MSRA Category: Respiratory Medicine

MSRA-2842

A breathless 65-year-old smoker presents with the following lung function tests:
FEV1 (forced expiratory volume in 1 second) 1.5 l (60%)
FVC (forced vital capacity) 1.8 l (55%)
FEV1:FVC ratio = 84%
TLC (total lung capacity) = 66% predicted
RV (residual volume) = 57% predicted
TLCO (carbon monoxide transfer factor) = 55% predicted
KCO (carbon monoxide transfer coefficient) = 60% predicted
Which of the following is the most likely diagnosis in this case?
Select the SINGLE most likely diagnosis.

MSRA-2843

An anxious, 30-year-old saleswoman presents with mild shortness of breath on exertion, which had come on gradually over several months. The symptom was intermittent and seemed to get worse in the evening. She has also been on treatment for depression over the last two months. On examination, she has minimal weakness of shoulder abductors and slight weakness of eye closure bilaterally. Deep tendon reflexes are present and symmetrical throughout and plantar responses are flexor. You now have the results of the investigations: FBC, U&E, LFT, TFT – normal; chest radiograph and lung function tests – normal; ECG – normal.
Which of the following is the most likely diagnosis?
Select the SINGLE most likely diagnosis.

MSRA-2844

A 30-year-old woman is brought to the emergency department with difficulty breathing. Her pulmonary function tests show a peak expiratory flow rate that is 60% below the normal range for her age and height.
What is the most likely diagnosis?

MSRA-2845

A patient with small-cell lung cancer at the age of 60 has a serum sodium concentration of 121 mmol/l. Which of the following is the most likely cause?

MSRA-2846

Patients with severe pneumonia may face various risk factors that increase their chances of death. Which of the following factors does not contribute to this risk?

MSRA-2847

A 47-year-old woman visits the local clinic with her husband, who reports that his wife has been experiencing chills, night sweats, coughing up yellow phlegm, and is having difficulty answering basic questions.
Which of the following is NOT part of the scoring evaluation for community-acquired pneumonia (CAP)?

MSRA-2848

A feature of a severe acute asthma exacerbation in an adult is:

MSRA-2849

A 32-year-old woman comes to the clinic complaining of sudden breathlessness and pain on the left side of her chest for the past 24 hours. She is generally healthy and takes the combined oral contraceptive pill.
What is the highest scoring factor in the Wells’ scoring system for suspected pulmonary embolism (PE)?

MSRA-2850

Which of the following is not a known side effect of the combined oral contraceptive pill?

MSRA-2839

A 57-year-old woman, who is known to have rheumatoid arthritis, complains that she has had recurrent haemoptysis for over five years. She has never smoked and only takes a non-steroidal anti-inflammatory agent. According to her, she coughs up phlegm every day and at times this contains streaks of fresh blood. She has no known respiratory disease, but tends to get frequent chest infections that are relieved by a course of antibiotics.
Which of the following is the most likely diagnosis?