Original EMREE questions on family medicine, with explanations.
Short answer: 10 original multiple-choice practice questions on family medicine for EMREE, the Emirates Medical Residency Entrance Examination, each with the correct answer and a full explanation. The blueprint gives this subject 15 percent of the exam. They are original and are not real exam items.
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.
What family medicine covers
Primary care, chronic disease, screening, common presentations and continuity of care.
Primary care items favour safe, proportionate care: red flags first, then evidence-based first-line management and follow-up.
Where it fits in the exam
The organiser's EMREE blueprint (November 2025 edition) gives Family Medicine 15 percent of the exam, which is about 18 of 120 questions. It says the distribution may differ by up to 5 percent in each category. These weights are official, and the question counts are our arithmetic.
The organiser 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.
How to use these questions
Decide your answer before you press Show answer. Then read the reason for every option, including the ones you rejected. Note the idea you missed and come back to it in a few days.
Practice questions
Question 1
Family MedicineEasy
A 66-year-old woman with a BMI of 33 has had 6 months of pain in the right knee on walking, with morning stiffness of under 10 minutes, crepitus and bony enlargement. Radiographs show joint space narrowing and osteophytes. Which is the most appropriate initial management?
AOption A: Education, local muscle-strengthening exercise and weight loss, with topical NSAID for pain
BOption B: Oral opioids on a regular basis
COption C: Glucosamine supplements
DOption D: Intra-articular hyaluronic acid injections given every 3 months into the knee for at least a year
Show answer for question 1
Correct answer: A. Education, local muscle-strengthening exercise and weight loss, with topical NSAID for pain
Osteoarthritis is managed first with core treatments: information, exercise (including strengthening) and weight loss in people who are overweight. Topical NSAIDs are the first pharmacological choice for knee pain, with paracetamol of limited value and oral NSAIDs with gastroprotection if needed. NICE does not recommend glucosamine or hyaluronic acid injections, and opioids add harm without benefit. Joint replacement is considered when symptoms are severe despite optimal care.
Why B is wrong. Opioids give little benefit and have notable adverse effects in osteoarthritis.
Why C is wrong. Glucosamine has not been shown to be better than placebo and is not recommended.
Why D is wrong. Hyaluronic acid injections are not recommended in guidelines because of weak evidence.
Topic: Knee osteoarthritis: first-line management. Reference: NICE NG226 Osteoarthritis in over 16s: diagnosis and management; OARSI guidelines for the non-surgical management of knee osteoarthritis
Question 2
Family MedicineMedium
A 67-year-old postmenopausal woman has never had a fracture and takes no glucocorticoids. Her mother had a hip fracture at 78. She is 160 cm, weighs 58 kg and does not smoke. She asks about bone health. Which is the most appropriate step?
AOption A: Reassure her because she has never had a fracture and does not smoke or take steroids
BOption B: Measure vitamin D and calcium and treat any low values only
COption C: Bone mineral density testing with DXA and fracture risk calculation
DOption D: Start alendronate without testing
Show answer for question 2
Correct answer: C. Bone mineral density testing with DXA and fracture risk calculation
Screening for osteoporosis is advised for women aged 65 and older, and earlier for younger postmenopausal women at increased risk. Central DXA is the standard test, and a risk calculator such as FRAX combines clinical factors with bone density to guide treatment.
Why A is wrong. Incorrect: Osteoporosis is silent until fracture and family history raises her risk.
Why B is wrong. Incorrect: These tests do not assess fracture risk.
Why D is wrong. Incorrect: Treatment is based on measured density or calculated fracture risk, not age alone.
Topic: Screening: osteoporosis in postmenopausal women. Reference: US Preventive Services Task Force: Screening for Osteoporosis to Prevent Fractures (2018)
Question 3
Family MedicineMedium
A 45-year-old woman has had 8 weeks of symmetrical pain and swelling in the metacarpophalangeal and proximal interphalangeal joints, with morning stiffness of 2 hours. The squeeze test across the metacarpophalangeal joints is positive, CRP is 30 mg/L and hand radiographs are normal. Which is the most appropriate management?
AOption A: Wait until erosions appear on radiographs before referring
BOption B: Refer urgently to rheumatology, aiming for assessment within weeks and early disease-modifying treatment
COption C: Reassure her that this is probably a viral arthritis and review in 6 months and advise simple paracetamol alone
DOption D: Start long-term prednisolone in primary care and avoid referral
Show answer for question 3
Correct answer: B. Refer urgently to rheumatology, aiming for assessment within weeks and early disease-modifying treatment
Persistent synovitis of small joints with prolonged morning stiffness suggests early rheumatoid arthritis. There is a window of opportunity in the first months in which early disease-modifying therapy, such as methotrexate, prevents erosions and disability, so patients are referred urgently, on NICE advice, even when radiographs and serology are normal. Erosions are a late finding, and long-term steroid alone does not alter the disease course.
Why A is wrong. Radiographs are often normal early, and waiting for erosions means that damage has already occurred.
Why C is wrong. Persistent symmetrical synovitis beyond 6 weeks is unlikely to be viral and should not wait 6 months.
Why D is wrong. Steroids alone mask symptoms and do not prevent joint damage.
Topic: Suspected rheumatoid arthritis. Reference: NICE NG100 Rheumatoid arthritis in adults; EULAR recommendations for the management of rheumatoid arthritis
Question 4
Family MedicineEasy
A 41-year-old man attends for a medical for work. He drinks about 6 pints of beer most evenings. His AUDIT score is 11. He has no withdrawal symptoms, no alcohol-related illness and normal liver tests. He is willing to discuss his drinking. Which is the most appropriate management?
AOption A: Start naltrexone today
BOption B: Hand out a leaflet and take no further action
COption C: Immediate referral to inpatient detoxification and a specialist alcohol service
DOption D: Structured brief advice on reducing intake, with follow-up
Show answer for question 4
Correct answer: D. Structured brief advice on reducing intake, with follow-up
The WHO Alcohol Use Disorders Identification Test (AUDIT) bands: 0 to 7 low risk, 8 to 15 hazardous (simple advice), 16 to 19 harmful (brief counselling and monitoring), and 20 or more suggests possible dependence needing specialist evaluation.
Why A is wrong. Incorrect: Pharmacotherapy is for established dependence and is not first-line at this level of risk.
Why B is wrong. Incorrect: Passive information is less effective than brief personalised advice.
Why C is wrong. Incorrect: Detoxification is for dependence with withdrawal risk, which is not present.
Topic: Screening: hazardous alcohol use and brief intervention. Reference: WHO: AUDIT, the Alcohol Use Disorders Identification Test, guidelines for use in primary care
Question 5
Family MedicineMedium
A 72-year-old woman has had 3 weeks of pain and stiffness in the shoulders and hips, with morning stiffness of 1 hour. She has no headache, jaw pain or visual disturbance. ESR is 78 mm/hour, CRP is raised, CK is normal and thyroid function is normal. Which is the most appropriate treatment?
AOption A: Prednisolone 60 mg daily
BOption B: Prednisolone about 15 mg daily with gradual tapering, with bone protection and monitoring
COption C: Long-term oral NSAID such as naproxen, with a proton pump inhibitor and review of the response after 3 months
DOption D: Methotrexate as monotherapy
Show answer for question 5
Correct answer: B. Prednisolone about 15 mg daily with gradual tapering, with bone protection and monitoring
This is polymyalgia rheumatica: age over 50, bilateral shoulder and hip girdle pain and stiffness, raised inflammatory markers and a normal CK. The first-line treatment is oral prednisolone at 12.5 to 25 mg daily (about 15 mg is common), with a prompt response, then gradual tapering over at least a year, together with bone protection and monitoring for relapse and for giant cell arteritis. Doses of 40 to 60 mg are for giant cell arteritis, and NSAIDs are inadequate.
Why A is wrong. A dose of 60 mg is used for giant cell arteritis, and she has no features of it.
Why C is wrong. NSAIDs do not control polymyalgia rheumatica and carry gastrointestinal risk in older patients.
Why D is wrong. Methotrexate is a steroid-sparing second-line option for relapse, and it is not used alone first.
Topic: Polymyalgia rheumatica: initial treatment. Reference: EULAR and ACR recommendations for the management of polymyalgia rheumatica; BSR and BHPR guideline for the management of polymyalgia rheumatica
Question 6
Family MedicineMedium
A 34-year-old man from a country with high hepatitis B prevalence registers with a new primary care clinic. He is well, has no vaccination record and no history of liver disease. Which is the most appropriate test?
AOption A: Anti-HBs alone, then vaccination if it is negative
BOption B: Hepatitis B surface antigen alone
COption C: Liver enzymes and liver ultrasound
DOption D: HBsAg, total anti-HBc and anti-HBs together
Show answer for question 6
Correct answer: D. HBsAg, total anti-HBc and anti-HBs together
Adults at higher risk, including those born in intermediate- and high-prevalence countries, should be screened for hepatitis B. The recommended screening test is the triple panel: HBsAg, anti-HBs and total anti-HBc. The result guides vaccination, follow-up and antiviral eligibility.
Why A is wrong. Incorrect: This would vaccinate someone who is already chronically infected and miss the diagnosis.
Why B is wrong. Incorrect: Surface antigen alone misses resolved infection and cannot show susceptibility or immunity.
Why C is wrong. Incorrect: Liver tests are normal in most chronic carriers and imaging does not identify infection status.
Topic: Screening: hepatitis B in adults. Reference: Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations, United States, 2023 (MMWR)
Question 7
Family MedicineEasy
A 55-year-old woman with diabetes has had 4 months of shoulder pain that is worse at night, with progressive stiffness. Both active and passive external rotation and abduction are markedly restricted. A radiograph of the shoulder is normal. Which is the most likely diagnosis and the most appropriate initial management?
AOption A: Rotator cuff tear, with urgent surgical repair, with urgent referral for a surgical opinion within a week
BOption B: Adhesive capsulitis, with analgesia, physiotherapy and a corticosteroid injection in the painful phase
COption C: Subacromial impingement, with decompression surgery
DOption D: Glenohumeral osteoarthritis, with joint replacement
Show answer for question 7
Correct answer: B. Adhesive capsulitis, with analgesia, physiotherapy and a corticosteroid injection in the painful phase
Global loss of active and passive movement, especially external rotation, with a normal radiograph and diabetes as a risk factor is typical of adhesive capsulitis (frozen shoulder). The condition is self-limiting over 1 to 3 years, and treatment is analgesia, exercise and physiotherapy, with an intra-articular corticosteroid injection for pain in the early freezing phase. A cuff tear causes weakness with preserved passive movement, and osteoarthritis would show joint space loss on radiographs.
Why A is wrong. A cuff tear causes active weakness with passive movement preserved.
Why C is wrong. Impingement gives painful arc and does not restrict passive movement globally.
Why D is wrong. Osteoarthritis shows narrowing and osteophytes on radiographs, and replacement is not first-line.
Topic: Adhesive capsulitis of the shoulder. Reference: NICE Clinical Knowledge Summaries: shoulder pain; British Elbow and Shoulder Society guidance on frozen shoulder
Question 8
Family MedicineMedium
A 26-year-old woman takes a combined oral contraceptive. She started a new pack on Monday and forgot the pills on Wednesday and Thursday, remembering on Friday morning. She had unprotected intercourse on Tuesday night. A pregnancy test today is negative. Which is the most appropriate advice?
AOption A: Continue the pack as normal with no further precautions
BOption B: Take the missed pill now, continue the pack and use condoms for 7 days, and take emergency contraception
COption C: Discard the pack and start a new one today
DOption D: Repeat the pregnancy test in 3 weeks and take no other action
Show answer for question 8
Correct answer: B. Take the missed pill now, continue the pack and use condoms for 7 days, and take emergency contraception
Pills missed in the first week after the pill-free interval carry the highest risk of ovulation. After two or more missed pills, take the most recent missed pill, continue the pack, use condoms or abstain for 7 days, and offer emergency contraception if unprotected sex occurred in the pill-free interval or the first week.
Why A is wrong. Incorrect: Missing two pills in the first week after the pill-free interval leaves ovulation suppression unreliable.
Why C is wrong. Incorrect: This does not address the pregnancy risk from recent sex.
Why D is wrong. Incorrect: A negative test so soon after sex is unreliable and emergency contraception would be missed.
Topic: Contraception: missed combined pills in the first week. Reference: FSRH Clinical Guideline: Combined Hormonal Contraception
Question 9
Family MedicineMedium
A 52-year-old woman with a uterus, a BMI of 36 kg/m2 and no previous thrombosis has severe hot flushes and wants to start hormone therapy. She has no personal history of breast cancer and no contraindication to hormones. Which regimen carries the lowest risk of venous thromboembolism?
AOption A: Oral oestradiol at a low dose with a levonorgestrel intrauterine system
BOption B: Oral oestradiol valerate with norethisterone
COption C: Oral conjugated equine oestrogen with medroxyprogesterone acetate
DOption D: Transdermal oestradiol (patch or gel) with a progestogen for endometrial protection
Show answer for question 9
Correct answer: D. Transdermal oestradiol (patch or gel) with a progestogen for endometrial protection
Oral oestrogen passes through the liver and raises clotting factors, increasing the risk of venous thromboembolism roughly twofold, and obesity raises the baseline risk further. Standard-dose transdermal oestradiol bypasses first-pass metabolism and does not appear to increase the risk above that of women not using hormone therapy, so NICE advises considering transdermal preparations for women at higher risk. Because she has a uterus she still needs a progestogen, given as a tablet or through a levonorgestrel intrauterine system. Oral preparations remain more thrombogenic even at low dose.
Why A is wrong. A lower oral dose reduces but does not remove the first-pass effect, so the risk stays above that of transdermal oestrogen.
Why B is wrong. Oral oestradiol valerate shares the first-pass hepatic effect and the higher thrombotic risk.
Why C is wrong. Oral conjugated equine oestrogen has the highest thrombotic risk among the commonly used regimens.
Topic: Menopause: hormone therapy route and thrombosis risk. Reference: NICE NG23 Menopause: diagnosis and management; British Menopause Society consensus statements on hormone replacement therapy
Question 10
Family MedicineEasy
A 44-year-old man with type 2 diabetes scores 5 out of 6 on the PHQ-2 (low mood and loss of interest over the past 2 weeks). He has no thoughts of self-harm. Which is the most appropriate next step?
AOption A: Complete a PHQ-9 and a clinical assessment
BOption B: Repeat the PHQ-2 at his next yearly review visit
COption C: Arrange an emergency psychiatric admission
DOption D: Start sertraline 50 mg today and review in 4 weeks
Show answer for question 10
Correct answer: A. Complete a PHQ-9 and a clinical assessment
The PHQ-2 is a two-item screen, and a score of 3 or more is positive. A positive screen does not itself diagnose depression, so the next step is a fuller assessment with the PHQ-9 and a clinical interview for symptoms, duration, functional impact, risk and contributing causes. Treatment is chosen after that, according to severity. Medicine without assessment, delay for a year or urgent admission without risk features does not match his presentation.
Why B is wrong. A positive screen needs follow-up now, as depression is common and treatable in diabetes.
Why C is wrong. Admission is for severe illness or immediate risk, and he has denied thoughts of self-harm.
Why D is wrong. Starting a drug before assessing severity and risk skips the diagnostic step.
Topic: Screening: depression with the PHQ-2 in primary care. Reference: NICE NG222 Depression in adults: treatment and management; USPSTF Recommendation: Screening for depression and suicide risk in adults
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Frequently asked questions
The blueprint gives Family Medicine 15 percent of the exam, about 18 of 120 questions, and says it may differ by up to 5 percent. It is the organiser's own figure from the November 2025 blueprint.
No. They are original practice questions written by Meddex for exam preparation. The organiser publishes a blueprint, not sample questions, and a confidentiality agreement covers the real exam, so we do not use or claim real or recalled items.
The Meddex app has the full bank, which you can practise by topic with a free account. These pages are a short sample, and the questions on them do not change.
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.