GMS 401 FINAL EXAM | PRACTICE EXAM | STUDY
GUIDE | TESTBANK | LATEST UPDATE 2026/2027 |
QUESTIONS & 100% CORRECT ANSWERS
## Table of Contents
- Patient Assessment & Clinical Decision-Making
- Internal Medicine
- Infectious Diseases
- Emergency & Critical Care
- Pharmacology & Therapeutics
- Obstetrics & Gynecology
- Pediatrics
- Surgery & Trauma
- Ethics, Professional Practice & Documentation
- Preventive & Community Health
Introduction
This practice examination is designed to simulate the depth, complexity, and clinical
reasoning expected in a GMS 401 Final Examination. It covers major areas of clinical
medicine including diagnosis, investigation, management, emergency care,
pharmacology, surgery, obstetrics, pediatrics, ethics, and preventive medicine. The
questions emphasize application of knowledge through realistic patient scenarios
requiring sound professional judgment rather than simple recall. Candidates should
expect challenging clinical decision-making, interpretation of investigations,
prioritization of management, and recognition of complications. Careful review of
explanations will strengthen conceptual understanding and improve preparedness
for high-level university and professional medical assessments.
Question 1
A 62-year-old man presents with crushing retrosternal chest pain lasting 45
minutes. ECG demonstrates ST-segment elevation in leads II, III, and aVF. The
nearest PCI center is 4 hours away.
,A. Administer fibrinolytic therapy if no contraindications exist.
B. Delay treatment until PCI becomes available.
C. Give only aspirin and observe.
D. Perform an exercise stress test.
Correct Answer: A
Explanation: Immediate reperfusion is indicated. When timely PCI is unavailable,
fibrinolysis within the recommended window significantly reduces mortality.
Question 2
A patient with septic shock remains hypotensive after receiving 30 mL/kg
crystalloid.
A. Dopamine
B. Norepinephrine
C. Verapamil
D. Furosemide
Correct Answer: B
Explanation: Norepinephrine is the preferred first-line vasopressor for persistent
hypotension following adequate fluid resuscitation.
Question 3
A diabetic patient develops fever, flank pain, dysuria, and hypotension.
A. Acute cystitis
B. Acute pyelonephritis with urosepsis
C. Renal colic
D. Chronic prostatitis
, Correct Answer: B
Explanation: Fever, systemic instability, urinary symptoms, and flank pain strongly
suggest complicated pyelonephritis with sepsis.
Question 4
A patient develops sudden unilateral weakness and aphasia 90 minutes after
symptom onset. CT brain excludes hemorrhage.
A. Aspirin alone
B. Intravenous thrombolysis if eligible
C. Immediate carotid endarterectomy
D. Oral anticoagulation immediately
Correct Answer: B
Explanation: Eligible patients presenting within the therapeutic window benefit
from intravenous thrombolytic therapy after hemorrhage is excluded.
Question 5
Which arterial blood gas pattern is most consistent with diabetic ketoacidosis?
A. Respiratory alkalosis
B. Metabolic acidosis with respiratory compensation
C. Metabolic alkalosis
D. Normal acid-base balance
Correct Answer: B
Explanation: Ketoacid accumulation produces metabolic acidosis, while
compensatory hyperventilation lowers PaCO₂.
, Question 6
A trauma patient becomes hypotensive, tachycardic, has distended neck veins,
absent breath sounds on the right, and tracheal deviation.
A. Massive hemothorax
B. Cardiac tamponade
C. Tension pneumothorax
D. Pulmonary embolism
Correct Answer: C
Explanation: Tension pneumothorax is a clinical diagnosis requiring immediate
decompression before imaging.
Question 7
A patient receiving warfarin develops life-threatening intracranial hemorrhage.
A. Stop warfarin only
B. Vitamin K and four-factor PCC
C. Fresh frozen plasma alone
D. Continue anticoagulation
Correct Answer: B
Explanation: Rapid reversal requires vitamin K together with prothrombin
complex concentrate.
Question 8
Which investigation best confirms pulmonary embolism in a hemodynamically
stable patient?
GUIDE | TESTBANK | LATEST UPDATE 2026/2027 |
QUESTIONS & 100% CORRECT ANSWERS
## Table of Contents
- Patient Assessment & Clinical Decision-Making
- Internal Medicine
- Infectious Diseases
- Emergency & Critical Care
- Pharmacology & Therapeutics
- Obstetrics & Gynecology
- Pediatrics
- Surgery & Trauma
- Ethics, Professional Practice & Documentation
- Preventive & Community Health
Introduction
This practice examination is designed to simulate the depth, complexity, and clinical
reasoning expected in a GMS 401 Final Examination. It covers major areas of clinical
medicine including diagnosis, investigation, management, emergency care,
pharmacology, surgery, obstetrics, pediatrics, ethics, and preventive medicine. The
questions emphasize application of knowledge through realistic patient scenarios
requiring sound professional judgment rather than simple recall. Candidates should
expect challenging clinical decision-making, interpretation of investigations,
prioritization of management, and recognition of complications. Careful review of
explanations will strengthen conceptual understanding and improve preparedness
for high-level university and professional medical assessments.
Question 1
A 62-year-old man presents with crushing retrosternal chest pain lasting 45
minutes. ECG demonstrates ST-segment elevation in leads II, III, and aVF. The
nearest PCI center is 4 hours away.
,A. Administer fibrinolytic therapy if no contraindications exist.
B. Delay treatment until PCI becomes available.
C. Give only aspirin and observe.
D. Perform an exercise stress test.
Correct Answer: A
Explanation: Immediate reperfusion is indicated. When timely PCI is unavailable,
fibrinolysis within the recommended window significantly reduces mortality.
Question 2
A patient with septic shock remains hypotensive after receiving 30 mL/kg
crystalloid.
A. Dopamine
B. Norepinephrine
C. Verapamil
D. Furosemide
Correct Answer: B
Explanation: Norepinephrine is the preferred first-line vasopressor for persistent
hypotension following adequate fluid resuscitation.
Question 3
A diabetic patient develops fever, flank pain, dysuria, and hypotension.
A. Acute cystitis
B. Acute pyelonephritis with urosepsis
C. Renal colic
D. Chronic prostatitis
, Correct Answer: B
Explanation: Fever, systemic instability, urinary symptoms, and flank pain strongly
suggest complicated pyelonephritis with sepsis.
Question 4
A patient develops sudden unilateral weakness and aphasia 90 minutes after
symptom onset. CT brain excludes hemorrhage.
A. Aspirin alone
B. Intravenous thrombolysis if eligible
C. Immediate carotid endarterectomy
D. Oral anticoagulation immediately
Correct Answer: B
Explanation: Eligible patients presenting within the therapeutic window benefit
from intravenous thrombolytic therapy after hemorrhage is excluded.
Question 5
Which arterial blood gas pattern is most consistent with diabetic ketoacidosis?
A. Respiratory alkalosis
B. Metabolic acidosis with respiratory compensation
C. Metabolic alkalosis
D. Normal acid-base balance
Correct Answer: B
Explanation: Ketoacid accumulation produces metabolic acidosis, while
compensatory hyperventilation lowers PaCO₂.
, Question 6
A trauma patient becomes hypotensive, tachycardic, has distended neck veins,
absent breath sounds on the right, and tracheal deviation.
A. Massive hemothorax
B. Cardiac tamponade
C. Tension pneumothorax
D. Pulmonary embolism
Correct Answer: C
Explanation: Tension pneumothorax is a clinical diagnosis requiring immediate
decompression before imaging.
Question 7
A patient receiving warfarin develops life-threatening intracranial hemorrhage.
A. Stop warfarin only
B. Vitamin K and four-factor PCC
C. Fresh frozen plasma alone
D. Continue anticoagulation
Correct Answer: B
Explanation: Rapid reversal requires vitamin K together with prothrombin
complex concentrate.
Question 8
Which investigation best confirms pulmonary embolism in a hemodynamically
stable patient?
