Archives: MRCGP AKT

AKT-0953

A 4-year-old boy is brought in by his father. His father reports that he has been eating less and refusing food for the past few weeks. Despite this his father has noticed that his abdomen is distended and he has developed a ‘beer belly’. For the past year he has opened his bowels around once every other day, passing a stool of ‘normal’ consistency. There are no urinary symptoms. On examination he is on the 50th centile for height and weight. His abdomen is soft but slightly distended and a non-tender ballotable mass can be felt on the left side. His father has tried lactulose but there has no significant improvement. What is the most appropriate next step in management?

AKT-0954

A 4-year-old girl is brought in by her mother who is worried about her occasional wheezing. The child is not experiencing any symptoms at the moment and her wheezing seems to only occur during upper respiratory tract infections. There is no history of atopy in the family or the child’s medical history. The girl was previously seen by another doctor 4 months ago and was given salbutamol to use as needed, but her mother reports that it doesn’t seem to help. What should be the next appropriate step to take?

AKT-0955

Which of the following conditions is NOT inherited in an X-linked recessive fashion?

AKT-0956

A 15-month old girl is brought to you by her father, concerned about her fine motor skills development. She was born at term without any complications during pregnancy or delivery. Her father feels that she is not progressing in the same way as her older siblings did at this age.

At 12 months old, she was able to pick up small objects using her thumb and index finger. What is the next fine motor developmental milestone that you would expect this child to have achieved by now?

AKT-0957

A 3-year-old girl presents with a 2-day history of right sided limp and reluctance to weight bear. She has been distressed, excessively sweaty and febrile overnight. She looks unwell and has a temperature of 38.9ºC. She refuses to walk but will lie on the couch to be examined; she is warm to the touch and there is erythema over her right hip. She is distressed when you check the range of movement in the right hip, the left hip examination is unremarkable. Her mother thinks her symptoms started following a fall in the garden 2 days ago. What is the most likely diagnosis?

AKT-0958

You see a 3-year-old girl with her mother. She has been coughing loudly since 3am this morning and her mother describes it as a barking cough. She has had a cold but is otherwise healthy. Today, she seems better but her mother wanted to have her checked out as she appeared more unwell during the night.

During the examination, the girl appears well and has a normal body temperature. Her breathing is normal and her heart rate and respiratory rate are within normal limits. Her throat is red and her eardrums are slightly pink but not bulging.

Based on the history, you suspect that the girl has mild croup and discuss this with her mother. She asks about the cause of croup. What is the primary pathogen responsible for most cases of croup?

AKT-0959

A 6-year-old boy is admitted to surgery with a worsening of his asthma symptoms. According to the British Thoracic Society guidelines, it is classified as a moderate attack. How should his salbutamol inhaler and spacer device be used correctly?

AKT-0960

A 35-year-old woman comes in for a postnatal check-up after an emergency C-section 10 weeks ago. She has also scheduled her baby’s first set of routine immunizations for today. During the appointment, she inquires about the MenB vaccine and asks when it is typically administered.

AKT-0961

A father brings his 3-year-old home-schooled daughter to a pediatrician concerned about her developmental progress, particularly her physical abilities. He mentions that his friends’ children her age are able to climb stairs, throw a ball, dress themselves partially, and ride a tricycle. However, his daughter is unable to do any of these things. During the examination, she is only able to stack four blocks and can draw a straight line. She speaks in 2-word phrases, with no being a common response, and imitates frequently. Based on her abilities, what is her developmental age?

AKT-0941

A mother brings her 2-year-old daughter to see you as she thinks she is experiencing a lot of pain in her mouth. Upon conducting a thorough assessment of the healthy child, you observe a swollen and tender upper gum with no other abnormalities and diagnose her with teething. What would be the most appropriate advice to give in this situation?