REVISION GUIDE FOR
MEDICAL STUDENTS
Gold Standard Diagnosis and First Line Treatment
(covering over 400 conditions in line with NICE
Guidelines)
L. P. BAGNALL
1
,About this document
This document provides you with the two most important pieces of information
you need to know about hundreds of medical conditions — the diagnosis and
the treatment. As healthcare professionals striving to deliver the best possible
patient care, we often perform a variety of tests and examinations to arrive at
the most accurate diagnosis. Treatment, in many cases, may involve multiple
steps or medications.
This guide is designed to help you during exams where you are required to give
one precise answer for each condition — the gold standard diagnosis and the
first-line treatment. Perfect for OSCEs and knowledge-based exams, this
resource provides you with NICE guideline–aligned answers, saving you the
time and effort of navigating the guidelines yourself.
In some sections, I have expanded on the answers to give you a broader
understanding of the treatment steps for specific conditions. Examiners in
OSCEs often expect more detailed responses; however, the “best” or “first-line”
answer is always listed first — this is the information most relevant for
knowledge-based or single best answer exams.
Throughout the document, you will also find italicised notes containing tips and
insights that I found particularly useful during my own learning.
I hope you find this document useful and I wish everyone sitting exams the very
best of luck.
KEY TERMS
D= Diagnosis (the gold standard diagnosis)
T= Treatment (the first treatment/management)
All answers are based on NICE guidelines, which all healthcare professionals
are expected to follow in the UK. All information is accurate at the time of the
creation of this document (2025). Please note, that a small number of conditions
are not covered by NICE guidelines, and therefore some information has been
retrieved from other reputable sources/guidance. If you have any questions, feel
free to contact me at
2
,Topics
• Cardiology (page 4)
• Respiratory (page 16)
• GI (Gastrointestinal) and Liver (page 24)
• Renal and Urology (page 39)
• Neurology (page 47)
• Endocrinology (page 56)
• ENT (page 63)
• Mental Health/Psychiatry (page 71)
• Obstetrics and Gynaecology (page 75)
• MSK/Rheumatology (page 86)
• Dermatology (page 98)
• Haematology (page 110)
• Ophthalmology (page 115)
• Infectious Diseases (page 118)
• Paediatrics (page 119)
3
, Gold standard Diagnosis and First-Line Treatments
Cardiology
Hypertension
D= Ambulatory blood pressure monitoring (ABPM) i.e 24hr blood
pressure monitoring
T= ACEi (Ramipiril)/ARB (Losartan)/Calcium-channel blockers
(Amlodipine)/Thiazide-type diuretics (Indapamide); if still
high/resistant, add an alpha blocker (doxazosin) or spironolactone (if
potassium if below 3.5)
-lifestyle advice would be first-line unless patient has comorbidities
such as diabetes or renal disease
[Patients of Africo-Caribbean descent and > 55 y/o and no diabetes are factors
for picking a CCB as antihypertensive treatment of choice BUT if someone is
Africo-Caribbean descent and has diabetes, the diabetes always trumps
everything and you should pick the ACEi/ARB]
Malignant Hypertension (medical emergency!)
D= Blood pressure check (malignant if around 180/120 or above)
T= Referral for same-day specialist assessment with IV CCB
(Nicardipine, Amlodipine) or beta-blocker (Atenolol)
Postural/orthostatic hypotension
D= Lying-standing blood pressure
T= Lifestyle advice (manage underling cause/ increase fluid intake/
compression stockings) or Fludrocortisone (corticosteroid that acts to
increase blood pressure by making the body retain sodium) if
medication required
Postural orthostatic tachycardia syndrome (POTS)- (condition where
heart rate increases very quickly when getting up from sitting or lying
down)
4
MEDICAL STUDENTS
Gold Standard Diagnosis and First Line Treatment
(covering over 400 conditions in line with NICE
Guidelines)
L. P. BAGNALL
1
,About this document
This document provides you with the two most important pieces of information
you need to know about hundreds of medical conditions — the diagnosis and
the treatment. As healthcare professionals striving to deliver the best possible
patient care, we often perform a variety of tests and examinations to arrive at
the most accurate diagnosis. Treatment, in many cases, may involve multiple
steps or medications.
This guide is designed to help you during exams where you are required to give
one precise answer for each condition — the gold standard diagnosis and the
first-line treatment. Perfect for OSCEs and knowledge-based exams, this
resource provides you with NICE guideline–aligned answers, saving you the
time and effort of navigating the guidelines yourself.
In some sections, I have expanded on the answers to give you a broader
understanding of the treatment steps for specific conditions. Examiners in
OSCEs often expect more detailed responses; however, the “best” or “first-line”
answer is always listed first — this is the information most relevant for
knowledge-based or single best answer exams.
Throughout the document, you will also find italicised notes containing tips and
insights that I found particularly useful during my own learning.
I hope you find this document useful and I wish everyone sitting exams the very
best of luck.
KEY TERMS
D= Diagnosis (the gold standard diagnosis)
T= Treatment (the first treatment/management)
All answers are based on NICE guidelines, which all healthcare professionals
are expected to follow in the UK. All information is accurate at the time of the
creation of this document (2025). Please note, that a small number of conditions
are not covered by NICE guidelines, and therefore some information has been
retrieved from other reputable sources/guidance. If you have any questions, feel
free to contact me at
2
,Topics
• Cardiology (page 4)
• Respiratory (page 16)
• GI (Gastrointestinal) and Liver (page 24)
• Renal and Urology (page 39)
• Neurology (page 47)
• Endocrinology (page 56)
• ENT (page 63)
• Mental Health/Psychiatry (page 71)
• Obstetrics and Gynaecology (page 75)
• MSK/Rheumatology (page 86)
• Dermatology (page 98)
• Haematology (page 110)
• Ophthalmology (page 115)
• Infectious Diseases (page 118)
• Paediatrics (page 119)
3
, Gold standard Diagnosis and First-Line Treatments
Cardiology
Hypertension
D= Ambulatory blood pressure monitoring (ABPM) i.e 24hr blood
pressure monitoring
T= ACEi (Ramipiril)/ARB (Losartan)/Calcium-channel blockers
(Amlodipine)/Thiazide-type diuretics (Indapamide); if still
high/resistant, add an alpha blocker (doxazosin) or spironolactone (if
potassium if below 3.5)
-lifestyle advice would be first-line unless patient has comorbidities
such as diabetes or renal disease
[Patients of Africo-Caribbean descent and > 55 y/o and no diabetes are factors
for picking a CCB as antihypertensive treatment of choice BUT if someone is
Africo-Caribbean descent and has diabetes, the diabetes always trumps
everything and you should pick the ACEi/ARB]
Malignant Hypertension (medical emergency!)
D= Blood pressure check (malignant if around 180/120 or above)
T= Referral for same-day specialist assessment with IV CCB
(Nicardipine, Amlodipine) or beta-blocker (Atenolol)
Postural/orthostatic hypotension
D= Lying-standing blood pressure
T= Lifestyle advice (manage underling cause/ increase fluid intake/
compression stockings) or Fludrocortisone (corticosteroid that acts to
increase blood pressure by making the body retain sodium) if
medication required
Postural orthostatic tachycardia syndrome (POTS)- (condition where
heart rate increases very quickly when getting up from sitting or lying
down)
4
