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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)

Trigeminal Neuralgia

Causes

Vascular compression (artery/vein, most common)
Tumour/mass effect
Multiple sclerosis (demyelination at nerve root)

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History

Severe, sharp, stabbing pain in V2/V3 distribution
Paroxysmal attacks (seconds to minutes) with refractory periods
Triggered by cold/hot drinks, brushing teeth, wind, shaving, light touch
Can mimic migraine (sudden intense pain)
More common in older adults, slight female predominance

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Examination

Trigger zones (nasolabial fold, upper cheek)
Tic douloureux (brief facial twitching from pain)
Allodynia/hyperalgesia in affected area
Neurological exam otherwise normal

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Investigations

MRI brain with trigeminal nerve focus (rule out MS, tumours)
Neurophysiological studies (if atypical presentation)

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Management

Educate on nerve irritation, trigger avoidance
Non-urgent neurology referral
First-line: Carbamazepine (start 100 mg BD, titrate as needed)
Second-line: Oxcarbazepine (if intolerant to carbamazepine)
Monitor for side effects: Depression, hyponatraemia, dizziness
Baclofen (adjunct or alternative in refractory cases)
Surgical decompression (if severe, persistent, or confirmed neurovascular compression)

Trigeminal Neuralgia

Causes

Vascular Compression of the trigeminal nerve root (most common)
Tumour or Mass effect on the nerve
Multiple Sclerosis (demyelination near nerve entry zone)

History

Severe, sharp, stabbing pain in V2 (maxillary) or V3 (mandibular) divisions of CN V
Attacks last seconds to minutes with refractory periods
Triggers: Cold/hot drinks, brushing teeth, shaving, gentle facial touch, wind
Can mimic migraine but typically short, intense bursts of pain
More common in older adults, slight female predominance

Examination

Trigger zones (e.g., nasolabial fold, cheek) → light touch can provoke pain
Tic Douloureux: Brief facial twitch with severe pain
Allodynia/Hyperalgesia in the affected dermatomes
Otherwise normal neuro exam

Investigations

MRI Brain (focus on trigeminal nerve) to rule out:
- Vascular loops compressing nerve
- Tumours, demyelinating plaques (MS)
Neurophysiological Studies if atypical features

Management

Education
- Explain nerve irritation, advise on trigger avoidance
Pharmacotherapy
- Carbamazepine: First-line (start 100 mg BD, titrate gradually)
- Oxcarbazepine if carbamazepine intolerance
- Monitor for side effects (hyponatraemia, dizziness, mood changes)
- Baclofen: Adjunct or alternative in refractory cases
Surgical Decompression
- Microvascular decompression if severe and recurrent or confirmed neurovascular conflict
Referral
- Non-urgent neurology referral for ongoing management, possible imaging to exclude secondary causes

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