Make success possible with our Latest and Unique FRCEM Certification FRCEM Practice Exam!
Name: FRCEM Primary Examination
Exam Code: FRCEM
Certification: FRCEM Certification
Vendor: RCEM
Total Questions: 180
Last Updated: June 10, 2025
752 Satisfied Customers
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A 35 year old man attends after a motorbike accident. He is complaining of abnormal visionand his right eye is slightly adducted when he looks straight ahead.Which cranial nerve has suffered the most damage?
A. Abducens
B. Inferior division of oculomotor
C. Superior division of oculomotor
D. Trigeminal
E. Trochlear
ANSWER : A
A 78 year old has a (all and hits her forehead During (he fall she hyperexlended her neckand now complains of weakness in her arms You suspect she may have central cordsyndromeWhat is the most likely anatomical cause of this injury during hyperextension?
A. Anterior osteophytes causing compression
B. Compression of the posterior vertebral artery
C. Herniation of a cervical disc
D. Infarction of the anterior spinal artery
E. Laxity of the ligamentum flavum
ANSWER : E
A 45 year old man with an acute kidney injury is found to have a metabolic acidosisWhat renal response is most likely to be involved in compensating for this metabolicabnormality?
A. Carbonic anhydrase - mediated production of phosphate
B. Reabsorption of H*
C. Secretion of ammonium into the tubular lumen
D. Secretion of glutamine into the interstitial fluid
E. Secretion of HC03" into the tubular lumen
ANSWER : C
A 34 year old man presents with bruising and swelling over the anterior arm after liftingweights at the gym. There is pain and weakness on attempted internal rotation andadduction of the shoulder.Rupture of which muscle best explains these findings?
A. Latissimus dorsi
B. Pectoralis major
C. Pectoralis minor
D. Serratus anterior
E. Trapezius
ANSWER : C
A 50 year old woman with longstanding severe asthma presents with a four day history of diarrhoea and vomiting An imbalance of which hormone is most likely to be causing this clinical picture'?
A. Aldosterone
B. Cortisol
C. Dihydroepiandrosterone
D. Insulin
E. Thyroxine
ANSWER : A
A 34 year old woman with Graves' disease presents with fever, palpitations, tremor andanxiety Which hormone is most likely to be causing her symptoms?
A. Adrenaline
B. Thyroid receptor hormone
C. Thyroid stimulating hormone
D. Thyroxine (T4)
E. Triiodothyronine (T3)
ANSWER : C
A patient presenting with acute onset neurological symptoms has a CT scan of their brainthat shows an acute pontine haemorrhage What is the most likely clinical finding?
A. Hemianopia
B. Reduced conscious level
C. Speech disturbance
D. Unilateral motor disturbance
E. Unilateral sensory disturbance
ANSWER : B
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. Atrial stretch receptors
B. Baroreceptors
C. Beta 2 vascular receptors
D. Cardiac receptors
E. Carotid body receptors
ANSWER : B
A 52 year old woman (alls from a root sustaining a fracture dislocation at T12/L1 levelWhich muscle is most likely to be injured*?
A. lliacus
B. Latissimus dorsi
C. Pectineus
D. Psoas minor
E. Rhomboid major
ANSWER : B
A patient is brought in unconscious following a collapse and a subsequent CT shows apontine haemorrhage Which clinical tindmg best describes what you expect on examinationof the eyes?
A. Convergent squint with failure to abduct
B. Deviation of eye laterally and downwards
C. Gaze deviation to affected site
D. Loss of direct light reflex
E. Ptosis of the eyelids
ANSWER : A
A 38 year old man with an atrial septal defect complains of chest pain. On auscultation youhear a loud and split second heart sound in the second intercostal space, left parasternal region.Closure of which structure is most likely responsible for this finding?
A. Aortic valve
B. Foramen ovale
C. Mitral valve
D. Pulmonary valve
E. Tricuspid valve
ANSWER : B
A 45 year old man with type II diabetes presents after a hypoglycaemic episode He has ahistory of diabetic eye disease He asks your advice about diabetes and driving.Which situation is most likely to allow him to continue driving according to the DVLA?
A. An episode of severe hypoglycaemia while driving
B. Development of impaired awareness of hypoglycaemia
C. Having more than one episode of severe hypoglycaemia in 12 months
D. Having type II diabetes treated with oral medications
E. Needing laser treatment to both eyes
ANSWER : D
A patient presents with anaphylaxis requiring adrenaline She is markedly vasodilatedWhich substance is most likely to be responsible for this appearance?
A. Histamine
B. Leukotrienes
C. Platelet activating factor.
D. Prostaglandin
E. Tumour necrosis factor alpha
ANSWER : A
You are managing a patient with life threatening asthma and you start IV aminophyllineWhich electrolyte is it most important to monitor in this patient?
A. Calcium
B. Chloride
C. Magnesium
D. Potassium
E. Sodium
ANSWER : D
A 37 year old man is injured and has significant blood loss Following blood transfusion hissystolic blood pressure increases from 70 to 100Which physiological parameter is most likely to decrease in response?
A. Cardiac output
B. Pulmonary artery pressure
C. Right atrial pressure
D. Stroke volume
E. Total peripheral resistance
ANSWER : E
A 50 year old man complains of pain and reduced movements of the shoulder joint after afall. He is unable to initiate abduction of his armWhich muscle is most likely to be injured?
A. Deltoid
B. Serratus anterior
C. Subscapulars
D. Supraspinatus
E. Trapezius
ANSWER : D
A patient presents with unilateral tongue swelling with no additional signs of allergicreaction She is on multiple cardiac medications Which drug is most likely to have causedthese symptoms?
A. Aspirin
B. Atenolol
C. Bendroflumethiazide
D. Lisinopril
E. Simvastatin
ANSWER : D
A 17 year old girl presents with a maculopapular rash She has a seven day history of feverand sore throat and was prescribed an antibiotic three days agoWhich antibiotic is most likely to have been prescribed?
A. Amoxicillin
B. Cephalexin
C. Ciprofloxacin
D. Clarithromycin
E. Phenoxymethylpemcillin
ANSWER : A
A 71 year old man with a history of heart failure and type II diabetes mellitus presents withan acute, painful, swollen first metatarsophalangeal joint in his foot You suspect gout.Which treatment would be most appropriate for the acute management of this patient*?
A. Allopunnol
B. Colchicine
C. Diclofenac
D. Naproxen
E. Prednisolone
ANSWER : D
A 54 year old man presents with an incised wound to the anterior compartment of his lowerleg Exploration of the wound identifies a complete transection at the origin of the tibialisanterior muscleWhat associated motor deficit of the toot is most likely in this patient?
A. Dorsiflexion and eversion
B. Dorsiflexion and inversion
C. Plantarflexion
D. Plantarflexion and eversion
E. Plantarflexion and inversion
ANSWER : A
A 75 year old man presents to the ED with burning epigastric abdominal pain You note thathe has rheumatoid arthritis and is on diclofenac.Which step would have been the most beneficial in preventing the development ot ulcers inthis patient?
A. Change diclofenac to indomethacm
B. Combining diclofenac with omeprazole
C. Eradication of Helicobacter pylori
D. Starting misoprostol
E. Use of enteric coated medication
ANSWER : A
A patient is in respiratory distress and you suspect left ventricular failure Which respiratory volume is most likely to be increased?
A. Anatomical dead space
B. Expiratory reserve
C. Inspiratory reserve
D. Physiological dead space
E. Residual volume
ANSWER : D
A 67 year old woman is being treated for haematemesis Within a few minutes of startingtransfusion of packed red cells she reports dizziness, breathlessness, tingling of her lipsand develops a maculopapular rashWhat type of hypersensitivity reaction is most likely to be occurring?
A. Type I
B. Type II
C. Type III
D. Type IV
E. Type V
ANSWER : A
A patient presents to the ED a few days after a significant head injury He is polyuric withhypernatremia and high plasma osmolality Which hormone is most likely to cause thispicture?
A. Adrenocorticotropic
B. Corticotropm-releasing
C. Dopamine
D. Somatostatin
E. Vasopressin
ANSWER : E
You are considering procedural sedation for a patient with vascular compromise due to afracture They ate a meal two hours ago You are trying to remember the factors that affectgastric emptytng in healthy patientsWhat factor will delay gastric emptying?
A. Decreased duodenal luminal pH
B. Increased gastric distention
C. Low fat content of chyme
D. More liquids than solids in the stomach
E. Release of gastrin
ANSWER : A
A 40 year old man attends with a fracture of the shaft of femur and you performed afemoral nerve block for pain relief. Which structure lies immediately medial to your needleinsertion in the groins A
A. Femoral artery
B. Femoral vein
C. Iliacus muscle
D. Inguinal ligament
E. Psoas muscle
ANSWER : A
A 28 year old woman has an expanding skin rash: lethargy and body ache You suspectLyme disease Which microorganism is most likely to be the cause?
A. Anaplasma phagocytophilum
B. Bartonella qumtana .
C. Borrelia burgdorferi
D. Brucella abortus
E. Theilena microti
ANSWER : C
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