In patients with AF, the CHA2DS2-VASc score determines the need for anticoagulation. For men, a score of 1 warrants consideration, and 2+ warrants offering anticoagulation (DOAC or Warfarin). Aspirin is not recommended for stroke prevention in AF.

Severe asthma is defined by any one of: PEFR 33-50% best/predicted, RR >25/min, HR >110/min, or inability to complete sentences in one breath.

NICE recommends IgA tTG as the first-line test. Total IgA is measured simultaneously to exclude IgA deficiency, which would cause a false negative tTG.

The combination of high calcium and low phosphate suggests primary hyperparathyroidism, where the PTH will be inappropriately elevated or 'normal' despite hypercalcemia.

NICE guidelines recommend Levodopa as first-line for patients whose motor symptoms impact their quality of life. Dopamine agonists or MAO-B inhibitors are alternatives if symptoms are mild.

ACE inhibitors (Ramipril) and ARBs should be withheld during an AKI as they reduce glomerular efferent arteriolar tone, potentially worsening the GFR drop.

In suspected meningococcal septicaemia/meningitis in secondary care, IV antibiotics (specifically Ceftriaxone) should be given immediately, ideally after blood cultures but without delaying treatment.

First-line treatment for acute gout is an NSAID (like Naproxen) or Colchicine. Allopurinol is for long-term prophylaxis and should not be started during an acute attack.

In stable patients where the diagnosis of ectopic is suspected but not definitively confirmed, serial β-hCG measurements 48 hours apart help determine viability or confirm the need for intervention.

Patients should be advised that antidepressants typically take 2-4 weeks to show a clinical effect and that side effects often appear earlier.

NICE recommends laparoscopic cholecystectomy within 1 week of diagnosis for acute cholecystitis.

For all children with croup (even mild), a single dose of oral dexamethasone (0.15 mg/kg) is recommended.

V1-V4 represent the anterior/septal wall of the heart, which is supplied by the LAD.

In an elderly patient (men >50 or post-menopausal women) with unexplained iron deficiency anemia, gastrointestinal malignancy must be ruled out with both upper and lower GI investigations.

The UK Resuscitation Council guidelines for adult anaphylaxis specify 500 micrograms (0.5 mL) of 1:1000 adrenaline given intramuscularly.

Nail changes, including pitting, onycholysis, and subungual hyperkeratosis, are common in psoriasis.

In an elderly patient with acute confusion (delirium), infection is the most common cause. UTI is a frequent trigger.

Recent NICE guidelines recommend SGLT2 inhibitors for patients with Type 2 diabetes and concurrent chronic heart failure or high cardiovascular risk.

Classical presentation of acute angle closure glaucoma: halo vision, semi-dilated fixed pupil, and hazy cornea due to high intraocular pressure.

Finasteride is a 5-alpha reductase inhibitor. Tamsulosin is an alpha-blocker (relaxes smooth muscle).

For a primary spontaneous pneumothorax >2cm and/or breathless, the first intervention should be needle aspiration. If unsuccessful, a chest drain is required.

For patients with HFrEF still symptomatic on an ACEi and Beta-blocker, the next step is adding a Mineralocorticoid Receptor Antagonist (MRA) such as Spironolactone or Eplerenone.

NICE recommends that children and young people with a suspected eating disorder should be referred urgently to a specialist CAMHS eating disorder service.

The NHS Breast Screening Programme invites women aged 50 to 70 every 3 years. (Note: Some trials take it from 47-73).

Flucloxacillin is the first-line antibiotic for cellulitis because it covers Staphylococcus aureus and Group A Streptococcus.

Minimal Change Disease is the most common cause of nephrotic syndrome in children.

Sodium Valproate is highly teratogenic. In girls and women of childbearing potential, it should be avoided and alternative AEDs like Lamotrigine or Levetiracetam used where possible.

Continuous inflammation starting from the rectum is characteristic of Ulcerative Colitis. Crohn's is typically 'patchy' (skip lesions) and can affect any part of the GI tract.

While RF is often used, Anti-CCP is more specific for Rheumatoid Arthritis and can predict more aggressive disease.

Adhesions from previous surgery are the leading cause of small bowel obstruction.

Initial screening for myeloma involves checking for monoclonal proteins in the serum and urine.

The target of treatment is to normalize the TSH. If TSH remains high, the levothyroxine dose should be increased.

For COPD patients without asthmatic features (e.g., no diurnal variation, no eosinophilia), the next step after SABA/SAMA is a LABA + LAMA combination.

The symptoms describe Delirium Tremens. First-line management of alcohol withdrawal symptoms is a benzodiazepine, such as Chlordiazepoxide or Diazepam.

Oral Labetalol is the first-line antihypertensive in pregnancy. ACE inhibitors and ARBs are contraindicated.

Staphylococcus aureus is the most common cause of acute infective endocarditis, particularly in IV drug users.

The clinical triad of coma, respiratory depression, and miosis (pin-point pupils) strongly suggests opioid overdose, treated urgently with Naloxone.

Any suspicious pigmented lesion (ABCDE criteria or a high weighted 7-point checklist score) requires a 2-week wait referral for specialist assessment.

Amitriptyline causes sedation and orthostatic hypotension. Beta-blockers and Calcium channel blockers also lower BP. A medication review is vital in falls clinics.

Testicular torsion is a surgical emergency. If suspected clinically, no time should be wasted on imaging; urgent surgical exploration is required.

The patient is hemodynamically unstable (shocked). The priority is resuscitation (ABC) before definitive diagnosis via endoscopy.

Close contacts of patients with meningococcal disease should be offered chemoprophylaxis, usually with a single dose of Ciprofloxacin or a course of Rifampicin.

Shortened and externally rotated leg is the classic sign of a displaced fracture of the neck of the femur.

In severe hyperkalemia (>6.5 or ECG changes), IV Calcium Gluconate (or Chloride) is given first to stabilize the myocardial membrane and prevent arrhythmias.

In most parts of the UK, women aged 25-49 are invited every 3 years, and 50-64 every 5 years.

The triad of abdominal/back pain, hypotension, and a pulsatile mass (though not always felt) is classic for a ruptured AAA.

For INR >8.0 with no bleeding, the recommendation is to stop Warfarin and give oral Vitamin K (phytomenadione).

The patient is within the 4.5-hour window for thrombolysis and has had an intracranial bleed ruled out by CT.

Sensitivity is the ability of a test to correctly identify those with the disease. A highly sensitive test has very few false negatives (SnNout).

If the Wells score indicates PE is likely (>4), the patient should proceed directly to definitive imaging (CTPA). D-dimer is used to rule out PE in 'unlikely' cases.