Station - Instructions for candidate
You are a medical student on placement in a general practice in Ellenbrook.
Mark Dunstan, a 55-year-old bricklayer, had a health check two weeks ago and is back for his results, which are printed on your sheet. The GP has calculated his cardiovascular risk and wants him to start a statin; Mark has told the receptionist he 'isn't keen on tablets'. The GP has asked you to go through the results with him and agree a plan.
Fasting lipids and cardiovascular risk calculation
| Item | Value | Reference range |
|---|---|---|
| Total cholesterol | 6.4 mmol/L | <5.5 mmol/L |
| LDL cholesterol | 4.3 mmol/L | <2.0 mmol/L (high risk) |
| HDL cholesterol | 1.0 mmol/L | >1.0 mmol/L |
| Triglycerides | 2.2 mmol/L | <2.0 mmol/L |
| Australian CVD risk calculator (2023) | 5-year risk 14 percent - high risk category (10 percent or above) | Low <5%; intermediate 5-9%; high 10% or above |
Inputs: male, 55, smoker, systolic 140, total cholesterol 6.4, HDL 1.0, no diabetes, no CVD, postcode-based socioeconomic adjustment applied.
Other bloods
| Item | Value | Reference range |
|---|---|---|
| HbA1c | 5.7 percent | <6.0 percent (no diabetes) |
| Fasting glucose | 5.6 mmol/L | 3.5-6.0 mmol/L |
| eGFR and urine ACR | 88 mL/min; ACR 1.0 mg/mmol | >60; <2.5 |
| ALT, TSH, CK | 30 U/L; 1.8 mIU/L; 120 U/L | <40; 0.4-4.0; <200 |
No diabetes, no renal, thyroid or liver contributor; baseline creatine kinase normal.
Your tasks are to:
- Take a focused history.
- Interpret the results and explain them to Mr Dunstan.
- Counsel him on reducing his risk.
- Discuss the plan with him.
- You do NOT need to examine the patient.
- You do NOT need to summarise your findings to the examiner.
This is a 10-minute station, with 2 minutes of reading time.