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Browse Latest MCQ Questions

Browse through thousands of multiple-choice question quizzes and expand your knowledge! MCQs are a great way to prepare for your incoming exams!
The Respiratory System Question
The most common manifestation of preliminary involvement in children with cystic fibrosis is:
Explanation
ExplanationThe cough begins as dry and nonproductive but progresses to loose with production of purulent sputum.
The Respiratory System Question
All of the following statements regarding cystic fibrosis are true except:
Explanation
ExplanationThe incidence of cystic fibrosis is highest in northern European whites (1 in 3500) and lowest in Asian infants in Hawaii (1 in 90,000).
The Respiratory System Question
All of the following are gastrointestinal manifestations of cystic fibrosis except:
Explanation
ExplanationOther causes of intestinal obstruction are possible and include neonatal meconium ileus, congenital ileal atresia, neonatal mucus plus syndrome, meconium ileus equivalent (from insufficient use of pancreatic enzyme replacement), intussusception, inguinal hernia, and appendiceal obstruction.
The Respiratory System Question
An 18-yr-old female patient presents with chest pain, tachypnea, and cyanosis of sudden onset 1 wk after the birth of her first child. Her chest radiograph is nondiagnostic, but her PaO2 is 60 mm Hg on 40% oxygen. The most likely diagnosis is:
Explanation
ExplanationPulmonary embolism must be considered with the sudden onset of chest pain, dyspnea, and cyanosis. A normal-appearing chest radiograph with significant hypoxia is classic for pulmonary embolism. A spiral CT study is a useful test to determine the presence of a pulmonary embolism.
The Respiratory System Question
A 3-yr-old child does well for the first 6 hr following surgery. Then dyspnea and tachycardia develop, with rapid shallow respirations. On physical examination the patient has decreased breath sounds and coarse rales on the right.Which of the following is the most appropriate first step in treatment?
Explanation
ExplanationThis patient has atelectases and needs assistance to achieve good inspiratory efforts, etc.Careful use of pain medications to control chest or abdominal pain and to avoid oversedation is also valuable.
The Respiratory System Question
A 6-yr-old girl presents 72 hr after undergoing a tonsillectomy/adenoidectomy with fever, cough, dyspnea, and right-sided chest pain. Examination reveals an ill-appearing child; her temperature is 104°F, pulse rate 110/min, and respiratory rate 40/min; her lungs have decreased air movement on the right, with dullness to percussion. Complete blood count demonstrates marked leukocytosis with left shift, and appearance on chest radiograph is consistent with a pulmonary abscess.Which of the following is the most appropriate initial management?
Explanation
ExplanationMost lung abscesses are the result of aspiration and contain anaerobic bacteria.They can usually be managed with high-dose antibiotics, with no need for drainage.
The Respiratory System Question
A 15-yr-old boy presents with a history of chronic cough productive of yellow-green sputum, dyspnea on exercise, digital clubbing, and poor weight gain. He has a history of recurrent sinopulmonary infections. The patient is a thin-appearing young man; his pulse rate is 95/min and respiratory rate is 24/min; auscultation of the lungs demonstrates diffuse fine crackles and end-expiratory wheezing.The gold standard technique for demonstrating bronchiectasis is:
Explanation
ExplanationCT scanning of the chest is the diagnostic test of choice to demonstrate bronchiectasis.
The Respiratory System Question
A 4-yr-old previously well girl presents with fever (temperature of 103°F), nonproductive cough, dyspnea, and left-sided chest pain. Initial examination reveals an ill-appearing child; pulse rate is 125/min, respiratory rate is 40/min, and room air oxygen saturation is 89%. Auscultation demonstrates decreased air movement on the left side, with crackles. Chest radiograph shows a left lower lobe consolidation.CBC reveals marked leukocytosis.The child was hospitalized and provided with supplemental oxygen and started on high-dose IV cefuroxime.Two days later the child is still febrile with a temperature of 102oF; respiratory rate is 35/min and room air oxygen saturation is 90%. Findings on lung examination and chest film are unchanged from admission.Which of the following is the most appropriate next step?
Explanation
ExplanationThis child probably has a pneumococcal infection with resistant organisms that has not responded to cefuroxime.
The Respiratory System Question
A 6-yr-old girl presents with a 1-mo history of mild cough, intermittent low-grade fever, intermittent wheezing, and an episode of hemoptysis. Pulse rate is 100/min; respiratory rate is 25/min; lung ausculation reveals diffuse end-expiratory wheeze. Chest film shows nonspecific bilateral diffuse infiltrates. There is marked peripheral eosinophilia on complete blood count.The most likely diagnosis is:
Explanation
ExplanationThis disorder has many potential causes, or it may be a primary disease.Eosinophilia is a major clue!
The Respiratory System Question
A 16-yr-old boy attempted suicide by ingesting the herbicide paraquat.Which of the following is the most ominous prognostic indicator?
Explanation
ExplanationThe dose is the most important.Smoking this agent when it is used as a herbicide is also toxic.
The Respiratory System Question
A 17-yr-old boy previously well presents with a history of cough and dyspnea 24 hr after working in a corn silo. Examination reveals a normal-appearing young man who is mildly tachypneic with normal findings on lung auscultation. There are no ill contacts.Silo filler's disease is typically a result of:
Explanation
ExplanationInhaled chemical or gaseous agents produce airway inflammation.Silo filler's disease results from fermentation and gas production in a closed space.
The Respiratory System Question
An 8-yr-old boy presents with a 24-hr history of fever, chills, cough, dyspnea, and malaise. Examination reveals an ill-appearing child who is mildly tachypneic with bibasilar crackles. There are no ill contacts; however, he did help his grandmother clean her pigeon coop the day before presentation.The diagnosis of hypersensitivity pneumonitis would be based primarily on:
Explanation
ExplanationThe history and clinical course are the key, especially if the patient gets better every time he or she is removed from the antigen (e.g., on weekends for factory workers).
The Respiratory System Question
An 11-mo-old infant is admitted to the hospital in December because of failure to thrive and recurrent pneumonia. Within 24 hr of his hospitalization, he develops progressive clear nasal drainage, mild respiratory distress with a respiratory rate of 48/min, intercostal retractions, and diffuse wheezing throughout the lung fields. His oxygen saturation is 88% on room air. His parents state that his 4-yr-old sibling has had cold symptoms for about 4 days.What is the most appropriate next step in the acute treatment of this patient?
Explanation
ExplanationAny previously well patient who becomes hypoxic and is in respiratory distress must be given warmed, humidified oxygen regardless of the diagnosis.
The Respiratory System Question
A 23-mo-old male infant with mild eczema is presented for evaluation of recurrent wheezing episodes. His mother reports that he developed recurrent wheezing with colds following acute RSV infection at age 6 mo for which he was hospitalized and received oxygen by nasal cannula and nebulizer treatments. This was his only hospitalization, but he has been seen on several occasions in the emergency department of their local hospital. She adds that there are no pets in the home and that his father does smoke, but always outside. She herself has moderate asthma and mild seasonal allergies and would like to know if this means her son will have asthma also. You inform the child's mother that her son may be at risk for persistent wheezing.Which of the following is not a risk factor for the persistent wheezing phenotype in this infant?
Explanation
ExplanationDrug or food allergies in themselves are not a risk factor for asthma.
The Respiratory System Question
A 4-yr-old boy with two older sisters is evaluated for symptoms of chronic hoarseness and strained voice, which has been present for several months. The hoarseness is worse in the evening and lessens in the morning. He has no symptoms of airway obstruction. The most likely cause of his symptoms is:
Explanation
ExplanationChronic hoarseness or deepness of the voice that is exacerbated with talking, singing, or crying is common.Treatment is symptomatic; no surgery is needed.
The Respiratory System Question
A 4-yr-old boy with a history of tracheoesophageal fistula (TEF) repair at birth is evaluated for a chronic cough. The cough has persisted since he was discharged from the hospital after his TEF repair. The cough is dry and barking and occasionally associated with expiratory wheezing. The most likely cause of the chronic cough is:
Explanation
Explanation Tracheomalacia is very common after a TEF repair.Some patients also develop reactive airways and reflux.
The Respiratory System Question
A 6-mo-old boy presents with biphasic stridor and a recent episode of croup. He has had minimal response to bronchodilator therapy. His past history reveals that he was a premature infant who was intubated and ventilated for 6 wk. The most likely cause of his respiratory distress is:
Explanation
ExplanationSubglottic stenosis may be congenital or acquired.Direct laryngoscopy will confirm the diagnosis.
The Respiratory System Question
The most common bronchial foreign body is:
Explanation
ExplanationAnything small enough can get into the bronchus."Small" is relative to the size of the bronchus and is thus age dependent.Nuts, sunflower seeds, and the like should not be given to small children.
The Respiratory System Question
A 3-mo-old infant has had progressively worsening biphasic stridor. Her parents report two brief episodes of croup. A 1-cm-diameter hemangioma is present on her right thigh. Airway radiographs are most likely to show:
Explanation
ExplanationAirway hemangiomas may produce stridor and crouplike symptoms with viral upper respiratory tract infections.Facial hemangiomas distributed in a "beard pattern" carry the highest risk for an associated airway hemangioma.Airway lesions may also occur in the absence of any cutaneous lesions.
The Respiratory System Question
A 4-wk-old healthy-appearing term infant is evaluated in the office for stridor, which has persisted since birth. The noisy breathing is accompanied by moderate signs of inspiratory obstruction including suprasternal and subcostal retractions. He feeds adequately and is gaining weight but frequently spits up. The most likely cause of his symptoms is:
Explanation
ExplanationLaryngomalacia is common and often produces noisy breathing that worsens with viral upper respiratory tract infections or in the supine position.
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