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

2. A 21 year old man with a history of epilepsy presents following a generalised seizure A deformity in his left shoulder was noted and an x-ray confirms a dislocation You plan to reduce the dislocation using midazolam for procedural sedation Sedation will occur as a result of mediation of which neurotransmitter?

A) Serotonin
B) Acetylcholine
C) Glutamate
D) Gamma-aminobutyric acid
E) Dopamine

3. 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) Phosphate
C) Sodium
D) Albumin
E) Chloride

4. A 54 year old man presents with headaches, palpitations and diaphoresis Imaging findings are consistent with a phaeochromocytoma The cells affected in this condition are most likely to be found in which region?

A) Zona glomerulosa
B) Adrenal cortex
C) Zona fasciculata
D) Zona reticularis
E) Adrenal medulla.

5. A patient with major trauma requires a central line. They have right sided neck and chest burns You decide to insert a left subclavian central line.
Which complication is more likely to occur during this procedure on the left in comparison to the right?

A) Pneumothorax
B) Injury to the recurrent laryngeal nerve
C) Injury to the thoracic duct ID.
D) Injury to the phrenic nerve
E) Perforation of the oesophagus.

Solutions: