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RCEM FRCEM Primary Examination Sample Questions:

1. A 56 year old presents unwell They are diagnosed with a hypertensive crisis. You decide to start sodium nitroprusside What best describes the mechanism of action of this drug?

A) Decreases the breakdown of bradykmin
B) Antagonises the renm-angiotensm-aldosterone system
C) Releases nitric oxide
D) Inhibits angiotensin converting enzyme
E) Decreases angiotensin II

2. A 35 year old man attends after a motorbike accident. He is complaining of abnormal vision and his right eye is slightly adducted when he looks straight ahead.
Which cranial nerve has suffered the most damage?

A) Inferior division of oculomotor
B) Superior division of oculomotor
C) Trochlear
D) Trigeminal
E) Abducens

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

4. A 35 year old man is hypotensive following a fracture of the right femoral shaft.
Which receptors are initially involved in increasing his BP?

A) Atrial stretch receptors
B) Cardiac receptors
C) Beta 2 vascular receptors
D) Carotid body receptors
E) Baroreceptors

5. A 40 year old woman wilh a new diagnosis of type II diabetes has significant hyperglycaemia What is the most likely cause of her elevated blood glucose?

A) Excessive glucocorticoid production
B) Increased cellular resistance to insulin
C) Production of abnormal insulin
D) Reduced insulin production by pancreatic beta cells
E) Reduced glucagon secretion

Solutions: