Respiratory exam questions

Question 1

Asthma associated with what hypersensitivity

Answer 1

type 1 hypersensitivity

Question 2

Type 3 hypersensitivity

Answer 2

is immune complex-mediated

free antigens and antibodies form immune complexes

and deposit into specific tissues

Question 3

in patients with COPD what is the most common culprit for pneumoniae

Answer 3

Haemophilus influenzae

Question 4

An anxious mother takes her 5 month to the out of hours GP. He has had a persistent cough for the past 2 days which is worsening. He has an audible wheeze and also a runny nose. The GP makes a diagnosis of bronchiolitis.

Child most likely has

Answer 4

respiratory syncytial virus

Question 5

Pneumocystis jirovecii

Answer 5

causes pneumocystis pneumonia

in patients with a weakened immune system

e.g. AIDS, cancer patients receiving chemotherapy.

Question 6

Ramsay Hunt syndrome

Answer 6

• Bell’s palsy facial paralysis
• in addition to the herpetic rash,
  deafness,
  tinnitus,
  vertigo.
• Sometimes the rash is not visible despite being present.

Question 7

Superior mesenteric artery comes off the abdominal aorta

Answer 7

transpyloric plane - Addison’s plane L1

Question 8

A 22-year-old woman presents to your general practice complaining of ear pain. She reports difficulty hearing on the affected side. On examination, she has a fever. On otoscopy, you note a bulging tympanic membrane. You believe the patient has an infection of the middle ear. Pain from the middle ear is transmitted via which nerve?

Answer 8

Glossopharyngeal nerve

vestibularcochlear nerve for inner ear.

Question 9

A 12-year-old boy presents to the general practice complaining of ear pain. The pain started last night and prevented him from sleeping. He has stayed off school today. He reports that sounds are muffled on the affected side. On otoscopy, you note a bulging tympanic membrane with a visible fluid level behind the tympanic membrane. You suspect he has an infection of the middle ear. Which of the following nerves pass through middle ear?

Answer 9

chorda tympani branch of the facial nerve

Question 10

Peripheral chemoreceptors: located

Answer 10

located in the bifurcation of carotid arteries and arch of the aorta.

They respond to changes in reduced pO2, increased H+ and increased pCO2 in ARTERIAL BLOOD.

Question 11

Central chemoreceptors:

Answer 11

• located in the medulla.

Respond to increased H+ in BRAIN INTERSTITIAL FLUID to increase ventilation.

NB the central receptors are NOT influenced by O2 levels.

Question 12

An elderly lady with long-standing chronic obstructive pulmonary disease (COPD) presents to the hospital with increasing breathlessness and a chesty cough. A chest X-ray is ordered as part of the initial assessment.

what might it show?

Answer 12

flattened diaphragm

Question 13

A 52-year-old woman presents to surgery with a two week history of dizziness when she rolls over in bed. She says it feels like the room is spinning around her. Examination of her ears and cranial nerves is unremarkable. Given the likely diagnosis, what is the most appropriate management?

Answer 13

benign paroxysmal positional vertigo

Epley manoeuvre is for treatment

Question 14

Which one of the following are not characteristic features of central chemoreceptors in the control of ventilation?

Answer 14

venous hypercapnia

Question 15

Meniere’s disease

Answer 15

This is a triad of :

1. vertigo
2. tinnitus
3. fluctuating hearing loss.

Question 16

Acute respiratory distress syndrome (ARDS) is caused by

Answer 16

Acute respiratory distress syndrome (ARDS): increased permeability of alveolar capillaries —–> leading to fluid accumulation in the alveoli

underlying pathophysiology involves a severe inflammatory response in the lungs:
1. sloughing of endothelium

2. leakage of protein-rich exudate into the alveolus
3. surfactant deficiency.

Question 17

A 22-year-old man presents with a 5 day history of sore throat, malaise and fatigue. On examination he has a large peritonsillar abscess. What is the most likely underlying infective organism?

Answer 17

streptococcus pyogenes