MRCGP AKT Category: Children And Young People

AKT-0951

Which of the following congenital infections is most commonly associated with sensorineural hearing loss in newborns?

AKT-0952

A 4-year-old boy is brought to the walk-in-clinic by his mother due to feeling unwell for the past week. The mother reports that her son has been very tired, appears to have lost weight, and has been bruising easily. Upon reviewing his medical records, you discover that he has had multiple chest infections in the last 2 months. During the examination, you observe that he is breathless, has a fever, and has a purplish skin rash on his limbs. He looks extremely ill. You decide to admit him directly to the paediatric assessment unit. What is the most likely condition he is suffering from?

AKT-0953

A 4-year-old boy is brought in by his father. His father reports that he has been eating less and refusing food for the past few weeks. Despite this his father has noticed that his abdomen is distended and he has developed a ‘beer belly’. For the past year he has opened his bowels around once every other day, passing a stool of ‘normal’ consistency. There are no urinary symptoms. On examination he is on the 50th centile for height and weight. His abdomen is soft but slightly distended and a non-tender ballotable mass can be felt on the left side. His father has tried lactulose but there has no significant improvement. What is the most appropriate next step in management?

AKT-0954

A 4-year-old girl is brought in by her mother who is worried about her occasional wheezing. The child is not experiencing any symptoms at the moment and her wheezing seems to only occur during upper respiratory tract infections. There is no history of atopy in the family or the child’s medical history. The girl was previously seen by another doctor 4 months ago and was given salbutamol to use as needed, but her mother reports that it doesn’t seem to help. What should be the next appropriate step to take?

AKT-0955

Which of the following conditions is NOT inherited in an X-linked recessive fashion?

AKT-0956

A 15-month old girl is brought to you by her father, concerned about her fine motor skills development. She was born at term without any complications during pregnancy or delivery. Her father feels that she is not progressing in the same way as her older siblings did at this age.

At 12 months old, she was able to pick up small objects using her thumb and index finger. What is the next fine motor developmental milestone that you would expect this child to have achieved by now?

AKT-0957

A 3-year-old girl presents with a 2-day history of right sided limp and reluctance to weight bear. She has been distressed, excessively sweaty and febrile overnight. She looks unwell and has a temperature of 38.9ºC. She refuses to walk but will lie on the couch to be examined; she is warm to the touch and there is erythema over her right hip. She is distressed when you check the range of movement in the right hip, the left hip examination is unremarkable. Her mother thinks her symptoms started following a fall in the garden 2 days ago. What is the most likely diagnosis?

AKT-0958

You see a 3-year-old girl with her mother. She has been coughing loudly since 3am this morning and her mother describes it as a barking cough. She has had a cold but is otherwise healthy. Today, she seems better but her mother wanted to have her checked out as she appeared more unwell during the night.

During the examination, the girl appears well and has a normal body temperature. Her breathing is normal and her heart rate and respiratory rate are within normal limits. Her throat is red and her eardrums are slightly pink but not bulging.

Based on the history, you suspect that the girl has mild croup and discuss this with her mother. She asks about the cause of croup. What is the primary pathogen responsible for most cases of croup?

AKT-0927

A 2-year-old girl with a barking cough is diagnosed with croup. However, she is feeding well and has only a low-grade fever of 37.9ºC. No intercostal recession is observed during examination. The decision is made to manage her in primary care. What is the best course of action?

AKT-0928

You assess an 8-year-old boy who was released from hospital 3 days ago after undergoing a tonsillectomy. His mother reports that he is experiencing a ‘sore throat’ despite taking both paracetamol and ibuprofen simultaneously. They were informed to anticipate some discomfort for approximately 5-7 days but are seeking your assistance in prescribing something to alleviate the pain. Physical examination reveals no abnormalities.

What is the best recommendation for pain relief?