[2022年02月02日]FRCEM試験ブレーン問題集で学習注釈と理論
合格させるRCEM FRCEMテスト練習テスト問題試験問題集
質問 40
A 60 year old man with alcoholic liver cirrhosis and portal hypertension is brought to the ED because he has been vomiting blood Which vein is the most likely origin of his haematemesis?
- A. Left gastric
- B. Inferior mesenteric
- C. Superior vena cava
- D. Periumbilical
- E. Azygos
正解: A
質問 41
A 26 year old man sustains a stab wound to the anterior aspect of the left side of his neck The wound involves the thoracic inlet Which structure is most likely to be encountered and injured first?
- A. Oesophagus
- B. Subclavian artery
- C. Subclavian vein
- D. Thoracic duct
- E. Pleura
正解: E
質問 42
A 34 year old man presents with bruising and swelling over the anterior arm after lifting weights at the gym.
There is pain and weakness on attempted internal rotation and adduction of the shoulder.
Rupture of which muscle best explains these findings?
- A. Pectoralis minor
- B. Serratus anterior
- C. Pectoralis major
- D. Trapezius
- E. Latissimus dorsi
正解: A
質問 43
A 32 year old woman presents with dizziness She has been laking medication tor low back pain Blood tests reveal a haemolytic anaemia.
Which drug is most likely to be responsible?
- A. Mefenamic acid
- B. Diclofenac
- C. Aspirin
- D. Naproxen
- E. Ibuprofen
正解: A
質問 44
An 80 year old man presents with a stroke This has resulted in loss of all vagal output to his gastrointestinal tract Which function is most likely to be completely abolished in this patient?
- A. Pancreatic polypeptide secretion
- B. Gastric acid secretion
- C. Glucagon release
- D. Secondary oesophageal peristalsis
- E. Primary oesophageal peristalsis
正解: D
質問 45
A 75 year old man is concerned about having frequent chest infections He is a heavy smoker and you explain to him that this can affect the normal mechanism of mucociliary clearance of microorganisms and pollutants What type of cell is primarily responsible for this method of pathogen clearance?
- A. Club cells
- B. Mast cells
- C. Goblet cells
- D. Columnar epithelial cells
- E. Acinar cells
正解: D
質問 46
A 20 year old woman presents with symptoms and signs suggestive of infectious mononucleosis Proliferation of which cells on the peripheral blood film would best support your diagnosis?
- A. Neutrophils
- B. Lymphocytes
- C. Basophils
- D. Eosinophils
- E. Monocytes
正解: B
質問 47
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?
- A. Moraxella catarrhalis
- B. Staphylococcus aureus
- C. Streptococcus pneumoniae
- D. Acinetobacter baumannii
- E. Neisseria meningitidis
正解: C
質問 48
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?
- A. Delta
- B. Somatic
- C. Parietal
- D. Epithelial
- E. Chief
正解: C
質問 49
You are treating a patient with left ventricular failure and decide to revise some cardiovascular physiology to help you understand the likely response to treatment Which statement best describes Starling's law in relation to cardiac output?
- A. Increased force of contraction due to an increase in preload
- B. Increased filling pressure leading to an increase in heart rate ID.
- C. Increased contractility leading to an increase in stroke volume
- D. Increased heart rate due to an increase in sympathetic stimulation
- E. Increased afterload due to an increase in cardiac output
正解: D
質問 50
A patient is brought into the ED unconscious Calculation from the venous blood gas confirms a low anion gap acidosis What is the most likely cause of this abnormality?
- A. Diabetic ketoacidosis
- B. Methanol
- C. Rhabdomyolysis
- D. Salicylates
- E. Hypoalbummaemia
正解: E
質問 51
A 47 year old woman with a diagnosis of pulmonary hypertension attends the ED with breathlessness An increase in which physiological parameter is the most likely consequence of this condition?
- A. Pulmonary arterial blood flow
- B. Left ventricular contractility
- C. Pulmonary venous resistance
- D. Right ventricular afterload
- E. Right atrial pressure
正解: C
質問 52
A 28 year old woman with a dislocated left shoulder has altered sensation along the radial aspect of her left forearm and loss of flexion at the elbow and wrist Injury at which location of the brachial plexus best explains her neurological symptoms?
- A. Medial cord
- B. Posterior cord
- C. Upper trunk
- D. Lateral cord
- E. Lower trunk
正解: D
質問 53
A16 year old girl is diagnosed with nephrotic syndrome
What is the most likely mechanism responsible for generalised oedema in this condition?
- A. Arterial occlusion
- B. Venous obstruction
- C. Oncotic pressure
- D. Capillary hydrostatic pressure
- E. Lymphatic obstruction
正解: C
質問 54
A 79 year old man with a direct inguinal hernia attends the ED when it becomes acutely more swollen, firm and painful Which feature of the hernia is likely to apply1?
- A. Sac extends into his scrotum
- B. Emerges inferior to the inguinal ligament
- C. Sac lies within the covering of the spermatic cord
- D. Emerges medial to the inferior epigastric artery
- E. Traverses the deep inguinal ring
正解: D
質問 55
A 56 year old man presenls with a rash in the supraclavicular fossa which is typical of herpes zoster Which dermatomal level best describes the area affected?
- A. C3
- B. C1
- C. C2
- D. C4
- E. C5
正解: E
質問 56
A four year old boy presents with a cough and fever for the last few weeks which became worse in the last 24 hours. There is no record of his vaccination history His temperature is 38.5 °C, heart rate 135 beats per minute, and oxygen saturations are 97% He is coughing frequently and has bilateral subconjunctival haemorrhages.
Which organism is most likely to have caused his condition?
- A. Respiratory syncytial virus
- B. Cornebactenum diphthenae
- C. Bordetella pertussis
- D. Mycobacterium tuberculosis
- E. Haemophilus influenzae
正解: E
質問 57
You are teaching a medical student and are discussing how fluid compartment ratios can change in relation to age and gender You note that some population groups have proportionally higher total body water which increases the extracellular to intracellular fluid ratio What population group best demonstrates this?
- A. Neonate
- B. Adult female
- C. Elderly
- D. Adult male
- E. Child
正解: B
質問 58
A father brings his febrile eight week old child to the ED. He tells you that the child's vaccinations are fully up to date. Which of the following vaccines has the child not yet received'?
- A. Pertussis
- B. Polio
- C. Diptheria
- D. Meningococcal
- E. Haemophilus influenzae B
正解: D
質問 59
A 56 year old presents unwell They are diagnosed with a hypertensive crisis. You decide to start sodium nitroprusside What best describes the mechanism of action of this drug?
- A. Decreases angiotensin II
- B. Releases nitric oxide
- C. Inhibits angiotensin converting enzyme
- D. Decreases the breakdown of bradykmin
- E. Antagonises the renm-angiotensm-aldosterone system
正解: B
質問 60
A three year old girl is diagnosed with measles in the ED and is well enough to be discharged Her dad wants to know when she can return to nursery.
What is the recommended absence period?
- A. Seven days after the rash has disappeared
- B. Four days after the onset of rash
- C. Until fever has settled for 24 hours
- D. Until conjunctivitis and mucous membrane rash has resolved
- E. Until the rash has disappeared
正解: A
質問 61
You are caring for a 68 year old patient with known heart failure and significant tachypnoea Stimulation of which receptor type is most likely to cause this increase in respiratory rate?
- A. Chemoreceptors
- B. Stretch receptors
- C. Juxtacapillary receptors
- D. Irritant receptors
- E. Mechanoreceptors
正解: B
質問 62
An 83 year old woman presents with acute dyspnoea and is diagnosed with cardiac failure She has a history of dysphagia and CT confirms oesophageal cancer.
Compression of which chamber of the heart is most likely to have caused her cardiac failure? A Both ventricles
- A. Left atrium
- B. Right ventricle
- C. Left ventricle
- D. Right atrium
正解: C
質問 63
A 20 year old woman complains of loss of taste from the posterior part of her tongue She is two days post tonsillectomy Which nerve is most likely damaged?
- A. Chorda tympanae
- B. Hypoglossal
- C. Glossopharyngeal
- D. Vagus
- E. Lingual
正解: C
質問 64
A keen cyclist attends the ED complaining of clumsiness and tingling in his right hand When he attempts to grip paper in his first web space he is only able to achieve this by flexing his right thumb.
Innervation of which muscle is most likely compromised?
- A. Opponens pollicis
- B. Extensor pollicis brevis
- C. Abductor pollicis brevis
- D. Adductor pollicis
- E. First dorsal interosseous
正解: A
質問 65
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