Archives: MRCGP AKT

AKT-3856

A 26-year-old lady presented 48hrs ago with a tender swelling in her left breast. She was prescribed flucloxacillin but her symptoms have failed to settle. She had been Breastfeeding her baby for three weeks and was well until four days prior to being seen when she noted a painful swelling developing.

On examination there was a tender, erythematous, warm area in the left breast. She has been fully compliant with her medication and an alternative diagnosis appears unlikely on clinical grounds.

What is the appropriate management for this patient?

AKT-3857

A 25-year-old female presents 16 weeks into her pregnancy with a vaginal discharge. Further investigation confirms infection with Chlamydia trachomatis.

Which of the following is the most appropriate treatment for this patient?

AKT-3826

A 32-year-old woman has come to see you to discuss the results of her smear test.

Unfortunately, the sample was inadequate and needs to be repeated.

How soon after the initial smear should she have the repeat smear taken?

AKT-3830

A 16-year-old primigravida reports experiencing constipation and arthralgia during her 28th week of pregnancy. Several biochemical tests are conducted, but which one holds clinical significance?

AKT-3831

A 25-year-old woman presents with secondary amenorrhoea and galactorrhoea.

What is the most appropriate first investigation to perform?

AKT-3832

What were the primary care lessons highlighted in the Confidential Enquiry into Maternal Deaths 2018 report?

AKT-3833

A 32-year-old woman is seen for review with her baby six weeks postpartum. She is using the lactational amenorrheoic method (LAM) for contraception.
Which of the following should she be advised may increase her risk of pregnancy?

AKT-3834

A 27-year-old female who is approximately 5 weeks pregnant presents to her GP. She reports a two-day history of scanty brownish discharge that resembled old blood; the bleeding has since stopped. She describes no associated abdominal or pelvic pain, has had no syncopal symptoms and no shoulder tip pain. She otherwise feels well.

On examination, she is haemodynamically stable, there is no abdominal or pelvic tenderness. Urine βHCG is positive.

As per NICE guidelines, what is the most appropriate course of action?

AKT-3835

A 28-year-old woman presents with classic signs of a lower urinary tract infection that developed after having sex with a new partner.

What is the most suitable course of action for this patient?

AKT-3836

A 20-year-old girl presents at the antenatal clinic.
She is approximately six weeks pregnant and the pregnancy was unplanned. She has a two year history of grand mal epilepsy for which she takes carbamazepine. She has had no fits for approximately six months. She wants to continue with her pregnancy if it is safe to do so.
She is worried about the anticonvulsant therapy and its effects on the baby. She asks how she should be managed.
Which of the following management plans is the most appropriate in this case?