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- 20 minutes a day, on your phone, planned week by week to your sitting.
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Dip PECQuestion & explanation
ECG interpretation
A 63-year-old man is brought by ambulance to a rural district hospital with 90 minutes of central chest pain and sweating. His pulse is 58/min, BP 102/64 mmHg and SpO2 96% on room air. The 12-lead ECG shows 3 mm ST elevation in leads II, III and aVF, with ST depression in I and aVL. Which part of the left ventricle is most likely infarcting?
A
Anteroseptal wall
B
High lateral wall
C
Inferior wall · Correct
D
Extensive anterior wall
Understand why.
His ST elevation in II, III and aVF, with reciprocal depression in I and aVL, localises the infarct to the inferior wall, usually supplied by the right coronary artery; the slow pulse fits right coronary involvement of the AV node. Anteroseptal infarction shows changes in V1 to V3, high lateral infarction in I and aVL (where he has depression, not elevation), and an extensive anterior infarct produces changes across V1 to V6.
Oxford Handbook of EM 5th ed · Myocardial infarction: ECG changes (lead localisation table)
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- Don’t know what’s next? A tracker that picks your next topic, made for 20-minute sessions on your phone
- How do you fit it all in? A week-by-week study plan to your sitting, rebuilt from your answers
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- What if you don’t pass? A refund or more time
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How refund or more time works. The bank and the mock exams are the plan. Answer at least 60% of the question bank and do every mock exam before your sitting, with no minimum score. If you still don’t pass, send your result within 30 days and choose your money back or twice your pass length, free. Read the refund terms.
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Switch from learning by topic to a timed Certiva mock exam. Review your results after the paper and return to the areas that need work.
Paper 1 mock exam
Included in your pass100 single-best-answer MCQs across the syllabus, in one uninterrupted, timed session.
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3 hourstimed practice
Paper 2 mock exam
Included in your pass100 image-based questions: ECGs, X-rays, CT, ultrasound, clinical photographs and lab, blood gas and statistical data, weighted like the CMSA leaflet.
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3 hourstimed practice
Each mock has the same number of questions and time as the real CMSA paper. Mock exams require active access. For official exam formats and dates, consult the CMSA.
Your syllabus
coverage.
Make your next decision count. Explore the topics covered by this question bank and their source references.
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25 topic sections
Cardiovascular
Acute coronary syndrome · ST elevation myocardial infarction · ECG interpretation · Chest pain evaluation · Tachyarrhythmias · Defibrillation and ventricular arrhythmias · and more
Source references: Oxford Handbook of EM 5th ed; RCSA algorithms 2025; LITFL ECG Library
Practise this topicCritical Care & Resuscitation
Adult basic and advanced life support · Paediatric basic and advanced life support · Reversible causes (4H/4T) · Post-ROSC care · Shock recognition and fluids · Peri-arrest drugs and inotropes
Source references: RCSA Basic Life Support, Advanced Cardiac Arrest, Post-ROSC algorithms 2025; Oxford Handbook of EM 5th ed (Resuscitation/Shock)
Practise this topicRespiratory Emergencies
Acute asthma · COPD exacerbation · Pneumonia · Spontaneous pneumothorax · Tension pneumothorax · Pulmonary embolism · and more
Source references: Oxford Handbook of Emergency Medicine 5th ed · Chapter 3 (Medicine: respiratory)
Practise this topicEar, Nose and Throat Emergencies
Epistaxis · Throat infections · Upper airway obstruction · Foreign bodies · Dental emergencies
Source references: Oxford Handbook of Emergency Medicine 5th ed · Chapter 12 (Ear, nose, and throat)
Practise this topicOphthalmology Emergencies
Chemical eye injury · Red eye · Acute visual loss · Eye trauma
Source references: Oxford Handbook of Emergency Medicine 5th ed · Chapter 11 (Ophthalmology)
Practise this topicApplied Basic Science for Emergency Care
Applied airway anatomy · Acid-base physiology · Applied respiratory physiology · Applied pharmacology
Source references: Oxford Handbook of Emergency Medicine 5th ed · applied anatomy, physiology and pharmacology
Practise this topicTrauma
Primary survey and ABCDE priorities · Head injury and Glasgow Coma Score · Spinal trauma and immobilisation · Chest trauma · Abdominal trauma · Pelvic and extremity trauma · and more
Source references: Oxford Handbook of Emergency Medicine 5th ed, Chapter 8 (Major trauma); RCSA Trauma Cardiac Arrest Algorithm 2023; LITFL Massive Transfusion Protocol
Practise this topicOrthopaedics and Musculoskeletal
Fractures and dislocations · Threatened limb and neurovascular assessment · Compartment syndrome · Septic joint · Soft-tissue infection · Sprains and strains
Source references: Oxford Handbook of Emergency Medicine 5th ed, Chapter 9 (Wounds, fractures, and orthopaedics); LITFL Compartment Syndrome
Practise this topicToxicology and Environmental Emergencies
Cholinergic / organophosphate toxidrome · Anticholinergic toxidrome · Opioid toxidrome · Sympathomimetic toxidrome · Paracetamol overdose · Tricyclic antidepressant overdose · and more
Source references: Oxford Handbook of EM 5th ed (Toxicology, Environmental emergencies); RCSA Organophosphate/Carbamate Poisoning Algorithm 2026
Practise this topicNeurology
Coma and altered consciousness · Headache assessment · Subarachnoid haemorrhage · Seizures and status epilepticus · Stroke · Transient ischaemic attack · and more
Source references: Oxford Handbook of EM 5th ed (Medicine - Neurology: Headache, Subarachnoid haemorrhage, Stroke, TIA, Seizures and status epilepticus; Infectious diseases - Meningitis)
Practise this topicPsychiatry
Organic versus functional · Suicide risk assessment · Acute psychosis · Mental state examination · Managing aggression and tranquillisation
Source references: Oxford Handbook of EM 5th ed (Psychiatry: Mental state examination, Self-harm, Assessment of suicide risk, Depression, Mania, Schizophrenia, Emergency tranquillisation; Acute confusional state)
Practise this topicClinical Practical Skills
Airway and RSI confirmation · Vascular access · Suturing and local anaesthesia · Imaging interpretation principles
Source references: Oxford Handbook of EM 5th ed (Emergency anaesthesia and rapid sequence induction, Local anaesthesia and toxicity, Central venous access, Resuscitation airway, imaging interpretation)
Practise this topicInfectious Disease Emergencies
Malaria · Meningococcal disease · Meningitis · Tetanus · Rabies · HIV/AIDS emergencies · and more
Source references: Oxford Handbook of EM 5th ed, Chapter 5 (Infectious diseases) & Chapter 2 (Sepsis/Shock); LITFL CCC Malaria
Practise this topicPaediatric Emergencies
Neonatal resuscitation · Prematurity · Common neonatal problems · Sudden infant death · Croup · Epiglottitis · and more
Source references: Oxford Handbook of EM 5th ed, Chapter 15 (Paediatric emergencies); RCSA Newborn Resuscitation 2025; RCSA Choking 2025
Practise this topicDermatological Emergencies
Cellulitis · Stevens-Johnson syndrome and toxic epidermal necrolysis · Urticaria and angio-oedema
Source references: Oxford Handbook of EM 5th ed - Cellulitis and erysipelas; Anaphylaxis/angio-oedema; Skin lesions in multisystem disease
Practise this topicHaematological and Oncological Emergencies
Transfusion reactions · Neutropenic sepsis · Sickle cell crisis
Source references: Oxford Handbook of EM 5th ed - Transfusion reactions; Neutropenic sepsis; Sickle-cell disease
Practise this topicGeriatric Emergencies
Falls in the elderly · Delirium · Polypharmacy · Atypical presentation in the elderly
Source references: Oxford Handbook of EM 5th ed - Falls in the elderly; Acute confusional state (delirium)
Practise this topicGastrointestinal Emergencies
Approach to the acute abdomen · Upper gastrointestinal haemorrhage · Lower gastrointestinal haemorrhage · Acute pancreatitis · Perforated peptic ulcer · Acute jaundice · and more
Source references: Oxford Handbook of Emergency Medicine 5th ed · Surgery (acute abdomen, GI bleeding, pancreatitis, peptic ulcer) and Medicine (jaundice); Dip PEC(SA) regulations 1.4.3 and 1.6.4
Practise this topicEndocrine and Metabolic Emergencies
Diabetic ketoacidosis · Hyperosmolar hyperglycaemic state · Hypoglycaemia · Sodium derangements · Hyperkalaemia · Acid-base disturbance · and more
Source references: Oxford Handbook of Emergency Medicine 5th ed · Medicine (hyperglycaemic crises, hypoglycaemia, electrolyte and acid-base disorders, Addisonian crisis, thyrotoxic crisis); LITFL CCC Diabetic Ketoacidosis; Dip PEC(SA) regulations 1.6.5
Practise this topicObstetric and Gynaecological Emergencies
Ectopic pregnancy · Miscarriage · Antepartum haemorrhage · Postpartum haemorrhage · Normal delivery · Abnormal delivery · and more
Source references: Oxford Handbook of Emergency Medicine 5th ed · Obstetrics and gynaecology (ectopic pregnancy, miscarriage, antepartum and postpartum haemorrhage, delivery, pre-eclampsia and eclampsia, ovarian torsion, sexual assault); Dip PEC(SA) regulations 1.8
Practise this topicGenitourinary Emergencies
Testicular torsion · Renal and ureteric colic · Acute urinary retention · Epididymitis
Source references: Oxford Handbook of Emergency Medicine 5th ed · Surgery and Paediatrics (testicular torsion, ureteric colic, urinary retention, epididymitis); Dip PEC(SA) regulations 1.4.4 and 1.6.6
Practise this topicPrehospital and Emergency Medical Services
Triage · Patient transfer · Scope of practice · Disaster and major incident · Outbreak response
Source references: Oxford Handbook of Emergency Medicine 5th ed · General approach (triage, major incidents); Dip PEC(SA) regulations 1.1 (EMS systems, scope of practice, disaster planning, outbreak response, patient transfer)
Practise this topicEthics and Medicolegal Aspects of Emergency Care
Consent and autonomy · Resuscitation ethics and end of life · Declaration and reporting of death · Organ donation · Confidentiality · Vicarious liability
Source references: Oxford Handbook of Emergency Medicine 5th ed · General approach (consent, capacity, confidentiality, end of life care, death); Dip PEC(SA) regulations 1.5 (ethics of resuscitation, autonomy and informed consent, organ donation, declaration of death, professional and vicarious liability)
Practise this topicResearch and Evidence-Based Medicine
Sensitivity and specificity · Predictive values · Number needed to treat · Study design · Intention-to-treat analysis
Source references: Standard emergency medicine evidence-based practice and statistics appropriate to the Dip PEC(SA) candidate information leaflet scope (diagnostic test characteristics, study design, treatment effect measures)
Practise this topicTeaching, Management and Leadership in Emergency Care
Clinical handover · Emergency centre leadership · Quality and triage management
Source references: Oxford Handbook of Emergency Medicine 5th ed · General approach (triage management, handover, referral); Dip PEC(SA) emergency centre management principles
Practise this topicNo matching topics. Try a broader subject or clear your search.
Your revision focus.
Topics below 60% with at least three first answers. A revision prompt, not an exam prediction.
Exam at a glance
What is the Dip PEC exam?
The Dip PEC(SA) is the Diploma in Primary Emergency Care of the College of Emergency Medicine, examined by the Colleges of Medicine of South Africa (CMSA). The written exam has two online papers: Paper 1 is multiple-choice questions and Paper 2 is a visually aided question (VAQ) paper. Certiva prepares you for both papers.
Last checked 1 October 2026 against the official CMSA page · blueprint (PDF). Certiva is independent of the CMSA, so always confirm details there.
Read the full Dip PEC guide: blueprint, textbooks and a 12-week plan →
| Official name | Dip PEC(SA) |
|---|---|
| Run by | Colleges of Medicine of South Africa (CMSA) |
| Papers | 2 online written papers |
| Questions and content | Paper 1: 100 single-best-answer MCQs. Paper 2: 100 single-best-answer image-based (VAQ) MCQs. |
| Duration | 3 hours per paper (CMSA candidate information leaflet) |
| Eligibility | 12 months supervised training at a teaching or CMSA-approved hospital, or a completed portfolio with supervisor letter |
| CMSA exam fee | R16,800 (at last check) |
| When it is written | Two written semesters a year: usually February/March and July/August. Next sitting: Thu 4 Feb 2027 (CMSA timetable; always confirm with the CMSA). |
| Past papers | Not published since 2021: questions stay in a secure CMSA bank. |
| Certiva bank | Explained, referenced questions and timed mock exams |
Good questions.
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What does the Dip PEC Exam Pass include?
Your Dip PEC Exam Pass includes the full question bank and two timed mock exams, mapped to the CMSA syllabus; the exact textbook chapter for every answer; a tracker that picks your next topic, with smart revision and a readiness score; a week-by-week study plan to your sitting; two UCT-accredited ethics CPD courses; and a refund or more time if you don’t pass. The 3-, 6- and 12-month passes have the same features, are paid once and don’t renew. The CV and cover-letter maker and one SAMA-accredited ethics CPD course are free for everyone.
Can I try it before paying?
Yes. Try five questions with explanations and textbook references, with no account or card. Then create a free account for the mini mock exam: 20 questions across the syllabus, then your weakest topics and the chapters to read. Try 5 questions free.
How does the tracker know what I should revise?
After each session, your tracker shows the topics you’re scoring below 60% and the exact chapter to read. Questions you get wrong come back after 10 minutes, then after 1, 3 and 7 days. Your readiness score appears after 50 questions across 3 topics. It is a study guide, not a prediction of your result.
What happens if I do not pass?
The bank and the mock exams are the plan. Answer at least 60% of the question bank and do every mock exam before your sitting, with no minimum score. If you still don’t pass, send your result within 30 days and choose your money back or twice your pass length, free. Monthly membership, group passes and the CPD bundle are excluded. Read the full refund terms.
Does it work on my phone between calls?
Yes. Certiva runs in your phone’s browser, so a 20-minute session between calls counts. Your progress is saved to your account, and questions you miss come back for revision after 10 minutes, then after 1, 3 and 7 days.
I’m writing in a few weeks. Is it still worth it?
Yes, if you use it to find and fix your weakest topics. Start with a timed mock exam, then let the tracker pick what to revise. To stay eligible for a refund or more time, answer at least 60% of the question bank and do every mock exam before your sitting.
Is Certiva the official CMSA resource?
No. Certiva is independent exam preparation and is not affiliated with or endorsed by the CMSA. This page describes Certiva’s practice material, not official exam regulations. Check the CMSA website for current regulations, eligibility and exam dates.
What is the format of the Dip PEC exam?
The Dip PEC(SA) is the Diploma in Primary Emergency Care of the College of Emergency Medicine, examined by the Colleges of Medicine of South Africa (CMSA). The written exam has two online papers: Paper 1 is multiple-choice questions and Paper 2 is a visually aided question (VAQ) paper. Certiva prepares you for both papers. See the full Dip PEC guide for the blueprint and a study plan.
Can I get Dip PEC past papers?
No. CMSA exams have been written online since 2021, and past papers are no longer published because the questions stay in a secure bank. A question bank mapped to the exam content, with explained answers, is the closest alternative. Try 5 questions free.