Clinical Reference Centre

Condition2 min read

Non-ST-Elevation Acute Coronary Syndrome: Risk Stratification and Management

NSTE-ACS requires integration of symptoms, ECG, serial high-sensitivity troponin and validated risk assessment. Management balances ischaemic risk, bleeding risk, coronary anatomy and comorbidity.

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Clinical Management2 min read

NSAID Gastroprotection and Ulcer Risk

NSAIDs increase peptic ulcer and bleeding risk, particularly with age, prior ulcer, anticoagulation, corticosteroids and comorbidity.

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Condition2 min read

Obesity Hypoventilation Syndrome: Diagnosis and Ventilatory Support

Obesity hypoventilation syndrome combines obesity, sleep-disordered breathing and awake hypercapnia after exclusion of other causes.

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Condition2 min read

Obstructive Shock: Pulmonary Embolism, Tamponade and Tension Pneumothorax

Obstructive shock occurs when a mechanical barrier limits cardiac filling or output. Time-critical causes include massive pulmonary embolism, cardiac tamponade and tension pneumothorax.

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Condition2 min read

Obstructive Sleep Apnoea: Assessment, Diagnosis and Treatment

Obstructive sleep apnoea causes recurrent upper-airway obstruction during sleep, sleep fragmentation and intermittent hypoxaemia.

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Condition2 min read

Oesophageal Dysphagia: Structured Investigation

Oesophageal dysphagia may result from cancer, stricture, eosinophilic oesophagitis or motility disease.

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Condition2 min read

Oesophagogastric Cancer: Recognition and Referral

Oesophageal and gastric cancers may present with dysphagia, weight loss, anaemia, vomiting or persistent dyspepsia.

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Laboratory Test3 min read

Osmolar Gap: Calculation, Toxic Alcohols and Clinical Limitations

A practical guide to the osmolar gap, toxic alcohol exposure, ketoacidosis, timing effects and limitations.

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Clinical Intervention2 min read

Oxygen Delivery Devices: Selection and Monitoring

Oxygen devices differ in achievable concentration, flow characteristics, entrainment and patient tolerance. Device choice should match the target saturation, minute ventilation, inspiratory demand and risk of carbon dioxide…

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Clinical Intervention2 min read

Oxygen Therapy in Acutely Ill Adults

Oxygen is a treatment for hypoxaemia rather than breathlessness alone. Prescribe a target saturation range, select an appropriate device, reassess promptly and identify patients at risk of hypercapnic…

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Condition2 min read

Pancreatic Exocrine Insufficiency: Diagnosis and Enzyme Replacement

Pancreatic exocrine insufficiency causes maldigestion, weight loss and fat-soluble vitamin deficiency.

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Condition2 min read

Paracetamol Overdose: Assessment and Antidote Pathway

Paracetamol overdose can cause delayed hepatic failure despite an initially well appearance. Establish timing, formulation, dose, staggered ingestion, risk factors and co-ingestants.

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Condition2 min read

Peptic Ulcer Disease: Causes, Complications and Management

Peptic ulcer disease is most often associated with H. pylori or NSAID exposure. Complications include bleeding, perforation and gastric outlet obstruction.

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Laboratory Test3 min read

Platelet Count: Thrombocytopenia and Thrombocytosis

A clinical guide to platelet count abnormalities, pseudothrombocytopenia, bleeding risk and urgent causes.

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Condition2 min read

Pleural Effusion: Diagnostic Assessment and Thoracentesis Strategy

Pleural effusion evaluation integrates symptoms, ultrasound, fluid appearance, biochemistry, microbiology and cytology.

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Condition2 min read

Pleural Infection: Recognition, Drainage and Escalation

Pleural infection ranges from uncomplicated parapneumonic effusion to empyema. Fluid pH, microbiology, imaging and clinical progress guide drainage decisions.

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Condition2 min read

Portal Hypertension: Non-Invasive Assessment and Management

Portal hypertension causes varices, ascites, splenomegaly and decompensation.

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Clinical Management2 min read

Postpartum Follow-Up After Gestational Diabetes

Previous gestational diabetes confers substantial future type 2 diabetes risk.

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Condition2 min read

Primary Aldosteronism: Screening, Confirmation and Subtyping

Primary aldosteronism is autonomous aldosterone production causing hypertension with suppressed renin and variable hypokalaemia.

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Condition2 min read

Primary Hypothyroidism: Diagnosis and Levothyroxine Management

Primary hypothyroidism is diagnosed using elevated TSH with low free T4, interpreted with symptoms and context.

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Laboratory Test3 min read

Procalcitonin: Interpretation and Antimicrobial Stewardship

A balanced guide to procalcitonin in bacterial infection, respiratory illness, critical care and antimicrobial stewardship.

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Laboratory Test3 min read

Prothrombin Time and INR: Interpretation and Clinical Use

A guide to PT, INR, warfarin monitoring, liver disease, vitamin K deficiency and urgent bleeding assessment.

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Condition2 min read

Pulmonary Embolism: Clinical Probability and Diagnostic Pathways

Assessment of suspected pulmonary embolism combines clinical probability, D-dimer in suitable patients and definitive imaging. Probability assessment should precede biomarker testing.

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Condition2 min read

Pulmonary Hypertension: Recognition, Classification and Referral

Pulmonary hypertension is elevated pulmonary arterial pressure arising from several disease groups. Symptoms are non-specific and diagnosis requires haemodynamic confirmation.

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Clinical Management2 min read

Pulmonary Rehabilitation: Referral, Components and Outcomes

Pulmonary rehabilitation combines exercise training, education and self-management support for people limited by chronic respiratory disease.

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Clinical Measurement8 min read

QTc Interval: Measurement, Correction and Clinical Risk

A comprehensive clinical reference to QT measurement, correction formulas, drug-related risk, torsades de pointes and practical management.

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Clinical Intervention2 min read

Renal Replacement Therapy in Acute Kidney Injury

Renal replacement therapy supports solute, acid-base and fluid control when kidney function is insufficient. Timing is driven by clinical indications rather than creatinine alone.

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Condition3 min read

Respiratory Acidosis: Acute and Chronic Hypercapnia

A clinical reference to hypercapnia, ventilatory failure, compensation, controlled oxygen and escalation.

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Condition3 min read

Respiratory Alkalosis: Causes, Compensation and Clinical Interpretation

A guide to hypocapnia from hypoxaemia, sepsis, pain, pregnancy, pulmonary embolism and central causes.

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Condition2 min read

Salicylate Toxicity: Acid-Base Patterns and Emergency Management

Salicylate poisoning commonly produces respiratory alkalosis, metabolic acidosis or a mixed disorder. Clinical severity can worsen despite a falling serum concentration if tissue distribution changes.

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Clinical Management2 min read

Secondary Prevention After Myocardial Infarction

Secondary prevention after myocardial infarction reduces recurrent ischaemic events, heart failure and premature death. It includes antiplatelet therapy, intensive lipid lowering, blood-pressure control, smoking cessation, cardiac rehabilitation and…

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Condition2 min read

Sepsis Recognition and Early Clinical Response

Sepsis is life-threatening organ dysfunction caused by a dysregulated response to infection. Recognition depends on clinical deterioration and organ dysfunction rather than a single score.

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Condition2 min read

Septic Shock: Haemodynamic Assessment and Escalation

Septic shock is a high-risk subset of sepsis with profound circulatory and metabolic abnormalities. Management requires rapid source control, appropriate antimicrobials, fluid assessment and vasopressor support when hypotension…

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Laboratory Test3 min read

Serum Albumin: Interpretation, Causes of Low Levels and Limitations

A guide to albumin synthesis, inflammation, renal and gastrointestinal loss, distribution and clinical limitations.

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Laboratory Test3 min read

Serum Magnesium: Interpretation, Deficiency and Replacement

A practical guide to magnesium deficiency, renal loss, arrhythmia risk, refractory hypokalaemia and safe replacement.

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Laboratory Test3 min read

Serum Osmolality: Measurement, Calculation and Clinical Interpretation

A clinical reference to measured and calculated osmolality, effective tonicity, glucose, urea and diagnostic use.

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Condition2 min read

Severe Asthma: Phenotyping, Biologic Therapy and Specialist Care

Severe asthma remains uncontrolled despite optimised high-intensity treatment or worsens when treatment is reduced. Confirm diagnosis and address modifiable factors before assigning this label.

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Condition2 min read

Shock Recognition: Perfusion, Phenotype and Immediate Priorities

Shock is inadequate tissue perfusion and may be hypovolaemic, distributive, cardiogenic, obstructive or mixed. Hypotension can be late, and normal blood pressure does not guarantee adequate perfusion.

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Clinical Measurement2 min read

Sleep Study Interpretation: AHI, Oxygenation and Clinical Context

Sleep studies quantify respiratory events, oxygenation, sleep time and sometimes carbon dioxide. The apnoea-hypopnoea index must be interpreted alongside symptoms and comorbidity.

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Clinical Measurement2 min read

Spirometry: Quality, Obstruction and Restriction

Spirometry measures expiratory volumes and flows. Interpretation requires acceptable, repeatable manoeuvres and comparison with appropriate reference equations.

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Condition2 min read

Spontaneous Bacterial Peritonitis: Diagnosis and Treatment

SBP is infection of ascitic fluid without a surgically treatable source and may present subtly.

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Condition2 min read

Spontaneous Pneumothorax: Assessment and Management

Pneumothorax management depends on symptoms, physiological compromise, underlying lung disease, size and patient preference.

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Condition2 min read

ST-Elevation Myocardial Infarction: Reperfusion and Early Management

STEMI is a time-critical coronary occlusion syndrome requiring immediate assessment for reperfusion. Primary PCI is preferred when it can be delivered within the recommended timeframe; fibrinolysis remains relevant…

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Condition2 min read

Stable Angina: Clinical Assessment and Antianginal Strategy

Stable angina is predictable chest discomfort or equivalent symptoms caused by myocardial ischaemia. Diagnosis depends on history, risk profile and appropriate cardiac testing.

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Condition2 min read

Subclinical Thyroid Disease: When to Treat and Monitor

Subclinical thyroid disease has abnormal TSH with thyroid hormones within the reference interval.

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Condition2 min read

Supraventricular Tachycardia: Acute Assessment and Management

Regular narrow-complex tachycardia is often AV nodal re-entry or AV re-entry tachycardia, but atrial tachycardia and flutter must be considered. Haemodynamic instability requires immediate synchronised cardioversion.

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Clinical Reference2 min read

Thalassaemia: Diagnosis and Long-Term Care

Define genotype and transfusion dependence, monitor iron overload and organ complications, and coordinate chelation and specialist follow-up.

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Clinical Reference2 min read

Thrombotic Thrombocytopenic Purpura

Suspect TTP with thrombocytopenia and microangiopathic haemolysis, send ADAMTS13 testing and begin emergency plasma exchange-based treatment without delay.

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