Archives: MRCGP AKT

AKT-0598

A 30-year-old woman brings her 4-year-old daughter to the surgery. According to both the family and the nursery she attends for day care, her left eye has become increasingly amblyopic, and she has developed a divergent squint. It appears also that she has become increasingly clumsy and has difficulty using stereoscopic vision to play with her lego.

She was born two months premature but has achieved normal milestones since and has had all of her planned vaccinations.

Which of the following is the most appropriate next step?

AKT-0562

A 14-year-old boy is referred by his GP with a two-week history of general malaise, fatigue and pharyngitis. On examination, multiple small lymph nodes were palpable in the neck, axillae and groins.

Investigations revealed:
Haemoglobin 125 g/L (130-180)
WBC 16.0 ×109/L (4-11)
Platelets 160 ×109/L (150-400)
Blood film Lymphocytosis noted

What is the most probable diagnosis?

AKT-0563

A 7-year-old boy has a one-year history of progressive weakness, finding it more difficult to stand from a sitting position and climb stairs. His maternal grandfather suffered from a similar condition but died in a motorboat accident at the age of 32. He has normal tone and reflexes in his limbs but weakness proximally in his arms and legs.
What is the most likely diagnosis?

AKT-0564

A 6-year-old child presents clinically with mumps and has not been immunised.

Which statement is true of notifiable diseases?

AKT-0565

A 4-month-old boy presents with an eight-hour history of vomiting and inconsolable crying. He has a tender, irreducible lump in the right groin that extends into the scrotum.
What is the most likely diagnosis?

AKT-0566

A 5-year-old girl comes to your clinic after her mother notices a lump in her abdomen while getting her dressed. During the examination, you find a mass in her left upper quadrant. You collect a urine sample, which shows positive results for blood on dipstick testing. Other than that, she appears to be healthy.
What is the probable diagnosis? Choose ONE answer only.

AKT-0567

During an out of hours session a 6-year-old girl is seen with croup. She doesn’t need to be admitted to hospital but you decide to treat her with a stat dose of dexamethasone.

She weighs 25 kg. Dexamethasone for croup is prescribed at a dose of 150 micrograms/kg. Dexamethasone oral solution is dispensed in a concentration of 2 mg/5 ml.

What is the correct stat dosage of dexamethasone in millilitres to prescribe?

AKT-0568

A 6-year-old girl with Down’s syndrome who has a congenital heart defect has been prescribed furosemide by the paediatric cardiologists. Her parents have come to get a refill.
Looking at the prescription, she has been prescribed furosemide at a dose of 0.5 mg/kg twice daily. Her current weight is 16 kg. Furosemide oral solution is available at a concentration of 20 mg/5 ml.
What is the appropriate amount in millilitres to prescribe?

AKT-0569

A mother brings in her 8-year-old boy to see you who has Down syndrome.
Recently she has noticed he is lethargic with a tendency to bleeding gums. On examination he looks a bit pale but not unduly so. His diet is poor, including a lot of fast food.
Which of the following conditions would you be most concerned about in terms of his symptoms and increased risk?

AKT-0570

A 5-year-old boy presents with his first febrile convulsion.

Which of the following is appropriate information for his parents?