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RCEM FRCEM Primary Examination Sample Questions:

1. An 87 year old man is brought to the ED from his nursing home with loose stools and abdominal pain. You suspect Clostridium difficile infection because he had a recent course of antibiotics for pneumonia.
What measure is most likely to reduce the spread of infection to other patients?

A) Wearing gloves and aprons for patient contact
B) Hand washing with soap and water
C) Use of alcohol hand gel
D) Isolation of the patient in a side room
E) Treatment with metronidazole

2. A five year old girl is brought to the ED by her parents She is pyrexial and has coryzal symptoms. Which diagnosis would require notification to a UK Public Health department?

A) Respiratory syncytial virus
B) Kawasaki's disease
C) Pneumococcal pneumonia
D) Influenza type A
E) Whooping cough

3. A 25 year old man sustains a crush injury to his chest A CT scan reveals an oesophageal rupture as it passes through the diaphragm At which vertebral level is this injury most likely to have occurred?

A) T11
B) T7
C) T9
D) T8
E) T10

4. A 56 year old woman with severe ascites attends the ED with breathlessness Chest auscultation is normal What findings would you expect on spirometry?

A) Increased FVC
B) Increased vital capacity
C) Increased total lung capacity
D) Increased FEV,/FVC ratio
E) Increased inspiratory capacity

5. A 20 year old woman presents with symptoms and signs suggestive of infectious mononucleosis Proliferation of which cells on the peripheral blood film would best support your diagnosis?

A) Basophils
B) Eosinophils
C) Neutrophils
D) Monocytes
E) Lymphocytes

Solutions: