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RCEM FRCEM Primary Examination Sample Questions:

1. A 67 year old woman is being treated for haematemesis Within a few minutes of starting transfusion of packed red cells she reports dizziness, breathlessness, tingling of her lips and develops a maculopapular rash What type of hypersensitivity reaction is most likely to be occurring?

A) Type III
B) Type V
C) Type I
D) Type II
E) Type IV

2. You are leaching medical students cardiovascular examination and the link between heart sounds and the cardiac cycle. Which phase best correlates with the start of the first heart sound?

A) Atrial systole
B) Isovolumetric relaxation
C) Ventricular filling
D) Isovolumetric contraction
E) Ventricular ejection

3. A newborn infant is brought to your ED He was born at 39 weeks gestation with low birthweight, a purpuric rash, hepatosplenomegaly and bilateral cataracts You suspect the signs are secondary to an infection acquired while khe baby was still in utero Which organism is most likely to cause this clinical presentation?

A) Treponema pallidum
B) Group B streptococcus
C) Cytomegalovirus
D) Rubella
E) Toxoplasma gondii

4. A patient presents with an area of cellulitis with discharge on their foot following a puncture wound A swab shows a large number of gram positive rods on initial culture.
Which organism does this most likely represent?

A) Clostridium perfnngens
B) Pseudomonas aeruginosa
C) Staphylococcal aureus
D) Streptococcus pyogenes
E) Helicobacter cinaedi

5. A 45 year old man with type II diabetes presents after a hypoglycaemic episode He has a history of diabetic eye disease He asks your advice about diabetes and driving.
Which situation is most likely to allow him to continue driving according to the DVLA?

A) Development of impaired awareness of hypoglycaemia
B) Having type II diabetes treated with oral medications
C) An episode of severe hypoglycaemia while driving
D) Needing laser treatment to both eyes
E) Having more than one episode of severe hypoglycaemia in 12 months

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