general practice

A 28-year-old female presents with a chronic cough and fatigue. She has no significant past medical history but reports recent travel to Southeast Asia. A chest PET-CT was performed. What is the MOST appropriate next step in the management of this patient?

A 35-year-old male presents to his general practitioner with a lesion on his nose that has been present for approximately 3 months. He initially thought it was a persistent pimple but it has not resolved and seems to be slowly growing. He denies pain, itching, or bleeding from the lesion. He has no significant past medical history and takes no regular medications. He works outdoors but reports using sunscreen inconsistently. On examination, vital signs are stable. The lesion is as shown in the image. There are no other skin lesions noted elsewhere. Regional lymph nodes are not palpable. Based on the appearance of the lesion shown, what is the most appropriate next step in the management of this patient?

A 68-year-old male presents with fatigue and weight loss. The provided image was obtained. Which of the following is the MOST appropriate next step in management?

A 72-year-old male with a history of smoking and hyperlipidemia presents for a health check. He is asymptomatic. A contrast-enhanced CT abdomen is performed as part of a screening protocol. An axial view is shown. Besides optimizing medical management, what is the MOST appropriate next step?

A 67-year-old man with a history of hypertension and type 2 diabetes is scheduled for elective cholecystectomy due to symptomatic gallstones. During the preoperative assessment, he mentions experiencing mild chest discomfort during exertion over the past few weeks. What is the most appropriate next step in his preoperative management?

A 62-year-old male presents to his general practitioner with a six-month history of a painless bulge in his right groin. On examination, a soft swelling is palpable in the right inguinal region, which increases in size on coughing or straining. The swelling is located medial to the inferior epigastric vessels. Which of the following is the most appropriate initial management strategy according to current Australian guidelines?

A 62-year-old man presents with a 4-month history of increasing fatigue, unintentional weight loss of 7 kg, and intermittent upper abdominal discomfort. He reports no change in bowel habits, dysphagia, or vomiting. His past medical history includes hypertension and osteoarthritis. He is a non-smoker and drinks alcohol occasionally. On examination, he is pale. His vital signs are stable. Abdominal examination reveals mild epigastric tenderness but no masses or organomegaly. There is no peripheral lymphadenopathy. Initial blood tests show haemoglobin 92 g/L (reference range 130-170), MCV 74 fL (80-95), ferritin 12 mcg/L (30-300), and CRP 18 mg/L (<5). Liver function tests and renal function tests are within normal limits. Which of the following is the most appropriate initial investigation?

A 3-year-old child is brought to the GP by their parents who are worried about the appearance of their child's abdomen, as shown in the image. The child is otherwise well, active, and has no pain, vomiting, or changes in bowel habits. On examination, the finding is soft and easily reducible. Vital signs are normal. Based on this presentation and the image, what is the most appropriate initial management?

A 68-year-old male presents to the emergency department with a 12-hour history of severe, constant left groin pain. He reports a bulge in his groin that has been present for several years, which he can usually reduce himself. However, today he has been unable to push it back in, and the pain has become excruciating. He denies any fever, nausea, or vomiting. On examination, his vital signs are stable: temperature 37.0°C, heart rate 88 bpm, blood pressure 130/80 mmHg, respiratory rate 16 breaths/min, and oxygen saturation 98% on room air. Abdominal examination is unremarkable. Palpation of the left groin reveals a firm, tender mass that is non-reducible. The overlying skin is erythematous, but there is no crepitus. A CT scan of the abdomen and pelvis is performed, and an axial slice is shown. Given the clinical scenario and the imaging findings, what is the MOST appropriate next step in management?

A 72-year-old male presents to his general practitioner for a routine check-up. He reports a history of hypertension, hyperlipidemia, and a 40-pack-year smoking history. He denies any abdominal pain, back pain, or lower extremity claudication. On physical examination, his vital signs are within normal limits. Auscultation of the abdomen is unremarkable, and peripheral pulses are palpable and symmetric. As part of his cardiovascular risk assessment, a contrast-enhanced CT scan of the abdomen and pelvis is performed. An axial view from the scan is shown. Based on the image and the patient's clinical presentation, which of the following is the MOST appropriate next step in management?

A 28-year-old woman with a mother diagnosed with colorectal cancer at 45 and a maternal uncle at 50 seeks advice. She is otherwise well. What is the most appropriate next step in her management?

A 58-year-old man presents to his general practitioner expressing concern about the appearance of his chest, which he feels has become more prominent over the past 18 months. He denies any pain, tenderness, or nipple discharge. His medical history includes well-controlled hypertension managed with perindopril and occasional use of ibuprofen for mild osteoarthritis. He reports no significant changes in weight, appetite, or energy levels. He is a non-smoker and drinks alcohol socially, approximately 5 standard drinks per week. He works as an accountant and reports no exposure to unusual chemicals or substances. On physical examination, his vital signs are within normal limits. Abdominal examination reveals no hepatosplenomegaly. Testicular examination is normal in size and consistency, with no palpable masses. The image provided shows the appearance of his chest. Considering the patient's presentation and the visual finding, what is the most appropriate initial investigation to pursue?

A 62-year-old male presents with left lower quadrant pain, fever, and leukocytosis. A CT scan of the abdomen and pelvis is performed, the axial view is shown. What is the most appropriate next step in management?

A 32-year-old woman presents to her GP complaining of a new, intensely itchy rash on her elbows, knees, and scalp. On examination, the GP notes symmetrical, erythematous papules and plaques with overlying silvery scales. The patient reports a family history of similar skin conditions. What is the most likely diagnosis?

A 48-year-old sheep farmer presents to his GP with a two-week history of persistent fever, severe retro-orbital headache, and profound fatigue. He denies cough, shortness of breath, or rash. On examination, his temperature is 38.5°C, pulse 85 bpm, BP 120/80 mmHg. The remainder of the examination, including chest auscultation, is unremarkable. He has not travelled outside the region recently.

A 62-year-old postmenopausal woman presents to her general practitioner with complaints of severe hot flashes that significantly affect her quality of life. She has a history of breast cancer diagnosed three years ago, which was treated with surgery and chemotherapy. Her cancer was estrogen receptor-positive. She is currently on tamoxifen as part of her ongoing treatment. She is concerned about the use of hormone replacement therapy due to her cancer history. What is the most appropriate management option for her hot flashes?

A 45-year-old woman presents with RUQ pain, fever, and nausea. The image shows the likely cause. What is the MOST appropriate next step in management?

A 62-year-old male with a history of poorly controlled diabetes presents with right upper quadrant pain, fever, and night sweats for 3 weeks. He is on immunosuppressants following a renal transplant 5 years ago. Blood cultures are pending. Imaging is performed, as shown. What is the MOST appropriate next step in management?

A 62-year-old man presents to his GP reporting a swelling in his right groin that has been present for approximately 18 months. He describes it as intermittent, appearing when he stands or strains, and disappearing when he lies down. He occasionally experiences a mild, dull ache in the area, but denies any severe pain, nausea, vomiting, or change in bowel habits. His past medical history includes hypertension controlled with medication. On examination, vital signs are stable, and the finding shown in the image is noted. It is easily reducible. Considering the patient's history, the absence of acute symptoms, and the physical examination finding depicted, what is the most appropriate next step in the management of this patient?

A 32-year-old woman, G1P1, presents to her general practitioner at 34 weeks gestation complaining of a new, intensely itchy rash. The rash started on her abdomen around the umbilicus and has now spread to her thighs and buttocks. On examination, there are erythematous papules and plaques, some with vesicles, located within the striae distensae of her abdomen. She denies any personal or family history of eczema or other skin conditions. She is otherwise well, with normal blood pressure and no proteinuria. Fetal movements are normal. Which of the following is the most appropriate initial management?

A 64-year-old woman presents for a routine health check. She reports intermittent episodes of colicky abdominal pain over the past year, which have since resolved. An abdominal ultrasound was performed, the image of which is shown. Liver function tests are within normal limits. Which of the following is the MOST appropriate next step in management?

A 32-year-old male, recent immigrant from a high-TB prevalence country, presents with a persistent cough and night sweats for the past two months. He denies fever or weight loss. Physical examination is unremarkable except for mild, diffuse rhonchi on auscultation. Sputum cultures are pending. A PET-CT scan of the chest was performed, the axial view is shown. Given the clinical context and imaging findings, what is the MOST appropriate next step in management?

A 64-year-old woman presents for a routine health check. She reports intermittent episodes of colicky abdominal pain over the past year, which have since resolved. An abdominal ultrasound, as shown, was performed. Liver function tests are normal. Which of the following is the MOST appropriate next step in management?

A 28-year-old female, recently emigrated from Southeast Asia, presents to her general practitioner with complaints of fatigue, a persistent low-grade fever (37.8°C), and a non-productive cough that has been present for approximately one month. She denies any significant past medical history and is not currently taking any medications. Physical examination reveals slightly diminished breath sounds in the upper right lobe, but is otherwise unremarkable. Initial blood work, including a complete blood count and comprehensive metabolic panel, are within normal limits. A chest X-ray revealed a suspicious lesion in the right upper lobe, prompting a PET-CT scan, an axial slice of which is shown. Given the patient's history, clinical presentation, and the findings on the PET-CT scan, which of the following is the MOST appropriate next step in the diagnostic workup?

A 28-year-old female presents with right lower quadrant pain for 3 days. She denies fever, vomiting, or vaginal discharge. Her last menstrual period was 2 weeks ago. The shown CT was performed. What is the MOST likely diagnosis?

A 50-year-old Aboriginal man presents for a routine check-up. He has a strong family history of type 2 diabetes. What is the most appropriate initial screening test?

A 62-year-old male presents with LLQ pain and fever. The provided image was obtained. What is the most appropriate initial management?

A 68-year-old woman presents with 3 days of left lower quadrant pain. She reports mild nausea but no vomiting or fever. On examination, she is afebrile, BP 130/80, HR 78, O2 sat 98% on air. There is localised tenderness in the LLQ. Bloods show WCC 13.2, CRP 45. A CT scan is performed. Considering the clinical presentation and the findings demonstrated in the image, what is the most appropriate initial management plan?

A 68-year-old male presents with constant RUQ pain for 3 days. The image was obtained. What is the MOST likely complication if definitive management is delayed?

A 72-year-old male presents with a painful, irreducible right groin mass. He reports vomiting and abdominal distension. His vitals are: HR 110, BP 100/60, RR 22, SpO2 96% RA. The provided image was obtained. What is the next step?

A 59-year-old male presents with a painful right groin bulge that has progressively worsened over the past week. He denies fever, chills, nausea, or vomiting. Vitals are stable. The provided image was obtained. What is the MOST appropriate next step?

A 45-year-old woman presents to the ED with right upper quadrant pain, fever, and nausea for 24 hours. Her vital signs are: HR 105 bpm, BP 130/80 mmHg, Temp 38.5°C. Physical exam reveals marked tenderness on palpation of the right upper quadrant. An abdominal CT scan is performed, as shown. What is the MOST appropriate next step in management?

A 28-year-old male presents with a persistent cough and fatigue. A PET-CT scan was performed. What is the MOST likely diagnosis?

A 72-year-old male with a history of hypertension and hyperlipidemia presents for a routine follow-up. He is asymptomatic. A contrast-enhanced CT abdomen, axial view shown, was performed as part of a screening protocol. What is the MOST appropriate next step?

A 58-year-old male presents with concerns about breast enlargement over the past year. He denies pain or nipple discharge. He takes no medications and has no known medical conditions. Examination reveals the findings in the image. What is the MOST appropriate initial investigation?

A 14-month-old child is brought to the general practitioner for a routine check-up and immunisations. The parents express mild concern about a bulge they have noticed around the child's navel, which seems more prominent when the child is crying or straining. They report it is easily pushed back in and does not appear to cause the child any pain or discomfort. The child is otherwise thriving, with normal feeding, bowel movements, and developmental progress. On physical examination, the child is alert and interactive. Vital signs are within normal limits for age. Abdominal examination reveals no distension or tenderness. The finding illustrated in the image is noted. Based on this clinical presentation and examination finding, what is the most appropriate initial management plan?

A 58-year-old man presents with concerns about breast enlargement over the past year. He denies pain or nipple discharge. He takes medication for hypertension. Examination reveals the findings in the image. Which of the following is the MOST appropriate initial investigation?

An Aboriginal woman, 48 years old, attends your general practice for a routine health check. She has a history of gestational diabetes and lives in a rural community. When discussing preventative health screening, which of the following is the MOST culturally appropriate and evidence-based approach?

A 58-year-old male presents to your GP clinic complaining of a dragging sensation in his groin, noticeable especially when standing for long periods. On examination, you observe the finding in the image. He denies any pain. What is the MOST appropriate initial management?

A 62-year-old woman presents to her general practitioner with a 3-month history of progressive shortness of breath, fatigue, and a persistent dry cough. She has a history of rheumatoid arthritis, for which she takes methotrexate and low-dose prednisone. She denies fever, weight loss, or night sweats. On examination, she has clubbing of the fingers and fine inspiratory crackles at the lung bases. Her oxygen saturation is 92% on room air. A chest X-ray shows reticular opacities predominantly in the lower lung zones. Pulmonary function tests reveal a restrictive pattern with reduced diffusion capacity for carbon monoxide (DLCO). Which of the following is the most appropriate next step in the management of this patient?

A 45-year-old male presents with a painless lesion on his nose that has been present for several months. He denies any trauma or recent illness. Examination reveals the image shown. What is the MOST appropriate initial management?

A patient on warfarin presents with leg pain. INR is 3.5. Given the image, what is the MOST appropriate initial pharmacological intervention?

A 65-year-old man presents to his GP with a 2-day history of constant, dull aching pain in the left lower quadrant of his abdomen. He reports mild nausea but no vomiting. His bowel movements have been normal. He denies fever or chills. His past medical history includes well-controlled hypertension. On examination, he is afebrile (37.2°C), blood pressure is 135/85 mmHg, heart rate 72 bpm, respiratory rate 16 bpm. Abdominal examination reveals mild tenderness on deep palpation in the left iliac fossa, without guarding or rebound tenderness. Bowel sounds are normal. Digital rectal examination is unremarkable. Laboratory investigations show a white cell count of 10.5 x 10^9/L (normal range 4-11) and a C-reactive protein of 25 mg/L (normal <5). A CT scan of the abdomen and pelvis is performed (image provided). Considering the patient's clinical presentation and the findings demonstrated in the provided image, which of the following represents the most appropriate initial management strategy?

A 45-year-old man presents to his GP with a lesion on his nose that he first noticed about 6 months ago. It has slowly increased in size but is not painful or itchy. He has no significant past medical history and takes no regular medications. On examination, vital signs are stable. The image shows the appearance of the lesion. Considering the clinical presentation and the appearance of the lesion shown, what is the most appropriate initial management step?

A 35-year-old Aboriginal woman presents for a routine health check. She reports feeling tired lately and sometimes short of breath on exertion. She has a history of type 2 diabetes diagnosed 5 years ago, managed with metformin 500mg twice daily, and untreated hypertension. On examination, her blood pressure is 145/90 mmHg. Urinalysis shows 2+ protein. Blood tests reveal creatinine 180 µmol/L, eGFR 35 mL/min/1.73m², HbA1c 8.5%, potassium 4.2 mmol/L. Given these findings, which of the following is the most appropriate initial management step?

A 20-year-old female medical student arrives late, parties, but is attentive in consultations. What is the next step?

66-year-old man, smoker with mild COPD, on salbutamol and tiotropium, confused regarding usage. Back for GPMP. Care plan?

A 65-year-old male presents with acute LLQ pain. The provided image was obtained. What dietary advice is most appropriate upon resolution of acute symptoms?

A 72-year-old man with a history of a reducible inguinal hernia presents to the emergency department with severe groin pain and a firm, tender mass in the right inguinal region. He reports that he has been unable to reduce the hernia despite his usual maneuvers. He also reports nausea and vomiting for the past 6 hours. On examination, his vital signs are stable, but he appears uncomfortable. The mass in his groin is erythematous and exquisitely tender to palpation. Which of the following is the most appropriate next step in management?

A 58-year-old male presents to his GP complaining of bilateral breast enlargement over the past year. He denies any pain or tenderness. He takes no medications and reports no significant past medical history. Examination reveals the findings in the image. What is the MOST appropriate initial investigation?