Clinical Reference Centre

Condition2 min read

Achalasia: Diagnosis and Treatment Selection

Achalasia is impaired lower oesophageal sphincter relaxation and absent or abnormal peristalsis.

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Laboratory Test3 min read

Activated Partial Thromboplastin Time: Interpretation and Investigation

A clinical guide to prolonged APTT, heparin, factor deficiency, lupus anticoagulant and mixing studies.

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Condition2 min read

Acute Asthma: Severity Assessment and Emergency Escalation

Acute asthma severity depends on symptoms, respiratory rate, pulse, oxygen saturation, peak flow, speech, exhaustion and response to initial therapy.

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Clinical Reference2 min read

Acute Chest Syndrome in Sickle Cell Disease

Recognise new pulmonary infiltrate with respiratory symptoms, give oxygen when hypoxaemic, antibiotics, analgesia and consider transfusion escalation.

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Condition2 min read

Acute Cholecystitis: Diagnosis and Early Surgery

Acute cholecystitis causes persistent right-upper-quadrant pain, inflammation and gallbladder wall changes.

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Condition2 min read

Acute Coronary Syndrome: Recognition and Immediate Assessment

Acute coronary syndrome includes ST-elevation myocardial infarction, non-ST-elevation myocardial infarction and unstable angina. Early assessment combines symptoms, serial ECGs, high-sensitivity troponin and haemodynamic stability.

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Condition2 min read

Acute Exacerbation of Fibrotic Lung Disease

Acute exacerbation is rapid respiratory deterioration with new bilateral alveolar abnormality not fully explained by fluid overload or another cause.

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Condition2 min read

Acute Heart Failure: Congestion, Oxygenation and Early Management

Acute heart failure presents with rapid onset or worsening congestion, hypoperfusion or both. Identify precipitating causes such as ACS, arrhythmia, infection, uncontrolled hypertension or medication interruption.

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Condition3 min read

Acute Kidney Injury: Recognition, Staging and Immediate Management

An updated reference to AKI recognition, staging, causes, medicines, obstruction, complications and follow-up.

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Clinical Reference2 min read

Acute Leukaemia: Recognition and Referral

Recognise cytopenias, blasts, bleeding, infection, organ infiltration and tumour lysis risk, and arrange urgent haematology assessment.

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Condition2 min read

Acute Liver Failure: Recognition and Initial Priorities

Acute liver failure is severe acute liver injury with coagulopathy and encephalopathy in a patient without established cirrhosis. It can deteriorate rapidly.

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Condition2 min read

Acute Liver Failure: Recognition, Aetiology and Transplant Referral

Acute liver failure is acute liver injury with coagulopathy and encephalopathy in a patient without established cirrhosis.

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Condition2 min read

Acute Pancreatitis: Diagnosis, Severity and Early Management

Acute pancreatitis is diagnosed using compatible pain, elevated pancreatic enzymes and/or imaging. Gallstones and alcohol are common causes.

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Condition2 min read

Acute Pericarditis: Diagnosis, Risk Features and Treatment

Acute pericarditis commonly presents with pleuritic positional pain, pericardial rub, ECG change or effusion. Diagnosis requires clinical criteria and exclusion of important alternatives.

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Condition2 min read

Acute Respiratory Acidosis: Ventilatory Failure and Escalation

Acute respiratory acidosis reflects carbon dioxide retention from inadequate alveolar ventilation. Falling pH, rising carbon dioxide and fatigue signal worsening ventilatory failure.

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Condition2 min read

Acute Respiratory Distress Syndrome: Recognition and Severity

ARDS is acute inflammatory lung injury with bilateral pulmonary opacities and hypoxaemia not fully explained by cardiac failure or fluid overload. Severity is commonly classified using oxygenation impairment…

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Condition2 min read

Acute Respiratory Failure: Recognition and Initial Management

Acute respiratory failure is failure of oxygenation, ventilation or both. Initial management should use an ABCDE approach while identifying reversible causes and the need for advanced respiratory support.

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Condition2 min read

Acute Severe Asthma: Assessment and Escalation

Acute asthma severity is determined by symptoms, objective airflow limitation, oxygenation, vital signs and response to initial treatment. A normal or rising carbon dioxide in a tiring patient…

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Condition2 min read

Adrenal Crisis: Emergency Recognition and Treatment

Adrenal crisis is a life-threatening endocrine emergency causing hypotension, electrolyte disturbance, hypoglycaemia and shock.

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Condition2 min read

Adrenal Insufficiency: Diagnosis and Long-Term Management

Adrenal insufficiency may be primary, secondary or tertiary and can present with fatigue, weight loss, hypotension, hyponatraemia or hypoglycaemia.

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Clinical Reference2 min read

Anaemia: Structured Diagnostic Assessment

Classify anaemia by haemoglobin, MCV, reticulocyte response and clinical context, then investigate blood loss, deficiency, inflammation, haemolysis and marrow disease.

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Laboratory Test10 min read

Anion Gap: Calculation, Interpretation and Clinical Use

A detailed clinical reference to anion gap calculation, albumin correction, differential diagnosis, mixed acid-base disorders and practical pitfalls.

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Condition2 min read

Aortic Regurgitation: Severity, Ventricular Response and Follow-Up

Aortic regurgitation assessment combines valve anatomy, regurgitant severity, left ventricular size and function, aortic dimensions and symptoms.

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Condition2 min read

Aortic Stenosis: Severity, Symptoms and Referral

Aortic stenosis severity is assessed using valve velocity, mean gradient, valve area, flow state and left ventricular response. Symptoms or ventricular dysfunction materially change prognosis.

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Clinical Measurement3 min read

Arterial Blood Gas Interpretation: A Structured Clinical Approach

A stepwise guide to pH, carbon dioxide, bicarbonate, oxygenation, compensation, mixed disorders and sampling pitfalls.

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Condition2 min read

Ascites in Cirrhosis: Diagnosis and Management

New or worsening ascites requires diagnostic paracentesis to assess infection and cause.

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Condition2 min read

Asthma: Diagnosis, Objective Testing and Monitoring

Asthma diagnosis should be based on a compatible history plus objective evidence of variable expiratory airflow limitation or airway inflammation. Symptoms alone are not sufficiently specific.

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Clinical Management2 min read

Asthma: Long-Term Management and Risk Reduction

Long-term asthma care aims to control symptoms, prevent attacks, preserve lung function and minimise treatment burden. Inhaled corticosteroid-containing therapy is central.

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Condition2 min read

Atrial Fibrillation: Diagnosis and Initial Clinical Assessment

Atrial fibrillation requires ECG confirmation. Initial assessment should define symptom burden, ventricular rate, haemodynamic stability, duration, reversible triggers and stroke risk.

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Clinical Management2 min read

Atrial Fibrillation: Rate-Control Strategy

Rate control can improve symptoms and prevent tachycardia-mediated cardiomyopathy. Choice of agent depends on ventricular function, blood pressure, activity level and comorbidity.

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Clinical Management2 min read

Atrial Fibrillation: Rhythm-Control Strategy and Cardioversion

Rhythm control includes cardioversion, antiarrhythmic medication and catheter ablation. It may improve symptoms and outcomes in selected patients, particularly when instituted early.

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Clinical Management2 min read

Atrial Fibrillation: Stroke Prevention and Anticoagulation

Stroke prevention is central to atrial fibrillation care. Use a validated stroke-risk assessment and identify modifiable bleeding risks without using bleeding scores to deny appropriate anticoagulation.

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Condition2 min read

Autoimmune Hepatitis: Diagnosis and Immunosuppressive Management

Autoimmune hepatitis is immune-mediated liver inflammation diagnosed using biochemistry, immunology, histology and exclusion of alternatives.

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Laboratory Test2 min read

Base Excess: Interpretation in Acid-Base Disorders

Base excess estimates the metabolic component of an acid-base disturbance under standardised conditions. A negative value suggests a metabolic acidifying effect; a positive value suggests a metabolic alkalinising…

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Laboratory Test3 min read

Bilirubin: Conjugated and Unconjugated Hyperbilirubinaemia

A clinical guide to bilirubin metabolism, haemolysis, Gilbert syndrome, cholestasis and urgent jaundice assessment.

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Clinical Management2 min read

Biologic and Advanced Therapy in Inflammatory Bowel Disease

Advanced IBD therapy includes biologic agents and small molecules with different efficacy, safety and monitoring profiles.

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Laboratory Test3 min read

Blood Lactate: Interpretation, Causes and Serial Monitoring

A clinical reference to lactate production, impaired clearance, sepsis, medicines, sampling and serial interpretation.

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Laboratory Test3 min read

BNP and NT-proBNP: Interpretation in Suspected Heart Failure

A guide to natriuretic peptides, heart failure referral thresholds, confounders and clinical limitations.

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Condition2 min read

Bradycardia: Recognition, Reversible Causes and Pacing

Bradycardia becomes an emergency when associated with shock, syncope, myocardial ischaemia or severe heart failure. Assess rhythm, symptoms and reversible causes.

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Condition2 min read

Bronchiectasis Exacerbation: Sputum, Antibiotics and Escalation

Bronchiectasis exacerbations involve worsening cough, sputum, breathlessness or systemic symptoms. Obtain sputum before antibiotics when possible and use prior microbiology.

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Condition2 min read

Bronchiectasis: Diagnosis, Aetiology and Baseline Assessment

Bronchiectasis is permanent bronchial dilatation associated with chronic infection, inflammation and impaired clearance. Diagnosis requires CT confirmation in the right clinical context.

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Clinical Management2 min read

Bronchiectasis: Long-Term Management and Exacerbation Prevention

Long-term management aims to reduce exacerbations, preserve lung function and improve symptoms. Airway clearance, microbiology-directed treatment and management of underlying cause are central.

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Laboratory Test3 min read

C-Reactive Protein: Interpretation, Kinetics and Clinical Use

A practical reference to CRP kinetics, infection, inflammation, serial trends and limitations.

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Clinical Reference2 min read

Cancer-Associated Thrombosis

Balance recurrent thrombosis, tumour site, bleeding risk, interactions and patient preference when selecting and reviewing anticoagulation.

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Condition2 min read

Carbon Monoxide Poisoning: Recognition and Management

Carbon monoxide poisoning causes tissue hypoxia and cellular toxicity. Symptoms are non-specific and pulse oximetry may appear normal.

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Condition2 min read

Cardiac Tamponade: Recognition and Emergency Management

Cardiac tamponade is haemodynamic compromise from pericardial pressure restricting cardiac filling. Clinical severity depends on rate of accumulation as well as volume.

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Laboratory Test8 min read

Cardiac Troponin: Clinical Interpretation and Diagnostic Pathways

A comprehensive reference to high-sensitivity cardiac troponin, myocardial injury, infarction, serial change, non-ischaemic causes and clinical pitfalls.

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Condition2 min read

Cardiogenic Shock: Recognition and Initial Management

Cardiogenic shock is critical reduction in cardiac output causing tissue hypoperfusion. Causes include acute myocardial infarction, mechanical complications, myocarditis, severe valve disease and decompensated cardiomyopathy.

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