KFP – Population health (Preventative)

John Wheeler, aged 52, presents for a routine health check. He works as a truck driver and has not seen a GP in over 5 years. He is asymptomatic, but expresses concern about his general health given that his father died of a heart attack at age 58 and his older brother has type 2 diabetes. John smokes 10–15 cigarettes per day, drinks approximately 6–8 standard drinks on most weekends, and has gained 12kg in the past 3 years.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father – myocardial infarction at 58, deceased. Brother – type 2 diabetes mellitus.

Social history: Lives with wife, three adult children have moved out. No regular exercise.

Preventative Healthcare: Has not had any screening blood tests or vaccinations for over 10 years. No recent colon screening.

Examination findings: BMI 32.1 kg/m², BP 144/88 mmHg, waist circumference 106cm. Cardiovascular and respiratory exams are normal.

What are the most appropriate next steps in preventative health management? Select four (4) from the following list:

Maria Lopes, a 29-year-old woman, presents for preconception counselling. She has been with her partner for 3 years and they are planning to conceive within the next 6 months. Maria reports she is generally well, has no chronic illnesses and takes a daily multivitamin. Her last Pap smear was two years ago and was normal. She works as a childcare worker and has not received any recent vaccinations.

Medications: Daily over-the-counter multivitamin

Allergies: Nil known

Past history: Uncomplicated appendectomy at age 17

Family history: Non-contributory

Social history: Non-smoker, drinks alcohol socially, no recreational drug use

Preventative Healthcare: Cervical screening up to date as per prior guidelines, no other screening or recent blood tests

Examination findings: BMI 24.2 kg/m², BP 118/74 mmHg, clinically well

What are the most appropriate next steps in preconception care? Select four (4) from the following list:

Henry Delaney, aged 67, presents for a general check-up. He has a past history of hypertension and hyperlipidaemia, both well controlled with medication. He has not had any screening tests in recent years and reports feeling well. He quit smoking 10 years ago after a 30 pack-year history. He is a retired accountant, lives with his wife, and walks daily. He has never had a colonoscopy or stool test for bowel cancer screening.

Medications: Atorvastatin 20 mg daily, Perindopril 5 mg daily

Allergies: Nil known

Past history: Hypertension, hyperlipidaemia

Family history: Father died of stroke at age 73, mother had osteoporosis

Preventative Healthcare: No bowel cancer screening to date, last PSA test over 5 years ago

Examination findings: BP 132/78 mmHg, BMI 26.4 kg/m², cardiovascular and respiratory exams normal

What are the most appropriate evidence-based preventative activities for Henry? Select three (3) from the following list:

Jasmeet Kaur, aged 35, presents for a routine check-up. She is in her first year of employment as a high school teacher. She is planning to conceive within the next year. She is originally from India, has lived in Australia for 4 years, and is unsure of her vaccination history. She has not seen a GP since moving to Australia and is uncertain if she has been screened for cervical cancer here.

Medications: None

Allergies: Nil known

Past history: None known

Family history: Mother has type 2 diabetes, no family history of malignancy

Social history: Non-smoker, no alcohol, vegetarian diet

Preventative Healthcare: No records of immunisation in Australia, cervical screening unknown

Examination findings: BP 116/70 mmHg, BMI 22.5 kg/m², clinically well

What are the most appropriate next steps in preventative health for Jasmeet? Select three (3) from the following list:

Clive Morrison, a 74-year-old man, attends your clinic for his annual flu vaccine. He mentions feeling generally well, with no new symptoms, and lives independently. He has a history of mild osteoarthritis and hypertension, both stable. He has not had any recent blood tests and is unsure if he’s due for any other health checks. He has never had a bone density test and is not currently taking calcium or vitamin D supplements.

Medications: Amlodipine 5 mg daily, paracetamol PRN

Allergies: Nil known

Past history: Hypertension, mild knee osteoarthritis

Family history: Sister had a hip fracture at age 76

Social history: Lives alone, drives, walks daily, no smoking, drinks wine occasionally

Preventative Healthcare: Regular flu vaccines, last FOBT 3 years ago

Examination findings: BP 130/74 mmHg, BMI 23.1 kg/m², no gait or balance issues noted

What preventative healthcare activities are appropriate for Clive? Select three (3) from the following list:

Emily Tran, aged 23, attends your clinic requesting advice before travelling to Thailand and Vietnam for a 6-week backpacking holiday. She is generally well, takes no regular medications, and has no chronic conditions. She will be staying in hostels and rural areas, eating local food and occasionally volunteering with animals at a rescue centre. She last received travel vaccines five years ago for a school trip to Bali.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Nil relevant

Social history: Non-smoker, drinks socially

Preventative Healthcare: Last cervical screening test 2 years ago – normal. No recent vaccines recorded since last trip.

Examination findings: Clinically well, BMI 21.5 kg/m², vital signs normal

What are the most appropriate travel-related preventative health measures for Emily? Select four (4) from the following list:

Thomas Rangi, a 49-year-old Aboriginal man, attends your clinic for a health check as part of his workplace wellness initiative. He is asymptomatic and has not had a check-up in several years. He works as a warehouse manager and reports high levels of work-related stress. He smokes 10 cigarettes a day, drinks 4–6 beers on most evenings, and has gained 8 kg in the past 2 years. He is unsure when he last had a health assessment.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father – myocardial infarction at 61; mother – type 2 diabetes

Social history: Lives with partner and two teenage children

Preventative Healthcare: No recent cardiovascular or diabetes screening

Examination findings: BP 142/86 mmHg, BMI 31.7 kg/m², waist circumference 108 cm

What are the most appropriate next steps in Thomas’ preventative health care? Select four (4) from the following list:

Lisa Nguyen, a 47-year-old woman, presents for a general health check. She works in a corporate role and has limited time for exercise. She has no chronic medical conditions and feels well, but is concerned about her long hours and sedentary lifestyle. Her menstrual cycles are regular. She has two teenage children and is up to date with cervical screening. She has not had a mammogram or blood tests in over five years.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Mother diagnosed with breast cancer at 52

Social history: Non-smoker, drinks 2–3 glasses of wine per week, no regular exercise

Preventative Healthcare: Last cervical screening 2 years ago – normal. No recent mammogram, lipids, or glucose testing

Examination findings: BP 124/78 mmHg, BMI 29.4 kg/m², clinically well

What are the most appropriate preventative health measures for Lisa? Select three (3) from the following list:

Daniel Scott, a 16-year-old boy, presents with his mother for a routine health check required for his part-time job at a fast-food outlet. He is currently in Year 11 and has no active medical complaints. He plays soccer weekly and spends most of his free time on his phone or computer. He has never had a formal health assessment with a GP. His mother is concerned about his posture, diet, and social withdrawal at home. Daniel is otherwise performing well academically and denies alcohol, drug use, or sexual activity.

Medications: None

Allergies: Nil known

Past history: Childhood asthma (resolved)

Family history: Father – depression; paternal grandfather – type 2 diabetes

Social history: Lives with both parents, one younger sibling, no smoking or alcohol

Preventative Healthcare: Up to date with childhood vaccinations, no recent assessments or mental health screening

Examination findings: Height and weight within normal range, BMI 21.4 kg/m², BP 118/70 mmHg

What are the most appropriate preventative health actions for Daniel? Select three (3) from the following list:

Angela Marino, a 62-year-old woman, presents for a routine check-up. She has no significant past medical history and feels well. She went through menopause at age 50 and has never used hormone replacement therapy. She has not had a bone density test or any recent preventative screenings. She is active, walking daily, and has a BMI of 24. She has never smoked and drinks 1–2 glasses of wine on weekends.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Mother had a hip fracture at 78, father had prostate cancer

Preventative Healthcare: Cervical screening up to date, last mammogram 4 years ago, no previous DEXA scan

Examination findings: BP 126/76 mmHg, BMI 24.0 kg/m², no clinical signs of osteoporosis

What preventative health interventions are appropriate for Angela? Select three (3) from the following list:

Mohammed Al-Sharif, a 53-year-old man, presents for a health check after being encouraged by his wife. He has not seen a GP in several years. He has no specific complaints but admits he has gained weight and has low energy. He is a taxi driver and reports long hours of sedentary work. He fasts during Ramadan and follows a traditional Middle Eastern diet. He has a history of mild asthma in childhood. He does not smoke and drinks alcohol rarely.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Both parents had type 2 diabetes

Social history: Married with four children, long working hours, limited physical activity

Preventative Healthcare: No recent health assessments, no cardiovascular or diabetes screening

Examination findings: BP 136/84 mmHg, BMI 32.5 kg/m², waist circumference 112 cm

What are the most appropriate preventative health actions for Mohammed? Select four (4) from the following list:

Claire D’Souza, a 34-year-old woman, presents for a pre-employment medical prior to starting work as a registered nurse in a hospital. She recently returned from a year-long working holiday in South America. She is asymptomatic and otherwise well. She is uncertain of her vaccination history since adolescence, though she believes she had some childhood immunisations. She is not pregnant and does not plan to conceive in the near future.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Nil significant

Social history: Lives with partner, non-smoker, occasional alcohol use

Preventative Healthcare: Cervical screening last year – normal, no recent vaccinations recorded

Examination findings: Clinically well, BMI 22.0 kg/m², vital signs normal

What are the most appropriate preventative health steps in Claire’s situation? Select three (3) from the following list:

Sarah Hollis, a 38-year-old woman, presents to discuss planning her second pregnancy. Her first child was born with spina bifida, and she is anxious to optimise her health before conceiving again. She is otherwise healthy, maintains a balanced diet, and takes a regular multivitamin. Her BMI is 23.8 kg/m². She has no history of diabetes or epilepsy. She is not taking any medications and has not yet started any pregnancy-specific supplements.

Medications: Daily multivitamin (non-pregnancy formulation)

Allergies: Nil known

Past history: Uncomplicated first pregnancy, except for fetal neural tube defect

Family history: Nil significant

Social history: Lives with husband and one child, non-smoker, minimal alcohol

Preventative Healthcare: Cervical screening up to date, vaccinations not recently reviewed

Examination findings: Clinically well, BP 118/76 mmHg

What are the most appropriate preventative health actions for Sarah? Select three (3) from the following list:

Trevor Banks, a 70-year-old retired carpenter, presents for his annual influenza vaccine. During the consultation, he asks if there is “anything else” he should be doing to stay healthy. He lives with his wife, plays bowls weekly, and maintains a small garden. He has no significant medical history and takes no medications. He has not seen a doctor in over 3 years and is unsure when he last had any screening tests.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father had prostate cancer at 78, mother had osteoporosis

Social history: Non-smoker, occasional alcohol use, independent in all ADLs

Preventative Healthcare: No documented bowel cancer screening, no bone health assessment, no recent cardiovascular screening

Examination findings: BMI 25.2 kg/m², BP 132/78 mmHg, cardiovascular exam normal

What are the most appropriate preventative health activities for Trevor? Select four (4) from the following list:

Amira Yusuf, a 28-year-old woman originally from Somalia, attends for a routine health check. She arrived in Australia two years ago and is currently studying at university. She has no current health concerns but would like to “stay on top of things”. She has not seen a doctor since her arrival and is unsure what health checks are recommended in Australia. She has never had a cervical screening test and does not know her vaccination history.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Nil known

Social history: Lives with her cousin, does not smoke or drink alcohol, no current partner

Preventative Healthcare: No immunisation records, no prior cervical screening

Examination findings: BMI 22.7 kg/m², BP 110/72 mmHg, no abnormalities on general examination

What are the most appropriate preventative health measures for Amira? Select four (4) from the following list:

Robert Jenkins, a 64-year-old man, presents for a routine follow-up. He has well-controlled hypertension and mild chronic kidney disease (stage 2). He asks if there are any cancer screening tests he should consider. He has no urinary symptoms, no family history of bowel or prostate cancer, and has never had a colonoscopy or faecal occult blood test (FOBT). He has not had a PSA test and is unsure about its benefits.

Medications: Perindopril 5 mg daily

Allergies: Nil known

Past history: Hypertension, CKD stage 2

Family history: Nil significant

Social history: Retired, lives with wife, non-smoker, drinks 1–2 glasses of wine per week

Preventative Healthcare: No FOBT or PSA test to date

Examination findings: BP 128/76 mmHg, BMI 26.1 kg/m², clinically well

What are the most appropriate preventative screening actions for Robert? Select three (3) from the following list:

Elena Grigoriou, a 31-year-old woman, presents to discuss pregnancy planning. She has recently stopped using contraception and would like to ensure she is “as healthy as possible” before conceiving. She has coeliac disease diagnosed 4 years ago and is compliant with a strict gluten-free diet. She feels well, has no gastrointestinal symptoms, and maintains a healthy weight. She is not taking any supplements currently.

Medications: None

Allergies: Nil known

Past history: Coeliac disease, no other medical conditions

Family history: Mother has hypothyroidism, no family history of neural tube defects

Social history: Lives with partner, non-smoker, does not drink alcohol, balanced gluten-free diet

Preventative Healthcare: Cervical screening up to date, no recent blood tests, no current supplements

Examination findings: BP 112/70 mmHg, BMI 21.9 kg/m², clinically well

What are the most appropriate preconception care actions for Elena? Select three (3) from the following list:

Barry Tomlinson, a 76-year-old man, presents for a medication review. During the consult, he asks whether there is “any point in doing check-ups at my age.” He has a history of hypercholesterolaemia and osteoarthritis, both stable. He lives alone, is independent with activities of daily living, and is cognitively intact. He has not had any recent vaccinations or cancer screening tests. He reports good functional status and walks daily.

Medications: Atorvastatin 20 mg daily, paracetamol as needed

Allergies: Nil known

Past history: Hypercholesterolaemia, osteoarthritis

Family history: Non-contributory

Social history: Lives alone, widowed, does not smoke, drinks 1–2 standard drinks/week

Preventative Healthcare: No recent vaccinations, has never had DEXA scan, last FOBT over 5 years ago

Examination findings: BMI 24.8 kg/m², BP 130/72 mmHg, no cognitive concerns

What preventative care measures are appropriate for Barry? Select four (4) from the following list:

Layla Habib, a 41-year-old woman, presents to discuss preventative health. She is a single mother of two children and works full-time as a primary school teacher. She has no chronic conditions and takes no regular medications. She last saw a GP several years ago. She has never had a cardiovascular risk assessment and is unsure about when she last had a cervical screening test. She has no family history of cancer or heart disease and does not smoke or drink alcohol.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Nil significant

Social history: Two children aged 9 and 12, moderate stress, minimal exercise

Preventative Healthcare: No recent blood tests, unsure of cervical screening status, no recent vaccinations

Examination findings: BP 128/80 mmHg, BMI 27.2 kg/m², cardiovascular and respiratory exams normal

What preventative care measures are appropriate for Layla? Select four (4) from the following list:

George Farrow, a 59-year-old Aboriginal man, presents for a routine health assessment. He has a history of well-controlled hypertension and is taking regular medication. He lives in a regional town and works part-time at the local community centre. He smokes 5–10 cigarettes per day and drinks 4 standard drinks on most weekends. He last saw a GP two years ago and has never had a full health check. He reports feeling well.

Medications: Ramipril 10 mg daily

Allergies: Nil known

Past history: Hypertension

Family history: Brother had a stroke at age 60, father had diabetes

Social history: Lives with wife, involved in local community, limited access to fresh food

Preventative Healthcare: No documented diabetes screening, no recent cardiovascular risk calculation or vaccinations

Examination findings: BP 138/84 mmHg, BMI 29.8 kg/m², waist circumference 105 cm

What are the most appropriate preventative health measures for George? Select four (4) from the following list:

Nina Zhao, a 45-year-old woman, presents for a health check. She works in IT and spends long hours at a desk. She feels generally well but is concerned about her lack of exercise and poor diet. She has two teenage children and is keen to improve her long-term health. She has not had any blood tests or screening in the past five years. She has never had a cardiovascular risk assessment and has no known chronic conditions.

Medications: None

Allergies: Nil known

Past history: Nil

Family history: Father had myocardial infarction at 51, mother has type 2 diabetes

Social history: Sedentary job, minimal physical activity, high stress, non-smoker, drinks 1–2 glasses of wine per week

Preventative Healthcare: No recent lipid or glucose screening, cervical screening up to date

Examination findings: BP 138/82 mmHg, BMI 30.2 kg/m², waist circumference 98 cm

What are the most appropriate preventative health actions for Nina? Select four (4) from the following list:

Isobel Ramsay, a 65-year-old woman, presents to discuss preventative care. She is postmenopausal and in generally good health. She takes no regular medications and remains active, walking daily and gardening. She has never had a bone density scan and is unsure if she needs one. She has had regular mammograms, with the last one done 3 years ago and reported as normal. She has no family history of osteoporosis or hip fractures. She is not taking calcium or vitamin D supplements.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: No history of osteoporosis or fractures

Social history: Widowed, lives independently, non-smoker, drinks 1–2 glasses of wine on weekends

Preventative Healthcare: Up to date with cervical and breast screening, no previous osteoporosis assessment

Examination findings: BMI 22.6 kg/m², BP 124/76 mmHg, no gait instability, no spinal deformity

What are the most appropriate preventative care actions for Isobel? Select three (3) from the following list:

Anthony Vella, a 55-year-old man, presents for a health check after recently turning 55. He has no chronic medical conditions and takes no regular medications. He has a strong family history of bowel cancer—his mother was diagnosed at age 50, and his brother at age 52. Anthony is asymptomatic and has never had a colonoscopy or any form of bowel screening. He is otherwise healthy, exercises regularly, and eats a mostly plant-based diet.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Mother and brother with colorectal cancer before age 55

Social history: Non-smoker, drinks alcohol socially, married with two adult children

Preventative Healthcare: No FOBT or colonoscopy to date

Examination findings: BP 122/74 mmHg, BMI 25.4 kg/m², physical examination unremarkable

What are the most appropriate preventative care steps for Anthony? Select three (3) from the following list:

Kylie Freeman, a 22-year-old university student, presents for a general check-up and to discuss sexual health. She has recently become sexually active with a new male partner. She has no symptoms of STIs and no past medical history. She is unsure if she ever received the full HPV vaccine course at school. She is otherwise healthy, takes the oral contraceptive pill, and has not had a cervical screening test before.

Medications: Levonorgestrel-ethinylestradiol oral contraceptive

Allergies: Nil known

Past history: Nil significant

Family history: Nil relevant

Social history: Lives with friends, sexually active, non-smoker, drinks socially

Preventative Healthcare: No prior STI screening, unclear HPV vaccination history, no cervical screening to date

Examination findings: BP 114/72 mmHg, BMI 23.0 kg/m², no abnormalities

What are the most appropriate preventative care actions for Kylie? Select four (4) from the following list:

Michael Tang, a 50-year-old man, presents for a health check at the request of his workplace as part of an employee wellness initiative. He is asymptomatic, has no known medical conditions, and takes no medications. He works in logistics and has a family history of type 2 diabetes and hypertension. He reports no regular exercise, eats mostly take-away meals due to shift work, and drinks 3–4 beers on most evenings. He has not seen a GP in over 10 years.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father – type 2 diabetes and hypertension; mother – stroke at 70

Social history: Married, two teenage children, night shift worker, no smoking

Preventative Healthcare: No recent blood tests, immunisations unknown, no prior cardiovascular assessment

Examination findings: BP 142/88 mmHg, BMI 31.6 kg/m², waist circumference 108 cm

What are the most appropriate preventative health actions for Michael? Select four (4) from the following list:

Jessica Morrell, a 33-year-old woman, presents for a preconception check-up. She and her partner are planning to try for a baby in the next few months. She has no chronic health issues and is not currently taking any medications or supplements. She is unsure of her vaccination status and has never had blood tests related to pregnancy planning. She follows a vegetarian diet, exercises regularly, and has a BMI of 20.9 kg/m².

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Nil significant

Social history: Non-smoker, does not drink alcohol, lives with partner

Preventative Healthcare: No recent cervical screening, no preconception bloods or supplements

Examination findings: Clinically well, BP 110/70 mmHg

What are the most appropriate preconception preventative care measures for Jessica? Select four (4) from the following list:

Markus Reid, a 68-year-old man, presents for a routine health check. He feels well and remains physically active, playing tennis weekly and walking daily. He has a history of hypercholesterolaemia, managed with a statin, and mild benign prostatic hyperplasia (BPH). He has never had a bone density scan and has not discussed osteoporosis before. He has no history of fractures. He eats a balanced diet and spends time outdoors, but does not take any supplements.

Medications: Rosuvastatin 10 mg daily, tamsulosin 0.4 mg daily

Allergies: Nil known

Past history: Hypercholesterolaemia, BPH

Family history: Mother had a hip fracture in her 80s

Social history: Retired teacher, lives with spouse, non-smoker, moderate alcohol intake

Preventative Healthcare: Up to date with colorectal and prostate screening, never assessed for osteoporosis

Examination findings: BMI 24.6 kg/m², BP 128/76 mmHg, gait and balance normal

What preventative health actions are appropriate for Markus? Select three (3) from the following list:

Tameka Curtis, a 19-year-old Aboriginal woman, presents for a routine health check and to get a script for the oral contraceptive pill. She is currently studying and working part-time. She feels well, has no past medical history, and takes no regular medications. She has not had any blood tests or health checks since she was a child. She has not had any cervical screening and is unsure about her immunisation history.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Mother has type 2 diabetes and hypertension

Social history: Lives with extended family, sexually active, does not smoke, drinks socially

Preventative Healthcare: No cervical screening to date, immunisation status uncertain, no previous STI screening

Examination findings: BMI 23.1 kg/m², BP 112/70 mmHg, no concerns on general examination

What are the most appropriate preventative health actions for Tameka? Select four (4) from the following list:

Leonard Black, a 73-year-old retired builder, presents for his annual influenza vaccine. He feels well and remains active, walking daily and helping care for his grandchildren. He has a history of well-controlled hypertension and osteoarthritis. He has not had any recent cancer screening and is unsure if further screening is needed at his age. He has no urinary or gastrointestinal symptoms. He last had a faecal occult blood test (FOBT) 5 years ago and has never had a prostate-specific antigen (PSA) test.

Medications: Perindopril 5 mg daily, paracetamol PRN

Allergies: Nil known

Past history: Hypertension, osteoarthritis

Family history: Brother had prostate cancer at 70

Social history: Lives with wife, non-smoker, drinks socially, independent in all ADLs

Preventative Healthcare: No PSA test to date, FOBT last completed 5 years ago

Examination findings: BP 128/74 mmHg, BMI 26.2 kg/m², clinically well

What are the most appropriate preventative health actions for Leonard? Select three (3) from the following list:

Yasmin Patel, a 37-year-old woman, presents to discuss health screening. She has a strong family history of cardiovascular disease and diabetes. Her father had a heart attack at 48, and her mother has type 2 diabetes. Yasmin feels well, exercises occasionally, and eats a mostly vegetarian diet. She has never had a cardiovascular risk assessment or diabetes screening. She works full-time in a sedentary role and has two young children. She has not had blood tests in the past five years.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father – myocardial infarction at 48; mother – type 2 diabetes

Social history: Married, works in office job, no smoking, minimal alcohol intake

Preventative Healthcare: Cervical screening up to date; no previous lipid or glucose screening

Examination findings: BMI 28.4 kg/m², BP 134/82 mmHg, waist circumference 96 cm

What are the most appropriate preventative care actions for Yasmin? Select four (4) from the following list:

Alejandro Torres, a 27-year-old international student from Colombia, presents for a general health check. He has been living in Australia for 18 months and has not seen a GP since arrival. He is healthy and has no chronic conditions. He does not recall his vaccination history and has not had any screening tests. He works part-time in hospitality and is sexually active with both male and female partners. He is not currently in a relationship and uses condoms inconsistently.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Nil relevant

Social history: Lives in shared accommodation, drinks alcohol socially, does not smoke

Preventative Healthcare: No STI testing since arrival in Australia, unsure of hepatitis B or HPV vaccination status

Examination findings: BMI 22.3 kg/m², BP 118/74 mmHg, clinically well

What are the most appropriate preventative health actions for Alejandro? Select four (4) from the following list:

Linda Forster, a 60-year-old woman, presents for a health check. She has no significant past medical history and is not on any regular medications. She leads a busy lifestyle working part-time and caring for her elderly mother. She has not seen a GP in several years and is unsure of what screening tests are recommended at her age. She went through menopause at age 52 and has not had any bleeding since. She has no urinary, bowel, or breast symptoms. Her last mammogram was more than 3 years ago, and she has never had a bone density test.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Sister had breast cancer at 64; mother has osteoporosis

Social history: Non-smoker, drinks 1–2 glasses of wine on weekends, active with gardening and walking

Preventative Healthcare: No mammogram in over 3 years, no prior DEXA scan

Examination findings: BMI 25.1 kg/m², BP 126/78 mmHg, cardiovascular and breast exams unremarkable

What are the most appropriate preventative care actions for Linda? Select four (4) from the following list:

Isaac Osei, a 44-year-old man originally from Ghana, presents for a routine health check. He has been living in Australia for 5 years and works as a delivery driver. He feels well and has no known medical conditions. He has not seen a doctor in several years. He has never had any screening tests in Australia and is unsure of his immunisation status. He has a family history of hypertension and stroke. He does not smoke, drinks occasionally, and does not follow any specific diet.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father had a stroke at 58; mother has hypertension

Social history: Married, three children, drives for work, minimal physical activity

Preventative Healthcare: No cardiovascular or diabetes screening, no immunisation record in Australia

Examination findings: BP 136/86 mmHg, BMI 29.2 kg/m², waist circumference 102 cm

What are the most appropriate preventative care actions for Isaac? Select four (4) from the following list:

Emily Zhao, a 5-year-old girl, is brought in by her mother for a school readiness check. Her mother reports that Emily has been healthy and has not had any major illnesses. She is fully immunised according to the schedule provided by her previous GP. She attends preschool and is developmentally appropriate for her age. Her mother is wondering if there is anything else that should be done before Emily starts school next term.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Non-contributory

Social history: Lives with parents and younger brother, no household smoking, no concerns with home environment

Preventative Healthcare: Immunisations up to date per Australian schedule; no previous vision or hearing screening documented

Examination findings: Height and weight within normal limits, BMI 16.5 kg/m², BP 94/62 mmHg, well-appearing and interactive

What are the most appropriate preventative health steps for Emily as part of a school entry assessment? Select four (4) from the following list:

Peter Langley, a 58-year-old man, presents for a general health check after a friend was recently diagnosed with bowel cancer. He has no current symptoms and no significant past medical history. He has never had any cancer screening. He works as an electrician, exercises occasionally, and eats a mixed diet. He smokes 5–10 cigarettes per day and drinks 2–3 standard drinks most evenings. He has no family history of colorectal or prostate cancer.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Non-contributory

Social history: Lives with partner, smokes daily, drinks regularly, works full-time

Preventative Healthcare: No prior FOBT or PSA screening, no recent vaccinations

Examination findings: BP 130/78 mmHg, BMI 27.6 kg/m², clinically well

What are the most appropriate preventative health measures for Peter? Select four (4) from the following list:

Sara Ahmed, a 30-year-old woman, presents for a routine health check. She recently moved from Egypt and has been living in Australia for six months. She is healthy, not taking any medications, and is not pregnant. She is unsure of her vaccination history and has not undergone any screening tests in Australia. She is sexually active with her husband and uses condoms inconsistently. She has never had a cervical screening test.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Non-contributory

Social history: Married, does not smoke or drink alcohol, follows a halal diet

Preventative Healthcare: No immunisation records available; no screening history since arriving in Australia

Examination findings: BMI 24.0 kg/m², BP 112/70 mmHg, clinically well

What are the most appropriate preventative health actions for Sara? Select four (4) from the following list:

Harrison Lee, a 16-year-old boy, presents for a general health check required for a school sports program. He is asymptomatic and participates in soccer and swimming. He has no known medical conditions, takes no regular medications, and has not seen a GP in the past few years. His mother would also like to discuss any important vaccinations or health topics relevant for his age. He has not had any mental health concerns but spends a lot of time gaming and has irregular sleep habits.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father has hypertension, mother well

Social history: Lives with parents and younger sister, not sexually active, no alcohol or drug use reported

Preventative Healthcare: No vaccinations recorded since age 12; no prior HEADSS assessment documented

Examination findings: Height and weight appropriate for age, BMI 21.0 kg/m², BP 116/72 mmHg

What are the most appropriate preventative care steps for Harrison? Select four (4) from the following list:

Angela De Luca, a 47-year-old woman, presents for a routine check-up. She works in administration and has two teenage children. She has a history of gestational diabetes in her last pregnancy 14 years ago, but no current chronic health conditions. She does not smoke or drink alcohol and maintains a mostly healthy diet. She exercises irregularly due to work commitments. She has not had any blood tests or screening since her last pregnancy and is unsure if she needs any specific monitoring.

Medications: None

Allergies: Nil known

Past history: Gestational diabetes (age 33), no postpartum follow-up

Family history: Mother has type 2 diabetes; father has hypertension

Social history: Lives with husband and children, office-based job, low stress, no substance use

Preventative Healthcare: No screening for diabetes or lipids since pregnancy; cervical screening up to date

Examination findings: BMI 29.0 kg/m², BP 130/84 mmHg, clinically well

What are the most appropriate preventative care actions for Angela? Select four (4) from the following list:

Paul McGregor, a 72-year-old retired farmer, presents for a general health check. He has a history of hypertension and osteoarthritis, both well managed with medication. He lives independently on a rural property and remains active. He has not had a hearing test since childhood and occasionally finds it difficult to follow conversations, especially in noisy environments. He has not had an eye check for several years and has not received a pneumococcal vaccine. He is due for his influenza vaccine.

Medications: Amlodipine 5 mg daily, paracetamol as needed

Allergies: Nil known

Past history: Hypertension, osteoarthritis

Family history: Non-contributory

Social history: Lives alone, non-smoker, occasional alcohol, drives independently

Preventative Healthcare: No hearing or vision screening in recent years, no pneumococcal vaccination recorded

Examination findings: BP 132/78 mmHg, BMI 24.7 kg/m², no gait or balance issues, conversational hearing slightly impaired

What are the most appropriate preventative care actions for Paul? Select four (4) from the following list:

Fatima Noor, a 25-year-old woman, presents for a pre-travel consultation before visiting family in Pakistan for six weeks. She will be staying in both urban and rural areas, eating local food, and visiting relatives, including elderly and young children. She is generally healthy, with no chronic conditions, and is not taking any medications. She last received travel vaccines as a teenager. She is unsure of her hepatitis B and typhoid vaccination status and has not had any vaccinations as an adult.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Non-contributory

Social history: Lives with parents, not currently sexually active, does not smoke or drink alcohol

Preventative Healthcare: No recent immunisation or screening; cervical screening up to date

Examination findings: Clinically well, BMI 22.8 kg/m², BP 114/70 mmHg

What are the most appropriate preventative care actions for Fatima prior to travel? Select four (4) from the following list:

Ngoc Tran, a 54-year-old woman, presents for a general health check. She migrated from Vietnam over 10 years ago and works as a hairdresser. She is generally well but has not seen a doctor in several years. She is unsure of her vaccination history, has not had any blood tests or cancer screening in Australia, and has never been screened for hepatitis. She has no chronic conditions and reports no current symptoms.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Mother had liver cancer, father had hypertension

Social history: Lives with husband, no smoking, drinks socially, eats traditional Vietnamese diet

Preventative Healthcare: No previous screening for hepatitis, bowel cancer, or cardiovascular risk

Examination findings: BMI 23.6 kg/m², BP 126/76 mmHg, clinically well

What are the most appropriate preventative care actions for Ngoc? Select four (4) from the following list:

James Barlow, a 67-year-old retired accountant, presents for a check-up and to discuss healthy ageing. He has no chronic diseases and is not on any medications. He reports feeling well, stays active with regular walks, and volunteers at a local community centre. He has not had a health assessment in over 5 years and is unsure which preventative screenings or vaccinations are still relevant at his age. He has not had any recent blood tests and does not recall receiving a shingles vaccine.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father had stroke at 72, mother had osteoporosis

Social history: Lives with wife, non-smoker, drinks wine occasionally, independent in ADLs

Preventative Healthcare: No recent immunisations, last FOBT over 4 years ago, no history of bone density testing

Examination findings: BMI 24.9 kg/m², BP 128/76 mmHg, normal gait and balance

What are the most appropriate preventative health actions for James? Select four (4) from the following list:

Amira Saleh, a 35-year-old woman, presents for preconception counselling. She is planning to start trying for her first pregnancy in the next few months. She has hypothyroidism diagnosed five years ago and is stable on thyroxine. She is otherwise healthy, follows a Mediterranean-style diet, and exercises regularly. She has not had any recent blood tests or reviewed her vaccination status since adolescence. Her last cervical screening test was 3 years ago and was normal.

Medications: Thyroxine 100 mcg daily

Allergies: Nil known

Past history: Hypothyroidism (Hashimoto’s thyroiditis)

Family history: Mother had gestational diabetes; father has hypertension

Social history: Lives with husband, non-smoker, no alcohol, balanced diet

Preventative Healthcare: No preconception investigations or supplement use

Examination findings: BMI 22.0 kg/m², BP 112/70 mmHg, clinically well

What are the most appropriate preventative care steps for Amira in the context of preconception planning? Select four (4) from the following list:

David Ng, a 62-year-old man, presents for a routine check-up after recently retiring from work. He feels well and takes no regular medications. He has a history of well-controlled hypertension diagnosed in his early 50s. He has not seen a doctor in several years and is unsure of his cancer screening or vaccination status. He has never had a colonoscopy or faecal occult blood test (FOBT), and he is unsure about shingles and pneumococcal vaccinations. He is a non-smoker, drinks wine occasionally, and exercises regularly.

Medications: None

Allergies: Nil known

Past history: Hypertension, diet-controlled

Family history: Father had bowel cancer at 72; mother had hypertension

Social history: Married, two adult children, enjoys hiking and gardening

Preventative Healthcare: No bowel cancer screening to date; no recent bloods or immunisation review

Examination findings: BP 128/78 mmHg, BMI 24.5 kg/m², clinically well

What are the most appropriate preventative care steps for David? Select four (4) from the following list:

Lucy Hamilton, a 52-year-old primary school teacher, presents for a general check-up. She is perimenopausal and reports occasional hot flushes but no other significant concerns. She has never had a mammogram and is unsure about what cancer screenings or preventative health measures are recommended at her age. She is up to date with cervical screening and has no significant medical history. She does not smoke, drinks occasionally, and walks daily.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Mother had osteoporosis, father had type 2 diabetes

Social history: Lives with partner, no children, works full-time, healthy diet

Preventative Healthcare: No mammogram to date, no DEXA scan, cervical screening last year – normal

Examination findings: BMI 25.3 kg/m², BP 122/76 mmHg, clinically well

What are the most appropriate preventative care actions for Lucy? Select four (4) from the following list:

Jared Wilson, a 32-year-old Aboriginal man, presents for a general health check. He is currently working full-time in construction and feels generally well. He has not seen a GP in several years and has never had a full health check. He smokes 15 cigarettes per day and drinks alcohol socially on weekends. He has no chronic medical conditions and takes no regular medications. His father had a heart attack in his mid-50s. Jared is interested in quitting smoking and wants to “get on top of things” health-wise.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father – myocardial infarction at 54

Social history: Lives with partner and young son, smokes daily, drinks 6–8 standard drinks per week, no recreational drugs

Preventative Healthcare: No previous cardiovascular screening, diabetes screening, or immunisation review

Examination findings: BMI 28.2 kg/m², BP 136/84 mmHg, clinically well

What are the most appropriate preventative health actions for Jared? Select four (4) from the following list:

Monica Evans, a 69-year-old woman, presents for a preventative health review. She has recently moved to a new area and is establishing care with your clinic. She is in good health and takes no regular medications. She has never had a bone density scan and is unsure of her vaccination status. She had a mammogram 2 years ago, which was normal. She had a cervical screening test 4 years ago, also normal. She does not smoke or drink alcohol, and she walks her dog daily.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Mother had a hip fracture in her 70s

Social history: Widowed, lives alone, independent, active in community gardening group

Preventative Healthcare: Up to date with breast and cervical screening, no previous DEXA scan or adult vaccinations

Examination findings: BMI 23.9 kg/m², BP 120/72 mmHg, no gait instability or postural hypotension

What are the most appropriate preventative health actions for Monica? Select four (4) from the following list:

Samuel Kim, a 45-year-old man, presents for a general health check at the request of his workplace. He works as an IT project manager, has a sedentary lifestyle, and reports high work-related stress. He has no history of chronic illness and takes no medications. He eats take-away food most days, rarely exercises, and sleeps poorly due to irregular work hours. He has not had any blood tests in over 5 years and is unsure if he’s ever had a cardiovascular risk assessment or diabetes screening.

Medications: None

Allergies: Nil known

Past history: Nil significant

Family history: Father – myocardial infarction at 59; mother – type 2 diabetes

Social history: Married, two children, drinks 2–3 beers on weekends, non-smoker

Preventative Healthcare: No recent screening for lipids, glucose, or cardiovascular risk

Examination findings: BP 138/86 mmHg, BMI 30.1 kg/m², waist circumference 104 cm

What are the most appropriate preventative care actions for Samuel? Select four (4) from the following list:

Melanie Brooks, a 39-year-old woman, presents for a check-up and to discuss family planning. She and her partner are considering trying for a baby in the next year. She has a history of coeliac disease, diagnosed 10 years ago, and adheres strictly to a gluten-free diet. She is otherwise well, takes no regular medications, and has not had any recent blood tests. She is unsure of her rubella immunity and is not currently taking any supplements.

Medications: None

Allergies: Nil known

Past history: Coeliac disease

Family history: Sister has hypothyroidism; no family history of congenital disorders

Social history: Lives with partner, non-smoker, occasional alcohol, balanced gluten-free diet

Preventative Healthcare: Cervical screening up to date, no preconception testing or supplement use

Examination findings: BMI 22.4 kg/m², BP 114/72 mmHg, clinically well

What are the most appropriate preventative care steps for Melanie? Select four (4) from the following list:

Thomas O’Neill, a 74-year-old man, presents for a general health review. He feels well and is independent in all activities of daily living. He has a history of mild osteoarthritis and controlled hypercholesterolaemia. He has not had any recent cancer screening and is unsure about his eligibility. He completed his last faecal occult blood test (FOBT) 3 years ago. He is uncertain whether he should continue with preventative screening now that he is in his mid-70s.

Medications: Atorvastatin 10 mg daily, paracetamol as needed

Allergies: Nil known

Past history: Osteoarthritis, hypercholesterolaemia

Family history: Father had bowel cancer at 80, mother had osteoporosis

Social history: Widower, lives independently, active, non-smoker, occasional alcohol

Preventative Healthcare: Last FOBT 3 years ago, no DEXA scan, influenza vaccine last year

Examination findings: BMI 24.8 kg/m², BP 126/74 mmHg, no falls, gait steady

What are the most appropriate preventative care steps for Thomas? Select four (4) from the following list: