101 Top Tips in Medicine

The 101 vital medical tips other textbooks don't teach you - Following the success of the award winning Cynical Acumen, John Larkin outlines key knowledge for medical students and junior doctors. Clustered around the headings of cynical, survival, clinical, career and miscellaneous tips.

John Larkin Consultant Rheumatologist/Physician, Victoria Infirmary, Glasgow, Honorary Clinical Senior Lecturer, Glasgow University and Examiner, Royal College of Physicians and Surgeons of Glasgow

Introduction. Cynical: 1 Press the spinous processes 2 Pay no attention to a family history of rheumatoid arthritis 3 Don't tell the patient what you're examining unless it's absolutely necessary 4 Examine upper limb dermatomes first-off in the non-anatomical position 5 Drugs do exactly what they say on the tin 6 You can get side effects from all the drugs some of the time . . .7 No one gets a perfect 10. 8 Doctors are people too . .9 Pain doesn't make you sigh 10 If the story of the 'emergency' begins five years ago, there's nothing wrong with the patient 11 Dogs lick their wounds, not their kneecaps 12 If a patient sleeps through your post-receiving ward round, there's nothing wrong with them 13 '. . since we're talking about vegetables . . .' 14 Breathlessness doesn't make you sigh either 15 'To let you understand, doctor . . .' 16 Vomiting has one 't', fitting has two 17 Arthritis doesn't cause .18 Diseases requiring emergency admission that don't cause tachycardia 19 GP surgeries aren't that dangerous 20 NP DNAs have NoWWT 21 Opiate withdrawal isn't trainspotting 22 Beware the stick in the wrong hand 23 Venepuncture is only medium-sore 24 'I wouldn't make this up, officer' 25 Quickies. Survival: 1 Don't answer the telephone 2 Check the gas mask 3 Don't assume a radiological diagnosis is correct 4 The vein you can feel is bigger than the vein you can see 5 (Geriatrics) Always put your hand on the bed - or soft furnishing -before sitting on it 6 Most dangerous causes of abdominal pain are surgical 7 Take a briefcase to all dommies 8 Don't stop the ward trolley right at the patient's bed 9 Clear the decks for a ward round 10 Don't knacker your back checking for knackered backs 11 Don't be too approachable 12 'How are all the/my/your patients (doing)?' 13 A quartet of percussion tips 14 Leave time for things other than medicine 15 Don't go on too many committees 16 Don't rush to establish a 'duty of care' 17 You can't 'use' Murphy's Law 18 Always have someone with you when talking to a relative 19 Do not look after any patient who obviously has two grown-up daughters 20 You have no obligation to speak to relatives 21 Don't just follow protocols, understand them 22 Don't sign anything unless you know it's true 23 Try to speak quietly when appropriate 24 Don't tell radiology what to do 25 Never work too hard. You have a finite time on this planet Clinical:  1 Listen to the Little Man .2 Don't blindly follow expert advice 3 Don't assume everyone else is better than you 4 How to take a tricky blood pressure 5 The patient's diagnosis isn't always the same as last time 6 A little learning is a dangerous thing 7 The Hinniegram 8 When is breathlessness not dyspnoea . . . ? 9 Calculating the cardiac axis from an ECG 10 Don't even look at the percentage saturation 11 Iron deficiency isn't a diagnosis12 Pulses are good for you 13 Melaena is sticky (and blood is red). Career Tips, Miscellaneous, Statistics Tips, From the 'Other Side' Tips, Survival/Career Tips.