1.

Revision Questions
1. Mr Z, a 34 y/o man has attended his GP, with a cough, weight loss, night
sweats and has had 2 episodes of haemoptysis. He has recently moved here
from India for work and is worried the new climate is making him ill. Following a
CXR, he is found to have apical lesions.'
What treatment should Mr Z be started on?
1. Amoxicillin
2. Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE)
3. Rifampin, Isoniazid
4. Amoxicillin + Gentamycin
5. Salmeterol
Discussion Points;
A) What is the most likely diagnosis and why?
B) Why is your chosen treatment the most appropriate?
C) Briefly explain the apical lesions

2. A 54 year old man (1.90m and 90kg) presents to his GP for a checkup. His
HbA1c is 64mmol/l. He then has a fasting glucose taken and it is 13mmol/L. He
has a previous diagnosis of NIDDM which is currently diet controlled. In terms
pharacological treatment what is the most likely next step?
1.
2.
3.
4.
5.

Metformin
Metformin + Sulphonylurea
Sulphonylurea
Glitazone
DPP4 Inhibitors

Discussion Points;
A) Why is your chosen treatment the most appropriate?
B) What is the common presentation of a diabetic patient with NIDDM?
C) Briefly explain the concept of insulin resistance and beta cell dysfunction
in NIDDM

3. A 44-year-old woman presents to her GP with pain and swelling affecting her
fingers, wrists, knees and feet. There are mild effusions over the painful joints
and they are warm on palpation. She suggests that the symptoms are worse in
the morning and relieved on movement. What is the most likely diagnosis?
1. Gout
2. Rheumatoid Arthritis
3. Polymyalgia Rheumatica

4. Osteoarthritis
5. Reiters Syndrome
Discussion Points;
A) What further investigations would you like to do in order to confirm the
diagnosis?
B) Briefly explain the reasons for the morning stiffness
C) What would you like to treat this patient with?