FRCEM Primary: Multiple Choice Quiz - FRCEM, MRCEM, Ultrasound Emergency Medicine Courses

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MRCEM Primary Course

Next Course: 22nd October 2021 and 3rd November 2021

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FRCEM Primary Practice MCQ

This MCQ has a mix of questions reflecting the content of the exam, one third anatomy, one third physiology, etc. Complete the MCQ first, get your score and then watch the webinar. This discusses the background to each question. Although there are only twenty questions the MCQ covers a range of important subjects.

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Question One:
Which of the following statements about the anatomical snuffbox is true?

The tendon of flexor carpi radialis forms the lateral wall

The radius articulates with the lunate in the floor

The radial artery runs parallel to, and just outside the lateral wall

The basilic vein originates in the overlying skin

The tendon of abductor pollicis longus forms the medial border

Question Two:
A patient attends the ED with a laceration at the medial side of the wrist which has raised concern of ulnar nerve damage. In assessing for this, which of the following tests would be most useful?

Testing pinch grip between thumb and middle finger

Testing for power of little finger abduction

Testing power of ring finger flexion

Testing for wrist flexion

Movement of the thumb away from the plane of the hand

Question Three:
A 30 year old man presents with pain in the scrotum. Which of the following statements about examining the scrotum is most accurate?

Rotation of the testis is limited by the scrotal ligament

The epididymis can be palpated separately behind the testis

The hydatid of Morgagni (testicular appendage) is palpable as a 5mm cystic structure at the top of the testis

The normal testis lies horizontally within the scrotal sac

The cremasteric reflex is elicited by stroking skin of the T12 dermatome

Question Four:
Which of the following statements regarding structures visible during direct laryngoscopy of a supine patient with a good laryngoscopic view is most accurate?

The pyriform fossa is found in the midline, behind the larynx

During quiet breathing the vocal cords will be closest together posteriorly

The epiglottis will be largely hidden behind the blade of the laryngoscope

The epiglottis lies posterior to the glottis

Tracheal rings will be visible

Question Five:
A 14 year old female horse rider has suffered an injury to the left lower leg when it was stood on by a horse while she was kneeling down. After removing her boot the foot is very tender, but without obvious bruising. She is numb between the first and second toes, but motor function appears intact. Where is the most likely site of the nerve injury?

Saphenous nerve in the medial lower leg

Sural nerve on the side of the foot

Superficial fibular (peroneal) nerve on the lateral aspect of the leg

Tibial nerve behind the distal tibia

Deep peroneal nerve at the anterior ankle

Question Six:
A 16 year old has been stabbed from in front. The blade passed above his left clavicle across the supraclavicular fossa and through the trapezius muscle above the first rib. Which of the following structures is most likely to have been injured?

Brachial plexus

Axillary nerve

Internal jugular vein

Phrenic nerve

Subclavian vein

Question Seven:
An 80yr old right-handed woman presents to the ED with sudden difficulty speaking. She can understand questions well. However her replies include a few words only which do not make sentences. Which vascular territory is likely to have been affected?

Left anterior cerebral artery

Right anterior cerebral artery

Right middle cerebral artery

Left middle cerebral artery

Basilar artery

Question Eight:
Which one of the flowing statements is most accurate regarding the ventilation-perfusion (V/Q) ratio of human lungs?

In health it is around 0.6

It increases from apex to base of the lung in the upright position

The higher the V/Q ratio, the more dead space in the lung

A V/Q ratio of one is called a shunt

V/Q mismatch causes type II respiratory failure

Question Nine:
Which of the following statements about the second heart sound is most accurate?

Atrial pressure exceeds ventricular pressure at this point

It corresponds with the C-wave in the JVP

It occurs during the T-wave of the ECG

It is best heard in the axilla

There is no systemic arteriolar blood flow at this point

Question Ten:
Which one of the following statements is true of the interstitial fluid compartment?

It contains about twice the volume of the plasma

Its protein concentration is the same as plasma

It has a lower calcium concentration than intracellular fluid

It is separated from plasma by the capillary basement membrane

It carries a net negative charge compared to plasma

Question Eleven:
Which one of the following statements is correct regarding the proximal convoluted tubule?

It receives hypotonic fluid

It is the main site of ketone reabsorption

Bicarbonate ions are secreted into the tubule

It reabsorbs about 50% of the filtered sodium

It is the main site of serum potassium control

Question Twelve:
Which of the following is most likely to be found in a patient with primary hyperparathyroidism?

Positive Chvostek’s sign

Diarrhoea

Raised serum phosphate (hyperphosphataemia)

Depression

Pituitary tumour

Question Thirteen:
Which of the following are true of cholecystokinin?

It is secreted by enteroendocrine cells in the duodenum

It stimulates hunger

It causes excretion of a bicarbonate-rich juice by the pancreas

It is a steroid hormone

It is central to iron absorption

Question Fourteen:
A 42-year-old patient with a head injury requires rapid sequence intubation. You are considering using suxamethonium to help with this. Which of the following statements about suxamethonium is most accurate?

It needs to be given through a fast-flowing drip

It can cause confusion after waking

It may rarely cause prolonged paralysis

It must be given at least two minutes before an induction agent

It is negatively inotropic

Question Fifteen:
Which of the following infectious diseases and their cutaneous manifestations are correctly paired?

Salmonella typhi – erythema nodosum

Measles virus – vesicular rash

Streptococcus pyogenes – Rose spots

Borrelia burgdorferi – erythema chronicum migrans

Herpes simplex type 1 – intertrigo

Question Sixteen:
In the battle against hospital acquired infection, which one of the following is correct?

Reusable instruments need to be autoclaved at 105° C for 20 minutes

Legionella pneumophila is spread through close personal contact

Clostridium difficile Is present in the intestines of 2% of the normal population

Alcohol gel is effective in killing spores of C. difficile

Chlorhexidine is reliably effective against Pseudomonas aeruginosa

Question Seventeen:
Which one of the following drugs is most useful in the treatment of acute dystonia in a patient recently started on haloperidol?

Hyoscine butylbromide

Benztropine

Carbamazepine

Cetirizine

Citalopram

Question Eighteen:
Which one of the following antibiotics would you recommend for home treatment to a 27-year-old female who is five months pregnant and has new clinical features of a lower urinary tract infection?

Trimethoprim

Nitrofurantoin

Fosfomycin

Gentamicin

Ciprofloxacin

Question Nineteen:
Which one of the following series correctly describes the sequence of bone laid down during fracture repair?

lamellar bone – woven bone – compact bone

woven bone – lamellar bone – compact bone

lamellar bone – compact bone – woven bone

woven bone – compact bone – lamellar bine

compact bone – lamellar bone – woven bone

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Bromley Emergency Courses

4.9

Based on 108 reviews

Emeka Elosiuba

23:53 04 Jun 20

Course recommended 100% for all clinicians wishing to have an excellent practice in life

Stefania Pintus

16:35 28 Apr 20

Great course! Interactive and focused lectures. Ideal for Emergency Physicians!

Ang Sk

14:05 18 Mar 20

It is easy to find, and located on 2rd and 3rd floor of the building. The course was interesting... and for ultrasound it is suitable for beginners. You have 5 or 6 stations with lectures in between. It is a full day course. You rotate between stations as a group or 4 or 5. Instructors are professional and knowledgeable. There is coffee before course starts, but lunch was little and limited for a large group of people. Otherwise its good overall :)read more

KENNETH O. IGWE

14:39 13 Mar 20

Highly recommended. I attended the level 1 Ultrasound course. Impressive and highly professional.... Faculty made the most impression on me. It has improved my practice as well.read more

Almagul Alim

14:45 28 Feb 20

Thanks to the whole Bromley team! The course is organized competently - time was allocated... correctly, the material was presented clearly, readilly, accessible to understanding and efficiently. I also liked the practical part - we were divided into small groups with a separate trainer - only 4 people each, so that everyone could do an ultrasound and ask questions to the coach. In such a short time I learned so much useful information. All people are open, friendly. I hope to come there to have the next levelread more

Muhammed Mohamed Yaseen

22:29 21 Feb 20

As a Doctor pursuing a career in Orthopaedic Surgical Training, Currently in an ED rotation, I... thought it would be a great idea to do this course as it would be a very handy skill to possess in times of need such as patients with difficult IV access, for ultrasound guided local blocks and also a valuable skill when attending trauma calls to help the trauma team. Went into the course with a different mind set but this course was beyond expectations. The trainers were amazing, lectures brilliantly structured and practical sessions given appropriate length of time so that nothing is done in haste. I have gained a skill which with practice will be an asset to my day to day practice. I would recommend this course to all doctors irrespective of whether they work in ED department or not as its a very important skill to possess and also you never know when you might need it and at that time you would wish you had done it. Amazing and mind blown from the experience. Thank you Bromley team, the entire faculty was amazing.read more

Rania Abdelmaksoud

22:16 19 Feb 20

Highly highly recommended , very professional and friendly educational faculty , staff and... simulators as well, excellent catering service too.read more

Junaid Siddique

10:42 17 Feb 20

It was my first ever course with Bromley but now i believe that every body should attend it. Its... not only for exam but to make you an effective and confident ED doctor.read more

M.Saoud

11:37 06 Feb 20

The course was very useful and informative. The staff were friendly and supportive. The course... covered the most important scenarios you might face in the real exam.read more

Tamunoemi Ndiukwu

09:56 27 Jan 20

It was very informative with caring and down to earth instructors.learning in a fun environment was... my experience and I got 4 of the stations done there in my exam.I hope to come and give a stronger review when my result is out and Im successful by God's grace.read more

Persistent Professional

10:28 26 Jan 20

I have managed to pass my PLAB2 exam with flying colors all thanks to Bromley! I thoroughly... benefited from all the feedback that was given from evaluators, actors and my other fellow candidates. I think Dr Ian is no doubt a legend. I admire all the doctors that guided us but I was particularly a fan of Dr Shane and his approach. I rated the course 4* because we didnt get enough time to review the otoscopy and ophthalmoscopy areas but otherwise, this course is definitely worth it!read more

Jifflet C

22:49 17 Jan 20

Extremely professional and well structured courses taught by professionals! Highly recommended!

Adrian Stallwood

14:33 17 Jan 20

Passed the FRCEM Primary first time with flying colours due in no small part to the team at Bromley... Emergency! Undoubtedly worth the money, used handout as my notebook for final weeks and wrote my own additions in. Highly recommended and respected courseread more

Ali Akhtar

01:47 17 Dec 19

I had a wonderful experience with the faculty. I would recommend their course definitely.

Suhaib Shukri

19:53 31 Oct 19

Great experience. Very informative course delivered by professional people.

Joyce Anne Tan

13:30 30 Sep 19

The PLAB2 emergency course was well-organized and well-executed. Two days full of OSCE stations... with adequate breaks. I particularly like that we are a small group and everyone is given due attention. Doctors and actors alike have provided substantial feedback on areas of improvement. They highlight mastery of technique (history, examination and management) rather than memorization of lines or phrases. Overall, this has been a very good preparation for both the exam and actual practice.read more

sachin pardeshi

15:04 27 Sep 19

Excellent course with very personalised feedback, covering almost entire syllabus, most importantly... very limited students in a batch. It makes sense to join this course after one has done some discussion with different study partner and then you will actually analyse yourself in this course and give you preparation final finishing touch. Thank you and all the best to team Bromley.read more

Bronwen Warner

08:52 19 Sep 19

Fantastic course relevant to acute medicine. Concise and clear lectures, lots of scanning time,... good venue, great organisation and communication by the admin team - thank youread more

Zoe Seymour

22:40 30 Jul 19

Excellent course, well taught and supported. Great lunch, good array of people to scan both with... and without pathology. Would definitely consider further courses with this company despite the long journey for me!read more

Next Reviews

Online MRCEM/FRCEM Revision

Subscribe to our online resources for only £16.95 per month to access over 300 online videos covering Primary, Intermediate SAQ, MRCEM OSCE, level 1 Ultrasound and PLAB 2. Click to find out more.

MRCEM Primary Course

Next Course: 22nd October 2021 and 3rd November 2021

FRCEM Primary Practice MCQ