NZREX Common Clinical Conditions

Question 1

A patient presents to a NZ general practice with symptoms of community-acquired pneumonia. According to NZ guidelines, what is the first-line antibiotic treatment for non-severe CAP?

Accepted Answer

Amoxicillin 500 mg three times daily for 5 days

Answer

In NZ, the first-line treatment for non-severe community-acquired pneumonia in adults is amoxicillin 500 mg three times daily for 5 days, according to the BPAC NZ and NZ antimicrobial guidelines.

Question 2

What is the CURB-65 score used for in NZ clinical practice?

Accepted Answer

Assessing the severity of community-acquired pneumonia and guiding management (outpatient vs. hospital admission)

Answer

CURB-65 assesses CAP severity using five criteria: Confusion, Urea >7 mmol/L, Respiratory rate ≥30, Blood pressure <90/60 mmHg, and age ≥65. Scores guide whether patients can be managed at home (0-1), in hospital (2), or in ICU (3-5).

Question 3

In NZ, what is the recommended approach to managing a patient with suspected acute appendicitis?

Accepted Answer

Clinical assessment (including McBurney's point tenderness, Rovsing's sign), blood tests (WCC, CRP), CT scan if diagnosis uncertain, and surgical referral for appendicectomy

Answer

In NZ, suspected appendicitis involves clinical assessment (McBurney's point tenderness, rebound tenderness, Rovsing's sign), blood tests (raised WCC and CRP support diagnosis), CT abdomen/pelvis if diagnosis is uncertain, and referral for surgical management (appendicectomy).

Question 4

A patient in NZ presents with a first unprovoked seizure. What investigations and management are appropriate?

Accepted Answer

Blood tests (glucose, electrolytes, calcium), CT brain, EEG referral, and discussion about driving restrictions under NZTA guidelines — antiepileptic medication not usually started after a single seizure

Answer

After a first unprovoked seizure in NZ, appropriate management includes blood tests (glucose, electrolytes, calcium), CT brain (to exclude structural cause), EEG referral, discussion about NZ driving restrictions, and safety advice. Antiepileptic drugs are not usually started after a single seizure.

Question 5

What is the NZ approach to managing type 2 diabetes, including the first-line pharmacological treatment?

Accepted Answer

Lifestyle modification (diet, exercise, weight management) plus metformin as first-line pharmacotherapy, with HbA1c monitoring every 3-6 months

Answer

NZ management of type 2 diabetes starts with lifestyle modification (healthy diet, regular exercise, weight management) and metformin as first-line pharmacotherapy. HbA1c targets are individualised (generally <53 mmol/mol), with monitoring every 3-6 months and treatment escalation as needed.

NZREX Practice Test

NZREX Practice Test

NZREX Common Clinical Conditions