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Respiratory Exam for FCPS part 1 exam
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Respiratory Exam for FCPS part 1 exam
Respiratory system for FCPS part 1 exam with Dr Sohrab
1
Personal info
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True or false
3
Multiple choice
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This is true false questions section.
1. Regarding Hb-0₂ dissociation curve- a) Decrease 2,3 DPG shift to right b) Right shift means more oxygen to cells. c) Methamohaemoglobin cause left shift d) Decreased pH shifts left e) Fetal Hb shifts left
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
2. Regarding inspiration- a) Abdominal pressure in more positive b) Diaphragm is flattened c) Anterior posterior diameter is increased d) Lateral diameter of lung is decreased e) Vertical diameter of lung in decreased
Opinion a is true
Opinion a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
3. Life threatening features of Bronchial asthma- a) PEF <30% predicted b) Inability to complete sentence in 1 breath c) Bradycardia d) SPCO₂ < 8 KPa e) Hypertension
Opinion a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
4. Surfactant-
a) Secreted by type I pneumocytes b) Lacking causes lung collapse c) Increases long compliance d) Contains only cholesterol. e) Associated with ARDS
Option a is true
Opinion a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
5. Systemic presentation of extra-pulmonary TB a) Hydrocephalus b) Kyphosis c) Psoas abscess d) Hematuria e) Lymphadenopathy
Option a is true
Opinion a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
6. PaO₂ and ↑ PaCO₂ may occur in - a) Bronchial asthma b) Pneumonia c) Pulmonary thromboembolism d) ARDS e) Lung Fibrosis
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
7. Regarding primary TB- a) MT test is positive b) Primary reaction is as like as vaccination c) Resolve spontaneity d) Give lifelong immunity e) Miliary TB occurs
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
8. CURB-65 for the plan of management of pneumonia include--- a) Convulsions b) Urca <7 mmol/L c) Respiratory rate > 30/min d) BP (systolic <90 mmHg or diastolic < 60 mmHg e) Age 65 pears
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
9. A patient with a chest X-ray showing collapse in right upper zone will have-- a) Reduced respiratory movement in the area b) A central trachea c) No breath sound in the area d) Reduced vocal resonance in the area e) Hyper resonant percussion notes in the area
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
10. FEV₁/VC is reduced in -- a) COPD b) Pulmonary fibrosis c) Pneumothorax d) Bronchiectasis e) Asthma
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
11. What are the causes of Type-I respiratory failure? a) ARDS b) Pneumoyhorax c) GBS d) COPD e) Kyphoscoliosis
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
12. Emphysema-- a) † FEV₁ b) FEV₁/VC ratio c) Residual volume d) ↑ TLC e) KCO decreased
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
13. Organisms associated with atypical pneumonia-- a) Chlamydia psittaci b) Mycoplasma hominis c) Haemophilus influenza d) Chlamydia pneumonia e) Influenza viruses
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
14. Pulmonary circulation -- a) Low blood flow system b) Low pressure system c) Low resistance system d) Low O₂ tension causes increased vascularity of the systemic vessels e) Can accommodate more blood in some conditions
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
15. Physiologic dead space † in -- a) Diaphragmatic palsy b) Emphysema c) COPD d) Asthma e) Fibrosis
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
16. What are the causes of hypoxia with normocapnia -- a) Acute severe asthma b) Narcotic drugs c) Alveolar ventilation d) Lobar collapse e) Brain stem lesion
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
17. Clinical features of sarcoidosis --- a) Bilateral hilar enlargement b) Lymohadenopathy c) No lung parenchymal disease d) Nephrocalcinosis e) Hypercalcemia
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
18. Functional residual capacity is -- a) Volume of air exhaled during expiration b) Maximal amount of air that can be expired c) Amount of air left in the lung at the end of expiration d) Measured by spirometry e) The resting volume of respiration system
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
19. BCG is --- a) A live attenuated vaccine b) Given to tuberculin skin test negative individuals in Bangladesh c) Should not be given to the HIV positive individuals d) Effective in preventing dissemination of tuberculosis e) Derived from mycobacterium africanum
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
20. Cause of hoarseness of voice- (No cold, normal TSH, Laryngoscopy normal) --- a) Paralysis of recurrent laryngeal nerve b) Lesion in cricoaretenoid joint c) Thyroiditis d) Parathyroid disease
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
21. Type II respiratory failure -- a) Hypoxia with hypocapnia b) Hypoxia with hypercapnia c) Respiratory acidosis d) Mismatch ventilation-perfusion e) Reduced total ventilation
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
22. Legionella pneumonia -- a) Fecal-oral route b) Causes diarrhea c) Cases hyponatraemia d) Shadowing may spread despite of antibiotic therapy e) Produce endotoxin
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
23. Contents of superior mediastinum -- a) Thymus b) Oesophagus c) Thoracic duct d) Principal bronchus e) Right and left brachiocephalic vein
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
24. Mantoux test -- a) Diagnostic for TB b) Used for contact tracing c) Positive in sarcoidosis d) Basis is CMI e) Positive in military TB
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
Option e is true
Option e is false
25. Lung cancer --- a) Typically present with massive hemoptysis b) 20% of all male cancer death c) Dermatomyositis, a non-metastatic feature d) Of large bronchus present later
Option a is true
Option a is false
Option b is true
Option b is false
Option c is true
Option c is false
Option d is true
Option d is false
26. Which one of the following would cause a rise in the carbon monoxide transfer factor (TLCO)?
Emphysema
Pulmonary embolism
Pulmonary haemorrhage
Pneumonia
Pulmonary fibrosis
27. A 31-year-old woman is referred to the acute medical unit with a 4 day history of polyarthritis and a low-grade pyrexia. Examination reveals shin lesions which the patient states are painful. Chest x-ray shows a bulky mediastinum. What is the most likely diagnosis?
Loffler's syndrome
Lofgren's syndrome
Systemic lupus erythematous
Gonococcal arthritis
Reiter's syndrome
28. A middle aged woman presents with progressive shortness of breath. Chest X ray shows bilateral hilar lymphadenopathy.
An upper GI endoscopy was reported as normal.
Given the likely diagnosis, which of the following features would be associated with a good prognosis?
Lupus pernio
Hypercalcaemia
Age>40
Erythema nodosum
HLA B13 subtype
29. Which one of the following markers is most useful for monitoring the progression of patients with chronic obstructive pulmonary disease?
FEV1/FVC ratio
Lifestyle questionnaire
Oxygen saturations
FEV1
Number of exacerbations per year
30. A 46-year-old female with a history of rheumatoid arthritis is investigated due to progressive shortness of breath. She is currently treated with methotrexate and ibuprofen. The following results are obtained from spirometry:
What is the most likely cause of the dyspnoea?
Bronchiolitis obliterans
Methotrexate pneumonitis
Pulmonary fibrosis
Caplan's syndrome
Lung cancer
31. A 62-year-old man with a history of recurrent lower respiratory tract infections is diagnosed as having bilateral bronchiectasis following a high resolution CT scan. Which one of the following is most important in the long term control of his symptoms?
Inhaled corticosteroids
Prophylactic antibiotics
Surgery
Postural drainage
Mucolytic therapy
32. You are reviewing the results from investigations requested at the previous respiratory clinic. A 40-year-old man is being investigated for increasing shortness of breath. The notes show he has smoked for the past 25 years. Pulmonary function tests reveal the following:
Which one of the following is the most likely explanation?
Asthma
Bronchiectasis
Kyphoscoliosis
Chronic obstructive pulmonary disease
Laryngeal malignancy
33. Which one of the following is least associated with small cell lung cancer?
Bad prognosis
Cushing's syndrome
PTH-related peptide secretion
Hyponatraemia
Lambert-Eaton syndrome
34. Vital capacity may be defined as:
Volume inspired or expired with each breath at rest
Volume of air remaining after maximal expiration
Maximum volume of air that can be inspired at the end of a normal tidal inspiration
Maximum volume of air that can be expired at the end of a normal tidal expiration
Maximum volume of air that can be expired after a maximal inspiration
35. Which one of the following types of lung cancer is most associated with cavitating lesions?
Carcinoid
Large cell
Small cell
Squamous cell
Adenocarcinoma
36. Each one of the following may result in bronchiectasis, except:
Kartagener's syndrome
Amyloidosis
Selective IgA deficiency
Lung cancer
Allergic bronchopulmonary aspergillosis
37. A 43-year-old lifelong non-smoker is diagnosed as having emphysema. Further tests reveal that he has alpha-1 antitrypsin deficiency. What is the main role of alpha-1 antitrypsin in the body?
Nicotinic receptor activator
Protease inhibitor
5-alpha-reductase inhibitor
Trypsin activator
Phosphodiesterase inhibitor
38. A 24-year-old heroin addict is admitted following an overdose. He is drowsy and has a respiratory rate of 6 / min. Which of the following arterial blood gas results (taken on room air) are most consistent with this?
pH = 7.49; pCO2 = 4.9 kPa; pO2 = 10.1 kPa
pH = 7.52; pCO2 = 2.9 kPa; pO2 = 13.1 kPa
pH = 7.31; pCO2 = 7.4 kPa; pO2 = 8.1 kPa
pH = 7.55; pCO2 = 3.4 kPa; pO2 = 14.3 kPa
pH = 7.32; pCO2 = 3.4 kPa; pO2 = 8.3 kPa
39. A 50-year-old gentleman's chest X-ray shows bilateral hilar lymphadenopathy. Which of the following is unlikely to be present in this way?
Sarcoidosis
Lymphoma
Tuberculosis
Silicosis
Lung cancer
40. Which of the following statement is correct related to respiratory function abnormalities of pulmonary fibrosis?
FEV1b increases
FEV1/FVC increases
TLco increases
TLC increases
RV increases
41. Which of the following is not a feature of psychogenic hyperventilation?
Frequent sighing at rest
Difficulty in performing spirometry measure
Low score on Nijmegen questionnaire
Resting end-tidal CO2<4.5%
Associated digital and perioral paraesthesia
42. A 40-year-old female went for a CT-scan which showed solid non-calcified nodule. Nodule size is 2 mm. What should be the next plan of management?
Consider checking previous imaging
PET-CT
CT surveillance
Discharge
Surgical excision
43. A 60-year-old male presents with cough an shortness of breath. He went for spirometry and FEV1 shows 40% of the predicted value. Which stage is he currently in?
Stage I
Stage II
Stage III
Stage IV
Stage V
44. A patient who is diagnosed with COPD has come to the follow up. He is being assesed for long term oxygen therapy. ABG shows PaO2: 7.5 kPa. Which of the following indicator would not be an indication of LTOT?
Pulmonary hypertension
Peripheral oedema
Nocturnal hypoxaemia
Secondary polycythemia
Resistant hypercapnoen
45. A patient is diagnosed with pneumonia. Chest X-ray shows multilobar shadowing, cavitation, pneumatocele, abscess. What is the most likely organism?
Aspergillus
Legionella pneumophilia
Klebsiella pneumoniae
Shaphylococcus aureus
Mycobacterium Tuberculosis
46. A 30-year-old presents with fever, SOB and productive sputum. He also mentions that he has worsening of asthmatic symptoms. Investigation shows-Eosinophilia and chest X-ray shows pulmonary infiltrates. What is the most likely diagnosis?
ABPA
Extrinsic allergic alveolitis
Chronic pulmonary aspergillosis
Invasive pulmonary aspergillosis
DPLD
47. A 25-year-old female presents with exertional dyspnoca, wheeze, headache and tingling sensation of hands and feet. Investigation shows eosinophilic . What is the most likely diagnosis?
Tropical pulmonary eosinophilia
ABPA
Churg-strauss syndrome
Chronic eosinophilic pneumonia
Cryptogenic eosinophilic pneumonia
48. A 40-year-old gentleman presents with wheezing and breathlessness which seem to improve over weekends and holiday periods when he is not at work. To which of the following is he most likely to be exposed during his work?
Aspergillus clavatus
Avian bloom
Exposure to spores of Actinomyces
Latex
Work in the silver industry
49. A 30-year-old female presents with chest pain and SOB following a flight from Australia. Chest X-ray is normal and ECG shows sinus tachycardia. What should be the diagnostic test?
CTPA
Colour doppler ultrasound
V/Q scanning
Troponin I
Echocardiography
50. A 45-year-old male present to the emergency with chest pain. Chest X-ray shows hypertranslucent area with no bronchovascular marking (size is 10% of hemithorax). On query she says no dyspnoea. There is no pre-existing lung disease. What should be the next plan of management?
Percutaneous needle aspiration
Intercostal chest drain tube
Observe patient for 6 hours
Discharge
Supportive measures
