Archives: MRCGP AKT

AKT-1585

A 28-year-old man comes in for a routine check-up with his GP. He is a non-smoker and has been feeling generally well. However, he has noticed that his gums have been bleeding when he brushes his teeth. He admits that he has been under a lot of stress lately and has not been brushing his teeth as regularly as he should.

Upon examination, there are no signs of ulceration or leukoplakia. The margins of his gums appear red but are not actively bleeding. There is no evidence of a dental abscess, and he has no fever.

What would be the most appropriate course of action based on his current presentation?

AKT-1586

Sarah is a 52-year-old woman who presents to you with a 4 month history of nasal congestion affecting her left nostril. She reports a reduction in her sense of smell on the left side as well. Her symptoms have been gradually worsening. Sarah is a non-smoker.

Upon examination, there is slight mucosal oedema but no significant nasal inflammation. There are no focal neurological signs.

What is the most appropriate initial management option?

AKT-1587

Samantha, aged 55, presents with sudden onset dizziness described as ‘the room spinning’ which started three days ago. She has been unable to leave her home due to constant dizziness and nausea that accompanies it. She reports that movement seems to worsen her symptoms and denies any changes to her hearing. Apart from a recent cold, she has had no other health problems in recent years and has no past medical history except for a hysterectomy ten years ago.

After conducting a Dix-Hallpike test and examining her ear canals, which both proved normal, you diagnose her with vestibular neuronitis. She asks if there is anything she can take to alleviate her symptoms.

What advice would you give her?

AKT-1588

You diagnose a middle-aged man with a left-sided sudden-onset sensorineural hearing loss that started 12 hours ago during your joint clinic with a medical student and refer directly to ENT who diagnose an idiopathic sudden-onset sensorineural hearing loss and begin treatment. Your medical student asks what will happen next for the patient.

What is the most suitable medication for treatment?

AKT-1589

A 25-year-old female complains of painful chewing and clicking in her jaw accompanied by a squeezing headache. She denies any joint pains and appears to be in good health. During the examination, she was able to open her mouth normally but experienced pain when opening wider. Mild pain was observed upon palpation of the area, and her temperature was 36.4ºC. What is the best course of action?

AKT-1590

You have a follow-up appointment with a 4-year-old boy. He was seen two weeks ago for left-sided ear pain and discharge, for which you prescribed amoxicillin. Today, his mother reports that he has improved and she has been able to keep his ear dry. However, upon examination of the left ear, a tympanic membrane perforation is observed. What should be done next?

AKT-1591

A 65-year-old man visits the clinic with a complaint of painful gums. Upon examination, he is found to have gingival hyperplasia. Which medication is the most probable cause of this condition?

AKT-1592

A 9-year-old girl undergoes pinnaplasty.
What is the most significant risk of the surgery that should be discussed with her parents?

AKT-1593

A 70-year-old man visits his doctor after his family complains about his hearing loss. He claims that they speak too softly, but admits that he struggles to hear in noisy settings. The patient reports feeling generally healthy, but has a history of hypertension and chronic obstructive pulmonary disease.

During the examination, the doctor discovers bilateral sensorineural hearing loss. Presbycusis is suspected as the cause and the patient is referred for audiometric testing.

What is the expected audiogram pattern for this individual?

AKT-1594

A 29-year-old man contacts his GP seeking advice for his seasonal allergic rhinitis. He has been managing his symptoms with intranasal decongestants, but lately, he has noticed that they are only partially effective. He experiences a runny nose and occasional sneezing, but there are no red flag symptoms such as unilateral obstruction or cacosmia. He has already taken the maximum dose of over-the-counter decongestants and is wondering if the GP can prescribe a higher dose.