Mount Kenya University · School of Medicine · Internal Medicine
Paper details
- Paper: "RESP CAT 1", time 1 hour. The scan has no printed date or unit code, so it is filed as undated.
- Questions: 30 multiple choice questions and 5 short answer questions (10 marks each).
- Answers: written by OmpathStudy for revision. They are not the official MKU marking scheme. Student marks and pen marks on the scan were ignored and are not published.
- Topics tested: pneumonia, pleural effusion, COPD, asthma, occupational lung disease, ARDS, sarcoidosis and interstitial lung disease.
- Questions that need care: Q3, Q8, Q10, Q20 and Q23 are loosely worded. The explanation says which option is best and why.
Section A: Multiple choice questions
1. Which bacterial pathogen is the most common cause of community-acquired pneumonia in adults?
- A. Staphylococcus aureus
- B. Mycoplasma pneumoniae
- C. Streptococcus pneumoniae
- D. Chlamydophila pneumoniae
2. All of the following are risk factors for community-acquired pneumonia EXCEPT:
- A. Female gender
- B. Smoking history
- C. Occupational dust exposure
- D. History of childhood pneumonia
3. Approximately what percentage of adult community-acquired pneumonia cases involve both bacterial and viral pathogens?
- A. 10%
- B. 30%
- C. 50%
- D. 80%
4. All of the following are common symptoms of community-acquired pneumonia in adults EXCEPT:
- A. Fever
- B. Bradycardia
- C. Sputum production
- D. Signs of consolidation
5. In adults with community-acquired pneumonia, which is NOT among the minor criteria suggesting ICU admission?
- A. Uraemia
- B. Leukopenia
- C. Decreased respiratory rate
- D. Low PaO2/FiO2 ratio
6. The following pleural fluid characteristics imply an exudative effusion EXCEPT:
- A. Pleural/serum protein ratio greater than 0.5
- B. Pleural pH of 7.40
- C. Pleural/serum LDH ratio greater than 0.6
- D. WBC content of 6000
7. A pleural effusion associated with pulmonary embolism can be:
- A. An exudate
- B. A transudate
- C. Bloody
- D. All of the above
8. Pleural effusion in rheumatoid or collagen vascular disease is all of the following EXCEPT:
- A. Often associated with onset of joint symptoms
- B. Has a low pH and glucose
- C. Often bilateral
- D. Empyema can occur in this setting
9. Pleural effusions that occur secondarily to ________ are most often treated with pleurodesis.
- A. Ascites
- B. Congestive heart failure
- C. Nephrotic syndrome
- D. Malignancy
10. Which classic exudate can present as a transudate?
- A. Malignancy
- B. CHF
- C. Infection
- D. Nephrotic syndrome
11. First-line management of a patient with CHF who presents to the emergency room with bilateral pleural effusion:
- A. Chest tube
- B. Diuretics
- C. Beta blockers
- D. Nitrates
12. Fluid from a pleural effusion shows lymphocyte dominance, indicating:
- A. Acute infection
- B. Cirrhosis
- C. TB
- D. Haemorrhagic pleural effusion
13. Which disease is included in the umbrella term COPD?
- A. Emphysema
- B. Chronic bronchitis
- C. Lung cancer
- D. A and B
14. In which age group are people most likely to have symptoms of COPD?
- A. 15 to 24
- B. 25 to 34
- C. 35 to 39
- D. 40 and older
15. Long-term exposure to which can increase the risk of COPD?
- A. Airborne chemicals
- B. Pollutants
- C. Lung irritants
- D. All of the above
16. Which of the following can help improve your health if you have COPD?
- A. Not smoking
- B. Exercising regularly
- C. Drinking alcohol
- D. A and B
17. Environmental risk factors for the development of asthma include:
- A. Socioeconomic status
- B. Allergen exposure
- C. Exposure to secondhand tobacco smoke in infancy
- D. All of the above
18. What is a common symptom of asthma?
- A. Wheezing
- B. Whistling
- C. Full breaths
- D. Snoring
19. What value is measured by spirometry?
- A. Residual volume
- B. Total lung capacity
- C. Functional residual capacity
- D. Forced expiratory volume
20. What drug therapy should be available to ALL asthma patients (intermittent and persistent)?
- A. Low-dose ICS
- B. PRN SABA
- C. LABA
- D. Leukotriene antagonist
21. Workers exposed to asbestos are at risk of which type of cancer?
- A. Mesothelioma
- B. Bladder cancer
- C. Bone cancer
- D. Bronchoalveolar carcinoma
22. A 28-year-old mine worker has dyspnoea and blackish sputum, and has rheumatoid arthritis. Most probable diagnosis?
- A. Adult respiratory distress syndrome
- B. Hyaline membrane disease
- C. Goodpasture syndrome
- D. Caplan syndrome
23. Which is an indirect injury to the lung?
- A. Fat embolism
- B. Sepsis
- C. Pneumonia
- D. Trauma
24. Which is an asymptomatic accumulation of coal pigment in the lung without cellular reaction?
- A. Coal worker's pneumoconiosis
- B. Silicosis
- C. Anthracosis
- D. Asbestosis
25. All are true about sarcoidosis EXCEPT:
- A. Characterised by caseating or necrotising granulomas in affected organs
- B. Unknown cause
- C. Affects all races
- D. Affects both sexes equally
26. Workers who handle unprocessed cotton are at risk of developing:
- A. Coccidioidomycosis
- B. Byssinosis
- C. Pertussis
- D. Sarcoidosis
27. All are true about ARDS EXCEPT:
- A. It generally arises in persons with serious comorbidities
- B. It may be life threatening
- C. It is a common complication of anaesthesia
- D. Some patients suffer permanent lung damage
28. A 40-year-old woman has progressive shortness of breath over 4 months. Examination is normal. The chest X-ray shows bilateral hilar adenopathy and a mild diffuse infiltrate. Most likely diagnosis?
- A. Interstitial pulmonary fibrosis (IPF)
- B. Sarcoidosis
- C. Wegener's granulomatosis
- D. Asbestosis
29. In interstitial lung diseases, lung function tests most often show:
- A. Reduced carbon monoxide diffusing capacity (DLCO)
- B. Increased total lung capacity
- C. Airflow obstruction
- D. Elevated arterial PCO2
30. Common medications that can cause ILD include all of the following EXCEPT:
- A. Methotrexate
- B. Nitrofurantoin
- C. Amiodarone
- D. Furosemide