Free General Practitioner (GP) mock test

General Practitioner (GP) sample questions with answers

10 more original exam-style General Practitioner (GP) questions, worked in full. They are not real or recalled exam questions, and none of them is in the mock above or on the bank page, so sit the mock first if you have not.

1. Question 1 · Internal Medicine

   A 25-year-old man has a generalized tonic-clonic seizure that has continued for more than 5 minutes without recovery. Airway is being supported and glucose is normal. What is the most appropriate first-line pharmacologic treatment?

   1. AIntravenous (or intramuscular/buccal) benzodiazepine such as lorazepam or midazolam
   2. BIntravenous phenytoin as the very first agent before any benzodiazepine
   3. COral levetiracetam
   4. DIntravenous propofol infusion as first-line
   Show answer and explanation

   Correct answer: A. Intravenous (or intramuscular/buccal) benzodiazepine such as lorazepam or midazolam

   Convulsive status epilepticus (a seizure lasting 5 minutes or more) is first treated with a benzodiazepine such as intravenous lorazepam, or intramuscular/buccal midazolam if no IV access. A second-line agent (phenytoin, valproate or levetiracetam) follows if seizures persist, and anesthetic agents like propofol are reserved for refractory status after first- and second-line failure.

   Reference: American Epilepsy Society Guideline on Status Epilepticus 2016; NICE Epilepsy Guideline

2. Question 2 · Obstetrics & Gynecology

   A 67-year-old multiparous woman complains of a dragging sensation and a bulge at the vaginal introitus that worsens through the day. Examination shows the cervix descending to the level of the hymen on straining. Using the POP-Q staging system, this degree of descent corresponds to which stage?

   1. AStage II
   2. BStage 0
   3. CStage I
   4. DStage IV
   Show answer and explanation

   Correct answer: A. Stage II

   In the POP-Q system, Stage II is defined as the most distal prolapse point lying between 1 cm above and 1 cm below the hymen (i.e. within 1 cm of the hymenal plane), which matches descent to the level of the hymen. Stage 0 is no prolapse and Stage I is descent more than 1 cm above the hymen. Stage IV represents complete or near-complete eversion/procidentia.

   Reference: International Urogynecological Association / International Continence Society POP-Q classification; Williams Gynecology, 4th edition (2020)

3. Question 3 · Psychiatry & Mental Health

   A 29-year-old woman presents with a first depressive episode and is started on an antidepressant. Two weeks later she develops elevated mood, marked overactivity, reduced need for sleep, and grandiose ideas. Her mother has bipolar disorder. What does this new presentation most likely represent?

   1. AA normal placebo response to the antidepressant
   2. BSerotonin syndrome
   3. CAn antidepressant-induced manic switch, indicating an underlying bipolar diathesis
   4. DNeuroleptic malignant syndrome
   Show answer and explanation

   Correct answer: C. An antidepressant-induced manic switch, indicating an underlying bipolar diathesis

   Emergence of manic symptoms after starting an antidepressant, especially with a family history of bipolar disorder, indicates an antidepressant-induced manic switch and unmasks bipolar disorder; the antidepressant should be reviewed and mood-stabilizing/antimanic treatment considered. Serotonin syndrome causes autonomic instability, hyperthermia, and neuromuscular hyperactivity, and neuroleptic malignant syndrome follows antipsychotic exposure with rigidity and fever, neither matching this mood-elevation picture.

   Reference: NICE Guideline CG185, Bipolar disorder: assessment and management (updated 2023)

4. Question 4 · Dermatology

   A 55-year-old man reports blistering and skin fragility on the dorsal hands with milia and hypertrichosis, worsened by sun. He drinks alcohol heavily and has hepatitis C. Urine fluoresces coral-pink under Wood lamp. Beyond sun protection and alcohol cessation, which is the most appropriate first-line treatment?

   1. AOral prednisolone
   2. BRepeated therapeutic phlebotomy
   3. CHigh-dose oral vitamin D
   4. DSystemic broad-spectrum antibiotics
   Show answer and explanation

   Correct answer: B. Repeated therapeutic phlebotomy

   The picture is porphyria cutanea tarda, driven by hepatic iron-mediated inhibition of uroporphyrinogen decarboxylase; coral-pink urine fluorescence reflects excess uroporphyrins. First-line therapy is repeated phlebotomy to reduce hepatic iron, or low-dose hydroxychloroquine when phlebotomy is contraindicated. Corticosteroids, vitamin D and antibiotics do not address the underlying porphyrin overload.

   Reference: American Porphyria Foundation / Bolognia Dermatology, 4th edition (2018), porphyrias chapter

5. Question 5 · Ophthalmology

   A patient newly diagnosed with primary open-angle glaucoma is started on treatment to lower intraocular pressure. Which topical agent is generally recommended as first-line therapy because of its efficacy and once-daily dosing?

   1. AA prostaglandin analogue (e.g., latanoprost)
   2. BPilocarpine
   3. CTopical acetazolamide
   4. DApraclonidine
   Show answer and explanation

   Correct answer: A. A prostaglandin analogue (e.g., latanoprost)

   Prostaglandin analogues such as latanoprost are first-line in open-angle glaucoma because of strong IOP-lowering efficacy, once-daily dosing and a favorable systemic safety profile. Pilocarpine (a miotic) has significant side effects and is now rarely first-line, carbonic anhydrase inhibitors and alpha-agonists are usually adjuncts. Prostaglandins increase uveoscleral outflow.

   Reference: European Glaucoma Society Guidelines, 5th Edition (2020); NICE NG81 Glaucoma (2022)

6. Question 6 · Radiology & Investigations

   A 50-year-old man with jaundice has an ALT of 800 U/L, AST of 720 U/L and an ALP of 130 U/L (mildly raised). Which pattern of liver injury do these results indicate?

   1. AHepatocellular injury
   2. BCholestatic injury
   3. CIsolated hyperbilirubinemia
   4. DNormal liver enzymes
   Show answer and explanation

   Correct answer: A. Hepatocellular injury

   A marked rise in transaminases (ALT/AST) with only a mild rise in ALP indicates a hepatocellular pattern of injury, typical of viral hepatitis, ischemia or drug toxicity. A cholestatic pattern shows disproportionately raised ALP and GGT, isolated hyperbilirubinemia has normal enzymes, and these values are clearly abnormal.

   Reference: American College of Gastroenterology Guideline: Evaluation of Abnormal Liver Chemistries, 2017

7. Question 7 · Family Medicine & Primary Care

   A 55-year-old man presents with 4 weeks of low back pain that is worse at night and unrelieved by rest, associated with 6 kg unintentional weight loss and a history of prostate cancer. What is the most appropriate action?

   1. APrescribe analgesia and review in 6 weeks
   2. BAdvise physiotherapy exercises only
   3. CReassure that this is mechanical back pain
   4. DArrange urgent investigation and referral to evaluate for possible spinal metastasis/malignancy
   Show answer and explanation

   Correct answer: D. Arrange urgent investigation and referral to evaluate for possible spinal metastasis/malignancy

   Night pain unrelieved by rest, unintentional weight loss, and a cancer history are red flags for malignancy such as spinal metastasis, mandating urgent investigation and referral. Simple analgesia with delayed review, physiotherapy alone, or reassurance as mechanical pain would dangerously miss a serious, potentially treatable diagnosis.

   Reference: NICE Low Back Pain and Sciatica NG59; NICE Suspected Cancer NG12 (2015)

8. Question 8 · Pediatrics

   A 7-year-old presents with an acute asthma attack: too breathless to complete sentences, respiratory rate 40, heart rate 140, and SpO2 90% in air. After high-flow oxygen, what is the most appropriate immediate pharmacological management?

   1. AInhaled salbutamol via spacer once and observe
   2. BRepeated/continuous nebulized salbutamol with ipratropium plus systemic corticosteroids
   3. COral montelukast and discharge
   4. DIntravenous antibiotics as first-line
   Show answer and explanation

   Correct answer: B. Repeated/continuous nebulized salbutamol with ipratropium plus systemic corticosteroids

   This is an acute severe asthma exacerbation requiring oxygen, repeated or continuous nebulized beta-agonists combined with nebulized ipratropium bromide, and early systemic corticosteroids (oral prednisolone or IV hydrocortisone). A single spacer dose is inadequate for severe distress, montelukast is not for acute rescue, and antibiotics are not first-line unless bacterial infection is evident.

   Reference: BTS/SIGN British Guideline on the Management of Asthma; GINA (2023)

9. Question 9 · Emergency Medicine (Adult & Pediatric)

   A 26-year-old woman is brought in agitated and confused after being found wandering. She is disoriented, has a temperature of 38.6 C, visual hallucinations, and fluctuating consciousness with inattention. Which feature most strongly indicates that this is delirium (an organic emergency) rather than a primary psychiatric disorder?

   1. AThe presence of hallucinations
   2. BAcute onset with fluctuating course, inattention and clouded consciousness
   3. CBeing young and female
   4. DA prior history of anxiety
   Show answer and explanation

   Correct answer: B. Acute onset with fluctuating course, inattention and clouded consciousness

   Delirium is defined by an acute onset, fluctuating course, disturbed attention/consciousness, and is usually driven by an underlying medical cause (here suggested by fever). These features, especially clouding of consciousness and inattention, distinguish it from primary psychiatric illness, which typically has a clear sensorium. Hallucinations occur in both, and demographics or an anxiety history do not reliably differentiate organic from functional causes.

   Reference: DSM-5-TR Delirium criteria; NICE CG103 Delirium (updated 2023)

10. Question 10 · General Surgery

    A 68-year-old woman presents with a well-demarcated, raised, fiery-red, indurated facial rash with a sharply defined border and fever. Which is the most likely diagnosis and its usual causative organism?

    1. AContact dermatitis
    2. BCellulitis caused by Pseudomonas aeruginosa
    3. CErysipelas caused by Streptococcus pyogenes
    4. DHerpes zoster caused by varicella-zoster virus
    Show answer and explanation

    Correct answer: C. Erysipelas caused by Streptococcus pyogenes

    Erysipelas is a superficial dermal infection producing a well-demarcated, raised, sharply bordered erythema, most commonly caused by Streptococcus pyogenes (group A streptococcus). Deeper cellulitis has an indistinct border, contact dermatitis is pruritic rather than febrile, and herpes zoster follows a dermatome with vesicles.

    Reference: IDSA Practice Guidelines for Skin and Soft Tissue Infections, 2014