31- A young child presents with respiratory distress, worsening over 2 days. Blood gases show a pH of 7.25, a PCO2 of 7.5kPa, a PO2 of 8.5kPa, and a base excess of -4. Which of the following interpretations is correct?
1) Results are consistent with bronchopulmonary dysplasia.
2) Blood gases suggest type 1 respiratory failure.
3) Immediate intubation is required.
4) Results are consistent with late severe asthma.
5) Bicarbonate may be necessary to correct the acidosis.
Answers-4
32- A 19 year old female presents with acute breathlessness. She has had asthma for approximately 3 years and recently commenced new therapy. Which agent may be responsible for this exacerbation?
1) Salmeterol
2) Theophylline
3) Beclomethasone
4) Ipratropium bromide
5) Monteleukast
Answers-1
33- A 22 year old lady recently returned from a holiday in Malta was admitted with a 3 day history of fever, generalised lymphadenopathy and a macular rash over the trunk and legs. Which of the following is the most likely diagnosis?
1) Sarcoidosis
2) Tuberulosis
3) Familial Mediterranean Fever
4) Infectious Mononucleosis
5) Actinomycosis
Answers-4
34- Which of the following is a recognised treatment for complications of cystic fibrosis?
1) DNAase to assist in reinflating collapsed lung segments.
2) Rectal pull-through and anastamosis for rectal prolapse.
3) Pancreatic transplant for diabetes mellitus.
4) Nebulised tobramycin for pseudomonas colonisation of the lower respiratory tract.
5) Hypotonic saline drinks for hypernatraemic dehydration.
Answers-4
35- Which of the following is a typical feature of Farmer's lung?
1) basal crackles
2) Eosinophilia
3) Haemoptysis
4) Increased pCO2
5) Positive serum paraproteins
Answers-1
36- A 28 year old man who had had tuberculosis of the mediastinal lymph nodes diagnosed two weeks previously and who had been started on chemotherapy with rifampicin, isoniazid and pyrazinamide was admitted because of the increasing dyspnoea and stridor. Chest X-ray showed compression of both main bronchi by carinal lymph node enlargement. What is the next step in management?
1) Start prednisolone
2) Mediastinoscopy and biopsy
3) Refer for stent insertion/tracheostomy
4) Refer for urgent CT scan of the mediastinum
5) The addition of ethambutol
Answers-1
37- A 24 year old male presents after developing a bluish discolouration of the body, lips and nails. He denies any relevant past medical history. Examination reveals a central cyanosis and a grey complexion.
Investigation revealed:
Haemoglobin 17.0 g/dL (13.0-18.0)
PaO2 13.0 kPa (11.3-12.6)
SaO2 (using an oximeter) 85% (>95)
What is the most likely diagnosis?
1) Argyria
2) Cyanotic congenital heart disease
3) Haemochromatosis
4) Methaemoglobinaemia
5) Methylene blue poisoning
Answers-4
38- Which of the following is true of BCG vaccination?
1) is contraindicated in neonates
2) is a killed polysaccharide antigen vaccine
3) should be given to all children who have a strongly positive tuberculin test
4) is presently routinely offered in the UK at age 16 years
5) Provides protection against leprosy
Answers-5
39 -Carcinoid tumors of the lung (bronchial adenomas) originate from which of the following cell types?
1) Ciliated cell
2) Clara cell
3) Kulchitsky (K) cell
4) Mucus (goblet) cell
5) Type 2 Alveolar cell
Answers-3
40- A 55-year-old woman on treatment for long-standing rheumatoid arthritis has recently become dyspnoeic on mild exertion and developed a dry cough. The oxygen saturation was found to be 87% on air. The chest x-ray showed a diffuse bilateral interstitial infiltrate. An extensive infection screen was negative and her symptoms were felt to be druginduced. Which drug is most likely to have caused this adverse effect?
1) azathioprine
2) cyclosporin
3) hydroxychloroquine
4) methotrexate
5) sulphasalazine
Answers-4
1) Results are consistent with bronchopulmonary dysplasia.
2) Blood gases suggest type 1 respiratory failure.
3) Immediate intubation is required.
4) Results are consistent with late severe asthma.
5) Bicarbonate may be necessary to correct the acidosis.
Answers-4
32- A 19 year old female presents with acute breathlessness. She has had asthma for approximately 3 years and recently commenced new therapy. Which agent may be responsible for this exacerbation?
1) Salmeterol
2) Theophylline
3) Beclomethasone
4) Ipratropium bromide
5) Monteleukast
Answers-1
33- A 22 year old lady recently returned from a holiday in Malta was admitted with a 3 day history of fever, generalised lymphadenopathy and a macular rash over the trunk and legs. Which of the following is the most likely diagnosis?
1) Sarcoidosis
2) Tuberulosis
3) Familial Mediterranean Fever
4) Infectious Mononucleosis
5) Actinomycosis
Answers-4
34- Which of the following is a recognised treatment for complications of cystic fibrosis?
1) DNAase to assist in reinflating collapsed lung segments.
2) Rectal pull-through and anastamosis for rectal prolapse.
3) Pancreatic transplant for diabetes mellitus.
4) Nebulised tobramycin for pseudomonas colonisation of the lower respiratory tract.
5) Hypotonic saline drinks for hypernatraemic dehydration.
Answers-4
35- Which of the following is a typical feature of Farmer's lung?
1) basal crackles
2) Eosinophilia
3) Haemoptysis
4) Increased pCO2
5) Positive serum paraproteins
Answers-1
36- A 28 year old man who had had tuberculosis of the mediastinal lymph nodes diagnosed two weeks previously and who had been started on chemotherapy with rifampicin, isoniazid and pyrazinamide was admitted because of the increasing dyspnoea and stridor. Chest X-ray showed compression of both main bronchi by carinal lymph node enlargement. What is the next step in management?
1) Start prednisolone
2) Mediastinoscopy and biopsy
3) Refer for stent insertion/tracheostomy
4) Refer for urgent CT scan of the mediastinum
5) The addition of ethambutol
Answers-1
37- A 24 year old male presents after developing a bluish discolouration of the body, lips and nails. He denies any relevant past medical history. Examination reveals a central cyanosis and a grey complexion.
Investigation revealed:
Haemoglobin 17.0 g/dL (13.0-18.0)
PaO2 13.0 kPa (11.3-12.6)
SaO2 (using an oximeter) 85% (>95)
What is the most likely diagnosis?
1) Argyria
2) Cyanotic congenital heart disease
3) Haemochromatosis
4) Methaemoglobinaemia
5) Methylene blue poisoning
Answers-4
38- Which of the following is true of BCG vaccination?
1) is contraindicated in neonates
2) is a killed polysaccharide antigen vaccine
3) should be given to all children who have a strongly positive tuberculin test
4) is presently routinely offered in the UK at age 16 years
5) Provides protection against leprosy
Answers-5
39 -Carcinoid tumors of the lung (bronchial adenomas) originate from which of the following cell types?
1) Ciliated cell
2) Clara cell
3) Kulchitsky (K) cell
4) Mucus (goblet) cell
5) Type 2 Alveolar cell
Answers-3
40- A 55-year-old woman on treatment for long-standing rheumatoid arthritis has recently become dyspnoeic on mild exertion and developed a dry cough. The oxygen saturation was found to be 87% on air. The chest x-ray showed a diffuse bilateral interstitial infiltrate. An extensive infection screen was negative and her symptoms were felt to be druginduced. Which drug is most likely to have caused this adverse effect?
1) azathioprine
2) cyclosporin
3) hydroxychloroquine
4) methotrexate
5) sulphasalazine
Answers-4
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.