MRCGP Applied Knowledge Test 1001 Questions and …

1 MRCGPA pplied Knowledge Test1001 Questions andAnswersRob DanielsMA (Cantab), MB BChir, MRCGPG eneral PractitioneriiiContentsAcknowledgementsv iDedicationviiContributors to the previous editionsviiiIntroductionxAbbreviationsxi i1 CardiovascularQuestions1 Answers192 DermatologyQuestions27 Answers443 Ear, nose and throatQuestions51 Answers664 EndocrinologyQuestions71 Answers815 GastroenterologyQuestions87 Answers976 GeneticsQuestions103 Answers1127 HaematologyQuestions119 Answers127 CONTENTSiv8 ImmunologyQuestions131 Answers1379 InfectionQuestions141 Answers15110 Mental health and learning disabilityQuestions157 Answers16511 MusculoskeletalQuestions171 Answers17912 NeurologyQuestions185 Answers19413 OphthalmologyQuestions199 Answers21014 PaediatricsQuestions215 Answers22815 RenalQuestions235

2 Answers24416 Reproductive: male and femaleQuestions247 Answers25617 RespiratoryQuestions261 Answers27118 Therapeutic indications and adverse reactionsQuestions277 Answers28619 Critical appraisalQuestions291 Answers311 CONTENTSv20 AdministrationQuestions319 Answers325 Practice paper 1 questions329 Practice paper 1 answers385 Practice paper 2 questions417 Practice paper 2 answers471 Index495 CONTENTSxIntroductionThis book is intended predominantly to help candidates prepare for theMembership examination of the Royal College

3 Of General Practitioners, which isthe qualifying exam for a career in general practice. It is also hoped that thisbook will be useful for established GPs to identify learning needs as part of theirappraisal process and perhaps prepare them for any future Knowledge -basedtest introduced as part of line with changes in other specialty exams , the MRCGP now consists of awritten exam, a formal clinical skills assessment and workplace-based assess-ment. The written paper encompasses clinical scenarios, hot topics and criticalreading, and is in the form of a 200 question MCQ exam known as the AppliedKnowledge Test (AKT).

4 The subject matter is divided between critical appraisaland evidence-based clinical practice components, which make up approximately10% of the Questions ; 10% will comprise health informatics and administrativequestions, with the remaining 80% clinical Questions . Questions are of thesingle best answer, extended matching Questions and free text forms, and mayrequire interpretation of pictures, results, and experimental or statistical exam aims to test higher problem-solving rather than simple fact recall.

5 Awealth of information about the curriculum and exam format is available onthe Royal College of General Practitioners website ( ).The Applied Knowledge tests take place at the end of January, May andOctober each year, via computer terminals at 152 Pearson Vue professionaltesting centres around the UK ( ). Detailed feedback willbe provided for candidates who are unsuccessful, allowing them to takeremedial action where necessary before the next sitting. Candidates may takethe exam at any point in their general practice specialty training, but it isexpected that most will do so during their third year of specialty training, whenthey will be working in primary care.

6 All Questions will address important issuesrelating to general practice in the UK, and international applicants should notethat the answers will relate to standard clinical practice in the UK, which maydiffer from their own key to successful preparation is twofold. Exam technique is vital in manymedical exams and the AKT is no exception. Two hundred Questions have to becompleted in 3 hours at a rate of just over one question a minute. The questionsare of the single best answer, extending matching question and algorithmcompletion format, and there are many examples of each type in this book.

7 Thesecond component of successful exam performance is an adequate knowledgebase. The content of the Questions in this book is based on the GP curriculum,which is available on the RCGP s website, and the Questions are loosely based onmy clinical experience. This GP curriculum ( ) is anINTRODUCTION xiexcellent resource in planning your revision, especially in less clinical areas ofthe curriculum such as practice management and information RCGP website gives the pass mark and exam feedback for each sitting.

8 In2012 the pass mark was 68% and the pass rate was 75%. It is well worth readingthe examiners reports on previous sittings as these describe areas of weakperformance, which the examiners may concentrate on in future exams . Candi-dates usually perform well in clinical medicine, less well in critical appraisal andworst in administration best way to prepare for clinical Questions is to read up on problems thatyou see in general practice, ideally keeping a list of PUNs and DENs (patient sunmet needs and doctor s educational needs) encountered during each to do as many practice multiple choice Questions as you can.

9 The old-styleMRCGP exam Questions are still mostly valid and there are a number of excellentpractice MCQ books still available in shops and medical libraries. PasTest alsooffer an online revision package specifically for the AKT, which gives instantprogress feedback (www. ). It should be possible to pick up on hottopics just through working in general practice and reading theBritish MedicalJournalandBritish Journal of General Practice, but a Hot topics course justbefore the exam is usually money well spent.

10 In the previous incarnation of theMRCGP exam, editorials from theBritish Journal of General Practicehad anuncanny habit of turning up as hot topic Questions in the next paper. Examquestions are likely to be drawn from several well-known journals, includingthose listed above. The RCGP s website gives useful information on this, so keepyour eyes on management issues is best picked up by spending a session ortwo with a practice manager, attending practice meetings and doing multiple-choice Questions to identify specific learning needs.