Respiratory Medicine MCQs

Medicine · 5 free questions with answers & explanations.

1. A 35-year-old non-smoker woman presents with progressive dyspnea on exertion and dry cough for 8 months. She works as a bird breeder. HRCT of the chest shows bilateral ground-glass opacities predominantly in the upper and middle lobes with mosaic attenuation. BAL fluid shows lymphocytosis with a CD4:CD8 ratio of 0.5. What is the MOST likely diagnosis?
2. A 62-year-old man with a 40 pack-year smoking history presents with worsening dyspnea and productive cough. Spirometry shows FEV1/FVC of 0.58 (post-bronchodilator), FEV1 42% of predicted. He has had two exacerbations in the past year requiring oral steroids. According to GOLD 2023 classification, which pharmacological therapy is MOST appropriate for long-term maintenance?
3. A 28-year-old woman presents with sudden-onset pleuritic chest pain and dyspnea while on oral contraceptive pills. CT pulmonary angiography confirms a right lower lobe pulmonary embolism. She has no prior VTE, no cancer, and no other provoking factors apart from OCP use. After completing 3 months of anticoagulation, what is the MOST appropriate next step?
4. A 50-year-old man of African descent presents with bilateral hilar lymphadenopathy on chest X-ray found incidentally. He is asymptomatic. Serum ACE is elevated. Biopsy of an enlarged supraclavicular lymph node shows non-caseating granulomas. Staining and culture for mycobacteria and fungi are negative. What is the MOST appropriate management?
5. A 70-year-old man presents with progressive dyspnea and dry cough for 2 years. He is a never-smoker. HRCT shows bilateral basal and subpleural honeycombing with traction bronchiectasis. Spirometry shows a restrictive pattern with FVC 58% and DLCO 45% of predicted. Bronchoalveolar lavage shows no lymphocytosis. Surgical lung biopsy confirms usual interstitial pneumonia (UIP) pattern. Which of the following best describes the pharmacotherapy with proven benefit in this condition?