Archives: Medical Student Finals

MSFinals-5762

A 67-year-old man, who had recently undergone a full bone marrow transplantation for acute myeloid leukaemia (AML), presented with progressive dyspnoea over the past 2 weeks. He also had a dry cough, but no fever. During examination, scattered wheeze and some expiratory high-pitched sounds were observed. The C-reactive protein (CRP) level was normal, and the Mantoux test was negative. Spirometry results showed a Forced expiratory volume in 1 second (FEV1) of 51%, Forced vital capacity (FVC) of 88%, and FEV1/FVC of 58%. What is the most likely diagnosis?

MSFinals-5763

A 35-year-old man visits his doctor seeking assistance in quitting smoking. He has been smoking 20 cigarettes daily for the past six years and has a history of epilepsy. Which smoking cessation aid is most likely to result in adverse effects for this individual?

MSFinals-5764

After reviewing a patient with chronic obstructive pulmonary disease (COPD) in clinic, the respiratory consultant discusses the anatomy of the lungs with a group of undergraduate students.
With regard to the lungs, which one of the following statements is accurate?

MSFinals-5765

A 65-year-old woman presents to a spirometry clinic with a history of progressive dyspnea on exertion over the past six months, particularly when hurrying or walking uphill. What spirometry result would indicate a possible diagnosis of chronic obstructive pulmonary disease in this patient?

MSFinals-5766

A 28-year-old woman presents to her Occupational Health Service. She works in the sterile supplies group at her local hospital. Over the past few months, she has noticed increasing shortness of breath with cough and wheeze during the course of a working week, but improves when she takes a week off on holiday. On examination at the general practitioner’s surgery, after a few weeks off, her chest is clear.
Peak flow diary:
Monday p.m 460 l/min (85% predicted)
Tuesday p.m 440 l/min
Wednesday p.m 400 l/min
Thursday p.m 370 l/min
Friday p.m 350 l/min
Saturday a.m 420 l/min
Which of the following is the most appropriate treatment choice?

MSFinals-5767

A 45-year-old man presents to his GP with persistent wheezing and difficulty breathing. Despite being prescribed a salbutamol inhaler, his symptoms continue and he is forced to take time off work. His GP increases his treatment by adding oral prednisolone, which initially helps but his symptoms return upon returning to work. However, during a two-week vacation, his wheezing significantly improves. Upon returning to work, he suffers an acute asthma attack and is taken to the hospital by ambulance. Which diagnostic test is most likely to confirm the diagnosis?

MSFinals-5768

A 46-year-old man, who had been working abroad in the hard metal industry, presented with progressive dyspnoea. A chest X-ray showed diffuse interstitial fibrosis bilaterally. What is the typical cellular component found in a bronchoalveolar lavage (BAL) of this patient?

MSFinals-5769

A 47-year-old woman has been hospitalized with haemoptysis and epistaxis. On her chest X-ray, there are several rounded lesions with alveolar shadowing. Her serum test shows a positive result for cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA). What is the probable diagnosis?

MSFinals-5770

A 65-year-old woman presents to the Emergency Department with a productive cough, difficulty breathing, and chills lasting for 4 days. Upon examination, bronchial breathing is heard at the left lower lung base. Inflammatory markers are elevated, and a chest X-ray shows consolidation in the left lower zone. What is the most frequently encountered pathogen linked to community-acquired pneumonia?

MSFinals-5771

A 40-year-old baker presents to his General Practitioner with rhinitis, breathlessness and wheeze. He reports his symptoms have acutely worsened since he returned from a 2-week holiday in Spain. He has been experiencing these symptoms on and off for the past year. He has a fifteen-pack-year smoking history.
What is the most likely diagnosis?