Archives: MRCGP AKT

AKT-1110

You see a 5-year-old girl with her mother. The girl has obvious burns on her feet. Her mother explains that hot water from the kettle splashed on her accidentally. A few days later you see her with her stepfather who says that she got into a bath that was too hot. The pattern of the burns is not consistent with either explanation.

You are concerned and think about contacting the child protection team.

You discuss with your colleagues and debate what should be the primary concern in this circumstance.

Which one of the following should be your primary concern?

AKT-1091

You see a 3-year-old child in your surgery with purple bruises in several different locations. Mum says that the child fell down stairs a week ago.

What age are bruises that are purple in colour?

AKT-1092

A 50-year-old truck driver presents for a follow-up appointment after being diagnosed with epilepsy. The specialist has determined that he is experiencing ‘absence’ seizures and has advised him that he is not fit to drive. Despite this, the patient admits to continuing to drive his truck and disagrees with the diagnosis. He has not informed the DVLA about his seizures. You explain to him his legal obligation to inform the DVLA and the dangers of driving with his condition. He understands but insists on continuing to drive and declines your offer to speak to a friend or family member. What is the best course of action in managing this situation?

AKT-1093

A 27-year-old GP trainee, who has been with the surgery for the past three months, announces that she is four months pregnant and would like to return to the practice one year after the birth of her child, then working only part time for the next two years.

Which one of the following is true with respect to your obligations?

AKT-1094

What is a Roger Neighbour ‘checkpoint’?

AKT-1095

You review a 56-year-old man who complains of epigastric pain radiating to his back. He has lost 6 kg in weight in the past three months.

On examination he has jaundiced sclera and looks emaciated. There is the suspicion of an epigastric mass on abdominal examination.

What is the most appropriate management plan for this patient?

AKT-1096

The practice nurse comes to see you. In her consulting room a carer has brought in a 13-month-old boy for his routine immunisations.
Which one of the following people doesn’t have the right to consent to the immunisations?

AKT-1097

You are creating a teaching presentation and need to include images in your slides. The presentation will be for students in your class and you also plan to share it with students in another class via video-conference.
Under what circumstances is it necessary to obtain patient consent before displaying images related to patients?

AKT-1098

Your friend and colleague, a 60-year-old nurse at the practice, asks for your help. She reports dysuria and frequency. These symptoms are typical of previous UTIs which she typically gets once a year. There is no haematuria, fevers or loin pain and she feels systemically well. She reports that it is difficult to get an appointment with her own practice and doesn’t want to take time off work. She says she will see her GP but doesn’t want to delay treatment as it has become worse in the past.

What would be the most appropriate next step for a 60-year-old nurse who reports dysuria and frequency, typical of previous UTIs, but is having difficulty getting an appointment with her own practice and doesn’t want to take time off work? She feels systemically well and there is no haematuria, fevers or loin pain, but doesn’t want to delay treatment as it has become worse in the past.

AKT-1099

You usually get a box of chocolates every birthday from a particular friend’s family. This year, you receive a deluxe collection from an expensive retailer from the family and you are astonished to see that it costs £110.

What would be the next most appropriate step?