Emergency MCQs - Medicine

Prepare for the UKMLA with our high-yield Emergency MCQs, designed to test and enhance your clinical knowledge in acute and life-threatening conditions. This quiz covers essential topics such as sepsis, trauma, cardiac emergencies, anaphylaxis, toxicology, and more—all aligned with the UKMLA Content Map.

Each question presents real-life emergency scenarios, requiring rapid diagnosis and decision-making. Whether you’re a medical student, doctor, or UKMLA candidate, these MCQs will help you build confidence in managing critical situations effectively.

Test yourself now and sharpen your emergency medicine skills! 🚑⚡

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UKMLA Practice Tests

Emergency (Medicine)

1 / 38

A 25-year-old man with a history of asthma presents with sudden-onset dyspnea, tracheal deviation, and absent breath sounds on the right side.

What is the next step?

Immediate needle decompression

Oxygen therapy only

Chest X-ray

CT chest

IV fluids

2 / 38

A 70-year-old man with a history of lung cancer presents with hypotension, distended neck veins, and muffled heart sounds.

What is the most appropriate next step?

CT chest

Pericardiocentesis

Chest X-ray

IV fluids

ECG

3 / 38

A 75-year-old woman on digoxin presents with nausea, confusion, and yellow vision. What ECG finding is expected?

ST elevation

Peaked T waves

Wide QRS

Scooped ST depression

QT prolongation

4 / 38

A 60-year-old man presents with severe central chest pain radiating to his left arm. He is diaphoretic and nauseous. His ECG shows ST elevation in leads II, III, and aVF.

What is the most appropriate immediate treatment?

Beta-blockers and atorvastatin

Primary PCI (percutaneous coronary intervention)

IV morphine and oxygen

IV thrombolysis

Aspirin and sublingual GTN

5 / 38

A 28-year-old man is having a tonic-clonic seizure lasting 8 minutes.

What is the first-line drug for treatment?

IV lorazepam

IV valproate

IV phenobarbital

IV propofol

IV phenytoin

6 / 38

A 35-year-old runner collapses during a marathon. His temperature is 41.5°C, HR 130 bpm, and BP 85/50 mmHg.

What is the best initial management?

IV paracetamol

IV fluids

IV corticosteroids

Oxygen therapy

Ice water immersion

7 / 38

Which of the following is not typically a sign of diabetic ketoacidosis?

Kussmaul breathing

Hypoglycemia

Fruity breath odor

Abdominal pain

Confusion

8 / 38

A 55-year-old man with metastatic cancer presents with confusion, polyuria, and constipation. His calcium is 3.5 mmol/L.

What is the first-line treatment?

Oral steroids

Dialysis

IV furosemide

IV fluids

IV bisphosphonates

9 / 38

A 70-year-old man with a history of chronic kidney disease presents with fever, confusion, and hypotension. His BP is 85/50 mmHg, and his lactate is 5.1 mmol/L.

What is the most appropriate initial management?

High-flow oxygen only

IV glucose and fluids

IV fluids, IV antibiotics, and blood cultures

IV steroids and vasopressors

Oral antibiotics and discharge

10 / 38

A 25-year-old man is brought to the ED after a stab wound to the chest. He is hypotensive, has distended neck veins, and is in respiratory distress. Tracheal deviation is noted.

What is the immediate next step?

IV antibiotics

Needle decompression in the second intercostal space

Urgent CT chest

Chest X-ray

Insertion of a chest drain in the 5th intercostal space

11 / 38

A 65-year-old woman presents with sudden-onset cold, pulseless, and painful leg.

What is the next step?

IV heparin

IV fluids

Aspirin

Doppler ultrasound

CT angiography

12 / 38

A 35-year-old woman develops wheezing, hypotension, and facial swelling after eating peanuts.

What is the most appropriate treatment?

Oral antihistamines

IV hydrocortisone

IV fluids only

IV chlorphenamine

IM adrenaline

13 / 38

A 25-year-old woman presents with severe dyspnea and a silent chest. Her oxygen saturation is 88% on air.

What is the most appropriate initial treatment?

IV antibiotics

IV hydrocortisone

IV aminophylline

Nebulized salbutamol and ipratropium

IV magnesium sulfate

14 / 38

A 40-year-old man presents with progressive ascending weakness and areflexia.

What is the next step?

CT head

MRI spine

Lumbar puncture

IV immunoglobulin

IV steroids

15 / 38

What is the typical blood glucose level threshold for diagnosing diabetic ketoacidosis?

>10 mmol/L

>25 mmol/L

>15 mmol/L

>20 mmol/L

>30 mmol/L

16 / 38

A 30-year-old man presents with headache, dizziness, and confusion after being found in a house fire. His SpO₂ is 98% on air.

What is the next step?

Chest X-ray

IV fluids

Intubation

IV antibiotics

High-flow oxygen

17 / 38

A 50-year-old man presents with severe chest pain, vomiting, and subcutaneous emphysema after heavy alcohol intake.

What is the next step?

Chest X-ray

ECG

Endoscopy

CT scan

Contrast esophagogram

18 / 38

A patient with chronic kidney disease has a potassium level of 6.8 mmol/L.

What is the most urgent treatment?

IV calcium gluconate

Dialysis

Salbutamol nebulization

IV sodium bicarbonate

IV dextrose + insulin

19 / 38

A 30-year-old woman presents with sudden-onset difficulty breathing, wheezing, and swelling of her lips after eating peanuts. Her BP is 80/50 mmHg, and her oxygen saturation is 88% on room air.

What is the first-line treatment?

IM adrenaline

IV chlorphenamine

IV salbutamol

IV fluids only

IV hydrocortisone

20 / 38

A 70-year-old man with heart failure presents with vomiting, dehydration, and oliguria. His creatinine has risen from 90 to 250 µmol/L in 48 hours.

What is the next step?

Dialysis

IV furosemide

Stop all medications

IV antibiotics

IV fluids

21 / 38

A 30-year-old man presents with pinpoint pupils, respiratory depression, and unconsciousness.

What is the most appropriate antidote?

Naloxone

Atropine

Flumazenil

Sodium bicarbonate

IV glucose

22 / 38

Which condition must be corrected first in the treatment of diabetic ketoacidosis?

Electrolyte imbalance

Hypoxia

Dehydration

Hyperglycemia

Acidosis

23 / 38

A 50-year-old head injury patient has hypertension, bradycardia, and irregular breathing.

What is the likely diagnosis?

Spinal cord injury

Hypoglycemia

Hyperkalemia

Stroke

Raised ICP

24 / 38

Which of the following is a common precipitating factor for diabetic ketoacidosis?

Infection

Overhydration

Excessive exercise

Chronic stress

Dietary changes

26 / 38

27 / 38

A 45-year-old woman presents with RUQ pain, fever, and positive Murphy’s sign.

What is the most appropriate management?

Oral antibiotics

ERCP

IV fluids only

NSAIDs

IV antibiotics and laparoscopic cholecystectomy

28 / 38

A 40-year-old woman presents with sudden-onset dyspnea, pleuritic chest pain, and hemoptysis. Her pulse is 120 bpm, BP 90/60 mmHg, and O2 saturation 85%.

What is the most appropriate immediate treatment?

CT pulmonary angiography

IV heparin

Oral warfarin

Oxygen therapy only

IV thrombolysis

29 / 38

A 45-year-old woman presents with a sudden “thunderclap” headache and neck stiffness.

What is the most appropriate investigation?

MRI brain

CT head

EEG

Carotid Doppler

Lumbar puncture

30 / 38

What is a classic symptom of ketoacidosis that affects breathing?

Hyperventilation

Cheyne-Stokes respiration

Bradypnea

Apnea

Kussmaul respiration

31 / 38

A 72-year-old man presents with sudden-onset right-sided weakness and slurred speech. His symptoms started 2 hours ago. His BP is 160/90 mmHg. A CT head shows no hemorrhage.

What is the most appropriate next step?

IV fluids and observation

Start high-dose statin therapy

Aspirin 300 mg immediately

Immediate carotid endarterectomy

IV thrombolysis with alteplase

32 / 38

A 50-year-old man presents with crushing central chest pain and ST elevation in leads II, III, and aVF.

What is the most appropriate management?

IV heparin

Primary PCI

IV morphine

IV thrombolysis

Aspirin only

33 / 38

A 19-year-old college student presents with fever, neck stiffness, and photophobia. His BP is 100/70 mmHg, HR 110 bpm, and GCS 13/15.

What is the most appropriate initial step?

Oral antibiotics

Observation and blood cultures

Lumbar puncture immediately

IV ceftriaxone and dexamethasone

IV acyclovir

34 / 38

A 60-year-old man with diabetes presents with fever, confusion, and BP 80/50 mmHg. His lactate is 4.5 mmol/L.

What is the first-line treatment?

Oxygen therapy only

IV hydrocortisone

IV fluids and IV antibiotics

IV insulin

IV paracetamol

35 / 38

A 24-year-old man presents to the Emergency Department with nausea, vomiting, and confusion. He has type 1 diabetes. His vitals are:

Pulse rate: 110 bpm
BP: 92/60 mmHg
Respiratory rate: 28 breaths/min
Oxygen saturation: 97% on room air
Investigations:
Blood glucose: 29 mmol/L
Blood ketones: 5.8 mmol/L (<0.6)
Venous pH: 7.12 (7.35–7.45)

What is the most appropriate initial management?

IV sodium bicarbonate

IV insulin and IV fluids

Oral fluids and antiemetics

Subcutaneous insulin

IV glucose

36 / 38

A 50-year-old diabetic patient is found unconscious. His blood glucose is 2.3 mmol/L.

What is the most appropriate initial treatment?

IV fluids

Oral glucose

IV insulin

IV 50% dextrose

IM glucagon

37 / 38

A 55-year-old man with hypertension presents with tearing chest pain radiating to the back. His BP is 180/100 mmHg.

Which investigation is most appropriate?

Troponin

CXR

Echocardiography

ECG

CT aortogram

38 / 38

A 20-year-old man is involved in a motorcycle accident and has unequal pupils and GCS 7/15.

What is the next step?

IV fluids only

Immediate intubation and CT head

IV steroids

Cervical spine X-ray

IV mannitol

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Emergency MCQs - Medicine

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