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 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?

IV paracetamol

IV insulin

Oxygen therapy only

IV fluids and IV antibiotics

IV hydrocortisone

2 / 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 phenytoin

IV propofol

IV phenobarbital

IV valproate

3 / 38

What is a classic symptom of ketoacidosis that affects breathing?

Hyperventilation

Cheyne-Stokes respiration

Bradypnea

Apnea

Kussmaul respiration

4 / 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?

Oral warfarin

CT pulmonary angiography

Oxygen therapy only

IV thrombolysis

IV heparin

5 / 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?

ECG

CT aortogram

Troponin

Echocardiography

CXR

6 / 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 mannitol

IV fluids only

Cervical spine X-ray

Immediate intubation and CT head

IV steroids

8 / 38

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

Peaked T waves

ST elevation

Scooped ST depression

QT prolongation

Wide QRS

9 / 38

10 / 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 corticosteroids

Ice water immersion

IV fluids

IV paracetamol

Oxygen therapy

11 / 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

Chest X-ray

Urgent CT chest

Insertion of a chest drain in the 5th intercostal space

12 / 38

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

What is the likely diagnosis?

Raised ICP

Stroke

Hypoglycemia

Hyperkalemia

Spinal cord injury

13 / 38

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

What is the next step?

Endoscopy

CT scan

Contrast esophagogram

ECG

Chest X-ray

14 / 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?

Pericardiocentesis

Chest X-ray

IV fluids

CT chest

ECG

15 / 38

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

Excessive exercise

Chronic stress

Dietary changes

Infection

Overhydration

16 / 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?

IV salbutamol

IV hydrocortisone

IV fluids only

IV chlorphenamine

IM adrenaline

17 / 38

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

What is the most appropriate antidote?

Atropine

Naloxone

Flumazenil

IV glucose

Sodium bicarbonate

18 / 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 insulin

Oral glucose

IM glucagon

IV fluids

IV 50% dextrose

19 / 38

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

What is the most appropriate treatment?

IV fluids only

Oral antihistamines

IV hydrocortisone

IM adrenaline

IV chlorphenamine

20 / 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?

Start high-dose statin therapy

Immediate carotid endarterectomy

IV thrombolysis with alteplase

Aspirin 300 mg immediately

IV fluids and observation

21 / 38

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

What is the most urgent treatment?

IV dextrose + insulin

IV sodium bicarbonate

Salbutamol nebulization

Dialysis

IV calcium gluconate

22 / 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?

IV furosemide

Dialysis

IV fluids

Stop all medications

IV antibiotics

23 / 38

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

What is the next step?

CT angiography

Doppler ultrasound

IV heparin

Aspirin

IV fluids

24 / 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?

Aspirin and sublingual GTN

IV thrombolysis

Beta-blockers and atorvastatin

Primary PCI (percutaneous coronary intervention)

IV morphine and oxygen

25 / 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?

Aspirin only

IV morphine

IV heparin

IV thrombolysis

Primary PCI

26 / 38

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

What is the next step?

IV immunoglobulin

IV steroids

Lumbar puncture

MRI spine

CT head

27 / 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?

Chest X-ray

Oxygen therapy only

Immediate needle decompression

IV fluids

CT chest

28 / 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 aminophylline

IV hydrocortisone

Nebulized salbutamol and ipratropium

IV magnesium sulfate

29 / 38

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

What is the most appropriate management?

ERCP

IV fluids only

NSAIDs

IV antibiotics and laparoscopic cholecystectomy

Oral antibiotics

30 / 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

IV furosemide

IV bisphosphonates

IV fluids

Dialysis

31 / 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?

Lumbar puncture immediately

IV ceftriaxone and dexamethasone

IV acyclovir

Observation and blood cultures

Oral antibiotics

32 / 38

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

Confusion

Fruity breath odor

Kussmaul breathing

Abdominal pain

Hypoglycemia

33 / 38

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

>10 mmol/L

>30 mmol/L

>15 mmol/L

>25 mmol/L

>20 mmol/L

34 / 38

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

What is the most appropriate investigation?

Lumbar puncture

CT head

Carotid Doppler

EEG

MRI brain

35 / 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?

High-flow oxygen

IV fluids

Intubation

IV antibiotics

Chest X-ray

36 / 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 insulin and IV fluids

Oral fluids and antiemetics

IV sodium bicarbonate

IV glucose

Subcutaneous insulin

37 / 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?

IV glucose and fluids

High-flow oxygen only

IV steroids and vasopressors

Oral antibiotics and discharge

IV fluids, IV antibiotics, and blood cultures

38 / 38

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

Hypoxia

Dehydration

Hyperglycemia

Electrolyte imbalance

Acidosis

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Emergency MCQs - Medicine

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