Medicalemergencies
SYMPTOMBASED
Acutechestpain409
Acutebreathlessness507
Coma741–745
Delirium(toxicconfusionalstate)799–800
Feverinthereturnedtraveller22–24
Headache717–719
Shock578b
SYSTEMBASED
Infectiousdiseasesandtropicalmedicine
Septicaemia14–16
Feverinthereturnedtraveller22–24
Malaria24–29
Gastroenterologyandnutrition
Oesophagealperforation80–81
Acuteuppergastrointestinalbleeding91b
Lowergastrointestinalbleeding93–94
Intestinalischaemia100
Acuteseverecolitis107b
Theacuteabdomen119–121
Liver,biliarytractandpancreaticdisease
Acutehepaticfailure160–164
Bleedingoesophagealvarices168–170
Acutecholecystitis187
Acutecholangitis188
Acutepancreatitis189–193
Diseasesofthebloodandhaematologicalmalignancies
Feverintheneutropenicpatient208b
Sicklecellcrisis217
Warfarinexcess249
Malignantdisease
Superiorvenacavasyndrome257
Acutetumourlysissyndrome257–258
Spinalcordcompression782–785
Feverintheneutropenicpatient208b
Hypercalcaemia653–656
Rheumatology
Septicarthritis300–301
Acutemonoarthritis301b
Giantcellarteritis781–782
Waterandelectrolytes
Hyponatraemia339
Hypernatraemia340–341
Hypokalaemia341–342
Hyperkalaemia345b
Hypomagnesaemia344–346
Hypermagnesaemia346
Disordersofacid–basebalance346–347
Renaldisease
Renalcolic382–384
Kidneyinjury386–390
Cardiovasculardisease
Acutechestpain409
Cardiacarrhythmias421–422
Cardiacarrest434b–435b
Acuteheartfailure445b
Acutecoronarysyndrome452b
STelevationmyocardialinfarction456b
Pulmonaryembolism475b
Pericardialtamponade480–482
Severehypertension487
Rupturedabdominalaorticaneurysm487–488
Aorticdissection487–488
Deepvenousthrombosis488
Respiratorydisease
Acutebreathlessness507
Massivehaemoptysis507
Inhaledforeignbody515
Acuteexacerbationofchronicobstructiveairwaysdisease520–522
Acutesevereasthma533b
Pneumonia538
Pneumothorax563
Intensivecaremedicine
Shock578b
Anaphylaxis576b
Sepsis577
Respiratoryfailure582–586
Poisoning,drugandalcoholabuse
Drugoverdose598b,592–595
Wernicke–Korsakoffsyndrome162–163
Alcoholwithdrawal163b
Deliriumtremens163
Endocrinology
Myxoedemacoma623b
Thyroidcrisis626–627
Addisoniancrisis639
SyndromeofinappropriateADHsecretion651–653
Hypercalcaemia656b
Hypocalcaemia656–658
Hypophosphataemia659–660
Hypothermia661b
Hyperthermia662
Diabetesmellitusandotherdisordersofmetabolism
Hypoglycaemia675–677
Diabeticketoacidosis679b
Hyperosmolarhyperglycaemicstate680–681
Thespecialsenses
Epistaxis706–707
Stridor707–708
Theredeye708–709
Suddenlossofvision715b
Neurology
Headache715–719
Coma741–745
Transientischaemicattack747–748
Stroke751b–752b
Intracranialhaemorrhage753–756
Statusepilepticus759b
Meningitis771b
Encephalitis771–772
Giantcellarteritis(temporalarteritis)781–782
Spinalcordcompression782–785
Guillain–Barresyndrome793–794
Delirium(toxicconfusionalstate)799–800
Dermatology
Necrotizingfasciitis809
Gasgangrene809
Angio-oedema813–814
Bullousdisease819–820
Abbreviations
AAT α1-antitrypsin
ABPM ambulatorybloodpressuremonitoring
ABV alcoholbyvolume
ABVD chemotherapyinvolvingdoxorubicin,bleomycin,vinblastine, dacarbazine
ACBT activecycleofbreathingtechnique
ACE angiotensin-convertingenzyme
ACEI angiotensin-convertingenzymeinhibitor
ACR urinealbumin-to-creatinineratio
ACSs acutecoronarysyndromes
ACT artemisinincombinationtherapy
ACTH adrenocorticotrophichormone
ADA AmericanDiabetesAssociation
ADC AIDS–dementiacomplex
ADH antidiuretichormone
ADP adenosinediphosphate
ADPKD autosomal-dominantpolycystickidneydisease
AED automatedexternaldefibrillator
AEDs antiepilepticdrugs
AF atrialfibrillation
AFP α-fetoprotein
AIDS acquiredimmunodeficiencysyndrome
AIH autoimmunehepatitis
AKI acutekidneyinjury
AKIN AcuteKidneyInjuryNetwork
ALL acutelymphoblasticleukaemia
ALP alkalinephosphatase
ALS advancedlifesupport
ALT alanineaminotransferase
AMAs antimitochondrialantibodies
AML acutemyeloidleukaemia
AMP adenosinemonophosphate
ANA antinuclearantibodies
ANCA antineutrophilcytoplasmicantibodies
ANF antinuclearfactor
ANP atrialnatriureticpeptide
anti-AChR antibodies autoantibodiestoacetylcholinereceptors
anti-CCP cycliccitrullinatedpeptideantibodies
anti-HBc anti-hepatitisBcoreantibody
anti-HBe anti-hepatitiseantibody
anti-HBs anti-hepatitisBsurfaceantibody
anti-MuSK antibodies antibodiesagainstamuscle-specificreceptortyrosinekinase
APACHE acutephysiologyandchronichealthevaluation
APML acutepromyelocyticleukaemia
APTT activatedpartialthromboplastintime
ARA angiotensinIIreceptorantagonist
ARD autoimmunerheumaticdisease
ARDS adultrespiratorydistresssyndrome
ARE angiotensinIItype1receptorantagonists
ARR aldosterone:reninratio
ART antiretroviraltherapy
ARVs
5-ASA aminosalicylicacid
AST aspartateaminotransferase
AT antithrombin
AT angiotensin
AT1 receptor type1subtypeoftheangiotensinIIreceptor
ATN acutetubularnecrosis
ATRA all-trans-retinoicacid
ATS amfetamine-typestimulants
AV atrioventricular
AVF augmentedvectorfoot(thenameofanECGlead)
AVL augmentedvectorLeft(thenameofanECGlead)
AVMs arteriovenousmalformations
AVNRT atrioventricularnodalre-entrytachycardia
AVPUscore Alert,respondstoVoice,respondstoPain,Unresponsive
AVR augmentedvectorright(thenameofanECGlead)
AVRT atrioventricularreciprocatingtachycardia
AXR abdominalX-ray
BCC basalcellcarcinoma
BCG bacilleCalmette–Guerin β-hCG β-humanchorionicgonadotrophin
BHL bilateralhilarlymphadenopathy
BiPAP bilevelpositiveairwaypressure
BLS basiclifesupport
BM bloodglucosemonitoring
BMD bonemineraldensity
BMI bodymassindex
BMT bonemarrowtransplantation
BNP brainnatriureticpeptide
BODEbodymassindex,degreeofairflow obstruction FEV1, dyspnoea, exercisecapacity
BP bloodpressure
BPH benignprostatichypertrophy
BSE bovinespongiformencephalopathy
CABG coronaryarterybypassgrafting
CAD coronaryarterydisease
cAMP cyclicadenosinemonophosphate
CAPD continuousambulatoryperitonealdialysis
CBD commonbileduct
CCF congestivecardiacfailure
CCU coronarycareunit
CD clusterdifferentiation
CD Crohn’sdisease
CDC CentersforDiseaseControlandPrevention
CDI cranialdiabetesinsipidus
CEA carcinoembryonicantigen
CF cysticfibrosis
CFTR cysticfibrosistransmembraneconductanceregulator
cGMP cyclicguanosinemonophosphate
CGRP calcitoningene-relatedpeptide
CHADS2 score congestiveheartfailure,hypertension,age 75years, diabetesmellitusandpreviousstrokeortransientischaemic attack
CHD coronaryheartdisease
CHOP+R chemo-immunotherapyinvolvingcyclophosphamide, hydroxydaunorubicin,vincristine,prednisoloneandrituximab
CJD Creutzfeldt–Jakobdisease
CK creatinekinase,creatinephosphokinase
CKD chronickidneydisease
CK-MB theMBisoformofcreatinekinase(CK)
CLL chroniclymphaticleukaemia
CML chronicmyeloidleukaemia
CMR cardiovascularmagneticresonance
CMV cytomegalovirus
CNS centralnervoussystem
COHb carboxyhaemoglobin
COPD chronicobstructivepulmonarydisease
COX cyclo-oxygenase
CPAP continuouspositiveairwaypressure
CPR cardiopulmonaryresuscitation
Cr creatinine
CRC colorectalcancer
CREST syndrome Calcinosis,Raynaud’sphenomenon,Esophageal involvement,Sclerodactyly,Telangiectasia
CRGP calcitoningene-relatedpeptide
CRH corticotrophin-releasinghormone
CRP C-reactiveprotein
CSII continuoussubcutaneousinsulininfusion
CSF cerebrospinalfluid
CT computedtomography
CTH corticotrophin-releasinghormone
CTPA CTpulmonaryangiogram
CTZ chemoreceptortriggerzone
CVC centralvenouscatheter
CVP centralvenouspressure
CVS cardiovascularsystem
CXR chestX-ray
DAEC diffuselyadhering E.coli
DAMPs damage-associatedmolecularpatterns
DaT dopaminetransporter
DBS deepbrainstimulation
DCM dilatedcardiomyopathy
DcSSc diffusecutaneousscleroderma
DCT directCoombs’ test
δ-ALA δ-aminolaevulinicacid
DHF denguehaemorrhagicfever
DI diabetesinsipidus
DIC disseminatedintravascularcoagulation
DIDMOAD syndrome hereditaryassociationofdiabetesinsipidus,diabetes mellitus,opticatrophyanddeafness
DIPJs distalinterphalangealjoints
DKA diabeticketoacidosis
DM dermatomyositis
DMARDs disease-modifyingantirheumaticdrugs
DNA deoxyribonucleicacid
Abbreviations xix
DNACPR donotattemptCPR
DOTS directlyobservedtherapy
DPLD diffuseparenchymallungdiseases
DPTA diethylenetriaminepentaaceticacid
ds double-stranded
DSH deliberateself-harm
DU duodenalulcer
DVLA DriverandVehicleLicensingAgency
DVT deepvenousthrombosis
DXA dual-energyX-rayabsorptiometry
EABV effectivearterialbloodvolume
EAggEC enteroaggregative E.coli
EB epidermolysisbullosa
EBNA Epstein–Barrvirusnuclearantigen
EBV Epstein–Barrvirus
ECG electrocardiogram
EDR extensivelydrug-resistant
EEG electroencephalogram
eGFR estimationoftheglomerularfiltrationrate
EHEC enterohaemorrhagic E.coli
EIA enzyme-linkedimmunoassay
EIEC enteroinvasive E.coli
ELISA enzyme-linkedimmunosorbentassay
EM erythemamigrans
EM erythemamultiforme
EMA endomysialantibodies
EMD electromechanicaldissociation
EMG electromyography,electromyogram
EMR endoscopicmucosalresection
ENT ear,noseandthroat
EPEC enteropathogenic E.coli
EPR electronicpatientrecord
ERC EuropeanResuscitationCouncil
ERCP endoscopicretrogradecholangiopancreatography
ESKD end-stagekidneydisease
ESR erythrocytesedimentationrate
ESWL extracorporealshockwavelithotripsy
ETEC enterotoxigenic E.coli
EUS endoscopicultrasound
FAST Face,Arm,Speech,Time
FAT fluorescentantibodytest
FBC fullbloodcount
FCU firstcatchurine
FDG fluorodeoxyglucose
FDPs fibrindegradationproducts
FEV forcedexpiratoryvolume
FEV1 forcedexpiratoryvolumein1second
FFP freshfrozenplasma
FNA fine-needleaspiration
FSH follicle-stimulatinghormone
FVC forcedvitalcapacity
GABA γ-aminobutyricacid
γ-GT γ-glutamyltranspeptidase
GBM glomerularbasementmembrane
GBS Guillain–Barresyndrome
GCA giantcellarteritis
GCS GlasgowComaScale
G-CSF granulocytecolonystimulatingfactor
GFR glomerularfiltrationrate
GH growthhormone
GHRH growthhormonereleasinghormone
GI gastrointestinal
GIST gastrointestinalstromaltumour
GLP-1 glucagon-likepeptide-1
GMC GeneralMedicalCouncil
GnRH gonadotropin-releasinghormone
GORD gastro-oesophagealrefluxdisease
Gp glycoprotein
GPA granulomatosiswithpolyangiitis(Wegener’sgranulomatosis)
G6PD glucose-6-phosphatedehydrogenase
GPI glycosylphosphatidylinositol
GRACE GlobalRegistryofAcuteCoronaryEvents
GTN glyceryltrinitrate
GTT glucosetolerancetest
GU gastriculcer
GVHD graft-versus-hostdisease
H haemagglutinin
HAV hepatitisAvirus
Hb haemoglobin
HbA1c glycosylatedhaemoglobin
HBeAg hepatitisBeantigen
HBPM homebloodpressuremonitoring
Abbreviations
HBsAg hepatitisBsurfaceantigen
HBV hepatitisBvirus
HCC hepatocellularcarcinoma
HCG humanchorionicgonadotrophin
HCM hypertrophiccardiomyopathy
HCV hepatitisCvirus
HDLs high-densitylipoproteins
HDU high-dependencyunit
HGPRT hypoxanthine-guaninephosphoribosyltransferase
HH hereditaryhaemochromatosis
5-HIAA 5-hydroxyindoleaceticacid
HIV humanimmunodeficiencyvirus
HLA humanleucocyteantigen
HMG-CoA hydroxymethylglutaryl-coenzymeA
HNPCC hereditarynon-polyposiscolorectalcancer
HPV humanpapillomavirus
HRT hormonereplacementtherapy
HSV herpessimplexvirus
5-HT 5-hydroxytryptamine
HTLV humanT-celllymphotropicvirus
IABCP intra-aorticballooncounterpulsation
IBD inflammatoryboweldiseases
IBS irritablebowelsyndrome
ICAM-1 intercellularadhesionmolecule-1
ICD implantablecardioverter–defibrillator
ICD InternationalClassificationofDiseases – theclassification usedtocodeandclassifymortalitydatafromdeath certificates
ICD-9-CM
ICD,ClinicalModification – usedtocodeandclassify morbiditydatafromtheinpatientandoutpatientrecords, generalpracticesandHealthStatisticsurveys
ICP intracranialpressure
ICU intensivecareunit
IDLs intermediate-densitylipoproteins
IFG impairedfastingglucose
IFN interferon
Ig immunoglobulin(e.g.IgM ¼ immunoglobulinMclass)
IGF-1 insulin-likegrowthfactor1
IGT impairedglucosetolerance
IHD ischaemicheartdisease
IL interleukin
i.m. intramuscular,intramuscularly
IMV intermittentmandatoryventilation
INR internationalnormalizedratio
IPF idiopathicpulmonaryfibrosis
IPJs interphalangealjoints
IPPV intermittentpositive-pressureventilation
ITP immunethrombocytopenicpurpura
iu/IU internationalunit
i.v. intravenous
IVP intravenouspyelogram,intravenouspyelography
IVU intravenousurography
JVP jugularvenouspressure
KUB kidney,uretersandbladder
LABA long-actingselectiveinhaled β2-adrenoceptorstimulants
LBBB leftbundlebranchblock
LcSSc limitedcutaneousscleroderma
LDH lactatedehydrogenase
LDLs low-densitylipoproteins
L-dopa levodopa
LEMS Lambert–Eatonmyasthenicsyndrome
LFT liverfunctiontest
LH luteinizinghormone
LHRH luteinizinghormone-releasinghormone
LMN lowermotorneurone
LMWH lowmolecularweightheparin
LOS loweroesophagealsphincter
LP lumbarpuncture
LTRA leukotrienereceptorantagonists
LVEF leftventricularejectionfraction
LVF leftventricularfailure
LVSD leftventricularsystolicdysfunction
MAI Mycobacteriumavium-intracellulare
MALT mucosa-associatedlymphoidtissue
MALToma mucosa-associatedlymphoidtissuetumour
MCA MentalCapacityAct
MCH meancorpuscularhaemoglobin
MCHC meancorpuscularhaemoglobinconcentration
MCP metacarpophalanges
MCV meancorpuscularvolume
MDIs metered-doseinhalers
MDR multidrug-resistant
MDRD modificationofdietinrenaldisease
MDS myelodysplasticsyndrome
MDT multidisciplinaryteam
ME myalgicencephalomyelitis
MEN multipleendocrineneoplasiasyndromes
MERS-CoV MiddleEastrespiratorysyndromecoronavirus
MEWS ModifiedEarlyWarningScore
MG myastheniagravis
MHRA MedicinesandHealthcareproductsRegulatoryAgency
MI myocardialinfarction
mIBG meta-[131I]-iodobenzylguanidine
MMR measles,mumpsandrubella
MMSE MiniMentalStateExamination
MODS multipleorgandysfunctionsyndrome
MPTP methylphenyltetrahydropyridine
MR magneticresonance
MRCP magneticresonancecholangiopancreatography
MRI magneticresonanceimaging
MRSA meticillin-resistant Staphylococcusaureus
MS multiplesclerosis
MSU mid-streamurine
M–Wtear Mallory–Weisstear
N neuraminidase
Na+ concentrationofsodiumions
NAC N-acetylcysteine
NAFLD non-alcoholicfattyliverdisease
NAPQI N-acetyl-p-benzoquinoneimine
NBT-PABA N-benzoyl-L-tryosyl-p-aminobenzoicacid
nd notifiabledisease
NDI nephrogenicdiabetesinsipidus
NERD non-erosiverefluxdisease
NG nasogastric
NHL non-Hodgkin’slymphoma
NHS NationalHealthService
NICE NationalInstituteforHealthandCareExcellence
NIPPV non-invasivepositive-pressureventilation
NK naturalkiller(cell)
NMDA N-methyl-D-aspartate
NOACs noveloralanticoagulants
NPH neutralprotamineHagedorn
NPS novelpsychoactivesubstances
NS1 non-structuralprotein1
NSAIDs non-steroidalanti-inflammatorydrugs
NSTEMI non-ST-segmentelevationmyocardialinfarction
NTproBNP Nterminalfragmentreleasedfrompro-BNP
NYHA NewYorkHeartAssociation
OA osteoarthritis
OCP oralcontraceptivepill
OGD oesophagogastroduodenoscopy
OPG osteoprotegerin
ORS oralrehydrationsolutions
OSA obstructivesleepapnoea
OSCE ObjectiveStructuredClinicalExamination
PA postero-anterior,postero-anteriorly
PaCO2 partialpressureofcarbondioxideinarterialblood
PAMPS pathogen-associatedmolecularpatterns
PAN polyarteritisnodosa
pANCA peripheralantineutrophiliccytoplasmicantibody
PaO2 partialpressureofoxygeninarterialblood
PAP pulmonaryarterypressure
PAS periodicacid-Schiff
PBC primarybiliarycirrhosis
PCA patient-controlledanalgesia
PCI percutaneouscoronaryintervention
PCOS polycysticovarysyndrome
PCR urineprotein-to-creatinineratio
PCR polymerasechainreaction
PCT porphyriacutaneatarda
PCV packedcellvolume
PD Parkinson’sdisease
PD-1 programmeddeathreceptor
PDE4 phosphodiesterasetype4
PDEI phosphodiesteraseinhibitor
PE pulmonaryembolism,pulmonaryembolus
PE phenytoinsodiumequivalent
PEEP positiveend-expiratorypressure
PEFR peakexpiratoryflowrate
PEG percutaneousendoscopicgastrostomy
PET positronemissiontomography
Abbreviations xxv
Ph Philadelphia
PHN post-herpeticneuralgia
PIPJs proximalinterphalangealjoints
PM polymyositis
PMF progressivemassivefibrosis
PML progressivemulti-focalleucoencephalopathy
PML-RARa fusionproteininvolvingpromyelocyticleukaemiageneand retinoicacidreceptoralpha
PMR polymyalgia
POEM peroralendoscopicmyotomy
PPAR-γ peroxisomeproliferator-activatedreceptor-gamma
PPI protonpumpinhibitor
PPMS primaryprogressivemultiplesclerosis
PPS phosphoribosyl-pyrophosphatesynthetase
PR perrectum(rectalinstillation)
PSA prostate-specificantigen
PSC primarysclerosingcholangitis
PSE portosystemicencephalopathy
PT prothrombintime
PTC percutaneoustranshepaticcholangiography
PTCA percutaneoustransluminalcoronaryangioplasty
PTH parathyroidhormone
PTTK partialthromboplastintimewithkaolin
PU pepticulcer,pepticulceration
PUO pyrexia(orfever)ofunknownorigin
PUVA ultravioletAradiationinconjunctionwithaphotosensitizing agent,oralortopicalpsoralen
PVS persistentvegetativestate
PWP pulmonarywedgepressure
RA rheumatoidarthritis
RANK receptoractivatorofnuclearfactor-κB
RANKL RANKligand
RAPD relativeafferentpupillarydefect
RAS renalarterystenosis
RAST radioallergosorbenttest
RBBB rightbundlebranchblock
RCC redcellcount
RDW redbloodcelldistributionwidth
RFA radiofrequencyablation
Rh rhesus
RhF rheumatoidfactor
RIA radioimmunoassay
RIF rightiliacfossa
RIFLE criteria Risk,Injury,Failure,Loss,End-stagerenaldisease
RNA ribonucleicacid
RNP ribonucleoprotein
r-PA reteplase
RR respiratoryrate
RRMS relapsing-remittingmultiplesclerosis
RSR0 secondaryRwave
RT-PCR reversetranscriptasepolymerasechainreaction
RUQ rightupperquadrant
RV rightventricle
RV residualvolume
RVSD rightventricularsystolicdysfunction
SAnode sinusnode
SAH subarachnoidhaemorrhage
SALT SpeechandLanguageTherapy
SaO2 arterialoxygensaturation
SARS severeacuterespiratorysyndrome
SBAR Situation-Background-Assessment-Recommendations
SBE subacute(bacterial)endocarditis
SBFT smallbowelfollow-through
SBP spontaneousbacterialperitonitis
SBP systolicbloodpressure
s.c. subcutaneous
SCC squamouscellcarcinoma
SCr serumcreatinine
ScvO2 centralvenousoxyhaemoglobinsaturation
SDH subduralhaematoma
SDs standarddeviations
SERMs selectiveoestrogenreceptormodulators
SGLT2 sodium/glucosetransporter2
SIADH syndromeofinappropriateADHsecretion
SIRS systemicinflammatoryresponsesyndrome
SLE systemiclupuserythematosus
SP standardizedpatient
SPECT singlephotonemissioncomputedtomography
SR slow-release
SRH stigmataofrecenthaemorrhage
SS Sj€ ogren’ssyndrome
SSc systemicscleroderma
STEMI ST-elevationmyocardialinfarction
STI sexuallytransmittedinfection
SUNCT short-lastingunilateralneuralgiformheadacheattackswith conjunctivalinjectionandtearing
SVC superiorvenacava
SVR sustainedvirologicalresponse
SVR systemicvascularresistance
SVT supraventriculartachycardia
T3 triiodothyronine
T4 thyroxine
TAVI transcatheteraorticvalveimplantation
TB tuberculosis
TBE tick-borneencephalitis
TBG thyroxine-bindingglobulin
TCAs tricyclicantidepressants
TEN toxicepidermalnecrolyis
TF tissuefactor
TFPI tissuefactorpathwayinhibitor
TFT thyroidfunctiontest
Th Thelper
THC tetrahydrocannabinol
TIA transientischaemicattack
TIBC totaliron-bindingcapacity
TIMI ThrombolysisinMyocardialInfarctionscoringsystem
TIN tubulointerstitialnephritis
TIPS transjugularintrahepaticportosystemicshunting
TLC totallungcapacity
TLESRs transientloweroesophagealsphincterrelaxations
TNF tumournecrosisfactor
TNK-PA tenecteplase
TNM tumour,node,metastasisclassification
TOE transoesophagealechocardiography
tPA tissueplasminogenactivator
TPN totalparenteralnutrition
TPMT thiopurinemethyltransferase
TRH thyrotrophin-releasinghormone
TSH thyroid-stimulatinghormone
TT thrombintime
TTE transthoracicechocardiography
tTG tissuetransglutaminase
