2018.2 KFP – public report

Pain Management

• Case 1: Chronic Pain Management
  • Key Topics: Opiate prescription request, chronic pain assessment.
  • Candidate Performance: Candidates struggled to differentiate between physical and psychological triggers, and between pharmacological and non-pharmacological management.
  • Improvement Areas: Candidates need to focus on comprehensive pain assessment techniques, consider non-opioid pain management strategies, and improve question comprehension.

Geriatrics & Gynecology

• Case 2: Post-Menopausal Bleeding
  • Key Topics: Identification and management of post-menopausal bleeding.
  • Candidate Performance: Inability to recognize post-menopausal status; inappropriate investigation and management strategies.
  • Improvement Areas: Enhance understanding of guidelines for managing post-menopausal bleeding and focus on targeted investigations.

Travel Medicine & Immunology

• Case 3: Immunizations for Elderly Travelers
  • Key Topics: Immunization requirements for older Aboriginal patients traveling.
  • Candidate Performance: Incorrect identification of necessary vaccines based on age and travel destination.
  • Improvement Areas: Improve knowledge on age-specific and destination-specific vaccination requirements.

Cardiology & Urology

• Case 4: Acute Chest Pain and Erectile Dysfunction
  • Key Topics: Management of acute chest pain and follow-up care for erectile dysfunction.
  • Candidate Performance: Errors in ECG interpretation; failure to identify appropriate management steps for erectile dysfunction.
  • Improvement Areas: Accurate ECG reading skills, understanding of initial investigations, and management options for erectile dysfunction.

Endocrinology

• Case 5: Post-Partum Thyroiditis
  • Key Topics: Management of post-partum thyroid issues.
  • Candidate Performance: Challenges in diagnosing and choosing correct investigations.
  • Improvement Areas: Focused on specific management strategies for thyroiditis and enhancing understanding of post-partum endocrine disorders.

Urology

• Case 6: Urge Incontinence Management
  • Key Topics: Management strategies for urge incontinence in elderly women.
  • Candidate Performance: Incorrect drug class examples and management plans.
  • Improvement Areas: Precise classification and examples of medications for urge incontinence, avoiding recommendations irrelevant to gender.

Pediatrics & Pulmonology

• Case 7: Acute Asthma and Impetigo
  • Key Topics: Management of acute asthma exacerbation and severe peri-oral impetigo in a rural setting.
  • Candidate Performance: Misidentification of asthma severity; inappropriate medication for impetigo.
  • Improvement Areas: Recognize severity levels of asthma to determine treatment, and select suitable pharmacological treatments for impetigo.

Rheumatology

• Case 8: Gout Flare Management
  • Key Topics: Clinical examination for gout complications and management.
  • Candidate Performance: Confusion between examination findings and signs of complications.
  • Improvement Areas: Focus on clinical examination specific to gout and its complications, and articulate specific management plans.

Psychiatry

• Case 9: Acute Psychosis in Medical Student
  • Key Topics: Diagnosis and management of acute psychosis, addressing academic concerns.
  • Candidate Performance: Difficulty in managing professional implications of psychiatric conditions.
  • Improvement Areas: Approach to psychiatric assessment and management, consideration of professional responsibilities, and providing clear guidance on academic impact.

Pediatrics & Orthopedics

• Case 10: Hip Pain in a Child
  • Key Topics: Differential diagnoses and management of pediatric hip pain.
  • Candidate Performance: Generalized diagnoses and misunderstanding specific causes.
  • Improvement Areas: Develop specific diagnoses and tailored management strategies for pediatric orthopedic issues.

Dermatology & Oncology

• Case 11: Melanoma Management
  • Key Topics: Diagnosis and management of melanoma, including biopsy interpretation.
  • Candidate Performance: Lack of urgency and inappropriate investigation choices.
  • Improvement Areas: Understanding of melanoma management protocols, appropriate follow-up, and urgent referral processes.

Gynecology

• Case 12: Vaginal Bleeding and Pelvic Pain
  • Key Topics: Differential diagnoses and immediate investigations for vaginal bleeding and pelvic pain.
  • Candidate Performance: Failure to recognize implications of pregnancy and selection of inappropriate differential diagnoses.
  • Improvement Areas: Focused history taking and understanding of pregnancy-related gynecological emergencies.

Geriatrics & Psychiatry

• Case 13: Delirium and Scabies in Elderly
  • Key Topics: Management of delirium and outbreak control of scabies in residential facilities.
  • Candidate Performance: Challenges in pharmacological management of scabies and delirium.
  • Improvement Areas: Comprehensive approach to delirium management, pharmacological treatment of scabies, and implementation of public health measures in care facilities.

Pediatrics & Gastroenterology

• Case 14: Pediatric Diarrhea and Lactose Intolerance
  • Key Topics: Management of post-infectious diarrhea and transient lactose intolerance in a toddler.
  • Candidate Performance: Mismanagement of acute diarrhea and misunderstanding of lactose intolerance management.
  • Improvement Areas: Correct management strategies for acute diarrhea and lactose intolerance, including dietary modifications.

Musculoskeletal Disorders

• Case 15: Interdigital Neuroma
  • Key Topics: Diagnosis and management of foot pain suggestive of an interdigital neuroma.
  • Candidate Performance: Difficulty in identifying examination findings and appropriate management.
  • Improvement Areas: Precise diagnosis and tailored management strategies for musculoskeletal foot disorders.

Dermatology & Oncology

• Case 16: Skin Lesions Identification
  • Key Topics: Diagnosis and management of dermatofibroma and amelanotic melanoma.
  • Candidate Performance: Incorrect identification and management of skin lesions.
  • Improvement Areas: Accurate diagnosis and specific treatment options for dermatological conditions.

Pharmacology & Geriatrics

• Case 17: Polypharmacy in Elderly
  • Key Topics: Managing polypharmacy and inappropriate prescriptions in elderly patients.
  • Candidate Performance: Inadequate medication regimen adjustments and handling of patient refusal.
  • Improvement Areas: Rationalizing drug therapy in the elderly and addressing patient concerns regarding medication changes.

Neurology & Geriatrics

• Case 18: Cognitive Decline in Elderly
  • Key Topics: Identification and management of cognitive decline in elderly patients.
  • Candidate Performance: Misdiagnosis and inappropriate management plans.
  • Improvement Areas: Accurate diagnosis of cognitive disorders and development of comprehensive management plans.

Musculoskeletal Disorders

• Case 19: Dupuytren’s Contracture
  • Key Topics: Diagnosis, underlying causes, and management of Dupuytren’s contracture.
  • Candidate Performance: Choosing irrelevant investigations and not identifying appropriate management strategies.
  • Improvement Areas: Understanding of Dupuytren’s contracture including risk factors and surgical referral criteria.

Endocrinology

• Case 20: Type 2 Diabetes Management
  • Key Topics: Assessment and optimization of diabetes management.
  • Candidate Performance: Failure to adjust medication regimens correctly and address non-adherence issues.
  • Improvement Areas: Effective diabetes management strategies and addressing patient adherence to treatment plans.

Pediatrics & Pulmonology

• Case 21: Croup in Pediatric Patients
  • Key Topics: Diagnosis and management of croup, including severe cases requiring emergency intervention.
  • Candidate Performance: Inadequate recognition of severe croup and its management.
  • Improvement Areas: Recognition of severity signs in croup and appropriate emergency management strategies.

Psychiatry & Toxicology

• Case 22: Serotonin Syndrome
  • Key Topics: Identification and management of serotonin syndrome in a patient with substance abuse.
  • Candidate Performance: Mismanagement of psychiatric emergencies and involuntary admission procedures.
  • Improvement Areas: Early recognition of serotonin syndrome and legal aspects of psychiatric care.

Rheumatology & Geriatrics

• Case 23: Paget’s Disease
  • Key Topics: Identification and investigation of Paget’s disease of bone.
  • Candidate Performance: Incorrect selection of diagnostic tests.
  • Improvement Areas: Understanding Paget’s disease diagnosis, including appropriate imaging and management strategies.

Neurology & Ophthalmology

• Case 24: Visual Field Loss
  • Key Topics: Diagnosis and differential diagnosis of bilateral peripheral visual field loss.
  • Candidate Performance: Misidentification of relevant examination findings.
  • Improvement Areas: Accurate neurological and ophthalmological examination techniques and diagnosis.

Gynecology & Practice Management

• Case 25: Follow-Up of Abnormal Pap Smear
  • Key Topics: Management of an overdue follow-up for an abnormal Pap smear result.
  • Candidate Performance: Struggle with practice management and follow-up protocols.
  • Improvement Areas: Adherence to cervical screening guidelines and implementation of follow-up systems in practice.

Pharmacology & Nephrology

• Case 26: Lithium Management in Renal Dysfunction
  • Key Topics: Management of lithium treatment in a patient with deteriorating renal function.
  • Candidate Performance: Inadequate management of renal dysfunction and hypertension in a patient on lithium.
  • Improvement Areas: Monitoring and adjusting lithium therapy in patients with renal changes and managing comorbid conditions.