AKT-5529
A 78-year-old male presents with cognitive impairment and is diagnosed with dementia.
Which of the following is the most probable cause of the dementia?
Archives: MRCGP AKT
AKT-5538
An 80-year-old man is accompanied by his family who are worried about his memory and behavior in the last six months. To rule out any reversible causes, a cognitive assessment is conducted which appears to validate the family’s apprehensions. A set of blood tests are ordered, including a complete blood count, liver function tests, urea and electrolytes, and bone profile. What other blood tests should be requested?
AKT-5525
A 68-year-old male patient mentions to you, in passing, that he is worried he might have a stroke.
Which of the following is the single, strongest risk factor for developing a stroke?
AKT-5534
Which of the following is not a known cause of acute pancreatitis in elderly patients?
AKT-5521
A 72-year-old man is admitted to hospital with shortness of breath. He is diagnosed with atrial fibrillation and heart failure.
Whilst in hospital he is started on:
Aspirin 75 mg OD
Simvastatin 40 mg ON
Bisoprolol 5 mg OD
Digoxin 125 mcg OD
Ramipril 10 mg OD and
Furosemide 40 mg OD.
He comes to see you a few days after discharge complaining of feeling generally unwell. His wife tells you that he has been a bit confused and that he has vomited on several occasions. The patient also reports that his vision is blurred and has a yellow tinge to it.
On examination, he is in atrial fibrillation at a rate of 60 beats per minute, his chest is clear and he has minimal pedal oedema.
He was seen two days ago by the practice nurse for blood tests.
The results showed
Sodium 136 mmol/L (137 – 144)
Potassium 2.8 mmol/L (3.5 – 4.9)
Urea 6.4 mmol/L (2.5 – 7.5)
Creatinine 124 μmol/L (60 – 110)
What is the underlying cause of his unwellness?
AKT-5535
You refer a 50-year-old patient with suspected dementia to the Memory clinic after a mini-mental state exam indicates mild cognitive impairment. A dementia blood screen performed by yourself is normal. What is the most appropriate role of neuroimaging in the evaluation of patients with suspected dementia?
AKT-5528
Which statement is accurate regarding the evaluation of a patient’s ability to make decisions?
AKT-5531
A 72-year-old man with a medical history of hypertension, type 2 diabetes and hypercholesterolaemia presents as an emergency. He was at home four days ago when he experienced slurred speech and weakness in his right arm. His wife noticed that his face appeared droopy on one side and he had difficulty raising his right arm. The episode lasted for about 90 minutes before resolving on its own. His wife ignored it, but his son insisted that they bring him to the clinic. On examination, his blood pressure is 160/90 mmHg, he is in sinus rhythm at 70 bpm, and there are no focal neurological findings. He takes aspirin 75 mg daily. The diagnosis is a transient ischaemic attack. What is the most appropriate management plan?
AKT-5532
A 72-year-old lady comes to your clinic complaining of headaches that have been bothering her for the past four months. She reports that the pain is located over the right fronto-parietal area and describes it as a constant dull ache that is worse at night and sometimes wakes her up from sleep. She has tried taking paracetamol, but it hasn’t provided much relief. She denies experiencing any nausea, vomiting, loss of consciousness, seizures, forgetfulness, or tinnitus. Her medical history includes breast cancer at the age of 35, which required a right mastectomy. She has been managing her hypertension with amlodipine 10 mg daily for the past ten years. On examination, there is evidence of mild osteoarthritis in several joints, a right-sided mastectomy scar, and no neurological abnormalities or papilloedema. What is the next step in managing this patient?
AKT-5530
A 68-year-old man presents to the clinic with his wife. She is worried about his significant cognitive decline over the past few months. Throughout the day, his level of consciousness fluctuates greatly, and he often sleeps for two hours or more. One of your colleagues prescribed him benzodiazepines to aid his sleep, and he reportedly drinks a glass of whisky in the evening. Additionally, there are concerns about visual hallucinations. During the examination, you observe signs of Parkinsonism.
What is the most probable diagnosis?