May 23rd-2, 2021

Question 1

63M, 3/12 intermittent epigastric pain and. nausea, no weight loss/night sweats, trialled H2Ant, brother bowel ca at 52, 20py smoking, TIA 3ya, anxiety, OA, aspirin, perindopril, atorvastatin 80, venlafaxine 75mg, 5 ddx

Answer 1

• gastro-oesophageal reflux disease
• aspirin induced peptic ulcer disease
• gastric cancer
• helicobacter pylori infection
• pancreatitis

Question 2

63M, 3/12 intermittent epigastric pain and. nausea, no weight loss/night sweats, trialled H2Ant, brother bowel ca at 52, 20py smoking, TIA 3ya, anxiety, OA, aspirin, perindopril, atorvastatin 80, venlafaxine 75mg, 2 management

Answer 2

commence 40mg, po, pantoprazole, daily

• cease smoking
• avoid spicy foods

Question 3

63M, 3/12 intermittent epigastric pain and. nausea, no weight loss/night sweats, trialled H2Ant, brother bowel ca at 52, 20py smoking, TIA 3ya, anxiety, OA, aspirin, perindopril, atorvastatin 80, venlafaxine 75mg, bowel cancer screening 2 mx?

Answer 3

• needs colonoscopy every 5 years from age 50-74
• benefit from aspirin for 2.5 years
• other siblings and parents in same risk group
• has moderate increase risk

Question 4

57F, 6/12 hx of fatigue, denies low mood, busy at home 3 kids, menopause 3ya, increase weightBMI 36, 4 aspects of history

c,e,g,h,j,p

Answer 4

• cold intolerance
• vegan diet with enough iron
• recent fevers?
• polyuria?
• snoring at night
• PRn bleeding?
• FHx coeliac

Question 5

57F, 6/12 hx of fatigue, denies low mood, busy at home 3 kids, menopause 3ya, increase weight BMI 36, OSA, 3 mx

Answer 5

• recommend CPAP machine
• mandibular advancement splint
• weight loss of 5-10%
• advise road licensing authority of diagnosis

Question 6

5M, aboriginal, 4/7 hx >38celsius, swollen left knee, vaccinated, no reg meds, severe penicillin allergy, pmhx: otitis media, scabies, trachoma: 5 examination

a,,c,d,f,h,n

Answer 6

• skin rash?
• new cardiac murmur?
• polyarthritis
• sydenham chorea
• subcut nodules
• restricted passive left knee range of motion pain
• tonsillar exudate
• inability to weight bear

Question 7

5M, aboriginal, 4/7 hx >38 celsius, swollen left knee, vaccinated, no reg meds, severe penicillin allergy, pmhx: otitis media, scabies, trachoma, has acute rheumatic fever, 2 pharm management

Answer 7

Azithromycin

Ibuprofen 10mg/kg, PO, QID, PRN

Question 8

5M, severe penicillin allergy has impetigo, what ABx?

Answer 8

trimethoprim-sulfamethoxazole

Question 9

5M, aboriginal, 4/7 hx >38 celsius, swollen left knee, vaccinated, no reg meds, severe penicillin allergy, pmhx: otitis media, scabies, trachoma, has acute rheumatic fever, 6 barriers to health care

Answer 9

• distance needed to travel for healthcare
• distrust of western medicine
• shortage of healthcare professionals
• poor health literacy
• lack of services in other languages
• lack of affordable healthcare
• perceived lack of confidentiality