Glossary of terms used in College examinations

The Royal College of Emergency Medicine uses several terms in examinations that may cause
confusion. The following definitions are intended as a guide to the understanding of these terms. It is
important to read the questions carefully and to understand the term in the context of that question.
Examiners and candidates are advised to be rigorous in the use of these terms.

Abnormality
This is any feature in an examination or investigation which is outside the standard deviation of the
population being studied. A Clinical abnormality however would be a pathologically relevant
abnormality and would not include the presence of tubes, prostheses etc.

Assessment
History taking, physical examination and use of investigations.

Characteristics
Something that describes a condition, or piece of equipment that is consistently present in that
condition or is pretty fundamental to how the piece of equipment works e.g. mercury is characteristic
of the content of thermometers.

Class of drug
This is the generic name for the type of drug with a particular pharmacological affect e.g.
anticoagulant, antihypertensive etc.

Clinical findings
This may include symptoms, signs and vital signs. It is information gleaned from the clinical
evaluation, but not the results of investigations even bedside ones (e.g. BM or Urine Dipstick)

Commonest/Common
>75% incidence, or prevalence.

Condition
This would suggest a well know pathological entity or diagnosis that should be mentioned as
contributing to the presenting complaint.

Criteria
This refers to the fact that there is a formal international/national guideline or scoring system that
allows you to define the seriousness of a condition e.g. CURB-65 score for pneumonia etc. Each
criterion may be a clinical sign, measurement, or bedside observation that helps discriminate in some
way for the management of the patient.
Definitive management/treatment
This may include things you would do in the department but usually requires you to list the operation
or procedure that will cure or contain the condition.
This may also refer to the gold standard treatment which has been proven to give best results, even if
not available in the institution where you work.

Disposition
Where the patient is sent following care in the ED including follow-up if discharged.

ED management
This requires you to list actions that are life or limb saving or that might improve the course of the
condition if done within the ED. It is not definitive management. This may however include analgesia,
referral to specialty team etc.

Essential
This indicates life saving treatments/management steps that are the priority, and would not normally
include things like analgesia, communication etc.

Factor
A contributing element or cause for the condition.

Features
This is used in a variety of ways
In the medical history – it indicated symptoms
In the examination – examination findings
In results – abnormalities that are clinically relevant or might simply be the presence of an ETT or
central line i.e. abnormality
If describing equipment or procedures, it is how the equipment looks, or key elements of the
procedure.
Clinical features can be symptoms or signs.

Immediate
This indicates what you will do now, rather than include within the general list of investigations or
treatments that a patient needs.

Implication
Something that is suggested or hinted at.

Important
Used to indicate something that needs treatment or has a very high chance of recurring e.g. important
complications are those that you warn patients about, or that you specifically wish to exclude if a
patient deteriorates.

Indicators
This is used in the context of a clinical evaluation. It should include history, examination and
investigations that might indicate that a particular diagnosis is likely.

Investigations
Specific tests undertaken to make a diagnosis or monitor the patient’s condition. They may include
bedside tests such as urine dipstick or BM unless otherwise specified.

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Management
Aspects of care including treatment, supportive care and disposition/disposal. This does not normally
include investigations unless an investigation leads to an immediate change in the treatment, i.e.
blood gas to check the correct Oxygen level is being given.

Measures
Actions that can be taken which may include physical procedures, prescriptions, referrals etc.

Most likely
This requires the commonest or best known item. For example, if asked for the most likely organisms
causing a UTI – you should list E Coli.

Pathophysiological sequence of events

This requires you to list in time order, the events that happen on a cellular, or hormonal level, leading
to the current condition. For example, if a lactate is high in the presence of sepsis, you could suggest
–
• Hypotension
• Poor organ perfusion
• Tissue hypoxia
• Anaerobic metabolism
• Glycolysis and lactate build up.

Pathognomonic
Refers to a symptom or sign that if present, would always lead to a particular diagnosis.

Pre-alert or Standby
These mean the same thing i.e. a radio call from an ambulance crew to inform ED of an acutely
unwell/injured patient arriving imminently.

Principles
These are the ideal or essential themes of a treatment or plan. e.g. Principles of drug treatment do not
usually require doses or routes but might include “broad spectrum antibiotics” or “antihistamines”.

Rarely
<10% of the time.

Recommended
This is the best treatment according to a National guideline or accepted practice.

Symptoms
This is what the patient complains of.

Signs
This is what you identify by examination and may include abnormal observations/measurements of
vital parameters.

Steps in a management plan

Actions that may include giving treatment, support or referring, if it included an investigation, the
investigation must lead to a change in the management plan.

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Strategy
This is your plan of action, and would normally include a list of investigations, prescriptions, physical
treatments, in a particular order.

Treatment
Measures undertaken to cure or stabilise the patient’s condition. This includes oxygen, fluids, drugs,
and may also mean surgery. It does not include investigations.

Usual/normal
>90% of the time.

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 Abbreviations that may be used in the examinations

AAA Abdominal Aortic Aneurysm

ABG Arterial Blood Gas
ACE Angiotensin Converting Enzyme
ACP Advance Clinical Practitioner
ACS Acute Coronary Syndrome
AECU Ambulatory Emergency Care Unit
AF Atrial Fibrillation
AKI Acute Kidney Injury
ALS Advanced Life Support
ALTE Apparent Life-Threatening Event
AP Anteroposterior
ARCP Annual Review of Competency Progression
ARDS Acute Respiratory Distress Syndrome
ATLS Advanced Trauma Life Support
AXR Abdominal x-ray
βHCG Beta Human Chorionic Gonadotropin
BiPAP BiLevel Positive Airway Pressure
BLS Basic Life Support
BM Blood glucose reading
BMI Body Mass Index
BNF British National Formulary
BP Blood Pressure
BPM Beats Per Minute
BRUE Brief Resolved Unexplained Event
CAMHS Child and adolescent mental health service
C-spine Cervical spine
CES Cauda Equina Syndrome
CKD Chronic Kidney Disease
CN Cranial Nerve
CNS Central Nervous System
COPD Chronic Obstructive Pulmonary Disease
COVID-19 Coronavirus 19
CPAP Continuous Positive Airway Pressure
CPR Cardiopulmonary Resuscitation
CRP C-Reactive Protein

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CSF Cerebrospinal Fluid
CT 1/2/3 Core Trainee years 1-3 of training
CT KUB Computed Tomography of Kidneys, Ureters and Bladder
CT scan Computerised Tomography Scan
CV Curriculum Vitae
CVC Central Venous Catheter
CXR Chest x-ray
DATIX Trusts electronic incident reporting system
DC Direct Current
DGH District General Hospital
DIC Disseminated Intravascular Coagulation
DNACPR Do Not Attempt Cardiopulmonary Resuscitation
DOAC Direct oral anticoagulant
DTaP/IPV Diphtheria/tetanus/acellular
DTap/IPV/Hib/HepB Diphtheria/tetanus/acellular pertussis/inactivated polio/Haemophilus
influenza type b/Hepatitis B
DVLA Driver and Vehicle Licensing Agency
DVT Deep Vein Thrombosis
ECG Electrocardiogram
ECHO Echocardiogram
ECMO Extracorporeal Membrane Oxygenation
ED Emergency Department
eGFR Estimated glomerular filtration rate
ELIZA Enzyme-Linked Immunosorbent Assay
ENP Emergency Nurse Practitioner
ENT Ear Nose and Throat
ESR Erythrocyte Sedimentation Rate
ETT Endotracheal Tube
FAST Focussed Assessment with Sonography for Trauma
FBC Full Blood Count
FEV1/FVC Forced Expiratory Volume in one second to Forced Vital Capacity ratio
FFP Fresh Frozen Plasma
FY1/2 Foundation Year doctor in year 1 or 2 of their foundation training
GCS Glasgow Coma Score
GI Gastrointestinal
GMC General Medical Council
GORD Gastro-oesophageal reflux disease

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GP General Practitioner
GTN Glyceryl trinitrate
Hb Haemoglobin
HELLP Hypertension, Elevated Liver Enzymes, Low Platelets
HIV Human Immunodeficiency Virus
HR Heart Rate
ICD Implantable Cardiac Defibrillator
ICP Intracranial Pressure
ICU Intensive Care Unit
IDDM Insulin Dependent Diabetes Mellitus
IHD Ischaemic Heart Diesease
IM Intramuscular
IN Intranasal
INR International Normalised Ratio
IO Intraosseous
IV Intravenous
IVDU Intravenous Drug User
JVP Jugular Venous Pressure
LVH Left Ventricular Hypertrophy
LVF Left Ventricular Failure
LP Lumbar Puncture
LFTs Liver Function Tests
LMN Lower Motor Neurone
LMP Last Menstrual Period
LRTI Lower Respiratory Tract Infection
mcg Microgram
mg Milligram
mg/dl Milligram/deciliter
MI Myocardial Infarction
mL Millilitre
MR Magnetic Resonance
MRI Magnetic Resonance Imaging
MRSA Methicillin Resistant Staphylococcus Aureus
NAI Non-Accidental Injury
NG Nasogastric
NICE National Institute for Health and Clinical Excellence

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NIDDM Non-Insulin Dependent Diabetes Mellitus
NIV Non-Invasive Ventilation
NOAC Novel oral anticoagulant
NSAID Non-Steroidal Anti-Inflammatory Drug
NSTEMI Non-ST Elevation Myocardial Infarction
OGD Oesophago-gastro duodenoscopy
OPG Orthopantomogram
OSCE Objective Structured Clinical Examination
PA Posteroanterior
PALS Patient Advice and Liaison Service
PCI Percutaneous coronary intervention
PCR Polymerase Chain Reaction
PE Pulmonary Embolism
PEA Pulseless Electrical Activity
PEEP Positive End Expiratory Pressure
PEFR Peek Expiratory Flow Rate
PEP Post Exposure Prophylaxis
PMH Past Medical History
PO By the mouth
POCUS Point of Care Ultrasound
PPE Personal Protective Equipment
QI Quality Improvement
QIP Quality Improvement Project
RCEM Royal College of Emergency Medicine
REBOA Resuscitative Endovascular Balloon Occlusion of the Aorta
ROSC Return of Spontaneous Circulation
RR Respiratory Rate
RSI Rapid Sequence Intubation
RTC or RTA Road Traffic Collision or Road Traffic Accident
RUQ Right Upper Quadrant
SC Subcutaneous
SIGN Scottish Intercollegiate Guidelines Network
SOB Shortness of Breath
SpO2 Oxygen Saturations
STEMI ST Elevation Myocardial Infarction
SUFE Slipped Upper Femoral Epiphysis

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SVT Supraventricular Tachycardia
TB Tuberculosis
Td/IPV Tetanus/diphtheria/inactivated polio
TELP Treatment escalation/limitation plan
Temp Temperature
TFTs Thyroid Function Tests
TIA Transient Ischaemic Attack
TLOC Transient Loss of Consciousness
TPD Training Programme Director
TSH Thyroid Stimulating Hormone
U&E’s Urea & Electrolytes
UMN Upper Motor Neurone
URTI Upper Respiratory Tract Infection
USS Ultrasound Scan
UTI Urinary Tract Infection
VBG Venous Blood Gases
VF Ventricular Fibrillation
VT Ventricular Tachycardia
V/Q Ventilation/Perfusion
WBPA Workplace Base Assessment
WCC or WBC White Cell Count or White Blood Cells

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Normal Values

Haematology

Haemoglobin 11.5 - 16.6g/dl

White blood cells 4 - 11 x 109/L
Platelets 150 - 450 109/L
MCV 80 - 96 fl
MCHC 32 - 36 g/dl
Neutrophils 2 - 7.5 x 109/L
Lymphocytes 1.5 - 4 x 109/L
Monocytes 0.3 - 1 x 109/L
Eosinophils 0.1- 0.5 x 109/L
Basophils <0.2 x 109/L
Reticulocytes <2 %
Haematocrit 0.35 - 0.49
Red Cell distribution width 11 - 15%

Biochemistry

Sodium 135 - 145 mmol/L

Potassium 3 - 4.5 mmol/L
Urea 2.5 - 7.5 mmol/L
Glucose 3.5 - 5 mmol/L
Creatinine 35 - 135 µmol/L
Alanine aminotransferase 5 - 35 U/L
Gamma GT <65 U/L
Alkaline phosphatase 30 - 135 U/L
AST <40 U/L
Total Protein 60 – 80 g/l
Albumin 35 - 50 g/L
Globulin 2.3 - 3.5 g/dl
Amylase <70 U/L
Total bilirubin 3 - 17 µmol/L
Calcium 2.1 - 2.5 mmol/L
Chloride 95 – 105 mmol/L
Phosphate 0.8 - 1.4 mmol/L

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Blood gases

pH 7.35 - 7.45
pO2 11 - 14 KPa
PCO2 4.5 - 6 KPa
Base excess -2 to +2 mmol/L
Bicarbonate 24 - 30
Lactate <2 mmol/L

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