Archives: MRCGP AKT

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-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-5104

A 10-year-old boy presents to your clinic with complaints of left hip pain. He is an avid runner. According to his mother, he has been limping intermittently and his gait has changed over the last few weeks.

During the examination, you observe that his left leg is shortened and externally rotated. He also has limited internal rotation and an antalgic gait.

What is the probable diagnosis?

AKT-5105

A 57-year-old woman comes to your clinic concerned about her bone health. She underwent a private DEXA scan after her sister was diagnosed with osteoporosis and the results showed a T-score of -1.9 for the femoral neck. Upon physical examination, there are no notable findings. What would be the best course of action for this patient?

AKT-5113

A 56-year-old woman presents with a four month history of right-sided hip pain. The pain has developed spontaneously without any apparent cause. She reports that the pain is more severe on the outer side of the hip and is particularly bothersome at night when she lies on her right side.

Upon examination, there is a complete range of motion in the hip joint, including internal and external rotation. However, deep palpation of the lateral aspect of the right hip joint reproduces the pain.

An x-ray of the right hip reveals the following findings:

Right hip: Slight narrowing of the joint space, but otherwise normal appearance.

What is the most probable diagnosis?

AKT-5115

You encounter a 35-year-old woman who is experiencing lower back pain. She reports that the pain began two months ago, but over the past week, it has started to radiate down her left leg. She cannot recall any specific incident that may have caused the pain. Currently, the leg pain is more severe than the back pain. The pain starts from her buttock and extends down the back of her leg and into her foot. She occasionally experiences a tingling sensation down the back of her leg. She finds that standing for extended periods exacerbates the pain. She is typically healthy, with no significant medical history, but she is overweight.

Upon examination, you perform a straight leg raise test, which elicits symptoms. Aside from that, her examination is normal, and she doesn’t exhibit any red flag symptoms.

You diagnose the patient with sciatica and provide self-management advice, including weight loss, exercise, and analgesia.

The patient inquires about the duration of these symptoms. Typically, how long does it take for sciatica symptoms to resolve?

AKT-5117

A 56-year-old woman who has had two Colle’s fractures in the past two years undergoes a DEXA scan:

T-score
L2-4 -1.4
Femoral neck -2.7

What is the result of the scan?

AKT-5114

A 14-year-old female comes to the clinic with her mother. She reports left knee pain for the past 4 weeks without any history of injury. She feels more tired than usual but is not otherwise unwell. Upon examination, her BMI is normal, and her vital signs are unremarkable. The left knee appears normal, and there is a full range of motion. All other joints are also normal. What is the best next step in management?

AKT-5118

A 24-year-old kayaker complains of discomfort in the right distal dorsoradial forearm, approximately 5-10 cm away from the wrist joint. Upon examination, there is slight redness and swelling in the area. The patient experiences crepitus when moving their right hand. What is the probable diagnosis?

AKT-5119

Which of the following features is not typically seen in Marfan’s syndrome?