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RCEM FRCEM Primary Examination Sample Questions:

1. A 33 year old man presents with signs of sepsis. A venous blood gas is taken which confirms an elevated haematocnt level What best describes the normal range of haematocnt you expect to find in a healthy male of this age?

A) 50-59%
B) 20-29%
C) 30-39%
D) 10-19%
E) 40-49%

2. A four year old boy presents with a cough and fever for the last few weeks which became worse in the last 24 hours. There is no record of his vaccination history His temperature is 38.5 °C, heart rate 135 beats per minute, and oxygen saturations are 97% He is coughing frequently and has bilateral subconjunctival haemorrhages.
Which organism is most likely to have caused his condition?

A) Mycobacterium tuberculosis
B) Bordetella pertussis
C) Cornebactenum diphthenae
D) Haemophilus influenzae
E) Respiratory syncytial virus

3. A pregnant patient presents to the department following an eclamptic seizure She requires management for her hypertension.
Which drug would be most appropriate in this case?

A) Glyceryl trinitrate
B) Sodium nitroprusside
C) Nifedipine
D) Labetalol
E) Atenolol

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

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

Solutions: