FRCEM exam questions

1. Question 1

   Single answer

   An 88 year old woman presents with haematemesis CT scan identifies a posterior ulcer of the superior part of the duodenum At what vertebral level would this be evident on the CT scan?

   • A

     L1

   • B

     L2

   • C

     L3

   • D

     L4

   • E

     T12

   Reveal answer

   Correct answer

   • A

     L1

2. Question 2

   Single answer

   A patient presents with acute cardiac failure and is prescribed a loop diuretic

   In which part of the nephron will the diuretic inhibit the sodium-potassium-chloride cotransporter?

   • A

     Collecting duct

   • B

     Distal convoluted tubule

   • C

     Proximal tubule

   • D

     Thick ascending limb

   • E

     Thin ascending limb

   Reveal answer

   Correct answer

   • D

     Thick ascending limb

3. Question 3

   Single answer

   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

     Forced expiratory volume

   • B

     Peak expiratory flow rate

   • C

     Physiological dead space

   • D

     Tidal volume

   • E

     Vital capacity

   Reveal answer

   Correct answer

   • A

     Forced expiratory volume

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5. Question 4

   Single answer

   A patient presents following a stabbing to his chest and has a cardiac arrest You perform an anterolateral thoracotomy. Which muscle in addition to pectoralis major are you most likely to incise?

   • A

     Latissimus dorsi

   • B

     Pectoralis minor

   • C

     Serratus anterior

   • D

     Subclavius

   • E

     Teres major

   Reveal answer

   Correct answer

   • C

     Serratus anterior

6. Question 5

   Single answer

   A 78 year old woman presents with a painful shoulder after a fall. On examination she is unable to lift the dorsum of her hand off her mid-lumbar spine (lift-off test).

   Which muscle is most likely to have been injured?

   • A

     Infraspinatus

   • B

     Subscapulars

   • C

     Supraspinatus

   • D

     Teres major

   • E

     Teres minor

   Reveal answer

   Correct answer

   • B

     Subscapulars

7. Question 6

   Single answer

   A therapeutic trial demonstrates that everyone who received the drug has improved while no one improved with placebo What best describes the expected number needed to treat?

   • A

     1

   • B

     2

   • C

     10

   • D

     50

   • E

     100

   Reveal answer

   Correct answer

   • A

     1

8. Question 7

   Single answer

   A five year old girl is brought to the ED by her parents She is pyrexial and has coryzal symptoms. Which diagnosis would require notification to a UK Public Health department?

   • A

     Influenza type A

   • B

     Kawasaki ' s disease

   • C

     Pneumococcal pneumonia

   • D

     Respiratory syncytial virus

   • E

     Whooping cough

   Reveal answer

   Correct answer

   • A

     Influenza type A

9. Question 8

   Single answer

   A 63 year old patienl presents with symptoms of hemiplegia and sensory loss of the right side of face and extremities. Which artery is most likely to be involved?

   • A

     Anterior cerebral

   • B

     Anterior communicating

   • C

     Middle cerebral

   • D

     Posterior cerebral

   • E

     Vertebral

   Reveal answer

   Correct answer

   • C

     Middle cerebral

10. Question 9

    Single answer

    A 52 year old woman (alls from a root sustaining a fracture dislocation at T12/L1 level Which muscle is most likely to be injured*?

    • A

      lliacus

    • B

      Latissimus dorsi

    • C

      Pectineus

    • D

      Psoas minor

    • E

      Rhomboid major

    Reveal answer

    Correct answer

    • B

      Latissimus dorsi

11. Question 10

    Single answer

    A 50 year old man with HIV has not been taking his treatment and presents with severe headache and neck stiffness His current CD4+ count is 180/mmc (normal 500-1400/mmc)

    What is the most likely causative agent of his meningitis?

    • A

      Aspergillus

    • B

      Candida

    • C

      Cryptococcus

    • D

      Malassezia

    • E

      Sporothrix

    Reveal answer

    Correct answer

    • C

      Cryptococcus

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