Archives: MRCGP AKT

AKT-5427

A 39-year-old plumber visits his GP complaining of increased clumsiness at work that has been getting worse over the past 6 months. He reports difficulty finding tools and has fallen multiple times due to tripping over his own feet. The patient has well-controlled type 1 diabetes and is in good health otherwise. He is not taking any medication other than insulin and has no family history of illness. During the examination, the GP notes absent ankle jerks and extensor plantars, but sensation is normal. What could be a potential cause for the patient’s symptoms?

AKT-5439

You are evaluating a 32-year-old woman who is presenting with migraine-like headaches but no accompanying aura. What is the estimated percentage of individuals with migraine who experience aura?

AKT-5437

A 30-year-old female with a past medical history of depression visits her primary care physician complaining of numbness in her right arm affecting the C6 distribution for the past two days. She denies any neck pain or injury. Upon neurological examination, there is a confirmed decrease in sensation in that dermatome, but otherwise, the exam is unremarkable. The patient reports no previous similar episodes, but she does recall an incident three months ago where she experienced reduced vision and painful movements in her right eye, which resolved on its own, and she did not seek medical attention. What is the most probable diagnosis?

AKT-5434

A 29-year-old man presents to the emergency department with a three-day history of foot drop and tingling to his hands. Today he has noticed difficulty rising from a chair and climbing stairs. His past medical history is unremarkable except for a recent respiratory tract infection.

Upon examination, the patient has normal limb tone, reduced strength in his legs bilaterally (distal muscles worse than proximal), and a loss of his patella and ankle reflexes. Additionally, he has reduced sensation in a glove and stocking distribution.

What is the most likely diagnosis for this individual?

AKT-5422

A 2-year-old boy is brought to the emergency room with a high fever. He has a history of febrile seizures. During the examination, he begins to have a seizure. The medical team quickly moves him to the treatment room and administers oxygen. However, after 5 minutes, the seizure persists. Unfortunately, there is no buccal midazolam available. What should be the next course of action?

AKT-5438

A 50-year-old man has been diagnosed with motor neuron disease. Is there any drug that has been proven to increase survival rates in such cases?

AKT-5440

A 68-year-old woman comes to see her GP complaining of increased clumsiness. She reports difficulty gripping objects and has spilled her tea on herself multiple times. The woman also mentions feeling extremely fatigued and describes her legs as feeling heavy. She has experienced a few falls, including one where she hit her head. After a neurological exam, the GP suspects motor neurone disease but is considering other diagnoses based on which of the following symptoms or signs?

AKT-5436

A 35-year-old truck driver has recently been diagnosed with epilepsy and started on sodium valproate. What guidance should be given regarding his group 2 license?

AKT-5428

A 38-year-old man visits his primary care physician complaining of headaches on the left side of his face and watery eyes for the past two weeks. He reports experiencing approximately two episodes per day, each lasting about 30 minutes. What is the probable diagnosis?

AKT-5441

You assess a 64-year-old man who has recently been released from the hospital after being admitted for acute coronary syndrome. He has a medical history of myasthenia gravis and has been taking prednisolone for a long time. However, since his admission, his myasthenia symptoms have significantly worsened, and you observe bilateral ptosis and slurred speech. Which of the newly prescribed medications is most likely responsible for this?