Archives: MRCGP AKT

AKT-0854

A 27-year-old man presents with a persistent cough for the past 20 days which initially started with a few days of cold symptoms. He describes it as ‘the worst cough I’ve ever had’. He has bouts of coughing followed by an inspiratory gasp. This is usually worse at night and can be so severe that he sometimes vomits. He is otherwise fit and well and confirms he completed all his childhood immunisations. Examination of his chest is unremarkable.

What is the most suitable initial management for this likely diagnosis?

AKT-0855

A 6-year-old boy presents with a blanching rash that started on his abdomen and chest and has now spread throughout his body. The rash has a rough texture similar to sandpaper. He also complains of a sore throat and has a high fever of 38.5ºC. Scarlet fever is suspected, but the child is otherwise healthy and doesn’t require hospitalization. However, he has a history of severe allergy to penicillin. What is the most suitable course of action for primary care management?

AKT-0856

A 6-month-old baby boy is being evaluated. Two weeks ago, a trial of alginate therapy (Gaviscon) was initiated for frequent regurgitation accompanied by discomfort. Unfortunately, there has been no improvement in the symptoms, and the mother now reports that the baby is refusing to eat. There are no other new symptoms, such as a rash or diarrhea, and the baby is gaining weight steadily. He is exclusively bottle-fed, as his mother stopped breastfeeding at 8 weeks of age. What is the most appropriate course of action for managing this situation?

AKT-0820

A 10-year-old girl comes in for a follow-up appointment. She was diagnosed with asthma two years ago by her primary care physician. She is currently taking a salbutamol inhaler, using 2 puffs 3 times a day, and a low-dose beclomethasone inhaler. She also takes oral montelukast. Despite this treatment, she still experiences a nighttime cough and needs to use her blue inhaler most days. Unfortunately, the addition of montelukast has not provided much relief. On examination today, her chest is clear with no wheezing and a near-normal peak flow.

What is the next step in managing her asthma?

AKT-0821

A father brings his 15-month-old daughter to your clinic. He reports that she has had a runny nose and cough for the past 3 days. He is concerned because this morning, her cough sounded like a seal. However, she has been eating and drinking normally. During the examination, the child seems content and plays with toys in the room. She has an occasional barking cough, but there is no audible stridor at rest. There is no intercostal or suprasternal recession, and her chest is clear. Vital signs are within normal limits. What is the most appropriate course of action for you to take in managing this situation?

AKT-0822

A 6-year-old girl presents with a 4-day history of genital itching, redness, and discomfort that worsens during urination. She is asymptomatic otherwise and has normal vital signs. What is the best initial approach to managing her symptoms?

AKT-0823

What is the suggested amount of prednisolone for kids aged 3-17 years who experience a worsening of their asthma symptoms?

AKT-0824

A 15-year-old girl asks to begin taking the combined oral contraceptive pill.

Which of the following is not a fundamental aspect of the Fraser guidelines?

AKT-0825

A worried father brings his 14 month old child into the clinic, concerned that he is not walking. He says that many other children his age in his playgroup are already walking but his child is still crawling.

At what age would you consider referring a child who is not yet walking?

AKT-0826

You see a 10-week-old baby boy with his father. He was born at 40+5 without complication. He is breastfeeding well but his father is concerned as he vomits small amounts of milk after most feeds, approximately a tablespoon full. He doesn’t seem distressed by the vomiting and is growing along the 75th centile. He has wet and full nappies. He would like some treatment for the regurgitation.

What would be your initial recommendation for managing this infant’s regurgitation?