MD2 Resp Block MCQs, SAQs PDF

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. Peripheral location & glandular differentiation B...

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. Peripheral location & glandular differentiation B. Central location & keratin pearl formation C. Peripheral location & keratin pearl formation D. Central location & glandular formation ANSWER: B, C 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. Tuberculin skin test (TST) B. Sputum acid-fast bacilli (AFB) smear and culture C. Chest x-ray D. Interferon gamma release assay ANSWER: B 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. Chronic Obstructive Pulmonary Disease (COPD) B. Asthma C. Pulmonary fibrosis D. Lung cancer ANSWER: A 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. Oral antibiotics B. Intravenous heparin C. Inhaled bronchodilators D. Thrombolytic therapy ANSWER: B 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. Streptococcus pneumoniae B. Mycoplasma pneumoniae C. Haemophilus influenzae D. Legionella pneumoniae ANSWER: A 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. Central lung mass B. Peripheral lung nodules C. Pleural plaques & thickening D. Ground-glass opacities ANSWER: C 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. Long-term antibiotic therapy B. Inhaled corticosteroids C. Lung transplant D. Inhaled bronchodilators ANSWER: A 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. Short-acting beta-agonists B. Inhaled corticosteroids C. Oral corticosteroids D. Leukotriene receptor antagonists ANSWER: B 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. Congestive heart failure B. Cirrhosis C. Pneumonia D. Nephrotic syndrome ANSWER: C 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. Klebsiella pneumoniae B. Mycoplasma pneumoniae C. Streptococcus pneumoniae D. Haemophilus influenzae ANSWER: A 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. Emphysema B. Pulmonary fibrosis C. Sarcoidosis D. Bronchiectasis ANSWER: B 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? A. SIADH B. Hypercalcaemia C. Myasthenia gravis D. Polycythemia ANSWER: A 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. Mycoplasma pneumoniae B. Respiratory syncytial virus (RSV) C. Streptococcus pneumoniae D. Haemophilus influenzae ANSWER: C 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. Idiopathic pulmonary fibrosis B. Sarcoidosis C. Lung cancer D. Chronic obstructive pulmonary disease ANSWER: A 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. Chronic obstructive pulmonary disease (COPD) B. Left-sided heart failure C. Pulmonary embolism D. Interstitial lung disease ANSWER: A 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. Congestive heart failure B. Acute respiratory distress syndrome (ARDS) C. Pulmonary embolism D. Chronic obstructive pulmonary disease (COPD) ANSWER: B 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. Parainfluenza virus 1 B. Respiratory syncytial virus (RSV) C. Adenovirus D. Bordetella pertussis ANSWER: B 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. Tuberculosis B. Sarcoidosis C. Silicosis D. Hypersensitivity pneumonitis ANSWER: B 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. Interstitial lung disease (ILD) B. Hypersensitivity pneumonitis C. Pulmonary fibrosis D. Chronic obstructive pulmonary disease (COPD) ANSWER: B 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. It is the most common type of lung cancer in non-smokers B. It often presents as a central lung mass C. EGFR mutations are commonly associated with it D. It usually has a better prognosis than squamous cell carcinoma ANSWER: B 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. It is primarily caused by Mycobacterium tuberculosis. B. It is primarily transmitted via aerosolised droplets. C. Granuloma formation is a key feature of its pathology. D. A positive tuberculin skin test indicates an active infection with the tuberculosis bacteria. ANSWER: D 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. It is characterised by irreversible airflow obstruction B. Smoking is the primary risk factor C. There are ground-glass opacities on imaging D. There are increased neutrophils on histology ANSWER: C 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. A common feature is pleuritic chest pain B. It is the most common cause of lung infarcts C. Thrombolytic therapy is the first line treatment D. It is a common cause of pulmonary hypertension ANSWER: C 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)? A. Antibiotic treatment is usually empirical B. Mild forms are treated with amoxicillin C. It can atypically be caused by Mycoplasma pneumoniae D. Transudate fluid accumulates in the lower lobe ANSWER: D Which of the following best defines cultural safety? A. Awareness of cultural differences B. Effective care by healthcare professionals after reflecting on their cultural identity C. Ensuring healthcare services do not compromise cultural rights D. Inclusion of traditional healing practices ANSWER: B What is the initial step in Coffin's Cultural Security Model? A. Cultural awareness B. Cultural security C. Cultural competence D. Cultural sensitivity ANSWER: A What percentage of pharyngitis cases are caused by rhinoviruses? A. 10% B. 20% C. 30% D. 40% ANSWER: B What happens to alveolar partial pressure of oxygen (PAO2) when there is low ventilation but normal perfusion (low VA/Q ratio)? A. PAO2 increases B. PAO2 decreases C. PAO2 remains the same D. PAO2 fluctuates randomly ANSWER: B Which of the following conditions is associated with a high ventilation-perfusion (VA/Q) ratio? A. Pulmonary embolism B. Chronic bronchitis C. Asthma D. Pulmonary oedema ANSWER: A What is the primary cause of hypoxaemia in cases of ventilation-perfusion mismatch? A. Reduced inspired oxygen B. Diffusion limitations C. Shunted blood bypassing oxygenation D. Increased ventilation ANSWER: C What is atelectasis? A. Inflammation of the pleura B. Collapse of the alveoli C. Swelling of the bronchial tree D. Blockage of the pulmonary artery ANSWER: B Which respiratory centre is primarily responsible for generating the basic rhythm of breathing? A. Pneumotaxic centre B. Ventral respiratory group (VRG) C. Dorsal respiratory group (DRG) D. Apneustic centre ANSWER: C Which area of the brainstem coordinates the transition between inhalation and exhalation? A. Pre-Botzinger complex B. Apneustic centre C. Dorsal respiratory group (DRG) D. Pneumotaxic centre ANSWER: D Which nerve supplies the anterior 2/3 of the tongue for general sensation? A. Glossopharyngeal nerve (CN IX) B. Facial nerve (CN VII) C. Lingual nerve (CN V3 branch) D. Vagus nerve (CN X) ANSWER: C What is the role of the greater petrosal nerve? A. General sensation of the anterior 2/3 of the tongue B. Parasympathetic innervation to the nasal cavity and palate C. Motor innervation to the muscles of mastication D. Sensory innervation to the lower teeth and gums ANSWER: B Which cytokines are primarily involved in the stimulation of allergen-specific IgE production? A. IL-2 and IL-12 B. IL-4 and IL-13 C. IL-1 and TNF-a D. IFN-y and IL-10 ANSWER: B Which immune cells are primarily responsible for the late-phase reaction in IgE- mediated hypersensitivity? A. Neutrophils and macrophages B. Eosinophils and Th2 cells C. B cells and Tregs D. NK cells and dendritic cells ANSWER: B What is the primary function of regulatory T (Treg) cells in allergic responses? A. Stimulating IgE production B. Suppressing Th2 cell responses via IL-10 and TGF-B C. Promoting eosinophil infiltration D. Enhancing mast cell degranulation ANSWER: B What is the primary goal of allergen-specific immunotherapy (SCIT or SLIT)? A. To increase IgE production B. To reduce Th2 cell responses and increase blocking antibodies (IgG4) C. To enhance mast cell sensitivity D. To induce acute hypersensitivity reactions ANSWER: B The presence of which sign on a chest x-ray indicates pneumothorax? A. Air bronchogram B. Silhouette sign C. Pleural line with no lung markings peripheral to it D. Cardiomegaly ANSWER: C What type of medication is tiotropium? A. Short-acting B2 adrenoreceptor agonist (SABA) B. Long-acting muscarinic antagonist (LAMA) C. Inhaled corticosteroids (ICS) D. Leukotriene receptor antagonist ANSWER: B What class of drugs includes medications like montelukast? A. B2 adrenoreceptor agonists B. Leukotriene receptor antagonists C. Inhaled corticosteroids D. Muscarinic antagonists ANSWER: B What feature is characteristic of obstructive lung diseases? A. Reduced total lung capacity B. Increased airway resistance C. Decreased lung compliance D. Increased gas exchange surface area ANSWER: B Which disease is associated with alpha-1 antitrypsin deficiency? A. Chronic bronchitis B. Emphysema C. Asthma D. Bronchiectasis ANSWER: B Which clinical feature is NOT typical of chronic bronchitis? A. Productive cough B. Frequent infections C. Dyspnoea on exertion D. Hyperinflation of the lungs ANSWER: D What is the main cause of bronchiectasis? A. Genetic mutations B. Recurrent infections C. Autoimmune disease D. Environmental toxins ANSWER: B Which term describes a high-pitched, polyphonic sound produced in the airways during expiration? A. Wheeze B. Stridor C. Crackles D. Rales ANSWER: A Which of the following is NOT a feature of restrictive lung disease? A. Reduced total lung capacity B. Decreased forced vital capacity (FVC) C. Increased airway resistance D. Reduced lung compliance ANSWER: C What histological pattern is commonly associated with ARDS? A. Honeycomb lung B. Diffuse alveolar damage (DAD) C. Granulomatous inflammation D. Mucous gland hyperplasia ANSWER: B Which disease is characterised by temporally heterogeneous fibrosis and honeycomb lung? A. Hypersensitivity pneumonitis B. Sarcoidosis C. Idiopathic Pulmonary Fibrosis (IPF) D. Chronic bronchitis ANSWER: C Which restrictive lung disease is associated with tight non-necrotising granulomas and multisystem involvement? A. Idiopathic Pulmonary Fibrosis B. Sarcoidosis C. Pneumoconiosis D. Cryptogenic organising pneumonia ANSWER: B What is the most common cause of Acute Lung Injury (ALI) leading to ARDS? A. Pneumonia B. Sepsis C. Trauma D. Inhalation injury ANSWER: B Which type of interstitial pneumonia is characterized by polyploid plugs of loose organizing connective tissue in alveolar ducts and alveoli? A. Unusual interstitial pneumonia (UIP) B. Non-specific interstitial pneumonia (NSIP) C. Cryptogenic organizing pneumonia (COP) D. Desquamative interstitial pneumonia (DIP) ANSWER: C What oxygen delivery device provides the highest concentration of oxygen? A. Nasal cannula B. Simple face mask C. Venturi mask D. Non-rebreather mask ANSWER: D What is the recommended target oxygen saturation for a patient with COPD? A. 85-90% B. 88-92% C. 92-96% D. 95-100% ANSWER: B Which test involves intradermal injection to detect TB infection? A. Quantiferon-TB test B. Sputum culture C. Mantoux test D. PCR ANSWER: C What form of extrapulmonary TB involves the spine? A. Scrofula B. Pott’s disease C. Intestinal TB D. Miliary TB ANSWER: B What statement about pulmonary embolism (PE) is true? A. It typically causes pale infarcts in the lung B. It cannot lead to right heart failure C. It causes a ventilation-perfusion mismatch D. It is always symptomatic ANSWER: C Goodpasture syndrome involves autoantibodies against which structure? A. Alveolar epithelial cells B. Basement membrane of the a3 chain of collagen IV C. Type I collagen D. Basement membrane of glomeruli ANSWER: B Which is NOT a common clinical feature of diffuse pulmonary hemorrhage? A. Hemoptysis B. Cough C. Pleuritic chest pain D. Dyspnea ANSWER: C Which pathogen is most commonly associated with healthcare-associated pneumonia (HCAP)? A. Streptococcus pyogenes B. Streptococcus pneumoniae C. Staphylococcus aureus D. Candida albicans ANSWER: B Which of the following is a common cause of ventilator-associated pneumonia (VAP)? A. Methicillin-Resistant Staphylococcus Aureus B. Candida albicans C. Staphylococcus epidermis D. Streptococcus pneumoniae ANSWER: A What type of pleural effusion is characterized by low glucose levels, pleural fluid acidosis, and elevated LDH? A. Transudative effusion B. Exudative effusion C. Uncomplicated parapneumonic effusion D. Complicated parapneumonic effusion ANSWER: D What condition is characterized by abnormal and permanent dilation of bronchi? A. Pneumonia B. Bronchiectasis C. Pleurisy D. Emphysema ANSWER: B Which organism is most commonly responsible for lung abscesses following aspiration? A. Klebsiella pneumoniae B. Mycoplasma pneumoniae C. Streptococcus pyogenes D. Haemophilus influenzae ANSWER: A What pathogen is associated with melioidosis? A. Burkholderia pseudomallei B. Legionella pneumophila C. Chlamydophila psittaci D. Coxiella burnetii ANSWER: A What is the most common opportunistic infection in HIV patients with a CD4 count below 200 cells/mm3? A. Aspergillus B. Pneumocystitis pneumonia (PCP) C. Cytomegalovirus (CMV) D. Cryptococcus ANSWER: B Which pathogen is most commonly associated with community-acquired pneumonia (CAP) in children? A. Streptococcus pneumoniae B. Haemophilus influenzae C. Mycoplasma pneumoniae D. Chlamydia pneumoniae ANSWER: A What is the most common bacterial cause of pharyngitis? A. Streptococcus pyogenes B. Staphylococcus aureus C. Haemophilus influenzae D. Mycoplasma pneumoniae ANSWER: A Which treatment is recommended for acute epiglottitis caused by Haemophilus influenzae type B (Hib)? A. Ceftriaxone B. Azithromycin C. Penicillin D. Doxycycline ANSWER: A What pathogen is most commonly responsible for acute otitis media? A. Streptococcus pneumoniae B. Haemophilus influenzae C. Moraxella catarrhalis D. Staphylococcus aureus ANSWER: A Which condition is characterized by fever, hoarseness, and a barking cough? A. Pharyngitis B. Croup C. Bronchiolitis D. Aspiration ANSWER: B What the most common pathogen associated with chronic sinusitis? A. Streptococcus pneumoniae B. Haemophilus influenzae C. Staphylococcus aureus D. Pseudomonas aeruginosa ANSWER: B, D Which of the following is a key feature of a granuloma in tuberculosis (TB)? A. Granulomas are fluid-filled cysts B. Granulomas contain central caseous necrosis C. Granulomas indicate active TB D. Granulomas have infiltrates of lymphocytes ANSWER: B What is the significance of a positive IGRA test? A. It confirms active TB disease B. It indicates prior exposure to TB antigens C. It is used to measure drug resistance D. It confirms immunity to TB ANSWER: B Which infection control measure is most effective in preventing TB transmission in healthcare settings? A. Regular hand washing and using N95 masks B. Wearing surgical masks C. Using N95 masks and natural ventilation D. Prophylactic antibiotics and air purifiers ANSWER: C Which type of lung cancer is most commonly found in non-smokers? A. Small cell carcinoma B. Large cell carcinoma C. Adenocarcinoma D. Squamous cell carcinoma ANSWER: C