Free practice questions
Free QCHP practice questions
These ten questions are pulled straight from the PassCurve QCHP bank and shown exactly as a candidate meets them in a real revision session, nothing held back and nothing simplified for the page. Answer one, then open the reveal underneath to see the correct option, why every option is right or wrong, and the specific guideline the answer rests on.
The Qatar qualifying examination for healthcare practitioners is sat in English, so every question here is written in English too, the language you will actually read on exam day. Ten questions from one sitting will not replace a full revision plan, but they are a fast, honest way to see where your knowledge already holds and where it still has gaps. Read the QCHP exam guide for the exam's format, eligibility and scoring, or start a free session in the app now to keep going past these ten.
Every explanation below is evidence based: each one names the specific guideline it rests on and the date that source was last read, so you can check it yourself rather than take our word for it. These questions are written and fact-checked with AI assistance; not individually signed off by a physician.
Internal Medicine
A 52-year-old South Asian male expatriate presents to a primary health care centre with a 2-month history of retrosternal chest tightness. The discomfort occurs after walking uphill and consistently resolves within 5 minutes of rest. He has a history of type 2 diabetes mellitus and hypertension. His current medications are metformin, ramipril, and atorvastatin. His blood pressure is 135/85 mmHg, and his heart rate is 86 bpm. Physical examination is unremarkable. An electrocardiogram shows normal sinus rhythm with no ST-segment or T-wave abnormalities. Aside from prescribing as-needed sublingual nitroglycerin, which of the following is the most appropriate next step in pharmacological management to prevent his symptoms?
- Initiate ivabradine
- Initiate bisoprolol
- Initiate isosorbide mononitrate
- Initiate trimetazidine
Show the answer and explanation
Correct answer: B
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A. Initiate ivabradine
Ivabradine is a second-line anti-anginal agent. It is indicated if beta-blockers are contraindicated, not tolerated, or if the heart rate remains above 70 bpm despite maximally tolerated beta-blocker therapy.
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B. Initiate bisoprolol
Beta-blockers (e.g., bisoprolol) or calcium channel blockers are recommended as first-line therapy to control angina symptoms and reduce myocardial oxygen demand. A beta-blocker is particularly effective and appropriate here given the patient's resting heart rate of 86 bpm.
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C. Initiate isosorbide mononitrate
Long-acting nitrates (e.g., isosorbide mononitrate) are second-line drugs for angina prophylaxis. They are typically added when first-line therapies are insufficient or contraindicated.
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D. Initiate trimetazidine
Trimetazidine is a metabolic agent used as a second-line or add-on anti-anginal therapy. It is not recommended as an initial preventive monotherapy for stable angina.
TAKEAWAY
Beta-blockers or calcium channel blockers are the standard first-line therapies for symptom relief and prevention in patients with stable coronary artery disease.
2024 ESC Guidelines for the management of chronic coronary syndromes · Section 5: Anti-ischaemic drugs (checked 15 August 2026)
A 52-year-old male patient presents to a primary health care centre in Qatar for a routine follow-up of type 2 diabetes mellitus. He has a history of a myocardial infarction two years ago. His current medications include metformin 1,000 mg twice daily, atorvastatin 40 mg daily, aspirin 75 mg daily, and bisoprolol 5 mg daily. His blood pressure is 128/78 mmHg, and his body mass index is 31 kg/m². Recent laboratory investigations reveal an HbA1c of 7.9% (63 mmol/mol) and an estimated glomerular filtration rate (eGFR) of 75 mL/min/1.73 m². Which of the following is the most appropriate medication to add to this patient's regimen?
- Empagliflozin
- Glimepiride
- Repaglinide
- Sitagliptin
Show the answer and explanation
Correct answer: A
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A. Empagliflozin
In patients with type 2 diabetes and established atherosclerotic cardiovascular disease (such as a previous myocardial infarction), guidelines strongly recommend incorporating a sodium-glucose cotransporter-2 (SGLT2) inhibitor with proven cardiovascular benefit to reduce the risk of major adverse cardiovascular events.
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B. Glimepiride
Sulfonylureas lower blood glucose but carry a risk of hypoglycemia and weight gain. They lack proven cardiovascular mortality benefits compared to SGLT2 inhibitors and are not first-line add-on therapies in patients with established cardiovascular disease.
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C. Repaglinide
Meglitinides stimulate insulin secretion and can cause weight gain and hypoglycemia. They do not offer cardiovascular protection and are not indicated as a preferred add-on therapy in patients with a history of myocardial infarction.
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D. Sitagliptin
DPP-4 inhibitors like sitagliptin are effective for glycemic control and are weight-neutral, but they do not provide cardiovascular risk reduction. They are not the preferred add-on therapy for patients with established atherosclerotic cardiovascular disease.
TAKEAWAY
For patients with type 2 diabetes and established atherosclerotic cardiovascular disease, an SGLT2 inhibitor or GLP-1 receptor agonist with proven cardiovascular benefit should be prioritized to reduce cardiovascular events, independent of baseline HbA1c.
American Diabetes Association (ADA) Standards of Care in Diabetes · Section 9: Pharmacologic Approaches to Glycemic Treatment (checked 15 August 2026)
A 32-year-old male expatriate from Bangladesh presents to a primary health care centre in Qatar for follow-up after a pre-employment medical fitness screening. He is completely asymptomatic. He has no significant past medical history and takes no medications. Vital signs are within normal limits, and physical examination reveals no stigmata of chronic liver disease. Laboratory investigations show: HBsAg: Positive Anti-HBs: Negative Total Anti-HBc: Positive IgM Anti-HBc: Negative HBeAg: Negative Anti-HBe: Positive HBV DNA: 800 IU/mL Alanine aminotransferase (ALT): 22 U/L (Normal: 10–40 U/L) Aspartate aminotransferase (AST): 24 U/L (Normal: 10–40 U/L) Platelet count: 210,000 /microL A liver ultrasound is unremarkable. What is the most appropriate next step in the management of this patient?
- Initiate oral tenofovir therapy
- Perform a percutaneous liver biopsy
- Administer hepatitis B vaccination series
- Monitor serum ALT and HBV DNA periodically
Show the answer and explanation
Correct answer: D
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A. Initiate oral tenofovir therapy
Antiviral therapy (e.g., tenofovir or entecavir) is indicated for patients with immune-active chronic HBV (elevated ALT, and HBV DNA > 2,000 IU/mL in HBeAg-negative patients) or those with cirrhosis. This patient does not meet these criteria.
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B. Perform a percutaneous liver biopsy
A liver biopsy is not indicated in a patient with persistently normal ALT, low HBV DNA, and normal imaging without evidence of cirrhosis or advanced fibrosis, as the clinical likelihood of significant liver injury is very low.
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C. Administer hepatitis B vaccination series
Hepatitis B vaccination is indicated for susceptible individuals (HBsAg negative, Anti-HBs negative, Anti-HBc negative). This patient is already chronically infected with the virus.
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D. Monitor serum ALT and HBV DNA periodically
This patient has an HBeAg-negative chronic HBV infection (formerly known as an 'inactive carrier state'), characterized by HBsAg positivity, HBeAg negativity, normal ALT, and HBV DNA < 2,000 IU/mL. The recommended management is periodic monitoring of ALT and HBV DNA (typically every 6-12 months) to detect potential disease reactivation.
TAKEAWAY
Patients with HBeAg-negative chronic HBV infection (inactive carriers) with normal ALT and HBV DNA < 2,000 IU/mL do not require immediate antiviral therapy and should be managed with periodic clinical and laboratory monitoring.
AASLD 2018 Hepatitis B Guidance: Update on Prevention, Diagnosis, and Treatment · Management of Persons with HBeAg-Negative Chronic Hepatitis B (checked 15 August 2026)
Obstetrics and Gynaecology
A 59-year-old South Asian expatriate woman presents to a primary health care centre in Qatar with a single episode of vaginal spotting. She attained menopause at age 52. Her medical history is significant for type 2 diabetes mellitus and obesity (BMI 35 kg/m²). Pelvic examination is unremarkable. A transvaginal ultrasound reveals an endometrial thickness of 14 mm. An outpatient pipelle endometrial biopsy is performed, and the histopathology report indicates "insufficient tissue for diagnosis". What is the most appropriate next step in management?
- Reassure the patient and schedule a follow-up visit in one year
- Arrange for a diagnostic hysteroscopy and directed biopsy
- Request a repeat transvaginal ultrasound in six months
- Prescribe a three-month course of continuous oral progestins
Show the answer and explanation
Correct answer: B
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A. Reassure the patient and schedule a follow-up visit in one year
Reassurance is inappropriate. An "insufficient" biopsy result in the presence of a thickened endometrium (14 mm) and postmenopausal bleeding is non-diagnostic and carries a significant risk of missing endometrial carcinoma, especially given her risk factors (obesity, diabetes).
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B. Arrange for a diagnostic hysteroscopy and directed biopsy
This is the correct step. When an outpatient or blind endometrial biopsy yields insufficient tissue in a patient with a thickened endometrium (>4 mm) and postmenopausal bleeding, it does not rule out pathology. Hysteroscopy with directed biopsy is required to visualize the cavity and definitively exclude focal lesions like polyps or cancer.
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C. Request a repeat transvaginal ultrasound in six months
Delaying investigation by six months is dangerous. Postmenopausal bleeding with a 14 mm endometrial thickness requires an immediate definitive tissue diagnosis, not watchful waiting.
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D. Prescribe a three-month course of continuous oral progestins
Progestin therapy is a treatment for histologically confirmed endometrial hyperplasia without atypia. It is not an appropriate initial or empirical step for an undiagnosed thickened endometrium with postmenopausal bleeding.
TAKEAWAY
An "insufficient tissue" result from a blind endometrial biopsy in a postmenopausal woman with bleeding and a thickened endometrium (>4 mm) is non-reassuring and mandates hysteroscopy with directed biopsy to rule out malignancy.
American College of Obstetricians and Gynecologists (ACOG), Committee Opinion No. 734: The Role of Transvaginal Ultrasonography in Evaluating Postmenopausal Bleeding · Management of Insufficient Tissue (checked 15 August 2026)
A 32-year-old woman presents to a primary health care centre for a routine postnatal visit at 6 weeks postpartum. Her recent pregnancy was complicated by gestational diabetes mellitus, which was managed with medical nutrition therapy. She delivered a healthy infant at 39 weeks of gestation. She is currently asymptomatic and exclusively breastfeeding. Her pre-pregnancy body mass index was 31 kg/m². Which of the following is the most appropriate test to assess her current glycemic status?
- Fasting plasma glucose measurement alone
- 75-g 2-hour oral glucose tolerance test
- 50-g 1-hour oral glucose challenge test
- Measurement of glycated hemoglobin (HbA1c)
Show the answer and explanation
Correct answer: B
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A. Fasting plasma glucose measurement alone
Fasting plasma glucose alone is less sensitive than the 75-g OGTT and may miss a significant proportion of women who have impaired glucose tolerance or early overt diabetes postpartum.
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B. 75-g 2-hour oral glucose tolerance test
The American Diabetes Association (ADA) and ACOG recommend screening women with a history of gestational diabetes at 4 to 12 weeks postpartum using a 75-g, 2-hour oral glucose tolerance test to detect overt diabetes or prediabetes.
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C. 50-g 1-hour oral glucose challenge test
The 50-g 1-hour glucose challenge test is used for initial screening of gestational diabetes during the second trimester of pregnancy (24-28 weeks), not for postpartum evaluation.
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D. Measurement of glycated hemoglobin (HbA1c)
HbA1c is not recommended for early postpartum screening because recent pregnancy-related red blood cell turnover and peripartum blood loss can falsely lower the result, rendering it inaccurate.
TAKEAWAY
Women with a history of gestational diabetes should undergo a 75-g 2-hour oral glucose tolerance test at 4 to 12 weeks postpartum to appropriately screen for persistent prediabetes or overt type 2 diabetes.
American Diabetes Association (ADA) Standards of Care in Diabetes · Chapter 15: Management of Diabetes in Pregnancy (checked 15 August 2026)
A 29-year-old Indian expatriate, G2P1, presents to a primary health care centre in Qatar for her first prenatal visit at 10 weeks of gestation. Her first pregnancy was complicated by a postpartum haemorrhage that required a red blood cell transfusion. She has no other significant medical history. Routine prenatal laboratory testing reveals her blood type is O, Rh-positive. The indirect Coombs test (antibody screen) is positive for anti-Kell (anti-K) antibodies with a titer of 1:8. Vital signs and physical examination are unremarkable. Which of the following is the most appropriate next step in management?
- Monitor with serial maternal anti-Kell antibody titers
- Administer prophylactic anti-D immune globulin
- Initiate serial fetal middle cerebral artery Doppler ultrasonography
- Determine paternal Kell erythrocyte antigen status
Show the answer and explanation
Correct answer: D
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A. Monitor with serial maternal anti-Kell antibody titers
Unlike Rh(D) alloimmunization, anti-Kell antibodies cause severe fetal anemia primarily by suppressing fetal erythropoiesis rather than through hemolysis alone. Consequently, maternal antibody titers do not correlate well with the severity of fetal anemia and should not be used to guide ongoing management once sensitization is confirmed.
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B. Administer prophylactic anti-D immune globulin
Anti-D immune globulin is indicated for the prevention of Rh(D) alloimmunization in Rh(D)-negative women. It provides no protection against Kell alloimmunization, and this patient is already Rh(D)-positive.
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C. Initiate serial fetal middle cerebral artery Doppler ultrasonography
Middle cerebral artery peak systolic velocity (MCA-PSV) Doppler is the gold standard for detecting fetal anemia. However, it is typically initiated between 18 and 24 weeks of gestation, and only after confirming the fetus is at risk (i.e., if the father is Kell-positive or his status is unknown).
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D. Determine paternal Kell erythrocyte antigen status
The first step in managing a pregnant patient with red blood cell alloimmunization (such as anti-Kell) is to determine the paternal erythrocyte antigen status. If the father is negative for the Kell antigen, the fetus cannot inherit the antigen, and no further monitoring for fetal anemia is required.
TAKEAWAY
In Kell alloimmunization, maternal titers do not correlate with fetal anemia severity; the first step in management is to determine the paternal erythrocyte antigen status to assess fetal risk.
ACOG Practice Bulletin No. 192: Management of Alloimmunization During Pregnancy · Clinical Considerations and Recommendations (checked 15 August 2026)
Pediatrics
A 3-day-old male newborn is evaluated at a primary health care centre in Qatar for yellowish discoloration of the skin. He was born at 39 weeks of gestation via uncomplicated spontaneous vaginal delivery to Middle Eastern expatriate parents. He is exclusively breastfed. The mother mentions that her brother has a history of severe anemia following the ingestion of fava beans. Vital signs are within normal limits. Physical examination reveals scleral icterus and jaundice extending to the lower abdomen. Laboratory investigations show a total serum bilirubin of 18 mg/dL and a direct bilirubin of 0.5 mg/dL. His hemoglobin is 12.5 g/dL, and the reticulocyte count is 8%. The direct antiglobulin (Coombs) test is negative. A peripheral blood smear reveals the presence of bite cells. Which of the following is the most likely diagnosis?
- Breast milk jaundice
- Glucose-6-phosphate dehydrogenase deficiency
- ABO hemolytic disease of the newborn
- Hereditary spherocytosis
Show the answer and explanation
Correct answer: B
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A. Breast milk jaundice
Breast milk jaundice causes unconjugated hyperbilirubinemia that typically peaks in the second week of life. It does not cause hemolysis, so the hemoglobin and reticulocyte count would be normal, and no bite cells would be seen.
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B. Glucose-6-phosphate dehydrogenase deficiency
The patient presents with unconjugated hyperbilirubinemia, hemolytic anemia (low hemoglobin for a neonate, elevated reticulocytes), and a negative Coombs test. The X-linked family history (maternal uncle) and bite cells on the peripheral smear strongly indicate Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a common enzymopathy in the Middle East.
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C. ABO hemolytic disease of the newborn
ABO incompatibility can cause early neonatal jaundice and hemolysis; however, the direct Coombs test is typically positive (or weakly positive), and the peripheral smear characteristically shows microspherocytes rather than bite cells.
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D. Hereditary spherocytosis
Hereditary spherocytosis presents with Coombs-negative hemolytic anemia and neonatal jaundice. However, it is an autosomal dominant condition, and the peripheral smear would show spherocytes (lacking central pallor) rather than bite cells.
TAKEAWAY
G6PD deficiency is a common cause of neonatal unconjugated hyperbilirubinemia in the Middle East, presenting with Coombs-negative hemolytic anemia and characteristic bite cells on a peripheral smear.
Nelson Textbook of Pediatrics, 21st Edition · Chapter 490: Hemolytic Anemias Resulting from Enzyme Deficiencies (checked 15 August 2026)
An 11-month-old boy is brought to a primary health care centre in Doha by his mother. He has had a high fever of up to 39.5°C (103.1°F) for the past three days. The mother reports that he was irritable but otherwise feeding normally. Today, the fever abruptly resolved, and a pink, blanching maculopapular rash appeared on his trunk, which is now spreading to his neck and arms. On examination, the child appears well, playful, and afebrile. Vital signs are within normal limits for his age. There is no mucosal involvement. Which of the following is the most likely causative organism?
- Human herpesvirus 6
- Measles virus
- Parvovirus B19
- Streptococcus pyogenes
Show the answer and explanation
Correct answer: A
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A. Human herpesvirus 6
Human herpesvirus 6 (HHV-6) causes roseola infantum (exanthem subitum). The classic presentation is 3 to 5 days of high fever in an infant, followed by an abrupt defervescence (drop in temperature) and the immediate appearance of a blanching maculopapular rash that starts on the trunk and spreads peripherally.
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B. Measles virus
Measles virus causes a prodrome of cough, coryza, and conjunctivitis, followed by a maculopapular rash that starts on the face and spreads downward. Crucially, the fever persists and often peaks when the rash appears, and the child typically appears toxic.
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C. Parvovirus B19
Parvovirus B19 causes erythema infectiosum (fifth disease). It typically presents with a bright red 'slapped cheek' facial rash and a lacy, reticular rash on the extremities, rather than a truncal rash appearing immediately after fever resolution.
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D. Streptococcus pyogenes
Streptococcus pyogenes causes scarlet fever, presenting with a sore throat, fever, and a finely papular 'sandpaper' rash that typically starts in the skin folds and spreads. The patient would have concurrent fever and appear unwell.
TAKEAWAY
Roseola infantum, caused by Human herpesvirus 6 (HHV-6), is characterized by 3-5 days of high fever in an infant, followed by an abrupt drop in temperature and the simultaneous appearance of a blanching maculopapular rash starting on the trunk.
Nelson Textbook of Pediatrics, 21st Edition · Chapter 282: Roseola Infantum (Exanthem Subitum) (checked 15 August 2026)
Surgery
A 34-year-old expatriate construction worker is brought to the emergency department of a government hospital in Qatar during August with severe, colicky left flank pain that started suddenly 4 hours ago. He reports severe nausea and one episode of vomiting. His temperature is 38.8°C (101.8°F), blood pressure is 95/60 mmHg, heart rate is 118/min, and respiratory rate is 22/min. Physical examination reveals marked left costovertebral angle tenderness. Laboratory investigations show a white blood cell count of 18 x 10^9/L and a serum creatinine of 145 micromol/L. A non-contrast computed tomography (CT) scan of the abdomen and pelvis demonstrates a 7-mm calculus in the proximal left ureter with moderate upstream hydronephrosis and perinephric fat stranding. Which of the following is the most appropriate next step in management?
- Extracorporeal shock wave lithotripsy
- Administration of intravenous antibiotics and observation
- Urgent decompression via ureteral stent placement
- Medical expulsive therapy with tamsulosin
Show the answer and explanation
Correct answer: C
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A. Extracorporeal shock wave lithotripsy
Extracorporeal shock wave lithotripsy (ESWL) is absolutely contraindicated in the presence of an active, untreated urinary tract infection or urosepsis, as fragmenting the stone can release a shower of bacteria into the bloodstream and precipitate severe septic shock.
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B. Administration of intravenous antibiotics and observation
While intravenous antibiotics are a critical component of the management of urosepsis, administering antibiotics alone without relieving the obstruction (source control) is insufficient. The infected urine under pressure in the renal pelvis will continue to cause systemic toxicity, risking progressive septic shock and irreversible renal damage.
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C. Urgent decompression via ureteral stent placement
The patient has an obstructing ureteral stone complicated by an upper urinary tract infection (fever, leukocytosis, tachycardia, borderline hypotension). This is a urological emergency (obstructive pyelonephritis/urosepsis) requiring immediate fluid resuscitation, broad-spectrum intravenous antibiotics, and urgent surgical decompression of the collecting system (via a double-J ureteral stent or percutaneous nephrostomy) to provide source control.
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D. Medical expulsive therapy with tamsulosin
Medical expulsive therapy (MET) using alpha-blockers is appropriate for uncomplicated ureteral stones (<10 mm) in patients with well-controlled pain and no signs of infection or acute kidney injury. The presence of fever and systemic inflammatory response makes MET highly inappropriate.
TAKEAWAY
An obstructing ureteral stone accompanied by signs of upper urinary tract infection (fever, leukocytosis, hemodynamic instability) is a true urological emergency. It dictates immediate broad-spectrum antibiotics and urgent decompression of the collecting system via ureteral stenting or percutaneous nephrostomy.
European Association of Urology (EAU) Guidelines on Urolithiasis · Management of Urosepsis and Obstructing Stones (checked 15 August 2026)
A 28-year-old male is brought to the emergency department of a government hospital in Qatar following a high-speed road traffic collision. He is complaining of severe pelvic pain. On examination, his airway is clear, respiratory rate is 18/min, and oxygen saturation is 98% on room air. His pulse is 130/min, and blood pressure is 80/50 mmHg. The pelvis is mechanically unstable on gentle compression. Extended Focused Assessment with Sonography for Trauma (eFAST) is negative for intra-abdominal and intrathoracic fluid. There is blood at the urethral meatus. What is the most appropriate next step in management?
- Performance of retrograde urethrography
- Computed tomography of the abdomen
- Application of a pelvic binder
- Immediate exploratory laparotomy
Show the answer and explanation
Correct answer: C
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A. Performance of retrograde urethrography
Although blood at the urethral meatus is a classic sign of urethral injury and warrants retrograde urethrography before catheterization, stabilizing the patient's hemodynamics with a pelvic binder takes precedence over evaluating the urethra.
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B. Computed tomography of the abdomen
Computed tomography is contraindicated in hemodynamically unstable patients. The patient must be stabilized first (e.g., with a pelvic binder and fluid/blood resuscitation) before safely undergoing a CT scan to further delineate the pelvic fracture or vascular injury.
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C. Application of a pelvic binder
In a hemodynamically unstable patient with a mechanically unstable pelvic fracture and a negative FAST, the primary source of bleeding is likely the pelvis. Application of a pelvic binder reduces pelvic volume, promotes tamponade of venous bleeding, and stabilizes the fracture. This is a priority in the 'Circulation' phase of ATLS.
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D. Immediate exploratory laparotomy
Exploratory laparotomy is indicated for hemodynamically unstable patients with evidence of intra-abdominal bleeding (e.g., positive FAST). A negative FAST makes intra-abdominal hemorrhage less likely, and opening the abdomen can release the retroperitoneal tamponade effect, worsening pelvic bleeding.
TAKEAWAY
Hemodynamically unstable patients with suspected pelvic fractures and negative FAST require immediate application of a pelvic binder to control potential life-threatening retroperitoneal hemorrhage prior to further diagnostic imaging.
ATLS - Advanced Trauma Life Support Student Course Manual · Chapter 5: Abdominal and Pelvic Trauma (checked 15 August 2026)
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