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Mcq Flashcards

1
Q

Which of the following is FALSE concerning the airflow in the lungs?

A

B. The acini have very small radii significantly increasing the total air flow resistance of the bronchial tree

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2
Q

Presentation of sarcoidosis… all are true except:

A

D. symptoms of hypercalcemia in 50% of cases

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3
Q

Acute exacerbation of COPD may present as all of the following except:

A

fever

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4
Q

Domanda: Which of the following will NOT increase the minute ventilation?

A

A. An increase in arterial pH

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5
Q

Which of the following is FALSE concerning the ventilation and perfusion of different regions ofthe lung?

A

Regional variation in ventilation?perfusion is more efficient for oxygenating blood than is uniform ventilation?perfusion

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6
Q

Which of the ing is FALSE ing the relationships of the variables; in diffusion of O2 across a membrane?

A

The lower the diffusion coefficient, the higher the total flow

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7
Q

Ho spital acquired pneumonia… all are wrong except:

A

include certain types of aspiration pneumonias

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8
Q

Feature suggestive of high mortality in pneumonias… all are true except:

A

B. blood urea more than 17 mg/L

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9
Q

Identify the incorrect statement

A

B. Respiratory muscles are more efficient than large muscle groups

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10
Q

Regarding community acquired pneumonia… identify the false statement

A

C. it is easy to differentiate between typical and atypical pneumonias

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11
Q

T he following microbiological investigations should be done in all cases of community acquired pneumonias… except one investigation:

A

B. pleural fluid aspirate

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12
Q

Which of the following is NOT true concerning respiratory distress syndrome in premature infants?

A

B. Alveoli tend to overexpand and sometimes burst at the end of inspiration

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13
Q

False negative tuberculin test may be seen in all of the following… except:

A

E. early in the course of TB meningitis

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14
Q

Which of the following statements about Hb is FALSE?

A

A. An increase in 2,3?DPG shifts the O2 uptake curve to the left

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15
Q

al veolar ventilation in a minute formula

A

Subtract the volume of dead space from the tidal volume and multiply it by the number of breaths per minute

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16
Q

Regarding the prognosis of COPD…all are true except:

A

. atopy patients have a bad prognosis

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17
Q

management of pneumonia… identify the false statement

A

looking for the development of complications is usually a minor thing

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18
Q

Which of the following does NOT apply to the alveoli at the base of the lungs?

A

They are less elastic than the alveoli at the apex

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19
Q

Cystic fibrosis… all are true except:

A

the commonest mutation is the delta 508 in CFTR gene on chromosome 6

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20
Q

COPD patients in air travel (select wrong answer)

A

Hypercapnia is an absolute contraindication to air travel

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21
Q

Bronchial asthma… in histopathological examination all are true except:

A

D. thickening of the basement membrane is rarely seen

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22
Q

differential diagnosis of pneumonia

A

paracolic abscess

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23
Q

COP
Is

A

characterized by bilateral, multifocal, patchy consolidation and ground?glass abnormalities with reverse halo/atoll sign as hallmark of disease

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24
Q

sarcoidosis (select wrong one)

A

A. STAGE 2 = lymphoadenopathy and parenchymal alterations (90%)

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25
Q

In cases of blunt thoracic trauma the initial assessment with chest radiography should be followed by a contrast-enhanced computed tomography scan:

A

B. when a fracture of the first to third ribs or of the scapula is evident on CXR

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26
Q

most common presentation of sarcoidosis

A

bilateral hilar lymph?node enlargement

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27
Q

An area of increased attenuation with “ground glass” pattern at high resolution CT

A

frequently identifies a reversible disease process

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28
Q

Which of the following is not true at FRC?

A

the relaxation pressure of the lung and chest wall combined is below atmospheric
pressure

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29
Q

Which of the following is false concerning airway resistance?

A

in the later generations, the radii are smaller, increasing the total resistance at each
successive generation

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30
Q

Which of the following is false concerning the effect of effort on airflow and volume during
inspiration and expiration?

A

portions of the inspiratory curve are effort independent

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31
Q

Which of the following does not apply to the alveoli at the base of the lungs?

A

they are less elastic than the alveoli at the apex

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32
Q

Section of the vagus nerve results in

A

all of the above

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33
Q

In contrast to the systemic circulation, the pulmonary circulation is characterized by

A

low mean pressure

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34
Q

Recognized features of chronic obstructive pulmonary disease include the following:

A

it is unusual in the absence of a history of cigarette smoking

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35
Q

Recognized features of cystic fibrosis include the following:

A

sweat testing for chloride > 60 mmol/L remains the gold standard for the diagnosis of CF

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36
Q

Recognized causes of hemoptysis include all the following except:

A

asthma

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37
Q

The following statements about ARDS are correct except

A

pulmonary hypertension is an exceptional finding

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38
Q

) Recognized causes of obstructive sleep apnea include all of the following except

A

arterial hypertension

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39
Q

A 33 y.o. man developed acute respiratory symptoms including high fever and cough. CXR
showed consolidation of right mid-zone. Leucocyte count was 4000/mL with normal
differential count. Attempts to make a blood smear were not successful as the erythrocytes
agglutinated. No bacterial pathogens were cultured.

A

this patient most likely has M.Pneumoniae infection

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40
Q

In a 65 y.o. patient with wheeze, the arterial blood gases analysis showed a PaO2 56 mmHg,
PaCO2 75 mmHg, HCO3- 25 mmol/L and a pH 7.2. His blood pressure is 240/110 mmHg

A

the blood gas picture is most likely due to an acute exacerbation of COPD

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41
Q

Complications of bronchiectasis include:

A

pleural effusion

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42
Q

Causes of cor pulmonal include all the following except

A

mitral stenosis

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43
Q

A 43 y.o. woman present with breathlessness and chest pains. She has a history of pulmonary
fibrosis associated with connective tissue disease. She takes prednisolone, -acetylcysteine,
salbutamol and ipratropium nebulizers. A lung function test was organized to investigate the
cause of breathlessness and results are: FVC (I) (% predicted) 2.28 (66%)
FEV1 (I) (% predicted)
2.04 (70%)
FEV1/FVC (%) 89
Total lung capacity (TLC) 2.9L (70%)
TLCO mmol/kPa/min (%
predicted) 8.5 (110) KCO mmol/kPa/min/L (% predicted) 4.4 (150) What is the diagnosis?

A

pulmonary hemorrhage

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44
Q

A 71 y.o. man who is a heavy smoker has been brought into the hospital, with a history of
cough and breathlessness. He has a history of COPD which has been managed with home
nebulizers but not oxygen. He was given 60% oxygen by the ambulance crew. He appears confused when he was brought into hospital. GCS is 14/15. An arterial blood gas shows: pH 7.21
PaO2 135 mmHg PaCO2 75 mmHg What should be done?

A

stop oxygen

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45
Q

) Exposure to the following is associated with an increased risk of carcinoma of the bronchus
except:

A

sulphur dioxide

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46
Q

Radiological shadowing and peripheral blood eosinophilia may be associated with:

A

extrinsic allergic alveolitis

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47
Q

The following conditions may involve the lung except:

A

gout

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48
Q

The following are true of Goodpasture’s syndrome except:

A

it may be caused by amyloidosis

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49
Q

In emphysema all are correct except:

A

in cigarette smokers it generally affects lower lobes more commonly

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50
Q

Pneumonia due to all of the following organisms frequently cavitates except:

A

mycoplasma pneumoniae

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51
Q

The most prominent effect of acute anoxic anoxia is:

A

lassitude

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52
Q

Air traveling for a patient with COPD… which one is the wrong statement:

A

hypercapnia is an absolute contraindication to air travel

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53
Q

Bronchial asthma… in histopathological examination all are true except:

A

thickening of the basement membrane is rarely seen

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54
Q

) Indications for mechanical ventilation in acute severe asthma… all are true… except:

A

pH less than 7 and rising

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55
Q

A homeless alcoholic presents to your ER complaining of cough, rigors, pleuritic chest pain and
difficulty breathing. Chest radiograph shows a right upper-lobe pneumonia. What organism must be considered?

A

K.Pneumoniae

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56
Q

Which of the following pulmonary infections is most commonly associated with rust colored
sputum?

A

Pneumococcus

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57
Q

A 52 yo gentleman presents with unwell with a cough productive of green sputum with occasional blood flecks. He is also complaining of shortness of breath and has a cold sore. On examination he is pyrexial, tachypneoic, tachycardic and there is left basal coarse crackles

A

Pneumonia due to Streptococcus Pneumoniae

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58
Q

A patient who was previously a coal miner is found on chest X-ray to have numerous small
round opacities with normal lung markings. What is the most likely diagnosis?

A

Simple antracosis (or simple pneumoconiosis category 2)

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59
Q

Which of the following is not a feature of ARDS?

A

Protein low fluid in alveolar space

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60
Q

What percentage increases in FEV1 post bronchodilator, is required for the diagnosis of
asthma?

A

> 12%

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61
Q

A 42 yo with rheumatoid arthritis presents with increasing dyspnea and a non productive
cough. A CXR reveals diffuse reticular opacities and pulmonary functions tests reveal a restrictive pattern. What is the most likely diagnosis?

A

Interstitial lung disease

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62
Q

Which of the following is not a poor prognostic factor for pneumonia?

A

Respiratory rate of 24

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63
Q

In regards with cryptogenic fibrosing alveolitis, which of the following is not true?

A

Reduced elastic recoil

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64
Q

A 55 yo gentleman presents to his GP with hemoptysis. He had a previous history of
tuberculosis. He has a cough and feels fevered at times. A CXR reveals a cavitating lesion in the
left upper lobe. Bloods reveal an elevated aspergillus precipitins. What is the most likely
diagnosis?

A

Aspergilloma

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65
Q

A 48 yo gentleman presents with extreme tiredness and difficulty concentrating. His wife
states he is irritable and he is a very loud snorer and occasionally chokes during the night. His
libido is low, he is suffering from headache and he has been falling asleep during the day as he
feels very unrefreshed after his sleep. His BMI is 35. Given the most likely diagnosis, which of
the following is not a risk factor?

A

Diabetes

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66
Q

Asthma leads to an increase in which of the following?

A

Residual volume

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67
Q

Which of the following is not true regarding alpha 1 antitrypsin deficiency?

A

Most commonly recessively inherited

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68
Q

Substances thought to mediate bronchospasm in asthma include the following except

A

methacholine

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69
Q

A 24 yo male is 160 cm tall and weights 130 kg. he is otherwise healthy and does not smoke.
All the following might be found in this patient except:

A

polycythemia

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70
Q

all the following connective tissue diseases may involve the pleura except:

A

polimyosotos/dermatomyositis

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71
Q

Pleuritis would be most likely in:

A

lobar pneumonia

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72
Q

In a 10 yo girl:

A

cystic fibrosis may be diagnosed for the first time

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73
Q

Radiological shadowing and peripheral blood eosinophilia may be associated with the
following except

A

Hypersensitivity pneumonitis

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74
Q

Which of the following is false concerning the ventilation and perfusion of different regions of
the lung?

A

Alveoli at the top of the lung have a smaller dynamic compliance

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75
Q

Which of the following will not increase the minute ventilation?

A

Increase in alveolar pressure of carbon dioxide

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76
Q

Which of the following is correct concerning alpha1 antitrypsin deficiency

A

The emphysema associated with homozygous deficiency occurs before age 40 rather than
in the fifth or sixth decade

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77
Q

In acute asthmatic attack, all of the following may indicate impending respiratory failure
except:

A

normal arterial carbon dioxide tension

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78
Q

Examination of the chest in pulmonary fibrosis is likely to show:

A

coarse crackles heard only during expiration

79
Q

Cystic fibrosis… all are true except:

A

the commonest mutation is the delta 508 in CFTR gene on chromosome 6

80
Q

Community acquired pneumonias…all are true…except:

A

in any severe community acquired pneumonia, legionella infection has to be excluded

81
Q

The following are true of Goodpasture’s syndrome except

A

A renal biopsy shows membranoproliferative disease with linear IgG deposits on the
glomerular basement membrane

82
Q

False negative tuberculin test may be seen in all of the following… except:

A

AIDS patients

83
Q

A patient presented with pleural plaques and reticular shadowing at the bases

A

asbestosis

84
Q

The patient presents with a history of staphylococcal pneumonia. Bibasal coarse crackles can
be heard

A

bronchiectasis

85
Q

Cystic fibrosis leads to

A

cystic/saccular bronchiectasis

86
Q

Which is not an acute complication of pneumonia?

A

Bronchiectasis

87
Q

Together with primary ciliary dysplasia and sinusitis, the Kartagener triad includes

A

situs inversus

88
Q

The patient has been previously diagnosed with coal worker pneumoconiosis

A

progressive massive fibrosis

89
Q

A flow volume loop is shown. It presents with plateauing of the inspiratory loop only

A

variable extra-thoracic obstruction

90
Q

O2 diffusion rate is decreased by:

A

anemia

91
Q

which is wrong regarding CFTR ( the channel protein, not the gene)

A

idiopathic pancreatitis is associated with abnormalities of CFTR not causing pulmonary disease

92
Q

which of the following causes the greatest increase in arterial O2 delivery?

A

An increase in Hb from 8 to 10

93
Q

Fatal asthma attacks are best predicted by

A

multiple hospital admission

94
Q

Oxygen desaturation in COPD during REM phase is mostly due to

A

intermittent upper respiratory obstruction

95
Q

Which of the following has been proven to improve survival in COPD?

A

Long term oxygen therapy

96
Q

A 25 year old female presents with dry cough, fever and shortness of breath. She has also been
suffering from night sweats and malaise. She has also noticed bruise like lesions on her shins.
She is found to have an elevated ESR and a CXR reveals bilateral hilar lymphadenopathy, a
pleural effusion and evidence of reticulo nodular shadowing in the upper lobes. What is the
most likely diagnosis?

A

Sarcoidosis

97
Q

A 66 year old male is brought in with severe pneumonia. He is in type 1 respiratory failure with
an O2 level of 6.9 kPa. He is normally fit and well and is only on antihypertensives. He states he
does not want to be on a “life support machine”. He requires intubation. What should be done
next?

A

Intubate

98
Q

Which of the following is not an absolute contraindications to CPAP?

A

COPD

99
Q

In which of the following is CPAP contraindicated?

A

Basilar skull fracture

100
Q

When a patient is diagnosed with COPD what is the most important step in management?

A

Smoking cessation

101
Q

What is the most appropriate management of a DVT during pregnancy?

A

Dalteparin

102
Q

Which of the following leads to an elevated alveolar arterial O2 gradient?

A

Pulmonary Embolism

103
Q

A patient is found to have chronic type 2 respiratory failure. Which one of the following is the
most likely cause?

A

Kyphoscoliosis

104
Q

Which of the following leads to low pleural effusion glucose levels?
- Rheumatoid disease

A

Rheumatoid disease

105
Q

Which of the following is not a cause for transudative pleural effusion

A

Pneumonia

106
Q

What is an appropriate treatment regime for someone diagnosed with pulmonary
tuberculosis?

A

Initially rifampicin, isoniazid, ethambutol and pyrazinamide for 2 months then isoniazid an
rifampicin for further 4 months

107
Q

A 72 yo gentleman who was a retired insulator fitter. He is suffering from increasing
shortness of breath and a dry cough. On examination there is evidence of bilateral inspiratory
crackles and clubbing. CXR reveals pleural plaques and reticular shadowing at both bases.
What is the most likely diagnosis?

A

COPD

108
Q

A 14 year old boy wo has previously had a staphylcoccal pneumonia presents with a
chronic very purlent cough with occasional haemoptysis and chest pain. On examination there
is bibasl coarse crackles. What is the most likely diagnosis?

A

Bronchiectasis

109
Q

A patient is found to have a pleural effusion. She states that she has also noticed she has
put on some weight and feels her abdomen is swollen. On examination there is evidence of
ascites and a large mass in her right iliac fossa. After removal of the mass her effusion and
ascites resolve. What is the most likely diagnosis?

A

Meigs syndrome

110
Q

A patient has an abnormal CXR which is suggestive of lung cancer. What investigation
should be performed next?

A

CT chest, abdomen and pelvis

111
Q

A patient presents with a history suggestive of asthma. Which investigation would you
organise next?

A

Pulmonary function tests

112
Q

A patient is suspected of having radiation pneumonitis. Which of the following is most
useful in the management?

A

Steroids

113
Q

Systemic sclerosis is predominantly associated with which one of the following?

A

Pulmonary fibrosis

114
Q

A 37 year old presents with fatigue, weight loss and nausea. He describes episodes of
haemoptysis and has noticed his urine being very dark. On examination he has bibasal
crepitations. His bloods reveal an iron deficiency anaemia and renal impairment and urinalysis
reveals proteinuria and microscopic haematuria. What is the most likely diagnosis?

A

Goddpastures syndrome

115
Q

What would suggest metabolic alkalosis in a patient with a bicarbonate of 36 mmol/l?

A

Raised CO2

116
Q

Which of the following is not useful in the diagnosis of occupational asthma in the primary
care setting?

A

Serial peak flow measurement at home and work

117
Q

Which of the following organisms is one of the most common colonising agents in cystic
fibrosis?

A

Pseudomonas aeruginosa

118
Q

A 32 year old presents with a one week history of malaise, fever, headache, myalgia with a
sore throat, dry cough and pleuritic chest pain. On examination there is bibasal crepitations.
There is evidence of erythema nodosum and bloods reveal a haemolytic anaemia and cold
agglutinins. Given the most likely diagnosis, what treatment should be commenced?

A

Erythromycin

119
Q

Which of the following is not a feature of pulmonary embolism?

A

Bradycardia

120
Q

If a patient has TB but is symptomatic and is clear with the CXR what do you do?

A

Isoniazid and rifampicin for 3 months

121
Q

A 22 year old presents with sudden onset of pleuritic chest pain. He is not breathless and
his saturations are 100%. A Chest Xray reveals a small pneumothorax which is less than 2cm
rim. How should this patient be managed?

A

Outpatient follow up

122
Q

A 44 year old male with a history of COPD presents with pleuritic chest pain. A CXR reveals
an air rim of less than 2cm and sats are 94%. How should this patient me managed initially?

A

Aspiration

123
Q

How are the majority of cases of familial primary pulmonary hypertension inherited?

A

Autosomal dominant

124
Q

A 44 year old male with a history of COPD presents with pleuritic chest pain. A CXR reveals
an air rim of less than 2cm and sats are 94%. How should this patient me managed initially?

A

Aspiration

125
Q

A 40 year old female presents with shortness of breath. She states she has suffered from
numerous chest infections and coughs up large volumes of sputum most days. She also
complains of yellow thickened nails which are slow growing. She is also complaining of
significant ankle swelling. On examination there is reduced air entry on the right side with
dullness to percussion and reduced vocal resonance. What is the most likely diagnosis?

A

Yellow nail syndrome

126
Q

All of these are features of pulmonary embolism except bradycardia. In PE there is
normally a tachycardia although this may be masked if a patient is on beta blockers.

A

Left axis deviation

127
Q

Which of the following leads to increased pulmonary compliance in COPD?

A

Elastic tissue loss

128
Q

Which of the following would lead to whispering pectoriloquy on auscultation?

A

Consolidation

129
Q

What would you expect to find on pulmonary function test in a patient with morbid
obesity?

A

Reduced FVC when lying flat

130
Q

Which of the following is not a risk factor for developing lung cancer?

A

Aromatic amines

131
Q

What is the mechanism of action of salbutamol?

A

Beta2 receptor agonist which increases cAMP levels and leads to muscle relaxation and
bronchodilation

132
Q

What advice should be given to patients specifically after using a steroid inhaler?

A

Rinse out mouth after use

133
Q

Which of the following drugs if utilised at high doses for the management of Tuberculosis,
leads to a peripheral neuropathy?

A

Isoniazid

134
Q

A 72 year old female who is a nursing home resident, with a previous history of a stroke, is
brought to A and E very unwell. She is tachypneoic, pyrexial and there is coarse crepitations in
her right base. What is the most likely diagnosis?

A

Aspiration pneumonia

135
Q

A 37 year old presents with fatigue, weight loss and nausea. He describes episodes of
haemoptysis and has noticed his urine being very dark. On examination he has bibasal
crepitations. His bloods reveal an iron deficiency anaemia and renal impairment and urinalysis
reveals proteinuria and microscopic haematuria. Which autoantibody would you expect to
find?

A

Anti GBM

136
Q

Which of the following is a contraindication to radiotherapy in lung cancer?

A

Malignant pleural effusion

137
Q

In bronchiectasis which part of the airway is affected?

A

Bronchi

138
Q

The sniff test is useful in the diagnosis of which of the following?

A

Phrenic nerve palsy

139
Q

Which of the following is most useful in differentiating ARDS from cardiogenic pulmonary
oedema?

A

Pulmonary catheter wedge pressure <19mmHg

140
Q

A 68 year old male presents with increasing shortness of breath and chest pain. On
examination there is reduced air entry on the left to the mid zone and dullness to percussion.
A Chest Xray reveals a left side pleural effusion. There is history of previous asbestos exposure.
Which investigation will be most useful in providing the definitive diagnosis?

A

Pleural Biopsy

141
Q

Which of the following sentence is false

A

a post-intubation stenosis of the airway never involves the larynx

142
Q

Regarding a thoracic trauma:

A

The main consequences of a thoracic trauma are the result of combined effects on
respiratory and hemodynamic function

143
Q

In tracheobronchial traumas:

A

Iatrogenic lesions are generally linear lesions

144
Q

Concerning tracheal tumors:

A

a characteristic of adenoid cystic carcinoma of the trachea may be the submucosal
extension over the long distances

145
Q

About lung cancer:

A

its incidence in women is decreasing

146
Q

In the pathologic classification of pleural empyema:

A

the third is the “organization” stage

147
Q

The pathogenesis of a pleural effusion in the following pathologies is related to altered
pleural membrane permeability in all cases except:

A

cirrhosis

148
Q

Concerning post-traumatic flail chest:

A

the chest wall moves paradoxically on respiration

149
Q

Which of the following sentences concerning pneumothorax is true?

A

a secondary spontanteous pneumothorax may occur in patients affected by lung
cancer

150
Q

) Concerning tracheal tumors:

A

in adenoid cystic carcinoma spread to para-tracheal or subcarinal lymph nodes
occurs less often than in squamous cell carcinoma

151
Q

Which of the following sentences is true:
Thoracic

A

the treatment of a post-intubation tracheal stenosis may require surgical
resection and reconstruction

152
Q

The most common cancers of the lung are:

A

Adenocarcinomas and squamous cell carcinomas

153
Q

Surgical resection of non small cell lung cancer:

A

A sleeve lobectomy in selected cases may be an alternative to a pneumonectomy

154
Q

Which of the following procedures enables a pleural effusion to be investigated?

A

Videothoracoscopy

155
Q

Studies about imaging based screening programs for lung cancer demonstrated that:

A

annual screening with low-dose computed tomography in heavy smokers is far
superior to conventional X-ray screening and results in 20% fewer deaths from lung cancer

156
Q

High Resolution Computed Tomography (HRCT):

A

is appropriate for the study of interstitial lung diseases

157
Q

Which one of the subsequent signs on chest radiography is not indicative of
pneumothorax:

A

evidence of the meniscus sign

158
Q

Magnetic resonance imaging:

A

is rarely indicated for the assessment of lungs

159
Q

Air bronchogram:

A

is a characteristic sign of logistic consolidation

160
Q

In the Idiopathic Pulmonary Fibrosis:

A

CT findings include honeycombing, peripheral reticular opacities, and minimal
ground-glass abnormality

161
Q

In a posterior-anterior chest radiography:

A

the left heart contour mainly consists in the left lateral border of the left ventricle

162
Q

Which of the subsequent symptoms does not represent a typical indication to perform
a chest X-ray?

A

nausea and headache

163
Q

In a patient with a thoracic trauma, indirect radiological signs that may suggest the
presence of a tracheobronchial lesion may include:

A
  • Pneumomediastinum with associated cervical emphysema
  • persistence of pneumothorax in the presence of functioning chest tubes
  • deviation of the endotracheal tube tip
  • overdistension of the endotracheal cuff
  • ALL OF THE ABOVE
164
Q

A 24 year old male presents with a primary pneumothorax. It is approximately 3 cm and he
is breathless. An aspiration was unsuccessful what is the next step in management?

A

Insertion of a chest drain

165
Q

Which of the following drugs utilised for the management of Tuberculosis, can lead to a
visual disturbance?

A

Ethambutol

166
Q

A 45 year old patient with rheumatoid arthritis has relapsing pneumonia which does not
respond to antibiotics. A CXR reveals bilateral parenchymal opacities. A lung biopsy is
performed and reveals buds of connective tissue within terminal bronchioles and alevolar
ducts. What is the most likely diagnosis?

A

Bronchial artery embolisation

167
Q

Which of the following is not a contraindication for surgical treatment of a bronchial
carcinoma?

A

Paraneoplastic syndrome

168
Q

Caplans syndrome refers to?

A

Rheumatoid lung nodules and pneumoconiosis

169
Q

Which of the following drugs does not require cautious use in asthma?

A

Paracetamol

170
Q

Which of the following leads to hypoxia with a normal Aa gradient?

A

Hypoventilation

171
Q

Which of the following causes of pleural effusion leads to an elevated triglyceride and
cholesterol level in the pleural fluid?

A

Chylothorax

172
Q

Which of the following advice would you give to a young patient who had suffered a
spontaneous pneumothorax?

A

Avoid scuba diving for life

173
Q

A 33 year old male with HIV presents unwell. He has a cough productive of green sputum,
is short of breath and is pyrexial. He is noticed to desaturate on minimal exertion. On
examination there is a few crackles bibasally. A chest X ray reveal perihilar bilateral diffuse
infiltrates. What is the most likely diagnosis?

A

Pneumocystis jiroveci pneumonia

174
Q

Calculate PA02 for a person at sea level for R = 0.82 and PACO2 = 40 mmHg.

A

: 101 mmHg

175
Q

Which is the pathophysiology of a ‘Tension pneumothorax”?

A

Unidirectional air flow entering the pleural space causing a progressive increase of pleural pressure, lung collapse and eventually mediastinal shift C: Pneumothorax associated with pleural effusion

176
Q

which is the definition of a massive haemothorax?

A

A: Presence of more than 1500 ml of blood in the hemithorax, or 200 ml per hour (3 mI/kg/h) from the chest drain

177
Q

non solid lung nodule is:

A

a frequent finding in smokers enrolled in screening program, should be observed for a period and removed only if increase in size, density of positive at PET

178
Q

What is an ‘open pneumothorax’?

A

D: A direct communication between the thoracic cavity and the external environment caused by a penetrating chest wall injury

179
Q

Concerning post traumatic tracheobronchial lesions:

A

A: Airway control is a main issue in the treatment strategy

180
Q

Which sentence is correct on lung cancer patients?

A

: Lung cancer is often a silent disease and thus detected at late stage in absence of screening programs

181
Q

Thymic tumors are frequently associated with an autoimmune disease. Which one is more frequently associated?

A

B: Miasthenia Gravis

182
Q

Which of the following is true about hemopericardium with cardiac tamponade:

A

Removal of little volumes of blood by pericardiocentesis may improve cardiac output

183
Q

The radiological signs of primary tuberculosis may include:

A

A: Parenchymal homogeneous consolidation B: Lung cavities C: Hilar and anorathy D: ALL E: Pleural effusio

184
Q

Thymomas are usually in the:

A

E: Anterior and upper mediastinum

185
Q

Which of the following diseases may cause an exudative pleural effusion?

A

Bacterial infection

186
Q

An area of increased attenuation with “ground glass” “ pattern at high resolution computed tomography:

A

Frequently identify a reversible disease process

187
Q

Select the wrong answer:

A

The three different interstitial components are axial interstitium, coronal interstitium and peripheral interstitium

188
Q

Which of the following establishes the radiographic diagnosis of pneumothorax?

A

D: Visceral pleural line

189
Q

Particles of the following size are deposited in the lower respiratory tract:

A

2 - 5 micron

190
Q

The following are smoking related Interstitial lung diseases EXCEPT:

A

Cryptogenic Organising Pneumonia

191
Q

A 30 year old male presents with a single sudden shaking chill with a rapid rise in temperature. Within a few hours agonizing left pleuritic pain and cough with rust coloured sputum supervene. On examination the man appears acutely ill with rapid shallow respiration. With no treatment he continues to run a temperature up to 40.5 deg C for a week at which time he experiences a dramatic improvement. Physical examination on day 2 of the illness would probably show all of the following over the left chest EXCEPT:

A

decreased fremitus

192
Q

With regards to obstructive sleep apnoca (OSA), which of the following statements is INCORRECT?

A

this syndrome occurs in up to 5% of adults

193
Q

The source of a pleural empyema is an hematogenous infections in % of all cases:

A

15

Pneumo (1 decks)

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