Clinical Reference Centre

Clinical Measurement2 min read

Lactate Clearance and Serial Lactate Interpretation

Serial lactate measurements can help assess trajectory in shock and severe illness. Percentage change should be interpreted with timing, treatment, liver function and clinical perfusion.

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Condition2 min read

Large-Bowel Obstruction: Cancer, Volvulus and Emergency Care

Large-bowel obstruction is commonly due to colorectal cancer, diverticular stricture or volvulus.

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Clinical Reference2 min read

Large-Vessel Vasculitis

Use imaging to assess aortic and branch-vessel inflammation, stenosis or aneurysm and monitor vascular complications.

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Clinical Reference2 min read

Latent Tuberculosis Infection

Use validated testing in risk groups, exclude active disease and select preventive therapy according to interactions and liver risk.

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Clinical Management2 min read

Lipid Management in Cardiovascular Disease Prevention

Lipid management reduces atherosclerotic cardiovascular risk. Treatment intensity should reflect established cardiovascular disease, baseline risk, LDL response, tolerance and comorbidity.

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Laboratory Test3 min read

Liver Blood Tests: Pattern Recognition and Clinical Interpretation

A structured guide to hepatocellular and cholestatic patterns, synthetic function, bilirubin and escalation.

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Clinical Management2 min read

Liver Transplant Assessment and Referral

Liver transplantation is considered for decompensated cirrhosis, acute liver failure, selected cancers and metabolic disease.

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Clinical Reference2 min read

Localised Prostate Cancer

Discuss active surveillance, surgery and radiotherapy using risk, life expectancy, adverse effects and preferences.

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Clinical Management2 min read

Long-Term Oxygen Therapy: Assessment and Follow-Up

Long-term oxygen therapy improves survival in selected patients with chronic severe resting hypoxaemia. Assessment should occur when clinically stable.

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Condition2 min read

Lower Gastrointestinal Bleeding: Assessment and Investigation

Lower GI bleeding ranges from self-limited rectal bleeding to major haemorrhage. Initial assessment should determine haemodynamic effect, bleeding rate and likely source.

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Clinical Reference2 min read

Lung Cancer: Diagnosis and Molecular Testing

Obtain adequate tissue for histology and biomarkers, stage with appropriate imaging and assess cardiopulmonary fitness.

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Condition2 min read

Lung Cancer: Recognition, Referral and Initial Staging

Suspect lung cancer in patients with persistent respiratory symptoms, haemoptysis, weight loss, clubbing or suspicious imaging, particularly with relevant exposure history.

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Clinical Measurement2 min read

Lung Volumes: Restriction, Hyperinflation and Air Trapping

Static lung volumes distinguish true restriction from low FVC due to air trapping or poor effort and quantify hyperinflation.

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Clinical Reference2 min read

Lupus Nephritis

Confirm renal involvement with urine, serology and biopsy when indicated and use class-directed induction and maintenance therapy.

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Clinical Reference2 min read

Macrocytic Anaemia

Assess vitamin B12 and folate status, alcohol, liver disease, thyroid dysfunction, medicines, reticulocytosis and marrow disorders.

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Clinical Reference2 min read

Macrophage Activation Syndrome

Suspect hyperinflammatory organ dysfunction with fever, cytopenias, coagulopathy and extreme ferritin and begin urgent specialist treatment.

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Clinical Reference2 min read

Major Haemorrhage: Haematological Management

Activate a major-haemorrhage protocol, control the source, prevent hypothermia and acidosis, and use laboratory or viscoelastic guidance for component therapy.

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Condition2 min read

Malabsorption: Structured Clinical Assessment

Malabsorption may result from mucosal disease, pancreatic insufficiency, bile acid disorders, surgery or infection.

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Clinical Reference2 min read

Malaria: Diagnosis and Emergency Treatment

Obtain urgent blood films or rapid testing in any febrile traveller from an endemic region and treat severe malaria immediately.

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Clinical Reference2 min read

Malignancy-Associated Hypercalcaemia

Correct dehydration, review calcium and renal function and use antiresorptive treatment while treating the underlying cancer.

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Clinical Reference2 min read

Malignant Spinal Cord Compression

Give urgent corticosteroid treatment when indicated, obtain whole-spine MRI and coordinate oncology, radiotherapy and spinal surgery assessment.

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Condition2 min read

MASLD: Assessment, Fibrosis Risk and Management

MASLD is hepatic steatosis associated with metabolic risk and can progress to steatohepatitis, fibrosis and cirrhosis.

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Clinical Reference2 min read

Massive Transfusion Complications

Monitor ionised calcium, temperature, potassium, acid-base status, fibrinogen and dilutional coagulopathy during high-volume transfusion.

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Clinical Reference2 min read

Maternal Cardiac Arrest

Maternal Cardiac Arrest 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 Measurement8 min read

Mean Arterial Pressure: Measurement, Targets and Clinical Interpretation

A detailed guide to MAP calculation, measurement reliability, organ perfusion, shock targets and patient-specific interpretation.

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Condition3 min read

Metabolic Acidosis: Classification, Investigation and Clinical Management

A comprehensive guide to high-gap and normal-gap metabolic acidosis, compensation, mixed disorders and emergency causes.

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Condition3 min read

Metabolic Alkalosis: Causes, Chloride Responsiveness and Management

A guide to metabolic alkalosis, vomiting, diuretics, mineralocorticoid excess, urine chloride and safe management.

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Clinical Reference2 min read

Metastatic Breast Cancer

Define receptor status and disease tempo and sequence endocrine, targeted, chemotherapy and supportive treatment around goals and prior exposure.

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Clinical Reference2 min read

Metastatic Colorectal Cancer

Assess molecular profile, sidedness, resectability and treatment goals and review liver or lung metastases in a specialist MDT.

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Clinical Reference2 min read

Methotrexate Safety and Monitoring

Use once-weekly dosing, folic acid, baseline screening and blood monitoring, and withhold or seek advice for toxicity or serious infection.

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Clinical Reference2 min read

Microcytic Anaemia

Differentiate iron deficiency, thalassaemia, inflammation, sideroblastic disease and lead toxicity using ferritin, transferrin saturation, CRP and haemoglobin studies.

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Condition2 min read

Microscopic Colitis: Diagnosis and Management

Microscopic colitis causes chronic watery diarrhoea with often normal endoscopic appearance. Diagnosis requires colonic biopsies.

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Condition2 min read

Mitral Regurgitation: Primary and Secondary Disease

Mitral regurgitation may be primary valve disease or secondary to ventricular or atrial remodelling. Assessment requires mechanism, severity, chamber response, pulmonary pressure and symptoms.

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Condition2 min read

Mitral Stenosis: Severity, Rhythm and Intervention

Mitral stenosis is commonly rheumatic and causes left atrial hypertension, pulmonary hypertension and atrial fibrillation. Valve area, mean gradient, heart rate and flow all influence severity assessment.

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Clinical Reference2 min read

Multidrug-Resistant Gram-Negative Infection

Use microbiology and infectious-disease expertise to select active, least-toxic therapy and apply strict infection-control measures.

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Clinical Reference2 min read

Multiple Myeloma

Evaluate monoclonal protein, marrow plasma cells, imaging and myeloma-defining events, then tailor induction, transplant and maintenance.

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Clinical Reference2 min read

Myelodysplastic Syndromes

Classify cytopenic clonal marrow disease using morphology, cytogenetics and molecular data and estimate risk to guide supportive or disease-modifying treatment.

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Condition2 min read

Myocarditis: Clinical Recognition and Diagnostic Strategy

Myocarditis ranges from mild chest pain to fulminant heart failure, arrhythmia or shock. Diagnosis integrates biomarkers, ECG, echocardiography, cardiac MRI and selected biopsy.

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Condition2 min read

Myxoedema Coma: Recognition and Emergency Management

Myxoedema coma is severe decompensated hypothyroidism with altered consciousness, hypothermia and organ dysfunction.

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Condition2 min read

Necrotising Pancreatitis: Infection, Intervention and Step-Up Care

Pancreatic or peripancreatic necrosis may remain sterile or become infected. Clinical deterioration after the first week raises concern for infection.

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Clinical Reference2 min read

Necrotising Soft-Tissue Infection

Recognise pain out of proportion, rapid progression, systemic toxicity and skin changes and arrange immediate surgery plus broad-spectrum antibiotics.

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Clinical Reference2 min read

Neonatal Hypoglycaemia

Neonatal Hypoglycaemia 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

Nephrotic Syndrome in Children

Nephrotic Syndrome in Children requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current paediatrics guidance. Interpret symptoms,…

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Clinical Reference2 min read

Neutropenia: Assessment and Referral

Assess severity, duration, infection, medicines, ethnicity, autoimmune disease and marrow failure; fever with severe neutropenia is an emergency.

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Clinical Score2 min read

NEWS2: Interpretation, Escalation and Limitations

NEWS2 standardises assessment of acute physiological deterioration using respiratory rate, oxygen saturation, supplemental oxygen, temperature, systolic pressure, pulse and consciousness.

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Clinical Reference2 min read

Non-Accidental Injury Recognition

Non-Accidental Injury Recognition 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…

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Clinical Measurement2 min read

Non-Invasive Liver Fibrosis Assessment

Non-invasive fibrosis assessment combines simple serum scores, proprietary biomarkers and elastography.

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Clinical Intervention2 min read

Non-Invasive Ventilation in Acute Respiratory Failure

Non-invasive ventilation provides positive-pressure ventilatory support without an invasive airway. Established indications include selected acute hypercapnic respiratory failure and acute cardiogenic pulmonary oedema.

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