Archives: MRCGP AKT

AKT-3815

You are requested by the community midwives to assess a 26-year-old woman who was discharged four days ago following the delivery of her first child via caesarean section. The infant is healthy. During the examination, she complains of diffuse tenderness in her abdomen, especially around her caesarean scar. She has a fever of 38.1°C and is experiencing a bloody discharge per vaginum, which has a notably strong odour.
What is the most significant risk factor associated with postpartum infection?

AKT-3816

A 25-year-old patient with complex partial seizures controlled with carbamazepine is 32 weeks pregnant.

She has not had a seizure throughout pregnancy. She expresses a wish to breastfeed, but is concerned that the carbamazepine may affect her child.

What advice should be given to her?

AKT-3817

A 30-year-old woman has had four previous live births.

Twenty weeks into her fifth pregnancy she presents with diffuse lower abdominal pain.

On examination she is tender in the suprapubic area. She has a fundal height of 28 cm and there is a firm mass related to the uterus. She has urinary frequency but no dysuria. Only one fetal heart is heard.

What is the most likely diagnosis?

AKT-3818

A 35-year-old patient presents to you for pre-pregnancy counseling and inquires about folic acid supplementation. The patient has a medical history of sickle cell disease and reports taking folic acid once a week. What recommendations would you make regarding the dose and duration of folic acid supplementation?

AKT-3819

A 25-year-old patient presents to you for a contraceptive pill review. She is considering discontinuing her pill to start a family and seeks your guidance on folic acid intake. She has no other medical conditions and is not taking any other medications.

What recommendations would you make regarding the dosage and duration of folic acid supplementation?

AKT-3820

A 48-year-old woman comes to see you to discuss her contraception. She has been using the progestogen-only pill for the past 4 years. She is currently amenorrhoeic. She is not sure how long she should continue to use contraception for and asks your advice.

She was seen two months ago by a colleague who advised her to have her FSH levels checked. This has shown an FSH level of 42 (normal range: less than 30).

What do you advise?

AKT-3821

A 28-year-old female presents with dysuria and vaginal discharge which has deteriorated over the past week. She is in a steady relationship and uses the oral contraceptive pill. Her partner is asymptomatic.

She has a temperature of 37.5°C. Vaginal examination reveals tenderness with an inflamed cervix and a purulent discharge, culture of which reveals Gram negative diplococci.

What is the probable diagnosis?

AKT-3801

A 17-year-old girl comes in with a magazine clipping and requests a prescription for Cerazette (desogestrel) progesterone-only contraceptive.

With regard to Cerazette, which one of these statements is true?

AKT-3802

A 32-year-old woman contacts the clinic seeking guidance regarding her cervical screening invitation, which indicates that her cervical screening test is now due. She has consistently attended screening and has never received an abnormal result. She is presently 28 weeks pregnant, and there is no significant obstetric or gynaecological history. When should she schedule her cervical screening test?

AKT-3803

What changes can occur in uterine fibromyomata?