MRCEM Primary Paper 2

A 20 year old man has been intubated after a significant head injury. While making a referral to the neurosurgeon they ask you for his mean arterial pressure.
How would you best calculate this?

A 14 year old girl fell off a horse and is now complaining of numbness in ring and little fingers and the ulnar border of the hands.
Which nerve root is most likely injured?

A journal article describes a diagnostic test for sepsis. A Receiver Operator Characteristic (ROC) curve is shown for a cut-off value of more than 10 mmol/L. The area under the curve is 0.5.
What are the most appropriate descriptors of the x and y axis?

A 30 year old man presents with symmetrical ascending muscle weakness. He had a diarrhoeal illness a few weeks previously.
What is the most likely pathogen?

A 42 year old man presents with an acutely inflamed ankle after noticing a small wound on it yesterday.
What is the most likely dominant cell type in the inflammatory response in this patient?

A 45 year old man presents with a deep vein thrombosis despite a long history of stable anticoagulation on warfarin. His international normalised ratio is 1 (target range 2-3). He has had some recent medication changes.
Which of the following is most likely to be responsible for his sub- therapeutic INR?

A 52 year old man presents with a stab wound to his scalp. The wound appears superficial but it is bleeding profusely.

What pathway is most important for primary haemostasis of this wound?

A 50 year old woman presents with a hoarse voice two weeks after neck surgery for an enlarged thyroid gland.
Which structure is most likely to have been injured during her surgery?

An 18 year old woman is brought to the ED with a stab wound to the anterior neck.
Which of these muscles is most likely to be injured?

A 78 year old man has a two hour history of increasing lip and tongue swelling unresponsive to intramuscular adrenaline. He has a history of ischaemic heart disease and hypertension.
Which of his medications is most likely to be implicated in his presentation?

A 76 year old man is brought to the resuscitation room with acute pulmonary oedema. You treat him with intravenous furosemide.

On which area of the nephron is this treatment most likely to act?

A man presents with headaches and complains that he is sweating more than usual, his voice has changed and he is getting tingling in his hands. On examining his visual fields you detect a bitemporal hemianopia.

Which part of the visual tract is most likely being affected by a compressive lesion?