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Support of the home-dialysis patient

Alastair Hutchison and Helen Hurst

in Supportive Care for the Renal Patient

This chapter discusses patients undergoing home-dialysis and the support that is provided to them. This system began after the dialysis centres in the locales became too crowded, and soon family ... More

This chapter discusses patients undergoing home-dialysis and the support that is provided to them. This system began after the dialysis centres in the locales became too crowded, and soon family members and spouses of the patients were able to go through training to perform haemodialysis at home. This allowed even more patients access to this treatment. The discussion includes the selection process of the patients suited for home-dialysis, the training process, and the support these patients should be provided with once they receive this treatment from home.Less

Parathyroid Gland and Bone Disease

Atul Kalhan (ed.)

in Best of Five MCQs for the Endocrinology and Diabetes SCE

Questions The four parathyroid glands play a key role in calcium homeostasis by secreting parathyroid hormone (PTH). Which one of the following statement regarding parathyroid gland/PTH physiology ... More

Questions The four parathyroid glands play a key role in calcium homeostasis by secreting parathyroid hormone (PTH). Which one of the following statement regarding parathyroid gland/PTH physiology is correct? 1, 25-dihydoxy vitamin D is the main storage form of vitamin D Parathyroid glands develop...Less

Communication skills and ethics

Michael Nandakumar and Rupa Bessant

in The Pocketbook for PACES

The communication skills and ethics station aims to assess your ability to guide and organize an interview with a patient, relative or surrogate (such as a healthcare worker). The skills ... More

The communication skills and ethics station aims to assess your ability to guide and organize an interview with a patient, relative or surrogate (such as a healthcare worker). The skills specifically tested in this station include: • Clinical communication skills • Managing patients’ concerns • Clinical judgement (including knowledge of ethics and law) • Managing patient welfare. Written instructions are provided for the scenario during the 5-minute interval before the station starts. 14 minutes are allowed for the patient interaction, followed by 1 minute for the candidate to reflect their thoughts. A 5-minute discussion with the 2 examiners will then take place after the patient has left the station. Each examiner has a structured marksheet for the case. • Approach the station as a 2-way discussion rather than a rigid ‘tick-box task’. • Set aside time each week to practise scenarios with colleagues under timed conditions. • Familiarize yourself with recent NICE guidance (especially with new or controversial or rationed treatments) and DVLA advice. • Remember that skills needed in this station are also particularly applicable to those required in station 2 (history taking) and station 5 (brief clinical consultations), and it is therefore essential that you spend adequate time practising these skills to maximize your performance in the examination. • Identify key issues that need to be addressed during the consultation (e.g. breaking bad news) as well as ‘hidden clues’ (e.g. a single parent may have concerns regarding childcare if she herself is admitted to hospital). • Make notes during this time, but avoid the temptation to make notes during the consultation itself, as it distracts from the flow of the discussion. • Start with open-ended questions and establish the patient’s understanding, knowledge and concerns at an early stage – these are all specifically mentioned in the clinical marksheet. • Use ‘2-way acting’ where appropriate – you can improvise within reason to aid the flow and realism of the consultation (e.g. ‘Are you feeling better since I saw you on the ward last week?’). Less

General medicine

Nicholas Longridge, Pete Clarke, Raheel Aftab, and Tariq Ali

Katharine Boursicot and David Sales (eds)

in Oxford Assess and Progress: Clinical Dentistry

The oral cavity is the largest and most used orifice in the human body. It is the opening of the aerodigestive tract, as well as a region of the body that is heavily involved in both sensing the ... More

The oral cavity is the largest and most used orifice in the human body. It is the opening of the aerodigestive tract, as well as a region of the body that is heavily involved in both sensing the outside world and communi­cating with it. Simply put, our mouths are complex and deeply intimate structures that can act as windows into the health of the rest of the body. Many disease processes that are systemically invisible may display quite overt oral manifestations. There are deep associations between bodily diseases and oral dis­ease counterparts, with considerable and mounting evidence to show that oral health may have an impact on systemic wellness. It is there­fore important to have an understanding of the wider human anatomy, physiology, and pathology. Understand and treat the patient as a whole, and think about all aspects of their health, whether it be routine pre­ventative treatment for periodontally compromised diabetic patients or polypharmacy patients requiring secondary dental care. Often at times, patients can be unclear about their own health condi­tion; having a fundamental understanding of general medicine will help to make those difficult choices regarding your patients a little easier and clarify when and whom to refer. Key topics are not included for this chapter, as it is a vast topic, and not the main focus of the dental undergraduate curriculum. It is, however, important to have a good basic knowledge of general human diseases, how they might interact with dental treatment, and the role that dentists can play in both diagnosis and management Less