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RCEM FRCEM Primary Examination Sample Questions:

1. You are considering procedural sedation for a patient with vascular compromise due to a fracture They ate a meal two hours ago You are trying to remember the factors that affect gastric emptytng in healthy patients What factor will delay gastric emptying?

A) Decreased duodenal luminal pH
B) Low fat content of chyme
C) Release of gastrin
D) More liquids than solids in the stomach
E) Increased gastric distention

2. A 19 year old old runner presents with pain in the lateral compartment of the lower leg when running and you suspect intermittent compartment syndrome Which movement of the ankle and foot would most likely replicate the pain?

A) Plantarflexion and inversion
B) Plantarflexion and eversion
C) Dorsiflexion and eversion
D) External rotation
E) Dorsiflexion and inversion

3. An eight year old boy presents with headache fever, fatigue and leg pain There is erythema and swelling over his thigh You suspect osteomyelitis.
What is the most likely causative organism?

A) Streptococcus pneumoniae
B) Haemophilus influenza
C) Streptococcus pyogenes
D) Staphylococcus aureus
E) Salmonella typhimunum

4. 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) Cholecystokinin
C) Phospholipase A2
D) Lipase
E) Amylase

5. You suspect cauda equina syndrome in an 85 year old man with metastatic cancer On examination there is loss of anal tone Which myotomes are most likely to be affected and causing this examination finding?

A) L5
B) S1.2
C) L12
D) L3,4
E) S2, 3, 4

Solutions: