Free Respiratory Medicine 15 Single Best Answer (SBA)
1. A 68-year-old man with a history of smoking presents with a chronic productive cough, wheezing, and shortness of breath. He has a barrel chest and uses accessory muscles for breathing. What is the most likely diagnosis?
Answer: C. Chronic obstructive pulmonary disease (COPD)
Explanation: Chronic obstructive pulmonary disease (COPD) typically presents with a chronic productive cough, wheezing, and shortness of breath, often in smokers.
2. A 3-year-old boy presents with a barking cough, stridor, and hoarseness. His symptoms worsen at night, and his mother reports that he recently had a cold. What is the most likely diagnosis?
Answer: B. Croup
Explanation: Croup typically presents with a barking cough, stridor, and hoarseness, often following an upper respiratory infection.
3. A 6-month-old infant presents with a cough, wheezing, and difficulty breathing. On examination, the infant has nasal flaring, intercostal retractions, and fine crackles on auscultation. What is the most likely diagnosis?
Answer: A. Respiratory syncytial virus (RSV) infection
Explanation: Respiratory syncytial virus (RSV) infection is a common cause of bronchiolitis in infants, presenting with cough, wheezing, and difficulty breathing.
4. A 75-year-old man with a history of COPD presents with fever, purulent sputum, and increased shortness of breath. His chest X-ray shows consolidation in the right lower lobe. What is the most likely diagnosis?
Answer: A. Bacterial pneumonia
Explanation: Bacterial pneumonia typically presents with fever, productive cough, and focal lung consolidation on chest X-ray.
5. A 27-year-old woman presents with sudden onset of sharp chest pain and shortness of breath. She recently returned from a long-haul flight. What is the most likely diagnosis?
Answer: A. Pulmonary embolism
Explanation: Pulmonary embolism typically presents with sudden onset of pleuritic chest pain and dyspnoea, often after prolonged immobility such as a long flight.
6. A 65-year-old man with a history of asbestos exposure presents with chest pain, weight loss, and a persistent cough. His chest X-ray shows pleural thickening. What is the most likely diagnosis?
Answer: B. Mesothelioma
Explanation: Mesothelioma, a malignancy associated with asbestos exposure, typically presents with chest pain, weight loss, and pleural thickening on chest X-ray.
7. A 2-year-old boy presents with a severe cough that ends in a "whooping" sound. His parents report that he has been coughing so hard that he has vomited several times. What is the most likely diagnosis?
Answer: A. Pertussis (Whooping Cough)
Explanation: Pertussis, or whooping cough, typically presents with severe paroxysms of coughing followed by a "whoop" sound.
8. A 60-year-old man presents with chronic cough, sputum production, and dyspnoea. He has a 40 pack-year smoking history. What is the most likely diagnosis?
Answer: A. Chronic bronchitis
Explanation: Chronic bronchitis, a type of COPD, typically presents with chronic cough, sputum production, and dyspnoea, especially in smokers.
9. A 32-year-old woman presents with dry cough, night sweats, and weight loss. She has recently returned from a trip to a high-prevalence area for tuberculosis. What is the most likely diagnosis?
Answer: A. Tuberculosis
Explanation: Tuberculosis typically presents with a chronic cough, night sweats, weight loss, and a history of travel to endemic areas.
10. A 3-year-old boy presents with fever, drooling, and stridor. He is sitting forward, refusing to lie down, and has difficulty breathing. What is the most likely diagnosis?
Answer: A. Acute epiglottitis
Explanation: Acute epiglottitis typically presents with fever, drooling, stridor, and respiratory distress, often in young children.
11. A 55-year-old woman presents with shortness of breath, a dry cough, and chest pain that is worse on inspiration. Her symptoms began after recovering from a recent surgery. What is the most likely diagnosis?
Answer: A. Pulmonary embolism
Explanation: Pulmonary embolism typically presents with sudden onset of pleuritic chest pain, dyspnoea, and a history of recent immobility, such as surgery.
12. A 35-year-old man presents with dyspnoea, non-productive cough, and fatigue. He has bilateral hilar lymphadenopathy on chest X-ray and hypercalcaemia on blood tests. What is the most likely diagnosis?
Answer: A. Sarcoidosis
Explanation: Sarcoidosis typically presents with dyspnoea, non-productive cough, bilateral hilar lymphadenopathy, and hypercalcaemia.
13. A 45-year-old woman presents with persistent dry cough and shortness of breath. She has a history of rheumatoid arthritis and has been on methotrexate therapy. What is the most likely diagnosis?
Answer: A. Drug-induced lung disease
Explanation: Methotrexate can cause drug-induced lung disease, which often presents with a persistent dry cough and shortness of breath.
14. A 28-year-old man presents with pleuritic chest pain, fever, and a productive cough. His chest X-ray shows a cavitating lesion in the upper lobe. What is the most likely diagnosis?
Answer: A. Tuberculosis
Explanation: Tuberculosis often presents with pleuritic chest pain, fever, and a productive cough, with cavitating lesions in the upper lobes on chest X-ray.
15. A 22-year-old man with a history of asthma presents with sudden onset of dyspnoea and pleuritic chest pain after playing basketball. On examination, he has decreased breath sounds on the right side. What is the most likely diagnosis?
Answer: A. Spontaneous pneumothorax
Explanation: A spontaneous pneumothorax, especially in a young, tall, thin male, can present with sudden onset of dyspnoea and pleuritic chest pain.
Total Score: 0/15
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