Cardiovascular

• Acute chest pain triage (ACS vs. PE vs. aortic dissection vs. pericarditis)
• New-onset heart failure with reduced EF
• Atrial fibrillation - rate vs. rhythm control, anticoagulation decisions
• Hypertensive emergency vs. urgency
• Infective endocarditis - Duke criteria, empirical antibiotics

Respiratory

• Community-acquired pneumonia severity scoring (CURB-65, PSI) and management
• Acute exacerbation of COPD - NIV vs. intubation
• Pulmonary embolism - Wells score, PESI, systemic vs. catheter-directed thrombolysis
• Pleural effusion workup (Light's criteria, exudate vs. transudate)
• Hemoptysis - massive vs. non-massive, causes and approach

Gastroenterology

• Upper GI bleed - Rockford/Glasgow-Blatchford scoring, PPI dosing, endoscopy timing
• Acute liver failure - etiology, King's College criteria, transplant eligibility
• Jaundice - obstructive vs. hepatocellular vs. hemolytic differentiation
• Acute pancreatitis severity (Ranson's, BISAP, revised Atlanta classification)
• Decompensated cirrhosis - SBP, HRS, hepatic encephalopathy management

Nephrology

• AKI workup - prerenal vs. intrinsic vs. postrenal; FENa, urine microscopy
• CKD-MBD, anemia of CKD, when to initiate dialysis
• Hyponatremia - SIADH vs. cerebral salt wasting vs. hypovolemic; correction rate
• Hyperkalemia - EKG changes, stepwise management
• Nephrotic vs. nephritic syndrome differentials

Endocrinology

• Diabetic ketoacidosis vs. hyperosmolar hyperglycemic state - fluid, insulin protocols
• Thyroid storm vs. myxedema coma
• Adrenal crisis - recognition and emergency management
• Hypercalcemia workup - PTH-mediated vs. non-PTH-mediated
• New diagnosis T2DM - pharmacotherapy algorithm (GLP-1, SGLT-2 decisions)

Infectious Disease

• Sepsis and septic shock - Sepsis-3 criteria, bundle management (Hour-1 bundle)
• Meningitis - bacterial vs. viral vs. TB; LP interpretation, empiric treatment
• Fever of unknown origin (FUO) - structured workup
• HIV - OI prophylaxis, ART initiation, immune reconstitution syndrome
• MDR organism infections - carbapenem-resistant Enterobacteriaceae, VRE approaches

Hematology / Oncology

• Anemia workup - microcytic vs. normocytic vs. macrocytic algorithm
• DVT / thrombophilia workup and long-term anticoagulation decisions
• Neutropenic fever - MASCC score, empiric antibiotics
• TTP vs. HUS vs. DIC - differentiation and management
• Tumor lysis syndrome - prophylaxis and treatment

Neurology

• Stroke - ischemic vs. hemorrhagic, thrombolysis eligibility (NIHSS, CT criteria), thrombectomy window
• Status epilepticus - benzodiazepine-first protocol, refractory SE
• Delirium vs. dementia vs. encephalopathy in hospitalized patients
• Guillain-Barre syndrome - AIDP vs. AMAN, IVIG vs. plasmapheresis
• Syncope - vasovagal vs. cardiac vs. orthostatic; workup algorithms

Rheumatology / Immunology

• Systemic lupus erythematosus flare - organ involvement, SLEDAI scoring
• Undifferentiated polyarthritis workup (RA vs. reactive vs. crystal arthropathy)
• Vasculitis - ANCA-associated vs. giant cell vs. polyarteritis nodosa
• Drug-induced lupus and drug reactions (DRESS, SJS/TEN)

Critical Care / Cross-Cutting

• Shock - distributive vs. cardiogenic vs. obstructive vs. hypovolemic management
• Acid-base disorders - stepwise systematic approach (ABG interpretation)
• Electrolyte emergencies on the ward
• Antibiotic stewardship - escalation and de-escalation decisions
• DNR/DNAR discussions, goals of care in deteriorating patients

1. Start with the presenting complaint and ask for a differential
2. Reveal investigations stepwise to teach clinical reasoning
3. Introduce a twist (e.g., atypical presentation, comorbidity, drug interaction)
4. End with a management decision or ethical dilemma
5. Tie back to a learning objective - pathophysiology, guidelines, or a key clinical pearl