www.rcgp-curriculum.org.uk Royal College of General Practitioners : Applied Knowledge Test Sample Questions

[mariammal]

MRCGP
Applied Knowledge Test

The following 50 questions are in single-best-answer, extended matching, table/algorithm and free-text formats. Some of these questions relate to current best practice. They should be answered in relation to national guidance and not according to an individual's local arrangements.
In the live test of three hours duration all 200 items will be used in calculating your score. Marks will not be deducted for incorrect answers; your total score on the test will be the number of correct answers you give. You are therefore advised to attempt all items.As these are demonstration questions, the answers are intentionally not given.

http://www.rcgp-curriculum.org.uk/mr...questions.aspx
http://www.rcgp-curriculum.org.uk/pd...ember%2011.pdf

1. Management of chest pain
A 55-year-old man has had severe central chest pain radiating into his left arm for the past two hours. He has no previous significant medical history. His BP is 150/85, his chest is clear and his pulse is regular 90/min.
In addition to aspirin, which is the SINGLE MOST appropriate NEXT drug for this patient? Select ONE option only.
A Amiodarone
B Carvedilol
C Diamorphine
D Furosemide
E Ramipril
2. Post-myocardial infarction
A 58-year-old woman attends two months after an ST-segment-elevation myocardial infarction. She has made a good recovery but has developed features of low mood and poor sleep pattern with early morning wakening.
Which is the SINGLE MOST appropriate antidepressant drug to consider for this patient’s current symptoms? Select ONE option only.
A Amitriptyline
B Fluoxetine
C Lofepramine
D Mirtazapine
E Venlafaxine
Viruses
A Adenovirus F Herpes simplex virus
B Cytomegalovirus G Human papilloma virus
C Echovirus H Respiratory syncytial virus
D Epstein-Barr virus I Rotavirus
E Hepatitis B virus J Rubella virus
For each of the clinical conditions below, select the SINGLE MOST likely causative virus from the list of options above. Each option may be used once, more than once, or not at all.
3. Hepatocellular carcinoma
4. Warts
5. Conjunctivitis
6. Infectious mononucleosis
7. Infantile gastroenteritis
Risk of hip fracture
A cohort study is conducted to evaluate the relationship between dietary calcium supplementation and the occurrence of hip fractures in post-menopausal women.
The study examines the hip fracture rate in 100 women taking calcium supplements and 100 women taking placebo over three years.
Over the three year period, five women have hip fractures in the calcium group and ten women have hip fractures in the placebo group. The 95% confidence interval is 0.18 to 1.4.
8. What is the RISK of a hip fracture in the TREATED group? Select ONE option only.
A 0.01
B 0.05
C 0.1
D 0.5
E 1.0
9. What is the RISK RATIO? Select ONE option only.
A 0.01 B 0.05 C 0.1 D 0.5 E 1.0
10. Child growth
An eight-month-old baby girl’s routine measurements have fallen from the 50th centile growth line to below the 25th centile growth line over the past three months. She has a history of minor respiratory infections and recurrent gastroenteritis.
Which is the SINGLE MOST appropriate INITIAL investigation? Select ONE option only.
A Chromosome analysis
B Glucose-6-phosphate dehydrogenase level
C Jejunal biopsy
D Sweat test
E Thyroid function test
11. Childhood illness
A seven-year-old girl has a fever associated with a sore throat and loss of appetite. She has small red ulcers in her mouth and itchy spots on the palms of her hands and soles of her feet.
Which is the SINGLE MOST likely virus causing her symptoms? Select ONE option only.
A Coxsackie A
B Herpes simplex
C Measles
D Parvo-virus B19
E Varicella-zoster
12. Epidemiological measures
A primary care organisation requires information to estimate the typical duration of hospice services required for patients with pancreatic cancer.
Which is the SINGLE MOST appropriate epidemiological measure for the situation described above? Select ONE option only.
A Case fatality
B Incidence
C Median survival
D Mortality
E Prevalence
13. Epidemiological measures
Which is the SINGLE MOST appropriate epidemiological measure to estimate the rate at which the new cases of papilloma virus infection occur among students on a college campus? Select ONE option only.
A Case fatality
B Incidence
C Median survival
D Mortality
E Prevalence
14. Weakness
A 35-year-old woman has noticed increasing weakness and numbness in her legs and arms over the past few days, and today she is feeling short of breath on exertion. Six weeks ago she had diarrhoea while on holiday abroad and stool culture confirmed infection with Campylobacter jejuni. She was treated with ciprofloxacin and recovered fully.
Which is the SINGLE MOST likely diagnosis? Select ONE option only.
A Drug-induced neuropathy
B Guillain-Barré syndrome
C Motor neurone disease
D Myasthenia gravis
E Multiple sclerosis
15. Lethargy
A 50-year-old man has a six month history of lethargy and impotence. His wife comments that he looks tanned in the winter months. His serum ferritin and iron levels are significantly raised, but his haemoglobin is normal.
Which is the SINGLE MOST likely diagnosis? Select ONE option only.
A Addison’s disease
B Chronic active hepatitis
C Diabetes mellitus
D Haemochromatosis
E Hypothyroidism
16. Tiredness
A 50-year-old woman, who has recently been diagnosed with hypertension, complains of pain in her knees. She feels tired and her memory is poor. She has lost her appetite recently and feels nauseated most of the time. Urinalysis is normal.
Which is the SINGLE MOST likely diagnosis? Select ONE option only.
A Chronic fatigue syndrome
B Chronic renal failure
C Coeliac disease
D Cushing’s syndrome
E Hyperparathyroidism
17. Tiredness
A 40-year-old woman stopped the combined oral contraceptive pill six months ago because of increased blood pressure. Her periods have not returned, she feels generally tired and has put on weight. A pregnancy test is negative and her fasting blood glucose is 9.2 mmol/L.
Which is the SINGLE MOST likely diagnosis? Select ONE option only.
A Anaemia
B Chronic active hepatitis
C Coeliac disease
D Cushing’s disease
E Hypothyroidism
18. Visual disturbance
A 20-year-old woman notices bright lines of light in both visual fields followed shortly afterwards by a partial loss of her vision. Her visual symptoms resolve after one hour but she has slight nausea.
Which is the SINGLE MOST likely diagnosis? Select ONE option only.
A Acute glaucoma
B Migraine
C Optic neuritis
D Retinal detachment
E Vitreous detachment
19. Visual disturbance
A 63-year-old man with poorly controlled hypertension, develops sudden visual loss in his left eye. The visual acuity on the left is reduced to hand movements only. Visual acuity on the right is 6/6. Fundoscopy of the left eye shows flame-shaped retinal haemorrhages spreading out from the disc.
Which is the SINGLE MOST likely diagnosis? Select ONE option only.
A Acute glaucoma
B Central retinal artery occlusion
C Central retinal vein occlusion
D Retinal detachment
E Vitreous haemorrhage
Contraceptive advice
A Two days of extra contraceptive precautions required
B Seven days of extra contraceptive precautions required
C Fourteen days of extra contraceptive precautions required
D Emergency contraception required
E No extra precautions required
F Omit pill free week

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