Archives: MRCGP AKT

AKT-0663

A 16-month-old girl presents with her mother to the General Practitioner, as her mother is concerned about her lack of energy and poor appetite. The girl drinks six 200-ml bottles of doorstep cow’s milk each day but eats very little at mealtimes. She is thriving (weight 97th centile) and examination is normal.
Investigations:
Investigation Result Normal value
Haemoglobin (Hb) 87 g/l 110–140 g/l
White blood count (WBC) 11 × 109/l 5–17× 109/l
Neutrophils 4.1 × 109/l 1–8.5× 109/l
Lymphocytes 5.9 × 109/l 1.5–9.5× 109/l
Platelets 357 × 109/l 150–400× 109/l
Mean corpuscular volume 65 fl 72–84 fl
What is the likely underlying cause of this patient’s presentation?

AKT-0664

A 5-year-old child is evaluated for recurrent chest infections, the most recent accompanied by green sputum. The child’s mother is opposed to vaccination and claims that the child had whooping cough approximately one year ago. What is the probable root cause of the child’s symptoms?

AKT-0665

You see a 9-month-old boy. He initially had of temperatures up to 39.5º, runny nose and was generally irritable. The fever has now settled but his mother is worried as the patient has developed a rash on his face and body. On examination, you note small red spots that blanch when touched. No itchiness or blisters are noted.

What is the most likely diagnosis?

AKT-0666

The parents of a 5-year-old child are worried about his bed wetting, as he has been dry at night for the past two years. What should they do?

AKT-0667

Which patient among these needs diagnostic evaluation?

AKT-0668

A 12-year-old boy who is undergoing investigations for nephrotic syndrome with the local nephrologists is brought to the surgery by his mother.

He has been complaining of pleuritic chest pain for the past 24 hours and told his mother that he has coughed up some blood. On one occasion he became distressed and vomited. Other past medical history of note includes asthma and some problems with tonsillitis.

On examination his BP is 90/60 mmHg, his pulse 105 regular. He looks in pain, but there are no focal signs on respiratory examination.

Which of the following is the most likely diagnosis?

AKT-0669

When is it suitable to give a pertussis vaccine?

AKT-0670

A 4-year-old boy struggles with temper tantrums, shyness and communication delay. His mother is concerned he may have autism.
What is the SINGLE ‘red flag’ feature that would make you most concerned that this boy might have an autistic spectrum disorder?

AKT-0671

A concerned mother brings her 2-year-old daughter to see you as she has not had a wet diaper for the past 12 hours. Her mother suspects a lump in her tummy. Additionally, she has been refusing to walk for the past 36 hours and has been crying excessively. What type of cancer is most likely to present with these symptoms?

AKT-0672

What immunizations are advised for a child between the ages of 14 and 16?