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RCEM FRCEM Primary Examination Sample Questions:

1. A 60 year old man with alcoholic liver cirrhosis and portal hypertension is brought to the ED because he has been vomiting blood Which vein is the most likely origin of his haematemesis?

A) Superior vena cava
B) Azygos
C) Periumbilical
D) Left gastric
E) Inferior mesenteric

2. A 60 year old woman presents following blunt trauma to her abdomen A CT scan demonstrates herniation of small intestine into the chest At what site is the diaphragmatic injury most likely to have occurred1?

A) 11-12th ribs
B) Central tendon
C) Xiphoid process
D) Costal cartilage of 7-10th ribs
E) Lumbar vertebrae

3. A 63 year old patienl presents with symptoms of hemiplegia and sensory loss of the right side of face and extremities. Which artery is most likely to be involved?

A) Posterior cerebral
B) Vertebral
C) Anterior cerebral
D) Middle cerebral
E) Anterior communicating

4. A comatose patient has a respiratory rate of live breaths per minute following an overdose of heroin He receives naloxone and his respiratory rate rapidly improves to 16 breaths per minute Which component of arterial blood gas sampling is most likely to rapidly decrease following this intervention?

A) Base Excess
B) PaC02
C) HC03
D) pH
E) Pa02

5. A five year old girl is brought to the ED by her parents She is pyrexial and has coryzal symptoms. Which diagnosis would require notification to a UK Public Health department?

A) Whooping cough
B) Kawasaki's disease
C) Influenza type A
D) Respiratory syncytial virus
E) Pneumococcal pneumonia

Solutions: