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RCEM FRCEM Primary Examination Sample Questions:

1. A 40 year old woman wilh a new diagnosis of type II diabetes has significant hyperglycaemia What is the most likely cause of her elevated blood glucose?

A) Reduced glucagon secretion
B) Excessive glucocorticoid production
C) Production of abnormal insulin
D) Increased cellular resistance to insulin
E) Reduced insulin production by pancreatic beta cells

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

3. A patient presents with septic shock A venous blood gas shows a metabolic acidosis Following treatment with crystalloid infusion and antibiotics their HR and BP are normal A repeat venous gas shows a persistent metabolic acidosis with a normal anion gap Which mechanism best explains the results of the repeat blood gas?

A) Metabolic acidosis due to occult aspirin overdose
B) Capillary leak due to sepsis causing continued hypovolamia
C) Acute kidney injury due to reduced renal blood flow
D) Lactic acidosis due to tissue hypoperfusion
E) Hyperchloraemic acidosis due to excessive infusion of normal saline

4. A 32 year old football player attends with a painful right knee after a tackle On examination she is unable to dorsiflex her foot Which nerve is most likely injured''

A) Medial calcaneal
B) Sural
C) Common peroneal
D) Pudendal
E) Tibial

5. You are discussing physiology of the body compartments and distribution of body water while teaching nurse practitioners.
Which extracellular fluid compartment is most likely to contain the most water?

A) Plasma
B) Dense connective tissue
C) Bone
D) Transcellular
E) Interstitial fluid

Solutions: