributes.body
https://www.bbc.co.uk/sounds/play/m0004skw

Includes interview with Heidi Larson of LSHTM Vaccine Confidence Project. https://www.vaccineconfidence.org/

# data[].attributes.body
Rheumatoid arthritis (disorder)
https://termbrowser.nhs.uk/?perspective=full&conceptId1=69896004&edition=uk-edition&release=v20190601&server=https://termbrowser.nhs.uk/sct-browser-api/snomed&langRefset=999001261000000100,999000691000001104

# data[].attributes.headline
Rheumatoid Arthritis Diagnosis - NICE Pathways - Case 3, q1d

# data[].attributes.subject
Rheumatoid Arthritis Diagnosis - NICE Pathways - Case 3, q1d

# data[].attributes.body
Investigations for diagnosis

Offer to carry out a blood test for rheumatoid factor in adults with suspected rheumatoid arthritis who are found to have synovitis on clinical examination.

Consider measuring anti-CCP antibodies in adults with suspected rheumatoid arthritis if they are negative for rheumatoid factor.

X-ray the hands and feet in adults with suspected rheumatoid arthritis and persistent synovitis.

# data[].attributes.body
https://drive.google.com/file/d/1cE3SmOEHdsV6dMpngfgvK4eKFy8v2-1Y/view

# data[].attributes.body
Browser: https://termbrowser.nhs.uk/?perspective=full&conceptId1=19030005&edition=uk-edition&release=v20190601&server=https://termbrowser.nhs.uk/sct-browser-api/snomed&langRefset=999001261000000100,999000691000001104

Induction training material:
https://isd.digital.nhs.uk/artefacts/trud3/e-learning/flash/EL_SCT/10_UKTC_Intro-SNOMED_eLearning_V06.htm

# data[].attributes.body
All I can currently find is information on the retirement of the April 2018 release of the Read Codes. It's all a bit weird. Am I being daft?

Have registered for a TRUD account to access, and still none the wiser!

https://digital.nhs.uk/services/terminology-and-classifications/read-codes

# data[].attributes.body
https://www.immunize.org/catg.d/p3072a.pdf?fbclid=IwAR1-yV09ttzBcVXXrksFYaP5kt028DObD2r8D45p5Kc27dzuBglKnr40hrc

# data[].attributes.body
https://accessmedicine.mhmedical.com/content.aspx?bookid=1088&sectionid=61699947#1102645871

# data[].attributes.body
• Malaria
• Enteric fever (typhoid and paratyphoid)
• Dengue
• HIV seroconversion
• Rickettsial infection
https://www.rcpe.ac.uk/sites/default/files/bell.pdf

# data[].attributes.body
https://www.nhs.uk/common-health-questions/medicines/can-post-exposure-prophylaxis-pep-stop-me-getting-hiv/

# data[].attributes.body
Observations. Timothy Ray Brown 2007 confirmed HIV+ to HIV- after stem cell transplant in leukaemia treatment. Generalisability of curative technique. Tri-drug ART cocktail therapy from 1996.

# data[].attributes.body
Time to detection of HIV RNA, p24 antigen and antibody via various HIV assays.

# data[].attributes.body
https://sites.google.com/exeter.ac.uk/y2pblstudyguide/host-defence/pbl-scenario?authuser=1

# data[].attributes.body
https://sites.google.com/exeter.ac.uk/hostdefencej2m2klnr?pli=1&authuser=1

# data[].attributes.body
https://www.youtube.com/watch?v=ld8PhyAHov8

# data[].attributes.body
https://www.youtube.com/watch?v=nYjzl3Xc_0E

Good animations and explanation if you can cope with the soundtrack.

# data[].attributes.body
1.       What is RD?

a.       How does it present?

b.       What is the pathophysiology of the disease?

c.       What’s the treatment and management?

d.       How is it diagnosed?

2.       Give 6-8 DD for acute joint pain.

3.       Outline the anatomy of the immune system.

4.       Common pathology affecting the immune system?

a.       Common sites of lymphadenopathy and lymphedema

# data[].attributes.headline
What is Acute HIV Infection? - John Hopkins

# data[].attributes.subject
What is Acute HIV Infection? - John Hopkins

# data[].attributes.body
https://www.jhsph.edu/research/centers-and-institutes/acute-and-early-seroconverter-studies/faqs.html

# data[].attributes.body
When the body is first producing detectable levels of HIV antibodies, people often experience symptoms similar to those of the flu or other viral infections.

Symptoms of seroconversion may include:

fatigue

fever

a sore throat

a headache

body aches

swollen lymph nodes

swollen tonsils

a rash

# data[].attributes.body
https://improvement.nhs.uk/documents/2142/plan-do-study-act.pdf

# data[].attributes.body
https://youtu.be/cCPyWFK0IKs

# data[].attributes.headline
Case 2 - including ** additional questions

# data[].attributes.subject
Case 2 - including ** additional questions

# data[].attributes.body
1.       Give an overview of HIV

a.       Presentation - **including significance of sero conversion

b.       Transmission

c.       Treatment and management (include access to treatment and inequality) - **including prophylaxis and egs in other diseases of prophylaxis

d.       Prognosis - **impact on pregnancy - established and intention

e.       Diagnosis

f.        Epidemiology

g.       Risk groups - **some comparison of risky behaviours

h.       Mechanism
i.        Prevention at individual an population level
j.        **Review other common STDs - how to distinguish
k.      **Why do pts feel stigmatised and what can we do about it?
l.      **What are our responsibilities towards Alistair - NOT OUR PT
m. **Differential diagnosis for fever on return from abroad

# data[].attributes.body
1.       What is the history and timeline of vaccination?

a.       Different types of vaccination

i.      How do they work?

ii.      What comprise cautions and contra-indications?

2.       What is the UK program for childhood vaccination?

a.       What vaccination do you need boosters for and when?

b.       How does it vary regionally?

3.       Compare the statistics between the SW and the GP

a.       https://fingertips.phe.org.uk/search/MMR

b.       What are Read codes?

i.      Why are they useful?

ii.      Examples for different diseases

4.       What makes people reluctant to have vaccination?

a.       For themselves and their children

5.       What are different types of hypersensitivity reactions?

a.       How do they present?

b.       How are they treated?

c.       What are some common types of HS reactions?

d.       How does that relate to vaccines?

# data[].attributes.body
https://sites.google.com/a/exeter.ac.uk/pbl-group-2019-20/

# data[].attributes.body
Case 3

1. What are the types of shock

2. How is shock recognised

3. Pathophysiology of septic shock and of cardiogenic shock

4. How is sepsis recognised include NEWS2. How is sepsis recognised and the common sites involved (organ system)

5.  How is sepsis treated (specific e.g. antibiotics and supportive e.g. fluids)

6. What are the common causes of meningitis  and how do they present

7. Differential diagnosis of chest pain, SOB, fever, diminished urine output

8. What is the difference between the interpretation of ABG and VBG