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RCEM FRCEM Primary Examination Sample Questions:

1. A 17 year old girl presents with a maculopapular rash She has a seven day history of fever and sore throat and was prescribed an antibiotic three days ago Which antibiotic is most likely to have been prescribed?

A) Amoxicillin
B) Phenoxymethylpemcillin
C) Cephalexin
D) Clarithromycin
E) Ciprofloxacin

2. A 15 year old girl with sickle cell anaemia attends with left leg swelling and pain Further investigations suggest a diagnosis of osteomyelitis of her tibia.
What is the most likely causative organism?

A) Escherichia coli
B) Pseudomonas aeruginosa
C) Salmonella typhimunum
D) Haemophilus influenza
E) Streptococcus pneumoniae

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

4. A 48 year old man presents to the ED with sudden onset, severe abdominal pain His CT shows pneumoretroperitoneum. Which of these structures is most likely to have perforated?

A) Transverse colon
B) Jejunum
C) Sigmoid colon
D) Ileum
E) Duodenum

5. A patient presents with anaphylaxis requiring adrenaline She is markedly vasodilated Which substance is most likely to be responsible for this appearance?

A) Platelet activating factor.
B) Histamine
C) Tumour necrosis factor alpha
D) Prostaglandin
E) Leukotrienes

Solutions: