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Question 1

Which of the following is correct regarding respiratory failure?

a) It is defined by a pO₂ less than 7 kPa.

b) Type 1 respiratory failure is usually due to generalized alveolar hypoventilation.

c) Treatment should be aimed at the underlying cause.

d) Patients with chronic respiratory failure eventually develop pulmonary hypertension and right-sided heart failure.

Question 2

Which of the following is correct regarding pulmonary embolism?

a) It may present with an isolated raised respiratory rate.

b) Emboli lodging at the bifurcation of the pulmonary artery present with breathlessness and pleuritic chest pain.

c) Most emboli are derived from thrombi in the superficial leg veins.

d) Hypoxia is due to alveolar hypoventilation.

Question 3

Which of the following is correct regarding chronic obstructive pulmonary disease (COPD)?

a) Most heavy smokers develop the disease.

b) The main source of airflow obstruction is thought to be narrowing of small airways.

c) The typical spirometric findings are a reduced FEV₁ and a preserved FEV₁/FVC ratio.

d) Most acute exacerbations of COPD are due to pneumothorax.

Question 4

Which of the following is correct regarding asthma?

a) Hyper-reactive bronchioles are characteristic.

b) Most children with asthma are also atopic, meaning they produce large quantities of IgA in response to environmental allergens.

c) The late inflammatory response in asthmatic airway is thought to be important in the development of hyper-reactive airways.

d) Peak flow in asthma is usually best in the morning with worsening during the day.

Question 5

Which of the following is correct regarding community-acquired pneumonia?

a) The most commonly implicated organism is Haemophilus influenzae.

b) If an "atypical" pneumonia is suspected, a macrolide antibiotic such as erythromycin should be added to the treatment regime.

c) A pneumothorax is a common complication.

d) The typical microscopic feature is the presence of neutrophils in the interstitium.

Question 6

Which of the following is correct regarding tuberculosis?

a) The disease is caused by Mycoplasma tuberculosis.

b) Most people acquiring the infection develop active pulmonary tuberculosis.

c) Symptoms of a chronic pneumonia is the typical presentation.

d) Microscopically, non-caseating granulomas are seen.

Question 7

Which of the following is correct regarding diffuse parenchymal lung diseases (DPLDs)?

a) Activation of macrophages leads to the laying down of fibrous tissue and irreversible lung scarring.

b) Open lung biopsy is usually required to reach a diagnosis.

c) Pnemoconioses now account for most DPLDs.

d) Idiopathic pulmonary fibrosis responds well to steroid treatment.

Question 8

Which of the following is correct regarding lung carcinomas?

a) It is the second most common cancer killer.

b) Squamous cell carcinomas are defined by gland formation or mucin production microscopically.

c) Adenocarcinomas typically arise centrally in the lung.

d) Small cell carcinomas have a tendency to early, widespread dissemination.

Question 9

Which of the following is correct regarding pneumothorax?

a) Spontaneous primary pneumothoraces in young tall men tend not to be recurrent.

b) It is a particular risk when placing central venous lines in the internal jugular vein.

c) It should always be ruled out as a cause of an acute asthma attack.

d) All pneumothoraces require insertion of a chest drain to allow re-expansion of the affected lung.

Question 10

Which of the following is correct regarding asbestos-related lung disease?

a) Pleural plaques imply high levels of asbestos exposure.

b) Asbestosis refers to fibrosis of the visceral pleura of the lungs.

c) Malignant mesothelioma is a highly aggressive malignancy with a tendency to widespread distant dissemination.

d) A death due to malignant mestholioma should to be referred to the Coroner.

Oxford University Press, Online Resource Centre, Chapter 07.

Chapter 07

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