Hypertension — MRCGP AKT MCQ
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Correct answer: C — A parent fails to seek medical advice to the extent that the child's health and wellbeing are compromised and the child remains in pain
Explanation lettering: E = shown as B · D = shown as C · C = shown as D · B = shown as E
D is correct because NG76 uses the instruction 'suspect neglect' when failure to seek medical advice compromises the child's health and wellbeing, explicitly including ongoing pain. A is an alerting feature for which NICE says to consider neglect, even though the treatment is essential. B is also assigned the consider threshold when essential follow-up appointments are repeatedly missed. C carries the consider threshold for persistent failure to engage with health-promotion programmes. E likewise carries the consider threshold when accessible treatment for dental caries is persistently not obtained. The clinical importance of A, B, C and E does not change the precise recommendation wording from 'consider' to 'suspect'.
Reference: NICE NG76, recommendations 1.3.39 to 1.3.43: https://www.nice.org.uk/guidance/ng76/chapter/Recommendations