Best Respiratory Multiple Choice Questions And Answers

31- A young child presents with respiratory distress, worsening over 2 days. Blood gases show a pH of 7.25, a PCO2 of 7.5kPa, a PO2 of 8.5kPa, and a base excess of -4. Which of the following interpretations is correct?
1) Results are consistent with bronchopulmonary dysplasia.
2) Blood gases suggest type 1 respiratory failure.
3) Immediate intubation is required.
4) Results are consistent with late severe asthma.
5) Bicarbonate may be necessary to correct the acidosis.
Answers-4

32- A 19 year old female presents with acute breathlessness. She has had asthma for approximately 3 years and recently commenced new therapy. Which agent may be responsible for this exacerbation?
1) Salmeterol
2) Theophylline
3) Beclomethasone
4) Ipratropium bromide
5) Monteleukast
Answers-1

33- A 22 year old lady recently returned from a holiday in Malta was admitted with a 3 day history of fever, generalised lymphadenopathy and a macular rash over the trunk and legs. Which of the following is the most likely diagnosis?
1) Sarcoidosis
2) Tuberulosis
3) Familial Mediterranean Fever
4) Infectious Mononucleosis
5) Actinomycosis
Answers-4

34- Which of the following is a recognised treatment for complications of cystic fibrosis?
1) DNAase to assist in reinflating collapsed lung segments.
2) Rectal pull-through and anastamosis for rectal prolapse.
3) Pancreatic transplant for diabetes mellitus.
4) Nebulised tobramycin for pseudomonas colonisation of the lower respiratory tract.
5) Hypotonic saline drinks for hypernatraemic dehydration.
Answers-4

35- Which of the following is a typical feature of Farmer's lung?
1) basal crackles
2) Eosinophilia
3) Haemoptysis
4) Increased pCO2
5) Positive serum paraproteins
Answers-1

36- A 28 year old man who had had tuberculosis of the mediastinal lymph nodes diagnosed two weeks previously and who had been started on chemotherapy with rifampicin, isoniazid and pyrazinamide was admitted because of the increasing dyspnoea and stridor. Chest X-ray showed compression of both main bronchi by carinal lymph node enlargement. What is the next step in management?
1) Start prednisolone
2) Mediastinoscopy and biopsy
3) Refer for stent insertion/tracheostomy
4) Refer for urgent CT scan of the mediastinum
5) The addition of ethambutol
Answers-1

37- A 24 year old male presents after developing a bluish discolouration of the body, lips and nails. He denies any relevant past medical history. Examination reveals a central cyanosis and a grey complexion.
Investigation revealed:
Haemoglobin 17.0 g/dL (13.0-18.0)
PaO2 13.0 kPa (11.3-12.6)
SaO2 (using an oximeter) 85% (>95)
What is the most likely diagnosis?
1) Argyria
2) Cyanotic congenital heart disease
3) Haemochromatosis
4) Methaemoglobinaemia
5) Methylene blue poisoning
Answers-4

38- Which of the following is true of BCG vaccination?
1) is contraindicated in neonates
2) is a killed polysaccharide antigen vaccine
3) should be given to all children who have a strongly positive tuberculin test
4) is presently routinely offered in the UK at age 16 years
5) Provides protection against leprosy
Answers-5

39 -Carcinoid tumors of the lung (bronchial adenomas) originate from which of the following cell types?
1) Ciliated cell
2) Clara cell
3) Kulchitsky (K) cell
4) Mucus (goblet) cell
5) Type 2 Alveolar cell
Answers-3

40- A 55-year-old woman on treatment for long-standing rheumatoid arthritis has recently become dyspnoeic on mild exertion and developed a dry cough. The oxygen saturation was found to be 87% on air. The chest x-ray showed a diffuse bilateral interstitial infiltrate. An extensive infection screen was negative and her symptoms were felt to be druginduced. Which drug is most likely to have caused this adverse effect?
1) azathioprine
2) cyclosporin
3) hydroxychloroquine
4) methotrexate
5) sulphasalazine
Answers-4

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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
Answers-5

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
Answers-5

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

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
Answers-3

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
Answers-2

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
Answers-5

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
Answers-3

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
Answers-2

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
Answers-3

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
Answers-2

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Respiratory Objective Type Questions And Answers

11- A 20-year-old male student is assessed for shortness of breath that occurs whilst running. He has no other symptoms and does not smoke. Examination, full blood count, and chest X-ray are normal. Which of the following is most likely to be helpful in confirming the suspected diagnosis?
1) Arterial blood gas studies before and after exercise
2) Determination of lung volumes and diffusing capacity
3) Measurement of venous blood lactate before and after exercise
4) Spirometry before and after administration of bronchodilators
5) Spirometry before and after exercise
Answers-5

12- A 40-year-old worker presents with wheezing and breathlessness which seem to improve over weekends and holiday periods when he is not working. What is he most likely to be exposed to at work?
1) Platinum salts
2) Avian bloom
3) Aspergillus clavatus
4) Work in the Silver industry
5) Exposure to spores of Actinomyces
Answers-1

13- The pulmonary vascular system is different from the systemic circulation in that the pulmonary system demonstrates which of the following?
1) High pressures, high flow rates, highly compliant vessels
2) High pressures, high flow rates, low compliance vessels
3) Low pressures, high flow rates, high compliance vessels
4) Low pressures, low flow rates, high compliance vessels
5) Low pressures, low flow rates, low compliance vessels
Answers-4

14- A 60 year old man with ankylosing spondylitis presents with cough, weight loss and tiredness. His CXR shows longstanding upper lobe fibrosis. Three sputum tests stain positive for Acid fast bacilli but are consistently negative for Mycobacterium tuberculosis on culture. Which of the following is the most likely cause?
1) Mycobacterium avium intracellulare complex
2) Micropolyspora faeni
3) Allergic Bronchopulmonary Aspergillosis
4) Sarcoidosis
5) Tuberculosis
Answers-1

15- Which of the following is a recognised cause of a phrenic nerve palsy?
1) Aortic aneurysm
2) Dermoid
3) Ganglioneuroma
4) Pericardial cyst
5) Sarcoidosis
Answers-1

16- Which of the following statements is true of the pulmonary function test's vital capacity (VC)?
1) Vital capacity cannot be measured from spirometry alone
2) Vital capacity is increased in emphysema and reduced in interstitial fibrosis
3) Vital capacity is the maximal amount of air which can be exhaled after maximal inspiration
4) Vital capacity is the sum of tidal volume (VT) and inspiratory capacity (IC)
5) Vital capacity, when reduced, is a specific indication of restrictive lung disease
Answers-3

17- A 24 year old asthmatic female is admitted with acute severe asthma. Which of the following statements regarding the diagnosis is correct?
1) Agitation should be managed with a benzodiazepine
2) A high inspired Oxygen concentration should be used routinely
3) Inhaled salmeterol is indicated as first line therapy
4) Normal arterial pCO2 is reassuring
5) Pulsus paradoxus is a reliable sign of severity
Answers-2

18- Recognised associations. Which of the following is correct?
1) pneumoconiosis and clubbing
2) lung carcinoids and pleural effusion
3) pulmonary embolus and left bundle branch block
4) pulmonary fibrosis and hypercapnia
5) bronchopulmonary aspergillosis and wheezing
Answers-5

19- dry cough. Her chest X-ray shows an area of dense pneumonia-like consolidation in the right lower lobe. A course of antibiotics did not improve her symptoms or chest X-ray. Bronchioalveolar lavage (BAL) retrieved 'atypical' cells. What is the most likely diagnosis?
1) Bronchioloalveolar cell carcinoma
2) Mycoplasma pneumonia
3) Pulmonary alveolar proteinosis
4) Pulmonary embolism with infarction
5) Sarcoidosis
Answers-1

20- Randomised controlled trials have shown that long-term oxygen therapy (LTOT) reduces mortality in:
1) cryptogenic fibrosing alveolitis
2) cor pulmonale due to chronic airflow obstruction
3) asthma
4) cystic fibrosis
5) pulmonary sarcoidosis
Answers-2

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105 Top Respiratory Objective Type Questions And Answers

1- The following are recognized features of Pancoast's tumour except:
1) ipsilateral Horner's syndrome
2) wasting of the dorsal interossei
3) pain in the arm radiating to the fourth and fifth fingers
4) erosion of the first rib
5) weakness of abduction at the shoulder
Answers-5

2- Which of the following is true concerning Whooping cough (pertussis)?
1) is a greater threat to children during the second 6 months of life, after maternal antibody has declined, than during the first 6 months
2) may lead to hemiplegia
3) is characteristically associated with a polymorph leucocytosis
4) is associated with convulsions less frequently than is the case with other febrile conditions
5) rapidly resolves with antibiotic treatment
Answers-2

3- A 19-year-old female developed pleural effusions, ascites and ankle swelling. Her blood pressure was 112/76 mmHg.
Investigations revealed:
serum alanine transferase 17 U/L (5 - 15)
serum total bilirubin 17 umol/L (1 - 22)
serum albumin 21 g/L (34 - 94)
serum total cholesterol 9.8 mmol/L (<5.2)
What is the next most appropriate investigation?
1) Antinuclear antibody
2) Pregnancy test
3) Prothrombin time
4) Serum protein electrophoresis
5) Urinary protein estimation
Answers-5

4- A 51 year old businessman complains of dyspnoea on exertion. He recently returned from a business trip to the USA. He has distant heart sounds on auscultation of the chest. A chest radiograph reveals that there is a thin rim of calcification surrounding the cardiac outline. Which of the following conditions is most likely responsible for these findings? 
1) Uraemia
2) Tuberculosis
3) Group B coxsackie virus
4) Sarcoidosis
5) Metastatic carcinoma
Answers-2

5- A 48-year-old woman presented with shortness of breath, cough with heavy sputum production, and a low grade fever. She has smoked 20 cigarettes per day for 30 years. Her arterial blood gases revealed pH of 7.4, PaCO2 of 45 and a PaO2 of 78. What is the most likely diagnosis?
1) Bronchial asthma
2) Chronic bronchitis
3) Cryptogenic fibrosing alveolitis
4) Paraneoplastic syndrome
5) Pulmonary embolism
Answers-2

6- A 49-year-old man with a long history of alcoholism presents with cough, haemoptysis and pleuritic chest pain. He has had night sweats and 10 kg weight loss in the last three months. On chest X-ray tgere is a subtle nodular pattern throughout the lung. He underwent a transbronchial biopsy which showed multinucleated giant cells, epithelioid cells and necrotic debris. Which of the following is the most likely diagnosis?
1) Aspergillosis
2) Pneumocystis carinii pneumonia
3) Small cell carcinoma
4) Squamous cell carcinoma
5) Tuberculosis
Answers-5

7- A 55 year old man who has a 25 year pack history of smoking presents with productive cough with mucoid sputum of 2 year duration. On examination he has scattered ronchi and wheezing. The likeliest diagnosis is :
1) Bronchial Asthma
2) Bronchiectasis
3) Chronic Bronchitis
4) Pneumonitis
5) Fibrosing Alveolitis
Answers-3

8- A 67 year old who is known to suffer from severe chronic bronchitis is admitted from home with an acute exacerbation. Which of the following is true?
1) An Acidosis with a low bicarbonate would be expected
2) Extensor plantar responses feature
3) Gentamicin would be a reasonable initial treatment until cultures are available
4) Oxygen therapy should aim to increase the pO2 to above 8kPa (60mmHg)
5) Peripheral oedema indicates coexisting heart failure
Answers-2

9- A 65-year-old woman, has smoked 50 cigarettes a day for 40 years. She has had increasing dyspnoea for the several years, but no 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. Her vital signs show T° 36.7 C, P 80, RR 15, and BP 120/80 mm Hg. Which of the following cardiac findings is most likely to be present?
1) Mitral valve stenosis
2) Constrictive pericarditis
3) Right ventricular hypertrophy
4) Left ventricular aneurysmm
5) Non-bacterial thrombotic endocarditis
Answers-3

10 -In which of the following cases of lung cancer would surgical resection of the tumour be a reasonable therapeutic option?
1) A 56-year-old woman with an adenocarcinoma of the right lung. CT scan shows enlarged lymph nodes in the right and left hilum. PFTs show an FEV1 of 2.25 L.
(55% predicted).
2) A 59-year-old man who is found at bronchoscopy to have a tumour in the right mainstem bronchus extending to within 1 cm of the carina. Pulmonary Function
Tests (PFTs) show an FEV1 of 2.1 liters (65% of predicted normal).
3) A 62-year-old lady with a small peripheral mass who has elevated liver enzymes and a computed tomography (CT) scan showing probable metastatic deposits in
the liver PFTs show an FEV1 of 3.5 Liters (80% of predicted normal).
4) A 70-year-old man with a right lower lobe tumour 2 cm in diameter with no evidence of regional adenopathy or distant spread of disease. PFTs show an FEV1
of 0.8 Liters (28% predicted).
5) A 71-year-old man with a 3 cm tumor obstructing the right lower lobe bronchus.
PFTs show an FEV1 of 1.98 L. (43% predicted).
Answers-5


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