In this episode, Edward Foo discusses spontaneous bleeding presentations and their identification and management with Dr Andrew Page. Dr Andrew Page is a Consultant Haematologist with a special interest in bleeding and thrombotic disorders at the Royal Infirmary of Edinburgh, and Director of the Edinburgh Haemophilia Centre. Before training as a medic, he worked in basic scientific research in the field of genetics. This continues to inform his clinical interests, and Dr Page is also the Clinical Lead of the Scottish Bleeding and Platelet Disorders Genetic Diagnostic Service. Edward Foo is a medical student at the University of Edinburgh and Student Observer of the RCPE Trainees and Members' Committee (T&MC). --- Notes for the listener --- At c. 10.55, Dr Page discusses European licensing for gene therapy in haemophilia B. The situation has changed since recording (13/12/2022), and gene therapy in haemophilia B now has conditional authorisation in Europe: https://www.ema.europa.eu/en/news/first-gene-therapy-treat-haemophilia-b At c. 24.23, Dr Page discusses reversal of warfarin. Dr Page mentions Beriplex, which is the brand of prothrombin complex concentrate (PCC) used in NHS Lothian, where Dr Page works. However, it should be noted that other brands are available and Beriplex is just being given as an example. Other brands can be found in the BNF: https://bnf.nice.org.uk/drugs/dried-prothrombin-complex/medicinal-forms/ --- Link --- The ISTH Bleeding Assessment Tool is available from: https://www.isth.org/page/reference_tools Recording date: 13 December 2022 -- Follow us -- https://www.instagram.com/rcpedintrainees https://twitter.com/RCPEdinTrainees -- Upcoming RCPE Events -- https://events.rcpe.ac.uk/ Feedback: [email protected]