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
Answers-4

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.
Answers-2

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.
Investigations:
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
Answers-5

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
Answers-5

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.
Answers-1

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
Answers-3

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
Answers-4

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
Answers-2

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.
Answers-4

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
Answers-3

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
Answers-1

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
Answers-3

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
Answers-2

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
Answers-1

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
Answers-1

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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
Answers-2

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
Answers-4

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
Answers-4

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
Answers-3

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%
Answers-3

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
Answers-3

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.
Answers-1

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
Answers-3

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
Answers-4

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
Answers-5

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Most recent asked Respiratory Multiple Choice Questions And Answers

71- Sleep Apnoea syndrome is best diagnosed by the following:
1) Polygraphic Sleep Studies
2) therapeutic trial of amphetamines
3) EEG
4) Blood gases during apneic episodes
5) Presence of HLA-DR2 and DQw1
Answers-1

72- A 70-year-old man presented with weight loss and haemoptysis. He was a heavy smoker. A chest radiograph showed a mass lesion in the left lung bronchoscopic biopsies confirmed a squamous carcinoma.
1) Chest wall invasion by primary tumour
2) An enlarged mediastinal lymph node on CT scanning
3) Forced expiratory volume (FEV1) of 1.2 litres
4) Hypercalcaemia
5) Malignant pleural effusion
Answers-5

73- Which of the following statements regarding prognosis in lung cancer is true?
1) Combined modality therapy (chemotherapy, radiation therapy and surgery) has improved overall lung cancer survival to 40% at 5 years.
2) Overall lung cancer survival is < 15% at 5 years.
3) Patients undergoing radiation therapy have a 5 year survival of 40%.
4) Patients who qualify for surgery have a 50% 5 year survival.
5) With chemotherapy, overall survival in small cell (oat cell) carcinomas has risen to 60% at 5 years.
Answers-2

74- A breathless patient undergoes pulmonary Function testing. The following results are obtained; FEV1 = 74% predicted, FVC = 68% predicted, TLC = 77% predicted, Tlco = 46% predicted, Kco = 53% predicted. Which of the following is the most likely cause ?
1) COPD
2) Asthma
3) Cryptogenic Fibrosing Alveolitis
4) Morbid obesity
5) kyphoscoliosis
Answers-3

75- A lifelong non-smoker is diagnosed with emphysema. Which of the following would be the most likely aetiological agent ?
1) Isocyanates
2) Cadmium Exposure
3) Steel
4) Zinc
5) Asbestos
Answers-2

76- Which cell type is responsible for the early asthmatic response?
1) Basophil
2) Eosinophil
3) Mast cell
4) Neutrophil
5) TH1-lymphocyte
Answers-3

77- A 43-year-old Caribbean female Comprehensive school teacher complains of slowly increasing breathlessness. She has no smoking history. Investigations reveal she has bilateral enlarged hilar lymph nodes, elevated serum calcium, interstitial lung disease, and enlarged liver and spleen. What is the most likely diagnosis?
1) Coccidioidomycosis [0]
2) Hyperparathyroidism [0]
3) Hypervitaminosis D [0]
4) Sarcoidosis [100]
5) Tuberculosis [0]
Answers-4

78- A 58-year-old man presents with weight loss and haemoptysis. He has smoked most of his life. On examination he is clubbed and has clinical evidence of right pleural effusion. His serum calcium is 3.2mM. Which of the following histological type of lung cancer is he most likely to suffer from?
1) mesothelioma
2) small cell carcinoma
3) large cell carcinoma
4) squamous cell carcinoma
5) adenocarcinoma
Answers-4

79- A 68-year-old man presents with a one-month history of dyspnoea and a 3kg weight loss. On examination there were signs of a large left pleural effusion, confirmed on Chest X-ray.
Investigations revealed:
Pleural fluid analysis:
Protein 38 g/L
Cytology a few lymphocytes and red blood cells.
Which one of the following investigations should be considered next?
1) Bronchoscopy.
2) CT scan of thorax.
3) Repeat pleural aspiration with biopsy.
4) Thoracoscopic pleural biopsy.
5) Tuberculin test.
Answers-4

80- A 63-year-old woman presents a 5 day history of progressive shortness of breath. Her family brought her in because she was increasingly sleepy during the last 24 hours. She was diagnosed with Chronic Obstructive Pulmonary Disease 3 years ago and has a FEV1 less than 50% of predicted. She has an oxygen concentrator at home.
Examination revealed depressed consciousness and a respiratory rate of 24 with shallow breaths. There were decreased breath sounds with minimal air movement. If an arterial blood gas on room air were to be performed, which of the following results would you expect?
1) pH 7.16 paCO2 70 paO2 50 HCO3 24
2) pH 7.24 paCO2 80 paO2 55 HCO3 30
3) pH 7.32 paCO2 60 paO2 70 HCO3 30
4) pH 7.41 paCO2 40 paO2 50 HCO3 24
5) pH 7.48 paCO2 30 paO2 85 HCO3 24
Answers-2

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Frequently Asked Respiratory Multiple Choice Questions And Answers

61- The morphological appearance of Pneumocystis carinii infection in the lung is best characterised as which one of the following?
1) A bronchopneumonia with abscess formation
2) A haemorrhagic and necrotizing pneumonia
3) An acute respiratory distress syndrome (ARDS) with widespread hyaline membrane formation
4) An interstitial pneumonitis with foamy intra-alveolar exudate
5) An organizing bronchopneumonia
Answers-4

62- Which of the following statements is NOT true of primary pulmonary tuberculosis:
1) It is characteristically asymptomatic
2) Miliary spread is commoner in a younger age group
3) The initial immunological response causes hilar lympadenopathy
4) pleural effusion occurs before tuberculin skin testing is positive
5) A positive tuberculin skin test develops within two weeks of infection
Answers-5

63- In which of the following have randomised controlled trials shown that long-term oxygen therapy (LTOT) reduces mortality?
1) Asthma
2) Cor pulmonale due to chronic airflow obstruction
3) Cryptogenic fibrosing alveolitis
4) Cystic fibrosis
5) Pulmonary sarcoidosis
Answers-2

64- Which ONE of the following is true regarding acute pulmonary embolism?
1) a normal ECG excludes the diagnosis
2) embolectomy is more effective than thrombolysis in improving survival
3) Heparin is as effective as thrombolytic therapy
4) the presence of hypoxaemia is an indication for thrombolysis
5) thrombolysis administered through a peripheral vein is as effective as through a pulmonary artery catheter
Answers-5

65- A 36 year old man complains of a persistent cough. A CXR shows fibrosis of both upper lobes. What is the most likely diagnosis?
1) Systemic Sclerosis
2) Primary Pulmonary Hypertension
3) Cystic Fibrosis
4) Ankylosing Spondylitis
5) Allergic bronchopulmonary aspergillosis
Answers-5

66- Which one of the following statements is true of chronic obstructive pulmonary disease?
1) patients show at least a 15 per cent improvement in the FEV1 after nebulised bronchodilator
2) inhaled corticosteroid usage does not improve long-term prognosis
3) breathlessness is uncommon until the FEV1 falls to approximately 50 per cent of predicted
4) emphysema is associated with increased transfer factor
5) in advanced cases there is reduced pulmonary vascular resistance
Answers-2

67- A 16 year old boy with cystic fibrosis presents with abdominal pain. Which of the following is most likely to be the cause?
1) Ulcerative colitis
2) Irritable Bowel Syndrome
3) Pyelonephritis
4) Meconium Ileus Equivalent Syndrome
5) Renal Calculi
Answers-4

68- A patients' arterial blood gases give the following results; pO2 10 kPa (75mmHg), pCO2 7 kPa (52 mmHg), pH 7.47, [HCO3-] 37. Which of the following is the most likely cause?
1) Chronic Hyperventilation Syndrome
2) Acute exacerbation of COPD
3) Several days of Pyloric obstruction
4) Pulmonary Embolism
5) Diabetic Coma
Answers-3

69- A patient with Rheumatoid arthritis complains of progressive breathlessness. Which of the following is the most likely cause?
1) Pulmonary Eosinophilia
2) Asthma [0]
3) Pulmonary nodules
4) Fibrosing Alveolitis
5) Pulmonary Embolus
Answers-4

70- In the normal adolescent lung which of the following is correct?
1) There is an intrapleural pressure of 30 cmH2O (3kPa) at the end of normal expiration.
2) There is a resting pulmonary blood flow of 10L/min.
3) The V:Q ratio is greater in apical than basal segments of the lung when upright and at rest.
4) The majority of airway resistance is from large airways.
5) Cartilage is present in all respiratory bronchioles.
Answers-3

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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.
Answers-2

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
Answers-1

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.
Answers-3

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
Answers-3

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
Answers-2

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
Answers-5

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
Answers-3

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.
Answers-4

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
Answers-5

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 µmol/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
Answers-2

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Common Respiratory Multiple Choice Questions And Answers

41- The following is true about Cystic Fibrosis:
1) Is an autosomal dominant condition.
2) Is due to mutation of CFTR gene on chromosome 17
3) Skin test may be positive for aspergillus
4) Median survival rate is 10 to 15 years.
5) Is a cause of mental retardation.
Answers-3

42- A 67-year-old man presents with a long history of cough,breathlessness on minimal exertion and ankle swelling. He smokes 30-40 cigarettes per day.
Investigations are as follows:
Haemoglobin 19g/dl
white blood count 7.3
PaO2 (air) 6.2kPa
PaCO2 (air) 8.9kPa
serum [H+] 44 nmol/l
serum [HCO3] 36 mmol/l
What is the most likely explanation of these results?
1) acute respiratory acidosis
2) chronic respiratory acidosis
3) chronic respiratory alkalosis
4) metabolic acidosis
5) metabolic alkalosis
Answers-2

43- Which of the following statement is true of infections with Mycobacterium tuberculosis:
1) non-sputum producing patients are non-infectious
2) a positive tuberculin test indicates active disease
3) lymph node positive disease requires longer treatment than pulmonary disease
4) in pregnant women treatment should not be given until after delivery
5) pyrazinamide has high activity against active extracellular organisms
Answers-1

44- In restrictive lung disease due to respiratory muscle weakness, which of the following statements is true?
1) Low FEV1/FVC, high RV/TLC
2) Low FEV1/FVC, normal TLC
3) Low VC, low FEV1, normal TLC, low RV/TLC
4) Low VC, low RV, low TLC
5) Low VC, low TLC, high RV/TLC
Answers-5

45- Which of the following would be the least likely finding in a patient with sarcoidosis?
1) Hepatic granulomas
2) Restrictive pulmonary function tests
3) Skin lesions
4) Uveitis
5) X bodies on bronchoalveolar lavage (BAL) fluid
Answers-5

46- A 72-year-old lifelong smoker presents with progressive dyspnoea on exertion. He has a chronic, nonproductive cough. On examination he is thin, breathing with pursed lips, respiratory rate 25/min, with mild wheezing on chest auscultation.
Investigations show
FEV1 0.8 L
FVC 1.6 L
pH 7.35
paCO2 45 mmHg
paO2 55 mmHg
What is the predominant mechanism of the airflow limitation in this gentleman?
1) Bronchospasm
2) Foreign body obstruction
3) Increased airways resistance
4) Loss of elastic recoil
5) Mucus plugging in the small airways
Answers-4

47- Which of the following statements regarding cryptogenic fibrosing alveolitis is correct?
1) Active inflammation may be suggested by a CT scan
2) peak flow rate is a good guide to severity
3) 80 per cent of patients iniiration
4) Reduced cardiac output
5) Reduced airway resistance
Answers-1

48- 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 and 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
Answers-5

49- A 76-year-old with a recent history of cerebral haemorrhage is admitted with a cough, worsening breathlessness and right pleuritic chest pain. He is also mildly pyrexial. His ventilation-perfusion scan reveals several areas of ventilation/perfusion mismatches. What is the most appropriate line of management?
1) aspirin therapy
2) antibiotics
3) inferior vena cava filter
4) low molecular weight heparin treatment
5) warfarin treatment
Answers-3

50- Which of the following is a recognised feature of massive pulmonary embolism?
1) reduced plasma lactate levels
2) an increase in serum troponin levels
3) an arterial pH less than 7.2
4) blood gases show increased pCO2 on air
5) normal D-dimer levels
Answers-2

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