GP Formative Flashcards
A 25 year old complains of an irritating, oily, and scaly red rash around his eyebrows, eyelids, inner cheeks, and between his nose and mouth. The rash has been developing gradually over the last few years and improves in summer. What condition is the most likely diagnosis?
E. Seborrhoeic dermatitis
In regards to seborrhhoeic dermatitis in adults, which statement is correct?
E. Topical ketoconazole cream is very effective when used on the face
A two year old child is brought in by his mother as he has developed a rash. His GP has diagnosed atopic dermatitis. When advising his mother about managing this rash, what option is correct?
B. Dust mite modification
A 47 year old male attends for a routine scuba diving medical. You find his blood pressure to be 163/89mmHg, although he assures you that when he monitors it at home on his own equipment, it averages around 125/85mmHg. What is the most appropriate management of this finding?
C. Ask him to return with his own monitor for comparison with yours next week
A 36 year old male bus driver has an acute exacerbation of his chronic low back pain. He is prescribed a combination of analgesic containing paracetamol 500mg and codeine 30mg. The dose recommended by the GP is two tablets, three times a day. What is the most important side effect that the patient must be made aware of?
D. Drowsiness
A 29 year old male ‘put his back out’ lifting a wheel nearly three weeks ago. He suffered almost immediate low back pain with numbness and pain extending down his left leg to his foot. The pain is constant but appears worse when standing for more than 10 minutes. The pain is slightly eased by lying down. What is the most likely diagnosis?
A. Left L5 root irritation by prolapsed disc
A 15 year old girl comes in to ask you for a prescription for the contraceptive pill. You have been her family’s GP since she was an infant. She says that her parents do not know of this visit and she is emphatic that she does not want her parents to know of this consultation. She seems confident that her parents would not support her request but she says that her aunt has said it is fine to use the pill. Should her request be granted and the pill be prescribed?
C. Yes once you are satisfied that she is mature and competent.
A 58 year old female presents complaining of six weeks of stabbing pain in her left cheek. The pain lasts a few seconds, is very debilitating, and comes without warning or provocation. The pain lasts a few seconds, after which she is fine until the next attack. What is the most likely diagnosis?
E. Trigeminal neuralgia
A four year old boy is brought in to his GP by his parents who are concerned about his poor language development. On further inquiry, it was found that he does not reciprocate when being cuddled or engage with other during play. His parents also comment that he had a habit of rocking backwards and forwards for long periods of time. What is the most probable diagnosis for this child?
B. Autism spectrum disorder
A 52 year old male road worker attends with an 8mm non-pigmented, slightly indurated scaly lesion on his right forehead. It occasionally bleeds a little. He explains that his wife is concerned about the possibility of melanoma, but he thinks its ‘just a spot’. It has been present for at least six months and might be growing. What is the most likely diagnosis?
E. Squamous cell carcinoma
A 19 year old male university student, with no history of prior substance misuse, is taken to the emergency department by his friends with whom he has been partying. He is tachycardic and is in an excited, irritable state. He is expressing paranoid ideation but has no hallucinations. What will be the most likely positive finding on urine drug screen?
A. Amphetamines
A 19 year old female who manages her asthma with inhaled B-agonists (salbutamol) purchased ‘over the counter’ on an ‘as needs’ basis, presents to her GP because the ‘puffers’ have not been working as well for the last week. You establish that her peak flow rate is reduced to 40% of normal. She is comfortable at rest but is short of breath with talking. She is afebrile. Her chest is clear at tidal breathing, but she wheezes on forced expiration. What is the most appropriate course of action?
D. Commence oral corticosteroids
During an examination for back pain, a 47 year old male is found to have minimal abdominal aortic aneurysmal dilatation with a maximum diameter of 3.7cm. You discuss the need for periodic follow up and explain the possibility of this becoming serious in the future. You enter a ‘Recall’ for one year in the practice’s IT system. What other action is essential to optimise continuity of care?
D. Ensure this finding is entered in the active problem list of active diagnoses
A 71 year old male with congestive cardiac failure and ischaemic heart disease had a second small infarct three months ago. Current medications include a beta-blocker, a diuretic, and a calcium channel blocker. He complains of being short of breath and feeling faint when he stands up. His sitting blood pressure is 115/68mmHg and his JVP is mildly elevated. What changes to his treatment give the best chance of addressing his two complaints?
E. Stop the calcium channel blocker and add an ACE inhibitor
A previously well 12 month old girl has been irritable and scratching her hands, feet, neck and arm pits for several weeks. On inspection there are scattered small areas of erythema, scaling, and excoriated papules in the finger webs, hands, elbows, axillae, buttocks, and soles of feet. What medication is most likely to benefit this child?
E. Permethrin 5% cream
An elderly female attends for a routine consultation but has a long list of problems to discuss. What is the most effective way to efficiently manage this consultation?
A. Ask her to run through the whole list and establish priorities
A 23 year old male complains of a widespread itch that is ‘driving him nuts’. Apart from signs of his own scratching, there are no other findings to indicate the cause. Even before the cause of this complaint is established, what is the most useful advice that can be given to the patient to reduce his distress?
D. Avoid heat and anything that increases skin temperature
A sales representative offers you a free trial of the ‘Diaquick’ Cassette CT test, a rapid test for chlamydia that can be performed in your practice, in order for patients to get their results in 10 minutes. Based on the product information, what decision would you make?
- A: Accept the free trial because you could reduce Medicare costs by using this test to decide which patients need a nucleic acid test for chlamydia
- B: Accept the free trial because you have nothing to lose from trying out a free product
- C: Decline the free trial because the test cannot be used with female urine specimens
- D: Decline the free trial because the test is ‘For in vitro diagnostic testing only’, ie. It cannot be used in humans
- E: Decline the free trial because there is insufficient information to tell you how to interpret a positive test
E. Decline the trial because there is insufficient information to tell you how to interpret a positive test
Which anthropometric measurement has the strongest relation to myocardial infarction to both sexes worldwide?
E. Waist: hip ratio
A 51 year old male presents for a review of his blood pressure after being started on an antihypertensive agent four weeks ago. His blood pressure today is 130/80mmHg. He reports that his ankles have been swollen, a problem he has never noticed before. What is the most likely medication he has been prescribed?
F. Calcium Channel Blocker
A 45 year old female presented six weeks ago for screening because of a family history of ischaemic heart disease. After investigation, she was prescribed medication for an abnormality requiring preventive treatment. She now complains of painful muscles, especially of her thighs, which affect her ability to rise from a sitting position. What is the most likely medication she has been prescribed?
J. Statin
A 64 year old male has Type II diabetes mellitus and hypertension. He is complaining of a dry cough which started shortly after you changed his antihypertensive medication six weeks ago. What is the most likely medication he has been changed to?
B. Angiotensin converting enzyme inhibitor (ACEI)
A 55 year old male has smoked 20 cigarettes a day for 32 years. He had a coronary artery bypass graft one month ago and was started on several new medications. Since then, he has noticed he regularly suffers from shortness of breath and wheezing. What is the most likely medication that is causing these symptoms?
E. Beta-receptor blocker
A 40 year old Aboriginal male has long standing hypertension and ischaemic heart disease. He was diagnosed with atrial fibrillation three months ago. He presents to the emergency department with a one hour history of severe headache and neck stiffness. What drug is most likely to have caused his symptoms?
L. Warfarin
A 17 year old female student presents with a six day history of a very sore throat, fever, lethargy, and several enlarged lymph glands in the neck. On examination, the throat has a profuse white-yellow exudate over the tonsils and some petechiae on the soft palate. What pathogen is most likely to have caused this presentation?
C. Epstein-Barr Virus
A 20 year old presents with a one day history of urinary frequency, dysuria, and lower abdominal pain. What pathogen is most likely to have caused this presentation?
D. Escherichia coli
A 32 year old HIV positive male presents with a two day history of dyspnoea, fever, and a non-productive cough. Chest examination reveals bilateral basal crackles. What pathogen is most likely to have caused this presentation?
J – Pneumocystis jirovecii
A 25 year old female single presents with three days of lower abdominal pain and vaginal discharge. She returned to Perth five days ago following a one week holiday on the Gold Coast. She has no significant past medical history and her only medication is the oral contraceptive pill. What pathogen is most likely to have caused this presentation?
A – Chlamydia trachomatis
A 19 year old male presents with a painful, slowly enlarging lump in his left groin for five days. On examination, the lump is hot, red, tender and fluctuant. What pathogen is most likely to have caused this presentation?
L – Staphylococcus aureus
