Archives: MRCGP AKT

AKT-3865

A 50-year-old lady presents to you seeking advice on how to manage her possible menopause. Her periods have been light and infrequent for a few years and stopped about three months ago. She has no significant medical or surgical history. Her family history doesn’t reveal any significant cardiovascular or thromboembolic disease, and she has never smoked. She has had two pregnancies, both resulting in healthy children. Currently, she feels well, and on further questioning, she reports experiencing mild flashes that are not bothersome. On examination, her blood pressure is 120/80, and her BMI is 23. What advice should you give her regarding her possible menopause?

AKT-3866

A 35-year-old woman is experiencing constant fatigue, sadness, and tearfulness. She is also having trouble sleeping. These symptoms have been present for the past six months. The woman gave birth to her second child eight months ago and recently lost her mother, which has made things worse. Her older child is two years old. Despite having two healthy children, she has no interest in socializing, returning to work, or engaging in sexual activity. She feels guilty about not being able to snap out of it. What is the most likely diagnosis?

AKT-3867

An 80-year-old woman is referred by a GP colleague to the hospital with a breast lump.

She is asymptomatic but her investigations reveal:

Corrected calcium 2.75 mmol/L (2.2-2.6)

Phosphate 0.81 mmol/L (0.8-1.4)

Alkaline phosphatase 115 U/L (45-105)

PTH concentration 5.7 pmol/L (0.9-5.4)

Whilst your colleague is away, you are shown these results by one of the receptionists.

What is the most likely diagnosis?

AKT-3868

A 55-year-old woman visits your office with chronic anxiety. She recently came across an article in the newspaper about breast cancer and is now concerned about her risk of developing it.

What is a known risk factor for breast cancer?

AKT-3869

A 25-year-old woman comes to the clinic complaining of vulval itch and irritation. Upon examination, an area of inflammation and excoriation is found. She has no other dermatological conditions and is in a stable relationship.

What is the appropriate management for this patient?

AKT-3870

A 56-year-old woman comes to you with complaints of post-coital bleeding. She has been in menopause for two years. Upon conducting a full pelvic examination, you find everything to be normal, including the cervix. She has been experiencing these symptoms for the past eight weeks. The patient has a history of breast cancer and is currently taking tamoxifen. What would be your next course of action?

AKT-3871

A woman aged 25 asks your practice nurse for advice on travel immunisations.

She is 16 weeks pregnant and is travelling to a rural part of Asia to visit her family as her father is very ill. She doesn’t know what vaccinations she may have had as a child and the practice doesn’t have any old records. The nurse wants to know if she can give the vaccines. Which vaccine should not be given to a pregnant woman?

AKT-3872

Which one of the following entries on a birth certificate would never be acceptable?

AKT-3875

A 21 year old vegan patient presents at 10 weeks gestation. She has a history of febrile seizures and anxiety but is not on any regular medications. She is seeking advice on whether she should take any vitamin supplements during her pregnancy. What is the most appropriate recommendation?

AKT-3876

A 20-year-old female comes in for a follow-up appointment. She had a Nexplanon implanted six months ago but has been experiencing light spotting on approximately 50% of days. Her medical history includes a first trimester abortion two years ago, but otherwise, she has no significant medical issues. A vaginal examination reveals no abnormalities, and she recently tested negative for sexually transmitted infections. What is the best course of action to take?