A good Acute Medicine SCE question bank should match the official 13-category blueprint, explain why the best answer beats the close alternatives and let you practise full three-hour papers. The number of questions matters less than those three things. Below is a checklist for choosing a bank, a short guide to the options, and 10 free sample questions with answers so you can judge the style for yourself.
This guide is for the UK Specialty Certificate Examination in Acute Medicine. Before comparing banks, read our Acute Medicine SCE syllabus and blueprint guide so you can check coverage against the exam you are actually sitting.
Exam information checked on 31 October 2026.
What makes a good Acute Medicine SCE question bank?
The real exam is two papers of 100 best-of-five questions, each lasting three hours. Every question has one best answer and four plausible alternatives, so the hard part is usually telling apart two options that both look reasonable. A useful bank trains that judgement, not just recall.
| Feature | What to check |
|---|---|
| Blueprint coverage | Does it reach all 13 categories, including the “Other” group (allergy, dermatology, psychiatry, genetics, immunology, patient safety, public health)? |
| Explanations | Does each one say why the best answer wins and why each distractor loses, with UK guidance named? |
| Guideline currency | Are management answers based on current NICE, SIGN, BTS and Resuscitation Council UK guidance? |
| Images | Does it include ECGs, chest radiographs and other images, as acute medicine depends on them? |
| Timed mocks | Can you sit a full 100-question, three-hour paper weighted like the real blueprint? |
| Access period | Will access last until your sitting, and does it work on your phone between shifts? |
Try a few free questions in an area you know well before paying. If the explanation would not help you teach the point to a colleague, it will not help you with the next unfamiliar question either.
Which question banks are available?
Start with the official material. The Federation offers online sample questions as an online mock that you register for, with answers shown when you finish. The Society for Acute Medicine trainee hub links to it and to a guideline map for revision.
Commercial banks with an Acute Medicine SCE product include StudyPRN, which describes a question bank with explanations, a mock exam and a free trial; BMJ OnExamination; iatroX, which describes blueprint-mapped questions, timed papers and a limited free allowance; and License Medical, which describes a question bank with timed mocks and optional notes. These are the providers’ own descriptions, checked on 31 October 2026, not an independent rating. Our Acute Medicine SCE resources guide compares them with books and other material.
Revision Pro’s Acute Medicine SCE bank has 1,766 best-of-five questions across all 13 blueprint categories, 118 of them with images such as ECGs, chest radiographs, CT, blood films and clinical photographs. Its Mock Mode sets two 100-question papers of three hours each, weighted across the 13 categories. The samples below are taken from it.
10 free Acute Medicine SCE sample questions
These questions cover 10 different blueprint categories. Eight are of medium difficulty and two are hard. Give yourself about 108 seconds for each, the average time available in the real exam, then open the answer.
Question 1: Cardiovascular medicine (medium)
A 57-year-old woman presented to the emergency department 3 hours after the onset of central chest heaviness with sweating, which had come on at rest and lasted 35 minutes. She had type 2 diabetes mellitus and hypertension.
On examination, her pulse was 82 beats per minute and her blood pressure was 142/84 mmHg. Her oxygen saturation was 98% breathing air. Heart sounds were normal and the chest was clear.
Investigations:
| Test | Result | Reference |
|---|---|---|
| 12-lead ECG | sinus rhythm, no ST-segment deviation | |
| chest radiograph | normal | |
| serum high-sensitivity troponin I on arrival | 11 ng/L | (99th centile: women 16, men 34) |
| serum high-sensitivity troponin I 2 hours after the first sample | 27 ng/L | (99th centile: women 16, men 34) |
What is the most appropriate next step in management?
A. Discharge as myocardial infarction is excluded
B. Manage as non-ST-elevation myocardial infarction
C. Manage as unstable angina
D. Repeat troponin at 12 hours after onset
E. Request CT coronary angiography before discharge
Show answer
Answer: B. Manage as non-ST-elevation myocardial infarction. Her troponin rose from 11 to 27 ng/L within 2 hours, and the second value is above the 99th centile for women (16 ng/L). A rise with at least one value above the sex-specific 99th centile, plus ischaemic symptoms, meets the definition of myocardial infarction. Reading her results against the male threshold of 34 ng/L would wrongly suggest that infarction had been excluded.
Question 2: Respiratory medicine (medium)
A 27-year-old woman with asthma was brought to the emergency department with breathlessness that had worsened over 2 days despite frequent use of her reliever inhaler. She could not complete sentences in one breath.
On examination, her respiratory rate was 30 breaths per minute, her pulse was 118 beats per minute and her blood pressure was 114/72 mmHg. Her oxygen saturation was 93% breathing air. She was alert and there was widespread wheeze. Her peak expiratory flow was 140 L/min; her best recorded value was 450 L/min.
How should the severity of this attack be classified?
A. Acute severe asthma
B. Life-threatening asthma
C. Moderate acute asthma
D. Near-fatal asthma
E. Type 2 brittle asthma
Show answer
Answer: B. Life-threatening asthma. She has features of acute severe asthma, but her peak flow of 140 L/min is 31% of her best of 450 L/min. A peak flow below 33% of best or predicted is a life-threatening feature, and any one such feature sets the band. UK guidance does not also require hypoxaemia, so a saturation of 93% does not keep her in a lower band.
Question 3: Gastroenterology and hepatology (medium)
A 58-year-old woman was brought to the emergency department after passing black, tarry stools three times over 24 hours. She had felt light-headed on standing but had not lost consciousness. She had no history of liver disease or cardiac failure and took ibuprofen for knee pain.
On examination, her pulse was 96 beats per minute and her blood pressure was 104/66 mmHg. Rectal examination confirmed melaena.
Investigations:
| Test | Result | Reference |
|---|---|---|
| haemoglobin | 112 g/L | (115 to 165) |
| platelet count | 248 × 10⁹/L | (150 to 400) |
| serum urea | 8.4 mmol/L | (2.5 to 7.0) |
| serum creatinine | 72 µmol/L | (60 to 110) |
What is her Glasgow-Blatchford score?
A. 4
B. 5
C. 6
D. 7
E. 8
Show answer
Answer: C. 6. Urea 8.4 mmol/L scores 3, haemoglobin 112 g/L in a woman scores 1, systolic pressure 104 mmHg (100 to 109 band) scores 1 and melaena scores 1, giving 6. A pulse of 96 scores nothing because the threshold is 100 beats per minute, and light-headedness without loss of consciousness is not syncope. Using the male haemoglobin bands would give the wrong total of 8.
Question 4: Neurology and ophthalmology (medium)
A 68-year-old man presented to the emergency department 90 minutes after the sudden onset of right arm weakness and expressive dysphasia. He weighed 74 kg. His capillary blood glucose was 6.4 mmol/L and non-enhanced CT of the head showed no haemorrhage.
The stroke team decided to give tenecteplase for acute ischaemic stroke.
What is the most appropriate dose of tenecteplase?
A. 17.5 mg
B. 20 mg
C. 22.5 mg
D. 25 mg
E. 40 mg
Show answer
Answer: B. 20 mg. Tenecteplase for acute ischaemic stroke is a single intravenous bolus dosed by weight band in 2.5 mg steps. At 74 kg he is in the 70 to 79 kg band, which the BNF gives as 20 mg. The 40 mg option is the myocardial infarction dose for the same weight, a common source of error.
Question 5: Diabetes and endocrine medicine (medium)
A 26-year-old man with no previous medical history presented with three weeks of thirst, polyuria and 6 kg weight loss, followed by a day of vomiting. He weighed 60 kg. Diabetic ketoacidosis was diagnosed and he was started on a fixed-rate intravenous insulin infusion at 6 units per hour with 0.9% sodium chloride and potassium chloride. Glutamic acid decarboxylase antibodies were sent.
Three hours after treatment started, he was still nauseated and had not eaten.
| Test | Result | Reference |
|---|---|---|
| capillary blood glucose | 15.8 mmol/L | |
| capillary blood ketones | 3.1 mmol/L | (<0.6) |
| venous pH | 7.22 | |
| venous bicarbonate | 12 mmol/L | (22 to 30) |
| serum potassium | 4.2 mmol/L | (3.5 to 4.9) |
What is the most appropriate additional insulin prescription?
A. Basal insulin 0.25 units/kg subcutaneously once daily
B. Basal insulin 0.25 units/kg when the infusion stops
C. Basal insulin 0.5 units/kg subcutaneously once daily
D. Premixed insulin 0.3 units/kg subcutaneously twice daily
E. Rapid-acting insulin 0.1 units/kg subcutaneously with meals
Show answer
Answer: A. Basal insulin 0.25 units/kg subcutaneously once daily. He has new diabetes, so there is no usual long-acting insulin to continue. UK guidance advises starting long-acting basal insulin at 0.25 units/kg once daily alongside the fixed-rate infusion, here 15 units, so background insulin is already working when the infusion stops. Starting it only when the infusion stops leaves a gap and risks rebound ketosis.
Question 6: Infectious diseases (medium)
A 74-year-old woman was brought to the emergency department with fever, rigors and left loin pain. The ambulance crew calculated a NEWS2 score of 4 at her home at 13:10. She arrived at 13:40.
On examination at triage at 13:55, her NEWS2 score was 7. She had left loin tenderness and her urine was cloudy. Her venous lactate, reported at 14:15, was 3.1 mmol/L, and at 14:25 the emergency department doctor recorded a diagnosis of sepsis from pyelonephritis. She had not received any antibiotic.
From which event should the time limit for her intravenous antibiotics be measured?
A. Arrival in the emergency department
B. Clinical diagnosis of sepsis by the doctor
C. First NEWS2 score calculated in the department
D. First NEWS2 score recorded by the ambulance crew
E. Reporting of the venous lactate result
Show answer
Answer: C. First NEWS2 score calculated in the department. UK guidance defines time zero as the first NEWS2 score calculated on initial assessment in the emergency department, together with suspected infection. Her triage score of 7 at 13:55 places her at high risk, so intravenous antibiotics are due within 1 hour of that time. The ambulance score is not time zero, although the rise from 4 to 7 is a reason to consider higher risk.
Question 7: Clinical pharmacology and poisoning (medium)
A 38-year-old man presented to the emergency department at 23:00 having taken 40 tablets of paracetamol 500 mg at 20:00, after separating from his partner. He had also drunk half a bottle of vodka. His 4-hour plasma paracetamol concentration was above the treatment line and the 12-hour acetylcysteine regimen was started at 00:30.
At 02:00 he was alert and orientated but tearful. His breath alcohol reading was still raised.
When should his psychosocial assessment take place?
A. After the acetylcysteine course
B. Alongside the acetylcysteine infusion
C. On the ward the following morning
D. Once the breath alcohol reading is zero
E. When he is medically fit for discharge
Show answer
Answer: B. Alongside the acetylcysteine infusion. UK guidance says the psychosocial assessment after self-harm should not be delayed until medical treatment is complete; the two run concurrently. He is alert and orientated, so he can take part now. A raised alcohol level is not in itself a reason to wait unless it stops him engaging.
Question 8: Critical care medicine (medium)
A 49-year-old woman was brought to the emergency department with sudden breathlessness 9 days after a 14-hour flight. Her left calf was swollen. While waiting for CT pulmonary angiography she became pulseless, and the monitor showed pulseless electrical activity. She was intubated, waveform capnography confirmed tube placement, and compressions were of good quality. Because pulmonary embolism was strongly suspected, she was given a thrombolytic drug 10 minutes into the arrest.
Twenty minutes after the thrombolytic drug, she remained in pulseless electrical activity despite repeated doses of adrenaline. Her end-tidal carbon dioxide was 1.5 kPa throughout.
What is the most appropriate next step in management?
A. Cease CPR because the ETCO2 has stayed low
B. Continue CPR for 60 to 90 minutes after thrombolysis
C. Continue CPR to 30 minutes after thrombolysis
D. Repeat the thrombolytic drug now
E. Stop CPR because there is no ROSC at 20 minutes
Show answer
Answer: B. Continue CPR for 60 to 90 minutes after thrombolysis. Pulmonary embolism is the suspected cause and a thrombolytic drug has been given. Resuscitation Council UK guidance advises considering CPR for 60 to 90 minutes after thrombolysis in selected patients, because clot lysis takes time. A persistently low end-tidal carbon dioxide should not be used alone to stop, and may itself support pulmonary embolism.
Question 9: Renal medicine (hard)
A 74-year-old man with chronic kidney disease was admitted with 4 days of vomiting and poor oral intake. His serum creatinine had been 232 µmol/L at a renal clinic visit 6 days before admission, when he had felt well.
On examination, his pulse was 102 beats per minute and his blood pressure was 104/66 mmHg. His mucous membranes were dry.
Investigations:
| Test | Result | Reference |
|---|---|---|
| serum sodium | 139 mmol/L | (137 to 144) |
| serum potassium | 5.1 mmol/L | (3.5 to 4.9) |
| serum urea | 31.4 mmol/L | (2.5 to 7.0) |
| serum creatinine | 362 µmol/L | (60 to 110) |
What is the most appropriate classification of his kidney function?
A. Acute kidney injury stage 1
B. Acute kidney injury stage 2
C. Acute kidney injury stage 3
D. Chronic kidney disease progression without acute injury
E. Not stageable until creatinine is repeated
Show answer
Answer: C. Acute kidney injury stage 3. His clinic creatinine of 232 µmol/L from 6 days earlier is a valid baseline, and the rise to 362 µmol/L (1.56 times) within 7 days defines acute kidney injury. By ratio alone that is stage 1, but a creatinine of 354 µmol/L or more with an acute rise is stage 3, and the worst stage applies. Stage 3 should be discussed with a nephrologist as soon as possible and within 24 hours.
Question 10: Other (allergy) (hard)
A 67-year-old man, an inpatient on the acute medical unit, was given intravenous contrast for a CT scan. Within 5 minutes he became flushed, wheezy and faint. He took bisoprolol and aspirin for ischaemic heart disease. He was laid flat and given high-flow oxygen and intramuscular adrenaline 500 micrograms, repeated after 5 minutes. A 1,000 mL crystalloid bolus was running through a wide-bore cannula and the resuscitation team had been called.
Five minutes after the second dose of adrenaline, he remained wheezy with a pulse of 62 beats per minute and a blood pressure of 74/40 mmHg. An intensive care registrar experienced in titrating vasopressors had now arrived.
What is the most appropriate next drug treatment?
A. Intravenous adrenaline bolus
B. Intravenous glucagon
C. Intravenous hydrocortisone
D. Intravenous infusion of adrenaline
E. Intravenous infusion of noradrenaline
Show answer
Answer: D. Intravenous infusion of adrenaline. Failure to improve after two appropriate doses of intramuscular adrenaline defines refractory anaphylaxis. UK guidance treats it with a low-dose adrenaline infusion and rapid fluid boluses, started by an experienced specialist. Glucagon is considered for a patient on a beta-blocker only when symptoms remain refractory to an adrenaline infusion and adequate fluids, and steroids must not take priority.
How to use your question bank
Begin with topic blocks to build knowledge, then move to mixed timed blocks once each category has been covered. Mixed blocks matter because the real exam gives no topic heading to prompt you.
For every important mistake, write one line on the decision you missed and the cue that should have pointed you to it. Include the questions you got right by guessing. Our 12-week Acute Medicine SCE revision plan shows how to fit this around a rota.
Record first-attempt scores separately from repeat attempts. Recognising a question you have seen before is useful revision, but it does not tell you how you will do on a new one.
Try the full question bank
Answer the rest of Revision Pro’s 1,766 Acute Medicine SCE questions, with full explanations, revision notes, flashcards and a timed Mock Mode. Your free trial lasts 72 hours.
Frequently asked questions
Is there an official Acute Medicine SCE question bank PDF?
We have not found an official PDF of sample questions. The Federation’s sample questions are an online mock that you register for, with answers shown at the end.
Is the largest question bank always the best?
No. Judge coverage of the 13 categories, the quality of explanations, timed mock papers and the access period alongside the number of questions.
Can my question bank score predict a pass?
There is no reliable conversion from a commercial bank score to an SCE result. Read our pass mark guide before treating a percentage as a target.
