100+ Free PRES 2 Practice Questions
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Key Facts: PRES 2 Exam
180 questions
PRES Level 2 is a written paper of 180 multiple-choice questions
Medical Council of Ireland / PRES candidate guidance
3 hours
Time allowed to complete the PRES 2 written paper
Medical Council of Ireland / PRES candidate guidance
5 disciplines
Medicine/GP, surgery, paediatrics, obstetrics & gynaecology and psychiatry
Medical Council of Ireland - PRES
Modified Angoff
Criterion-referenced standard setting means there is no fixed percentage pass mark
PRES candidate guidance
3 attempts
Candidates are normally allowed a maximum of three attempts per PRES level
S.I. No. 480/2010 Medical Council Rules
About EUR 460
Approximate PRES Level 2 examination fee per attempt
Medical Council of Ireland fees (confirm current value)
Pass Level 2 first
PRES 2 must be passed before sitting the PRES 3 clinical OSCE
Medical Council of Ireland - PRES
100
Free original single-best-answer practice questions here
OpenExamPrep
PRES Level 2 is the written multiple-choice component of the Medical Council of Ireland's Pre-Registration Examination System for international medical graduates. It is a computer-based paper of 180 single-best-answer and extended-matching questions answered in 3 hours, covering medicine and general practice, surgery, paediatrics, obstetrics & gynaecology and psychiatry at the level of a doctor completing internship. There is no fixed pass mark; a modified-Angoff standard is set for each sitting and candidates are normally allowed three attempts. The fee is approximately EUR 460 per attempt. This 100-question bank provides original single-best-answer practice modelled on the PRES 2 disciplines and emphasises diagnosis, first-line investigation and management.
Sample PRES 2 Practice Questions
Try these sample questions to test your PRES 2 exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 64-year-old man presents with central crushing chest pain for 40 minutes, radiating to the left arm, with sweating and nausea. His ECG shows 2 mm ST-segment elevation in leads II, III and aVF. Which is the single most appropriate immediate management priority?
2A 72-year-old woman with hypertension presents with sudden palpitations. ECG shows an irregularly irregular rhythm with absent P waves at a rate of 140/min, and she is haemodynamically stable. What is the most appropriate first-line assessment to guide stroke-prevention therapy?
3A 58-year-old smoker presents with progressive exertional breathlessness and a chronic productive cough. Spirometry shows a post-bronchodilator FEV1/FVC ratio of 0.62 that does not normalise. Which diagnosis is most consistent with these findings?
4A 25-year-old woman with known asthma presents acutely breathless and unable to complete sentences, with a respiratory rate of 32/min, heart rate 120/min and peak flow 40% of predicted. What is the single most appropriate first treatment?
5A 45-year-old man with a history of alcohol excess presents with epigastric pain radiating to the back and vomiting. Serum lipase is markedly elevated at six times the upper limit of normal. Which is the single best initial investigation to assess severity and exclude gallstones as a cause?
6A 30-year-old woman presents with several months of intermittent bloody diarrhoea, lower abdominal cramping and weight loss. Colonoscopy shows continuous inflammation extending proximally from the rectum with a granular, friable mucosa. Which is the most likely diagnosis?
7A 68-year-old man presents with reduced urine output after a vomiting illness. Investigations show urea 18 mmol/L, creatinine raised from baseline, and a urinary sodium that is low with concentrated urine. Which type of acute kidney injury is most likely?
8A 19-year-old presents with polyuria, polydipsia, weight loss and lethargy. Capillary glucose is 26 mmol/L, blood ketones are 4.5 mmol/L and venous pH is 7.21. Which is the single most appropriate first step in management?
9A 40-year-old woman presents with tiredness, weight gain, cold intolerance and constipation. TSH is markedly elevated and free T4 is low. Which is the most appropriate first-line treatment?
10A 70-year-old man presents with sudden right-sided weakness and slurred speech that began 90 minutes ago. CT brain shows no haemorrhage. He has no contraindications to thrombolysis. Which is the single most appropriate management?
About the PRES 2 Exam
The Pre-Registration Examination System (PRES) is the Medical Council of Ireland's assessment for certain international medical graduates seeking registration to practise medicine in Ireland. PRES Level 2 is the written, computer-based multiple-choice examination that tests applied clinical knowledge across the main disciplines of medicine and general practice, surgery, paediatrics, obstetrics & gynaecology and psychiatry, framed within Irish and European clinical practice and the Council's eight domains of Good Professional Practice. It comprises 180 single-best-answer and extended-matching questions to be answered in three hours. Candidates must pass PRES Level 2 before sitting PRES Level 3, the clinical OSCE, which is a separate assessment and is not covered by this written-paper practice bank.
Assessment
A single computer-based written paper of 180 multiple-choice questions in single-best-answer and extended-matching formats, covering medicine and general practice, surgery, paediatrics, obstetrics & gynaecology and psychiatry, based on the Medical Council's eight domains of Good Professional Practice.
Time Limit
3 hours (180 minutes) for the 180-question written paper.
Passing Score
No fixed percentage pass mark. A criterion-referenced standard (modified Angoff) is applied to each sitting, so the cut score varies slightly with question difficulty. Candidates are normally allowed up to three attempts.
Exam Fee
Set by the Medical Council of Ireland and approximately EUR 460 per attempt; confirm the current fee on medicalcouncil.ie before applying. (Medical Council of Ireland)
PRES 2 Exam Content Outline
Medicine and General Practice
Core internal medicine and primary care across cardiology, respiratory, gastroenterology, renal, endocrinology, neurology and infectious disease, plus common general-practice presentations. Practice here emphasises diagnosis, first-line investigation, interpretation of results and evidence-based management in an Irish/HSE context.
Surgery
General surgery, the acute abdomen, trauma, urology and orthopaedics. Practice covers recognising surgical emergencies, initial assessment and resuscitation, appropriate imaging and investigation, and decisions about operative versus conservative management and referral.
Paediatrics
Common and serious childhood presentations, growth and development, immunisation, fluid and feeding issues and the febrile or unwell child. Practice emphasises recognising the seriously ill child, age-appropriate management and safe prescribing.
Obstetrics and Gynaecology
Antenatal and intrapartum care, obstetric emergencies such as pre-eclampsia and postpartum haemorrhage, contraception, menstrual and bleeding disorders and common gynaecological conditions. Practice emphasises early recognition and first-line management.
Psychiatry
Mood, anxiety and psychotic disorders, organic and substance-related presentations, and risk and suicide assessment. Practice covers diagnosis, first-line pharmacological and psychological treatment, and recognition of psychiatric emergencies.
How to Pass the PRES 2 Exam
What You Need to Know
- Passing score: No fixed percentage pass mark. A criterion-referenced standard (modified Angoff) is applied to each sitting, so the cut score varies slightly with question difficulty. Candidates are normally allowed up to three attempts.
- Assessment: A single computer-based written paper of 180 multiple-choice questions in single-best-answer and extended-matching formats, covering medicine and general practice, surgery, paediatrics, obstetrics & gynaecology and psychiatry, based on the Medical Council's eight domains of Good Professional Practice.
- Time limit: 3 hours (180 minutes) for the 180-question written paper.
- Exam fee: Set by the Medical Council of Ireland and approximately EUR 460 per attempt; confirm the current fee on medicalcouncil.ie before applying.
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
PRES 2 Study Tips from Top Performers
Frequently Asked Questions
What is PRES Level 2?
PRES Level 2 is the written, computer-based multiple-choice examination in the Medical Council of Ireland's Pre-Registration Examination System. It tests applied clinical knowledge across medicine, surgery, paediatrics, obstetrics & gynaecology and psychiatry for international medical graduates seeking registration in Ireland.
How many questions are on PRES 2 and how long is it?
PRES Level 2 is a written paper of 180 multiple-choice questions (single-best-answer and extended-matching) to be answered in 3 hours.
Is there a fixed pass mark for PRES 2?
No. The pass standard is set for each sitting using a criterion-referenced method (modified Angoff), so the exact cut score varies slightly between examinations depending on question difficulty. Candidates are normally allowed up to three attempts.
What is the difference between PRES 2 and PRES 3?
PRES Level 2 is the written MCQ examination of clinical knowledge. PRES Level 3 is a separate clinical OSCE that assesses practical and communication skills. Candidates must pass Level 2 before being permitted to sit Level 3.
Can I be exempt from PRES 2?
Some candidates are exempt, for example those who hold an accepted assessment such as PLAB, USMLE, AMC or MCCEE within recognised time limits, or who completed a recognised internship. Check current exemption criteria with the Medical Council of Ireland.
Are these official Medical Council of Ireland questions?
No. These are original OpenExamPrep practice questions modelled on the PRES 2 disciplines and standard. They are not copied from any Medical Council of Ireland past paper. Always confirm exam details on medicalcouncil.ie.