Clinical Reference Centre

Clinical Reference2 min read

Direct Oral Anticoagulant Management

Select and dose DOACs using indication, renal function, weight, age and interactions, with planned interruption and reversal strategies.

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Clinical Reference2 min read

Disseminated Intravascular Coagulation

Identify systemic coagulation activation using clinical context, platelets, PT, fibrinogen and D-dimer, while treating the underlying cause.

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Condition2 min read

Distributive Shock: Vasodilation, Sepsis and Anaphylaxis

Distributive shock features pathological vasodilation and maldistribution of blood flow. Sepsis is common, but anaphylaxis, neurogenic shock and endocrine crises must be considered.

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Condition2 min read

Diverticular Disease and Acute Diverticulitis

Diverticular disease may cause chronic symptoms, inflammation, abscess, perforation, fistula or bleeding.

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Condition2 min read

Drug-Induced Liver Injury: Pattern, Causality and Management

Drug-induced liver injury may be hepatocellular, cholestatic or mixed and ranges from asymptomatic tests to acute liver failure.

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Clinical Management2 min read

Dual Antiplatelet Therapy: Duration, Bleeding Risk and Review

Dual antiplatelet therapy commonly combines aspirin with a P2Y12 inhibitor after ACS or PCI. Duration depends on presentation, stent strategy, ischaemic risk, bleeding risk and need for oral…

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Condition2 min read

Dyspepsia: Assessment, H. pylori Testing and Referral

Dyspepsia includes upper abdominal pain, early satiety, postprandial fullness and related symptoms. Initial assessment should identify alarm features, medicine causes and the need for endoscopy.

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Clinical Reference2 min read

Early Breast Cancer: Adjuvant Treatment

Use tumour biology, stage, genomic risk where validated, menopausal status and patient preference to select systemic and local treatment.

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Clinical Reference2 min read

Early Pregnancy Bleeding

Early Pregnancy Bleeding requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current obstetrics & gynaecology guidance. Interpret…

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Clinical Reference2 min read

Eclampsia

Eclampsia requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current obstetrics & gynaecology guidance. Interpret symptoms, examination…

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Clinical Reference2 min read

Ectopic Pregnancy

Ectopic Pregnancy requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current obstetrics & gynaecology guidance. Interpret symptoms,…

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Condition2 min read

Eosinophilic Oesophagitis: Diagnosis and Treatment

Eosinophilic oesophagitis is chronic immune-mediated oesophageal inflammation causing dysphagia and food bolus obstruction.

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Laboratory Test9 min read

Estimated Glomerular Filtration Rate (eGFR): Interpretation and Clinical Use

A comprehensive guide to eGFR equations, CKD classification, albuminuria, limitations, drug dosing and longitudinal interpretation.

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Condition2 min read

Faecal Impaction: Recognition and Treatment

Faecal impaction is retained hardened stool causing pain, overflow diarrhoea, urinary symptoms or bowel obstruction.

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Clinical Reference2 min read

Febrile Neutropenia

Begin prompt empirical antimicrobial treatment after cultures when feasible, assess severity and source, and follow the local neutropenic sepsis pathway.

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Clinical Reference2 min read

Febrile Seizures

Febrile Seizures requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current paediatrics guidance. Interpret symptoms, examination findings,…

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Clinical Reference2 min read

Fetal Growth Restriction

Fetal Growth Restriction requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current obstetrics & gynaecology guidance. Interpret…

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Clinical Reference2 min read

Fever in Infants Under 3 Months

Fever in Infants Under 3 Months requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current paediatrics guidance.…

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Clinical Reference2 min read

Fibromyalgia

Make a positive diagnosis of widespread pain with fatigue, sleep and cognitive symptoms and use education, exercise and tailored psychological or pharmacological support.

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Clinical Management2 min read

Fitness Assessment Before Curative-Intent Lung Cancer Treatment

Fitness assessment estimates peri-treatment risk and projected pulmonary reserve before surgery, radiotherapy or multimodal treatment.

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Clinical Reference2 min read

Folate Deficiency

Confirm folate deficiency, review nutrition, alcohol, pregnancy, medicines and malabsorption, and exclude concomitant vitamin B12 deficiency.

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Condition2 min read

Food Bolus Obstruction: Emergency Endoscopic Management

Food bolus obstruction can compromise secretion handling and may reflect eosinophilic oesophagitis, stricture or malignancy.

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Clinical Reference2 min read

G6PD Deficiency

Recognise oxidant-triggered haemolysis, interpret testing outside the acute reticulocytosis phase and provide medicine and food avoidance advice.

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Condition2 min read

Gallstone Disease: Diagnosis and Management

Gallstones may cause biliary colic, cholecystitis, pancreatitis or common bile duct obstruction.

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Condition2 min read

Gallstone Pancreatitis: Biliary Assessment and Definitive Treatment

Gallstone pancreatitis requires severity assessment and evaluation for persistent biliary obstruction or cholangitis.

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Condition2 min read

Gastro-Oesophageal Reflux Disease: Diagnosis and Long-Term Management

GORD is reflux of gastric contents causing troublesome symptoms or complications. Typical symptoms can often be managed clinically, while atypical or alarm features require investigation.

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Condition2 min read

Gastrointestinal Bleeding During Anticoagulant Therapy

GI bleeding during anticoagulation requires simultaneous haemorrhage control and thromboembolic-risk assessment.

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Condition2 min read

Gastrointestinal Perforation: Recognition and Emergency Management

Gastrointestinal perforation causes contamination, peritonitis and sepsis.

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Condition2 min read

Gestational Diabetes: Diagnosis and Management

Gestational diabetes is hyperglycaemia first recognised during pregnancy that does not meet criteria for overt diabetes.

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Clinical Reference2 min read

Gestational Hypertension

Gestational Hypertension requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current obstetrics & gynaecology guidance. Interpret symptoms,…

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Clinical Reference2 min read

Gestational Trophoblastic Disease

Gestational Trophoblastic Disease requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current obstetrics & gynaecology guidance. Interpret…

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Clinical Reference2 min read

Giant Cell Arteritis

Treat immediately when suspected to prevent visual loss and arrange urgent vascular imaging or temporal-artery assessment.

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Condition2 min read

Glucocorticoid-Induced Adrenal Insufficiency

Exogenous glucocorticoids can suppress the hypothalamic-pituitary-adrenal axis.

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Clinical Reference2 min read

Gout: Diagnosis and Flare Treatment

Use crystal confirmation when possible, treat acute inflammation promptly and address medicines and comorbidity.

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Clinical Reference2 min read

Gout: Urate-Lowering Therapy

Offer treat-to-target urate lowering with prophylaxis, adherence support and dose titration, including in chronic kidney disease.

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Clinical Reference2 min read

Gram-Negative Bloodstream Infection

Identify source and resistance risk, achieve source control and use susceptibility-guided treatment with appropriate duration.

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Clinical Reference2 min read

Haemolytic Anaemia

Identify haemolysis using reticulocytes, bilirubin, LDH, haptoglobin and blood film, then distinguish immune, membrane, enzyme and mechanical causes.

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Condition2 min read

Haemoptysis: Severity Assessment and Investigation

Haemoptysis ranges from blood-streaked sputum to life-threatening airway bleeding. Severity is determined by physiological effect and airway risk rather than volume alone.

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Condition2 min read

Heart Failure With Preserved Ejection Fraction: Diagnosis and Management

HFpEF diagnosis requires evidence of elevated filling pressures or structural heart disease in the setting of compatible symptoms and preserved ejection fraction. Obesity, atrial fibrillation, hypertension and kidney…

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Condition2 min read

Heart Failure With Reduced Ejection Fraction: Guideline-Directed Therapy

HFrEF management combines disease-modifying drug classes, diuretics for congestion, device assessment, rehabilitation and treatment of aetiology and comorbidity.

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Condition2 min read

Heart Failure: Diagnostic Assessment and Phenotyping

Heart failure is a clinical syndrome caused by structural or functional cardiac abnormality. Diagnosis combines symptoms, signs, natriuretic peptides, ECG and cardiac imaging.

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Condition2 min read

Heart Valve Disease: Murmur Assessment and Referral

Heart valve disease should be suspected from symptoms, murmur characteristics, ECG or imaging abnormalities. Echocardiography defines anatomy, severity and ventricular response.

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Condition2 min read

Helicobacter pylori: Testing, Eradication and Confirmation

H. pylori causes chronic gastritis and contributes to peptic ulcer disease and gastric cancer risk. Testing should use an appropriate non-invasive or invasive method.

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Clinical Reference2 min read

Henoch-Schönlein Purpura

Henoch-Schönlein Purpura requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current paediatrics guidance. Interpret symptoms, examination findings,…

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Clinical Reference2 min read

Heparin-Induced Thrombocytopenia

Use pre-test probability before laboratory testing, stop all heparin and start suitable non-heparin anticoagulation when HIT is likely.

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Condition2 min read

Hepatic Encephalopathy: Recognition and Precipitant Management

Hepatic encephalopathy is brain dysfunction from liver insufficiency or portosystemic shunting.

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Clinical Reference2 min read

Hepatitis B Reactivation During Immunosuppression

Screen before immunosuppression and provide antiviral prophylaxis or monitoring according to serology and regimen risk.

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Clinical Management2 min read

Hepatocellular Carcinoma Surveillance in Chronic Liver Disease

HCC surveillance aims to detect cancer at a stage suitable for curative treatment.

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