Core Knowledge and Fundamentals Flashcards

A 40-year-old male presents with severe colicky right-sided flank pain radiating to the groin, haematuria, and nausea. A KUB X-ray is negative. The MOST appropriate next investigation is:

Answer: Non-contrast CT of the kidneys, ureters, and bladder (CT KUB)

Non-contrast CT KUB is the gold standard for detecting urolithiasis, with >95% sensitivity, and is preferred over IVP or plain X-ray.

A 62-year-old woman is found to have a fasting plasma glucose of 6.6 mmol/L on two separate occasions. Her HbA1c is 42 mmol/mol (6.0%). How should this be classified?

Answer: Impaired fasting glucose (pre-diabetes)

Fasting glucose 6.1–6.9 mmol/L meets criteria for impaired fasting glucose (IFG/pre-diabetes) when HbA1c is below the diabetic threshold of 48 mmol/mol.

Under the Australian Privacy Act and the RACGP Standards, a GP may disclose patient information without consent in which of the following situations?

Answer: There is a serious and imminent threat to the life of an identifiable third party

Disclosure without consent is permissible under mandatory exceptions such as an imminent serious threat to the life or safety of another identifiable person.

A 3-year-old child presents with inspiratory stridor, a barking cough, and low-grade fever for 24 hours. Stridor is present only with agitation. Oxygen saturation is 97%. The MOST appropriate first-line treatment is:

Answer: Oral dexamethasone 0.15 mg/kg as a single dose

Mild-to-moderate croup is managed with a single dose of oral dexamethasone, which reduces subglottic oedema and decreases return visits to hospital.

Which ONE of the following findings on urinalysis is MOST consistent with acute glomerulonephritis?

Answer: Dysmorphic red cells and red cell casts

Dysmorphic red blood cells and red cell casts in the urine are pathognomonic of glomerular bleeding and indicate glomerulonephritis.

A 29-year-old woman with a history of bipolar disorder is planning pregnancy. She is currently stable on sodium valproate. The MOST important action is:

Answer: Discuss teratogenicity risk and consider switching to a safer mood stabiliser before conception

Valproate carries a >10% risk of major congenital malformations and neurodevelopmental harm; it should ideally be switched to a safer alternative before conception in close collaboration with psychiatry.

A GP performs a clinical audit and finds that 40% of patients with established CVD are not on a statin. According to the RACGP Quality Improvement framework, the NEXT best step after identifying this gap is:

Answer: Develop and implement a systematic recall strategy targeting those patients

Quality improvement requires closing the identified gap through a proactive intervention such as a systematic recall or reminder system for high-risk patients.