Friday, 30 October 2015

Respiratory Multiple Choice Questions And Answers

21- A 65-year-old woman, a heavy smoker for many years, has had worsening dyspnoea for the past 5 years, without a significant cough. A chest X-ray shows increased lung size along with flattening of the diaphragms, consistent with emphysema. Over the next several years she develops worsening peripheral oedema. BP 115/70 mmHg. Which of the following cardiac findings is most likely to be present?
1) Constrictive pericarditis
2) Left ventricular aneurysm
3) Mitral valve stenosis
4) Non-bacterial thrombotic endocarditis
5) Right ventricular hypertrophy

22- A 45-year-old solicitor had an onset of severe, crushing, substernal chest pain while attending a football match. He collapsed on his way to the car. Bystander Cardiorespiratory Resuscitation was begun immediately and continued until arrival in Casualty where an endotracheal tube was inserted and ventilation was maintained on 100% oxygen. Investigations revealed:
pH 7.13
PaO2 560 mmHg
PaCO2 18 mmHg
Bicarbonate 5.8
SaO2 98%
Based on these laboratory values, which of the following statements best describes his current pathophysiology?
1) He is demonstrating a primary respiratory alkalosis
2) He probably developed a large right to left intracardiac shunt
3) His anion gap is probably normal
4) His oxyhemoglobin curve is shifted to the left
5) His pulmonary artery pressure is probably elevated

23- Obstructive sleep apnoea characteristically associated with:
1) hypersomnolence
2) impotence
3) macrognathia
4) insomnia
5) polydipsia

24- A 26-year-old man with a history of alcohol and drug abuse was admitted with a 14 day history of fever, cough and fatigue. He was emaciated. His temperature was 39.4°C. Cervical and axillary lymphadenopathy were present. Chest X-ray revealed bilateral areas of pulmonary shadowing. Which of the following is the most likely diagnosis?
1) alcoholic cardiomyopathy
2) pneumococcal pneumonia
3) pneumocystis pneumonia
4) pulmonary tuberculosis
5) tricuspid endocarditis

25- A 75-year-old man with squamous cell carcinoma is thought to have resectable disease. Which of the following would be a contraindication to surgery?
1) clubbing
2) FEV1 of 0.75 L
3) his age of 75 years
4) pleural effusion
5) Syndrome of Inappropriate ADH

26- A 36 year old woman presents with dyspnoea, cough and fever. Crackles are heard on auscultation of the lungs. Circulating precipitans to Micropolyspora faeni are positive. Which of the following is the most likely diagnosis?
1) Malt workers' lung
2) Pigeon fanciers' lung
3) Allergic Bronchopulmonary Aspergillosis
4) Brucellosis
5) Farmers' lung

27- A 41 year old man with a history of nasal congestion, breathlessness, cough and wheeze presents with a left foot drop. Which of the following is the most likely diagnosis?
1) Diabetes mellitus
2) Wegeners Granulomatosis
3) Churg Staus Syndrome
4) Pulmonary eosinophilia
5) Polyarteritsis Nodosa

28- In asbestos related disorders which of the following statements is correct?
1) basal fibrotic shadowing on CXR suggests coincidental idiopathic fibrosing alveolitis
2) increased incidence of primary lung cancer
3) pleural effusion develops more than 20 years after causative asbestos exposure
4) pleural plaques are recognized precursors of mesothelioma
5) the risk of malignant mesothelioma is greatly increased in smokers compared with non-smokers

29- A 60 year old man was admitted with community-acquired pneumonia and deteriorated over the next few hours. Which one of the following indicates a poor prognosis?
1) A total white cell count of 17 x 109/L (4-11)
2) Blood pressure of 110/70 mm Hg
3) Respiratory rate of 35 breaths/min
4) Rigors
5) Temperature of 39oC

30- Which of the following statements concerning industrial lung disorders is correct?
1) pneumoconiosis can be diagnosed in the absence of chest X-ray abnormalities
2) occupational asthma occurs more frequently in atopic persons
3) silo fillers disease is caused by allergy to grain
4) widespread crepitations are typically heard in extrinsic allergic alveolitis
5) symptoms occur within minutes if exposure to mouldy hay in Farmer's lung

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