Archives: MRCGP AKT

AKT-0923

A 5-year-old girl, who has been wetting the bed at night attends surgery today with her father, as her mother is at work. Her father is worried because it was also an issue for her older sister, who is 10-years-old and she is prescribed desmopressin. The girl in front of you is otherwise well and her bowels open regularly. An examination is unremarkable and she has a soft non-tender abdomen.

What recommendations would you make?

AKT-0924

A 25-year-old nanny, Sarah, cares for 5 different children during the week. What is a concerning sign to look out for in one of her charges?

AKT-0925

You are working in a Saturday morning clinic and a mother brings in her 10-year-old daughter who has developed new pustular, honey-coloured crusted lesions over her chin. She is otherwise healthy with normal vital signs and no evidence of lymphadenopathy on examination. She has no known allergies to any medications and is usually in good health.

You diagnose localised non-bullous impetigo.

The daughter is scheduled to go on a field trip to the zoo the next day and is very excited about it. The mother asks if it is safe for her daughter to go on the field trip.

What is your plan for managing this situation?

AKT-0926

Liam is a 9 month old infant who has been experiencing coryzal symptoms for the past 4 days. Despite this, he seems to be in good spirits and his physical examination is normal. He is playing with his toys and seems to favor using his left hand. What is the appropriate course of action?

AKT-0927

A 2-year-old girl with a barking cough is diagnosed with croup. However, she is feeding well and has only a low-grade fever of 37.9ºC. No intercostal recession is observed during examination. The decision is made to manage her in primary care. What is the best course of action?

AKT-0928

You assess an 8-year-old boy who was released from hospital 3 days ago after undergoing a tonsillectomy. His mother reports that he is experiencing a ‘sore throat’ despite taking both paracetamol and ibuprofen simultaneously. They were informed to anticipate some discomfort for approximately 5-7 days but are seeking your assistance in prescribing something to alleviate the pain. Physical examination reveals no abnormalities.

What is the best recommendation for pain relief?

AKT-0929

A 2-year-old girl is presented by her father who is concerned about a rash that appeared after a recent fever, as she was recovering.

During the examination, you observe numerous pink-red papules and macules (2-5 mm in size) spread across the trunk, which disappear when pressed. The child seems unaffected by them and appears healthy with regular vital signs.

What is the probable diagnosis?

AKT-0930

Liam is a 6-year-old boy who visits you with his father complaining of dysuria, frequency, and fever. During the urine dip test, nitrites and leukocytes are detected. Liam has no known allergies and is in good health otherwise. You decide to prescribe trimethoprim (50 mg/5ml). His current weight is 20 kg. According to the BNF, the recommended dosage is 4 mg/kg trimethoprim twice daily. What volume will you instruct his father to administer?

AKT-0931

A 7-year-old girl presents to your clinic with a blanching rash that started on her abdomen and chest before spreading to her neck, legs, and arms. The rash is rough and has a sandpaper-like texture. She reports feeling feverish with a temperature of 38.5 ºC, a sore throat, and nausea two days before the rash appeared. On examination, you note her tongue has a beefy, red appearance and prominent cervical lymphadenopathy. You suspect scarlet fever. The patient has no significant medical history and no allergies. Hospital admission is not necessary. What is the most appropriate management option in primary care?