Archives: MRCGP AKT

AKT-3934

A 35-year-old woman has been diagnosed with gestational diabetes during her second pregnancy. Despite progressing well, she has been experiencing persistent nausea and vomiting throughout her pregnancy. During her previous pregnancy, she tried metformin, but it worsened her symptoms and caused frequent loose stools. As a result, she is unwilling to take metformin again. She has made changes to her diet and lifestyle for the past two weeks.

Her recent blood test results are as follows:

– On diagnosis: Fasting plasma glucose of 6.7 mmol/L (normal range <5.6mmol/L)
– Two weeks later: Fasting plasma glucose of 6.8 mmol/L (normal range <5.3mmol/L) What should be the next step in managing her condition?

AKT-3935

A 23-year-old female contacts you seeking guidance. She missed taking her Microgynon 30 pill yesterday. For the past 14 days, she has been sexually active with her partner. She is currently on her fifth day of a new pill packet and has not missed any other pills.

What advice would you provide?

AKT-3936

A 32-year-old woman who is 36 weeks pregnant attends her routine appointment with the midwife. She reports feeling generally well, but mentions experiencing constipation and has been taking lactulose.

Upon examination, the midwife notes the following:

– Fundal height: 37cm
– Blood pressure: 140/90 mmHg
– Urine dip: protein 2+

What would be the most suitable course of action for the midwife to take in managing this patient?

AKT-3937

A 28-year-old woman is worried about her contraception. She is currently taking rigevidon but has forgotten to take the last two pills due to misplacing her medication. Her last pill-free break started 20 days ago, and she had unprotected sex 2 days ago. What is the best course of action to manage her risk of pregnancy?

AKT-3938

Sophie is a 23-year-old female who recently began taking the combined contraceptive pill due to irregular periods and starting a new relationship with her partner. However, Sophie forgot to take her pill for the past 3 days during week 2 of her cycle.

What would be the recommended course of action for management, considering Sophie’s desire to avoid pregnancy?

AKT-3939

A 27-year-old African American woman who is 28 weeks pregnant undergoes an oral glucose tolerance test (OGTT) due to her ethnicity and a history of being overweight. An ultrasound reveals that the fetus is measuring larger than expected for its gestational age. The results of the OGTT are as follows:

Time (hours) Blood glucose (mmol/l)
0 9.5
2 15.1

What would be the most suitable course of action?

AKT-3940

A 35-year-old woman with a significant family history of diabetes is currently 30 weeks pregnant in her first pregnancy.

Upon completing the oral glucose tolerance test, she has been diagnosed with gestational diabetes, with a fasting glucose level of 7.3mmol/L and a 2-hour glucose level of 9.2mmol/L.

What would be the most suitable course of action for managing this situation?

AKT-3941

A 22-year-old female patient visits the surgery seeking advice on contraception. She has a medical history of epilepsy, which is under control with carbamazepine. The patient is a non-smoker with a body mass index of 24 kg/m². There is no personal or family history of venous thromboembolism or migraine.

Based on the UKMEC guidelines, what is the most suitable contraceptive option for this patient?

AKT-3942

A 32-year-old pregnant woman presents to your clinic with concerns about her rubella status. Her sister’s child has recently been diagnosed with rubella, and she is currently 10 weeks pregnant.

What would be the initial course of action in this situation?

AKT-3943

A 30-year-old woman who is 20 weeks pregnant visits your clinic after being exposed to a child with Chickenpox, for the second time. She had received VZIG 29 days ago due to being non-immune. What is the appropriate course of action for her now?