Postmenopausal bleeding is the entry point here, but the useful move is knowing when ultrasound stops being enough. Persistent bleeding, fibroids, and a distorted cavity all push this towards biopsy, and the episode keeps staging and referral tied to what happens next.

The trigger is a child with headache, dizziness or balance change after sport, especially when symptoms declare themselves within 24 hours. Open this for a concise bedside review of red flags, oculomotor checks, gait testing and why return-to-play decisions need more than a symptom checklist.

The clue is fatigue with craving ice, restless legs, heavy menstrual bleeding, pregnancy, or prior bariatric surgery, even before anaemia appears. Start here because the episode turns iron deficiency into a usable plan: ferritin first, fasting transferrin saturation when ferritin misleads, then low-frequency oral or early intravenous iron.

An abnormal shoulder MRI after 40 is often a trap, not a diagnosis. The teaching point is interpretation: match rotator cuff or labral findings to history and examination, and reserve MRI for questions that change management rather than escalating because the report looks dramatic.

Resistant hypertension should not be diagnosed from officereadings alone. Home or ambulatory monitoring, adherence review, and screening for white coat effect, obstructive sleep apnoea, and primary aldosteronism should come before further escalation, because normal potassium does not ruleout aldosteronism.

‍

Peanut allergy is diagnosed by history first, not by a positive test alone. Rapid onset after exposure, multisystem features and high-risk eczema matter most, while early regular peanut introduction and prompt epinephrine remain the practical prevention and treatment anchors.

MASLD triage is practical when anchored to fibrosis risk rather than transaminases alone. FIB-4 from routine bloods separates low-risk patients from those needing ELF testing, elastography, or hepatology referral, while 5%, 7–10%, and 10–15% weight-loss targets map to steatosis, inflammation, and fibrosis.