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September 25, 2016

MCQs on Respiratory System for Staff Nurse and Medical Exams

1- The following are recognized features of Pancoast's tumour except:
1) ipsilateral Horner's syndrome
2) wasting of the dorsal interossei
3) pain in the arm radiating to the fourth and fifth fingers
4) erosion of the first rib
5) weakness of abduction at the shoulder


2- Which of the following is true concerning Whooping cough (pertussis)?
1) is a greater threat to children during the second 6 months of life, after maternal antibody has declined, than during the first 6 months
2) may lead to hemiplegia
3) is characteristically associated with a polymorph leucocytosis
4) is associated with convulsions less frequently than is the case with other febrile conditions
5) rapidly resolves with antibiotic treatment


3- A 19-year-old female developed pleural effusions, ascites and ankle swelling. Her blood pressure was 112/76 mmHg.
Investigations revealed:

  • serum alanine transferase 17 U/L (5 - 15)
  • serum total bilirubin 17 umol/L (1 - 22)
  • serum albumin 21 g/L (34 - 94)
  • serum total cholesterol 9.8 mmol/L (<5.2)

What is the next most appropriate investigation?
1) Antinuclear antibody
2) Pregnancy test
3) Prothrombin time
4) Serum protein electrophoresis
5) Urinary protein estimation


4- A 51 year old businessman complains of dyspnoea on exertion. He recently returned from a business trip to the USA. He has distant heart sounds on auscultation of the chest. A chest radiograph reveals that there is a thin rim of calcification surrounding the cardiac outline. Which of the following conditions is most likely responsible for these findings?
1) Uraemia
2) Tuberculosis
3) Group B coxsackie virus
4) Sarcoidosis
5) Metastatic carcinoma


5- A 48-year-old woman presented with shortness of breath, cough with heavy sputum production, and a low grade fever. She has smoked 20 cigarettes per day for 30 years. Her arterial blood gases revealed pH of 7.4, PaCO2 of 45 and a PaO2 of 78. What is the most likely diagnosis?
1) Bronchial asthma
2) Chronic bronchitis
3) Cryptogenic fibrosing alveolitis
4) Paraneoplastic syndrome
5) Pulmonary embolism


6- A 49-year-old man with a long history of alcoholism presents with cough, haemoptysis and pleuritic chest pain. He has had night sweats and 10 kg weight loss in the last three months. On chest X-ray tgere is a subtle nodular pattern throughout the lung. He underwent a transbronchial biopsy which showed multinucleated giant cells, epithelioid cells and necrotic debris. Which of the following is the most likely diagnosis?
1) Aspergillosis
2) Pneumocystis carinii pneumonia
3) Small cell carcinoma
4) Squamous cell carcinoma
5) Tuberculosis


7- A 55 year old man who has a 25 year pack history of smoking presents with productive cough with mucoid sputum of 2 year duration. On examination he has scattered ronchi and wheezing. The likeliest diagnosis is :
1) Bronchial Asthma
2) Bronchiectasis
3) Chronic Bronchitis
4) Pneumonitis
5) Fibrosing Alveolitis


8- A 67 year old who is known to suffer from severe chronic bronchitis is admitted from home with an acute exacerbation. Which of the following is true?
1) An Acidosis with a low bicarbonate would be expected
2) Extensor plantar responses feature
3) Gentamicin would be a reasonable initial treatment until cultures are available
4) Oxygen therapy should aim to increase the pO2 to above 8kPa (60mmHg)
5) Peripheral oedema indicates coexisting heart failure


9- A 65-year-old woman, has smoked 50 cigarettes a day for 40 years. She has had increasing dyspnoea for the several years, but no cough. A Chest X-ray shows increased lung size along with flattening of the diaphragms, consistent with emphysema. Over the next several years she develops worsening peripheral oedema. Her vital signs show T° 36.7 C, P 80, RR 15, and BP 120/80 mm Hg. Which of the following cardiac findings is most likely to be present?
1) Mitral valve stenosis
2) Constrictive pericarditis
3) Right ventricular hypertrophy
4) Left ventricular aneurysmm
5) Non-bacterial thrombotic endocarditis


10 -In which of the following cases of lung cancer would surgical resection of the tumour be a reasonable therapeutic option?
1) A 56-year-old woman with an adenocarcinoma of the right lung. CT scan shows enlarged lymph nodes in the right and left hilum. PFTs show an FEV1 of 2.25 L.
(55% predicted).
2) A 59-year-old man who is found at bronchoscopy to have a tumour in the right mainstem bronchus extending to within 1 cm of the carina. Pulmonary Function
Tests (PFTs) show an FEV1 of 2.1 liters (65% of predicted normal).
3) A 62-year-old lady with a small peripheral mass who has elevated liver enzymes and a computed tomography (CT) scan showing probable metastatic deposits in
the liver PFTs show an FEV1 of 3.5 Liters (80% of predicted normal).
4) A 70-year-old man with a right lower lobe tumour 2 cm in diameter with no evidence of regional adenopathy or distant spread of disease. PFTs show an FEV1
of 0.8 Liters (28% predicted).
5) A 71-year-old man with a 3 cm tumor obstructing the right lower lobe bronchus.
PFTs show an FEV1 of 1.98 L. (43% predicted).


MCQs on Respiratory System for Staff Nurse and Medical Exams Reviewed by Rohit Ranjan on Sunday, September 25, 2016 Rating: 5 1- The following are recognized features of Pancoast's tumour except: 1) ipsilateral Horner's syndrome 2) wasting of the dorsa...
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