2023.2 KFP – public report

1. Dermatology/Infectious Diseases/Ophthalmology

• Case 1: Herpes Zoster Ophthalmicus
  • Insight: Early recognition and management are crucial to prevent complications. The urgent referral to ophthalmology is critical for preserving vision.
  • Strengths: Effective identification of immediate management steps and pharmacological treatments for post-herpetic neuralgia.
  • Improvements: Enhance understanding of confidentiality, capacity assessment, and legal aspects regarding patient information sharing.

2. Primary Care/Community Health

• Case 2: Finger Injury and Healthcare Access
  • Insight: Importance of a thorough examination to diagnose finger injuries correctly and understanding cultural competencies to improve healthcare access for Aboriginal and Torres Strait Islander men.
  • Strengths: Proposing specific strategies to encourage healthcare access.
  • Improvements: Avoid assumptions about the patient’s history; improve knowledge on finger examination techniques.

3. Geriatrics/Psychiatry

• Case 3: Dementia Management
  • Insight: Differential diagnosis of memory difficulties is essential, with a focus on dementia and mood disorders. Non-pharmacological management in dementia care is pivotal.
  • Strengths: Accurate identification of differential diagnoses and initial investigations.
  • Improvements: Avoid over-reliance on pharmacological interventions for behavioral and psychological symptoms in dementia.

4. Obstetrics/Urology

• Case 4: Pyelonephritis in Pregnancy
  • Insight: Recognizing the seriousness of pyelonephritis in pregnancy and the necessity for immediate management, including hospital transfer.
  • Strengths: Identifying appropriate pharmacological management and the need for transfer to a tertiary center.
  • Improvements: Improve severity assessment skills to avoid underestimating the patient’s condition.

5. Endocrinology/Oncology/Palliative Care

• Case 5: Diabetes and Palliative Care for Metastatic Cancer
  • Insight: The importance of individualized care, focusing on non-pharmacological strategies for diabetes management and anxiety in palliative care.
  • Strengths: Tailoring management plans to the patient’s overall context, especially in palliative settings.
  • Improvements: Recognize the importance of quality of life in palliative care decisions, avoiding generic or life-prolonging interventions that may not align with patient wishes.

6. Dermatology/Pediatrics

• Case 6: Severe Facial Acne and Online Bullying
  • Insight: Effective acne management considering patient history and contraindications, coupled with addressing psychological impacts like online bullying.
  • Strengths: Providing specific actionable advice for both acne treatment and managing the psychosocial aspects of bullying.
  • Improvements: Enhance understanding of contraindications and side effects in acne pharmacotherapy, especially in complex cases.

7. Infectious Diseases/Cardiology

• Case 7: Infective Endocarditis
  • Insight: Early detection and management of infective endocarditis are vital to prevent severe complications. Immediate pharmacological management is crucial.
  • Strengths: Good performance on diagnosis and initial investigations.
  • Improvements: Focus on accurate and specific immediate pharmacological interventions without defaulting to routine monitoring or non-pharmacological measures.

8. Infectious Diseases

• Case 8: Epstein–Barr Virus Infection
  • Insight: Recognizing the importance of stopping unnecessary antibiotics in the management of viral infections like Epstein–Barr virus.
  • Strengths: Accurate diagnosis and management including the cessation of unnecessary medication.
  • Improvements: Emphasize the role of supportive care and patient education in managing viral infections.

9. ENT

• Case 9: Hearing Loss and Tinnitus
  • Insight: The importance of appropriate investigations for hearing loss and tinnitus to exclude serious underlying conditions.
  • Strengths: Providing practical advice for communication with hearing-impaired individuals.
  • Improvements: Avoid overcoding in responses and focus on specific, actionable advice.

10. Pediatrics/Public Health

• Case 10: Immunization in Aboriginal Children
  • Insight: Understanding specific healthcare needs and barriers in Aboriginal and Torres Strait Islander communities, especially in immunization practices.
  • Strengths: Recognition of the importance of prophylactic paracetamol in certain immunizations.
  • Improvements: Improve awareness of cultural and logistical factors influencing vaccination rates in remote communities.

11. Dermatology/Oncology

• Case 11: Lentigo Maligna
  • Insight: The necessity of timely and specific diagnosis and management of skin cancers, highlighting the importance of urgent excisional biopsy.
  • Strengths: Identifying urgent management strategies for potential malignancies.
  • Improvements: Enhance understanding of patient-physician relationship dynamics, especially after diagnostic or therapeutic challenges.

12. Gastroenterology/Hepatology

• Case 12: Ascites due to Cirrhosis
  • Insight: Tailoring management to the specifics of cirrhosis complications, emphasizing the balance between pharmacological and non-pharmacological treatments.
  • Strengths: Appropriate selection of investigations to monitor cirrhosis.
  • Improvements: Avoid non-specific advice and focus on cirrhosis-specific management strategies.

13. Dermatology

• Case 13: Chronic Paronychia and Onychomycosis
  • Insight: Differentiating between various nail disorders and their specific treatments.
  • Strengths: Identifying appropriate pharmacological treatment for onychomycosis.
  • Improvements: Improve the specificity of non-pharmacological advice for chronic paronychia management.

14. Cardiology/Ophthalmology

• Case 14: Hypertension and Retinal Artery Occlusion
  • Insight: The link between systemic diseases like hypertension and specific ocular emergencies, such as retinal artery occlusion.
  • Strengths: Recognizing secondary causes of hypertension and the importance of targeted investigations.
  • Improvements: Enhance skills in emergency management and referral for ocular conditions.

15. Respiratory/Sleep Medicine

• Case 15: Obstructive Sleep Apnoea (OSA)
  • Insight: Comprehensive assessment and management of OSA, including driving safety considerations.
  • Strengths: Broad approach to history taking and non-pharmacological management advice.
  • Improvements: Focus on the integration of sleep hygiene and lifestyle modifications alongside driving restrictions.

16. Geriatrics/Pharmacology

• Case 16: Digoxin Toxicity
  • Insight: Identifying signs of digoxin toxicity, especially in the elderly, and the importance of appropriate diagnostic investigations.
  • Strengths: Diagnosis based on clinical presentation and medication history.
  • Improvements: Avoid assumptions not supported by clinical information and focus on targeted investigations.

17. Gynecology/Medico-Legal

• Case 17: Heavy Menstrual Bleeding and Sexual Assault
  • Insight: The complexity of managing gynecological symptoms and the critical importance of understanding and responding to sexual assault in a clinical setting.
  • Strengths: Identifying the need for sensitive and appropriate immediate management following assault.
  • Improvements: Improve knowledge of mandatory reporting obligations and patient support mechanisms.

18. Cardiology

• Case 18: ST-Elevation Myocardial Infarction (STEMI)
  • Insight: The urgency of recognizing and managing STEMI, including secondary prevention.
  • Strengths: Identifying specific diagnosis and immediate management strategies.
  • Improvements: Enhance application of guideline-directed medical therapy for secondary prevention.

19. Gastroenterology

• Case 19: Gastroesophageal Reflux Disease and H. pylori Infection
  • Insight: The importance of accurate diagnosis and tailored treatment for gastroesophageal reflux and H. pylori infection.
  • Strengths: Effective identification of initial investigations and combination pharmacotherapy for H. pylori.
  • Improvements: Improve specificity in history-taking and preparation advice for diagnostic tests.

20. Infectious Diseases

• Case 20: Ross River Virus Infection
  • Insight: Recognizing and managing vector-borne diseases, considering long-term patient expectations.
  • Strengths: Correct diagnosis and management of zoonotic infections.
  • Improvements: Enhance understanding of the epidemiology and clinical presentation of endemic infections.

21. Respiratory/Emergency Medicine

• Case 21: Spontaneous Pneumothorax
  • Insight: Immediate management of spontaneous pneumothorax and considerations regarding air travel.
  • Strengths: Accurate diagnosis and understanding of the risks associated with flying.
  • Improvements: Specificity in management plans, avoiding generic responses.

22. Orthopedics

• Case 22: Slipped Upper Femoral Epiphysis
  • Insight: The importance of timely diagnosis and management to prevent complications in pediatric orthopedic conditions.
  • Strengths: Recognizing the need for immediate management and referral.
  • Improvements: Avoiding non-specific or inappropriate management strategies that could harm the patient.

23. Psychiatry

• Case 23: Specific Delusions and Paranoia
  • Insight: Comprehensive management of psychiatric conditions, including the role of non-pharmacological interventions and the importance of appropriate referrals.
  • Strengths: Identifying a broad differential diagnosis and taking a holistic approach to management.
  • Improvements: Avoid repetition of information and focus on specific, actionable management steps.

24. Endocrinology/Diabetes Management

• Case 24: Diabetic Charcot Foot
  • Insight: Early identification and management of Charcot foot to prevent further complications.
  • Strengths: Diagnosis and initial management strategies, including patient education on foot care.
  • Improvements: Improve knowledge on diabetic foot care and address barriers to accessing medical treatment.

25. Neurology

• Case 25: Vertigo
  • Insight: Differentiating between central and peripheral causes of vertigo through targeted examination and history.
  • Strengths: Identification of red flag signs and a systematic approach to diagnosis.
  • Improvements: Clarify management strategies for vertigo, considering patient safety and quality of life.

26. Pulmonology/Genetics

• Case 26: Cystic Fibrosis Management and Genetic Counseling
  • Insight: Comprehensive care in cystic fibrosis, including annual investigations and minimizing infection risk, alongside the importance of genetic counseling.
  • Strengths: Identifying appropriate monitoring investigations and specific non-pharmacological advice.
  • Improvements: Enhance counseling skills, especially in genetics, to provide patient and family-centered care.