Build one useful MRCEM/FRCEM flashcard deck

For MRCEM/FRCEM revision, a useful deck tests actions and decisions you can explain in an acute case—not isolated facts detached from practice. This worked deck focuses on adult anaphylaxis. It covers early recognition, first-line treatment, escalation and disposition: areas relevant to applied emergency medicine and clinical decision-making.

Treatment details below follow Resuscitation Council UK guidance. Check its current anaphylaxis guideline and your local protocol before using doses in practice. The MRCEM/FRCEM pathway includes written assessments and structured clinical or viva-style stations depending on stage; check the relevant official exam information for the assessment details that apply to you.

A MySummaries flashcard drill on this topic starts with one card face-up; answer it, turn it over, then grade how well you knew it. Work through the full deck this way rather than reading the answers as a list.

Cards — Adult anaphylaxis17 due

What is the first-line drug for anaphylaxis with airway, breathing or circulation problems?

Intramuscular adrenaline.

All 17 cards
What is the first-line drug for anaphylaxis with airway, breathing or circulation problems?Intramuscular adrenaline.
What adult IM adrenaline dose should you give for anaphylaxis?500 micrograms (0.5 mL of 1 mg/mL adrenaline).
Where should IM adrenaline be injected?Into the anterolateral thigh.
When should you repeat IM adrenaline if airway, breathing or circulation problems persist?After 5 minutes.
How should you position a patient with anaphylaxis who can tolerate lying flat?Lay them flat with their legs raised; do not let them stand or walk.
How should you position a pregnant patient with anaphylaxis?Use a left lateral position, or manual left uterine displacement if supine positioning is needed for resuscitation.
What should you do with a suspected trigger that is still being administered?Stop exposure where possible, such as stopping an implicated infusion.
What adult crystalloid bolus is recommended for anaphylaxis with hypotension?Give 500–1,000 mL IV crystalloid rapidly, then reassess and repeat if needed.
What is the role of high-concentration oxygen in anaphylaxis with respiratory or circulatory compromise?Give high-concentration oxygen while treating the airway, breathing or circulation problem.
When are antihistamines considered in anaphylaxis?After initial ABC problems have been treated, for persistent skin symptoms; they do not treat airway, breathing or circulation problems.
Are corticosteroids routine initial treatment for anaphylaxis?No. They are not recommended routinely for emergency treatment.
A patient with anaphylaxis is wheezing. What is the role of an inhaled bronchodilator?It can be an adjunct for persistent bronchospasm, but must not replace IM adrenaline.
What should happen if respiratory or cardiovascular problems persist despite two appropriate IM adrenaline doses?Treat as refractory anaphylaxis and seek urgent expert help for further treatment, including consideration of an IV adrenaline infusion.
Why should IV adrenaline boluses generally be avoided in anaphylaxis outside specialist settings?They can cause serious harm, including potentially fatal arrhythmias; IV adrenaline requires appropriate expertise and monitoring.
What should you do if anaphylaxis progresses to cardiac arrest?Start CPR and follow the current resuscitation guidance for cardiac arrest.
How should you decide how long to observe a patient after anaphylaxis resolves?Use the Resuscitation Council UK risk-stratified observation guidance; duration depends on the clinical course and risk factors.
What should discharge planning include after anaphylaxis?Provide or check access to two in-date adrenaline auto-injectors where indicated, teach their use, and arrange specialist allergy follow-up.

That is a MySummaries deck, filled with MRCEM/FRCEM material. Yours is written from your own notes. Start free

Study each card actively

For every card, commit to an answer before turning it over. Then grade yourself honestly: a correct answer that took effort is not the same as a prompt, complete answer. If you recalled “give adrenaline” but missed the adult dose or route, mark the card as needing work. The useful distinction is between knowing the headline and being able to state the action safely.

Say the answer in a form you could use in a clinical station: “I would give 500 micrograms of IM adrenaline into the anterolateral thigh now, and repeat after five minutes if ABC problems persist.” That makes the dose, route, site and reassessment trigger retrievable together. Do not bundle unrelated facts into one card, though. If you cannot answer the position question because you are recalling the drug dose, split or revise the cards separately.

A MySummaries core checklist cut from the deck keeps the immediate actions visible for a quick review:

Must not miss coreAdult anaphylaxis
First-line treatment for airway, breathing or circulation problems: IM adrenaline; adult dose 500 micrograms (0.5 mL of 1 mg/mL) into the anterolateral thigh.
Reassess and repeat IM adrenaline after 5 minutes if ABC problems persist; call for help and support ABCs.
For hypotension, give 500–1,000 mL IV crystalloid rapidly and reassess; position flat with legs raised if tolerated, with left lateral positioning in pregnancy.
Antihistamines do not treat ABC problems; corticosteroids are not routine initial emergency treatment.
If problems persist after two appropriate IM doses, seek expert help for refractory anaphylaxis; plan risk-based observation and safe follow-up.

Turn missed marks into the next revision task

The deck is a starting point, not a reason to memorise a single script for every patient. Practise the sequence: recognise the immediate threat, treat it, reassess, and explain what would change your next step. In a case with wheeze, for instance, an inhaled bronchodilator may be an adjunct, but the presence of anaphylaxis with ABC compromise keeps IM adrenaline first-line. In a patient whose symptoms settle, disposition still needs an observation decision and a safe follow-up plan.

After a session, sort misses by cause. Was it a forgotten value, such as the 500–1,000 mL crystalloid bolus for adult hypotension? A sequencing error, such as reaching for an antihistamine before treating ABC problems? Or a missing safety decision, such as failing to address auto-injectors and referral at discharge? Make the next revision task specific to the error. Repeating every card equally wastes time when only one part of the response is weak.

A MySummaries remediation tray might bring back a repeatedly missed decision as one direct prompt:

Remediation tray

You lost this mark twice: a patient remains hypotensive after two appropriate IM adrenaline doses for anaphylaxis. What makes this refractory, and who should guide further treatment?

Add cardDismiss

Use the tray prompt to practise a complete response aloud: identify refractory anaphylaxis, call for urgent expert help, continue ABC support and explain that further treatment such as an IV adrenaline infusion requires appropriate expertise and monitoring. Then return to the source guideline if you are uncertain about a detail. Avoid turning a remembered phrase into an unsafe universal rule: clinical context, current guidance and local protocol still matter.

A practical revision loop

Start with this deck, then add cards only when your own notes or practice reveal a specific gap. Keep each question narrow enough to grade clearly. Review due cards first, then spend a short session answering a case aloud using ordered headings: immediate actions and safety, focused assessment, investigations, management, and disposition with safety-netting. The headings help structure an answer; tailor the details to the patient rather than reciting them mechanically.

Once you can retrieve the core actions reliably, test the decisions around them: when to escalate, how to reassess response, and what makes discharge safe. If you are preparing for a particular MRCEM or FRCEM stage, use the official exam information for its current requirements and practise the relevant assessment tasks rather than assuming every stage tests the same way.

How MySummaries helps

MySummaries lets you build a revision board from your own notes and turn it into spaced-repetition flashcards. For this task, that means keeping your anaphylaxis notes, action checklist and missed-card prompts together, then revisiting the facts you have not yet retrieved reliably.