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Free Practice Questions for CONAREME Residentado Médico

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Key Facts: CONAREME Residentado Médico Exam

200 questions

Written exam length for specialty applicants (100 for subspecialty applicants)

D.S. N.° 007-2017-SA, Reglamento de la Ley N.° 30453

80% / 20%

Weight of the written exam and the curricular evaluation in the final score out of 100

D.S. N.° 007-2017-SA, Reglamento de la Ley N.° 30453

4 hours

Specialty exam duration, in two parts with a 1-hour intermission (2 hours for subspecialties)

CONAREME Disposiciones Complementarias 2026

S/ 1,200

Single application fee for the 2026 concurso, covering registration, evaluation and adjudication

CONAREME Disposiciones Complementarias 2026

6 areas

Clinical medicine, surgery, pediatrics, obstetrics-gynecology, public health and basic sciences

D.S. N.° 007-2017-SA, Reglamento de la Ley N.° 30453

40%

Share of written-exam questions that the regulation requires to be based on clinical cases

D.S. N.° 007-2017-SA, Reglamento de la Ley N.° 30453

6 Sep 2026

Date of the 2026 national written exam

CONAREME Disposiciones Complementarias 2026

CONAREME's residency entrance exam is a 200-item Spanish-language multiple-choice test worth 80% of the final score, plus a curricular evaluation worth 20%; vacancies go in strict order of merit. This free English-language MCQ adaptation covers the six official areas.

Sample CONAREME Residentado Médico Practice Questions

Try these sample questions to review concepts for the CONAREME Residentado Médico exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 107+ question experience with AI tutoring.

1A 58-year-old man presents to the emergency department with severe substernal chest pressure of 90 minutes' duration radiating to his left arm. Electrocardiogram reveals 3-mm ST-segment elevation in leads V1 through V4. The facility does not have a cardiac catheterization laboratory, and expected emergency transfer time to a percutaneous coronary intervention (PCI) center is 150 minutes. Which reperfusion strategy is indicated according to clinical guidelines?
A.Emergency transfer for primary percutaneous coronary intervention despite the anticipated transport delay
B.Immediate intravenous fibrinolytic therapy within 30 minutes of arrival, followed by transfer to a PCI-capable center
C.Administration of unfractionated heparin and observation for spontaneous ST-segment resolution before reperfusion
D.Immediate coronary artery bypass graft surgery consultation without antecedent pharmacological thrombolysis
Explanation: International STEMI guidelines (ACC/AHA and ESC) recommend that when primary PCI cannot be performed within 120 minutes of STEMI diagnosis, intravenous fibrinolytic therapy be given promptly (ACC/AHA door-to-needle goal: within 30 minutes of arrival) provided there are no contraindications. Following fibrinolysis, the patient must be transferred promptly to a PCI-capable hospital for rescue PCI or routine pharmacoinvasive angiography within 2 to 24 hours.
2A 64-year-old woman with chronic heart failure with reduced ejection fraction (HFrEF; left ventricular ejection fraction 32%) is clinically euvolemic on lisinopril and carvedilol. Which medication class is recommended as part of the guideline-directed medical therapy (GDMT) 'four pillars' to reduce cardiovascular mortality and heart failure hospitalization?
A.Loop diuretic e.g. furosemide administered continuously at high maintenance doses
B.Non-dihydropyridine calcium channel blocker e.g. diltiazem or verapamil
C.Sodium-glucose cotransporter 2 (SGLT2) inhibitor e.g. dapagliflozin or empagliflozin
D.Class Ic antiarrhythmic medication e.g. flecainide
Explanation: The four pillars of guideline-directed medical therapy for HFrEF are: (1) an ARNI (sacubitril/valsartan) or ACE inhibitor/ARB, (2) an evidence-based beta-blocker (carvedilol, metoprolol succinate, or bisoprolol), (3) a mineralocorticoid receptor antagonist (spironolactone or eplerenone), and (4) an SGLT2 inhibitor (dapagliflozin or empagliflozin). SGLT2 inhibitors confer significant mortality reduction and hospitalization benefit in HFrEF regardless of diabetic status.
3A 69-year-old woman has paroxysmal non-valvular atrial fibrillation and treated hypertension. She has no diabetes, heart failure, vascular disease, or prior stroke/TIA, and her renal function is normal. Which antithrombotic strategy is recommended to prevent thromboembolism?
A.No antithrombotic therapy because the arrhythmia is paroxysmal rather than permanent
B.Aspirin 100 mg daily monotherapy
C.Dual antiplatelet therapy with aspirin and clopidogrel
D.Direct oral anticoagulant (DOAC) e.g. apixaban or rivaroxaban
Explanation: Her CHA2DS2-VASc score is 3 (age 65-74 = 1, hypertension = 1, female sex = 1); oral anticoagulation is recommended for women with a score >= 3 (men >= 2). The 2024 ESC guideline drops sex from the score (CHA2DS2-VA = 2 here), and a score >= 2 still carries a Class I recommendation for anticoagulation. DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) are preferred over warfarin in non-valvular AF because of lower intracranial hemorrhage rates and no need for routine INR monitoring.
4A 28-year-old man presents with sharp anterior chest pain that improves when sitting upright and leaning forward, and worsens with deep inspiration and lying supine. Physical examination reveals a three-component pericardial friction rub. Which electrocardiographic finding characteristically distinguishes acute pericarditis from acute myocardial infarction in early stages?
A.Diffuse concave-upward ST-segment elevation with PR-segment depression across multiple limb and precordial leads
B.Convex-upward localized ST-segment elevation with reciprocal ST-segment depression in opposing leads
C.Prolonged QT interval with prominent pathological Q waves across leads V1 through V3
D.Persistent electrical alternans with right bundle branch block pattern
Explanation: Acute pericarditis characteristically produces widespread, diffuse concave-upward ST-segment elevation and concurrent PR-segment depression in both limb and precordial leads (except in lead aVR, which shows reciprocal PR elevation and ST depression). In contrast, acute myocardial infarction typically exhibits localized convex-upward ('tombstone') ST elevations adhering to a coronary artery distribution, accompanied by reciprocal ST depression in anatomically opposite leads.
5A 68-year-old man presents with a 3-day history of cough, purulent sputum, and fever. Vital signs: blood pressure 118/72 mmHg, heart rate 94 bpm, respiratory rate 24 breaths/min, temperature 38.4 °C. He is alert and oriented to person, place, and time. Laboratory testing reveals a blood urea nitrogen (BUN) of 14 mg/dL. Applying the CURB-65 criteria, what is his score and appropriate initial management setting?
A.CURB-65 score 0; discharge home with symptomatic treatment only
B.CURB-65 score 1; outpatient management is appropriate
C.CURB-65 score 3; immediate intensive care unit admission
D.CURB-65 score 2; mandatory inpatient telemetry admission
Explanation: The CURB-65 score assigns 1 point each for: Confusion (0), Urea > 7 mmol/L (BUN > 19 mg/dL) (0), Respiratory rate >= 30 breaths/min (0), Blood pressure < 90 mmHg systolic or <= 60 mmHg diastolic (0), and Age >= 65 years (1 point). The patient's score is 1 (only age >= 65). Patients with a CURB-65 score of 0 or 1 have low 30-day mortality (< 1.5–2%) and are suitable for outpatient oral antibiotic therapy.
6A 52-year-old woman is admitted to the general medical ward (not the ICU) with non-severe community-acquired pneumonia (CAP). She has no risk factors for Pseudomonas aeruginosa or MRSA. Which empiric intravenous antibiotic regimen is recommended by clinical practice guidelines?
A.Ciprofloxacin 400 mg IV every 12 hours monotherapy
B.Vancomycin 15 mg/kg IV every 12 hours plus piperacillin-tazobactam
C.Ceftriaxone 2 g IV once daily plus azithromycin 500 mg IV once daily
D.Amikacin 15 mg/kg IV once daily monotherapy
Explanation: ATS/IDSA empiric therapy for hospitalized patients with non-severe CAP (without risk factors for Pseudomonas or MRSA) is either a beta-lactam (e.g. ceftriaxone 1–2 g IV daily or ampicillin-sulbactam) combined with a macrolide (e.g. azithromycin), or monotherapy with a respiratory fluoroquinolone (e.g. levofloxacin or moxifloxacin). The combination provides dual coverage against Streptococcus pneumoniae and atypical intracellular pathogens (Legionella, Mycoplasma, Chlamydia pneumoniae).
7A 66-year-old chronic smoker with severe chronic obstructive pulmonary disease (COPD) presents with worsening dyspnea, increased sputum volume, and new purulent sputum over the past 48 hours. He is alert, with no accessory-muscle use. Arterial blood gas shows pH 7.39, PaCO2 48 mmHg, PaO2 62 mmHg on room air (his known chronic baseline). According to the Anthonisen criteria and GOLD guidelines, which management step is indicated?
A.Initiate long-term maintenance oral prednisone at 40 mg daily for at least six months
B.Withhold antibiotics because all acute COPD exacerbations are exclusively viral in origin
C.Administer 100% high-flow oxygen via non-rebreather mask to achieve SpO2 of 100%
D.Initiate systemic corticosteroids, inhaled short-acting bronchodilators, and an oral antibiotic course
Explanation: The patient exhibits all three cardinal Anthonisen symptoms of a Type 1 COPD exacerbation: worsening dyspnea, increased sputum volume, and increased sputum purulence. According to GOLD guidelines, management requires inhaled short-acting bronchodilators (SABA/SAMA), a 5-day course of systemic corticosteroids (prednisone 40 mg daily), and empiric antibiotic therapy (e.g. amoxicillin-clavulanate, azithromycin, or doxycycline) for 5 to 7 days. His pH is above 7.35, so the GOLD criterion for non-invasive ventilation (acute respiratory acidosis with pH <= 7.35 and PaCO2 >= 45 mmHg) is not met.
8Under Peru's MINSA tuberculosis norm (NTS N° 200-MINSA/DGIESP-2023), what is the standard regimen for an HIV-negative adult with newly diagnosed drug-sensitive pulmonary tuberculosis?
A.2 months of daily HRZE, then 4 months of isoniazid and rifampicin three times a week (2HRZE/4H3R3)
B.6 months of daily rifampicin and isoniazid without an initial four-drug intensive phase
C.2 months of streptomycin, isoniazid, and rifampicin followed by 7 months of ethambutol monotherapy
D.9 months of daily pyrazinamide, levofloxacin, and bedaquiline from the start of treatment
Explanation: Peru's regimen for drug-sensitive TB lasts 6 months: a first phase of 2 months with daily isoniazid (H), rifampicin (R), pyrazinamide (Z), and ethambutol (E) (50 doses), then a second phase of 4 months with isoniazid and rifampicin three times a week (54 doses), given as directly observed therapy. People living with HIV receive the second phase daily instead.
9A sputum sample from a 34-year-old male with persistent cough tested with GeneXpert MTB/RIF detects Mycobacterium tuberculosis with rifampicin resistance. By definition, multidrug-resistant tuberculosis (MDR-TB) requires microbiological resistance to which combination of medications?
A.Rifampicin and Pyrazinamide only
B.At least Isoniazid and Rifampicin simultaneously
C.Ethambutol and Streptomycin only
D.Any fluoroquinolone and one injectable aminoglycoside
Explanation: Multidrug-resistant tuberculosis (MDR-TB) is defined microbiologically by confirmed in vitro resistance to both of the two most potent first-line anti-TB drugs: Isoniazid and Rifampicin, with or without resistance to other drugs. Rifampicin resistance detected by GeneXpert is treated as a surrogate for MDR-TB until phenotypic or line probe assay susceptibility testing confirms the full profile.
10A 55-year-old man with newly diagnosed type 2 diabetes mellitus has an HbA1c of 8.2%. His estimated glomerular filtration rate (eGFR) is 78 mL/min/1.73m2, and liver enzymes are normal. He has no history of cardiovascular disease or renal disease. Which agent is the first-line pharmacological treatment of choice alongside lifestyle modifications?
A.Regular insulin monotherapy
B.Glibenclamide
C.Metformin
D.Acarbose
Explanation: Metformin remains the foundational first-line pharmacological agent for patients with type 2 diabetes mellitus due to its robust glycemic efficacy, absence of hypoglycemia risk as monotherapy, weight neutrality, favorable cardiovascular profile, and low cost. It is safe down to an eGFR of 30 mL/min/1.73m2 (dose reduction recommended between 30 and 44 mL/min).

About the CONAREME Residentado Médico Exam

The Concurso Nacional de Admisión al Residentado Médico is the single, annual national competition through which physicians in Peru obtain medical residency (specialty training) vacancies funded by MINSA, regional governments, EsSalud, the armed forces and police health services, the Instituto de Medicina Legal and private providers, under Ley N.° 30453 and D.S. N.° 007-2017-SA. Applicants are ranked on a curricular evaluation (20 points) and a 200-item Spanish-language written exam (80 points) covering clinical medicine, surgery, pediatrics, obstetrics and gynecology, public health and basic sciences; the 2026 exam was held on 6 September 2026. This page offers independent practice by OpenExamPrep on those six areas. It is an English-language multiple-choice study adaptation, not an official translation or a simulation of the Spanish-language exam.

Exam sponsor: Consejo Nacional de Residentado Médico (CONAREME) — Jurado de Admisión. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The evaluation stage has two parts. First, the Jurado de Admisión scores the online SIGESIN application file in a curricular evaluation worth 20 points. Second, applicants found apto sit a single national, standardized, paper-based written exam worth 80 points, taken at the same time at sites in Lima and the regions. Specialty applicants answer 200 items in two parts (4 hours with a 1-hour intermission); subspecialty applicants answer 100 items in 2 hours. The final score out of 100 ranks applicants nationally by specialty or subspecialty and application modality, and vacancies are adjudicated in strict order of merit.

Time Limit

4 hours for specialties (two parts with a 1-hour intermission); 2 hours for subspecialties

Passing Score

No fixed pass mark; vacancies are assigned in strict order of merit using a final score out of 100 (written exam 80 points + curricular evaluation 20 points)

Exam / Certification Fees

S/ 1,200.00 single application fee covering registration, evaluation and adjudication (2026 cycle)

Exam sponsor website

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

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.

Not published by CONAREME

Clínicas Médicas (clinical medicine)

Cardiology, pulmonology, endocrinology, nephrology, gastroenterology, hematology, rheumatology, neurology, and infectious and tropical diseases such as tuberculosis, dengue, malaria and Carrion's disease, using current guidelines and MINSA norms.

Not published by CONAREME

Clínicas Quirúrgicas (surgery)

Acute abdomen, biliary and pancreatic disease, bowel obstruction, hernias, trauma under ATLS 11 (xABCDE), hemorrhagic shock, burns, surgical-site infection and wound classification.

Not published by CONAREME

Clínicas Pediátricas (pediatrics)

Neonatal resuscitation and neonatal problems, nutrition and growth, Peru's 2026 immunization schedule, bronchiolitis, croup, pneumonia, dehydration plans, exanthems and pediatric emergencies.

Not published by CONAREME

Clínicas Gíneco-Obstétricas (obstetrics and gynecology)

Prenatal care and dating, gestational diabetes, preeclampsia and magnesium sulfate, obstetric hemorrhage, labor management, shoulder dystocia, gynecologic infections, contraception and Peru's 2025 cervical cancer screening directive.

Not published by CONAREME

Salud Pública (public health)

Measures of association and diagnostic tests, outbreak investigation, epidemiological surveillance and notification, MINSA facility categories, Redes Integradas de Salud, immunization of pregnant women, health-facility waste, bioethics and informed consent under Ley N.° 26842.

Not published by CONAREME

Ciencias Básicas (basic sciences)

Pharmacokinetics and autonomic pharmacology, renal physiology, biochemistry and inborn errors of metabolism, hepatitis B serology, cellular adaptation and parasitology.

Preparing for the CONAREME Residentado Médico Exam

What You Need to Know

  • Passing score: No fixed pass mark; vacancies are assigned in strict order of merit using a final score out of 100 (written exam 80 points + curricular evaluation 20 points)
  • Assessment: The evaluation stage has two parts. First, the Jurado de Admisión scores the online SIGESIN application file in a curricular evaluation worth 20 points. Second, applicants found apto sit a single national, standardized, paper-based written exam worth 80 points, taken at the same time at sites in Lima and the regions. Specialty applicants answer 200 items in two parts (4 hours with a 1-hour intermission); subspecialty applicants answer 100 items in 2 hours. The final score out of 100 ranks applicants nationally by specialty or subspecialty and application modality, and vacancies are adjudicated in strict order of merit.
  • Time limit: 4 hours for specialties (two parts with a 1-hour intermission); 2 hours for subspecialties
  • Exam / certification fees: S/ 1,200.00 single application fee covering registration, evaluation and adjudication (2026 cycle) Official sources

Using Our Practice Resources

  • Work through all 107 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

CONAREME Residentado Médico: Suggested Study Strategy

1Work through the exam booklets CONAREME publishes after each concurso (for 2026, Prueba A and Prueba B); most 2026 items were clinical vignettes asking for a diagnosis or the next step.
2Study all six official areas. Public health and basic sciences carry fewer questions than the clinical areas but are tested every year.
3Learn the current MINSA norms the exam draws on, such as the tuberculosis norm (NTS N.° 200-MINSA/DGIESP-2023), the 2026 immunization schedule (NTS N.° 246-MINSA/DGIESP-2026) and the 2025 cervical cancer screening directive.
4Practice quick calculations (anion gap, FeNa, Parkland, relative risk, odds ratio, sensitivity and specificity) until you can do them reliably under time pressure.
5Check guideline dates: recent changes include the 2024 DKA consensus (potassium below 3.5 before insulin) and ATLS 11 (xABCDE).
6Remember that the written exam is only 80% of your score; confirm early which curricular documents (SERUMS, ENAM, quinto superior, first-level service) you can submit.

Frequently Asked Questions

What is the CONAREME Concurso Nacional de Admisión al Residentado Médico?

It is the single annual national competition, run by the Consejo Nacional de Residentado Médico (CONAREME) under Ley N.° 30453, through which physicians in Peru obtain residency vacancies in medical and surgical specialties and subspecialties. Applicants register on the SIGESIN platform, pass a curricular evaluation and sit a national written exam, and then choose vacancies in strict order of merit.

How is the CONAREME written exam structured?

D.S. N.° 007-2017-SA sets 200 multiple-choice questions for specialty applicants and 100 for subspecialty applicants, covering clinical medicine, surgery, pediatrics, obstetrics and gynecology, public health and basic sciences, with 40% based on clinical cases. In 2026 the specialty exam lasted 4 hours in two parts with a 1-hour intermission, and each 100-item booklet had four answer options per question.

How is the final score calculated?

The written exam is worth 80% of the final score (80 points) and the curricular evaluation 20% (20 points). The curricular points come from SERUMS (up to 10), years in first-level public care (up to 4), belonging to the quinto superior (1), and the ENAM score and undergraduate average (up to 5). There is no fixed pass mark: vacancies are assigned by rank.

How much does it cost to apply?

In the 2026 concurso, applicants made a single payment of S/ 1,200.00 to CONAREME's collection account, covering registration, evaluation and adjudication.

Who can apply?

Physicians with a SUNEDU-registered Médico Cirujano degree, a current constancia de habilidad from the Colegio Médico del Perú, and a resolution showing completed SERUMS, plus a signed declaración jurada. Subspecialty applicants also need the prerequisite specialty title, and some application modalities require institutional authorization.

When is the exam held?

The concurso runs once a year. In 2026, registration opened in July and the written exam was held on 6 September 2026, followed by adjudication. Check CONAREME's website for the next cycle's schedule, rules and vacancies.

Is this practice official, and is it in Spanish?

No. The official exam is written in Spanish and prepared by CONAREME's Jurado de Admisión. This page offers independent practice by OpenExamPrep as an English-language MCQ study adaptation; it is not an official translation or a simulation of the exam. CONAREME publishes the booklets from past exams, which are the best source for the real Spanish wording.