Exam Craft/Epi+Stats/Clinical Skills

Question 1

Factors in evidence based medicine

Answer 1

Overlap of
- Best available evidence
- Doctors judgement
- Patients value

Question 2

Reviewing medical lit/evidence
- what makes the study strong (VALID) (4)

Answer 2

• does it have an appropaite PICO (is the patient applicable, is the intervention what we want, do we care about this outcome)
• is it blinded (and to what extent)
• is it randomised (and did this work - are the patient groups similar)
• p<0.05 = statistically significant. comment on both statistical significance and then if also clinically significant

Question 3

KFP Management Steps

Answer 3

PPP ASF
P - Pharmacological + non pharma
P - Public Health
P - Prevention
A - Administrative/notifiable
S - Side effects of treatment
F - Follow-up

Question 4

Medical DDx - murtaghs

Answer 4

PROMPT
Probable diagnosis
Red flags
Often Missed
Masquerades - Depression, Diabetes, Drugs, Anaemia, Thyroid, Spinal , UTI (3 DATSUs)
Patient trying to
Tell me something

Question 5

Medical DDx - VITAMIN CDE

Answer 5

V - Vascular
I - infectious/inflammatory
T - Trauma + Toxin
A- Autoimmune
M - Metabolic
I - Iatrogenic + Idiopathic
N - Neoplastic
C - Congenital
D- Degenerative
E - Endocrine

Question 6

Delivering bad news/results (6)

Answer 6

1. Setting - need anyone else, organise long appt
2. Perception - what do they know OR expecting
3. Deliver Knowledge - simple and short
4. Empathy - acknowledge
5. Summarise - simple plan, summarize, written info
6. Follow-up - within 1 wk

Question 7

Four concerns that would trigger mandatory report to AHPRA for colleague

Answer 7

• impairment
• intoxication whilst practicing
• sexual misconduct
• significant departure from accepted standards

Question 8

TH appt, personal attended funeral, asking for sick cert for sick leave for last 10 days
Steps? (5)

Answer 8

1. Offer condolences
2. Explain medical certificate only for medical illness
3. Explain might be eligble for personal leave
4. Offer letter of support
5. Offer F2F follow-up to assess further

Question 9

Common KFP answers that need more specificity (5)

Answer 9

1. Referrals timing - urgent or routine
2. Referral reason - refer to AH for this reason
3. Unilateral pathology - left or right
4. Route of medication
5. Acuity of diagnosis - acute pancreatitis

Question 10

Describing Hx or examination finding in KFP??

Answer 10

Be specific
- reduced sensation for peripheral neuropathy. NOT just sensation -> ie give the positive finding
- Hx, avoid starting with any -> ends up vague

Question 11

KFP: Patient with high risk hx+ex for eg. cancer. You send for investigations but they dont attend follow-up.
What actions may you take to follow this up? (5)

Answer 11

1. Contact patient urgently because of possible serious underlying pathology
2. Sen registered letter to request urgent contact as serious consequences of delay
3. Contact NOK and request that patient contact me
4. Check with local hospital if pt admitted
5. Check with emergency services to see if they have attended her

Question 12

Conta-indications for bupropion (3)

Answer 12

1. Hx of Seizures
   + during abrupt withdrawal from ETOH + BZD
2. Eating disorders
3. Irreversible MAO-inhibitors

Question 13

19yo with CP + ID, some communication difficulties. What methods could you employ to support pt with communication (6)

Answer 13

1. Speak directly to pt
2. Avoid medical jargon
3. Use visual aids
4. Ask simple yes/no questions
5. Involve family member if relevant
6. Check regularly that they have understood

Question 14

Referral answers

Answer 14

SURFeR
S- Send (via ambulance if relevant)
U- Urgent (or routine)
R- Referral
F- For
R- Reason