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100+ Free Examen Estatal de Medicina General Integral Practice Questions

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Sample Examen Estatal de Medicina General Integral Practice Questions

Try these sample questions to test your Examen Estatal de Medicina General Integral exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 48-year-old male attends the Consultorio del Médico y Enfermera de la Familia (CMF) for a routine health check-up. He has no prior medical history. On physical examination, his blood pressure is 148/94 mmHg. According to the Cuban Clinical Practice Guidelines for Arterial Hypertension (Guía Cubana de Diagnóstico, Evaluación y Tratamiento de la Hipertensión Arterial), what is the appropriate diagnostic approach to confirm arterial hypertension in this asymptomatic patient?
A.Confirm the diagnosis by obtaining blood pressure readings of 140/90 mmHg or higher on at least three separate clinical visits spaced over 1 to 3 weeks
B.Immediately diagnose arterial hypertension and initiate dual antihypertensive therapy based on this single office reading
C.Perform a single 24-hour ambulatory blood pressure monitoring test (ABPM) before any further clinical evaluations can be considered
D.Classify the patient immediately as prehypertensive and re-evaluate in 12 months without further interim blood pressure checks
Explanation: According to the Cuban National Guidelines for Arterial Hypertension (MINSAP), the diagnosis of hypertension in asymptomatic individuals without acute target organ damage requires corroboration of elevated blood pressure (systolic >= 140 mmHg and/or diastolic >= 90 mmHg) on at least three separate visits spaced over 1 to 3 weeks. This clinical method approach avoids overdiagnosis due to white-coat response or transient emotional/physical stressors.
2A 56-year-old postmenopausal female with newly diagnosed Stage 1 hypertension (mean BP 146/92 mmHg) has a body mass index (BMI) of 29 kg/m², a 15 pack-year smoking history, and a lipid profile showing total cholesterol of 6.2 mmol/L. She has no microalbuminuria or target organ damage. Based on the Cuban cardiovascular risk stratification tables (estratificación del riesgo cardiovascular global), which risk stratum does this patient belong to?
A.Low cardiovascular risk
B.Moderate cardiovascular risk
C.High cardiovascular risk
D.Very high cardiovascular risk
Explanation: In the Cuban hypertension stratification matrix adapted from WHO/PAHO guidelines, Stage 1 hypertension with 1 to 2 major cardiovascular risk factors (in this case, active tobacco smoking and hypercholesterolemia with overweight) classifies the patient into the Moderate Risk (Riesgo Moderado) category. This guides both the urgency and timeline of non-pharmacological and pharmacological interventions.
3A 52-year-old male with confirmed Stage 1 hypertension has failed to reach target blood pressure after 3 months of structured therapeutic lifestyle changes (dietary sodium reduction, aerobic exercise, and smoking cessation). He has no other comorbidities. According to Cuban MINSAP therapeutic protocols for primary care, which drug regimen represents the most appropriate initial monotherapy?
A.A thiazide-like diuretic (e.g., chlorthalidone 12.5–25 mg daily or hydrochlorothiazide 12.5–25 mg daily) or an ACE inhibitor (e.g., enalapril 10–20 mg daily)
B.High-dose loop diuretic therapy (e.g., furosemide 40 mg twice daily)
C.Direct peripheral alpha-1 adrenergic antagonist monotherapy (e.g., prazosin 5 mg twice daily)
D.Centrally acting alpha-2 agonist monotherapy (e.g., methyldopa 500 mg three times daily)
Explanation: Cuban primary care guidelines recommend a low-dose thiazide/thiazide-like diuretic (chlorthalidone or hydrochlorothiazide) or an ACE inhibitor (such as enalapril) as the initial first-line monotherapy for uncomplicated essential hypertension. These agents have proven mortality and morbidity reduction benefits, excellent cost-effectiveness, and wide national availability.
4A 45-year-old female presents to the consultorio for an annual routine dispensary evaluation. She is asymptomatic with a BMI of 31 kg/m². Her fasting venous plasma glucose is reported at 7.4 mmol/L (133 mg/dL). According to the Cuban National Comprehensive Diabetes Care Program (Programa Nacional de Atención Integral al Diabético), what is the mandatory next step to confirm the diagnosis of diabetes mellitus?
A.Immediately prescribe metformin 850 mg twice daily without any confirmatory laboratory test
B.Repeat the fasting plasma glucose test on a separate day under standardized resting conditions
C.Perform an immediate random capillary blood fingerstick test with a glucometer to confirm the diagnosis
D.Order an immediate intravenous glucose tolerance test with hospital admission
Explanation: Under MINSAP guidelines and international diagnostic consensus, an asymptomatic patient with an elevated fasting plasma glucose (>= 7.0 mmol/L or 126 mg/dL) must have the result confirmed by repeating the fasting plasma glucose test on a separate day. A diagnosis of diabetes is established if the second fasting result is also >= 7.0 mmol/L.
5A 50-year-old male is confirmed to have Type 2 Diabetes Mellitus with a fasting plasma glucose of 8.2 mmol/L and an HbA1c of 7.8%. His estimated glomerular filtration rate (eGFR) is 78 mL/min/1.73 m² and liver function tests are normal. Along with individualized nutrition and exercise counseling, what is the initial first-line pharmacological treatment per Cuban clinical guidelines?
A.Metformin oral monotherapy, starting with 500 mg once or twice daily with meals and titrating upward
B.Basal-bolus subcutaneous insulin therapy with NPH and regular crystalline insulin
C.Glibenclamide monotherapy at maximum dosage (15 mg daily)
D.AcarBOSE 100 mg three times daily as sole therapy
Explanation: Metformin is the first-line oral antidiabetic agent recommended by MINSAP for newly diagnosed Type 2 diabetes mellitus in patients with preserved renal function (eGFR > 30 mL/min). Titration starting at 500 mg with meals minimizes gastrointestinal adverse effects while improving hepatic insulin sensitivity and promoting modest weight neutrality or reduction.
6During the periodic dispensary consultation of a 62-year-old patient who has had Type 2 Diabetes Mellitus for 7 years, the family physician schedules annual microvascular screening. Which set of investigations is mandatory in primary care per MINSAP diabetes norms?
A.Annual urinary albumin-to-creatinine ratio (or microalbuminuria), comprehensive bilateral foot sensory examination (monofilament), and dilated fundoscopic eye exam
B.Monthly 24-hour urine protein quantification, quarterly head CT scan, and nerve conduction studies
C.Biannual renal biopsy, yearly cardiac catheterization, and lower limb Doppler ultrasound
D.Annual screening limited strictly to fasting capillary blood glucose, with no ocular or podiatric examinations
Explanation: The Cuban National Diabetes Program mandates annual screening for microvascular complications in all patients with Type 2 diabetes. This consists of assessing diabetic nephropathy via microalbuminuria (or albumin-to-creatinine ratio), diabetic retinopathy via dilated fundus examination, and diabetic peripheral neuropathy/foot complications using standardized podiatric clinical inspection and 10-g Semmes-Weinstein monofilament testing.
7A 64-year-old diabetic male presents with a non-healing neuropathic plantar ulcer of 6 weeks duration. On physical examination, the ulcer measures 3 x 2 cm, extends down to the subcutaneous tissue with clean granulation tissue, without bone involvement, probe-to-bone test is negative, and peripheral dorsalis pedis pulses are palpable (Wagner grade 2). Per the Cuban National Program for Diabetic Foot Care (Programa de Atención Integral al Paciente con Úlcera de Pie Diabético), which intervention is indicated?
A.Immediate supracondylar lower limb amputation
B.Application of recombinant human epidermal growth factor (Heberprot-P) by intralesional infiltration along with strict mechanical off-loading and wound care
C.Application of topical corticosteroids and topical antibiotics without off-loading
D.Immediate discharge with oral analgesics and instructions to walk barefoot on sand
Explanation: Cuba's breakthrough biotechnology product Heberprot-P (recombinant human epidermal growth factor, rhEGF) is indicated for complex, deep diabetic foot ulcers (Wagner grades 1 to 4) with adequate granulation tissue after sharp debridement and control of infection. Intralesional infiltration 3 times per week accelerates granulation and closure, dramatically reducing the relative risk of major amputation.
8A 24-year-old female presents to the consultorio reporting daytime wheezing and shortness of breath 3 days per week over the past month. She wakes up at night coughing approximately 3 times a month and uses her inhaled salbutamol canister 3 days per week. Her baseline FEV1 is 84% of predicted. According to the Cuban National Asthma Program (Programa Nacional de Asma Bronquial), how is her chronic asthma classified?
A.Intermittent asthma (Asma intermitente)
B.Mild persistent asthma (Asma persistente leve)
C.Moderate persistent asthma (Asma persistente moderada)
D.Severe persistent asthma (Asma persistente severa)
Explanation: According to Cuban asthma guidelines, mild persistent asthma is characterized by daytime symptoms occurring more than twice a week but less than daily, nocturnal awakenings 3 to 4 times a month, rescue bronchodilator use more than 2 days per week (but not daily), and preserved pulmonary function with FEV1 or PEF >= 80% of predicted.
9A 32-year-old male with mild persistent asthma has been using short-acting beta-2 agonist (salbutamol) inhalers as needed for symptomatic relief, but continues to have wheezing episodes 4 days a week. What is the fundamental maintenance anti-inflammatory therapy indicated in primary care under MINSAP asthma norms?
A.Daily inhaled corticosteroid (e.g., beclometasone dipropionate 200–400 mcg daily in divided doses) with spacer device
B.Continuous daily oral prednisone 40 mg daily for 6 months
C.Oral broad-spectrum macrolide antibiotic monotherapy for 12 weeks
D.Regular scheduled use of oral salbutamol syrup 4 mg three times daily without anti-inflammatory medication
Explanation: Inhaled corticosteroids (ICS), such as beclometasone dipropionate, represent the cornerstone of maintenance controller therapy for persistent asthma in the Cuban primary care system. Regular low-dose ICS suppresses chronic airway inflammation, reduces bronchial hyperresponsiveness, prevents exacerbations, and decreases asthma-related mortality.
10A 20-year-old known asthmatic arrives at the consultorio during morning consultation with acute dyspnea, expiratory wheezing, respiratory rate of 22 breaths/min, pulse 88 bpm, and peak expiratory flow (PEF) of 75% of his personal best. He can speak in complete sentences. What is the immediate treatment of choice in the primary care clinic?
A.Inhaled short-acting beta-2 agonist (salbutamol 2–4 puffs via metered-dose inhaler with a spacer, repeated every 20 minutes for up to 1 hour)
B.Immediate intravenous aminophylline bolus 6 mg/kg without prior inhaled therapy
C.Immediate subcutaneous epinephrine 0.5 mg and emergency endotracheal intubation
D.Immediate intramuscular injection of penicillin benzathine 1.2 million units
Explanation: For a mild acute asthma exacerbation (PEF > 70%, hemodynamically stable, able to speak in full sentences), inhaled short-acting beta-2 agonists (salbutamol 2–4 puffs with a spacer device, repeated every 20 minutes for the first hour) are the primary, rapid, and safest initial intervention in the primary care consultorio.

About the Examen Estatal de Medicina General Integral Exam

The Examen Estatal de la Especialidad en Medicina General Integral (MGI) is the definitive credentialing milestone for postgraduate medical residents completing Cuba's national 3-year residency programme in Comprehensive General Medicine (Family Medicine), governed by the Plan de Estudios (5ta versión, 2018, which restored the three-year design). Administered biannually under MINSAP Resolución Ministerial No. 108/2004, the examination is evaluated by external (cruzados) national or provincial tribunals and combines academic transcript scoring, thesis defense (Trabajo de Terminación de la Especialidad - TTE), and theoretical and practical examinations spanning five core primary care settings: la consulta, el ingreso en el hogar, la visita a la familia, la discusión de un problema de salud, and el análisis de la situación de salud (ASIS). This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice.

Assessment

The graduation evaluation (Evaluación de Graduación) consists of three mandatory components: (1) Final Academic Transcript Evaluation (Calificación Final del Expediente); (2) Thesis defense (Trabajo de Terminación de la Especialidad - TTE); and (3) Examen Estatal, comprising an Ejercicio Teórico-Práctico (clinical performance evaluated across five canonical scenarios: consultation, home hospitalization, family visit, discussion of a health problem, and community health diagnosis) and an Ejercicio Teórico (written examination of generalizing clinical questions evaluated by an external national or provincial tribunal).

Time Limit

Multi-day schedule convened twice annually (April-May and October-November)

Passing Score

70% of the marks assigned by the plan de estudios (MINSAP Res. 108/2004 Art. 116)

Exam Fee

There is no candidate sitting fee for Cuban nationals (postgraduate medical residency in Cuba is state-funded and salaried). Self-financed international residents pay tuition through Servicios Médicos Cubanos (SMC), which covers all examinations including the final state exam. (Ministerio de Salud Pública de Cuba (MINSAP) — Dirección de Docencia Médica)

Examen Estatal de Medicina General Integral Exam Content Outline

~25% of this local bank

La Consulta (Outpatient Clinical Practice & Primary Medical Care)

Clinical decision-making at the Consultorio del Médico y Enfermera de la Familia (CMF), comprehensive history taking, clinical method (método clínico), chronic non-communicable diseases (hypertension, diabetes, asthma, COPD, ischemic heart disease), rational therapeutics, and acute primary presentations.

~20% of this local bank

Ingreso en el Hogar (Home Hospitalization & Domiciliary Care)

Indications, admission criteria, daily clinical surveillance, and discharge protocols for home-based hospitalization; domiciliary palliative care, geriatric syndromes, post-stroke rehabilitation, and management of acute respiratory or low-risk infectious conditions in the household setting.

~20% of this local bank

Visita a la Familia (Family Health Assessment & Dynamics)

Evaluation of the family health status, structural and developmental family life cycle, familiogram (genogram) construction, family functional assessment (FF-SIL instrument), crisis intervention (normative and paranormative crises), and primary prevention interventions across household members.

~20% of this local bank

Discusión de un Problema de Salud (Clinical Epidemiology & Disease Control)

Epidemiological surveillance, case-control investigation, outbreak response, Dispensarización classification (Groups I: Apparent Health, II: At-Risk, III: Ill/Chronic, IV: Deficient/Disabled), Programa de Atención Materno Infantil (PAMI), National Immunization Program (Esquema Nacional de Vacunación), and control of communicable diseases (Dengue, Arboviruses, TB, HIV/STIs).

~15% of this local bank

Análisis de la Situación de Salud (ASIS & Community Health Diagnosis)

Methodology of the community health diagnosis (ASIS) for the consultorio catchment area, demographic and vital statistics analysis, identification and prioritization of community health problems (Hanlon method, matrix ranking), formulation of the community action plan (Plan de Acción), and intersectoral coordination.

How to Pass the Examen Estatal de Medicina General Integral Exam

What You Need to Know

  • Passing score: 70% of the marks assigned by the plan de estudios (MINSAP Res. 108/2004 Art. 116)
  • Assessment: The graduation evaluation (Evaluación de Graduación) consists of three mandatory components: (1) Final Academic Transcript Evaluation (Calificación Final del Expediente); (2) Thesis defense (Trabajo de Terminación de la Especialidad - TTE); and (3) Examen Estatal, comprising an Ejercicio Teórico-Práctico (clinical performance evaluated across five canonical scenarios: consultation, home hospitalization, family visit, discussion of a health problem, and community health diagnosis) and an Ejercicio Teórico (written examination of generalizing clinical questions evaluated by an external national or provincial tribunal).
  • Time limit: Multi-day schedule convened twice annually (April-May and October-November)
  • Exam fee: There is no candidate sitting fee for Cuban nationals (postgraduate medical residency in Cuba is state-funded and salaried). Self-financed international residents pay tuition through Servicios Médicos Cubanos (SMC), which covers all examinations including the final state exam.

Keys to Passing

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Examen Estatal de Medicina General Integral Study Tips from Top Performers

1Master the principles and classification of Dispensarización (Grupo I: Supuestamente Sanos, Grupo II: Con Riesgo, Grupo III: Enfermos, Grupo IV: Con Deficiencia o Discapacidad) and scheduling of active continuous follow-up evaluations.
2Thoroughly review the Programa de Atención Materno Infantil (PAMI) protocols, focusing on prenatal risk stratification, gestational diabetes, hypertensive disorders of pregnancy, and infant growth monitoring.
3Practice constructing and interpreting structural familiograms (genograms) and assessing family functionality using the FF-SIL instrument (Funcionalidad Familiar - Silveira et al.) across normative and paranormative family crises.
4Understand criteria and daily monitoring requirements for Ingreso en el Hogar (home hospitalization), ensuring patient safety, consent, and appropriate level-of-care criteria.
5Consolidate community health diagnosis methodology (ASIS), including demographic indicator calculation, identification of community health problems, and prioritization using the Hanlon method and ranking matrix.

Frequently Asked Questions

What is the official structure of the Cuban Examen Estatal in Medicina General Integral (MGI)?

Under MINSAP Resolución Ministerial No. 108/2004 (Capítulo VI, Arts. 115-118), the evaluation of graduation consists of three components: (1) Final Academic Transcript Evaluation (Expediente); (2) Evaluation of the Trabajo de Terminación de la Especialidad (TTE thesis and oral defense); and (3) The Examen Estatal itself, which includes a clinical practical examination (ejercicio teórico-práctico) evaluating performance across five canonical primary care scenarios (la consulta médica, el ingreso en el hogar, la visita a la familia, la discusión de un problema de salud y el análisis de la situación de salud - ASIS) and a theoretical examination (ejercicio teórico) consisting of generalizing clinical questions evaluated by external tribunals. This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice.

What is the passing score for the Examen Estatal in Cuba?

According to Article 116 of MINSAP Resolution 108/2004, every component (academic record, thesis defense, and practical/theoretical state examination) must be passed with a minimum score of 70% of the maximum marks allocated by the Plan de Estudios. Failing any component requires repeating that evaluation in its entirety, with a maximum attainable mark of 70% upon re-examination (Art. 121).

When and how are the tribunals convened?

Under Article 109 of Resolution 108/2004, state examinations are convened twice annually in April-May and October-November. The tribunals (Tribunales Estatales) may be provincial or national and are composed of external examiners ('tribunales cruzados') appointed by MINSAP to ensure objective, rigorous evaluation (Arts. 110-111).

How long is the MGI residency programme in Cuba?

Under the current national curriculum ('Plan de Estudios de la Residencia de MGI', 5ta versión, 2018), the MGI residency is designed for three years of full-time training at the Consultorio del Médico y Enfermera de la Familia (CMF), Policlínico Universitario, and secondary care rotations. The specialty ran on a two-year design from the 2004 programme; the 2018 fifth version restored the original three-year duration.

What are the fees to sit the Cuban MGI State Exam?

There is no candidate sitting fee for Cuban citizens, as all postgraduate medical education in Cuba is state-funded and residents receive a salary throughout their training. Self-financed international residents pay training fees via Servicios Médicos Cubanos (SMC), which encompasses all examination and graduation administration costs.

Is this 100-question practice test an official MINSAP examination?

No. This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice. It is designed as an educational tool to test core knowledge across all curriculum domains.