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RCEM FRCEM Primary Examination Sample Questions:

1. A 75 year old man presents to the ED with burning epigastric abdominal pain You note that he has rheumatoid arthritis and is on diclofenac.
Which step would have been the most beneficial in preventing the development ot ulcers in this patient?

A) Change diclofenac to indomethacm
B) Eradication of Helicobacter pylori
C) Starting misoprostol
D) Use of enteric coated medication
E) Combining diclofenac with omeprazole

2. A 35 year old man is hypotensive following a fracture of the right femoral shaft.
Which receptors are initially involved in increasing his BP?

A) Baroreceptors
B) Atrial stretch receptors
C) Cardiac receptors
D) Carotid body receptors
E) Beta 2 vascular receptors

3. A 20 year old woman has an incised wound over the angle of her jaw and you suspect damage to a branch of the facial nerve What action are you most likely to test to confirm your suspicion?

A) Mandibular retraction
B) Pull corner of lips out and down
C) Protrude lower lip
D) Mandibular elevation
E) Stick tongue out

4. A patient presents with septic shock A venous blood gas shows a metabolic acidosis Following treatment with crystalloid infusion and antibiotics their HR and BP are normal A repeat venous gas shows a persistent metabolic acidosis with a normal anion gap Which mechanism best explains the results of the repeat blood gas?

A) Hyperchloraemic acidosis due to excessive infusion of normal saline
B) Acute kidney injury due to reduced renal blood flow
C) Capillary leak due to sepsis causing continued hypovolamia
D) Metabolic acidosis due to occult aspirin overdose
E) Lactic acidosis due to tissue hypoperfusion

5. A patient presents with muscle spasms caused by hypocalcaemia Which substance is used to adjust (or an abnormality in the calcium level?

A) Vitamin D
B) Chloride
C) Phosphate
D) Albumin
E) Sodium

Solutions: