Quiz: Chest MCQs

In acute severe asthma, the following drugs are used except

A A. Systemic steroids B B. inhaled ß agonist C C. aspirin D D -inhaled steroidsb

Cough usually caused by the following drug

A a-corticosteroid B b-ACE inhibitors C c-salbutamol D d-theophylline

The followings are risk factors for bronchogenic carcinoma except

A A.Air pollution B B.Occupational exposure C C.Alcohol D D. Smoking

All are correct with regard to bronchial asthma, except

A A- Disease of children only B B-LABA and ICS used as a reliever C C-systemic steroids used in severe asthma D D-Montelukast used as a controller

The main differences between asthma and COPD

A a. Decreased FEV1 B b. Decreased FEV1/FVC C c. Reversibility after bronchodilation more than 12% in bronchial asthma D d. COPD more common in female than male

Pneumothorax that causes mediastinal shift and compression of the functioning lungis called

A a- primary pneumothorax B b- secondary pneumothorax C c- traumatic pneumothorax D d- tension pneumothorax

Secondary pneumothorax is a particular risk for

A a-mechanical ventilation B b-tuberculosis C c-pneumonia D d-asthma

The following common features of non complicated bronchiectasis except

A a)cough B b) expectoration C c) clubbing of fingers D d) edema of the lower limbs

Lymphoma most common tumor

A A-Anterior mediastinum B B-Posterior mediastinum C C-Middle mediastinum D D-Superior mediastinum

Treatment Of IPF includes all of the following

A a.pirfenidone B b. lung Transplantation C c.corticosteroids D d.all of the above

the most common cause of hemoptysis

A a-COPD B b-bronchial asthma C c-chronic bronchitis D d-acute bronchitis

The most accurate diagnostic procedure for IPF is

A A.PFT B B. Lung biopsy C C.HRCT chest D D.non of the above

The following drugs can cause Interstitial lung diseases

A A. Amiodaron B B. nitrofurantoin C C. Methotrexate D D.all of the above

The most important risk factor for COPD is

A a- cigarette smoking B b- alcohol C c- high altitude D d- all of the above

All of the following are treatment of COPD except

A a- STERIODS B b- LABA C c- LAMA D d- Inderal

All the following are anti-tuberculous drugs except

A a- HNI-e B b- Ethambutol C c- Rifampicin D d- Heparin

Atypical pneumonia is caused by

A a) Chlamydia P B b)Mycoplasma P C c)Legionella P D d)All of the above

Pulmonary complications of SLE are

A a)pleurisy B b)pleural effusion C c)pneumonitis D d) All of the above

Dry cough mainly caused by

A a.ACE inhibitors B b.aspirin C c.Inderal D d.all of the above

in type 2 respiratory failure

A a.PaCO2 increased B b.Pa 02 decreased C c.cyanosis D d.all of the above

In obstructive pulmonary diseases

A a.FEV1 is increased B b.FVC is increased C c.FEV1/FVC increased D d.non of the above

The gold standard of diagnosis of bronchiectasis is

A a. HRCT B b.Chest X-ray C c.surgical biopsy D d.non of the above

Accumulation of pus in the pleural space is

A a) pneumonia B b)bronchiectasis C c)lung abscess D d)empyema

Where is the safe triangle for chest drain insertion located?

A a-5th intercostal space mid clavicular line B b-3th intercostal space post axillary line C c-5th intercostal space axillary line"Ant-Mid" D d-4th intercostal space mid clavicular line

Chest X-ray showing pneumothorax:the intercostal tube directed"best"

A a.Upward B b.downward C c.transverse D d. no need

Kronig’s isthmus borders include all the following except

A a. Medial two thirds of the clavicle ofsame side B b. Medial one third ofscapular spine C c. Angle of Lewis D d. Tip of 7 th cervical spine

Bifurcation of trachea (carina) lies opposite

A a. Angle of Lewis B b. Second thoracic vertebral body C c. Above arch of aorta D d. Below bifurcation of pulmonary conus

Tension pneumothorax shows the following clinical signs except

A a. Shift of mediastinum to opposite side B b. Hyperresonance C c. Cavernous breathing D d. Amphoric breathing

Taking history in a case suspected to be pulmonary T.B. should stress upon

A a. Present history B b. Past history C c. Family history D d. Contact history

Cor-pulmonale shows the following except

A a. Pistol shot at femoral artery B b. Tricuspid facies C c. Positive hepatic sign. D d. Congested pulsating neck veins

Shifting dullness is positive in

A a. Pleural effusion B b. Pulmonary consolidation C c. Hydropneumothorax D d. none of the above

Pleural effusion is accompanied by the following physical signs except

A a. Skodaic resonance above its upper border B b. Shifting dullness C c. Aegophony at its upper border D d. none of the above

Emphysema maybe accompanied by all the following except

A a. Increased T.V.Eof lung apices B b. Encroachment on dullness of the bare area of the heart C c. Positive tracheal tug D d. none of the above

Angle of Lewis is opposite the following except

A a. Aortic arch B b. Right upper lobe bronchial stump C c. Carina of trachea D d. none of the above

About Litten sign, the following is right except

A a. Should be in fatty patients B b. Positive in diaphragmatic paralysis C c. Should be detected with patient against sunlight D d. none

Bronchial breathing can be heard above

A a. Collapse B b. Consolidation C c. Pneumothorax D d. none

Traub's dullness occurs with

A a. Left lower lobe consolidation B b. Left lower lobe collapse C c. Left sided pleural effusion D d. none

In emphysema

A a. Bare area of heart becomes widened B b. Pigeon-shaped chest C c. Encroachment over hepatic dullness D d. none

Dull Kronig’s isthmus maybe due to

A a. Superior sulcus tumor B b. Consolidated anterior segment of upper lobe C c. Emphysema D d. none

Positive shifting dullness occurs with

A a. Hydrothorax B b. Pneumothorax C c. Hydropneumothorax D d. none

T.V.F. usually occurs over

A a. Consolidation B b. Emphysema C c. Pneumothorax D d. none

Boundaries of Traub's area include the following except

A a. Tip of left 8 th costal cartilage B b. Tip of left 6 th costal cartilage C c. Left 9 th rib in mid-axillary line (MAL). D d. Left 11th rib in MAL

In pulmonary hypertension, there maybe

A a. Wide splitting of 2 nd heart sound B b. Dull 2 nd right intercostal space C c. Organic tricuspid regurge D d. none of the above

Suppurative lung syndromes include the following except

A a. Lung abscess B b. Empyema C c. Bronchiectasis D d. Infected lung cyst.

Bronchogenic carcinoma can be presented by

A a. Lung abscessformation B b. Pneumonic consolidation C c. Normal physical findings D d. Allof the above

d'Espine sign is

A a. Bronchial breathing below 2 nd thoracic spine in adults B b. Bronchial breathing below 4 th thoracic spine in children C c. Whispering pectoriloquy below 2 nd thoracic spine in adults D d. None of the above

Upper border of liver can be detected by

A a. Heavy percussion at right mid clavicular line. B b. Light percussion at right mid clavicular line. C c. Both D d. none

Lateral end of Kronig's isthmus is

A a. Contact of acromion process with clavicle B b. Tip of cervical spine C c. Line of contact between junction of medial two thirds &lateral one third of clavicle and junction of lateral two thirds & medial one third ofscapular line D d. none

Amphoric breathing is a sign of presence of

A a. Cavity B b. Tension cavity C c. Closed pneumothorax D d. none

Tracheal tug could be detected in

A a. Emphysema B b. Acute severe asthma C c. Bilateral pulmonary T.B.(acute). D d. none

Main symptom in asthma is

A a. Chest pain B b. Hemoptysis C c. Dyspnea & wheezes D d. none

Emphysema is characterized by

A a. Hemoptysis B b. Progressive dyspnea C c. Chest pain D d. none

Main finding in pleural effusion is

A a. Dullness with increased breath sounds B b. Stony dullness with diminished breath sounds C c. Dullness with ++TVF D d. none

Bronchial carcinoma may present with

A a. Collapse B b. Consolidation C c. Effusion D d. Allof the above

Collapse is characterized by

A a. ++TVF B b. --TVF C c.both D d. none

Barrel shaped chest is characterized by the following except

A a. Antero-posterior diameter = transverse diameter B b. Acute subcostal angle C c. Dorsal kyphosis D d. Shoulders are transverse

TVF is decreased in the following except

A a. Bigcavity with relaxed wall B b. Pleural effusion C c. Pleural fibrosis D d. Pulmonary emphysema

Shifting dullness over the chest occurs with

A a. Encysted pleural effusion B b. Free pleural effusion C c. Hydropneumothorax D d. Encysted pneumothorax

Positive whispering pectoriloquy occurs with

A a. Bronchial proper breathing B b. Tubular bronchial breathing C c. Cavernous bronchial breathing D d. Amphoric bronchial breathing

Post-tussive suction occurs with

A a. Simple pneumothorax B b. Large cavity C c. Lobar pneumonia D d. Lung collapse

Unilateral chest retraction occurs with the following except

A a. Pleural fibrosis B b. Pulmonary fibrosis C c. Lung consolidation D d. Kyphoscoliosis

TVF is increased in the following except

A a. Pneumonic consolidation B b. Superficial cavity C c. Deep cavity D d. Cavity surrounded by consolidation

Traub’s area is dull in the following except

A a. Left pleural effusion B b. Left lower lobe consolidation C c. Splenomegaly D d. Situs inversus totalis

Amphoric bronchial breathing occurs with

A a. Superficial tense cavity B b. Bigcavity with relaxed wall C c. Encysted pneumothorax D d. Pneumonic consolidation

Late inspiratory crepitations occurs with

A a. Pulmonary edema B b. Pulmonary emphysema C c. Pulmonary TB D d. Interstitial pulmonary fibrosis

Bilateral congested non pulsating neck veins occur in all the following except

A a. Fibrosing mediastinitis B b. Cardiac tamponade C c. SVCthrombosis D d. Extra-pulmonary non metastatic manifestations of oat cell carcinoma

Pleural rub is characterized by all except

A a. It is a to & fro sound B b. Intensity increases by pressing the stethoscope against chest wall C c. Intensity decreases by pressing the stethoscope against chest wall D d. Disappears upon occurrence of pleural effusion

Clinically, right border of the heart can be percussed normally at

A a. One finger to the right of the sternum B b. One cm to the right of the lower half of the sternum C c. One cm to the right of mid-sternal line at lower half of the sternum D d. none

In pulmonary hypertension, all are true excep

A a. Wide splitting of 2 nd heart sound at pulmonary area B b. Reversed splitting of 2 nd heart sound at pulmonary area. C c. Systolic murmur at tricuspid area D d. Dullness in pulmonary area

Diagnostic investigation for T.B

A a. Tuberculin test B b. Bacteriologic C c. Chest x-ray D d. none

Simple spirometry can measure all except

A a. Inspiratory capacity B b. Tidal volume C c. Expiratory reserve volume D d. Residual volume

A short case about a patient complaining of dyspnea, diminished air entry on left side, mediastinal shift to left side. What do you think the diagnosis is?

A a. Left sided pneumothorax B b. Left sided massive collapse C c. Pleural effusion D d. Collapse

All the following are causes of unilateral chest retraction except

A a. Lung fibrosis B b. Pleural fibrosis C c. Lung collapse D d. Lung consolidation

Causes of acute dyspnea include all the following except

A a. Pneumothorax B b. Pulmonary embolism C c. Interstitial pulmonary fibrosis D d. Bronchial asthma

In restrictive lung disease, the following volumes are reduced

A a. Vital capacity B b. Residual volume C c. Total lung capacity D d. Allof the above

Positive tuberculin test denotes

A a. Infection ± disease B b. Infection without disease C c. Active disease only D d. None of the above

Decreased TVF + dullness + diminished breath sounds in the right infraclavicular area + shift of trachea to left side

A a. Upper right lung consolidation B b. Upper right lung collapse C c. Upper right lung bronchogenic carcinoma D d. Upper right lung bulla

Continuous agonizing dull aching pain

A a. Bronchogenic carcinoma B b. Pulmonary embolism C c. Pleurisy D d. Allof the above

fever followed by cough + large amount of purulent offensive sputum increased by lying on left side + right infra- scapular dullness

A a. Right lower lobe abscess B b. Right upper lobe abscess C c. Left lower lobe abscess D d. Left lower lobe bronchiectasis

All are causes of gradual progressive dyspnea except

A a. Pneumothorax B b. COPD C c. Asthma D d. Showers of emboli

Organisms resistant to T.B drugs are mainly resistant to

A a. Ethambutol 8cRifampicin B b. Ethambutol 8cStreptomycin C c. Ethambutol 8c INH D d. INH & Rifampicin

Bare area of the heart is normally

A a. Dull on light percussion B b. Hyper resonant on light percussion C c. all of the above D d. none

In COPD all increases except

A a. FVC B b. RV C c. TLC D d. FRV

Decrease in TVF + dullness + decrease in breath sounds + shift of mediastinum to left side

A a. Left pleural effusion B b. Left consolidation C c. Left pneumothorax D d. Left collapse

Bronchial breathing is characterized by all except

A a. Hollow B b. Presence of gap C c. Inspiration = 3 expiration D d. Inspiration = expiration

Diagnosis of bronchiectasis is confirmed nowadays by

A a. X-ray B b. High resolution CT C c. Bronchoscopy D d. none

Patient with progressive dyspnea, dry irritative cough, 3 rd degree finger clubbing, bilateral diffuse late inspiratory crepitations

A a. Interstitial pulmonary fibrosis B b. Bronchiectasis C c. Bronchogenic carcinoma D d. Congestive heart failure

The following anti T.B. drugs can be used safely in renal impairment except

A a. Pyrazinamide B b. Streptomycin C c. both D d. none

All are hazards of cough except

A a. Hernia B b. Pneumothorax C c. Cerebral hemorrhage D d. Transudative pleural effusion

Acute dyspnea + chest pain in all except

A a. Myocardial infarction B b. Bronchial asthma C c. Pneumothorax D d. none

Complications of chronic cough include all except

A a. Cerebral hemorrhage B b. Hernia C c. Pneumothorax D d. Transudative pleural effusion

Acute dyspnea with chest pain is caused by the following except

A a. Pneumothorax B b. Myocardial infarction C c. Pulmonary embolism D d. Attack of asthma

Dyspnea with chest wheezes occur in

A a. Pleural effusion B b. Pneumothorax C c. COPD D d. Allof the above

PCO2 in arterial blood is

A a. 30-35 mmHg B b. 20-25 mmHg C c. 35-45 mmHg D d. 50-60 mmHg

Causes of productive cough include all except

A a. Pneumonia B b. Bronchiectasis C c. Lung abscess D d. Interstitial pulmonary fibrosis

Localized fixed wheezes are caused by all except

A a. Foreign body inhalation B b. Endobronchial tumor C c. Bronchial asthma D d. none

Bronchial breathing characters include all except

A a. Hollow B b. Inspiration equals expiration C c. Having a gap D d. Inspiration equals 3 expiration

Bare area of the heart is normally

A a. Resonant on light percussion B b. Dull on light percussion C c. Dull on heavy percussion D d. none

Case of increased TVF, bronchial breathing & dullness on percussion. Diagnosis is

A a. Consolidation B b. Pleural effusion C c. Pneumothorax D d. none

Localized fixed wheezes could be due to

A a. Bronchial asthma B b. Chronic bronchitis C c. Emphysema D d. Endobronchial tumor

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