Bristol stool chart
The Assessment of abdominal pain page has been updated with the addition of the Bristol stool chart used to describe stool type.
Bob Dunn
Serum lactate and Hartmann’s administration
The Metabolic acidosis page has been updated with some additional information about how large volumes of Hartmann’s solution may contribute to lactic acidosis. Zitek, T, Skaggs, ZD, Rahbar, A, et al. Does Intravenous Lactated Ringer’s Solution Raise Serum Lactate? J Emerg Med 2018
Lactic acidosis
The Metabolic acidosis page has been updated with some additional causes of lactic acidosis.
Enhanced peritoneal stripe sign
The US of the bowel page has been updated with additional information about the enhanced peritoneal stripe sign of pneumoperitoneum.
ECG changes of RV infarction
The ECG in ACS page has been updated with some additional information about ECG changes in RV infarction, as well as some improved formatting.
Video management
To improve the efficiency of the site, we have removed all the videos from within the text of the manual and replaced them with links to the same videos that can also be found on the videos page. This should speed page loading and reduce bandwidth when loading pages that previously had videos emebedded in … Read more
MAC of N2O – correction
The Inhalational anaesthetic agents page has been corrected so the MAC value of N2O is now shown as 102 instead of 1.02 as previously stated. Thanks to Luke for picking this up.
September 2018 update quiz
The September 2018 update quiz has just been added. As a result the total number of quiz questions on the website has just passed 2000. Do the quiz here.
Which version do you prefer poll?
Due to the challenges of updating multiple formats of the manual online, we would like to reduce the number of versions from 3 to 2. At the moment Version 2 is the most problematic, so is the version we would prefer to stop updating. So we have just opened a poll to find out which … Read more
Patterns of LFT abnormality table
The table of patterns of LFT abnormality on the Liver function tests page has been extensively revised and updated.
AST/ALT ratio and LDH
The Liver function tests page has been updated with some additional information about the AST/ALT ratio and causes of LDH elevation.
SAAG and protein content
The Ascites page has had a few minor updates, including making it clearer that high SAAG means low ascitic fluid protein content and vice versa.
SBP organisms
The Spontaneous bacterial peritonitis page has had a few other modifications, including a table of the most commonly responsible organisms.
Causes of free gas
The Assessment of abdominal pain page has been updated, including the addition of a segment on the causes and features of free intraperitoneal gas.
Cellulitis
The Cellulitis page has been updated, including more information about oral antibiotic treatment and features that suggest necrotising fasciitis.
Necrotising fasciitis
The Gas gangrene & necrotising fasciitis page has been updated, including more information about features that differentiate it from simple cellulitis.
PET image of Takayasu aortitis
A PET scan image has been added to the Takayasu arteritis page.
High SAAG (low protein) ascites and SBP risk – correction
The Spontaneous bacterial peritonitis page has been corrected to state that SBP is rare in patients with SAAG < 11g/L, not >11g/L as previously stated. Thanks to Simon for picking this up.
ASPECTs score and thrombolysis – correction
The Thrombolytic therapy in stroke page has been corrected to reflect that thrombolytic therapy is indicated with an ASPECTS score of 8 or more, not 7 or more as previously stated. Thanks to Ker for picking this up.
Gout crystals have -ve birefringence – correction
The treatment algorithm on the Gout and pseudogout page has been corrected to show that gout crystals are negatively birefringent, not positively birefringent as previously shown. Thanks to Ming for picking this up.