Respiratory MCQ’s



Respiratory MCQ’s Di Flood

RESPIRATORY SUSAN TUCKER

1.Which is the most common organism causing community acquired pneumonia?

a) pneumococcus

b) hemophilus influenzi

c) viral

d) gm negatives

e) mycoplasma

2.which organism causing pneumonia has an increased association with COPD

a) pneumococcus

b) hemophilus influenzi

c) viral

d) gm negatives

e) mycoplasma

3.Which organism causing pneumonia has an increased incidence in IV drug users and those post-influenza?

a) pneumococcus

b) staph aureus

c) viral

d) gm negatives

e) mycoplasma

4.Which drug/s should be used in adult mild-mod. Community acquired pneumonia?

a) amoxycillin

b) doxycycline

c) rulide

d) any of the above as a single drug

e) amoxycillin and rulide

5.Which drug regimen is suggested for severe community acquired pneumonia initially?

a) benzyl penicillin and gentamicin and erythromycin

b) benzyl penicillin and gentamicin

c) ceftriaxone and gentamicin

d) gentamicin and erythromycin

e) flucloxacillin and gentamicin

6.Which bug makes up 50% of hospital acquired pneumonia?

a) pneumococcus

b) staph aureus

c) gm –ve bacilli

d) legionella

e) chlamydia psittici

7.What is the largest size spontaneous primary pneumothorax that can be managaed without aspiration or thoracostomy?

a) 10%

b) 15%

c) 20%

d) 30%

e) 35%

8.In which sort of pneumoathorax is aspiration likely to be most successful?

a) traumatic

b) secondary

c) primary

d) iatrogenic

e) equally effective in all of the above

9.What if the role of aspiration in traumatic pneumothoraces?

a) there is no role

b) first line management in small pneumathoraces only

c) it should be tried in all pneumathoraces as long as there is no respiratory compromise

d) it can be repeated twice before thoracostomy tube is considered

e) none of the above

10.Whatis the recurrence rate of primary spontaneous pneumathoraces?

a) 10%

b) 20%

c) 30%

d) 40%

e) 50%

11.Which is not a biochemical feature of transudative pleural effusions?

a) protein 20 mm Hg) indicates excessive negative intrathoracic pressure and correlates with severe asthma. In this situation, left ventricular after load and venous return to the right heart are increased, thereby causing a transient reduction in cardiac output and systolic blood pressure.

58. What is the best position in which to place patient with massive haemoptysis?

a) Affected side up

b) Affected side down

c) Trendelenburg

d) Reverse Trendelenburg

e) None of the above

Tint chap 63

B

60. The following can cause a rise in peak inspiratory pressure (PIP) in a mechanically ventilated patient EXCEPT:

a) insufficient muscle paralysis

b) increased tidal volume

c) bronchospasm

d) pneumothorax

e) increased I:E ratio

E

9Severe Asthma is indicated by all of the following except

a. Pt talking in words

b. Silent chest

c. PCO2 44mmHg

d. PO2 89mmHg

e. Pulsus paradoxus

47All of the following may have a role in the acute management of severe asthma EXCEPT

A. magnesium

B. salmeterol

C. halothane

D. helium

E. ketamine.

50Symptoms heralding respiratory arrest during an asthma exacerbation include all of the following EXCEPT

F. lethargy

G. severe respiratory alkalosis and the use of accessory muscles of respiration

H. a normal pCO2 on arterial blood gas

I. a silent chest on auscultation

J. agitation.

51Complications of Mycoplasma pneumonia infection include all of the following EXCEPT

K. Guillain-Barré syndrome

L. aseptic meningitis and encephalitis

M. haemolytic anaemia

N. pericarditis and myocarditis

O. septic arthritis

52Which of the following is the BEST view to request when assessing for the presence of pneumothorax on chest x-ray?

P. Supine anteroposterior

Q. Upright posteroanterior (PA)

R. Inspiratory PA

S. Lateral decubitus with the patient lying on the unaffected side

T. Expiratory PA

10. Bronchiolitis

a) CRX: hyperinflation

b) Bronchodilators are controversial

c) WBC usually normal

d) Steroids contraindicated

CXR: hyperinflation without infiltrates, peribronchial cuffing, atelectasis

Steroids possible beneficial for mild to moderate, definitely not contra-indicated

Adrenaline most effective therapy

Bronchodilators may help, are controversial

WCC doesn’t help assessment

1. A 43 year old man is receiving positive pressure ventilation on a respirator following a road traffic crash. His ABG shows a pH 7.54, PC02 28mmHg, P02 87mmHg, Bic 16 mmol/L.

This blood gas shows:

a) pure respiratory alkalosis

b) respiratory alkalosis and hypoxaemia

c) respiratory alkalosis and metabolic acidosis

d) mixed respiratory and metabolic alkalosis

e) metabolic alkalosis with partial respiratory compensation

C

6. Uncuffed endotracheal tubes should be used for:

a) tube sizes less than 6mm

b) acute epiglottis

c) blind nasotracheal intubation

d) intubations with a Macintosh blade

e) known fractured base of skull

A

7. Cricoid pressure was first described by:

a) Mendelson

b) Danzi

c) Sellick

d)Tintinalli

e)Meller

C

9. All of the following drugs can be used in rapid sequence induction EXCEPT:

a) atropine

b) fentanyl

c) isoflurane

d) atracurium

e) ketamine

C

47. In asthma:

a) the white blood cell count will often be elevated

b) the ECG may show signs of acute left heart strain

c) a CXR should be routine in all patients admitted

d) blood gas results correlate well with pulmonary function testing

e) theophylline dosing needs to be increased if erythromycin is given

A

49. Regarding pleural effusion all of the following are true EXCEPT:

a) can be tapped to make a diagnosis of pancreatitis

b) can be detected radiographically when 10 ml of fluid is present

c) is most commonly caused by congestive cardiac failure

d) can result from rheumatoid arthritis

e) will not produce mediastinal shift

E

50. Sore throat is caused by all of the following

a) neisseria gonorrheae

b) mycoplasma pneumoniae

c) bacteroides fragilis

d) cytomegalovirus

e) corynebacterium diptheriae

C

51. Regarding empiric antibiotic therapy in pneumonia:

a) cetazidime is used for atypical pneumonia

b) clindamycin is used for aspiration pneumonia

c) acyclovir is used for post influenza pneumonia

d) erythromycin is used for PCP pneumonia

e) amoxycillin alone is used for neonates with pneumonia

86. The patient with normal lungs and pulmonary gas exchange breathing 40% oxygen at sea level and breathing normally could be expected to achieve an arterial oxygen tension of about:

a) 180 mm Hg

b) 210 mm Hg

c) 235 mm Hg

d) 260 mm Hg

e) 290 mm Hg

11) Regarding aspiration pneumonitis which is true

a. Should be treated with high dose IV steroids

b. Commonest organisms involved in community acquired are anaerobes and GNB

c.

d.

e.

a. Should be treated with high dose steroids. Can’t find evidence for this

b. *Commonest organisms are GNB and anaerobes. Staph aureus also common in mouth but more so in aspirated saliva than vomit

55) Which of the following is true of COPD

a. Associated with decreased compliance

b. Associated with low output cardiac failure

c. Associated with reduced FVC but normal FEV1

d.

e.

55) Which of the following is true of COPD

a. Associated with decreased compliance – false….increased compliance

b. *Associated with low output CCF. Pulmonary HPT with RV hypertrophy and then dilation with cor pulmonale (LVF) and low LV output

c. Associated with decreased FVC but normal FEV1. both reduced FEV1 > FVC

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