10/10/2026
📚 OCT RECALLS FCPS -1
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Q1. A patient undergoes extensive resection of the terminal ileum for Crohn disease. Which complication is most likely?
A. Steatorrhoea
B. Iron-deficiency anaemia
C. Hypercalcaemia
D. Lactose intolerance
E. Gastric outlet obstruction
Answer: A
Q2. Motilin stimulates the migrating motor complex (MMC) during fasting. Absence of the MMC predisposes to which condition?
A. Small intestinal bacterial overgrowth
B. Dumping syndrome
C. Achalasia
D. Hirschsprung disease
E. Lactose intolerance
Answer: A
Q3. A patient has a deficiency of motilin. Which gastrointestinal function is most likely to be decreased?
A. Mass movements
B. Receptive relaxation of the stomach
C. Swallowing
D. Duodenal motility
E. Gallbladder contraction
Answer: D
Q4. Which of the following is an expected effect of bilateral truncal vagotomy on the gut?
A. Reduced gastric acid secretion
B. Faster emptying of solids from the stomach
C. Enhanced receptive relaxation of the stomach
D. Increased gallbladder emptying
E. Abolition of the gastric basic electrical rhythm
Answer: A
Q5. A 6-year-old boy has apathy, a hoarse cry and a protruding tongue. He is found to have deficiency of a hormone. What is the normal effect of this hormone on metabolism?
A. Inhibition of lipolysis
B. Inhibition of protein catabolism
C. Increased basal metabolic rate and oxygen consumption
D. Decreased intestinal glucose absorption
E. Increased plasma cholesterol
Answer: C
Q6. A young woman who was recently treated for an infection presents with pallor and fatigue. Her blood counts show RBC 1.6 × 10^12/L, WBC 7 × 10^9/L, platelets 320 × 10^9/L, reticulocyte count 24% and haematocrit 15%. What is the most likely cause of her anaemia?
A. G6PD deficiency
B. Aplastic anaemia
C. Iron deficiency anaemia
D. Anaemia of chronic disease
E. Megaloblastic anaemia
Answer: A
Q7. A 7-year-old child presents with pallor, jaundice, fatigue and splenomegaly. Peripheral blood smear shows prickle cells. A sibling has the same condition. What is the most likely diagnosis?
A. Beta-thalassemia major
B. Pyruvate kinase deficiency
C. Hereditary spherocytosis
D. G6PD deficiency
E. Sickle cell anemia
Answer: B
Q8. A 50-year-old strict vegetarian complains of tingling and numbness in his toes with reduced vibration sense. Blood count shows macrocytic anaemia. Which vitamin deficiency is most likely?
A. Vitamin B12
B. Folic acid
C. Vitamin B6
D. Vitamin B1
E. Vitamin C
Answer: A
Q9. A patient's ECG shows ST elevation in leads V1–V4. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Posterior descending artery
E. Left main coronary artery
Answer: A
Q10. A 60-year-old chronic smoker with progressive dyspnoea and a barrel-shaped chest is diagnosed with emphysema. Which of the following is characteristically decreased on pulmonary function testing?
A. Diffusing capacity for carbon monoxide
B. Total lung capacity
C. Residual volume
D. Functional residual capacity
E. Lung compliance
Answer: A
Q11. Which of the following is characteristic of an exudate?
A. Contains numerous inflammatory cells
B. Specific gravity less than 1.012
C. Contains remnants of killed bacteria
D. Presence of large number of platelets
E. Low protein content
Answer: A
Q12. An antenatal anomaly scan of a male fetus shows bilateral hydronephrosis, a distended thick-walled bladder with a "keyhole sign" and oligohydramnios. What is the most likely diagnosis?
A. Posterior urethral valves
B. Bilateral vesicoureteric junction obstruction
C. Bilateral pelviureteric junction obstruction
D. Vesicoureteric reflux
E. Prune-belly syndrome
Answer: A
Q13. A 55-year-old smoker presents with haematuria, flank pain and a renal mass. Nephrectomy shows clear cell renal cell carcinoma. Which gene is most commonly inactivated in this tumour?
A. VHL
B. MET
C. WT1
D. TSC2
E. Fumarate hydratase
Answer: A
Q14. A young woman has chronic diarrhoea, bloating and iron-deficiency anaemia. Which antibody is the recommended first-line serological test for celiac disease?
A. IgA anti-tissue transglutaminase antibody
B. IgG anti-gliadin antibody
C. Anti-Saccharomyces cerevisiae antibody (ASCA)
D. p-ANCA
E. Anti-mitochondrial antibody
Answer: A
Q15. A 40-year-old alcoholic with repeated attacks of pancreatitis presents with persistent epigastric fullness and a raised amylase weeks after the last attack. What is the most likely complication?
A. Pancreatic pseudocyst
B. Pancreatic abscess
C. Splenic vein thrombosis
D. Pancreatic carcinoma
E. Diabetes insipidus
Answer: A
Q16. A patient has ascites with lymphocyte-predominant exudative fluid and suspected abdominal tuberculosis. Which ascitic fluid investigation is most useful for rapid diagnosis?
A. Adenosine deaminase level
B. Serum-ascites albumin gradient
C. Ascitic amylase
D. Ascitic fluid Gram stain
E. Ascitic fluid triglyceride level
Answer: A
Q17. A 12-year-old boy has diarrhoea unresponsive to routine therapy. Jejunal biopsy shows partial villous atrophy and many PAS-positive foamy macrophages. Diagnosis:
A. Celiac disease
B. Tropical sprue
C. Giardiasis
D. Immunoproliferative small intestinal disease
E. Whipple disease
Answer: E
Q18. A 45-year-old man notices that his rings and shoes no longer fit; he has coarse facial features, prognathism and impaired glucose tolerance. What is the best screening investigation?
A. Serum IGF-1
B. Random growth hormone level
C. MRI pituitary
D. Serum prolactin
E. Skull X-ray
Answer: A
Q19. Anti-thyroid peroxidase (anti-TPO) antibodies in high titre are most characteristic of which condition?
A. Hashimoto thyroiditis
B. Graves disease
C. De Quervain thyroiditis
D. Riedel thyroiditis
E. Papillary carcinoma of thyroid
Answer: A
Q20. A 20-year-old man with no previous illness has episodes of severe hypertension with headache, palpitations and sweating. Which biochemical abnormality is most likely to accompany this condition?
A. Hyperglycaemia
B. Hyperkalaemia
C. Hyponatraemia
D. Hypocalcaemia
E. Hypomagnesaemia
Answer: A
Q21. A 28-year-old pregnant woman presents with intrauterine fetal death. Undiagnosed gestational diabetes is suspected as the cause. Which test is most useful to assess her glycaemic status?
A. HbA1c
B. Oral glucose tolerance test (OGTT)
C. Fasting plasma glucose
D. Random blood glucose
E. Urine glucose
Answer: Ambiguous — A or B; requires clarification.
Q22. A primigravida at 9 weeks presents with persistent vomiting, weight loss and ketonuria; she is diagnosed with hyperemesis gravidarum. After IV fluids and thiamine, which is the first-line antiemetic?
A. Promethazine
B. Ondansetron
C. Metoclopramide
D. Hydrocortisone
E. Domperidone
Answer: A
Q23. A 37-year-old man presents with a painless testicular mass. Tumour markers show AFP is normal and β-hCG is normal. What is the most likely diagnosis?
A. Seminoma
B. Lymphoma
C. Yolk sac tumour
D. Embryonal carcinoma
E. Choriocarcinoma
Answer: A
Q24. A 25-year-old man presents with chronic inflammatory back pain and recurrent episodes of eye redness. Which of the following is most strongly associated with his condition?
A. Elevated C-reactive protein
B. HLA-DR4
C. HLA-B27
D. Anti-CCP antibody
E. Rheumatoid factor
Answer: C
Q25. A patient with gout and long-standing hyperuricaemia develops facial weakness. What is the most likely mechanism?
A. Vascular insufficiency causing ischaemic nerve damage
B. Monosodium urate crystal deposition within the cranial nerves
C. Hyperuricaemic renal dysfunction causing cranial nerve damage
D. Direct urate neurotoxicity to the facial nucleus
E. Calcium pyrophosphate deposition in the facial canal
Answer: Cannot be determined from the information provided.
Q26. A doctor is checking the pulse of an artery between the infrahyoid and sternocleidomastoid muscles. Which artery is being palpated?
A. External carotid artery
B. Inferior thyroid artery
C. Subclavian artery
D. Common carotid artery
E. Internal carotid artery
Answer: D
Q27. The common carotid artery bifurcates at the level of the:
A. Jugular notch
B. Superior border of the thyroid cartilage
C. Angle of the mandible
D. Hyoid bone
E. Cricoid cartilage
Answer: B
Q28. During retrobulbar anaesthesia for eye surgery, a patient suddenly becomes bradycardic and hypotensive. Which structure mediates the efferent limb of this reflex bradycardia?
A. Ciliary ganglion
B. Trigeminal ganglion
C. Vagus nerve
D. Oculomotor nerve
E. Ophthalmic nerve
Answer: C
Q29. The ascending reticular activating system, responsible for wakefulness and arousal, is located mainly in the:
A. Upper pontine and midbrain tegmentum
B. Cerebellar vermis
C. Basal ganglia
D. Medullary pyramids
E. Hippocampus
Answer: A
Q30. A patient has left hemiplegia with weakness of the lower half of the LEFT side of the face. Occlusion of which artery is most likely?
A. Right middle cerebral artery
B. Left middle cerebral artery
C. Right anterior cerebral artery
D. Left posterior inferior cerebellar artery
E. Basilar artery
Answer: A
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