Free PreviewSample Respiratory Medicine questions
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Sample MCQ 1Which acid-base pattern is typical in chronic compensated hypercapnic respiratory failure due to advanced COPD?
A. High PaCO2 with elevated bicarbonate
B. Low PaCO2 with low bicarbonate
C. Normal PaCO2 with severe metabolic acidosis
D. Low PaCO2 with elevated anion gap only
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Correct Answer: Option AChronic respiratory acidosis is compensated by renal bicarbonate retention, so both PaCO2 and serum bicarbonate are elevated.
A patient after long-haul travel has unilateral leg swelling and sudden dyspnea. He becomes hypotensive and bedside echo shows right ventricular strain. If there is no major contraindication, what treatment should be considered?
A. Systemic thrombolysis
B. Oral antihistamine
C. Pleural aspiration
D. Inhaled corticosteroid only
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Correct Answer: Option AHemodynamically unstable high-risk pulmonary embolism may require urgent reperfusion therapy such as systemic thrombolysis when not contraindicated.
A patient with COPD and chronic severe resting hypoxemia despite optimal therapy is most likely to benefit from which intervention for survival?
A. Long-term oxygen therapy when criteria are met
B. Routine oral steroids indefinitely
C. Daily antibiotics for life in all cases
D. SABA monotherapy
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Correct Answer: Option ALong-term oxygen therapy improves survival in appropriately selected COPD patients with severe chronic resting hypoxemia.
A 44-year-old woman has episodic dyspnea, normal chest X-ray and normal baseline spirometry, but asthma remains suspected. Which test can demonstrate variable airway hyperresponsiveness?
A. Methacholine challenge
B. D-dimer
C. Pleural biopsy
D. Right heart catheterization
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Correct Answer: Option ABronchoprovocation testing can demonstrate airway hyperresponsiveness when baseline spirometry is normal but asthma remains clinically suspected.
A patient with pneumonia develops a loculated pleural effusion with low pleural pH and frank pus. What management is required?
A. Observation only
B. Chest-tube drainage plus antibiotics
C. Inhaled bronchodilator only
D. Immediate lung transplant
Show Answer & Explanation
Correct Answer: Option BEmpyema or a complicated parapneumonic effusion generally requires pleural drainage in addition to antimicrobial therapy.