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RCEM FRCEM Primary Examination Sample Questions:

1. A 23 year old presents with episodes of a painful left arm which becomes swollen and cyanosed after they have been kayaking Obstruction of which structure is most likely to cause these symptoms'?

A) Subclavian artery
B) Subclavian vein
C) Axillary vein
D) Brachiocephalic vein
E) Brachiocephalic trunk

2. A patient presents following a stabbing to his chest and has a cardiac arrest You perform an anterolateral thoracotomy. Which muscle in addition to pectoralis major are you most likely to incise?

A) Pectoralis minor
B) Subclavius
C) Serratus anterior
D) Latissimus dorsi
E) Teres major

3. A 47 year old woman with a diagnosis of pulmonary hypertension attends the ED with breathlessness An increase in which physiological parameter is the most likely consequence of this condition?

A) Right atrial pressure
B) Left ventricular contractility
C) Right ventricular afterload
D) Pulmonary venous resistance
E) Pulmonary arterial blood flow

4. A patient presents with anaphylaxis requiring adrenaline She is markedly vasodilated Which substance is most likely to be responsible for this appearance?

A) Histamine
B) Platelet activating factor.
C) Tumour necrosis factor alpha
D) Prostaglandin
E) Leukotrienes

5. A patient presents with acute cardiac failure and is prescribed a loop diuretic In which part of the nephron will the diuretic inhibit the sodium-potassium-chloride cotransporter?

A) Distal convoluted tubule
B) Collecting duct
C) Proximal tubule
D) Thick ascending limb
E) Thin ascending limb

Solutions: