Trial test · GP General Practitioner MCQs (Prometric)

Question 1 of 10

Ocular ultrasound showing an echogenic folded membrane separated from the posterior wall of the globe.

A 59-year-old highly myopic man reports sudden flashes and numerous floaters followed several hours later by a painless dark curtain spreading across the vision of his left eye. Visual acuity is reduced, a relative afferent pupillary defect is present, and intraocular pressure is normal. Dense cataract prevents adequate fundus visualization. There is no headache, ocular discharge, or focal neurological deficit. Bedside ocular ultrasonography is shown. What is the most appropriate next step?

Arrange next-day optometry review and provide retinal-detachment safety advice

Start ocular antibiotics and arrange routine ophthalmology evaluation

Reassure, prescribe migraine therapy, and review symptoms tomorrow

Arrange immediate ophthalmology transfer for urgent retinal repair assessment

Question 2 of 10

Clinical photograph showing marked unilateral eyelid swelling, conjunctival edema, and forward displacement of the eye.

A 36-year-old woman develops fever, severe pain around her left eye, and worsening eyelid swelling after five days of sinus symptoms. Temperature is 39.0°C, pulse is 116/min, and visual acuity is reduced on the affected side. Examination reveals the appearance shown, painful restricted eye movements, and mild proptosis. There is no trauma, insect bite, or medication allergy. What is the most appropriate next step?

Admit for intravenous antibiotics and urgent specialist imaging

Start topical antibiotic drops without systemic treatment

Observe at home while continuing sinus decongestants

Prescribe oral antibiotics and arrange next-day review

Question 3 of 10

A 3-year-old girl is brought because she uses only a few single words and rarely points to share interest. She does not respond consistently to her name, becomes distressed by changes in routine, and repeatedly spins toy wheels. Gross motor development is normal, and there has been no loss of acquired skills. Otoscopy is normal, but formal hearing testing has not been completed. What is the most appropriate next step?

Wait until school entry before requesting developmental assessment

Reassure because gross motor milestones remain age appropriate

Arrange developmental assessment and formal hearing evaluation

Refer for speech therapy without assessing hearing or development

Question 4 of 10

An 18-month-old girl has a generalized tonic-clonic seizure lasting three minutes during the first day of a febrile respiratory illness. She had no previous seizures, and there was no focal onset or recurrence. On assessment 40 minutes later, temperature is 39.0°C, she is alert, drinks normally, and has no neck stiffness, petechiae, focal neurological deficit, or developmental concern. Otoscopy and chest examination show no bacterial focus. What is the most appropriate management?

Arrange urgent brain imaging before allowing oral fluids

Start daily anticonvulsant medication to prevent future febrile seizures

Perform lumbar puncture despite complete recovery and normal examination

Observe recovery, manage fever source, and provide seizure safety advice

Question 5 of 10

An 8-month-old girl presents with fever, vomiting, and reduced feeding for 24 hours. Temperature is 39.1°C, pulse is 164/min, capillary refill is three seconds, and she has produced one wet diaper in 12 hours. There is no cough, rash, diarrhea, or clear examination focus. A catheter urine specimen is positive for leukocyte esterase and nitrites. She vomits an observed oral fluid and antibiotic dose. What is the most appropriate management?

Await urine culture confirmation before giving any antibiotics

Prescribe oral antibiotics and arrange routine review tomorrow

Arrange admission for intravenous fluids, antibiotics, and urine culture

Repeat testing with a urine bag before starting treatment

Question 6 of 10

A 5-year-old boy develops pallor, reduced urine output, and lethargy six days after bloody diarrhea following a farm visit. Temperature is 37.4°C, pulse is 118/min, and blood pressure is 138/86 mmHg. Hemoglobin is 78 g/L, platelets are 54 × 10⁹/L, creatinine is markedly elevated, and the blood film shows fragmented red cells. He has no purpura before the diarrheal illness or medication exposure. What is the most appropriate management?

Start routine antibiotics to eradicate the intestinal organism

Begin corticosteroids for presumed immune thrombocytopenic purpura

Give antimotility medication and encourage unrestricted oral fluids

Admit urgently for supportive renal and hematological management

Question 7 of 10

Obstetric illustration showing the umbilical cord descending through the cervix below the fetal presenting part.

A 31-year-old multiparous woman at 39 weeks presents after spontaneous rupture of membranes at home. On arrival, fetal heart rate is 78/min and remains low despite left lateral positioning. Vaginal examination reveals a pulsating structure below the presenting fetal head, matching the configuration shown. The cervix is 5 cm dilated, the head remains high, and emergency cesarean facilities are available. What is the most appropriate immediate management?

Continue monitoring until full cervical dilation occurs

Elevate the presenting part and arrange emergency cesarean delivery

Replace the cord manually and await spontaneous labor

Start oxytocin to accelerate vaginal delivery

Question 8 of 10

Pelvic radiograph showing flattening, sclerosis, and fragmentation affecting the femoral heads.

A 7-year-old boy has six weeks of progressive limping and intermittent right groin and knee pain. There was no trauma or recent infection. Temperature is normal, inflammatory markers are not elevated, and hip abduction and internal rotation are restricted. He remains able to bear weight but walks with an antalgic gait. His height and weight are age appropriate. Review the supplied pelvic radiograph. What is the most appropriate next step?

Inject intra-articular corticosteroid before requesting specialist assessment

Start intravenous antibiotics for presumed septic hip disease

Permit unrestricted sport and review after three months

Restrict impact activity and arrange prompt pediatric orthopaedic referral

Question 9 of 10

Noncontrast axial brain CT showing a crescent-shaped extra-axial collection compressing the adjacent cerebral hemisphere.

A 76-year-old man taking apixaban is brought after ten days of worsening headache, slowed thinking, and unsteady walking. He fell from standing three weeks ago but did not lose consciousness. Blood pressure is 158/86 mmHg, Glasgow Coma Scale is 14, and examination shows mild left-arm weakness. Glucose is normal, and there is no fever or meningism. The noncontrast brain CT is shown. What is the most appropriate next step?

Reverse anticoagulation and obtain emergency neurosurgical assessment

Perform lumbar puncture to investigate persistent headache

Continue anticoagulation and repeat neurological examination tomorrow

Arrange outpatient observation with repeat imaging next month

Question 10 of 10

A 70-year-old man with hypertension and carotid atherosclerosis develops sudden painless loss of vision in his left eye 45 minutes before presentation. He can detect only hand movement. The pupil shows a relative afferent defect, but there is no eye redness, headache, jaw pain, weakness, or speech disturbance. Blood pressure is 172/94 mmHg, and cardiac rhythm is irregular. The fundus image is shown. What is the most appropriate next action?

Start pressure-lowering eye drops and observe

Arrange routine ophthalmology review within one week

Activate an emergency retinal stroke pathway

Begin anticoagulation before emergency diagnostic assessment