Gen Med CBA Formative

Question 1

A 33 year old female presents to the ED with a 48-hour history of high fever and confusion. List three possible differential diagnoses for this presentation and for each diagnosis, indicate at least three relevant aspects of the history that should be sought to support each diagnosis. (6 marks)

Answer 1

Question 2

• A 33 year old female presents to the ED with a 48-hour history of high fever and confusion.
• The patient is a regular IV drug user and appears septic. Her GCS is 14.
• What specific findings should be looked for on examination? (6 marks)

Answer 2

Question 3

Answer 3

Aortic regurgitation (0.5 marks) due to infective endocarditis (0.5 marks) (Total 1 mark)

Question 4

Answer 4

1. 2 sets Blood cultures (1 mark) (0.5 marks for just ‘blood cultures’)
2. Transthoracic echocardiogram (1 mark) - (The following are 0.5 marks each to max 2 marks)
3. FBP (0.5 marks)
4. Renal function (0.5 marks)
5. Liver function (0.5 marks)
6. Urinalysis (0.5 marks)
7. ECG (0.5 marks)
8. ESR OR CRP OR procalcitonin (0.5 marks)
   (Total 4 marks)

Question 5

Answer 5

• Urgent cardiothoracic surgical consult (may require valve replacement) (0.5 marks)
• Appropriate IV antibiotics with consult to infectious diseases specialist / clinical microbiologist (0.5 marks)
• Treat left ventricular failure (0.5 marks) - diuretics, salt and fluid management, (0.5 marks)
  (Total 2 marks)

Question 6

Answer 6

Staph aureus and is it methicillin sensitive (0.5 marks each) (Total 1 mark)