Original clinical questions for doctors preparing for the DHA exam, with explanations.
Short answer: 12 original multiple-choice practice questions for doctors preparing for the DHA licensing exam, each with the correct answer and a full explanation. They span the main clinical subjects, are original and are not real exam items. Use them to practise clinical reasoning and to find gaps.
About these questions
Every question here is original. Meddex wrote it for exam preparation. None is a real, recalled or leaked exam item, and none comes from DHA, Prometric, UAE University or the NIHS.
Meddex is independent and is not affiliated with DHA, Prometric, UAE University or the NIHS.
Clinical review of the question bank is not complete yet. Treat the explanations as study aids and check official guidance before you rely on a fact.
This is a sample, not the whole bank, and doing well on it does not predict an exam result.
The exam these questions prepare you for
DHA's CBT Guideline (cover "Updated - Sep 2026") lists 150 questions in a stated 3 hours for the General Practice title, with a pass score of 60 percent. DHA says the stated time includes registration and the process introduction, and that it can change the format or the pass score without updating the guideline, so confirm on DHA's own site. DHA does not state how many answer options its questions have or whether each has one best answer. Meddex practice items use four options with one best answer, as a practice format.
DHA runs a separate exam for each physician title, and the pass score depends on the title: the guideline gives General Practice 60 percent, specialists a range and consultants more. These questions suit general clinical reasoning. They are not written for one specialty, so check your own title on DHA's site.
What this set covers
This set has 12 physician questions drawn from 10 clinical subjects, such as cardiovascular and respiratory medicine, emergencies, infection, medical-surgical conditions, women's and children's health, mental health, ethics and public health.
Questions are spread across the subjects, so you meet each one rather than five of the same kind. The set is fixed and chosen by a simple rule, so the same questions appear every time you come back.
How to use these questions
Read the stem and cover the options if you can, then decide what you would do. Choose an answer before you press Show answer. If you were wrong, read the reason for your option as well as the correct one, and write down the idea you missed.
Answer all the questions once without looking.
Press Show answer one question at a time and read every explanation.
List the subjects where you missed two or more, then use the topic pages or the app to practise those.
Practice questions
Question 1
Fundamentals & Patient SafetyMedium
A 58-year-old man with type 2 diabetes has burning, shooting pain and allodynia in both feet, worse at night. Examination suggests painful diabetic neuropathy and renal function is normal. Which initial treatment is most appropriate?
AOption A: Regular tramadol, titrated up until the pain is controlled
BOption B: Paracetamol with codeine, which is the standard first step for nerve pain
COption C: Oral morphine at night, starting at a low dose and titrating upward
DOption D: Amitriptyline at a low dose at night, titrated upwards as tolerated
Show answer for question 1
Correct answer: D. Amitriptyline at a low dose at night, titrated upwards as tolerated
For neuropathic pain, NICE advises offering amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment, with another of these tried if the first fails or is not tolerated. Opioids, including tramadol, are not recommended for initial treatment of neuropathic pain.
Why A is wrong. Tramadol is not recommended for initial treatment of neuropathic pain, and it carries risks of dependence.
Why B is wrong. Simple analgesics and weak opioids are of little benefit in neuropathic pain.
Why C is wrong. Strong opioids are not recommended as initial treatment and carry significant risk.
Topic: Pain - neuropathic pain, choosing the initial drug. Reference: NICE CG173 Neuropathic pain in adults: pharmacological management in non-specialist settings
Question 2
Infection Prevention & ControlMedium
A 44-year-old farm worker has had three weeks of fever, night sweats and weight loss, with a new aortic regurgitant murmur. Echocardiography shows an aortic valve vegetation. Three sets of blood cultures taken before any antibiotic and incubated for five days are negative. He works closely with goats and sheep. What is the most appropriate next step?
AOption A: Exclude endocarditis because the cultures are negative and review him in clinic after a month
BOption B: Send valve tissue for culture only after surgery, with no further tests before then
COption C: Request serology for Coxiella burnetii and Bartonella species and discuss further testing with microbiology
DOption D: Repeat blood cultures every day for a month before considering any other test
Show answer for question 2
Correct answer: C. Request serology for Coxiella burnetii and Bartonella species and discuss further testing with microbiology
Blood cultures are negative in a minority of endocarditis cases, usually because of earlier antibiotics or fastidious intracellular organisms such as Coxiella burnetii, Bartonella and Brucella. Contact with livestock points towards Q fever. With negative cultures and a vegetation, guidelines advise serology for these organisms, with PCR on valve tissue if surgery is needed, and early discussion with microbiology and the endocarditis team.
Why A is wrong. A vegetation with fever and a new murmur still meets the picture of endocarditis, and negative cultures do not exclude it.
Why B is wrong. Waiting for surgery leaves a possible treatable infection undiagnosed, and valve PCR is an addition to serology, not a replacement.
Why D is wrong. Further cultures rarely help when three good sets were taken before antibiotics.
Topic: Blood cultures: negative cultures in suspected endocarditis. Reference: 2023 ESC Guidelines for the management of endocarditis
Question 3
Pharmacology & Medication SafetyMedium
A 16-year-old with focal epilepsy has been seizure-free for two months on levetiracetam. His mother reports that over the past weeks he has become irritable, tearful and aggressive at home, which is out of character. He has no other new medicines. What is the best next step?
AOption A: Increase the dose, because irritability and aggression are signs that the blood level is too low
BOption B: Review with the epilepsy team to consider a dose change or switch, and do not stop it abruptly
COption C: Reassure the family that changes in behaviour at this age cannot be related to his drug treatment
DOption D: Stop levetiracetam today, because a psychiatric adverse effect means that it cannot be continued
Show answer for question 3
Correct answer: B. Review with the epilepsy team to consider a dose change or switch, and do not stop it abruptly
Irritability, aggression and low mood are well-recognised adverse effects of levetiracetam, especially in adolescents. Abrupt withdrawal risks seizure recurrence, so the dose is reviewed with the epilepsy team, who may reduce it, or switch to another drug. Mood and risk are assessed, and the family is told that the effect is reversible.
Why A is wrong. A higher dose is likely to make a drug-related behavioural effect worse.
Why C is wrong. Behavioural effects are common and reported, so dismissing the link overlooks a treatable cause.
Why D is wrong. Abrupt withdrawal can provoke seizures, so a planned change is safer than stopping at once.
Topic: Antiepileptic: levetiracetam behavioural effects. Reference: NICE NG217 Epilepsies in children, young people and adults; BNF: Levetiracetam (adverse effects)
Question 4
Medical-Surgical & Chronic DiseaseEasy
A 29-year-old woman has had 8 months of abdominal pain that eases after opening her bowels, bloating and alternating loose and hard stools. There is no weight loss, rectal bleeding or family history of bowel cancer. Full blood count, CRP, coeliac serology and faecal calprotectin are normal. What is the most appropriate next step?
AOption A: Colonoscopy to exclude inflammatory bowel disease and cancer
BOption B: CT of the abdomen and pelvis
COption C: Diagnose irritable bowel syndrome and give dietary and lifestyle advice
DOption D: A six-month course of a gluten-free diet before any further assessment is made
Show answer for question 4
Correct answer: C. Diagnose irritable bowel syndrome and give dietary and lifestyle advice
In a young patient with typical symptoms, no alarm features and normal basic tests, irritable bowel syndrome can be diagnosed positively without further investigation. A normal faecal calprotectin makes inflammatory bowel disease unlikely. Management starts with explanation, dietary advice (regular meals, adjusting fibre and, if needed, a low FODMAP diet), activity and, for symptom control, antispasmodics or laxatives. Colonoscopy and CT add cost and risk without benefit here.
Why A is wrong. Colonoscopy is for those with alarm features or abnormal tests, and neither applies here.
Why B is wrong. CT exposes her to radiation and is not indicated with typical symptoms and no alarm features.
Why D is wrong. Her coeliac serology is normal, so a long gluten-free trial is not justified.
Topic: Gastrointestinal disease: irritable bowel syndrome. Reference: NICE CG61 Irritable bowel syndrome in adults: diagnosis and management
Question 5
Medical-Surgical & Chronic DiseaseMedium
A 35-year-old woman has 3 months of fatigue and joint aches. ALT is 480 U/L, AST 420 U/L and ALP is mildly raised. IgG is raised and antinuclear antibody is positive at 1 in 320. Viral hepatitis serology is negative, and she takes no medicines or supplements. Liver biopsy shows interface hepatitis with plasma cells. What is the most appropriate treatment?
AOption A: Entecavir, started as antiviral therapy
BOption B: Prednisolone, then azathioprine to maintain remission
COption C: Ursodeoxycholic acid alone, to improve bile flow and protect the liver
DOption D: Observation with repeat liver tests in six months
Show answer for question 5
Correct answer: B. Prednisolone, then azathioprine to maintain remission
Raised transaminases with raised IgG, positive autoantibodies and interface hepatitis with plasma cells on biopsy establish autoimmune hepatitis, after viral, drug-induced and metabolic causes are excluded. Treatment is prednisolone to induce remission, with azathioprine added to maintain remission and allow the steroid dose to fall. Untreated disease progresses to cirrhosis. Ursodeoxycholic acid is used in cholestatic diseases, and entecavir treats hepatitis B.
Why A is wrong. Entecavir treats hepatitis B, which has been excluded.
Why C is wrong. Ursodeoxycholic acid alone does not suppress the immune injury of hepatitis.
Why D is wrong. Active disease with this degree of enzyme rise progresses without treatment, so observation is not appropriate.
A 78-year-old man who drinks heavily has had three weeks of worsening headache and fluctuating confusion after a minor fall. He is now drowsy with a Glasgow Coma Scale score of 12 and mild left-sided weakness. CT shows a crescentic low-density collection over the right hemisphere that crosses suture lines, with 9 mm of midline shift. He takes no anticoagulant. What is the most appropriate management?
AOption A: Admission for observation and a repeat scan next week, because these collections settle on their own
BOption B: Lumbar puncture to measure the opening pressure and guide further treatment
COption C: Oral dexamethasone and discharge with outpatient neurology review in four weeks
DOption D: Urgent neurosurgical referral for burr-hole drainage of the collection
Show answer for question 8
Correct answer: D. Urgent neurosurgical referral for burr-hole drainage of the collection
A chronic subdural haematoma in an older person who drinks heavily or has brain atrophy may present weeks after a minor fall with headache, confusion and focal signs. A symptomatic collection with midline shift and falling consciousness needs surgical drainage, usually through burr holes. Conservative management is kept for small collections without deficit, and lumbar puncture is dangerous when there is mass effect.
Why A is wrong. Observation is suitable only for small collections without neurological deficit, which is not the picture here.
Why B is wrong. Lumbar puncture risks brain herniation when there is a mass and midline shift.
Why C is wrong. Steroids and discharge leave a growing mass with a falling conscious level untreated.
Topic: Intracranial haematoma: chronic subdural. Reference: Santarius T et al. Use of drains versus no drains after burr-hole evacuation of chronic subdural haematoma: a randomised controlled trial. Lancet 2009;374:1067-1073; Oxford Handbook of Emergency Medicine
Question 9
Maternal & Child HealthEasy
An 8-year-old girl has influenza with a temperature of 39.2 C and aches. Her mother has aspirin tablets at home and asks if she can give one to bring the temperature down. What is the best advice?
AOption A: A low dose of aspirin is safe, because Reye syndrome has been reported only after high doses taken for days
BOption B: Avoid aspirin because of the risk of Reye syndrome, and use paracetamol or ibuprofen for comfort
COption C: Aspirin is the best antipyretic for children over five years, because it also reduces inflammation
DOption D: Give aspirin only if the fever stays above 39 C for more than 48 hours despite paracetamol
Show answer for question 9
Correct answer: B. Avoid aspirin because of the risk of Reye syndrome, and use paracetamol or ibuprofen for comfort
Aspirin given to children and teenagers during a viral illness such as influenza or chickenpox has been linked to Reye syndrome, a rare illness with acute encephalopathy and fatty liver that can be fatal. Aspirin is therefore avoided in children under 16 unless there is a specific indication, for example Kawasaki disease, and paracetamol or ibuprofen are used for comfort at weight-based doses. A lower dose or a longer fever does not make aspirin safe for this purpose.
Why A is wrong. Reye syndrome has followed ordinary doses of aspirin, so a low dose does not remove the risk.
Why C is wrong. Aspirin is not recommended as an antipyretic in children because of the link with Reye syndrome.
Why D is wrong. A longer fever is not a reason to take the risk, and the other antipyretics remain available.
Topic: Fever in infants and children: aspirin and Reye syndrome. Reference: BNF: Aspirin, contra-indications in children under 16; CDC: Reye syndrome, information for health professionals
Question 10
Mental Health & NeurologyMedium
A 41-year-old man with schizophrenia has taken clozapine 400 mg daily for two years and smokes 25 cigarettes a day. He is admitted to a smoke-free unit where he cannot smoke, and nicotine patches are started. What is the most appropriate action about his clozapine?
AOption A: Check a clozapine level and reduce the dose, because levels rise when smoking stops
BOption B: Stop clozapine for a week and then restart at 12.5 mg and titrate as for a new patient
COption C: Make no change, because nicotine patches keep up the enzyme induction that smoking causes
DOption D: Increase the dose, because nicotine withdrawal will make his psychosis worse
Show answer for question 10
Correct answer: A. Check a clozapine level and reduce the dose, because levels rise when smoking stops
Tobacco smoke, not nicotine, induces the liver enzyme CYP1A2, which clears clozapine. When a person stops smoking, induction wears off over days and clozapine levels can rise by about half, with a risk of sedation, seizures and other toxicity. A level is checked and the dose is reduced, with monitoring, when smoking stops. Nicotine replacement does not maintain the induction.
Why B is wrong. Stopping and restarting treatment is not needed and carries a risk of relapse, and the restart schedule is for long gaps.
Why C is wrong. Nicotine does not induce CYP1A2, so patches do not maintain the effect of smoking.
Why D is wrong. A higher dose would add to the rise in levels and raise the risk of toxicity.
Topic: Clozapine: effect of stopping smoking. Reference: Wagner E et al. Impact of smoking behavior on clozapine blood levels: a systematic review and meta-analysis. Acta Psychiatr Scand 2020; The Maudsley Prescribing Guidelines in Psychiatry
Question 11
Ethics, Law & ProfessionalismMedium
A junior doctor realises that her ward round entry for Mr A was written in Mr B's electronic record. The content is correct for Mr A. What is the most appropriate action?
AOption A: Ask a colleague to overwrite the entry in Mr B's record with the details of his own care
BOption B: Delete the whole entry from Mr B's record so that no trace remains, then write it again in Mr A's
COption C: Mark the entry as made in error under the records policy, rewrite it in Mr A's record, and report it as an incident
DOption D: Leave it as it is, because the clinical content is correct and only the patient is wrong
Show answer for question 11
Correct answer: C. Mark the entry as made in error under the records policy, rewrite it in Mr A's record, and report it as an incident
Records are legal documents and must not be deleted or overwritten. An entry in the wrong record is flagged as made in error following the organisation's policy, so that the original remains visible in the audit trail, and the correct entry is made in the right record. The event is reported as an incident because it may also have exposed Mr A's information and could mislead others reading Mr B's notes. Leaving it unchanged would leave misleading information in Mr B's notes.
Why A is wrong. Overwriting the entry hides the original and involves another person in altering a record.
Why B is wrong. Deleting an entry removes the audit trail and breaches record-keeping standards.
Why D is wrong. Leaving a wrong-patient entry in place could mislead clinicians and exposes Mr A's information.
Topic: Error: an entry written in the wrong patient's record. Reference: GMC: Good medical practice, record keeping; WHO Patient Safety Curriculum Guide: Multi-professional edition
Question 12
Public Health & PreventionMedium
A randomised trial reports a hazard ratio for death of 0.70 (95 percent confidence interval 0.55 to 0.89) for a new drug versus placebo. Which interpretation is correct?
AOption A: 70 percent of the patients on the drug were still alive at the end of the follow-up period of the study
BOption B: The drug reduced the absolute risk of death by 30 percentage points
COption C: The result is not statistically significant because the hazard ratio is below 1
DOption D: About 30 percent lower risk of death at any time, and the result is statistically significant
Show answer for question 12
Correct answer: D. About 30 percent lower risk of death at any time, and the result is statistically significant
A hazard ratio compares the instantaneous risk of the event over time between groups. A value of 0.70 means about 30 percent lower hazard in the treated group. Because the 95 percent confidence interval of 0.55 to 0.89 does not include 1, the difference is statistically significant at the 5 percent level. A hazard ratio is a relative measure and not an absolute risk difference.
Why A is wrong. A hazard ratio is not the proportion who survived.
Why B is wrong. The ratio is a relative effect, so it does not tell us how many percentage points absolute risk fell.
Why C is wrong. A ratio below 1 with an interval that excludes 1 is significant, not insignificant.
Topic: Trial - interpreting a hazard ratio. Reference: Kirkwood and Sterne, Essential Medical Statistics
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Frequently asked questions
No. They are original practice questions written by Meddex for exam preparation. DHA does not publish sample questions, and its Assessment Manual says sharing assessment questions is not allowed, so we do not use or claim real or recalled items.
No. EMREE is a residency entrance exam and the DHA exam is part of licensing. They have different organisers and formats, and the EMREE questions are on a separate page.
No. It is a sample for practice and to spot gaps. Nothing here predicts a result. Practise across all subjects, review explanations and confirm exam details on the official sites.
No. Each question has a Show answer button. The answer, the explanation and the reason each wrong option is wrong are part of the page text, so they are there when you press it.
Not yet. Clinical review is still being arranged. Treat the explanations as study aids and check official guidance before you rely on a fact.