Murtagh's Triads

Headache + visual obscurations + nausea / papilloedema
(often in an obese young female)

Dizziness + hearing loss + tinnitus (unilateral)
Dysarthria + intention tremor + nystagmus (Charcot's triad)
Fever + malaise (extreme) + anorexia / nausea / vomiting (+/- anaemia)
Vertigo + vomiting + tinnitus + sensorineural deafness

Spot Dx

What is the most likely diagnosis?
  • Classic migraine
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    • Classic migraine
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    Study Topic Ideas

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    For investigations, consider the indications for ordering the test and the key findings for common or critical conditions.
    • Antiepileptic monitoring edit
    • Brain CT / MRI edit
    • Mini-mental / MOCA edit
    • Nerve conduction studies edit
    • Prolactin edit
    In addition to managing the key diagnoses related to each of the presenting problems above, here are some examples of key management issues to think about.
    • Chronic pain management edit
    • Drugs and Parkinson’s edit
    • Fitness to drive edit
    • Meningococcal acute management edit
    • Migraine prophylaxis edit
    • Stimulant medications edit
    For each diagnosis that arises from your differentials, you can then consider the key signs, investigations and management. This list is by no means exhaustive, but here are a few assorted diagnoses to consider.
    • Absence seizures edit
    • Acoustic neuroma edit
    • Acute labyrinthitis edit
    • Alzheimer dementia edit
    • Amyloidosis edit
    • Atypical migraine edit
    • Bell’s palsy edit
    • Benign intracranial hypertension edit
    • Benign Paroxysmal Positional Vertigo edit
    • Brain abscess edit
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    • Cavernous angioma edit
    • Cerebellar disease edit
    • Cerebral aneurysms edit
    • Cerebral tumour edit
    • Cervical dysfunction edit
    • Chronic subdural haematoma edit
    • Classic migraine edit
    • Cluster headache edit
    • Complex partial seizure edit
    • Concussion edit
    • Encephalitis edit
    • Epilepsy edit
    • Essential tremor edit
    • Glossopharyngeal neuralgia edit
    • Guillain Barre Syndrome edit
    • Guillain-Barré edit
    • Haemorrhagic stroke edit
    • Huntington disease edit
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    • Hypopituitarism edit
    • Ischaemic stroke edit
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    • Lewy body dementia edit
    • Lumbar disc bulge edit
    • Medulloblastoma edit
    • Meniere syndrome edit
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    • Miller-Fisher variant of Guillain Barre Syndrome edit
    • Motor neuron disease edit
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    • Myotonic dystrophy edit
    • Neuroblastoma edit
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    • Parkinson disease edit
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    • Trigeminal neuralgia edit
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    • Vertebrobasilar insufficiency edit
    • Vestibular neuritis edit
    Foundation topics like anatomy, physiology and embryology are not the main focus of GP fellowship exams. The following are examples of topics that may be useful for quizzing any medical students you are supervising:
    Medical students may be more focused on learning basic definitions, aetiology and pathophysiology of specific diagnoses, but registrars need to focus more on clinical problem solving. For each common presenting problem, consider what would be the red flag features, the most common differentials, as well as the most dangerous and most often missed (see Murtagh for more information on this model). For each diagnosis that arises from your differentials, you can then consider the key signs, investigations and management.
    Medicine is nebulous with many conditions that arise infrequently in General Practice. These topics are not the main focus of college exams but nonetheless might occasionally appear - just as they can appear in your consultation room on a Friday afternoon. Other topics are so controversial that they are very difficult to examine. Here are some examples of topics that should not be the main focus of your study.

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