FRACGP Chronic Disease Management 3

Question 1

Which blood pressure target is recommended for most adults with hypertension and no major comorbidities according to current Australian guidelines?

Accepted Answer

Below 140/90 mmHg

Answer

Current Australian Hypertension guidelines recommend a target of below 140/90 mmHg for most adults, with more intensive targets considered for high-risk patients.

Question 2

A patient with type 2 diabetes develops microalbuminuria. Besides optimising glycaemic and blood pressure control, which medication class is recommended to slow nephropathy progression?

Accepted Answer

ACE inhibitors or ARBs

Answer

ACE inhibitors and ARBs reduce intraglomerular pressure and proteinuria, slowing the progression of diabetic nephropathy independent of their blood pressure-lowering effects.

Question 3

When initiating urate-lowering therapy with allopurinol in a patient with gout, what is the recommended approach to minimise the risk of triggering a flare?

Accepted Answer

Start at a low dose (e.g., 50–100 mg/day) and titrate gradually

Answer

Allopurinol should be started at a low dose (50–100 mg/day) and titrated up slowly to minimise the risk of precipitating acute gout flares from rapid urate mobilisation.

Question 4

Which preventive intervention has the strongest evidence for reducing fracture risk in postmenopausal women with osteoporosis?

Accepted Answer

Bisphosphonate therapy (e.g., alendronate)

Answer

Bisphosphonates such as alendronate have the highest level of evidence for reducing vertebral, hip, and non-vertebral fracture risk in postmenopausal osteoporosis.

Question 5

In managing patients with atrial fibrillation and a CHA2DS2-VASc score of 2 or more, what is the recommended antithrombotic strategy?

Accepted Answer

Oral anticoagulation with a DOAC or warfarin

Answer

A CHA2DS2-VASc score of ≥2 confers sufficient stroke risk to recommend oral anticoagulation; DOACs are preferred over warfarin for non-valvular AF due to better safety and efficacy profiles.

(FRACGP) Fellowship of the Royal Australian College of General Practitioners Practice Test

(FRACGP) Fellowship of the Royal Australian College of General Practitioners Practice Test

FRACGP Chronic Disease Management 3