Blueprint-Aligned • Updated 2026

25 Free EMREE Practice Questions With Answers & Explanations

Test yourself with 25 clinical MCQs designed around the current official EMREE blueprint.

This free mini-mock includes questions from all seven official EMREE disciplines and uses a mixture of straightforward, moderately difficult and challenging clinical decisions.

Answer each question before reading the explanation. For a realistic pace, aim for approximately 90 seconds per question.

25Clinical MCQs
7Official disciplines
37.5 minSuggested time
40/40/20Difficulty model

How This Free EMREE Mini-Mock Is Distributed

Discipline Official Blueprint Questions in This Set
Internal Medicine20%5
Obstetrics & Gynaecology15%4
Paediatrics15%4
Surgery15%4
Family Medicine15%3
Psychiatry10%3
Public Health / Preventive Medicine10%2
Difficulty mix: approximately 10 straightforward questions, 10 moderately difficult questions and 5 difficult clinical questions.

Free EMREE Practice Questions

Internal Medicine Moderate

Question 1

A 68-year-old man with chronic kidney disease presents with generalized weakness. ECG shows tall peaked T waves and widening of the QRS complex. Serum potassium is 7.1 mmol/L.

What is the most appropriate immediate treatment?

  1. IV calcium gluconate
  2. IV insulin alone
  3. Oral sodium polystyrene sulfonate
  4. IV furosemide
  5. Restrict dietary potassium
Correct answer: A. IV calcium gluconate
Hyperkalaemia with significant ECG changes requires immediate cardiac membrane stabilization with intravenous calcium. Insulin with glucose should follow to shift potassium intracellularly, while definitive potassium removal is addressed subsequently.
Internal Medicine Easy

Question 2

A 72-year-old man develops sudden right-sided weakness and aphasia 75 minutes ago. Non-contrast CT of the brain shows no haemorrhage. Blood glucose is normal and no contraindication to thrombolysis is found.

What is the most appropriate next treatment?

  1. IV thrombolytic therapy
  2. Immediate lumbar puncture
  3. IV unfractionated heparin for all patients
  4. Observe for 24 hours before treatment
  5. Start warfarin immediately
Correct answer: A. IV thrombolytic therapy
An eligible patient with acute ischaemic stroke presenting within the reperfusion window and without intracranial haemorrhage should receive appropriate reperfusion therapy without unnecessary delay.
Internal Medicine Moderate

Question 3

A 59-year-old man with cirrhosis and ascites presents with fever, abdominal discomfort and confusion. Diagnostic paracentesis shows an ascitic neutrophil count of 620 cells/mm³.

What is the most appropriate management?

  1. Start a third-generation cephalosporin
  2. Wait for ascitic fluid culture before treatment
  3. Start oral metronidazole only
  4. Perform emergency laparotomy
  5. Increase the dose of diuretics
Correct answer: A. Start a third-generation cephalosporin
An ascitic polymorphonuclear leukocyte count ≥250 cells/mm³ in a patient with cirrhosis supports spontaneous bacterial peritonitis. Empiric antibiotics should be started promptly rather than waiting for culture.
Internal Medicine Difficult

Question 4

A 24-year-old woman with type 1 diabetes presents with vomiting, abdominal pain and deep respirations. Glucose is 430 mg/dL, bicarbonate 11 mmol/L and serum potassium 3.0 mmol/L.

What should be done before starting insulin infusion?

  1. Begin potassium replacement
  2. Give IV sodium bicarbonate immediately
  3. Administer long-acting subcutaneous insulin
  4. Restrict intravenous fluids
  5. Give IV calcium gluconate
Correct answer: A. Begin potassium replacement
Insulin drives potassium into cells and can precipitate dangerous hypokalaemia. When potassium is significantly low in DKA, potassium replacement should precede insulin until the potassium is safely corrected.
Internal Medicine Difficult

Question 5

A 40-year-old woman with autoimmune adrenal insufficiency presents with vomiting, severe weakness and confusion after a gastrointestinal illness. BP is 78/46 mmHg. Sodium is 126 mmol/L, potassium 5.8 mmol/L and glucose 55 mg/dL.

What is the most appropriate immediate management?

  1. IV hydrocortisone and rapid isotonic saline
  2. Oral fludrocortisone only
  3. Fluid restriction
  4. IV insulin infusion without glucose
  5. Wait for a serum cortisol result before treatment
Correct answer: A. IV hydrocortisone and rapid isotonic saline
This is an adrenal crisis with shock, hyponatraemia, hyperkalaemia and hypoglycaemia. Treatment must not wait for confirmatory testing. Immediate glucocorticoid replacement and aggressive fluid resuscitation are required.
OBGYN Moderate

Question 6

A 29-year-old woman at 8 weeks' gestation presents with severe lower abdominal pain and vaginal bleeding. BP is 82/48 mmHg and pulse is 124/min. Ultrasound shows an empty uterus and free intraperitoneal fluid.

What is the most appropriate next step?

  1. Urgent operative management
  2. Repeat β-hCG after 48 hours
  3. Methotrexate and outpatient follow-up
  4. Expectant management
  5. Repeat ultrasound in one week
Correct answer: A. Urgent operative management
Haemodynamic instability with suspected ruptured ectopic pregnancy requires urgent resuscitation and operative management. Methotrexate is inappropriate in an unstable patient.
OBGYN Moderate

Question 7

A woman at 35 weeks' gestation presents with BP 172/114 mmHg, severe headache, visual disturbance and proteinuria. Fetal monitoring is reassuring.

What is the most appropriate management strategy?

  1. Stabilize, give magnesium sulfate and proceed toward delivery
  2. Discharge with oral antihypertensive therapy
  3. Observe until 40 weeks if fetal monitoring remains normal
  4. Give magnesium sulfate only after delivery
  5. Perform amniocentesis before deciding management
Correct answer: A. Stabilize, give magnesium sulfate and proceed toward delivery
Severe pre-eclampsia with neurological symptoms requires maternal stabilization, seizure prophylaxis and definitive obstetric management. Continuing the pregnancy without a compelling reason exposes the mother to substantial risk.
OBGYN Easy

Question 8

Ten minutes after vaginal delivery, a woman develops heavy vaginal bleeding. The uterus is enlarged and boggy. The placenta appears complete.

What is the most appropriate initial treatment?

  1. Uterine massage and oxytocin
  2. Immediate hysterectomy
  3. Methotrexate
  4. Magnesium sulfate
  5. Expectant observation
Correct answer: A. Uterine massage and oxytocin
A boggy enlarged uterus after delivery strongly suggests uterine atony, the most common cause of postpartum haemorrhage. Immediate uterine massage and uterotonic therapy are first-line measures while resuscitation proceeds.
OBGYN Difficult

Question 9

A 62-year-old woman presents with a single episode of postmenopausal vaginal bleeding. She has no pelvic pain and is haemodynamically stable.

Which investigation is appropriate for initial endometrial assessment?

  1. Transvaginal ultrasonography
  2. CT abdomen and pelvis
  3. Serum CA-125 only
  4. Pap smear only
  5. Diagnostic laparoscopy
Correct answer: A. Transvaginal ultrasonography
Postmenopausal bleeding requires evaluation for endometrial pathology. Transvaginal ultrasonography is an accepted initial approach to assess endometrial thickness, with endometrial sampling indicated according to findings and clinical risk.
Paediatrics Easy

Question 10

An 18-month-old boy has a generalized tonic-clonic seizure lasting 3 minutes during a febrile illness. He rapidly returns to baseline. Neurological examination is normal and this is his first seizure.

What is the most appropriate management?

  1. Reassure the parents and treat the underlying fever source appropriately
  2. Start long-term sodium valproate
  3. Arrange urgent brain MRI in every case
  4. Start phenobarbital prophylaxis
  5. Perform lumbar puncture routinely regardless of clinical findings
Correct answer: A. Reassure the parents and treat the underlying fever source appropriately
This is a simple febrile seizure: generalized, brief, single and followed by complete recovery. Long-term antiepileptic treatment is not routinely indicated.
Paediatrics Moderate

Question 11

A 4-year-old boy has fever for 6 days, bilateral non-purulent conjunctivitis, strawberry tongue, cervical lymphadenopathy, erythematous palms and a polymorphous rash.

Which treatment reduces the risk of his most important complication?

  1. IV immunoglobulin with aspirin
  2. Oral amoxicillin
  3. IV acyclovir
  4. Inhaled corticosteroids
  5. Oral antihistamine alone
Correct answer: A. IV immunoglobulin with aspirin
Kawasaki disease can cause coronary artery aneurysms. Prompt IVIG therapy, together with aspirin according to the treatment phase, reduces coronary complications.
Paediatrics Easy

Question 12

A 7-month-old infant presents with rhinorrhoea, cough, wheezing and mild subcostal recession. Oxygen saturation is 95% on room air. The infant is feeding adequately.

What is the most appropriate management?

  1. Supportive care
  2. Routine antibiotics
  3. Routine systemic corticosteroids
  4. Immediate intubation
  5. Daily oral salbutamol for one month
Correct answer: A. Supportive care
Typical mild bronchiolitis is managed primarily with supportive measures, including attention to hydration, feeding and oxygenation when required. Antibiotics do not treat the usual viral cause.
Paediatrics Difficult

Question 13

A 5-week-old infant has progressive projectile non-bilious vomiting. He is dehydrated. Laboratory tests show sodium 133 mmol/L, potassium 3.0 mmol/L, chloride 86 mmol/L and bicarbonate 34 mmol/L. Ultrasound confirms hypertrophic pyloric stenosis.

What should occur before pyloromyotomy?

  1. Correct dehydration and electrolyte abnormalities
  2. Proceed immediately to surgery without resuscitation
  3. Administer sodium bicarbonate
  4. Start broad-spectrum antibiotics for one week
  5. Begin oral feeding to correct the alkalosis
Correct answer: A. Correct dehydration and electrolyte abnormalities
Pyloric stenosis classically causes hypochloraemic, hypokalaemic metabolic alkalosis. The condition is surgically corrected, but dehydration and electrolyte derangements must first be stabilized.
Surgery Easy

Question 14

After a road traffic collision, a 30-year-old man develops severe dyspnoea, hypotension and distended neck veins. Breath sounds are absent on the right and the trachea is displaced to the left.

What is the most appropriate immediate action?

  1. Immediate thoracic decompression
  2. Wait for chest X-ray confirmation
  3. CT chest
  4. IV furosemide
  5. Diagnostic bronchoscopy
Correct answer: A. Immediate thoracic decompression
This is a tension pneumothorax causing obstructive shock. It is a clinical diagnosis requiring immediate decompression; imaging must not delay life-saving treatment.
Surgery Moderate

Question 15

A 64-year-old man with previous abdominal surgery presents with vomiting, abdominal distension and colicky pain. Several hours later the pain becomes constant, temperature rises to 38.8°C and examination reveals guarding and rebound tenderness.

What is the most appropriate next step?

  1. Urgent surgical evaluation for possible strangulated obstruction
  2. Discharge with laxatives
  3. Routine outpatient colonoscopy
  4. Continue observation for 48 hours without reassessment
  5. Start an oral high-fibre diet
Correct answer: A. Urgent surgical evaluation for possible strangulated obstruction
Constant pain, fever and peritoneal signs in bowel obstruction suggest ischaemia or strangulation. This requires urgent surgical management rather than routine conservative treatment.
Surgery Difficult

Question 16

A 70-year-old man presents with fever, jaundice and right upper quadrant pain. He becomes hypotensive and confused. Ultrasound shows a dilated common bile duct with stones.

After initial resuscitation and antibiotics, what is the most important definitive next step?

  1. Urgent biliary decompression, usually by ERCP
  2. Elective cholecystectomy in six months without decompression
  3. Oral ursodeoxycholic acid
  4. Observation until bilirubin normalizes
  5. Diagnostic colonoscopy
Correct answer: A. Urgent biliary decompression, usually by ERCP
Fever, jaundice, RUQ pain, hypotension and confusion indicate severe acute cholangitis. Source control through urgent biliary drainage is essential after stabilization and antimicrobial therapy.
Surgery Easy

Question 17

A 17-year-old boy develops sudden severe unilateral testicular pain with nausea. The affected testis is high-riding and the cremasteric reflex is absent.

What is the most appropriate management?

  1. Immediate surgical exploration
  2. Oral antibiotics and review in one week
  3. Wait for tumour markers
  4. Bed rest and scrotal support only
  5. Schedule elective surgery next month
Correct answer: A. Immediate surgical exploration
The presentation is highly suggestive of testicular torsion. Testicular viability is time-dependent, so definitive treatment must not be delayed when clinical suspicion is high.
Family Medicine Easy

Question 18

A 46-year-old man who smokes 20 cigarettes daily says he wants to quit. Previous unassisted attempts failed. He has no contraindication to smoking-cessation medication.

Which approach is most likely to improve his chance of successful cessation?

  1. Behavioural support combined with appropriate pharmacotherapy
  2. Tell him to reduce smoking gradually without follow-up
  3. Wait until he develops smoking-related symptoms
  4. Recommend switching permanently to cigars
  5. Avoid discussing smoking because it may damage rapport
Correct answer: A. Behavioural support combined with appropriate pharmacotherapy
Combining structured behavioural support with evidence-based pharmacotherapy generally improves smoking-cessation success compared with unsupported attempts.
Family Medicine Moderate

Question 19

A 78-year-old woman reports two falls in the last month. Her medications include metformin, atorvastatin, paracetamol and diazepam taken nightly for several years. Examination reveals no focal neurological deficit.

Which medication deserves particular review as a potentially modifiable contributor to her falls?

  1. Diazepam
  2. Metformin
  3. Atorvastatin
  4. Paracetamol
  5. Topical moisturizer
Correct answer: A. Diazepam
Long-acting benzodiazepines can cause sedation, impaired balance and cognitive effects in older adults, increasing fall risk. Medication review and cautious deprescribing may be appropriate.
Family Medicine Moderate

Question 20

A 56-year-old man with type 2 diabetes has persistent hypertension and increased urinary albumin excretion. Serum potassium and renal function permit renin-angiotensin system blockade.

Which antihypertensive class is particularly appropriate?

  1. ACE inhibitor or angiotensin receptor blocker
  2. Short-acting nitrate
  3. Alpha blocker as mandatory first-line therapy
  4. Loop diuretic regardless of volume status
  5. Digoxin
Correct answer: A. ACE inhibitor or angiotensin receptor blocker
In a patient with diabetes, hypertension and albuminuria, renin-angiotensin system blockade is particularly useful when not contraindicated because of its blood-pressure and renal protective effects.
Psychiatry Easy

Question 21

A 32-year-old man with major depression tells you that he intends to kill himself tonight. He has purchased a firearm and says his family will be better off without him.

What is the most appropriate immediate action?

  1. Ensure immediate safety and arrange urgent psychiatric assessment
  2. Ask him to promise not to harm himself and send him home
  3. Book routine follow-up in one month
  4. Give a sleeping tablet and discharge him
  5. Maintain confidentiality even if doing so prevents necessary protection
Correct answer: A. Ensure immediate safety and arrange urgent psychiatric assessment
A specific plan, available means and expressed intent indicate high immediate suicide risk. Safety takes priority, with urgent psychiatric assessment and appropriate protective intervention.
Psychiatry Moderate

Question 22

A 29-year-old woman has had 10 days of decreased need for sleep, pressured speech, grandiosity, excessive spending and increasingly disruptive behaviour. She has no substance use.

Which diagnosis is most likely?

  1. Manic episode
  2. Generalized anxiety disorder
  3. Persistent depressive disorder
  4. Obsessive-compulsive disorder
  5. Adjustment disorder
Correct answer: A. Manic episode
Decreased need for sleep, pressured speech, grandiosity and high-risk activity with marked functional disturbance are characteristic of mania.
Psychiatry Difficult

Question 23

A patient taking sertraline develops agitation, diaphoresis and diarrhoea shortly after another serotonergic medication is added. Temperature is 39°C. Examination shows hyperreflexia and inducible ankle clonus.

What is the most likely diagnosis?

  1. Serotonin syndrome
  2. Neuroleptic malignant syndrome
  3. Malignant hyperthermia
  4. Anticholinergic toxicity
  5. Alcohol withdrawal only
Correct answer: A. Serotonin syndrome
Rapid onset after serotonergic drug exposure, autonomic instability, gastrointestinal symptoms, hyperreflexia and clonus strongly favour serotonin syndrome. Neuroleptic malignant syndrome more typically features lead-pipe rigidity and evolves after dopamine antagonist exposure.
Public Health Moderate

Question 24

Investigators study a rare disease by selecting 200 patients with the disease and 200 controls without it. They then determine each participant's previous exposure to a suspected risk factor.

Which measure of association is most appropriate?

  1. Odds ratio
  2. Relative risk calculated directly from incidence
  3. Prevalence ratio only
  4. Number needed to treat
  5. Hazard ratio from survival time
Correct answer: A. Odds ratio
This is a case-control study because participants are selected according to disease status and prior exposure is assessed retrospectively. The standard measure of association is the odds ratio.
Public Health Easy

Question 25

A screening test is intended primarily to minimize the number of people with disease who are incorrectly classified as disease-free.

Which test characteristic is most important?

  1. High sensitivity
  2. High specificity only
  3. Low negative predictive value
  4. Low reproducibility
  5. Low likelihood ratio for a positive result
Correct answer: A. High sensitivity
A highly sensitive test identifies most people who truly have the disease and therefore minimizes false-negative results, an important property for many screening tests.

How to Score Your Free EMREE Mini-Mock

This 25-question set is a learning exercise rather than an official EMREE score conversion.

Use your result mainly to identify patterns:

  • Which disciplines produced the most errors?
  • Were your errors knowledge gaps or reasoning errors?
  • Did you choose the correct diagnosis but the wrong next step?
  • Did you miss instability or an emergency priority?
  • Did time pressure affect your decisions?
Do not convert your 25-question score into an unofficial EMREE percentile or residency ranking. The real EMREE result is processed and reported by NIHS/UAEU.

Use an EMREE Error Log

For every incorrect answer, classify the reason:

  • Knowledge gap — you did not know the concept.
  • Diagnostic error — you misidentified the condition.
  • Investigation error — you chose the wrong test.
  • Priority error — you chose a later step instead of the immediate one.
  • Treatment error — you chose the wrong therapy.
  • Safety error — you missed instability or a contraindication.
  • Interpretation error — you overlooked a key clue.
Your goal is not simply to complete more MCQs. Your goal is to stop repeating the same type of error.

What to Do Next

Twenty-five questions are useful for identifying weaknesses, but they cannot represent the full breadth of a 120-question residency entrance examination.

Your next preparation stage should include larger blueprint-based question blocks, mixed-specialty practice and timed mock examinations.

Continue Your EMREE Preparation

Understand the official blueprint, practise clinical reasoning and then test yourself under realistic time pressure.

Start Free EMREE Sampler Explore EMREE MCQ Bank Official EMREE Blueprint Complete EMREE Guide

Official Sources

NIHS/UAEU — Official EMREE Blueprint, November 2025
Defines the current discipline distribution, difficulty distribution, competencies and examination content outline.
View the official EMREE Blueprint

NIHS/UAEU — EMREE Exam Structure
Official information on question format, usual 120-question examination, three-hour duration and clinical application focus.
View official EMREE exam structure

Important: Examination specifications and clinical guidance can change. Candidates should verify current official NIHS/UAEU information and current clinical guidelines when preparing for EMREE.

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