MRCP-0938
A 40-year-old non-smoker is diagnosed as having emphysema. Further tests reveal that he has alpha-1 antitrypsin deficiency. What is the main role of alpha-1 antitrypsin in the body?
Category: Respiratory
MRCP-0939
A 47-year-old woman complains of dyspnoea, occasional fevers and mild weight loss which have all gotten worse over the past months. She does not complain of a cough but remembered that she had coughed once and produced a twig-shaped mucoid sputum mass. She has no haemoptysis. She has no past medical history and is on no medications. Her chest X-ray reveals bilateral, perihilar, dense airspace shadowing. A HRCT of her thorax showed a ‘crazy paving’ pattern of extensive, dense, white infiltrates. Her spirometry was a restrictive pattern with reduced total lung capacity. She also had a bronchoscopy and lavage, which revealed periodic acid–Schiff (PAS)-positive proteinaceous fluid and elevated levels of surfactant proteins A and D. What is the most likely diagnosis?
MRCP-0940
A 65 year old retired postman has been complaining of a two-month history of lethargy associated with dyspnoea. He has never smoked and takes no medication. The chest X-ray shows multiple round lesions increasing in size and numbers at the base. There is no hilar lymphadenopathy. What condition does he most likely have?
MRCP-0941
A 51 year old obese female, with a history of smoking, presents to the clinic with worsening dyspnoea. She is currently on oestrogen therapy for menopausal symptoms. Clinical examination, ECG and radiological findings correspond to right sided heart failure. There are no signs of left ventricular dysfunction. Which of the following is the most likely cause of cor pulmonale?
MRCP-0942
Which of the following statements regarding the clinical effects of long-term oxygen therapy (LTOT) is the most accurate?
MRCP-0943
Which of the following parameters is increased as a result of asthma?
MRCP-0944
A 32 year old primigravida, with a history of pulmonary hypertension, presents to the clinic at 36 weeks gestation with worsening shortness of breath. Which of the following is the most accurate statements regarding her condition?
MRCP-0945
A 78 year old male presents to the emergency department with shortness of breath that has developed gradually over the last 4 days. His symptoms include fever and cough productive of greenish sputum. Past history is notable for COPD for which he was once admitted to the ICU, 2 years back. He now takes nebulizers (ipratropium bromide) at home. The patient previously suffered from myocardial infarction 7 years ago. He also has Diabetes Mellitus type II controlled by lifestyle modification. On examination, the following vitals are obtained. BP : 159/92 mmHg Pulse: 91/min (regular) Temp: Febrile On auscultation, there are scattered ronchi bilaterally and right sided basal crackles. Cardiovascular and abdominal examinations are unremarkable. Lab findings are given below: pH 7.31 pa(O2) 7.6 kPa pa(CO2) 6.3 kPa Bicarbonate 30 mmol/L, Sodium 136 mmol/L, Potassium 3.7 mmol/L, Urea 7.0 mmol/L, Creatinine 111 μmol/L, Haemoglobin 11.3 g/dL, Platelets 233 x 109 /l Mean cell volume (MCV) 83 fl White blood cells (WBC) 15.2 x 109 /l. CXR shows an opacity obscuring the right heart border. Which of the following interventions should be started immediately while managing this patient?
MRCP-0946
A 35 year old factory worker presents with a history of episodic dyspnoea. The complaint worsens when he is working. He starts to feel wheezy, with a tendency to cough. Which diagnostic investigation would be the most useful in this case?
MRCP-0947
A 54 year old male, with a smoking history of 15 pack years presents with worsening dyspnoea, fever and cough. He works at a foundry. Vitals are as follows: Respiratory rate: 28/min Heart rate: 80 bpm Temp: 37.6C Chest auscultation reveals bilateral crepitations throughout the lung fields. Calcified hilar nodules are visible on the chest X-ray. Further evaluation shows an eggshell calcification on HRCT. Which of the following is the most likely diagnosis?