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Exam Review

Key Facts: Dip PEC(SA) Exam

100 Qs

MCQ Study Adaptation

OpenExamPrep Bank

R16 800

Exam Fee

CMSA Fee Schedule

50%

Passing Score

CMSA Regulations

CMSA

Exam Body

College of Emergency Medicine

The Dip PEC(SA) evaluates primary emergency care practitioners across resuscitation, cardiovascular, respiratory, trauma, toxicology, paediatric, and obstetric emergencies. This 100-MCQ practice bank provides focused written revision.

Sample Dip PEC(SA) Practice Questions

Try these sample questions to review concepts for the Dip PEC(SA) exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 45-year-old male presents to the Emergency Centre (EC) in ventricular fibrillation (VF) cardiac arrest. High-quality CPR is initiated, and a shock of 200 J (biphasic) is delivered. What is the immediate next step in management?
A.Resume high-quality chest compressions immediately for 2 minutes
B.Check the carotid pulse for 10 seconds to assess rhythm conversion
C.Administer 1 mg intravenous adrenaline immediately
D.Perform immediate endotracheal intubation before chest compressions
Explanation: According to ACLS guidelines, high-quality CPR must be resumed immediately for 2 minutes after a shock is delivered. Pulse checks or rhythm assessments are performed only after completing 5 cycles (2 minutes) of CPR. Immediate resumption of compressions maintains coronary perfusion pressure during the vulnerable post-shock period.
2A 32-year-old female presents to the EC following a motor vehicle collision. Her vital signs are: BP 85/50 mmHg, HR 125 bpm, RR 26 breaths/min. She has pale, cool skin and delayed capillary refill (4 seconds). According to the ATLS classification of haemorrhagic shock, which class of shock is she demonstrating?
A.Class I shock
B.Class III shock
C.Class II shock
D.Class IV shock
Explanation: This patient demonstrates Class III haemorrhagic shock (30-40% blood volume loss or 1500-2000 mL). Key features include hypotension (systolic BP < 90 mmHg), marked tachycardia (HR > 120 bpm), tachypnoea, cool pale peripheries, and altered mental state or delayed capillary refill.
3A 6-year-old boy is brought to the EC with severe respiratory distress, stridor at rest, sternal retractions, and a barking cough. What is the first-line pharmacotherapy according to South African primary emergency care guidelines?
A.Intravenous hydrocortisone 4 mg/kg
B.Nebulised L-adrenaline (epinephrine) 1:1000 and single-dose oral dexamethasone 0.6 mg/kg
C.Inhaled salbutamol via jet nebuliser
D.Oral amoxicillin/clavulanic acid
Explanation: Nebulised L-adrenaline (epinephrine) 1:1000 (2-5 mL) rapidly reduces upper airway mucosal oedema in severe croup, while single-dose oral dexamethasone (0.6 mg/kg) provides anti-inflammatory benefit. Dexamethasone is absorbed rapidly and reduces admission rates and symptom duration.
4A 28-year-old farmworker is brought to the EC after accidental exposure to an organophosphate pesticide. He is salivating excessively, lacrimating, wheezing, and has pinpoint pupils. What is the immediate definitive antidote to reverse his muscarinic manifestations?
A.N-acetylcysteine
B.Pralidoxime
C.Atropine sulphate
D.Flumazenil
Explanation: Atropine sulphate is the competitive antagonist at muscarinic acetylcholine receptors. In organophosphate toxicity, atropine is titrated rapidly (1-2 mg IV every 3-5 minutes, doubling doses) to clear bronchorrhoea and bronchospasm. Target endpoints are dry lungs and clear chest auscultation.
5A 58-year-old diabetic male presents with crushing substernal chest pain of 2 hours duration. The 12-lead ECG reveals 3 mm ST-segment elevation in leads II, III, and aVF with reciprocal ST depression in lead aVL. Which arterial territory is affected?
A.Left anterior descending coronary artery (LAD)
B.Left circumflex coronary artery (LCx)
C.Right coronary artery (RCA)
D.Left main coronary artery (LMCA)
Explanation: ST-segment elevation in leads II, III, and aVF indicates an inferior wall myocardial infarction, which is supplied by the Right Coronary Artery (RCA) in approximately 85-90% of individuals (right-dominant circulation).
6In the South African Triage Scale (SATS), a patient presenting with a pulse rate of 135 bpm, blood pressure of 82/45 mmHg, and GCS of 13 would be assigned which triage category?
A.Green (Routine)
B.Yellow (Urgent)
C.Red (Emergency / Resuscitation)
D.Orange (Very Urgent)
Explanation: Under the South African Triage Scale (SATS), a high Triage Early Warning Score (TEWS) or discriminator like severe hypotension (SBP < 90 mmHg), marked tachycardia, or reduced level of consciousness automatically triages the patient as RED (Emergency/Resuscitation), requiring immediate medical evaluation.
7A 30-year-old primigravida at 34 weeks gestation is brought to the EC having a generalized tonic-clonic seizure. Her blood pressure is 170/110 mmHg. What is the first-line anticonvulsant medication of choice?
A.Phenytoin sodium 18 mg/kg IV loading dose
B.Sodium valproate 400 mg IV bolus
C.Magnesium sulphate 4 g IV loading dose followed by 5 g IM in each buttock (or 1 g/hr IV infusion)
D.Diazepam 10 mg IV push
Explanation: Magnesium sulphate is the gold-standard treatment for eclampsia seizures and preeclampsia prevention (MAGPIE trial). The standard loading dose is 4 g IV over 10-15 minutes followed by 10 g IM (5 g in each buttock) or a continuous IV infusion of 1-2 g/hour.
8A 22-year-old asthmatic female presents with severe acute asthma exacerbation. She is unable to complete sentences in one breath, has a respiratory rate of 32/min, and HR 130 bpm. Peak expiratory flow (PEF) is 40% of predicted. Initial nebulised salbutamol and ipratropium bromide are started. What systemic corticosteroid regimen is indicated?
A.Oral prednisone 40-50 mg daily (or IV hydrocortisone 100-200 mg)
B.Inhaled fluticasone 250 mcg 2 puffs twice daily alone
C.Intravenous dexamethasone 100 mg push
D.Oral methylprednisolone 4 mg daily
Explanation: Systemic corticosteroids (oral prednisone 40-50 mg daily or IV hydrocortisone 100-200 mg 6-hourly) are mandatory in acute severe asthma to resolve airway inflammation, reduce hospital admissions, and prevent relapse.
9A 50-year-old male presents with sharp left-sided chest pain and sudden dyspnoea. Tracheal deviation to the right, hyper-resonance on left chest percussion, and absent left breath sounds are noted. His BP is 80/50 mmHg. What is the immediate mandatory intervention?
A.Immediate urgent chest radiograph (X-ray)
B.Immediate needle decompression of the left chest (2nd intercostal space mid-clavicular line or 5th intercostal space anterior axillary line)
C.Endotracheal intubation with positive pressure ventilation
D.Intravenous bolus of alteplase 50 mg
Explanation: Tension pneumothorax is a clinical diagnosis requiring immediate needle decompression prior to obtaining any chest radiograph. Delaying decompression for an X-ray can lead to rapid cardiovascular collapse due to obstructed venous return.
10A 3-year-old child presents with a 2-day history of acute watery diarrhoea and vomiting. Examination shows sunken eyes, loss of skin turgor (recoil > 2 seconds), and lethargy. According to WHO / IMCI guidelines, what is the hydration classification and recommended treatment?
A.No dehydration; send home with oral rehydration solution (ORS)
B.Some dehydration; treat with Plan B oral rehydration over 4 hours
C.Severe dehydration; initiate Plan C with rapid intravenous Ringer's Lactate (100 mL/kg)
D.Hypernatraemic dehydration; administer 5% Dextrose IV bolus
Explanation: Lethargy, sunken eyes, and very slow skin pinch (> 2 seconds) define severe dehydration under WHO/IMCI guidelines. Immediate Plan C resuscitation with IV fluid (Ringer's Lactate 100 mL/kg split into rapid boluses) is required.

About the Dip PEC(SA) Exam

The Diploma in Primary Emergency Care Dip PEC(SA) is awarded by the College of Emergency Medicine of South Africa. It assesses clinical competence in managing life-threatening emergencies, acute trauma, toxidromes, and paediatric/obstetric emergencies in South African emergency centres.

Exam sponsor: Colleges of Medicine of South Africa (CMSA), College of Emergency Medicine. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Written papers, OSCE, and oral examination testing emergency care competence across resuscitation, acute internal medicine, trauma, toxicology, paediatrics, obstetrics, and emergency procedures.

Time Limit

Written, OSCE, and Oral components

Passing Score

Overall 50% with written subminimum

Exam / Certification Fees

R16 800

Exam sponsor website

Reported exam pass rate: ~60-70%. Determined by the CMSA Senate and College of Emergency Medicine Examination Board. This describes exam candidates, not OpenExamPrep users or results from using our resources. 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.

25%

Resuscitation & Critical Care Emergencies

ACLS protocols, airway management, rapid sequence intubation (RSI), cardiac arrest rhythms, shock classification and fluid/pressor therapy, post-cardiac arrest care, and ventilator basics in the EC.

20%

Cardiovascular & Respiratory Emergencies

Acute coronary syndromes (STEMI/NSTEMI), acute heart failure, arrhythmias, pulmonary embolism, tension pneumothorax, acute severe asthma, COPD exacerbation, and emergency ECG interpretation.

20%

Trauma Management & Surgical Emergencies

ATLS primary and secondary survey, massive transfusion protocol (MTP), traumatic brain injury (TBI), chest trauma, abdominal trauma, burns, pelvic fractures, and South African Triage Scale (SATS).

15%

Toxicology, Environmental & Envenomation Emergencies

Organophosphate poisoning, paracetamol overdose, toxic alcohols, snakebite envenomation (cytotoxic, neurotoxic, haemotoxic), spider/scorpion envenomation, hypothermia, heat stroke, and electrical injuries.

20%

Paediatric, Obstetric & Procedural Emergencies

PALS resuscitation, paediatric respiratory distress, neonatal resuscitation, eclampsia/preeclampsia, antepartum/postpartum haemorrhage, emergency delivery, procedural sedation and analgesia (PSA), and diagnostic X-ray/POCUS interpretation.

Preparing for the Dip PEC(SA) Exam

What You Need to Know

  • Passing score: Overall 50% with written subminimum
  • Assessment: Written papers, OSCE, and oral examination testing emergency care competence across resuscitation, acute internal medicine, trauma, toxicology, paediatrics, obstetrics, and emergency procedures.
  • Time limit: Written, OSCE, and Oral components
  • Exam / certification fees: R16 800 Official sources

Using Our Practice Resources

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

Dip PEC(SA): Suggested Study Strategy

1Master ACLS and PALS resuscitation algorithms, including rapid sequence intubation (RSI) dosing and ventilator initial settings.
2Review ATLS principles, massive transfusion protocols (MTP), FAST ultrasound, and South African Triage Scale (SATS) color categories.
3Know the clinical presentations and antivenom indications for South African snakebites (puff adder, mamba, cobra) and organophosphate toxidromes.

Frequently Asked Questions

What is the examination format for the CMSA Dip PEC(SA)?

The examination comprises written papers, an Objective Structured Clinical Examination (OSCE), and an oral examination testing emergency medical decision-making.

What is the passing score and exam fee for Dip PEC(SA)?

The passing score is Overall 50% with written subminimum, and the official examination fee is R16 800.

What short courses are recommended before sitting the Dip PEC(SA)?

Candidates are strongly advised to hold active Provider status in Advanced Cardiovascular Life Support (ACLS), Advanced Trauma Life Support (ATLS), and Paediatric Advanced Life Support (PALS).