Archives: MRCGP AKT

AKT-5125

A 15-year-old boy who is active in sports comes to you for consultation after seeing your colleague 4 weeks ago due to right knee pain. He plays basketball and had a fall during a game 6 weeks ago. Despite the initial consultation, his pain has not subsided and he experiences discomfort at night, which affects his sleep. During the examination, you detect a solid, immovable lump on his distal femur. What would be the best course of action to take next?

AKT-5133

You encounter a 41-year-old male patient complaining of lower back pain. He cannot recall a specific injury but reports that the pain has been worsening for the past 2 months. He has experienced muscle spasms in his lower back over the last 48 hours, causing him significant discomfort and preventing him from working. He works in a warehouse and frequently engages in heavy lifting. He is overweight but has no other relevant medical history. There are no red flag symptoms of back pain.

What is a true statement about nonspecific lower back pain?

AKT-5120

What is the primary treatment for Morton’s neuroma?

AKT-5132

A 50-year-old woman presents with lower back and bilateral leg pain. The lower back pain has been present for 6 months but gradually getting worse. Recently she has noticed that her legs ache when she walks further than about 300 meters. She is normally very active and enjoys hiking. The pain radiates to her buttocks, thighs and legs bilaterally (but her right leg is worse than the left). She describes the pain as ‘aching’ and ‘tingling’. If she walks further than about 300 meters her legs become weak and numb. If she sits down and leans forward the symptoms go, and she can then carry on for another 300 meters. She says that the pain is better if she walks downhill. She finds standing exacerbates the symptoms but she can swim without any problems.

The patient has a history of hypertension and hyperlipidemia, but is otherwise healthy.

What is the most likely diagnosis in this case, and what is the first line investigation to confirm the diagnosis?

AKT-5135

A 67-year-old female with a history of rheumatoid arthritis complains of increased difficulty in walking. During examination, weakness of ankle dorsiflexion and of the extensor hallucis longus is observed, along with loss of sensation on the lateral aspect of the lower leg. What is the probable diagnosis?

AKT-5129

A 49-year-old patient comes in with a severely tender and swollen big toe on their left foot. The area is very sensitive to touch and moving the toe causes pain. The patient reports no fever and is able to move their toe in all directions despite the discomfort. They have a history of chronic kidney disease and are currently taking ramipril for hypertension. Additionally, they have had a past duodenal ulcer. What is the initial medication recommended for treatment?

AKT-5128

Mrs Patel is a 75-year-old woman who presents with a burning pain in her buttock when walking. The pain radiates down her leg. She doesn’t complain of any back pain. She finds that sitting helps ease the pain. In addition, she did find that leaning forwards on the shopping trolley at the supermarket made it easier to walk. On examination of her lower legs, there was no focal neurology and foot pulses were palpable.

What investigation is most likely to be useful in diagnosing this condition?

AKT-5136

What is the most precise statement about the effectiveness of cervical spine X-rays in evaluating degenerative cervical myelopathy (DCM) in elderly patients?

AKT-5134

What is the most probable outcome of using allopurinol as the sole treatment for an acute gout attack?