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Prepare for the TEME — Título de Especialista em Medicina de Emergência (ABRAMEDE, Brazil) exam with instant access — no signup required.

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2026 Statistics

Key Facts: TEME Exam

100 MCQs

Theoretical examination items (Prova Teórica)

ABRAMEDE / AMB Edital TEME

70% (7.0/10)

Minimum passing score in theoretical and practical stages

ABRAMEDE / AMB Edital TEME

2 Stages

Prova Teórica + Prova Prática (Simulation/OSCE)

ABRAMEDE / AMB Edital TEME

R$ 1.500 / 3.000

Registration fee (ABRAMEDE/AMB members vs non-members)

ABRAMEDE / AMB Edital TEME

CFM 2.149/2016

Federal recognition of Emergency Medicine as a specialty

Conselho Federal de Medicina

Permanent

Validity of Specialist Title (RQE registration at CRM)

Conselho Federal de Medicina

The TEME is the official board certification for Emergency Medicine in Brazil, administered by ABRAMEDE and AMB. The exam comprises a 100-question Prova Teórica and a practical OSCE simulation stage, requiring a 70% passing score across resuscitation, critical care, trauma, POCUS, and Brazilian toxicology protocols.

Sample TEME Practice Questions

Try these sample questions to test your TEME 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 collapses suddenly in the hospital lobby and is brought to the emergency department resuscitation bay. Monitor reveals ventricular fibrillation (VF). Chest compressions are immediately initiated. According to current ACLS and ABRAMEDE resuscitation guidelines, what are the optimal characteristics for high-quality manual chest compressions in an adult cardiac arrest?
A.Rate of 100 to 120 compressions/min, depth of at least 5 cm (not exceeding 6 cm), full chest recoil, and minimal interruptions.
B.Rate of 80 to 100 compressions/min, depth of at least 7 cm, with continuous ventilation via bag-valve-mask.
C.Rate of 120 to 140 compressions/min, depth of 4 cm, maintaining constant pressure on the sternum between compressions.
D.Rate of 100 compressions/min, depth of at least 3 cm, pausing 10 seconds every 15 compressions for pulse assessment.
Explanation: High-quality CPR is the cornerstone of cardiac arrest resuscitation. Guidelines specify a compression rate of 100–120 per minute, a depth of 5 to 6 cm (2 to 2.4 inches) in adults, allowing complete chest recoil between compressions without leaning, and minimizing interruptions to maintain coronary and cerebral perfusion pressures.
2A 62-year-old female experiences out-of-hospital cardiac arrest with refractory ventricular fibrillation (VF). After 3 standard defibrillation shocks (200 J biphasic), 1 mg of epinephrine IV, and 300 mg of amiodarone IV, the rhythm remains coarse VF. High-quality CPR is ongoing. According to advanced emergency resuscitation strategies for refractory VF (DOSE VF trial), what is the most appropriate next intervention?
A.Dual sequential external defibrillation (DSED) or vector change (VC) defibrillation.
B.Immediate administration of high-dose intravenous calcium chloride (2 g).
C.Administration of high-dose vasopressin (40 IU) replacing all further epinephrine.
D.Cessation of chest compressions for a 60-second rhythm observation period.
Explanation: In refractory ventricular fibrillation (defined as persistent VF after >=3 consecutive standard defibrillation attempts, antiarrhythmics, and epinephrine), recent randomized clinical trial evidence (DOSE VF) and emergency resuscitation guidelines endorse vector change (VC) defibrillation (anteroposterior pad placement) or dual sequential external defibrillation (DSED) using two defibrillators fired sequentially with a brief delay, which significantly increases termination of refractory VF and survival to hospital discharge.
3A 71-year-old male is brought to the emergency department in pulseless electrical activity (PEA) arrest. The monitor shows a wide-complex rhythm at 35 bpm with no palpable central pulse. Chest compressions and bag-valve-mask ventilation are underway. What is the primary first-line pharmacological intervention recommended for non-shockable cardiac arrest (PEA/Asystole)?
A.Epinephrine 1 mg IV/IO administered as early as possible and repeated every 3 to 5 minutes.
B.Amiodarone 300 mg IV bolus followed by 150 mg after 5 minutes.
C.Immediate synchronized electrical cardioversion at 100 J.
D.Sodium bicarbonate 100 mEq IV push as standard empiric initial therapy.
Explanation: In non-shockable cardiac arrest rhythms (asystole and PEA), early administration of epinephrine 1 mg IV/IO is strongly recommended as soon as vascular access is established. Early epinephrine is associated with increased rates of ROSC and survival, and should be repeated every 3 to 5 minutes while identifying reversible causes (5 Hs and 5 Ts).
4A 54-year-old male with end-stage renal disease on hemodialysis missed his last two dialysis sessions. He arrives in the emergency department confused and hypotensive, and abruptly suffers cardiac arrest with PEA. The telemetry strip immediately prior to arrest showed peaked T waves, absent P waves, and severe QRS widening ('sine wave' appearance). Alongside CPR and epinephrine, which immediate pharmacological intervention is essential to stabilize the cardiac membrane?
A.Intravenous Calcium Chloride 10% (10 mL / 1 g) or Calcium Gluconate 10% (30 mL / 3 g).
B.Subcutaneous regular insulin 50 units without dextrose.
C.Intravenous potassium chloride 20 mEq infusion over 15 minutes.
D.High-dose intravenous magnesium sulfate 10 g push.
Explanation: In cardiac arrest secondary to severe hyperkalemia, immediate intravenous calcium (calcium chloride 1 g IV or calcium gluconate 3 g IV) antagonizes the membrane excitability effects of hyperkalemia and stabilizes the cardiac myocyte membrane within 1–3 minutes. This should be followed by shifting agents (insulin with dextrose, sodium bicarbonate, beta-2 agonists) and definitive potassium elimination.
5A 49-year-old male achieves Return of Spontaneous Circulation (ROSC) after 18 minutes of CPR for out-of-hospital ventricular fibrillation. In the emergency department, he remains comatose (GCS 3T) with an intact blood pressure of 124/78 mmHg on a low-dose norepinephrine infusion. What are the current international and ABRAMEDE recommendations regarding Targeted Temperature Management (TTM) in comatose post-cardiac arrest adults?
A.Maintain a constant core body temperature between 32°C and 36°C or strictly prevent fever (maintaining <=37.5°C) for at least 36 to 72 hours.
B.Induce rapid deep hypothermia to 28°C to 30°C for 48 hours using ice-cold saline infusions.
C.Allow permissive hyperthermia up to 39°C to stimulate cerebral immunologic recovery.
D.Maintain core temperature strictly at 30°C for 12 hours followed by rapid rewarming at 2.0°C per hour.
Explanation: Post-cardiac arrest guidelines recommend Targeted Temperature Management (TTM) for all comatose adult patients after ROSC. The target is either a constant selected temperature between 32°C and 36°C or active normothermia with strict fever prevention (maintaining core temperature <=37.5°C) for at least 24 to 72 hours, as fever is independently associated with secondary neuronal injury and worsened neurological outcome.
6A 29-year-old pregnant woman at 32 weeks of gestation suffers sudden out-of-hospital cardiac arrest and is transported to the emergency department with ongoing CPR. The uterine fundus is palpable 4 cm above the umbilicus. After 4 minutes of advanced resuscitation in the ED without ROSC, what critical obstetrical emergency procedure must be initiated simultaneously to optimize maternal and fetal survival?
A.Resuscitative hysterotomy (perimortem cesarean delivery) with continued left uterine displacement.
B.Immediate placement of the patient in the full prone position to decompress the vena cava.
C.Intravenous infusion of high-dose oxytocin bolus (20 units) to stimulate uterine contraction.
D.Emergency abdominal CT scan to identify the cause of the arrest prior to surgical intervention.
Explanation: In maternal cardiac arrest where gestational age is >=20 weeks (uterine fundus at or above the umbilicus), the gravid uterus compresses the inferior vena cava and abdominal aorta, severely limiting venous return and CPR cardiac output. If ROSC is not achieved within 4 minutes of resuscitation, immediate resuscitative hysterotomy (perimortem cesarean section) should be performed at the bedside (aiming for delivery by minute 5) to relieve aortocaval compression, which dramatically improves maternal hemodynamics and fetal survival.
7Following successful resuscitation from a 12-minute cardiac arrest, a 65-year-old male is intubated in the ED. An arterial line is placed. What are the recommended post-ROSC hemodynamic and ventilation goals to optimize cerebral and myocardial recovery?
A.Target Mean Arterial Pressure (MAP) >=65 mmHg (or SBP >=90 mmHg), PaO2 80–100 mmHg (SpO2 92–98%), and normocapnia (PaCO2 35–45 mmHg).
B.Target MAP >=110 mmHg, PaO2 >300 mmHg (100% FiO2 indefinitely), and hyperventilation to PaCO2 20–25 mmHg.
C.Target MAP 50–55 mmHg, permissive hypoxemia (SpO2 85–88%), and permissive hypercapnia (PaCO2 60–70 mmHg).
D.Target SBP 80 mmHg, PaO2 50 mmHg, and aggressive hyperventilation with respiratory rate >35 bpm.
Explanation: Post-ROSC care requires optimizing organ perfusion while avoiding secondary injury. Target MAP is >=65 mmHg to maintain cerebral and coronary perfusion. Hyperoxia produces reactive oxygen species that worsen reperfusion brain injury, so FiO2 should be titrated to maintain PaO2 80–100 mmHg (SpO2 92–98%). Hyperventilation causes cerebral vasoconstriction and reduces cerebral blood flow, so normocapnia (PaCO2 35–45 mmHg or ETCO2 35–40 mmHg) must be maintained.
8A 4-year-old child weighing 16 kg collapses in the pediatric emergency room. The monitor demonstrates ventricular fibrillation. What is the recommended initial defibrillation energy dose according to pediatric advanced life support (PALS/ABRAMEDE) protocols?
A.2 J/kg (32 J for the initial shock), followed by 4 J/kg (64 J) for subsequent shocks.
B.10 J/kg for all shocks regardless of rhythm persistence.
C.Fixed adult dose of 200 J biphasic for the initial shock.
D.0.5 J/kg for the initial shock, repeated up to 5 times before CPR resumes.
Explanation: In pediatric cardiac arrest with a shockable rhythm (VF or pulseless VT), the initial defibrillation energy dose is 2 J/kg. If VF persists after the subsequent 2-minute cycle of CPR, the second shock should be delivered at 4 J/kg. Subsequent shocks should be at least 4 J/kg (up to 10 J/kg or maximum adult dose).
9A 42-year-old marathon runner experiences witnessed cardiac arrest with immediate bystander CPR. Upon ED arrival after 25 minutes of resuscitation, he has refractory ventricular fibrillation despite 5 shocks, antiarrhythmics, and epinephrine. The emergency team considers cannulation for Extracorporeal Cardiopulmonary Resuscitation (eCPR / VA-ECMO). Which clinical profile represents the optimal candidate for eCPR in refractory cardiac arrest?
A.Young patient (<65 years) with witnessed arrest, immediate bystander CPR, initial shockable rhythm, and short no-flow time.
B.Elderly patient (>80 years) with unwitnessed asystolic arrest and unknown duration of downtime.
C.Patient with advanced metastatic terminal malignancy and severe pre-existing multiorgan failure.
D.Trauma patient with exsanguinating uncontrolled retroperitoneal pelvic hemorrhage in cardiac arrest.
Explanation: Extracorporeal CPR (eCPR / venoarterial ECMO) in the ED is reserved for highly selected patients with reversible etiology: young age (<65–70 years), witnessed arrest, immediate high-quality bystander CPR (zero or minimal no-flow time), initial shockable rhythm (VF/pVT), and low-flow time under 60 minutes.
10A 35-year-old hiker is rescued from an icy river and brought to the emergency department in cardiac arrest. Core body temperature measured by esophageal probe is 24°C (severe accidental hypothermia). The monitor shows ventricular fibrillation. How should resuscitation protocols be modified for severe hypothermic cardiac arrest according to international and emergency guidelines?
A.Deliver up to 3 initial defibrillation shocks, withhold or space epinephrine doses until core temperature reaches >=30°C, and continue active internal and external rewarming.
B.Administer standard doses of epinephrine 1 mg IV every 2 minutes and give 600 mg of amiodarone immediately.
C.Pronounce death immediately if no pulse is detected within 5 minutes of ED arrival.
D.Warm the patient rapidly using unheated peripheral crystalloids and avoid any electrical shocks until 37°C.
Explanation: In severe hypothermic cardiac arrest (core temperature <30°C), drug metabolism is severely decreased; repeated epinephrine doses can accumulate to toxic levels and cause lethal arrhythmias upon rewarming. Guidelines recommend delivering up to 3 shocks for VF, withholding or increasing the interval of epinephrine/antiarrhythmics until core temp is >=30°C, and continuing CPR with aggressive core rewarming ('a patient is not dead until warm and dead' >=32–35°C).

About the TEME Exam

The Título de Especialista em Medicina de Emergência (TEME) is the official board certification for emergency medicine physicians in Brazil, granted by the Associação Brasileira de Medicina de Emergência (ABRAMEDE) in partnership with the Associação Médica Brasileira (AMB) and registered with the Conselho Federal de Medicina (CFM). Emergency Medicine was formally recognized as an independent medical specialty in Brazil by CFM Resolution No. 2.149/2016. The TEME sufficiency examination evaluates the comprehensive knowledge, rapid diagnostic acuity, procedural competence, and crisis management required of a specialist emergency physician. The assessment comprises an objective theoretical examination (Prova Teórica) covering resuscitation, advanced airway management, shock states, cardiology, neurology, respiratory emergencies, trauma, point-of-care ultrasound (POCUS), toxicology and Brazilian envenomations, followed by practical simulation stations (Prova Prática / Teórico-Prática). The official examination is conducted in Portuguese; this question bank provides an English-language multiple-choice study adaptation designed to master clinical decision-making, international guidelines, and Brazilian emergency care protocols.

Assessment

Two-stage examination run by the Associação Brasileira de Medicina de Emergência with the AMB. Primeira Etapa: an eliminatory presencial Prova Teórica of 100 four-option multiple-choice questions worth 100 points. Segunda Etapa: a Prova Prática using clinical scenarios and simulations drawn from emergency medicine practice, worth 100 points and recorded digitally for marking by the TEME commission. An Análise Curricular forms part of the second stage but is not eliminatory: it can add up to ten points, and only for candidates scoring between 60 and 70 points on the practical after appeals.

Time Limit

Primeira Etapa: presencial written paper. Segunda Etapa: practical scenario and simulation stations on a separate day.

Passing Score

Primeira Etapa: at least 70% of the highest mark awarded after appeals; where that value falls below 60% of the total paper, the cut is fixed at 60% of the total (60 questions). Segunda Etapa: at least 70 of the 100 available points.

Exam Fee

R$ 2.200,00 / R$ 3.300,00 depending on membership category (Associação Brasileira de Medicina de Emergência (ABRAMEDE) — Associação Médica Brasileira (AMB))

TEME Exam Content Outline

12%

Ressuscitação e Parada Cardíaca (ACLS/PALS)

High-quality CPR, defibrillation strategies, antiarrhythmics in cardiac arrest, post-ROSC targeted temperature management and hemodynamic optimization, pediatric resuscitation, and perimortem cesarean delivery.

10%

Via Aérea na Emergência e Sequência Rápida (RSI)

Rapid sequence intubation protocols, induction and paralytic drug pharmacology, difficult airway prediction (LEMON), rescue supraglottic devices, and emergency surgical cricothyroidotomy.

10%

Choque e Ressuscitação Hemodinâmica

Surviving Sepsis Campaign bundles, anaphylaxis emergency treatment, cardiogenic and obstructive shock pathophysiology, vasoactive and inotropic support, and damage control balanced transfusion.

12%

Emergências Cardiovasculares

STEMI and NSTE-ACS reperfusion strategies, acute heart failure and pulmonary edema, unstable tachyarrhythmias and bradycardias, aortic dissection, and hypertensive emergencies.

10%

Emergências Neurológicas

Acute ischemic stroke thrombolysis and thrombectomy windows, intracerebral hemorrhage blood pressure and anticoagulation reversal, subarachnoid hemorrhage, status epilepticus, and intracranial hypertension.

10%

Emergências Respiratórias e Ventilação Mecânica

Acute respiratory failure, severe asthma and COPD exacerbations, massive pulmonary embolism thrombolysis, ARDS lung-protective ventilation, and non-invasive positive pressure ventilation.

12%

Trauma e Queimaduras na Sala de Emergência (ATLS)

ATLS primary and secondary survey, pelvic ring disruption and binders, severe traumatic brain injury, emergent thoracotomy indications, severe burns fluid resuscitation, and compartment syndrome.

10%

POCUS — Ultrassonografia Point-of-Care

eFAST examination in trauma, focused cardiac ultrasound (FoCUS), lung ultrasound BLUE protocol, vascular DVT compression, AAA screening, and RUSH protocol in shock.

12%

Toxicologia de Emergência e Animais Peçonhentos no Brasil

Brazilian venomous snakebites (Bothrops, Crotalus, Lachesis, Micrurus) and arthropods (Tityus serrulatus, Loxosceles, Phoneutria) per Ministério da Saúde protocols; drug overdoses, toxidromes, and antidotes.

10%

Gestão, Triagem e Resposta a Desastres

Manchester Triage System (MTS) flowcharts and discriminators, disaster mass-casualty triage (START/JumpSTART), ED overcrowding metrics, medical ethics, and advance directives.

How to Pass the TEME Exam

What You Need to Know

  • Passing score: Primeira Etapa: at least 70% of the highest mark awarded after appeals; where that value falls below 60% of the total paper, the cut is fixed at 60% of the total (60 questions). Segunda Etapa: at least 70 of the 100 available points.
  • Assessment: Two-stage examination run by the Associação Brasileira de Medicina de Emergência with the AMB. Primeira Etapa: an eliminatory presencial Prova Teórica of 100 four-option multiple-choice questions worth 100 points. Segunda Etapa: a Prova Prática using clinical scenarios and simulations drawn from emergency medicine practice, worth 100 points and recorded digitally for marking by the TEME commission. An Análise Curricular forms part of the second stage but is not eliminatory: it can add up to ten points, and only for candidates scoring between 60 and 70 points on the practical after appeals.
  • Time limit: Primeira Etapa: presencial written paper. Segunda Etapa: practical scenario and simulation stations on a separate day.
  • Exam fee: R$ 2.200,00 / R$ 3.300,00 depending on membership category

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

TEME Study Tips from Top Performers

1Master Brazilian venomous animal protocols: Distinguish Bothrops (proteolytic/coagulant, local necrosis), Crotalus (neurotoxic/myotoxic, dark urine, ptosis), Lachesis (vagal bradycardia/diarrhea), and Micrurus (pure neurotoxic paralysis), along with official antivenom dosages from the Ministério da Saúde.
2Understand POCUS protocols inside out: Be prepared to interpret eFAST windows, FoCUS cardiac signs (tamponade, acute RV strain McConnell's sign), and BLUE lung ultrasound profiles (A-lines, B-lines, shred sign, lung point).
3Memorize airway and RSI pharmacology: Focus on ketamine vs etomidate vs propofol hemodynamics, rocuronium dosing (1.2 mg/kg) and sugammadex reversal, and the scalpel-finger-bougie surgical cricothyroidotomy technique.
4Know acute stroke and coronary reperfusion timelines: Thrombolysis windows (4.5 hours for ischemic stroke, 12 hours / 30-min door-to-needle for STEMI if PCI unavailable), blood pressure cut-offs, and contraindications.
5Familiarize yourself with the Manchester Triage System: Learn the standard 5 priority levels, specific discriminators, and target initial medical assessment response times (Red: 0 min, Orange: 10 min, Yellow: 60 min, Green: 120 min, Blue: 240 min).

Frequently Asked Questions

What is the TEME examination and who administers it?

The TEME (Título de Especialista em Medicina de Emergência) is the official specialist title examination for Emergency Medicine in Brazil. It is administered by the Associação Brasileira de Medicina de Emergência (ABRAMEDE) in partnership with the Associação Médica Brasileira (AMB) and registered with the Conselho Federal de Medicina (CFM).

What are the prerequisites to take the TEME exam?

Candidates must have an active CRM registration in Brazil and either: (1) completed an accredited 3-year Emergency Medicine residency program (Residência Médica em Medicina de Emergência credenciada pela CNRM/MEC), or (2) accumulated proven clinical emergency practice time and completed accredited training courses as specified in the official ABRAMEDE/AMB edital.

How is the TEME examination structured?

The exam consists of two stages: (1) Prova Teórica, an objective multiple-choice examination with 100 questions testing core emergency medicine knowledge, and (2) Prova Prática / Teórico-Prática, consisting of clinical simulation stations (OSCE) evaluating practical procedural skills (airway, POCUS, vascular access), resuscitation algorithms, and team communication.

What is the passing score for the TEME?

Candidates must achieve at least 70% (a grade of 7.0 out of 10.0) in the theoretical examination to qualify and must achieve at least 70% in the practical simulation stations.

What topics are emphasized in the Brazilian emergency context?

In addition to universal international guidelines (ACLS, ATLS, Surviving Sepsis, POCUS), the TEME specifically tests Brazilian-specific emergency protocols, including the Ministério da Saúde guidelines for venomous snake and scorpion envenomations (Bothrops, Crotalus, Tityus serrulatus), the Manchester Triage System (Sistema de Triagem de Manchester) widely adopted in Brazilian emergency departments, and CFM ethical resolutions.

Is this practice bank an official exam replica or an English study adaptation?

This practice bank is an English-language four-option multiple-choice study adaptation designed to teach the clinical principles, resuscitation protocols, and specific Brazilian toxicological and triage frameworks tested on the TEME. It preserves exact Brazilian medical terms inline while enabling rigorous bilingual preparation.