AKT-5075
You are conducting the yearly evaluation of a 55-year-old woman with rheumatoid arthritis. What is the most probable complication that may arise due to her condition?
Archives: MRCGP AKT
AKT-5079
You are evaluating a 32-year-old male patient who has chronic plaque psoriasis that is currently managed with calcipotriol monotherapy. He has previously used potent corticosteroids to control flares of his condition. During the examination, he mentions a swollen finger that has been stiff and slightly painful for the past three weeks. There is no history of trauma. Upon examination, you confirm the swelling. What would be the most suitable course of action to take next?
AKT-5071
An 80-year-old woman trips and falls, landing on her outstretched hand and resulting in a distal radius fracture (Colles’ fracture). She has a history of depression and osteoarthritis but no other significant medical conditions. What is the best course of action to address her risk of future fractures?
AKT-5076
A 65-year-old woman presents with gradual onset proximal shoulder and pelvic girdle muscular pains and stiffness. She is experiencing difficulty getting dressed in the morning and cannot raise her arms above the horizontal. She is currently taking atorvastatin 20 mg for primary prevention and recently completed a course of clarithromycin for a lower respiratory tract infection (penicillin-allergic). Blood tests reveal the following results:
Hb 128 g/L Male: (135-180) Female: (115 – 160)
WBC 12.8 * 109/L (4.0 – 11.0)
Platelets 380 * 109/L (150 – 400)
Na+ 142 mmol/L (135 – 145)
K+ 4.2 mmol/L (3.5 – 5.0)
Urea 6.1 mmol/L (2.0 – 7.0)
Creatinine 66 µmol/L (55 – 120)
Bilirubin 10 µmol/L (3 – 17)
ALP 64 u/L (30 – 100)
ALT 32 u/L (3 – 40)
γGT 55 u/L (8 – 60)
Albumin 37 g/L (35 – 50)
CRP 72 mg/L (< 5)
ESR 68 mg/L (< 30)
Creatine kinase 58 U/L (35 – 250)
What is the most likely underlying diagnosis?
AKT-5051
A 57-year-old man comes to your clinic complaining of persistent pain in his right hip. He underwent a metal-on-metal hip resurfacing arthroplasty 3 years ago to address early osteoarthritis. Despite improved mobility after the procedure, he has been experiencing discomfort in his hip.
AKT-5066
A 45-year-old man comes to his GP complaining of lower back pain and stiffness that has been gradually developing over the past month. He reports using a hot water bottle for some relief, but the pain persists. He denies any loss of bladder or bowel control and his neurological exam is unremarkable.
What would be the best course of action for managing this patient’s symptoms?
AKT-5067
A 67-year-old African American male comes to his doctor complaining of muscle weakness and bone pain all over his body. Upon conducting tests, the following results are obtained:
Calcium 2.05 mmol/l
Phosphate 0.68 mmol/l
ALP 270 U/l
What is the probable diagnosis?
AKT-5059
You are reviewing a 40-year-old lady who has recently been diagnosed with rheumatoid arthritis (RA). She presented to you with swollen and tender multiple metacarpal-phalangeal (MCP) joints. Blood tests revealed a raised rheumatoid factor, and you referred her urgently to rheumatology.
She was seen by a rheumatologist last week who diagnosed RA and started treatment.
Can you provide her with some additional information about RA?
AKT-5065
A 65-year-old woman presents for her medication review. She was prescribed alendronate three years ago after being diagnosed with osteoporosis following a wrist fracture. The patient inquires about the duration of bone protection therapy.
When is the optimal time to evaluate her risk and determine if ongoing treatment is necessary?
AKT-5060
What is the minimum steroid dosage that a patient should be on before being considered for osteoporosis prevention?