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Haemoglobin as a buffer
Haemoglobin's buffering comes mainly from its 38 histidine residues, and with its high concentration it has six times the buffering capacity of plasma proteins. The imidazole groups of deoxyhaemoglobin dissociate less, making it a weaker acid and a better buffer than oxyhaemoglobin. Terminal carboxyl and amino groups contribute little in the physiological pH range.
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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.
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.
100 single-best-answer questions: 25 each in clinical anatomy, physiology, pathology and pharmacology, spread across every blueprint topic, in one timed session.
Start Paper 1 mockResume Paper 1 mockA second, different 100-question paper with the same 25-25-25-25 split, so you can measure your progress closer to the exam.
Start Paper 2 mockResume Paper 2 mockEach mock matches the CMSA regulations: 100 questions in three hours, 25 per subject. Mock exams require active access. For official exam formats and dates, consult the CMSA.
Make your next decision count. Explore the topics covered by this question bank and their source references.
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51 topic sections
Skin tension lines · Lacerations · Burns – partial thickness · Burns – full thickness · Burns – severity · Burns – mortality · and more
Source references: Moore 2023
Practise this topicExtradural haematoma – source · Extradural haematoma – course · Subdural (dural border) haematoma · Subarachnoid haemorrhage · Tentorial herniation · Oculomotor compression – pupil first · and more
Source references: Moore 2023
Practise this topicClavicle fracture · Flexor tenosynovitis · Surgical neck of humerus / axillary nerve · Mid-shaft humerus / radial nerve · Radial nerve – wrist-drop · Deep branch of radial nerve · and more
Source references: Moore 2023
Practise this topicFemoral neck fracture – blood supply · Femoral neck fracture – posture · Posterior hip dislocation · Anterior hip dislocation · Slipped femoral epiphysis · Tibial fracture · and more
Source references: Moore 2023
Practise this topicLe Fort fractures · Mandible fracture · TMJ dislocation · Scalp – danger layer · Scalp wounds · Periorbital bruising · and more
Source references: Moore 2023
Practise this topicFirst rib fracture · Rib fractures – lower ribs · Flail chest · Sternal fracture · Intercostal neurovascular bundle · Thoracentesis · and more
Source references: Moore 2023
Practise this topicIndirect inguinal hernia · Inguinal hernia examination · Testicular torsion · Peritoneal fluid spread · Hepatorenal recess · Paracentesis · and more
Source references: Moore 2023
Practise this topicFontanelles · Cephalohaematoma · Otoscopy in infants · Cervical pleura · Infant trachea · Infant mediastinum · and more
Source references: Moore 2023
Practise this topicAppendicitis in pregnancy · Gravid uterus size · Pelvic ligament relaxation · Joint laxity · Lumbar lordosis · Labour epidural · and more
Source references: Moore 2023
Practise this topicSternal angle · SVC surface anatomy · Pleural and lung margins · Horizontal fissure · Transpyloric plane · McBurney point · and more
Source references: Moore 2023
Practise this topicPlasma osmolality and the osmolar gap · Tonicity of intravenous fluids · Resting membrane potential · Hyperkalaemia and paralysis · Emergency treatment of hyperkalaemia · Hypokalaemia · and more
Source references: Ganong 27th ed
Practise this topicBicarbonate buffer as an open system · Haemoglobin as a buffer · Respiratory compensation for metabolic acidosis · Metabolic alkalosis from vomiting · Chronic respiratory acidosis · Chronic respiratory alkalosis · and more
Source references: Ganong 27th ed
Practise this topicExcitatory postsynaptic potential · Inhibitory postsynaptic potential · Summation of synaptic potentials · Neuromuscular transmission · Botulism · Tetanus · and more
Source references: Ganong 27th ed
Practise this topicKetone bodies · Conditions causing ketosis · Ketone formation in the liver · Fasting glucose supply · Countercurrent heat exchange in the limbs · Brown fat thermogenesis · and more
Source references: Ganong 27th ed
Practise this topicOsmotic control of vasopressin · Vasopressin V2 receptor · Nephrogenic diabetes insipidus · SIADH · Permissive action of glucocorticoids · Addisonian crisis · and more
Source references: Ganong 27th ed
Practise this topicCarbohydrate absorption · Lactose intolerance · Protein absorption · Role of micelles in fat absorption · Chylomicrons and lymph · Short-chain fatty acids · and more
Source references: Ganong 27th ed
Practise this topicParietal cell acid secretion · Agonists of the parietal cell · Gastrin and somatostatin · Secretin · Cholecystokinin · Lower oesophageal sphincter · and more
Source references: Ganong 27th ed
Practise this topicNeonatal unconjugated hyperbilirubinaemia · Methaemoglobinaemia · Red cell catabolism · Erythropoietin · Platelet production · Initial haemostasis · and more
Source references: Ganong 27th ed
Practise this topicPacemaker potential · Vagal slowing of the node · Autonomic control of AV nodal delay · Hyperkalaemia and the ECG · Hypokalaemia and the ECG · Calcium and the myocardium · and more
Source references: Ganong 27th ed
Practise this topicSurfactant and alveolar stability · Surfactant and pulmonary oedema · Type II cells · Anatomic dead space · Physiological dead space · Regional ventilation and perfusion · and more
Source references: Ganong 27th ed
Practise this topicMeasuring GFR · PAH clearance · Determinants of filtration · Renal autoregulation · ACE inhibitors and the efferent arteriole · Glucose transport maximum · and more
Source references: Ganong 27th ed
Practise this topicCoagulative necrosis · Colliquative necrosis · Fat necrosis · Fibrinoid necrosis · Gangrene · Apoptosis versus necrosis · and more
Source references: Raftery 2017
Practise this topicVessel calibre: triple response · Vascular permeability and exudate · Neutrophil chemotaxis · Kinin system · Complement · Nitric oxide · and more
Source references: Raftery 2017
Practise this topicVenous thrombosis · Arterial thrombosis · Fate of thrombi · Pulmonary embolism · Paradoxical embolism · Arterial thromboembolism · and more
Source references: Raftery 2017
Practise this topicType I hypersensitivity · Type II hypersensitivity · Type III hypersensitivity · Type IV hypersensitivity · Stimulatory antibodies · Organ-specific autoimmunity · and more
Source references: Raftery 2017
Practise this topicParaneoplastic: hypercalcaemia · Paraneoplastic: SIADH · Local invasion: SVC · Local invasion: Pancoast · Haematogenous spread to bone · Sarcoma spread · and more
Source references: Raftery 2017
Practise this topicGas gangrene · Tetanus: mechanism · Necrotising fasciitis · Fournier's gangrene · Erysipelas · Lymphangitis · and more
Source references: Raftery 2017
Practise this topicBurn wound zones · Burn depth · Total body surface area · Circumferential burns · Systemic response to burns · Carbon monoxide poisoning · and more
Source references: Raftery 2017
Practise this topicCerebral atrophy and subdural haemorrhage · Pressure sores · Disuse and denervation atrophy · Neurogenic bladder · Age and cancer
Source references: Raftery 2017
Practise this topicComplicated atherosclerotic plaque · Atherosclerosis: pathogenesis · Subendocardial infarction · Ischaemia from impaired oxygen transport · MI complication: papillary muscle rupture · MI complication: mural thrombus · and more
Source references: Raftery 2017
Practise this topicTension pneumothorax · Open pneumothorax · Spontaneous pneumothorax · Pleural fluid: transudate and exudate · Lobar pneumonia: referred pain · Lobar pneumonia: pathology · and more
Source references: Raftery 2017
Practise this topicExtradural haemorrhage · Transtentorial herniation: pupil · False localising signs · Systemic effects of raised ICP · Cerebral perfusion pressure · Lumbar puncture and herniation · and more
Source references: Raftery 2017
Practise this topicPrehepatic jaundice · Cholestatic jaundice · Hepatocellular jaundice · Congenital hyperbilirubinaemia · Gallstones after ileal resection · Mucocoele and empyema of gall bladder · and more
Source references: Raftery 2017
Practise this topicHypocalcaemia in acute pancreatitis · Haemorrhagic pancreatitis · Pancreatic pseudocyst · Aetiology of acute pancreatitis · High-output pancreatic fistula
Source references: Raftery 2017
Practise this topicPre-renal oliguria · Acute tubular necrosis · Renal autoregulation · Indications for renal replacement therapy · Staghorn calculus · Urate calculi · and more
Source references: Raftery 2017
Practise this topicSickle cell disease: pathogenesis · Sickle cell disease: infection · Laboratory features of haemolysis · Hereditary spherocytosis · Morphological classification of anaemia · Relative polycythaemia · and more
Source references: Raftery 2017
Practise this topicPrimary adrenal insufficiency · Secondary adrenal insufficiency · Waterhouse–Friderichsen syndrome · Sheehan's syndrome · Pituitary apoplexy · Diabetic ketoacidosis · and more
Source references: Raftery 2017
Practise this topicCompartment syndrome · Avascular necrosis · Acute osteomyelitis · Septic arthritis · Fracture haemorrhage
Source references: Raftery 2017
Practise this topicIonisation · Protein binding · Bioavailability · Prodrugs · Phase I metabolism · Metabolism in liver failure · and more
Source references: Peck & Harris 5th ed
Practise this topicSalbutamol · Salmeterol · Ipratropium, STG · Aminophylline · Aminophylline, STG · Magnesium, STG · and more
Source references: Peck & Harris 5th ed; Adult Hospital STG 2024 (updated 2026)
Practise this topicAdrenoceptors · Adrenaline · Noradrenaline · Dopamine · Dobutamine · Ephedrine · and more
Source references: Peck & Harris 5th ed; Adult Hospital STG 2024 (updated 2026)
Practise this topicBeta-lactamase inhibitor · Carbapenems · Aminoglycoside toxicity · Vancomycin · Metronidazole · Quinolones · and more
Source references: Raftery; Peck & Harris 5th ed; Adult Hospital STG 2024 (updated 2026)
Practise this topicInduction agents · Inhaled agents · Local anaesthetics · Local anaesthetic toxicity · Neuromuscular blockers · Reversal agents · and more
Source references: Adult Hospital STG 2024 (updated 2026); Peck & Harris 5th ed
Practise this topicAnaphylaxis · Anaphylaxis adjuncts · Corticosteroid mechanism · H1 antihistamines · Anaphylaxis rationale · Anaphylaxis bronchospasm
Source references: Adult Hospital STG 2024 (updated 2026); Peck & Harris 5th ed
Practise this topicMetoclopramide · Domperidone · Ondansetron · H2 antagonists · Proton pump inhibitors
Source references: Peck & Harris 5th ed
Practise this topicOpioid receptors · Pethidine · Tramadol · NSAID mechanism · Aspirin and platelets · NSAID and asthma · and more
Source references: Peck & Harris 5th ed; Adult Hospital STG 2024 (updated 2026)
Practise this topicParacetamol · Salicylates · Opioids · Tricyclic antidepressants · Benzodiazepines · Organophosphates · and more
Source references: Peck & Harris 5th ed; Adult Hospital STG 2024 (updated 2026)
Practise this topicDKA fluids · DKA potassium · DKA bicarbonate · DKA sodium · DKA complication · Hyperkalaemia · and more
Source references: Adult Hospital STG 2024 (updated 2026)
Practise this topicNeonatal distribution · Neonatal metabolism · Neonatal excretion · Neonatal protein binding · Suxamethonium in children · Elderly distribution · and more
Source references: Peck & Harris 5th ed; Paediatric Hospital STG 2023
Practise this topicLoop diuretic mechanism · Furosemide in pulmonary oedema · Diuretics and calcium · Thiazides and urate · Spironolactone and potassium · Mannitol and the blood-brain barrier · and more
Source references: Peck & Harris 2021; Adult Hospital STG 2024 (updated 2026)
Practise this topicClopidogrel activation · Streptokinase antigenicity · Alteplase fibrin selectivity · Tranexamic acid mechanism · Heparin-induced thrombocytopenia · Warfarin reversal · and more
Source references: Peck & Harris 2021; Adult Hospital STG 2024 (updated 2026)
Practise this topicExam at a glance
FCEM(SA) Part I is the basic sciences exam of the Fellowship of the College of Emergency Medicine, examined by the Colleges of Medicine of South Africa (CMSA). It has two digital multiple-choice papers. Each paper has 100 questions: 25 each in clinical anatomy, physiology, pathology and pharmacology, applied to emergency patients. There is no oral in Part I.
Last checked 9 November 2026 against the official CMSA page · regulations (PDF) · Part I blueprint (PDF). Certiva is independent of the CMSA, so always confirm details there.
| Official name | FCEM(SA) Part I |
|---|---|
| Run by | Colleges of Medicine of South Africa (CMSA), College of Emergency Medicine |
| Papers | 2 digital MCQ papers of 100 questions (single correct answer) |
| Content | Each paper: 25 clinical anatomy, 25 physiology, 25 pathology, 25 pharmacology, applied to emergency medicine |
| Duration | Three hours per paper |
| Pass mark | Standard set, with a 40% subminimum per paper; no negative marking |
| CMSA exam fee | R12,950 for Part I (at last check) |
| When it is written | Twice a year, February and July. Next sitting: Thu 11 Feb 2027 (CMSA timetable; always confirm with the CMSA). |
| Past papers | Not published: questions stay in a secure CMSA bank. |
| Certiva bank | Explained questions on every Part I blueprint topic, each with its textbook chapter, and two timed mock exams |
Need a hand? Ask Certiva.
Your FCEM Part I 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.
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.
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.
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.
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.
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.
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.
FCEM(SA) Part I is the basic sciences exam of the Fellowship of the College of Emergency Medicine, examined by the CMSA. There are two digital MCQ papers of 100 questions, three hours each. Every paper has 25 questions each in clinical anatomy, physiology, pathology and pharmacology, applied to emergency patients. Certiva covers all four subjects and gives you two timed mock papers in the same format.
No. The CMSA keeps its MCQs in a secure bank and does not release them. A question bank mapped to the Part I blueprint, with explained answers and textbook references, is the closest alternative. Try 5 questions free.