General Practitioner (GP) Prometric exam questions

The General Practitioner (GP) exam in every GCC country

From each regulator's own exam pages; anything a regulator does not publish says so. Assessment mode also depends on your licence title, so confirm your route on your eligibility notice.

12 worked General Practitioner (GP) practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Family Medicine & Primary Care

   A healthy 62-year-old woman with no diabetes, no prior cardiovascular disease, and no bleeding risk asks whether she should take daily low-dose aspirin to prevent a first heart attack. What is the most appropriate advice?

   1. AStart aspirin 81 mg daily for all adults over 60
   2. BRoutine aspirin for primary prevention is generally not recommended for adults 60 and older because bleeding risk outweighs benefit
   3. CStart aspirin 300 mg daily indefinitely
   4. DAspirin is contraindicated in all women
   Show answer and explanation

   Correct answer: B. Routine aspirin for primary prevention is generally not recommended for adults 60 and older because bleeding risk outweighs benefit

   Current guidance advises against initiating routine aspirin for primary prevention in adults aged 60 and older because the risk of bleeding outweighs the modest cardiovascular benefit. Universal aspirin initiation and high-dose aspirin are not supported, and aspirin is certainly not contraindicated in all women, so that statement is incorrect.

   Reference: USPSTF, Aspirin Use to Prevent Cardiovascular Disease (2022)

2. Question 2 · Pediatrics

   A neonate is well at birth but becomes acutely cyanosed and collapses on day 3 as the ductus arteriosus closes. There is no response to supplemental oxygen. Pending urgent cardiology assessment, which medication is most appropriate to stabilize a suspected duct-dependent congenital heart lesion?

   1. AProstaglandin E1 (alprostadil) infusion
   2. BIntravenous furosemide
   3. COral propranolol
   4. DIntramuscular vitamin K
   Show answer and explanation

   Correct answer: A. Prostaglandin E1 (alprostadil) infusion

   Duct-dependent congenital heart lesions present with cyanosis or collapse as the ductus arteriosus closes and fail to improve with oxygen (the hyperoxia test); a prostaglandin E1 (alprostadil) infusion maintains ductal patency and is life-saving while awaiting definitive diagnosis and intervention. Furosemide, propranolol, and vitamin K do not address ductal closure.

   Reference: Nelson Textbook of Pediatrics (2020); APLS / neonatal cardiology guidance

3. Question 3 · Emergency Medicine (Adult & Pediatric)

   A 55-year-old presents with a blood pressure of 230/130 mmHg, headache, blurred vision, and papilledema, plus a rising creatinine. This is a hypertensive emergency. What is the recommended approach to blood pressure reduction in the first hour (excluding specific conditions like aortic dissection)?

   1. AGive oral antihypertensives and reassess in 24 hours
   2. BRapidly normalize blood pressure to below 120/80 mmHg
   3. CReduce mean arterial pressure by no more than about 20-25 percent
   4. DWithhold treatment until end-organ damage worsens
   Show answer and explanation

   Correct answer: C. Reduce mean arterial pressure by no more than about 20-25 percent

   In most hypertensive emergencies, blood pressure should be lowered in a controlled manner, reducing mean arterial pressure by no more than roughly 20-25 percent in the first hour using titratable intravenous agents, to avoid cerebral, coronary, or renal hypoperfusion. Rapid normalization can precipitate ischemia. Oral therapy with delayed reassessment is inappropriate when end-organ damage is present.

   Reference: ESC/ESH Guidelines for the Management of Arterial Hypertension, 2018

4. Question 4 · General Surgery

   A 68-year-old man undergoes surgery for presumed appendicitis. At operation the appendix is normal, but a segment of terminal ileum is inflamed and there is a palpable mass. Which additional finding would most strongly suggest a Meckel's diverticulum as the cause rather than Crohn's disease?

   1. ACobblestone mucosa and skip lesions
   2. BCreeping fat over the serosa
   3. CA diverticulum arising from the antimesenteric border about 60 cm from the ileocecal valve
   4. DTransmural granulomatous inflammation
   Show answer and explanation

   Correct answer: C. A diverticulum arising from the antimesenteric border about 60 cm from the ileocecal valve

   A Meckel's diverticulum is a true diverticulum on the antimesenteric border of the ileum, typically around 60 cm (2 feet) proximal to the ileocecal valve, and can mimic appendicitis. Cobblestone mucosa, skip lesions, creeping fat and transmural granulomas are all characteristic of Crohn's disease.

   Reference: Schwartz's Principles of Surgery, 11th ed., 2019

5. Question 5 · Orthopedics & Musculoskeletal

   An 80-year-old woman presents with acute knee pain and swelling. Aspiration reveals positively birefringent, rhomboid-shaped crystals, and radiographs show linear calcification of the articular cartilage. Which condition is most likely?

   1. AGout
   2. BSeptic arthritis
   3. CCalcium pyrophosphate deposition disease (pseudogout)
   4. DRheumatoid arthritis
   Show answer and explanation

   Correct answer: C. Calcium pyrophosphate deposition disease (pseudogout)

   Positively birefringent rhomboid crystals with chondrocalcinosis on X-ray are diagnostic of calcium pyrophosphate deposition (pseudogout), which classically affects large joints such as the knee in the elderly. Gout crystals are negatively birefringent needles, septic arthritis shows organisms/high neutrophils, and RA is a chronic symmetrical synovitis.

   Reference: EULAR CPPD Recommendations (2011); Kelley's Textbook of Rheumatology

6. Question 6 · Otolaryngology (ENT)

   A 25-year-old man with allergic rhinitis reports that despite good adherence to a daily intranasal corticosteroid, he still has significant nasal itching, sneezing, and rhinorrhea. He wishes to add another agent. Which of the following add-on therapies is most appropriate for these residual symptoms?

   1. AOral first-generation sedating antihistamine at night
   2. BIntranasal or oral second-generation antihistamine
   3. CLong-term oral corticosteroids
   4. DRegular topical decongestant
   Show answer and explanation

   Correct answer: B. Intranasal or oral second-generation antihistamine

   For residual allergic symptoms despite intranasal steroids, adding a non-sedating (second-generation) antihistamine, given intranasally or orally, targets itch, sneeze, and rhinorrhea with minimal sedation. First-generation antihistamines cause sedation and anticholinergic effects and are less preferred. Long-term systemic steroids carry unacceptable risks, and regular decongestants cause rebound congestion.

   Reference: ARIA Guidelines 2020; AAO-HNS Clinical Practice Guideline: Allergic Rhinitis, Otolaryngol Head Neck Surg 2015

7. Question 7 · Preventive Medicine, Public Health, EBM, Ethics & Professionalism

   A preventive treatment reduces the annual risk of a stroke from 5% to 3%. What is the number needed to treat (NNT) for one year to prevent one stroke?

   1. A2
   2. B20
   3. C100
   4. D50
   Show answer and explanation

   Correct answer: D. 50

   The absolute risk reduction is 5% − 3% = 2%, or 0.02; the NNT is the reciprocal of the absolute risk reduction, so 1/0.02 = 50. This means 50 patients must be treated for one year to prevent one stroke. Using the relative risk reduction or other figures would give the incorrect distractor values.

   Reference: Guyatt et al., Users' Guides to the Medical Literature, 3rd edition (2015)

8. Question 8 · Internal Medicine

   A 72-year-old man in the emergency department is being assessed for possible sepsis using the qSOFA score. Which of the following is one of the three qSOFA criteria?

   1. ATemperature above 38 C
   2. BWhite cell count above 12,000/mm3
   3. CHeart rate above 90 beats per minute
   4. DRespiratory rate of 22 breaths per minute or higher
   Show answer and explanation

   Correct answer: D. Respiratory rate of 22 breaths per minute or higher

   The quick SOFA (qSOFA) score comprises three bedside criteria: respiratory rate of 22 breaths per minute or higher, altered mentation (GCS <15), and systolic blood pressure of 100 mmHg or lower; two or more suggest higher risk of poor outcome from sepsis. Temperature, white cell count and heart rate are part of the older SIRS criteria, not qSOFA.

   Reference: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), JAMA 2016

9. Question 9 · Obstetrics & Gynecology

   A 58-year-old woman who reached menopause 6 years ago presents with a single episode of postmenopausal vaginal bleeding. Which is the most important next investigation?

   1. AReassurance and review in 6 months
   2. BTransvaginal ultrasound to assess endometrial thickness, with endometrial biopsy as indicated
   3. CStart hormone replacement therapy
   4. DCervical smear only
   Show answer and explanation

   Correct answer: B. Transvaginal ultrasound to assess endometrial thickness, with endometrial biopsy as indicated

   Postmenopausal bleeding is endometrial cancer until proven otherwise, so transvaginal ultrasound to measure endometrial thickness with endometrial sampling for a thickened or persistently bleeding endometrium is required. Reassurance, starting HRT or a smear alone would miss a potential malignancy.

   Reference: NICE Guideline NG12, Suspected Cancer Referral, 2015 (updated 2021)

10. Question 10 · Psychiatry & Mental Health

    An 80-year-old man with dementia is agitated and distressed due to delirium from a chest infection. Non-pharmacological measures have failed and he is a danger to himself. If short-term pharmacological control of severe agitation is unavoidable, which approach is generally most appropriate?

    1. AA high-dose long-acting benzodiazepine as first choice in all cases
    2. BThe lowest effective dose of a short-term antipsychotic (e.g., low-dose haloperidol), avoiding it in Parkinson disease and Lewy body dementia
    3. CRegular high-dose antipsychotics for several months
    4. DNo treatment is ever acceptable under any circumstances
    Show answer and explanation

    Correct answer: B. The lowest effective dose of a short-term antipsychotic (e.g., low-dose haloperidol), avoiding it in Parkinson disease and Lewy body dementia

    When drug treatment of delirium-related agitation is truly necessary and non-drug measures fail, guidelines advise short-term use of the lowest effective dose of an antipsychotic such as haloperidol, cautiously and briefly, while avoiding antipsychotics in Parkinson disease and Lewy body dementia where they can cause severe reactions. Benzodiazepines can worsen delirium (except in alcohol/benzodiazepine withdrawal or Lewy body/Parkinson cases), and prolonged high-dose antipsychotics are inappropriate.

    Reference: NICE Guideline CG103, Delirium: prevention, diagnosis and management (updated 2023)

11. Question 11 · Dermatology

    A 40-year-old woman has thickened, discolored, crumbling toenails with subungual debris. Before starting oral terbinafine for confirmed dermatophyte onychomycosis, which investigation is most important to check and monitor?

    1. ALiver function tests
    2. BSerum amylase
    3. CFasting lipid profile
    4. DThyroid function tests
    Show answer and explanation

    Correct answer: A. Liver function tests

    Oral terbinafine can cause hepatotoxicity, so baseline and periodic liver function testing is recommended, particularly for prolonged courses used in onychomycosis. Confirmation of dermatophyte infection (microscopy/culture) is also advised before treatment. Amylase, lipid profile and thyroid tests are not part of routine terbinafine monitoring.

    Reference: British Association of Dermatologists Guidelines for the management of onychomycosis (2014)

12. Question 12 · Orthopedics & Musculoskeletal

    A 65-year-old man cannot initiate abduction of the arm and, when the arm is passively raised, it drops suddenly when unsupported. There is weakness of external rotation. Which test/finding best supports a large rotator cuff tear?

    1. APositive drop-arm sign with weak external rotation
    2. BPositive Spurling test
    3. CPositive Tinel sign at the wrist
    4. DPositive Trendelenburg test
    Show answer and explanation

    Correct answer: A. Positive drop-arm sign with weak external rotation

    A positive drop-arm sign with weakness of abduction and external rotation indicates a significant rotator cuff (supraspinatus/infraspinatus) tear. Spurling test assesses cervical radiculopathy, Tinel is for nerve entrapment at the wrist, and Trendelenburg evaluates hip abductor function.

    Reference: AAOS Rotator Cuff CPG; Hoppenfeld Physical Examination of the Spine and Extremities

General Practitioner (GP) reference books and guidelines

Every question in this bank names the textbook or guideline its answer rests on. These are the sources our General Practitioner (GP) questions cite most often - the reading list to revise from alongside the bank.

Sitting the SMLE? SCFHS publishes its own list: SCFHS's SMLE reading list. Where your regulator publishes a reading list, use the editions it names. Exam questions are not taken from any one book.