100+ Free Arab Board Emergency Medicine Clinical Exam Practice Questions

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Sample Arab Board Emergency Medicine Clinical Exam Practice Questions

Try these sample questions to test your Arab Board Emergency Medicine Clinical Exam exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old male is in cardiac arrest from refractory ventricular fibrillation (VF). He has received three standard 200 J biphasic shocks, CPR, 1 mg IV epinephrine, and 300 mg IV amiodarone, but VF persists on the monitor. Which intervention has the strongest clinical evidence for terminating refractory ventricular fibrillation in this scenario?

A.Double sequential external defibrillation (DSED) with a second defibrillator

B.Immediate administration of high-dose intravenous epinephrine (5 mg bolus)

C.Intravenous calcium chloride 1 g bolus followed by sodium bicarbonate

D.Immediate administration of intravenous bretylium tosylate

Explanation: Double sequential external defibrillation (DSED) or vector-change defibrillation has demonstrated superior rates of VF termination and survival to hospital discharge in refractory VF cardiac arrest. The DOSE VF trial confirmed that applying a second set of defibrillator pads in the anterior-posterior position and delivering sequential shocks overcomes high transthoracic impedance. High-dose epinephrine and calcium are not indicated and have not shown survival benefit.

2A 62-year-old female achieves return of spontaneous circulation (ROSC) after a 15-minute resuscitation for an out-of-hospital VF arrest. She remains comatose (GCS 3) with a blood pressure of 110/70 mmHg. According to current post-cardiac arrest care guidelines, what is the recommended target temperature management strategy?

A.Rapid active warming to induce hyperthermia above 38.5°C

B.Targeted temperature management maintaining constant core temperature between 32°C and 36°C with strict fever avoidance

C.Permissive uncontrolled hypothermia allowed to drop below 28°C

D.Immediate administration of routine prophylactic antiepileptic infusions without EEG indication

Explanation: Current post-cardiac arrest guidelines recommend targeted temperature management (TTM) selecting a constant target between 32°C and 36°C, or actively preventing fever (temperature <= 37.5°C) for at least 72 hours in comatose post-ROSC patients. Strict avoidance of hyperthermia prevents secondary ischemic neuronal injury. Uncontrolled deep hypothermia (<28°C) triggers severe dysrhythmias, coagulopathy, and hemodynamic collapse.

3A 52-year-old male with end-stage renal disease missing hemodialysis for four days arrives in cardiac arrest with pulseless electrical activity (PEA). The resuscitation monitor demonstrates an extremely wide, sinusoidal QRS complex. What is the immediate first-line medication required to stabilize the cardiac membrane?

A.Intravenous amiodarone 300 mg push

B.Intravenous regular insulin 10 units without dextrose

C.Intravenous calcium gluconate or calcium chloride

D.Intravenous sodium polystyrene sulfonate via nasogastric tube

Explanation: In severe hyperkalemia-induced cardiac arrest or peri-arrest sinusoidal rhythm, intravenous calcium (10 mL of 10% calcium chloride or 30 mL of 10% calcium gluconate) directly antagonizes potassium-induced membrane hyperexcitability and normalizes the cardiac resting membrane potential within minutes. Intracellular shifting agents (insulin/dextrose, albuterol, bicarbonate) follow immediately. Ion-exchange resins have a delayed onset of hours and have no role in acute resuscitation.

4A 70-year-old female with urosepsis remains hypotensive with a blood pressure of 78/42 mmHg (MAP 54 mmHg) despite completion of a 30 mL/kg IV balanced crystalloid bolus. What is the first-line vasopressor of choice according to the Surviving Sepsis Campaign guidelines?

A.Phenylephrine boluses titrated to systolic BP >= 140 mmHg

B.Dopamine infusion at low renal-protective doses

C.Epinephrine boluses 1 mg IV every 3 minutes

D.Norepinephrine infusion titrated to a target MAP >= 65 mmHg

Explanation: Norepinephrine is the first-choice vasopressor in septic shock due to its potent alpha-1 vasoconstrictive effects combined with modest beta-1 inotropic support, which reliably increases MAP with lower tachyarrhythmia rates compared to dopamine. Vasopressin can be added as a second-line agent if norepinephrine requirements escalate. High-dose cardiac arrest epinephrine boluses are not appropriate for perfusing septic shock.

5A 65-year-old male 4 days post-inferior STEMI suddenly develops acute respiratory distress, pulmonary edema, and hypotension (BP 72/40 mmHg). On examination, a new harsh, holosystolic murmur is loudest at the cardiac apex radiating to the axilla. Bedside echocardiogram reveals acute severe mitral regurgitation due to posteromedial papillary muscle rupture. What is the definitive emergency management strategy?

A.Immediate beta-blocker administration to slow heart rate

B.Hemodynamic stabilization with afterload reduction and inotropes/mechanical circulatory support followed by emergent surgical repair

C.Aggressive high-volume isotonic crystalloid fluid loading (4 liters)

D.Discharge to outpatient cardiology clinic for elective valve repair

Explanation: Papillary muscle rupture leading to acute mitral regurgitation is a catastrophic mechanical complication of myocardial infarction causing severe cardiogenic shock and pulmonary edema. Medical stabilization aims to decrease left ventricular afterload (e.g., intra-aortic balloon pump [IABP] or judicious inodilators/vasopressors) to reduce regurgitant fraction while urgently mobilizing the cardiothoracic surgical team for emergent operative valve repair or replacement. Beta-blockers worsen cardiogenic shock, and excessive fluids exacerbate pulmonary edema.

6A 28-year-old male with a known severe peanut allergy presents in refractory anaphylactic shock with severe stridor, diffuse urticaria, and a blood pressure of 65/35 mmHg. He has already received two intramuscular doses of epinephrine (0.5 mg each in the anterolateral thigh) and 2 liters of IV crystalloid without hemodynamic improvement. What is the next most appropriate pharmacologic step?

A.Administer intravenous diphenhydramine 50 mg as sole therapy

B.Administer oral methylprednisolone and observe for 2 hours

C.Initiate an intravenous epinephrine continuous infusion titrated to clinical response

D.Administer intravenous glucagon bolus only without further epinephrine

Explanation: Refractory anaphylaxis failing repeated intramuscular epinephrine and crystalloid resuscitation warrants continuous intravenous epinephrine infusion (e.g., 0.1-0.5 mcg/kg/min or 2-10 mcg/min titrated to blood pressure and resolution of airway/bronchial obstruction). Antihistamines and corticosteroids are secondary adjuncts with slow onset that do not reverse life-threatening cardiovascular collapse or airway compromise. Glucagon is specifically reserved for patients on beta-blockers who fail epinephrine.

7During resuscitation of a 45-year-old patient in prolonged cardiac arrest, arterial blood gas shows pH 6.88, PaCO2 58 mmHg, PaO2 120 mmHg, and HCO3 11 mEq/L. In which specific clinical scenario does sodium bicarbonate administration have a clear guideline-supported indication during cardiac arrest?

A.Routine undifferentiated cardiac arrest at minute 5 of CPR

B.Hypovolemic cardiac arrest due to acute hemorrhagic shock

C.Anaphylactic shock cardiac arrest after insect envenomation

D.Pre-existing severe hyperkalemia or tricyclic antidepressant (TCA) toxicity

Explanation: Routine empiric sodium bicarbonate administration is not recommended in cardiac arrest because it generates carbon dioxide (which diffuses into cells causing intracellular acidosis) and shifts the oxyhemoglobin dissociation curve to the left. However, guideline-supported exceptions include pre-existing severe hyperkalemia, sodium-channel blocking poisonings (such as tricyclic antidepressants), and prolonged cardiac arrest with documented severe pre-existing metabolic acidosis.

8A 44-year-old female experiences a witnessed cardiac arrest in the emergency department waiting room. Initial rhythm is ventricular fibrillation. After 25 minutes of high-quality CPR, multiple shocks, and ACLS medications, refractory VF persists. The team considers Extracorporeal Cardiopulmonary Resuscitation (eCPR / VA-ECMO). Which set of clinical criteria represents the ideal candidate profile for eCPR initiation?

A.Witnessed arrest, immediate bystander CPR, initial shockable rhythm, age <65 years, and interval from arrest to ECMO flow <60 minutes

B.Unwitnessed arrest, asystole for 45 minutes, severe end-stage dementia, and severe coagulopathy

C.Traumatic cardiac arrest with penetrating thoracic injury and massive exsanguination

D.Any patient in cardiac arrest regardless of downtime, age, or baseline comorbidities

Explanation: Extracorporeal CPR (eCPR) using veno-arterial ECMO provides temporary mechanical circulatory support for patients with reversible etiologies of cardiac arrest. Favorable prognostic criteria include witnessed arrest, immediate high-quality bystander CPR, initial shockable rhythm (VF/pVT), younger age (<65), few severe baseline comorbidities, and rapid cannulation achieving ECMO flow within 60 minutes of collapse.

9A 55-year-old male achieves ROSC following defibrillation for ventricular tachycardia. He is mechanically ventilated in the emergency resuscitation bay. Pulse oximetry displays an SpO2 of 100% on an FiO2 of 1.0. What is the recommended target oxygen saturation range during post-resuscitation care?

A.SpO2 100% maintained continuously with 100% oxygen for the first 24 hours

B.SpO2 80% to 85% to induce therapeutic hypoxemia

C.SpO2 92% to 98% (or PaO2 70 to 100 mmHg) to avoid hyperoxic neuronal injury

D.SpO2 >= 99% with PaO2 > 300 mmHg

Explanation: Post-cardiac arrest guidelines recommend titrating supplemental oxygen to maintain SpO2 between 92% and 98% (or PaO2 70-100 mmHg). Hyperoxia (excess PaO2 > 300 mmHg) promotes reactive oxygen species (ROS) formation, cerebral vasoconstriction, and worsened post-ischemic reperfusion neurotoxicity, while avoiding hypoxemia.

10A 24-year-old male is brought to the trauma resuscitation bay following a diving accident resulting in complete C5 cervical spinal cord transection. Vital signs show blood pressure 76/40 mmHg, heart rate 46 bpm, respiratory rate 14, and warm, dry skin. Which hemodynamic disorder and initial vasopressor choice are most appropriate?

A.Hypovolemic shock; manage with 6 liters of normal saline and high-dose epinephrine

B.Septic shock; manage with immediate broad-spectrum antibiotics and phenylephrine

C.Cardiogenic shock; manage with urgent coronary angiography and intra-aortic balloon pump

D.Neurogenic shock; manage with IV fluids and norepinephrine or dopamine (alpha-1 and beta-1 support)

Explanation: Neurogenic shock results from disruption of descending sympathetic autonomic pathways above T6, leading to loss of vasomotor tone (vasodilation with hypotension) and loss of cardiac accelerator fibers (unopposed vagal parasympathetic tone with bradycardia and warm extremities). Management requires judicious fluid resuscitation and vasopressors with combined alpha-1 (vasoconstriction) and beta-1 (inotropic/chronotropic) activity, such as norepinephrine or dopamine, to maintain spinal cord perfusion pressure (target MAP 85-90 mmHg).

About the Arab Board Emergency Medicine Clinical Exam Exam

The Arab Board Emergency Medicine Final Clinical and Oral Examination is the definitive exit assessment for senior emergency medicine residents completing their ABHS specialist training across Arab League member nations. Conducted by senior consultant emergency physician examiners, the examination evaluates real-time clinical judgment, advanced resuscitation leadership, bedside procedural competence, diagnostic imaging and POCUS interpretation, trauma resuscitation, crisis resource management, and high-stakes communication. This resource provides an English-language clinical scenario question bank adapted from authentic Arab Board clinical and oral exam blueprints to hone diagnostic decision-making under exam conditions.

Assessment

Performance-based assessment

Time Limit

Approximately 2 to 3 hours

Passing Score

A standard passing mark of around 60% is established by the ABHS Scientific Council of Emergency Medicine across clinical stations, simulated resuscitation scenarios, and structured oral viva panels.

Exam Fee

Set by ABHS and national councils (Arab Board of Health Specializations (ABHS) - Scientific Council of Emergency Medicine)

Arab Board Emergency Medicine Clinical Exam Exam Content Outline

16%

Resuscitation & Critical Care

ACLS/PALS algorithms, cardiac arrest resuscitation, refractory VF/VT, ROSC care, cardiogenic/septic/neurogenic shock, invasive hemodynamic monitoring, and ECMO CPR.

16%

Acute Trauma Management (ATLS)

Primary and secondary surveys, massive hemorrhage protocols, pelvic binders, thoracostomy, emergency front-of-neck access, traumatic brain injury, and spinal cord immobilization.

14%

Cardiovascular Emergencies

STEMI and STEMI equivalents (de Winter, Wellens, Sgarbossa), unstable dysrhythmias, aortic dissection, acute decompensated heart failure, and acute pericardial tamponade.

12%

Emergency Airway & Procedural Skills

Rapid sequence intubation (RSI) in physiologically difficult airways, surgical cricothyroidotomy (eFONA), difficult airway algorithms, pericardiocentesis, and procedural sedation.

10%

Point-of-Care Ultrasound (POCUS)

eFAST in trauma, RUSH protocol in undifferentiated shock, cardiac echocardiography (tamponade, RV strain), lung ultrasound (pneumothorax, pulmonary edema), and DVT assessment.

10%

Pediatric & Neonatal Emergencies

Pediatric septic shock, severe respiratory distress (croup, bronchiolitis, foreign body), pediatric status epilepticus, pediatric trauma resuscitation, and neonatal stabilization.

10%

Toxicology & Environmental Emergencies

Toxidromes and antidotes (toxic alcohols, calcium channel blockers, organophosphates, paracetamol, carbon monoxide), severe heat stroke, hypothermia, drowning, and envenomation.

Disaster Triage & Clinical Communication

Mass casualty incident (MCI) triage (START algorithm), chemical/HAZMAT decontamination, breaking bad news, medical ethics, patient refusal of care, and surrogate decision-making.

Neurologic & Metabolic Emergencies

Acute ischemic stroke thrombolysis/thrombectomy windows, non-traumatic intracranial hemorrhage, status epilepticus, DKA/HHS management, and severe electrolyte emergencies.

How to Pass the Arab Board Emergency Medicine Clinical Exam Exam

What You Need to Know

Passing score: A standard passing mark of around 60% is established by the ABHS Scientific Council of Emergency Medicine across clinical stations, simulated resuscitation scenarios, and structured oral viva panels.
Assessment: Performance-based assessment
Time limit: Approximately 2 to 3 hours
Exam fee: Set by ABHS and national councils

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Arab Board Emergency Medicine Clinical Exam Study Tips from Top Performers

1Practice vocalizing your resuscitation algorithms (ACLS, ATLS, PALS) in structured, prioritized steps: airway control, breathing and oxygenation, circulation and hemorrhage control, targeted bedside ultrasound, and definitive disposition.

2Develop a rapid, systematic approach to high-yield emergency artifacts including 12-lead ECGs (subtle STEMI equivalents like de Winter and Wellens), traumatic and medical POCUS video loops, chest/pelvic radiographs, and emergency toxicologic nomograms.

3Rehearse simulated crisis communication and structured oral viva encounters under timed conditions with senior colleagues, focusing on clear leadership directives, closed-loop communication, and ethical consensus building.

4Review regional environmental priorities including exertional heat stroke cooling protocols, marine and terrestrial envenomations, and mass casualty triage frameworks.

Frequently Asked Questions

What is the format and structure of the Arab Board Emergency Medicine Clinical & Oral Examination?

The Arab Board (ABHS) Emergency Medicine Final Clinical and Oral Exam consists of multi-station Objective Structured Clinical Examinations (OSCEs), high-fidelity simulated resuscitation scenarios (testing team leadership, ATLS, and ACLS crisis management), and structured oral viva voce stations where consultant examiner panels evaluate clinical reasoning, ECG/imaging/POCUS interpretation, and toxicologic or disaster management.

What is the passing standard for the Arab Board EM Clinical Exam?

The ABHS Scientific Council of Emergency Medicine establishes a standard passing threshold (commonly set around 60% across all stations). Candidates must achieve a passing score across core domains including resuscitation leadership, clinical decision-making, procedural safety, and professional communication.

How are clinical procedures and bedside ultrasound assessed during the exam?

Bedside procedural competence—including surgical airway (scalpel-bougie-tube eFONA), tube thoracostomy, ultrasound-guided vascular access, and pericardiocentesis—is evaluated using task trainers, anatomical models, and structured scenario prompts. Point-of-care ultrasound (POCUS) skills are tested through real-time video clips, static images, and case-based interpretation of eFAST, RUSH, lung, and cardiac scans.

Are these 100 practice questions an official Arab Board examination paper?

No. This 100-question practice bank represents an English-language clinical scenario study adaptation designed by emergency medical educators to mirror the high-stakes diagnostic decision-making, resuscitation algorithms, procedural steps, and viva scenarios assessed in the ABHS Emergency Medicine Clinical and Oral Exit Examination.

100+ Free Arab Board Emergency Medicine Clinical Exam Practice Questions

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