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RCEMLearning
@rcemlearning.bsky.social
230 followers 300 following 410 posts
Royal College of Emergency Medicine. ELearning and #FOAMed resource
https://www.rcemlearning.co.uk/
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SUNDAY QUESTION - What is the best diagnostic test to order?

What do you think?

#Care #Children #ChildrenCare
SUNDAY QUESTION: This toddler has no medical history of note. He is the 3rd of 4 children under 6 years. His mum cannot attend as she has a 1-week old and is breastfeeding. The family are of Asian ethnicity. On examination, you note him to have marked genu varum or “bow-legs”. What is the best diagnostic test to order? a). Bone Scan b). Skeletal Survey c). Wrist x-ray d). Serum calcium
December 14, 2025 at 4:00 PM
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Taken from the #blog - Combatting the Crowd

www.rcemlearning.co....

A missed dose can harm your patients!
a missed dose can harm your patients Movement disorders - Parkinson’s/myasthenia medication Immunomodulators (including HIV meds) Sugar - diabetes medication Steroids - Addison’s & adrenal insufficiency Epilepsy - anticonvulsants DOACs & warfarin
December 13, 2025 at 7:55 PM
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NEW: An 83-year-old male is pre-alerted to your emergency department (ED) following an intentional overdose of one of his medications. On arrival, he admits to taking the medication around 12 hours ago with the intent to end his own life

#ClinicalCase www.rcemlearning.co....
RCEMLearning logo in white. Overdose of an Ancient Drug. Clinical Case. NEW. A picture of a man in distress.
December 12, 2025 at 7:00 PM
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NEW: These modules discusses the management of genitourinary foreign bodies (GUFB) in the Emergency Department

Learning Objectives:
Understand the clinical features of genitourinary foreign bodies (GUFB)
Consider the clinical management options of GUFBs (1/2)
RCEMLearning logo in white. An Xray of a latex foreign object within the rectum. Alt text: Genitourinary Foreign Bodies. NEW. Learning Session/Reference
December 11, 2025 at 6:41 PM
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UPDATE: A 20-year-old woman presents with lower abdominal pain waking her from sleep and radiating into her right lower back. She feels her lower abdomen is swollen and she is finding it difficult to urinate. (1/2)
RCEMLearning logo in white. A picture of a lady with abdominal pain. Alt text: Acute Abdominal Pain. SBA. UPDATE.
December 10, 2025 at 12:00 PM
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UPDATE: '"Doctor to cubicle 5 for c-spine assessment please," you hear over the tannoy. Unfortunately, you're the only doctor around, and so, with a heavy heart, you pop to cubicle five, and try to think how you can assess the patient's c-spine.'
RCEMLearning logo in white. A drawing of skeleton. Alt text: C-Spine, Induction, UPDATE
December 9, 2025 at 3:30 PM
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UPDATE: A 29-year-old woman is referred to your Emergency Department (ED) from the local Mental Health team for medical clearance prior to further treatment. She had attended them on two occasions with a six-week history of agitation, anxiety, intermittently slurred speech [CONT]
RCEMLearning logo in white. A picture of a medical practitioner holding an older person hand. Alt text: Never Make Diagnostic Assumptions! UPDATE. Clinical Case
December 8, 2025 at 4:01 PM
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First #SundayQuestion of December!

Which of the following options is the most likely diagnosis?
A 67-year-old man presents to the Emergency Department (ED) with a painful swollen left knee. He looks systemically unwell, cannot actively move his left knee and does not allow any passive movement either. There is no history of trauma. Observations: Oxygen Saturations 90% on room air Respiratory rate 24 breaths per minute Heart rate 128 beats per minute Blood pressure 92/60 mmHg Temperature 39 degrees Celsius He is usually independent. He has a background of diabetes, gout and chronic obstructive pulmonary disease (COPD). Which of the following options is the most likely diagnosis? a). Fracture b). Osteoarthritis c). Rheumatoid arthritis d). Sepsis
December 7, 2025 at 4:00 PM
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Have you tried our latest Curriculum Cup - Gastroenterology and Hepatology?

The current high score is 86.67%! Can you beat this score?

www.rcemlearning.co....
December 6, 2025 at 12:30 PM
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NEW: A 32-year-old man presents to emergency department (ED) after being found to have elevated blood pressure during a military fitness assessment. He has no significant past medical or surgical history, takes no medications, and does not smoke or drink alcohol.
RCEMLearning logo in white. A Chest X-ray reveals figure 3 sign and rib notching. Alt text: NEW, A Persistent Hypertensive Colonel. Clinical Case.
December 5, 2025 at 4:30 PM
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UPDATE: Whilst Vaccination programmes have resulted in a reduction in the occurrence of many childhood illnesses, Emergency Clinicians should still be aware of common childhood exanthems, as well as newer types such as Gianotti-Crosti Syndrome.
RCEMLearning logo in white. A picture of a child with a red rash sitting outside. Alt text: Common Childhood Exanthems. Learning Session/Reference.
December 4, 2025 at 4:00 PM
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NEW: It's #SBA day

A 68-year-old man with a prior history of MI is pre-alerted to hospital as having had a pre-syncopal episode with an abnormal ECG.

What should be the initial first steps?

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RCEMLearning logo in white. A person holding their chest looking down. An Electrical Storm. SBA. NEW
December 3, 2025 at 5:00 PM
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UPDATE: ECGs can be challenging, right? And so can children. Add the two together and……..arrghh - Paediatric ECGs!! Don't worry, we got you covered in our updated #blog

www.rcemlearning.co....
RCEMLearning logo in white. A close up picture of ECG. Alt text: Do away with the Heartache – ECGs in Children. Blog. UPDATE
December 2, 2025 at 5:01 PM
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NEW: A male presents with a large bulge to his bicep area after going to punch and then missing a punch bag in an arcade. Why does he now have such a big bicep? #ClinicalCase

www.rcemlearning.co....
NEW. A picture of a young man with a bulging bicep. The Case of the Bulging Bicep. Clinical Case. RCEMLearning logo in white.
December 1, 2025 at 2:42 PM
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The last SUNDAY QUESTION of the month!

What is the correct answer?
A 34-year-old female presented to the emergency department (ED) with a 3-day history of left ear pain, without discharge or tinnitus. Over the last 24 hours this had progressed to a severe generalised headache with a high fever. On examination, she appeared unwell, septic and drowsy. She was tachycardic and febrile. Observations were as follows: HR 110, BP 98/50, RR 24, Sats 98% on air, GCS 14 (E3, V5, M6), Temp 39.3 degrees centigrade Heart sounds were normal and the chest was clear to auscultation. Abdomen was soft. She had no mastoid tenderness or meninigism. Neurological examination was normal. Which one of the following will be least helpful in the initial clinical assessment of this patient? a). Travel history b). Mental state examination c). ENT examination d). Collateral history
November 30, 2025 at 4:00 PM
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UPDATE: A 60-year-old man presented to the emergency department with a 1 week history of increasing lethargy, intermittent tingling in both arms and palpitations

Check out our updated #ClinicalCase here: www.rcemlearning.co....
RCEMLearning logo in white. A bunch of bananas in the aisle. Alt text: Hyperkalemia. Clinical Case. UPDATE.
November 29, 2025 at 9:30 AM
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It's time!!

We've released our latest #CurriculumCup - Gastroenterology and Hepatology

Can you reach the top of our leader board? Give it a try here: www.rcemlearning.co....
RCEMLearning logo in white. A picture of a generated image of a person's organs. Alt text: Curriculum Cup: Gastroenterology and Hepatology. NEW.
November 28, 2025 at 4:46 PM
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NEW: A female patient in her 50s’ presents to the Emergency Department (ED) at 8:00am following ingestion of tea brewed with yew tree leaves at approximately 3:30am. Her partner found her at 7:20am drowsy but rousable

Check out our latest #ClinicalCase www.rcemlearning.co....
RCEMLearning logo in white. A ECG showing Monomorphic VT. Alt Text: Brewing Trouble. Clinical Case. NEW
November 27, 2025 at 1:15 PM
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NEW: A 75-year-old male patient is brought in by an ambulance with 3 episodes of frank hematemesis, total volume around 500ml. He is on Rivaroxaban and Bisoprolol for Atrial Fibrillation and last took his tablets 4 hours ago #SBA

www.rcemlearning.co....
RCEMLearning logo in white. A traditionally painted picture of a person holding another person vomiting blood. Alt text: Haemetemesis in Anticoagulated Patient. SBA. NEW
November 26, 2025 at 7:41 PM
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UPDATE: For Addiction Awareness Week (24th - 30th November), we revisit our #blog. Stories can help us understand patients, ourselves and colleagues better, and so be better emergency physicians

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RCEMLearning logo in white. A picture of a police care and police tape. Alt text: Anecdote-based Emergency Medicine #1: excited delirium. Blog. UPDATE.
November 25, 2025 at 4:19 PM
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"A failure to act means more people will be left to grieve the loss of a loved one."

The deaths of more than 900 people in Wales were associated with long waits in A&E last year, new analysis from the Royal College of Emergency Medicine reveals.

Read more here:
'A failure to act means more people will be left to grieve the loss of a loved one’ - Over 900 excess deaths associated with long A&E waits in Wales last year - RCEM
25/11/25 - It comes as RCEM publishes it's political manifesto ahead of next year's election in Wales.
rcem.ac.uk
November 25, 2025 at 7:11 AM
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UPDATE: An 18-year-old male is brought to the emergency department (ED) by his mother complaining of a 1-week history of worsening weakness of both lower limbs, a tingling sensation in both hands and an unsteady gait.

Read our updated #ClinicalCase here: www.rcemlearning.co....
RCEMLearning logo in white. A picture of a grey rabbit in grass and a yellow circle with a V inside. Alt text: LOL, it’s not funny! Clinical Case. UPDATE.
November 24, 2025 at 4:00 PM
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SUNDAY QUESTION: Taken from our module "Picking your brain (or blood) cells …"

What is the correct answer?
A 30-year-old gentleman with a history of Glucose-6-phosphate dehydrogenase (G6PD) deficiency presents with significant abdominal pain, indigestion and nausea. His pain is worse after eating fatty or spicy meals. He admits to a recent alcohol binge and says that he drinks at least four strong coffees per day. He has also been taking ibuprofen regularly for neck pain. The patient has no other medical illnesses and is not known to have any allergies. He is a heavy smoker and is of average build. Which of the following drugs should generally be avoided in G6PD deficiency? a). Ibuprofen b). Omeprazole c). Primaquine d). Codeine
November 23, 2025 at 4:00 PM
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UPDATE: Has being overwhelmed with tasks become “the norm"?

What are your thoughts? #blog

www.rcemlearning.co....
RCEMLearning logo in white. A birds eye picture of winding motorway. Alt Text: Is Normalisation of Deviance the “Standard” in Medicine? Blog
November 22, 2025 at 4:34 PM
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NEW: A 46-year-old male self-presents to the Emergency Department (ED) with 3 months refractory headache, subacute forehead swelling (unknown duration) with acute periorbital oedema

What is the most appropriate first line of investigation? #ClinicalCase

www.rcemlearning.co....
RCEMLearning logo in white. A picture of a head xray. Alt text: An Abnormal Forehead Swelling. NEW. Clinical Case
November 21, 2025 at 7:45 PM