Friday, 30 October 2015

Tricky Respiratory Multiple Choice Questions And Answers

51- Which of the following statements is true of the diffusion capacity of carbon monoxide?
1) Is a specific measure of lung perfusion.
2) Depends on the thickness of the alveolar wall.
3) Depends on the surface area available for gas exchange.
4) Is increased in cigarette smokers.
5) Is increased in emphysema.

52- A 19 year old woman became breathless while travelling on an aeroplane. Which one of the following features most strongly supports a diagnosis of acute hyperventilation related to a panic disorder?
1) Carpal spasm.
2) Finger paraesthesiae.
3) Hypotension.
4) Light-headedness.
5) Loss of conciousness

53- A 64-year-old man is found to have squamous cell bronchogenic carcinoma. Which of the following statements is true regarding surgical resection?
1) An FEV1 of 2 L is a major contraindication to surgical resection.
2) Hypercalcaemia makes further assessment for surgery unnecessary.
3) Is precluded if a CT scan of the thorax shows enlarged mediastinal lymph nodes.
4) Positive sputum cytology excludes the need for bronchoscopic examination of the airways.
5) The presence of finger clubbing indicates that liver metastases are already present.

54- A 60-year-old man with breathlessness, fever and headache is suspected of having Farmers Lung. A CXR shows diffuse nodular shadowing predominantly in the mid and lower zones. What would be the most useful diagnostic test?
1) Blood Culture
2) Sputum Culture
3) Serum precipitating antibodies to Micropolyspora faeni
4) Serum Precipitating antibodies to Aspergillus clavatus
5) Serum Precipitating antibodies to Cryptostroma corticale

55- A 43-year-old asthmatic develops worsening breathlessness and his full blood count has revealed an eosinophilia. Which of the following statements is true with allergic bronchopulmonary aspergillosis that the patient is likely to suffer from?
1) The immediate skin test to an extract of aspergillus fumigatus is negative
2) Circulating IgG precipitins to aspergillus fumigatus are positive
3) The CO transfer factor is unaffected
4) Recurrent haemoptysis is a characteristic feature
5) Pleural effusion is a complication

56- A 35-year-old man presents after 3 months of chronic cough with purulent sputum and shortness of breath on exertion. He gives a history of at least two sinus or bronchial infections per year requiring treatment with antibiotics. He also says he and his wife have been unable to have children. He smokes 15 cigarettes per day. Examination is normal except for some wheezing and an area of focal crackles at the left lung base.
Chest X-ray shows patchy infiltrates at both bases.
Investigations revealed
FEV1 2.0 L
FVC 2.7 L
pH 7.38
PaCO2 40 mmHg
PaO2 82 mmHg
What is the most likely diagnosis?
1) alpha-1-Antitrypsin (Antiprotease) deficiency
2) Asthma
3) Cystic fibrosis
4) Hypogammaglobulinemia
5) Immotile cilia syndrome

57- An 18 year old attending the A+E department is noted to have central cyanosis. She is perfectly well but was told to go to A+E by her friends who said she looked blue. What is the most likely cause?
1) Carbon Monoxide Poisoning
2) Lead Poisoning
3) Drinking water contaminated with nitrates
4) Anorexia Nervosa
5) Severe Anaemia

58- A 59 year old female smoker is diagnosed with oat cell carcinoma of the bronchus. Which of the following relating to this diagnosis is true?
1) The tumour is likely to be radiosensitive
2) occurs with equal frequency in smokers and non-smokers
3) has a 5 year survival greater than 20%
4) Is associated with the elaboration of ectopic ADH secretion
5) Is typically associated with ectopic parathormone secretion.

59- Which of the following conditions may give a false/positive sweat test?
1) Congenital adrenal hyperplasia
2) Hyperthyroidism
3) Hyperparathyroidism
4) Obesity
5) Glucose-6-phosphatase deficiency

60- A 60-year-old man was diagnosed last year with adenocarcinoma of the lung, and a 4 cm mass lesion was treated with a right lower lobectomy. He now has an abdominal CT scan that reveals scattered hepatic mass lesions and hilar lymphadenopathy. For several weeks, he has had increasing malaise. A urinalysis reveals marked proteinuria, and a 24 hour urine protein collection is 2.7 g/24hr. His serum urea is 30 mmol/L (2.5 - 7.5) with creatinine of 450 ยตmol/L (60 - 110). A renal biopsy is performed, and there is focal deposition of IgG and C3 with a granular pattern. He is most likely to have which of the following conditions?
1) Goodpasture's syndrome
2) Membranous glomerulonephritis
3) Minimal change glomerulonephritis
4) Nodular glomerulosclerosis
5) Rapidly progressive glomerulonephritis

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