Normal Vital Signs
Adult reference ranges
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| Parameter | Normal Range | Notes |
|---|---|---|
| Heart Rate | 60-100 bpm | <60 = bradycardia, >100 = tachycardia |
| Blood Pressure | 120/80 mmHg | Hypertension: >140/90 |
| Respiratory Rate | 12-20 /min | >20 = tachypnoea |
| SpO2 | 94-98% | COPD target: 88-92% |
| Temperature | 36.1-37.2°C | >38°C = fever |
| GCS | 15/15 | E4 V5 M6. <8 = intubate |
💡 NEWS2 Score: National Early Warning Score. Tracks 6 parameters + O2 supplementation. Score ≥5 = urgent review. Score ≥7 = emergency.
ECG Quick Reference
Waves, intervals, and territories
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📊 Normal ECG Values
| Component | Normal | Abnormal |
|---|---|---|
| P wave | <0.12s, <2.5mm | Absent = AF. Peaked = P pulmonale. Bifid = P mitrale |
| PR interval | 0.12-0.20s | >0.20s = heart block. <0.12s = pre-excitation |
| QRS complex | <0.12s | >0.12s = bundle branch block |
| QT interval | <0.44s (corrected) | Long QT = risk of Torsades de Pointes |
| ST segment | Isoelectric | Elevation = STEMI. Depression = ischaemia |
🗺️ ECG Territories
| Leads | Territory | Artery |
|---|---|---|
| II, III, aVF | Inferior | Right Coronary (RCA) |
| V1-V4 | Anterior | LAD |
| V5-V6, I, aVL | Lateral | Circumflex |
| V1-V2 | Septal | LAD (septal branch) |
💡 Rate calculation: 300 ÷ number of large squares between R-R. Regular rhythm only.
ABG Interpretation
Step-by-step blood gas analysis
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📊 Normal ABG Values
| Parameter | Normal |
|---|---|
| pH | 7.35-7.45 |
| PaO2 | 10-13 kPa |
| PaCO2 | 4.7-6.0 kPa |
| HCO3 | 22-26 mmol/L |
| BE | -2 to +2 |
| Lactate | <2 mmol/L |
🔍 5-Step Interpretation
- Step 1: Is the patient acidotic (<7.35) or alkalotic (>7.45)?
- Step 2: Is it respiratory (CO2) or metabolic (HCO3)?
- Step 3: Is there compensation?
- Step 4: Check PaO2 — Type 1 or Type 2 respiratory failure?
- Step 5: Calculate anion gap if metabolic acidosis
| Disorder | pH | CO2 | HCO3 |
|---|---|---|---|
| Respiratory acidosis | ↓ | ↑ | Normal/↑ |
| Respiratory alkalosis | ↑ | ↓ | Normal/↓ |
| Metabolic acidosis | ↓ | Normal/↓ | ↓ |
| Metabolic alkalosis | ↑ | Normal/↑ | ↑ |
💡 MUDPILES = raised anion gap metabolic acidosis: Methanol, Uraemia, DKA, Propylene glycol, Isoniazid/Iron, Lactic acidosis, Ethylene glycol, Salicylates.
Cranial Nerves
All 12 with functions and mnemonics
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| # | Nerve | Type | Function |
|---|---|---|---|
| I | Olfactory | S | Smell |
| II | Optic | S | Vision |
| III | Oculomotor | M | Eye movement (most), pupil constriction, eyelid |
| IV | Trochlear | M | Superior oblique (down and in) |
| V | Trigeminal | B | Face sensation (V1,V2,V3) + mastication |
| VI | Abducens | M | Lateral rectus (abduction) |
| VII | Facial | B | Face expression, taste (ant 2/3), lacrimation |
| VIII | Vestibulocochlear | S | Hearing + balance |
| IX | Glossopharyngeal | B | Taste (post 1/3), swallow, parotid, carotid body |
| X | Vagus | B | Parasympathetic to organs, voice, swallow |
| XI | Spinal Accessory | M | SCM + trapezius |
| XII | Hypoglossal | M | Tongue movement |
💡 Names: Oh Oh Oh To Touch And Feel Very Good Velvet AH!
Types (S/M/B): Some Say Marry Money But My Brother Says Big Brains Matter More
Types (S/M/B): Some Say Marry Money But My Brother Says Big Brains Matter More
Common Blood Results
Normal ranges and clinical significance
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| Test | Normal Range | High | Low |
|---|---|---|---|
| Hb | M: 130-170 g/L F: 120-150 g/L | Polycythaemia | Anaemia |
| WCC | 4-11 ×10⁹/L | Infection, leukaemia | Immunosuppression |
| Platelets | 150-400 ×10⁹/L | Reactive, CML | Bleeding risk |
| Na+ | 135-145 mmol/L | Dehydration | SIADH, diuretics |
| K+ | 3.5-5.0 mmol/L | AKI, ACEi, K-sparing | Diuretics, vomiting |
| Urea | 2.5-6.7 mmol/L | Dehydration, AKI, GI bleed | Liver failure |
| Creatinine | 55-120 µmol/L | AKI, CKD | Low muscle mass |
| eGFR | >90 mL/min | — | CKD staging |
| CRP | <5 mg/L | Infection, inflammation | — |
| Troponin | <14 ng/L | MI, PE, myocarditis | — |
| BNP | <100 pg/mL | Heart failure | — |
| TSH | 0.4-4.0 mU/L | Hypothyroid | Hyperthyroid |
| HbA1c | <42 mmol/mol | Diabetes (>48) | — |
⚠️ Critical values requiring urgent action: K+ >6.5 or <2.5, Na+ <120 or >160, Hb <70, Platelets <20, pH <7.1 or >7.6
Drug Suffix Cheat Sheet
Identify drug classes by their names
▼
| Suffix | Drug Class | Example | Key Fact |
|---|---|---|---|
| -pril | ACE inhibitor | Ramipril | Dry cough, hyperkalaemia |
| -sartan | ARB | Losartan | No cough (unlike ACEi) |
| -olol | Beta-blocker | Bisoprolol | Dont stop suddenly |
| -dipine | CCB (dihydropyridine) | Amlodipine | Ankle oedema |
| -statin | HMG-CoA reductase inhibitor | Atorvastatin | Take at night, myalgia |
| -prazole | PPI | Omeprazole | 30 min before food |
| -cillin | Penicillin | Amoxicillin | Rash with EBV |
| -mycin | Macrolide | Clarithromycin | QT prolongation |
| -floxacin | Fluoroquinolone | Ciprofloxacin | Tendon rupture |
| -asone/-ide | Corticosteroid | Beclometasone | Rinse mouth after ICS |
| -xaban | DOAC (factor Xa) | Apixaban | No monitoring needed |
| -gliflozin | SGLT2 inhibitor | Dapagliflozin | UTI risk, DKA risk |
💡 Tip: Learning suffixes lets you identify ANY drug class instantly — even drugs you've never seen before!
Glasgow Coma Scale (GCS)
Consciousness assessment
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| Response | Score | Description |
|---|---|---|
| 👁️ Eye Opening (E) | ||
| Spontaneous | 4 | Opens eyes without stimulation |
| To voice | 3 | Opens eyes to verbal command |
| To pain | 2 | Opens eyes to painful stimulus |
| None | 1 | No eye opening |
| 🗣️ Verbal Response (V) | ||
| Orientated | 5 | Knows who, where, when |
| Confused | 4 | Talking but disoriented |
| Inappropriate words | 3 | Random words, no conversation |
| Incomprehensible | 2 | Moaning, no words |
| None | 1 | No verbal response |
| 💪 Motor Response (M) | ||
| Obeys commands | 6 | Follows instructions |
| Localises pain | 5 | Reaches toward stimulus |
| Withdraws | 4 | Pulls away from pain |
| Abnormal flexion | 3 | Decorticate posturing |
| Extension | 2 | Decerebrate posturing |
| None | 1 | No motor response |
⚠️ GCS ≤8 = cannot protect airway = consider intubation. Always report as E_V_M_ (e.g. E4V5M6 = 15).
Asthma vs COPD
Key differences at a glance
▼
| Feature | Asthma | COPD |
|---|---|---|
| Age | Young (<40) | Older (>40) |
| Smoking | Not always | Almost always |
| Reversibility | Reversible | Partially reversible |
| FEV1/FVC | <0.7 (reversible) | <0.7 (persistent) |
| Diurnal variation | Yes (worse morning) | No |
| Atopy | Common | Uncommon |
| First-line | ICS + SABA | SABA/SAMA → LABA/LAMA |
🚨 Acute Asthma Severity
| Severity | PEF | Features |
|---|---|---|
| Moderate | 50-75% | Increasing symptoms, no severe features |
| Acute Severe | 33-50% | RR ≥25, HR ≥110, cant complete sentences |
| Life-threatening | <33% | SpO2 <92%, silent chest, cyanosis, exhaustion |
| Near-fatal | — | Raised CO2, needs ventilation |
💡 Acute asthma Rx: O-SHIT = Oxygen, Salbutamol nebs, Hydrocortisone IV, Ipratropium nebs, Theophylline/MgSO4 if severe.
Diabetes Quick Reference
T1DM vs T2DM, DKA, HHS
▼
| Feature | Type 1 | Type 2 |
|---|---|---|
| Cause | Autoimmune beta cell destruction | Insulin resistance + relative deficiency |
| Age | Young (<30) | Older (>40), increasingly younger |
| Onset | Acute (days-weeks) | Gradual (months-years) |
| Weight | Often thin | Often overweight |
| Ketosis | Common (DKA) | Rare (HHS instead) |
| Treatment | Insulin (always) | Metformin first → add agents → insulin |
| Antibodies | GAD, IA-2, ZnT8 | None |
| C-peptide | Low/absent | Normal/high |
🚨 DKA vs HHS
| Feature | DKA | HHS |
|---|---|---|
| Type | Usually T1DM | Usually T2DM |
| Onset | Hours-days | Days-weeks |
| Glucose | >11 mmol/L | >30 mmol/L |
| Ketones | High (>3) | Low/absent |
| pH | <7.3 | Normal |
| Osmolality | Normal | >320 mOsm/kg |
| Mortality | ~1% | ~20% |
| Treatment | IV fluids + insulin | IV fluids first (cautious insulin) |
⚠️ DKA triad: Hyperglycaemia + Ketosis + Metabolic acidosis. Always check K+ before giving insulin!
GI Emergencies
Upper GI bleed, acute abdomen
▼
🩸 Upper GI Bleed
| Feature | Details |
|---|---|
| Causes | Peptic ulcer (most common), varices, Mallory-Weiss, malignancy |
| Signs | Haematemesis, melaena, tachycardia, hypotension |
| Score | Glasgow-Blatchford (pre-endoscopy), Rockall (post-endoscopy) |
| Management | ABC, IV access x2, fluid resus, crossmatch, PPI IV, OGD within 24h |
| Variceal | Terlipressin + antibiotics + band ligation. Sengstaken tube if massive. |
🔥 Acute Abdomen — Location Guide
| Location | Think of... |
|---|---|
| RUQ | Cholecystitis, hepatitis, liver abscess |
| Epigastric | Peptic ulcer, pancreatitis, MI |
| LUQ | Splenic rupture, gastric ulcer |
| RIF | Appendicitis, ectopic pregnancy, ovarian torsion |
| Suprapubic | UTI, urinary retention, PID |
| LIF | Diverticulitis, IBD, ovarian pathology |
| Generalised | Peritonitis, bowel obstruction, mesenteric ischaemia |
💡 Pancreatitis causes — GET SMASHED: Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune, Scorpion stings, Hyperlipidaemia, ERCP, Drugs.