MRCGP AKT Category: Children And Young People

AKT-0521

A 7-year-old girl has recently been seen by the dermatologists.
She had some scalp scrapings and hair samples sent to the laboratory for analysis following a clinical diagnosis of tinea capitis. The laboratory results confirmed the diagnosis of tinea capitis and the dermatologists faxed through a letter asking you to prescribe griseofulvin suspension at a dose of 12 mg/kg once daily.
The child weighs 20 kg. Griseofulvin suspension is dispensed at a concentration of 125 mg/5 ml.
What is the correct dosage of griseofulvin in millilitres to prescribe?

AKT-0506

An 8-year-old boy comes to the General Practitioner with his father complaining of bed-wetting, thirst and increasing lethargy for the past 2 weeks. The father reports that his son has lost some weight. The patient appears healthy and the examination is normal. Urinalysis reveals 4+ glucose and moderate ketones. His capillary blood glucose level is 16 mmol/l.
What is the most suitable course of action?

AKT-0522

A 6-year-old boy with a medical history of asthma is seen as an emergency with an acute exacerbation.

He has widespread wheeze on auscultation of the chest despite regular use of his salbutamol inhaler via a spacer. There is no respiratory distress and he is suitable to be managed in the community. You decide to prescribe him a three day course of prednisolone.

He weighs 20 kg. You decide to give him a dose of 2 mg/kg once daily. Prednisolone soluble tablets come as 5 mg tablets.

What is the correct dosage of prednisolone soluble tablets to prescribe?

AKT-0507

Which medical conditions are included in the February 2022 UK immunisation schedule for receiving the Meningococcal ACWY vaccine?

AKT-0523

You are reviewing a 4-year-old boy who is under the paediatric cardiologists with a congenital heart condition. He is prescribed propranolol.

The latest hospital letter following a recent appointment has advised an increase in his dosage from 0.25 mg/kg three times daily to a dose of 0.5 mg/kg three times daily.

His current weight is 15 kg. Propranolol oral solution is dispensed at a concentration of 5 mg/5 ml.

What is the correct dosage in millilitres to prescribe?

AKT-0508

A 9-month-old girl has gradually become more short of breath following an upper respiratory tract infection and her mother is very worried about her. What is the single finding on examination that is a high-risk sign rather than an intermediate sign?

AKT-0509

A 4-year-old girl presents as febrile. On examination, there are no focal symptoms to suggest the site of an infection.
According to NICE guidelines, which of the following is most appropriate in regards for the need for urgent admission to hospital?

AKT-0510

A 4-year-old boy is brought to the General Practitioner (GP) by his mother because he is experiencing diarrhoea and vomiting. He has no significant medical history and has been unwell for 48 hours with fever (up to 38.5 °C) and gastroenteritis symptoms. The GP examines the child.
Which of the following findings would most strongly suggest the need for urgent admission to hospital?

AKT-0511

A 10-year-old girl presents to the GP with fever, vomiting and dysuria. Upon examination, she has right renal angle and bladder tenderness and is pyrexial at 38.2°C. Co-amoxiclav is prescribed and urine microscopy and culture is arranged. The following investigations are conducted: Haemoglobin 120 g/L (115-165), White cell count 13.2 ×109/L (4-11), Platelets 140 ×109/L (150-400), Sodium 139 mmol/L (137-144), Potassium 5.1 mmol/L (3.5-4.9), Creatinine 130 µmol/L (60-110), and MSU: blood++, protein+, enterococcus faecalis isolated. What is the most appropriate imaging investigation for this patient?

AKT-0512

What is a condition that is not included in the routine immunisation schedule in the United Kingdom?