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Sample Questions

20 Hand picked questions to give you a taste of our premium question bank.

1 / 20

Category: Endocrine and Metabolic

1) A 43-year-old woman attends the GP surgery feeling generally unwell with episodes of abdominal pain and vomiting. During the history, she tells you that she has felt fatigued and lower in mood for the past 12-18 months. She has had no bereavements or significant life events in that time that she can think of.

On inspection, you notice bronze patches in her skin creases, dry mucosae and when taking her vital observations, she has a low-grade fever and a blood pressure of 86/58mmHg.

Given the most likely diagnosis, what would you expect to see on her blood results?

 

2 / 20

Category: Paediatrics

2) You are a Physician Associate working in General Practice. Your next patient is a child with confirmed scarlet fever who has been given a prescription for  phenoxymethylpenicillin (penicillin V). The child's mother wants to know how long she should keep the child at home and off school.

Please select the most appropriate advice to give her.

 

3 / 20

Category: Renal and Genito-urinary

3) You are a Physician Associate in General Practice. Your next patient is a 65 year old lady presenting with increased urinary frequency over the past 3 days. During this time she has also experienced some discomfort on passing urine and a frequent feeling of urgency to pass urine. She has not noticed any blood in her urine and is otherwise well. She has a past medical history of type 2 diabetes. The patient reports having these symptoms a couple of times in the past for which she says she was given medication.

Which of the following statements is correct?

 

4 / 20

Category: Gastroenterology

4) A 10 year old boy has arrived in A&E, complaining of a sharp intense pain in the right iliac fossa (RIF) accompanied with a fever. He feels nauseous but has not vomited and has no appetite today. 

On examination, he is very tender in the RIF and displays guarding and rebound tenderness. You notice palpation in the left iliac fossa (LIF) increases pain on the opposing side in his RIF.  

What is this sign called? 

 

5 / 20

Category: Respiratory

5) You are a Physician Associate working in a GP practice. Your next patient is a  66 year old woman who is complaining of feeling unwell. She has a productive cough producing clear mucus, some nasal congestion, headache and fatigue that has been going on for 3 days. She describes a new increased breathlessness. She has a low grade fever. She does not seem confused, has no significant medical history and is a non-smoker. On examination she has a bilateral upper zone wheeze.

Vital signs: 38.3ºC. Her RR is 21, Sp02 is 97% and her BP is 130/96.

What is the most appropriate course of action? 

 

6 / 20

Category: Paediatrics

6) You are a Physician Associate working in the Paediatric Assessment Unit. A 12 year old boy has been sent in by his GP with a suspected Slipped Upper Femoral Epiphysis (SUFE) with a moderate slip. 

What is the definitive management for this patient? 

 

7 / 20

Category: Sexual Health

7) You are a Physician Associate working in the GUM clinic. A patient has received a positive HIV test result after consenting to the test, which included counseling and information about the necessity of contacting partners. He admits to engaging in unprotected sexual activity with multiple partners. However, when informed of the result and asked for consent to initiate contact tracing, even with the assurance of anonymity, he declines.

Which is the most appropriate course of action?

 

8 / 20

Category: Musculoskeletal

8) An 86 year old female presents to the emergency department after falling over at her nursing home. She has a past medical history of osteoporosis, dementia and is clinically frail.

On examination, her left leg is shortened and her hip is externally rotated. 

A X-ray is performed and identifies a displaced intracapsular fracture.

What is the definitive management for this condition? 

 

9 / 20

Category: Ophthalmology

9) You are a Physician Associate working in GP. Your next patient is a 20 year old woman who presents with a painless lump over the lower eyelid. The lump has been present for 7 days and is painless with no associated symptoms. A diagnosis of a chalazion is made.

What is the most appropriate management for this patient?

 

10 / 20

Category: Endocrine and Metabolic

10) A 72-year-old woman presents to the emergency department after a fall at her nursing home, with a suspected fractured neck of femur. She has a history of COPD and type 2 diabetes.

Her diabetes medications include gliclazide, metformin, sitagliptin, and empagliflozin, while she uses a budesonide inhaler for her COPD.

She reports feeling light-headed and dizzy before the fall. Paramedics measure her capillary blood glucose level at 2.9 mmol/L, and on arrival at the hospital, it is repeated and found to be 3.1 mmol/L.

What medication is most likely to have caused her fall?

 

11 / 20

Category: Gastroenterology

11) You are a Physician associate in general practice. You see Mrs Jones, a 45-year-old woman with a 2-week history of heart burn and reflux. She denies any triggers, pain, problems swallowing or weight loss and feels otherwise well. She has no past medical history and isn’t taking any medication. She is allergic to penicillin. She has tried lifestyle and a proton pump inhibitor for one month with no relief. You decided to order a urea (13C) breath test for the suspected diagnosis. This has come back positive.  

Given the likely diagnosis, how will you manage Mrs Jones? 

 

12 / 20

Category: Rheumatology

12) You are a Physician Associate working in General Practice. Your next patient is a 4 year old girl who has been brought in by her mother. Her mother tells you that her daughter is currently complaining of pain in her knees and ankles. On further questioning, you learn that 2 months ago the patient had a period of fevers that lasted for 2 weeks before resolving. These fevers peaked in the afternoon/evening and were accompanied with a salmon pink rash on the patients back. The mother does not think these are related. 

What is the most likely diagnosis? 

 

13 / 20

Category: Neurology

13) You are a Physician Associate working in the Emergency Department. You see a patient who has presented to A&E with what they describe as ‘the worst headache they have ever had’. The patient states the headache started suddenly about 30 minutes ago and felt like they had been hit on the back of the head. On examination: there are no signs of papilloedema and the patient has no focal neurological defects. A CT scan is done and there are no abnormalities found. Your supervisor is still concerned that the patient may have had a subarachnoid haemorrhage and orders a lumbar puncture. 

What result would suggest the presence of a subarachnoid haemorrhage?

 

14 / 20

Category: Emergency Medicine

14) You are a Physcian Associate working within the Emergency Department. A 56 year old man has been admitted following chest pain. He is having an acute coronary event.

Vital signs: stats SpO2 97%, normotensive, pulse 70bpm, RR 19, patient is conscious and alert. 

An ECG conducted within the department confirms the patient is having a STEMI. He is determined to be eligible for PCI and needs to be transferred to the closest hospital that can provide this, the patient would arrive within the 120 minute timeline for treatment. 

What is the most appropriate next step?

 

15 / 20

Category: Mental Health

15) You are in an Outpatient Clinic for children with behavioural issues. Your next patient is a 13 year old boy who has had problems with attention and is struggling with behaving in school. The boys mother tells you that she is concerned that her son is not growing as he should.

What medication is most likely to have the side effect of growth restrictions?

 

16 / 20

Category: Rheumatology

16) You are a Physician Associate working in General Practice. Your next patient, a 58 year old female presents to you with dry eyes, dry mouth, arthralgia and fatigue. She also has a positive Schirmer’s test. 

Which antibody test would support the likely diagnosis? 

 

17 / 20

Category: Ophthalmology

17) You are a Physician Associate working in General Practice. Your next patient is a 65 year old man that presents with a 3 day history of a unilateral painful red eye that has been very watery. He also notes an itchy rash with spots on the side of his nose and feeling quite unwell 5 days prior to the appearance of the rash. On examination, you note a right diffuse conjunctival injection with watering, a vesicular rash on the right side of his nose and moderate peri-orbital oedema. 

What is the single most likely diagnosis?

 

18 / 20

Category: Infectious Disease

18) A 80 year old women living in a care home presents with an itchy rash on her finger webs and axillary folds with noticeable track marks. She complains it is keeping her up at night.  

Based off the likely given diagnosis, what is the single most appropriate management? 

 

19 / 20

Category: Cardiovascular

19) A 50 year old gentleman has been brought in by ambulance to A&E. He is complaining of chest pain.  

Vital signs: Heart rate 100bpm, blood pressure 90/110 mmHg, heart sounds are distant, he has an elevated jugular venous pressure and pulsus paradoxus >10mmHg. ECG shows electrical alternans.  

Based off the likely diagnosis what triad is seen in this presentation?

 

20 / 20

Category: Neurology

20) A 74-year-old man visits the GP with sudden-onset symptoms, including the inability to close his right eye, difficulty forming facial expressions, and new-onset drooling, all of which developed overnight. Upon examination, he demonstrates an inability to fully close his right eye, lift the corners of the right side of his mouth, and elevate his right eyebrow. The patient has no significant medical history, vital signs are stable and there is no apparent limb weakness.

What is the most likely diagnosis?

 

Your score is

The average score is 49%

0%

Reference Ranges:

Full blood count (FBC)
Haemoglobin (Hb)
  • Male: 130 – 180 g/L
  • Female: 115 – 165 g/L
White cell count (WCC)
  • Total: 3.6 – 11.0 x 10⁹/L
  • Neutrophils: 1.8 – 7.5 x 10⁹/L
  • Lymphocytes: 1.0 – 4.0 x 10⁹/L
  • Monocytes: 0.2 – 0.8 x 10⁹/L
  • Eosinophils: 0.1 – 0.4 x 10⁹/L
  • Basophils: 0.02 – 0.10 x 10⁹/L
Platelet count
  • 140 – 400 x10⁹/L
Red cell count (RCC)
  • Male: 4.5 – 6.5 x 10⁹/L
  • Female: 3.8 – 5.8 x 10⁹/L
Haematocrit
  • Male: 0.40 – 0.54 /L
  • Female: 0.37 – 0.47 /L
Mean cell volume (MCV)
  • 80 – 100 fL
Mean corpuscular haemoglobin (MCH)
  • 27 – 32 pg/cell
Reticulocyte count
  • 0.2 – 2%
Coagulation
Prothrombin time (PT)
  • 10 – 14 seconds
Activated partial thromboplastin time (APTT)
  • 24 – 37 seconds
Fibrinogen
  • 1.50 – 4.50 g/L
D-Dimer
  • 500 ng/mL
Haematinics
Ferritin
  • Male: 25 – 350 ng/mL
  • Female: 10 – 300 ng/mL
Vitamin B12
  • 180 – 1000 pg/mL
Folate
  • 4.0 ng/mL
Total serum iron
  • Male: 11.6 – 35.0 μmol/L
  • Female: 4.6 – 30.4 μmol/L
Transferrin
  • 2.0 – 3.6 g/L
Transferrin saturation
  • 20 – 50%
Total iron binding capacity (TIBC)
  • 45 – 81 μmol/L
Erythrocyte sedimentation rate (ESR)
  • Male: ≤ 49 years: 1 – 7
  • Male: ≥ 50 years: 2 – 10
  • Female: ≤ 49 years: 3 – 9
  • Female: ≥ 50 years: 5 – 15
 
Urea & electrolytes
Na⁺
  • 133 – 146 mmol/L
K⁺
  • 3.5 – 5.3 mmol/L
Ca²⁺ (adjusted)
  • 2.2 – 2.6 mmol/L
Mg²⁺
  • 0.7 – 1.0 mmol/L
Phosphate
  • 0.74 – 1.4 mmol/L
Chloride
  • 98 – 106 mmol/L
Urea
  • 2.5 – 7.8 mmol/L
Creatinine
  • Male: 59 – 104 μmol/L
  • Female: 45 – 84 μmol/ L
Liver function tests (LFTs)
Alkaline phosphatase (ALP)
  • 30 – 130 U/L
Alanine aminotransferase (ALT)
  • Male: < 41 U/L
  • Female: < 33 U/L
Aspartate aminotransferase (AST)
  • 1 – 45 U/l
Bilirubin
  • <21 μmol/L
GGT
  • Male: < 60 U/L
  • Female: < 40 U/L
Albumin
  • 35 – 50 g/L
Inflammatory markers
CRP
  • 5mg/L
Arterial blood gas
pH
  • 7.35 – 7.45
PaO₂
  • 11 – 13 kPa (82.5 – 97.5 mmHg)
PaCO₂
  • 4.7 – 6.0 kPa (35.2 – 45 mmHg)
HCO₃
  • 22 – 26 mmol/L
Base excess (BE)
  • (-2 to +2 mmol/L)
Metabolic tests
Serum ketones
  • < 0.6 mmol/L
Fasting blood glucose
  • 4.0 to 6.0 mmol/L
Postprandial (2 hours after eating)
  • up to 7.8 mmol/L
HbA1c
  • < 42 mmol/mol (6.0%)
Cholesterol
  • < 5 mmol/L
Triglyceride
  • 0.55 – 1.90 mmol/L
LDL
  • < 3mmol/L
HDL
  • > 1 mmol/L
Cholesterol/HDL
  • < 4
Endocrinology
TSH
  • 0.4 – 5.0 mU/L²
Free T4
  • 9 – 24 pmol/L
Free T3
  • 3.5 – 7.8 pmol/L
Parathyroid hormone
  • 10 – 65 ng/L
Growth hormone (random)
  • < 5 ng/mL
  • < 10 ng/mL
Cortisol (random)
  • 137 – 429 nmol/L
Testosterone
  • Male <50: 10-45 nmol
  • Male >50: 6.2-26 nmol
Other biochemistry tests
Serum total protein
  • 60 – 78 g/L
Troponin T
  • < 0.01 µg/L
Creatine kinase (CK)
  • Male: 40 – 320 U/L
  • Female: 25 – 200 U/L
Lactate dehydrogenase (LDH)
  • 240 – 480 U/L
Lactate (plasma)
  • 0.5 – 2.2 mmol/L
Urate
  • Male: 200 – 430 μmol/L
  • Female: 140 – 360 μmol/L
Amylase
  • 28 – 100 U/dL
Ammonia
  • 10 – 35 μmol/L
NT-proBNP
  • <75 years: <125 pg/mL
  • >75 years: <450 pg/mL
Copper
  • 70 – 150 μg/dL
Ceruloplasmin
  • 15 – 60 μmol/L
Vitamin D
  • >50 nmol/L
Serum osmolality
  • 275 – 295 mOsmol/kg
24h urine osmolality
  • 500 – 800 mOsm/kg
Random urine osmolality
  • 300 – 900 mOsm/kg
12h fluid restricted urine osmolality
  • >850 mOsm/kg
24h urine sodium (Na⁺)
  • 100 – 260 mmol/24h
24h urine potassium (K⁺)
  • 25 – 100 mmol/24h
24h urine total protein
  • < 100 mg/24h
Urine pH (random)
  • 5 – 7
Adult vital signs
Body temperature
  • 36.5°C to 37.3°C
  • 97.8°F to 99.1°F
Pulse
  • 60 – 100 beats per minute
Blood pressure
  • 90/60 – 120/80 mmHg
Respiratory rate
  • 18 breaths per minute
Pulse oximetry
  • >94%
Paediatric vital signs
Blood pressure
  • < 1 year: 70 – 90 mmHg
  • 1 – 2 years: 80 – 95 mmHg
  • 2 – 5 years: 80 – 100 mmHg
  • 5 – 12 years: 90– 110 mmHg
Heart rate
  • < 1 year: 110 – 160
  • 1 – 2 years: 100 – 150
  • 2 – 5 years: 95 – 140
  • 5 – 12 years: 80 – 120
Respiratory rate
  • < 1 year: 30 – 40
  • 1 – 2 years: 25 – 35
  • 2 – 5 years: 25 – 30
  • 5 – 12 years: 20 – 25
Tumour markers
Beta human chorionic gonadotrophin (bHCG)
  • < 5 mU/mL
Alpha fetoprotein
  • < 44 ng/mL
Prostate specific antigen (PSA)
  • < 4.0 ng/mL
Carcinoembryonic antigen (CEA)
  • Non-smokers at 50 years: < 3.6μg/L
  • Non-smokers at 70 years: < 4.1μg/L
  • Smokers: < 5μg/L
CA-125
  • < 35 U/mL
CA19-9
  • < 40 U/mL
Immunology
Anti-SS-A (La)
  • Negative: < 3 U/mL
  • Positive: > 4 U/mL
Anti-streptolysin O titre (ASOT)
  • Pre-school age: < 100
  • School age: < 250
  • Adults: < 125
Rheumatoid factor (RF)
  • Negative: < 20 U/mL
  • Positive: > 30 U/mL
Anti-mitochondrial antibodies (AMA)
  • Negative: < 10 U/mL
  • Positive: > 10 U/mL
Perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)
  • Negative: < 5 U/mL
  • Positive: > 5 U/mL
Anti-histone antibodies
  • Negative: < 25 U/mL
  • Positive: > 25 U/mL
IgA
  • 110 – 560 mg/dL
IgD
  • 0.5 – 3.0 mg/dL
IgE
  • 0.01 – 0.04 mg/dL
IgG
  • 800 – 1800 mg/dL
IgM
  • 54 – 200 mg/d
Anti-ds-DNA
  • Negative: < 40 U/mL
  • Positive: > 60 U/mL
Anti-ss-DNA
  • Negative: < 8 U/mL
  • Positive: > 10 U/mL
Cytoplasmic anti-neutrophil cytoplasmic antibodies (c-ANCA)
  • Negative: < 20 U/mL
  • Positive: > 30 U/mL
Anti-SS-A (Ro)
  • Negative: < 15 U/mL
  • Positive: > 25 U/mL
Lumbar puncture results
Appearance
  • Clear and colourless
White blood cells (WBC)
  • 0 – 5 cells/µL
  • No neutrophils present, primarily lymphocytes
  • Normal cell counts do not rule out meningitis or any other pathology
Red blood cells (RBC)
  • 0 – 10/mm³
Protein
  • 0.15 – 0.45 g/L (or <1% of the serum protein concentration)
Glucose
  • 2.8 – 4.2 mmol/L (or ≥ 60% plasma glucose concentration)
Opening pressure
  • 10 – 20 cm H₂O