AKT-0729
A 6-year-old girl has started soiling her pants. She was apparently toilet-trained prior to this happening.
Which of these features is MOST COMMONLY found in children with faecal incontinence?
Archives: MRCGP AKT
AKT-0701
You see a 5-year-old girl who is being abused by her father. The foundation programme doctor who is working with you is shocked by how common abuse of children seems to be.
Which is the most common form of child abuse?
AKT-0702
A 7-year-old boy comes to the clinic complaining of an extremely tender right testicle that started four hours ago. There was no history of trauma or concurrent medical illness.
During the examination, the right testicle was found to be retracted and lying horizontally, but it was too painful to palpate fully. The left hemiscrotum appeared normal.
What is the probable diagnosis?
AKT-0703
You are summoned from a bustling city GP practice to visit a 5-year-old child by their parents, having been seen earlier in the same day.
Despite the absence of a rash, you suspect that the child may have bacterial meningitis. The medical record indicates that the child is allergic to penicillin. You inquire with the mother who confirms that the child had a previous serious reaction immediately after taking penicillin a few years ago that necessitated hospitalization.
You have benzylpenicillin in your bag, but would need to return to the surgery to retrieve a different antibiotic. An ambulance is waiting to transport the child directly to a nearby hospital.
What is the most appropriate course of action to take urgently in the community?
AKT-0704
A 10-year-old girl is brought in for a follow-up appointment regarding her asthma treatment. She is currently using salbutamol inhaler as needed and Symbicort 100/6 (budesonide 100 micrograms/formoterol 6 micrograms) two puffs twice a day. She has been using these inhalers for the past six months. Before that, she was using salbutamol as needed and budesonide 200 micrograms twice a day. The Symbicort was added to her regimen to include a long-acting beta2 agonist as she was using her salbutamol once or twice a day. Despite the addition of the long-acting beta2 agonist, she still experiences occasional tightness in her chest and nighttime coughing. She uses her salbutamol inhaler an average of three to four times a week. Her parents confirm that she is compliant with her inhalers and her inhaler technique is good. What is the most appropriate management plan for her current asthma treatment?
AKT-0705
A 6-year-old girl is brought in for a follow-up appointment regarding her asthma. She has been using inhaled treatment for the past 12 months and is currently taking salbutamol as needed and a very low dose of inhaled corticosteroids (ICS) daily. She has been using the very low dose ICS at the current dose for the past six months. Her parents report that she still needs to use her salbutamol on most days of the week, but never more than once a day. On clinical examination, her chest is clear and there are no focal cardiorespiratory findings. Her inhaler technique is good and there are no issues with compliance. Based on BTS/SIGN guidelines, what is the most appropriate plan for her current management?
AKT-0706
A 4-year-old boy presents with croup to the out-of-hours centre. He has a temperature of 38.2°C, a respiratory rate of 24 breaths/min and a croupy cough. There is no intercostal recession.
What is the most appropriate treatment for him? Select ONE answer only.
AKT-0707
What is the accurate statement about depression in individuals below 18 years of age?
AKT-0708
A 7-year-old girl still wets the bed most nights. She is dry by day. Her development has been normal and she is otherwise well. She has never had a urinary infection. There are no behavioural problems or family issues.
What is the most appropriate management option?
AKT-0709
A 6-year-old girl has a history of intermittent constipation. Her mother says that her pants are now frequently soiled with loose, smelly stools and this is why she has brought her in. She is otherwise well and has a normal development history.
What is the most appropriate initial management option?