Prometric Exam Questions for Family Medicine Specialists 2026: 15 Practice MCQs with Answers and Rationale for the FAM5871 Paper

The family medicine specialist paper (FAM5871; consultants sit FAM5742) is the primary-care paper: the diabetic review, the child with fever, the woman with heavy periods, the man with back pain, the elderly patient with falls, and the one presentation in fifty that is a red flag. Gulf health systems are expanding primary care fast, and family physicians are in demand. It is usually 100 to 150 single-best-answer questions in 2.5 to 3 hours, with a pass mark of about 60%.

The fifteen questions below follow that blueprint. Allow about 70 seconds each and read every rationale. The paper follows current international guidance on targets, screening intervals and first-line drugs.

For titles and the route, read the family medicine guide. For timed papers use the Family Medicine specialist bank, about 2,700 questions. GPs without a family medicine qualification sit the GP paper (GP sample questions).

Chronic disease management

Question 1

A 52-year-old with type 2 diabetes has an HbA1c of 8.2% on maximum-dose metformin, a BMI of 34 and established atherosclerotic cardiovascular disease. The best next agent is:

1. A sulfonylurea
2. A GLP-1 receptor agonist or an SGLT2 inhibitor with proven cardiovascular benefit
3. Insulin immediately
4. No change; recheck in a year

Answer: B. In patients with cardiovascular disease, SGLT2 inhibitors and GLP-1 agonists reduce events independent of glucose lowering; GLP-1 agonists also support weight loss. Sulfonylureas add hypoglycaemia and weight gain.

Question 2

A 60-year-old has a clinic blood pressure of 150/95 mmHg confirmed by home readings averaging 145/92. He has no diabetes or kidney disease. The management is:

1. Lifestyle advice only for a year
2. Lifestyle advice plus starting antihypertensive therapy, usually a calcium channel blocker or ACE inhibitor/ARB, aiming below 140/90 and lower if tolerated, with assessment of cardiovascular risk and end-organ damage
3. A beta blocker as first line
4. Refer to hospital

Answer: B. Stage 1 hypertension with confirmed out-of-office readings is treated when cardiovascular risk is raised, and at age 60 with these readings most guidelines recommend treatment. Baseline bloods, ECG and urine albumin assess damage.

Question 3

A 45-year-old with asthma uses a salbutamol inhaler four times a week and wakes once a week with symptoms. He is on no preventer. The appropriate step is:

1. Increase salbutamol use
2. Start regular inhaled corticosteroid, or an ICS-formoterol maintenance-and-reliever regimen, check inhaler technique and adherence, and give a written action plan
3. Oral steroids long term
4. Antibiotics

Answer: B. Reliever use more than twice a week indicates uncontrolled asthma needing anti-inflammatory therapy. Current guidance discourages salbutamol-only treatment at any severity.

Preventive care and screening

Question 4

Which screening recommendation is correct for an average-risk 50-year-old woman in a Gulf primary care setting?

1. No screening until symptoms
2. Mammography every one to two years from 40 to 50 depending on the national programme, cervical screening with HPV testing every five years if previously normal, and colorectal screening from 45 to 50 by FIT or colonoscopy
3. Annual whole-body CT
4. Cervical screening only after menopause

Answer: B. Gulf national programmes mirror international guidance with earlier breast screening in some countries; the exam expects knowledge of intervals and modalities rather than one country's exact start age.

Question 5

A 35-year-old man has a 10-year cardiovascular risk of 12%, an LDL cholesterol of 4.2 mmol/L and no diabetes. The appropriate advice is:

1. No statin at any risk level under 20%
2. Lifestyle modification, and discussion of a statin where the risk threshold used locally (commonly 7.5 to 10%) is reached, with shared decision-making
3. Immediate high-intensity statin and aspirin
4. Fibrate only

Answer: B. Primary prevention statins are offered above a risk threshold after lifestyle advice; aspirin is not recommended for primary prevention in most adults.

Paediatrics and women's health

Question 6

A 3-year-old has a temperature of 39 °C, is drinking, alert, with a red bulging right tympanic membrane and no complications. The management is:

1. Immediate intravenous antibiotics
2. Analgesia and safety-netting, with amoxicillin if symptoms persist beyond 48 to 72 hours, bilateral disease under two years, otorrhoea or systemic illness
3. Ear syringing
4. Antihistamines

Answer: B. Most acute otitis media resolves without antibiotics; delayed prescribing reduces resistance. Red flags such as mastoid tenderness or facial palsy need urgent referral.

Question 7

A 28-year-old woman has heavy regular periods, a normal examination and a haemoglobin of 10.5 g/dL. She wants contraception. First-line treatment is:

1. Hysterectomy
2. The levonorgestrel intrauterine system, with iron replacement, after excluding structural causes by ultrasound where indicated
3. Tranexamic acid only
4. No treatment

Answer: B. The LNG-IUS treats heavy menstrual bleeding and provides contraception. Combined pills are an alternative; tranexamic acid suits women not wanting hormones.

Question 8

A woman at 10 weeks of pregnancy asks which supplements she should take. Correct advice is:

1. High-dose vitamin A
2. Folic acid 400 micrograms daily (5 mg if high risk), vitamin D, and iron only if deficient; avoid liver and high-dose vitamin A
3. No supplements
4. Iron 200 mg three times a day for all

Answer: B. Vitamin D deficiency is near-universal in the Gulf, so supplementation is routine. Folic acid is ideally started before conception.

Mental health and musculoskeletal

Question 9

A 40-year-old reports low mood, anhedonia, poor sleep and reduced concentration for eight weeks, with a PHQ-9 of 16 and no suicidal ideation. The management is:

1. Reassurance only
2. Offer psychological therapy and an SSRI for moderate depression, with review in one to two weeks and safety-netting
3. Benzodiazepines
4. Antipsychotics

Answer: B. Moderate depression warrants active treatment; combined therapy is most effective. Early review monitors adverse effects and risk.

Question 10

A 50-year-old has four weeks of low back pain with no leg symptoms, normal neurology and no red flags. The management is:

1. Urgent MRI
2. Reassurance, staying active, simple analgesia such as an NSAID if not contraindicated, and physiotherapy or exercise referral if not improving, without routine imaging
3. Bed rest for two weeks
4. Opioids

Answer: B. Non-specific low back pain does not need imaging. Red flags (cauda equina, cancer, infection, fracture, age with new pain) change the pathway.

Question 11

A 65-year-old woman has a knee with mild effusion, morning stiffness under 30 minutes, crepitus and osteophytes on x-ray. First-line management is:

1. Joint replacement now
2. Education, weight loss, exercise and physiotherapy, topical NSAIDs or paracetamol, with oral NSAIDs for short courses and intra-articular steroid for flares
3. Long-term oral steroids
4. Arthroscopic washout

Answer: B. Osteoarthritis is managed conservatively first; surgery is for refractory pain and function. Arthroscopy has no role in uncomplicated OA.

Geriatrics, infections and red flags

Question 12

An 80-year-old has had two falls in six months. The most useful intervention is:

1. Advise walking less
2. A multifactorial assessment: medication review (especially sedatives and antihypertensives), gait and balance, vision, postural blood pressure, home hazards, vitamin D and bone health, with strength and balance training
3. Hip protectors only
4. Bed rails

Answer: B. Multifactorial intervention reduces falls; polypharmacy review is the single highest-yield element.

Question 13

A 25-year-old woman has dysuria and frequency for two days with no fever, flank pain or vaginal discharge, and is not pregnant. The management is:

1. Urine culture and wait for results
2. Empirical short-course antibiotic for uncomplicated cystitis such as nitrofurantoin for 5 days (or fosfomycin single dose), with culture only if recurrent, pregnant or failing treatment
3. Intravenous antibiotics
4. Fluoroquinolone for 10 days

Answer: B. Uncomplicated cystitis is treated empirically; fluoroquinolones are reserved because of resistance and adverse effects. Pregnancy changes the drug choice and mandates culture.

Question 14

A 58-year-old smoker has a three-week cough with haemoptysis and weight loss. The next step is:

1. Antibiotics and review in a month
2. Urgent chest x-ray and referral on a suspected cancer pathway, with CT if the x-ray is abnormal or suspicion remains
3. Reassurance
4. Inhaled steroids

Answer: B. Haemoptysis with weight loss in a smoker is a red flag for lung cancer and, in the Gulf's migrant population, tuberculosis. Both need urgent imaging.

Question 15

A 70-year-old with chronic kidney disease (eGFR 38) and type 2 diabetes has a urine albumin-to-creatinine ratio of 45 mg/mmol. Which drug slows progression?

1. A thiazide diuretic
2. An ACE inhibitor or ARB titrated to maximum tolerated dose, plus an SGLT2 inhibitor, with blood pressure control
3. Metformin at full dose
4. NSAIDs for joint pain

Answer: B. RAS blockade and SGLT2 inhibition both reduce progression of diabetic kidney disease; metformin is dose-reduced below eGFR 45 and stopped below 30; NSAIDs are avoided.

How to use these questions

• Learn the targets and first-line drugs for diabetes, hypertension, asthma, lipids and CKD from current guidelines.
• Know screening intervals and red flags; they are the fastest marks in primary care papers.
• Cover every age group: the paper moves from newborn to nursing home.
• Practise under time in the Family Medicine bank with the error-log method.

The GP paper covers similar ground at a different level (GP high-yield topics). Other specialty banks are listed in specialty question banks for doctors. When you hold eligibility, join the doctor talent pool; primary care networks across the Gulf are recruiting family physicians.

Frequently asked questions

How many questions are in the family medicine Prometric exam?

Usually 100 to 150 in 2.5 to 3 hours. Your eligibility notice states the exact format.

What is the pass mark?

About 60% for the specialist paper, scaled at some authorities, and about 70% for consultants.

What is the difference between the family medicine paper and the GP paper?

The family medicine paper assumes postgraduate training and tests chronic disease management, prevention and guideline detail at specialist level; the GP paper is a broader entry-level sweep.

Can an MRCGP or Arab Board family medicine holder skip the exam?

Often, depending on the authority's recognition list; see the exemptions guide.

Are these real exam questions?

No. They are original practice questions written to the published blueprint. Real exam content is confidential.