AKT-1777
A 68-year-old man has metastatic prostate cancer. Because he is now experiencing excessive fatigue, some routine blood tests are performed.
Which of the following findings would raise the most concern?
Archives: MRCGP AKT
AKT-1778
A 63-year-old man currently under the care of local cancer services, and being treated with chemotherapy for Non-Hodgkin’s lymphoma, presents to the general practice clinic with a cough and sore throat, which have persisted for two days.
On examination, his temperature is 38.2 oC. His pulse is 88 bpm, while his blood pressure (BP) is 110/65 mmHg. His respiratory rate is 20 breaths per minute, while his oxygen saturations are 97% on air. He is alert and his chest examination is normal. He has no known allergies.
What is the most appropriate next step in this patient’s management?
AKT-1751
Sophie is a 84-year-old woman with a history of osteoporosis and arthritis who was discharged from hospital 4 weeks ago following a hip replacement surgery. Her GP last saw her during a home visit 3 days after discharge. She had been regularly seen by the district nurse since then. Unfortunately, she had declined significantly since her hospital admission and was found dead by her daughter this morning.
What is the appropriate course of action for the GP regarding Sophie’s death certificate?
AKT-1752
A 75-year-old man has been recently diagnosed with terminal pancreatic cancer. His son attends with the patient and requests more support at home. When would it be appropriate to complete a DS1500 form?
AKT-1753
You assess a 65-year-old man with motor neuron disease. He mentions that he intends to travel to Switzerland for euthanasia if his condition worsens. What would be your initial response?
AKT-1754
You are tasked with completing a death certificate for an 85-year-old patient under your care. She passed away yesterday due to pneumonia at home, following a joint decision made by her family and medical team not to admit her to the hospital for further treatment. The patient had a history of dementia and osteoporosis, and you had last assessed her two days prior.
The patient had recently undergone surgery for a fractured neck of femur, which she sustained after tripping on a step at home. Although her surgery had been successful and she had been recovering well, she began experiencing respiratory symptoms shortly after being discharged from the hospital. What is the appropriate course of action regarding the completion of the death certificate?
AKT-1755
As a member of staff at a GP practice, your supervising GP begins discussing the coroner’s responsibilities and when it is necessary to refer deceased patients to them. She asks you to identify which of the following cases should be referred to the coroner for an autopsy:
A patient in their 90s who passed away peacefully in their sleep at home.
Please indicate which case requires referral to the coroner.
AKT-1756
You are evaluating a patient with advanced breast cancer. The patient has asked you to fill out a DS1500 form. When is it appropriate to complete this form?
AKT-1757
The District Nurse requests a prescription for a syringe driver for a patient you assessed earlier in the day. The patient, who is in their late 70s, is dying from metastatic renal cancer. You recommend a 24-hour dose of 60mg of diamorphine. Please provide the correct wording for the prescription.
AKT-1758
You receive a call from the Coroner’s officer regarding the sudden death of a patient you were treating. Upon reviewing your written report on the patient’s care, you are summoned to appear in person at the Coroner’s court to provide evidence, along with other healthcare professionals who also treated the patient. What is the purpose of this procedure?