AKT-0747
When should the pneumococcal conjugate (PCV) vaccine be given to a healthy individual based on the UK immunisation schedule?
Archives: MRCGP AKT
AKT-0748
According to the UK immunisation schedule, at what age would you administer the pneumococcal polysaccharide (PPV) vaccine to an otherwise healthy individual?
AKT-0711
A 16-year-old boy is brought to surgery by his father.
He has symptoms of a moderate depression and has been recommended pharmacological therapy by another health professional. You refer him to the local young people’s mental health service for further treatment. His father asks about medication, as he is on citalopram himself for depression.
What is the recommended first line antidepressant medication for adolescents with moderate depression?
AKT-0712
A mother brings in her 7-year-old girl and is worried about her daughter’s swollen, painful fingers. The mother describes the fingers as looking like sausages when they are swollen. You observe that the patient has had previous consultations for joint pains in her knees and hands. During the examination, you notice some nail pitting.
What is the MOST LIKELY diagnosis?
AKT-0713
A 12-year-old girl is seen for review with her mother. She has been seen on several occasions over the last 2-3 months, feeling increasingly tired and weak.
The last occasion was about two weeks ago when she was diagnosed with gastroenteritis. Her mother says this seems to have settle but she still complains of feeling generally weak and tired. She thinks she has lost weight.
A colleague of yours had requested some blood tests and you can see there is a normal full blood count, liver function, thyroid function, and anti-TTG results on the computer system. Her renal function is normal with a low sodium being the only result outside of normal range.
On examination: the child looks thin and a little pale. There is no fever, or rashes. She is not breathless or in pain. Her blood glucose is 4.1 mmol/L. Her heart sounds are normal and her chest is clear. There is no lymphadenopathy or organomegaly.
Which of the following clinical features is most likely be present on further examination of this patient?
AKT-0714
A 10-year-old girl presents with behaviour issues. Her father is concerned that she may have attention deficit hyperactivity disorder (ADHD).
Which of the following would most support this diagnosis?
AKT-0715
A 10-year-old girl presents with her father to the General Practitioner, as her father is concerned that she may have attention-deficit/hyperactivity disorder (ADHD). He reports that she achieves well in school academically but has difficulty taking turns in games at break times and often interrupts the teacher by blurting out the answer to a question before she has finished it. She can get cross with her father at home when he asks her to carry out chores and sometimes gets in physical fights with her sister.
Which of the following is one of the diagnostic criteria for ADHD and is displayed by this child?
AKT-0716
An 8-year-old girl is brought to see you by her parents.
The school had spoken to them because despite good educational progress they had noticed that she spends a lot of time on her own and doesn’t really make friends with the other children or engage in group activities. She has quite restricted interests both at home and at school. The parents report that she has ‘always been like this’ and that at home she likes to read and write a lot but other than that doesn’t really engage and play with other children.
During the consultation the child seems to have appropriate language skills and be of normal intelligence but doesn’t engage fully with your attempts at conversation and play, and avoids eye contact with you.
What is the likely underlying problem?
AKT-0717
A 6-year-old girl comes to see you with her father. She is known to have a mild learning disability but he is now more concerned about her behaviour.
She tends to speak very little and when she does it is in a monotonic way. She doesn’t seem to understand jokes. She spends a lot of time alone and rarely seeks out the company of others. He says he finds it difficult to engage her in play; she just wants to play alone with her dolls.
What is the most likely diagnosis?
AKT-0718
You are working an out-of-hours session one evening when a mother brings her 9-month-old child in for assessment.
The child has been well up until two days ago and has no significant past medical history. She tells you that the child has had a ‘cold’ and has been sounding wheezy. The mother has brought the child this evening because a cough has developed and the child’s feeding has been reduced because of breathlessness.
On examination, the child has a sharp cough and is tachypnoeic. Auscultation of the chest reveals widespread high pitched wheezes and diffuse fine crackles.
What is the most likely diagnosis?