UKMLA Applied Knowledge Test (MSRA-style single best answer) · Cardiovascular and Respiratory Medicine

Respiratory medicine

18 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 18 questions

  1. A 70-year-old man is newly confused. His respiratory rate is 28, blood pressure 100/70 mmHg, urea 9 mmol/L and he has consolidation on chest X-ray. What is his CURB-65 score?
  2. What is the first-line antibiotic for community-acquired pneumonia of low severity in an adult, according to NICE?
  3. Under NICE, BTS and SIGN asthma guidance, what is the preferred initial reliever approach in a newly diagnosed adult with asthma?
  4. A 66-year-old ex-smoker with COPD has breathlessness affecting daily activities and no asthmatic features. His inhaled SABA is not enough. What is the next step according to NICE?
  5. A patient with severe COPD is given high-flow oxygen on the way to hospital and becomes drowsy. What oxygen saturation target is recommended for those at risk of hypercapnic respiratory failure?
  6. A tall, thin 19-year-old smoker has sudden right pleuritic chest pain and breathlessness. There is hyperresonance and reduced breath sounds on the right. What is the most likely diagnosis?
  7. A 58-year-old smoker has coughed up blood on several occasions over three weeks. What is the most appropriate management?
  8. A man who worked for years in a shipyard has progressive breathlessness, finger clubbing and bibasal fine end-inspiratory crackles. Lung function tests are most likely to show what?
  9. A young woman has erythema nodosum, bilateral hilar lymphadenopathy on chest X-ray and arthralgia. What is the most likely diagnosis?
  10. A pleural fluid sample shows protein 22 g/L, with a serum protein of 68 g/L and a pleural-to-serum LDH ratio of 0.3. Which interpretation is correct?
  11. An arterial blood gas on air in a drowsy patient with COPD shows pH 7.28, PaCO2 9.2 kPa, PaO2 6.8 kPa and bicarbonate 25 mmol/L. How should it be interpreted?
  12. What FEV1/FVC ratio after bronchodilator confirms airflow obstruction in the diagnosis of COPD?
  13. A man with obesity is sleepy during the day and snores loudly, with witnessed apnoeas. What is the usual treatment for moderate-to-severe obstructive sleep apnoea?
  14. A patient with chronic productive cough, recurrent chest infections and thickened bronchial walls on CT with dilated airways has Pseudomonas aeruginosa grown on sputum. What is the diagnosis?
  15. After failed back-to-back nebulised salbutamol and ipratropium in life-threatening asthma, what additional single-dose treatment should be considered by a senior clinician?
  16. A patient with a right-to-left cardiac shunt has an oxygen saturation of 80 percent. Why does breathing 100 percent oxygen fail to correct the hypoxaemia?
  17. A healthy 22-year-old has a primary pneumothorax with only minimal symptoms, meaning no significant pain or breathlessness. What does BTS guidance suggest?
  18. A man with an occupational exposure to asbestos develops pleural thickening, weight loss and chest pain, and biopsy shows a malignancy. What is the most likely tumour?

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