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G1BE209 - Respiratory MCQ

Respiratory MCQ (Model Answer)

1.

A - TYPES
The image below shows the cut surface of a lung in a 65 year-old patient from Gauteng who died in
a cachectic state after an illness lasting only a few months.

Which of the following is the most likely diagnosis?

a. Cavitating sarcoidosis

b. Cavitating tuberculosis

c. Confluent broncho-pneumonia

d. Metastatic carcinoma

e. Metastatic osteosarcoma

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G1BE209 - Respiratory MCQ

2.

The images below show the lung and heart of a patient in whom a lung condition has given rise to a
lesion in the heart.

Which of the following is the most likely process by which this occurred?

a. Direct spread

b. Emboli from the right atrium

c. Lymphatic spread

d. Pyaemia via the pulmonary artery

e. Septicaemia

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G1BE209 - Respiratory MCQ

3.

The image below is a sagittal section of the left lung taken from a patient who had previously worked
in a mine.

Which of the following is the most likely lung pathology present?

a. Asbestos pleural plaques

b. Bronchogenic carcinoma

c. Mesothelioma

d. Metastatic adenocarcinoma

e. Tuberculous pleurisy

4.

When IgE on a mast cell FcE receptor is cross-linked by an allergen, the mast cell responds by:

a. undergoing apoptosis.

b. presenting antigen to Th cells.

c. secreting more IgE.

d. secreting histamine.

e. stimulating macrophage phagocytosis of coated antigen.

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G1BE209 - Respiratory MCQ

5.

Of the following choices, identify the statement which commonly defines the term "strong
anthropocentrism".

a. Human beings prioritise their satisfaction of immediate wants and desires, no matter how
trivial, above the wants and desires of other sentient animals.

b. Human beings are intrinsically valuable. This means that we are valuable in a way that
transcends our utility to other beings.

c. Human beings are the centre of the universe. As such, we are concerned with the
satisfaction of our wants, needs, and desires above all else.

d. Human beings are the top of the evolutionary scale. Because of this, we have been given
dominion over all living things.

e. Human beings are capable of feeling pleasure and pain. This sets us apart from lower life
forms.

6.

X TYPES
In obstructive lung disease there is
a. an increased FEV1

True

False

Don't know

b. an increased total dead space

True

False

Don't know

c. a decreased inspiratory reserve volume

True

False

Don't know

d. a reduced total lung capacity

True

False

Don't know

e. a decreased residual volume

True

False

Don't know

a) Incorrect. Bronchoconstriction increases resistance to air-flow and so results in a

reduced expiration of air in the 1st second. Bronchoconstriction may be due to a number
of factors such as bronchitis, a mucous plug or inadequate smooth muscle in the
bronchi.
b) Correct. Air that is not expired in previous breath remains behind and is not available
for gaseous exchange on the next breath
c) Correct. Previous unexpired air results in an inability to inspire more air on the next
breath
d) Incorrect. The unexpired air results in an increasing total lung capacity barrel chest
e) Incorrect. Unexpired air increases the residual volume

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G1BE209 - Respiratory MCQ

7.

The following flow loop graphic (obtained in an 80 kg Caucasian man) indicates

a. decreased FEV1/FVC

True

False

Don't know

b. the presence of restrictive lung disease

True

False

Don't know

c. decreased PEFR

True

False

Don't know

d. the presence of asthma

True

False

Don't know

e. reduced measured FVC/predicted FVC

True

False

Don't know

Correct. In obstructive lung disease, seen graphically by a scooped expiration

curve, the FEV1/FVC is below 70%
b) Incorrect. Restrictive lung disease has an FVC that is decreased to less than 80%
of the predicted FVC not evident in this flow loop
c) Correct. A decreased PEFR is evident on the expiratory curve 3l/sec
d) Correct. The flow volume for an untreated asthmatic patient will have a similar
profile to that seen in this flow loop
e) Incorrect. Reduced measured FVC/predicted FVC is a feature of restrictive lung
disease and is not present in primary obstructive lung disease prior to progression
to a restrictive disorder.
a)

8.

Acute bronchoconstriction results in a reduced

a. peak expiratory flow rate

True

False

Don't know

b. total lung capacity

True

False

Don't know

c. residual volume

True

False

Don't know

d. ventilation / perfusion ratio

True

False

Don't know

e. FEV1/FVC ratio

True

False

Don't know

a) Correct. A decreased PEFR is a feature of severe bronchoconstriction (obstructive

lung disease)
b) Incorrect. Lung capacity does not change rapidly in acute bronchoconstriction

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G1BE209 - Respiratory MCQ

c) Incorrect. Residual volumes are increased

d) Correct. Ventilation is decreased due to the unexpired air that is trapped in the
lungs, not being available for gaseous exchange
e) Correct. Reduced FEV1/ FVC is characteristic of obstructive lung disease (acute
bronchoconstriction)

9.

In people with emphysema there is a reduced

a. peak expiratory flow rate

True

False

Don''t know

b. total lung compliance

True

False

Don''t know

c. residual volume

True

False

Don''t know

d. predicted FVC

True

False

Don''t know

e. FEV1/FVC ratio

True

False

Don''t know

a) Correct. A decreased PEFR is a feature of the obstructive lung component of

emphysema
b) Incorrect. Lung compliance increases in people with emphysema due to the
destruction of alveoli cells.
c) Incorrect. Residual volumes are increased due to retention of inspired air patient is
unable to expire due to the obstructive component of the disease development of a
barrel chest
d) Correct. FVC is decreased due to restrictive component of emphysema. Patient is
unable to inspire effectively
e) Incorrect. With emphysema air-way narrowing creates resistance to air-flow which
increases time taken to expire, which increases the FEV1/FVC.

10. The affinity of haemoglobin for oxygen increases with an increase in plasma
a. carbon dioxide partial pressure

True

False

Don't know

b. pH

True

False

Don't know

c. oxygen partial pressure

True

False

Don't know

d. carbon monoxide (CO) partial pressure.

True

False

Don't know

e. temperature

True

False

Don't know

a) Incorrect: PCO2 produces a right shift in the O2-Hb saturation curve lower affinity
b) Correct: pH produces a left shift in the O2-Hb saturation curve affinity
c) Correct: PaO2 directly increases the affinity of Hb to oxygen (shape changes)
d) Incorrect: CO binds competitively to Hb displacing O2
e) Incorrect: temp produces a right shift in the O2-Hb saturation curve lower affinity

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G1BE209 - Respiratory MCQ

11. The pulmonary ventilation to perfusion ratio (V/Q)

a. is greater at the base of the lung than it is at the
apex of the lung

True

False

Don't know

b. increases with an increase in pulmonary shunt

True

False

Don't know

c. increases with an increase in physiological dead

space

True

False

Don't know

d. is increased during exercise

True

False

Don't know

e. is decreased in obstructive lung disease

True

False

Don't know

a)
b)
c)
d)
e)

Incorrect: better blood flow than ventilation at the base of the lung
Incorrect: Pulmonary shunt is unventilated blood flow Q and V ratio
Correct: Physiological dead space is unperfused alveoli Q and V ratio
Correct: exercise = VA (10 times or more), smallerQ Q but V ratio
Correct: VA ratio

12. An acute decrease in pulmonary ventilation results in an increased

a. PaCO2

True

False

Don't know

b. plasma bicarbonate concentration

True

False

Don't know

c. plasma chloride concentration

True

False

Don't know

d. plasma hydrogen ion concentration

True

False

Don't know

e. urine pH

True

False

Don't know

a) Correct: VA diffusion of CO2 removal of CO2 PaCO2

b) Correct: PaCO2 Carbonic anhydrase activity HCO3-+ H+
c) Incorrect: PaCO2 produces HCO3- in RBCs exchanged for plasma Cl- plasma Cl-
or normal
d) Correct: PaCO2 Carbonic anhydrase activity HCO3-+ H+
e) Incorrect: increase plasma [H+] stimulates urinary H+ secretion; also acute changes =
little time for urinary compensation.

13. Respiratory control centres

a. are found in the hypothalamus

True

False

Don't know

b. receive inputs from pulmonary stretch receptors

True

False

Don't know

c. receive inputs from skeletal muscle

chemoreceptors

True

False

Don't know

d. receive inputs from chemoreceptors in the brain

True

False

Don't know

e. are more sensitive to changes in plasma carbon

dioxide partial pressure than they are to plasma
oxygen partial pressure

True

False

Don't know

a) Incorrect: they are found in the brainstem (medulla and Pons)

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G1BE209 - Respiratory MCQ

b) Correct: an increase in stimulation of pulmonary stretch receptors inhibits inspiratory

neurons.
c) Incorrect: they do receive input from muscle receptors but these are mechanoreceptors
(muscle spindles).
d) Correct: central chemoreceptors respond to increased H+ concentrations by stimulating
the respiratory centre.
e) Correct: under normal condition respiratory centres are far more sensitive to CO2

14. Hypoxia results

a. from carbon monoxide poisoning

True

False

Don't know

b. from reduced inspired oxygen

True

False

Don't know

c. in right heart failure

True

False

Don't know

d. from left heart failure

True

False

Don't know

e. in reduced erythropoietin production

True

False

Don't know

(a) Correct: Carbon monoxide poisoning results in reduced oxygen carrying capacity of
haemoglobin causing reduced tissue oxygenation
(b) Correct: any condition that reduces atmospheric oxygen will eventually lead to
reduced oxygen in the tissues
(c) Correct: hypoxic hypoxia causes pulmonary vasoconstriction which causes increased
work load to the right heart leading to right heart failure
(d) Correct: left heart failure causes reduced blood flow leading to stagnant hypoxia
(e) Incorrect: hypoxic hypoxia leads to stimulation of erythropoietin secretion

15. Causes of anaemic hypoxia include

a.

a reduced haemoglobin concentration

True

False

Don't know

b.

vitamin B12 deficiency

True

False

Don't know

c.

cyanide poisoning

True

False

Don't know

d.

heart failure

True

False

Don't know

e.

bone marrow failure

True

False

Don't know

(a) Correct: reduced haemoglobin leads to reduced tissue oxygenation hence hypoxia
(b) Correct: Vitamin B12 deficiency cause haemolysis of red blood cells leading to reduced
tissue oxygenation
(c) Incorrect: Cyanide poisoning inhibits oxidative phosphorylation leading to histotoxic
anaemia
(d) Incorrect: Heart failure leads to reduced cardiac output causing stagnant hypoxia
(e) Correct: reduced rbc synthesis leads to reduced tissue oxygenation

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G1BE209 - Respiratory MCQ

16. Histotoxic hypoxia is characterized by a reduced

a.

PaO2

True

False

Don't know

b.

oxidative phosphorylation

True

False

Don't know

c.

arterio-venous oxygen difference

True

False

Don't know

d.

blood flow

True

False

Don't know

e.

oxygen uptake by tissues

True

False

Don't know

(a) Incorrect: PaO2 is normal but cell cannot utilize oxygen

(b) Correct: Cyanide inhibits oxidative phosphorylation
(c) Correct: Since tissues cannot utilize oxygen, the arterio-venus oxygen difference is
reduced
(d) Incorrect: reduced blood flow is the characteristic of stagnant hypoxia
(e) Correct: tissues take less oxygen because they cannot utilize it

17. The tympanic membrane is a clinically important structure. Which of the following
statements about its anatomy are true and which are false?
a. It is lined internally by a mucous membrane.

True

False

Don't know

b. It is derived from ectoderm, mesoderm and

endoderm.

True

False

Don't know

c. It is circular in shape.

True

False

Don't know

d. It slopes inferomedially.

True

False

Don't know

e. It is crossed by the glossopharyngeal nerve.

True

False

Don't know

18. The middle ear is an important site of infections, particularly in children. Infections from
the middle ear can spread to the mastoid bone and to the middle cranial fossa and can
also result in conductive deafness. Which of the following statements about the middle
ear are true and which are false?
a. The tympanic cavity is joined to the oropharynx
by the pharyngotympanic tube.

True

False

Don't know

b. The tympanic cavity is separated from the middle

cranial fossa by the tegmen tympani.

True

False

Don't know

c. The epitympanic recess opens medially into the

mastoid air cells.

True

False

Don't know

d. The stapes is positioned over the round window.

True

False

Don't know

e. Infections in the pharynx can result in otitis

media.

True

False

Don't know

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G1BE209 - Respiratory MCQ

19. A number of critically important anatomical structures are found in the mediastinum.
Which of the following statements about the mediastinum are true and which are false?
a. The trachea bifurcates at the level of the sternal
angle.

True

False

Don't know

b. The heart occupies the anterior mediastinum.

True

False

Don't know

c. The trachea lies posterior to the oesophagus in

the superior mediastinum.

True

False

Don't know

d. The right recurrent laryngeal nerve loops around

under the pulmonary artery on the same side.

True

False

Don't know

e. The phrenic nerves pass across the surface of the

pericardium.

True

False

Don't know

20. The diaphragm, ribs and pleural cavity play critical roles in the process of respiration.
Which of the following statements about these structures and their function are true
and which are false?
a. The diaphragm attaches to the lower 6 ribs and
costal cartilages.

True

False

Don't know

b. The diaphragm contracts to cause expiration.

True

False

Don't know

c. The pressure within the pleural cavity is

approximately 4-7 mm Hg.

True

False

Don't know

d. Visceral pleura covers the diaphragm.

True

False

Don't know

e. The external intercostal muscles actively elevate

the ribs during quiet inspiration.

True

False

Don't know

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G1BE209 - Respiratory MCQ

21. The paranasal sinuses are clinically important as sites of infection and even of
malignancy (particularly in smokers). Which of the following statements about these
sinuses are true and which are false?
a. Each maxillary sinus opens into the inferior
meatus of the nasal cavity.

True

False

Don't know

b. The frontal sinuses drain via a frontonasal duct.

True

False

Don't know

c. Infection may spread from the ethmoid sinuses to

the orbit.

True

False

Don't know

d. The sphenoid sinus lies laterally to the cavernous

venous sinuses.

True

False

Don't know

e. The sinuses are innervated by branches of the

trigeminal nerve.

True

False

Don't know

22. In the management of asthma glucocorticosteroids occupy a prominent position. Which

of the following statements regarding their use in asthma are correct?
a.

Inhaled budesonide is more likely than oral

betamethasone to cause adrenal suppression.

True

False

Don't know

b.

Inhaled fluticasone causes oesophageal

candidiasis.

True

False

Don't know

c.

Oral prednisone increases blood glucose

levels.

True

False

Don't know

d.

Oral dexamethasone stimulates calcium

deposition in bone.

True

False

Don't know

e.

Budesonide is contraindicated for use in

children with asthma.

True

False

Don't know

23. Non-steroidal therapy plays a vital part in the treatment of asthma and COPD. Which of
the following statements about this type of therapy are correct?

True

False

Don't know

b. Aminophylline causes convulsions at high

dosages.

True

False

Don't know

c. Inhaled salbutamol is used for the treatment of

acute asthma.

True

False

Don't know

d. Inhaled ipratropium bromide is a

phosphodiesterase inhibitor.

True

False

Don't know

e.

True

False

Don't know

a.

Salmeterol causes bradycardia.

Montelukast is a 2-adrenoceptor agonist.

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24. Which of the following statements regarding the use of antibacterial drugs in respiratory
infections are correct?
a. Azithromycin is contraindicated in penicillinallergic patients.

True

False

Don't know

b. Moxifloxacin is contraindicated for use in

neonates.

True

False

Don't know

c.

Ceftriaxone causes grey baby syndrome.

True

False

Don't know

d.

Benzylpenicillin is safe to use during pregnancy.

True

False

Don't know

e.

Amoxicillin is -lactamase resistant.

True

False

Don't know

25. Symptoms related to the respiratory system often have allergic origins and therefore
require treatment with antihistamine drugs. Which of the following statements
regarding antihistamine therapy are correct?
a. Diphenhydramine causes less sedation than
loratadine.

True

False

Don't know

b. Cinnarizine is used for the treatment of motion

sickness.

True

False

Don't know

c.

Promethazine is safe to use in asthmatics.

True

False

Don't know

d. Loratidine is used to treat seasonal allergic

rhinitis.

True

False

Don't know

e. Diphenhydramine is used in the treatment of

atopic dermatitis in young children.

True

False

Don't know

26. The full and correct management of tuberculosis disease is of critical importance in
South Africa today. Which of the following statements about the agents used against
Mycobacterium tuberculosis are correct?
a. Ethambutol inhibits mycobacterial DNAdependent RNA polymerase

True

False

Don't know

b. Isoniazid-induced peripheral neuropathy is

reversed by vitamin B6

True

False

Don't know

c.

True

False

Don't know

d. Rifampicin decreases the plasma concentration

of indinavir

True

False

Don't know

e. Hydrochlorothiazide is used to treat

pyrazinamide-induced hyperuricaemia

True

False

Don't know

Streptomycin is safe for use during pregnancy

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G1BE209 - Respiratory MCQ

27. Respiratory disease is a major public health concern at the start of the 21st century.
Which of the following statements about the public health aspects of these diseases in
Africa is/ are correct?
a. Respiratory diseases account for approximately
20% of deaths in Africa annually.

True

False

Don't know

b. The increase in asthma is due to urbanization

and increasing occupational exposures.

True

False

Don't know

c. In the pathogenesis of COPD, smoking and

exposure to hazardous dusts have an additive effect.

True

False

Don't know

d. Notification processes are likely to produce

statistics on malignancies which are a good reflection
of the actual rates.

True

False

Don't know

e. The PAL (Practical Approach to Lung health)

strategy relies on accurate diagnosis of respiratory
symptoms.

True

False

Don't know

28. Tuberculosis is a major public health problem in the developing world including South
Africa. It is essential that the diagnosis, management and control of TB should be
optimally carried out. Which of the following statements about TB control are correct?
a. Robert Kochs postulates set out the criteria for
determining the causative agent in an infectious
disease.

True

False

Don't know

b. Labour sending areas have historically been

relatively protected from the TB epidemic as the
populations there are generally healthy.

True

False

Don't know

c.
The Labour Relations Act is an important piece
of legislation that can be used in addressing
occupational determinants of TB.

True

False

Don't know

d.
In line with the Stop TB strategy, the global
target for reduction of TB incidence by 2015 is 75%
of 1990 levels.

True

False

Don't know

e.
The City of Johannesburg has consistently
managed to achieve a cure rate of above 70% since
2006.

True

False

Don't know

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G1BE209 - Respiratory MCQ

29. Exposure of workers to asbestos fibres in the mining and industrial sectors, as well as in
housing, has been one of the environmental health disasters of the past century.
Which of the following statements about asbestos related disease is/ are correct?
a. As asbestos has been banned in over 40
countries a subsequent reduction in occupational
lung cancers can be expected in the next decade.

True

False

Don't know

b. Unlike the other types of asbestos chrysotile

(white) asbestos has a threshold above which it
becomes carcinogenic, therefore it is the least
carcinogenic type.

True

False

Don't know

c. Environmental exposure to asbestos is a legacy

that has remained in many asbestos mining towns
and this poses a challenge for compensation.

True

False

Don't know

d. The historical documentation of asbestos related

disease has been matched by a marked positive
research interest by the asbestos industry.

True

False

Don't know

e. Unlike the other types of asbestos, crocidolite

(blue) asbestos in South Africa is found largely in
Mpumalanga.

True

False

Don't know

30. Occupational disease remains a public health problem worldwide and also in South
Africa, and one which medical practitioners in working class communities are likely to
encounter on a regular basis. Which of the following statements about occupational
diseases is/ are correct?
a. A doctor should suspect that a condition is
occupational when symptoms are better on
weekends when the patient is not at work.

True

False

Don't know

b. Occupational conditions can often be traced back

to preexisting factors/ determinants of a patients
health.

True

False

Don't know

c. In assessing a workers ability to return to work,

provision of personal protective equipment is
cheaper and more important than considering better
engineering controls in the workplace.

True

False

Don't know

d. In cases of acute occupational exposure the

dose-response relationship can usually be easily
proven.

True

False

Don't know

e. Illiterate workers in the construction industry

mostly do casual, low risk work so it is not important
to get a full occupational history from them.

True

False

Don't know

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31. Following on a decade of relative neglect the World Health Organisation is again
stressing the need to put the Primary Health Care (PHC) philosophy at the centre of
health service provision in all member countries. Which of the following statements
relating to health and Primary Health Care in South Africa are correct?
a. The right to health and health care is a basic
right enshrined in the South Africa Constitution.

True

False

Don't know

b. PHC is predominantly concerned with organizing

services to ensure patient convenience i.e. a onestop shop.

True

False

Don't know

c. PHC includes access to basic health care as well

as essential services such as safe water, sanitation
and nutrition.

True

False

Don't know

d. Selective application of PHC has resulted in an

underinvestment in the health of the communities
concerned.

True

False

Don't know

e. PHC is a fixed package of services and is applied

uniformly in all populations regardless of their health
status.

True

False

Don't know

32. Community-acquired pneumonia (CAP) is a common clinical entity. Which of the

following statements about CAP are correct?
a. CAP is mostly acquired by individuals while they
are in hospital.

True

False

Don't know

b. Common bacterial causes in children include

Streptococcus pneumoniae and Haemophilus
influenzae.

True

False

Don't know

c. In diagnosing CAP the Bartlett score is used to

quantify the number of neutrophils and epithelial
cells in sputum.

True

False

Don't know

d. Empirical therapy of CAP depends on age,

severity of the illness and the likely aetiological
agent.

True

False

Don't know

e. Radiological diagnosis is of value in cases of CAP.

True

False

Don't know

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33. The detection of acid-fast bacilli by examination of sputum is of central importance in

diagnosing pulmonary tuberculosis. Which of the following statements about the
examination of sputum in such cases is correct?
a. The auramine O fluorescent stain is less sensitive
than the Ziehl-Neelsen stain for detection of acid fast
bacilli by microscopy.

True

False

Don't know

b. A minimum of 1000 bacilli per ml of sputum is

required for them to be detected by direct
microscopy.

True

False

Don't know

c. Sputum specimens submitted for culture of acid

fast bacilli require decontamination with alkaline
agents to eliminate more rapidly growing bacteria.

True

False

Don't know

d. Some nucleic acid tests like PCR (polymerase

chain reaction) may be performed on sputum directly
if the smear is positive for acid fast bacilli.

True

False

Don't know

e. Smear microscopy grade is directly proportional

to the severity of disease in the lungs in HIV
negative adults.

True

False

Don't know

34. Which of the following are vaccine preventable diseases that are also notifiable to the
Department of Health in South Africa?
a. Polio

True

False

Don't know

b. H1N1 (swine) influenza

True

False

Don't know

c. Haemophilus influenzae disease

True

False

Don't know

d. Meningococcal disease

True

False

Don't know

e. Mumps

True

False

Don't know

35. A 22 year old male presents following a motor vehicle accident. He has multiple facial
lacerations and is confused. In their preparation for the patient, the Emergency
Department Team tasked with his care make use of Universal Precautions. Which of the
following would be considered Universal Precautions?

True

False

Don't know

True

False

Don't know

c. Shoe covers

True

False

Don't know

d. Hepa Filtration Mask

True

False

Don't know

e. Goggles/ face shield

True

False

Don't know

a. Cap and gown

b. Gloves

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36. A victim of a hijack is brought to the Emergency Room by paramedics. He has been
shot in the face. His vitals signs are as follows: Glasgow Coma Scale 15/15 (E4,M6,V5);
blood pressure 139/87 mm Hg; heart rate 107 b.p.m.; respiratory rate 22/minute.
Which of the following statements about his initial management are correct?
a. He may need definitive airway management due
to profuse bleeding.

True

False

Don't know

b. He will need to be intubated due to his low level

of consciousness.

True

False

Don't know

c. He will need an urgent blood transfusion due to

low heart rate.

True

False

Don't know

d. He may have a cervical spine injury and should

be protected until it is excluded.

True

False

Don't know

e. He would be considered a Priority One patient.

True

False

Don't know

37. A young mother brings her 18 month old child to the Emergency Room with severe
dyspnoea. On questioning the mother you find out that the child had been eating
Smarties when the problem started. In this situation emergency management and an
accurate diagnosis are clearly essential. Which of the following statements about
emergency management and diagnosis are correct?
a. Supplemental oxygen should immediately be
applied.

True

False

Don't know

b. The first priority is to establish an intravenous

line.

True

False

Don't know

c. An allergic reaction to the sweets is the most

likely diagnosis.

True

False

Don't know

d. Foreign body aspiration is a potential diagnosis.

True

False

Don't know

e. A detailed family history would exclude acute

asthma.

True

False

Don't know

38. Which of the following processes are consequences of mast cell activation?
a. Bronchoconstriction

True

False

Don't know

b. Cyotokine production

True

False

Don't know

c. Leukotriene synthesis

True

False

Don't know

d. Opsonisation

True

False

Don't know

e. Vasodilation

True

False

Don't know

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G1BE209 - Respiratory MCQ

39. Which of the following are proven risk factors for the development of active TB infection
in South Africa?
a. Adolescence

True

False

Don't know

b. Coal mining

True

False

Don't know

c. Being a health care worker

True

False

Don't know

d. Latent TB infection

True

False

Don't know

e. Cigarette smoking

True

False

Don't know

40. A 15 year old boy presents complaining of a tight chest for the past 2 days, with a
nocturnal cough. He has an inhaler that he uses intermittently. He is afebrile. Which of
the following clinical features would you expect to find on examination?
a. Pleural rub

True

False

Don't know

b. Tachycardia and tachypnoea

True

False

Don't know

c. Stridor

True

False

Don't know

d. Bilateral expiratory wheezes

True

False

Don't know

e. Pulsus paradoxus

True

False

Don't know

41. Upper respiratory tract infections are among the most common conditions that general
medical practitioners have to deal with. Indicate which of the following statements
about upper respiratory tract infections are correct
a. 85% of children with acute otitis media and
otalgia are free of pain within 24 hours without
receiving antibiotics..

True

False

Don't know

b. The anatomical cut-off between upper and lower

respiratory tract infections is the carina (bifurcation
of the trachea).

True

False

Don't know

c. Sitting in a cold wind can contribute to

developing an upper respiratory tract infection.

True

False

Don't know

d.

True

False

Don't know

True

False

Don't know

Most sore throats are caused by viral infections.

e. Streptococcus pneumoniae is a common

causative organism of acute sinusitis

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G1BE209 - Respiratory MCQ

Of the following choices, identify the statement which commonly defines the term strong
anthropocentrism.

a.
b.
c.
d.
e.

Human beings prioritise their satisfaction of immediate wants and desires, no matter
how trivial, above the wants and desires of other sentient animals.
Human beings are intrinsically valuable. This means that we are valuable in a way that
transcends our utility to other beings.
Human beings are the centre of the universe. As such, we are concerned with the
satisfaction of our wants, needs, and desires above all else.
Human beings are the top of the evolutionary scale. Because of this, we have been
given dominion over all living things.
Human beings are capable of feeling pleasure and pain. This sets us apart from lower
life forms.

Answer: c

42. A new Public Health (PH) paradigm in ethics is being advanced because the existing one
is flawed. Which of the following are necessary components of such a new paradigm in
Public Health ethics?
a. It should hold that the state has the final
responsibility for Public Health.

True

False

Don't know

b. It should consider benefits and burdens to the

human population as an aggregate.

True

False

Don't know

c. It should reflect the idea of individual rights/

responsibilities.

True

False

Don't know

d. It should concentrate on the development of

health policy above that of health education.

True

False

Don't know

e. It should include an emphasis on the effects of

environmental degradation on human health.

True

False

Don't know

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G1BE209 - Respiratory MCQ

43. R TYPES
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.

Acute bronchiolitis
Adenocarcinoma
Bagassosis
Bronchopneumonia
Byssinosis
Crohns disease
Emphysema
Farmers lung
Lobar pneumonia
Metastatic tumour
Miliary tuberculosis
Sarcoid
Silicosis
Small airways disease
Squamous carcinoma

For each of the sets of images below, select the condition from the list A to N above
that was most likely involved in the resulting pathology.

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4 August 2009
G1BE209 - Respiratory MCQ

43. SET 1

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

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G1BE209 - Respiratory MCQ

44. SET 2

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

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G1BE209 - Respiratory MCQ
45. SET 3

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

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4 August 2009
G1BE209 - Respiratory MCQ

44. A. Acute lobar pneumonia

B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
P.
Q.
R.

Bronchiectasis
Bronchiolar-alveolar carcinoma
Bronchogenic carcinoma
Bullous centrilobular emphysema
Cor pulmonale
Diffuse alveolar damage
Hilar lymphadenopathy
Isolated organ tuberculosis
Lung abscess
Metastatic tumour
Panlobular emphysema
Paraseptal emphysema
Phlebo-thrombosis of the deep calf veins
Poorly-formed granulomas
Small airways disease
Small cell carcinoma
Uraemic pneumonitis

For each of the scenarios listed below choose the pathological condition listed which
most accurately explains the patients symptoms/disease (note that answers may be
used more than once):
46. A 60 year old female patient on treatment for chronic obstructive airways disease
developed a sudden sharp stabbing pain in the left chest associated with haemoptysis

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

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G1BE209 - Respiratory MCQ

47. A male living in shack dwelling is trapped inside when the house is accidentally catches
fire. He is admitted to hospital with severe burns and dies a few days later.

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R
48. A young male is being investigated for progressive dyspnoea. He is found to have
decreased levels of alpha 1-antitrypsin activity in a sample of his peripheral blood.

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

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G1BE209 - Respiratory MCQ

49. A 65 year old male is admitted in cardiac failure. He has been a cigarette smoker for
many years and more recently has had a productive cough for the past 3 years. A
radiograph of his chest confirms the presence of right ventricular hypertrophy.

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R
50. A 65 year old female is admitted to hospital for investigation of productive cough and
more recently several episodes of haemoptysis. In addition, she also admits that she has
had a increasingly severe lower back pain over the passed few months. A radiograph of the
chest is clear, but a radiograph of her lumbar spine is highly suggestive of her primary
pathology.

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

Page 26