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Key Facts: CMMU Medicina de Urgencias Exam

Online + ECOE

Theory exam online, then an in-person practical ECOE

CMMU Convocatoria 2026

26 Jun / 10 Jul 2026

XLVIII cycle theory exam / ECOE (Mexico City and Guadalajara)

CMMU Convocatoria 2026

MXN 6,900

Non-refundable donation (2026 cycle)

CMMU Convocatoria 2026

500

Candidate cap for the 2026 cycle

CMMU Convocatoria 2026

The CMMU certification is the CONACEM-recognized board process for Emergency Medicine in Mexico: an online theory exam followed by an in-person ECOE. In the XLVIII (2026) cycle, registration closed on 22 June, the theory exam was on 26 June, the ECOE was on 10 July, and the fee was MXN 6,900; watch cmmu.mx for the next convocatoria.

Sample CMMU Medicina de Urgencias Practice Questions

Try these sample questions to review concepts for the CMMU Medicina de Urgencias exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 106+ question experience with AI tutoring.

1A 58-year-old man in cardiac arrest presents with ventricular fibrillation. After an initial 200 J biphasic shock and 2 minutes of high-quality CPR, rhythm check shows persistent ventricular fibrillation. A second shock is delivered, CPR resumed, and intravenous access established. Which antiarrhythmic regimen is indicated if ventricular fibrillation persists after the third shock?
A.Magnesium sulfate 4 g IV bolus over 1 minute
B.Amiodarone 300 mg IV push (or lidocaine 1 to 1.5 mg/kg IV)
C.Procainamide 17 mg/kg IV infusion at 50 mg/min
D.Adenosine 12 mg rapid IV push followed by flush
Explanation: In shock-refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) that persists after the second or third shock and epinephrine administration, the primary antiarrhythmic choice is amiodarone 300 mg IV push (a second dose of 150 mg may follow) or alternatively lidocaine 1.0 to 1.5 mg/kg IV bolus.
2An emergency team initiates resuscitation for an adult patient with witnessed sudden collapse and monitor-confirmed ventricular fibrillation. Using a modern biphasic truncated exponential defibrillator with unknown manufacturer specifications, what is the initial recommended defibrillation energy dose?
A.50 Joules
B.100 Joules
C.120 to 200 Joules (or 200 Joules if device range is unknown)
D.360 Joules
Explanation: Current ACLS guidelines state that for adult cardiac arrest with shockable rhythms (VF/pVT), the initial biphasic energy should follow the manufacturer's recommendation (typically 120 to 200 J). If the operator is uncertain of the manufacturer recommendation, the maximum default dose (typically 200 J) should be selected.
3A 65-year-old woman is brought to the emergency department in pulseless electrical activity (PEA) cardiac arrest with a rate of 28 bpm on the monitor. High-quality chest compressions and bag-mask ventilation with 100% O2 are underway. Intravenous access is established. At what point should the first dose of epinephrine be administered?
A.Immediately, as soon as IV or IO access is established
B.Only after 2 complete 2-minute cycles of CPR have elapsed
C.After performing diagnostic ultrasound to verify absent wall motion
D.Only if atropine 1 mg fails to produce an organized rhythm
Explanation: In non-shockable cardiac arrest rhythms (asystole and PEA), evidence indicates that earlier administration of epinephrine is associated with increased rates of return of spontaneous circulation (ROSC) and survival. Epinephrine 1 mg IV/IO should be administered as soon as vascular access is available.
4A 52-year-old male achieves return of spontaneous circulation (ROSC) after 16 minutes of CPR for out-of-hospital ventricular fibrillation. On exam, he has a blood pressure of 118/74 mmHg, pulse of 92 bpm, and does not follow commands or open his eyes. According to current post-cardiac arrest temperature control guidelines, what is the recommended approach?
A.Aggressive deep hypothermia between 28°C and 30°C for 72 hours
B.Permissive hyperthermia up to 38.5°C to preserve enzymatic activity
C.No temperature management; treat fever only if it exceeds 39°C
D.Deliberate temperature control at a constant target between 32°C and 37.5°C, with active fever prevention, for at least 36 hours
Explanation: The 2025 AHA post-cardiac arrest guidelines recommend deliberate temperature control for adults who do not follow commands after ROSC, selecting and maintaining a constant temperature between 32°C and 37.5°C (Class 1), and consider it reasonable to continue temperature control for at least 36 hours. The range covers both hypothermic (32–34°C) and normothermic fever-prevention (36–37.5°C) strategies; ERC-ESICM guidance likewise emphasizes preventing fever (>37.7°C) for at least 72 hours. The key principle is continuous core temperature monitoring with active prevention of hyperthermia.
5A 62-year-old man with end-stage renal disease who missed two hemodialysis sessions develops PEA cardiac arrest. The monitor shows a sine-wave appearance with marked QRS widening. The resuscitation team suspects severe hyperkalemia. Which medication should be administered immediately as the first-line membrane-stabilizing therapy?
A.Sodium bicarbonate 50 mEq IV push
B.Calcium gluconate 10% (10 to 20 mL IV) or calcium chloride 10% (5 to 10 mL IV)
C.Regular insulin 10 units IV with 50 mL of 50% dextrose
D.Nebulized salbutamol 20 mg via facemask
Explanation: Intravenous calcium (calcium gluconate or calcium chloride) directly antagonizes the cardiotoxic membrane effects of hyperkalemia by restoring the resting membrane potential gradient and narrowing the QRS complex within 1 to 3 minutes. It does not lower serum potassium, but it prevents fatal dysrhythmias while shifting agents take effect.
6During resuscitation for ventricular fibrillation, an initial defibrillation shock of 200 J fails, and the patient remains in VF after 2 minutes of CPR. A second shock is delivered. At what specific point in the shockable ACLS algorithm should the first dose of epinephrine (1 mg IV/IO) be administered?
A.Prior to delivering the initial defibrillation shock
B.Immediately after the first shock while compressions are held
C.During CPR immediately following the second defibrillation shock
D.Only after amiodarone has been completely infused
Explanation: In adult shockable cardiac arrest (VF/pVT), high-quality CPR and early defibrillation take precedence. If VF persists after the second shock, epinephrine 1 mg IV/IO is administered during the CPR cycle that follows the second shock, and repeated every 3 to 5 minutes thereafter.
7A patient with refractory ventricular fibrillation received an initial dose of amiodarone 300 mg IV push after the third defibrillation attempt. Resuscitation continues, and VF persists after a fourth shock and additional CPR. What is the recommended second dose of amiodarone?
A.150 mg IV push
B.300 mg IV push
C.450 mg IV push
D.50 mg IV bolus followed by a 24-hour infusion
Explanation: In cardiac arrest due to refractory VF or pulseless VT, the initial amiodarone dose is 300 mg IV/IO bolus. If the shockable dysrhythmia persists or recurs, a single supplementary dose of 150 mg IV/IO bolus is administered.
8A 44-year-old woman with severe septic shock due to ascending pyelonephritis presents with respiratory failure and worsening encephalopathy. Her vital signs are: BP 70/42 mmHg, HR 128 bpm, SpO2 86% on high-flow mask. Emergency rapid sequence intubation (RSI) is planned. Which induction agent is preferred for its minimal hemodynamic impact?
A.Propofol 2.0 mg/kg IV
B.Midazolam 0.3 mg/kg IV
C.Thiopental sodium 4.0 mg/kg IV
D.Etomidate 0.3 mg/kg IV (or dose-reduced ketamine 1.0 to 1.5 mg/kg IV)
Explanation: Etomidate (0.2 to 0.3 mg/kg IV) provides rapid hypnotic induction with exceptional cardiovascular stability, avoiding significant myocardial depression or peripheral vasodilation in hemodynamically unstable septic shock. Ketamine at titrated doses is also a safe alternative.
9A 36-year-old construction worker sustained third-degree burns covering 45% of his body surface area 5 days ago and is admitted to the emergency department in acute respiratory distress from nosocomial pneumonia. RSI is indicated. Why is succinylcholine strictly contraindicated in this patient?
A.Risk of triggering acute hepatic necrosis and porphyria
B.Risk of catastrophic hyperkalemia due to extrajunctional acetylcholine receptor proliferation
C.High incidence of acute bronchospasm and laryngeal edema
D.Resistance to depolarizing blockade requiring 10-fold dosing
Explanation: Following severe burns, major crush injuries, denervation, or prolonged immobility starting after 24 to 48 hours, extrajunctional nicotinic acetylcholine receptors upregulate across the entire sarcolemma. Succinylcholine causes widespread channel opening, releasing massive quantities of potassium into the plasma, triggering fatal ventricular dysrhythmias.
10A 50-year-old obese male underwent emergency RSI with rocuronium 1.2 mg/kg. Direct laryngoscopy and video laryngoscopy fail to visualize the vocal cords (Grade 4 view). Insertion of a second-generation laryngeal mask airway fails to provide ventilation, and face-mask ventilation cannot maintain SpO2 above 70%. In this 'cannot intubate, cannot oxygenate' scenario, which specific pharmacological reversal agent can rapidly encapsulate rocuronium?
A.Neostigmine 0.05 mg/kg with glycopyrrolate 0.01 mg/kg
B.Physostigmine 2.0 mg IV push
C.Sugammadex 16 mg/kg IV bolus
D.Dantrolene sodium 2.5 mg/kg IV push
Explanation: Sugammadex at a high dose of 16 mg/kg IV is the selective relaxant binding agent capable of immediate (within 3 minutes) reversal of deep or profound neuromuscular blockade induced by high-dose rocuronium (1.2 mg/kg), while the emergency airway team prepares front-of-neck access.

About the CMMU Medicina de Urgencias Exam

Independent study practice by OpenExamPrep for the Examen Nacional de Certificación in Medicina de Urgencias run by the Consejo Mexicano de Medicina de Urgencias, A.C. (CMMU), a CONACEM-recognized specialty council. This bank is an independent English-language MCQ study adaptation organized around the areas of the CMMU suggested study guide; it is not an official translation or simulation of the Spanish-language CMMU exams, and it does not cover the practical ECOE.

Exam sponsor: Consejo Mexicano de Medicina de Urgencias, A.C. (CMMU). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The CMMU certification has two stages. The theoretical exam is taken online; candidates then sit an in-person practical exam in ECOE format (objective structured clinical examination). In the XLVIII (2026) cycle, the theory exam was on 26 June 2026 and the ECOE on 10 July 2026 in Mexico City and Guadalajara, with final results on 24 July 2026; the council states the final result cannot be appealed. The CMMU does not publish an item count, time limit, pass mark or topic weights.

Time Limit

Not published

Passing Score

not-published

Exam / Certification Fees

MXN 6,900 non-refundable donation (XLVIII cycle, 2026)

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Core section (weight not published)

Reanimación Cardiopulmonar, Vía Aérea Difícil y Soporte Cardiovascular Avanzado

ACLS resuscitation guidelines, defibrillation energies, antiarrhythmics, H's and T's reversible causes, post-cardiac arrest temperature control, rapid sequence intubation (7 Ps), difficult airway rescue algorithms, cardiogenic shock, transcutaneous pacing, and pediatric CPR

Core section (weight not published)

Trauma y Medicina de Desastres

ATLS 10th/11th edition principles, damage control resuscitation with 1:1:1 blood product ratios, tranexamic acid administration (CRASH-2), tension pneumothorax decompressions, flail chest, cardiac tamponade, pelvic binder application, NEXUS/Canadian C-spine clearance, and disaster triage (START/SALT)

Core section (weight not published)

Emergencias Neurológicas y Cardiovasculares

Acute ischemic stroke thrombolysis window (4.5 hours) and endovascular thrombectomy (up to 24 hours), permissive hypertension targets, subarachnoid hemorrhage grading (Hunt-Hess, Fisher), status epilepticus step-wise escalation, acute aortic syndrome dissection classifications, and hypertensive emergencies

Core section (weight not published)

Toxicología de Urgencia y Emergencias Ambientales

Toxidrome recognition (anticholinergic, cholinergic, sympathomimetic, opioid, sedative-hypnotic), specific antidotes (naloxone, N-acetylcysteine, glucagon, high-dose insulin-euglycemia, atropine/pralidoxime), Mexican venomous bites and stings (Bothrops, Micrurus, Latrodectus, Loxosceles, Centruroides antivenom Faboterápicos), heat stroke, and accidental hypothermia

Core section (weight not published)

Emergencias Gastrointestinales, Respiratorias y Metabólicas

Septic shock (Surviving Sepsis Campaign), life-threatening asthma and COPD exacerbations, acute mesenteric ischemia and CT angiography, acute necrotizing pancreatitis antibiotic strategy, variceal bleeding, diabetic ketoacidosis versus hyperosmolar hyperglycemic state (2024 consensus), sodium and calcium emergencies, eclampsia, Ludwig angina, and adrenal and thyroid crises

Preparing for the CMMU Medicina de Urgencias Exam

What You Need to Know

  • Passing score: not-published
  • Assessment: The CMMU certification has two stages. The theoretical exam is taken online; candidates then sit an in-person practical exam in ECOE format (objective structured clinical examination). In the XLVIII (2026) cycle, the theory exam was on 26 June 2026 and the ECOE on 10 July 2026 in Mexico City and Guadalajara, with final results on 24 July 2026; the council states the final result cannot be appealed. The CMMU does not publish an item count, time limit, pass mark or topic weights.
  • Time limit: Not published
  • Exam / certification fees: MXN 6,900 non-refundable donation (XLVIII cycle, 2026) Official sources

Using Our Practice Resources

  • Work through all 106 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

CMMU Medicina de Urgencias: Suggested Study Strategy

1Master advanced resuscitation protocols: energy levels for synchronized cardioversion vs defibrillation, amiodarone and lidocaine dosing in shock-refractory cardiac arrest, and post-arrest temperature control (a constant 32-37.5°C with active fever prevention, per the 2025 AHA guidelines).
2Rehearse rapid sequence intubation (RSI) pharmacology in hemodynamic compromise, prioritizing etomidate or ketamine over propofol, knowing succinylcholine contraindications, and executing the CICO scalpel-bougie-tube cricothyroidotomy algorithm.
3Review trauma resuscitation principles: implementing massive transfusion protocols (1:1:1 ratio), administering tranexamic acid within 3 hours of injury, applying pelvic binders over the greater trochanters, and applying NEXUS/Canadian C-spine rules.
4Know acute stroke and acute aortic syndrome management: tissue plasminogen activator (rtPA) inclusion/exclusion criteria, blood pressure targets before and during thrombolysis (<185/110 mmHg), and Stanford type A (emergent surgery) vs type B (medical therapy with IV beta-blockers) protocols.
5Memorize toxidromes and antidotes, especially Mexican fabotherapy (Antivipmyn, Coralmyn, Alacramyn, Aracmyn) for Bothrops asper, Micrurus, Centruroides and Latrodectus envenomation, the management of loxoscelism, and high-dose insulin for calcium channel blocker toxicity.
6Cover the whole CMMU study guide, including pediatric, obstetric, ophthalmologic and ENT emergencies, not only adult resuscitation and trauma.

Frequently Asked Questions

What is the CMMU certification exam?

The Examen Nacional de Certificación en Medicina de Urgencias is run by the Consejo Mexicano de Medicina de Urgencias, A.C. (CMMU), whose certification carries CONACEM idoneidad. Emergency medicine specialists who finish residency apply through the CMMU platform and sit a theory exam and a practical ECOE.

How was the 2026 (XLVIII) exam organized?

According to the official 2026 convocatoria, registration and document upload closed on 22 June 2026 with a cap of 500 candidates. The theory exam was held online on Friday 26 June 2026, theory results were released on 3 July, the practical ECOE took place on Friday 10 July 2026 in Mexico City and Guadalajara, and final results were published on 24 July 2026. The council states that the final result cannot be appealed.

How much does it cost, and what is the pass mark?

The 2026 convocatoria lists a non-refundable donation of MXN 6,900, paid by bank deposit with the receipt uploaded to the CMMU platform. The council does not publish an item count, time limit or pass mark.

What does the exam cover?

The CMMU publishes a suggested study guide (Guía de Estudio Sugerida) grouped by area: the critically ill patient, cardiology, pulmonology, trauma, neurology, endocrinology, gastroenterology, ophthalmology, ENT, environmental emergencies, toxicology, pediatrics and obstetrics-gynecology. No topic weights are published.

Why is this practice bank in English?

The CMMU exams are conducted in Spanish. This OpenExamPrep bank is an independent English-language MCQ study adaptation for reviewing the clinical content; it is not an official translation or simulation of the CMMU exams, and it does not replicate the practical ECOE.