Clinical Reference Centre

Condition2 min read

Primary Biliary Cholangitis: Diagnosis and Risk Stratification

PBC is autoimmune destruction of small intrahepatic bile ducts causing cholestasis and progressive fibrosis.

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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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Condition2 min read

Primary Sclerosing Cholangitis: Diagnosis and Surveillance

PSC is chronic fibroinflammatory disease of the bile ducts associated with IBD and cancer risk.

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Clinical Reference2 min read

Principles of Cancer Staging

Use disease-specific TNM or other staging systems with imaging, pathology and molecular data to define prognosis and treatment intent.

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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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Clinical Reference2 min read

Prostate Cancer: Diagnosis and Risk Stratification

Use PSA, examination, MRI and biopsy selectively and classify localised disease by stage, grade and PSA.

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Clinical Reference2 min read

Prosthetic Joint Infection

Classify by timing and implant stability and manage through a multidisciplinary pathway using surgery plus prolonged targeted antimicrobials.

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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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Clinical Reference2 min read

Psoriatic Arthritis

Assess peripheral arthritis, enthesitis, dactylitis, axial disease, skin, nails and comorbidity and select domain-based therapy.

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Clinical Reference2 min read

Puerperal Psychosis Recognition

Puerperal Psychosis Recognition 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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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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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 Reference2 min read

Reactive Arthritis

Identify recent gastrointestinal or genitourinary infection, exclude septic arthritis and treat persistent musculoskeletal and extra-articular disease.

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Recurrent Miscarriage

Recurrent Miscarriage 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

Recurrent Urinary Tract Infection

Confirm recurrence pattern, review behavioural and anatomical factors and use non-antibiotic prevention before long-term prophylaxis where possible.

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Reduced Fetal Movements

Reduced Fetal Movements 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 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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Clinical Reference2 min read

Reported Penicillin Allergy

Take a structured allergy history, distinguish intolerance from immediate hypersensitivity and refer suitable patients for de-labelling.

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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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Clinical Reference2 min read

Respiratory Distress in the Newborn

Respiratory Distress in the Newborn requires a structured clinical assessment that identifies immediate risk, confirms the working diagnosis where possible and links treatment to current paediatrics guidance. Interpret…

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Clinical Reference2 min read

Rheumatic Disease in Pregnancy

Plan conception during stable disease, review teratogenic medicines and coordinate obstetric and rheumatology monitoring.

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Clinical Reference2 min read

Rheumatoid Arthritis: Diagnosis and Early Treatment

Confirm persistent synovitis, assess prognostic factors and begin treat-to-target DMARD therapy promptly through specialist care.

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Clinical Reference2 min read

Rheumatoid Arthritis: Treat-to-Target Monitoring

Measure disease activity regularly, escalate therapy when the target is not met and address pain, function, cardiovascular and bone risk.

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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 Reference2 min read

Sarcoidosis

Confirm compatible granulomatous disease, assess pulmonary and extrapulmonary organs and treat only when organ risk or substantial symptoms justify therapy.

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Scleroderma Renal Crisis

Recognise abrupt hypertension and kidney injury and begin an ACE inhibitor urgently under specialist care.

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Clinical Reference2 min read

Secondary Postpartum Haemorrhage

Secondary Postpartum Haemorrhage 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 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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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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Clinical Reference2 min read

Sepsis: Infection-Focused Diagnostic Strategy

Identify likely source, obtain microbiology and imaging without delaying treatment, and reassess diagnosis and antimicrobial choice as data emerge.

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Septic Arthritis

Perform urgent joint aspiration, begin treatment after cultures when feasible and arrange drainage for infected native or prosthetic joints.

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Clinical Reference2 min read

Septic Arthritis: Rheumatology Differential

Urgently aspirate a hot swollen joint and do not attribute it to gout or inflammatory arthritis without excluding infection.

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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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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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Condition2 min read

Short Bowel Syndrome and Intestinal Failure

Short bowel syndrome causes malabsorption and fluid or electrolyte loss after extensive intestinal resection.

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Clinical Reference2 min read

Short Stature Assessment

Short Stature Assessment 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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Shoulder Dystocia

Shoulder Dystocia 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

Sickle Cell Disease in Children

Sickle Cell Disease 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…

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Clinical Reference2 min read

Sickle Cell Disease: Routine Care

Coordinate hydroxycarbamide, vaccination, infection prevention, organ surveillance, pregnancy planning and psychosocial support.

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Clinical Reference2 min read

Sickle Cell Painful Crisis

Provide rapid analgesia, hydration assessment and evaluation for infection, acute chest syndrome, sequestration, stroke and other complications.

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Clinical Reference2 min read

Sjögren Disease

Assess sicca symptoms, systemic disease, neuropathy, lung and kidney involvement and lymphoma risk.

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