Reasoning GP
Management protocols
The "what to do next" for a condition you've already diagnosed. One visual pathway per disease, taking you through everything achievable in primary care — non-drug measures, the stepwise drug ladder, monitoring, follow-up and safety-netting — up to the point of referral. Re-enter the ladder at any follow-up where the patient isn't responding.
No protocol matches that search yet.
Cardiovascular & Renal
16 live
HypertensionA→C→D ladder · targets · resistant-HTN loop · NG136→
Atrial FibrillationStroke prevention + rate/rhythm · NG196→
Antiplatelets & AnticoagulantsDAPT durations · DOAC choice/dose · bleeding · peri-procedural · NG196/158→
Heart Failure (HFrEF)Four pillars + diuretics · NG106→
Chronic Kidney DiseaseSlow progression + cardio-renal protection · NG203→
HypercholesterolaemiaStatin ladder + >40% non-HDL goal · NG238→
TIAUrgent pathway + secondary prevention · NG128→
Stable AnginaAnti-anginals + secondary prevention→
Peripheral Arterial DiseaseSupervised exercise + risk reduction→
Familial HypercholesterolaemiaCascade testing + ≥50% LDL reduction · CG71→
MI Secondary PreventionFive-drug bundle + cardiac rehab · NG185→
Deep Vein ThrombosisDOAC choice + duration + PE net · NG158→
Varicose VeinsConservative measures + referral thresholds · CG168→
TIA & StrokeAcute emergencies + secondary prevention · NG128→
Acute Kidney InjurySick-day rules · stop nephrotoxins · find cause · ng148→
Pulmonary EmbolismWells · CTPA · DOAC · NG158→
Endocrine & Metabolic
10 live
Type 2 DiabetesGlucose ladder + early organ protection · NG28→
Insulin in Type 2 DiabetesBasal start/titrate · add prandial · pre-mix · hypos · prescribe by brand→
HypothyroidismLevothyroxine titration + subclinical · NG145→
HyperthyroidismSymptom control + safe shared care · NG145→
GoutFlare + treat-to-target ULT · NG219→
OsteoporosisFRAX · bisphosphonates · monitoring→
Type 1 DiabetesInsulin self-management + annual screening · NG17→
Addison's DiseaseHydrocortisone · sick-day rules · adrenal crisis→
Metabolic SyndromeWeight · QRISK3 · treat each component to target→
ObesityTiered weight management · GLP-1 · bariatric · CG189→
Respiratory
4 liveMental Health
7 live
DepressionRisk-first · stepped care · SSRI ladder · NG222→
Generalised AnxietyStepped care · SSRI ladder · CG113→
InsomniaCBT-I first · short-term hypnotics · CKS→
Benzodiazepines & Z-drugsShort-course only · diazepam-equivalent taper · deprescribing · TA77→
PTSDTrauma-focused therapy · SSRI · NG116→
OCDCBT/ERP + higher-dose SSRI · CG31→
Postnatal DepressionScreen · therapy ± sertraline · psychosis red flag · NG192→
Neurology
14 live
MigraineAcute + prophylaxis + MOH avoidance · CG150→
Tension-Type HeadacheReassurance + analgesia + MOH · CG150→
Restless Legs SyndromeIron · triggers · dopaminergic caution→
DementiaCognitive enhancers · BPSD · support→
Bell's PalsyEarly prednisolone + eye protection · CKS→
Parkinson's DiseaseShared care · on-time meds · non-motor · NG71→
Essential TremorPropranolol / primidone · vs Parkinson's→
Neuropathic PainNG173 ladder · 4 first-line · switch not stack→
Opioids (Non-Cancer Pain)Trial · 120mg/day OME cap · named opioids · taper & stop · Opioids Aware→
Sensory NeuropathyFind cause · foot care · NG173 pain→
Trigeminal NeuralgiaCarbamazepine · MRI red flags · NG173→
Post-Herpetic NeuralgiaNG173 ladder · topical · prevent→
Carpal Tunnel SyndromeSplint · injection · decompression→
ME/CFSPacing · avoid GET · NG206→
Gastroenterology
14 live
Irritable Bowel SyndromeDiet (FODMAP) · antispasmodics · neuromodulators→
Ulcerative Colitis5-ASA maintenance · flare management→
Crohn's DiseaseShared-care maintenance · flare pathway→
Diverticular DiseaseFibre · symptom control · safety net→
Constipation (Adult)Laxative ladder · review→
Aphthous UlcerSymptomatic relief + 3-week cancer rule · CKS→
HaemorrhoidsFibre + topical + procedures · CKS→
Anal FissureStool softening + GTN/diltiazem · CKS→
GORD / Acid RefluxLifestyle · PPI step-down · H. pylori · ng12→
PPI Prescribing & DeprescribingCheap first-line · gastroprotection · step-down/stop · rebound · CG184→
GastroenteritisOral rehydration · avoid antibiotics · exclusion 48h · CKS→
Gilbert's SyndromeBenign unconjugated hyperbilirubinaemia · reassure · CKS→
Cholecystitis & GallstonesAdmit acute · USS · lap cholecystectomy · CG188→
Coeliac DiseaseTest on gluten · biopsy · gluten-free diet · NG20→
Musculoskeletal & Rheumatology
16 live
Rheumatoid ArthritisRefer early · DMARD shared care
Giant Cell ArteritisSight-threatening · steroid NOW
OsteoarthritisExercise-first · topical/oral analgesia · NG226→
SciaticaActivity · neuropathic options · red flags · NG59→
Leg CrampsStretching · review drugs · quinine caution→
TMDsSelf-care + analgesia + dental splint · CKS→
Polymyalgia RheumaticaSteroid taper + bone protection + GCA net · BSR→
Raynaud's PhenomenonPrimary vs secondary · warmth + nifedipine · CKS→ Ankylosing SpondylitisExercise + NSAID → biologic · NG65→
Plantar FasciitisFirst-step heel pain · stretching · footwear · CKS→
Greater Trochanteric Pain SyndromeLateral hip pain · load management · physio · CKS→
Osgood-Schlatter DiseaseAdolescent knee · activity modification · self-limiting · CKS→
Achilles TendinopathyLoad mgmt · exclude rupture · no steroid→
Tennis ElbowActivity mod · exercise · self-limiting→
Morton's NeuromaFootwear · injection · surgery→
Shoulder PainRotator cuff / frozen · rehab · injection→
Women's Health
15 live
PCOSWeight · cycle control · hirsutism · fertility→
MenopauseHRT selection · risks · review · NG23→
HRT Prescribing — Step-by-StepChoose regimen · named preparations · switching · side effects · SEL/BMS→
Nausea/Vomiting in PregnancyAntiemetic ladder + hyperemesis · RCOG→
Heavy Menstrual BleedingFBC · LNG-IUS first-line · tranexamic acid · NG88→
ContraceptionUKMEC screen · LARC-led · emergency contraception · FSRH→
Hypertension in PregnancyLabetalol · aspirin prophylaxis · pre-eclampsia · NG133→
InfertilityInvestigate after 1 year · semen + progesterone · CG156→
Vaginal DischargeBV · candida · trichomonas · PID + cancer red flags→
Bacterial VaginosisMetronidazole · not an STI · BASHH→
Pruritus VulvaeExamine · treat cause · don’t miss VIN→
Pelvic Inflammatory DiseaseTreat empirically · protect fertility · BASHH→
DysmenorrhoeaNSAID / hormonal · spot secondary→
Mastitis & Breast AbscessKeep feeding · antibiotics · drain abscess→
Premenstrual SyndromeSymptom diary · SSRI · hormonal→
Urology & Men's Health
13 live
Male LUTSAlpha-blocker · 5-ARI · anticholinergic→
Female Urinary IncontinencePFMT · bladder training · drugs→
Erectile DysfunctionCV risk · PDE5 inhibitors · referral→
Premature EjaculationBehavioural · topical · SSRI→
VaricoceleReassure + red-flag imaging + fertility · BAUS→
BalanitisHygiene + cause-directed treatment · CKS→
UTI in WomenEmpirical antibiotics + recurrent prevention · NG109→
UTI in MenComplicated by default · prostate-aware · NG112→
UTI in ChildrenSample + antibiotics + imaging rules · NG224→ Benign Prostate EnlargementConservative → alpha-blocker/5-ARI · NG97→
ProstatitisProlonged abx (acute) · multimodal (chronic)→
Renal Colic & StonesNSAID · CT KUB · obstructed/infected = emergency→
Undescended TestisOrchidopexy · vs retractile · CKS→
Children
6 live
Nocturnal EnuresisAlarm · desmopressin · NG111→
Constipation (Child)Disimpaction · maintenance · NG99→
Cow's Milk Protein AllergyElimination · formula ladder · reintroduction→
Reflux in InfantsPositioning · feeds · stepwise · NG1→
Asthma in ChildrenStepwise ICS · spacer · action plan · acute attack · NG245→
Nappy RashBarrier + nappy care · antifungal for candida→
Allergy & Immunology
3 liveInfections
7 live
CellulitisEron class · flucloxacillin · treat the portal
ThreadwormWhole-household treatment + hygiene · CKS→
Lyme DiseaseTreat EM clinically · doxycycline · NG95→
Hepatitis ANotifiable · supportive · PEP + vaccine · UKHSA→
Malaria ProphylaxisABCD · region-specific · fever after travel = urgent→
Whooping CoughNotify · macrolide · protect infants→
Glandular FeverSupportive · avoid amoxicillin + contact sport→
Dermatology
18 live
Acne VulgarisTopical → oral → isotretinoin referral · NG198→
Atopic EczemaEmollients + TCS + infection · CG57→
PsoriasisTopical ladder by site + PsA/CVD screen · CG153→
RosaceaFeature-led: triggers · topicals · oral · CKS→
HyperhidrosisAntiperspirants · iontophoresis · referral→
HirsutismCosmetic · COC · antiandrogens→ Bullous PemphigoidRefer to confirm + steroid shared care · BAD→
Anogenital WartsHPV 6/11 · GUM + STI screen · topical/cryo · vaccine→
Male Pattern Hair LossReassure · minoxidil / finasteride→
Female Pattern Hair LossScreen · minoxidil · exclude virilisation→
ChilblainsKeep warm · skin care · nifedipine if severe→
ScabiesPermethrin ×2 · treat ALL contacts→
Seborrhoeic DermatitisAntifungal + anti-inflammatory · maintenance→
Shingles (Herpes Zoster)Antiviral ≤72h · watch the eye · vaccine→
ImpetigoLocalised topical · widespread oral · NG153→
Fungal Skin InfectionTopical · oral for scalp/nail · avoid steroid alone→
Pityriasis RoseaSelf-limiting · reassure · exclude syphilis→
Pityriasis VersicolorAntifungal · pigment recovers slowly→
ENT & Vestibular
6 live
Sore Throat & TonsillitisFeverPAIN/Centor · stewardship
Otitis Media & ExternaAOM vs OE · mastoiditis red flag
BPPVDix–Hallpike + Epley manoeuvre · CKS→
Vestibular NeuronitisShort-term relief + rehab + stroke exclusion · CKS→
Ménière's DiseaseAcute relief + betahistine/salt + ENT · CKS→
SinusitisMostly viral · INCS >10d · antibiotics rarely · NG79→
Ophthalmology
7 live
Dry Eye DiseaseLubricants ladder + lid hygiene · CKS→
GlaucomaAcute angle-closure emergency · chronic shared care · NG81→
Allergic ConjunctivitisItch · avoidance + antihistamine/MCS · CKS→
BlepharitisLid hygiene + warm compress · antibiotic/doxycycline · CKS→
Macular Degeneration (AMD)Urgent wet AMD referral · dry support · NG82→
Chalazion (Meibomian Cyst)Warm compress · refer persistent · CKS→
UveitisSame-day referral · painful red eye · systemic links · CKS→
Lifestyle & Prevention
2 liveSexual Health
6 live
Genital HerpesAciclovir · episodic/suppressive · BASHH→
HIVTest widely · ART · U=U · BHIVA→
ChlamydiaNAAT · doxycycline · partner notification→
GonorrhoeaCeftriaxone IM · culture · test of cure→
TrichomoniasisMetronidazole · treat partner · BASHH→
Urethritis (Male)NGU doxycycline · gonococcal ceftriaxone→
Haematology
3 livePalliative & End of Life Care
9 live
Palliative Pain & OpioidsWHO ladder · strong-opioid choice · conversion charts · breakthrough · adjuvants→
Nausea & VomitingCause-based antiemetic choice · receptor sites · syringe driver→
Constipation (Palliative)Opioid-induced · stimulant + softener · methylnaltrexone→
Breathlessness (Palliative)Non-drug measures · low-dose opioid · benzodiazepine→
Respiratory SecretionsDeath rattle · antimuscarinics · reposition · reassure family→
Delirium & Terminal AgitationFind reversible causes · haloperidol · midazolam · levomepromazine→
Anxiety & DepressionPsychological support · SSRI/mirtazapine · benzodiazepine for crisis→
Care of the DyingRecognising dying · anticipatory meds · syringe driver · the 4 PRN drugs→
Corticosteroids (Palliative)Dexamethasone indications · dosing · morning dose · taper · gastroprotection→
How to use. These pathways assume the diagnosis is already made. They are static visual references — print any one to a clean handout for the consultation room. Educational use only; always verify against current NICE CKS and your local formulary.