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RCEM FRCEM Primary Examination Sample Questions:

1. A 28 year old woman has an expanding skin rash: lethargy and body ache You suspect Lyme disease Which microorganism is most likely to be the cause?

A) Brucella abortus
B) Anaplasma phagocytophilum
C) Borrelia burgdorferi
D) Theilena microti
E) Bartonella qumtana .

2. A 20 year old woman with known diabetes presents with hypoglycaemia She was given glucagon with good recovery. Which cells ot the pancreas normally secrete this hormone?

A) Beta
B) Gamma
C) Exocrine
D) Alpha
E) Delta

3. You are discussing the different muscles within the medial thigh and movements at the hip joint with a medical student. Which muscle within this compartment is most likely to be involved in hip extension?

A) Adductor longus
B) Pectineus
C) Gracilis
D) Adductor magnus
E) Adductor brevis

4. A patient presents with septic shock A venous blood gas shows a metabolic acidosis Following treatment with crystalloid infusion and antibiotics their HR and BP are normal A repeat venous gas shows a persistent metabolic acidosis with a normal anion gap Which mechanism best explains the results of the repeat blood gas?

A) Lactic acidosis due to tissue hypoperfusion
B) Acute kidney injury due to reduced renal blood flow
C) Hyperchloraemic acidosis due to excessive infusion of normal saline
D) Capillary leak due to sepsis causing continued hypovolamia
E) Metabolic acidosis due to occult aspirin overdose

5. A 48 year old man presents to the ED with sudden onset, severe abdominal pain His CT shows pneumoretroperitoneum. Which of these structures is most likely to have perforated?

A) Duodenum
B) Ileum
C) Jejunum
D) Transverse colon
E) Sigmoid colon

Solutions: