MRCGP AKT Category: Evidence Based Practice, Research And Sharing Knowledge

AKT-2036

A 54-year-old businessman has just registered with your practice and has asked the receptionists for an appointment to discuss prevention of cardiovascular disease.

He was generally well but had suffered a myocardial infarction six months ago whilst on business in South Africa. He was diagnosed with diabetes three years ago and is on diet control alone.

He had an eight year history of hypertension with a blood pressure of 150/90 mmHg. He was obese with a BMI of 34 kg/m2.

Investigations reveal:

Total cholesterol 5.0 mmol/L (<5.2) Which would be the most appropriate management?

AKT-2021

Which of the following is a risk factor for bowel cancer?

AKT-2022

What is the highest ranked source of evidence in the hierarchy of evidence based medicine?

AKT-2023

A 60-year-old man with a BMI of 32 kg/m2 has uncontrolled hypertension, with a blood pressure of 165/88 mmHg. He doesn’t currently receive treatment for his hypertension.

He has normal glucose tolerance (no evidence of impaired fasting glycaemia, impaired glucose tolerance or diabetes).

When considering treatment of his hypertension which of these drugs has been shown to be associated with an increase in the risk of developing diabetes compared with an ACE inhibitor or ARB?

AKT-2024

You plan to look at the effectiveness of a Chlamydia screening programme on detection rates for the disease among teenagers at the clinic.

The research is designed to look merely at detection rates, not the effectiveness of treatment.

Which of the following is true with respect to rules around ethical approval and consent for this project?

AKT-2009

A 50-year-old woman with chronic pain is undergoing evaluation. The effectiveness of pain management strategies is discussed with her, but she expresses doubt about the data. Upon closer examination, studies are presented that include a visual pain scale with paired data before and after non-pharmacological interventions are implemented. The data reveals a negative skew towards reduced pain levels with the use of non-pharmacological pain management techniques.

What statistical test would be appropriate to demonstrate the efficacy of this approach in managing pain?

AKT-2025

A study of individuals with cognitive impairment was conducted. The 112 participants who underwent program A demonstrated an average increase of 6 points in their IQ score. On the other hand, the 115 participants who underwent program B showed an average increase of 4 points in their IQ score. The p value was greater than 0.05. What is accurate?

AKT-2010

A trial is proposed to see whether excess alcohol use is a risk factor for osteoporosis. It is decided to perform a case-control study rather than a cohort study.

What is an advantage of a case-control study?

AKT-2026

A 68-year-old male presents with a productive cough with regular sputum production, wheeze and breathlessness on exertion.

On examination his FEV1 is 75% of predicted with no diurnal variation. He has smoked 30 cigarettes a day for the past 50 years.

What is considered to be the most appropriate aspect of the long term management in this patient?

AKT-2011

A 25-year-old man presents to the clinic with symptoms of acute sinusitis. He had a severe cold 10 days ago and thought he was recovering, but now has pain over his left cheek and a purulent nasal discharge, more pronounced from the left nostril. On examination, he is febrile with a temperature of 38.5°C and is tender when pressure is applied over the left maxilla. As he is feeling unwell, you decide to prescribe antibiotics, but he has a penicillin allergy. What would be your approach to treating this patient?