GP General Practitioner MCQs (Prometric)

An 8-year-old boy develops ankle pain, intermittent central abdominal discomfort, and a lower-limb eruption one week after an upper respiratory illness. Temperature is 37.3°C, blood pressure is 108/68 mmHg, and he is well perfused. Platelet count and coagulation studies are normal. Urinalysis shows trace blood without protein, and creatinine is normal. The accompanying photograph shows the decisive skin finding. Which follow-up plan is most appropriate after confirming the likely diagnosis?

A 6-year-old girl develops rapidly worsening sore throat, fever, and breathing difficulty over six hours. She sits upright, leans forward, drools continuously, and speaks with a muffled voice. Temperature is 39.4°C, pulse is 142/min, respiratory rate is 34/min, and oxygen saturation is 92% on room air. She is anxious and refuses to lie down. A lateral neck radiograph obtained before arrival is shown. What is the most appropriate immediate management?

A 66-year-old man reports four months of altered bowel habit, increasing fatigue, and unintentional loss of 6 kg. Hemoglobin is 9.6 g/dL with microcytosis, ferritin is low, and a fecal immunochemical test is markedly positive. He has no overt rectal bleeding, abdominal mass, or hemodynamic instability. His last colorectal screening test six years ago was negative, and he has been taking ibuprofen intermittently for knee pain. What is the most appropriate next step?

A 27-year-old woman with asthma presents after six hours of worsening wheeze despite repeated salbutamol through a spacer. She speaks only in short phrases, respiratory rate is 34/min, pulse is 126/min, and oxygen saturation is 89% in room air. Peak expiratory flow is 28% of predicted, and air entry is markedly reduced bilaterally. There is no fever, urticaria, or focal chest finding. What is the most appropriate immediate management?

A 32-year-old woman presents with recurrent severe abdominal pain, constipation, vomiting, and anxiety. During attacks she develops tachycardia and dark urine, but abdominal examination remains soft without peritonism. Sodium is 124 mmol/L, liver enzymes and lipase are normal, and repeated abdominal imaging has found no structural cause. Her symptoms began after starting an enzyme-inducing antiseizure medicine. What is the most appropriate next investigation?

An 80-year-old woman falls at home and develops severe right-groin pain. She cannot stand, and the affected leg appears shortened and externally rotated. Pulse is 96/min, blood pressure is 146/82 mmHg, and distal neurovascular examination is normal. She takes apixaban for atrial fibrillation and last ate six hours ago. The pelvic radiograph is shown. What is the most appropriate management?

A 30-year-old woman at 14 weeks’ gestation presents after a minor road collision. She wore a seat belt and has mild lower abdominal discomfort with scant vaginal spotting. Blood pressure is 118/72 mmHg, pulse is 82/min, and the abdomen is soft without guarding. Ultrasound confirms a viable intrauterine pregnancy without placental separation. Her blood group is O RhD-negative, and the biological father is RhD-positive. What is the most appropriate additional management?

A 10-year-old girl with known type 1 diabetes becomes pale, shaky, and confused during a school sports event. Capillary glucose is 2.4 mmol/L. She is awake, follows instructions, and can swallow safely. There has been no seizure, vomiting, or recent long-acting insulin overdose. Her next meal is more than one hour away, and repeat testing is available. What is the most appropriate immediate management?

A 56-year-old woman attends after a screening mammogram was reported as abnormal. She has no breast lump, nipple discharge, skin change, or axillary lymphadenopathy. Her mother developed breast cancer at age 74, but there is no known hereditary syndrome. The magnified craniocaudal mammographic view is shown. Previous imaging three years ago did not show this abnormality. She asks whether another mammogram in six months would be sufficient. What is the most appropriate next step?

A 7-year-old boy has wet the bed five nights weekly since toilet training. He has never remained dry for six consecutive months. Daytime continence is normal, bowel movements are soft and daily, growth is appropriate, and examination is normal. Urinalysis shows no glucose, protein, leukocytes, or nitrites. His family has tried fluid restriction and waking him at night without success. He is motivated to become dry before a school trip in four months. Which initial treatment is most appropriate?