AKT-1472
Which of the following is the least acknowledged as a negative consequence of using phenytoin?
Archives: MRCGP AKT
AKT-1473
You are working in a GP practice, and your next patient is a female aged 35, who has recently registered. She is living in a hostel near to the practice. She has a previous medical history of anxiety and depression, and is coded to be an ex-intravenous drug user.
She reports having intensely itchy ‘lumps’ on her arms and legs for the past two weeks. Upon examination, she has multiple red bumps and raised areas on her limbs and torso, with some of these appearing in a curved line pattern. Her hands, feet, and groin are unaffected.
What is the most probable diagnosis?
AKT-1474
A 27-year-old male visits his GP after experiencing 3 episodes of prickling sensations in his left arm accompanied by involuntary jerking, lasting for a minute each time. He remains conscious during the episodes. The patient has a history of asthma and a nut allergy but is not taking any regular medications. After being referred to a neurologist, he is diagnosed with focal epilepsy and prescribed lamotrigine. What uncommon side effect should the patient be advised about, particularly in the initial 8 weeks of treatment?
AKT-1475
A 25-year-old man presents to the emergency department with a painful skin rash that started as circular lesions on his trunk and limbs and has now spread to his face, lips, and mouth. He also reports flu-like symptoms and headache. On examination, he has marked facial and lip swelling with crusty sores, blistering, and ulceration in the oral cavity, as well as an erythematous rash on the trunk with small vesicles and bullae. What medication is linked to this condition?
AKT-1476
A 29-year-old man who has recently moved to the UK from Uganda presents with complaints of fatigue and purple skin lesions all over his body. During examination, multiple raised purple lesions are observed on his trunk and arms. Additionally, smaller purple lesions are noticed in his mouth. The patient has recently begun taking acyclovir for herpes zoster infection.
What is the most probable diagnosis?
AKT-1477
A 60-year-old patient visits their doctor after experiencing an urticarial skin rash upon starting a new medication. What is the most probable cause of the rash?
AKT-1478
An obese 57-year-old man presents with a discharge from under the foreskin and a sore penis. There are small, red erosions on the glans, and the foreskin is also swollen and red. He denies any recent sexual contact. He is otherwise fit and well and doesn’t take any regular medications.
Which condition is most likely to have led to these signs and symptoms?
AKT-1479
An 80-year-old man comes to the clinic with painful swelling of his penis and a retracted foreskin. He has a long-term catheter in place. What is the most frequent cause of paraphimosis in a non-diabetic man of this age? Choose ONE answer.
AKT-1480
A 5-year-old boy presents with recurrent balanitis. He has swelling and redness of his glans penis and foreskin, and his mother reports a foul odor and slight discharge. What is the most frequently isolated organism in cases of balanitis?
AKT-1481
A 43-year-old man presents to you with complaints of tinnitus and hearing loss for the past few weeks. He has a history of chronic obstructive pulmonary disease and is currently on medications including salbutamol inhaler, azithromycin, beclomethasone-formoterol (Fostair) inhaler, tiotropium inhaler, and glycopyrronium bromide.
Upon examination, you note a positive Rinne test bilaterally with reduced hearing on both sides, worse on the left. The Weber test lateralizes to the right, and otoscopy is normal. You suspect a sensorineural hearing loss and urgently refer the patient to an ENT specialist.
Which medication from his current regimen may be contributing to his symptoms and should be discontinued?