A 40-year-old male patient complains of a lump in his right scrotum that has been present for the past 2 weeks. He denies any pain or urinary symptoms and reports stable weight. Upon examination, a smooth 4mm lump is palpated above and separate from the testicle, which is mobile and non-tender. What is the probable diagnosis?
A 58-year-old woman with diet-controlled type II diabetes is being treated with a thiazide, a beta blocker and an angiotensin-converting enzyme (ACE) inhibitor for hypertension. Her General Practitioner has recently increased some of her medication and has asked her to return to the surgery for a repeat blood pressure measurement and blood test to check for renal function and electrolytes.
Investigations:
Investigation Results Normal value
Serum potassium concentration 3.1 mmol/l 3.5-5.0 mmol/l
Blood pressure 156/94 mmHg <140/90 mmHg
Serum creatinine concentration 115 µmol/l 70-120 µmol/l
Which of the following is the single most likely cause of her hypokalaemia?
A 66-year-old man is experiencing difficulty starting to urinate and frequently wakes up at night to use the bathroom. His PSA level is normal and a prostatic biopsy did not show any signs of cancer. What is the quickest treatment option to relieve his symptoms?
You receive a gift basket in the post from a patient that you have been treating for the past 5 years. You know it is worth £15. This is the first time the patient or their family has given you a gift.
What would be the next most appropriate step?
You are completing an ESA113 medical report that has been requested by the Department of Work and Pensions with regards a patient of yours who has applied for employment and support allowance.
Which of the following should you omit from such a medical report?
You receive a phone call from a 60-year-old man who reports a several hour history of acute onset chest pain. He has previously had a DVT and is known to have hypertension and smoke. You advise him to ring 999 but he refuses and wants to wait for a home visit. You are later informed he has passed away.
How should you proceed in terms of death certification?
A 35-year-old man with epilepsy visits your clinic. He had been seizure free for a few years and holds a Group 1 (car) licence. He expressed his desire to decrease his anti-epileptic medication dosage, and you had consented to monitor this. He had ceased driving while doing so. You concur that he should revert to his previous, lower, anti-epileptic medication dosage. If he doesn’t have any more seizures, when will he be permitted to drive again?
You are asked to complete a DS1500 form for a patient with advanced cancer who is in their 80s.
Which of the following applies to completion of the DS1500 form?
A patient who is well known to you and is a minor has applied for Disability Living Allowance (DLA). The Department of Work and Pensions (DWP) contact you requesting an associated medical report to be completed.
What would be the next most appropriate step?
One of the nurses at your hospital sustains a needlestick injury while administering medication to a patient.
What is the single, most appropriate, immediate management?