aboriginal and torres strait islander health

A 45-year-old male with poorly controlled diabetes mellitus and ischaemic heart disease, living in a rural Indigenous community, presents with fevers, cough, lethargy, night sweats, and occasional hemoptysis. What is the most appropriate initial investigation for suspected tuberculosis in this patient if he is unable to produce sputum spontaneously?

A 25-year-old Aboriginal man presents to a remote clinic with increasing shortness of breath on exertion and palpitations over the past month. He recalls having a sore throat as a child but no specific diagnosis. On examination, his pulse is 95 bpm, blood pressure 110/70 mmHg, respiratory rate 20 breaths/min. Auscultation reveals a pansystolic murmur loudest at the apex, radiating to the axilla. There are no signs of heart failure currently. Considering the likely diagnosis and the patient's background, which of the following is the most appropriate initial investigation?

A 62-year-old Aboriginal and Torres Strait Islander man presents for a routine check-up. He has a history of smoking, obesity, and type 2 diabetes, managed with metformin. His blood pressure is 150/90 mmHg. Which of the following is the MOST significant modifiable risk factor for cardiovascular disease in this patient?

A 50-year-old Aboriginal man presents for a routine check-up. He has a strong family history of type 2 diabetes. What is the most appropriate initial screening test?

A 50-year-old Aboriginal man presents for a routine check. He has a history of smoking and lives in a remote community. What screening is most important to address his increased risk?

A 40-year-old Aboriginal man presents for a health check. He has a strong family history of diabetes and cardiovascular disease. What is the most appropriate initial screening test to assess his risk?

A 32-year-old male, recent immigrant from a high-TB prevalence country, presents with a persistent cough and night sweats for the past two months. He denies fever or weight loss. Physical examination is unremarkable except for mild scattered rhonchi on auscultation. Sputum cultures are negative for acid-fast bacilli. A PET-CT scan of the chest is performed, the axial view is shown. Given the clinical context and imaging findings, what is the MOST appropriate next step in management?

An Aboriginal woman, 48 years old, attends your general practice for a routine health check. She has a history of gestational diabetes and lives in a rural community. When discussing preventative health screening, which of the following is the MOST culturally appropriate and evidence-based approach?

A 45-year-old Aboriginal man from a remote community presents to the clinic for a routine health check. He has a history of smoking (20 pack-years) and reports drinking alcohol occasionally (3-4 standard drinks per week). He denies any chronic medical conditions. His blood pressure is 145/95 mmHg. BMI is 32 kg/m2. Fasting blood glucose is 6.5 mmol/L. Which of the following is the MOST appropriate initial management strategy, considering the principles of culturally safe care?

A 40-year-old Aboriginal man presents for a health check. He reports feeling well but has a strong family history of diabetes and cardiovascular disease. What is the most appropriate initial screening test?

A 16-year-old Aboriginal boy from a remote community presents to the local clinic with a two-week history of increasing fatigue, occasional shortness of breath on exertion, and migratory joint pains affecting his knees and ankles. He had a documented episode of acute rheumatic fever (ARF) three years ago, complicated by mild mitral regurgitation, and was commenced on monthly benzathine penicillin G injections for secondary prophylaxis. However, his adherence has been inconsistent over the past year due to difficulties accessing the clinic. On examination, he is afebrile. His pulse is 95 bpm, blood pressure 110/70 mmHg, and respiratory rate 18 breaths/min. Cardiac auscultation reveals a soft apical pansystolic murmur, unchanged from his last review six months ago. There is mild swelling and tenderness in his left ankle joint, but no erythema or warmth. His throat swab for *Streptococcus pyogenes* is negative. Laboratory tests show a CRP of 45 mg/L (normal <5), ESR 60 mm/hr (normal <15), and a normal full blood count. An ECG shows sinus rhythm with no PR interval prolongation. A point-of-care ultrasound shows mild mitral regurgitation. Considering the clinical presentation, history, and the significant burden of rheumatic heart disease in this population, which of the following is the most appropriate immediate management step regarding his secondary prophylaxis?

A 60-year-old Aboriginal man presents for a routine check-up. He has a history of smoking and lives in a remote community. Which screening is MOST important, considering higher prevalence in this population?

A 35-year-old Aboriginal woman presents for a routine health check. She reports feeling tired lately and sometimes short of breath on exertion. She has a history of type 2 diabetes diagnosed 5 years ago, managed with metformin 500mg twice daily, and untreated hypertension. On examination, her blood pressure is 145/90 mmHg. Urinalysis shows 2+ protein. Blood tests reveal creatinine 180 µmol/L, eGFR 35 mL/min/1.73m², HbA1c 8.5%, potassium 4.2 mmol/L. Given these findings, which of the following is the most appropriate initial management step?