Friday, 30 October 2015

Latest Respiratory Multiple Choice Questions And Answers

91- Which of the following statements is true of psittacosis (ornithosis):
1) It is only a risk from contact with psittacines (parrots), not other birds
2) It usually causes many polymorphs to be present in the sputem
3) It is more of a risk to children than to adults who are exposed to birds
4) It does spread from person to person
5) Infection responds rapidly to penicillin therapy

92- Which of the following statements is true regarding smoking in pregnancy?
1) Smoking assists in maturation of the fetal lung.
2) The reduction in birth weight is related to the number of cigarettes smoked per day.
3) Maternal smoking may adversely affect testicular function in male children.
4) Dysmorphic facies is a recognised complication.
5) The newborn baby may require adjustments in drug dosages because of it.

93- A 54-year old woman was admitted with acute breathlessness. On examination she had a temperature of 37.9oC, a respiratory rate of 32 breaths per minute, a pulse of 120 beats per minute, a blood pressure of 100/60 mmHg, and a peak expiratory flow rate of 250 litres per minute.
Auscultation of the heart and chest was normal.
The Chest X-ray was normal.
blood gases on air showed:
pH 7.35 (7.36 - 7.44)
Pa02 6.0
kPa (11.3 - 12.6)
PaC02 3.9
kPa (4.7 - 6.0)
Serum bicarbonate 20 mmol/l (20 - 28)
She was started on high flow oxygen. What is the most important next treatment?
1) amoxycillin intravenously
2) aminophylline intravenously
3) intravenous fluids
4) low molecular weight heparin
5) nebulised salbutamol

94- A 45 year old female presents with a 6 month history of exertional dyspnoea and is diagnosed with pulmonary fibrosis. Over the last one year she has received a variety of medications. Which of the following drugs could be responsible?
1) Dexamethasone
2) Ibuprofen
3) nalidixic acid
4) penicillamine
5) sulphasalazine

95- Which one of the following is correct regarding long-acting beta-2 agonists?
1) Can be used to prevent activity-induced symptoms without anti-inflammatory therapy.
2) Become less effective over time (tolerance).
3) Are beneficial in acute viral croup.
4) Protect against allergen challenge for up to 48 hours.
5) Should not be used in association with erythromycin.

96- A 45-year-old man develops facial swelling and breathlessness. His chest X-ray reveals paratracheal lymphadenopathy. Which of the following statements is most accurate regarding the superior vena caval obstruction?
1) the most common cause is squamous cell carcinoma
2) treatment of choice is radiotherapy
3) it may be associated with voice hoarseness
4) it is associated with Kussmaul's sign
5) the commonest symptom is stridor

97- A 55 year old man presents with ataxia and bilateral gynaecomastia.
Which of the following is the most likely diagnosis?
1) Kleinfelters Syndrome
2) Long term treatment with cyclophosphamide for Wegener's Granulomatosis
3) Long term treatment with oral steroids for chronic asthma
4) Bronchial Carcinoma
5) Hypereosinophilic Syndrome

98- A 55-year-old plumber presented with a dry nocturnal cough and increasing exertional breathlessness.
On examination he had early finger clubbing, cyanosis and bilateral basal crackles. A chest X-ray showed bilateral lower zone shadowing.
Investigations revealed:
PaO2 (breathing air) 8.2 kPa (11.3-12.6)
FEV1/FVC ratio 85%
Which of the following investigations is most likely to establish the diagnosis?
1) Echocardiography.
2) High resolution CT scan of chest
3) Measurement of diffusion capacity
4) Serum angiotensin-converting enzyme (ACE) level
5) Transbronchial lung biopsy

99- Which of the following statemtns regarding the sweat test is true?
1) Sweating is enhanced by application of atropine.
2) The filter paper is left on for a total of about 4 hours.
3) At least 25mg of sweat is necessary for a reliable result.
4) More than 60mmol/L of chloride in sweat is diagnostic of cystic fibrosis.
5) False/positive results may be encountered in children with nephrotic syndrome.

100- A 7 month old boy is presented to a doctor by his parents with symptoms of reccurent upper respiratory tract infections. No other members of the family suffer from any smiliar infections.Physical examination showed mild facial hypoplasia. Biochemistry investigations revealed hypocalcaemia. Microbiological investigations were normal and immunoglobulins were within normal limits. The infants immune function would show the following deficiency:
1) Complement Deficieny
2) B cell number and function
3) T cell number and function
4) Plasma Cell
5) Macrophage number and function

101- Progressive Massive Fibrosis (PMF) is most likely to be found in which of the following?
1) Complicated silicosis
2) Extrinsic allergic alveolitis
3) Lobar pneumonia
4) Sarcoidosis
5) Simple coal workers pneumoconiosis

102-A 17-year-old girl with known cystic fibrosis presents with a chest infection. What antibiotic would be most suitable for her?
1) Augmentin
2) Cefotaxime
3) Ceftazidime
4) Gentamicin
5) Amoxicillin

103-A 21-year-old gentleman with cystic fibrosis presents with infertility. What is the most likely cause for this?
1) Chronic prostatic insufficiency
2) Failure of development of the vas deferens
3) Increasing alkalinisation of semen
4) Primary failure of testosterone production
5) Production of anti-sperm antibodies

104-A 16-year-old girl presents with shortness of breath and insomnia prior to an examination. Clinical examination is normal. CXR and PEFR are normal. Which of the following investigations is most suggestive of asthma?
1) diurnal variation in PEFR> 20%
2) positive skin prick test to common allergens
3) past medical history of hayfever and eczema
4) increased total IgE
5) resolution of symptoms the day after the exam

105-A 65-year-old female presents with a 3 week history of malaise and blood in her sputum. Bronchoscopy reveals a mass in the right main bronchus, and histology demonstrates it to be a small cell carcinoma. Further investigation fails to show any metastases. What is the most appropriate step in management?
1) Chemotherapy
2) Endobronchial laser therapy
3) Radiotherapy
4) Surgery
5) Palliative therapy

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