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RCEM FRCEM Primary Examination Sample Questions:

1. You are leaching medical students cardiovascular examination and the link between heart sounds and the cardiac cycle. Which phase best correlates with the start of the first heart sound?

A) Isovolumetric contraction
B) Ventricular filling
C) Isovolumetric relaxation
D) Atrial systole
E) Ventricular ejection

2. A 43 year old man with presents with an infective exacerbation of COPD Your consultant advises you to give IV hydrocortisone What best describes the mechanism of action of this treatment for this acute condition?

A) Activation of phospholipid A2
B) Binding with glucocorticoid receptor
C) Activation of NF-kappa B
D) Inhibition of prostaglandin synthesis
E) Adrenal suppression

3. A 23 year old woman presents with facial swelling She has hereditary angioedema due to complement deficiency Which organism is it most important for this patient to be vaccinated agains?

A) Influenza
B) Herpes zoster
C) Clostridium tetani
D) Parainfluenza
E) Neisseria meningitidis

4. A 21 year old woman attends with an earring becoming lodged in the lobule of her ear You decide to perform a nerve block to allow removal of the earring Which nerve are you most likely to need to block?

A) Posterior auncular branch of facial
B) Lesser occipital
C) Greater auricular
D) Auricular branch of vagus
E) Auriculotemporal

5. A 56 year old woman with severe ascites attends the ED with breathlessness Chest auscultation is normal What findings would you expect on spirometry?

A) Increased FVC
B) Increased FEV,/FVC ratio
C) Increased total lung capacity
D) Increased inspiratory capacity
E) Increased vital capacity

Solutions: