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RCEM FRCEM Primary Examination Sample Questions:

1. A 60 year old woman presents lo the ED feeling generally unwell She is found to be uraemic She has missed several of her renal dialysis sessions.
Urea will most likely move through the dialysis membranes by which mechanism?

A) Active transport
B) Osmosis
C) Facilitated diffusion
D) Co-transport
E) Simple diffusion

2. A 28 year old woman presents to the ED after taking an overdose of amitriptyline. Her ECG shows a broad complex tachycardia Blockade of what type of ion channel is most likely to have occurred?

A) Potassium channels
B) Cyclic nucleotide-gated channels
C) Gap junction channels.
D) Sodium channels
E) Calcium channels

3. A 34 year old woman with Graves' disease presents with fever, palpitations, tremor and anxiety Which hormone is most likely to be causing her symptoms?

A) Triiodothyronine (T3)
B) Thyroid stimulating hormone
C) Thyroid receptor hormone
D) Thyroxine (T4)
E) Adrenaline

4. 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) L4
B) L3
C) L1
D) L2
E) T12

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

Solutions: