Friday, 30 October 2015

Experienced Respiratory Multiple Choice Questions And Answers

81- A 47 year old woman presenting with breathlessness has arterial blood gases taken which give the following results: pO2 8.7 kPa (65mmHg), pCO2 4.4 kPa (33mmHg), pH 7.46, {HCO3-] 24. Which of the following is the most likely diagnosis.
1) Hyperventilation syndrome
2) Acute severe asthma
3) Emphysema
4) Kyphoscoliosis
5) Opiate overdose

82- Which of the following forms of pulmonary embolism is the commonest cause of secondary pulmonary hypertension?
1) Air embolism (Caisson's disease)
2) Fat embolism
3) Massive pulmonary embolism (e.g., saddle embolism)
4) Multiple small recurrent pulmonary embolism
5) Paradoxical embolism

83- Primary Pulmonary tuberculosis:
1) Leads to pleural effusion
2) Is highly infective
3) Commonly leads to military TB
4) May be totally asymptomatic
5) Usually produces cavitation

84- An elderly man with a history of asthma, congestive heart failure, and peptic ulcer disease is admitted with bronchospasm and rapid atrial fibrillation. He recieves frequent nebulised salbutamol and IV digoxin loading, his regular medications are continued. 24 hours after admission his serum potassium is noted to be 2.8 mmol/l. Which of his medications is most likely to have caused this abnormality.
1) Digoxin
2) ACE inhibitor
3) Salbutamol
4) Ranitidine
5) Spironolactone

85- The parents of a child with cystic fibrosis consult you wishing to know what is the risk of their next child being a carrier of the condition. Which ONE of the following percentages is the correct risk?
1) 0%
2) 25%
3) 50%
4) 75%
5) 100%

86- Most of the cells that fill the alveoli in desquamative interstitial pneumonitis (DIP) are which of the following?
1) Eosinophils
2) Lymphocytes
3) Macrophages
4) Neutrophils
5) Plasma cells

87- A 50-year-old male is taken to the General Practitioner by his long suffering wife. His snoring (which has been steadily increasing in loudness over the past 18 months) is troublesome at home. She says that he makes noises and moves around whilst asleep. He reports no problems with sleeping. He does admit to gaining 20 kg in weight over the past one year, and to falling asleep during the day.
A sleep study is performed. Which of the following findings would be most compatible with this man's clinical presentation?
1) Fragmented sleep, cessations of airflow measured at the nose accompanied by an increase in oesophageal pressure swings and episodic oxygen desaturation.
2) Normal sleep quality, bradycardic episodes, oxygen desaturation but normal airflow.
3) Normal sleep quality but cessations of airflow measured at the nose with decreased abdominal wall motion during these flow cessations.
4) Progressive oxygen desaturation during the night and alternating periods of hyperventilation and hypoventilation.
5) Tachycardia, sleep fragmentation, episodes of hypoventilation with minimal oxygen desaturation.

88- A 42 year old woman presents with an acute attack of asthma. She is able to speak in short sentences. Her respiratory rate is 28 breaths per minute and the peak expiratory flow rate 120L/min (predicted 480 L/min. What is the most appropriate treatment for this patient?
1) Intravenous aminophylline.
2) Intravenous salbutamol
3) Nebulized salbutamol
4) Oral salbutamol
5) Oral theophylline

89- A 15 year old boy presented with wheezing when playing football and nocturnal cough.
Which is the best test to confirm the underlying condition?
1) A trial of oral corticosteroids
2) A trial of inhaled corticosteroids
3) A trial of inhaled salbutamol
4) Serial peak expiratory flow rate measurements
5) Spirometry alone

90- Which of the following is NOT true with regard to the radiological appearance of a chest X-ray?
1) Consolidation of the right middle lobe will obliterate the right atrial shadow in the PA view
2) Consolidation of the right apical lobe will extend to the horizontal fissure in the PA view
3) Consolidation of the right anterior segment of the right middle lobe will extend to the right transverse fissure and the right hilum in PA view
4) A consolidation of the lingular lobe will obliterate the aortic knuckle and pulmonary trunk in the PA view
5) A consolidation of the left lower lobe will elevate the left hemidiaphragm

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