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RCEM FRCEM Primary Examination Sample Questions:

1. A 50 year old man with HIV has not been taking his treatment and presents with severe headache and neck stiffness His current CD4+ count is 180/mmc (normal 500-1400/mmc) What is the most likely causative agent of his meningitis?

A) Cryptococcus
B) Sporothrix
C) Malassezia
D) Candida
E) Aspergillus

2. 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) C7/T1
C) C5/C6
D) T1/T2
E) C6/C7

3. 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?

A) Escherichia coli
B) Pseudomonas aeruginosa
C) Streptococcus pneumoniae
D) Salmonella typhimunum
E) Haemophilus influenza

4. A 37 year old man presents wilh progressive bilateral ascending weakness following a one week history of diarrhoea and vomiting What is the most likely causative organism?

A) Klebsiella spp
B) Salmonella typhii
C) Shigella spp
D) Mycoplasma pneumoniae
E) Campylobacter jejuni

5. A 40 year old woman wilh a new diagnosis of type II diabetes has significant hyperglycaemia What is the most likely cause of her elevated blood glucose?

A) Reduced insulin production by pancreatic beta cells
B) Increased cellular resistance to insulin
C) Reduced glucagon secretion
D) Production of abnormal insulin
E) Excessive glucocorticoid production

Solutions: