Test your knowledge

Try these sample AKT questions provided by Dr Mahibur Rahman from Emedica

1. A 15-year-old boy attends surgery alone and requests treatment for severe acne. His parents are also registered patients at the surgery, and he has always attended with his mother in the past. Regarding consent to treatment, which ONE of the following is correct?

A – The patient cannot consent as he is under 16 years old. 
B – The patient can consent but his parents must be informed first. 
C – The patient can consent as long as his parents are told afterwards. 
D – The patient can consent if he meets the Fraser guidelines. 
E – The patient can consent if the GP deems him to be Gillick competent. 
 

2. A 44-year-old woman presents with a suspected breast lump. She accepts the offer of a chaperone during the examination, and a healthcare assistant is present throughout the examination. With regards to the medical record, which ONE of the following is correct?

A – The fact that a chaperone was present does not need to be noted. 
B – The fact that a chaperone was present should be noted, along with their identity (including name and job role). 
C – The fact that a chaperone was present should be noted, but no further details are necessary. 
D – The fact that a chaperone was present should be noted, along with their job title only. 
E – Details of the chaperone should be noted only with the chaperone’s permission. 
  

3. A 21-year-old university student with a long history of migraine requests prophylactic treatment. He has frequent attacks which respond well to high dose aspirin taken with an antiemetic. He is keen to try a prophylactic treatment as the number of attacks are affecting his studies. Which of the following would be a suitable first line treatment to prevent migraine?

A – Oral amitriptyline. 
B – Oral sumatriptan. 
C – Nasal sumatriptan. 
D – Oral topiramate. 
E – Oral gabapentin.


1. The correct answer is E – The patient can consent if the GP deems him to be Gillick competent. 
   
A patient under the age of 16 may consent to treatment if they are deemed to be Gillick competent. If he is deemed competent, then parental permission is not needed, and the validity of the consent is NOT dependent on the parents being informed, although unless the child objects, it would be good practice to keep them informed. Fraser guidelines are specific to contraception, so do not apply here.
   
  
2. The correct answer is B – The fact that a chaperone was present should be noted, along with their identity (including name and job role). 
   
GMC guidance recommends that where a chaperone is present during an examination, this should be recorded, along with the identity of the chaperone. The job title alone is not enough as it may be difficult to identify exactly WHO chaperoned (eg, there may be many receptionists). 
  
  
3. The correct answer is D – Oral topiramate. 
  
The NICE guidelines on management of headache (NICE 2012) recommend either topiraramate or propranolol as first line treatment options for the prophylaxis of migraine. Gabapentin is usually reserved for patient that are unable to tolerate first line treatments or where there is no response. It is not licensed for this indication and so should not be used first line where a licensed alternative is available.