The Medical Joyworks Monthly


Connect to MJ's thriving community

Issue #6 (March 2020)


The latest from MJ

  • Since October 2019, we've been diligently updating all our Clinical Sense and Prognosis content. The process has consisted of carefully revising every single scenario and case to ensure that they are up to date. When something does not stand up to the latest medical knowledge, it is removed from public viewing, and sent back to the content team for a thorough rewrite. Naturally, this takes time. And with over 600 stories in our directory, some scenarios and cases may not be available for a while.
  • Given the intense workload described above, the content team is keen for new Medical Contributors to join us! If you have more than a year of clinical experience, a flair for writing, and like a good challenge, send a note to Ms. Poornima Perera at Include your CV and 500 word sample of your writing. Please note, we will only consider applicants with a CEFR level C2 in English, and proof of language proficiency may be required.
  • That's it for now. Remember to check out the jobs page on our website for the latest vacancies available. If something catches your interest, simply follow the instructions provided in the job posting. For details, visit


Q&As from our user community

Clinical Sense: Infected (Varicella-updated)

Q: Why not start acyclovir for this child with varicella?
A: There is some evidence to suggest that in immunocompetent children, starting acyclovir within 24 hours of the onset of the rash may reduce the duration of fever. However, there is insufficient evidence to conclude whether the number of lesions is reduced as well.

Given the limited evidence, and as the child in this scenario has relatively mild symptoms, it's perhaps better not to burden her family with the additional cost of anti-viral drugs. For more details, please see:
If you would like to play this scenario or join the conversation, go to the Clinical Sense app in your mobile device.

Prognosis: Your Diagnosis: Closed (Renal artery stenosis)

Q: This patient has renal artery stenosis (RAS). Isn't it risky to recommend ACE inhibitors, as they can precipitate acute kidney injury (AKI)?
A: There is a common misconception that ACE inhibitors are absolutely contraindicated in RAS. In fact, they are the first-line anti-hypertensive therapy in most such patients. There is a risk that AKI or pulmonary edema may be precipitated, but this is mainly in patients with bilateral RAS. Such individuals should receive close monitoring.

Please see the following recent consensus document on the diagnosis and management of RAS secondary to fibromuscular dysplasia:
If you would like to play this scenario or join the conversation, go to the Prognosis: Your Diagnosis app in your mobile device.


Recently released stories

Clinical Sense

Unexpected (Updated)
Pained (Updated)
More pain (Updated)
Acidotic (Updated)
That's all for now!

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