MRCP SCE in Respiratory Medicine: 300 SBAs

Cover
Title Page
Copyright
Preface
Contents
Exam revision advice
Glossary
Normal values
Chapter-1 : Respiratory physiology
Chapter-2 : Asthma and allergy
Chapter-3 : Chronic obstructive pulmonary disease
Chapter-4 : Lung cancer and thoracic surgery
Chapter-5 : Pulmonary infection
Chapter-6 : Tuberculosis and nontuberculous mycobacteria
Chapter-7 : HIV and immunocompromise
Chapter-8 : Bronchiectasis and Cystic Fibrosis
Chapter-9 : Interstitial lung diseases
Chapter-10 : Sleep-related disorders and hypoventilation
Chapter-11 : Pulmonary vascular disease
Chapter-12 : Pleura and mediastinum
	the single most appropriate allocation of pleural fluid to each laboratorydepartment to optimise diagnostic accuracy?
	the following nerves is responsible for the sensory supply of themediastinal parietal pleura?
	The single most likely diagnosis of an incidental pleural effusion occupying approximately half of the hemithorax with pH: 7.3• Total protein: 39 g/L (serum 70 g/L)• Lactate dehydrogenase (LDH): 944 U/L (serum – 300 U/L)• Glucose: 0.3 mmol/L• Cytology: Few polymorphs, lymphocytes 89%?
	Most likely underlying diagnosis of orthopnoea and exertional dyspnoea, distended abdomen and a \'milky\' appearance of pleural fluid analysis reveals:• Fluid pH: 7.55• Fluid triglyceride level: 1.5 g/L • Fluid cholesterol level: 0.5 g/L• Protein: 22 g/L (serum – 64 g/L)• LDH: 100 U/L (serum – 220 U/L) • Glucose: 3.5 mmol/L?
	In relation to pleural plaques in a 73-year-old retired heating engineer, which one of the following is true?
	Most likely causative agent for exertional dyspnoea, eosinophilia, & pleural effusion 3 weeks after commencing on a medication for tonic–clonic seizures?
	Malignant effusions
		The single most accurate estimate of survival in a case of a left upper lobe mass and moderate pleural effusion with abnormal cells consistent with lung cancer & positive for TTF1 and CK7 on immunocytochemistry. Tests for molecular markers reveal EGFR negative, ALK negative, and PD-L1 expression 10%?
		The single most accurate statement about malignanteffusions?
	The next most appropriate investigation for a right sided unilateral pleural effusion with • Protein: 31 g/L, serum protein 60 g/L • LDH: 110 g/L, serum 150 g/L • Glucose: 7.5 mmol/L, serum 9.0 mmol/L in a 76-year-old patient with a history of ischaemic heart disease, hypertension, heart failure with ejection fraction of 35% and diabetes on a number of drugs including: aspirin, simvastatin, bisoprolol, enalapril, gliclazide, and bumetanide?
	The following indicates the need for immediate chest tube drainage in the context of a 1 week history of cough, fever, and pleuritic chest pain. A CRP of 222, a WCC of 14 on blood tests and a pleural effusion on CXR?
Chapter-13 : Occupational and environmental lung disease
	The single best immediate course of action in a man with feeling like a constant cold, with nasal stuffiness, eye irritation, cough, breathlessness and wheezing with no improvement on days off, but on a recent 2 week holiday abroad felt much better for the last 10 months after that he has been responsible for quality assurance on the production line of a new antibiotic?
		1.
	The single most likely diagnosis based on peak expiratory flow rate (PEFR) diary for a 2-week period when a 26-year-old man who has recently changed jobs, and began an apprentice scheme as a baker 1 month ago performed 2 hourly PEFR whilst at work and at home?
	The single most likely cause of  a 2 month history of breathlessness, fevers, cough, and 6 kg unintentional weight loss in a 41-year-old man who moved from Bangladesh to the UK 2 years ago presents with. from the ages of 20–35 years he worked in a slate roof tile production factory in India without protective respiratory equipment on a thorough occupational history. He does not think he was exposed to asbestos. No known Tuberculosis contacts. Fine nodular fibrotic changes in the upper and mid zones. Area of
	The single best test to confirm the diagnosis of non-productive cough and dyspnoea which has developed over around 8 months in 50-year-old man who works on a fluorescent light manufacturing production line. Bilateral hilar lymphadenopathy and a fine reticulonodular appearance bilaterally on CXR?
	Hypersensitivity pneumonitis
		the following is known to be protective against hypersensitivitypneumonitis?
		the following statements about hypersensitivity pneumonitisdiagnosis is true?
		The single most likely causative agent of hypersensitivity pneumonitis?
	Most appropriate management plan of breathlessness, cough and weight loss over the course of 6 weeks, with episodes described as flu-like, where he has fever and dry cough, which seem to last 2–3 days and then subside with no improvement on salbutamol inhaler & a course of amoxicillin and then clarithromycin. Inspiratory crackles are heard on auscultation of chest & normal full blood count, with normal eosinophil levels & CT of the chest is shown in a 22-year-old farm worker?
	The most likely findings on broncho-alveolar lavage in a 65-year-old woman who runs an animal rescue shelter with progressive breathlessness, persistent cough, and weight loss over the last 6 months that have not responded to three courses of antibiotics. Clubbing and there are inspiratory crackles in both lower lobes. Bilateral ground glass opacities, centrilobular nodules, and lobular areas of decreased attenuation on CT of the chest?
	The single most likely diagnosis in a 51-year-old UK-born non-smoker Black African woman works in a factory which makes strip-lights with sub-acute breathlessness, gradually reducing exercise tolerance, breathlessness, intermittent fevers and joint pains over a period of 2 months. Tender nodules on her shins, and pain without swelling in wrists and ankles on examination. Bilateral hilar lymphadenopathy on CXR?
	The most likely cause of a spirometry shows FEV1 1.2 L (66% predicted) FVC 2.0 L (91% predicted) FEV1/FVC 0.6 in a recent migrant non-smoker 70-year-old woman from rural Bangladesh with breathlessness & her husband was non-smoker before he died?
	The single most likely diagnosis of chest tightness, respiratory distress, coughing, a high respiratory rate and an audible wheeze and requires supplemental oxygen 40% via venturi mask to maintain Spo2 of 94% following exposure to chlorine for use in swimming pools?
	Most likely diagnosis in a 23-year-old migrant worker who is working as an undocumented migrant in a hemp factory, producing fabric and rope presents with recurrent episodes of breathlessness, cough, wheeze and chest tightness?
	Most likely diagnosis in a 19-year-old man recently joined an apprenticeship programme as a welder of galvanised steel has felt unwell for the last 4 weeks during the week with like flu like illness, fever, nausea, headache, joint pains, a dry irritated throat with some hoarseness and shortness of breath. The symptoms resolve by Sunday, but return again on Monday evening?
	asbestos
		A 65-year-old retired plumber with 3 breathlessness on the mMRC breathlessness scale, numerous calcified pleural plaques consistent with asbestos exposure. In addition there is circumferential non-calcified pleural thickening bilaterally. This is worse on the left, involving the apex and costophrenic angleasks on CT chest whether you can help him claim compensation for asbestos exposure?
		one of the following occupations is most closely associated withmesothelioma risk?
	With regards to COPD and coalminers which one is the single most accuratestatement?
	air pollution
		The single most accurate statement regarding air pollution and lunghealth?
Chapter-14 : Lung transplantation
Chapter-15 : Other Smoking cessation, ethics, pharmacology, genetic and developmental lung disease, and statistics