41- The following is true about Cystic Fibrosis:
1) Is an autosomal dominant condition.
2) Is due to mutation of CFTR gene on chromosome 17
3) Skin test may be positive for aspergillus
4) Median survival rate is 10 to 15 years.
5) Is a cause of mental retardation.
Answers-3
42- A 67-year-old man presents with a long history of cough,breathlessness on minimal exertion and ankle swelling. He smokes 30-40 cigarettes per day.
Investigations are as follows:
Haemoglobin 19g/dl
white blood count 7.3
PaO2 (air) 6.2kPa
PaCO2 (air) 8.9kPa
serum [H+] 44 nmol/l
serum [HCO3] 36 mmol/l
What is the most likely explanation of these results?
1) acute respiratory acidosis
2) chronic respiratory acidosis
3) chronic respiratory alkalosis
4) metabolic acidosis
5) metabolic alkalosis
Answers-2
43- Which of the following statement is true of infections with Mycobacterium tuberculosis:
1) non-sputum producing patients are non-infectious
2) a positive tuberculin test indicates active disease
3) lymph node positive disease requires longer treatment than pulmonary disease
4) in pregnant women treatment should not be given until after delivery
5) pyrazinamide has high activity against active extracellular organisms
Answers-1
44- In restrictive lung disease due to respiratory muscle weakness, which of the following statements is true?
1) Low FEV1/FVC, high RV/TLC
2) Low FEV1/FVC, normal TLC
3) Low VC, low FEV1, normal TLC, low RV/TLC
4) Low VC, low RV, low TLC
5) Low VC, low TLC, high RV/TLC
Answers-5
45- Which of the following would be the least likely finding in a patient with sarcoidosis?
1) Hepatic granulomas
2) Restrictive pulmonary function tests
3) Skin lesions
4) Uveitis
5) X bodies on bronchoalveolar lavage (BAL) fluid
Answers-5
46- A 72-year-old lifelong smoker presents with progressive dyspnoea on exertion. He has a chronic, nonproductive cough. On examination he is thin, breathing with pursed lips, respiratory rate 25/min, with mild wheezing on chest auscultation.
Investigations show
FEV1 0.8 L
FVC 1.6 L
pH 7.35
paCO2 45 mmHg
paO2 55 mmHg
What is the predominant mechanism of the airflow limitation in this gentleman?
1) Bronchospasm
2) Foreign body obstruction
3) Increased airways resistance
4) Loss of elastic recoil
5) Mucus plugging in the small airways
Answers-4
47- Which of the following statements regarding cryptogenic fibrosing alveolitis is correct?
1) Active inflammation may be suggested by a CT scan
2) peak flow rate is a good guide to severity
3) 80 per cent of patients iniiration
4) Reduced cardiac output
5) Reduced airway resistance
Answers-1
48- A 54-year old woman was admitted with acute breathlessness. On examination she had a temperature of 37.9oC, a respiratory rate of 32 breaths per minute, a pulse of 120 beats per minute, a blood pressure of 100/60 mmHg, and a peak expiratory flow rate of 250 litres per minute. Auscultation of the heart and chest was normal. The Chest X-ray was normal and blood gases on air showed: pH 7.35 (7.36 - 7.44)
Pa02 6.0
kPa (11.3 - 12.6)
PaC02 3.9
kPa (4.7 - 6.0)
Serum bicarbonate 20 mmol/l (20 - 28)
She was started on high flow oxygen. What is the most important next treatment?
1) amoxycillin intravenously
2) aminophylline intravenously
3) intravenous fluids
4) low molecular weight heparin
5) nebulised salbutamol
Answers-5
49- A 76-year-old with a recent history of cerebral haemorrhage is admitted with a cough, worsening breathlessness and right pleuritic chest pain. He is also mildly pyrexial. His ventilation-perfusion scan reveals several areas of ventilation/perfusion mismatches. What is the most appropriate line of management?
1) aspirin therapy
2) antibiotics
3) inferior vena cava filter
4) low molecular weight heparin treatment
5) warfarin treatment
Answers-3
50- Which of the following is a recognised feature of massive pulmonary embolism?
1) reduced plasma lactate levels
2) an increase in serum troponin levels
3) an arterial pH less than 7.2
4) blood gases show increased pCO2 on air
5) normal D-dimer levels
Answers-2
1) Is an autosomal dominant condition.
2) Is due to mutation of CFTR gene on chromosome 17
3) Skin test may be positive for aspergillus
4) Median survival rate is 10 to 15 years.
5) Is a cause of mental retardation.
Answers-3
42- A 67-year-old man presents with a long history of cough,breathlessness on minimal exertion and ankle swelling. He smokes 30-40 cigarettes per day.
Investigations are as follows:
Haemoglobin 19g/dl
white blood count 7.3
PaO2 (air) 6.2kPa
PaCO2 (air) 8.9kPa
serum [H+] 44 nmol/l
serum [HCO3] 36 mmol/l
What is the most likely explanation of these results?
1) acute respiratory acidosis
2) chronic respiratory acidosis
3) chronic respiratory alkalosis
4) metabolic acidosis
5) metabolic alkalosis
Answers-2
43- Which of the following statement is true of infections with Mycobacterium tuberculosis:
1) non-sputum producing patients are non-infectious
2) a positive tuberculin test indicates active disease
3) lymph node positive disease requires longer treatment than pulmonary disease
4) in pregnant women treatment should not be given until after delivery
5) pyrazinamide has high activity against active extracellular organisms
Answers-1
44- In restrictive lung disease due to respiratory muscle weakness, which of the following statements is true?
1) Low FEV1/FVC, high RV/TLC
2) Low FEV1/FVC, normal TLC
3) Low VC, low FEV1, normal TLC, low RV/TLC
4) Low VC, low RV, low TLC
5) Low VC, low TLC, high RV/TLC
Answers-5
45- Which of the following would be the least likely finding in a patient with sarcoidosis?
1) Hepatic granulomas
2) Restrictive pulmonary function tests
3) Skin lesions
4) Uveitis
5) X bodies on bronchoalveolar lavage (BAL) fluid
Answers-5
46- A 72-year-old lifelong smoker presents with progressive dyspnoea on exertion. He has a chronic, nonproductive cough. On examination he is thin, breathing with pursed lips, respiratory rate 25/min, with mild wheezing on chest auscultation.
Investigations show
FEV1 0.8 L
FVC 1.6 L
pH 7.35
paCO2 45 mmHg
paO2 55 mmHg
What is the predominant mechanism of the airflow limitation in this gentleman?
1) Bronchospasm
2) Foreign body obstruction
3) Increased airways resistance
4) Loss of elastic recoil
5) Mucus plugging in the small airways
Answers-4
47- Which of the following statements regarding cryptogenic fibrosing alveolitis is correct?
1) Active inflammation may be suggested by a CT scan
2) peak flow rate is a good guide to severity
3) 80 per cent of patients iniiration
4) Reduced cardiac output
5) Reduced airway resistance
Answers-1
48- A 54-year old woman was admitted with acute breathlessness. On examination she had a temperature of 37.9oC, a respiratory rate of 32 breaths per minute, a pulse of 120 beats per minute, a blood pressure of 100/60 mmHg, and a peak expiratory flow rate of 250 litres per minute. Auscultation of the heart and chest was normal. The Chest X-ray was normal and blood gases on air showed: pH 7.35 (7.36 - 7.44)
Pa02 6.0
kPa (11.3 - 12.6)
PaC02 3.9
kPa (4.7 - 6.0)
Serum bicarbonate 20 mmol/l (20 - 28)
She was started on high flow oxygen. What is the most important next treatment?
1) amoxycillin intravenously
2) aminophylline intravenously
3) intravenous fluids
4) low molecular weight heparin
5) nebulised salbutamol
Answers-5
49- A 76-year-old with a recent history of cerebral haemorrhage is admitted with a cough, worsening breathlessness and right pleuritic chest pain. He is also mildly pyrexial. His ventilation-perfusion scan reveals several areas of ventilation/perfusion mismatches. What is the most appropriate line of management?
1) aspirin therapy
2) antibiotics
3) inferior vena cava filter
4) low molecular weight heparin treatment
5) warfarin treatment
Answers-3
50- Which of the following is a recognised feature of massive pulmonary embolism?
1) reduced plasma lactate levels
2) an increase in serum troponin levels
3) an arterial pH less than 7.2
4) blood gases show increased pCO2 on air
5) normal D-dimer levels
Answers-2
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