Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
17 Respiratory medicine MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 9 practice questions
- Lung cancer
- Interstitial and immune lung disease
- Respiratory failure
- Imaging
- Cystic fibrosis
- Pneumonia in immunosuppression
- Tuberculosis
- COPD
1. A man has cough and sputum for 3 months in each of 2 consecutive years and another has permanent enlargement of airspaces distal to terminal bronchioles with wall destruction. Which conditions fit?
- AAsthma and cystic fibrosis
- BEmphysema and chronic bronchitis
- CChronic bronchitis and emphysema
- DBronchiectasis and asthma
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C. Chronic bronchitis and emphysema These are the definitions; both fall within COPD, which is defined as persistent respiratory symptoms and airflow limitation.
2. A patient with COPD given 60% oxygen becomes drowsy with pH 7.25 and PaCO2 9.2 kPa, and another has stable chronic hypercapnia with normal pH. Which statements are correct?
- AThe target should have been 100%, and normal pH reflects buffering by haemoglobin
- BThe target should have been 70%, and normal pH reflects lung compensation
- CThe target saturation should have been 88-92% for patients at risk of type II failure, and the normal pH reflects renal bicarbonate retention
- DThe target should have been 94-98%, and normal pH reflects hyperventilation
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C. The target saturation should have been 88-92% for patients at risk of type II failure, and the normal pH reflects renal bicarbonate retention Lower concentrations via Venturi mask are used in susceptible patients; compensated chronic type II failure has raised PaCO2 with normal pH because the kidneys retain bicarbonate.
3. A patient with suspected pulmonary embolism needs imaging, and a smoker has a lung mass needing staging. Which statements are correct?
- AMRI is first line, and bone scan stages nodes
- BV/Q is preferred, and PET-CT is unhelpful
- CChest X-ray is diagnostic, and ultrasound stages nodes
- DCTPA is the investigation of choice and has largely replaced V/Q scanning, and combined CT with FDG-PET detects occult metabolically active metastases
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D. CTPA is the investigation of choice and has largely replaced V/Q scanning, and combined CT with FDG-PET detects occult metabolically active metastases CTPA may confirm PE or reveal an alternative diagnosis; PET-CT enhances localisation of metabolically active deposits though FDG uptake depends on blood glucose and body fat.
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