Step-by-Step Guide to Register and Pass
the EMREE Exam
By ExamCure | [Link]
Section 1: Introduction to the EMREE (UAE)
The EMREE — or Emirates Medical Residency Entrance Examination — is the national
standardized exam for doctors aspiring to join the residency training system in the United Arab
Emirates.
Whether you're a top graduate from a local medical school or an international medical graduate
seeking UAE licensure and training, the EMREE is your official gateway into competitive
postgraduate medical programs in the Emirates.
What is the EMREE?
The EMREE is an entry-level medical exam required for acceptance into UAE-based residency
training programs, particularly under the Ministry of Health and Prevention (MOHAP), DHA,
DOH (Abu Dhabi), and other institutions affiliated with government health services.
This exam evaluates your:
• Core clinical knowledge
• Clinical reasoning and decision-making
• Evidence-based understanding of diagnosis and management
It reflects the standards expected of graduates entering structured residency training in the UAE.
Who Should Take the EMREE?
• Graduates of UAE medical schools applying for local residency training
• International Medical Graduates (IMGs) applying for MOH/DHA residency opportunities
• Recent interns ( امتيازdoctors) completing internship year in UAE
• Doctors looking to switch specialties or re-enter formal training pathways
Why Is It Important?
The EMREE ranks candidates for available residency seats across UAE government and semi-
government institutions. High performance boosts your chances of securing competitive
specialties like:
• Dermatology
• Surgery
• Internal Medicine
• Pediatrics
• Radiology
• Emergency Medicine
The exam is also used as part of the national unified matching system for residency placement.
Structure of the EMREE Exam
While exact formats may vary slightly by year or institution, EMREE typically follows this format:
• Format: 100–150 MCQs
• Time: 2–3 hours
• Subjects Covered:
o Internal Medicine
o Surgery
o Obstetrics & Gynecology
o Pediatrics
o Psychiatry
o Ethics & Public Health
o Basic Pharmacology & Pathology
Where & When Is the EMREE Held?
• Testing Centers: Usually held in UAE-based exam centers or approved institutions
• Frequency: Often once or twice a year (spring and/or autumn cycles)
• Registration: Coordinated through official portals like MOHAP or university hospitals
Section 2: How to Prepare for the EMREE
Preparing for the EMREE isn’t just about memorizing facts — it’s about mastering high-yield
clinical concepts, thinking like a safe and rational doctor, and organizing your preparation in
a way that fits your life, energy, and goals.
Here’s a step-by-step roadmap to help you prepare smart, not just hard.
Step 1: Understand the Format and Scope
Before you open your first book or click your first MCQ, get super clear on what you’re
preparing for.
Exam Format (typical structure):
• 100–150 multiple choice questions (A-type — one best answer)
• Duration: 2–3 hours
• No negative marking
• Computer-based testing
Core Subjects Tested:
• Internal Medicine
• Surgery
• Pediatrics
• Obstetrics & Gynecology
• Psychiatry
• Public Health & Ethics
• Pharmacology
• Emergency Medicine
• Clinical Problem Solving
The EMREE focuses on clinical reasoning, diagnosis, investigation, and management — not
obscure trivia.
Step 2: Gather the Right Resources
The quality of your materials matters more than the quantity. Choose resources that explain
clinical logic, not just lists.
Top Recommended Texts:
• Oxford Handbook of Clinical Medicine
• Toronto Notes
• USMLE Step 2 CK (First Aid / UWorld concepts)
• John Murtagh's General Practice (esp. for outpatient-style questions)
• Kaplan Lecture Notes (Clinical subjects only)
For MCQs:
• Past EMREE recall questions (if available)
• USMLE Step 2-style Qbanks
• Prometric-style practice MCQs
• AMC/PLAB question banks (helpful for reasoning style)
Step 3: Build a Study Schedule
Whether you’re studying full-time or alongside internship/work, a realistic and disciplined plan
is key.
Sample Weekly Plan:
• 1–2 major subjects per week
• 1 hour per day = revision pace
• 2–3 hours/day = deep prep
• Dedicate last 3 weeks to intensive MCQ practice + mock exams
We'll give you a 12-week plan in Section 3 to follow easily.
Step 4: Practice MCQs Daily
This is non-negotiable.
• Do clinical-style MCQs every day (start early)
• Focus on why an answer is right — and why others are wrong
• Review mistakes in a “weak points” notebook or digital tracker
• Aim for progressive exposure to full-length practice sets
Step 5: Think Like a Doctor, Not a Student
The EMREE rewards:
• Clinical judgment
• Prioritization of safe actions
• Knowing when to refer or observe
• Ethical reasoning under pressure
Avoid memorizing rare syndromes or minutiae. Focus on:
• First-line investigations
• Emergency management
• Treatment thresholds
• Patient-centered care
Step 6: Study Smart with Support
Studying in isolation = burnout risk. Try:
• WhatsApp/Telegram EMREE groups
• Study partners for accountability
• Join mock MCQ challenges with friends
• Attend MOH/DHA prep workshops if available
Step 7: Rest, Reset, Recharge
No brain works well under chronic stress. Take breaks, move your body, hydrate, sleep. Treat
this like a marathon, not a sprint.
Section 3: 12-Week EMREE Study Plan
Week Focus Topic Notes / Goals
Week 1 Orientation & Exam Overview
Week 2 Internal Medicine – Part 1
Week 3 Internal Medicine – Part 2
Week 4 Surgery – Part 1
Week 5 Surgery – Part 2
Week 6 Pediatrics & Neonatology
Week 7 Obstetrics & Gynecology
Week 8 Psychiatry + Ethics & Communication
Week 9 Pharmacology + Emergency Medicine
Week 10 Public Health + Clinical Reasoning
Week 11 Mock Exams + Full-Length Practice
Week 12 Final Review + Rest & Confidence Boost
Section 4: Sample MCQs
Chapter 1: Internal Medicine
MCQs
MCQ 1
A 60-year-old man presents with fatigue, night sweats, and weight loss. Examination reveals
splenomegaly. CBC shows elevated white cell count with left shift. What is the most likely
diagnosis?
A. Chronic lymphocytic leukemia
B. Chronic myeloid leukemia
C. Acute myeloid leukemia
D. Lymphoma
E. Polycythemia vera
MCQ 2
A 55-year-old woman with a history of hypertension presents with sudden severe chest pain
radiating to the back. Her BP is unequal in both arms. What is the most likely diagnosis?
A. Acute coronary syndrome
B. Pulmonary embolism
C. Pericarditis
D. Aortic dissection
E. Tension pneumothorax
MCQ 3
A patient presents with polyuria, polydipsia, and fatigue. Lab results show:
• Na⁺ 136 mmol/L
• K⁺ 4.1 mmol/L
• Glucose 380 mg/dL
• pH 7.25
• Ketones: Positive
What is the most likely diagnosis?
A. Type 2 diabetes mellitus
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic state
D. Renal tubular acidosis
E. Addison’s disease
MCQ 4
A 65-year-old man with chronic smoking presents with hemoptysis, weight loss, and right-sided
ptosis with miosis. What is the most likely diagnosis?
A. Squamous cell carcinoma
B. Small cell lung carcinoma
C. Adenocarcinoma
D. Tuberculosis
E. Bronchiectasis
MCQ 5
A 72-year-old female with atrial fibrillation presents with acute left lower limb pain, pallor, and
pulselessness. What is the most likely diagnosis?
A. Deep vein thrombosis
B. Cellulitis
C. Acute limb ischemia
D. Peripheral neuropathy
E. Compartment syndrome
Answer Key
• MCQ 1: B
• MCQ 2: D
• MCQ 3: B
• MCQ 4: B
• MCQ 5: C
Explanations
MCQ 1 – Chronic Myeloid Leukemia (CML):
CML often presents with constitutional symptoms (fatigue, night sweats), splenomegaly, and
elevated WBC count. The BCR-ABL gene is diagnostic.
MCQ 2 – Aortic Dissection:
Sudden chest pain radiating to the back and unequal BP in arms are classic signs. Confirm
with CT angiography.
MCQ 3 – Diabetic Ketoacidosis (DKA):
The presence of hyperglycemia, acidosis (pH 7.25), and ketones points to DKA, usually seen in
type 1 diabetes.
MCQ 4 – Small Cell Lung Carcinoma:
Associated with paraneoplastic syndromes and Horner’s syndrome (ptosis, miosis,
anhidrosis). Strongly linked to smoking.
MCQ 5 – Acute Limb Ischemia:
Characterized by the 6 P’s: Pain, Pallor, Pulselessness, Paresthesia, Paralysis,
Poikilothermia. A vascular emergency.
Chapter 2: Surgery
MCQs
MCQ 1
A 25-year-old man presents with sudden right lower quadrant abdominal pain, nausea, and mild
fever. On exam, there is tenderness at McBurney’s point. What is the most likely diagnosis?
A. Gastroenteritis
B. Acute appendicitis
C. Renal colic
D. Inguinal hernia
E. Mesenteric adenitis
MCQ 2
A 60-year-old man presents with a non-healing ulcer on the lower leg. Biopsy confirms
squamous cell carcinoma. What is the most appropriate management?
A. Oral antibiotics
B. Observation
C. Radiotherapy only
D. Wide local excision
E. Cryotherapy
MCQ 3
A 70-year-old woman develops sudden-onset abdominal pain out of proportion to physical
findings. She has atrial fibrillation and hypotension. What is the most likely diagnosis?
A. Acute appendicitis
B. Intestinal obstruction
C. Acute mesenteric ischemia
D. Perforated peptic ulcer
E. Diverticulitis
MCQ 4
A 40-year-old male is brought after a motor vehicle accident. He is hypotensive, tachycardic, and
has decreased breath sounds on the left. Trachea is shifted to the right. What is the immediate
next step?
A. Chest X-ray
B. Pericardiocentesis
C. Needle decompression
D. IV antibiotics
E. Intubation
MCQ 5
A 45-year-old woman presents with a painless breast lump. Mammography shows
microcalcifications. What is the next best step?
A. Observation
B. Fine-needle aspiration
C. Ultrasound only
D. Core needle biopsy
E. MRI breast
Answer Key
• MCQ 1: B
• MCQ 2: D
• MCQ 3: C
• MCQ 4: C
• MCQ 5: D
Explanations
MCQ 1 – Acute Appendicitis:
Typical presentation includes RLQ pain, nausea, and McBurney’s point tenderness. Early
diagnosis reduces the risk of perforation.
MCQ 2 – Wide Local Excision:
For cutaneous squamous cell carcinoma, wide local excision with clear margins is the standard
first-line treatment.
MCQ 3 – Acute Mesenteric Ischemia:
Often in elderly with AFib, presents with severe abdominal pain but minimal findings on
exam. Diagnosis confirmed by CT angiography.
MCQ 4 – Needle Decompression:
Classic for tension pneumothorax: hypotension, tracheal shift, unilateral decreased breath
sounds. Requires immediate needle decompression.
MCQ 5 – Core Needle Biopsy:
For suspicious breast lesions (esp. with microcalcifications), core biopsy is the next best step to
confirm malignancy.
Chapter 3: Pediatrics
MCQs
MCQ 1
A 2-year-old boy presents with barking cough, inspiratory stridor, and hoarseness that worsens at
night. What is the most likely diagnosis?
A. Asthma
B. Bronchiolitis
C. Croup
D. Epiglottitis
E. Foreign body aspiration
MCQ 2
A neonate fails to pass meconium within the first 48 hours of life. He has abdominal distension
and vomiting. What is the most likely diagnosis?
A. Duodenal atresia
B. Hirschsprung disease
C. Necrotizing enterocolitis
D. Meconium ileus
E. Pyloric stenosis
MCQ 3
A 5-year-old presents with fever, sore throat, and a fine sandpaper-like rash. He also has a
"strawberry" tongue. What is the most likely diagnosis?
A. Measles
B. Scarlet fever
C. Kawasaki disease
D. Rubella
E. Infectious mononucleosis
MCQ 4
A 4-year-old boy presents with generalized edema, frothy urine, and proteinuria on urinalysis.
What is the most likely diagnosis?
A. Glomerulonephritis
B. Nephrotic syndrome
C. Hemolytic uremic syndrome
D. Urinary tract infection
E. Renal tubular acidosis
MCQ 5
A 6-year-old girl presents with a limp, low-grade fever, and hip pain. She had an upper
respiratory tract infection one week ago. What is the most likely diagnosis?
A. Septic arthritis
B. Legg-Calvé-Perthes disease
C. Juvenile idiopathic arthritis
D. Transient synovitis
E. Slipped capital femoral epiphysis
Answer Key
• MCQ 1: C
• MCQ 2: B
• MCQ 3: B
• MCQ 4: B
• MCQ 5: D
Explanations
MCQ 1 – Croup:
Croup is caused by parainfluenza virus and presents with barking cough, inspiratory stridor,
and hoarseness, especially worse at night.
MCQ 2 – Hirschsprung Disease:
Caused by absence of ganglion cells in the colon. Presents with delayed meconium, distension,
and vomiting. Confirm with rectal biopsy.
MCQ 3 – Scarlet Fever:
Caused by Group A Strep. Classic signs include fever, sore throat, sandpaper rash, and
strawberry tongue.
MCQ 4 – Nephrotic Syndrome:
Characterized by proteinuria, hypoalbuminemia, edema, and frothy urine. Most common in
children is minimal change disease.
MCQ 5 – Transient Synovitis:
Common cause of hip pain after viral illness. Low-grade fever, limp, and normal
inflammatory markers help distinguish it from septic arthritis.
Chapter 4: Obstetrics & Gynecology
MCQs
MCQ 1
A 30-year-old woman at 32 weeks of gestation presents with painless vaginal bleeding. Her
vitals and fetal heart rate are stable. What is the most likely diagnosis?
A. Placental abruption
B. Uterine rupture
C. Vasa previa
D. Placenta previa
E. Cervical insufficiency
MCQ 2
A 24-year-old woman presents with lower abdominal pain, fever, and purulent cervical
discharge. Cervical motion tenderness is present on exam. What is the most likely diagnosis?
A. Urinary tract infection
B. Ectopic pregnancy
C. Pelvic inflammatory disease
D. Endometriosis
E. Ovarian torsion
MCQ 3
A pregnant woman at 38 weeks presents with hypertension, proteinuria, and generalized edema.
What is the most likely diagnosis?
A. Chronic hypertension
B. Gestational hypertension
C. Pre-eclampsia
D. HELLP syndrome
E. Nephrotic syndrome
MCQ 4
A 28-year-old woman with PCOS is trying to conceive. Which of the following is the first-line
medication to induce ovulation?
A. Clomiphene citrate
B. Progesterone
C. Metformin
D. Letrozole
E. Tamoxifen
MCQ 5
A 26-year-old primigravida presents in labor. On vaginal exam, the cervix is 8 cm dilated, and
the fetal head is at -1 station. What stage of labor is this?
A. Latent phase of first stage
B. Active phase of first stage
C. Second stage
D. Third stage
E. Early transition phase
Answer Key
• MCQ 1: D
• MCQ 2: C
• MCQ 3: C
• MCQ 4: D
• MCQ 5: B
Explanations
MCQ 1 – Placenta Previa:
Presents with painless vaginal bleeding in the third trimester. Confirmed via transabdominal
or transvaginal ultrasound. Vaginal exams are avoided.
MCQ 2 – Pelvic Inflammatory Disease (PID):
Common in young, sexually active women. Presents with pelvic pain, fever, discharge, and
cervical motion tenderness.
MCQ 3 – Pre-eclampsia:
Characterized by hypertension, proteinuria, and often edema after 20 weeks gestation. Severe
cases may progress to eclampsia or HELLP.
MCQ 4 – Letrozole:
Letrozole is now preferred over clomiphene in PCOS patients for ovulation induction, especially
when fertility is the goal.
MCQ 5 – Active Phase of First Stage:
The first stage of labor includes cervical dilation from 0–10 cm. Active phase begins after 6 cm
dilation and includes rapid progress until full dilation.
Chapter 5: Psychiatry
MCQs
MCQ 1
A 22-year-old man presents with auditory hallucinations, social withdrawal, and flat affect for
the past 8 months. What is the most likely diagnosis?
A. Schizophrenia
B. Bipolar disorder
C. Schizoaffective disorder
D. Delusional disorder
E. Major depressive disorder with psychotic features
MCQ 2
A 30-year-old woman complains of persistent anxiety, restlessness, and sleep disturbance for the
past 8 months. She constantly worries about work, health, and finances. What is the most likely
diagnosis?
A. Panic disorder
B. Generalized anxiety disorder
C. Obsessive-compulsive disorder
D. PTSD
E. Adjustment disorder
MCQ 3
A 19-year-old university student presents to the emergency room with chest tightness, dizziness,
palpitations, and fear of dying. The episode lasted 15 minutes and resolved on its own. What is
the most likely diagnosis?
A. Panic attack
B. Hyperthyroidism
C. Generalized anxiety disorder
D. Cardiac arrhythmia
E. Social anxiety disorder
MCQ 4
A 45-year-old woman presents with low mood, fatigue, loss of appetite, and poor concentration.
Symptoms have persisted for 6 weeks and interfere with her daily functioning. What is the most
likely diagnosis?
A. Dysthymia
B. Bipolar II disorder
C. Adjustment disorder
D. Major depressive disorder
E. Cyclothymic disorder
MCQ 5
A 35-year-old man has been using heroin for 5 years. He suddenly stops and presents with
nausea, muscle aches, sweating, and dilated pupils. What is the most appropriate management?
A. Diazepam
B. Naloxone
C. Methadone
D. Haloperidol
E. Lorazepam
Answer Key
• MCQ 1: A
• MCQ 2: B
• MCQ 3: A
• MCQ 4: D
• MCQ 5: C
Explanations
MCQ 1 – Schizophrenia:
Persistent psychotic symptoms (>6 months), such as hallucinations, disorganized behavior,
and flat affect, are diagnostic of schizophrenia.
MCQ 2 – Generalized Anxiety Disorder (GAD):
Characterized by chronic, excessive worry about various aspects of life, lasting 6 months or
more, often with physical symptoms like insomnia.
MCQ 3 – Panic Attack:
Sudden episodes of intense fear, physical symptoms, and fear of dying, resolving
spontaneously. Recurrent attacks may indicate panic disorder.
MCQ 4 – Major Depressive Disorder (MDD):
Diagnosis requires ≥2 weeks of low mood and ≥5 associated symptoms (e.g., fatigue, appetite
change, guilt, sleep disturbance, etc.).
MCQ 5 – Methadone:
Used in opioid withdrawal management to reduce withdrawal symptoms and cravings.
Naloxone is for acute overdose, not withdrawal.
Chapter 6: Public Health & Preventive Medicine
MCQs
MCQ 1
A screening test for breast cancer has high sensitivity but low specificity. What does this mean?
A. It identifies most people without the disease
B. It misses most true cases
C. It produces more false positives
D. It produces more false negatives
E. It is not suitable for screening
MCQ 2
Which of the following is an example of a primary prevention strategy?
A. Mammography
B. Chemotherapy
C. Vaccination
D. Palliative care
E. Rehabilitation
MCQ 3
A 35-year-old man is diagnosed with latent tuberculosis after a routine health screen. What type
of prevention is this?
A. Primary
B. Secondary
C. Tertiary
D. Primordial
E. Curative
MCQ 4
In a population of 1000 people, 100 have a disease. A test correctly identifies 90 of them and
falsely labels 50 healthy people as positive. What is the sensitivity of the test?
A. 50%
B. 60%
C. 70%
D. 80%
E. 90%
MCQ 5
Which of the following measures reflects the burden of disease, accounting for both morbidity
and mortality?
A. Prevalence
B. Incidence
C. DALY (Disability Adjusted Life Years)
D. Relative Risk
E. Case Fatality Rate
Answer Key
• MCQ 1: C
• MCQ 2: C
• MCQ 3: B
• MCQ 4: E
• MCQ 5: C
Explanations
MCQ 1 – False Positives (Low Specificity):
A test with high sensitivity catches most true cases, but low specificity leads to many false
positives — people without the disease flagged as positive.
MCQ 2 – Vaccination = Primary Prevention:
Primary prevention aims to stop a disease before it occurs — vaccines, lifestyle advice,
smoking cessation.
MCQ 3 – Secondary Prevention:
Early detection (like latent TB via screening) falls under secondary prevention — identifying
disease before symptoms appear to treat early.
MCQ 4 – Sensitivity = 90%:
Sensitivity = True Positives / All Actual Positives = 90 / 100 = 90%.
MCQ 5 – DALY:
Disability Adjusted Life Years (DALY) combines years of life lost (YLL) and years lived
with disability (YLD) to reflect total burden of disease.
Chapter 7: Ethics & Communication
MCQs
MCQ 1
A competent adult patient refuses a life-saving treatment. What is the doctor’s ethical obligation?
A. Proceed with treatment despite refusal
B. Ask the family for consent
C. Respect the patient’s decision
D. Seek legal approval
E. Delay decision until the patient reconsiders
MCQ 2
A 17-year-old girl requests contraception but asks that her parents not be informed. She
understands the risks and benefits. What should the physician do?
A. Deny the request due to age
B. Inform the parents
C. Respect confidentiality and provide care
D. Refer her to legal services
E. Delay until parental consent is obtained
MCQ 3
A doctor makes a medication error but the patient is unharmed. What is the most ethical next
step?
A. Ignore it
B. Report to supervisor only
C. Inform the patient honestly
D. Document it privately
E. Wait to see if symptoms develop
MCQ 4
Which ethical principle refers to doing good and promoting the best interest of the patient?
A. Autonomy
B. Justice
C. Non-maleficence
D. Beneficence
E. Fidelity
MCQ 5
During a difficult breaking bad news conversation, the patient becomes tearful and silent. What
is the most appropriate response?
A. Change the subject
B. Keep talking to fill the silence
C. Pause and allow space for emotion
D. End the conversation
E. Offer more medical facts immediately
Answer Key
• MCQ 1: C
• MCQ 2: C
• MCQ 3: C
• MCQ 4: D
• MCQ 5: C
Explanations
MCQ 1 – Respect for Autonomy:
A competent adult has the right to refuse any treatment, even life-saving. The physician must
respect this decision under the principle of autonomy.
MCQ 2 – Confidentiality in Adolescents:
If a minor is assessed as Gillick competent (understands risks/benefits), the doctor can respect
confidentiality and provide care.
MCQ 3 – Truth-Telling and Professionalism:
Ethically and legally, doctors must disclose medical errors to patients, even if no harm
occurred. Transparency builds trust.
MCQ 4 – Beneficence:
This principle refers to doing good for the patient and promoting their health and wellbeing.
MCQ 5 – Active Listening:
Silence and emotion are normal reactions to bad news. The most respectful action is to pause,
acknowledge their feelings, and give space to process.
Chapter 8: Clinical Pharmacology
MCQs
MCQ 1
A 70-year-old man with atrial fibrillation is started on warfarin. Which parameter is used to
monitor therapeutic response?
A. aPTT
B. PT
C. INR
D. Bleeding time
E. Platelet count
MCQ 2
A young woman on isoniazid therapy for latent TB develops numbness and tingling in her hands
and feet. What is the most likely cause?
A. Vitamin B12 deficiency
B. Pyridoxine (B6) deficiency
C. Hypokalemia
D. Drug-induced lupus
E. Hepatotoxicity
MCQ 3
A child on phenytoin for epilepsy develops gum swelling and overgrowth. What is the side effect
called?
A. Gingivitis
B. Dental caries
C. Gingival hyperplasia
D. Mucositis
E. Periodontitis
MCQ 4
A 50-year-old woman starts lisinopril for hypertension. A week later, she complains of a dry,
persistent cough. What is the best next step?
A. Add a cough suppressant
B. Switch to a calcium channel blocker
C. Switch to an angiotensin receptor blocker
D. Continue the ACE inhibitor
E. Stop treatment and monitor
MCQ 5
A patient taking digoxin develops nausea, confusion, and visual disturbances. Which electrolyte
abnormality increases the risk of this toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hypermagnesemia
D. Hypocalcemia
E. Hyperkalemia
Answer Key
• MCQ 1: C
• MCQ 2: B
• MCQ 3: C
• MCQ 4: C
• MCQ 5: B
Explanations
MCQ 1 – INR for Warfarin Monitoring:
INR (international normalized ratio) is the standardized value for adjusting warfarin dosage. It
reflects the effectiveness of anticoagulation.
MCQ 2 – Pyridoxine Deficiency:
Isoniazid interferes with vitamin B6 metabolism, causing peripheral neuropathy. Supplement
with pyridoxine to prevent this.
MCQ 3 – Gingival Hyperplasia:
A known side effect of phenytoin, especially in children. It presents as painless gum
overgrowth.
MCQ 4 – ARB for ACE Inhibitor Cough:
Dry cough is a common side effect of ACE inhibitors. Replace with an ARB (e.g., losartan)
which has similar benefits without cough.
MCQ 5 – Hypokalemia & Digoxin Toxicity:
Low potassium enhances the effect of digoxin and increases the risk of arrhythmias and
toxicity (vision changes, nausea).
Chapter 9: Radiology & Imaging
MCQs
MCQ 1
A 55-year-old man presents with sudden onset severe headache, nausea, and photophobia. What
is the best initial investigation?
A. MRI brain
B. CT head without contrast
C. Lumbar puncture
D. EEG
E. CT angiogram
MCQ 2
A 65-year-old woman with breast cancer presents with back pain and urinary incontinence. MRI
of the spine shows a mass compressing the spinal cord. What is the most likely diagnosis?
A. Osteoarthritis
B. Vertebral fracture
C. Spinal epidural abscess
D. Spinal metastasis
E. Disc prolapse
MCQ 3
A 50-year-old woman presents with a breast lump. Mammogram shows a spiculated lesion with
microcalcifications. What is the most likely diagnosis?
A. Fibroadenoma
B. Breast cyst
C. Phyllodes tumor
D. Fat necrosis
E. Breast carcinoma
MCQ 4
A patient with a history of smoking presents with cough and weight loss. Chest X-ray reveals a
central mass and widened mediastinum. What is the next best step?
A. CT chest
B. PET scan
C. Sputum culture
D. Bronchoscopy
E. MRI chest
MCQ 5
Which imaging modality is most sensitive for early detection of acute ischemic stroke within
the first few hours?
A. Non-contrast CT
B. CT angiography
C. MRI T1
D. MRI diffusion-weighted imaging (DWI)
E. EEG
Answer Key
• MCQ 1: B
• MCQ 2: D
• MCQ 3: E
• MCQ 4: A
• MCQ 5: D
Explanations
MCQ 1 – Non-contrast CT for Acute Headache:
Suspected subarachnoid hemorrhage is best evaluated first with a non-contrast CT head to
detect blood.
MCQ 2 – Spinal Metastasis:
Common in patients with breast cancer. Symptoms include back pain, neurological deficits,
and incontinence. MRI confirms cord compression.
MCQ 3 – Breast Carcinoma:
A spiculated mass with microcalcifications is highly suspicious for invasive ductal
carcinoma.
MCQ 4 – CT Chest for Lung Mass:
Next step after abnormal chest X-ray is CT chest to evaluate lesion size, extent, and mediastinal
involvement.
MCQ 5 – MRI DWI:
Diffusion-weighted MRI is the most sensitive tool for detecting acute ischemia within minutes
to hours after onset.
Chapter 10: Emergency Medicine / Critical Care
MCQs
MCQ 1
A 68-year-old man presents with chest pain, diaphoresis, and ECG shows ST elevation in leads
II, III, and aVF. What is the most appropriate immediate treatment?
A. Thrombolysis
B. IV morphine and fluids
C. Percutaneous coronary intervention (PCI)
D. Heparin and aspirin only
E. Cardiac stress testing
MCQ 2
A trauma patient arrives with hypotension, jugular venous distention, and muffled heart sounds.
What is the most likely diagnosis?
A. Tension pneumothorax
B. Hemothorax
C. Cardiac tamponade
D. Pulmonary embolism
E. Flail chest
MCQ 3
A 27-year-old man is found unconscious with pinpoint pupils, bradypnea, and low oxygen
saturation. What is the immediate treatment?
A. Flumazenil
B. Naloxone
C. Atropine
D. Diazepam
E. Glucose
MCQ 4
A 65-year-old diabetic presents with fever, altered mental status, hypotension, and elevated
lactate. What is the first-line treatment for suspected septic shock?
A. Vasopressors
B. Blood transfusion
C. IV fluids and broad-spectrum antibiotics
D. Corticosteroids
E. Immediate dialysis
MCQ 5
A 20-year-old male diver presents with shortness of breath and chest pain after rapid ascent.
Chest X-ray shows decreased breath sounds and hyperlucency on one side. What is the most
likely diagnosis?
A. Pneumomediastinum
B. Tension pneumothorax
C. Hemothorax
D. Pulmonary embolism
E. Pneumonia
Answer Key
• MCQ 1: C
• MCQ 2: C
• MCQ 3: B
• MCQ 4: C
• MCQ 5: B
Explanations
MCQ 1 – PCI in Inferior STEMI:
ST elevation in leads II, III, aVF indicates inferior MI. The gold standard treatment is
emergency PCI if available within 90 minutes.
MCQ 2 – Cardiac Tamponade (Beck’s Triad):
Hypotension, muffled heart sounds, and JVD = Beck's triad, classic for cardiac tamponade.
Requires urgent pericardiocentesis.
MCQ 3 – Naloxone for Opioid Overdose:
Pinpoint pupils + respiratory depression = classic opioid overdose. Treat with naloxone
immediately.
MCQ 4 – Septic Shock Management:
First-line treatment includes aggressive IV fluids and broad-spectrum antibiotics.
Vasopressors follow if hypotension persists.
MCQ 5 – Tension Pneumothorax from Barotrauma:
Rapid ascent in diving can cause barotrauma, leading to tension pneumothorax. Treated
urgently with needle decompression.
Chapter 11: Infectious Diseases
MCQs
MCQ 1
A 30-year-old man returns from India with fever, abdominal pain, and rose-colored spots on his
abdomen. Blood culture confirms Salmonella typhi. What is the treatment of choice?
A. Amoxicillin
B. Ciprofloxacin
C. Azithromycin
D. Ceftriaxone
E. Metronidazole
MCQ 2
A 45-year-old HIV-positive man with a CD4 count of 80 presents with progressive shortness of
breath, fever, and dry cough. Chest X-ray shows bilateral ground-glass infiltrates. What is the
most likely diagnosis?
A. Tuberculosis
B. Streptococcus pneumoniae
C. Pneumocystis jirovecii pneumonia (PJP)
D. Histoplasmosis
E. CMV pneumonitis
MCQ 3
A child presents with high fever, headache, and a petechial rash. He is lethargic and
photophobic. What is the most likely diagnosis?
A. Viral meningitis
B. Meningococcal meningitis
C. Measles
D. Scarlet fever
E. TTP
MCQ 4
A 23-year-old woman presents with dysuria and increased urinary frequency. Urine dipstick
shows nitrites and leukocyte esterase. What is the most appropriate first-line antibiotic?
A. Ciprofloxacin
B. Nitrofurantoin
C. Trimethoprim-sulfamethoxazole
D. Amoxicillin
E. Doxycycline
MCQ 5
A 33-year-old man presents with painless genital ulcer. VDRL test is positive. What is the most
appropriate treatment?
A. Doxycycline for 14 days
B. Ceftriaxone IM
C. Acyclovir
D. Benzathine penicillin G IM single dose
E. Metronidazole
Answer Key
• MCQ 1: D
• MCQ 2: C
• MCQ 3: B
• MCQ 4: B
• MCQ 5: D
Explanations
MCQ 1 – Ceftriaxone for Typhoid Fever:
Salmonella typhi is commonly treated with ceftriaxone, especially in resistant or complicated
cases.
MCQ 2 – PJP in HIV:
A CD4 <200 with dry cough, hypoxia, and bilateral infiltrates points to Pneumocystis
jirovecii pneumonia. Treat with TMP-SMX.
MCQ 3 – Meningococcal Meningitis:
Presents with petechial rash, fever, meningeal signs, and often rapid progression. Empiric
treatment and isolation are crucial.
MCQ 4 – Nitrofurantoin for UTI:
In uncomplicated cystitis in young women, nitrofurantoin is first-line due to low resistance and
urinary tract specificity.
MCQ 5 – Syphilis (Primary Stage):
A painless chancre and positive VDRL = primary syphilis. First-line treatment is a single IM
dose of benzathine penicillin G.
Chapter 12: Dermatology
MCQs
MCQ 1
A 6-year-old child presents with a red, crusted lesion around the mouth. It is non-painful and
appears golden and sticky. What is the most likely diagnosis?
A. Atopic dermatitis
B. Tinea faciei
C. Impetigo
D. Herpes simplex
E. Contact dermatitis
MCQ 2
A 28-year-old woman presents with a butterfly-shaped rash on her cheeks and nose that worsens
with sunlight. What is the most likely diagnosis?
A. Rosacea
B. Acne vulgaris
C. Systemic lupus erythematosus
D. Dermatomyositis
E. Seborrheic dermatitis
MCQ 3
A 35-year-old man presents with well-demarcated erythematous plaques with silvery scales over
the elbows and knees. What is the most likely diagnosis?
A. Eczema
B. Psoriasis
C. Tinea corporis
D. Lichen planus
E. Drug eruption
MCQ 4
A patient presents with a single large, scaly patch on the trunk followed by multiple oval lesions
in a “Christmas tree” pattern. What is the most likely diagnosis?
A. Pityriasis rosea
B. Psoriasis
C. Tinea versicolor
D. Secondary syphilis
E. Contact dermatitis
MCQ 5
A 19-year-old man presents with multiple itchy, annular, scaly lesions with central clearing on
his arm. What is the most appropriate treatment?
A. Oral steroids
B. Topical antifungal
C. Antibiotic cream
D. Moisturizers
E. Oral antihistamines
Answer Key
• MCQ 1: C
• MCQ 2: C
• MCQ 3: B
• MCQ 4: A
• MCQ 5: B
Explanations
MCQ 1 – Impetigo:
Caused by Staph aureus or Strep pyogenes, impetigo is common in children and presents with
golden, honey-colored crusts. It’s highly contagious.
MCQ 2 – Systemic Lupus Erythematosus (SLE):
A malar (butterfly) rash that spares the nasolabial folds and worsens with sun exposure is a
hallmark of SLE.
MCQ 3 – Psoriasis:
Silvery scales on well-demarcated plaques, commonly on extensor surfaces like knees and
elbows. Chronic immune-mediated condition.
MCQ 4 – Pityriasis Rosea:
Begins with a “herald patch” followed by a widespread rash in a Christmas tree pattern on the
back and trunk. Self-limited.
MCQ 5 – Tinea Corporis (Ringworm):
Fungal infection causing annular, scaly lesions with central clearing. Treated with topical
antifungals like clotrimazole.
Chapter 13: Ophthalmology
MCQs
MCQ 1
A 70-year-old woman presents with progressive loss of central vision. Fundoscopy shows drusen
deposits in the macula. What is the most likely diagnosis?
A. Glaucoma
B. Retinal detachment
C. Diabetic retinopathy
D. Macular degeneration
E. Cataract
MCQ 2
A 60-year-old man presents with sudden painless loss of vision in one eye. Fundoscopy reveals a
cherry-red spot at the macula and pale retina. What is the most likely diagnosis?
A. Central retinal vein occlusion
B. Retinal detachment
C. Optic neuritis
D. Central retinal artery occlusion
E. Anterior uveitis
MCQ 3
A 25-year-old presents with painful red eye, photophobia, and blurred vision. Slit-lamp exam
reveals ciliary injection and keratic precipitates. What is the most likely diagnosis?
A. Bacterial conjunctivitis
B. Acute angle-closure glaucoma
C. Anterior uveitis (iritis)
D. Episcleritis
E. Scleritis
MCQ 4
A 50-year-old man complains of gradually worsening peripheral vision. Fundoscopy shows
cupping of the optic disc and intraocular pressure is elevated. What is the most likely diagnosis?
A. Cataract
B. Open-angle glaucoma
C. Acute angle-closure glaucoma
D. Retinitis pigmentosa
E. Diabetic macular edema
MCQ 5
A 4-year-old child presents with a white reflex in photographs. What is the most likely
diagnosis?
A. Congenital cataract
B. Retinal detachment
C. Retinoblastoma
D. Strabismus
E. Conjunctivitis
Answer Key
• MCQ 1: D
• MCQ 2: D
• MCQ 3: C
• MCQ 4: B
• MCQ 5: C
Explanations
MCQ 1 – Macular Degeneration:
Age-related macular degeneration causes central vision loss and is associated with drusen
deposits in the retina.
MCQ 2 – Central Retinal Artery Occlusion (CRAO):
Sudden, painless vision loss with cherry-red spot and pale retina is classic for CRAO — an
ophthalmologic emergency.
MCQ 3 – Anterior Uveitis (Iritis):
Presents with red eye, photophobia, and blurred vision. Slit-lamp exam shows keratic
precipitates and ciliary injection.
MCQ 4 – Open-Angle Glaucoma:
Causes gradual peripheral vision loss, with increased intraocular pressure and optic disc
cupping.
MCQ 5 – Retinoblastoma:
A white pupillary reflex (leukocoria) in children raises concern for retinoblastoma, a life-
threatening intraocular malignancy.
Chapter 14: Ear, Nose & Throat (ENT)
MCQs
MCQ 1
A 4-year-old child presents with fever, ear pain, and pulling at the ear. Otoscopy shows a red,
bulging tympanic membrane with decreased mobility. What is the most likely diagnosis?
A. Otitis externa
B. Acute otitis media
C. Serous otitis media
D. Mastoiditis
E. Foreign body in the ear
MCQ 2
A 35-year-old man presents with hoarseness lasting more than 4 weeks. He is a smoker and has
no signs of infection. What is the most appropriate next step?
A. Laryngoscopy
B. Chest X-ray
C. Voice rest
D. Empirical antibiotics
E. Nasal endoscopy
MCQ 3
A 6-year-old child presents with night snoring, mouth breathing, and poor school performance.
Exam shows enlarged tonsils. What is the most likely cause?
A. Viral pharyngitis
B. Acute tonsillitis
C. Obstructive sleep apnea
D. Nasal polyps
E. Asthma
MCQ 4
A diver experiences sudden ear pain and hearing loss during ascent. Otoscopy reveals a visible
perforation in the tympanic membrane. What is the most likely diagnosis?
A. Otitis media with effusion
B. Eustachian tube dysfunction
C. Tympanic membrane rupture
D. Cholesteatoma
E. Labyrinthitis
MCQ 5
A 40-year-old woman complains of recurrent episodes of vertigo, tinnitus, and hearing loss.
What is the most likely diagnosis?
A. Vestibular neuritis
B. Ménière’s disease
C. Acoustic neuroma
D. Benign positional vertigo
E. Otosclerosis
Answer Key
• MCQ 1: B
• MCQ 2: A
• MCQ 3: C
• MCQ 4: C
• MCQ 5: B
Explanations
MCQ 1 – Acute Otitis Media:
Common in children, especially after URTIs. Presents with ear pain, fever, and red, bulging
tympanic membrane.
MCQ 2 – Persistent Hoarseness in Smokers:
Any hoarseness lasting >3 weeks, especially in smokers, requires direct laryngoscopy to rule
out laryngeal carcinoma.
MCQ 3 – Obstructive Sleep Apnea (OSA):
In children, enlarged tonsils/adenoids are the most common cause of OSA, leading to snoring
and poor school performance.
MCQ 4 – Tympanic Membrane Rupture:
Rapid pressure change (like in diving) can rupture the TM. Presents with sudden pain, hearing
loss, and visible perforation.
MCQ 5 – Ménière’s Disease:
Triad of episodic vertigo, sensorineural hearing loss, and tinnitus due to endolymphatic
hydrops.
Chapter 15: Musculoskeletal / Orthopedics
MCQs
MCQ 1
A 65-year-old woman presents with hip pain after a fall. Her leg appears shortened and
externally rotated. What is the most likely diagnosis?
A. Posterior hip dislocation
B. Femoral shaft fracture
C. Intertrochanteric fracture
D. Pelvic fracture
E. Acetabular fracture
MCQ 2
A 25-year-old athlete presents with knee pain and instability after a twisting injury. He reports
hearing a "pop" and cannot bear weight. What is the most likely injury?
A. Medial meniscus tear
B. Patellar dislocation
C. ACL tear
D. Lateral collateral ligament tear
E. PCL tear
MCQ 3
A 10-year-old boy presents with a painful swollen knee and a fever. He refuses to walk. What is
the most appropriate initial investigation?
A. Knee X-ray
B. Blood culture
C. Joint aspiration
D. Ultrasound
E. MRI knee
MCQ 4
A 55-year-old woman presents with morning stiffness in both hands lasting over 1 hour. She has
swelling in the MCP and PIP joints. What is the most likely diagnosis?
A. Osteoarthritis
B. Gout
C. Rheumatoid arthritis
D. Psoriatic arthritis
E. Systemic lupus erythematosus
MCQ 5
A 40-year-old man presents with acute pain, redness, and swelling of the first
metatarsophalangeal joint. What is the most likely diagnosis?
A. Septic arthritis
B. Gout
C. Osteoarthritis
D. Pseudogout
E. Rheumatoid arthritis
Answer Key
• MCQ 1: C
• MCQ 2: C
• MCQ 3: C
• MCQ 4: C
• MCQ 5: B
Explanations
MCQ 1 – Intertrochanteric Fracture:
A fall in an elderly woman with a shortened, externally rotated leg is classic for
intertrochanteric femoral fracture. Common with osteoporosis.
MCQ 2 – ACL Tear:
A "pop" sound, instability, and inability to bear weight suggest ACL rupture, especially in
athletes after pivoting injuries.
MCQ 3 – Joint Aspiration:
In a febrile child with a swollen, painful joint, septic arthritis must be ruled out via joint
aspiration before imaging or antibiotics.
MCQ 4 – Rheumatoid Arthritis:
Characterized by morning stiffness >1 hour and symmetrical small joint involvement,
especially MCPs and PIPs.
MCQ 5 – Gout:
Sudden onset pain, swelling, and redness in the big toe (podagra) is classic for gout, caused by
urate crystal deposition.
Chapter 16: Geriatrics
MCQs
MCQ 1
An 82-year-old woman is brought in by her family for confusion and new-onset urinary
incontinence. Her temperature is 37.4°C. What is the most likely cause?
A. Alzheimer’s disease
B. Vascular dementia
C. Delirium secondary to UTI
D. Stroke
E. Depression
MCQ 2
A 76-year-old man presents with a 1-month history of low mood, fatigue, and lack of interest in
daily activities. What is the most appropriate next step?
A. Wait and observe
B. Start cognitive screening
C. Refer to psychiatry
D. Trial of antidepressants
E. Family counseling only
MCQ 3
A 78-year-old woman has been falling frequently. Her medications include metformin, aspirin,
diazepam, and amlodipine. Which medication most likely increases her fall risk?
A. Metformin
B. Aspirin
C. Diazepam
D. Amlodipine
E. None of the above
MCQ 4
A 75-year-old man has mild memory loss but is independent in daily activities. His cognitive
testing shows slight deficits. What is the most likely diagnosis?
A. Alzheimer’s disease
B. Normal aging
C. Mild cognitive impairment
D. Vascular dementia
E. Lewy body dementia
MCQ 5
Which of the following is most associated with functional decline during hospitalization in
elderly patients?
A. Length of stay
B. Polypharmacy
C. Hypotension
D. Low BMI
E. Depression
Answer Key
• MCQ 1: C
• MCQ 2: D
• MCQ 3: C
• MCQ 4: C
• MCQ 5: B
Explanations
MCQ 1 – Delirium from UTI:
UTIs in the elderly often present with delirium, confusion, and incontinence, even without
fever. Always consider infection in acute cognitive changes.
MCQ 2 – Antidepressant Trial:
Late-onset depression is common and treatable. Empiric antidepressants are appropriate in a
patient without urgent suicidal ideation or psychosis.
MCQ 3 – Diazepam (Benzodiazepines):
Increased fall risk due to sedation and impaired balance. Avoid in older adults unless
absolutely necessary.
MCQ 4 – Mild Cognitive Impairment (MCI):
Defined by mild memory/cognitive decline without functional impairment. It’s a risk factor
for dementia but not dementia itself.
MCQ 5 – Polypharmacy:
Taking 5+ medications increases risk of falls, adverse effects, hospital complications, and
functional loss in the elderly.
Chapter 17: Communication & Medical Law
MCQs
MCQ 1
A competent adult refuses a recommended life-saving surgery. What should the physician do?
A. Persuade the patient’s family to convince them
B. Proceed with surgery in the patient’s best interest
C. Respect the patient's autonomy and decision
D. Delay the procedure until a psychiatrist evaluates
E. Ask the hospital legal team to override the refusal
MCQ 2
A 16-year-old girl asks for contraception and does not want her parents informed. She
demonstrates full understanding. What is the most appropriate response?
A. Deny request due to age
B. Require parental consent
C. Respect her confidentiality
D. Inform the parents
E. Refer to legal services
MCQ 3
A physician accidentally administers the wrong medication, but no harm occurs. What is the
most ethical next step?
A. Wait to see if the patient reacts
B. Tell the nurse only
C. Document it quietly
D. Inform the patient and disclose the error
E. Say nothing since there was no harm
MCQ 4
Which of the following best defines the principle of non-maleficence?
A. Do good for the patient
B. Treat all patients fairly
C. Avoid doing harm
D. Honor patient choices
E. Keep patient information private
MCQ 5
While discussing a cancer diagnosis, the patient becomes silent and tearful. What should the
physician do?
A. Fill the silence by talking
B. Offer clinical information
C. Change the topic
D. Pause and allow the patient to process
E. End the conversation
Answer Key
• MCQ 1: C
• MCQ 2: C
• MCQ 3: D
• MCQ 4: C
• MCQ 5: D
Explanations
MCQ 1 – Autonomy:
Patients have the legal and ethical right to refuse treatment, even if it results in harm.
Respecting autonomy is essential.
MCQ 2 – Confidentiality in Mature Minors:
If a minor is judged competent (understanding risks and benefits), confidential care (like
contraception) may be provided ethically and legally.
MCQ 3 – Error Disclosure:
Physicians have an ethical duty to disclose medical errors, even without harm, to maintain
trust and transparency.
MCQ 4 – Non-maleficence:
This principle means “do no harm” — avoid actions that cause unnecessary injury or suffering.
MCQ 5 – Silence and Emotional Processing:
In emotionally charged conversations, respectful silence allows the patient to process. Listening
is often more powerful than speaking.