Six to eight FMGE marks every session sit in “drug of choice” questions. They are the closest thing to free marks — the stem gives you the condition, the right answer is one drug, and there is no negative marking to punish a confident pick. The catch is that you must actually remember the pairing.
Fifty pairings cover almost every drug-of-choice question asked in the last eight FMGEs, with overlap into NEET PG and INICET. Memorise the list, drill the FMGEPrep MCQs that wrap each pairing, and walk into the exam confident on a half-dozen marks.
Quick Answer
Fifty drug-of-choice pairings cover essentially every FMGE drug-of-choice question across the last 9 years. They are organised here by clinical scenario: cardiac emergencies, neurology, infectious disease, OBG, paediatrics, poisoning, GI, endocrine and miscellaneous. Memorise the table, drill the wrapped MCQs, and you secure 6–8 marks in 60 seconds of exam time.
1 Cardiac & haematology emergencies (1–10)
| # | Condition | Drug of choice |
|---|---|---|
| 1 | Acute MI antiplatelet | Aspirin + ticagrelor / clopidogrel |
| 2 | SVT termination | IV adenosine (after vagal manoeuvres) |
| 3 | AF rate control | Beta-blocker (metoprolol) or diltiazem |
| 4 | Hypertensive emergency | IV labetalol or nicardipine |
| 5 | Hypertension in pregnancy | Labetalol (or methyldopa, nifedipine) |
| 6 | Heart failure (HFrEF) cornerstone | ACE-I/ARNI + beta-blocker + MRA + SGLT2-i |
| 7 | VT (stable) | IV amiodarone |
| 8 | Bradycardia (symptomatic) | IV atropine |
| 9 | Acute pulmonary embolism (haemodynamically unstable) | Thrombolysis (alteplase) |
| 10 | Sickle cell crisis | IV fluids + opioids; hydroxyurea for prevention |
2 Neurology & psychiatry (11–18)
| # | Condition | Drug of choice |
|---|---|---|
| 11 | Status epilepticus (first line) | IV lorazepam |
| 12 | Generalised tonic-clonic seizures (chronic) | Sodium valproate or levetiracetam |
| 13 | Absence seizures | Ethosuximide |
| 14 | Trigeminal neuralgia | Carbamazepine |
| 15 | Migraine acute attack | Triptan (sumatriptan) |
| 16 | Parkinson disease (early) | Levodopa + carbidopa |
| 17 | Schizophrenia first-line | Atypical antipsychotic (risperidone, olanzapine) |
| 18 | Bipolar mania (acute) | Lithium / valproate / atypical antipsychotic |
3 Infectious disease & antimicrobials (19–28)
| # | Condition | Drug of choice |
|---|---|---|
| 19 | Tuberculosis (drug-sensitive) | HRZE for 2 mo, HR for 4 mo (NTEP) |
| 20 | MDR-TB | Bedaquiline-based regimen (NTEP) |
| 21 | Falciparum malaria (uncomplicated) | ACT (artesunate-sulfadoxine-pyrimethamine in India) |
| 22 | Severe malaria | IV artesunate |
| 23 | Bacterial meningitis empiric (adults < 50) | Ceftriaxone + vancomycin (+ ampicillin if > 50) |
| 24 | Community-acquired pneumonia (outpatient) | Amoxicillin (or doxycycline / macrolide) |
| 25 | Uncomplicated UTI (female) | Nitrofurantoin or trimethoprim-sulfamethoxazole |
| 26 | HIV first-line ART (India) | TLD: tenofovir + lamivudine + dolutegravir |
| 27 | Pneumocystis pneumonia (PCP) | Cotrimoxazole (TMP-SMX) |
| 28 | Anaerobic infection (empiric) | Metronidazole |
4 OBG & paediatrics (29–36)
| # | Condition | Drug of choice |
|---|---|---|
| 29 | Eclampsia (and severe pre-eclampsia) | Magnesium sulphate (Pritchard / Zuspan) |
| 30 | PPH (postpartum haemorrhage) first-line | IV oxytocin |
| 31 | Induction of labour | Misoprostol or dinoprostone (PGE2) |
| 32 | Tocolysis (premature labour) | Nifedipine (or atosiban) |
| 33 | Foetal lung maturation | Antenatal betamethasone |
| 34 | Neonatal apnoea | IV caffeine citrate |
| 35 | Acute paediatric asthma | Inhaled salbutamol + oral steroid |
| 36 | Acute bacterial diarrhoea (paediatric) | ORS + zinc (antibiotic only if dysentery) |
5 Poisoning & antidotes (37–44)
| # | Poisoning | Antidote |
|---|---|---|
| 37 | Paracetamol overdose | N-acetylcysteine |
| 38 | Organophosphate poisoning | Atropine + pralidoxime |
| 39 | Benzodiazepine overdose | Flumazenil |
| 40 | Opioid overdose | Naloxone |
| 41 | Heparin overdose | Protamine sulphate |
| 42 | Warfarin overdose | Vitamin K (FFP if active bleed) |
| 43 | Methanol or ethylene glycol | Fomepizole (or ethanol) |
| 44 | Iron overdose | Deferoxamine |
6 Endocrine, GI & miscellaneous (45–50)
| # | Condition | Drug of choice |
|---|---|---|
| 45 | Type 2 diabetes (no contraindication) | Metformin (add SGLT2-i in HF/CKD) |
| 46 | Diabetic ketoacidosis | IV fluids → potassium check → insulin |
| 47 | Hyperthyroidism (Graves) | Carbimazole (or PTU in pregnancy 1st trimester) |
| 48 | Variceal bleed | IV octreotide / terlipressin |
| 49 | Anaphylaxis | IM adrenaline (1:1000) |
| 50 | Wilson disease | D-penicillamine (or trientine) |
7 The five trap distractors aspirants pick
- ×DKA — insulin first. Trap is starting insulin. Correct order is fluids → potassium check → insulin.
- ×Bacterial meningitis — ceftriaxone alone. In adults over 50, add ampicillin to cover Listeria.
- ×Type 2 diabetes + heart failure — metformin only. SGLT2 inhibitor is the modern add-on with HF mortality benefit.
- ×Hyperthyroidism in 1st trimester — carbimazole. Trap is using carbimazole; PTU is preferred in 1st trimester due to teratogenicity risk.
- ×SVT — verapamil first. Vagal manoeuvres → adenosine is the real first line.
How to drill this list
Convert the table into 50 spaced-repetition flashcards. Five days, ten cards a day. From Day 6, drill the FMGEPrep tagged drug-of-choice MCQs in the Medicine PYQ section — each pairing has a wrapped clinical vignette and the explanation of why the trap distractor is wrong. Two weeks of disciplined repetition locks the entire list.
Frequently asked questions
How many drug-of-choice questions are in the FMGE?
Six to eight straight-up drug-of-choice questions appear on every recent FMGE, spread across Pharmacology and Medicine sections. Including drug-related management vignettes (where the answer is a drug), the count rises to 12–15 marks per session.
What is the drug of choice for status epilepticus in FMGE?
IV lorazepam is the first-line drug for status epilepticus. If lorazepam is unavailable, IV diazepam is acceptable. Phenytoin or fosphenytoin is added next if seizures persist after the benzodiazepine.
What is the drug of choice for eclampsia?
Magnesium sulphate is the drug of choice for eclampsia and severe pre-eclampsia. Both Pritchard regimen (IM) and Zuspan regimen (IV) are accepted. Magnesium reduces seizure recurrence and is preferred over diazepam or phenytoin in this setting.
What is the drug of choice for organophosphate poisoning?
Atropine combined with pralidoxime (2-PAM) is the drug regimen of choice for organophosphate poisoning. Atropine reverses the muscarinic effects; pralidoxime reactivates acetylcholinesterase if given early.
How do I memorise the FMGE drug-of-choice list?
Convert the 50-entry list into spaced-repetition flashcards (10 cards a day for 5 days), then drill tagged drug-of-choice MCQs daily for two weeks. Each pairing should be revisable in under 5 seconds by exam day.
Are FMGE drug-of-choice questions the same as NEET PG?
Roughly 80% overlap. NEET PG occasionally tests less common pairings (rare antidotes, third-line drugs in resistant cases). The 50-entry FMGE list is a strong base; NEET PG preparation adds another 20–30 niche pairings on top.
Drill the 50-entry drug-of-choice list
Tagged drug-of-choice MCQs in the FMGEPrep Medicine PYQ section. Each pairing comes with a wrapped vignette and trap-distractor explanation. Free trial without a credit card.
Open FMGE Medicine PYQ Bank →