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RCEM FRCEM Primary Examination Sample Questions:

1. A 15 year old girl with sickle cell anaemia attends with left leg swelling and pain Further investigations suggest a diagnosis of osteomyelitis of her tibia.
What is the most likely causative organism?

A) Pseudomonas aeruginosa
B) Escherichia coli
C) Streptococcus pneumoniae
D) Haemophilus influenza
E) Salmonella typhimunum

2. A 56 year old presents unwell They are diagnosed with a hypertensive crisis. You decide to start sodium nitroprusside What best describes the mechanism of action of this drug?

A) Inhibits angiotensin converting enzyme
B) Releases nitric oxide
C) Decreases the breakdown of bradykmin
D) Decreases angiotensin II
E) Antagonises the renm-angiotensm-aldosterone system

3. You are considering procedural sedation for a patient with vascular compromise due to a fracture They ate a meal two hours ago You are trying to remember the factors that affect gastric emptytng in healthy patients What factor will delay gastric emptying?

A) More liquids than solids in the stomach
B) Decreased duodenal luminal pH
C) Low fat content of chyme
D) Increased gastric distention
E) Release of gastrin

4. A 20 year old woman complains of loss of taste from the posterior part of her tongue She is two days post tonsillectomy Which nerve is most likely damaged?

A) Lingual
B) Hypoglossal
C) Chorda tympanae
D) Vagus
E) Glossopharyngeal

5. A three year old girl is diagnosed with measles in the ED and is well enough to be discharged Her dad wants to know when she can return to nursery.
What is the recommended absence period?

A) Until fever has settled for 24 hours
B) Four days after the onset of rash
C) Until the rash has disappeared
D) Until conjunctivitis and mucous membrane rash has resolved
E) Seven days after the rash has disappeared

Solutions: