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RCEM FRCEM Primary Examination Sample Questions:

1. A 71 year old man with a history of heart failure and type II diabetes mellitus presents with an acute, painful, swollen first metatarsophalangeal joint in his foot You suspect gout.
Which treatment would be most appropriate for the acute management of this patient*?

A) Diclofenac
B) Allopunnol
C) Colchicine
D) Naproxen
E) Prednisolone

2. An eight year old boy presents with headache fever, fatigue and leg pain There is erythema and swelling over his thigh You suspect osteomyelitis.
What is the most likely causative organism?

A) Haemophilus influenza
B) Salmonella typhimunum
C) Staphylococcus aureus
D) Streptococcus pneumoniae
E) Streptococcus pyogenes

3. A 43 year old Afghan national presents to the ED with a four month history of cough, weight loss and night sweats What test is most consistent with active tuberculosis?

A) Positive mantoux test
B) Absence of a bacille calmette-guenn scar
C) Chest x-ray showing lobar consolidation
D) Chest x-ray showing a cavitating lesion
E) Sputum sample showing ziehl-nielsen stain negative bactena

4. A 34 year old man presents with bruising and swelling over the anterior arm after lifting weights at the gym.
There is pain and weakness on attempted internal rotation and adduction of the shoulder.
Rupture of which muscle best explains these findings?

A) Latissimus dorsi
B) Pectoralis major
C) Trapezius
D) Pectoralis minor
E) Serratus anterior

5. You see a patient with steatorrhea, weight loss and abdominal pain You suspect they have exocrine pancreatic insufficiency The secretion of which substance is least likely to be affected by this condition?

A) Cholecystokinin
B) Phospholipase A2
C) Protease
D) Amylase
E) Lipase

Solutions: