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

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

Question Twenty:
A new biomarker has been developed to identify myocardial infarction. It has a higher sensitivity at 3 hours from onset of pain (97%), than the existing test; but a lower specificity (82%).

This test would be likely to lead to fewer admissions in your hospital

A test with low specificity is useful to rule in the disease in those who test positive

Sensitivity and specificity are not useful in evaluating this new test

Prevalence information would be needed to work-out the predictive value of a positive test

Sensitivity and specificity depend on the prevalence of the disease

Study for the FRCEM exams online

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FRCEM Primary Examination

Next Course: 15 - 16 October and 6 - 8 November 2019

FRCEM Primary Practice MCQ

Study for the FRCEM exams online

Subscribe to our online resources for only £16.95 per month (renews automatically on a monthly basis until cancelled) Access over 130 online videos covering Primary, Intermediate SAQ, SJP & MRCEM OSCE

FRCEM Primary Examination

Next Course: 15 - 16 October and 6 - 8 November 2019

FRCEM Primary Practice MCQ

Subscribe to our online resources for only £16.95 per month
(renews automatically on a monthly basis until cancelled)
Access over 130 online videos covering Primary, Intermediate SAQ, SJP & MRCEM OSCE