Prometric Exam Questions for Doctors 2026: 15 GP-Level MCQs with Answers and Explanations

The General Practitioner Prometric paper is the broadest exam any GCC regulator sets. DHA, MOHAP, SHA, SCFHS and QCHP all expect a candidate to handle adult medicine, paediatrics, obstetrics and gynaecology, basic surgery, emergency presentations and rational prescribing at the level of a competent primary-care physician. There is no specialty to hide in.

The fifteen questions below follow the format of the real exam: a short clinical vignette, a single best answer from four options, and a bias toward management decisions rather than pathophysiology trivia. Time yourself at roughly 70 seconds per item. Then read every explanation, because the exam repeats reasoning patterns far more often than it repeats facts.

For the full syllabus weighting, see the high-yield topics for the GP exam. For timed, authority-specific mocks, use the practice exam banks.

Internal medicine

Question 1

A 62-year-old man with hypertension and type 2 diabetes has a blood pressure of 152/94 mmHg on two visits and a urine albumin-creatinine ratio of 8 mg/mmol. The most appropriate antihypertensive to start is:

1. Amlodipine
2. Hydrochlorothiazide
3. Ramipril
4. Atenolol

Answer: C. In a diabetic patient with albuminuria, an ACE inhibitor or angiotensin receptor blocker is first-line because it reduces intraglomerular pressure and slows progression of nephropathy. Calcium channel blockers and thiazides are added later if targets are not met.

Question 2

A 45-year-old woman presents with fatigue, weight gain, constipation and a TSH of 18 mU/L with a low free T4. The next step is to:

1. Order a radioactive iodine uptake scan
2. Start levothyroxine and recheck TSH in 6 to 8 weeks
3. Refer for thyroidectomy
4. Start carbimazole

Answer: B. Raised TSH with low free T4 is overt primary hypothyroidism. Treatment is levothyroxine, titrated against TSH measured after 6 to 8 weeks. Uptake scans are for hyperthyroidism, and carbimazole would worsen the condition.

Question 3

A 30-year-old man has had three days of watery diarrhoea after returning from travel. He is afebrile, passing urine normally and has no blood in the stool. The most appropriate management is:

1. Oral rehydration solution and observation
2. Loperamide plus intravenous fluids
3. Empirical metronidazole
4. Stool culture and admission

Answer: A. Uncomplicated traveller's diarrhoea in a well-hydrated adult without fever or dysentery is self-limiting. Oral rehydration is the mainstay. Antibiotics are reserved for severe, febrile or bloody diarrhoea, and admission is unnecessary with normal urine output.

Question 4

Which finding is most specific for iron deficiency anaemia?

1. Low mean corpuscular volume
2. Raised total iron-binding capacity with low ferritin
3. Low serum iron alone
4. Raised reticulocyte count

Answer: B. Ferritin is the most specific marker of body iron stores; a low ferritin with a raised total iron-binding capacity confirms deficiency. A low MCV also occurs in thalassaemia trait and anaemia of chronic disease, and serum iron alone fluctuates with diet and inflammation.

Paediatrics and obstetrics

Question 5

A 4-month-old exclusively breastfed infant is brought for a routine visit. Which supplement should be recommended?

1. Iron
2. Vitamin D
3. Vitamin C
4. Zinc

Answer: B. Breast milk is low in vitamin D, and GCC guidelines recommend 400 IU daily for breastfed infants from birth. Iron stores are usually adequate until about six months, when complementary foods are introduced.

Question 6

A 3-year-old presents with fever, drooling, muffled voice and sits leaning forward with the neck extended. The most appropriate immediate action is to:

1. Examine the throat with a tongue depressor
2. Obtain a lateral neck X-ray in the radiology department
3. Keep the child calm and arrange urgent airway assessment by anaesthesia and ENT
4. Give oral amoxicillin and review in 24 hours

Answer: C. Drooling, tripod positioning and a muffled voice indicate epiglottitis, a true airway emergency. The child must not be distressed or examined until a team able to secure the airway is present. Imaging away from resuscitation facilities is dangerous.

Question 7

A woman at 28 weeks of gestation has a 75 g oral glucose tolerance test result of fasting 5.4 mmol/L and 2-hour 9.2 mmol/L. The diagnosis is:

1. Normal result
2. Gestational diabetes
3. Pre-existing type 2 diabetes
4. Impaired fasting glucose only

Answer: B. Using the widely adopted IADPSG/WHO thresholds (fasting 5.1, 1-hour 10.0, 2-hour 8.5 mmol/L), either value exceeding the cut-off confirms gestational diabetes. Management begins with diet and glucose monitoring, with metformin or insulin if targets are not met.

Question 8

A 26-year-old woman at 9 weeks of gestation presents with vaginal bleeding and cramping. Ultrasound shows an intrauterine gestational sac with a fetal pole and cardiac activity, and the cervical os is closed. The diagnosis is:

1. Inevitable miscarriage
2. Threatened miscarriage
3. Missed miscarriage
4. Ectopic pregnancy

Answer: B. Bleeding with a closed os and a live intrauterine pregnancy is a threatened miscarriage. Management is expectant with reassurance and safety-netting advice. An open os would make it inevitable; absent cardiac activity would indicate a missed miscarriage.

Surgery and emergency medicine

Question 9

A 22-year-old man presents with 12 hours of periumbilical pain that has migrated to the right iliac fossa, with nausea and a temperature of 38.1 °C. The most appropriate next step is:

1. Discharge with analgesia and review in 48 hours
2. Surgical referral for suspected appendicitis
3. Prescribe a proton pump inhibitor
4. Order a barium enema

Answer: B. Migratory pain to the right iliac fossa with fever and anorexia is the classic presentation of acute appendicitis. The patient should be kept nil by mouth and referred for surgical assessment. Delay risks perforation.

Question 10

A patient is found collapsed and unresponsive with no normal breathing. After confirming the scene is safe and calling for help, the next action is to:

1. Give two rescue breaths
2. Check the blood glucose
3. Start chest compressions at 100 to 120 per minute
4. Place in the recovery position

Answer: C. Current resuscitation guidelines prioritise immediate high-quality chest compressions for an unresponsive adult who is not breathing normally, with a 30:2 compression-to-ventilation ratio once ventilation is available. Delays to check glucose or position the patient reduce survival.

Question 11

A 55-year-old man presents with sudden severe chest pain radiating to the back, a blood pressure of 180/100 mmHg in the right arm and 140/80 mmHg in the left. The diagnosis to exclude first is:

1. Acute pericarditis
2. Aortic dissection
3. Pulmonary embolism
4. Oesophageal spasm

Answer: B. Tearing chest pain radiating to the back with a blood pressure difference between the arms is aortic dissection until proven otherwise. Thrombolysis or anticoagulation for a presumed myocardial infarction would be catastrophic, so imaging with CT angiography is urgent.

Question 12

In a patient with a suspected cervical spine injury after a road traffic collision, the airway should be opened using:

1. Head tilt and chin lift
2. Jaw thrust with manual in-line stabilisation
3. Hyperextension of the neck
4. Placing the patient prone

Answer: B. Jaw thrust with the neck held in neutral alignment opens the airway without moving the cervical spine. Head tilt and any extension of the neck risk converting an unstable injury into a spinal cord injury.

Prescribing and professional practice

Question 13

Which antibiotic is contraindicated in a pregnant woman with a urinary tract infection?

1. Nitrofurantoin in the second trimester
2. Cefalexin
3. Ciprofloxacin
4. Amoxicillin

Answer: C. Fluoroquinolones are avoided in pregnancy because of concerns about fetal cartilage development. Cefalexin and amoxicillin are safe first-line options, and nitrofurantoin is acceptable outside the last weeks before delivery.

Question 14

A 70-year-old woman on multiple medicines develops confusion, dry mouth, urinary retention and constipation. The most likely culprit is:

1. Metformin
2. Amitriptyline
3. Lisinopril
4. Simvastatin

Answer: B. The combination of confusion, dry mouth, urinary retention and constipation is the anticholinergic syndrome. Tricyclic antidepressants such as amitriptyline are a common cause in older adults, and deprescribing is the treatment.

Question 15

A patient asks the doctor not to record a sensitive diagnosis in the hospital electronic record. The most appropriate response is to:

1. Agree, and keep a separate paper note
2. Explain that the record must be accurate and complete, and that access is restricted to those involved in care
3. Record a different diagnosis to protect the patient
4. Refuse further care

Answer: B. Medical records must be accurate and complete for patient safety and legal reasons. Confidentiality is protected by access controls, not by falsifying or omitting information. The doctor should explain this and address the patient's specific concern about who can see the record.

What the exam is really testing

Notice that thirteen of the fifteen items asked for a management decision: what to start, what to exclude, what to do first. That is the GP paper. Candidates who revise pathophysiology textbooks and neglect guideline-based management routinely score in the 50s and miss the cut by a handful of questions.

• Revise from current guidelines (NICE, AHA, WHO and the GCC authorities' own clinical standards), not from older textbooks.
• Do at least five full-length timed papers before exam day. Stamina matters in a three-hour, 150-question sitting.
• Know the drug lists: contraindications in pregnancy, renal dosing, anticholinergic burden and common interactions are on every paper.
• Confirm your tier before you book. GP, Specialist and Consultant sit different papers, and classification errors are a leading cause of wasted exam fees. The specialist and consultant recognition guide explains the tiers.

Practice with authority-specific question banks on our Prometric practice exams page, and run the free eligibility check to see which licences you qualify for before you spend anything.

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Frequently asked questions

How many questions are on the Prometric GP exam?

Usually 150 single-best-answer MCQs in 3 hours for DHA and SCFHS; QCHP and the other authorities run 100 to 150. The pass mark is around 60%.

Is the DHA GP exam harder than the SCFHS one?

The blueprints overlap by more than 80%. Candidates report SCFHS leaning more toward Saudi clinical protocols and the DHA paper toward guideline-based management, but a candidate who is ready for one is ready for the other. See the DHA exam for doctors and SCFHS exam for doctors guides for each format.

Which specialties do GP questions come from most?

Internal medicine is the largest block, followed by paediatrics, obstetrics and gynaecology, surgery and emergency medicine, then psychiatry, dermatology, ENT and ophthalmology in smaller shares.

Can I use these questions to prepare for the Specialist exam?

Only as a warm-up. Specialist papers are specialty-specific and deeper. The blog has dedicated guides for cardiology, emergency medicine, orthopaedics and most other specialties.

What happens if I fail?

Every authority allows re-attempts, usually three per eligibility with a waiting period between them. The retake rules guide lists the exact rules per regulator.