Essay Tips
\n2500 +\/_ 10% = 2750 words. (Anything over 2750 will not be read \u2013 new word count policy)
\nUse of CONCISE tables – bullet points.
\nHow does a word count\u2026count a word?? Or spaces?? (do not have additional spaces \u2013 for example: Strathdee(2022)
\nIf using Ely et al (Framework for diagnostics) \u2013 suggests just looking at differentials after the history and physical exam \u2013 We suggest doing this after History, and Physical examination rather than after both\u2026
\nLINK THEORY TO CASE \u2013 Not large chucks of theory please!!
\nFirst person
\n\uf0a7\tWrite in FIRST person \u2013 I am a trainee Advanced\u2026
\n\uf0a7\tI did this, I did that.
\n\uf0a7\tDo not write in first person when discussing literature: For Example: I think Strathdees (2022) study on DADM tutorials is rubbish\u2026 It should be: For example: It could be argued\u2026
\nIntroduction
\n\uf0a7\tSummary of essay
\n\uf0a7\tJob role – I am a\u2026 (ACCP can discuss FICM \u2013 BRIEFLY)
\n\uf0a7\tDiscuss confidently – use of a pseudonym \u2013 mention latest code (NMC is 2018!!)
\n\uf0a7\t(We do not want a section on advanced practice \u2013 not enough words)
\nCase study
\nParagraph on your patient – case study – Paint the picture
\nHandover
\n\uf0a7\tYou start when you first get the information about the patient
\n\uf0a7\tInitial thoughts – early thinking
\n\uf0a7\tLink to underpinning theory – Your type 1 thinking \u2013 related to experience, related to your speciality. Bias: Pattern recognition \u2013 seen something like this before. Framing \u2013 did someone \u2018frame\u2019 the diagnosis for you?
\n\uf0a7\tConsider Red flags
\nHistory
\n\uf0a7\tUse of OLDCART – presented complaint. Or PQRST – Use a framework – table or summarise. Pain Score\u2026
\n\uf0a7\tRelevant factors – past medical history
\n\uf0a7\tDifferentials – enough information to come up with differentials (Differential is a diagnosis not a symptom) \u2013 how likely they are. In Order – likelihoods. The rationale for your differentials – Expose your reasoning\u2026.
\nExamples:
\nDifferential\tLikelihood\tRationale
\nPE
\n(Must not miss)\tHighly likely\t+Immobile
\n+Long stay in hospital
\n+History of central chest pain
\n+Cough
\n+Haemoptysis
\nMet lung cancer
\n(Must not miss)\tLikely\t+Known Bowel ca
\n+Haemoptysis
\n+Known cough
\n+Chest pain
\n-No loss of weight
\n-Recent scan showing remission
\nMallory-Weiss tear\tUnlikely\t+Cough<\/p>\n
Likelihood \u2013 pre-test probability \u2013 estimates \u2013 educated guess. There is data out there.
\nPhysical assessment – this could be prior to history – (if critical and need to be seen first)
\n\uf0a7\tJustify what you are going to examine and WHY.
\n\uf0a7\tLook for ALL differentials not just one that is most likely
\n\uf0a7\tPresent findings – table: do not need to tell us every \u2018normal\u2019 finding – just findings that prove or disprove your differentials
\n\uf0a7\tHow have your differentials and your likelihood changes? Could use same table but change likelihoods and add additional rationales. You may add a differential as you have seen something new, you may rule out differentials, but you need to consider ALL the differentials
\n\uf0a7\tDon\u2019t forget any underpinning theory – type 2, dual process, bias
\nDifferential\tLikelihood\tRationale
\nPE\tHighly likely\t+Immobile
\n+Long stay in hospital
\n+History of central chest pain
\n+Cough
\n+Haemoptysis
\n+Tachycardia
\n+Auscultation normal
\n+Right heart strain on ECG (What is the S and S of this?)
\nMet lung cancer\tLikely \t+Known lung ca
\n+Haemoptysis
\n+Known cough
\n+Chest pain
\n-Auscultation normal
\nMallory-Weiss tear\tUnlikely\t+Cough<\/p>\n
Focus on one Test \u2013 (minimal word count for lots of tests)
\n\uf0a7\tClinical test accuracy
\n\uf0a7\tDebate what test you use – cost, radiation\u2026 Think about how many patients do not have a PE that have a CTScan?? But of course it is a do not miss, but may be worth looking at within your test\u2026
\n\uf0a7\tSensitivity and specifically, negative and positive predictive values
\n\uf0a7\tConsider what tests are good For example: – ?CXR ?Ultrasound ? CT Scan \u2013 What\u2019s best? Why? What\u2019s the Sensitivity and Specifically of these? What does it mean – thinking about what is the chance of a false negative or a false positive? – the bits that may tell you that you are wrong??
\n\uf0a7\t** critical appraise the test – the study is only as good as the research that was carried out is, does the study include your patient population\u2026 For example: your patient is a female, the study you look at includes 99 males and 1 female = how does this change things?
\nPut it all together
\n\uf0a7\tDo we know what is wrong with the patient? – brief
\n\uf0a7\tSafety net
\n\uf0a7\tSometimes we don\u2019t? but normally have a front runner
\nTreatment – No marks for treatment! (Unless you are discussing how the patient is getting on with the \u2018treatment\u2019 they are having!! – as medications could be the
\n \u2018test\u2019)
\nConclusion
\nCritical Reflection. From doing this course I have learnt<\/p>\n
CASE STUDY<\/p>\n
ad symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118\u2013127 mg\/dl, which were described to him as indicative of \u201cborderline diabetes.\u201d He also remembered past episodes of nocturia associated with large pasta meals and Italian pastries. At the time of initial diagnosis, he was advised to lose weight (\u201cat least 10 lb.\u201d), but no further action was taken.Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon.A.B. also takes atorvastatin (Lipitor), 10 mg daily, for hypercholesterolemia (elevated LDL cholesterol, low HDL cholesterol, and elevated triglycerides). He has tolerated this medication and adheres to the daily schedule. During the past 6 months, he has also taken chromium picolinate, gymnema sylvestre, and a \u201cpancreas elixir\u201d in <\/p>\n
AB is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 1997
\nattempt to improve his diabetes control. He stopped these supplements when he did not see any positive results.He does not test his blood glucose levels at home and expresses doubt that this procedure would help him improve his diabetes control. \u201cWhat would knowing the numbers do for me?,\u201d he asks. \u201cThe doctor already knows the sugars are high.\u201dA.B. states that he has \u201cnever been sick a day in my life.\u201d He recently sold his business and has become very active in a variety of volunteer organizations. He lives with his wife of 48 years and has two married children. Although both his mother and father had type 2 diabetes, A.B. has limited knowledge regarding diabetes self-care management and states that he does not understand why he has diabetes since he never eats sugar. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements, and she frequently scans the Internet for the latest diabetes remedies.During the past year, A.B. has gained 22 lb. Since retiring, he has been more physically active, playing golf once a week and gardening, but he has been unable to lose more than 2\u20133 lb. He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose (SMBG).A.B.\u2019s diet history reveals excessive carbohydrate intake in the form of bread and pasta. His normal dinners consist of 2 cups of cooked pasta with homemade sauce and three to four slices of Italian bread. During the day, he often has \u201ca slice or two\u201d of bread with butter or olive oil. He also eats eight to ten pieces of fresh fruit per day at meals and as snacks. He prefers chicken and fish, but it is usually served with a tomato or cream sauce accompanied by pasta. His wife has offered to make him plain grilled meats, but he finds them \u201ctasteless.\u201d He drinks 8 oz. of red wine with dinner each evening. He stopped smoking more than 10 years ago, he reports, \u201cwhen the cost of cigarettes topped a buck-fifty.\u201dThe medical documents that A.B. brings to this appointment indicate that his hemoglobin A1c(A1C) has never been <8%. His blood pressure has been measured at 150\/70, 148\/92, and 166\/88 mmHg on separate occasions during the past year at the local senior center screening clinic. Although he was told that his blood pressure was \u201cup a little,\u201d he was not aware of the need to keep his blood pressure \u2264130\/80 mmHg for both cardiovascular and renal health.11A.B. has never had a foot exam as part of his primary care exams, nor has he been instructed in preventive foot care. However, his medical records also indicate that he has had no surgeries or hospitalizations, his immunizations are up to date, and, in general, he has been remarkably healthy for many years\n\n\n\n\n\n\n\n\n\n\n\n\n\n\u2026\n<\/p>\n","protected":false},"excerpt":{"rendered":"
Essay Tips 2500 +\/_ 10% = 2750 words. (Anything over 2750 will not be read \u2013 new word count policy) Use of CONCISE tables – bullet points. How does a word count\u2026count a word?? Or spaces?? (do not have additional spaces \u2013 for example: Strathdee(2022) If using Ely et al (Framework for diagnostics) \u2013 suggests […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","meta":[],"disciplines":[13],"paper_types":[],"tagged":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/questions\/18992"}],"collection":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/questions"}],"about":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/types\/questions"}],"author":[{"embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/comments?post=18992"}],"version-history":[{"count":0,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/questions\/18992\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/media?parent=18992"}],"wp:term":[{"taxonomy":"disciplines","embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/disciplines?post=18992"},{"taxonomy":"paper_types","embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/paper_types?post=18992"},{"taxonomy":"tagged","embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/tagged?post=18992"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}