MSRA Cheat Sheet 2026

The 30 highest-yield MSRA facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A PD scenario describes a colleague who appears intoxicated on shift. The most appropriate first priority is to: → Ensure patient safety and raise the concern appropriately
2. What is a key logistical step to take before MSRA test day? → Confirm the test centre location, booking and required ID in advance
3. When unsure between two close CPS options, the best strategy is to: → Identify which fits the most clues in the vignette
4. You notice a colleague has documented observations in the notes that you are certain were never taken. What should you do first? → Speak to the colleague directly to understand what happened
5. A 30-year-old woman presents with butterfly rash, joint pain, fatigue, and a positive ANA. Complement levels are low. What is the most likely diagnosis? → Systemic lupus erythematosus
6. A candidate consistently runs out of time on CPS. What is the most appropriate adjustment? → Practice pacing so each question gets a fixed, brief time budget
7. A 68-year-old man presents with painless macroscopic haematuria. What is the most important diagnosis to exclude? → Bladder cancer
8. In the Professional Dilemmas paper, what are the two main question formats? → Ranking and multiple-choice (most/least appropriate)
9. In an SJT, you make a prescribing error that reaches a patient but causes no harm. What should you do? → Be open, report it, and inform the patient as appropriate
10. When a PD question asks for the 'least appropriate' action, you should select the option that: → Most clearly breaches professional standards or risks patient safety
11. A nurse tells you a drug chart you wrote contains a dose she believes is too high. You think it is correct. What should you do? → Recheck the dose against guidelines and discuss it with the nurse
12. Which two papers make up the MSRA? → Professional Dilemmas and Clinical Problem Solving
13. In Professional Dilemmas, what is the best way to handle scenarios involving probity (honesty)? → Always choose options that are honest and transparent
14. According to NICE guidelines, which antihypertensive is recommended as first-line for a patient aged 55 or older with uncomplicated hypertension? → Calcium channel blocker
15. MSRA results are typically reported as: → Scores for each paper that contribute to an overall ranking
16. An OGTT shows fasting glucose 5.9 mmol/L and 2-hour glucose 9.5 mmol/L. How should this be classified? → Impaired glucose tolerance
17. You smell alcohol on a colleague who is about to start a clinical shift. What is the most appropriate first action? → Speak to them privately and raise it with a senior to ensure patient safety
18. A patient presents with a painful, red, swollen calf after a long-haul flight. What is the most likely diagnosis? → Deep vein thrombosis
19. In an SJT scenario, a patient asks you not to tell their family about their diagnosis. What should you do? → Respect the patient's confidentiality if they have capacity
20. You are running an hour behind in clinic and patients are visibly frustrated. What is the most appropriate action? → Apologise to waiting patients and ask reception to keep them updated
21. Which of the following is a mandatory notification to the Care Quality Commission (CQC) in England? → Deaths of service users where abuse or neglect may have contributed
22. A patient presents with an acute gout attack. Which intervention should be avoided during the acute phase? → Initiating allopurinol
23. Which sign is characteristic of appendicitis on examination? → Rovsing's sign
24. A patient asks you to keep a diagnosis secret from their family. What governs your response? → Patient confidentiality and capacity
25. Time management is critical in the MSRA mainly because: → There are many questions in a limited time
26. The Professional Dilemmas paper question types typically include: → Ranking and multiple-best-response items
27. A patient with depression expresses active suicidal thoughts with a plan. What is the most appropriate action? → Urgent mental health assessment and ensure safety
28. On exam day, what is a sensible strategy for the Professional Dilemmas paper's tight timing? → Go with your first well-reasoned instinct and avoid over-analysing each scenario
29. A patient with capacity refuses a treatment you strongly believe they need. What is the most appropriate response? → Respect their decision after ensuring they understand the consequences
30. Which of the following medications routinely requires therapeutic drug level monitoring in clinical practice? → Phenytoin