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RCEM FRCEM Primary Examination Sample Questions:

1. A 60 year old woman presents lo the ED feeling generally unwell She is found to be uraemic She has missed several of her renal dialysis sessions.
Urea will most likely move through the dialysis membranes by which mechanism?

A) Facilitated diffusion
B) Osmosis
C) Simple diffusion
D) Active transport
E) Co-transport

2. A patient presents to the ED a few days after a significant head injury He is polyuric with hypernatremia and high plasma osmolality Which hormone is most likely to cause this picture?

A) Adrenocorticotropic
B) Vasopressin
C) Somatostatin
D) Dopamine
E) Corticotropm-releasing

3. A 67 year old woman presents with sudden onset poor balance. vertigo; ataxia, dysarthria and staggering to the left Her condition is most likely to be caused by an infarct in which area?

A) Left cerebellar
B) Right cerebellar
C) Left basal ganglia
D) Right basal ganglia
E) Bilateral hemispheric

4. 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) Activation of phospholipid A2
B) Binding with glucocorticoid receptor
C) Activation of NF-kappa B
D) Adrenal suppression
E) Inhibition of prostaglandin synthesis

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

Solutions: