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%

% abv

% abv is percentage alcohol by volume.

RCPE's partner organisation SHAAP works on reducing alcohol-related harm and deaths.


A

AAA

Abdominal aortic aneurysm (AAA, termed 'triple A') is a swelling in the aorta (the main artery from the heart) that can grow over time and can rupture, which is a medical emergency.

There is AAA screening in the UK.

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ABG

Arterial blood gas (ABG) testing assesses gas exchange, acid/base status and provides immediate information on electrolytes. ABG analysis helps to diagnose respiratory failure and may reveal acid/base disturbance (and if the body is compensating or not).


ABPA

Allergic bronchopulmonary aspergillosis (ABPA) is characterised by a hypersensitivity allergic response to the spores of Aspergillus mould. ABPA is the non-invasive form of aspergillosis.

ABPA is most common in people with asthma, CF or bronchiectasis.

Radiopaedia - ABPA


ABPI

The ankle-brachial pressure index (ABPI) is the ratio of the systolic blood pressure at the ankle (highest of the dorsalis pedis and posterior tibial artery pressures) to the systolic blood pressure in the upper arm (brachial artery pressure).

ABPI is measured on the same side of the body (left ankle compared with left upper arm).

Lower blood pressure in the leg than the arm (a low ABPI, less than 1) suggests blocked arteries due to PAD.


ACS

Acute coronary syndrome (ACS) encompasses myocardial infarction (MI, both STEMI and NSTEMI) and unstable angina.

SIGN 148 - Acute coronary syndrome


ADHD

Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness.

Source: NHS Inform - ADHD


ADR

An ADR is an adverse drug reaction, an unwanted symptom/reaction brought on by a medication (when prescribed and taken appropriately).

ADRs can be reported via the MHRA's Yellow Card Scheme.

NICE CKS -ย Adverse drug reactions


AF

Atrial fibrillation (AF)ย is a type of cardiac arrhythmia characterised by rapid and irregular beating of the heart's atria, due to aberrant electrical activity.

NICE CKS -ย Atrial fibrillation


AHP

The NHS recognises 14 Allied Health Profession(al)s (AHPs), including OT, PT and SALT.


AI

Artificial intelligence (AI) is intelligence demonstrated by machines.

Mendeley - AI in medicine


AIDS

Acquired immune deficiency syndrome (AIDS) occurs when the body is severely damaged by the HIV virus, and encompasses a number of potentially life-threatening infections and illnesses.

NICE CKS - HIV infection and AIDS


AIH

Autoimmune hepatitis (AIH) is a chronic, autoimmune, inflammatory liver disease.ย 

Without immunosuppressive treatment, AIH may lead to cirrhosis.

British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis - Gleeson and Heneghan (2011)


AKI

Acute kidney injury (AKI, also termed acute renal failure, ARF) is when the kidneys suddenly stop working.ย EdRen - more info

NICE CKS - AKI

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ALL

Acute lymphoblastic leukaemia (ALL) is a rapidly-developing blood cancer where an abundance of immature lymphocytes are produced.

ALL is the most common type of leukaemia to affect children but can also affect adults.

Chemotherapy is the mainstay of treatment.

Cancer Research UK - ALL


ALS

Advanced life support (ALS) expands on BLS with the addition of airway equipment, cardiac monitoring, manual defibrillation, and medications used in cardiac arrest, with increased focus on working in a multi-disciplinary team.

Resuscitation Council (UK) - Adult advanced life support


AML

Acute myeloid leukaemia (AML) is an aggressive blood cancer of myeloid cells.

Risk increases with age, and AML is most common in people over 65.

Chemotherapy is the mainstay of treatment, but bone marrow or stem cell transplants may also be considered.

Cancer Research UK - AML


AMR

Antimicrobial resistance (AMR) includes resistance of infectious microorganisms to antibiotics, antivirals, antiprotozoals, antimalarials, and antifungals.

AMR makes these treatments ineffective, meaning infections persist and are more likely to cause harm and be spread to others.


AMTS

The Abbreviated Mental Test (AMT, or Abbreviated Mental Test Score, AMTS) is a quick screening test produced in 1972 to detect cognitive impairment in the elderly.

It may not be culturally appropriate to continue using this test, and its validity has been questioned.

Patient.info - AMTS


AMU

The acute medical/medicine unit (AMU), also known as the medical assessment unit (MAU), provides rapid definitive assessment, investigations and management for patients admitted as an emergency by their GP or who require admission from the ED.


APD

Automated peritoneal dialysis (APD) is a form of dialysis in which a machine fills and empties the peritoneal cavity 3-5 times during the night. The other form of peritoneal dialysis is CAPD.

APD is an example of RRT.

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ARDS

Acute respiratory distress syndrome (ARDS) is characterised by rapid onset of widespread inflammation in the lungs.


ASD

Autism spectrum disorder (ASD) is a condition that affects social interaction, communication, interests and behaviour.

Source: NHS Inform - ASD


ATLS

Advanced Trauma Life Support (ATLS) involves the management of a trauma patient.

In the UK, Trauma and Orthopaedics (T&O) is a paired specialty.


AVNRT

Atrioventricular nodal re-entry tachycardia (AVNRT) is the most common type of SVT.

LITFL - AVNRT


AVPU

AVPU is a responsiveness scale: Alert, responds to Voice, responds to Pain, Unresponsive

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AVRT

Atrioventricular re-entrant tachycardia (AVRT), also termed atrioventricular reciprocating tachycardia, is a type of SVT most commonly associated with Wolffโ€“Parkinsonโ€“White syndrome.

LITFL - Pre-excitation syndromes


AXR

Abdominal X-ray (AXR, more accurately abdominal radiograph) may be used to confirm diagnoses such as bowel obstruction, toxic megacolon and renal colic (using a KUB AXR, Kidneys-Ureters-Bladder).

Radiopaedia - AXR


B

BCG

The BCG vaccine (Bacillus Calmette-Guรฉrin) protects against TB.

NHS Inform - BCG vaccine


BLS

Basic life support (BLS) includes CPR and may include use of an AED, but does not include advanced monitoring or interventions such as use of airway equipment.

More advanced support is provided by ALS.

Resuscitation Council (UK) - Adult BLS

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BMA

The British Medical Association (BMA) is the trade union and professional association for doctors and medical students in the UK.

BMA website


BMD

Bone mineral density (BMD) is the amount of bone mineral in bone tissue, and can be measured using DEXA.


BMI

Body mass index (BMI) is defined as the body mass divided by the square of the body height (kg/mยฒ).

BMI classifies people as underweight (BMI less than 18.5), healthy weight (18.5-24.9), overweight (25-29.9) and obese (30-39.9).


BNF

The British National Formulary (BNF) is a UK pharmaceutical reference source (publication/App) that contains information and advice on prescribing and pharmacology for medicines available on the NHS.


BNFc

The BNF for Children (BNFc) is the paediatric version of the adult BNF.


BPH

Benign prostatic hyperplasia/hypertrophy (BPH) is an enlargement of the prostate gland (benign prostate enlargement, BPE) common in elderly men. BPH can cause a number of LUTS (lower urinary tract symptoms), such as increased frequency and poor stream.

NICE CKS - LUTS in men


bpm

Beats per minute


BPPV

Benign paroxysmal positional vertigo (BPPV) is an inner ear disorder.

BPPV causes repeated, brief periods of vertigo with movements such as turning in bed or changing position. N&V are common.

Diagnosis can be made with the Dixโ€“Hallpike test and BPPV can be treated with the Epley manoeuvre.

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BSE

Bovine spongiform encephalopathy (BSE, or "mad cow" disease) causes variant CJD.

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BV

Bacterial vaginosis (BV) is a common cause of unusual vaginal discharge (white/grey with a characteristic fishy smell) due to an imbalance of bacteria in the vagina.

BV is not an STI, but increases the risk of developing an STI.

BV is treated with antibiotics.


C

CABG

A coronary artery bypass graft (CABG), commonly termed heart bypass surgery, involves creating an alternative channel to improve blood flow to the heart when a coronary artery is blocked.


CAP

Community-acquired pneumonia (CAP) is a pneumonia developed by a person with little contact with the healthcare system - in contrast with HAP.

NICE Guideline (NG138) - Pneumonia (community-acquired): antimicrobial prescribing

BMJ Best Practice - CAP


CAPD

Continuous ambulatory peritoneal dialysis (CAPD) is a form of dialysis which happens throughout the day/night, in which the person drains and exchanges their own fluid.ย 

During CAPD, dialysis fluid is left in the peritoneal cavity for 4-6 hours to allow waste products from the blood to accumulate. The fluid is then drained out. Fluid can be left overnight.

The other form of peritoneal dialysis is APD.

CAPD is an example of RRT.

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CBT

Cognitive behavioral therapy (CBT) is a psycho-social 'talking therapy' focussing on how your thoughts, beliefs and attitudes affect your feelings and behaviour. CBT teaches coping strategies.

Patient.info - CBT


CCF

Congestive cardiac failure (CCF, or congestive heart failure, CHF) refers to combined left and right heart failure.


CCT

Certificate of Completion of Training (CCT) confirms that a doctor has completed an approved training programme in the UK and is eligible for entry onto the specialist register (or GP register).

CESR provides an alternative route to the specialist register.

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CDC

The Centers for Disease Control and Prevention (CDC) is a public health institute of the United States.


CESR

Certificate of Eligibility for Specialist Registration (CESR) provides a route for doctors who do not hold a Certificate of Completion of Training (CCT) to gain entry onto the Specialist Register.

RCPE information on CESR


CF

Cystic fibrosis (CF) is an autosomal recessive genetic disorder that mostly affects the lungs, but also the pancreas, liver, kidneys, and GI tract.

CF typically leads to frequent lung infections, sinus infections, poor growth, fatty stool, and infertility in males due to congenital absence of the vas deferens.

There is no cure. CF is managed with pulmonary rehabilitation, antibiotics, mucolytics (drugs that loosen and thin mucus) and pancreatic enzyme replacement; lung transplantation may be considered. Ivacaftor may also be considered.

NICE Guideline (NG78) - Cystic fibrosis: Diagnosis and management


CHD

Coronary heart disease (CHD), previously called ischaemic heart disease (IHD), occurs when the coronary arteries are narrowed by a build-up of fatty material within their walls, limiting oxygen delivery to the heart.

NB: CHD may also refer to congenital heart disease.

BHF - Coronary heart disease


CiPs

Capabilities in Practice (CiPs) are learning outcomes for internal medicine training (IMT) that cover the key professional activities expected of a fully-trained physician.

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CJD

Creutzfeldtโ€“Jakob disease (CJD) is a rare and fatal degenerative brain disorder. CJD is a prion disease and there are four main types:ย 

  • Sporadic CJD: the most common type, the precise cause is unclear
  • Variant CJD: caused by consuming BSE-infected beef
  • Familial or inherited CJD
  • Iatrogenic CJD
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CK

Creatinine kinase (CK) is an enzyme expressed by various tissues, particularly in muscles.

CK is measured as a marker of damage of CK-rich tissue such as in rhabdomyolysis (severe muscle breakdown) and muscular dystrophy. CK used to be used to diagnose MI but has been replaced by troponin.


CKD

Chronic kidney disease (CKD) is typically staged - mild-moderate (stages 1-3) and severe (stages 4/5) CKD.

NICE CKS - Chronic kidney disease

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CLL

Chronic lymphocytic leukaemia (CLL) is a type of blood cancer that affects B lymphocytes and tends to progress slowly over many years.

CLL mostly affects people over the age of 60.

CLL is often asymptomatic and found on routine blood tests.

Chemotherapy is the mainstay of treatment, if needed.

Cancer Research UK - CLL


CML

Chronic myeloid leukaemia (CML) is a type of blood cancer where too many myeloid cells are produced โ€“ immature white blood cells that are not fully developed and do not work properly.

CML tends to progress slowly over many years.

CML can occur at any age, but is most common in older adults around 60-65 years of age.

The main treatment for CML are tyrosine kinase inhibitors, such as imatinib.

CML is classically associated with the Philadelphia chromosome.

Cancer Research UK - CML


CMV

Cytomegalovirus (CMV) is a common virus that is usually harmless (but poses a risk to developing babies and people with immunodeficiency). CMV persists for life.


CNS

CNS refers to the central nervous system , consisting of the brain and spinal cord (in contrast to the PNS, the peripheral nervous system).


COPD

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties.

NICE CKS -ย Chronic obstructive pulmonary disease


CPD

Continuing professional development (CPD), colloquially termed 'lifelong learning', is an important part of every physicianly career.

RCPE provides its Fellows and Members with access to the online CPD Diary, to maintain a personal and validated record of CPD activities on an annual basis.

RCPE educational events are CPD accredited/approved.

RCPE - CPD

GMC - CPD


CPR

Cardio-pulmonary resuscitation (CPR) is a life-saving intervention for cardiac arrest.

How to do CPR

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CQC

The Care Quality Commission (CQC) is the independent regulator of all health and social care services in England.

The CQC monitors, inspects and regulates hospitals, GP practices, hospices, care homes and other services including mental health, dental care and the ambulance service.

CQC website


CSF

Cerebrospinal fluid (CSF) is a clear, colourless fluid found in the brain and spinal cord.

CSF can be obtained by lumbar puncture (LP). LP can determine intracranial pressure and CSF analysis (colour, cell contents, chemical composition, presence of pathogens) can help to diagnose a number of neurological conditions.

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CT

Computerised tomography (CT, as in CT/CAT scan) uses several X-ray images and computer processing to create cross-sectional images of the body.

Radiopaedia - CT


CTPA

CT pulmonary angiography (CTPA) is a commonly performed diagnostic test to exclude PE (acute or chronic), which uses CT angiography to obtain an image of the pulmonary arteries.

Radiopaedia - CTPA


CUP

Carcinoma of unknown primary (CUP) is a diagnosis for a metastatic cancer (a cancer that has spread) with an unclear site of origin (the originalย 'primary' cancer is unknown).

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CVA

Cerebrovascular accident (CVA) is synonymous with stroke.


CXR

The Chest X-ray (CXR, more accurately chest radiograph) is a common radiological investigation used to diagnose conditions affecting the lungs and chest.

An erect CXR (a CXR taken when the patient is standing) may be used to confirm diagnosis of bowel perforation.

Radiopaedia - Systematic chest radiograph assessment (approach)


D

D&V

D&V refers to Diarrhoea and Vomiting.


DBS

Deep brain stimulation (DBS) is a neurosurgical procedure involving the placement of electrodes and a neurostimulator (colloquially termed a brain pacemaker) in order to deliver electrical impulses to specific brain (nuclei) targets.

DBS is used in the management of movement disorders (such as PD) and epilepsy.


DCIS

Ductal carcinoma in situ (DCIS) is an early, non-invasive form of breast cancer.

In DCIS, the cancer cells are completely contained in the ducts and lobules and have not invaded into surrounding breast tissue. However, DCIS can transform into invasive breast cancer. DCIS is therefore surgically managed; hormone therapy or radiotherapy may be considered.

Macmillan Cancer Support - DCIS

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DDx

Differential diagnosis (DDx) is the process of distinguishing a particular disease from others that present with similar clinical features.


DEXA

Dual-energy X-ray absorptiometry (DEXA) scans are used to measure BMD and to diagnose and monitor osteopaenia and osteoporosis.

Radiopaedia - DEXA


DI

Diabetes insipidus (DI) is not related to diabetes mellitus (T1DM / T2DM), although shares similar signs/symptoms.

DI is a rare condition characterised by the production of large amounts of dilute urine (polyuria) and greatly increased thirst (polydipsia).

DI is caused by a problem with either the production or action of the hormone arginine vasopressin (AVP; also known as anti-diuretic hormone, ADH). Lack/inaction of AVP means the kidneys are unable to retain water.

There are two main forms: central DI (also known as cranial or neurogenic DI), caused by a deficiency of AVP and nephrogenic DI, caused by resistance to AVP in the kidneys (the kidneys do not respond to AVP). DI can also be related to pregnancy (gestational DI) or a problem with the body's thirst mechanism (dipsogenic DI).

Diabetes UK - DI


DILI

Drug-induced liver injury (DILI) is a challenging disorder faced by hepatologists.

Liver injury can result from a vast number of drugs used in clinical practice, and from a number of herbs and dietary supplements.

Drug-Induced Liver Injury EASL Guideline


DKA

Diabetes ketoacidosis (DKA) is an acute metabolic complication of diabetes (triad of hyperglycaemia, ketonaemia and acidaemia), characterised by absolute insulin deficiency. DKA is potentially fatal and is a medical emergency, and it is the most common acute hyperglycaemic complication of type 1 diabetes.

BMJ Best Practice - DKA


DMARD

DMARDs are disease-modifying antirheumatic drugs.


DNACPR

The purpose of a Do Not Attempt CPR (DNACPR) decision is to provide immediate guidance to those present (mostly healthcare professionals) on the best action to take (or not take) should the person suffer cardiac arrest or die suddenly.

Resuscitation Council (UK) - DNACPR

DOAC

Direct-acting oral anticoagulants (DOACs) are direct-acting oral anticoagulants (first called 'novel'ย oral anticoagulants, NOACs).

DRE

A digital rectal examination (DRE) is an internal examination of the rectum.

DRE is also known as a PR (per rectum/rectal) examination.


DRESS

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare reaction to certain medications causing widespread rash, fever, swollen lymph nodes, and characteristic blood abnormalities including eosinophilia.

Management consists of stopping the offending medication and supportive care. Systemic corticosteroids are commonly used.


DVLA

The Driver and Vehicle Licensing Agency (DVLA) maintains the registration and licensing of drivers in Great Britain, and responsibilities include recording driver medical conditions.


DVT

Deep vein thrombosis (DVT) is a blood clot in a deep vein, typically in the leg.

NICE CKS -ย Deep vein thrombosis


E

ECG

The electrocardiogram (ECG or EKG) measures electrical activity of the heart to detect cardiac problems.


ECT

Electroconclusive therapy (ECT, previously termed electroshock therapy) involves the intentional induction of seizures by applying electricity to one (unilateral ECT) or both brain hemispheres (bilateral ECT), and is used in the management of a number of psychiatric conditions.


ED

ED is the Emergency Department (also known as A+E, Accident and Emergency).

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EEG

The electro-encephalogram (EEG) measures electrical activity of the brain and can be used to diagnose epilepsy, sleep disorders and other conditions.

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eGFR

Estimated glomerular filtration rate (eGFR) is a measure of kidney function, calculated using creatinine and patient charateristics: age, sex and ethnicity.

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EMU

An EMU is an Evening Medical Update, organised by RCPE.

Upcoming EMUs

EMUs on the Education Portal


ENT

Ears, nose and throat (ENT), formally otorhinolaryngology, is a surgical specialty.


ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) can be used to help diagnose conditions of the liver, bile ducts, pancreas or gallbladder, although non-invasive magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound are preferred, unless there is therapeutic intent.

Through the endoscope, the inside of the stomach and duodenum can be visualised. Contrast (dye) can be injected into the ducts in the biliary tree and pancreas so they can be assessed using X-rays. Biopsies can also be taken.

Stents can be inserted during ERCP to relieve ductal blockage.


ESR

The erythrocyte sedimentation rate (ESR) is a non-specific measure of inflammation.


F

Fair dealing

There is no statutory definition of fair dealing and, in a court of law, use would be judged on a case-by-case basis.

โ€˜Fair dealingโ€™ includes the use of works for illustration for instruction and quotation. Works made available to the public can be used for criticism and review.

In essence, โ€˜fair dealingโ€™ means use is limited to only the minimum necessary amount of content for its purpose (reasonable and appropriate to the context) and use does not negatively impact on the market for the original works. Copying should not harm the copyright holder, financially or otherwise.

Further reading from The University of Manchester Library


FBC

The Full Blood Count (FBC, also termed Complete Blood Count, CBC) provides information on the cellular contents of the blood: red blood cells, white blood cells (e.g. WBC) and platelets.


FFP

Fresh frozen plasma (FFP) is made from the liquid portion of whole blood.ย 

FFP is used to replace low blood clotting factors or low levels of other blood proteins, and can be used to treat TTP.


FIT

The Faecal Immunochemical Test (FIT), also termed Quantitative Faecal Immunochemical Test (qFIT), is used in bowel cancer screening.

qFIT uses antibodies that specifically recognise human haemoglobin and is therefore more sensitive and specific than the older guaiac-based FOB test.

Macmillan Cancer Support - FOB test and FIT test


FNA

Fine needle aspiration (FNA) is a minimally-invasive biopsy procedure to acquire tissue, cell or fluid samples.

FNA is often guided by USS.

Radiopaedia - FNA


FOB

The faecal occult blood (FOB) test detects small amounts of blood in faeces, and is used in bowel cancer screening.

FOB is being replaced by FIT.

Macmillan Cancer Support - FOB test and FIT test


FY

The two foundation years (FY1 and FY2) form the initial post-graduate training for doctors in the UK.

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G

GAD

Generalised anxiety disorder (GAD) is a long-term condition that causes anxiety about a wide range of situations and issues, rather than one specific event.

Disproportionate, pervasive, uncontrollable, and widespread worry leads to a range of somatic, cognitive, and behavioural symptoms (Hoge, Ivkovic and Fricchione, 2012; NICE CKS).

Other anxiety disorders include PTSD and OCD.

NICE CKS - GAD


GBS

Guillainโ€“Barrรฉ Syndrome (GBS) is an autoimmune disease affecting the peripheral nerves, which causes rapid-onset muscle weakness.

The main treatments are IVIG and plasma exchange (plasmapheresis).

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GCA

Giant cell arteritis (GCA) is a vasculitis of arteries, typically those in the head and neck.ย 

GCA is a medical emergency.

Symptoms typically include headache, severe pain and tenderness over the temples (hence GCA is also calledย temporal arteritis)ย and the scalp, jaw pain while eating (jaw claudication), and flu-like symptoms.ย 

Visual disturbance (double vision or visual loss) and jaw claudication demands urgent medical attention, with high-dose steroid as management.

GCA is frequently associated with PMR.

NICE CKS - GCA


GCS

The Glasgow Coma Scale (GCS) is a neurological scale which aims to give a reliable and objective way of recording the state of a person's consciousness for initial as well as subsequent assessment. A person is assessed against the criteria of the scale, and the resulting points give a person's score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (more widely used, modified or revised scale).

GCS Resources and FAQs

GDM

Gestational diabetes mellitus (GDM) is diabetes (high blood glucose) that develops during pregnancy. GDM is usually diagnosed from a blood test 24 to 28 weeks into pregnancy. Women with GDM donโ€™t have diabetes before their pregnancy, and it usually goes away after giving birth.

In the UK, roughly 16 out of every 100 women will develop GDM.

The most common problem associated with GDM is a large baby (macrosomia), which can make vaginal delivery more difficult and may mean caesarean section is required.

Diabetes UK - GDM


GGT

Gamma-glutamyl transferase (GGT) is an enzyme found mainly in the liver.

GGT has three key uses beyond revealing liver disease:

  • Diagnosing bile duct obstruction
  • Differentiating hepatobiliary disease (raised ALP and GGT) from bone disease (isolated raised ALP)
  • Screening for chronic alcohol abuse

Lab Tests Online - GGT


GI

GI refers to the gastrointestinal system, the focus of the gastroenterology specialism.


GIRFT

Getting It Right First Time (GIRFT) is an NHS improvement programme.

GIRFT website


GMC

The General Medical Council (GMC) is the regulator for doctors in the UK.

GMC website


GORD

Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus.

GORD causes heartburn, acid regurgitation and may cause oesophagitis.

Left untreated, GORD may lead to stricture formation or Barrett's oesophagus, which may develop into cancer.

Management focusses on lifestyle change (such as weight loss) and acid-lowering medications (such as PPIs). Surgery may be considered.

NICE CKS - Proven GORD

BMJ Best Practice - GORD


GP

'General Practitioner' (GP) is UK-terminology for a primary care physician ('family doctor').

GP can also refer to General Practice, the remit of a General Practitioner.


GTN

Glyceryl trinitrate (GTN) is a medication used in the prophylaxis and treatment of angina and the management of anal fissures, amongst other indications.

NICE - GTN


GUM

Genitourinary medicine (GUM) involves the investigation and management of STIs and HIV.


H

HAI

Healthcare-associated infection (HAI) is an infection acquired in the hospital or other healthcare setting.

Examples include catheter-associated infections and HAP.


HAP

Hospital-acquired pneumonia (HAP) is an example of a nosocomial infection. HAP is a new pneumonia arising two or more days after admission to hospital.

NICE Guideline (NG139) - Pneumonia (hospital-acquired): antimicrobial prescribing

BMJ Best Practice - HAP


HBCCC

Hospital-Based Complex Clinical Care (HBCCC) provides hospital care (nursing and medical input) for patients who cannot be looked after anywhere else due to their frailty and complexity. The medical input should involve consultant geriatrician input as well as day to day input which varies between facilities (some GP, some specialty or junior doctor).

Criterion for eligibility is "cannot be looked after anywhere else" as assessed by consultant geriatrician. Eligibility should be reviewed every three months, and patients who no longer meet the criterion should be moved on (usually nursing home).


HDU

The high-dependency unit (HDU) offers a level of care (Level 2) between ward-level (Level 1) and ICU-level (Level 3).

A HDU is for "patients needing single organ support (excluding mechanical ventilation) such as renal haemofiltration or ionotropes and invasive BP monitoring. They are staffed with one nurse to two patients." (reference).


HFpEF


HHT

Hereditary haemorrhagic telangiectasia (HHT), also known as Oslerโ€“Weberโ€“Rendu syndrome, is a rare autosomal dominant genetic disorder that leads to abnormal blood vessel formation:

  • Telangiectasia: in the skin and mucous membranes (red or purple spots under the skin)
  • Arteriovenous malformations (AVMs): in organs such as the lungs, liver and brain

The most common problem is nosebleeds (epistaxis), acute GI blood loss, and chronic GI blood loss, leading to IDA.

Management may include iron supplementation, blood transfusion, laser treatment for telangiectasia and embolisation or surgery for AVMs.


HIV

Human immunodeficiency virus (HIV) damages cells in the immune system. Once acquired, HIV persists for life. There is no cure, but antiretroviral drugs can control infection and stop transmission to others. HIV can be transmitted in a number of ways, all of which are preventable.

HIV can lead to acquired immune deficiency syndrome (AIDS).

Sexwise - HIV

NICE CKS - HIV infection and AIDS


HPA

The hypothalamicโ€“pituitaryโ€“adrenal (HPA) axis is a hormone-based system that regulates the bodyโ€™s reaction to stress.


HRCT

High-resolution computerised tomography (HRCT) is a high-resolution form of CT, used most commonly for interstitial lung diseases.

Radiopaedia - HRCT


HRT

Hormone replacement therapy (HRT) is a form of hormone therapy used to treat symptoms associated with menopause, including hot flushes and night sweats, vaginal dryness, reduced sex drive, and bone loss.

NICE Guideline (NG23) - Menopause: diagnosis and management


HSE

The Health and Safety Executive (HSE) is Great Britain's independent regulator for work-related health, safety and illness. HSE also researches occupational risks, producing statistics, and enforces the law surrounding health and safety at work.

HSE website


HUS

Haemolytic-Uraemic Syndrome (HUS) is a group of blood disorders mainly affecting infants and children.ย 

HUS is characterised by low red blood cells, AKI, and low platelets. Bloody diarrhoea is a common early symptom - kidney problems and low platelets then occur as the diarrhoea is improving.ย 

Most cases occur after infectious diarrhoea due to E. coli O157:H7.


I

IBD

Inflammatory bowel disease (IBD) includes Crohn's Disease and Ulcerative Colitis (UC).


IBS

Irritable bowel syndrome (IBS) is a common condition affecting the digestive system.

NICE CKS -ย Irritable bowel syndrome


ICH

Intracerebral haemorrhage (ICH) occurs when a blood vessel in the brain ruptures, causing bleeding in the brain.

NICE CKS - Stroke and TIA


ICP

Intracranial pressure (ICP) is the pressure inside the skull: in brain tissue and CSF.

Raised ICP signs/symptoms include headache (particularly morning headache - the headache is worse with coughing, sneezing and bending, and progressively worsens over time), vomiting, altered level of consciousness, and papilloedema.

ICP is normally 7โ€“15 mmHg. At 20โ€“25 mmHg (the ULN), treatment to reduce ICP may be needed (such as therapeutic LP).


ICU/ITU

Intensive Care Unit (ICU) and Intensive Therapy Unit (ITU) are synonymous.

An ICU offers 'Level 3' care, for "Patients requiring two or more organ support (or needing mechanical ventilation alone). Staffed with one nurse per patient and usually with a doctor present in the unit 24 hours per day." (reference)

An ICU is therefore used for patients with severe or life-threatening illnesses (particularly multi-organ failure) and injuries, requiring constant care and specialist equipment, monitoring, medications and interventions.


IDA

Iron deficiency anaemia (IDA) is the most common form of microcytic anaemia.

IDA can be caused by chronic blood loss (including menstruation in pre-menopausal women or from the GI tract, such as in the case of bowel cancer), malabsorption of iron,ย or dietary deficiency of iron.

NICE CKS - Anaemia (IDA)

BSG Guidelines for the management of iron deficiency anaemia


IE

Infective endocarditis (IE) is an infection of the heart's inner lining (the endocardial surface), which may include valves and chordae tendineae.

BMJ Best Practice - Infective endocarditis


IFG

IFG is Impaired Fasting Glycaemia/Hyperglycaemia. Like IGT, IFG is known as 'prediabetes'.

IFG is defined as a fasting plasma glucose between 6.1 and 6.9 mmol/L (source: NICE).

IFG is managed by lifestyle intervention.


IGT

Like IFG, IGT is a form of 'prediabetes'.

The current WHO diagnostic criteria for IGT are: a fasting plasma glucose of less than 7.0 mmol/L and a 2-hour venous plasma glucose (after ingestion of 75 g oral glucose load) of 7.8 mmol/L or greater, and less than 11.1 mmol/L. (source: NICE)

IGT is a strong risk factor for developing diabetes and cardiovascular disease, and therefore IGT is managed using lifestyle change ยฑ medication.


ILD

Interstitial lung disease (ILD) refers to a group of diseases affecting the lung interstitium (the tissue and space around the alveoli).


IMT

Internal Medicine Training (IMT) replaced Core Medical Training (CMT) in August 2019. This new curriculum was introduced in response to the recommendations set out in the Shape of Training Report, and other drivers.

IMT forms the first three years of post-foundation training and, for the main specialties supporting acute hospital care, an indicative 12 months of further internal medicine training will be integrated flexibly with specialty training in a dual programme.

IMT aims to prepare doctors for the management of the acutely unwell patient, with an increased focus on chronic disease management, comorbidity and complexity. Generic professional capabilities (GPCs) as set out in the GMC's framework will be embedded in all curricula to emphasise the importance of these professional qualities as well as helping to promote flexibility in postgraduate training.

Source:ย JRCPTB - More information on IMT

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INR

The international normalised ratio (INR) is a laboratory measurement of how long it takes blood to clot, used to monitor individuals taking the anticoagulant warfarin.

INR is derived from the prothrombin time, which evaluates the extrinsic pathway and common pathway of coagulation.


IPF

Idiopathic pulmonary fibrosis (IPF) is a progressive condition causing lung scarring, making breathing increasingly difficult.

IPF is the most common type of pulmonary fibrosis.

The clinical course of IPF can be unpredictable, but its five-year survival from diagnosis is comparable to, or even worse than, a number of common cancers.

BMJ Best Practice - Idiopathic pulmonary fibrosis


IV

Intravenous (IV) means existing within or administered into a vein or veins.

NICE Clinical Guideline (CG174) - Intravenous fluid therapy in adults in hospital


IVC

The inferior vena cava (IVC) is a large vein that returns deoxygenated blood from the lower and mid body to the right atrium of the heart. Valves prevent backflow due to gravity.

Radiopaedia - IVC

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IVIG

Intravenous immunoglobulin (IVIG) is a therapy for autoimmune disease, including GBS.


J

JRCPE

The Journal of the Royal College of Physicians of Edinburghย (JRCPE) is the Collegeโ€™s quarterly, peer-reviewed journal, with an international circulation of 8,000. It has three main emphases โ€“ clinical medicine, education and medical history and humanities.

JRCPE homepage


JRCPTB

The Joint Royal Colleges of Physicians Training Board (JRCPTB) sets and maintains standards for physician training in the UK on behalf of the Royal College of Physicians of London, Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow.

JRCPTB are involved in curriculum design and implementation, recruitment and certification of trainees, and support the GMC in quality management.

JRCPTB website

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JVP

The jugular venous pulse (JVP)ย provides an indirect measure of central venous pressure.

Patient.info: JVP


L

LFT

Liver function tests (LFTs) assess the functioning of the liver, by measuring levels of proteins, enzymes, blood clotting ability, and waste products in the blood.


LMWH

Low-molecular-weight heparin (LMWH) is an anticoagulant used in VTE prophylaxis and management, and in the management of ACS.

LMWH is derived from unfractionated heparin (UFH), but does not require APTT monitoring and has more predictable pharmacokinetics (with a longer half-life) and anticoagulant effect. LMWH less commonly causes heparin-induced thrombocytopenia than UFH.

LMWH is cleared renally.


LP

Lumbar puncture (LP, colloquially termed spinal tap) obtains a CSF sample for analysis and is also used in the management of conditions such as idiopathic intracranial hypertension.

LP is a sterile procedure, performed by inserting a needle into the subarachnoid space, usually between the third and fourth lumbar vertebrae.

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M

MCI

Mild cognitive impairment (MCI) refers to minor difficulties with cognition (mental abilities such as memory or thinking) that are worse than would normally be expected for a healthy person of that age.

Symptoms are not severe enough to interfere significantly with daily life.


MHRA

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for protecting and promoting public health and patient safety by ensuring that medicines, medical devices and blood components for transfusion meet appropriate standards of safety, quality and efficacy.

MHRA website


MI

Myocardial infarction (MI, commonly termed heart attack) describes necrosis (death) of myocardial tissue (heart muscle) due to ischaemia (an inadequate supply of blood to the affected tissue) - typically due to sudden blockage by a blood clot.ย 

CHD is a leading cause of MI.


MMSE

The Mini Mental State Examination (MMSE), not to be confused with the MSE, measures cognitive impairment and is used to assess severity and progression of cognitive impairment. The MMSE can be used to help diagnose and monitor dementia. It takes 5-10 minutes to administer.

The MMSE tests a number of mental abilities, including memory, attention and language.

Patient.info - MMSE


MND

Motor neurone disease (MND) is a group of rare neurodegenerative conditions that progressively damage the motor neurones. Messages from the motor neurones gradually stop reaching voluntary muscles, leading to muscle weakness and wasting.

Amyotrophic lateral sclerosis (ALS) is the most common form of MND.

MND is life-limiting and there is no cure.

MND Association - What is MND?

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MODY

Maturity onset diabetes of the young (MODY) is a rare genetic form of diabetes caused by a mutation in an autosomal dominant gene disrupting insulin production. MODY is also known as monogenic diabetes. There are many forms of MODY, depending on the gene affected.

MODY affects around 1-2% of people with diabetes.

The charity Diabetes UK lists the key features of MODY as: being diagnosed with diabetes under the age of 25; having a parent with diabetes, with diabetes in two or more generations; not necessarily needing insulin.

MODY - Diabetes UK


MRCP(UK)

Membership of the Royal College of Physicians (MRCP(UK))

RCPE information on MRCP(UK)

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MRI

Magnetic resonance imaging (MRI) is an imaging modality, particularly useful for soft tissues, which does not involve ionising radiation.

Radiopaedia - MRI


MS

Multiple sclerosis (MS) is an autoimmune demyelinating disease: the insulating cover of nerve cells in the brain and spinal cord (myelin) is attacked by the body's immune system.

There are three main types of MS:

  • Relapsing-remitting: isolated attacks (relapses) are followed by recovery (remission)
  • Secondary progressive: starting as relapsing-remitting, this type later progressively worsens without remission
  • Primary progressive: a steady worsening from the onset, without remissions.

Signs/symptoms are unpredictable, but can include fatigue, optic neuritis and other visual disturbance, weakness of limbs, pain, bowel and bladder problems, and sexual problems.

NICE CKS - MS

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MSE

The Mental State Examination (MSE) is used to assess a patient's emotions, thoughts, and behaviour. Present mental state informs differential diagnosis and can allow risk assessment.ย 

Student BMJ article on MSE


MSU

Mid-stream specimen of urine


MTI / IMTF

The Medical Training Initiative (MTI) and International Medical Training Fellowship Programme (IMTF) are ran by the College and allow international (non-EU) junior and middle-grade doctors to train and work in the UK for up to two years, whilst enabling NHS Boards and Trusts to fill rota gaps with high quality staff.

RCPE MTI/IMTF information

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MUP

Minimum unit pricing (MUP) is a policy aimed at improving public health by reducing alcohol consumption and thus alcohol-related harm, disease and death.

SHAAP champions MUP in Scotland (introduced in May 2018).


N

N&V

N&V refers to Nausea and Vomiting.


NAC

N-acetylcysteine (NAC) is a medication used to treat paracetamol OD and to loosen thick mucus in CF and COPD.


NAD

NAD means 'no abnormality detected'.


NAFLD

Non-alcoholic fatty liver disease (NAFLD) is caused by a build-up of fat in the liver, typically seen in people who are overweight or obese.

NAFLD is a progressive disease: starting from simple fatty liver (steatosis), NAFLD progresses to non-alcoholic steatohepatitis (NASH), to fibrosis, and ultimately to cirrhosis.

NICE CKS -ย Non-alcoholic fatty liver disease


NBM

NBM means 'nil by mouth', that is, no food, drink, or medications should be taken orally.ย 

NBM is typically done pre-operatively to avoid aspiration risk.

Maintenance IV fluids should be prescribed.


NET

A neuroendocrine tumour (NET) is a tumour that develops from cells of the neuroendocrine system. These cells are similar to nerve cells, but make hormones.

NETs can be benign or malignant, and functioning (hormone-producing) or non-functioning.

NETs typically affect the GI system or lungs.

Macmillan Cancer Support - NETs

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NEWS

The National Early Warning Score (NEWS)

Learn more


NHS

The National Health Service (NHS) encompasses the four separate and independent public healthcare providers in the United Kingdom: the National Health Service in England, NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland.

NHS website


NICE

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care in the United Kingdom.

NICE website


NIV

Non-invasive ventilation (NIV) involves ventilatory support without an invasive artificial airway (endotracheal tube or tracheostomy tube), using a face or nasal mask or similar device.


NMC

The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK.

NMC website


Non-Clinical

View allย Non-Clinical content


NPIS and TOXBASE

The National Poisons Information Service (NPIS) is a national UK service providing expert advice on all aspects of acute and chronic poisoning.

TOXBASEยฎ is the primary clinical toxicology database of the NPIS.


NSAID

NSAIDs are non-steroidal anti-inflammatory drugs.


NSTEMI

NSTEMI is non-ST-elevation MI.


O

OA

Osteoarthritis (OA) is the most common type of arthritis. OA tends to occur in middle age or due to an injury or obesity.

OA can affect any joint, but it typically occurs in the hands, knees, hips, lower back and neck.

NICE CKS - Osteoarthritis


OCD

Obsessive-compulsive disorder (OCD) is an anxiety disorder where a person has obsessive thoughts and/or compulsive activity (commonly both).

  • An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters a person's mind, causing feelings of anxiety, disgust or unease.
  • A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought

Other anxiety disorders include PTSD and GAD.

Source: NHS Inform - OCD

NICE CKS - OCD


OD

'Overdose' can be abbreviated to 'OD'.


OSA

Obstructive sleep apnoea (OSA) occurs when the walls of the throat relax and narrow or close during sleep, interrupting normal breathing. This disturbs sleep.

When asleep, OSA may cause snoring and snorting alongside interrupted breathing. When awake, OSA causes excessive daytime sleepiness (hypersomnia). Hypersomnia poses a danger to driving and should be reported by patients and explored by doctors - the driving licencing/regulatory agency (such as the DVLA) should be informed.

NICE CKS - OSA


OT

Occupational therapy (OT) is an AHP.

OT provides support to people whose health prevents them from doing activities or the occupation they wish to do.


P

PACES

Practical Assessment of Clinical Examination Skills (PACES) is an exam designed to test the clinical knowledge and skills of trainee doctors who hope to enter higher specialty training.

This is the third of three MRCP(UK) exams required before you can start specialist internal medicine training in the UK.

RCPE information:ย Preparing for PACES exams

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PAD

Peripheral arterial disease (PAD) occurs where a build-up of fatty deposits in the peripheral arteries causes narrowing or blockage, restricting blood supply to the lower limbs, particularly the leg muscles.

PAD classically causes intermittent claudication, leg pain when walking which resolves with rest.

PAD can be assessed using ABPI initially, and if abnormal, Doppler USS and angiography may be undertaken.


PAH

Pulmonary arterial hypertension (PAH) is a rare, progressive disorder characterised by high blood pressure in the arteries of the lungs, due to thickening and stiffening of the walls of the smaller branches of the pulmonary arteries. Over time, PAH damages the heart, which has to work harder to overcome this arterial resistance.

PAH can be associated with a number of conditions, including connective tissue diseases (such as scleroderma), portal hypertension, HIV, and certain medications/drugs. The cause may be unknown (idiopathic PAH).


PCI

Percutaneous coronary intervention (PCI, coronary angioplasty with stent insertion) is a non-surgical procedure used to treat narrowing or blockage of the coronary arteries, as found in CHD / MI.

Primary PCI is the urgent use of PCI in people with acute MI.


PCSK9

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new type of cholesterol-lowering drug.


PD

Parkinson's disease (PD) is a chronic, progressive neurodegenerative condition caused by lack of dopamine in the brain, due to loss of the dopamine-containing cells of the substantia nigra.

PD is a movement disorder with four core features: tremor (shaking), bradykinesia (slowness of movement), rigidity (muscle stiffness) and postural instability (difficulty with balance and coordination).

NICE CKS - Parkinson's disease


PE

Pulmonary embolism/emboli (PE) occurs when a blood vessel in the lung(s) is blocked by a blood clot.

NICE CKS - Pulmonary embolism


PERLA

PERLA means pupils equal and reactive to light and accommodation.

PEARL means pupils equal and reactive to light; PERRLA means pupils equal, round and reactive to light and accommodation.


PET

Positron emission tomography (PET) is a non-invasive, nuclear medicine imaging technique (similar to SPECT), providing metabolic and functional information.

PET is often combined with CT or MRI.

Radiopaedia - PET

Radiopaedia - SPECT vs. PET


PFO

Patent foramen ovale (PFO) occurs if the foramen ovale, a hole between the heart's atria made in normal foetal development, does not close after birth as it should.

PFO is common, affecting about 1 in 4 people.ย 

PFO can increase risk of ischaemic stroke, because thrombi (blood clots) can pass from the right to the left side of the circulation and more easily reach the brain - normally small thrombi are filtered out by the lungs.


PHE

Public Health England (PHE) ceased to exist in late 2021.

Since 1 October 2021, PHE's health protection functions have been delivered by the UK Health Security Agency (UKHSA), while its health improvement functions have been delivered by the Office for Health Improvement and Disparities (OHID, DHSC), NHS England, and NHS Digital.


PID

Pelvic inflammatory disease/disorder (PID) is an infection of the female upper genital tract, including the uterus, Fallopian tubes and ovaries.ย In about 1 in 4 cases, STI is the cause.

PID can lead to a number of complications including infertility and ectopic pregnancy.ย 

Prompt and effective treatment with antibiotics is important (after STI screening), of both the affected female ยฑ recent sexual partner(s).ย 

NICE CKS - PID


PMR

Polymyalgia rheumatica (PMR) is an inflammatory condition which presents with aching and morning stiffness in the neck, shoulders, and/or pelvic girdle (hips and thighs) in people older than 50 years of age.

PMR is frequently associated with GCA.

NICE CKS - PMR


PoCUS

Point-of-Care Ultrasound (PoCUS) refers to USS performed at the patient's bedside (or wherever they are - in the ED, in a GP practice, or in an ambulance, for example), as opposed to in a dedicated radiology department.

Radiopaedia - PoCUS Curriculum


PPE

Personal protective equipment


PPI

Proton-pump inhibitors (PPIs) are a group of medications which reduce stomach acid production.

PPIs are used in the management of PUD and GORD.


PT

Physiotherapy (preferred UK terminology) and physical therapy (preferred US terminology) help to restore movement and function when someone is affected by injury, illness or disability.


PTSD

Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very stressful or distressing events.

People with PTSD often relive the traumatic event through nightmares and intrusive thoughts or images when awake (flashbacks). Symptoms last for at least one month after the traumatic event.

Other anxiety disorders include OCD and GAD.

NICE CKS - PTSD


PUD


PUO

PUO is pyrexia (fever) of unknown origin.

Patient.info -ย Pyrexia of Unknown Origin


Q

QOF

The Quality and Outcomes Framework (QOF) is a voluntary annual reward and incentive programme for all GP practices in England, detailing practice achievement results.

QOF consists of a number of achievement measures (indicators) against which GP practices score points according to their level of achievement. The higher the score, the higher the financial reward for the practice.

QOF helps standardise improvements in the delivery of primary care.

NICE QOF indicators


Quality Governance Collaborative

The Quality Governance Collaborative (QGC) is an independent, neutral, non-governmental body committed to a new approach to governance in health and social care.

QGC information

R

RA

Rheumatoid arthritis (RA) is a common, long-term autoimmune inflammatory disease that causes pain, swelling and stiffness in the joints (typically affecting the hands, feet and wrists).

NICE CKS - RA


RCGP

The Royal College of General Practitioners (RCGP) is the professional body for GPs in the UK.

RCGP website


RCPCH

The Royal College of Paediatrics and Child Health (RCPCH) is the professional body for paediatricians in the UK, responsible for postgraduate training, education and career support.

RCPCH works on a range of programmes, including research, to improve child health in the UK and across the world.

RCPCH website


RCPE

The Royal College of Physicians of Edinburgh (RCPE) is here to support you throughout your career to enable you to deliver the highest standards of healthcare to patients.

RCPE website

RCPE events website

RCPE venue website


RCPsych

The Royal College of Psychiatrists (RCPsych) is the professional body responsible for education and training, and setting and raising standards in psychiatry.

RCPsych website


ROSC

Return of spontaneous circulation (ROSC) is resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest.

Resuscitation Council (UK) - Post-resuscitation care

RRT

Renal replacement therapy (RRT) includes dialysis and transplantation.

NICE Guideline 107 - Renal replacement therapy and conservative management

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S

SAH

Subarachnoid haemorrhage (SAH) is an uncommon type of stroke caused by bleeding into the space around the brain (the subarachnoid space, found between the arachnoid and pia mater).

SAH classically produces a thunderclap headache - patients report a sudden-onset headache that is the worst headache of their life.

SAH can be traumatic (the most common cause), caused by head injury, or be spontaneous, typically due to a ruptured berry aneurysm.

Radiopaedia - SAH


SALT

Speech and Language Therapy (SALT or SLT) is an AHP.

SALT involves the support and treatment for people who have speech, language, communication or swallowing difficulties.


SAS Doctors

SAS Doctors are not in training grades and nor are they consultants or GPs.

Doctors who have knowledge, skills and experience in a specialty that is approved for the award of a CCT by the GMC but have gained these outside of an approved training programme (including as a SAS Doctor) may apply for entry onto the Specialist Register with a CESR in a CCT specialty.


SBE

Subacute bacterial endocarditis (SBE) is a slowly-developing IE, typically caused by the Streptococcus species S. viridans.

SBE is an infection of the inner lining of the heart (the endocardium) and is associated with vegetations on heart valve surfaces with eventual valve destruction if the infection is not treated effectively.


SCAD

Spontaneous coronary artery disease (SCAD) occurs when a tear appears in the wall of a coronary artery.

SCAD presents similarly to angina or a heart attack, and may cause an MI or even cardiac arrest.

SCAD typically affects young to middle-aged women, many of whom have no/few risk factors for CHD.

ESC Position Paper on SCAD - Adlam et al. (2018)


SHAAP

Scottish Health Action on Alcohol Problems (SHAAP) was set up in 2006 by the Medical Royal Colleges in Scotland and is based within the RCPE. Clinicians had become increasingly concerned at the escalation in alcohol-related health damage in Scotland - both in its acute effects seen in admissions to EDs and in chronic conditions such as liver disease and brain damage.

SHAAP website


SIGN

The Scottish Intercollegiate Guidelines Network (SIGN) develops evidence-based clinical practice guidelines for the NHS in Scotland.

SIGN website


SLE

Systemic lupus erythematosus (SLE, known as lupus) is an autoimmune disease where the body mistakenly attacks healthy tissue.

Lupus can affect many systems of the body, including the skin, heart, lungs, kidneys and brain.

BMJ Best Practice - SLE


SMC

The Scottish Medicines Consortium (SMC) is the national source of advice on the clinical and cost-effectiveness of all new medicines for NHS Scotland.

SMC website


SOB

Shortness of breath (SOB) is termed dyspnoea.


SOBOE

Shortness of breath on exertion (SOBOE) refers to SOB when exercising.ย  Causes include COPD and CCF.


SPECT

Single-photon emission computed tomography (SPECT) is a non-invasive, nuclear medicine imaging technique (similar to PET), combining the information gained from scintigraphy with that of CT.

SPECT provides metabolic and functional information.

SPECT may be combined with a separate CT machine, providing hybrid imaging: single photon emission computed tomography-computerised tomography (SPECT-CT).

Radiopaedia - SPECT

Radiopaedia - SPECT vs. PET


STEMI

STEMI is ST-elevation MI


STI

STI is a sexually-transmitted infection (also termed STD, sexually-transmitted disease).

STIs are passed through unprotected sex or genital contact.


SVC

The superior vena cava (SVC) is a large valveless vein that returns deoxygenated blood from the upper body to the right atrium of the heart.

Radiopaedia - SVC

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SVT

Supraventricular tachycardia (SVT) is an abnormally fast heart rhythm due to aberrant electrical activity in the upper heart (arising in the atria or atrioventricular node).

There are four main types: AF, paroxysmal SVT, atrial flutter, and Wolffโ€“Parkinsonโ€“White syndrome.

Patient.info - SVT in adults


T

T&MC

The Trainees and Membersโ€™ Committee (T&MC) is a representative Committee of elected Trainees and Members of the College (RCPE). The Committee provides support for trainees and to ensure that the views of trainees are represented in all College discussions and to represent trainees in our external discussions, such as within the Joint Royal Colleges of Physicians Training Board (JRCPTB).

T&MC committee member information


T1DM

Type 1 diabetes mellitus (T1DM) is caused by absolute insulin deficiency due to destruction (most commonly autoimmune destruction) of pancreatic beta-cells.

NICE CKS - T1DM


T2DM

Type 2 diabetes mellitus (T2DM) is caused by insulin resistance and a relative insulin deficiency.

NICE CKS - T2DM


T3

Tri-iodothyronine (T3) is active thyroid hormone, and regulates the body's metabolism.


T4

Thyroxine (T4) is a prohormone, converted to active T3ย byย peripheral deiodination.

T4ย isย the transported in the blood from the thyroid; the majority is protein-bound.ย Free and total (free and bound) T4 is measured in TFTs.


TB

Tuberculosis (TB) is an infection caused by Mycobacterium tuberculosis, and typically affects the lungs (pulmonary TB) but can also affect other organs and sites (extrapulmonary TB), such as the meninges, lymph nodes and bones/joints.

TB infection can be 'active' (symptomatic and transmissible) or 'latent' (asymptomatic and non-transmissible).

NICE CKS - TB


TBI

TBI is traumatic brain injury.


TENS

Transcutaneous electrical nerve stimulation (TENS) uses a mild electrical current to help manage pain or muscle spasm.

TENS can be used in a number of painful conditions including joint pain, pelvic pain (such as in endometriosis) and during labour.

NHS - TENS information


TFTs

Thyroid function tests (TFTs) are a group of blood tests (measuring TSH, T4, T3) used to check the function of the thyroid.

TFTs can be used to diagnose thyroid disease and to monitor treatment (thyroid suppression or thyroid hormone replacement).

Thyroid antibodies may also be tested.

NICE CKS - Hypothyroidism

NICE CKS - Hyperthyroidism


TIA

A transient ischaemic attack (TIA, also known as 'mini-stroke') is a "transient (less than 24 hours) neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without evidence of acute infarction".

TIAs are associated with increased risk of ischaemic stroke (particularly in the short-term), highlighting higher risk patients who should be assessed for aggressive management of stroke risk factors.

NICE CKS - Stroke and TIA


TIPS

A transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is an artificial channel within the liver connecting the portal vein with the hepatic vein, allowing (a proportion of) blood draining from the bowel to bypass the liver's portal venous circulation.

TIPS is used to treat portal hypertension and is a life-saving procedure in oesophageal/gastric variceal bleeding.

Radiopaedia - TIPS


TLoC

TLoC is transient loss of consciousness - also known as 'blackout'.

NICE Clinical Guideline (CG109) - Transient loss of consciousness ('blackouts') in over 16s

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TPN

Total parenteral nutrition (TPN) is the feeding of specialist nutritional products to a person intravenously, bypassing the GI tract.

BNF - Intravenous nutrition


TTP

Thrombotic thrombocytopaenic purpura (TTP) is a rare blood disorder that results in blood clots forming in small blood vessels throughout the body (disseminated microvascular platelet rich-thrombi).

TTP results in a low platelet count, low red blood cells (microangiopathic haemolytic anaemia), and often kidney, heart, and brain dysfunction due to reduced oxygen-rich blood flow.

TTP is managed with plasma therapy (plasma exchange for acquired TTP; FFP for inherited TTP) and immunosuppression.


U

U&E

Urea and Electrolytes (U&E) is a common blood test to assess kidney function and electrolyte balance.

U&E typically includes sodium, potassium, urea, creatinine and eGFR.

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UC

Ulcerative colitis (UC) is a form of IBD, which causes inflammation of the colon and rectum.

NICE CKS - UC


ULN

ULN means 'upper limit of normal'.


USA

USA and US refers to the United States (of America).

NB: for ultrasound, see USS.


USS

An ultrasound scan, or ultrasound (USS) uses ultrasonography: non-ionising, high-frequency sound waves to characterise tissue.

USS is used for diagnosis and investigation (including in pregnant women, obstetric ultrasound) and to guide intervention (such as USS-guided FNA).

PoCUS is a specific example of USS.

NB: To avoid confusion, USS is used in place of US, which refers to the United States (of America).

Radiopaedia - Ultrasound


UTI

Urinary tract infection (UTI) is an infection in any part of the urinary system. Lower UTI affects the bladder (cystitis); upper UTI affects the ureters or kidneys (pyelonephritis).

UTI is more common in females.

Complicated UTI occurs when the urinary tract is abnormal, if a patient has a catheter (catheter-associated UTI), if the causative organisms are atypical, or if there are predisposing co-morbidities such as poorly controlled diabetes. Uncomplicated UTI is caused by typical organisms in people with a normal urinary tract and kidney function. Complicated UTI increases risk of persistent infection, treatment failure and recurrent infection (recurrent UTI).

Most UTIs can be easily treated with antibiotics, although recurrence is possible, particularly in women.

NICE CKS - Lower UTI in women

NICE CKS - Lower UTI in men

NICE CKS - Pyelonephritis (acute)

NICE CKS - UTI in children


V

V/Q

Ventilation (V, air reaching the lung alveoli) / Perfusion (Q, blood reaching lung alveoli via capillaries) is an important concept in respiratory physiology.

The V/Q ratio refers to the ratio of the amount of air reaching the alveoli per minute to the amount of blood reaching the alveoli per minute. V and Q are the main determinants of blood oxygen and carbon dioxide concentration.

V/Q mismatch occurs when one or more areas of the lung receive oxygen but no/little blood flow, or they receive blood flow but no/little oxygen.

V/Q ratio can be determined using a V/Q lung scan, medical imaging using scintigraphy and medical isotopes to evaluate the circulation of air and blood within the lungs. The V/Q scan is used in preference to a CTPA for the investigation of PE in patients with kidney failure or in pregnancy, to avoid significant radiation exposure.

Radiopaedia - V/Q scan


VF

Ventricular fibrillation (VF) is a type of cardiac arrhythmia where the heart's ventricles twitch randomly rather than contracting in a co-ordinated fashion, due to aberrant electrical activity in the ventricles.

VF results in cardiac arrest with loss of consciousness and no pulse, as the ventricles fail to pump blood around the body.

Prompt CPR and defibrillation are needed to survive VF.


VSD

Ventricular septal defect (VSD) is a form of congenital heart disease where there is a hole in the ventricular septum, between the ventricles of the heart. This hole allows blood to flow from the left side of the heart to the right, meaning a large volume of blood flows to the lungs.ย 

A large VSD causes high blood pressure in the pulmonary arteries (pulmonary hypertension) and means the left heart has to work harder than normal. This may lead to heart failure.

VSDs may close over time and not need treatment. Alternatively, surgery may be required. Pulmonary artery banding may be performed, allowing surgery to take place at a later date.


VTE

Venous thromboembolism (VTE) describes a blood clot that forms in a vein and travels to another location causing blockage. Typically VTE involves a clot from a DVT causing a PE.


W

WBC

White Blood Cell Count (WBC) or White Cell Count (WCC)

Normal ranges
Patient typeLower limit (x109/L)Upper limitย (x109/L)
Adult4.1 - 4.510.9-11
Newborn930
1 year old618

WHO

Theย World Health Organization (WHO) is a United Nations agency, headquartered in Geneva, Switzerland, concerned with international public health.

WHO website



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