MRCGP AKT Category: Children And Young People

AKT-0575

You are requested by the practice nurse to assess a mother who has brought in her 12-week-old baby who appears unwell. The mother is concerned because the baby seems to have a fever.

Upon examination, you observe that the baby has an upper respiratory tract infection. The family members have recently had a cold. Although the baby is pyrexial at 37.8°C, you cannot detect any indications of lower respiratory tract infection.

What is the appropriate course of action for managing this baby?

AKT-0576

A mother comes to see you about her 16-year-old daughter. She has been diagnosed with major depression and is due to see a specialist the next day.

You discuss both medical and non-medical therapies.

It is anticipated that she will need medical therapy. Which of the following drugs, if required, is most likely to be prescribed for her?

AKT-0577

A 5-year-old boy is brought into the minor injury unit by his mother after suddenly developing a cough and wheeze. His symptoms seem to have started suddenly at a birthday party. On examination, he is irritable, afebrile, with a raised respiratory rate and cough. He has a wheeze heard on the right side and breath sounds are more prominent on the left.
What is the most likely diagnosis?

AKT-0562

A 14-year-old boy is referred by his GP with a two-week history of general malaise, fatigue and pharyngitis. On examination, multiple small lymph nodes were palpable in the neck, axillae and groins.

Investigations revealed:
Haemoglobin 125 g/L (130-180)
WBC 16.0 ×109/L (4-11)
Platelets 160 ×109/L (150-400)
Blood film Lymphocytosis noted

What is the most probable diagnosis?

AKT-0578

A 16-year-old girl comes to see you and requests the contraceptive pill. She has come to the surgery alone. You attempt to discuss the request in more detail but she seems nervous and fidgety, not making eye contact with you. You ask her if she would like someone else present for the discussion.
She says she wants to start taking the pill as she is in a relationship and wants to be safe. She appears to be listening but is not asking any questions.
You explain to her that you need to make a thorough assessment if you are to prescribe, and you need to make sure she understands the implications of using contraception and becoming sexually active. You ask her if she has any questions or concerns, and she asks a few questions but seems hesitant to discuss further.
What is the most appropriate approach?

AKT-0563

A 7-year-old boy has a one-year history of progressive weakness, finding it more difficult to stand from a sitting position and climb stairs. His maternal grandfather suffered from a similar condition but died in a motorboat accident at the age of 32. He has normal tone and reflexes in his limbs but weakness proximally in his arms and legs.
What is the most likely diagnosis?

AKT-0579

A 6-year-old boy comes to his General Practitioner with his mother and stepfather. He has a 2-month history of intermittent abdominal pain. The pain is colicky in nature and periumbilical. His appetite is slightly reduced. He is not constipated. The pain is causing him to miss some school, but he also experiences it at the weekend. The patient is otherwise normal and his height and weight are on the 50th centile.
What is the most likely diagnosis?

AKT-0564

A 6-year-old child presents clinically with mumps and has not been immunised.

Which statement is true of notifiable diseases?

AKT-0580

A 6-month-old, full-term boy presents with a four-week history of regurgitation of feeds. He is otherwise well, with a normal growth chart. Examination is also normal.
What is the most appropriate diagnosis?

AKT-0565

A 4-month-old boy presents with an eight-hour history of vomiting and inconsolable crying. He has a tender, irreducible lump in the right groin that extends into the scrotum.
What is the most likely diagnosis?