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RCEM FRCEM Primary Examination Sample Questions:

1. A three week old baby is brought in by her concerned parents She is vomiting substantially after feeds and is failing to gain weight. Investigation reveals an alkalosis and a low serum potassium.
The alkalosis is most likely to be due to which mechanism?

A) Exchange of H* at the gastric protein pump
B) Hypoventilation causing reduced pC02
C) Loss of hydrochloric acid
D) Increased loss of magnesium
E) Increased production of bicarbonate

2. A ten day old baby is brought in with purulent conjunctivitis. The gram stain of the purulent exudate did not show any organisms. Which bacteria is the most likely cause?

A) Neisseria gonorrhoeae
B) Chlamydia trachomatis
C) Escherichia coli
D) Listeria monocytogenes
E) Streptococcus pneumoniae

3. A 75 year old man presents to the ED with burning epigastric abdominal pain You note that he has rheumatoid arthritis and is on diclofenac.
Which step would have been the most beneficial in preventing the development ot ulcers in this patient?

A) Combining diclofenac with omeprazole
B) Change diclofenac to indomethacm
C) Eradication of Helicobacter pylori
D) Starting misoprostol
E) Use of enteric coated medication

4. A patient presents with unilateral tongue swelling with no additional signs of allergic reaction She is on multiple cardiac medications Which drug is most likely to have caused these symptoms?

A) Aspirin
B) Atenolol
C) Simvastatin
D) Lisinopril
E) Bendroflumethiazide

5. A 75 year old man is concerned about having frequent chest infections He is a heavy smoker and you explain to him that this can affect the normal mechanism of mucociliary clearance of microorganisms and pollutants What type of cell is primarily responsible for this method of pathogen clearance?

A) Columnar epithelial cells
B) Acinar cells
C) Club cells
D) Goblet cells
E) Mast cells

Solutions: