[2022] FRCEM Actual Exam Dumps, FRCEM Practice Test [Q72-Q95]

NO.72 A 70 year old woman presents with reduced I6vel of consciousness following a recent chest infection She has signs of meningeal irritation Gram staining of CSF demonstrates gram positive diplococci.
Which organism is most likely in this case1?

NO.73 A patient with severe renal impairment requires regular opioid analgesia for their pain You are concerned about opiate accumulation Which drug in this class is most appropriate in this patient?

NO.74 A 77 year old woman is brought to the ED following a house fire Arterial blood gas confirms she has an increased carboxyhaemoglobin level What is the most likely effect on the oxygen dissociation curve?

NO.75 A 23 year old man presents to the ED after cutting his wrist with a kitchen knife There is a wound on the flexor aspect of the wrist and you are concerned about median nerve injury.
Which examination of motor function would best test for damage to this nerve?

NO.76 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?

NO.77 A 78 year old woman presents with a painful shoulder after a fall. On examination she is unable to lift the dorsum of her hand off her mid-lumbar spine (lift-off test).
Which muscle is most likely to have been injured?

NO.78 A three week old baby is brought in by her concerned parents She is vomiting substantially after feeds and is failing to gain weight. Investigation reveals an alkalosis and a low serum potassium.
The alkalosis is most likely to be due to which mechanism?

NO.79 A 35 year old with an extensive history of using multiple recreational drugs but no alcohol use is diagnosed with a megaloblastic anaemia in the ED Which drug is the most likely cause of this anaemia’?

NO.80 A 34 year old man presents wrth shortness of breath He has a normal alveolar-arterial <A-a) gradient What is the most likely diagnosis?

NO.81 A 24 year old man sustains an injury to his right eye The x-rays confirm an orbital floor fracture He complains of double vision on upward gaze Entrapment of which muscle is most likely responsible for his symptom?

NO.82 A patient arrives with shortness of breath Their venous blood gas shows they have a low haemoglobin They have a past medical history of pernicious anaemia Which cells in the gastrointestinal tract are most likely to be attacked in this autoimmune condition1?

NO.83 A therapeutic trial demonstrates that everyone who received the drug has improved while no one improved with placebo What best describes the expected number needed to treat?

NO.84 A doctor about to sit an important examination has become aware of the urge to detaecate Involuntary relaxation of which muscle is most likely to have occurred?

NO.85 You have designed a randomised control trial and need to make a calculation as to the sample size required such that we do not reject the null hypothesis when it is false Which component of the sample size calculation is most likely to avoid this error’?

NO.86 A premature baby is born at 28 weeks’ gestation in your ED. They are at risk of respiratory distress syndrome due to lack of surfactant What best describes the composition of this substance?

NO.87 A patient is brought in unconscious following a collapse and a subsequent CT shows a pontine haemorrhage Which clinical tindmg best describes what you expect on examination of the eyes?

NO.88 A 21 year old woman attends with an earring becoming lodged in the lobule of her ear You decide to perform a nerve block to allow removal of the earring Which nerve are you most likely to need to block?

NO.89 A 54 year old man presents with an incised wound to the anterior compartment of his lower leg Exploration of the wound identifies a complete transection at the origin of the tibialis anterior muscle What associated motor deficit of the toot is most likely in this patient?

NO.90 An 80 year old woman presents to the ED with diarrhoea and vomiting. She is clinically dehydrated The physiological response to this involves release of antidiuretic hormone Where is this hormone most likely to be released from?

NO.91 A 55 year old heavy smoker presents with cough, sputum production and dyspnoea A chest x-ray shows hyperinflation with diminished pulmonary vasculature Which measurement is likely to be increased on lung function testing?

NO.92 A 20 year old woman has an incised wound over the angle of her jaw and you suspect damage to a branch of the facial nerve What action are you most likely to test to confirm your suspicion?

NO.93 A clinical pathway uses a predictive tool to guide use of diagnostic tests. Your patient has a high risk score, but a negative test They ask you how likely it is that they have the disease in question.
Which statistic are you most likely to use in your explanation?

NO.94 A 68 year old man with a history of Addison’s disease presents having recently been diagnosed with a urinary tract infection He is hypotensive, tachycardic and clammy His biochemistry shows hyponatraemia and hyperkalemia.
Which hormone imbalance best explains his biochemical abnormalities?

NO.95 A 15 year old girl with sickle cell anaemia attends with left leg swelling and pain Further investigations suggest a diagnosis of osteomyelitis of her tibia.
What is the most likely causative organism?