Table Of ContentContents
Foreword v
About the authors vii
About the publisher vii
Acknowledgements ix
Preface xi
About the exam and tips on passing xiii
Single Best Answer (SBA) Question Paper 1
Answer section: Single Best Answer 42
Extended Match Question (EMQ) Paper 66
Answer section: Extended Match Questions 88
Picture Question Paper 102
Answer section: Picture Questions 151
Mock Paper: 200 questions 162
Answer section: Mock Paper 226
Subject Index 260
Copyright Permission list 262
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Succeeding in the nMRCGP
AKT (Applied Knowledge
Test) – 500 SBAs, EMQs and
Picture MCQs, with a full
Mock Test
Chirag Mehta, Mark Williams & Milan Mehta
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Published by Developmedica
Castle Court
Duke Street
New Basford,
Nottingham, NG7 7JN
0845 838 0571
www.developmedica.com
© 2009 Developmedica
Digital Edition converted and published by Andrews UK Limited 2010
www.andrewsuk.com
All rights reserved. Purchasers of this book are instructed that they can only use
this guide for the sole purpose of preparing for their nMRCGP AKT and are
prohibited from redistributing this book or any part thereof. This book cannot be
reproduced in full or in part without the express written consent of Developmedica.
Developmedica recommend that you consult the GP Recruitment website regarding
your nMRCGP AKT. The views expressed in this book are those of Developmedica
and not those of Royal College of General Practioners and Developmedica are in
no way associated with the Royal College of General Practioners or Pearson Vue.
The contents of this book are intended as a guide only and although every effort has been
made to ensure that the contents of this book are correct, Developmedica cannot be held
responsible for the outcome of any loss or damage that arises through the use of this
guide. Readers are advised to seek independent advice regarding their nMRCGP AKT.
Warning: The contents of this revision guide are for the purposes
of aiding you to prepare for your nMRCGP AKT only and are
not intended to replace the protocols of your current employer.
Every effort has been made to contact the copyright holders of any material
reproduced within this publication. If any have been inadvertently overlooked,
the publishers will be pleased to make restitution at the earliest opportunity.
A catalogue record for this title is available from the British Library
ISBN: 9781906839543
Typeset by Replika Press Pvt. Ltd. (India)
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Foreword
Doctors are good at passing exams. That is how we all got to where we
are.
But assessment in general practice, as in all the specialties, has moved
on. Multiple choice questions have undergone subtle changes and the
applied knowledge test (AKT) for Membership of the Royal College of
General Practitioners is a different sort of exam. Candidates are not asked
to demonstrate knowledge but to apply it.
The computer-based, multi-centre AKT was offered for the sixth time
in April 2009. 1102 candidates sat the exam and their mean score was
143 out of 199 questions, with the best candidate scoring 183. 83.8% of
candidates passed. Thus bright, well motivated learners are doing well -
especially if you sit the exam later on in your training period.
The answers on how to pass the exam will not be found in this book.
They will be found during your time in practice seeing lots of patients,
focussing on those ‘awkward moments’ when you realise your training
so far has left you completely unprepared for the worries of the patient
in front of you. Looking things up in response to patients’ unmet needs
or doctor’s educational needs, talking to your trainer and colleagues,
discussing issues that are important to patients and reading widely will
get you through the exam. Such is the alignment between this exam and
practice that that is also how you will get to be a good GP.
What this book will give you is a way of self-assessing your areas of
weakness, showing you where to focus your reading and getting you to
think about the breadth and depth of the RCGP curriculum. You won’t
see everything in practice, rare but important conditions are also part of
this exam and you may need reminding of those.
The authors are all trainees who have recently passed the AKT. They
have worked hard to develop something that can act as a signpost for
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vi Foreword
you, based on their experience. This book is an excellent jumping off
point for your reading.
Good luck!
Kay Mohanna
Chair, RCGP Midland Faculty and Director of Postgraduate Medicine,
Keele University.
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About the authors
Chirag Mehta is a GP trainee in the West Midland Deanery who qualified
from Manchester University in 2006. He has had articles published in the
British Medical Journal, the GP trainee journal InnovAit and also in the
journal Public Health. He has recently passed his nMRCGP AKT exam
in April 2009.
Milan Mehta has come to the end of his GP vocational training within
the West Midlands Deanery and has successfully obtained his nMRCGP
qualification. He has had articles published in a number of international
medical journals and will shortly be taking up a Teaching Fellow post in
academic General Practice at Keele University. Together with this he will
also continue to work as a part-time salaried GP in Staffordshire.
Mark Williams is a GP trainee who has previously co-authored
a book on medical careers, ‘The Medical Student Career
Handbook’ and has had articles published in the British Medical
Journal and Emergency Medical Journal. He has recently
passed the nMRCGP AKT.
About the publisher
Developmedica is a specialist provider of books, courses and eLearning
solutions tailored to meet your career development needs. Visit our web
site at www.developmedica.com and find out more.
Our approach is friendly and personal, and we are only a phone call or
an email away.
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Acknowledgements
We would like to thank Dr Sarah Gear (GP) for her assistance in reviewing
the book. We would also like to thank Dr Kay Mohana (Chair of the RCGP
Midland Faculty) for writing the foreword for the book. We are also very
grateful to Matt Green and his team at Developmedica.
The dermatology pictures Figure 2, Figure 3, Figure 8, Figure 10, Figure
12, Figure 16 and Figure 25 are from © Ashton, Richard and Leppard,
Barbara, Differential Diagnosis in Dermatology 3rd edition. Oxford:
Radcliffe Publishing; 2005. Reproduced with the permission of the
copyright holder.
The ophthalmology pictures Figure 18, Figure 19, Figure 21, Figure 23,
Figure 28, Figure 31 are reproduced with permission from James B, Chew
C and Bron A (2007) Lecture notes Ophthalmology (10e). Blackwell
Publishing.
We would also like to thank the National Institute for Clinical Excellence
for allowing us to adapt their tables and algorithms that we have used in
Figure 1, Figure 6, Table 4, Figure 24, Figure 45.
National Institute for Clinical Excellence (2003) Adapted from CG 5
Chronic heart failure: management of chronic heart failure in adults in
primary and secondary care. London: NICE. Available from www.nice.
org.uk/CG5 Reproduced with permission.
National Institute for Health and Clinical Excellence (2005) Adapted from
CG 30 Long-acting reversible contraception. London: NICE. Available
from www.nice.org.uk/CG30 Reproduced with permission.
National Institute for Health and Clinical Excellence (2006) Adapted
from CG 34 Hypertension: the management of hypertension in adults
in primary care. London: NICE. Available from www.nice.org.uk/CG34
Reproduced with permission.
National Institute for Health and Clinical Excellence (2007) Adapted from
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