Practice Questions Single Best Answers

Practice Questions Single Best Answers

SingleBest Answers


1.   Which of these are most commonly associatedwith sarcoidosis?

a)    Erythemanodosum

b)    Erythemamulti form

c)     Gout

d)    Pyodermagangrenosum

2.   Which of these is not a cause ofbronchiectasis?

a)    CysticFibrosis

b)    Bronchialobstruction

c)     Immunodeficiency

d)    Ramipril

3.   Which of the following does not have aroutine role in the management of CF?

a)    Dietaryadvice

b)    Supplementalpancreatic enzymes

c)     Steroids

d)    Antibiotics

4.   Which of the following is associated with thegreatest risk of lung cancer?

a)    Asbestos

b)    Silicaparticles

c)     Coaldust particles

d)    Aspergillusclavatus

5.   Which of the following is not associated withobstructive sleep apnoea?

a)    Morningheadaches

b)    Daytimesleepiness

c)     Obstructivedefect on spirometry

d)    Decreasedlibido

6.   Which of the following is not a cause of pulmonaryhypertension?

a)    COPD

b)    PE

c)     Myocardialinfarction

d)    Motorneuron disease

7.   Which of the following is the most commontype of lung cancer?

a)    Squamouscell carcinoma

b)    Adenocarcinoma

c)     Smallcell lung cancer

d)    Alveolarcell carcinoma




8.   Which of the following is needed to make adiagnosis of COPD?

a)    ChestX-Ray

b)    Highresolution CT scan

c)     Spirometry

d)    Peakflow


9.     A 67 year old man is diagnosed withpneumonia. He has a respiratory rate of 28 breaths per minute, a  blood pressure of 91/58 mmHg, he is notconfused, has a urea of 7.9 mmol/L and a C-reactive protein of 258. What is hisCURB65 score?


a)  0

b) 1

c)  2

d) 3


10.  Which of the following pleural fluid analysisis suggestive of an exudate?


a)  Sample protein 30g/L with a serum protein62g/L

b) Sample protein 29g/L with a serum protein 57g/L

c)  Sample LDH half the upper limit of normal forserum LDH

d) Sample pH 7.4


11.  Which of the following arterial blood gasesis most compatible with acute pulmonary embolism?


a)  PaO2 11 kPa, PCO2 5.9 kPa – on 24% oxygen

b) PaO2 7.1 kPa, PCO2 8.3 kPa – Fi02 0.4

c)  PaO2 8.1 kPa, PC02 3.7 kPa – on room air

d) PaO2 14.1, PCO2 5.0 – on 24% oxygen


12. Features of a pneumothorax include


a)  A dull percussion note

b) Pleural rub

c)  Decreased breath sounds on auscultation

d) Increased vocal fremitus


13.  Patient presents with a peak expiratory flowrate which is 40% of their predicted value, a respiratory rate of 24 breathsper minute, pulse of 108 beats per minute and oxygen saturations of 93% on air.How would you class the severity of this exacerbation of their asthma?


a)  Moderate

b) Acute severe

c)  Life threatening

d) Near fatal


14.        Whichof the following spirometry results demonstrates airflow obstruction?


a)  FEV1 1.5 L, FVC 2.0 L

b) FEV1 2.5 L, FVC 3.0 L

c)  FEV1 0.7, FVC 1.8 L

d) FEV1 0.8, FVC 1.1 L



Extended Matching Questions

Breathlessness on Exertion

a.      Bronchopneumonia

b.     IronDeficiency Anaemia

c.      Congestivecardiac failure

d.     Pulmonarytuberculosis

e.      Sarcoidosis

f.       Pulmonaryembolus

g.      AML

h.     COPD

i.       Pulmonaryfibrosis

j.        CLL


Match thedescription of the patient with the most likely diagnosis


1                   A 70 year old retired boilermaker gives a 5 year history of exertionaldyspnoea, & a dry cough.  The patientis a non-smoker.  On examination, finecrackles are heard at the base of both lung fields.


2                   A 25 year old HIV positive man who has had a productive cough for thelast 3 months with haemoptysis & night sweats.  Chest x-ray shows hilar lymphadenopathy.


3                   A 76 year old lady seven days post-total hip replacement suddenly dropsher saturations to 80%. The nurses note that her right leg had looked red andswollen


4                   A 60 year old publican who smokes 20 cigarettes a day.  He has a 10 year history of having a ‘smokersmorning cough’ when he expectorates clear sputum.  This is worse in the winter when it sometimesturns green & he has to go to his general practitioner forantibiotics.  On examination, he has poorair entry over both lung fields & his Peak Expiratory Flow Rate is 210l/min(reduced by 80%).


5                   A 35 year old lady with shortness of breath & tiredness over 6weeks.  She had decided to consult herdoctor when multiple mauve lesions 1-3cms in diameter appeared over bothshins.  Chest x-ray shows hilarlymphadenopathy.













Causes of Cough

a.      Bronchiectasis

b.     Postnasaldrip

c.      Asthma

d.     Carcinomaof the bronchus

e.      Oesophagealreflux

f.       Foreignbody

g.      COPD

h.     Drugadverse effect

i.       Sarcoidosis

j.        InhaledSubstance


For eachpatient below, choose the SINGLE most likely diagnosis from the above list ofoptions.  


6.              A 58 year old man, who smoked 30 cigarettes a day, presents with a 6week history of cough, malaise, anorexia & weight loss.

7.              A 45 year old woman with essential hypertension is prescribed Lisinopril.  2 weeks later she complains of a constant drycough which keeps her awake. There are no systemic symptoms.


8.              A 40 year old Afro-Caribbean woman presents with bilateral parotidswelling, & painful nodules on the front of her shins.  She has a dry cough & slight shortness ofbreath on exertion.


9.              An 18 year old man presents with a night-time cough & shortness ofbreath while playing football.  This hasgot progressively worse over the previous 2 months.


10.          A 30 year old man, lifelong non-smoker, presents with a history of atleast 6 months of purulent sputum.  Hehas had an infection since an attack of measles at the age of 14.
















Causes of Cough

a.      Tuberculosis

b.     Bronchialcarcinoma

c.      Asthma

d.     Pneumonia

e.      Extrinsicallergic alveolitis

f.       Influenza

g.      Chronicbronchitis

h.     ACEinhibitor therapy

i.       Fibrosingalveolitis

j.        Leftventricular failure


For each ofthe following patients choose the SINGLE most likely diagnosis from the abovelist of options.  


11.          A 50 year old male smoker presents with a 3 month history of cough,haemoptysis & weight loss.  Chestexamination is unremarkable.


12.          A 5 year old child coughs most nights. He has frequent courses of antibiotics for a “bad chest” especially inthe winter.  He also has eczema.


13.          A 50 year old male smoker has a cough productive of clear sputum mostdays especially in the winter.  He hasnot lost weight.  On examination, he hasa hyper-expanded chest & a few scattered wheezes & crackles.


14.          A 40 year old Asian man has a 2 month history of cough, haemoptysis,weight loss & night sweats.  He hasswollen cervical lymph nodes & his trachea is deviated to the left.





















Answers To Practice Questions





1.       A

2.       D

3.       C

4.       A

5.       C

6.       C

7.       A

8.       C

9.       D

10.  B

11.  C

12.  C

13.  B

14.  C



1. I        

2. D      

3. F      

4. H      

5. E      

6. D      

7. H

8. I

9. C

10. A

11. B

12. C

13. G

14. A



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