|
Presenting complaint |
Common self-limiting problems |
Serious or chronic conditions |
Acute life-threatening conditions |
|
Knowledge depth required |
Able to asses in detail and manage largely independently |
Able to diagnose/perform detailed assessment. Assess for complications Refer to specialist in appropriate time frame. Co-manage |
Able to diagnose, perform key investigations (if possible), resuscitate, initially manage and acutely refer (usually requiring admission) |
|
Seizure |
Breakthrough seizures in epileptic |
Space Occupying Lesions |
Acute seizure |
|
Epilepsy |
Eclampsia |
||
|
Chronic drug toxicity |
Severe drug poisoning |
||
|
CNS infection |
|||
|
Acute drug toxicity |
|||
|
Collapse |
Vasovagal |
Cardiac syncope |
|
|
Confusion |
Chronic dementia |
Sepsis |
|
|
Altered mental state |
Chronic dementia |
Acute raised ICP |
|
|
CNS infection |
|||
|
Drug withdrawals |
|||
|
Myxoedema coma |
|||
|
Reyes (infant) |
|||
|
Hemiplegias |
TIA |
Stroke syndromes |
|
|
Stroke survivor – rehab issues |
|||
|
Headache |
Recurrent migraine |
Temporal arteritis |
CNS infection/abscesses |
|
SOL - tumours |
Sub-arachnoid haemorrhage |
||
|
Chronic raised ICP |
Cerebral v thrombosis (pregnant) |
||
|
Benign ICH |
Acute intracranial bleeding |
||
|
Acute mountain sickness |
|||
|
Vertigo / Nystagmus |
Labyrinthitis |
Post-fossa lesions |
Acute space occupying lesions / bleeding |
|
Benign positional vertigo |
Meniere’s disease |
||
|
Gait abnormality |
Chronic or self-limiting MSS conditions |
Pyramidal / Extrapyramidal / Cerebellar dysfunction |
|
|
Movement disorders |
Acute dystonic reactions |
Cerebellar lesions |
|
|
Parksinson's syndromes |
|||
|
Weakness |
Non-specific general debilitation |
Guillaine Barre syndrome |
|
|
Periodic paralysis |
|||
|
Drug/Poisons/Toxins |
|||
|
Paraplegia |
Spina bifida (child) |
Acute spinal lesions |
|
|
Acute spinal trauma |
|||
|
"The spinal patient" |
Common minor conditions |
Major complications |
Sepsis |
|
Skin care / Continence care |
Autonomic hyper-reflexia |
||
|
Long-term spinal patients |
|||
|
Spasticity |
Cerebral palsy |
Tetanus |
|
|
Developmental delay |
Familial dysfunction |
Non-accidental injury |
|
|
Behavioural |
Chronic psychosis |
Acute psychosis |
|
|
Abnormal illness behaviour |
Acute agitation / public harm |
||
|
ADHD (paediatrics) |
|||
|
Red eye / Painful eye |
Conjunctivitis |
Iritis / Scleritis |
Acute glaucoma |
|
Visual disturbance |
Refractive error |
Vitreous haemorrhage |
Retinal vessel occlusion |
|
Cataracts |
TIA |
||
|
Retinal tear |
|||
|
Chronic glaucoma |
Optic neuritis |
||
|
Eye swellings |
Blocked tear duct |
Tumours |
Periorbital/Orbital cellulitis |
|
Chalazion |
|||
|
Ptosis |
Horner's syndrome |
||
|
Gaze abnormality |
Squints |
Cavernous sinus thrombosis |
|
|
Pupillary abnormality |
Aniscoria |
Severe head injury |
|
|
Ear pain |
Ear wax |
Malignant otitis externa |
|
|
Otitis media |
|||
|
Otitis externa |
|||
|
Epistaxis |
Minor epistaxis |
Post-op bleeding |
|
|
Massive epistaxis |
|||
|
Hearing impairment Tinnitus |
Occupational hearing loss |
||
|
Otosclerosis |
Acute idiopathic hearing loss |
||
|
Acoustic neuroma |
|||
|
Speech abnormality |
Bulbar palsy /Dysphonia |
Acute stroke syndromes / dysphasia |
|
|
Cerebellar /Dysarthria |
|||
|
Developmental delay (children) |
|||
|
Facial pain |
Sinusitis |
Trigeminal neuralgia |
|
|
Facial weakness |
Bell’s palsy |
||
|
Ramsay-Hunt syndrome |
|||
|
Nasal rhinorrhea |
URTI |
||
|
Sinusitis |
|||
|
Allergic rhinitis |
|||
|
Cough |
Pneumonia |
Lung Ca |
|
|
SOB |
Chronic heart failure |
Occupational lung |
Status asthmaticus |
|
Chronic Asthma |
Pulmonary fibrosis |
Acute pulmonary oedema Acute heart failure |
|
|
COAD |
Mild exacerbation COAD |
Moderate/Severe exacerbation COAD |
|
|
Severe mountain sickness |
|||
|
Respiratory distress |
Mild Bronchiolitis (infant) |
Moderate/Severe bronchiolitis |
|
|
Hoarseness |
Pharyngitis |
Tumour |
|
|
Wheeze |
Asthma |
LVF |
|
|
Haemoptysis |
Pneumonia |
Lung Ca |
PE |
|
Massive haemoptysis |
|||
|
Sore throat |
Tonsillitis |
Quinsy |
|
|
Pharyngitis |
Retropharyngeal abscess |
||
|
Stridor / Snoring |
Mild Croup |
Sleep apnoea |
Epiglottis |
|
Foreign body |
|||
|
Cardiac arrest |
VT / VF |
||
|
Asystole |
|||
|
PEA – 4H / 4T |
|||
|
Shock |
Anaphylaxis |
||
|
Haemorrhage, Sepsis |
|||
|
Spinal / Epidural anaesthetic complications |
|||
|
Postural hypotension (see shock) |
Drug side effects |
Autonomic dysfunction |
Addisonian crisis |
|
Chest pain |
GOR |
Stable angina |
PE |
|
Costochondritis |
Dissection |
||
|
Viral Pericarditis |
ACS/AMI |
||
|
Pleuritic CP |
Mild pneumonia |
Moderate/Severe pneumonia |
|
|
Pleurisy |
Pneumothorax < 20% |
Pneumothorax > 20% |
|
|
PE |
|||
|
Palpitations |
APC/VPCs |
Atrial fibrillation |
VT / Torsades |
|
Paroxsmal SVT |
Thyrotoxicosis |
Thyrotoxic storm |
|
|
Leg swelling |
Venous insufficiency |
Lymphoedema |
Phlegmasia alba dolens (complete venous occlusion) |
|
DVT |
|||
|
Nephrotic syndrome |
|||
|
Cor pulmonale |
|||
|
Murmur |
Benign murmurs (paediatrics) |
Sub-acute Endocarditis |
Acute endocarditis |
|
Hypertension |
Essential hypertension (Asymptomatic patients) |
Secondary hypertension Refractory hypertension |
Autonomic hyper-reflexia (spinal patients) |
|
Malignant hypertension |
Hypertensive encephalopathy |
||
|
Pre-eclampsia (pregnancy) |
|||
|
Claudication / Leg pain |
Chronic arterial insufficiency |
Necrotising fasciitis |
|
|
PVD |
Acute arterial occlusion |
||
|
Spinal stenosis |
Acute osteomyelitis |
||
|
Chronic osteomyelitis |
Gas gangrene |
||
|
Leg ulcers |
Chronic ulcers / wounds |
||
|
Skin cancer |
|||
|
Chronic venous insufficiency |
|||
|
Chronic wounds |
Nutritional deficiencies |
||
|
Pallor |
Chronic anaemia |
Acute haemolysis |
|
|
Obesity |
Dietary issues |
Endocrine dysfunction |
|
|
LOA |
Cancer (CAUTION symptoms) |
||
|
Weight change |
Cancer (CAUTION symptoms) |
||
|
FTT |
Familial social issues |
Cystic fibrosis |
|
|
Hypothermia |
Mild exposure |
Post-op |
Moderate/Severe hypothermia |
|
Chill blains / Frost bite |
Sepsis |
||
|
Fever / Hyperthermia |
UTI |
Chronic recurrent fevers PUO |
Malignant hyperthermia Neuroleptic Malignant Syn. Serotonergic syn. |
|
LRTI |
Heat stroke |
||
|
Cellulitis |
Sepsis / Septic shock |
||
|
Lymphadenopathy |
Viral |
Lymphoma |
|
|
Local infection |
|||
|
Neck mass |
Reactive nodes |
Cancer |
Acute airway compromise |
|
Goitre |
Paracervical abscess |
||
|
Odynophagia |
URTI |
Quinsy |
|
|
Throat FB |
|||
|
Breast lump |
Mastitis |
Breast Ca |
Breast abscess |
|
Skin lump |
Lipoma |
Skin Ca |
|
|
Dysphagia |
Globus hystericus |
Throat cancer |
Oesophageal FB |
|
Bulbar palsy |
Rabies |
||
|
Oesophageal stricture |
|||
|
Oesophageal cancer |
|||
|
LOW / FTT |
Diabetes |
||
|
Cancer |
|||
|
HIV |
|||
|
Nausea / Vomiting |
Gastroenteritis |
Pyloric stenosis (neonate) |
Severe dehydration |
|
Hyperemesis gravidarum |
Bowel obstruction |
||
|
Fasting/NBM patient |
Pre-op evaluation |
Malabsorption |
Total gut failure |
|
Ileus |
Post abdominal surgery |
||
|
Indigestion |
GOR |
ACS / MI |
|
|
Jaundice |
Viral hepatitis |
Alcoholic cirrhosis |
Ascending cholangitis |
|
Ca pancreas |
Neonatal jaundice |
||
|
Breast milk jaundice |
|||
|
Abdominal mass |
Reducible hernias |
Incarcerated/Strangulated hernia |
|
|
Asymptomatic AAA |
|||
|
Hepatomegaly |
Alcoholic hepatitis |
||
|
Cancer |
|||
|
Myelofibrosis |
|||
|
Splenomegaly |
Leukaemia/Lymphoma |
||
|
Renal mass |
Cancer |
||
|
Hydronephrosis |
|||
|
Abdo swelling |
FFFFFs , Ascites |
||
|
Hernias |
|||
|
H & M |
Cancer |
Varices |
|
|
Mallory Weiss Tear |
Gastritis / Peptic ulcer |
||
|
Abdominal pain |
Gastroenteritis |
Biliary colic |
Leaking AAA |
|
UTI (mild) |
Diverticulitis (mild) |
Rupture ectopic pregnancy |
|
|
Pancreatitis |
|||
|
Diverticulitis |
|||
|
Stretching AAA |
|||
|
Appendicitis |
|||
|
Cholecystitis |
|||
|
Loin/Flank pain |
Pyelonephritis |
Renal calculi |
Pyelonephritis (severe) |
|
PR bleed |
Haemorrhoids |
Chronic colitis |
Acute colitis / megacolon |
|
Diverticular disease |
|||
|
Cancer |
|||
|
Inflammatory bowel disease |
|||
|
Constipation |
Encopresis |
Cancer |
Faecal impaction |
|
Constipation |
|||
|
Diarrhoea |
Gastroenteritis / Dysentery |
Colitis |
|
|
Giardia |
Malabsorption |
||
|
Pruritis ani |
Anal Fissure |
Thrombosed haemorrhoid |
|
|
Haemorrhoids |
|||
|
Faecal incontinence |
Dementia |
Cancer |
|
|
Post-procedure complications |
|||
|
Urinary incontinence |
Stress incontinence |
Uterine prolapse |
Acute spinal cord compression |
|
Enuresis (child) |
|||
|
Prostatism |
BPH |
Acute urinary retention |
|
|
Prostate cancer |
|||
|
Urgency |
UTI |
Urinary retention |
|
|
Polyuria |
Diabetes mellitus |
||
|
Diabetes inspidus |
|||
|
Dysuria / Frequency |
UTI / Pyelopheritis |
||
|
Oliguria / Anuria |
Dehydration |
ATN |
Haemorrhage |
|
Sepsis |
|||
|
Haematuria |
UTI |
Urinary tract tumour |
|
|
Testicular pain |
Epididymo-orchitis |
Testicular torsion |
|
|
Swollen penis |
Balanitis |
Irreducible paraphimosis |
|
|
Paraphimosis |
|||
|
Amenorrhea |
Pregnancy diagnosis |
||
|
Infertility |
Infertility |
||
|
Post menopausal bleeding |
Cervical erosions |
Uterine cancer |
|
|
Early pregnancy |
Threatened miscarriage |
Missed abortion |
Ectopic pregnancy |
|
Complete miscarriage |
Inevitable miscarriage |
||
|
PV bleeding |
DUB |
Cancer |
|
|
Pelvic pain |
UTI |
Gynaecological cancer |
Appendicitis |
|
Mittleschmertz |
Endometriosis |
Tubo-ovarian abscess |
|
|
Ovarian cyst rupture |
Toxic shock syndrome |
||
|
PID |
Ovarian torsion |
||
|
Dyspareunia |
Genital lesions |
Cervical pathology |
|
|
Dysmenorrhoea |
Primary dysmenorrhoea |
Secondary dysmenorrhoea |
|
|
Endometriosis |
|||
|
Pregnant women |
Common conditions |
High risk |
|
|
Common medical issues |
Predictors for dystocia |
||
|
Standard Pregnancy care |
Major complications - poly/oligo hydramnios, SFD/LFD, praevia |
||
|
Labour |
Braxton Hicks contractions |
Established Labour |
|
|
Delivering women |
Normal Vag delivery |
Emergency delivery |
|
|
Fetal distress |
|||
|
PPH |
|||
|
Dystocia |
|||
|
GA section |
|||
|
Post-menopausal women |
Climacteric |
||
|
Third trimester bleeding |
Placental abruption |
||
|
Placenta Praevia |
|||
|
Joint pain / swelling |
OA |
RA |
Septic arthritis |
|
Gout |
Connective tissue disorders |
||
|
Sero-ve arthritides |
|||
|
Tendonitis/Bursitis |
|||
|
Back pain |
Mechanical back pain |
Cancer |
Epidural abscess |
|
Spontaneous crush fractures |
Disciitis |
||
|
Infection |
|||
|
Limping |
Acute sports injury |
Slipped epiphysis |
Septic arthritis |
|
Chronic MSS disorders |
Perthes |
Osteomyelitis |
|
|
Pruritus |
Urticaria |
Chronic liver failure |
|
|
Chronic renal failure |
|||
|
Anaphylaxis (acute) |
|||
|
Rash |
Psoriasis |
Steven-Johnson’s syndrome |
|
|
Eczema |
Meningococcaemia |
||
|
Impetigo |
|||
|
Herpes zoster/simplex |
|||
|
Molluscum contagiosum |
|||
|
Acne |
|||
|
Hand-foot-mouth |
|||
|
Scabies |
|||
|
Skin infection |
Cellulitis |
Necrotising fascitis |
|
|
Paed exanthem |
Measles |
||
|
Rubella |
Kawasaki’s disease |
||
|
German measles |
|||
|
Scarlet fever |
|||
|
Purpuric rash |
ITP |
Meningococcaemia |
|
|
HSP |
|||
|
Skin lesions |
Warts |
Skin cancer |
|
|
Campbell de Morgan spots |
|||
|
Lentigo |
|||
|
Hirsuitism |
Drug-induced hirsutism |
Polycystic ovaries |
|
|
Androgens |
|||
|
Self harm |
Personality Disorders. |
Acute suicidality |
|
|
Depression |
|||
|
Irritable infant |
Minor Infections |
Sepsis/Meningitis |
|
|
Colic |
|||
|
Pre-term infant |
Normal development |
Nutritional issues |
RDS, NEC, IVH |
|
Congenital malformation / Dysmorphia |
Down's syndrome |
||
|
Neonatal screen |
6 week baby check |
Congenital hip dislocation |
|
|
Abnormal murmurs |
|||
|
Congenital malformation |
|||
|
Multi-trauma |
EMST principles |
Paediatric major trauma |
|
|
Maternal major trauma |
|||
|
CHI |
Concussion |
ICH |
|
|
Eye trauma |
Subconjunctival haemorrhage |
Retinal detachment |
|
|
Traumatic mydriasis |
Penetrating eye injury |
||
|
Hyphaema |
|||
|
Facial trauma |
Un-displaced nasal # |
Displaced nasal # facial bone |
Sub-mucosal haematoma Mandibular # |
|
Neck trauma |
Whiplash |
Spinal #s |
|
|
Wry neck |
|||
|
Chest trauma |
#ribs |
Pneumo/Haemo-thorax |
|
|
Flail chest |
|||
|
Lung contusions |
|||
|
Abdo trauma |
Solid organ |
||
|
Hollow organ |
|||
|
Extremity trauma |
Ankle / Knee sprains |
Major #s / Amputation |
|
|
Colles # |
Compartment syndrome |
||
|
Scaphoid # |
Sudeck's atrophy |
||
|
NOH # |
|||
|
Clavicle # |
|||
|
Uncomplicated Ankle # |
|||
|
Hand trauma |
Metacarpal # |
Tendon |
|
|
Phalangeal # |
Nail bed injury |
||
|
Finger tip crush # |
|||
|
Repetitive trauma |
Shin splints |
Stress #s |
|
|
Sports injury |
Plantar fasciiitis |
||
|
Hand conditions |
Tenosynovitis |
||
|
Bites/Stings |
Bee stings |
Jellyfish |
|
|
Insect bites |
Snake |
||
|
Low Hb |
Chronic anaemias |
Severe haemorrhage |
|
|
High Hb |
Polycythaemai rubra vera |
||
|
High WCC |
Infection |
Leukaemia |
|
|
Lymphoma |
|||
|
Low WCC |
Infection |
Chemotherapy complications |
|
|
High Plt |
Reactive thrombocytosis |
Essential thrombocytosis |
DIC |
|
Low Plt |
ITP |
Snake bites |
|
|
TTP |
|||
|
Electrolyte abnormalities (see below) |
Mild (asymptomatic) |
Moderate |
Severe/Life-threatening (altered CVS/CNS/Neuromuscular function) |
|
Low sodium |
SIADH |
CCF/Cirrhosis/CRF |
Water intoxication |
|
High sodium |
Diabetes insipidus |
Severe dehydration |
|
|
Low potassium |
Diuretics |
||
|
High potassium |
CRF |
||
|
Spirinolactone / ACE-I / other |
|||
|
High creatinine |
Acute and chronic renal failure |
Severe renal failure requiring dialysis |
|
|
Metabolic acid |
Normal anion gap |
Shock |
|
|
Metabolic alkalosis |
Diuretics |
Anorexia nervosa |
|
|
Resp acidosis |
Chronic respiratory failure |
Acute respiratory failure |
|
|
Resp alkalosis |
Anxiety |
PE |
|
|
Sepsis |
|||
|
High calcium |
Hyper-parathyroidism |
||
|
Low calcium |
Hypo-parathyroidism |
Tetany |
|
|
Post thyroid/Parathyroid surgery |
|||
|
High glucose |
Diabetes |
DKA / HONK |
|
|
Low glucose |
Brittle diabetes |
Hypoglycaemia |
|
|
Abnormal LFTS |
|||
|
Cholestatic LFTs |
Gallstones |
Cholestasis of pregnancy |
|
|
Alcohol |
Primary biliary cirrhosis (child) |
||
|
Drug related |
|||
|
Hepatic LFTS |
Hepatitides |
Reye's syn (child) |
Acute hepatic encephalopathy |
|
Alcohol |
Metabolic liver diseases |
Severe paracetamol toxicity |
|
|
Abnormal coagulation profile |
Warfarin maintenance |
Severe or symptomatic over anticoagulation |
|
|
Behavioural abnormality |
Chronic schizophrenia |
Autism (child) |
|
|
Chronic Anxiety |
Suicidal patient |
||
|
Personality disorder |
Drug-induced psychosis |
||
|
Self-harming behaviour |
Disorders of mood |
||
|
Chronic depression / BPAD |
Acute Psychosis |
||
|
Agitated/Aggressive patient |
|||
|
Abnormal illness behaviour |
Methadone treatment |
Substance abuse |
|
|
Non compliance |
Munchausen's disorder |
||
|
Personality disorder |
|||
|
Substance abuse |
|||
|
Grieving patient |
Reactive grief |
Adjustment disorder |
|
|
Abused patient |
|||
|
NESB/Cross cultural patient |
Using professional translators |
||
|
Pt going to theatre |
Peri-op diabetic managment |
||
|
Cardio-resp optimisation |
|||
|
Warfarin reversal |
|||
|
GOR |
|||
|
Pt post-op/recovery |
DVT prophylaxis |
Post-operative infections or minor bleeding |
Post-operative haemorrhage |
|
Wound infection prophylaxis |
Other common complications |
||
|
Epidural assessment |
|||
|
Rehabilitating/ Recovering patient |
Prognostication Work rehabilitation plan |
||
|
PREVENTATIVE CARE / HEALTH MAINTENANCE |
Smoking cessation / counselling |
||
|
Osteoporosis screening |
|||
|
Prostate Ca screen |
|||
|
Breast Ca screen |
|||
|
Cholesterol monitoring |
|||
|
Cervical CA screen |
|||
|
Contraception advice ,Fertility control OCP, Implanon |
IUCD, Mirena |
||
|
Childhood vaccination schedule |
Post Hep B/ HIV exposure |
||
|
Tetanus |
Travel immunisation |
||
|
Hep B |
|||
|
MRSA surveillance |
|||
|
Climacteric advice, HRT |
|||