Clinical medicine Flashcards
1
Q
A 59 y/o male smoker presents with weight loss, haemoptysis, cough & shortness of breath. On general examination he has finger clubbing, is anaemic and apyrexial(no fever). A. anaemia B. Pneumonia C. Tuberculosis D. Bronchial carcinoma E. Pneumothorax F. Pulmonary embolus G. Cryptogenic fibrosing alveolitis H. Pleural effusion I. Pulmonary oedema J. Fractured rib
A
D. Bronchial carcinoma.
Finger clubbing is very non specific.
2
Q
A 65 y/o female presents to A&E with shortness of breath and right-sided pleuritic chest pain. On examination she has a pleural rub. A. anaemia B. Pneumonia C. Tuberculosis D. Bronchial carcinoma E. Pneumothorax F. Pulmonary embolus G. Cryptogenic fibrosing alveolitis H. Pleural effusion I. Pulmonary oedema J. Fractured rib
A
Pleural effusion
3
Q
A 62 y/o female presents with a one day history of fever, rigors, shortness of breath and right sided pleuritic chest pain. On examination of the chest there is decreased expansion, dullness to percussion and bronchial breathing on the right-side. A. anaemia B. Pneumonia C. Tuberculosis D. Bronchial carcinoma E. Pneumothorax F. Pulmonary embolus G. Cryptogenic fibrosing alveolitis H. Pleural effusion I. Pulmonary oedema J. Fractured rib
A
M
4
Q
A 25 y/o male presents to A&E after falling from a 6ft wall the previous night. He describes shortness of breath and right-sided chest pain, worse on inspiration. On examination there is localised tenderness to palpitation of the right-sided chest wall. Equal air entry bilaterally. A. anaemia B. Pneumonia C. Tuberculosis D. Bronchial carcinoma E. Pneumothorax F. Pulmonary embolus G. Cryptogenic fibrosing alveolitis H. Pleural effusion I. Pulmonary oedema J. Fractured rib
A
E
5
Q
A 65 y/o man is a life time smoker presenting with dyspnoea. On examination he has decreased chest expansion on right side, stony dullness and decreased air entry at the right base. Name the pathology elicited on examination. A. anaemia B. Pneumonia C. Tuberculosis D. Bronchial carcinoma E. Pneumothorax F. Pulmonary embolus G. Cryptogenic fibrosing alveolitis H. Pleural effusion I. Pulmonary oedema J. Fractured rib
A
H. Pleural effusion
6
Q
85 y/o woman presented to A&E with shortness of breath. On examination she was noted to have bilateral, pitting, ankle oedema to mid-shin, and bilateral basal crackles. Chest x-ray showed Kerley B lines, prominent upper lobe vessels and cardiomegaly. A. anaemia B. Pneumonia C. Tuberculosis D. Bronchial carcinoma E. Pneumothorax F. Pulmonary embolus G. Cryptogenic fibrosing alveolitis H. Pleural effusion I. Pulmonary oedema J. Fractured rib
A
I
7
Q
A 58 y/o man presents to the respiratory clinic with an 18 month history of increasing shortness of breath. On examination he is tachypnoeic and has gross finger clubbing. On auscultation he has fine-end inspiratory crackles. A. anaemia B. Pneumonia C. Tuberculosis D. Bronchial carcinoma E. Pneumothorax F. Pulmonary embolus G. Cryptogenic fibrosing alveolitis H. Pleural effusion I. Pulmonary oedema J. Fractured rib
A
G
8
Q
A 35 y/o female presents with fever, night sweats, weight loss and productive cough with haemoptysis. Ziehl-neelson stain of a sputum is positive for acid fast bacilli. A. Traumatic, post-intubation B. Pulmonary oedema C. Pneumonia D. Tuberculosis E. Goodpasture's syndrome F. Haemophilia G. Pulmonary embolus H. Bronchial carcinoma I. Haemothorax J. Pulmonary metastases
A
D
9
Q
A 76 y/o female presents with shortness of breath and a cough productive of pink frothy sputum. On examination she is peripherally cyanosed tachycardic, tachypnoeic, and has bilateral inspiratory crackles on auscultation of her chest. A. Traumatic, post-intubation B. Pulmonary oedema C. Pneumonia D. Tuberculosis E. Goodpasture's syndrome F. Haemophilia G. Pulmonary embolus H. Bronchial carcinoma I. Haemothorax J. Pulmonary metastases
A
B
10
Q
A 65 y/o female presents with a cough and haemoptysis. She also complains of hoarsening of her voice. On examination her chests is clear, but supra-clavicular lymphadenopathy is noted. A. Traumatic, post-intubation B. Pulmonary oedema C. Pneumonia D. Tuberculosis E. Goodpasture's syndrome F. Haemophilia G. Pulmonary embolus H. Bronchial carcinoma I. Haemothorax J. Pulmonary metastases
A
H. Bronchial carcinoma
11
Q
A 34 y/o man presents to A&E with a short history of haemoptysis. He has had a cough for a fortnight and noticed his ankles beginning to swell 5 days ago. Initial blood tests show a creatinine of 400umol/l. An autoantibody screen is positive for p-ANCA and anti-glomerular basement membrane antibodies. A. Traumatic, post-intubation B. Pulmonary oedema C. Pneumonia D. Tuberculosis E. Goodpasture's syndrome F. Haemophilia G. Pulmonary embolus H. Bronchial carcinoma I. Haemothorax J. Pulmonary metastases
A
E goodpasture’s syndrome
12
Q
A 48 year old woman with ovarian carcinoma presents to A&E with a 12 hour history of haemoptysis. She also complains of dyspnoea and pleuritic chest pain. On examination she is apyrexial and has a right sided pleural rub. The chest x-ray shows a wedge-shaped infarct peripherally on the right but is otherwise normal. A. Traumatic, post-intubation B. Pulmonary oedema C. Pneumonia D. Tuberculosis E. Goodpasture's syndrome F. Haemophilia G. Pulmonary embolus H. Bronchial carcinoma I. Haemothorax J. Pulmonary metastases
A
G
13
Q
60 y/o man with a dry cough, confusion and diarrhoea. His wife noted his symptoms started shortly after returning home from a business trip in Spain. A. Streptococcus pneumonia B. Haemophilus influenzae C. Rhinovirus D. Pneumocystis carnii E. Chlamydia psittaci F. Legionella pneumophilia G. Mycoplasma H. Staphylococcus aureus I. Pseudomonas aeroginosa
A
A
14
Q
A 35 year old woman with a 10 year history of HIV, known to be poorly compliant to medication. She is complaining of progressive shortness of breath and a dry cough. A. Streptococcus pneumonia B. Haemophilus influenzae C. Rhinovirus D. Pneumocystis carnii E. Chlamydia psittaci F. Legionella pneumophilia G. Mycoplasma H. Staphylococcus aureus I. Pseudomonas aeroginosa
A
B haemophilus influenzae
15
Q
42 y/o male with fever, arthralgia and mucoid sputum. Blood cultures were negative, but chest x-ray showed patchy consolidation in the right lung. He mentions that he has recently bought a parrot. A. Streptococcus pneumonia B. Haemophilus influenzae C. Rhinovirus D. Pneumocystis carnii E. Chlamydia psittaci F. Legionella pneumophilia G. Mycoplasma H. Staphylococcus aureus I. Pseudomonas aeroginosa
A
E. Chlamydia psittaci
