Check Study Program

#Steroid_Withdrawal

#Steroid_Abuse

https://www.healthymale.org.au/news/do-testosterone-boosting-supplements-work#:~:text=At%20a%20minimum%2C%20testosterone%20supplements,regulated%20market%20could%20cause%20harm.

James, aged 22 years, is currently studying business at university and working part-time in an accounting firm. He plays football in the local league and attends the gym regularly for strength training. James has a female partner but is not looking to settle down or start a family. James attends for a medical review after prompting from his partner because his libido has diminished, their frequency of sexual activity has declined and he has been feeling quite tired for several months now. 1. James has initially identified a vague set of symptoms. What further history and examination could be helpful when assessing James? 2. What investigations might you undertake at this time? 3. When reviewing James’s history, physical examination and pathology results (Table 1), what options for differential diagnosis are you considering? 4. What explanation for his symptoms can you provide to James at this stage? 5. How can you support James with sustained behaviour change as he is withdrawing from the use of performance-enhancing substances? 6. What would you need to consider, regarding male fertility, when faced with the use of synthetic androgens? #Week26_Case1

Lydia, aged 32 years, is a financial planner. She is pregnant for the first time and comes to talk to you about some of her concerns at 14 weeks’ gestation. While the pregnancy was planned, it was a difficult decision for Lydia and her partner to make as they have increasing anxiety about climate change. Lydia is particularly worried about the upcoming summer and what this may bring in the way of bushfire, smoke and heat exposure. 1. How does environmental heat exposure affect pregnancy and birth outcomes? 2. What advice can you provide to Lydia about reducing her risks from heat exposure? 3. What are the impacts of air pollution (including bushfire smoke) on pregnancy and birth outcomes? 4. What advice can you provide to Lydia about reducing her risks from air pollution? 5. What are the benefits of a plant-based diet? 6. What are some considerations for plant-based diets during pregnancy? 7. Why are sexual and reproductive rights of women key to climate mitigation? 8. What would you advise Lydia specifically regarding postnatal contraception? #Week25_Case5

Sheree, aged 44 years, is a teacher and has been your patient for several years. She is worried about her mood. She has been feeling tired and anxious for the past six months. Sheree has been having trouble sleeping, feeling forgetful and having difficulty concentrating at work. She is also worried that she is overreacting to minor issues, and this is affecting her home life. 1. What additional information do you need? 2. What investigations would you order? 3. What differential diagnosis would you consider as a cause of Sheree’s mood symptoms? 4. On the basis of Sheree’s age, are there any additional diagnoses you need to consider? 5. On the basis of your history, examination and investigations, how would you manage Sheree’s symptoms? 6. What further information do you need to assess Sheree’s hot flushes? 7. What further investigations should be performed to assess Sheree’s symptoms? 8. How would you manage Sheree’s hot flushes? #Week24_Case4

#Sexual_Pain_Mx

#Sexual_Pain

Kyung Mi, aged 23 years, has come to see you with her boyfriend, Tom, for a standard 15-minute appointment. Kyung Mi says that sexual intercourse has recently become more painful. She is embarrassed and upset talking about it but is able to tell you that since being with Tom, penetration has become so painful that she now cannot tolerate penetrative sex. Kyung Mi says it is putting a strain on their relationship and says tearily, ‘I just want to be able to have sex like a normal person’. 1. How would you manage this consultation, and what would you ask Kyung Mi to help you make a diagnosis? 2. What is your working diagnosis at this stage? 3. What would you do next? 4. How would you explain this to Kyung Mi? 5. What treatment options are available for vaginismus? 6. What would you consider at Kyung Mi’s follow-up appointment? #Week25_Case3