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RCEM FRCEM Primary Examination Sample Questions:
1. 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) Protease
B) Phospholipase A2
C) Cholecystokinin
D) Lipase
E) Amylase
2. A 43 year old man with presents with an infective exacerbation of COPD Your consultant advises you to give IV hydrocortisone What best describes the mechanism of action of this treatment for this acute condition?
A) Adrenal suppression
B) Activation of NF-kappa B
C) Activation of phospholipid A2
D) Binding with glucocorticoid receptor
E) Inhibition of prostaglandin synthesis
3. A 21 year old man is diagnosed with diabetic ketoacidosis. A medical student asks you to assist them in calculating the patients blood pH using the Henderson-Hasselbach equation.
What best describes the two required constituents for this equation?
A) Chloride and PaC02
B) Bicarbonate and Pa02
C) Bicarbonate and PaC02
D) Bicarbonate and sodium
E) Sodium and calcium
4. A 40 year old man attends with a fracture of the shaft of femur and you performed a femoral nerve block for pain relief. Which structure lies immediately medial to your needle insertion in the groins A
A) Femoral artery
B) Psoas muscle
C) Femoral vein
D) Inguinal ligament
E) Iliacus muscle
5. 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) Lactic acidosis due to tissue hypoperfusion
B) Acute kidney injury due to reduced renal blood flow
C) Hyperchloraemic acidosis due to excessive infusion of normal saline
D) Capillary leak due to sepsis causing continued hypovolamia
E) Metabolic acidosis due to occult aspirin overdose
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: D | Question # 3 Answer: C | Question # 4 Answer: A | Question # 5 Answer: C |
