HAEMATOLOGY

1. Abnormal blood film

a) Peripheral blood film (red cell, white cell and platelets)
b) Differential white cell count
c) Pancytopenia
d) Bone marrow failure
e) ESR
f) Hyperviscosity syndrome
g) Spleen and splenectomy
2. Haematological malignancies and myeloproliferative disorders
a) Leukaemia
b) Myeloma
c) Paraproteinemia
d) Amyloidosis
3. Bruising/ bleeding/ purpura
a) Intrinsic and extrinsic pathways (clotting)
b) Any cause including
c) Bleeding disorder
d) Anticoagulants
e) Thrombophilia
4. Immunosuppressive drugs
5. Inherited bleeding disorders Anaemia of any cause
a) Iron deficiency anaemia
b) Refractory anaemia
c) Anaemia of chronic disease
d) Sideroblastic anaemia
e) Macrocytic anaemia (all causes)
f) Pernicious anaemia
g) Haemolytic anaemia
h) Sickle cell anaemia
i) Thalassaemia anaemia
j) Transfusion (safety & procedures)
k) (Myeloproliferative disorders)
6. Generalised enlarged lymph nodes: any cause
BREAST LUMP AND/OR PAIN
1. Cancer
2. Infection
a) abscess;
b) puerperal mastitis
3. Benign
a) fibro-adenoma;
b) fibro-adenosis;
c) fat necrosis; cysts)
4. Nipple

a) discharge;
b) inversion;
c) Paget's
5. Request for reduction/augmentation
CARDIOVASCULAR
1. Chest Pain
a) Acute myocardial infarction, acute coronary syndrome and angina
b) Acute myocardial infarction (MI)
c) Acute coronary syndrome (ACS)
d) Angina pectoris
e) Electrocardiogram (ECG) normal and abnormal
f) Investigations (cardiac catheterisation; echocardiography; nuclear
cardiology; ECG: exercise/ ambulatory)
g) Complications of MI (arrhythmias; hypertension)
h) Atherosclerosis
2. Heart Murmur: any cause
3. Hypertension: all, including risk fator
4. Palpitations
a) Bradycardia
b) Narrow complex tachycardia
c) Atrial fibrillation and flutter
d) Broad complex tachycardia
e) Pacemakers
5. Peripheral arterial disease
a) Aneurisms
b) Ischaemic limb
c) Occlusions
6. Peripheral oedema and Heart failure including valvular heart disorder and
rheumatic heart disease
a) Rheumatic fever
b) Mitral valve disease
c) Aortic valve disease
d) Right heart valve disease
e) Indications for cardiac surgery
f) Infective endocarditis
g) Diseases of heart muscle including myocarditis
h) Pericardial disease
i) Dyspnoea in heart failure
7. Peripheral Venous problems
a) VTE
b) DVT
c) Risk Factors
d) Varicose Veins

DEVELOPMENTAL PROBLEMS
1. Congenital Abnormalities
a) Ventricular septal defect
b) Atrial septal defect
c) Patent ductus arteriosus
d) Aortic stenosis
e) Pulmonary stenosis
f) Coarctation of the aorta
g) Fallot's tetralogy
h) Transposition of the great arteries
i) Tricuspid atresia
j) Total anomalous pulmonary venous return
k) Persistent truncus arteriosus
l) Hypoplastic left heart
m) Pulmonary atresia
n) Ebstein's anomaly
o) Polycystic kidneys
p) Congenital adrenal hyperplasia
q) Chromosomal abnormalities (including Turner's; Down's; Tay Sachs')
r) Inherited conditions (cystic fibrosis; PKU)
s) Acquired conditions (including caused by drugs/alcohol)
t) Neural tube defects (including spina bifida)
u) Developmental abnormalities of the musculoskeletal system (including
talipes)
2. Developmental Delay/ Failure to thrive
a) Endocrine problems/ Metabolic disorders
b) Malabsorption (see also under Digestive)
c) Inadequate diet
3. Psychological and Social
a) Non-accidental injury
b) Sexual abuse
c) Emotional deprivation
d) Bullying
e) Manifestations of neglect
DIGESTIVE
1. Abdominal Mass
a) Organomegaly
b) Hernias
c) Ascites
2. Abdominal Pain
a) Perforation
b) Obstruction
c) Ischaemia
d) Aneurysm (see also under Cardiovascular/ Peripheral arterial disease)

3.

4.

5.

6.

7.

e) Inflammatory conditions (including diverticulitis; appendicitis, pancreatitis)

f) Colic: ureteric (see also under Renal), Biliary/ gallbladder (see also under
Jaundice)
Anorexia and weight loss
a) Cancer
b) Metabolic causes including diabetes (see under Endocrine/ Abnormal
blood sugar);
c) thyroid (see under Endocrine/ Thyroid abnormalities)
d) Malabsorption
e) Physical causes of anorexia
f) Psychological causes of anorexia (see also under Mental health/ Eating
problems
Facial Swelling
a) Cancer
b) Sinusitis
c) Salivary glands
d) Teeth
e) Oral cavity
f) Lymph nodes (see also under Blood and lymph)
Jaundice
a) Pre-hepatic (including haemolysis)
b) Hepatic (including drug-induced)
c) Post-hepatic (including biliary obstruction)
Lower GI Problems
a) Including faecal incontinence
b) Spurious diarrhoea and encopresis
c) Cancer
d) Ulceration
e) Bleeding
f) Abnormal anatomy (fissures, piles, prolapse)
g) Masses (including polyps)
h) Altered bowel habit (constipation, diarrhoea)
i) Rectal pain
j) Pruritis ani
k) Inflammation (including IBD)
Upper GI Problems
a) Including nausea and vomiting
b) Infections (including food poisoning, UTI, gastroenteritis)
c) Pyloric stenosis (see also under Developmental)
d) Drug-induced
e) Raised intracranial pressure
f) Pregnancy (see also under Reproductive)
g) Constipation
h) Cancer
i) Ulceration

j) GORD
k) Bleeding
l) Dysphagia (including tumours; benign; neurological causes; congenital;
acquired)
8. Nutrition
a) Recognises nutritional disorders are common in patients with long-term
conditions
b) Performs basic nutritional screen and recognises patients with potential for
nutritional deficiencies and considers this in planning care
c) Formulates a plan for investigation and management of weight loss or
weight gain
d) Demonstrates the knowledge, skills, attitudes and behaviours to assess
patients basic nutritional requirements
e) Recognises major nutritional abnormalities and eating disorders and
establishes a management plan, where relevant with other healthcare
professional input
f) Works with other healthcare professionals in addressing nutritional needs
and communicating these during care planning
g) Makes nutritional care part of daily practice
h) Considers the additional effects of long-term ill-health on nutritional status
and the effect of poor nutrition on long-term health.
ENDOCRINE
1. Diabetes Mellitus
a) Type 1 diabetes
b) Type 2 diabetes
c) Complications (including diabetic retinopathy; neuropathy; arterial disease)
d) Diabetic foot care
e) Hypoglycaemia/ hyperglycaemia
f) Patient with diabetes undergoing surgery
g) Diabetes in pregnancy (see also under Reproductive)
2. General
a) Hyperparathyroidism
b) Hypoparathyroidism
c) Multiple endocrine neoplasia (MEN 1 and MEN 2)
3. Adrenal
a) Adrenal gland
b) Addisonian crisis
c) Addisons disease
d) Hyperaldosteronism
e) Phaeochromocytoma
f) Virilism
g) Gynaecomastia (see under Breast)
h) Impotence (see under Reproductive/ Fertility problems)
i) Cushings syndrome

4. Pituitary gland
a) Hypopituitarism
b) Pituitary tumours
c) Hyperprolactinaemia; hypoprolactinaemia
d) Acromegaly
e) Diabetes insipidus
f) Hypopituitary coma
5. Thyroid Disorders
a) Cancer
b) Hyperthyroidism
c) Thyroid eye disease
d) Hypothyroidism
e) Thyroid disease in pregnancy (see also under Reproductive/ Problems in
pregnancy)
f) Goitre; nodules
g) Thyroid emergency
ENT
1. Earache any cause
a) Cancer
b) Infection
c) Eustachian tube dysfunction
2. Hearing Problems: any cause
a) Foreign body (including wax)
b) Conductive and nerve deafness
3. Hoarseness and stridor any cause
a) Cancer
b) Infection (including epiglottitis)
c) Voice misuse (including nodules)
d) Nerve injury (including palsies)
e) Stridor (see also under Thyroid abnormalities/ Goitre)
4. Nasal Symptons
a) Cancer
b) Bleeding
c) Nasal obstruction (including polyps; allergic rhinitis)
d) Infections
e) Trauma (including fractures)
5. Vertigo any cause
a)
Mnires disease
b)
Labyrinthitis
c)
Cancer
d)
Cerebellar lesions (see also under Neurological)
e)
Benign positional
f)
Toxins (including alcohol)

EYE
1. Eye Pain
a) Cancer
b) Sinusitis (see also under ENT)
c) Glaucoma
d) Migraine (see also under Neurological/ Headache
e) Foreign body
2. Orbital Swelling
a) Cancer
b) Infection (including cellulitis; blepharitis)
c) Thyroid disease (see under Endocrine)
d) Cysts: congenital and acquired
e) Eyelid Disorder
3. Red eye
a) Infection
b) Conjunctivitis
c) Iritis
d) Trauma (including foreign body)
e) Scleritis/ episcleritis
f) Glaucoma
g) Subconjunctival haemorrhage
h) Polycythaemia
4. Visual impairment
a) Tumours (including pituitary)
b) Arterial and venous
c) Lens (including cataract; dislocation)
d) Degenerative
e) Hereditary
f) Systemic conditions: including connective tissue; diabetes (see also under
Endocrine)
g) Drug-induced
h) Infections
i) Detached retina
j) Vitreous haemorrhage (including floaters)
GENITOURINARY
1. Uretrhal Discharge any cause
a) Infection (including STI)
b) Cancer
c) Foreign body
2. Vaginal Discharge any cause
a) Pruritis vulvae
b) Normal physiological
c) Cancer
d) Infection (including STI)

e) Foreign body
f) Child sexual abuse (see also under Developmental problems)
HOEMOSTATIC
1. Acid-base imbalance and blood gas abnormalities
a) Metabolic and respiratory acidosis or alkalosis
b) Kidney function (tubular dysfunction, low GFR, chronic renal failure)
2. Electrolyte abnormalities
a) Sodium,
b) potassium,
c) glucose,
d) calcium
e) SIADH
f) Magnesium
g) Zinc
h) Selenium
i) Water
INFECTIOUS DISEASE
1. Hospital Acquired inefction
a) Infection Control
b) MRSA
c) C. diff
d) Manages sepsis
a. Understands the seriousness of sepsis
b. Understands and applies the principles of managing a patient with
sepsis
c. Involves the infection control team at an appropriate early stage
d. Takes appropriate microbiological specimens in a timely fashion
e. Follows local guidelines/protocols for antibiotic prescribing.
2. Serious infection
a) HIV
b) AIDS
c) Hep B
d) And Tb
3. Travel Medicine and Tropical infections: any cause
a) Malaria
b) Bilharzia
c) Dengue fever
d) Lyme disease
e) Toxoplasma
f) Rabies
g) Yellow fever
4. Viral Infections
a) Exanthemata

b)
c)
d)
e)
f)
g)
h)

Mumps
Measles
Rubella
Herpes simplex
Herpes zoster
Viral meningitis
Influenza

MENTAL HEALTH
1. Alcohol and drug misuse and dependence
a) Including co-morbidity and withdrawal
b) Substitution therapy
c) Acute intoxication
d) Harmful use
2. Anxiety
a) Including generalised anxiety disorder, phobias and OCD
b) Panic attack
c) Obsessive compulsive disorder
3. Deliberate self harm
a) Overdose, poisoning and other self-harm
b) Suicidal risk
4. Eating Problems
a) Anorexia
b) Bulimia nervosa
5. Learning and communication problems Any cause
a) Intellectual disability
b) Acquired brain injury
6. Medically-unexplained physical symptons
a) Including psychosomatic disorders,
b) somatisation disorders
7. Mood/ affective problems
a) Depressive disorders
b) Bipolar disorders
c) Suicidal risk
8. Organic Brain Sybdrome
a) Delirium
b) Dementia
c) Encephalopathy
9. Personallity and behavioural disorders
a)
Emotionally unstable personality disorder
b)
Antisocial personality disorder
c)
Pathological gambling
d)
Pyromania
10. Psychosis
a) Schizoaffective disorder

b) Delusional disorders
MUSCULOSKELETAL
1. Back and Neck
2. Connective tissue Disorders
3. Foor and Ankle
4. Hand and Wrist
5. Hip
6. Knee
7. Rheumatological problemas
a) Rheumatoid
b) Osteoarthrosis
c) Psoriatic
d) Lupus
e) Polymyalgia rheumatica
f) Gout
8. Upper limb
9. Skeletal
a) Disorders of calcium homeostasis (osteoporosis, osteomalacia, Paget's)
b) Infections
c) Tumours (benign, malignant, secondaries)
d) Fractures of long bones
10. Fractures
NEUROLOGICAL
1. Blackouts and Faints
a) Loss of consciousness of any cause
b) Vasovagal syncope
c) Cough syncope
d) Effort syncope
e) Micturition syncope
f) Carotid sinus syncope
g) Epilepsy
h) Stokes Adams attacks
i) Hypoglycaemia
j) Orthostatic hypotension
k) Drop attacks
2. Cranial Nerve Problems
a) Any cause including visual field defects
b) Multiple sclerosis (MS)
c) Space occupying lesions
d) Bells palsy
3. Falls
a) Complications including subdural, extradural
b) Any cause including environmental

c)
d)
e)
f)
g)
4.

5.

6.

7.

8.
9.

Dizziness
Vertigo (benign positional vertigo)
Mnires disease
Ototoxicity
Vestibular nerve problems (Acoustic neuroma, vestibular neuronitis,
herpes zoster, brain stem)
Headache
a) Any cause including environmental
b) Dizziness
c) Vertigo (benign positional vertigo)
d) Mnires disease
e) Ototoxicity
f) Vestibular nerve problems (Acoustic neuroma, vestibular neuronitis,
herpes zoster, brain stem)
Movment Disorder including tremor and gait
a) Abnormalities of the motor nervous system
b) Chorea
c) Athetosis
d) Hemiballismus
e) Tics, myoclonus, dystonia and tardive dyskinesia
f) Parkinsons disease
g) Parkinsonism
Peripheral nerve problem
a) Testing peripheral nerves
b) Dermatomes
c) Including neuropathies of any cause
d) Autonomic neuropathy
e) Mononeuropathys
f) Polyneuropathys
g) Bulbar palsy
h) MND
i) Cervical spondylosis
j) Neurofibromatosis
k) Syringomyelia
Seizure
a) Epilepsy
b) Convulsion
Speech and Language
Weakness and Fatigue
a) Cerebral artery territories
b) Upper motor neurone vs lower motor neurone
c) Muscle weakness grading
d) Cord compression
e) Transverse myelitis
f) Carcinomatosis

g)
h)
i)
j)
k)
l)
m)
n)
o)

Meningitis
Guillain-barre
Cord infarction
Spinal artery thrombosis
Trauma
Dissecting aortic aneurism
Cauda equina lesions
Management of paralysed patient
Leg weakness (spastic paraparesis, flaccid paraparesis, unilateral foot
drop, weak legs with no sensory loss, absent knee jerks and extensor
plantars)
p) Recognition of different gait disorders
q) Stroke (mimics, risk factors, site of lesion, investigation management and
treatment, rehabilitation, TIA, SAH)
r) Myopathy
s) Myaesthenia gravis
RENAL
1. Urine Abnormalitis
a) Blood, protein, pH, volumes
b) Renal calculi
c) Renal tract obstruction
d) Retroperitoneal fibrosis
e) Glomerulonephritis
f) Nephrotic syndrome
g) Renal vein thrombosis
2. Renal Problems
a) Urinary tract imaging
b) Renal biopsy
c) Acute renal failure
d) Chronic renal failure, renal replacement therapy, renal transplantation
e) Interstitial nephritis
f) Nephrotoxins
g) Renal vascular disease
h) Renal tubular disease
i) Inherited kidney diseases
j) Renal manifestations of systemic disease
3. Urinary excretion
a) Oliguria and polyuria including renal failure;
b) urate
4. Urinary Symptons
a) Pyelonephritis
b) Acute and chronic urinary tract infection (UTI)
c) Frequency
d) Incontinence

e) Enuresis
REPRODUCTIVE
1. Contraception
a) Oral contraceptive pill
b) Intrauterine contraceptive devices (IUCDs)
c) Implants
2. Fertility Problems
a) Both male and female;
b) including normal development in puberty
3. Normal Pregnancy and care
a) Including prenatal diagnosis
b) Role of folic acid
c) Risks to fetus including smoking, alcohol, food issues
4. Problems in Pregnancy
a) Including antepartum haemorrhage, postpartum haemorrhage
miscarriage
b) Ectopic pregnancy
c) Pre-eclampsia, eclampsia and hyperemesis
d) Thyroid disease in pregnancy
e) Epilepsy
f) Anticoagulation
g) Prematurity
h) Low birth weight
5. Irregular vaginal bleeding
a) Including antepartum haemorrhage, postpartum haemorrhage
miscarriage
b) Ectopic pregnancy
c) Pre-eclampsia, eclampsia and hyperemesis
d) Thyroid disease in pregnancy
e) Epilepsy
f) Anticoagulation
g) Prematurity
h) Low birth weight
6. Pelvic mass
a) Including antepartum haemorrhage, postpartum haemorrhage
miscarriage
b) Ectopic pregnancy
c) Pre-eclampsia, eclampsia and hyperemesis
d) Thyroid disease in pregnancy
e) Epilepsy
f) AnticoagulationBreath
g) Prematurity
h) Low birth weight
7. Pelvic Pain

a) Endometriosis
b) PID
c) Dyspareunia
8. Vulval and vaginal lump/lesions

and

and

and

RESPIRATORY
1. Breathlessness
a) Pulmonary fibrosis
b) Any infection, inflammation, including COPD, asthma, occupational lung
disease, sleep apnoea and cyanosis
c) Respiratory system examination, age related changes, chest x-ray
d) Pneumonia including CURB 65
e) Chronic obstructive pulmonary disease (COPD), acute respiratory distress
syndrome
f) Respiratory failure
g) Pulmonary embolus
h) Pneumothorax
i) Pleural effusion
j) Extrinsic allergic alveolitis
k) Cryptogenic fibrosing alveolitis
l) Industrial dust diseases
m) Obstructive sleep apnoea
n) Cor pulmonale
2. Chest Pain
a) Including any pleuritic cause
b) Mesothelioma
c) Pneumothorax
3. Cough and Haemoptiasis
a) Cough and haemoptysis
b) Bronchiectasis
c) Cystic fibrosis
d) Fungi
e) Lung cancer
f) Sarcoidosis
4. Wheeze/ Stridor
a) Asthma acute and chronic
b) Bronchodilators and steroids
SERIOUSLY ILL PATIENT
1. Collapse
a) Subdural, extradural, intracerebral haemorrhage including subarachnoid
haemorrhage (SAH)
b) Hypertensive encephalopathy
c) Epilepsy
d) Addisonian crisis

e) Drug poisoning
f) Hypoglycaemia
g) Hyperglycaemia
h) Hypoxia
i) Hypothermia
j) Encephalopathy
2. Fever/Infection
a) Including pyrexia of unknown origin, septicaemia, meningitis and
neutropaenic sepsis
b) Bacterial viral meningitis
c) Pneumonia
d) Acute severe asthma
e) PE
3. Multiple Trauma
a) Including head injury and intra-abdominal injury
4. Schock
a) Paracetamol overdose
b) Salicylate overdose
c) Any cause including blood loss
d) Acute myocardial infarction (MI)
e) Intra abdominal blood loss
f) Massive pulmonary embolus
g) Burns
SKIN
1. Bites and Stings
a) Including infestations
b) Insect
c) Fish
d) Scorpion
e) Snake
f) Dog/cat bites
g) Human bite
h) Scabies
i) Lice
2. Bullous
a) Pemphigus
b) Pemphigoid
3. Dermatological manifestations of systemic disease
a) Endocrine
b) Cancer
c) Connective tissue
4. Extreme of Temperature
a) Burns,
b) frostbite,

5.

6.

7.

8.

9.

10.

c) hyperthermia
d) hypothermia
Itchy ando r scaly rashes
a) Excess hair
b) Hair loss
c) Nail changes in systemic diseases
d) Psoriasis
e) Fungal infections of nails
Hair and nail
a) Including eczema,
b) dermatoses (psoriasis etc.)
c) reactions (drugs/food)
Infections
a) Including viral,
b) bacterial and
c) fungal infections
Lumps
a) Nodular lesions
b) Skin tumour
c) BCC
d) Ganglion
Moles and Pingmented lesios
a) Benign
b) Vitiligo
c) Malignant including melanoma
Ulcers
a) Arterial
b) Venous
c) Neuropathic
d) Malignant

UROLOGICAL
1. Groin scrotal pain and or swelling
a) Torsion of testis
b) Hernias
c) Hydrocele
d) Tumour
e) Orchitis
f) Infection
2. Urinary tract obstruction
a) Calculus
b) Tumours (benign and malignant)
c) Strictures
d) Bladder neck obstruction
e) Enuresis