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)
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
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
RSV infection is a common cause of bronchiolitis in infants, presenting with cough, wheezing, and difficulty breathing.
4. 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
Mesothelioma typically presents with chest pain, weight loss, and pleural thickening on chest X-ray.
5. A 27-year-old man presents with sudden onset of sharp chest pain and shortness of breath. He recently returned from a long-haul flight. What is the most likely diagnosis?
Answer: A. Pulmonary embolism
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 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
Chronic bronchitis, a type of COPD, typically presents with chronic cough, sputum production, and dyspnoea, especially in smokers.
7. A 22-year-old man 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)
Pertussis, or whooping cough, typically presents with severe paroxysms of coughing followed by a "whoop" sound.
8. A 35-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
Tuberculosis typically presents with a chronic cough, night sweats, weight loss, and a history of travel to endemic areas.
9. 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
Methotrexate can cause drug-induced lung disease, which often presents with a persistent dry cough and shortness of breath.
10. A 60-year-old man presents with dyspnoea, non-productive cough, and chest pain that is worse on inspiration. His symptoms began after recovering from a recent surgery. What is the most likely diagnosis?
Answer: A. Pulmonary embolism
Pulmonary embolism typically presents with sudden onset of pleuritic chest pain and dyspnoea, often after prolonged immobility such as surgery.
11. A 35-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
Tuberculosis typically presents with a chronic cough, night sweats, weight loss, and a history of travel to endemic areas.
12. 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
Methotrexate can cause drug-induced lung disease, which often presents with a persistent dry cough and shortness of breath.
13. 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
Tuberculosis often presents with pleuritic chest pain, fever, and a productive cough, with cavitating lesions in the upper lobes on chest X-ray.
14. A 35-year-old man presents with dyspnoea, non-productive cough, and chest pain that is worse on inspiration. His symptoms began after recovering from a recent surgery. What is the most likely diagnosis?
Answer: A. Pulmonary embolism
Pulmonary embolism typically presents with sudden onset of pleuritic chest pain and dyspnoea, often after prolonged immobility such as surgery.
15. A 40-year-old man presents with a holosystolic murmur heard best at the left lower sternal border, increasing with inspiration. What is the most likely diagnosis?
Answer: A. Tricuspid regurgitation
Tricuspid regurgitation presents with a holosystolic murmur heard best at the left lower sternal border, increasing with inspiration.
Total Score: 0/15