MRCEM Primary Paper 7

A 22 year old man has dislocated his shoulder. He will need procedural sedation and you are considering whether the risks of sedation outweigh the benefits because he is not fasted.
hich factor is most likely to increase gastric emptying?

A 50 year old man presents with chest pain and the following ECG is taken.
Which artery is most likely to be occluded?

On taking a drug history from a 55 year old man you discover he is taking a proton pump inhibitor (PPI) for gastro-intestinal reflux disease.
On which cells does a PPI irreversibly bind to the hydrogen/potassium ATPase?

An 87 year old man attends the ED with lightheadedness. His ECG shows a prolonged PR interval (first degree heart block).
Which part of the cardiac conducting system is most likely to be responsible for this abnormality?

A 26 year old woman presents with severe abdominal pain and has a positive urinary pregnancy test. An urgent ultrasound scan shows an ectopic pregnancy.

Which part of the fallopian tube is the most likely location of the pregnancy?

A 23 year old man presents with severe epigastric pain and dyspepsia following a course of non-steroidal anti inflammatory medication for a sports injury.

What is the most likely explanation for his symptoms?

A five year old girl presents with confirmed meningococcal septicaemia and requires intubation in the ED. You liaise with Public Health regarding chemoprophylaxis.

Which of these people is most likely to require treatment?

A 55 year old woman complains of pain and numbness over the anterior aspect of her thigh which is worse on sitting. There is no history of injury. The only positive finding is altered sensation over the anterolateral thigh.

What nerve is most likely to be involved?

A 36 year old woman attends the ED complaining of palpitations. She is known to have Graves’ disease. Her heart rate is 134 and irregular.

What laboratory finding is most likely to be consistent with her presentation?

A traveller returns from India with cough, fever, breathlessness and haemoptysis.

What investigation would be most helpful in excluding acute tuberculosis?

A 30 year old man has cut his arm whilst using a saw. The ambulance crew estimate one litre of blood loss at the scene.

What is the approximate normal adult value for total blood volume?

A 35 year old man has a dislocation reduced under sedation using propofol.

Which neurotransmitter receptor is propofol most likely to act on?