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  • Question 1 - Under what circumstances is an individual's autonomy right infringed upon? ...

    Incorrect

    • Under what circumstances is an individual's autonomy right infringed upon?

      Your Answer: An infant whose parents elect for surgery to correct a congenital heart defect

      Correct Answer: A Jehovah's witness patient with symptomatic anaemia who refuses blood transfusion

      Explanation:

      Autonomy in Medical Decision Making

      Autonomy refers to an individual’s right to self-governance. In medical decision making, this means that patients have the right to make informed decisions about their own healthcare, free from external coercion. Even if a procedure is in the patient’s best interest, if they refuse and their refusal is informed, doctors and relatives cannot force them to undergo the procedure.

      According to the BMA’s guide to ethics, two conditions must be met for a decision to be considered autonomous. First, the individual must have the internal capacity for self-governance. Second, they must be free from external constraints. In a medical context, a decision is considered autonomous when the individual has the capacity to make the decision, has sufficient information to make an informed choice, and does so voluntarily.

      In summary, autonomy is a fundamental principle in medical ethics that recognizes patients’ right to make decisions about their own healthcare. Healthcare providers must respect patients’ autonomy and ensure that they have the information and support they need to make informed decisions.

    • This question is part of the following fields:

      • Improving Quality, Safety And Prescribing
      15743.9
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  • Question 2 - You are examining a 48-year-old female patient with breast cancer that is positive...

    Incorrect

    • You are examining a 48-year-old female patient with breast cancer that is positive for oestrogen receptors. The patient has been prescribed a daily dose of 20 mg of tamoxifen. What is the most frequent adverse effect of tamoxifen?

      Your Answer: Neutropenia

      Correct Answer: Headache

      Explanation:

      Tamoxifen Side Effects According to BNF

      The British National Formulary (BNF) is often used to set questions for the AKT, and it lists the frequency of side effects for medications. Tamoxifen, for example, has common or very common side effects such as headaches, while all the other options are rare or very rare. Patients taking tamoxifen should be informed about the increased risk of thromboembolism and advised to watch for symptoms of DVT and PE. Additionally, patients should be warned about the increased risk of endometrial cancer and instructed to report any relevant symptoms. It is important for healthcare professionals to be aware of these potential side effects and counsel patients accordingly.

    • This question is part of the following fields:

      • Maternity And Reproductive Health
      17.7
      Seconds
  • Question 3 - A 35-year-old woman presents with complaints of a dull ache and numbness in...

    Incorrect

    • A 35-year-old woman presents with complaints of a dull ache and numbness in her right hand. She reports that her symptoms are more severe at night and she has to hang her arm out of bed and shake it to get relief. On examination, forced flexion of the wrist and pressure over the proximal wrist crease with thumbs reproduces the paraesthesia in her thumb, index finger, and middle finger. What is the most appropriate initial management strategy?

      Your Answer: Surgery

      Correct Answer: Local corticosteroid injection

      Explanation:

      Treatment Options for Carpal Tunnel Syndrome

      Carpal tunnel syndrome is a condition that affects many people, and it can be quite debilitating. However, there are several treatment options available to help manage the symptoms. It is important to note that anti-inflammatories may exacerbate symptoms, and there is no significant evidence behind using a diuretic or amitriptyline as a treatment option. Instead, treatment options include avoiding precipitating causes, simple advice about minimizing activities that trigger symptoms, nocturnal wrist splintage, and corticosteroid injection. Referral for nerve conduction studies is appropriate in some cases where there is diagnostic doubt, but if there is a clear clinical diagnosis, further investigation is not needed, and treatment can be initiated. Corticosteroid injection is a first-line treatment option and can be performed based on a clinical diagnosis in primary care by an adequately trained and competent clinician. Surgery, which would not be an appropriate initial management, would clearly need referral to secondary care. By understanding these treatment options, individuals with carpal tunnel syndrome can work with their healthcare provider to find the best approach for managing their symptoms.

    • This question is part of the following fields:

      • Musculoskeletal Health
      17170.2
      Seconds
  • Question 4 - A 5-year-old boy presents with recurrent balanitis. He has swelling and redness of...

    Incorrect

    • A 5-year-old boy presents with recurrent balanitis. He has swelling and redness of his glans penis and foreskin, and his mother reports a foul odor and slight discharge. What is the most frequently isolated organism in cases of balanitis?

      Your Answer: Staphylococcus

      Correct Answer: C. albicans

      Explanation:

      Balanitis is most commonly caused by C. albicans, with group B beta-haemolytic streptococci being a less frequent cause among bacterial infections. The other options listed may also cause balanitis, but are not as commonly isolated.

      Understanding Balanitis: Causes, Assessment, and Treatment

      Balanitis is a condition characterized by inflammation of the glans penis and sometimes extending to the underside of the foreskin. It can be caused by a variety of factors, including bacterial and candidal infections, autoimmune conditions, and poor hygiene. Proper assessment of balanitis involves taking a thorough history and conducting a physical examination to determine the cause and severity of the condition. In most cases, diagnosis is made clinically based on the history and examination, but in some cases, a swab or biopsy may be necessary to confirm the diagnosis.

      Treatment of balanitis involves a combination of general and specific measures. General treatment includes gentle saline washes and proper hygiene practices, while specific treatment depends on the underlying cause of the condition. For example, candidiasis is treated with topical clotrimazole, while bacterial balanitis may be treated with oral antibiotics. Dermatitis and circinate balanitis are managed with mild potency topical corticosteroids, while lichen sclerosus and plasma cell balanitis of Zoon may require high potency topical steroids or circumcision.

      Understanding the causes, assessment, and treatment of balanitis is important for both children and adults who may be affected by this condition. By taking proper hygiene measures and seeking appropriate medical treatment, individuals with balanitis can manage their symptoms and prevent complications.

    • This question is part of the following fields:

      • Dermatology
      20.7
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  • Question 5 - A 35-year-old patient is evaluated after starting orlistat for weight management. Her initial...

    Correct

    • A 35-year-old patient is evaluated after starting orlistat for weight management. Her initial weight was 85kg and now it is 78kg, indicating an 8.2% weight loss. As per the 2014 NICE Guidelines, what is the minimum percentage of weight loss that is considered acceptable for patients to continue orlistat therapy after three months?

      Your Answer: 5%

      Explanation:

      The recommended dosage for orlistat is 120 mg three times a day with meals, for patients with a BMI of 30 or higher, or a BMI of 27 or higher with other risk factors such as high blood pressure or diabetes. However, the guidelines suggest that a lower target could be considered for patients with type 2 diabetes. It is important to note that orlistat can also be bought without a prescription.

      Obesity can be managed through a stepwise approach that includes conservative, medical, and surgical options. The first step is usually conservative, which involves implementing changes in diet and exercise. If this is not effective, medical options such as Orlistat may be considered. Orlistat is a pancreatic lipase inhibitor that is used to treat obesity. However, it can cause adverse effects such as faecal urgency/incontinence and flatulence. A lower dose version of Orlistat is now available without prescription, known as ‘Alli’. The National Institute for Health and Care Excellence (NICE) has defined criteria for the use of Orlistat. It should only be prescribed as part of an overall plan for managing obesity in adults who have a BMI of 28 kg/m^2 or more with associated risk factors, or a BMI of 30 kg/m^2 or more, and continued weight loss of at least 5% at 3 months. Orlistat is typically used for less than one year.

    • This question is part of the following fields:

      • Metabolic Problems And Endocrinology
      38.7
      Seconds
  • Question 6 - A 50-year-old man with hypertension presents with frank haematuria. He gives a history...

    Correct

    • A 50-year-old man with hypertension presents with frank haematuria. He gives a history that his uncle recently underwent a renal transplant and that his father died of renal failure. On physical examination, a large mass is felt over the right lumbar area. A smaller mass is felt in the left flank. Blood urea and serum creatinine levels are raised.
      Select the single most probable diagnosis.

      Your Answer: Autosomal dominant polycystic kidney disease

      Explanation:

      Common Renal Conditions and Their Presentations

      Adult polycystic kidney disease, a bilateral and gradual decline in renal function, presents with acute loin pain and/or haematuria. Hypertension is an early and common feature. Renal cell carcinoma presents with haematuria, loin pain, and a unilateral mass in the flank, with malaise, anorexia, and weight loss as possible symptoms. Ureteric calculus causes extremely severe pain and is usually associated with haematuria. Prostatic carcinoma appears in older men and presents with lower urinary tract obstruction or metastatic spread, particularly to the bone. Renal amyloidosis presents with asymptomatic proteinuria, nephrotic syndrome, or renal failure, but not frank haematuria.

      Understanding Common Renal Conditions and Their Presentations

    • This question is part of the following fields:

      • Kidney And Urology
      42.2
      Seconds
  • Question 7 - A 28-year-old woman who is 8 weeks pregnant presents with excessive sweating and...

    Incorrect

    • A 28-year-old woman who is 8 weeks pregnant presents with excessive sweating and tremors. Upon blood testing, the following results are obtained:

      - TSH < 0.05 mu/l
      - T4 188 nmol/l

      What is the best course of action for management?

      Your Answer: Carbimazole

      Correct Answer: Propylthiouracil

      Explanation:

      CKS recommends using propylthiouracil instead of carbimazole during the first trimester of pregnancy due to the potential risk of congenital abnormalities associated with carbimazole. However, in the second trimester, it is advised to switch back to carbimazole as propylthiouracil has been linked to a slight risk of severe liver damage.

      During pregnancy, there is an increase in the levels of thyroxine-binding globulin (TBG), which causes an increase in the levels of total thyroxine. However, this doesn’t affect the free thyroxine level. If left untreated, thyrotoxicosis can increase the risk of fetal loss, maternal heart failure, and premature labor. Graves’ disease is the most common cause of thyrotoxicosis during pregnancy, but transient gestational hyperthyroidism can also occur due to the activation of the TSH receptor by HCG. Propylthiouracil has traditionally been the antithyroid drug of choice, but it is associated with an increased risk of severe hepatic injury. Therefore, NICE Clinical Knowledge Summaries recommend using propylthiouracil in the first trimester and switching to carbimazole in the second trimester. Maternal free thyroxine levels should be kept in the upper third of the normal reference range to avoid fetal hypothyroidism. Thyrotrophin receptor stimulating antibodies should be checked at 30-36 weeks gestation to determine the risk of neonatal thyroid problems. Block-and-replace regimens should not be used in pregnancy, and radioiodine therapy is contraindicated.

      On the other hand, thyroxine is safe during pregnancy, and serum thyroid-stimulating hormone should be measured in each trimester and 6-8 weeks postpartum. Women require an increased dose of thyroxine during pregnancy, up to 50% as early as 4-6 weeks of pregnancy. Breastfeeding is safe while on thyroxine. It is important to manage thyroid problems during pregnancy to ensure the health of both the mother and the baby.

    • This question is part of the following fields:

      • Maternity And Reproductive Health
      88
      Seconds
  • Question 8 - A 42-year-old man presents to his GP with his sister. She is worried...

    Incorrect

    • A 42-year-old man presents to his GP with his sister. She is worried about his well-being as he lives alone and has been isolating himself for some time. He rarely goes out and has no interests other than using his computer. He is generally distant when his family visits and speaks very little. He has not been in a relationship for many years. He appears disheveled and avoids making eye contact during the appointment. His sister is concerned that he may have Schizophrenia as their father exhibited similar behavior before his diagnosis.

      The patient denies experiencing any visual or auditory hallucinations and doesn't express any delusional beliefs.

      What is the most probable diagnosis for this individual?

      Your Answer: Avoidant personality disorder

      Correct Answer: Schizoid personality disorder

      Explanation:

      The absence of delusion or hallucination symptoms rules out schizophrenia, schizotypal personality disorder, and delusional beliefs. Avoidant personality disorder is characterized by a greater concern for being accepted and social status anxiety. Schizoid personality disorder, on the other hand, exhibits negative symptoms of schizophrenia, making it the most probable diagnosis.

      Personality disorders are a set of maladaptive personality traits that interfere with normal functioning in life. They are categorized into three clusters: Cluster A, which includes odd or eccentric disorders such as paranoid, schizoid, and schizotypal; Cluster B, which includes dramatic, emotional, or erratic disorders such as antisocial, borderline, histrionic, and narcissistic; and Cluster C, which includes anxious and fearful disorders such as obsessive-compulsive, avoidant, and dependent. These disorders affect around 1 in 20 people and can be difficult to treat. However, psychological therapies such as dialectical behaviour therapy and treatment of any coexisting psychiatric conditions have been shown to help patients.

    • This question is part of the following fields:

      • Mental Health
      140.4
      Seconds
  • Question 9 - A 58-year-old woman presents with painless haematuria. She is a heavy smoker and...

    Correct

    • A 58-year-old woman presents with painless haematuria. She is a heavy smoker and has a history of chronic obstructive pulmonary disease. She previously lived in Australia and has used substantial amounts of non-steroidal anti-inflammatory drugs for arthritis and also phenacetin some years ago. Renal function testing is normal. She has a raised plasma viscosity and is anaemic with a haemoglobin of 100 g/l (115-155).
      Select the most likely diagnosis to fit with this clinical picture.

      Your Answer: Transitional-cell carcinoma of the bladder

      Explanation:

      Bladder Cancer: Risk Factors, Presentation, and Survival Rates

      Bladder cancer is a relatively uncommon malignancy, accounting for around 3% of cancer deaths. It is more prevalent in males, with a male to female ratio of 4:1, and is rare in individuals under 40 years of age. The most common type of bladder cancer is transitional-cell carcinoma.

      Several risk factors have been identified, including smoking, exposure to certain chemicals found in industrial settings, and the use of certain medications such as phenacetin and cyclophosphamide. Chronic inflammation caused by conditions such as schistosomiasis, indwelling catheters, or stones is associated with squamous-cell carcinoma of the bladder.

      The most common presentation of bladder cancer is painless hematuria (blood in the urine), although pain may occur due to clot retention. Women are more likely to have muscle-invasive disease at presentation.

      The 5-year survival rate for bladder cancer varies depending on the stage of the disease at diagnosis. Patients with small, early superficial tumors have a survival rate of 80-90%, while those with metastases at presentation have a survival rate of only 5%.

      In conclusion, bladder cancer is a serious condition that can be caused by a variety of factors. Early detection and treatment are crucial for improving survival rates.

    • This question is part of the following fields:

      • Kidney And Urology
      65.9
      Seconds
  • Question 10 - A 4-year-old boy from a traveller community family is brought to the surgery...

    Incorrect

    • A 4-year-old boy from a traveller community family is brought to the surgery by his mother.

      She informs you that he began with what appeared to be a severe catarrhal cold, but now experiences intense paroxysms of coughing, causing him to turn completely red in the face and struggle to catch his breath. Upon examination, he has no fever.

      What feature on history, examination, or investigation, although not conclusive, is consistent with the presence of whooping cough?

      Your Answer: Neutrophilia

      Correct Answer: Lack of pyrexia

      Explanation:

      Whooping Cough: Symptoms and Risk Factors

      The incubation period for whooping cough, also known as pertussis, typically lasts seven to 10 days but can extend up to 21 days. Patients with this condition often experience a paroxysmal cough with an inspiratory whoop, and lymphocytosis is commonly observed. While extensive consolidation is uncommon, pockets of lower respiratory tract infection may occur due to atelectasis. Notably, a lack of fever is a strong indication of whooping cough.

      Children from travelling families may be at a higher risk of contracting whooping cough if they have missed the standard vaccination schedule. It is important to be aware of the symptoms and risk factors associated with this condition to ensure prompt diagnosis and treatment.

    • This question is part of the following fields:

      • Children And Young People
      42.4
      Seconds
  • Question 11 - A 65-year-old woman presents with a feeling of shortness of breath and choking,...

    Incorrect

    • A 65-year-old woman presents with a feeling of shortness of breath and choking, on lying down. Some six months earlier she had been diagnosed with atrial fibrillation. On examination, she has a goitre. Plain radiography confirms retrosternal extension, which is presumed to be contributing to her shortness of breath. Her thyroid-stimulating hormone (TSH) level is less than 0.04 mIU/l (normal range 0.17 - 3.2 mIU/l). Thyroid autoantibodies are negative.
      Which of the following diagnoses best fits with this patients clinical picture?

      Your Answer: Hashimoto’s thyroiditis

      Correct Answer: Toxic multinodular goitre

      Explanation:

      Toxic multinodular goitre is a condition that commonly affects women over 55 years of age and is more prevalent than Graves’ disease in the elderly. It is characterized by a goitre that obstructs and extends retrosternally, which may cause atrial fibrillation. The preferred treatment is surgery, but the patient should first be made euthyroid with carbimazole. Graves’ disease, on the other hand, is an autoimmune disorder that accounts for 75% of thyrotoxicosis cases. It is characterized by hyperthyroidism, diffuse goitre, and eye changes. Hashimoto’s thyroiditis is another autoimmune thyroiditis that initially causes hyperthyroidism followed by hypothyroidism. It is characterized by the aggressive destruction of thyroid cells, resulting in a goitre and high levels of autoantibodies against thyroid peroxidase. Thyroglossal cyst is a cyst that forms from a persistent thyroglossal duct and presents as an asymptomatic midline neck mass. Thyroid carcinoma, on the other hand, presents as a non-tender thyroid nodule with normal thyroid function tests.

    • This question is part of the following fields:

      • Metabolic Problems And Endocrinology
      271.5
      Seconds
  • Question 12 - A 75-year old woman with diabetes and end stage renal failure is visited...

    Incorrect

    • A 75-year old woman with diabetes and end stage renal failure is visited for a home visit. She is receiving at-home dialysis through a Tenckhoff catheter. She has been feeling increasingly unwell for the past 24 hours, experiencing vomiting and abdominal pain. She had a normal bowel movement this morning.

      During the examination, she appears to be dehydrated with a blood pressure of 96/68 mmHg and a pulse rate of 108. Her temperature is 38.1℃. She experiences diffuse abdominal pain and general tenderness throughout the abdomen upon superficial palpation.

      What is the most probable cause of her symptoms?

      Your Answer: Peritonitis

      Correct Answer: Aluminium toxicity

      Explanation:

      Peritonitis in a Patient with Tenckhoff Catheter

      This patient has a Tenckhoff catheter in-situ for peritoneal dialysis, which puts them at risk of peritonitis, most commonly caused by Staphylococci. Symptoms such as pyrexia, low BP, tachycardia, and diffuse abdominal pain make peritonitis the most likely answer. Cloudy dialysis fluid is also a common sign of peritonitis.

      Aluminium toxicity is now rare due to the removal of aluminium from dialysate, which has reduced the incidence of dialysis dementia. Dialysis disequilibrium syndrome is a phenomenon that occurs with haemodialysis, not peritoneal dialysis, and is characterised by symptoms such as disorientation, headache, blurred vision, nausea, and seizures.

      Hernias and exit site infections can develop at the site of the Tenckhoff catheter, but they would not typically cause systemic unwellness such as pyrexia and diffuse abdominal pain. Bowel obstruction can occur secondary to a hernia, but peritonitis is a much more likely answer in this case. Exit site infections are characterised by localised erythema and sometimes pus exudation.

    • This question is part of the following fields:

      • Urgent And Unscheduled Care
      79.5
      Seconds
  • Question 13 - A 25-year-old medical student presents to the emergency department accompanied by his friend,...

    Correct

    • A 25-year-old medical student presents to the emergency department accompanied by his friend, reporting a 24-hour history of aggressive behaviour, irritability, and hallucinations. The friend suspects that the patient has experienced a mental breakdown due to sleep deprivation from studying for exams. Laboratory tests reveal no evidence of drug use or infection. The patient is admitted to the hospital for observation and returns to his usual behaviour the following day.

      What is the probable diagnosis in this case?

      Your Answer: Brief psychotic disorder

      Explanation:

      The correct answer is brief psychotic disorder, which is a short-term condition characterized by the sudden onset of at least one positive psychotic symptom, such as delusions, hallucinations, disorganized speech, or catatonic behavior. Unlike other disorders, brief psychotic disorder often resolves with a return to baseline functioning. Adjustment disorder, bipolar disorder, and schizoaffective disorder are not the correct answers as they have different symptoms and characteristics.

      Understanding Psychosis: Symptoms and Associated Features

      Psychosis is a term used to describe a person’s experience of perceiving things differently from those around them. This can manifest in a variety of ways, including hallucinations, delusions, thought disorganization, alogia, tangentiality, clanging, and word salad. These symptoms can be associated with agitation, aggression, neurocognitive impairment, depression, and thoughts of self-harm.

      Psychotic symptoms can occur in a number of conditions, including schizophrenia, depression, bipolar disorder, puerperal psychosis, brief psychotic disorder, neurological conditions like Parkinson’s disease and Huntington’s disease, and as a result of prescribed drugs or certain illicit drugs like cannabis and phencyclidine.

      The peak age of first-episode psychosis is around 15-30 years. It is important to understand the symptoms and associated features of psychosis in order to recognize and seek appropriate treatment for those experiencing these symptoms.

    • This question is part of the following fields:

      • Mental Health
      62.4
      Seconds
  • Question 14 - A 45-year-old woman is newly diagnosed with ankylosing spondylitis. An echocardiogram shows a...

    Incorrect

    • A 45-year-old woman is newly diagnosed with ankylosing spondylitis. An echocardiogram shows a valvular anomaly.
      What is the most probable diagnosis?

      Your Answer: Aortic stenosis

      Correct Answer: Aortic regurgitation

      Explanation:

      Cardiovascular Complications in Ankylosing Spondylitis

      Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints. However, it can also lead to cardiovascular complications. The most common complication is aortic regurgitation, which occurs due to inflammation of the ascending aorta. On the other hand, mitral regurgitation is not typically associated with ankylosing spondylitis and is usually caused by congenital conditions or cardiomyopathies. Aortic stenosis is also not commonly associated with ankylosing spondylitis, as it is usually caused by age-related calcification or congenital bicuspid valve. Similarly, mitral stenosis is more commonly associated with rheumatic heart disease than ankylosing spondylitis. Tricuspid stenosis is a rare cardiac defect that is usually associated with rheumatic fever. Therefore, it is important for individuals with ankylosing spondylitis to be aware of the potential cardiovascular complications and to seek medical attention if any symptoms arise.

    • This question is part of the following fields:

      • Cardiovascular Health
      60
      Seconds
  • Question 15 - A 25-year-old male patient complains of feeling unwell for the past three days...

    Correct

    • A 25-year-old male patient complains of feeling unwell for the past three days with a low-grade fever. He has developed painful ulcers in his mouth and gums. During examination, submandibular lymphadenopathy is observed. What is the probable diagnosis?

      Your Answer: Herpes simplex virus infection

      Explanation:

      Primary herpes simplex virus infection is indicated by gingivostomatitis, which this man is experiencing.

      The herpes simplex virus (HSV) comes in two strains: HSV-1 and HSV-2. It was once believed that HSV-1 caused cold sores and HSV-2 caused genital herpes, but there is now significant overlap between the two. Symptoms of a primary infection may include severe gingivostomatitis, while cold sores and painful genital ulceration are also common. Treatment options include oral aciclovir and chlorhexidine mouthwash for gingivostomatitis, topical aciclovir for cold sores (although the evidence for its effectiveness is limited), and oral aciclovir for genital herpes. Pregnant women with herpes should be treated with suppressive therapy, and those who experience a primary attack during pregnancy after 28 weeks gestation should have an elective caesarean section. The risk of transmission to the baby is low for women with recurrent herpes. Pap smear images can show the cytopathic effect of HSV, including multinucleation, marginated chromatin, and molding of the nuclei.

    • This question is part of the following fields:

      • Infectious Disease And Travel Health
      307.5
      Seconds
  • Question 16 - A 49-year-old man seeks guidance on Universal Credit benefits. He had to quit...

    Incorrect

    • A 49-year-old man seeks guidance on Universal Credit benefits. He had to quit his job as an engineer due to a motorcycle accident that resulted in a fractured femur. His orthopaedic surgeon predicts that his recovery will take several months. Currently, he works part-time as a freelance web developer, earning less than £200 per month.

      He resides in the UK with his wife and two young children. They have a combined savings of £30,000, and his wife is currently unemployed, taking care of their children.

      What advice would you offer him regarding his eligibility for Universal Credit?

      Your Answer: He is eligible for Universal Credit

      Correct Answer: He is not eligible for Universal Credit owing to his collective savings

      Explanation:

      To be eligible for Universal Credit, an individual must have savings below £16,000. However, in the case of co-habiting couples, the partner’s income and savings will also be taken into consideration. It is important to note that intentionally transferring or reducing savings to increase the amount of Universal Credit received is considered deprivation of capital and will be investigated by the Department of Work and Pensions. Employment doesn’t disqualify an individual from receiving Universal Credit, as long as their earnings do not exceed the administrative earnings threshold of £338 per individual or £541 for a household. Age and marital status also do not affect eligibility for Universal Credit.

      Understanding Universal Credit: Benefits, Eligibility, and Controversies

      Universal Credit is a new benefit system in the UK that aims to simplify the welfare system by combining six benefits into one payment. It is designed to help people meet the cost of living and encourage them to work. To be eligible for Universal Credit, a person and their partner must live in the UK, be 18 years old or over, earn a low income or be out of work, have less than £16,000 in savings, and be below the age of receiving the state pension.

      The amount of money a person receives from Universal Credit depends on their circumstances. It includes a standard allowance and extra payments for up to two children, disability, or housing costs. However, there is a benefit cap that limits the total amount one can receive. The payment reduces as people earn money, but they have a work allowance of how much they can earn before their payment is decreased.

      Universal Credit is supposed to help people learn to budget their money and prepare them for having a job. It also allows people to work and still receive support through a ‘work allowance.’ Applying for Universal Credit is done online, which cuts down the cost of managing benefits to the government.

      Despite its supposed benefits, Universal Credit is controversial. Some people take issue with the fact that people have to wait five weeks to receive their first payment and then struggle due to only receiving payments every month. Childcare must be paid by parents upfront and is then refunded by Universal Credit. Many disabled people and households receive less than they did with the old benefits system. Universal Credit will only pay for the first two children for children born after April 2017, whereas the old benefits paid benefits for each child per year. Private tenants find it harder to rent.

    • This question is part of the following fields:

      • Equality, Diversity And Inclusion
      59.8
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  • Question 17 - A 10-week-old boy has not opened his bowels for five days. The mother...

    Incorrect

    • A 10-week-old boy has not opened his bowels for five days. The mother reports that he is exclusively breastfed. The baby appears healthy, and examination findings are unremarkable. Meconium was passed within the first 24 hours after birth. What is the most suitable course of action?

      Your Answer: Urgent referral to hospital

      Correct Answer: Reassure the parents that this is usually normal in a breastfed infant

      Explanation:

      Understanding Infant Bowel Movements: Breastfed Babies and Constipation

      Breastfed infants tend to have more frequent bowel movements than formula-fed babies, but there is a wide range of normal variation. It is common for breastfed babies to have frequent bowel movements up to six weeks of age due to the gastro-colic reflex. However, it is also normal for breastfed babies to go several days without a bowel movement, sometimes up to 7-10 days. When a bowel movement does occur after a longer period of time, it may be a blow-out of normal consistency and should not cause concern as long as it appears painless.

      It is important to note that simple straining to pass stool is also normal and doesn’t necessarily indicate constipation. However, if there are worrying signs such as difficulty with feeding, failure to gain weight, or signs of discomfort, medical attention should be sought.

      It is not necessary to give a macrogol laxative unless a diagnosis of constipation is made. Additionally, introducing baby food containing fruit and vegetables is not appropriate for exclusively breastfed infants. Prune juice may help with constipation, but it is not recommended for infants until they are weaned at 4-6 months.

      Overall, as long as the baby is well and examination is normal, there is no need for urgent referral to hospital. However, if constipation appears during the first few weeks of life, it may be a sign of a more serious condition such as Hirschsprung’s disease, which requires medical attention.

    • This question is part of the following fields:

      • Children And Young People
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  • Question 18 - A 16-year-old girl has been diagnosed with glandular fever. What advice should be...

    Correct

    • A 16-year-old girl has been diagnosed with glandular fever. What advice should be given regarding participation in sports?

      Your Answer: Avoid contact sports for 4 weeks after having glandular fever

      Explanation:

      Screening for splenomegaly cannot be effectively done through clinical examination alone. Additionally, individuals with glandular fever should refrain from participating in contact sports for a period of 4 weeks.

      Understanding Infectious Mononucleosis

      Infectious mononucleosis, also known as glandular fever, is a viral infection caused by the Epstein-Barr virus (EBV) in 90% of cases. It is most commonly seen in adolescents and young adults. The classic symptoms of sore throat, pyrexia, and lymphadenopathy are present in around 98% of patients. Other symptoms include malaise, anorexia, headache, palatal petechiae, splenomegaly, hepatitis, lymphocytosis, haemolytic anaemia, and a rash. The symptoms typically resolve after 2-4 weeks.

      The diagnosis of infectious mononucleosis is confirmed through a heterophil antibody test (Monospot test) in the second week of the illness. Management is supportive and includes rest, drinking plenty of fluids, avoiding alcohol, and taking simple analgesia for any aches or pains. It is recommended to avoid playing contact sports for 4 weeks after having glandular fever to reduce the risk of splenic rupture.

      Interestingly, there is a correlation between EBV and socioeconomic groups. Lower socioeconomic groups have high rates of EBV seropositivity, having frequently acquired EBV in early childhood when the primary infection is often subclinical. However, higher socioeconomic groups show a higher incidence of infectious mononucleosis, as acquiring EBV in adolescence or early adulthood results in symptomatic disease.

    • This question is part of the following fields:

      • Infectious Disease And Travel Health
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  • Question 19 - A 63-year-old woman presents to her General Practitioner complaining of a burning sensation...

    Incorrect

    • A 63-year-old woman presents to her General Practitioner complaining of a burning sensation on the anterolateral aspect of her right thigh. She has diabetes and has not attended the diabetic follow-up clinic for a year. Eight months ago she had a mild stroke that affected her right side. She was also found to have atrial fibrillation, for which she is taking warfarin.
      On examination, she is obese. She has normal muscle power. Her tone is slightly increased on the right, with right-sided reflexes are slightly brisker than those on the left. Pinprick is reduced over the anterolateral aspect of her right thigh.
      What is the most likely diagnosis?

      Your Answer: Diabetic femoral nerve amyotrophy

      Correct Answer: Compression of the lateral cutaneous nerve of the thigh

      Explanation:

      Possible Causes of Anterolateral Thigh Pain in a Stroke Patient with Increased Reflexes and Tone

      The patient’s symptoms suggest meralgia paraesthetica, which is caused by compression of the lateral cutaneous nerve of the thigh. This condition typically causes pain and sensory abnormalities in the anterolateral thigh and is more common in obese individuals. The patient’s increased reflexes and tone on the right side are likely due to the stroke she suffered seven months ago.

      Other possible causes of anterolateral thigh pain and weakness include diabetic femoral nerve amyotrophy, femoral hernia, and iliopsoas haematoma from warfarin use. However, these conditions are less likely based on the patient’s presentation.

      Thalamic pain from a previous stroke is another potential cause, although it is not typically as well-localized as the patient’s symptoms suggest. It is important to consider the patient’s diabetes as a factor that may increase the susceptibility of any peripheral nerve damage.

    • This question is part of the following fields:

      • Neurology
      18288.8
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  • Question 20 - A 54-year-old gentleman presents with recurrent painful and erythematous left first metatarsal joint....

    Incorrect

    • A 54-year-old gentleman presents with recurrent painful and erythematous left first metatarsal joint. After diagnosis of gout and treatment with an anti-inflammatory, you check his blood tests during the acute attack and find his uric acid level to be 260 µmol/L (180-380). He has experienced four episodes of gout in the past 18 months and seeks advice on how to prevent future attacks. What recommendations should you provide?

      Your Answer: A low dose anti-inflammatory should be continued regularly to prevent recurrence

      Correct Answer: As his uric acid level is normal he doesn't need prophylactic treatment with uric acid lowering drug therapy (such as allopurinol)

      Explanation:

      Management of Acute Gout and Prophylactic Treatment

      During an acute attack of gout, serum urate levels may appear lower than usual and should not be used to guide management or rule out the diagnosis of gout. It is recommended to check serum urate levels four to six weeks after an attack to obtain an accurate reflection of levels. Patients with recurrent attacks of acute gout are excellent candidates for prophylactic treatment. Allopurinol is the usual first-line drug, and the dose should be titrated to maintain a serum urate level of less than 300 µmol/L. While initiating and titrating allopurinol, a nonsteroidal anti-inflammatory drug (NSAID) or colchicine should be co-prescribed to cover against precipitating an acute flare. However, a low dose anti-inflammatory is not a recommended long-term prophylactic approach. Genetic testing is not a usual part of the workup, although some genetic conditions are associated with hyperuricaemia, such as Lesch-Nyhan syndrome.

    • This question is part of the following fields:

      • Musculoskeletal Health
      826.6
      Seconds
  • Question 21 - A father brings his 14-year-old son to see you. The boy is a...

    Incorrect

    • A father brings his 14-year-old son to see you. The boy is a high achiever and is about to take his 'GCSEs'.
      In recent months he has broken up with his girlfriend, has lost interest in his usual hobbies, and has lost a stone in weight so that his BMI is now 17. He cries frequently, struggles to focus on his school work, and is not interested in playing video games, one of his favourite pastimes.
      His father feels he is depressed, and you are inclined to agree.
      Which of the following symptoms would make you suspect this was more than a straightforward depression?

      Your Answer: Weight loss

      Correct Answer: Feelings of guilt

      Explanation:

      Anorexia Nervosa and Disproportionate Body Image Perception

      Disproportionate perception of one’s body image, often characterized by the belief of being overweight, is a common feature of anorexia nervosa. This condition is often accompanied by symptoms of depression, but treating it with antidepressants alone may not yield significant improvement. It is important to consider alternative diagnoses, especially in age groups where depression is not prevalent.

      In summary, anorexia nervosa is a serious condition that affects one’s perception of their body image. It is crucial to seek appropriate treatment and consider other potential diagnoses to ensure proper care.

    • This question is part of the following fields:

      • Mental Health
      35.7
      Seconds
  • Question 22 - A 32 year old woman comes to your clinic 3 weeks after giving...

    Correct

    • A 32 year old woman comes to your clinic 3 weeks after giving birth to a healthy baby girl. She is worried that her baby is not breastfeeding properly, unlike her previous two children. The baby seems to struggle with latching on and the mother experiences pain during attachment. You suspect that the baby may have tongue-tie. What is true about tongue-tie?

      Your Answer: Division of the tongue-tie is usually performed without anaesthesia

      Explanation:

      Understanding Tongue-Tie

      Tongue-tie, also known as ankyloglossia, is a congenital condition that is characterized by a short, thick lingual frenulum that restricts the movement of the tongue. The severity of the condition varies, with some cases being mild and others more severe. In mild cases, the tongue is only bound by a thin mucous membrane, while in more severe cases, the tongue is tethered to the floor of the mouth.

      While some cases of tongue-tie are asymptomatic and can be managed with simple interventions such as breastfeeding advice and tongue exercises, others can cause significant problems with breastfeeding, speech, and oral hygiene. A tethered tongue can prevent the tongue from contacting the anterior palate, which can lead to open bite deformity and mandibular prognathism.

      To prevent future problems with speech, swallowing, and feeding, many clinicians advocate for early surgical division of the lingual frenulum. This procedure, known as frenotomy, involves using sharp, blunt-ended scissors to divide the frenulum. In infants, the procedure is usually performed without anesthesia, although local anesthesia may be used in some cases. In older infants and children, general anesthesia is typically required.

      Overall, understanding tongue-tie and its potential consequences is important for parents and healthcare providers alike. Early intervention can help prevent future problems and ensure that children are able to breastfeed, speak, and eat properly.

    • This question is part of the following fields:

      • Children And Young People
      978.7
      Seconds
  • Question 23 - A 16-year-old female presents with a sore throat. Upon examination, she has enlarged...

    Incorrect

    • A 16-year-old female presents with a sore throat. Upon examination, she has enlarged tonsils on both sides and tender cervical lymphadenopathy. Her medical history shows that she has had six episodes of tonsillitis in the past year and has missed several days of school due to her sore throat. With a Centor score of 3/4, you decide to prescribe penicillin V. What other treatment options should be considered?

      Your Answer: Advise her to take vitamin C and zinc supplements

      Correct Answer: Refer to ENT for consideration of a tonsillectomy

      Explanation:

      The frequency of tonsillectomies has significantly decreased in recent years due to increased recognition of the possible risks and limited advantages. Nevertheless, the patient meets the referral standards outlined by NICE.

      Tonsillitis and Tonsillectomy: Complications and Indications

      Tonsillitis is a condition that can lead to various complications, including otitis media, peritonsillar abscess, and, in rare cases, rheumatic fever and glomerulonephritis. Tonsillectomy, the surgical removal of the tonsils, is a controversial procedure that should only be considered if the person meets specific criteria. According to NICE, surgery should only be considered if the person experiences sore throats due to tonsillitis, has five or more episodes of sore throat per year, has been experiencing symptoms for at least a year, and the episodes of sore throat are disabling and prevent normal functioning. Other established indications for a tonsillectomy include recurrent febrile convulsions, obstructive sleep apnoea, stridor, dysphagia, and peritonsillar abscess if unresponsive to standard treatment.

      Despite the benefits of tonsillectomy, the procedure also carries some risks. Primary complications, which occur within 24 hours of the surgery, include haemorrhage and pain. Secondary complications, which occur between 24 hours to 10 days after the surgery, include haemorrhage (most commonly due to infection) and pain. Therefore, it is essential to weigh the benefits and risks of tonsillectomy before deciding to undergo the procedure.

    • This question is part of the following fields:

      • Ear, Nose And Throat, Speech And Hearing
      374.3
      Seconds
  • Question 24 - A 40-year-old woman comes in for a check-up. She has recently noticed several...

    Incorrect

    • A 40-year-old woman comes in for a check-up. She has recently noticed several areas of 'pale skin' on her hands. Despite using an emollient and topical hydrocortisone, there has been no improvement. During the examination, you observe multiple depigmented patches on the back of both hands. The patient's medical history includes a previous diagnosis of thyrotoxicosis, for which she is currently taking carbimazole and thyroxine.

      What could be the probable reason behind her symptoms?

      Your Answer: Carbimazole-induced hypopigmentation

      Correct Answer: Vitiligo

      Explanation:

      Patients with autoimmune conditions like thyrotoxicosis are more likely to have vitiligo, but there are no other indications in the medical history that point towards Addison’s disease.

      Understanding Vitiligo

      Vitiligo is a medical condition that occurs when the immune system attacks and destroys melanocytes, leading to the loss of skin pigmentation. It is estimated to affect about 1% of the population, with symptoms typically appearing in individuals between the ages of 20 and 30 years. The condition is characterized by well-defined patches of depigmented skin, with the edges of the affected areas being the most prominent. Trauma to the skin may also trigger the development of new lesions, a phenomenon known as the Koebner phenomenon.

      Vitiligo is often associated with other autoimmune disorders such as type 1 diabetes mellitus, Addison’s disease, autoimmune thyroid disorders, pernicious anemia, and alopecia areata. While there is no cure for vitiligo, there are several management options available. These include the use of sunblock to protect the affected areas of skin, camouflage make-up to conceal the depigmented patches, and topical corticosteroids to reverse the changes if applied early. Other treatment options may include topical tacrolimus and phototherapy, although caution is advised when using these treatments on patients with light skin. Overall, early diagnosis and management of vitiligo can help to improve the quality of life for affected individuals.

    • This question is part of the following fields:

      • Dermatology
      402.4
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  • Question 25 - A 2-year-old girl with a barking cough is diagnosed with croup. However, she...

    Correct

    • A 2-year-old girl with a barking cough is diagnosed with croup. However, she is feeding well and has only a low-grade fever of 37.9ºC. No intercostal recession is observed during examination. The decision is made to manage her in primary care. What is the best course of action?

      Your Answer: Dexamethasone 0.15mg/kg single dose

      Explanation:

      Regardless of severity, a one-time oral dose of dexamethasone (0.15 mg/kg) should be taken immediately for croup.

      Croup is a respiratory infection that affects young children, typically those between 6 months and 3 years old. It is most common in the autumn and is caused by parainfluenza viruses. The main symptom is stridor, which is caused by swelling and secretions in the larynx. Other symptoms include a barking cough, fever, and cold-like symptoms. The severity of croup can be graded based on the child’s symptoms, with mild cases having occasional coughing and no audible stridor at rest, and severe cases having frequent coughing, prominent stridor, and significant distress or lethargy. Children with moderate or severe croup should be admitted to the hospital, especially if they are under 6 months old or have other airway abnormalities. Diagnosis is usually made based on clinical symptoms, but a chest x-ray can show subglottic narrowing. Treatment typically involves a single dose of oral dexamethasone or prednisolone, and emergency treatment may include high-flow oxygen or nebulized adrenaline.

    • This question is part of the following fields:

      • Children And Young People
      77
      Seconds
  • Question 26 - A 50-year-old man comes in for a check-up. He is of Afro-Caribbean heritage...

    Incorrect

    • A 50-year-old man comes in for a check-up. He is of Afro-Caribbean heritage and has been on a daily dose of amlodipine 10 mg. Upon reviewing his blood pressure readings, it has been found that he has an average of 154/93 mmHg over the past 2 months. Today, his blood pressure is at 161/96 mmHg. The patient is eager to bring his blood pressure under control. What is the most effective treatment to initiate in this scenario?

      Your Answer: Add beta blocker

      Correct Answer: Add angiotensin receptor blocker

      Explanation:

      If a black African or African-Caribbean patient with hypertension is already taking a calcium channel blocker and requires a second medication, it is recommended to add an angiotensin receptor blocker instead of an ACE inhibitor. This is because studies have shown that this class of medication is more effective in patients of this heritage. In this case, the patient would benefit from the addition of candesartan to lower their blood pressure. An alpha-blocker is not necessary at this stage, and a beta-blocker is not recommended as it is better suited for heart failure and post-myocardial infarction. Increasing the dose of amlodipine is also unlikely to be helpful as the patient is already on the maximum dose.

      Hypertension, or high blood pressure, is a common condition that can lead to serious health problems if left untreated. The National Institute for Health and Care Excellence (NICE) has published updated guidelines for the management of hypertension in 2019. Some of the key changes include lowering the threshold for treating stage 1 hypertension in patients under 80 years old, allowing the use of angiotensin receptor blockers instead of ACE inhibitors, and recommending the use of calcium channel blockers or thiazide-like diuretics in addition to ACE inhibitors or angiotensin receptor blockers.

      Lifestyle changes are also important in managing hypertension. Patients should aim for a low salt diet, reduce caffeine intake, stop smoking, drink less alcohol, eat a balanced diet rich in fruits and vegetables, exercise more, and lose weight.

      Treatment for hypertension depends on the patient’s blood pressure classification. For stage 1 hypertension with ABPM/HBPM readings of 135/85 mmHg or higher, treatment is recommended for patients under 80 years old with target organ damage, established cardiovascular disease, renal disease, diabetes, or a 10-year cardiovascular risk equivalent to 10% or greater. For stage 2 hypertension with ABPM/HBPM readings of 150/95 mmHg or higher, drug treatment is recommended regardless of age.

      The first-line treatment for patients under 55 years old or with a background of type 2 diabetes mellitus is an ACE inhibitor or angiotensin receptor blocker. Calcium channel blockers are recommended for patients over 55 years old or of black African or African-Caribbean origin. If a patient is already taking an ACE inhibitor or angiotensin receptor blocker, a calcium channel blocker or thiazide-like diuretic can be added.

      If blood pressure remains uncontrolled with the optimal or maximum tolerated doses of four drugs, NICE recommends seeking expert advice or adding a fourth drug. Blood pressure targets vary depending on age, with a target of 140/90 mmHg for patients under 80 years old and 150/90 mmHg for patients over 80 years old. Direct renin inhibitors, such as Aliskiren, may be used in patients who are intolerant of other antihypertensive drugs, but their role is currently limited.

    • This question is part of the following fields:

      • Cardiovascular Health
      47
      Seconds
  • Question 27 - A 42-year-old woman with a learning disability and communication difficulties seeks advice for...

    Incorrect

    • A 42-year-old woman with a learning disability and communication difficulties seeks advice for heavy menstrual bleeding. She is accompanied by another woman who introduces herself as a support person, there to assist the patient in making her own decisions and promoting her independence.
      What is the role of the accompanying woman in this scenario? Choose ONE answer.

      Your Answer: Carer

      Correct Answer: Patient advocate

      Explanation:

      Different Roles in Healthcare: Patient Advocate, Carer, Chaperone, IMCA, and Attorney

      In healthcare, there are various roles that individuals can take to support patients in different ways. One of these roles is that of a patient advocate, whose primary responsibility is to help patients communicate their views or decisions when they have difficulty doing so themselves. This role is independent and doesn’t involve making decisions on behalf of the patient.

      Another role is that of a carer, who provides practical and emotional support to patients, often in a long-term capacity. A chaperone, on the other hand, acts as a witness during medical procedures to ensure the safety and comfort of both the patient and the practitioner.

      An independent mental-capacity advocate (IMCA) is appointed to safeguard the rights of individuals who lack the capacity to make decisions for themselves. Finally, an attorney can be appointed by a patient to help them make decisions or make decisions on their behalf if they lack capacity.

      Overall, these different roles play important and distinct functions in supporting patients in healthcare settings.

    • This question is part of the following fields:

      • Neurodevelopmental Disorders, Intellectual And Social Disability
      83.1
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  • Question 28 - A 50-year-old lady comes to the clinic with tortuous, dilated, superficial leg veins....

    Incorrect

    • A 50-year-old lady comes to the clinic with tortuous, dilated, superficial leg veins. These have been present for a few years and do not cause any discomfort, but she is unhappy with their appearance.

      Upon examination, there are no skin changes, leg ulcers, or signs of thrombophlebitis.

      What is the MOST SUITABLE NEXT step in management?

      Your Answer: Refer to secondary care

      Correct Answer: Aspirin 75 mg OD

      Explanation:

      Conservative Management of Varicose Veins

      Conservative management is recommended for patients with asymptomatic varicose veins, meaning those that are not causing pain, skin changes, or ulcers. This approach includes lifestyle changes such as weight loss, light/moderate physical activity, leg elevation, and avoiding prolonged standing. Compression stockings are also recommended to alleviate symptoms.

      There is no medication available for varicose veins, and ultrasound is not necessary in the absence of thrombosis. Referral to secondary care may be necessary based on local guidelines, particularly if the patient is experiencing discomfort, swelling, heaviness, or itching, or if skin changes such as eczema are present due to chronic venous insufficiency. Urgent referral is required for venous leg ulcers and superficial vein thrombosis.

    • This question is part of the following fields:

      • Cardiovascular Health
      82.5
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  • Question 29 - You are requested to visit a 38-year-old man with motor neurone disease at...

    Incorrect

    • You are requested to visit a 38-year-old man with motor neurone disease at his residence. He was hospitalized for urosepsis and has just returned home. During his hospital stay, he underwent percutaneous endoscopic gastrostomy to facilitate enteral nutrition at home. What is the most probable complication of enteral feeding that he may experience?

      Your Answer: Refeeding syndrome

      Correct Answer: Aspiration pneumonia

      Explanation:

      Common Problems with Enteral Feeding

      Enteral feeding, or tube feeding, can cause various gastrointestinal problems. Nausea is a common issue that can be caused by administering the feed too quickly or altered gastric emptying. Abdominal bloating and cramps can also occur for similar reasons. Constipation may be a problem, but it is unlikely that the lack of fiber in enteral feeds is the underlying cause. Diarrhea is the most common complication of enteral tube feeding, affecting up to 30% of patients on general medical and surgical wards and 68% of those on ITU. Diarrhea can be unpleasant for the patient and can worsen pressure sores and contribute to fluid and electrolyte imbalances.

    • This question is part of the following fields:

      • Gastroenterology
      27.9
      Seconds
  • Question 30 - A 7-year-old boy comes to the GP with his father complaining of bedwetting...

    Incorrect

    • A 7-year-old boy comes to the GP with his father complaining of bedwetting at night. He is wetting the bed almost every night. Despite trying to use the toilet before bedtime, limiting fluid intake before bedtime, and implementing a reward system for dry nights, there has been no improvement. What should be the next course of action for treatment?

      Your Answer:

      Correct Answer: Enuresis alarm

      Explanation:

      If lifestyle measures and a reward chart have not helped with nocturnal enuresis in a child over the age of 5, the next step would be to consider an enuresis alarm or desmopressin. As the child in this scenario is 6 years-old, the first-line treatment would be to try an enuresis alarm before considering other options. Desmopressin may be used first-line for children over the age of 7 who do not wish to use an enuresis alarm or if a short term solution is needed.

      Managing Nocturnal Enuresis in Children

      Nocturnal enuresis, also known as bedwetting, is a common condition in children. It is defined as the involuntary discharge of urine during sleep in children aged 5 years or older who have not yet achieved continence. There are two types of nocturnal enuresis: primary and secondary. Primary enuresis occurs when a child has never achieved continence, while secondary enuresis occurs when a child has been dry for at least 6 months before.

      When managing nocturnal enuresis, it is important to look for possible underlying causes or triggers such as constipation, diabetes mellitus, or recent onset urinary tract infections. General advice includes monitoring fluid intake and encouraging regular toileting patterns, such as emptying the bladder before sleep. Lifting and waking techniques and reward systems, such as star charts, can also be effective.

      The first-line treatment for nocturnal enuresis is an enuresis alarm, which has a high success rate. These alarms have sensor pads that detect wetness and wake the child up when they start to wet the bed. If an enuresis alarm is not effective or not acceptable to the family, desmopressin can be used for short-term control, such as for sleepovers. It is important to note that reward systems should be given for agreed behavior rather than dry nights, such as using the toilet to pass urine before sleep. By following these management strategies, children with nocturnal enuresis can achieve continence and improve their quality of life.

    • This question is part of the following fields:

      • Children And Young People
      0
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SESSION STATS - PERFORMANCE PER SPECIALTY

Improving Quality, Safety And Prescribing (0/1) 0%
Maternity And Reproductive Health (0/2) 0%
Musculoskeletal Health (0/2) 0%
Dermatology (0/2) 0%
Metabolic Problems And Endocrinology (1/2) 50%
Kidney And Urology (2/2) 100%
Mental Health (1/3) 33%
Children And Young People (2/4) 50%
Urgent And Unscheduled Care (0/1) 0%
Cardiovascular Health (0/3) 0%
Infectious Disease And Travel Health (2/2) 100%
Equality, Diversity And Inclusion (0/1) 0%
Neurology (0/1) 0%
Ear, Nose And Throat, Speech And Hearing (0/1) 0%
Neurodevelopmental Disorders, Intellectual And Social Disability (0/1) 0%
Gastroenterology (0/1) 0%
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