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Cardiovascular

Abdominal pain in kids

Abnormal/Dysfunctional Uterine Bleeding (AUB/DUB)

Acanthosis Nigricans

Actinic Cheilitis

Acute Kidney Injury (AKI)

Acute Swollen Joint with Fever

Acute Vision Loss

Acute and Progressive Vision Loss

Adjustment Disorder and Anxiety

Adjustment Disorder with Depressed Mood

Age related macular degeneration

Alcohol Cessation

Allergic rhinitis

Angular Cheilitis

Ankylosing Spondylitis (AS)

Anorexia Nervosa

Anticholinergics and TCAs

Antidepressants

Antimetabolite drugs

Antiphospholipid syndrome

Anxiety Disorders

Aortic Dissection

Atrial Fibrillation

Behavioural / learning disorders

Behavioural disturbances

Bell’s palsy and Ramsey Hunt syndrome

Beta-Human Chorionic Gonadotropin (β-hCG)

Biologic agents

Bipolar Disorder

Bleeding disorders

Bronchiectasis (Updated)

CA-125 (Cancer Antigen 125)

CVD Risk Assessment

Calluses and Corns

Candida (Candidiasis as an STI)

Carpal tunnel syndrome and de quervains tenosynovitis

Cervical spondylosis

Chickenpox (Varicella)

Chronic Cough in Children

Chronic Fatigue Syndrome (CFS)

Chronic Kidney Disease (CKD)

Chronic Rhinosinusitis

Chronic Stridor

Clavicular fracture

Colorectal Cancer Screening Recommendations

Congestive Cardiac Failure

Connective Tissue Diseases

Contact Dermatitis

Cutaneous Drug Eruptions

Dacrocystitis, dacyrostenosis, dacyrocystocoele

Deep Vein Thrombosis (DVT)

Depression and Delirium

Dermal melanocystosis (mongolian spot)

Developmental Dysplasia of the Hip (DDH)

Diabetes Insipidus (DI) vs Primary Polydipsia

Diabetic Neuropathy

Dizziness / syncope

Duchenne muscular dystrophy

Dupuytrens / trigger finger

Dyspnoea (Shortness of Breath)

Delirium

Confusion Assessment Method (CAM)

Requires 1 + 2 and either 3 or 4:

Acute onset, fluctuating course (changes in mental status, attention deficits)
Inattention (key criterion)
Disorganised thinking
Altered consciousness (hyperalert or drowsy)
Alternative rapid tool: 4AT (validated for quick screening)

____________________________________

Differentials

Medications/withdrawal (alcohol, illicit drugs)
Sleep deprivation, pain, abuse
B12 deficiency
Infections: UTI, pneumonia
Constipation, urinary retention
Dementia (including Lewy body dementia)
Neurological: Stroke, brain tumour
Organ failure: Respiratory, cardiac, renal
Electrolytes: Hyponatraemia, hypoglycaemia
MI, arrhythmia

____________________________________

Prevention (also risk factors)

Quiet environment, minimal stimulation
Familiar objects, clocks, calendars
Regular sleep schedule, optimise sleep hygiene
Correct vision/hearing impairments
Adequate pain relief, avoid deliriogenic meds
Proper lighting (day-night cycle support)
Encourage familiar person’s presence
Hydration, nutrition
Avoid restraints unless essential
Structured reorientation, cognitive stimulation

____________________________________

Management

Non-Pharmacological

Low-stimulus environment, minimise noise
Frequent reorientation, clear/calm communication
Approach from the front, maintain eye contact
Encourage familiar person's presence, ensure personal belongings
Secure sharp objects, one-to-one nursing if needed
Inform family of status changes
Review medications & fluid balance

Pharmacological (if severe behavioural disturbance, hallucinations, or delusions)

First-line: Risperidone 0.25 mg BD (max 1 mg BD)
Second-line: Olanzapine 2.5 mg OD (max 10 mg OD)
Dementia/Lewy body dementia: Low-dose quetiapine
Use lowest effective dose, shortest duration, monitor vitals

For Anxiety/Agitation

Oxazepam 7.5 mg TDS PRN

For Acute Behavioural Changes (Stat Dose)

First-line: Haloperidol or risperidone 0.5 mg PO (repeat in 30 min if needed)
If oral not feasible: Haloperidol 0.5 mg IM
Monitor & adjust therapy based on response & EPSE risk

Delirium

Confusion Assessment Method (CAM)

Requires 1 + 2 and either 3 or 4:
- Acute onset, fluctuating course (changes in mental status, attention deficits)
- Inattention (key criterion)
- Disorganised thinking
- Altered consciousness (hyperalert or drowsy)
Alternative rapid tool: 4AT (validated for quick screening)

Differentials

Medications/withdrawal (alcohol, illicit drugs)
Sleep deprivation, pain, possible abuse
B12 deficiency
Infections (UTI, pneumonia)
Constipation, urinary retention
Dementia (including Lewy body dementia)
Neurological (stroke, brain tumour)
Organ failure (respiratory, cardiac, renal)
Electrolyte imbalances (hyponatraemia, hypoglycaemia)
Cardiac (MI, arrhythmia)

Prevention (Also Risk Factors)

Quiet environment, minimal stimulation
Familiar objects, clocks, calendars
Regular sleep schedule, optimise sleep hygiene
Correct vision/hearing impairments
Adequate pain relief, avoid deliriogenic meds
Proper lighting to maintain day-night cycle
Encourage presence of familiar person
Ensure hydration, nutrition
Avoid restraints unless absolutely essential
Structured reorientation and cognitive stimulation

Management

Non-Pharmacological
- Low-stimulus environment, minimise noise
- Frequent reorientation, clear and calm communication
- Approach from the front, maintain eye contact
- Encourage presence of a familiar person, use personal belongings
- Secure sharp objects, consider one-to-one nursing if needed
- Inform family of status changes
- Review medications and fluid balance
Pharmacological (for severe agitation, hallucinations, delusions)
- First-line: Risperidone 0.25 mg BD (max 1 mg BD)
- Second-line: Olanzapine 2.5 mg OD (max 10 mg OD)
- Dementia or Lewy body dementia: Low-dose quetiapine
- Use lowest effective dose for the shortest duration; monitor vitals
For Anxiety/Agitation
- Oxazepam 7.5 mg TDS PRN
For Acute Behavioural Changes (Stat Dose)
- First-line: Haloperidol or risperidone 0.5 mg PO (can repeat in 30 min if needed)
- If oral not feasible: Haloperidol 0.5 mg IM
- Monitor and adjust based on response; watch for EPSE risks

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