Archives: MRCGP AKT

AKT-0571

A 14-month-old boy presents with eye-rolling followed by generalised shaking of the limbs for three minutes. He has had a cold for two days, but became very warm this morning just prior to the episode.

He has no previous history of note, and had a full term normal delivery with no neonatal complications. His immunisations are up to date. There is no family history of note.

On examination he is alert though febrile at 39.2°C, with flushed cheeks. He has a runny nose. Respiratory rate is 22/min and heart rate 130/min. His chest is clear and urinalysis is negative.

What is the most likely diagnosis?

AKT-0572

A toddler has had a seizure. He has been unwell for a few hours and has a temperature of 38.2°C. There are no concerning features in his previous medical history.
Which of the following is most compatible with a diagnosis of ‘simple febrile seizure’?

AKT-0573

A 3-year-old boy had a seizure associated with a fever of 38.2°C. He fully recovered and he was thought to have had a febrile convulsion. Now that he has had a seizure his parents are anxious about his future.

Which of the following statements is CORRECT?

AKT-0574

You see a 5-year-old boy who is brought by his foster parents for review.

His medical problems include: growth restriction, developmental delay and he has had a ventricular septal defect repaired.

On examination he has a saddle-shaped nose, hypertelorism, a thin upper lip and absent philtrum.

Maternal abuse of which of the following during pregnancy has caused this clinical picture?

AKT-0575

You are requested by the practice nurse to assess a mother who has brought in her 12-week-old baby who appears unwell. The mother is concerned because the baby seems to have a fever.

Upon examination, you observe that the baby has an upper respiratory tract infection. The family members have recently had a cold. Although the baby is pyrexial at 37.8°C, you cannot detect any indications of lower respiratory tract infection.

What is the appropriate course of action for managing this baby?

AKT-0576

A mother comes to see you about her 16-year-old daughter. She has been diagnosed with major depression and is due to see a specialist the next day.

You discuss both medical and non-medical therapies.

It is anticipated that she will need medical therapy. Which of the following drugs, if required, is most likely to be prescribed for her?

AKT-0577

A 5-year-old boy is brought into the minor injury unit by his mother after suddenly developing a cough and wheeze. His symptoms seem to have started suddenly at a birthday party. On examination, he is irritable, afebrile, with a raised respiratory rate and cough. He has a wheeze heard on the right side and breath sounds are more prominent on the left.
What is the most likely diagnosis?

AKT-0578

A 16-year-old girl comes to see you and requests the contraceptive pill. She has come to the surgery alone. You attempt to discuss the request in more detail but she seems nervous and fidgety, not making eye contact with you. You ask her if she would like someone else present for the discussion.
She says she wants to start taking the pill as she is in a relationship and wants to be safe. She appears to be listening but is not asking any questions.
You explain to her that you need to make a thorough assessment if you are to prescribe, and you need to make sure she understands the implications of using contraception and becoming sexually active. You ask her if she has any questions or concerns, and she asks a few questions but seems hesitant to discuss further.
What is the most appropriate approach?

AKT-0579

A 6-year-old boy comes to his General Practitioner with his mother and stepfather. He has a 2-month history of intermittent abdominal pain. The pain is colicky in nature and periumbilical. His appetite is slightly reduced. He is not constipated. The pain is causing him to miss some school, but he also experiences it at the weekend. The patient is otherwise normal and his height and weight are on the 50th centile.
What is the most likely diagnosis?

AKT-0580

A 6-month-old, full-term boy presents with a four-week history of regurgitation of feeds. He is otherwise well, with a normal growth chart. Examination is also normal.
What is the most appropriate diagnosis?