Several years later, Miss C is thinking about trying to start a family. She sees her GP, who arranges thyroid function tests.   Patient Result Reference Range Free T4                   60 mmol/L (70-140 mmol/L) TSH                       9 mIU/L (0.3-4.7 mIU/L)

What action should be taken in relation to Mr A’s other glucose lowering medication when initiating insulin?

As part of his annual monitoring, Mr A brings a first pass urine sample for analysis. Why is a first pass urine sample analysed as part of routine diabetic monitoring?

Miss C usually takes her contraceptive pill with good adherence every day without any problems, but she realised she missed her pill yesterday as she was feeling quite anxious about her appointment at the sexual health clinic and had left the house at a different time to normal. She is on day 4 of her pill pack and last had sex 3 days ago without a condom. She confirms she has not missed any other doses of her Mercilon tablets. What advice would be most appropriate regarding contraceptive cover?

Which of the following is the most appropriate advice to provide to Mr A relating to diabetic monitoring during periods of acute illness?

In addition to informing her partner about the diagnosis, what is the most appropriate advice for Miss C to follow, after her treatment?

Mr A is commenced on metformin 500mg tablets and titrated to two tablets twice a day. One month later he requests a review due to persistent abdominal pain and loose stools. What is the most appropriate action to take?

Mr A is scheduled for major abdominal surgery. With reference to the SmPC for canagliflozin, what is the most appropriate action to take? https://www.medicines.org.uk/emc/product/8855/smpc#gref 

Are there any specific checks that should to be carried out following completion of gonorrhoea treatment?

Miss C, a 23-year-old woman presents to her local sexual health clinic with unusual vaginal discharge and lower abdominal pain for the past week. She also reports increased urinary frequency and discomfort during urination. The symptoms started mildly but have progressively worsened. She reports no fever or chills.   Past Medical History Hypothyroidism (2023)   Drug History Mercilon (ethinylestradiol 20 micrograms, desogestrel 150 micrograms) Drug allergies – Ofloxacin (rash)   Social History Lives alone Full time professional employment Sexually active with a new partner for the past two months. They occasionally use condoms. Non-smoker Drinks alcohol 10-15 units per week   Observations and test results: BP: 128/72 mmHg Heart rate: 70 beats per minute Respiratory rate: 15 breaths per minute Temperature: 37.1 degrees C BMI: 20 kg/m2 Abdominal exam: Mild tenderness in the lower abdomen, no rebound tenderness Pelvic exam: Mucopurulent discharge, cervical motion tenderness FBC: normal Urinalysis: no signs of urinary tract infection NAAT: positive for Neisseria gonorrhoeae