MRCGP AKT Category: Mental Health

AKT-4284

A 27-year-old woman was admitted to hospital after she took a paracetamol overdose. She was given a treatment dose of N-acetylcysteine and her baseline and repeat biochemical and haematological indices were normal. She doesn’t enjoy her work as a secretary, and she has a regular partner but they have been arguing recently. She didn’t intend to kill herself. She denies regularly using alcohol and illicit drugs. She has a past history of an aspirin ‘overdose’, but you note that at the time the blood level was very low and she was not admitted. There is no other significant past medical history. Her parents are divorced and she lives with her mother.
Select from the list the SINGLE FACTOR in the history that suggests she is likely to repeat this behaviour.

AKT-4285

A 75-year-old woman is concerned about the possibility of developing dementia. What are the typical initial symptoms of Alzheimer’s disease?

AKT-4286

A 24-year-old woman is brought to the practice by her mother who is extremely concerned.

For the past three months, she has been low in mood and over the last three weeks is increasingly withdrawn. She has stopped going to work and her evening fitness classes, has lost weight and has eaten nothing for two days. She is not sleeping and is unable to concentrate for any length of time. She had expressed feelings of guilt and hopelessness to her mother but is now barely speaking at all.

She is usually bright and cheerful. Her father has a history of severe depression. Her engagement was broken off about four months ago. She doesn’t have any children.

How should this situation be managed?

AKT-4287

You see a 26-year-old male patient with erectile dysfunction. He is typically healthy and doesn’t take any regular medications. He is a non-smoker and drinks alcohol in moderation.

You proceed to gather a more comprehensive history of his issue and conduct a thorough psychosexual evaluation.

Which of the following history findings would indicate a psychogenic origin rather than an organic cause for his condition?

AKT-4288

You see a 20-year-old male patient who is worried about his erections. He has been experiencing problems for the past 8 months. He is generally healthy with no medical history. He doesn’t use any illegal drugs and is a non-smoker. He drinks occasionally on weekends. He lives with his parents and has recently started dating a girl from his university.

Which of the following history findings would indicate a psychogenic cause rather than an organic cause for his erectile dysfunction?

AKT-4289

A 39-year-old man complains of ongoing fatigue over the last 10 months. What is the least indicative feature for a diagnosis of chronic fatigue syndrome?

AKT-4290

Olivia is a 27 year old who comes to you with symptoms of severe obsessive compulsive disorder (OCD). As per NICE guidelines, what is the recommended first line pharmacological treatment for OCD?

AKT-4291

A 22-year-old college student presents with insomnia, anxiety, and flashbacks. She experienced a traumatic event two weeks ago when a young man demanded her phone and purse while she was walking home from a party. She was alone and feared for her safety. Since then, she has been struggling with nightmares and flashbacks, which have disrupted her sleep. She has also been avoiding going out alone. Can you prescribe something to help her sleep?

Is this response appropriate for a patient who has experienced a traumatic event?

AKT-4292

A 42-year-old man was robbed two weeks ago while walking home alone. He frequently experiences flashbacks of the incident. His companions have observed that he is more cautious of his environment when they accompany him. He is having difficulty sleeping and refrains from going out by himself.

What is the probable diagnosis?

AKT-4293

A 30-year-old female presents after her partner encouraged her to see the GP. She has had hyperarousal to loud noises and difficulty concentrating at work following a car accident 4 weeks ago. Her partner did some reading online and feels she is suffering from an acute stress disorder. You advise her that she has post-traumatic stress disorder (PTSD) and discuss treatment options. She asks what the difference is, so that she can explain it to her partner. You advise there are similarities in the presentation and the main difference is temporal.

At what point after the event can you confirm a diagnosis of PTSD?