UKMLA Applied Knowledge Test (MSRA-style single best answer) · Acute and Perioperative Care

Acute and emergency care

32 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 32 questions

  1. A man develops facial swelling, wheeze and hypotension minutes after a wasp sting. What is the most appropriate immediate drug treatment in the UK?
  2. During cardiac arrest in a monitored ward bed the rhythm is ventricular fibrillation, and three shocks have been delivered. Which drugs are given at this point in the Resuscitation Council UK adult al…
  3. What are the recommended rate and depth of chest compressions for an adult in cardiac arrest, according to Resuscitation Council UK?
  4. A patient in pulseless electrical activity after a road collision has distended neck veins, absent breath sounds on the left and a deviated trachea. Which treatment addresses the most likely reversibl…
  5. Which combination best describes the components of the Sepsis Six bundle that should be completed within the first hour?
  6. A woman with type 1 diabetes presents with ketoacidosis. Her admission potassium is 2.8 mmol/L. What is the most appropriate approach to insulin and potassium?
  7. A man with renal failure has peaked T waves and a widened QRS complex with a potassium of 7.4 mmol/L. What is the first treatment?
  8. A man is found unresponsive with a respiratory rate of 6 per minute and pinpoint pupils. Which drug is the most appropriate antidote?
  9. Why does acetylcysteine protect the liver in paracetamol overdose?
  10. A trauma patient has severe respiratory distress, hypotension and hyperresonance of one hemithorax. Which action is correct?
  11. A man with known alcohol-related cirrhosis vomits fresh blood and is hypotensive. Alongside resuscitation, which combination is the most appropriate while arranging endoscopy?
  12. A young adult has a tonic-clonic seizure that has lasted more than five minutes in a hospital emergency department. Which is the first-line drug?
  13. An unconscious man with type 1 diabetes has a capillary glucose of 1.8 mmol/L and a working intravenous cannula. What should be given?
  14. Which finding in a patient with acute asthma indicates life-threatening disease according to the BTS/NICE/SIGN-based classification?
  15. A man is brought in after a motorbike crash with major bleeding. Within what time of injury should tranexamic acid ideally be given?
  16. What is the recommended first-aid cooling for a thermal burn?
  17. A patient with a head injury has a Glasgow Coma Scale of 7 and is not protecting their airway. What is the priority?
  18. A febrile 3-year-old has stridor, drooling and refuses to lie flat. What is the most appropriate action?
  19. A haemodynamically stable patient has a regular narrow-complex tachycardia at 180 per minute. What is the first step?
  20. A man with acute pulmonary oedema is hypoxic and distressed with a systolic blood pressure of 150 mmHg. Which is the most appropriate treatment?
  21. A patient with chest trauma has hypotension, muffled heart sounds and distended neck veins. What is this triad called and what is the diagnosis?
  22. A woman on long-term prednisolone presents vomiting, hypotensive and drowsy after missing doses with an intercurrent illness. What is the most appropriate treatment?
  23. In the NEWS2 chart, which single finding scores 3 points on its own?
  24. In major trauma, which problem is dealt with before airway management in the updated ATLS and UK approach?
  25. A man collapses at home and is found with a cherry-pink complexion and headache next to a faulty gas boiler. His pulse oximeter reads 99 percent on air. What is the correct interpretation and treatmen…
  26. A woman who took a large aspirin overdose has tinnitus, rapid breathing and a pH of 7.50 with a low bicarbonate. Which statement describes the acid-base disturbance and a treatment principle?
  27. A man with chronic alcohol dependence is admitted with confusion, ataxia and ophthalmoplegia. What should be given before any glucose infusion?
  28. A man with atrial fibrillation presents with a cold, pale, painful, pulseless left leg of 3 hours' duration. What is the most appropriate immediate management?
  29. A patient develops hypotension and bradycardia with warm peripheries soon after a cervical spinal cord injury. What is the most likely diagnosis?
  30. A man is found after a long lie with dark urine, a creatine kinase of 40 000 U/L and a potassium of 6.8 mmol/L. What is the most important initial treatment?
  31. An older man with type 2 diabetes is drowsy with a glucose of 52 mmol/L, serum osmolality of 360 mOsm/kg and no significant ketones. Which approach to initial treatment is recommended?
  32. A patient with alcohol dependence is admitted and is expected to develop withdrawal. Which drug class is used in a reducing regimen?

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