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RCEM FRCEM Exam Syllabus Topics:

RCEM FRCEM Primary Examination Sample Questions:

Question 1

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

Question 2

A 34 year old man presents wrth shortness of breath He has a normal alveolar-arterial <A-a) gradient What is the most likely diagnosis?

A. Atelectasis
B. Congestive cardiac failure
C. Pulmonary thromboembolism
D. Acute respiratory distress syndrome
E. Neuromuscular disorder

Question 3

You are leaching medical students cardiovascular examination and the link between heart sounds and the cardiac cycle. Which phase best correlates with the start of the first heart sound?

A. Ventricular filling
B. Ventricular ejection
C. Isovolumetric contraction
D. Isovolumetric relaxation
E. Atrial systole

Question 4

A 45 year old man with an acute kidney injury is found to have a metabolic acidosis What renal response is most likely to be involved in compensating for this metabolic abnormality?

A. Secretion of glutamine into the interstitial fluid
B. Secretion of ammonium into the tubular lumen
C. Reabsorption of H*
D. Carbonic anhydrase - mediated production of phosphate
E. Secretion of HC03" into the tubular lumen

Question 5

A 75 year old woman is prescribed aspirin for secondary prevention following myocardial infarction The formation by platelets of what substance is most likely to be inhibited by this medication?

A. Prostacyclin
B. Plasminogen
C. Thromboxane
D. Fibrin
E. Fibrinogen

Solutions: