Investigations of the Respiratory System

Question 1

What is the purpose of respiratory investigations?

Answer 1

Confirm diagnosis, assess severity, determine treatment fitness.

Question 2

Which of the following is NOT an imaging technique?
A) CT scan
B) Bronchoscopy
C) Spirometry
D) MRI

Answer 2

Correct Answer: C) Spirometry

Question 3

What is the primary use of a PET scan in lung cancer?

Answer 3

Assess metabolic activity of tumors.

Question 4

Which imaging technique is best for detecting a Pancoast tumor?

Answer 4

MRI
- better at determining invasion of chest wall or mediastinum by cancer

Question 5

Which test is used to collect lung fluid for analysis?

Answer 5

Bronchoalveolar lavage (BAL)

Question 6

Which biopsy method is best for pleural disease?

Answer 6

Abrams needle biopsy

Question 7

Which test differentiates obstructive from restrictive lung disease?

Answer 7

Spirometry

Question 8

What gas is measured in arterial blood gas (ABG) to assess ventilation?

Answer 8

CO2

Question 9

What does TNM stand for in lung cancer staging?

Answer 9

Tumor, Node, Metastasis

Question 10

Which test is used for lung cancer lymph node assessment?

Answer 10

Endobronchial ultrasound (EBUS)

Question 11

Which of the following is NOT a primary reason for performing a respiratory investigation?
A) Confirm diagnosis
B) Establish severity and prognosis
C) Determine the effectiveness of past treatments
D) Assess patient fitness for treatment

Answer 11

Correct Answer: C) Determine the effectiveness of past treatments

Question 12

What is the biggest limitation of imaging-based investigations in diagnosing lung pathology?
A) Cannot differentiate between benign and malignant lesions
B) Limited accessibility in hospitals
C) High cost of imaging procedures
D) Inability to visualize the mediastinum

Answer 12

Correct Answer: A) Cannot differentiate between benign and malignant lesions

Question 13

A patient with suspected lung cancer presents with a lesion at the apex of the lung and severe shoulder pain. Which imaging modality is most appropriate?
A) Chest X-ray
B) CT scan
C) MRI
D) PET scan

Answer 13

Correct Answer: C) MRI (best for Pancoast tumors)

Question 14

Why is a V/Q scan used instead of a CT Pulmonary Angiogram (CTPA) in pregnant patients with suspected pulmonary embolism?
A) Lower radiation exposure
B) Higher sensitivity for detecting small emboli
C) Faster scan time
D) More accurate in detecting embolism

Answer 14

Correct Answer: A) Lower radiation exposure

Question 15

Which imaging modality is best for detecting early interstitial lung disease?
A) Chest X-ray
B) High-resolution CT (HRCT)
C) MRI
D) PET scan

Answer 15

Correct Answer: B) High-resolution CT (HRCT)

Question 16

Which of the following tests is NOT commonly performed on bronchoalveolar lavage (BAL) fluid?
A) Bacterial culture
B) Cytology
C) Genetic testing
D) Spirometry

Answer 16

Correct Answer: D) Spirometry

Question 17

A patient presents with pleural effusion of unknown cause. Which biopsy technique provides the highest diagnostic yield?
A) Abrams pleural biopsy
B) Fine-needle aspiration (FNA)
C) Video-assisted thoracoscopic surgery (VATS) biopsy
D) Sputum cytology

Answer 17

Correct Answer: C) Video-assisted thoracoscopic surgery (VATS) biopsy

Question 18

What is the main advantage of using Endobronchial Ultrasound (EBUS) over traditional bronchoscopy?
A) Lower risk of complications
B) Higher resolution imaging
C) Allows real-time guided lymph node sampling
D) Less patient discomfort

Answer 18

Correct Answer: C) Allows real-time guided lymph node sampling

Question 19

A patient’s spirometry shows a decreased FEV1/FVC ratio. What does this indicate?
A) Restrictive lung disease
B) Obstructive lung disease
C) Pulmonary embolism
D) Lung fibrosis

Answer 19

Correct Answer: B) Obstructive lung disease

Question 20

Which measurement is most useful for differentiating COPD from asthma?
A) DLCO (Diffusing capacity for carbon monoxide)
B) Spirometry FEV1/FVC ratio
C) Peak Expiratory Flow Rate (PEFR)
D) Bronchodilator reversibility testing

Answer 20

Correct Answer: D) Bronchodilator reversibility testing

Question 21

Which arterial blood gas (ABG) pattern is characteristic of an acute pulmonary embolism?
A) Low pH, low CO2, low O2
B) Normal pH, normal CO2, low O2
C) High pH, low CO2, low O2
D) High pH, high CO2, low O2

Answer 21

Correct Answer: C) High pH, low CO2, low O2 (Respiratory alkalosis due to hyperventilation)

Question 22

Which of the following conditions is LEAST likely to cause Type 2 respiratory failure?
A) COPD
B) Myasthenia Gravis
C) Pulmonary fibrosis
D) Opiate overdose

Answer 22

Correct Answer: C) Pulmonary fibrosis (causes Type 1 respiratory failure)

Question 23

Which diagnostic tool provides the most definitive method for confirming lung cancer?
A) PET scan
B) CT-guided biopsy
C) Chest X-ray
D) Lung ultrasound

Answer 23

Correct Answer: B) CT-guided biopsy

Question 24

Which biomarker is commonly measured in lung cancer for targeted therapy?
A) BNP
B) ALK gene rearrangement
C) D-dimer
D) IgE

Answer 24

Correct Answer: B) ALK gene rearrangement

Question 25

Which of the following clinical signs increases the probability of a pulmonary embolism? A) Bradycardia B) Unilateral leg swelling C) Cough with purulent sputum D) Hyperresonance on percussion

Answer 25

Correct Answer: B) Unilateral leg swelling (suggestive of deep vein thrombosis)

Question 26

What is the main disadvantage of using D-dimer as a diagnostic test for pulmonary embolism? A) Low sensitivity B) Low specificity C) Slow result time D) High radiation exposure

Answer 26

Correct Answer: B) Low specificity (many conditions can cause elevated D-dimer)

Question 27

What does a normal ventilation scan with a mismatched perfusion defect indicate? A) COPD B) Pulmonary embolism C) Asthma D) Pneumonia

Answer 27

Correct Answer: B) Pulmonary embolism

Question 28

Which condition is most likely to cause a matched defect (both ventilation and perfusion abnormalities) on V/Q scanning? A) Pulmonary embolism B) COPD C) Interstitial lung disease D) Pulmonary edema

Answer 28

Correct Answer: A) Pulmonary embolism

Question 29

A patient with suspected lung cancer has no distant metastases but has a mediastinal lymph node >3 cm. What is the correct TNM staging? A) T2N1M0 B) T3N2M0 C) T1N3M0 D) T4N2M1

Answer 29

Correct Answer: B) T3N2M0

Question 30

Which treatment is NOT appropriate for a patient with a massive pulmonary embolism? A) IV thrombolysis B) Mechanical thrombectomy C) Low-dose aspirin D) Heparin infusion

Answer 30

Correct Answer: C) Low-dose aspirin

Question 31

What does a LAT stand for

Answer 31

Local Anaesthetic Thoracscopy under local anaesthetic

Question 32

What does VATS stand for

Answer 32

Video Assisted Thoracoscopic Surgery under general anaesthetic

Question 33

What are the three investigations

Answer 33

imaging sampling function

Question 34

how do you test pulmonary function

Answer 34

Spirometry Arterial Blood gases Progressive exercise tests sleep studies

Question 35

who is ultra sound

Answer 35

IZZY

Question 36

what does Pet stand for

Answer 36

Positron Emission Tomography

Question 37

when is a PET scan used

Answer 37

Radio labels with sugar Glucose is injected into the patient, it will be taken up by things in the patient, like cancers, it will be taken up and glow, when used in a scan, you will see the glowing area and will think it is a metastatic disease can also be used to identify infectious diseases

Question 38

what does EBUS stand for

Answer 38

Endo brachial ultrasound sampling

Question 39

if there is increased white on a chest X ray

Answer 39

effusion pneumonia

Question 40

venous blood sampling is usually used to check what

Answer 40

general organ function

Question 41

What is a D-dimer test?

Answer 41

A D-dimer test is a blood test that measures D-dimer, which is a protein fragment that your body makes when a blood clot dissolves in your body. D-dimer is normally undetectable or only detectable at a very low level unless your body is forming and breaking down significant blood clots.

Question 42

red flag symptoms for respiratory exam

Answer 42

New cough fever persistant cough weight loss haemotpysis

Question 43

what imaging technique would be used to identify metastasised cancer

Answer 43

PET scan

Question 44

what does the mask measure in a progressive exercise test

Answer 44

how much carbon dioxide they are producing and how much oxygen they are consuming

Question 45

Interpretation of Arterial Blood gasses (H+, pCO2, p)2, HCO3) What would be indicative for type 1 respiratory failure

Answer 45

Low O2 <8kPa

Question 46

Interpretation of Arterial Blood gasses (H+, pCO2, p)2, HCO3) What would be indicative of Type 2 respiratory failure

Answer 46

Low O2 <8kPa High CO2 >6kPa

Question 47

What is acidosis

Answer 47

H+

Question 48

what would be indicative of alkalynotic

Answer 48

HCO3-

Question 49

How would an individual get Type 1 respiratory failure

Answer 49

Asthma Pneumonia

Question 50

What if someone takes an opitio=te overdose what type odf respiratory failure will they have, and how do you reverse it

Answer 50

Type 2 Naloxone

Question 51

If someone has COPD what type of respiratory failure will they have, and what will their HC)3 levels be

Answer 51

Type 2 respiratory failure their kidneys will produce more HCO3 to try balance the too much CO2 levels in their blood they cannot breath properly

Question 52

what test would you do to test for Cardiac failure

Answer 52

BNP

Question 53

What would you look for if you thought someone was at risk of a pulmonary embolism

Answer 53

D-Dimer - large amounts of clotting

Question 54

What are some investigations of PE

Answer 54

troponin Echo RV dysfunction on CPTA

Question 55

What are the treatment options of PE

Answer 55

S/C fractionated heparin Oral anticoagulants IV thrombolytics Mechanical interventions

Question 56

What is a CPTA

Answer 56

A CT pulmonary angiogram (or CTPA) is a CT scan that looks for blood clots in the lungs (also known as pulmonary embolism or PE).