Respiratory 1-48 MRQ

A 45-year-old man presents to your clinic with progressive shortness of breath and fatigue over the past six months. On examination, he has clubbing of his fingers and mild central cyanosis. His respiratory examination reveals bilateral fine inspiratory crackles at the lung bases. His past medical history includes gastroesophageal reflux disease but no history of smoking. A chest X-ray shows reticular opacities at the lung bases, and high-resolution CT confirms honeycombing and traction bronchiectasis.

Which of the following conditions are potential causes of his digital clubbing? Select four (4) Correct answer.

A 52-year-old woman is referred for evaluation of chronic cough and weight loss. She has noticed progressive thickening of her fingernails over the past year. Examination reveals digital clubbing and mild wheezing on auscultation. A chest X-ray shows a well-defined opacity in the left upper lobe, and CT thorax confirms a 4 cm mass.

Which of the following conditions are potential causes of her digital clubbing? Select four (4) Correct answer.

A 60-year-old retired miner presents with progressive dyspnea and a persistent dry cough for the past year. On examination, you note clubbing of his fingers and bibasilar fine inspiratory crackles. He has a history of working in coal mines for 35 years. A chest X-ray shows diffuse reticular opacities, and high-resolution CT confirms fibrosis with pleural plaques.

Which of the following conditions are potential causes of his digital clubbing? Select four (4) Correct answer.

A 35-year-old man with a history of chronic sinus infections presents with a productive cough, fatigue, and shortness of breath. He has noticed thickening of his fingernails over the past few months. Examination reveals digital clubbing, hyperresonant lung fields, and scattered wheezes. A sweat chloride test is positive.

Which of the following conditions are potential causes of his digital clubbing? Select four (4) Correct answer.

A 67-year-old man presents to your clinic with a three-day history of fever, productive cough, and pleuritic chest pain.. He does not smoke Examination reveals a temperature of 38.5°C, crackles in the right lower lung field, and oxygen saturation of 92% on room air. A chest X-ray confirms a right lower lobe consolidation.

Which of the following are recognized risk factors for community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 45-year-old healthcare worker presents with fever, chills, cough, and dyspnea. She has a history of asthma. She reports taking oral corticosteroids intermittently for exacerbations. She has no history of smoking. On examination, she has a temperature of 39°C, respiratory rate of 24 breaths per minute, and oxygen saturation of 95% on room air. Chest auscultation reveals right-sided crackles.

Which of the following are recognized risk factors for community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 68-year-old man presents with a four-day history of fever, productive cough, and shortness of breath. He has a history of chronic obstructive pulmonary disease (COPD) and hypertension. On examination, he appears mildly unwell with a respiratory rate of 22 breaths per minute and oxygen saturation of 94% on room air.

Which of the following are clinical signs you would look for in a patient with suspected community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 55-year-old woman presents with fever, cough, and chest pain for five days. She has no significant medical history but smokes 15 cigarettes per day. On examination, you suspect pneumonia. Which of the following are important clinical signs to assess in a patient with suspected community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 72-year-old man presents with a five-day history of fever, productive cough, and shortness of breath. He has a history of type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD). On examination, he is febrile (38.6°C), with a respiratory rate of 26 breaths per minute and oxygen saturation of 90% on room air. Crackles are heard in the right lower lung field.

Which of the following investigations are important in the assessment of suspected community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 50-year-old woman presents with fever, cough, and chest pain for the past four days. She has a history of asthma and is on inhaled corticosteroids. On examination, she has a temperature of 39°C, a respiratory rate of 28 breaths per minute, and oxygen saturation of 91% on room air. Crackles are heard bilaterally.

Which of the following investigations are important in evaluating suspected community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 70-year-old man presents with fever, productive cough, and dyspnea for the past four days. He has a history of type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD). On examination, he has a temperature of 38.5°C, respiratory rate of 28 breaths per minute, and oxygen saturation of 90% on room air. Chest auscultation reveals crackles and bronchial breath sounds over the right lower lung field. A chest X-ray confirms right lower lobe consolidation.

According to Australian RACGP guidelines, which of the following are appropriate management steps for this patient? Select five (5) Correct answer.

A 50-year-old woman with no significant past medical history presents with a four-day history of fever, cough, and malaise. She is otherwise well and has oxygen saturation of 97% on room air. A chest X-ray confirms left lower lobe consolidation, and her vital signs are stable.

According to Australian RACGP guidelines, which of the following are appropriate management steps for this patient? Select five (5) Correct answer.

A 65-year-old man with type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD) presents with a seven-day history of fever, productive cough, and worsening breathlessness. Despite completing a course of antibiotics, his symptoms persist. On examination, he is febrile (38.9°C), tachypneic (RR 30/min), and has oxygen saturation of 88% on room air. Chest auscultation reveals diminished breath sounds over the right lower lung field. A repeat chest X-ray shows a loculated pleural effusion.

Which of the following are possible complications of community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 58-year-old woman with no significant past medical history presents with fever, cough, and chest pain for eight days. She was diagnosed with community-acquired pneumonia (CAP) a week ago and started on antibiotics, but her symptoms have worsened. She now reports pleuritic chest pain and increasing fatigue. On examination, she has a temperature of 39°C, respiratory rate of 32 breaths per minute, and oxygen saturation of 89% on room air. A repeat chest X-ray shows worsening consolidation and new pleural effusion.

Which of the following are possible complications of community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 78-year-old man with a history of ischemic heart disease and chronic obstructive pulmonary disease (COPD) presents with fever, productive cough, and dyspnea for the past five days. His respiratory rate is 30 breaths per minute, oxygen saturation is 88% on room air, and his blood pressure is 90/60 mmHg. Chest X-ray confirms right lower lobe consolidation. His arterial blood gas shows a PaO₂ of 55 mmHg.

Which of the following factors are associated with a poor prognosis in community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 56-year-old woman with hypertension and chronic kidney disease presents with fever, cough, and dyspnea. She was diagnosed with mild community-acquired pneumonia (CAP) three days ago and started on oral antibiotics. She now feels better but asks about her recovery and potential risks.

Which of the following factors are associated with a good prognosis in community-acquired pneumonia (CAP)? Select five (5) Correct answer.

A 68-year-old man is admitted to the hospital for a hip fracture and undergoes surgical repair. On day five postoperatively, he develops a fever, productive cough, and increasing oxygen requirements. His temperature is 38.9°C, respiratory rate is 26 breaths per minute, and oxygen saturation is 90% on room air. A chest X-ray shows new right lower lobe consolidation.

Which of the following are recognized risk factors for hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 75-year-old woman with a history of ischemic heart disease and type 2 diabetes mellitus is admitted to the hospital for a urinary tract infection. On day six of her admission, she develops fever, dyspnea, and a new productive cough. A chest X-ray reveals a left lower lobe infiltrate.

Which of the following are risk factors for hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 74-year-old man with a history of type 2 diabetes and chronic kidney disease has been in the hospital for seven days following a hip replacement surgery. He develops a fever, productive cough, and increasing breathlessness.. A chest X-ray reveals a new left lower lobe consolidation.

Which of the following are clinical signs you would look for in a patient with suspected hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 67-year-old woman with hypertension and a history of chronic obstructive pulmonary disease (COPD) has been in the hospital for five days following an abdominal surgery. She now develops fever, worsening cough, and increased oxygen requirements. Which of the following are important clinical signs in a patient with suspected hospital-acquired pneumonia (HAP)? Select four (4) Correct answer.

A 70-year-old man is admitted to the hospital for a hip fracture. On day six, he develops a fever, productive cough, and shortness of breath. His temperature is 38.6°C, respiratory rate is 28 breaths per minute, and oxygen saturation is 91% on room air. Chest auscultation reveals crackles and bronchial breath sounds over the right lung base. A chest X-ray confirms right lower lobe consolidation.

Which of the following investigations are important in the assessment of hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 60-year-old woman with type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD) is admitted for an elective knee replacement. On day seven, she develops fever, dyspnea, and a productive cough. A chest X-ray reveals a new left lower lobe consolidation.

Which of the following investigations are important in evaluating suspected hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 75-year-old man with a history of type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD) is admitted to the hospital for a hip replacement. On day six, he develops fever, cough, and worsening shortness of breath. His respiratory rate is 28 breaths per minute, oxygen saturation is 89% on room air, and a chest X-ray confirms right lower lobe consolidation.

According to Australian RACGP guidelines, which of the following are appropriate management steps for hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 68-year-old woman with chronic kidney disease and hypertension has been admitted for a urinary tract infection. On day seven, she develops fever, dyspnea, and increased sputum production. Her oxygen saturation is 91% on room air, and a chest X-ray shows left lower lobe consolidation.

According to Australian RACGP guidelines, which of the following are appropriate management steps for hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 70-year-old man with type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD) was admitted to the hospital for a hip replacement. On day six, he developed hospital-acquired pneumonia (HAP) and was started on intravenous piperacillin-tazobactam. Despite five days of treatment, he remains febrile and increasingly dyspneic. A repeat chest X-ray shows a new loculated pleural effusion.

Which of the following are possible complications of hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 65-year-old woman with chronic kidney disease was admitted for surgery and developed hospital-acquired pneumonia (HAP) on day five. She was treated with broad-spectrum antibiotics but remains hypoxic despite therapy. Her oxygen saturation is 85% on high-flow oxygen, and a repeat chest X-ray shows worsening bilateral infiltrates.

Which of the following are possible complications of hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 78-year-old man with a history of ischemic heart disease and type 2 diabetes mellitus developed hospital-acquired pneumonia (HAP) five days after undergoing abdominal surgery. Despite receiving appropriate antibiotics, his condition has worsened, requiring high-flow oxygen therapy. His respiratory rate is 32 breaths per minute, and his blood pressure is 88/60 mmHg. Blood cultures are positive for Klebsiella pneumoniae.

Which of the following factors are associated with a poor prognosis in hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 62-year-old woman with chronic kidney disease and hypertension develops hospital-acquired pneumonia (HAP) while recovering from an elective knee replacement. She receives appropriate antibiotics and shows gradual clinical improvement. She is now afebrile, her oxygen saturation is 97% on room air, and she is mobilizing with physiotherapy.

Which of the following factors are associated with a good prognosis in hospital-acquired pneumonia (HAP)? Select five (5) Correct answer.

A 65-year-old man presents with fever, cough, and shortness of breath for the past four days. He has a history of type 2 diabetes mellitus and hypertension. On examination, he has a temperature of 38.5°C, respiratory rate of 26 breaths per minute, and oxygen saturation of 94% on room air. A chest X-ray shows right lower lobe consolidation.

Which of the following history questions would be important to ask in a patient with suspected pneumonia? Select five (5) Correct answer.

A 50-year-old woman presents with a fever, cough, and worsening breathlessness for the past five days. She reports recent flu-like symptoms before the onset of her cough. On examination, she has a temperature of 39°C, respiratory rate of 30 breaths per minute, and oxygen saturation of 92% on room air. A chest X-ray shows bilateral patchy infiltrates.

Which of the following history questions would be important in a patient with suspected pneumonia? Select five (5) Correct answer.

A 10-year-old boy presents to your clinic with recurrent episodes of wheezing, cough, and shortness of breath, particularly at night and after playing sports.. His symptoms improve with a short-acting beta-agonist inhaler.

Which of the following are recognized risk factors for asthma? Select five (5) Correct answer.

A 45-year-old woman with a history of childhood asthma presents with worsening shortness of breath and wheezing. She reports frequent asthma exacerbations over the past year and increased use of her reliever inhaler. She has a BMI of 32 kg/m² and works as a cleaner in a commercial building.

Which of the following are risk factors for adult-onset or persistent asthma? Select five (5) Correct answer.

A 28-year-old woman presents to the emergency department with acute shortness of breath and wheezing. She reports a history of asthma since childhood, but her symptoms have worsened over the past two days. She has been using her salbutamol inhaler every three hours with minimal relief. She denies fever but reports chest tightness and difficulty speaking in full sentences

Which of the following are clinical signs you would assess in a patient with suspected asthma? Select five (5) Correct answer.

A 45-year-old man with poorly controlled asthma presents with worsening shortness of breath over the past two days. He has been using his inhalers regularly but has needed his reliever inhaler more frequently than usual. He is speaking in short phrases and appears fatigued. His oxygen saturation is 91% on room air.

Which of the following are clinical signs indicating asthma exacerbation? Select five (5) Correct answer.

A 30-year-old woman presents to your clinic with recurrent episodes of shortness of breath, wheezing, and chest tightness over the past six months. Her symptoms worsen at night and after exposure to dust. She has no history of smoking or recent infections. Examination reveals mild expiratory wheezing but normal oxygen saturation.

Which of the following investigations are important in the assessment of suspected asthma? Select five (5) Correct answer.

A 50-year-old man with a history of asthma presents to the emergency department with worsening shortness of breath over the past 12 hours. He has been using his salbutamol inhaler every two hours but is still struggling to breathe. On examination, he is tachypneic with an oxygen saturation of 89% on room air, and his peak expiratory flow rate (PEFR) is 35% of his predicted value.

Which of the following investigations are crucial in the emergency assessment of an acute asthma exacerbation? Select five (5) Correct answer.

A 26-year-old woman with a history of mild persistent asthma presents to your clinic for a review of her asthma management. She has been experiencing shortness of breath and wheezing about twice a week, and she wakes up with symptoms once or twice a month. She is currently using a short-acting beta-agonist (SABA) inhaler as needed but has not been on any long-term preventer therapy. She denies recent exacerbations or emergency department visits.

According to Australian RACGP guidelines, which of the following are appropriate management steps for this patient’s asthma? Select five (5) Correct answer.

A 55-year-old man with severe persistent asthma presents to the emergency department with worsening dyspnea, wheezing, and inability to complete sentences. His oxygen saturation is 90% on room air, respiratory rate is 34 breaths per minute, and peak expiratory flow rate (PEFR) is 30% of predicted. He has been using his salbutamol inhaler every two hours with little relief. He denies fever, and his chest X-ray is clear.

According to Australian RACGP guidelines, which of the following are appropriate acute management steps for this patient? Select five (5) Correct answer.

A 60-year-old man with a history of poorly controlled asthma presents to the emergency department with worsening dyspnea, wheezing, and chest tightness over the past 12 hours. Despite frequent use of his salbutamol inhaler, his symptoms have not improved. On examination, he is tachypneic with a respiratory rate of 32 breaths per minute, using accessory muscles, and has reduced breath sounds bilaterally. His oxygen saturation is 89% on room air.

Which of the following are potential complications of asthma? Select five (5) Correct answer.

A 45-year-old woman with a long-standing history of asthma presents with worsening symptoms over the past year. She has been requiring her inhaler multiple times a day and has had several hospital visits for exacerbations. On examination, she has mild wheezing and a prolonged expiratory phase, but her oxygen saturation is 96% on room air. Pulmonary function tests show reduced FEV₁/FVC ratio with incomplete reversibility after bronchodilator use.

Which of the following are potential long-term complications of asthma? Select five (5) Correct answer.

A 34-year-old woman with a history of mild intermittent asthma presents for a routine follow-up. She experiences occasional wheezing and shortness of breath but has never required hospitalization for her asthma. She uses a short-acting beta-agonist (SABA) inhaler approximately once a week and has never required oral corticosteroids. She is physically active and has no other medical conditions.

Which of the following factors are associated with a good prognosis in asthma? Select five (5) Correct answer.

A 58-year-old man with severe persistent asthma presents for a follow-up review. He has had multiple hospital admissions over the past year and is on high-dose inhaled corticosteroids and long-acting beta-agonists (ICS-LABA). He requires frequent courses of oral corticosteroids and reports daily symptoms, including nocturnal awakenings due to breathlessness.

Which of the following factors are associated with a poor prognosis in asthma? Select five (5) Correct answer.