Murtagh's Triads
Stepladder fever + abdominal pain + relative bradycardia
Painful / itchy bite + agitation + hydrophobia (pain with drinking)
Fever + bradycardia + jaundice
Fever + sore throat + cervical lymphadenopathy
Fatigue + psychiatric symptoms + myoclonus
Malaise + headache + undulant fever
(with cattle contact, unpasteurised milk or undercooked meat)

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Spot Dx

What is the most likely diagnosis?
  • Rubella
  • Measles
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    • Rubella
    • Measles
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    For investigations, consider the indications for ordering the test and the key findings for common or critical conditions.
    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.
    • Antibiotic overuse edit
    • Contact tracing edit
    • Hepatitis C edit
    • Incision and drainage edit
    • Influenza immunisation edit
    • Malaria prophylaxis edit
    • Meningococcal acute management edit
    • Pertussis prophylaxis edit
    • Public health notification edit
    • School exclusion periods 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.
    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:
    • Innate & acquired immunity edit
    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.
    • Fever edit
    • Fever in a returned traveller edit
    • Lymphadenopathy edit
    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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