Archives: MRCGP AKT

AKT-0688

A 13-year-old boy has been experiencing pain in his left hip and knee, causing him to stop playing rugby for the past month. There was no known injury, but his symptoms have worsened in the last 24 hours. Despite having an upper respiratory tract infection the week before, he is currently feeling well with no fever. He took one of his mother’s co-codamol 30/500 an hour ago, which provided some relief. However, he is unable to walk without assistance.

During the examination, his knee appears normal, but his hip tends to externally rotate when flexed. He is in the 95th percentile for weight, but all other observations are normal. He is currently taking 50 mcg of levothyroxine daily for hypothyroidism.

What would be the appropriate management for this patient?

AKT-0689

A 10-year-old boy is brought in by his father. He has been complaining of hip pain and he is concerned because he has started to limp over the past five weeks. He is otherwise fit and well. Although he regularly plays football with his friends, there is no history of trauma.

On examination, he is limping a little but is able to weight bear. He appears plump but there is no anaemia or lymphadenopathy. There is no fever. Examination of the knee is normal but you think that the affected leg is shortened and externally rotated a little.

What is the most likely diagnosis?

AKT-0690

A 15-year-old sustains an injury playing football and presents with pain in the thigh and a shorter leg.

Possible diagnoses include which of the following?

AKT-0691

A couple bring their 20-month-old baby girl to the clinic. They are concerned that she is not making the required progress with respect to speech development.

What could you tell the parents about speech and language expectations in this child?

AKT-0692

A toddler is brought in for a development review. The child has a vocabulary of approximately 50 single words, some two-word phrases and many of the words can be easily understood by strangers.
Which of the following is the most likely age range for this child if development is normal?

AKT-0693

A 5-year-old boy complains of two months of widespread muscle aches and joint pains in his knees and ankles. In the last four weeks, he has experienced recurrent fevers reaching up to 39.5ºC that resolve spontaneously without the use of antipyretics. His mother also notes the emergence of a transient pink rash during the fevers. What is the MOST PROBABLE diagnosis?

AKT-0694

You are taking the family history of an adult whom you suspect may have a cancer.
Which of the following conditions would alert you to an increased risk of cancer?

AKT-0695

A 6-month-old girl is brought to the General Practitioner for a consultation. The infant was born at home in the presence of a midwife. The midwife is concerned about the appearance of the feet of the infant. Both feet are involved and appear turned inwards and downwards.
Which of the following is the most likely diagnosis?

AKT-0696

For a mother who is breastfeeding, which medication should be avoided?

AKT-0697

A 4-year-old boy has a 4-week history of loose stools. He was febrile, with vomiting for the first 48 hours, but this has resolved. The diarrhoea persists. Prior to this episode of illness, he had a normal diet with no exclusions. A stool sample was sent last week, the report from which has come back, and states that there is no evidence of infection, no organisms seen and the stool is positive for reducing substances.
What is the best course of action to take?