Respiratory block MCQs

Questions and Answers

A 60-year-old male with a significant smoking history presents with a persistent cough, weight loss, and haemoptysis. Imaging studies reveal a lung mass.

Which of the following is a characteristic feature of squamous cell carcinoma of the lung?

Peripheral location & glandular differentiation

Central location & keratin pearl formation (correct)

Peripheral location & keratin pearl formation (correct)

Central location & glandular formation

A 32-year-old male presents with a chronic cough, night sweats, weight loss, and haemoptysis. He recently travelled to a country with a high prevalence of tuberculosis. Chest x-ray shows cavitary lesions in the upper lobes.

Which diagnostic test would confirm active tuberculosis?

Tuberculin skin test (TST)

Sputum acid-fast bacilli (AFB) smear and culture (correct)

Chest x-ray

Interferon gamma release assay

A 65-year-old female with a 40-pack-year history of smoking presents with chronic cough, sputum production, and dyspnoea on exertion. Pulmonary function tests show a reduced FEV1/FVC ratio. Which of the following is the most likely diagnosis?

Chronic Obstructive Pulmonary Disease (COPD) (correct)

Asthma

Pulmonary fibrosis

Lung cancer

A 45-year-old male presents to the emergency department with a sudden onset of chest pain and shortness of breath. He has just returned from an overseas trip. What is the most appropriate initial treatment for this patient?

Intravenous heparin Signup and view all the answers

A 30-year-old female presents with fever, productive cough, pleuritic chest pain, and dyspnoea. Chest x-ray shows consolidation in the right lower lobe. What is the most likely causative organism?

Streptococcus pneumoniae Signup and view all the answers

A 70-year-old male with a history of asbestos exposure presents with progressive dyspnoea, chest pain, and weight loss. Which of the following findings is most indicative of mesothelioma?

Pleural plaques & thickening Signup and view all the answers

A 40-year-old female presents with chronic productive cough, haemoptysis, and recurrent pneumonia. High-resolution CT scan shows dilated bronchi with thickened walls. What is the most appropriate management strategy for this patient?

Long-term antibiotic therapy Signup and view all the answers

A 12-year-old male presents with episodes of wheezing, chest tightness, and shortness of breath, particularly at night and during exercise. He has a history of atopic dermatitis. Which of the following is the most appropriate long-term management for his condition?

Inhaled corticosteroids Signup and view all the answers

A 50-year-old female presents with dyspnoea and pleuritic chest pain. Physical examination reveals decreased breath sounds and dullness to percussion on the left side. Thoracentesis shows an exudative effusion. What is the most likely cause of her pleural effusion?

Pneumonia Signup and view all the answers

A 60-year-old male with a history of alcoholism presents with fever, productive cough with foul-smelling sputum, and pleuritic chest pain. Chest x-ray shows a cavity with an air-fluid level in the right lower lobe. What is the most likely causative organism?

Klebsiella pneumoniae Signup and view all the answers

A 65-year-old female presents with progressive dyspnoea on exertion and a dry cough. Pulmonary function tests show a restrictive pattern, and a high-resolution CT scan reveals a honeycomb pattern. What is the likely diagnosis?

Pulmonary fibrosis Signup and view all the answers

A 60-year-old male with a significant smoking history presents with cough, weight loss, and haemoptysis. Imaging studies reveal a centrally located mass, and biopsy confirms small cell lung carcinoma. Which of the following paraneoplastic syndromes is most commonly associated with small cell lung carcinoma?

SIADH Signup and view all the answers

A 5 year old boy presents with fever, cough, and difficulty breathing. His mother reports that he has had similar episodes in the past. Physical examination reveals crackles in the right lower lung zone, and chest x-ray shows consolidation. What is the most likely causative organism?

Streptococcus pneumoniae Signup and view all the answers

A 55-year-old female presents with progressive dyspnoea and a dry cough. She has a history of rheumatoid arthritis. Pulmonary function tests show a restrictive pattern, and a CT scan reveals reticular opacities and honeycombing. What is the likely diagnosis?

Idiopathic pulmonary fibrosis Signup and view all the answers

A 45-year-old male presents with progressive dyspnoea, fatigue, and chest pain. Echocardiography reveals increased pulmonary artery pressure, and right heart catheterisation confirms pulmonary hypertension. What is the most likely underlying cause of pulmonary hypertension in this patient?

Chronic obstructive pulmonary disease (COPD) Signup and view all the answers

A 35-year-old female is admitted to the ICU with severe shortness of breath, hypoxaemia, and bilateral pulmonary infiltrates on chest x-ray following a severe pneumonia. What is the most likely diagnosis?

Acute respiratory distress syndrome (ARDS) Signup and view all the answers

A 6-month-old infant presents with fever, cough, wheezing, and difficulty breathing. She has been diagnosed with bronchiolitis. What is the most likely causative organism?

Respiratory syncytial virus (RSV) Signup and view all the answers

A 40-year-old male presents with cough, dyspnoea, and fatigue. Chest x-ray shows bilateral hilar lymphadenopathy, and a biopsy reveals non-caseating granulomas. What is the most likely diagnosis?

Sarcoidosis Signup and view all the answers

A 50-year-old female presents with cough, dyspnoea, and fatigue after working in a bird breeding facility. Pulmonary function tests show a restrictive pattern, and chest CT reveals ground-glass opacities. What is the most likely diagnosis?

Hypersensitivity pneumonitis Signup and view all the answers

A 54-year-old female smoker presents with progressive weight loss, tiredness, and increasing shortness of breath. Which statement is NOT correct about lung adenocarcinoma?

It often presents as a central lung mass Signup and view all the answers

A 32-year-old male presents with a chronic cough, night sweats, weight loss, and hemoptysis. Chest x-ray shows cavitary lesions in the upper lobes and he has a positive tuberculin skin test. Which statement is NOT correct about tuberculosis?

A positive tuberculin skin test indicates an active infection with the tuberculosis bacteria. Signup and view all the answers

A 65-year-old female with a 40-pack year history of smoking presents with chronic cough, sputum production, and dyspnoea on exertion. Pulmonary function tests show a reduced FEV1/FVC ratio. Which statement is NOT correct about her diagnosis?

There are ground-glass opacities on imaging Signup and view all the answers

A 45-year-old female presents to the emergency department with a sudden onset of chest pain and shortness of breath after returning from a trip overseas. What statement is NOT correct about her diagnosis?

Thrombolytic therapy is the first line treatment Signup and view all the answers

A 30-year-old female presents with fever, productive cough, pleuritic chest pain, and dyspnoea. A chest x-ray shows consolidation in the right lower lobe. Which statement is NOT correct about Community-Acquired Pneumonia (CAP)?

Transudate fluid accumulates in the lower lobe Signup and view all the answers

Which of the following best defines cultural safety?

Effective care by healthcare professionals after reflecting on their cultural identity Signup and view all the answers

What is the initial step in Coffin's Cultural Security Model?

Cultural awareness Signup and view all the answers

What percentage of pharyngitis cases are caused by rhinoviruses?

20% Signup and view all the answers

What happens to alveolar partial pressure of oxygen (PAO2) when there is low ventilation but normal perfusion (low VA/Q ratio)?

PAO2 decreases Signup and view all the answers

Which of the following conditions is associated with a high ventilation-perfusion (VA/Q) ratio?

Pulmonary embolism Signup and view all the answers

What is the primary cause of hypoxaemia in cases of ventilation-perfusion mismatch?

Shunted blood bypassing oxygenation Signup and view all the answers

What is atelectasis?

Collapse of the alveoli Signup and view all the answers

Which respiratory centre is primarily responsible for generating the basic rhythm of breathing?

Dorsal respiratory group (DRG) Signup and view all the answers

Which area of the brainstem coordinates the transition between inhalation and exhalation?

Pneumotaxic centre Signup and view all the answers

Which nerve supplies the anterior 2/3 of the tongue for general sensation?

Lingual nerve (CN V3 branch) Signup and view all the answers

What is the role of the greater petrosal nerve?

Parasympathetic innervation to the nasal cavity and palate Signup and view all the answers

Which cytokines are primarily involved in the stimulation of allergen-specific IgE production?

IL-4 and IL-13 Signup and view all the answers

Which immune cells are primarily responsible for the late-phase reaction in IgE-mediated hypersensitivity?

Eosinophils and Th2 cells Signup and view all the answers

What is the primary function of regulatory T (Treg) cells in allergic responses?

Suppressing Th2 cell responses via IL-10 and TGF-B Signup and view all the answers

What is the primary goal of allergen-specific immunotherapy (SCIT or SLIT)?

To reduce Th2 cell responses and increase blocking antibodies (IgG4) Signup and view all the answers

The presence of which sign on a chest x-ray indicates pneumothorax?

Pleural line with no lung markings peripheral to it Signup and view all the answers

What type of medication is tiotropium?

Long-acting muscarinic antagonist (LAMA) Signup and view all the answers

What class of drugs includes medications like montelukast?

Leukotriene receptor antagonists Signup and view all the answers

What feature is characteristic of obstructive lung diseases?

Increased airway resistance Signup and view all the answers

Which disease is associated with alpha-1 antitrypsin deficiency?

Emphysema Signup and view all the answers

Which clinical feature is NOT typical of chronic bronchitis?

Hyperinflation of the lungs Signup and view all the answers

What is the main cause of bronchiectasis?

Recurrent infections Signup and view all the answers

Which term describes a high-pitched, polyphonic sound produced in the airways during expiration?

Wheeze Signup and view all the answers

Which of the following is NOT a feature of restrictive lung disease?

Increased airway resistance Signup and view all the answers

What histological pattern is commonly associated with ARDS?

Diffuse alveolar damage (DAD) Signup and view all the answers

Which disease is characterised by temporally heterogeneous fibrosis and honeycomb lung?

Idiopathic Pulmonary Fibrosis (IPF) Signup and view all the answers

Which restrictive lung disease is associated with tight non-necrotising granulomas and multisystem involvement?

Sarcoidosis Signup and view all the answers

What is the most common cause of Acute Lung Injury (ALI) leading to ARDS?

Sepsis Signup and view all the answers

Which type of interstitial pneumonia is characterized by polyploid plugs of loose organizing connective tissue in alveolar ducts and alveoli?

Cryptogenic organizing pneumonia (COP) Signup and view all the answers

What oxygen delivery device provides the highest concentration of oxygen?

Non-rebreather mask Signup and view all the answers

What is the recommended target oxygen saturation for a patient with COPD?

88-92% Signup and view all the answers

Which test involves intradermal injection to detect TB infection?

Mantoux test Signup and view all the answers

What form of extrapulmonary TB involves the spine?

Pott’s disease Signup and view all the answers

What statement about pulmonary embolism (PE) is true?

It causes a ventilation-perfusion mismatch Signup and view all the answers

Goodpasture syndrome involves autoantibodies against which structure?

Basement membrane of the a3 chain of collagen IV Signup and view all the answers

Which is NOT a common clinical feature of diffuse pulmonary hemorrhage?

Pleuritic chest pain Signup and view all the answers

Which pathogen is most commonly associated with healthcare-associated pneumonia (HCAP)?

Streptococcus pneumoniae Signup and view all the answers

Which of the following is a common cause of ventilator-associated pneumonia (VAP)?

Methicillin-Resistant Staphylococcus Aureus Signup and view all the answers

What type of pleural effusion is characterized by low glucose levels, pleural fluid acidosis, and elevated LDH?

Complicated parapneumonic effusion Signup and view all the answers

What condition is characterized by abnormal and permanent dilation of bronchi?

Bronchiectasis Signup and view all the answers

Which organism is most commonly responsible for lung abscesses following aspiration?

Klebsiella pneumoniae Signup and view all the answers

What pathogen is associated with melioidosis?

Burkholderia pseudomallei Signup and view all the answers

What is the most common opportunistic infection in HIV patients with a CD4 count below 200 cells/mm3?

Pneumocystitis pneumonia (PCP) Signup and view all the answers

Which pathogen is most commonly associated with community-acquired pneumonia (CAP) in children?

Streptococcus pneumoniae Signup and view all the answers

What is the most common bacterial cause of pharyngitis?

Streptococcus pyogenes Signup and view all the answers

Which treatment is recommended for acute epiglottitis caused by Haemophilus influenzae type B (Hib)?

Ceftriaxone Signup and view all the answers

What pathogen is most commonly responsible for acute otitis media?

Streptococcus pneumoniae Signup and view all the answers

Which condition is characterized by fever, hoarseness, and a barking cough?

Croup Signup and view all the answers

What the most common pathogen associated with chronic sinusitis?

Haemophilus influenzae Signup and view all the answers

Which of the following is a key feature of a granuloma in tuberculosis (TB)?

Granulomas contain central caseous necrosis Signup and view all the answers

What is the significance of a positive IGRA test?

It indicates prior exposure to TB antigens Signup and view all the answers

Which infection control measure is most effective in preventing TB transmission in healthcare settings?

Using N95 masks and natural ventilation Signup and view all the answers

Which type of lung cancer is most commonly found in non-smokers?

Adenocarcinoma Signup and view all the answers

Study Notes

Patient Profile

60-year-old male, significant history of smoking.
Symptomatic with a persistent cough, weight loss, and hemoptysis.

Clinical Signs and Symptoms

Persistent cough indicating possible underlying pathology.
Weight loss suggesting systemic illness or malignancy.
Hemoptysis, a concerning symptom often associated with lung disorders.

Imaging Findings

Centrally located lung mass observed in imaging studies.
Central lung masses often indicate squamous cell carcinoma or other malignancies.

Diagnosis Characteristics

Often associated with a long history of smoking, increasing the risk of lung cancer.
Commonly presents with symptoms such as cough, weight loss, and blood in sputum.
Characteristic features may include cavitation or invasion of adjacent structures depending on the tumor type.

Risk Factors

Strong correlation between smoking history and lung cancer development.
Male gender and older age contribute to increased risk.

Importance of Further Investigation

Need for biopsy and histological examination to confirm diagnosis.
Additional imaging may be required to assess for metastasis.

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Description

Test your knowledge on diagnosing lung cancer in a patient with significant smoking history. Explore the characteristic features that accompany persistent cough, weight loss, and haemoptysis. Are you prepared for the challenges of this critical diagnosis?

Respiratory block MCQs

Questions and Answers

A 60-year-old male with a significant smoking history presents with a persistent cough, weight loss, and haemoptysis. Imaging studies reveal a lung mass. Which of the following is a characteristic feature of squamous cell carcinoma of the lung?

A 32-year-old male presents with a chronic cough, night sweats, weight loss, and haemoptysis. He recently travelled to a country with a high prevalence of tuberculosis. Chest x-ray shows cavitary lesions in the upper lobes. Which diagnostic test would confirm active tuberculosis?

A 65-year-old female with a 40-pack-year history of smoking presents with chronic cough, sputum production, and dyspnoea on exertion. Pulmonary function tests show a reduced FEV1/FVC ratio. Which of the following is the most likely diagnosis?

A 45-year-old male presents to the emergency department with a sudden onset of chest pain and shortness of breath. He has just returned from an overseas trip. What is the most appropriate initial treatment for this patient?

A 30-year-old female presents with fever, productive cough, pleuritic chest pain, and dyspnoea. Chest x-ray shows consolidation in the right lower lobe. What is the most likely causative organism?

A 70-year-old male with a history of asbestos exposure presents with progressive dyspnoea, chest pain, and weight loss. Which of the following findings is most indicative of mesothelioma?

A 40-year-old female presents with chronic productive cough, haemoptysis, and recurrent pneumonia. High-resolution CT scan shows dilated bronchi with thickened walls. What is the most appropriate management strategy for this patient?

A 12-year-old male presents with episodes of wheezing, chest tightness, and shortness of breath, particularly at night and during exercise. He has a history of atopic dermatitis. Which of the following is the most appropriate long-term management for his condition?

A 50-year-old female presents with dyspnoea and pleuritic chest pain. Physical examination reveals decreased breath sounds and dullness to percussion on the left side. Thoracentesis shows an exudative effusion. What is the most likely cause of her pleural effusion?

A 60-year-old male with a history of alcoholism presents with fever, productive cough with foul-smelling sputum, and pleuritic chest pain. Chest x-ray shows a cavity with an air-fluid level in the right lower lobe. What is the most likely causative organism?

A 65-year-old female presents with progressive dyspnoea on exertion and a dry cough. Pulmonary function tests show a restrictive pattern, and a high-resolution CT scan reveals a honeycomb pattern. What is the likely diagnosis?

A 5 year old boy presents with fever, cough, and difficulty breathing. His mother reports that he has had similar episodes in the past. Physical examination reveals crackles in the right lower lung zone, and chest x-ray shows consolidation. What is the most likely causative organism?

A 55-year-old female presents with progressive dyspnoea and a dry cough. She has a history of rheumatoid arthritis. Pulmonary function tests show a restrictive pattern, and a CT scan reveals reticular opacities and honeycombing. What is the likely diagnosis?

A 45-year-old male presents with progressive dyspnoea, fatigue, and chest pain. Echocardiography reveals increased pulmonary artery pressure, and right heart catheterisation confirms pulmonary hypertension. What is the most likely underlying cause of pulmonary hypertension in this patient?

A 35-year-old female is admitted to the ICU with severe shortness of breath, hypoxaemia, and bilateral pulmonary infiltrates on chest x-ray following a severe pneumonia. What is the most likely diagnosis?

A 6-month-old infant presents with fever, cough, wheezing, and difficulty breathing. She has been diagnosed with bronchiolitis. What is the most likely causative organism?

A 40-year-old male presents with cough, dyspnoea, and fatigue. Chest x-ray shows bilateral hilar lymphadenopathy, and a biopsy reveals non-caseating granulomas. What is the most likely diagnosis?

A 50-year-old female presents with cough, dyspnoea, and fatigue after working in a bird breeding facility. Pulmonary function tests show a restrictive pattern, and chest CT reveals ground-glass opacities. What is the most likely diagnosis?

A 54-year-old female smoker presents with progressive weight loss, tiredness, and increasing shortness of breath. Which statement is NOT correct about lung adenocarcinoma?

A 32-year-old male presents with a chronic cough, night sweats, weight loss, and hemoptysis. Chest x-ray shows cavitary lesions in the upper lobes and he has a positive tuberculin skin test. Which statement is NOT correct about tuberculosis?

A 65-year-old female with a 40-pack year history of smoking presents with chronic cough, sputum production, and dyspnoea on exertion. Pulmonary function tests show a reduced FEV1/FVC ratio. Which statement is NOT correct about her diagnosis?

A 45-year-old female presents to the emergency department with a sudden onset of chest pain and shortness of breath after returning from a trip overseas. What statement is NOT correct about her diagnosis?

A 30-year-old female presents with fever, productive cough, pleuritic chest pain, and dyspnoea. A chest x-ray shows consolidation in the right lower lobe. Which statement is NOT correct about Community-Acquired Pneumonia (CAP)?

Which of the following best defines cultural safety?

What is the initial step in Coffin's Cultural Security Model?

What percentage of pharyngitis cases are caused by rhinoviruses?

What happens to alveolar partial pressure of oxygen (PAO2) when there is low ventilation but normal perfusion (low VA/Q ratio)?

Which of the following conditions is associated with a high ventilation-perfusion (VA/Q) ratio?

What is the primary cause of hypoxaemia in cases of ventilation-perfusion mismatch?

What is atelectasis?

Which respiratory centre is primarily responsible for generating the basic rhythm of breathing?

Which area of the brainstem coordinates the transition between inhalation and exhalation?

Which nerve supplies the anterior 2/3 of the tongue for general sensation?

What is the role of the greater petrosal nerve?

Which cytokines are primarily involved in the stimulation of allergen-specific IgE production?

Which immune cells are primarily responsible for the late-phase reaction in IgE-mediated hypersensitivity?

What is the primary function of regulatory T (Treg) cells in allergic responses?

What is the primary goal of allergen-specific immunotherapy (SCIT or SLIT)?

The presence of which sign on a chest x-ray indicates pneumothorax?

What type of medication is tiotropium?

What class of drugs includes medications like montelukast?

What feature is characteristic of obstructive lung diseases?

Which disease is associated with alpha-1 antitrypsin deficiency?

Which clinical feature is NOT typical of chronic bronchitis?

What is the main cause of bronchiectasis?

Which term describes a high-pitched, polyphonic sound produced in the airways during expiration?

Which of the following is NOT a feature of restrictive lung disease?

What histological pattern is commonly associated with ARDS?

Which disease is characterised by temporally heterogeneous fibrosis and honeycomb lung?

Which restrictive lung disease is associated with tight non-necrotising granulomas and multisystem involvement?

What is the most common cause of Acute Lung Injury (ALI) leading to ARDS?

Which type of interstitial pneumonia is characterized by polyploid plugs of loose organizing connective tissue in alveolar ducts and alveoli?

What oxygen delivery device provides the highest concentration of oxygen?

What is the recommended target oxygen saturation for a patient with COPD?

Which test involves intradermal injection to detect TB infection?

What form of extrapulmonary TB involves the spine?

What statement about pulmonary embolism (PE) is true?

Goodpasture syndrome involves autoantibodies against which structure?

Which is NOT a common clinical feature of diffuse pulmonary hemorrhage?

Which pathogen is most commonly associated with healthcare-associated pneumonia (HCAP)?

Which of the following is a common cause of ventilator-associated pneumonia (VAP)?

What type of pleural effusion is characterized by low glucose levels, pleural fluid acidosis, and elevated LDH?

What condition is characterized by abnormal and permanent dilation of bronchi?

Which organism is most commonly responsible for lung abscesses following aspiration?

What pathogen is associated with melioidosis?

What is the most common opportunistic infection in HIV patients with a CD4 count below 200 cells/mm3?

Which pathogen is most commonly associated with community-acquired pneumonia (CAP) in children?

What is the most common bacterial cause of pharyngitis?

Which treatment is recommended for acute epiglottitis caused by Haemophilus influenzae type B (Hib)?

What pathogen is most commonly responsible for acute otitis media?

Which condition is characterized by fever, hoarseness, and a barking cough?

What the most common pathogen associated with chronic sinusitis?

Which of the following is a key feature of a granuloma in tuberculosis (TB)?

What is the significance of a positive IGRA test?

Which infection control measure is most effective in preventing TB transmission in healthcare settings?

Which type of lung cancer is most commonly found in non-smokers?

Study Notes

Patient Profile

A 60-year-old male with a significant smoking history presents with a persistent cough, weight loss, and haemoptysis. Imaging studies reveal a lung mass.

Which of the following is a characteristic feature of squamous cell carcinoma of the lung?

A 32-year-old male presents with a chronic cough, night sweats, weight loss, and haemoptysis. He recently travelled to a country with a high prevalence of tuberculosis. Chest x-ray shows cavitary lesions in the upper lobes.

Which diagnostic test would confirm active tuberculosis?