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Medicine Exam-Style Questions > Respiratory MCQs > Flashcards

Respiratory MCQs Flashcards

1
Q

Match the myoglobin dissociation curve to its description.

A - A sigmoid curve, shifted left

B - A sigmoid curve, shifted right

C - A hyperbolic curve, shifted left

D - A hyperbolic curve shifted right

E - A linear relationship, shifted left

F - A linear relationship, shifted right

G - A sigmoid curve

H - A hyperbolic curve

I - A linear relationship

A

H - A hyperbolic curve

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2
Q

Match the haemoglobin dissociation curve to its description.

A - A sigmoid curve, shifted left

B - A sigmoid curve, shifted right

C - A hyperbolic curve, shifted left

D - A hyperbolic curve shifted right

E - A linear relationship, shifted left

F - A linear relationship, shifted right

G - A sigmoid curve

H - A hyperbolic curve

I - A linear relationship

A

G - A sigmoid curve​

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3
Q

Match the Bohr effect on the haemoglobin dissociation curve to its description.

A - A sigmoid curve, shifted left

B - A sigmoid curve, shifted right

C - A hyperbolic curve, shifted left

D - A hyperbolic curve shifted right

E - A linear relationship, shifted left

F - A linear relationship, shifted right

G - A sigmoid curve

H - A hyperbolic curve

I - A linear relationship

A

B - A sigmoid curve, shifted right

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4
Q

Results in increased pulmonary compliance, produces hyperinflated lungs and will show an obstructive defect on spirometry.

A - Asthma

B - Emphysema

C - Pulmonary fibrosis

D - Obstructive lung disease

E - Restrictive lung disease

F - Pneumonia

G - combined restrictive-obstructive lung disease

H - Normal lungs

A

B - Emphysema

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5
Q

Causes shortness of breath on exertion, a restrictive defect on spirometry and reduced pulmonary compliance but no sign of infection.

A - Asthma

B - Emphysema

C - Pulmonary fibrosis

D - Obstructive lung disease

E - Restrictive lung disease

F - Pneumonia

G - combined restrictive-obstructive lung disease

H - Normal lungs

A

C - Pulmonary fibrosis

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6
Q

Will show a low FVC, a low FEV1 and a low FEV1/FVC% on spirometry

A - Asthma

B - Emphysema

C - Pulmonary fibrosis

D - Obstructive lung disease

E - Restrictive lung disease

F - Pneumonia

G - combined restrictive-obstructive lung disease

H - Normal lungs

A

G - combined restrictive-obstructive lung disease

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7
Q

Match a monoclonal antibody against IgE that also reduces IgE receptor expression to its description.

A - Subcutaneous omalizumab

B - Inhaled sodium cromoglycate

C - Oral theophylline

D - Oral ibuprofen

E - Inhaled salmeterol

F - Inhaled beclometasone

G - Oral prednisolone

H - Inhaled salbutamol

I - Oral montelukast

A

A - Subcutaneous omalizumab

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8
Q

Match a short acting B-2 agonist used to relieve bronchospasm in mild to moderate asthma to its description.

A - Subcutaneous omalizumab

B - Inhaled sodium cromoglycate

C - Oral theophylline

D - Oral ibuprofen

E - Inhaled salmeterol

F - Inhaled beclometasone

G - Oral prednisolone

H - Inhaled salbutamol

I - Oral montelukast

A

H - Inhaled salbutamol

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9
Q

Match an add-on B-2 agonist used in asthma that responds poorly to initial management to its description.

A - Subcutaneous omalizumab

B - Inhaled sodium cromoglycate

C - Oral theophylline

D - Oral ibuprofen

E - Inhaled salmeterol

F - Inhaled beclometasone

G - Oral prednisolone

H - Inhaled salbutamol

I - Oral montelukast

A

E - Inhaled salmeterol

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10
Q

The intracellular mechanisms and processes that comsume oxygen and produce carbon dioxide.

A - Transmjural pressure gradient

B - Boyle’s Law

C - Internal respiration

D - External respiration

E - Law of LaPlace

F - Type II alveolar cells

G - Alveolar interdependence

H - Elastic recoil

I - Alveolar surfactant

J - Intrapleural fluid

A

C - Internal respiration

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11
Q

At a constant temperature, the pressure exerted by a gas varies inversely with the volume of the gas.

A - Transmjural pressure gradient

B - Boyle’s Law

C - Internal respiration

D - External respiration

E - Law of LaPlace

F - Type II alveolar cells

G - Alveolar interdependence

H - Elastic recoil

I - Alveolar surfactant

J - Intrapleural fluid

A

B - Boyle’s Law

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12
Q

P=2T/r describes the relationship between alveolar radius and the tendency to collapse. A smaller alveolar radius means a higher tendency to collapse.

A - Transmjural pressure gradient

B - Boyle’s Law

C - Internal respiration

D - External respiration

E - Law of LaPlace

F - Type II alveolar cells

G - Alveolar interdependence

H - Elastic recoil

I - Alveolar surfactant

J - Intrapleural fluid

A

E - Law of LaPlace

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13
Q

Fick’s law of diffusion

A - Smaller alveoli have a greater tendency to collapse

B - Gas diffusion accross a surface is proportional to surface thickness and inversely proportional to its area

C - Larger alveoli have a greater tendency to collapse

D - The total pressure of a mixture of gases equals the sum of the partial pressures of each component gas

E - Alveolar surfactant helps prevent alveolar collapse

F - The total pressure of a mixtureof gases equals the product of the partial pressures of each component gas

G - Gas diffusion across a surface is proportional to surface thickness and area

H - The total pressure of a mixtureof gas equals the mean of the partial pressures of each component gas

I - Gas diffusion across a surface is inversely proportional to surface thickness and proportioal to area

A

I - Gas diffusion across a surface is inversely proportional to surface thickness and proportioal to area

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14
Q

Dalton’s Law

A - Smaller alveoli have a greater tendency to collapse

B - Gas diffusion accross a surface is proportional to surface thickness and inversely proportional to its area

C - Larger alveoli have a greater tendency to collapse

D - The total pressure of a mixture of gases equals the sum of the partial pressures of each component gas

E - Alveolar surfactant helps prevent alveolar collapse

F - The total pressure of a mixtureof gases equals the product of the partial pressures of each component gas

G - Gas diffusion across a surface is proportional to surface thickness and area

H - The total pressure of a mixtureof gas equals the mean of the partial pressures of each component gas

I - Gas diffusion across a surface is inversely proportional to surface thickness and proportioal to area

A

D - The total pressure of a mixture of gases equals the sum of the partial pressures of each component gas

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15
Q

The law of LaPlace

A - Smaller alveoli have a greater tendency to collapse

B - Gas diffusion accross a surface is proportional to surface thickness and inversely proportional to its area

C - Larger alveoli have a greater tendency to collapse

D - The total pressure of a mixture of gases equals the sum of the partial pressures of each component gas

E - Alveolar surfactant helps prevent alveolar collapse

F - The total pressure of a mixtureof gases equals the product of the partial pressures of each component gas

G - Gas diffusion across a surface is proportional to surface thickness and area

H - The total pressure of a mixtureof gas equals the mean of the partial pressures of each component gas

I - Gas diffusion across a surface is inversely proportional to surface thickness and proportioal to area

A

A - Smaller alveoli have a greater tendency to collapse

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16
Q

Where the middle lobe is ausculated

A - Right 4th rib

B - Rib 2

C - Rib 6

D - Superior to the clavicle

E - Between ight ribs 4 and 6

F - 2nd intercostal space

G - T11 vertebra

H - Xiphoid process

I - T3 vertebra

J - 5th intercostal space

A

E - Between ight ribs 4 and 6

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17
Q

The site of the lung apex

A - Right 4th rib

B - Rib 2

C - Rib 6

D - Superior to the clavicle

E - Between ight ribs 4 and 6

F - 2nd intercostal space

G - T11 vertebra

H - Xiphoid process

I - T3 vertebra

J - 5th intercostal space

A

D - Superior to the clavicle

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18
Q

Where the lung base is auscultated

A - Right 4th rib

B - Rib 2

C - Rib 6

D - Superior to the clavicle

E - Between ight ribs 4 and 6

F - 2nd intercostal space

G - T11 vertebra

H - Xiphoid process

I - T3 vertebra

J - 5th intercostal space

A

G - T11 vertebra

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19
Q

An 18 year old man is admitted to hospital to hospital acutely short of breath. He cannot speak in full sentences and is audibly wheezing. He has been given a beta-2 adrenoceptor agonist and steroids, and his doctor wishes to give him a further inhaled drug.

A - Salbutamol as requires

B - Inhaled beclometasone

C - Oral prednisolone

D - Nebulised salbutamol

E - Domicilary oxygen

F - IV aminophylline

G - Nebulised ipratropium

H - Oral carbocysteione

I - Oral theophylline

J - Subcutaneous omalizumab

A

G - Nebulised ipratropium

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20
Q

An 68 year old man. with long-standing COPD has been prescribed several medications. However, he is struggling to cope at home, and when he is examined you see SaO2 is 82%.

A - Salbutamol as requires

B - Inhaled beclometasone

C - Oral prednisolone

D - Nebulised salbutamol

E - Domicilary oxygen

F - IV aminophylline

G - Nebulised ipratropium

H - Oral carbocysteione

I - Oral theophylline

J - Subcutaneous omalizumab

A

E - Domicilary oxygen

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21
Q

A 22 year old woman has been using a reliever inhaler for some time, but is finding she is now wheezing and feels more breathless when she exercises.

A - Salbutamol as requires

B - Inhaled beclometasone

C - Oral prednisolone

D - Nebulised salbutamol

E - Domicilary oxygen

F - IV aminophylline

G - Nebulised ipratropium

H - Oral carbocysteione

I - Oral theophylline

J - Subcutaneous omalizumab

A

B - Inhaled beclometasone

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22
Q

Equals expiratory reserve volume plus residual volume

A - Tidal colume

B - Vital capacity

C - Inspiratory capacity

D - Expiratory reserve volume

E - Residual volume

F - Inspiratory reserve volume

G - Functional residual capacity

H - Total lung capacity

A

G - Functional residual capacity

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23
Q

Equals inspiratory reserve volume plus tidal volume

A - Tidal colume

B - Vital capacity

C - Inspiratory capacity

D - Expiratory reserve volume

E - Residual volume

F - Inspiratory reserve volume

G - Functional residual capacity

H - Total lung capacity

A

C - Inspiratory capacity

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24
Q

The maximum volume of air that can be inspired at the end of a normal, quiet respiration

A - Tidal colume

B - Vital capacity

C - Inspiratory capacity

D - Expiratory reserve volume

E - Residual volume

F - Inspiratory reserve volume

G - Functional residual capacity

H - Total lung capacity

A

C - Inspiratory capacity

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25
Q

A 40 year old woman has been treated for asthma for several years, and has known allergies to various allergens including the house dust mite. She has been escalated through the available therapy and is still poorly controlled, with frequent exabations and hospital admissions. She already takes a beta-2 adrenoceptor agonist, an inhaled and an oral steroid and several ass-on treatments. She is particularly worried about steroid side effects

A - Salbutamol as required

B - Inhaled beclomethasone

C - Oral prednisolone

D - Nebulised salbutamol

E - Domicilary oxygen

F - IV aminophylline

G - Nebulised ipratropium

H - Oral carbocysteine

I - Oral theorphylline

J - Subcutaneous omalizumab

A

J - Subcutaneous omalizumab

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26
Q

A 66 year old man with a long-standing history of COPD is finding it increasingly difficult to breathe, despite being on several different medications. He tells his GP that he cannot cough as easily and struggles to expectorate sputum. He is already recieveing physiotherapy.

A - Salbutamol as required

B - Inhaled beclomethasone

C - Oral prednisolone

D - Nebulised salbutamol

E - Domicilary oxygen

F - IV aminophylline

G - Nebulised ipratropium

H - Oral carbocysteine

I - Oral theorphylline

J - Subcutaneous omalizumab

A

H - Oral carbocysteine

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27
Q

These chemoreceptors detect arterial oxygen partial pressure. When stimulated, they cause hyperventilation and increased cardiac output.

A - Central chemoreceptors in the pons

B - Central chemoreceptors in the midbrain

C - Central chemoreceptors in the medulla

D - Chemoreceptors in the kidney

E - Chemoreceptors in the carotid bodies only

F - Peripheral chemoreceptors in the pons

G - Chemoreceptors in the aortic bodies only

H - Peripheral chemoreceptors in the medulla

I - Peripheral chemoreceptors

J - Peripheral chemoreceptors in the midbrain

A

I - Peripheral chemoreceptors

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28
Q

These chemoreceptors are found in the brainstem. They respond to CSF [H+].

A - Central chemoreceptors in the pons

B - Central chemoreceptors in the midbrain

C - Central chemoreceptors in the medulla

D - Chemoreceptors in the kidney

E - Chemoreceptors in the carotid bodies only

F - Peripheral chemoreceptors in the pons

G - Chemoreceptors in the aortic bodies only

H - Peripheral chemoreceptors in the medulla

I - Peripheral chemoreceptors

J - Peripheral chemoreceptors in the midbrain

A

C - Central chemoreceptors in the medulla

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29
Q

These chemoreceptors, when stimulated, can compensate for metabolic acidosis by triggering increased elimination of CO2.

A - Central chemoreceptors in the pons

B - Central chemoreceptors in the midbrain

C - Central chemoreceptors in the medulla

D - Chemoreceptors in the kidney

E - Chemoreceptors in the carotid bodies only

F - Peripheral chemoreceptors in the pons

G - Chemoreceptors in the aortic bodies only

H - Peripheral chemoreceptors in the medulla

I - Peripheral chemoreceptors

J - Peripheral chemoreceptors in the midbrain

A

I - Peripheral chemoreceptors

30
Q

Match Tiotropium to its mechanism of action.

A - A short acting drug that blocks acetylcholine receptors non-selectively. Can be delivered intranasally to treat rhinorrhoea.

B - An anticholinergic drug, selective for M3 receptors with a long half life.

C - A phosphodiesterase-4 inhibitor, given orally for severe COPD

D - A long-acting beta-2 adrenoceptor agonist. Used in combination with antimuscarinic drugs in increase FEV1 in moderate COPD

E - An inhaled corticosteroid. Used in combination with a beta-2 adrenoceptor agonist, particularly in frequent exacerbations of COPD.

F - A competative H1 receptor antagonist used to treat allergic rhinitis

G - A drug that acts as a mast cell stabiliser, used in asthma llergic rhinitis

H - A cysteinyl leukotriene receptor antagonist used to treat asthma and allergice rhinitis

I - A methylxanthine drug with bronchodilator and anti-inflammatory action. Has many side effects and drug interactions

J - An oral steroid, used in severe or interactable rhinitis, acute asthma or an exacerbation of COPD.

A

B - An anticholinergic drug, selective for M3 receptors with a long half life.

31
Q

Match monteleukast to its mechanism of action.

A - A short acting drug that blocks acetylcholine receptors non-selectively. Can be delivered intranasally to treat rhinorrhoea.

B - An anticholinergic drug, selective for M3 receptors with a long half life.

C - A phosphodiesterase-4 inhibitor, given orally for severe COPD

D - A long-acting beta-2 adrenoceptor agonist. Used in combination with antimuscarinic drugs in increase FEV1 in moderate COPD

E - An inhaled corticosteroid. Used in combination with a beta-2 adrenoceptor agonist, particularly in frequent exacerbations of COPD.

F - A competative H1 receptor antagonist used to treat allergic rhinitis

G - A drug that acts as a mast cell stabiliser, used in asthma llergic rhinitis

H - A cysteinyl leukotriene receptor antagonist used to treat asthma and allergice rhinitis

I - A methylxanthine drug with bronchodilator and anti-inflammatory action. Has many side effects and drug interactions

J - An oral steroid, used in severe or interactable rhinitis, acute asthma or an exacerbation of COPD.

A

H - A cysteinyl leukotriene receptor antagonist used to treat asthma and allergice rhinitis

32
Q

Match beclometasone to its mechanism of action.

A - A short acting drug that blocks acetylcholine receptors non-selectively. Can be delivered intranasally to treat rhinorrhoea.

B - An anticholinergic drug, selective for M3 receptors with a long half life.

C - A phosphodiesterase-4 inhibitor, given orally for severe COPD

D - A long-acting beta-2 adrenoceptor agonist. Used in combination with antimuscarinic drugs in increase FEV1 in moderate COPD

E - An inhaled corticosteroid. Used in combination with a beta-2 adrenoceptor agonist, particularly in frequent exacerbations of COPD.

F - A competative H1 receptor antagonist used to treat allergic rhinitis

G - A drug that acts as a mast cell stabiliser, used in asthma llergic rhinitis

H - A cysteinyl leukotriene receptor antagonist used to treat asthma and allergice rhinitis

I - A methylxanthine drug with bronchodilator and anti-inflammatory action. Has many side effects and drug interactions

J - An oral steroid, used in severe or interactable rhinitis, acute asthma or an exacerbation of COPD.

A

E - An inhaled corticosteroid. Used in combination with a beta-2 adrenoceptor agonist, particularly in frequent exacerbations of COPD.

33
Q

The volume of air in the lungs after a maximal expiration

A - Tidal volume

B - Vital capacity

C - Inspiratory capacity

D - Expiratory reserve volume

E - Residual volume

F - Inspiratory reserve volume

G - Functional residual capacity

H - Total lung capacity

A

E - Residual volume

34
Q

Equals inspiratory reserve volume plus tidal volume plus expiratory reserve volume.

A - Tidal volume

B - Vital capacity

C - Inspiratory capacity

D - Expiratory reserve volume

E - Residual volume

F - Inspiratory reserve volume

G - Functional residual capacity

H - Total lung capacity

A

B - Vital capacity

35
Q

The volume of air in the lungs at the end of a normal, passive expiration.

A - Tidal volume

B - Vital capacity

C - Inspiratory capacity

D - Expiratory reserve volume

E - Residual volume

F - Inspiratory reserve volume

G - Functional residual capacity

H - Total lung capacity

A

G - Functional residual capacity

36
Q

Pseudostratified ciliated columnar epithelium and goblet cells. Incomplete cartilage rings. Basal lamina. Lamina propria of connective tissue and elastic fibres. Submucosa of loose connective tissue and subserous glands

A - Vocal folds

B - Trachea

C - Larynx, excluding the vocal folds

D - Bronchioles

E - Main bronchi

F - Oropharynx

G - Roof of the nasal cavity

H - Nasal cavity

I - Terminal bronchioles

J - Alveoli

A

B - Trachea

37
Q

Pseudostratified ciliated columnar epithelium and goblet cells coverage cartilage and intrinsic muscles.

A - Vocal folds

B - Trachea

C - Larynx, excluding the vocal folds

D - Bronchioles

E - Main bronchi

F - Oropharynx

G - Roof of the nasal cavity

H - Nasal cavity

I - Terminal bronchioles

J - Alveoli

A

C - Larynx, excluding the vocal folds

38
Q

Stratified squamous epithelium surrounded by respiratory epithelium.

A - Vocal folds

B - Trachea

C - Larynx, excluding the vocal folds

D - Bronchioles

E - Main bronchi

F - Oropharynx

G - Roof of the nasal cavity

H - Nasal cavity

I - Terminal bronchioles

J - Alveoli

A

A - Vocal folds

39
Q

A phagocytic cell that migrates up the brochial tree and is eventually swallowed. Also known as a dust cell.

A - Clara cell

B - Type I pneumocyte

C - Type 2 pneumocyte

D - Alveolar macropage

E - Goblet cell

F - Smooth muscle cell

G - Lymphocyte

H - Endothelial cell

I - Olfactory epithelial cell

J - Cubodial epithelial cell

A

D - Alveolar macropage

40
Q

The majority cell type lining the terminal bronchioles.

A - Clara cell

B - Type I pneumocyte

C - Type 2 pneumocyte

D - Alveolar macropage

E - Goblet cell

F - Smooth muscle cell

G - Lymphocyte

H - Endothelial cell

I - Olfactory epithelial cell

J - Cubodial epithelial cell

A

J - Cubodial epithelial cell

41
Q

An immunologically active cell recruited to the lungs in the later stages of inflammation.

A - Clara cell

B - Type I pneumocyte

C - Type 2 pneumocyte

D - Alveolar macropage

E - Goblet cell

F - Smooth muscle cell

G - Lymphocyte

H - Endothelial cell

I - Olfactory epithelial cell

J - Cubodial epithelial cell

A

G - Lymphocyte

42
Q

Phrenic nerves

A - Provides sensory innervation to the nasal mucosa and soft palate

B - Stimulation triggers a reflex cough response

C - Stimulation triggers a reflex sneeze response

D - Provides motor innervation to the diaphragm

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

F - Provides otor innervation to the soft palate and intrinsic laryngeal muscle

G - Innervate the abdominal wall with somatic sensory, somatic motor and sympathetic nerve supply

A

D - Provides motor innervation to the diaphragm

43
Q

Thoracoabdominal nerves

A - Provides sensory innervation to the nasal mucosa and soft palate

B - Stimulation triggers a reflex cough response

C - Stimulation triggers a reflex sneeze response

D - Provides motor innervation to the diaphragm

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

F - Provides otor innervation to the soft palate and intrinsic laryngeal muscle

G - Innervate the abdominal wall with somatic sensory, somatic motor and sympathetic nerve supply

A

G - Innervate the abdominal wall with somatic sensory, somatic motor and sympathetic nerve supply

44
Q

Intercostal nerves

A - Provides sensory innervation to the nasal mucosa and soft palate

B - Stimulation triggers a reflex cough response

C - Stimulation triggers a reflex sneeze response

D - Provides motor innervation to the diaphragm

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

F - Provides otor innervation to the soft palate and intrinsic laryngeal muscle

G - Innervate the abdominal wall with somatic sensory, somatic motor and sympathetic nerve supply

A

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

45
Q

An 18 year old man is admitted with sudden onset shortness of breath and is complaining of right-sided chest pain. On examination he is tachycardic, tachypnoeic and hypertensive. His right side is hyperresonant when percussed. His PA chest X-ray shows a line parallel to the right chest wall.

A - Left upper lobe collapse

B - Right upper lobe collapse

C - Right lower lobe collapse

D - Left lower lobe collapse

E - Right middle lobe pneumonia

F - Lingular pneumonia

G - Left lower lobe pneumonia

H - Left upper lobe pneumonia

I - Right-sided tension pneumothorax

J - Left-sided tension pneumothorax

A

I - Right-sided tension pneumothorax

46
Q

A 60 year old woman is admitted to hospital by her GP. She has been unwell for the past few days and has not responded to the GP’s initial treatment. On examination she is tachycardic, tachypnoeic, pyrexial and mildly hypertensive. On percussion her right middle zone is dull. Her PA chest X-ray shows loss of the right heart border.

A - Left upper lobe collapse

B - Right upper lobe collapse

C - Right lower lobe collapse

D - Left lower lobe collapse

E - Right middle lobe pneumonia

F - Lingular pneumonia

G - Left lower lobe pneumonia

H - Left upper lobe pneumonia

I - Right-sided tension pneumothorax

J - Left-sided tension pneumothorax

A

E - Right middle lobe pneumonia

47
Q

A 20 year old male patient complains of shortness of breath. On PA chest X-ray his right horizontal ssure is displaced. There is an opacity in his upper right zone.

A - Left upper lobe collapse

B - Right upper lobe collapse

C - Right lower lobe collapse

D - Left lower lobe collapse

E - Right middle lobe pneumonia

F - Lingular pneumonia

G - Left lower lobe pneumonia

H - Left upper lobe pneumonia

I - Right-sided tension pneumothorax

J - Left-sided tension pneumothorax

A

B - Right upper lobe collapse

48
Q

A patient is admitted with pyrexia, dyspnoea and a productive cough. On chest X-ray, the left heart border is obscured.

A - Left upper lobe collapse

B - Right upper lobe collapse

C - Right lower lobe collapse

D - Left lower lobe collapse

E - Right middle lobe pneumonia

F - Lingular pneumonia

G - Left lower lobe pneumonia

H - Left upper lobe pneumonia

I - Right-sided tension pneumothorax

J - Left-sided tension pneumothorax

A

F - Lingular pneumonia

49
Q

A 20 year old male patient complains of shortness of breath. On chest X-ray his left oblique ssure is displaced, and the medial left hemidiaphragm is obscured

A - Left upper lobe collapse

B - Right upper lobe collapse

C - Right lower lobe collapse

D - Left lower lobe collapse

E - Right middle lobe pneumonia

F - Lingular pneumonia

G - Left lower lobe pneumonia

H - Left upper lobe pneumonia

I - Right-sided tension pneumothorax

J - Left-sided tension pneumothorax

A

D - Left lower lobe collapse

50
Q

A 20 year old male patient complains of shortness of breath. On lateral chest X-ray his oblique ssure seems to be very anterior, and on PA chest X-ray his left heart border is obscured and there is a veil-like opacity.

A - Left upper lobe collapse

B - Right upper lobe collapse

C - Right lower lobe collapse

D - Left lower lobe collapse

E - Right middle lobe pneumonia

F - Lingular pneumonia

G - Left lower lobe pneumonia

H - Left upper lobe pneumonia

I - Right-sided tension pneumothorax

J - Left-sided tension pneumothorax

A

A - Left upper lobe collapse

51
Q

Intercostal nerves

A - Provides sensory innervation to the nasal mucosa and motor innervation to the soft palate

B - Stimulation triggers a reflex cough response

C - Stimulation triggers a reflex sneeze response

D - Provides motor innervation to the diaphragm

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

F - Provides motor innervation to the soft palate and intrinsic laryngeal muscles

G - Innervate the abdominal wall with somatic sensory, somatc motor and sympathetic nerve supply

A

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

52
Q

Vagus nerve (CN X)

A - Provides sensory innervation to the nasal mucosa and motor innervation to the soft palate

B - Stimulation triggers a reflex cough response

C - Stimulation triggers a reflex sneeze response

D - Provides motor innervation to the diaphragm

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

F - Provides motor innervation to the soft palate and intrinsic laryngeal muscles

G - Innervate the abdominal wall with somatic sensory, somatc motor and sympathetic nerve supply

A

F - Provides motor innervation to the soft palate and intrinsic laryngeal muscles

53
Q

Glossopharyngeal nerve (CN XI) and vagus nerve (CN X)

A - Provides sensory innervation to the nasal mucosa and motor innervation to the soft palate

B - Stimulation triggers a reflex cough response

C - Stimulation triggers a reflex sneeze response

D - Provides motor innervation to the diaphragm

E - Provides motor innervation to the intercostal muscles and anterolateral abdominal wall muscles

F - Provides motor innervation to the soft palate and intrinsic laryngeal muscles

G - Innervate the abdominal wall with somatic sensory, somatc motor and sympathetic nerve supply

A

B - Stimulation triggers a reflex cough response

54
Q

A 22 year old nursery nurse visits her GP for the fourth time this year. She has had multiple chest infections and is worrying about how much time she needs to spend away from work. She says she is coughing up yellow-green phlegm most of the time and experiences chest pain. She is referred to the chest clinic. Investigations include a HRCT, which does not show widened airways. Her sputum does return abnormal growth.

A - Empyema

B - Cystic brosis

C - Intrapulmonary abscess

D - Pneumonia

E - Right sided bacterial endocarditis

F - Kartagener’s syndrome

G - Bronchiectasis

H - Pharyngeal pouch

I - Chronic bronchial sepsis

J - Simple eusion

A

I - Chronic bronchial sepsis

55
Q

A 43 year old man who is normally t and well fails to recover from what he thought was a winter cold. He is admitted to hospital and diagnosed with community acquired pneumonia. A repeat CXR shows a D sign, and his pleural tap is frank pus.

A - Empyema

B - Cystic brosis

C - Intrapulmonary abscess

D - Pneumonia

E - Right sided bacterial endocarditis

F - Kartagener’s syndrome

G - Bronchiectasis

H - Pharyngeal pouch

I - Chronic bronchial sepsis

J - Simple eusion

A

A - Empyema

56
Q

A 5 year old girl is referred to hospital by her GP, primarily for failure to thrive. When taking a history with her parents, you discover she struggles to gain weight. She is small for her age. Her parents say she is intolerant to many foods, and often complains of an upset tummy and what sounds like steatorrhoea. She has had multiple chest infections that don’t respond well for antibiotics, and a HRCT shows widened airways. Genetic testing revels a recessive defect.

A - Empyema

B - Cystic brosis

C - Intrapulmonary abscess

D - Pneumonia

E - Right sided bacterial endocarditis

F - Kartagener’s syndrome

G - Bronchiectasis

H - Pharyngeal pouch

I - Chronic bronchial sepsis

J - Simple eusion

A

B - Cystic brosis

57
Q

Early morning headache, no photophobia, distended external jugular vein, anastamoses visible on abdomen.

A - Finger clubbing

B - Stridor

C - Superior vena cava obstruction

D - Horner’s syndrome

E - Pericardial invasion

F - lymphadenopathy

G - Thrombophlebitis

H - Pancoast tumour

I - Eaton Lambert syndrome

J - hypertrophic pulmonary osteoarthropathy

A

C - Superior vena cava obstruction

58
Q

A paraneoplastic change aecting the ends of long bones, causing pain and altered shape.

A - Finger clubbing

B - Stridor

C - Superior vena cava obstruction

D - Horner’s syndrome

E - Pericardial invasion

F - lymphadenopathy

G - Thrombophlebitis

H - Pancoast tumour

I - Eaton Lambert syndrome

J - hypertrophic pulmonary osteoarthropathy

A

J - hypertrophic pulmonary osteoarthropathy

59
Q

A non-specic sign of respiratory disease, with loss of nail bed angle and increased uctuation on examination.

A - Finger clubbing

B - Stridor

C - Superior vena cava obstruction

D - Horner’s syndrome

E - Pericardial invasion

F - lymphadenopathy

G - Thrombophlebitis

H - Pancoast tumour

I - Eaton Lambert syndrome

J - hypertrophic pulmonary osteoarthropathy

A

A - Finger clubbing

60
Q

Occurs when the airway is narrowed. May be distressing, can be associated with shortness of breath. Can be relieved with stents.

A - Finger clubbing

B - Stridor

C - Superior vena cava obstruction

D - Horner’s syndrome

E - Pericardial invasion

F - lymphadenopathy

G - Thrombophlebitis

H - Pancoast tumour

I - Eaton Lambert syndrome

J - hypertrophic pulmonary osteoarthropathy

A

B - Stridor

61
Q

An interruption in the sympathetic chain aecting the innervation of the face. Includes ptosis, anhydrosis and miosis.

A - Finger clubbing

B - Stridor

C - Superior vena cava obstruction

D - Horner’s syndrome

E - Pericardial invasion

F - lymphadenopathy

G - Thrombophlebitis

H - Pancoast tumour

I - Eaton Lambert syndrome

J - hypertrophic pulmonary osteoarthropathy

A

D - Horner’s syndrome

62
Q

A lung cancer in the apex of the lung which can invade into the brachial plexus, causing wasting of the small muscles of the hand and interrupts sympathetic innervation to the head.

A - Finger clubbing

B - Stridor

C - Superior vena cava obstruction

D - Horner’s syndrome

E - Pericardial invasion

F - lymphadenopathy

G - Thrombophlebitis

H - Pancoast tumour

I - Eaton Lambert syndrome

J - hypertrophic pulmonary osteoarthropathy

A

H - Pancoast tumour

63
Q

Have a major role in innate immunity. Kill pathogens by oxidative free radicals. Can test function using the NBT (nitroblue tetrazdium) test. Important in the defence against bacterial and fungal infection.

A - CD4 T cell

B - memory B cell

C - plasma cell

D - CD8 T cell

E - interleukin 2 recepto

F - complement

G - neutrophil

H - Fc receptor

I - macrophage

J - NK cell

A

G - neutrophil

64
Q

Respond to pathogen peptides bound to HLA class 1 molecules. Directly kill infected cells via the production of perforin, inducing apoptosis. Protect against viral infections and tumours.

A - CD4 T cell

B - memory B cell

C - plasma cell

D - CD8 T cell

E - interleukin 2 recepto

F - complement

G - neutrophil

H - Fc receptor

I - macrophage

J - NK cell

A

D - CD8 T cell

65
Q

Antibody producing cells. Fully dierentiated.

A - CD4 T cell

B - memory B cell

C - plasma cell

D - CD8 T cell

E - interleukin 2 recepto

F - complement

G - neutrophil

H - Fc receptor

I - macrophage

J - NK cell

A

C - plasma cell

66
Q

Infects children, with peak incidence in winter. May be secondary to another infection, and can cause mild to severe illness, which may be u-like. Diagnosis is conrmed by PCR.

A - Inuenza A

B - Haemophilus inuenzae

C - Parainuenza

D - Chlamidophila psittaci

E - Mycoplasma pneumoniae

F - Respiratory syncytial virus

G - Chlamydia trachomatis

H - Streptococcus pneumoniae

I - Metapneumovirus

J - Coxiella burnetti

A

I - Metapneumovirus

67
Q

The commonest cause of bronchiolitis. Diagnosis is by PCR on throat or pernasal swabs. Treatment is supportive.

A - Inuenza A

B - Haemophilus inuenzae

C - Parainuenza

D - Chlamidophila psittaci

E - Mycoplasma pneumoniae

F - Respiratory syncytial virus

G - Chlamydia trachomatis

H - Streptococcus pneumoniae

I - Metapneumovirus

J - Coxiella burnetti

A

F - Respiratory syncytial virus

68
Q

A sexually-transmitted infection that can cause infantile pneumonia by vertical transmission.

A - Inuenza A

B - Haemophilus inuenzae

C - Parainuenza

D - Chlamidophila psittaci

E - Mycoplasma pneumoniae

F - Respiratory syncytial virus

G - Chlamydia trachomatis

H - Streptococcus pneumoniae

I - Metapneumovirus

J - Coxiella burnetti

A

G - Chlamydia trachomatis

69
Q

A boy is referred to genetics following investigation for repeated infections. He has had multiple viral and bacterial infections, and has had recurrent oral candidiasis. Clinically he has multiple facial features suggestive of a genetic cause to his condition. His investigations to date have revealed a low T cell count and hypocalcaemia. His cardiovascular system is abnormal.

A - Congenital neutropenia

B - Severe Combined Immunodeciency

C - Chronic granulomatous disease

D - Di George syndrome

E - Reactivation of latent tuberculosis

F - transient hypogammaglobulinaemia of infancy

G - Kostmann syndrome

H - Graft versus host disease

I - Neutropenic sepsis

J - Cyclic neutropenia

A

D - Di George syndrome

70
Q

A patient with psoriatic arthritis is started on an immunological therapy for their joint disease. They had no clinical features of chest disease prior to treatment, but now they are short of breath and feel generally unwell. A new chest x ray shows a suspicious cavitating lesion in their left lung apex.

A - Congenital neutropenia

B - Severe Combined Immunodeciency

C - Chronic granulomatous disease

D - Di George syndrome

E - Reactivation of latent tuberculosis

F - transient hypogammaglobulinaemia of infancy

G - Kostmann syndrome

H - Graft versus host disease

I - Neutropenic sepsis

J - Cyclic neutropenia

A

E - Reactivation of latent tuberculosis

71
Q

A 3 month old baby boy is referred to dermatology with recurrent skin rashes and infections, and the GP was unsure if this was eczema or another underlying diagnosis. His skin is noted to be abnormal across his whole body, and the underlying diagnosis is found to be a form of SCID, though his skin condition has a specic cause.

A - Congenital neutropenia

B - Severe Combined Immunodeciency

C - Chronic granulomatous disease

D - Di George syndrome

E - Reactivation of latent tuberculosis

F - transient hypogammaglobulinaemia of infancy

G - Kostmann syndrome

H - Graft versus host disease

I - Neutropenic sepsis

J - Cyclic neutropenia

A

H - Graft versus host disease

Medicine Exam-Style Questions (2 decks)

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