Practice Questions for the MRCEM Intermediate Exam

Practice Questions for the MRCEM Intermediate Exam

The FRCEM Intermediate (and the MRCEM Part B before it) is a difficult but essential step entering the Specialist Register. The paper is three hours long and comprises 60, three mark short answer questions (SAQs). The majority of the questions are 2 or 3 parts and...
Severe Chest Pain Following Blunt Thoracic Trauma

Severe Chest Pain Following Blunt Thoracic Trauma

A 37-year-old man is involved in a high-speed motor vehicle collision. He was not wearing a seat belt and struck his chest on the steering wheel. He has presented complaining of severe central chest pain and breathlessness. You are the trauma call team leader. His...
‘Ripping’ Chest Pain in a 38-Year-Old Man

‘Ripping’ Chest Pain in a 38-Year-Old Man

A 38-year-old man with Marfan syndrome presents with sudden severe chest pain that radiates through to his back. He describes the pain as being sharp and ‘ripping’ in nature. He smokes 25 cigarettes per day. He is sweaty, nauseated and appears pallid. On examination...
A 60-Year-Old with Abdominal Pain

A 60-Year-Old with Abdominal Pain

A 60-year-old woman presents with a one-week history of abdominal pain, nausea and reduced frequency of bowel motions. Her observations are as follows: HR 97, BP 113/76, RR 19, SaO2 98% on air. On examination she has right upper quadrant tenderness. Her chest X-ray is...
The Strange Case of the ‘Octopus Pot’ Heart

The Strange Case of the ‘Octopus Pot’ Heart

A 53-year-old woman presents with severe central crushing chest pain that radiates to her left arm. She has been under a significant amount of stress recently following the unexpected death of her husband. Her ECG is shown below: She is taken to the cath lab for a...

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