SBA vs EMQ: How to Answer Extended Matching Questions in the GPhC Exam

GPhC Part 2 has 90 SBAs and 30 EMQs. How each format works, a step-by-step method for answering them, worked examples with explanations and the traps that cost trainees marks.

By Umar Majid · 9 Nov 2026

Part 2 of the GPhC registration assessment has 90 single best answer (SBA) questions, each with five options, and 30 extended matching questions (EMQs) in 15 sets of two that share the same eight options. Both test whether you can apply what you know to a real patient. You answer each format slightly differently, and knowing the method saves you time and marks.

How do SBAs and EMQs compare?

	SBA	EMQ
Number in Part 2	90	30 (15 sets of 2)
Options	5	8, shared by both questions in the set
Structure	Scenario, lead-in question, options	Theme, option list, instruction, scenario
Rough time per question	About 1 minute	About 2 minutes
What it rewards	Choosing the best answer among several plausible ones	Recognising a pattern quickly from a longer list

Part 2 lasts 2.5 hours in total. There's no negative marking, so never leave a question blank.

How to answer an SBA

The GPhC's question writers aim for questions you can answer before you look at the options. Use that.

Read the lead-in first. It's the bold question at the end, and you want to know what you're being asked before you read the scenario.
Pick out the facts in the scenario that matter: age, kidney function, other medicines, allergies, pregnancy, results.
Cover the options and predict the answer.
Uncover them and look for your prediction. If it's there, it's probably right.
If it isn't, compare the options. Several may be true, so pick the one that's best for this patient.

Example SBA

A 58-year-old man has tested positive for Helicobacter pylori. He had anaphylaxis to penicillin in the past and has not taken clarithromycin or metronidazole in the last year. He takes simvastatin 40 mg at night and metformin 500 mg twice daily. His GP prescribes lansoprazole 30 mg, clarithromycin and metronidazole, all twice daily for 7 days.

What is the most appropriate advice about his simvastatin?

A. Continue simvastatin and report any unexplained muscle pain
B. Reduce simvastatin to 20 mg at night during the course
C. Stop simvastatin during the 7-day course and restart when it finishes
D. Switch permanently from simvastatin to pravastatin
E. Take simvastatin in the morning instead of at night

The answer is C.

Clarithromycin strongly inhibits the breakdown of simvastatin, which raises the risk of myopathy and rhabdomyolysis, and the MHRA lists clarithromycin as contraindicated with simvastatin. When clarithromycin is needed, the statin should be stopped for the course and restarted once it finishes. The regimen itself is the NICE option for people allergic to penicillin.

Why not the others?

A sounds safe, but monitoring doesn't make a contraindicated combination acceptable.
B is the classic trap. A 20 mg limit applies to simvastatin with amlodipine, diltiazem, verapamil or amiodarone, not with clarithromycin.
D is a bigger change than a 7-day course needs.
E changes nothing about the interaction.

Drug interactions, especially enzyme inhibition, were one of the areas the Board of Assessors highlighted as difficult in its November 2025 feedback.

How to answer an EMQ

EMQs look intimidating because of the long option list, but they reward a calm, consistent method.

Read the theme and the instruction. They tell you what kind of answer you're looking for.
Skim the eight options once so you know what's on the list. Don't study them yet.
Read the first scenario and predict the answer in your own words.
Find it in the list, then check the runner-up options against the scenario.
Treat each scenario as a separate question. Don't rule out an option just because you used it for the other question in the set.

Example EMQ

In the real exam each set has two questions. This practice example has three, to give you more to work with.

Theme: Medicines causing adverse effects

A. Amlodipine
B. Atorvastatin
C. Bendroflumethiazide
D. Ciprofloxacin
E. Doxazosin
F. Lisinopril
G. Metformin
H. Spironolactone

For each patient, select the medicine most likely to have caused the problem described.

Question 1. A 76-year-old woman with heart failure has taken lisinopril and furosemide for two years. Her potassium was normal three months ago. Spironolactone was added two weeks ago. Her blood test today shows potassium 6.2 mmol/L.

Question 2. A 68-year-old man takes atorvastatin 20 mg at night, which he has taken for five years, and prednisolone for polymyalgia rheumatica. Four days ago he started ciprofloxacin for acute prostatitis. He now has pain and swelling at the back of his right heel.

Question 3. A 71-year-old man has taken amlodipine 10 mg daily for hypertension for a year. Bendroflumethiazide 2.5 mg daily was added six weeks ago. He now has a hot, red, very painful and swollen big toe joint.

Answers explained

Question	Answer	Why	Trap
1	H. Spironolactone	Spironolactone with an ACE inhibitor can cause serious hyperkalaemia, and the MHRA advises regular monitoring of potassium and kidney function. The new medicine is the most likely cause.	Lisinopril also raises potassium, but it has been stable for two years. Look at what changed.
2	D. Ciprofloxacin	Fluoroquinolones can cause tendon damage, sometimes within 48 hours. The risk is higher in people over 60 and those taking corticosteroids. The MHRA advises stopping the fluoroquinolone at the first sign of tendon pain.	Atorvastatin can cause muscle pain, but he has taken it for five years. The timing, the single tendon and his risk factors all point to the antibiotic.
3	C. Bendroflumethiazide	Thiazides can raise uric acid and may bring on gout. A hot, red, painful big toe is a typical gout presentation.	"Swollen" pulls you towards amlodipine, which commonly causes ankle swelling. That's not a hot, painful single joint.

Every one of these needed you to use the timeline in the scenario. That's very common in GPhC-style questions.

Which traps catch people out?

Most of them apply to both formats.

True but not best. In SBAs, more than one option can be correct, but the question asks for the most appropriate one for this patient.
The safe-looking option. "Monitor and continue" or "refer" isn't automatically right. Question writers deliberately avoid making the safest-looking option the default answer.
Mixing up similar rules. Dose caps, contraindications and "use with caution" are different things, so learn which applies to which combination.
Grabbing a keyword. Words like "swollen" or "pain" can point to several options. Read the whole scenario.
Ignoring the timeline. What was started, stopped or changed recently is often what decides it.
Skipping the resources. Some questions include an extract on screen. If it's there, it's there for a reason.
Running over time on EMQs. If one is taking more than 3 minutes, pick your best answer, flag it and move on.

To build this into your revision, read our guide to high-yield therapeutics for the GPhC exam and how to use a GPhC mock paper.

Common questions

How many EMQs are in the GPhC exam? 30, in 15 sets of two. Each set shares a list of eight options.

How many SBAs are there? 90, each with five options.

How long should I spend on each? Roughly 1 minute per SBA and 2 minutes per EMQ, which adds up to the 2.5 hours you get for Part 2.

Is there negative marking? No. A wrong answer scores the same as a blank, so always answer.

Can the GPhC example questions help? Yes. The GPhC publishes example SBAs and EMQs that show you the style and the exam platform.

Practise until the method is automatic

The methods only stick once you've practised them on realistic questions with full explanations. Try a mixed set of clinical questions in the Pre-Reg Shortcuts question bank, use the methods above on every one, and review the ones you got right as well as the ones you got wrong.

Start a mixed clinical quiz or try the free clinical sample quiz.