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RCEM FRCEM Primary Examination Sample Questions:

1. A 43 year old woman has fallen from a horse and has paralysis of the legs She has full movement at the shoulder and wrist but is unable to flex or abduct/adduct her fingers What is the most likely vertebral level of the spinal injury1?

A) C4/C5
B) C5/C6
C) C6/C7
D) C7/T1
E) T1/T2

2. A 20 year old man presents lo the ED with a slab wound to the antecubital fossa Exploration of the wound reveals a large nerve has been transected Which function is most likely to be preserved on clinical examination'?

A) Flexion of the proximal interphalangeal joints
B) Flexion of the distal interphalangeal joints
C) Opposition of the thumb
D) Abduction of the little finger
E) Flexion of the wrist

3. 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) Jejunum
B) Ileum
C) Sigmoid colon
D) Transverse colon
E) Duodenum

4. 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) Left ventricle
B) Right ventricle
C) Left atrium
D) Right atrium

5. A patient presents with a fracture to the mid-clavicle after a fall The medial part of the clavicle is displaced superiorly Which muscle is most likely to cause this displacement?

A) Scalenus anterior
B) Platysma
C) Trapezius
D) Pectoralis major
E) Sternocleidomastoid

Solutions: