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 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 30-year-old immigrant presents with chronic cough and night sweats. Sputum is negative for AFB. 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 35-year-old presents with colicky abdominal pain and vomiting. An X-ray is performed. What is the MOST likely finding on subsequent CT imaging?

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 62-year-old male presents to his general practitioner complaining of a dragging sensation in his right groin, particularly noticeable when standing for prolonged periods or straining during bowel movements. He denies any acute pain, nausea, vomiting, or changes in bowel habits. His past medical history is significant for benign prostatic hyperplasia (BPH) managed with tamsulosin. On examination, the patient is afebrile with normal vital signs. Palpation of the abdomen is unremarkable. Examination of the groin reveals the finding shown in the image. The swelling increases with coughing. Which of the following is the MOST appropriate next step in the management of this patient?

A 62-year-old female has high blood pressure (162/97 mmHg) but is not concerned. She has white coat hypertension and declines 24-hour BP monitoring. What is the correct instruction about home blood pressure readings?

A 32-year-old woman presents to her general practitioner with a 3-month history of intermittent abdominal pain and bloating. She reports that the pain is crampy, occurs mainly in the lower abdomen, and is often relieved by defecation. She also notes a change in her bowel habits, alternating between constipation and diarrhea. She denies any weight loss, fever, or blood in her stool. Her medical history is unremarkable, and she is not on any medications. On examination, her abdomen is soft with mild tenderness in the lower quadrants but no palpable masses. Blood tests, including a complete blood count and C-reactive protein, are normal. What is the most appropriate next step in the management of this patient?

A 50-year-old Aboriginal man presents for a routine check. He has a history of smoking and lives in a remote community. What screening is most important to address his increased risk?

A 72-year-old man with a history of hypertension, type 2 diabetes, and chronic kidney disease (CKD) presents to his general practitioner for a routine check-up. His current medications include metformin, insulin, amlodipine, and aspirin. His blood pressure today is 150/90 mmHg. Laboratory results show a serum creatinine of 2.5 mg/dL (221 micromol/L) and a potassium level of 5.4 mEq/L. The GP decides to add an ACE inhibitor to his treatment regimen to help manage his blood pressure and provide renal protection. One week later, the patient returns complaining of fatigue and muscle weakness. Repeat laboratory tests reveal a serum creatinine of 3.1 mg/dL (274 micromol/L) and a potassium level of 6.2 mEq/L. Which of the following is the most appropriate next step in managing this patient?

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 62-year-old man presents to his GP with a history of a bulge in his right groin that has been present for approximately 18 months. He reports it is more prominent with straining or standing and disappears completely when he lies down. He denies any associated pain, nausea, vomiting, or change in bowel habits. He has no significant past medical history. His physical examination reveals the finding depicted in the image. Vital signs are within normal limits. Based on this clinical picture, which of the following represents the most appropriate definitive management strategy for this patient?

A 14-month-old child is presented to the general practitioner by their parents, who are concerned about a noticeable protrusion around the navel. They report this bulge is more prominent when the child cries or strains but easily disappears when the child is relaxed or sleeping. There are no reports of pain, discomfort, changes in bowel habits, or feeding difficulties. The child is meeting all developmental milestones and appears well. On examination, vital signs are stable and within age-appropriate ranges. The abdomen is soft and non-tender, with no distension. The finding illustrated in the accompanying image is observed. Based on this clinical presentation and examination, what is the most appropriate initial management plan?

A 55-year-old non-smoker with no known comorbidities has a consistent office BP of 155/98 mmHg. His 10-year CVD risk is calculated as low. According to Australian guidelines, 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 next step?

A 68-year-old male presents with abdominal distension and obstipation. An upright abdominal X-ray is performed. What is the MOST appropriate next step in management?

A 72-year-old man with a history of hypertension and hyperlipidemia presents for a routine health check. He is asymptomatic. A contrast-enhanced CT abdomen is performed, axial view shown. Besides optimizing medical management, what is the MOST appropriate next step?

A 55-year-old man presents with the condition depicted, which has been present for 12 months and is mildly tender. Initial investigations including hormonal profile, liver function tests, and renal function tests are unremarkable. He takes no regular medications. Considering the clinical presentation and the findings shown, what is the most appropriate next step in the management of this patient?

A 52-year-old woman presents to her general practitioner with fatigue, increased thirst, and frequent urination over the past three months. She has a history of hypertension and hyperlipidemia, for which she takes lisinopril and atorvastatin. Her BMI is 32 kg/m². On examination, her blood pressure is 140/85 mmHg, and her heart rate is 78 bpm. Laboratory tests reveal a fasting plasma glucose of 8.5 mmol/L and an HbA1c of 7.2%. She is diagnosed with type 2 diabetes mellitus. Which of the following is the most appropriate initial management step for this patient according to Australian guidelines?

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 male presents with concerns about breast enlargement over the past year. He denies pain or nipple discharge. 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?

A 28-year-old woman presents to the clinic with a 2-week history of fever, night sweats, and a non-productive cough. She has recently returned from a trip to rural Queensland. On examination, she has crackles in the right upper lung field. A chest X-ray shows a cavitary lesion in the right upper lobe. What is the most likely diagnosis?

A 67-year-old woman presents to her GP with fatigue, weight loss, and night sweats over the past two months. She has a history of smoking and hypertension. On examination, she has palpable lymphadenopathy in the cervical and axillary regions. Blood tests reveal a hemoglobin level of 10 g/dL, elevated lactate dehydrogenase (LDH), and a peripheral blood smear showing atypical lymphocytes. What is the most likely diagnosis?

A 65-year-old man with a history of COPD presents with fever, productive cough, and shortness of breath for 3 days. On examination, he has crackles in the right lower lung field. A chest X-ray shows a right lower lobe consolidation. What is the most likely diagnosis?

A 35-year-old woman presents to her GP with worsening shortness of breath, cough, and wheeze over 2 days, requiring her salbutamol reliever daily and waking her at night. Her PEF is 60% of her personal best. She is alert, speaking in sentences, RR 22, HR 95. Based on Australian guidelines, what is the most appropriate initial management step?

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 45-year-old man presents to the clinic with a 3-month history of persistent cough, night sweats, and weight loss. He has a history of smoking and works as a miner. On examination, he has decreased breath sounds and dullness to percussion over the right upper lobe. A chest X-ray shows a cavitary lesion in the right upper lobe. What is the most likely diagnosis?

A 40-year-old Aboriginal man presents for a health check. He reports feeling well but has a strong family history of diabetes and cardiovascular disease. What is the most appropriate initial screening test?

A 62-year-old male presents with acute onset of LLQ pain, fever, and vomiting. His WBC count is elevated. A CT scan of the abdomen and pelvis is performed. Based on the image, what is the most appropriate next step in management?

A 50-year-old man presents with a slowly growing nasal lesion. Examination reveals the image shown. What is the MOST appropriate initial management?

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

An 80-year-old male with a history of smoking and hypertension presents to his GP with mild, intermittent lower back pain. Physical examination is unremarkable. Routine blood tests are normal. A CT scan of the abdomen is performed to investigate the back pain. Considering the findings demonstrated in the provided image in the context of this patient's presentation, what is the most appropriate next step in management?

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 60-year-old man presents to his GP with a 3-month history of fatigue, weight loss, and night sweats. He has a history of smoking and hypertension. On examination, he has palpable lymphadenopathy in the cervical and axillary regions. Blood tests reveal anemia and elevated lactate dehydrogenase (LDH). What is the most appropriate next step in the investigation of this patient?

An 68-year-old man attends his GP for a routine check-up. He has a history of well-controlled type 2 diabetes, hypertension, and smoked for 30 years, quitting 5 years ago. He denies any abdominal pain, back pain, or pulsatile sensation. Physical examination is unremarkable. As part of a cardiovascular risk assessment, an abdominal ultrasound is initially performed, which is inconclusive due to bowel gas. A follow-up contrast-enhanced CT scan is arranged. Considering the findings demonstrated in the image, what is the most appropriate next step in the management of this patient?

A 70-year-old male presents with a painful groin mass and constipation. The provided image was taken. What is the most appropriate next step?

A 60-year-old Aboriginal man presents for a routine check-up. He has a history of smoking and lives in a remote community. Which screening is MOST important, considering higher prevalence in this population?

A 62-year-old male presents with a 6-month history of a painless swelling in his right groin, visible especially when standing. Examination reveals the finding in the image. The mass reduces when lying down. What is the MOST appropriate initial management?

A 55-year-old man presents to the clinic with a 3-month history of worsening cough, weight loss, and night sweats. He has a 30-pack-year smoking history and worked in construction for 20 years. On examination, he has clubbing of the fingers and decreased breath sounds in the right lower lung field. A chest X-ray shows a right lower lobe mass. What is the most appropriate next step in the management of this patient?

A 55-year-old male presents to his GP with bilateral breast tenderness and swelling over six months. He denies nipple discharge or other systemic symptoms. Past medical history is unremarkable, and he takes no regular medications. Physical examination reveals the findings shown in the image. Vital signs are normal. Initial investigations including liver function tests, renal function tests, thyroid function tests, LH, FSH, prolactin, and testosterone are all within normal limits. Considering the clinical presentation, image findings, and normal initial investigations, which of the following is the most appropriate next step in the evaluation of this patient?

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 25-year-old woman presents to the clinic with a 2-week history of fatigue, sore throat, and swollen glands. She also reports a low-grade fever and mild headache. On examination, she has cervical lymphadenopathy and mild splenomegaly. A monospot test is positive. What is the most appropriate advice regarding her physical activity?

A 64-year-old woman presents for a routine health check. She reports intermittent episodes of colicky abdominal pain over the past year, but denies any current pain, jaundice, or fever. An abdominal ultrasound is performed, the image is shown. What is the MOST appropriate next step in management?

A 72-year-old male presents with abdominal distension, vomiting, and inability to pass flatus for 48 hours. He has a history of prior bowel resection. Examination reveals a tympanitic abdomen and tenderness to palpation. His vitals are stable. An abdominal X-ray is performed, as shown. What is the MOST appropriate next step in the management of this patient?

A 45-year-old man presents to his general practitioner with a 3-month history of persistent cough and occasional wheezing. He is a non-smoker and works as a carpenter. He reports that his symptoms worsen at work and improve on weekends. He has no significant past medical history and is not on any medications. What is the most likely diagnosis?

A 55-year-old lady presents with a painless, white, lacy pattern on her buccal mucosa that has been present for several weeks. She feels well and has no significant medical history. What is the likely diagnosis?