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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) Combining diclofenac with omeprazole
C) Eradication of Helicobacter pylori
D) Use of enteric coated medication
E) Starting misoprostol

2. A 55 year old heavy smoker presents with cough, sputum production and dyspnoea A chest x-ray shows hyperinflation with diminished pulmonary vasculature Which measurement is likely to be increased on lung function testing?

A) Physiological dead space
B) Peak expiratory flow rate
C) Vital capacity
D) Forced expiratory volume
E) Tidal volume

3. 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) Periumbilical
C) Inferior mesenteric
D) Left gastric
E) Azygos

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

5. A 50 year old man presents with hypoglycaemia You decide to give him intramuscular glucagon Which organ is most affected by this treatment to increase blood sugar levels?

A) Liver
B) Adrenal
C) Pancreas
D) Ileum
E) Kidney

Solutions: