AKT-0650
You see a 3-year-old girl who presents with fever, irritability and offensive smelling urine. A urine dipstick shows leucocytes+, nitrites -.
What would be the next most appropriate management step?
Archives: MRCGP AKT
AKT-0651
A 7-year-old boy is seen with a markedly painful left leg. He is holding it immobile and is reluctant to walk. His parents report that over the last 48 hours he has not been himself, the pain in the leg has become more prominent and the child has had a temperature.
On examination, the child has a temperature of 37.9°C and there is a slight swelling with extreme tenderness over the proximal left tibia. The area is warm to touch and any movement of the child’s leg cause severe pain. The knee joint itself appears normal with no effusion; and the hip and ankle joints also appear normal.
What is the likely underlying diagnosis?
AKT-0652
A 6-month-old boy is brought to the General Practitioner for a consultation. The child’s mother is worried about the appearance of her infant’s face. The back of the head appears flattened and the right side of the head appears pushed forward relative to the left side. The mother thinks the shape of the skull was normal at birth.
Which of the following is the most probable diagnosis?
AKT-0653
A mother is worried about the white reflection in her 11-month-old son’s eye. What is the MOST APPROPRIATE test to detect retinoblastoma in a child? Choose ONE option only.
AKT-0654
A 4-year-old boy presents with recurrent urinary tract infections (UTIs). His parents want to know what is causing these infections.
What is the most common cause of this problem in a child of this age?
AKT-0655
At what age do children receive their initial pertussis immunization?
AKT-0615
A 4-year-old child presents to the out of hours service with a two-night history of earache. The child has a fever, but no ear discharge. There is no vomiting, but loose stool was reported twice today and the child passed urine four hours ago. The child had a similar episode six months ago that resolved with antibiotics. The child has no significant medical history. On examination, the child is well hydrated, has no rash, and clear chest. The left ear has an erythematous bulging eardrum with no perforation or discharge. The right ear and throat show no abnormalities, and there is no cervical lymphadenopathy or mastoid tenderness. The child has a fever of 39°C, HR 130, RR 30, CRT <2 sec. Based on the NICE 'traffic light' system, what is the most appropriate management?
AKT-0616
What is the appropriate course of action for managing a newborn boy with an undescended left testicle and nappy rash?
AKT-0617
A 12-year-old girl presents with symptoms that meet the criteria for a diagnosis of mild attention-deficit hyperactivity disorder (ADHD). You are considering referring the child to the Child and Adolescent Mental Health Services (CAMHS). Her father would like information about managing this condition.
What is the most suitable advice to provide regarding the management of ADHD?
AKT-0618
A 9-month-old baby is brought to the emergency department by her parents. They report that she has been experiencing a runny nose and cough for the past few days and has been more irritable than usual. The baby was born at full term and has no significant medical history.
According to the parents, the baby has been refusing to eat but is managing to drink with encouragement. Upon examination, the baby’s temperature is 37.7°C, and there are no signs of chest wall recession, nasal flaring, or grunting. The respiratory rate is 48/minute, and auscultation of the chest reveals fine inspiratory crackles and a slight high-pitched wheeze heard throughout both lung fields. Oxygen saturations are 97% in room air.
What is the most appropriate course of action for management?