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RCEM FRCEM Primary Examination Sample Questions:

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

2. A 56 year old man presents with a spiral fracture of the humerus and wrist drop Which structure is most likely to be damaged?

A) Brachial artery
B) Radial nerve
C) Musculocutaneous nerve
D) Axillary artery
E) Ulnar nerve

3. A 21 year old man with a history of epilepsy presents following a generalised seizure A deformity in his left shoulder was noted and an x-ray confirms a dislocation You plan to reduce the dislocation using midazolam for procedural sedation Sedation will occur as a result of mediation of which neurotransmitter?

A) Serotonin
B) Gamma-aminobutyric acid
C) Acetylcholine
D) Glutamate
E) Dopamine

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 vein
B) Femoral artery
C) Inguinal ligament
D) Psoas muscle
E) Iliacus muscle

5. A patient is noted to have a low sodium level. The urinary biochemistry suggests a diagnosis of syndrome of inappropriate anti-diuretic hormone secretion.
Which of these medications is the most likely cause of this abnormality?

A) Prednisolone
B) Spironolactone
C) Ramipnl
D) Furosemtde
E) Fluoxetine

Solutions: