Archives: MRCGP AKT

AKT-0844

As a GP in central London, you see a 10-year-old Polish boy with his mother. The mother reports that her son has been feeling unwell for the past four days with a runny nose and sticky eyes. Yesterday, he developed a fever of 39.1 ºC and a rash on his face. The rash has now spread all over his body, and he has lost his appetite but is drinking well. When asked about his immunization history, the mother is unsure of what he has had.

During the examination, the patient appears coryzal and has small white spots on the inside of his cheeks. He also has a rash with flat red blotches on his face and brown blotches on his torso. All his observations are within normal limits. Based on these findings, you suspect that the patient has measles.

The mother asks how long her son needs to stay off school.

AKT-0845

Oliver is an 8-year-old boy brought in by his mother with a 2 day history of fever and sore throat. Today he has developed a rash on his torso. He is eating and drinking well, but has not been to school for the last 2 days and has been feeling tired.

On examination, Oliver is alert, smiling and playful. He has a temperature of 37.8°C. His throat appears red with petechiae on the hard and soft palate and his tongue is covered with a white coat through which red papillae are visible. There is a blanching rash present on his trunk which is red and punctate with a rough, sandpaper-like texture.

What is the appropriate time for Oliver to return to school based on the most likely diagnosis?

AKT-0846

Samantha is a 6-year-old girl who has presented with symptoms of high fever, white spots on the mouth, conjunctival injection, and a blotchy red rash. You suspect measles infection. Her father asks how many days she should stay home from school?

AKT-0847

A parent brings her 2-year-old daughter for her routine vaccinations. What would be a contraindication for her to receive the vaccinations?

AKT-0848

A 3-month-old girl is brought to the morning clinic by her father. Since yesterday she has been taking reduced feeds and has been ‘not her usual self’. On examination the baby appears well but has a low-grade temperature of 38.2ºC. What is the most suitable course of action?

AKT-0849

You receive a call from the mother of a 2-year-old boy who has been suffering from a suspected viral upper respiratory tract infection for the past few days. The mother reports that the child has just had a seizure, and three months ago, he had a confirmed febrile convulsion after a similar illness. You schedule an appointment to see the child that morning. What factor should indicate the need for referral to paediatrics?

AKT-0850

A mother of a 12-week-old baby expresses concern that her baby has been acting differently for the past day. The baby is not smiling as much and is having 20% fewer breastfeeds. The baby was born at full term without any complications, has been thriving well, and has received all of his immunizations. During examination, the only notable finding is a temperature of 38.5ºC. What would be the best initial course of action in managing this situation?

AKT-0851

A 6-year-old boy is seen by his doctor for inadequate asthma management. He is currently on a daily steroid inhaler (Clenil – 50 mcg, two puffs twice a day) and uses a salbutamol inhaler as needed. What should be the next course of action in his treatment plan?

AKT-0852

A mother brings her 10 week old baby to your morning GP clinic with a three day history of noisy breathing, coryza, reduced feeding, and increased fussiness. What signs would prompt you to consider admitting the infant?

AKT-0853

The mother of a 6-year-old girl contacts you for a prescription. During the night, the child had complained of an itchy bottom, and upon inspection, the parents found a few live tiny white worms near the anus. What advice should you give regarding household contacts?

Advice: It is important to treat all household contacts, including parents and siblings, as they may also be infected with the same type of worm. They should also practice good hygiene, such as washing hands regularly and keeping fingernails short, to prevent the spread of infection. Additionally, it may be helpful to wash all bedding, towels, and clothing in hot water to eliminate any remaining eggs or larvae.