Renal artery stenosis – how do we confirm the diagnosis?

12th December 2023, NIA Diagnostic Imaging

Renal artery stenosis

One of the standout diagnoses I remember from medical school is renal artery stenosis. In practice, it is usually someone else that makes that diagnosis. It is not that uncommon. We may hear an abdominal bruit in our general vascular screen. We might struggle to get our patient’s BP to target despite the 4th or 5th agent.…

Welcome to our newest sponsor – South West Radiology

10th December 2023

GPVoice has become a busy portal keeping GPs up-to-date with new information that helps us look after our patients. We keep you abreast with new guidelines, new practice paradigms, new drugs coming our way and new ways of thinking about problems. We are regularly joined by our radiology colleagues with their useful articles as well as keeping up-to-date with what is available in the radiology world.…

Sarcopenia – can we measure it and how bad is it?

10th December 2023, A/Prof Chee L Khoo

Old and weak?

We don’t get old and weak. Actually, if we get weak, we become old. We all see that in practice. It doesn’t matter how old our patient is. When they become weak, they slow down. They can’t walk very far and they don’t. They become weaker and weaker. They have difficulty get off a chair.…

LDL-C – is lower necessarily better?

9th December 2023, A/Prof Chee L Khoo


We know how effective statins are in lowering cholesterol levels. Lowering of cholesterol levels, especially LDL-C, have been shown to incrementally reduce adverse cardiovascular events in patients with atherosclerotic disease. We have data to show that for every 1 mmol/L of LDL-C reduction there is a 23% reduction in cardiovascular events, which means, the lower the better (1).…

Foot injuries – is that a Lisfranc injury?

Foot injury

30th November, Spectrum Medical Imaging

The midfoot consist of 5 bones, cuboid, navicular and three cuneiform bones. These bones articulate with the base of the five metatarsals. In the Lisfranc injuries, it is these articulations (and their ligamemts) that are damage. Sometimes, there are fractures easily seen on plain xrays. Sometimes, one can see separation of the bones on plain xrays.…

Acne – the ABC of management in primary care

27th November 2023, A/Prof Chee L Khoo

Although moderate to severe acne is pretty common in primary care, our management tends to be haphazard. We have our favourite topical and oral therapy but I am not sure that that is evidence-based nor pathophysiological in our approach. When all else fails, we refer on to our friendly dermatologist. I recently attended a brilliant lecture at the Melbourne GPCE presented by Dr Ryan de Cruz, a Melbournian dermatologist.…

Cervical screening – hands up who’s not here?

25th November 2023, A/Prof Chee L Khoo

Cervical screening for cervical cancer for the prevention of cervical cancer has to be one of the most successful campaigns in primary care. For most, instead of having an intimate check every two years, doing it every 5 years is such a relief. For others, it is still having to endure an insertion of a vaginal speculum.…

Genetic carrier screening on MBS now – what does that mean?

25th November 2023, A/Prof Chee L Khoo

genetic carrier screening

Reproductive genetic carrier screening for cystic fibrosis (CF), spinal muscular atrophy (SMA) and fragile X syndrome (FXS) has become available on the Medicare Benefits Scheme (MBS). Screening for those three conditions is recommended for all couples prior to, or in the early stages of pregnancy. Great but what is this genetic screening all about?…

GLP1RAs – do they reduce CV events?

14th November 2023, A/Prof Chee L Khoo

Cardiovascular Events

Obesity is a recognised risk factor for cardiovascular disease (CVD). We are all used to treating cardiovascular risk factors such as hypertension, dyslipidaemia and diabetes in an attempt to reduce CV events. We should also treat the obesity, shouldn’t we? Logically, weight reduction should lead to reduction in CV events but, unfortunately, lifestyle changes and pharmacological interventions to reduce obesity have not been shown to improve cardiovascular outcomes (1-5).…

Exacerbation of COPD – do oral steroids make any difference?

12th November 2023, Conjoint Assoc. Prof Chee L Khoo

It is pretty standard for us to treat an infective exacerbation of COPD with antibiotics and a shot of oral corticosteroids, usually oral prednisolone for 5-7 days. Almost all of them seems to get better with that regimen. Or do they? We explored when to use and when not to use inhaled corticosteroids (ICS) in COPD in the September 2023 issue.…

CT cholangiogram – when should we order one?

12th November 2023, NIA Diagnostic Imaging

epigastric pain

Epigastric pain has to be one of the most common presenting symptoms in primary care. The differential diagnoses include cholelithiasis and cholecystitis. With increasing prevalence of obesity and type 2 diabetes, the prevalence of gallbladder disease is also increasing. Often, abdominal ultrasound can confirm or exclude gallbladder disease but sometimes, the results are inconclusive or we suspect additional bile duct obstruction.…