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NCBI STATPEARLS + PUBMED + OPEN-I VERIFIED SEED TAXONOMY

Medipaedia.org Master Clinical Topic Taxonomy (By Specialty & ICD-10/11)

Standardized 10-Section High-Yield Clinical Reference Matrix across 19 Medical Specialties with verified ICD-10/11 codes, Classic Triads, Gold-Standard Diagnostic Tests, and First-Line Treatment Protocols.

All 19 Specialties (60)CardiologyRespiratoryGastroenterology & HepatologyNephrology & UrologyNeurologyEndocrinology & MetabolismHaematology & OncologyInfectious DiseasesRheumatology & ImmunologyEmergency Medicine & Critical CareGeneral & Specialty SurgeryPaediatricsObstetrics & GynaecologyDermatologyPsychiatryOphthalmology & ENTPathology & Laboratory MedicineMusculoskeletal & TraumaRadiology & Medical Imaging
# Topic, Specialty & ICD-10/11 Classic Triad / Key Presentation Gold-Standard Diagnostic Test First-Line Treatment Protocol Status
1 Acute pericarditis
ICD-10: I30.9 ICD-11: BB20.Z Cardiology
Pleuritic chest pain relieved by sitting forward + Pericardial friction rub + Widespread concave ST elevation & PR depression 12-Lead ECG + Transthoracic Echocardiography (β‰₯2 of 4 ESC Criteria) High-dose Aspirin (750–1000 mg q8h) or Ibuprofen (600 mg q8h) + Colchicine (0.5 mg OD/BD for 3 months) βœ“ Published (mID 10001)
2 ST-elevation myocardial infarction
ICD-10: I21.3 ICD-11: BA41.0 Cardiology
Crushing retrosternal chest pain >20 min + Diaphoresis/autonomic surge + Contiguous J-point ST elevation (or new LBBB) 12-Lead ECG within 10 min of FMC + Emergency Coronary Angiography Immediate DAPT loading (Aspirin 300 mg + Ticagrelor 180 mg / Prasugrel 60 mg) + Primary PCI within 120 minutes βœ“ Published (mID 10002)
3 Atrial fibrillation
ICD-10: I48.91 ICD-11: BC81.3 Cardiology
Irregularly irregular pulse + Absence of distinct P waves on ECG + Variable ventricular rate (palpitations/dyspnoea) 12-Lead ECG (or β‰₯30s single-lead rhythm strip showing absent P waves and irregular RR intervals) CHAβ‚‚DSβ‚‚-VASc stroke anticoagulation (DOAC: Apixaban/Rivaroxaban) + Rate control (Bisoprolol/Diltiazem) or Rhythm control βœ“ Published (mID 10016)
4 Infective endocarditis (modified Duke criteria)
ICD-10: I33.0 ICD-11: BB40 Cardiology
Persistent fever + New regurgitant heart murmur + Embolic/immunological phenomena (Janeway lesions, Osler nodes, splinter haemorrhages) 3 sets of peripheral blood cultures prior to antibiotics + Transoesophageal Echocardiography (TOE/TEE) Empiric IV bactericidal antibiotics (Amoxicillin + Flucloxacillin + Gentamicin or Vancomycin) for 4–6 weeks + early valve surgery if heart failure βœ“ Published (mID 10018)
5 Cardiac tamponade (Beck triad)
ICD-10: I31.4 ICD-11: BB24 Cardiology
Beck's Triad: Systemic hypotension + Distended neck veins (raised JVP with absent y-descent) + Muffled heart sounds (+ Pulsus paradoxus >10 mmHg) Bedside Transthoracic Echocardiography (diastolic RV collapse, systolic RA collapse, swinging heart, electrical alternans on ECG) Immediate ultrasound-guided pericardiocentesis (or surgical pericardiotomy in traumatic/post-cardiotomy tamponade) βœ“ Published (mID 10019)
6 Aortic dissection
ICD-10: I71.00 ICD-11: BD50.0 Cardiology
Sudden tearing interscapular chest/back pain + Inter-arm BP differential >20 mmHg / pulse deficit + Mediastinal widening / aortic regurgitation ECG-gated CT Aortography (CTA) demonstrating intimal flap separating true and false lumens (TOE if unstable) Anti-impulse therapy (IV Labetalol/Esmolol targeting HR <60 bpm and SBP 100–120 mmHg) + Emergency surgical repair for Stanford Type A βœ“ Published (mID 10020)
7 Brugada syndrome
ICD-10: I49.8 ICD-11: BC65.0 Cardiology
Type 1 coved ST-segment elevation β‰₯2 mm in V1–V2 + Negative T wave + Syncope or nocturnal polymorphic VT/VF in structurally normal heart 12-Lead ECG with high precordial leads (2nd/3rd intercostal space) Β± Sodium channel blocker provocation (Ajmaline/Flecainide) Implantable Cardioverter-Defibrillator (ICD) for cardiac arrest survivors/spontaneous Type 1 + syncope; aggressive antipyretics during fever βœ“ Published (mID 10009)
8 De Winter T waves
ICD-10: I21.0 ICD-11: BA41.0 Cardiology
Upsloping J-point ST depression (1–3 mm) in V1–V6 + Tall, prominent symmetric hyperacute T waves + ST elevation (0.5–2 mm) in lead aVR 12-Lead ECG (recognized immediately as an acute proximal LAD occlusion STEMI equivalent) + Emergent Coronary Angiography Immediate Cath Lab activation for Primary PCI + Dual Antiplatelet Therapy (Aspirin + Ticagrelor/Prasugrel) + Anticoagulation βœ“ Published (mID 10010)
9 Sgarbossa criteria
ICD-10: I21.9 ICD-11: BA41 Cardiology
Concordant ST elevation β‰₯1 mm in positive QRS lead (5 pts) + Concordant ST depression β‰₯1 mm in V1–V3 (3 pts) + Smith-modified discordant STE/S-wave ratio ≀ -0.25 12-Lead ECG using Smith-Modified Sgarbossa Rule in LBBB or Ventricular Paced Rhythm Treat immediately as STEMI equivalent -> Emergent Primary PCI reperfusion protocol βœ“ Published (mID 10011)
10 Dressler syndrome
ICD-10: I24.1 ICD-11: BB20.2 Cardiology
Fever + Pleuritic pericarditic chest pain (2–8 weeks post-MI or cardiac surgery) + Pericardial/pleural effusion with elevated CRP/ESR Transthoracic Echocardiography + 12-Lead ECG + Inflammatory markers (CRP/ESR) after excluding recurrent ischaemia High-dose Aspirin (750–1000 mg q8h) + Colchicine (0.5 mg BD for 3 months) βœ“ Published (mID 10012)
11 Takotsubo cardiomyopathy
ICD-10: I51.81 ICD-11: BC43.4 Cardiology
Acute chest pain/dyspnoea after severe emotional/physical stressor + Transient LV apical ballooning + Absence of obstructive culprit coronary artery disease Coronary Angiography with Left Ventriculography + Transthoracic Echocardiography / Cardiac MRI (InterTAK Criteria) Supportive heart failure therapy (ACE inhibitor/ARB + Beta-blocker); avoid inotropes if LV outflow tract obstruction (LVOTO) is present βœ“ Published (mID 10013)
12 Pulmonary embolism
ICD-10: I26.99 ICD-11: BB00 Respiratory
Sudden-onset dyspnoea + Pleuritic chest pain + Tachycardia / Hypoxaemia (or obstructive shock in massive PE) CT Pulmonary Angiography (CTPA) (after Wells Score + Age-adjusted D-dimer in low/intermediate probability) Direct Oral Anticoagulant (Apixaban or Rivaroxaban); Systemic Thrombolysis (Alteplase) for haemodynamically unstable high-risk PE βœ“ Published (mID 10003)
13 Light criteria for pleural effusion
ICD-10: J90 ICD-11: CB27 Respiratory
Exudate if β‰₯1 of 3: Pleural/Serum protein >0.5 + Pleural/Serum LDH >0.6 + Pleural LDH >2/3 upper limit of normal serum LDH Ultrasound-guided diagnostic thoracentesis with paired pleural fluid and serum protein, LDH, pH, glucose, cytology, and microbiology Treat underlying cause; chest tube drainage if complicated parapneumonic effusion/empyema (pleural pH <7.20, frank pus, or positive Gram stain) βœ“ Published (mID 10021)
14 CURB-65 pneumonia severity score
ICD-10: J18.9 ICD-11: CA40 Respiratory
Confusion (AMTS ≀8) + Urea >7 mmol/L + Respiratory rate β‰₯30/min + BP <90 systolic or ≀60 diastolic + Age β‰₯65 years (1 point each) Chest Radiograph (new focal consolidation) + Clinical/Biochemical CURB-65 stratification Score 0–1: Oral Amoxicillin outpatient; Score 2: Inpatient IV/PO Amoxicillin + Clarithromycin; Score β‰₯3: Co-amoxiclav + Clarithromycin Β± ICU assessment βœ“ Published (mID 10023)
15 Acute severe asthma
ICD-10: J45.901 ICD-11: CA23.3 Respiratory
PEF 33–50% best/predicted + Respiratory rate β‰₯25/min + Heart rate β‰₯110/min and inability to complete sentences in one breath (Life-threatening: silent chest, PEF <33%, normal/raised PaCO2) Serial Peak Expiratory Flow (PEF) + Arterial Blood Gas (ABG β€” normal or rising PaCO2 >4.6 kPa indicates impending respiratory arrest) High-flow Oxygen (target SpO2 94–98%) + Back-to-back nebulised Salbutamol (5 mg) & Ipratropium (0.5 mg) + Systemic Corticosteroids (Prednisolone 40–50 mg PO or Hydrocortisone 100 mg IV) + IV Magnesium sulfate (2 g over 20 min) βœ“ Published (mID 10024)
16 Tension pneumothorax
ICD-10: J93.0 ICD-11: CB21.0 Respiratory
Severe respiratory distress & hypoxia + Unilateral absent breath sounds & hyperresonance + Tracheal deviation away from affected side with obstructive shock Clinical diagnosis (NEVER delay decompression for chest X-ray; bedside eFAST ultrasound shows absent lung sliding and 'barcode/stratosphere sign') Immediate needle thoracostomy decompression (5th intercostal space, mid-axillary line in adults, or 2nd ICS mid-clavicular line) followed by chest drain insertion βœ“ Published (mID 10022)
17 Acute pancreatitis
ICD-10: K85.9 ICD-11: DC31 Gastroenterology & Hepatology
Revised Atlanta Criteria (β‰₯2 of 3): Severe epigastric pain radiating to the back + Serum lipase/amylase β‰₯3Γ— ULN + Characteristic CECT/MRI pancreatitis findings Serum Lipase (more specific and stays elevated longer than amylase) + Right Upper Quadrant Ultrasound (to detect gallstones) Goal-directed balanced crystalloid resuscitation (Ringer's Lactate) + Multimodal analgesia + Early oral/enteral nutrition within 24–48h + Index laparoscopic cholecystectomy if gallstone-induced βœ“ Published (mID 10006)
18 Spontaneous bacterial peritonitis
ICD-10: K65.2 ICD-11: DB99.7 Gastroenterology & Hepatology
Ascites in cirrhotic patient + Fever / Diffuse abdominal tenderness + Hepatic encephalopathy or acute kidney injury (often asymptomatic in 30%) Diagnostic Paracentesis showing Ascitic Fluid Absolute Polymorphonuclear (PMN / Neutrophil) count β‰₯250 cells/mmΒ³ (β‰₯0.25 Γ— 10⁹/L) Empiric IV 3rd-generation Cephalosporin (Cefotaxime 2 g q8h or Ceftriaxone 2 g OD for 5 days) + IV Albumin (1.5 g/kg on Day 1 and 1.0 g/kg on Day 3 to prevent Hepatorenal Syndrome) βœ“ Published (mID 10025)
19 Acute cholangitis
ICD-10: K83.0 ICD-11: DC12.0 Gastroenterology & Hepatology
Charcot's Triad: Fever with rigors + Right upper quadrant pain + Obstructive jaundice (Reynolds' Pentad adds: Septic shock + Confusion/altered mental status) Tokyo Guidelines (systemic inflammation + cholestasis + biliary dilatation/choledocholithiasis on RUQ Ultrasound, MRCP, or EUS) IV broad-spectrum antibiotics (Piperacillin-tazobactam or Ceftriaxone + Metronidazole) + Crystalloid resuscitation + Urgent biliary decompression via ERCP within 24–48 hours βœ“ Published (mID 10026)
20 Upper gastrointestinal bleeding
ICD-10: K92.2 ICD-11: ME24.90 Gastroenterology & Hepatology
Haematemesis (red blood or coffee-ground emesis) + Melaena (black, tarry stools) + Haemodynamic instability / elevated urea-to-creatinine ratio Oesophagogastroduodenoscopy (OGD / EGD) within 24 hours (within 12 hours if suspected variceal bleed) + Glasgow-Blatchford Score risk stratification Restrictive RBC transfusion (threshold Hb <70 g/L) + Non-variceal: Endoscopic therapy (clips/adrenaline/thermal) + IV PPI; Variceal: IV Terlipressin/Octreotide + IV Ceftriaxone + Endoscopic variceal band ligation βœ“ Published (mID 10027)
21 Acute appendicitis
ICD-10: K35.80 ICD-11: DB10.0 General & Specialty Surgery
Migratory periumbilical pain localising to McBurney's point (RIF) + Anorexia/nausea + Rebound tenderness / Rovsing's / Psoas / Obturator sign & low-grade pyrexia Contrast-enhanced CT Abdomen & Pelvis in adults (appendiceal diameter >6 mm, wall thickening, periappendiceal fat stranding); Graded-compression Ultrasound in children/pregnancy Laparoscopic Appendicectomy + Perioperative IV broad-spectrum antibiotics (e.g., Cefuroxime + Metronidazole or Co-amoxiclav) βœ“ Published (mID 10015)
22 Boerhaave syndrome (oesophageal perforation)
ICD-10: K22.3 ICD-11: DA25.2 General & Specialty Surgery
Mackler's Triad: Forceful retching/vomiting + Sudden severe lower thoracic/epigastric chest pain + Subcutaneous cervical emphysema (+ Hamman's crunch) CT Thorax/Oesophagography with water-soluble oral contrast (Gastrografin β€” NEVER barium due to mediastinitis risk) showing transmural posterolateral left distal oesophageal leak NPO + Nasogastric decompression + Broad-spectrum IV antibiotics & antifungals + Urgent primary surgical repair (<24h) or endoscopic covered stent/vacuum therapy βœ“ Published (mID 10028)
23 Acute mesenteric ischaemia
ICD-10: K55.0 ICD-11: DD30.0 General & Specialty Surgery
Sudden severe abdominal pain out of proportion to physical examination findings + Gut emptying (vomiting/diarrhoea) + Embolic source (Atrial fibrillation) & rising serum lactate Biphasic CT Mesenteric Angiography (CTA) demonstrating superior mesenteric artery (SMA) thromboembolism, absent bowel wall enhancement, or pneumatosis intestinalis Immediate IV unfractionated heparin + Fluid resuscitation + Broad-spectrum antibiotics + Emergent endovascular/open SMA embolectomy and laparotomy for necrotic bowel resection βœ“ Published (mID 10029)
24 Diabetic ketoacidosis
ICD-10: E10.10 ICD-11: 5A10 Endocrinology & Metabolism
UK JBDS Triad: Ketonaemia β‰₯3.0 mmol/L (or ketonuria β‰₯2+) + Blood glucose >11.0 mmol/L (or known diabetes) + Venous HCO3- <15.0 mmol/L and/or venous pH <7.3 Bedside capillary beta-hydroxybutyrate ketones + Venous Blood Gas (pH, HCO3-, anion gap, K+) + Plasma glucose IV 0.9% NaCl resuscitation + Potassium replacement (40 mmol/L if K+ 3.5–5.5) + Fixed-Rate IV Insulin Infusion (0.1 units/kg/hr; add 10% glucose when BG <14 mmol/L) βœ“ Published (mID 10004)
25 Thyroid storm (Burch-Wartofsky score)
ICD-10: E05.91 ICD-11: 5A02.Z Endocrinology & Metabolism
Hyperpyrexia (>38.5–40Β°C) + Severe tachycardia / atrial fibrillation / high-output heart failure + CNS agitation, delirium, or coma Clinical diagnosis supported by Burch-Wartofsky Point Scale (β‰₯45 points highly suggestive) + Suppressed TSH (<0.01 mIU/L) and markedly elevated free T4/free T3 1. Beta-blockade (IV Propranolol/Esmolol) -> 2. Thionamide (Propylthiouracil 500–1000 mg loading then 250 mg q4h) -> 3. Lugol's Iodine (given β‰₯1 hour AFTER PTU) -> 4. IV Hydrocortisone (100 mg q8h) βœ“ Published (mID 10030)
26 Addisonian crisis (acute adrenal insufficiency)
ICD-10: E27.2 ICD-11: 5A74.1 Endocrinology & Metabolism
Vasopressor-refractory hypotensive shock + Acute abdominal pain/vomiting + Classic biochemical pattern: Hyponatraemia, Hyperkalaemia, and Hypoglycaemia Random serum cortisol & ACTH drawn prior to steroid administration (never delay treatment for Short Synacthen / Cosyntropin stimulation test) Immediate IV Hydrocortisone 100 mg stat bolus (followed by 200 mg/24h infusion or 50 mg q6h) + Rapid IV 0.9% Sodium chloride resuscitation + IV Dextrose for hypoglycaemia βœ“ Published (mID 10031)
27 Phaeochromocytoma
ICD-10: D35.00 ICD-11: 2F37 Endocrinology & Metabolism
Classic Episodic Triad: Paroxysmal headache + Profuse diaphoresis + Palpitations/tachycardia with severe episodic or sustained hypertension Plasma free metanephrines or 24-hour urinary fractionated metanephrines and catecholamines + Adrenal CT/MRI (T2 'light-bulb' hyperintensity) Β± 68Ga-DOTATATE PET Pre-operative Alpha-blockade FIRST (Phenoxybenzamine or Doxazosin for 10–14 days) + high-sodium/fluid intake, FOLLOWED BY Beta-blockade (never give beta-blocker before alpha-blockade), then Laparoscopic Adrenalectomy βœ“ Published (mID 10032)
28 Guillain-BarrΓ© syndrome
ICD-10: G61.0 ICD-11: 8C01.0 Neurology
Progressive symmetrical ascending flaccid weakness + Areflexia/hyporeflexia + Preceding respiratory or Campylobacter jejuni GI infection 1–4 weeks prior Lumbar Puncture CSF showing Albuminocytological Dissociation (elevated CSF protein with normal WCC <5/mmΒ³) + Nerve Conduction Studies (demyelination / absent F-waves) Serial Forced Vital Capacity (FVC <20 mL/kg mandates intubation/ICU) + IV Immunoglobulin (IVIG 0.4 g/kg/day for 5 days) or Plasma Exchange (corticosteroids are ineffective) βœ“ Published (mID 10008)
29 Myasthenia gravis and myasthenic crisis
ICD-10: G70.00 ICD-11: 8C60 Neurology
Fatigable fluctuating skeletal muscle weakness (worsening at end of day) + Ocular ptosis & diplopia + Bulbar dysphagia/dysarthria with preserved deep tendon reflexes and sensation Serum anti-Acetylcholine Receptor (anti-AChR) antibodies (or anti-MuSK if seronegative) + Repetitive Nerve Stimulation (decremental response) / Single-fibre EMG + CT Thorax (to exclude thymoma) Symptomatic: Pyridostigmine + Immunosuppression (Prednisolone/Azathioprine) + Thymectomy; Myasthenic Crisis: Intubation (if FVC <15–20 mL/kg) + Plasma Exchange or IVIG βœ“ Published (mID 10033)
30 Wallenberg syndrome (lateral medullary syndrome)
ICD-10: I63.53 ICD-11: 8B11 Neurology
Ipsilateral Horner's syndrome + Ipsilateral facial pain/temperature loss & cerebellar ataxia + Contralateral trunk/limb pain & temperature loss (+ dysphagia/hoarseness from nucleus ambiguus) Diffusion-Weighted MRI (DWI) of the Brain & Posterior Fossa + CT/MR Angiography of the Vertebral and Posterior Inferior Cerebellar Artery (PICA) Acute ischaemic stroke protocol (IV Alteplase/Tenecteplase if within 4.5h window) + Strict NPO & speech/swallow evaluation to prevent aspiration pneumonia + Secondary stroke prevention βœ“ Published (mID 10034)
31 Wernicke encephalopathy
ICD-10: E51.2 ICD-11: 5B55.1 Neurology
Classic Triad: Acute confusion/encephalopathy + Oculomotor dysfunction (horizontal nystagmus, bilateral CN VI palsy, conjugate gaze palsy) + Gait ataxia Clinical diagnosis (MRI Brain shows symmetric T2/FLAIR hyperintensity in mammillary bodies, dorsomedial thalami, tectal plate, and periaqueductal grey) Immediate high-dose parenteral IV Thiamine (Vitamin B1, 500 mg IV TDS for 3–5 days) ALWAYS administered BEFORE or concurrently with IV glucose to prevent precipitating Korsakoff syndrome βœ“ Published (mID 10035)
32 Pre-eclampsia and eclampsia
ICD-10: O14.9 ICD-11: JA24 Obstetrics & Gynaecology
New-onset hypertension (BP β‰₯140/90 mmHg) after 20 weeks' gestation + Proteinuria (urine PCR β‰₯30 mg/mmol or β‰₯300 mg/24h) or maternal end-organ dysfunction (thrombocytopenia, elevated transaminases, renal insufficiency, pulmonary oedema, visual/cerebral symptoms) Repeated BP measurements + Spot Urine Protein:Creatinine Ratio (PCR β‰₯30 mg/mmol) + sFlt-1:PlGF ratio + FBC, LFTs, Creatinine, and Fetal Umbilical Artery Doppler Antihypertensive control (Oral Labetalol, Nifedipine MR, or Methyldopa; IV Labetalol/Hydralazine if BP β‰₯160/110) + IV Magnesium sulfate (4 g loading over 15–20 min then 1 g/hr infusion) for seizure prophylaxis/eclampsia + Definitive delivery βœ“ Published (mID 10017)
33 HELLP syndrome
ICD-10: O14.2 ICD-11: JA24.2 Obstetrics & Gynaecology
Tennessee Criteria Triad: Haemolysis (schistocytes on blood film, LDH β‰₯600 IU/L, or bilirubin β‰₯1.2 mg/dL) + Elevated Liver enzymes (AST/ALT β‰₯2Γ— ULN) + Low Platelets (<100 Γ— 10⁹/L) with RUQ/epigastric pain Peripheral Blood Smear (schistocytes/helmet cells) + Serum LDH, haptoglobin, AST/ALT, and platelet count Maternal stabilization (IV Magnesium sulfate for eclampsia prophylaxis + IV Labetalol/Nifedipine for severe hypertension) + Prompt delivery once maternal coagulopathy/BP stabilized (if β‰₯34 weeks or deteriorating) βœ“ Published (mID 10036)
34 Ectopic pregnancy
ICD-10: O00.9 ICD-11: JA01 Obstetrics & Gynaecology
Amenorrhoea (6–8 weeks) + Unilateral iliac fossa/pelvic pain + Vaginal bleeding (+ shoulder-tip pain and haemodynamic shock if ruptured) Transvaginal Ultrasound (TVUS showing empty uterine cavity with adnexal mass / 'tubal ring sign' / free fluid in Pouch of Douglas) + Serial serum quantitative beta-hCG (48h rise <63%) Ruptured/haemodynamically unstable or fetal heartbeat or beta-hCG >5000 IU/L: Laparoscopic Salpingectomy; Unruptured, stable, adnexal mass <35 mm, beta-hCG <1500–5000 IU/L: Single-dose IM Methotrexate (50 mg/mΒ²) βœ“ Published (mID 10037)
35 Henoch-SchΓΆnlein purpura (IgA vasculitis)
ICD-10: D69.0 ICD-11: 4A44.90 Paediatrics
Classic Tetrad: Palpable purpura over buttocks & extensor lower limbs (with normal platelets) + Arthralgia/arthritis + Colicky abdominal pain (risk of intussusception) + IgA glomerulonephritis (haematuria/proteinuria) Clinical diagnosis (EULAR/PRINTO/PRES criteria) + FBC/coagulation screen (normal platelets exclude ITP) + Urine dipstick/PCR & BP monitoring (skin/renal biopsy shows IgA immune complex deposition) Supportive analgesia + 6–12 months of regular urinalysis and blood pressure monitoring for HSP nephritis; corticosteroids reserved for severe GI pain/haemorrhage or progressive crescentic nephritis βœ“ Published (mID 10038)
36 Toxic epidermal necrolysis (SCORTEN score)
ICD-10: L51.2 ICD-11: EB13.1 Dermatology
Febrile prodrome after culprit drug (Allopurinol, Lamotrigine, Carbamazepine, Sulfonamides) + Painful erythematous/dusky macules with positive Nikolsky sign (>30% BSA detachment in TEN; <10% in SJS) + Haemorrhagic mucositis of β‰₯2 mucosal surfaces (oral, ocular, urogenital) Clinical assessment of Body Surface Area (BSA) epidermal detachment + Skin Biopsy (frozen/paraffin section showing full-thickness epidermal keratinocyte necrosis and subepidermal split) + SCORTEN prognostic score Immediate withdrawal of culprit drug + Transfer to ICU / Severe Burns Unit + Aggressive fluid/electrolyte & nutritional support + Non-adherent wound dressings + Urgent Ophthalmology review (Ciclosporin/Etanercept/IVIG per specialist protocol) βœ“ Published (mID 10039)
37 Heparin-induced thrombocytopenia (HIT)
ICD-10: D75.82 ICD-11: 3B64.13 Haematology & Oncology
4Ts Score: Platelet count fall >50% (nadir typically 20–100 Γ— 10⁹/L) + Onset 5–10 days after starting UFH/LMWH + Paradoxical arterial or venous thrombosis (white clot syndrome) with absence of other causes 4Ts Pre-test Probability Score + Anti-PF4/heparin IgG ELISA immunoassay, confirmed by functional Serotonin Release Assay (SRA) or HIPA STOP all heparin immediately (including heparin flushes and LMWH) + Start non-heparin therapeutic anticoagulation (Argatroban, Bivalirudin, Fondaparinux, or Danaparoid; avoid warfarin until platelets recover >150 Γ— 10⁹/L; avoid platelet transfusions) βœ“ Published (mID 10040)
38 Thrombotic thrombocytopenic purpura (TTP)
ICD-10: M31.1 ICD-11: 3B64.14 Haematology & Oncology
Classic Pentad: Microangiopathic haemolytic anaemia (MAHA with schistocytes) + Severe thrombocytopenia + Fluctuating neurological deficits + Renal impairment + Fever (caused by severe ADAMTS13 deficiency <10%) Peripheral Blood Film (numerous schistocytes) + PLASMIC Score + Severe ADAMTS13 activity deficiency (<10%) with anti-ADAMTS13 autoantibodies Emergency daily Plasma Exchange (PEX) started within 4–8 hours + High-dose Corticosteroids (Methylprednisolone) + Rituximab + Caplacizumab (anti-vWF nanobody); NEVER transfuse platelets unless life-threatening haemorrhage + Generate / Claim
39 Biceps femoris avulsion fracture
ICD-10: S82.40 ICD-11: NC92 Musculoskeletal & Trauma
Acute posterolateral knee pain after varus/hyperextension trauma + Tenderness/swelling over lateral fibular head with varus laxity + Avulsed osseous fragment from lateral fibular head (risk of common peroneal nerve foot drop) AP/Lateral Knee Radiograph + Knee MRI (delineating conjoined biceps femoris & fibular collateral ligament tendon attachment, posterolateral corner structures, ACL/PCL, and common peroneal nerve) Displaced fragment or posterolateral rotatory instability: Prompt open anatomic suture-anchor / screw fixation of the fibular head avulsion with common peroneal nerve neurolysis and concurrent cruciate reconstruction βœ“ Published (mID 10005)
40 Acute kidney injury (KDIGO classification)
ICD-10: N17.9 ICD-11: GB60 Nephrology & Urology
KDIGO Criteria: Serum creatinine rise β‰₯26.5 Β΅mol/L (0.3 mg/dL) within 48h + OR β‰₯1.5Γ— baseline within 7 days + OR Urine output <0.5 mL/kg/h for β‰₯6 hours Serial Serum Creatinine & Hourly Urine Output + Urinalysis/Microscopy (muddy brown granular casts in ATN) + Renal Tract Ultrasound (to exclude post-renal hydronephrosis) Stop nephrotoxins (NSAIDs, ACEi/ARBs, aminoglycosides, iodinated contrast) + Euvolaemic isotonic crystalloid resuscitation + Treat hyperkalaemia (IV Calcium gluconate + Insulin/Dextrose) + Urgent RRT if refractory βœ“ Published (mID 10041)
41 Nephrotic syndrome
ICD-10: N04.9 ICD-11: GB41 Nephrology & Urology
Classic Tetrad: Heavy proteinuria (>3.5 g/24h or Urine PCR >300–350 mg/mmol) + Hypoalbuminaemia (<25–30 g/L) + Generalized pitting oedema (periorbital/peripheral) + Hyperlipidaemia / lipiduria ('Maltese cross' casts) 24-hour Urine Protein or Spot Urine Protein:Creatinine Ratio (PCR) + Serum Albumin + Ultrasound-guided Percutaneous Renal Biopsy in adults (Light, Immunofluorescence, and Electron Microscopy) Sodium restriction + Loop diuretics (Furosemide) + ACE inhibitor/ARB (antiproteinuric) + VTE prophylaxis if albumin <20 g/L + Disease-specific immunosuppression (Prednisolone in Paediatric Minimal Change Disease; Rituximab/Calcineurin inhibitor in Membranous Nephropathy) βœ“ Published (mID 10042)
42 Testicular torsion
ICD-10: N44.00 ICD-11: GB01 Nephrology & Urology
Sudden-onset severe unilateral scrotal/inguinal pain + High-riding transversely oriented testis ('bell-clapper deformity') + Absent ipsilateral cremasteric reflex & negative Prehn's sign with nausea/vomiting Clinical diagnosis (NEVER delay theatre for imaging if high suspicion; Color Doppler Scrotal Ultrasound shows absent intratesticular arterial blood flow and 'whirlpool sign' of twisted spermatic cord) Emergency surgical scrotal exploration within the 6-hour golden viability window: Detorsion and bilateral orchidopexy (or orchidectomy if necrotic + contralateral orchidopexy) βœ“ Published (mID 10043)
43 Hepatorenal syndrome
ICD-10: K76.7 ICD-11: DB99.6 Nephrology & Urology
Decompensated cirrhosis with ascites + Progressive KDIGO AKI (unresponsive after 48h of diuretic withdrawal and IV Albumin 1 g/kg/day expansion) + Bland urine sediment (<50 RBCs/hpf, protein <500 mg/day) and normal renal ultrasound International Club of Ascites (ICA) Diagnostic Criteria + Fractional Excretion of Sodium (FENa <0.2%) + Diagnostic Paracentesis (to exclude Spontaneous Bacterial Peritonitis) IV Terlipressin (2–12 mg/24h continuous infusion or 1 mg q4–6h) OR IV Noradrenaline + Daily IV 20% Albumin (20–40 g/day) + Expedited Liver Transplantation evaluation βœ“ Published (mID 10044)
44 Acute bacterial meningitis
ICD-10: G00.9 ICD-11: 1D01.0 Infectious Diseases
Classic Triad: Fever + Neck stiffness (nuchal rigidity) + Altered mental status/photophobia (+ Kernig's sign, Brudzinski's sign, and non-blanching petechial/purpuric rash in meningococcal septicaemia) Lumbar Puncture CSF Analysis (elevated opening pressure, turbid appearance, polymorphonuclear pleocytosis >1000/mmΒ³, CSF protein >1 g/L, CSF:serum glucose ratio <0.4) + CSF PCR & Blood Cultures Immediate IV Ceftriaxone (2 g BD) + IV Dexamethasone (10 mg q6h for 4 days given before or with first antibiotic dose) + Add IV Amoxicillin (2 g q4h) if age >50, immunocompromised, or pregnant (Listeria coverage) βœ“ Published (mID 10045)
45 Sepsis and septic shock (Sepsis-3 criteria)
ICD-10: A41.9 ICD-11: 1G40 Infectious Diseases
Sepsis-3: Suspected/confirmed infection + Acute SOFA score increase β‰₯2 points; Septic Shock adds: Vasopressor requirement to maintain MAP β‰₯65 mmHg + Serum Lactate >2.0 mmol/L despite adequate fluid resuscitation 2 sets of Blood Cultures (aerobic & anaerobic) prior to antimicrobials + Serial Arterial/Venous Serum Lactate + Full SOFA organ dysfunction panel (PaO2/FiO2, platelets, bilirubin, creatinine, GCS, MAP) Sepsis Six / Surviving Sepsis 1-Hour Bundle: IV broad-spectrum antimicrobials within 1 hour + 30 mL/kg balanced crystalloid for hypotension/lactate β‰₯4 mmol/L + Early Noradrenaline vasopressor targeting MAP β‰₯65 mmHg + Source control βœ“ Published (mID 10046)
46 Severe falciparum malaria
ICD-10: B50.0 ICD-11: 1F40 Infectious Diseases
Cyclical fever/rigors in returning traveller from endemic region + Thick & thin blood film showing Plasmodium falciparum hyperparasitaemia (>2–5%) / Maurer's clefts + Cerebral malaria, severe anaemia, hypoglycaemia, metabolic acidosis, or blackwater fever (AKI) 3 serial Giemsa-stained Thick (sensitivity) and Thin (species identification & percentage parasitaemia) Peripheral Blood Films + Rapid Diagnostic Antigen Test (HRP2/pLDH) Parenteral IV Artesunate (2.4 mg/kg at 0, 12, and 24 hours, then daily) followed by a full 3-day oral Artemisinin-based Combination Therapy (ACT, e.g., Artemether-lumefantrine) + Strict blood glucose monitoring βœ“ Published (mID 10047)
47 Dengue haemorrhagic fever and dengue shock syndrome
ICD-10: A97.2 ICD-11: 1D2Z Infectious Diseases
Defervescence critical phase (Days 3–7): High fever with retro-orbital headache/myalgia + Progressive thrombocytopenia (<100 Γ— 10⁹/L) with rising haematocrit (β‰₯20% haemoconcentration from plasma leakage) + Narrow pulse pressure (≀20 mmHg) / pleural effusion / ascites Dengue NS1 Antigen ELISA/Rapid Test (Days 1–5) + Dengue IgM/IgG MAC-ELISA (Day β‰₯5) + Serial hourly Haematocrit (PCV) and Platelet monitoring Protocolized judicious isotonic crystalloid titration (0.9% NaCl / Ringer's Lactate guided by hourly urine output 0.5–1 mL/kg/h and serial haematocrit; rescue colloid/blood transfusion if refractory shock; strictly avoid NSAIDs/Aspirin) βœ“ Published (mID 10048)
48 Systemic lupus erythematosus (EULAR/ACR criteria)
ICD-10: M32.9 ICD-11: 4A40.0 Rheumatology & Immunology
Entry criterion ANA β‰₯1:80 + Mucocutaneous (malar butterfly rash sparing nasolabial folds, photosensitivity, oral ulcers) + Non-erosive polyarthritis / Serositis / Lupus nephritis / Cytopenias with hypocomplementaemia (low C3/C4) Antinuclear Antibody (ANA β‰₯1:80 screening) + High-specificity Anti-dsDNA (correlates with lupus nephritis disease activity) and Anti-Smith (Anti-Sm) antibodies + Complement C3/C4 + Urine PCR/Renal Biopsy Universal Hydroxychloroquine (≀5 mg/kg/day for all patients unless contraindicated) + Photoprotection + Corticosteroids for flares + Mycophenolate mofetil / Cyclophosphamide / Belimumab / Rituximab for organ-threatening Lupus Nephritis βœ“ Published (mID 10049)
49 Giant cell arteritis (temporal arteritis)
ICD-10: M31.6 ICD-11: 4A44.2 Rheumatology & Immunology
Age >50 years with new unilateral temporal headache & scalp tenderness + Jaw claudication + Visual disturbance (amaurosis fugax / anterior ischaemic optic neuropathy) & Polymyalgia rheumatica with ESR >50 mm/hr / elevated CRP Colour Duplex Ultrasound of the Temporal & Axillary Arteries (non-compressible hypoechoic 'halo sign') + Temporal Artery Biopsy within 2 weeks of starting steroids (granulomatous panarteritis with multinucleated giant cells and internal elastic lamina fragmentation) IMMEDIATE High-Dose Corticosteroids (NEVER wait for biopsy): Visual symptoms present -> IV Methylprednisolone 500–1000 mg daily for 3 days then Prednisolone 60 mg OD; No visual loss -> Oral Prednisolone 40–60 mg OD + Tocilizumab (IL-6 inhibitor) steroid-sparing therapy βœ“ Published (mID 10050)
50 Septic arthritis
ICD-10: M00.9 ICD-11: FA10 Rheumatology & Immunology
Acute hot, swollen, erythematous monoarthritis + Severe pain with complete inability to bear weight or tolerate passive range of motion + Fever & elevated CRP/ESR/WCC (Kocher criteria in paediatric hip) Urgent Synovial Fluid Aspiration PRIOR to antibiotics (Synovial WCC >50,000/mmΒ³ with >90% neutrophils, Gram stain, culture, and polarized light microscopy to exclude crystal arthropathy) + Blood Cultures Emergency arthroscopic or open surgical joint washout/debridement + Empiric IV antibiotics (Flucloxacillin or Vancomycin + Ceftriaxone if gonococcal/Gram-negative risk) for 4–6 weeks βœ“ Published (mID 10051)
51 Neuroleptic malignant syndrome
ICD-10: G21.0 ICD-11: 8A04.4 Psychiatry
FEVER Mnemonic after dopamine D2 antagonist (Haloperidol/Olanzapine) or dopamine withdrawal: Fever (>38.5–40Β°C) + Encephalopathy (delirium/stupor) + Vitals unstable (autonomic lability/tachycardia/diaphoresis) + Elevated enzymes (CK >1,000–100,000 IU/L) + Lead-pipe muscle Rigidity (hyporeflexia) Clinical diagnosis (DSM-5 / Levenson Criteria) + Markedly elevated Serum Creatine Kinase (CK), leukocytosis, metabolic acidosis, and urine myoglobin (to monitor for rhabdomyolysis-induced AKI) Immediate cessation of causative antipsychotic (or restart dopaminergic agent if withdrawal-induced) + ICU supportive cooling & aggressive IV crystalloid hydration + IV Dantrolene (1–2.5 mg/kg) + Oral Bromocriptine (dopamine agonist) or Lorazepam βœ“ Published (mID 10052)
52 Serotonin syndrome (Hunter criteria)
ICD-10: G92.0 ICD-11: NE60 Psychiatry
Rapid-onset (<24h) Classic Triad after serotonergic drug (SSRI + MAOI/Tramadol/Linezolid/MDMA): Neuromuscular hyperactivity (spontaneous/inducible ankle clonus, hyperreflexia, tremor) + Autonomic hyperactivity (hyperthermia, diaphoresis, mydriasis, tachycardia) + Altered mental status (agitation/delirium) Hunter Serotonin Toxicity Criteria (clinical diagnosis in the presence of a serotonergic agent + inducible/spontaneous/ocular clonus, agitation, diaphoresis, tremor, and hyperreflexia) Stop all serotonergic agents immediately + Benzodiazepines (IV Lorazepam/Diazepam for agitation, tremor, and hyperthermia) + IV fluids & active cooling + Serotonin 5-HT2A antagonist Cyproheptadine (12 mg PO/NG stat then 2 mg q2h) in moderate-to-severe cases βœ“ Published (mID 10053)
53 Delirium tremens (alcohol withdrawal delirium)
ICD-10: F10.231 ICD-11: 6C40.4 Psychiatry
Onset 48–96 hours after last alcohol drink: Global confusion & terrifying visual/tactile hallucinations (formication / Lilliputian hallucinations) + Severe autonomic hyperactivity (fever, profuse diaphoresis, tachycardia, hypertension) + Coarse tremor / generalized tonic-clonic withdrawal seizures Clinical assessment using CIWA-Ar Score (β‰₯20 indicates severe withdrawal) + Serum Electrolytes (correct hypomagnesaemia, hypokalaemia, and hypophosphataemia), glucose, and LFTs Symptom-triggered or front-loaded long-acting Benzodiazepines (Oral Chlordiazepoxide or IV Diazepam; use Lorazepam/Oxazepam in severe hepatic cirrhosis) + High-dose parenteral IV Thiamine (Pabrinex) BEFORE glucose + Magnesium/potassium replacement βœ“ Published (mID 10054)
54 Acute angle-closure glaucoma
ICD-10: H40.21 ICD-11: 9C61.2 Ophthalmology & ENT
Sudden severe unilateral ocular/peri-orbital pain with headache, nausea & vomiting + Blurred vision with rainbow-coloured halos around lights + Red eye (ciliary flush), hazy oedematous cornea, fixed mid-dilated non-reactive pupil, and rock-hard globe on palpation Goldmann Applanation Tonometry (Intraocular Pressure IOP typically >40–60 mmHg; normal 10–21 mmHg) + Slit-lamp examination & Gonioscopy of both eyes showing closed iridocorneal angle Immediate IOP reduction: IV Acetazolamide (500 mg stat) + Topical Timolol 0.5%, Apraclonidine/Brimonidine, and Pilocarpine 2%–4% (once IOP <40 mmHg) + Supine positioning + Definitive Bilateral Laser Peripheral Iridotomy (LPI) once corneal oedema clears βœ“ Published (mID 10055)
55 Central retinal artery occlusion (CRAO)
ICD-10: H34.1 ICD-11: 9B75.0 Ophthalmology & ENT
Sudden, painless, profound unilateral visual loss (counting fingers/light perception) + Relative Afferent Pupillary Defect (RAPD / Marcus Gunn pupil) + Fundoscopy showing pale whitened oedematous retina with a pathognomonic foveal 'Cherry-Red Spot' and cattle-trucking of retinal arterioles Urgent Dilated Fundoscopy & Optical Coherence Tomography (OCT) + Immediate ESR/CRP (to exclude Giant Cell Arteritis in patients >50 years) + Carotid Duplex Ultrasound & Echocardiography/ECG (stroke workup) Ophthalmic & Stroke Emergency (<4.5h window): Exclude arteritic CRAO (give IV Methylprednisolone immediately if GCA suspected) + Ocular massage / IOP reduction (IV Acetazolamide) + Hyperacute Stroke Unit assessment for thrombolysis and secondary vascular prevention βœ“ Published (mID 10056)
56 Ludwig angina
ICD-10: K12.2 ICD-11: DA04 Ophthalmology & ENT
Rapidly progressive bilateral cellulitis of submandibular, sublingual, and submental spaces (usually from mandibular 2nd/3rd molar dental infection) + Woody, brawny induration of the floor of the mouth + Superior/posterior displacement of the tongue causing drooling, trismus, 'hot-potato voice', stridor, and impending airway occlusion Clinical airway assessment first + Contrast-enhanced CT Neck & Thorax (performed ONLY after airway is secure) demonstrating polymicrobial gas-forming submandibular space phlegmon/abscess 1. Immediate Airway Security (Awake fibreoptic nasotracheal intubation or surgical tracheostomy) -> 2. High-dose IV broad-spectrum antibiotics (Ceftriaxone + Metronidazole or Piperacillin-tazobactam + IV Dexamethasone) -> 3. Surgical decompression and extraction of culprit mandibular molars βœ“ Published (mID 10057)
57 High anion gap metabolic acidosis (GOLD MARK)
ICD-10: E87.2 ICD-11: 5C73 Pathology & Laboratory Medicine
Arterial pH <7.35 + Serum Bicarbonate (HCO3-) <22 mmol/L + Elevated Serum Anion Gap ([Na+] - ([Cl-] + [HCO3-])) >12 mmol/L (adjusted for hypoalbuminaemia) with compensatory Kussmaul hyperventilation (Winter's formula: PaCO2 = 1.5 Γ— [HCO3-] + 8 Β± 2) Arterial Blood Gas (ABG) + Serum Electrolytes & Albumin-Corrected Anion Gap + Delta Ratio (Ξ”AG / Ξ”HCO3-) + Serum Osms & Osmolar Gap + Lactate, Beta-hydroxybutyrate, Urinalysis (oxalate crystals), and Salicylate/Toxicology screen Treat the underlying GOLD MARK cause (Glycols -> Fomepizole/Haemodialysis; Oxoproline -> stop paracetamol/NAC; L-lactate -> shock resuscitation; D-lactate -> short-bowel antibiotics; Methanol -> Fomepizole; Aspirin -> urinary alkalinisation with IV NaHCO3; Renal failure -> RRT; Ketoacidosis -> Insulin/fluids) βœ“ Published (mID 10058)
58 Disseminated intravascular coagulation (ISTH score)
ICD-10: D65 ICD-11: 3B62.0 Pathology & Laboratory Medicine
Systemic thrombo-haemorrhagic activation (triggered by sepsis, obstetric catastrophe, trauma, or APL/malignancy) + Diffuse mucocutaneous oozing from venepuncture sites / purpura fulminans + Microvascular thrombosis causing multi-organ dysfunction ISTH Overt DIC Scoring System (β‰₯5 points): Thrombocytopenia (<100 Γ— 10⁹/L) + Prolonged PT and APTT + Markedly elevated D-dimer / Fibrin Degradation Products + Consumed low Fibrinogen (<1.0–1.5 g/L) + Schistocytes on peripheral blood smear Aggressively treat the underlying trigger (sepsis/obstetric/APL) + Supportive blood component replacement in bleeding patients: Platelets (keep >50 Γ— 10⁹/L), Fresh Frozen Plasma (15 mL/kg for prolonged PT/APTT), and Cryoprecipitate or Fibrinogen concentrate (if fibrinogen <1.5 g/L) βœ“ Published (mID 10059)
59 Subarachnoid haemorrhage
ICD-10: I60.9 ICD-11: 8B01 Radiology & Medical Imaging
Sudden-onset 'thunderclap' occipital headache reaching maximal intensity within seconds to <1–5 minutes + Meningism (neck stiffness, photophobia, vomiting) + Transient loss of consciousness or focal cranial nerve palsy (e.g., pupil-involving CN III palsy from PCom aneurysm) Non-contrast CT Head within 6 hours of headache onset (>98.5% sensitivity showing hyperdense blood in basal cisterns/Sylvian fissures); if CT negative >6 hours -> Lumbar Puncture at β‰₯12 hours for CSF Spectrophotometry (bilirubin xanthochromia) + CT Angiography (CTA) / Digital Subtraction Angiography (DSA) Neurosurgical ICU admission + Oral Nimodipine (60 mg q4h for 21 days to prevent delayed cerebral ischaemia/vasospasm) + BP control (SBP <160 mmHg pre-securing) + Urgent Endovascular Coiling or Microsurgical Clipping of ruptured berry aneurysm within 24–72 hours βœ“ Published (mID 10060)
60 Acute ischaemic stroke (ASPECTS and NIHSS)
ICD-10: I63.9 ICD-11: 8B11 Radiology & Medical Imaging
Sudden-onset focal neurological deficit conforming to a vascular territory (FAST: Contralateral hemiparesis, facial droop, aphasia/dysarthria, gaze deviation, or homonymous hemianopia) + NIHSS quantification + Hyperdense MCA sign / loss of insular ribbon on non-contrast CT Immediate Non-Contrast CT Head (to exclude haemorrhage and calculate ASPECTS score) + CT Angiography (arch-to-vertex for Large Vessel Occlusion in ICA/M1/M2/Basilar) + CT Perfusion (core-to-penumbra mismatch in 6–24h window) IV Thrombolysis within 4.5 hours of onset (Alteplase 0.9 mg/kg or Tenecteplase 0.25 mg/kg after excluding haemorrhage; keep BP <185/110 mmHg) + Mechanical Endovascular Thrombectomy within 6–24 hours for anterior/posterior Large Vessel Occlusion + Aspirin 300 mg started 24h post-thrombolysis after repeat CT βœ“ Published (mID 10061)