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26 Cards in this Set
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MR48 [Aug08]
COPD patient with pulmonary hypertension and acute RHF. Which is TRUE? a. 100% oxygen will decrease the pulmonary artery pressure b. Sildenafil will be useful for treating RHF c. Noradrenaline is an appropriate inotrope for this patient d. ? e. ? |
ANSWER B
A. FALSE : HPV is most prominent with PAO2<70mmHg. -Alveolar PAO2>100mmHg there is little change in vascular resistence B. TRUE : Oral sildenafil has been used successfully to manage acute RV dysfunction in heart transplant recipients, wean patients from nitric oxide, prevent rebound hypertension in patients on nitric oxide, reduce the duration requirement for mechanical ventilation, and prevent the occurrence of pulmonary endothelial cell dysfunction C. FALSE : Noradrenaline will partially constrict pulmonary vasculature increasing pulmonary vascular resistance. Furthermore, noradrenaline is almost never used for its apparent inotropy, rather for its pressor action. If an inotrope is required Milronone would be a better agent. |
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MR47 [Mar06] [Apr07]
Unequal consolidation on a CXR can be caused by all except: A. pulmonary oedema B. pneumonia C. pulmonary haemorrhage D. pulmonary infarction E. pulmonary effusion |
ANSWER A
A. FALSE : strictly is not a form of consolidation The remainder are causes of unilateral consolidation. |
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MR46 ANZCA version [2004-Aug] Q93, [Jul06]
Physiological consequences of obstructive sleep apnoea usually include each of the following EXCEPT A. stimulation of erythropoiesis B. pulmonary vasoconstriction C. tachycardia followed by bradycardia D. systemic vasoconstriction E. loss of deep sleep |
ANSWER C
Obstructive sleep apnoea -cessation of airflow for over 10 seconds, despite continuing ventilatory effort, 5 or more times per hour of sleep, and is usually associated with a decrease in arterial oxygen saturation (SaO2) of more than 4% Obstructive sleep hypopnea (OSH) is "as a decrease in airflow of more than 50% for more than 10 seconds, 15 or more times per hour of sleep, and is usually associated with snoring and may be associated with a decrease in SaO2 of greater than 4% AHI = apnoea hyponea index. This index is the number of apnoeas and hyponeas per hour of sleep. 5-20=mild, 21-50=moderate, above 51 severe LAST (lowest saturation) <= 80% --> these highly predict perioperative airway complications. Consequences 1. Respiratory -CO2 insensity 2. Cardiac -systemic hypertension -pulmonary hypertension -right heart strain / RHF / LVF -IHD -CCF Neurological -daytime solmnence Haematological -polycythmia Autonomic -sympathetic hyperstimulation |
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MR45 ANZCA version [2003-Aug] Q99, [2005-Sep] Q90, [Apr07] Q99, [Jul07]
In chronic obstructive pulmonary disease (COPD), the variable most closely associated with prognosis is A. arterial carbon dioxide partial pressure (PaC02) B. arterial oxygen partial pressure (Pa02) C. forced expiratory volume in one second (FEV1) D. forced vital capacity (FVC) E. response to bronchodilators |
ANSWER C
Spirometry is the most reproducible, standardised and objective way of measuring airflow limitation, and FEV1 is the variable most closely associated with prognosis. 30% of patients (with FEV <35% of predicted) are dead within 1 year and 95% within 10 years On the other hand, pCO2 >45mmHg or more (OR 61.0)" was a statistically significant (and best) predictor of post-operative pulmonary risk NOT prognosis in general. |
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MR44 ANZCA version [2003-Aug] Q148, [2004-Aug] Q89, [2005-Apr] Q85, [Mar06] Q82, [Jul06] Q70, [Mar10]
Correct statements regarding expiratory-inspiratory flow-volume loops include all of the following EXCEPT A. in obstructive disease the expiratory curve has a scooped out or concave appearance B. in restrictive disease expiratory flows are usually decreased in relation to lung volume C. in restrictive disease the expiratory curve has a convex appearance D. the expiratory curve is largely effort independent E. the inspiratory curve is effort dependent |
ANSWER B
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MR43 ANZCA version [2001-Apr] Q99
Unilateral diaphragmatic paralysis causes 1. no change in total lung capacity 2. a decrease in forced vital capacity 3. no change in maximum voluntary ventilation 4. a decrease in inspiratory reserve volume |
A - FALSE
B - TRUE C - FALSE D - TRUE Lung function studies can be used to assess the impact a paralysed hemidiaphragm has on the mechanics of ventilation. A mild restrictive pattern is evident with total lung capacity generally reduced to about 85 % of predicted, and vital capacity to about 75 % of predicted; a fall in forced vital capacity of greater than 20 % on lying supine suggests diaphragmatic paralysis. Maximal inspiratory pressures are only mildly reduced in unilateral disease. Functional residual capacity and the forced expiratory volume in one second are usually normal, as the mechanics of expiration and elastic recoil of the lung are unaffected. It must be remembered that there is great reserve in the lungs, and it can take a considerable degree of weakness of the diaphragm(s) before there is a fall in the forced vital capacity. This reserve may differ between individuals and may explain why some patients become symptomatic and others don’t |
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MR42 ANZCA version [2001-Aug] Q18
A 30 year old male presents with a single sudden shaking chill with a rapid rise in temperature. Within a few hours agonizing left pleuritic pain and cough with rust coloured sputum supervene. On examination the man appears acutely ill with rapid shallow respiration. With no treatment he continues to run a temperature up to 40.5 deg C for a week at which time he experiences a dramatic improvement. Physical examination on day 2 of the illness would probably show all of the following over the left chest EXCEPT A. restricted hemithorax movement B. flat percussion sound C. bronchial breathing D. decreased fremitus E. whispering pectoriloquy |
ANSWER D
The presumptive diagnosis in this case is left sided pneumonia. Typical signs of pneumonia include: * Decreased chest wall movement on the affected side * Decreased percusion sounds * Bronchial breath sounds * Increased fremitus (fremitus is the condition where consolidation increases the passage of sound through the chest) * Whispering pectoriloquy |
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MR39c ANZCA version [2005-Sep] Q150, [Mar06]
The most correct statement concerning the respiratory changes of morbid obesity is that A. alveolar hypoventilation is characteristic of Pickwickian obesity B. the functional residual capacity (FRC) is unchanged C. the residual volume (RV) is decreased D. the weight of the torso is responsible for increased chest wall compliance E. the work of breathing is unchanged |
ANSWER A
At its extreme, obesity hypoventilation syndrome culminates in the pickwickian syndrome, which is characterized by obesity, daytime hypersomnolence, arterial hypoxemia, polycythemia, hypercarbia, respiratory acidosis, pulmonary hypertension, and right ventricular failure. |
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MR37 ANZCA version [2005-Apr] Q20
The most useful clinical finding to exclude the presence of airflow limitation in a 60 year old is A. a history of never smoking B. absence of hyperresonance to chest percussion C. normal cardiac dullness to percussion D. absence of pulsus paradoxus E. non-use of accessory muscles at rest |
ANSWER A
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MR36 ANZCA version [2002-Aug] Q106, [2003-Apr] Q2, [2004-Aug] Q14, [2005-Apr] Q5
The most likely cause of superior vena cava syndrome is A. bronchogenic carcinoma B. mesothelioma C. thymoma D. teratoma E. apical pulmonary bullae |
ANSWER A
Bronchogenic carcinoma is BEST answer: Lung cancer is now the underlying process in approximately 85% of the patients with SVC syndrome 1. SVC Obstruction and Collateral a) Obstruction below azygous vein · Azygous - hemiazygous, lumbar veins to IVC b) Obstruction above azygous vein · Venous collateral in neck to azygous to SVC c) Obstruction includes azygous vein · Internal mammary, paraspinous, esophageal and subcutaneous vein to IVC d) Cerebral decompression through a single jugular vein via midline intracranial venous sinuses 2. Pathogenesis a) Extrinsic compression of SVC · Gradual SVC obstruction b) Invasion of SVC · Obstruction develops rapidly c) Thrombosis of SVC · Acute obstruction d) Venous hypertension and lymphatic obstruction - all empty into the subclavian veins 3. Causes a) Benign 10% · Inflammatory - histoplasmosis, idiopathic fibrosing mediastinitis · Iatrogenic - pacemaker electrode, hyperalimentation or other CV line b) Malignant 90% · Bronchogenic, epidermoid 65-80% · Small cell 12-30% · Lymphoma 12-20% 4. Symptoms and Signs · Swelling face, neck, arms · Shortness of breath, orthopnea, cough and chest pain suggest upper airway obstruction · Hoarseness, stridor, tongue swelling, nasal congestion · Headaches, syncope and lethargy are caused by cerebral edema from venous hypertension · Symptoms worse lying down, bending forward · Symptoms of cerebral or laryngeal edema is associated witha reduced life expectancy of about 6 weeks, demanding urgent intervention · Caval obstruction may be the life-limiting problem of patients with underlying malignancy 5. Diagnosis a) Chest x-ray · Right hilar mass - bronchogenic carcinoma · Anterior mediastinal mass - lymphoma · Calcification - histoplasmosis b) Simultaneous bilateral arm venogram · Defines obstruction and collateral circulation · Identifies thrombus c) Computerized axial tomography · Assessment of mediastinum · Determine patency of jugular veins · Directed needle biopsy 6. Radiation Therapy · Since most cases due to malignancy, nearly all patients receive radiation · 80-90% relieved of SVC Syndrome · 50% of patients relapse · Relapse occurs in benign disease as well; although collaterals develop, thrombosis will continue to propogate and occlude these collaterals over time 7. Medical Therapy · Chemotherapy for lymphomas and small cell carcinoma · Diuretics and corticosteroids reduce cerebral edema · Anticoagulants in selected cases to prevent clot propagation · Thrombolytic therapy for selected acute thrombosis 8. Surgery · Severe SVC Syndrome associated with thrombosis of caval tributaries and inadequate collateral circulation · SVC bypass with composite autogenous vein grafts or PTFE 6-12 months after onset in benign causes or for palliation in malignant causes with severe or acute onset SVC syndrome |
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MR35 ANZCA version [2001-Aug] Q16 (Similar reported question in [Jul97] [Jul98] [Apr99] [Mar00])
The lobar collapse which is most easily missed on chest X-ray, is A. right upper lobe B. left lower lobe C. right lower lobe D. left upper lobe E. right middle lobe |
ANSWER D
Structures behind the heart are obscured, and left lower lobe pathology may be easily missed. |
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MR34 ANZCA version [2003-Apr] Q76, [2003-Aug] Q88
Asbestos exposure is typically associated with each of the following EXCEPT A. pleural effusions B. mesothelioma of the pleura C. laryngeal cancer D. hilar lymphadenopathy E. gastrointestinal cancer |
ALL are TRUE
A. pleural effusions Association Benign exudative pleural effusions usually occur within 15 years of first exposure to asbestos [6]. They may resolve spontaneously, but leave visible blunting of the costophrenic angle or thickening of the visceral pleura. Exclusion of associated malignancy may require thoracoscopic evaluation. Uptodate B. mesothelioma of the pleura Typical Association C. laryngeal cancer Association + smoking D. hilar lymphadenopathy Secondary association. Hilar and mediastinal lymphadenopathy are not seen with asbestosis and should suggest the presence of another process – Uptodate However mesothelioma is associated with hilar lymphadenopathy though this is not a common feature. E. gastrointestinal cancer Association Oesophageal Cancer.... Asbestos exposure increases the incidence of other neoplasms as well. Asbestos is the only known risk factor for malignant mesothelioma. Other malignancies that have been linked to asbestos include cancers of the larynx, oropharynx, kidney, esophagus, and biliary system. |
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MR33c ANZCA version [2003-Aug] Q42
The most useful tool for evaluation of the condition of a patient with an acute asthmatic attack and in assessing the response to therapy is A. chest radiography B. arterial blood gas measurement C. measurement of pulsus paradoxes D. observation of the degree of use of accessory muscles of respiration E. measurement of peak expiratory flow or FEV1 |
ANSWER E
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MR27
Compliance is increased in: A. Pneumonia B. CCF C. Emphysema D. Obesity |
ANSWER C
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MR24 [1988]
Legionnaire's Disease: A. Diarrhoea B. Conjunctivitis C. Pneumonia D. Liver disease E. Encephalopathy |
ALL have been reported to occur.
Legionella are gram negative bacilli. They are intracellular organisms. Legionella bacteria cause 2 distinct clinical conditions: 1. Legionnaires disease, a severe multisystem disease which includes pneumonia 2. Pontiac fever, a self-limiting flu-like illness without pneumonia The natural environment for legionella is water, and they multiple at temperatures between 25 and 42C, with 35C being their optimal temperature meaning that hot water systems, whirlpools etc are ideal breeding grounds. Many outbreaks have also been associated with air-conditioning systems or with travel, especially cruise ships. Symptoms of Legionnaire disease include * Fever * Dry cough * Dyspneoa * Nausea, vomiting and abdominal pain * Confusion Relative bradycardia may occur in up to 66% of patients. The vital signs may reveal high fever' and tachypnoea. Other pulmonary manifestations include dyspnea, pleuritic chest pain, and hemoptysis, which may be present in as many as one third of cases. Pericarditis and endocarditis may be present. Legionnaire disease is also associated with * Hyponatraemia (SIADH is associated) * Deranged LFTs (very common, may help distringuish Legionnaires disease from other pneumonias) * Thrombocytopeaenia *pleural effusion (up to50%) Diagnosis may be by * Urinary antigen * Sputum culture * Serology Most patients have abnormal CXR at presentation, most commonly patchy basal consolidation. Up to 30% have pleural effusions. Treatment is with antibiotics with a high intracellular concenration, such as azithromycin, clarithromycin, fluroquinolone or rifampacin. Note that Legionnaires disease is a notifiable disease. |
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MR25 [1989] [Sep90] [Mar91] [Mar92]
Legionnaire's disease - Which is NOT true? A. Gram negative bacillus as causative organism B. Aminoglycosides effective C. Endocarditis D. Haemoptysis in 20% E. Relative bradycardia F. A rapidly rising fever |
ANSWER B
Legionella are gram negative bacilli. They are intracellular organisms. Legionella bacteria cause 2 distinct clinical conditions: 1. Legionnaires disease, a severe multisystem disease which includes pneumonia 2. Pontiac fever, a self-limiting flu-like illness without pneumonia The natural environment for legionella is water, and they multiple at temperatures between 25 and 42C, with 35C being their optimal temperature meaning that hot water systems, whirlpools etc are ideal breeding grounds. Many outbreaks have also been associated with air-conditioning systems or with travel, especially cruise ships. Symptoms of Legionnaire disease include * Fever * Dry cough * Dyspneoa * Nausea, vomiting and abdominal pain * Confusion Relative bradycardia may occur in up to 66% of patients. The vital signs may reveal high fever' and tachypnoea. Other pulmonary manifestations include dyspnea, pleuritic chest pain, and hemoptysis, which may be present in as many as one third of cases. Pericarditis and endocarditis may be present. Legionnaire disease is also associated with * Hyponatraemia (SIADH is associated) * Deranged LFTs (very common, may help distringuish Legionnaires disease from other pneumonias) * Thrombocytopeaenia *pleural effusion (up to50%) Diagnosis may be by * Urinary antigen * Sputum culture * Serology Most patients have abnormal CXR at presentation, most commonly patchy basal consolidation. Up to 30% have pleural effusions. Treatment is with antibiotics with a high intracellular concenration, such as azithromycin, clarithromycin, fluroquinolone or rifampacin. Note that Legionnaires disease is a notifiable disease. |
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MR21
A superior sulcus tumour (Pancoast tumour) is usually: A. Metastatic B. Bronchogenic C. Frontal lobe of brain D. Osteosarcoma of upper rib E. Tumour involving lymph nodes of neck |
ANSWER B
Pancoast Syndrome - also called a pulmonary sulcus tumor or superior sulcus tumor, is a tumor of the pulmonary apex Clinical Presentation 1. Arm pain 2. Horner's Syndrome 3. Weakness/atropy of hand muscles Pathology -mostly non-small cell lung cancer (squamous cell) -small cell ca 5% Treatment is dependent on malignant cause. |
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MR08 ANZCA version [2002-Mar] Q8, [2003-Apr] Q46 (Similar reported question in [1985] [1987] [1988] [Sep90] [Mar91] [Aug91] [Mar06])
The development of a pleural effusion would be an unusual complication of A. streptococcal pneumonia B. staphylococcal pneumonia C. mycoplasma pneumonia D. pneumococcal pneumonia E. none of the above |
ANSWER C
In community-acquired pneumonia with pleural infection, the most common organisms are Streptococcus pneumoniae and the Streptococcus anginosus/milleri group, with Staphylococcus species accounting for 10% or less of infections. |
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EM31 ANZCA version [2001-Apr] Q39, [2001-Aug] Q38, [2003-Apr] Q40, [2003-Aug] Q45, [Mar06]Q37
The end-tidal CO2 partial pressure (PetCO2) may be greater than the arterial CO2 partial pressure (PaCO2). Causes of this do NOT include A. transitory variations in V/Q matching and deadspace B. breathing with small tidal volumes C. PaCO2 fluctuations during the respiratory cycle D. exercise E. slow emptying of long time constant alveoli containing CO2 levels approximating mixed venous CO2 levels |
ANSWER B
NEAGATIVE Pa-ET CO2 Where can they occur? * Healthy subjects during low frequency high tidal volume ventilation * Pregnant subjects * Infants and Children * After coming off cardiac bypass * During and after exercise. What are the reasons for negative values? * Experimental errors * Rebreathing * Inadvertent addition of CO2 to the inspired gases * Physiological reasons * Smaller alveolar dead space and inherent upward slope of phase III * Increase in the slope of phase III * Exaggerated alveolar PCO2 fluctuations during respiratory cycle due to increased CO2 production and decreased FRC which make it more likely to sample higher alveolar PCO 2 (sampled as PETCO2 ) during expiration greater than mean PaCO2 * Occurrence of phase IV |
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AC18b ANZCA version [2002-Aug] Q68, [2004-Apr] Q85 & [2004-Aug] Q98, [Jul06] Q92 (Similar question reported in [Jul98] [Apr99] [Apr07])
When providing general anaesthesia to a patient with a history of asthma A. thiopentone should not be used as it may cause bronchospasm B. intravenous and topical tracheal lignocaine are equally effective in preventing bronchial hyperreactivity C. ketamine provides little benefit in a patient with active wheezing D. induction with propofol is effective in reducing the incidence of wheezing following intubation E. isoflurane is as effective a bronchodilator as halothane when given in MAC equivalent doses |
ANSWER D
* A. thiopentone should not be used as it may cause bronchospasm - false: o "When general anesthesia is selected, induction of anesthesia is most often accomplished with an intravenous induction drug. The incidence of wheezing is higher in asthmatic patients receiving thiopental for induction than in those given propofol. Thiopental itself does not cause bronchospasm, but it may inadequately suppress upper airway reflexes so airway instrumentation may trigger bronchospasm." (From Stoelting's Anesthesia and Co-existing Diease 5E Ch 9 p.167) * B. intravenous and topical tracheal lignocaine are equally effective in preventing bronchial hyperreactivity - unsure but probably incorrect: o "An alternative method to suppress airway reflexes prior to intubation is the intravenous or intratracheal injection of lidocaine 1 to 3 minutes before tracheal intubation" (Stoelting's Anesthesia and Co-existing Disease, 5E, Ch 9, p. 167) * C. ketamine provides little benefit in a patient with active wheezing - false: o "Ketamine may produce smooth muscle relaxation and contribute to decreased airway resistance, especially in patients who are actively wheezing." (Stoelting's Anesthesia and Co-existing Disease, 5E, Ch 9, p. 167) * D. induction with propofol is effective in reducing the incidence of wheezing following intubation - true: o "When general anesthesia is selected, induction of anesthesia is most often accomplished with an intravenous induction drug. The incidence of wheezing is higher in asthmatic patients receiving thiopental for induction than in those given propofol... The mechanism of propofol's relative bronchodilating effect is unknown." (Stoelting's Anesthesia and Co-existing Disease, 5E, Ch 9, p. 167) * E. isoflurane is as effective a bronchodilator as halothane when given in MAC equivalent doses - false: o "The lesser pungency of halothane and sevoflurane (compared with isoflurane and desflurane) may make coughing, which can trigger bronchospasm, less likely" (Stoelting's Anesthesia and Co-existing Disease, 5E, Ch 9, p. 167) |
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TMP-138 [Apr08] Q100
A 63-year-old, 70 kg man is in the recovery room following a lobectomy for small cell carcinoma of the lung. You are asked to review him because he is complaining of difficulty breathing. He is unable to lift his arms or flex his hips. He has a weak but sustained grip. Cisatracurium 8 mg was given 90 minutes previously. Neostigmine 2.5 mg and atropine 1.2 mg were given at the conclusion of the surgery. The likely diagnosis is: A. Eaton-Lambert syndrome B. limb-girdle muscular dystrophy C. myasthenia gravis D. myotonic dystrophy E. steroid myopathy |
ANSWER A
Eaton-Lambert Syndrome -rare condition -weakness results from pre-synaptic abnormality of ACh release at NMJ -associated with small cell carcinoma -antibodies against voltage gated Ca++ channels on presynaptic motor terminal Features -proximal muscle weakness better with repitition -decreased tendon reflexes Treatment -steriods -plasma exchange -IV immunoglobins |
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MZ-25 Post op patient (surgery 3/7 ago). Patient dyspnoeic. V/Q scan organized which shows non segmental matched perfusion/ventilation defects. This is consistent with
a. Atelectasis b. COPD (multiple, segmental, peripheral, bilateral, matched) c. Pulmonary embolus (mismatched) d. Pneumonia (reverse mismatch) e. Pulmonary infarction (mismatched) |
ANSWER A
Atelectasis : both compression of pulmonary vessels and alveoli (matched VQ defect plus non segmental) |
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MN38 ANZCA version [2004-Apr] Q124, [2005-Apr] Q100, [2005-Sep] Q94, [Jul07] [Apr08] [Aug08] [Aug09][Mar10] [Aug10]
Respiratory function in quadriplegics is improved by A. abdominal distension B. an increase in chest wall spasticity C. interscalene nerve block D. the upright position E. unilateral compliance reduction |
ANSWER B
A. Abdominal distention? This doesn't make sense "as is". It does occur, reduced ab tone improves diaphragmatic effect, but abdo distention eg constipation, will reduce diaphragm effect. B. Spasticity of intercostal muscles may improve VC after a period of weeks the chest no longer collapses outwards. However how does compliance change? presumably more bang for your buck (incr V change/P change) From JCA [1] (http://www.sciencedirect.com.ezproxy.anzca.edu.au/science?_ob=ArticleURL&_udi=B6T83-49JFPP2-J&_user=2850510&_coverDate=08%2F31%2F2003&_rdoc=16&_fmt=full&_orig=browse&_srch=doc-info(%23toc%235075%232003%23999849994%23453360%23FLA%23display%23Volume)&_cdi=5075&_sort=d&_docanchor=&view=c&_ct=17&_acct=C000056830&_version=1&_urlVersion=0&_userid=2850510&md5=9daf80181f2b6676679ec23c07dcaa69) "Lesions below the C5 level (T1–T12) affect intercostal and abdominal muscles. In this situation, respiratory impairment results predominately from inspiratory and expiratory muscle weakness; intercostal muscle function is altered and there is a resulting paradoxic inward rib cage movement on inspiration. These patients most often do not require mechanical ventilatory support unless there are also associated injuries, such as cerebral involvement, cardiac or pulmonary contusions, pulmonary edema, or respiratory insufficiency from pneumonia. In this type of injury, improvement in ventilatory mechanics begins as early as 3 to 5 days after the initial insult, because muscle function improves as a result of the transition from flaccid paralysis to muscle spasticity. During this transition, there is an increase in muscular tone that promotes rib cage stability and decreases paradoxical chest wall movement during the inspiratory phase, improving vital capacity, and overall inspiratory function for up to 6 months. This gradual improvement is more prominently noted for inspiratory than expiratory muscles." Hence I think B is correct, increased spasticity causes increased chest wall compliance. C. Anyone with the ability to do an interscalene block hopefully isn't stupid enough to do it in a quad. D. when patients are nursed in the upright position the diaphragm is at a disadvantage. If the diaphragm is able to contract effectively in this position, the patient will ventilate supine as well, but not vice versa. E. FALSE: presumably if quadraplegia is present compliance would be affected on both sides. This may be an incomplete answer. |
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TMP-Jul10-043
Young asthmatic male in emergency department. Resp rate 26/min, pCO2 27, SAO2 92%, struggling, talking in sentences. Given nebulised salbutamol, and ipratropium, 200mg IV hydrocortisone. After 30 minutes - no improvement. Further management: (NEXT step) A. IV salbutamol B. IV aminophylline C. IV magnesium D. Intubate and ventilate E. helium/oxygen mixture |
ANSWER D
A Cochrane meta-analysis of 7 studies concluded that IV magnesium sulfate improves pulmonary function and reduces hospital admissions, particularly for patients with the most severe exacerbations of asthma. |
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MZ71 [2005-Sep] Q145 | Aug10
With regards to obstructive sleep apnoea (OSA), which of the following statements is INCORRECT? A. hypoxaemia is the main stimulus to arousal B. the main method of treating this syndrome is with Continuous Positive Airway Pressure (CPAP) C. this syndrome is the most likely diagnosis in patients presenting with excessive daytime sleepiness D. this syndrome occurs in up to 5% of adults E. this syndrome rarely has an obstructive component |
ANSWER E
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TMP-Jul10-055
Patient with history of COAD and suspected pneumonia. Clinical findings supporting right-sided pneumonia on examination: A. R Dull percussion note & increased vocal resonance B. R Dull percussion note & decreased vocal resonance C. R Decreased air entry D. Tracheal deviation to left E. Tracheal deviation to right |
ANSWER A
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