Station - Instructions for candidate
You are a junior doctor working in a general practice in Perth.
Hao Lim, a 49-year-old fly-in fly-out electrician, has come to discuss blood results from his mine-site medical last week. The site doctor told him his 'sugar was up' and asked him to see his GP. The results are printed below. He flies out for his next two-week swing in three days.
Fasting bloods from the mine-site medical (7 days ago)
| Item | Value | Reference range |
|---|---|---|
| HbA1c | 8.1% (65 mmol/mol) | <6.0% |
| Fasting plasma glucose | 8.6 mmol/L | 3.5-5.4 mmol/L |
| Total cholesterol | 5.8 mmol/L | <5.5 mmol/L |
| LDL cholesterol | 3.6 mmol/L | <2.0 mmol/L |
| HDL cholesterol | 0.9 mmol/L | >1.0 mmol/L |
| Triglycerides | 2.4 mmol/L | <2.0 mmol/L |
| Creatinine | 84 umol/L | 60-110 umol/L |
| eGFR | 88 mL/min/1.73m2 | >90 mL/min/1.73m2 |
| Urine albumin-creatinine ratio | 1.8 mg/mmol | <2.5 mg/mmol |
| ALT | 52 U/L | <40 U/L |
| GGT | 68 U/L | <60 U/L |
Your tasks are to:
- Take a focused history.
- Explain the results and what they mean to Mr Lim.
- Counsel him on starting metformin.
- You do NOT need to examine the patient.
- You do NOT need to summarise your findings to the examiner.
- You do not need to write a prescription or a care plan in this station.
This is a 10-minute station, with 2 minutes of reading time.