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[Sep-2021] Verified RCEM Exam Dumps with FRCEM Exam Study Guide
NEW QUESTION 85
A 63 year old woman has confirmed Leptospirosis
Which is the most common way people contract this infection?
- A. Invasion of intact skin
- B. Sexually
- C. Faeco-oral
- D. Invasion of breached skin
- E. Droplet
Answer: D
NEW QUESTION 86
A 50 year old man complains of pain and reduced movements of the shoulder joint after a fall. He is unable to initiate abduction of his arm Which muscle is most likely to be injured?
- A. Supraspinatus
- B. Trapezius
- C. Subscapulars
- D. Deltoid
- E. Serratus anterior
Answer: A
NEW QUESTION 87
A 46 year old woman arrives after being hit by a car She has sustained a head injury You suspect she may have increased intracranial pressure due to a traumatic brain injury.
Which is the earliest clinical finding you are likely to see?
- A. Bilateral fixed dilated pupils
- B. Impaired corneal reflex
- C. Papilledema
- D. Cushmg's triad
- E. Dilated ipsilateral pupil
Answer: C
NEW QUESTION 88
A patient presents with a food bolus obstruction and you decide hyoscine butylbromide should not be administered Presence of which physiological feature is most likely to have influenced your decision?
- A. Hypotension
- B. Pyrexia
- C. Hypertension
- D. Tachycardia
- E. Bradycardia
Answer: D
NEW QUESTION 89
A 79 year old man with a direct inguinal hernia attends the ED when it becomes acutely more swollen, firm and painful Which feature of the hernia is likely to apply1?
- A. Traverses the deep inguinal ring
- B. Emerges medial to the inferior epigastric artery
- C. Sac lies within the covering of the spermatic cord
- D. Sac extends into his scrotum
- E. Emerges inferior to the inguinal ligament
Answer: B
NEW QUESTION 90
A 50 year old man with HIV has not been taking his treatment and presents with severe headache and neck stiffness His current CD4+ count is 180/mmc (normal 500-1400/mmc) What is the most likely causative agent of his meningitis?
- A. Aspergillus
- B. Sporothrix
- C. Malassezia
- D. Cryptococcus
- E. Candida
Answer: D
NEW QUESTION 91
A 35 year old man is hypotensive following a fracture of the right femoral shaft.
Which receptors are initially involved in increasing his BP?
- A. Carotid body receptors
- B. Cardiac receptors
- C. Atrial stretch receptors
- D. Baroreceptors
- E. Beta 2 vascular receptors
Answer: D
NEW QUESTION 92
You plan to use a local anaesthetic to provide intravenous regional anaesthesia to reduce a patient's wrist fracture Which local anaesthetic is most appropriate?
- A. Tetracaine
- B. Ropivacame
- C. Lidocaine
- D. Prilocaine
- E. Bupivacaine
Answer: A
NEW QUESTION 93
An 83 year old woman presents with acute dyspnoea and is diagnosed with cardiac failure She has a history of dysphagia and CT confirms oesophageal cancer.
Compression of which chamber of the heart is most likely to have caused her cardiac failure? A Both ventricles
- A. Right atrium
- B. Left ventricle
- C. Right ventricle
- D. Left atrium
Answer: B
NEW QUESTION 94
A 60 year old man with alcoholic liver cirrhosis and portal hypertension is brought to the ED because he has been vomiting blood Which vein is the most likely origin of his haematemesis?
- A. Azygos
- B. Left gastric
- C. Superior vena cava
- D. Periumbilical
- E. Inferior mesenteric
Answer: B
NEW QUESTION 95
An 80 year old man presents with a stroke This has resulted in loss of all vagal output to his gastrointestinal tract Which function is most likely to be completely abolished in this patient?
- A. Gastric acid secretion
- B. Glucagon release
- C. Primary oesophageal peristalsis
- D. Pancreatic polypeptide secretion
- E. Secondary oesophageal peristalsis
Answer: E
NEW QUESTION 96
A patient presents with anaphylaxis requiring adrenaline She is markedly vasodilated Which substance is most likely to be responsible for this appearance?
- A. Tumour necrosis factor alpha
- B. Platelet activating factor.
- C. Prostaglandin
- D. Histamine
- E. Leukotrienes
Answer: D
NEW QUESTION 97
A 21 year old man is diagnosed with diabetic ketoacidosis. A medical student asks you to assist them in calculating the patients blood pH using the Henderson-Hasselbach equation.
What best describes the two required constituents for this equation?
- A. Chloride and PaC02
- B. Bicarbonate and Pa02
- C. Sodium and calcium
- D. Bicarbonate and sodium
- E. Bicarbonate and PaC02
Answer: E
NEW QUESTION 98
A 20 year old woman complains of loss of taste from the posterior part of her tongue She is two days post tonsillectomy Which nerve is most likely damaged?
- A. Lingual
- B. Vagus
- C. Chorda tympanae
- D. Hypoglossal
- E. Glossopharyngeal
Answer: E
NEW QUESTION 99
A 28 year old woman presents to the ED after taking an overdose of amitriptyline. Her ECG shows a broad complex tachycardia Blockade of what type of ion channel is most likely to have occurred?
- A. Cyclic nucleotide-gated channels
- B. Sodium channels
- C. Gap junction channels.
- D. Calcium channels
- E. Potassium channels
Answer: B
NEW QUESTION 100
A patient presents with muscle spasms caused by hypocalcaemia What is the most likely physiological response to this abnormality?
- A. Decreased renal excretion of phosphate
- B. Increased parathyroid secretion
- C. Increased calcitonin secretion
- D. Decreased secretion of calcium from bone
- E. Decreased vitamin D synthesis
Answer: B
NEW QUESTION 101
A patient presents following a stabbing to his chest and has a cardiac arrest You perform an anterolateral thoracotomy. Which muscle in addition to pectoralis major are you most likely to incise?
- A. Teres major
- B. Subclavius
- C. Serratus anterior
- D. Pectoralis minor
- E. Latissimus dorsi
Answer: C
NEW QUESTION 102
A 34 year old woman presents with flank pain She has recently been diagnosed with glomerulosclerosis.
Which part of the kidney is most likely to be affected in this condition?
- A. Cortex
- B. Pelvis
- C. Capsule
- D. Medulla
- E. Calyx
Answer: A
NEW QUESTION 103
A 43 year old Afghan national presents to the ED with a four month history of cough, weight loss and night sweats What test is most consistent with active tuberculosis?
- A. Absence of a bacille calmette-guenn scar
- B. Sputum sample showing ziehl-nielsen stain negative bactena
- C. Positive mantoux test
- D. Chest x-ray showing a cavitating lesion
- E. Chest x-ray showing lobar consolidation
Answer: D
NEW QUESTION 104
A four year old girl presents with a fever Her skin feels warm to touch What is the most likely mechanism of effective thermoregulation?
- A. Increased sympathetic supply to cutaneous vessels
- B. Cutaneous vasoconstriction
- C. Increased cutaneous blood pressure
- D. Reduced blood volume in cutaneous vessels
- E. Reduced blood velocity in cutaneous vessels
Answer: A
NEW QUESTION 105
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