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RCEM FRCEM Primary Examination Sample Questions:

1. A 70 year old woman presents with reduced I6vel of consciousness following a recent chest infection She has signs of meningeal irritation Gram staining of CSF demonstrates gram positive diplococci.
Which organism is most likely in this case1?

A) Acinetobacter baumannii
B) Moraxella catarrhalis
C) Staphylococcus aureus
D) Neisseria meningitidis
E) Streptococcus pneumoniae

2. A 55 year old woman is found to have clinical and biochemical features of cholestatic jaundice. You think her jaundice might be caused by one of her medications.
Which medication is the most likely cause of her jaundice?

A) Phenytoin
B) Thyroxine
C) Co-amoxiclav
D) Aspirin
E) Paracetamol

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

4. 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) Candida
B) Sporothrix
C) Aspergillus
D) Cryptococcus
E) Malassezia

5. You are considering procedural sedation for a patient with vascular compromise due to a fracture They ate a meal two hours ago You are trying to remember the factors that affect gastric emptytng in healthy patients What factor will delay gastric emptying?

A) Release of gastrin
B) Increased gastric distention
C) Decreased duodenal luminal pH
D) More liquids than solids in the stomach
E) Low fat content of chyme

Solutions: