Mcqs Resp 3

MCQs
A 26-year-old female presents with a two-day history of right sided pleuritic chest pain
and shortness of breath. She has recently commenced the combined oral contraceptive
pill. On examination, she appears tachypnoeic and oxygen saturations measure 93% on
room air. You suspect pulmonary embolism.
What is the diagnostic test of your choice?

A. Age-adjusted d-dimers
B. D-dimers [if low suspicion PE to rule out PE if negative, a positive result is not
definitive! Get a CTPA]
C. CT thorax (non-contrast)
D. CT Pulmonary Angiogram
E. High resolution CT Thorax
A 46 year old female patient with asthma presents to the clinic with an increase in her asthma
symptoms. She describes nocturnal wheeze at least two nights per week and worsening
dyspnoea on exertion. She is using her salbutamol at least twice per day. She describes
good compliance with her inhaled corticosteroid and long-acting β2 agonist.
All of the following conditions may exacerbate her asthma except:
A. Chronic sinusitis
B. Depression
C. Gastro-oesophageal reflux
D. Obesity
E. Psoriasis (or IBD)
A 28 year old female with known asthma presents to the emergency department with a two-
day history of increasing cough, wheeze and chest tightness. On examination, she was able
to speak full sentences. Her respiratory rate measured 26 breaths per minute and her
oxygen saturations measured 91% on room air. There was scattered wheeze on auscultation
throughout all lung fields.
All of the following interventions are indicated as part of this patients management plan
except:
A. Nebulised salbutamol
B. Nebulised ipratropium bromide
C. Non-invasive ventilation [contraindicated]
D. Oxygen [bring O2 to 88%-92%]
E. Steroids [prednisolone]
A 58 year old gentleman with a BMI of 38 presents to the respiratory clinic with a 2 year
history of snoring and witnessed apnoeic episodes. You suspect obstructive sleep apnoea
syndrome (OSAS).
All of the following are scoring systems used in the work up of suspected OSAS except:
A. Berlin questionnaire
B. Epworth score
C. GO-SNORE score
D. Mallampati score
E. STOP-BANG score
A 60 year old construction worker presents with shortness of breath, unintentional weight
loss and right sided chest discomfort. He was exposed to asbestos for approximately 10
years.
All of the following are associated with asbestos exposure except:
A. Asbestosis
B. Bronchiectasis
C. Mesothelioma
D. Pleural effusion [malignant Pl Eff]
E. Pleural plaques
An 86 year old female presents with dyspnoea on exertion and a dry cough. Symptoms were
gradually worsening over the past six months. She had a past medical history of
hypertension, Type 2 diabetes, hyperlipidemia, recurrent urinary tract infections and gout.
Her medications included amlodipine, metformin, atorvastatin, nitrofurantoin and
allopurinol. Chest X-ray demonstrated bilateral interstitial changes throughout all lung
fields. You suspect a drug-induced interstitial lung disease.
What is the most likely causative drug?
A. Allopurinol
B. Amlodipine
C. Atorvastatin
D. Metformin
E. Nitrofurantoin [amiodarone, bleomycin, cyclophosphamide, methotrexate]
A 69 year old female presents with cough, fever and purulent green sputum production. She
has no past medical history. On examination, she is orientated and has crepitations in the left
lung base. Her temperature measures 38°C, blood pressure measures 100/70mmHg,
respiratory rate 26 per minute, heart rate 110 beats per minute. Bloods demonstrate a white
cell count of 14 x 1012/L and a urea of 10 mmol/L.
What is her CURB-65 score?
A. CURB-65 score of 0
B. CURB-65 score of 1
C. CURB-65 score of 2
D. CURB-65 score of 3
E. CURB-54 score of 4
A 19 year old female presents to the chest clinic with intermittent wheeze and shortness of
breath. Symptoms are worse at night and after exercise. Chest examination is normal. You
suspect asthma & perform spirometry with reversibility.
Which of the following indicates a significant bronchodilator response?
A. FEV1 improvement of 100mls

B. FEV1 improvement of 200mls [or 12%]
C. FEV1/FVC improvement of 200mls
D. FVC improvement of 12%
E. FVC improvement of 70%
No neuro symptoms
More likely to be ACC
16%
Correct
Female smokers more likely
Wrong; absence of vas deferens, normal sperm production

Common haemoptysis
Pancreatic insufficiency could be developed for CF
Correct
Sputum: S. aureus (>30 y/o p. aeruginosa)
Now used as thoracoscopy

Pleural signs – exudate
No association
Not specific for mesothelioma but true
No sign of crepiations at lung bases

Mcqs Resp 3

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MCQs

What is the diagnostic test of your choice?

All of the following conditions may exacerbate her asthma except:

All of the following are associated with asbestos exposure except:

What is the most likely causative drug?

What is her CURB-65 score?

Which of the following indicates a significant bronchodilator response?

A. FEV1 improvement of 100mls

More likely to be ACC

Wrong; absence of vas deferens, normal sperm production

Now used as thoracoscopy

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