Pulmonology — MCQs

A 36-year-old woman with a history of obstructive sleep apnea is admitted with acute shortness of breath, cough with greenish sputum, and fever. On physical examination, she is febrile and has decreased breath sounds generally and diffuse bilateral rhonchi. ABGs: pH 7.32; PCO2 47 mm Hg; PO2 65 mm Hg with O2 saturation 87%. The patient improves initially but has a respiratory arrest as she is being moved to the ICU, requiring emergency endotracheal intubation. While a CXR is ordered, it is noted that she has absent breath sounds on the left side. What is the most likely diagnosis based on the clinical presentation and the finding of absent breath sounds on the left side prior to CXR results?

A 45-year-old male presents with 2 days of haemoptysis, coughing up 1-3 tablespoons of blood daily. He also reports mild chest pain, low-grade fevers, and weight loss. For the past year, he has experienced severe upper respiratory symptoms, including frequent epistaxis and purulent discharge, treated with multiple antibiotic courses. His medications include daily aspirin and lovastatin. On examination, vital signs are normal. The upper airway shows a saddle nose deformity, and lung auscultation is clear. A CT scan of the chest reveals multiple cavitating nodules, and urinalysis shows RBCs. Which of the following tests offers the highest diagnostic yield to make the appropriate diagnosis?

Which is a biomarker for ventilator-associated pneumonia?

A 65-year-old man presents with intermittent hemoptysis for the past 1 week. He denies chest pain, fever, cough, or chronic sputum production. He has a 35-pack-year smoking history. Physical examination reveals normal vital signs, a JVP of 2 cm, normal heart sounds, and clear lungs on auscultation. There are no palpable lymph nodes. Sputum cytology is positive for malignant cells, but chest X-ray and CT chest are normal. What is the next best step in management?

What is the most common cause of pulmonary embolism?

A 60-year-old hypertensive male had a stroke 2 weeks prior to a sudden attack of dyspnea. The present ECG shows changes of S1 Q3 T3, and the V/Q pulmonary scan shows major areas of reduced perfusion. What is the probable diagnosis?

A 63-year-old woman presents with acute shortness of breath. She has a recent diagnosis of breast cancer and is undergoing active treatment. Her vital signs are: blood pressure 120/80 mm Hg, pulse 100/min. Cardiac and pulmonary examinations are normal. There are no clinical signs of deep venous thrombosis (DVT). Which of the following investigations is most likely to rule out a pulmonary embolism (PE)?

Which of the following is a clinical sign of tension pneumothorax?

A 65-year-old man presents with severe chest pain and difficulty in breathing. His ECG showed an S1Q3T3 pattern with sinus tachycardia. What diagnosis does this ECG suggest?

Which of the following features would be seen in a patient with suspected aspergillosis?