Medical Licensing Assessment (MLA) List of Presentations

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Introduction

All medical students in the UK will need to pass the Medical Licensing Assessment (MLA) before being able to join the medical register and work as a doctor. The MLA will consist of two parts:

  • Applied knowledge test (AKT): a 200-question online multiple choice exam using single best answer (SBA) questions
  • Clinical and professional skills assessmentΒ (CPSA): a practical examination (e.g. OSCE) run by medical schools

The medical licensing assessment content map sets out the content which could be tested as part of the MLA, either as part of the AKTΒ orΒ CPSA.Β 

As part of the content map, there is aΒ list of patient presentations which could be tested in the MLA. These medical conditions could be tested in aΒ single best answer (SBA) questionΒ in the applied knowledge test or as part of anΒ OSCE stationΒ in the clinical and professional skills assessment.

Presentations vs conditions

In the MLA, presentationsΒ are defined as “signs, symptoms, investigation results and other relevant patient-related issues”, whereas conditionsΒ are defined as “pathophysiological diseases or clinical diagnoses”.

AΒ presentation could be associated with multiple conditions. For example, breathlessness is a very broad patient presentation with multiple possible causative conditions (e.g. pulmonary embolism, cardiac failure, lower respiratory tract infection, anaemia).

Being familiar with these patient presentations is important before taking the medical licensing assessment. We’ve included an alphabetical list of the patient presentations below, with relevant links to Geeky Medics articles. We’ve also included a breakdown of patient presentations listed by areas of clinical practice. This list is based on theΒ General Medical Council’s MLA content map.Β 


List of MLA presentations

A

  • Abdominal distension
  • Abdominal mass
  • Abnormal cervical smear result
  • Abnormal development/ developmental delay
  • Abnormal eating or exercising behaviour
  • Abnormal involuntary movements
  • Abnormal urinalysis
  • Acute abdominal pain
  • Acute and chronic pain management
  • Acute change in or loss of vision
  • Acute joint pain/swelling
  • Acute kidney injury
  • Acute rash
  • Addiction
  • Allergies
  • Altered sensation, numbness and tingling
  • Amenorrhoea
  • Anaphylaxis
  • Anosmia
  • Anxiety, phobias, OCD
  • Ascites
  • Auditory hallucinations

B

C

D

E

F

G

  • Gradual change in or loss of vision
  • Gynaecomastia

H

I

  • Immobility
  • Incidental findings
  • Infant feeding problems
  • Intrauterine death

J

  • Jaundice

L

  • Labour
  • Lacerations
  • Learning disability
  • Limb claudication
  • Limb weakness
  • Limp
  • Loin pain
  • Loss of libido
  • Loss of red reflex
  • Low blood pressure
  • Low mood/affective problems
  • Lump in groin
  • Lymphadenopathy

M

  • Massive haemorrhage
  • Melaena
  • Memory loss
  • Menopausal problems
  • Menstrual problems
  • Mental capacity concerns
  • Mental health problems in pregnancy or post partum
  • Misplaced nasogastric tube
  • Muscle pain/myalgia
  • Musculoskeletal deformities

N

  • Nail abnormalities
  • Nasal obstruction
  • Nausea
  • Neck lump
  • Neck pain/stiffness
  • Neonatal death or cot death
  • Neuromuscular weakness
  • Night sweats
  • Nipple discharge
  • Normal pregnancy and antenatal care

O

  • Oliguria
  • Organomegaly
  • Overdose

P

R

  • Rectal prolapse
  • Red eye
  • Reduced/change in fetal movements

S

T

  • The sick child
  • Threats to harm others
  • Tinnitus
  • Trauma
  • Travel health advice
  • Tremor

U

V

W

  • Weight gain
  • Weight loss
  • Wellbeing checks
  • Wheeze

Presentations by MLA area of clinical practice

There areΒ 24 areas of clinical practice as part of the UK medical licensing assessment content map. Patient presentations can be mapped to multiple areas of clinical practice.

For example, breathlessnessΒ is mapped to nine areas of clinical practice: acute and emergency, cancer, cardiovascular, child health, general practice and primary healthcare, neurosciences, obstetrics and gynaecology, perioperative medicine, and respiratory.

When we look closer at the MLA content map, we can see some patient presentations frequently appearing across multiple areas of clinical practiceΒ (Figure 1). The top three patient presentations in the MLA content map are breathlessness,Β trauma andΒ urinary symptoms.Β 

Top 10 MLA conditions
Figure 1. The top 10 most common patient presentations in the MLA content map

Below is a list of MLA patient presentations mapped to each area of clinical practice.Β 

Acute and emergency πŸš‘

Link: Emergency Medicine

  • Abnormal urinalysis
  • Acute and chronic pain management
  • Acute change in or loss of vision
  • Acute kidney injury
  • Anaphylaxis
  • Bites and stings
  • Bleeding antepartum
  • Bleeding from lower GI tract
  • Bleeding from upper GI tract
  • Breathlessness
  • Burns
  • Cardiorespiratory arrest
  • Chest pain
  • Cyanosis
  • Decreased/loss of consciousness
  • Dehydration
  • Deteriorating patient
  • Electrolyte abnormalities
  • Epistaxis
  • Eye trauma
  • Facial/periorbital swelling
  • Foreign body in eye
  • Head injury
  • Headache
  • Lacerations
  • Massive haemorrhage
  • Melaena
  • Overdose
  • Poisoning
  • Post-surgical care and complications
  • Scrotal/testicular pain and/or lump/swelling
  • Self-harm
  • Shock
  • Soft tissue injury
  • Stridor
  • Substance misuse
  • Trauma
  • Vomiting
  • Wheeze

Cancer β™‹

Link: Oncology

  • Abdominal distension
  • Abdominal mass
  • Acute and chronic pain management
  • Ascites
  • Bleeding from lower GI tract
  • Bleeding from upper GI tract
  • Bone pain
  • Breast lump
  • Breathlessness
  • Change in bowel habit
  • Cough
  • Decreased appetite
  • Electrolyte abnormalities
  • Fatigue
  • Haematuria
  • Haemoptysis
  • Headache
  • Jaundice
  • Limb weakness
  • Lump in groin
  • Lymphadenopathy
  • Neck lump
  • Pain on inspiration
  • Painful swollen leg
  • Pelvic mass
  • Pleural effusion
  • Scrotal/testicular pain and/or lump/swelling
  • Swallowing problems
  • Weight loss

Cardiovascular πŸ«€

Link: Cardiology

  • Acute abdominal pain
  • Acute change in or loss of vision
  • Blackouts and faints
  • Breathlessness
  • Cardiorespiratory arrest
  • Chest pain
  • Cold, painful, pale, pulseless leg/foot
  • Cough
  • Cyanosis
  • Dizziness
  • Driving advice
  • Erectile dysfunction
  • Fever
  • Heart murmurs
  • Hypertension
  • Limb claudication
  • Limb weakness
  • Low blood pressure
  • Pain on inspiration
  • Painful swollen leg
  • Palpitations
  • Peripheral oedema and ankle swelling
  • Pregnancy risk assessment
  • Skin ulcers
  • Wheeze

Child health πŸ‘Ά

Link: Paediatrics

  • Abdominal mass
  • Abnormal development/ developmental delay
  • Abnormal involuntary movements
  • Acute abdominal pain
  • Acute joint pain/swelling
  • Acute kidney injury
  • Acute rash
  • Allergies
  • Behavioural difficulties in childhood
  • Breathlessness
  • Bruising
  • Child abuse
  • Chronic abdominal pain
  • Chronic kidney disease
  • Chronic rash
  • Congenital abnormalities
  • Constipation
  • Cough
  • Crying baby
  • Cyanosis
  • Decreased/loss of consciousness
  • Dehydration
  • Deteriorating patient
  • Diarrhoea
  • Difficulty with breast feeding
  • Dysmorphic child
  • Fever
  • Fits/seizures
  • Food intolerance
  • Haematuria
  • Headache
  • Infant feeding problems
  • Jaundice
  • Learning disability
  • Limp
  • Lymphadenopathy
  • Musculoskeletal deformities
  • Neonatal death or cot death
  • Overdose
  • Pallor
  • Peripheral oedema and ankle swelling
  • Poisoning
  • Polydipsia (thirst)
  • Prematurity
  • Pubertal development
  • Scrotal/testicular pain and/or lump/swelling
  • Self-harm
  • Shock
  • Speech and language problems
  • Squint
  • Stridor
  • Substance misuse
  • Suicidal thoughts
  • The sick child
  • Trauma
  • Urinary incontinence
  • Urinary symptoms
  • Vaccination
  • Vomiting
  • Wheeze

Clinical haematology 🩸

Link: Haematology

  • Bleeding from lower GI tract
  • Bone pain
  • Bruising
  • Epistaxis
  • Fatigue
  • Fever
  • Jaundice
  • Lump in groin
  • Lymphadenopathy
  • Massive haemorrhage
  • Neck lump
  • Organomegaly
  • Pallor
  • Petechial rash
  • Purpura

Clinical imaging 🩻

Link: Radiology Interpretation

  • Misplaced nasogastric tube
  • Trauma

Dermatology β˜€οΈ

Link: Dermatology

  • Acute rash
  • Bites and stings
  • Burns
  • Chronic rash
  • Nail abnormalities
  • Pruritus
  • Scarring
  • Skin lesion
  • Skin or subcutaneous lump
  • Skin ulcers

Ear, nose and throat πŸ‘‚

Link: ENT Surgery

  • Allergies
  • Anosmia
  • Cough
  • Dizziness
  • Ear and nasal discharge
  • Epistaxis
  • Facial pain
  • Facial/periorbital swelling
  • Hearing loss
  • Hoarseness and voice change
  • Nasal obstruction
  • Neck lump
  • Painful ear
  • Snoring
  • Sore throat
  • Stridor
  • Swallowing problems
  • Tinnitus
  • Vertigo

Endocrine and metabolic πŸ’§

Link: Endocrinology

  • Amenorrhoea
  • Bone pain
  • Confusion
  • Decreased/loss of consciousness
  • Electrolyte abnormalities
  • Erectile dysfunction
  • Fatigue
  • Gradual change in or loss of vision
  • Gynaecomastia
  • Hoarseness and voice change
  • Hypertension
  • Menstrual problems
  • Nausea
  • Neck lump
  • Nipple discharge
  • Palpitations
  • Polydipsia (thirst)
  • Pubertal development
  • Urinary symptoms
  • Weight gain
  • Weight loss

Gastrointestinal including liver 🍺

Link: Gastroenterology

  • Abdominal distension
  • Abdominal mass
  • Acute abdominal pain
  • Ascites
  • Bleeding from lower GI tract
  • Bleeding from upper GI tract
  • Change in bowel habit
  • Change in stool colour
  • Chronic abdominal pain
  • Constipation
  • Decreased appetite
  • Diarrhoea
  • Faecal incontinence
  • Food intolerance
  • Jaundice
  • Lump in groin
  • Melaena
  • Nausea
  • Organomegaly
  • Perianal symptoms
  • Pruritus
  • Rectal prolapse
  • Swallowing problems
  • Vomiting
  • Weight gain

General practice and primary healthcare πŸ‘©β€βš•οΈ

  • Abdominal distension
  • Abnormal eating or exercising behaviour
  • Abnormal urinalysis
  • Acute abdominal pain
  • Acute and chronic pain management
  • Acute joint pain/swelling
  • Acute rash
  • Allergies
  • Anxiety, phobias, OCD
  • Back pain
  • Behaviour/personality change
  • Bites and stings
  • Bleeding from lower GI tract
  • Breast lump
  • Breast tenderness/pain
  • Breathlessness
  • Change in bowel habit
  • Chest pain
  • Chronic abdominal pain
  • Chronic joint pain/stiffness
  • Chronic kidney disease
  • Chronic rash
  • Constipation
  • Contraception request/advice
  • Cough
  • Crying baby
  • Deteriorating patient
  • Diarrhoea
  • Dizziness
  • Driving advice
  • Ear and nasal discharge
  • Erectile dysfunction
  • Eye pain/discomfort
  • Facial/periorbital swelling
  • Falls
  • Fatigue
  • Fever
  • Fit notes
  • Frailty
  • Haematuria
  • Haemoptysis
  • Headache
  • Hypertension
  • Infant feeding problems
  • Loss of libido
  • Low mood/affective problems
  • Lymphadenopathy
  • Menopausal problems
  • Menstrual problems
  • Muscle pain/ myalgia
  • Painful ear
  • Painful sexual intercourse
  • Painful swollen leg
  • Pelvic pain
  • Perianal symptoms
  • Peripheral oedema and ankle swelling
  • Sleep problems
  • Soft tissue injury
  • Somatisation/ medically unexplained physical symptoms
  • Sore throat
  • Struggling to cope at home
  • Subfertility
  • Substance misuse
  • Swallowing problems
  • The sick child
  • Tinnitus
  • Trauma
  • Travel health advice
  • Tremor
  • Unwanted pregnancy and termination
  • Urinary symptoms
  • Vaccination
  • Vaginal discharge
  • Vertigo
  • Weight gain
  • Wellbeing checks
  • Wheeze

Infection 🦠

Link: Infectious Diseases

  • Acute rash
  • Anosmia
  • Chest pain
  • Diarrhoea
  • Facial/periorbital swelling
  • Fever
  • Haematuria
  • Haemoptysis
  • Loss of smell
  • Neck pain/stiffness
  • Night sweats
  • Painful swollen leg
  • Petechial rash
  • Pleural effusion
  • Sore throat
  • Stridor
  • Travel health advice
  • Urethral discharge and genital ulcers/warts
  • Urinary symptoms
  • Vaccination
  • Vaginal discharge
  • Vomiting
  • Vulval itching/lesion
  • Vulval/vaginal lump
  • Weight loss

Medicine of older adult πŸ‘΄

Link: Geriatrics

  • Abnormal involuntary movements
  • Auditory hallucinations
  • Blackouts and faints
  • Chest pain
  • Confusion
  • Constipation
  • Dizziness
  • Driving advice
  • Elder abuse
  • Electrolyte abnormalities
  • Faecal incontinence
  • Falls
  • Frailty
  • Hearing loss
  • Hypertension
  • Immobility
  • Memory loss
  • Mental capacity concerns
  • Peripheral oedema and ankle swelling
  • Skin ulcers
  • Struggling to cope at home
  • Trauma
  • Urinary incontinence
  • Urinary symptoms
  • Vertigo
  • Visual hallucinations

Mental health 🧠

Link: Mental Health

  • Abnormal eating or exercising behaviour
  • Addiction
  • Anxiety, phobias, OCD
  • Auditory hallucinations
  • Behaviour/personality change
  • Behavioural difficulties in childhood
  • Child abuse
  • Chronic abdominal pain
  • Confusion
  • Decreased appetite
  • Driving advice
  • Elation/elated mood
  • Elder abuse
  • End of life care/symptoms of terminal illness
  • Fatigue
  • Fixed abnormal beliefs
  • Learning disability
  • Loss of libido
  • Low mood/affective problems
  • Memory loss
  • Mental capacity concerns
  • Mental health problems in pregnancy or postpartum
  • Overdose
  • Palpitations
  • Pressure of speech
  • Self-harm
  • Sleep problems
  • Somatisation/ medically unexplained physical symptoms
  • Struggling to cope at home
  • Substance misuse
  • Suicidal thoughts
  • Threats to harm others
  • Visual hallucinations
  • Weight gain
  • Weight loss

Musculoskeletal 🦴

Links: Rheumatology | Orthopaedic Surgery

  • Acute joint pain/swelling
  • Back pain
  • Bone pain
  • Bruising
  • Chronic joint pain/stiffness
  • Congenital abnormalities
  • Eye pain/discomfort
  • Fever
  • Limp
  • Muscle pain/myalgia
  • Musculoskeletal deformities
  • Neck pain/stiffness
  • Red eye
  • Soft tissue injury
  • Trauma

Neurosciences 🧠

Links: Neurology | Neurosurgery

  • Abnormal development/ developmental delay
  • Abnormal involuntary movements
  • Acute and chronic pain management
  • Acute change in or loss of vision
  • Altered sensation, numbness and tingling
  • Anosmia
  • Back pain
  • Behaviour/personality change
  • Blackouts and faints
  • Breathlessness
  • Confusion
  • Decreased/loss of consciousness
  • Diplopia
  • Dizziness
  • Driving advice
  • Eye pain/discomfort
  • Facial pain
  • Facial weakness
  • Fasciculation
  • Fits/seizures
  • Head injury
  • Headache
  • Limb weakness
  • Limp
  • Memory loss
  • Muscle pain/ myalgia
  • Neck pain/stiffness
  • Neuromuscular weakness
  • Ptosis
  • Sleep problems
  • Speech and language problems
  • Swallowing problems
  • Trauma
  • Tremor
  • Urinary symptoms
  • Unsteadiness
  • Vertigo

Obstetrics and gynaecology 🚼

Links: Obstetrics and Gynaecology | Gynaecological Surgery

  • Abdominal distension
  • Abdominal mass
  • Abnormal cervical smear result
  • Abnormal urinalysis
  • Acute abdominal pain
  • Acute and chronic pain management
  • Amenorrhoea
  • Bleeding antepartum
  • Bleeding postpartum
  • Breast tenderness/pain
  • Breathlessness
  • Chest pain
  • Complications of labour
  • Contraception request/advice
  • Difficulty with breast feeding
  • Fits/seizures
  • Headache
  • Hypertension
  • Hyperemesis
  • Intrauterine death
  • Jaundice
  • Labour
  • Loss of libido
  • Menopausal problems
  • Menstrual problems
  • Mental health problems in pregnancy or postpartum
  • Nipple discharge
  • Normal pregnancy and antenatal care
  • Painful sexual intercourse
  • Painful swollen leg
  • Pelvic mass
  • Pelvic pain
  • Pregnancy risk assessment
  • Pruritus
  • Reduced/change in fetal movements
  • Shock
  • Small for gestational age/ large for gestational age
  • Subfertility
  • Substance misuse
  • Unwanted pregnancy and termination
  • Urethral discharge and genital ulcers/warts
  • Urinary incontinence
  • Urinary symptoms
  • Vaginal discharge
  • Vaginal prolapse
  • Vulval itching/lesion
  • Vulval/vaginal lump

Ophthalmology πŸ‘οΈ

Link: Ophthalmology

  • Acute change in or loss of vision
  • Allergies
  • Diplopia
  • Eye pain/discomfort
  • Eye trauma
  • Facial/periorbital swelling
  • Flashes and floaters in visual fields
  • Foreign body in eye
  • Gradual change in or loss of vision
  • Loss of red reflex
  • Red eye
  • Squint

Palliative and end of life care πŸ’Š

Link: Palliative care

  • Acute and chronic pain management
  • End of life care/symptoms of terminal illness
  • Nausea
  • Neuromuscular weakness

Perioperative medicine and anaesthesia 😴

Link: Anaesthetics

  • Acute and chronic pain management
  • Acute kidney injury
  • Back pain
  • Bleeding antepartum
  • Bleeding postpartum
  • Bone pain
  • Breathlessness
  • Cardiorespiratory arrest
  • Chronic kidney disease
  • Confusion
  • Decreased/loss of consciousness
  • Dehydration
  • Electrolyte abnormalities
  • End of life care/symptoms of terminal illness
  • Facial pain
  • Frailty
  • Head injury
  • Labour
  • Learning disability
  • Massive haemorrhage
  • Misplaced nasogastric tube
  • Nausea
  • Neuromuscular weakness
  • Overdose
  • Post-surgical care and complications
  • Shock
  • Substance misuse
  • Trauma

Renal and urology 🫘

Links: Renal | Urology

  • Abnormal urinalysis
  • Acute kidney injury
  • Chronic kidney disease
  • Dehydration
  • Electrolyte abnormalities
  • Erectile dysfunction
  • Haematuria
  • Hypertension
  • Oliguria
  • Peripheral oedema and ankle swelling
  • Scrotal/testicular pain and/or lump/swelling
  • Urinary symptoms

Respiratory 🫁

Link: Respiratory

  • Allergies
  • Breathlessness
  • Cardiorespiratory arrest
  • Chest pain
  • Cough
  • Cyanosis
  • Fever
  • Haemoptysis
  • Hoarseness and voice change
  • Pain on inspiration
  • Pleural effusion
  • Snoring
  • Stridor
  • Wheeze

Sexual health 🧫

Link: Sexual Health

  • Erectile dysfunction
  • Loss of libido
  • Painful sexual intercourse
  • Urethral discharge and genital ulcers/warts
  • Vaginal discharge
  • Vulval itching/lesion
  • Vulval/vaginal lump

Surgery πŸͺ‘

Link: Surgery

  • Abdominal distension
  • Abdominal mass
  • Acute abdominal pain
  • Ascites
  • Bleeding from lower GI tract
  • Bleeding from upper GI tract
  • Breast lump
  • Breast tenderness/pain
  • Change in bowel habit
  • Change in stool colour
  • Haematuria
  • Lacerations
  • Loin pain
  • Lump in groin
  • Nipple discharge
  • Painful sexual intercourse
  • Post-surgical care and complications
  • Rectal prolapse
  • Scrotal/testicular pain and/or lump/swelling
  • Subfertility
  • Trauma
  • Urinary incontinence
  • Urinary symptoms
  • Vaginal prolapse

All areas of clinical practice

  • Death and dying
  • Family history of possible genetic disorder
  • Incidental findings

References

  • General Medical Council. MLA content map. Published in 2021. Available from: [LINK]

 

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