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RCEM FRCEM Primary Examination Sample Questions:

1. A 68 year old man with a history of Addison's disease presents having recently been diagnosed with a urinary tract infection He is hypotensive, tachycardic and clammy His biochemistry shows hyponatraemia and hyperkalemia.
Which hormone imbalance best explains his biochemical abnormalities?

A) Glucocorticoid deficiency
B) Cortisol deficiency
C) Beta lipotropin excess
D) Adrenocorticotropic hormone excess
E) Mineralocorticoid deficiency

2. A 14 year old boy presents after a bicycle accident He has a suspected pelvic fracture and the cremasteric reflex is absent Which nerve is most likely to be affected1?

A) Subcostal
B) Genitofemoral
C) Lateral femoral cutaneous
D) Iliohypogastric .
E) Femoral

3. 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) Rhomboid major
B) Pectineus
C) Latissimus dorsi
D) Psoas minor
E) lliacus

4. A 32 year old football player attends with a painful right knee after a tackle On examination she is unable to dorsiflex her foot Which nerve is most likely injured''

A) Medial calcaneal
B) Tibial
C) Common peroneal
D) Sural
E) Pudendal

5. A newborn infant is brought to your ED He was born at 39 weeks gestation with low birthweight, a purpuric rash, hepatosplenomegaly and bilateral cataracts You suspect the signs are secondary to an infection acquired while khe baby was still in utero Which organism is most likely to cause this clinical presentation?

A) Cytomegalovirus
B) Toxoplasma gondii
C) Treponema pallidum
D) Rubella
E) Group B streptococcus

Solutions: