2017 Respiratory Physician Attending Physician "Professional Practice Ability" Mock Questions and Answers
Mock Questions 1:
B-type questions
Male, 64 years old, with a history of pulmonary heart disease for 5 years, frequent headache and dizziness, cough worsened over the past week, coughing up yellow sputum, dyspnea, worsening headache, drowsiness and delirium since yesterday. Drowsiness and delirium since yesterday. Examination: confusion, facial edema, bulbar conjunctival edema, cyanosis of the lips and mouth, jugular venous filling, extensive dry and wet rales in both lungs, liver 4 cm below the ribs, ascites sign (+), lower limb edema, knee reflexes are weakened, Babinski's sign (+). pH 7.20, PaCO2100mmHg, PaO2mmHg, HCO3-21mmol/L.
1.(01) The The patient is confused, most likely due to the occurrence of:
A. hypertensive encephalopathy
B. cerebral infarction
C. pulmonary encephalopathy
D. infectious toxic encephalopathy
E. none of the above
A. hypertensive encephalopathy B. cerebral infarction C. pulmonary encephalopathy D. infectious toxic encephalopathy E. none of the above
Answer C
2.(02) Which type of acid-base balance imbalance has occurred in the patient:
A. decompensated respiratory acidosis
B. compensated respiratory acidosis
C. exhalation of acid combined with metabolic acidosis
D. metabolic acidosis
E. exhalation of acid combined with metabolic alkalosis
A. Uncompensated respiratory acidosis B. Compensated respiratory acidosis C. Combined metabolic acidosis with huffing acid D. Metabolic acidosis E. Combined metabolic alkalosis with huffing acid
Answer C
3.(03) The immediate therapeutic intervention in this patient is:
A. Selection of effective antibiotics
B. Improvement of ventilation and low-flow C. Respiratory stimulants
D. Antihypertensive medications
E. Intravenous mannitol drip
A. Effective antibiotics B. Improved ventilation and low-flow oxygen C. Respiratory stimulants D. Antihypertensive medications E. Intravenous mannitol drip
Answer B
A 45-year-old woman has been suffering from recurrent coughing and purulent sputum for more than 20 years. She has been hospitalized repeatedly for more than 20 years. One week ago, the patient had a recurrent cough and yellow-green purulent sputum with fever.
4.(01) The most likely diagnosis for this patient is:
A. chronic bronchitis
B. bronchiectasis
C. tuberculosis
D. lung cancer
E. pyothorax
A. chronic bronchitis B. bronchiectasis C. tuberculosis D. lung cancer E. pyothorax
ANSWERS B
5.(02) The most valuable test for diagnosis is:
A. Blood count
B. Sputum culture
C. High-resolution CT of the thoracic cavity
D. Fiberoptic bronchoscopy
E. Ultrasound of the thoracic cavity
A. Blood count, B. Sputum culture, C. High-resolution CT of the thoracic cavity, D. Fiberoptic bronchoscopy, E. Ultrasound of the thoracic cavity. Chest ultrasound
Answer C
Male, 60 years old, cough, blood in sputum, weight loss for 2 months, had been given penicillin 8 million units intramuscular injection for 5 days, oral cough suppressant, expectorant drugs are ineffective, physical examination: left lateral chest 4th and 5th intercostal spaces speech tremor is reduced, turbid tones on percussion, WBC 8.7?109 / L, N69%.
6.(01) In the history, special attention should be paid to asking:
A. the presence of chest pain and its location, nature
B. history of coronary heart disease, angina pectoris
C. history of smoking
D. history of night sweats
E. history of chronic bronchitis
A. the presence of chest pain and its location, nature B. history of coronary heart disease, angina pectoris C. history of smoking D. history of night sweats E. history of chronic bronchitis
Answer C
7.(02) The most valuable adjunctive test to confirm the diagnosis is:
A. MRI
B. blood CEA
C. ESR
D. fiberoptic bronchoscopy
E. nuclear lung scan
A. MRI B. Blood CEA C. ESR D. Fiberoptic bronchoscopy E. Nuclide lung scan
Answer D
8.(03) For this patient, the main sputum test to send is:
A. Sputum culture + drug sensitivity
B. Sputum for tuberculosis bacteria
C. Sputum for tumor cells
D. Sputum TB culture
E. Sputum for Charcot-Lyden crystals
A. Sputum culture + drug sensitivity B. Sputum for TB bacilli C. Sputum for tumor cells D. Sputum for TB culture E. Sputum for Charcot-Lyden crystals
ANSWER C
9.(04) The most probable diagnosis is:
A. Chronic bronchitis
B. Left pneumonitis
C. Tuberculosis
D. Lung cancer
E. Bronchiectasis
A. Chronic bronchitis B. Left pneumonitis C. Tuberculosis D. Lung cancer E. Bronchiectasis
ANSWER D
10.(05) Treatment focuses on:
A. Intensive anti-infective therapy
B. Anti-tuberculosis therapy
C. Surgery
D. Radiation therapy
E. Hormone therapy
A. Intensive anti-infective therapy B. Anti-tuberculosis therapy C. Surgery D. Radiation therapy E. Hormone therapy
ANSWER C
A male, 58 years of age, with pulmonary cardiac disease was admitted to the hospital coughing, with respiratory distress and coma, and his symptoms improved after tracheotomy He has been coughing up yellow sputum for 4 days. wbc11?109/L.
11.(01) The probable complication at the time of this patient's admission was:
A. Pulmonary encephalopathy
B. Cerebrovascular accident
C. Toxic encephalopathy
D. Shock
E. None of the above
A. Pulmonary encephalopathy B . . cerebrovascular accident C. toxic encephalopathy D. shock E. none of the above
ANSWER A
12.(02) The acid-base imbalance that may be present in a patient after a tracheotomy is:
A. respiratory acidosis
B. respiratory alkalosis
C. exhalation of acid combined with substitution of acid
D. exhalation of acid combined with substitution of alkaline
E. Metabolic alkalosis
A. Respiratory acidosis B. Respiratory alkalosis C. Combined acid exhalation and acid replacement D. Combined acid exhalation and alkalosis E. Metabolic alkalosis
Answer B
A male, 30 years old, has been coughing up yellow sputum for more than 10 years, which has been aggravated by a week of fever. The sputum was purulent and foul-smelling sputum with stratification at rest, and the patient was hospitalized several times for bronchiectasis. Physical examination: T39 ℃, severe emaciation, acute febrile appearance, cough weakness, fixed wet rales in the left lower lung, tubular breath sounds in the right lower lung. wbc19.6?109/L, N85%. Sputum culture was suggestive of Pseudomonas aeruginosa 3+. x-ray suggested a honeycomb shadow in the left lower lung with small fluid flats and a solid shadow in the right lower lung.
13.(01) The exact diagnosis of this patient is:
A. Tuberculosis
B. Bronchiectasis with lung infection
C. Wegener's granulomatosis
D. Middle lobe syndrome
E. Dry bronchiectasis
A. Tuberculosis B. Bronchiectasis with lung infection C. Wegener's Granuloma D. Middle lobe syndrome E. Dry bronchiectasis
Answer B
14.(02) Which of the following is the most appropriate anti-infective therapy for this patient:
A. ceftazidime + tinidazole
B. butylcarbamoyl + penicillin
C. cefuroxime
D. tinidazole
E . . gatifloxacin
A. ceftazidime + tinidazole B. butamidocarbamycin + penicillin C. cefuroxime D. tinidazole E. gatifloxacin
Answer A
15.(03) After vigorous anti-infective as well as expectorant, bronchodilator medication, and positional drainage measures, the patient still had intermittent fever with a T of about 38.5°C and a blood WBC 14? 109/L, N80%, X-ray review of the right lower lung still has a solid shadow, which is reduced from the previous. Which of the following measures should be taken:
A. Surgery
B. Change to a stronger antibiotic to fight infection
C. Perform a CT scan of the lungs
D. Perform a fiberoptic bronchoscopy to aspirate sputum, irrigate it, and inject antibiotics into the area locally
E. Expectorant medication is added to the dosage of expectorant medicine
Answer D
16.(04) Which of the following post-discharge prophylaxis is not correct in this patient who was discharged from the hospital after being treated for acute and chronic respiratory infections:
A. Prevention of aspiration of foreign bodies into the trachea
B. Prevention of B. preventing foreign bodies from being aspirated into the trachea
C. enhancing immunity and disease resistance
D. adhering to long-term antibiotics
E. strengthening nutritional support
A. preventing acute and chronic respiratory tract infections B. preventing foreign bodies from being aspirated into the trachea C. enhancing immunity and disease resistance D. adhering to long-term antibiotics E. strengthening nutritional support
Answer D
Female, 25 years old, coughing, coughing up sputum for 10 years, with purulent sputum, sputum volume of 60 ml/d. Chest X-ray of the two lower lungs with textural disorder, visible cystic cavities, and air-liquid planes in the cavities.
17.(01) The diagnosis of this patient is first considered:
A. Chronic bronchitis
B. Bronchiectasis
C. Chronic lung abscess
D. Congenital lung cyst
E. Kartagener syndrome
A. Chronic bronchitis B. Bronchiectasis C. Chronic lung abscess D. Congenital pulmonary cyst E. Kartagener syndrome
Answer B
18.(02) Which of the following is incorrect:
A. Lifelong antibiotics
B. Positional drainage
C. Physical exercise
D. Phlegmolytic therapy
E. Recombinant Deoxyribonuclease nebulized inhalation
A. Life-long antibiotics B. Positional drainage C. Physical exercise D. Sputum treatment E. Recombinant deoxyribonuclease nebulized inhalation
Answer A
A woman, 50 years old, with afternoon fever and coughing blood in sputum for 1 week, Physical examination: wet rhonchi in the left scapular region, sedimentation rate of 50 mm/h, blood leukocytes 10.0? 109/L, N0.78, chest X-ray showed patchy shadow in the left upper lung with 1cm?1cm translucent area.
19.(01) The most likely diagnosis is:
A. Mycoplasma pneumonia
B. Pneumococcal pneumonia
C. Infiltrative tuberculosis
D. Lung fungal disease
E. Bronchopulmonary cancer
A. Mycoplasma pneumonia B. Pneumococcal pneumonia C. Infiltrative tuberculosis D. Pulmonary fungal disease E . . bronchopulmonary cancer
Answer C
20.(02) The test of choice to confirm the diagnosis is:
A. Chest CT
B. Chest nuclear magnetic **** vibration
C. Tuberculin test
D. Sputum search for bacillus antipersistant
E. Sputum cytology
A. Chest CT B. Chest NMR*** vibration C. Tuberculin test D. Sputum looking for antacid bacilli E. Sputum cytology
Answer D
Mock question 2:
B-type question
Male, 66 years old, smoked for 30 years, 1 pack/day, chronic coughing, coughing up sputum for 15 years, most of them are white mucous sputum, with episodes of 3 months per year. Around, in the last 6 months, shortness of breath on 2 or 3 floors, occasional wheezing sounds, no significant recent aggravation. Blood: WBC7.6?109/L, neutral 0.80, urine routine normal.
0.(02) (0 points) To clarify the severity of the disease and detect changes, the most valuable `examination is:
A. Chest X-ray
B. CT of the lungs
C. Lung function
D. Magnetic **** vibratory imaging
E. Blood gas analysis
A. Chest X-ray B. Lung CT C. Lung function D. Magnetic **** vibratory imaging E. Blood gas analysis
Answer C
A 50-year-old man with a chronic cough of 5 years and a 2-year history of diabetes mellitus. He came to the clinic with worsening cough for a month and fever for a week, and his findings were, blood pH 7.25, PaO2 40 mmHg, PaCO 285 mmHg, and BE-10 mmol/L.
1.(01) (0 points) Your diagnosis is:
A. Loss of compensated exhalation of acidity
B. Loss of compensated exhalation of acidity combined with pronation of alkaloids
C. Loss of compensated exacerbic acid combined with substitute base
D. uncompensated substitute acid
E. triple acid-base imbalance
A. uncompensated exacerbic acid B. uncompensated exacerbic acid combined with substitute acid C. uncompensated exacerbic acid combined with substitute base D. uncompensated substitute acid E. triple acid-base imbalance
ANSWER B
2. (02) (0 pts.) Oxygen concentration during oxygen administration in this patient should be controlled at:
A. 20% to 25%
B. 25% to 30%
C. 30% to 40%
D. 40% to 50%
E. 50% or more
A. 20% to 25% B. 25% to 30% C. 30% to 40% D. 40% to 50% E. 50% or more
Answer B
3.(03) (0 points) After comprehensive treatment with anti-inflammatory, airway patency, hypoglycemia, and acid correction, the patient's coughing and wheezing is significantly reduced, and the pulmonary rales are markedly reduced; the blood gases are restored to pH 7.3, PaO2 70 mmHg, and PaCO 248 mmHg after ten days, but the patient is still febrile, so which test would you consider should be performed first:
A. blood bacterial culture + drug sensitization
B. sputum bacterial culture + drug sensitization
C. chest CT examination
D. chest X-ray
E. bone marrow aspiration
A. blood bacterial culture + drug sensitization B. sputum bacterial culture + drug sensitization C. chest CT examination D. chest X-ray examination E. bone marrow aspiration
Answer D
Male patient, 23 years old, coughing, coughing up a lot of purulent sputum, and repeated hemoptysis for 8 years. In the last 2 days, fever developed after exposure to cold, cough worsened, and sputum increased in volume, which was greenish-purulent sputum mixed with a small amount of blood. Physical examination: T4℃, shortness of breath, fixed and persistent wet rales were heard in the left lower lung.WBC18?109/L, N85%.
4.(01) (0 pts) The most likely diagnosis for this patient is:
A. Chronic bronchitis
B. Abscess chest
C. Tuberculosis
D. Pneumothorax
E. Bronchodilatation
A. Chronic bronchitis B. Abscess chest C. Tuberculosis D. Pneumothorax E. Bronchiectasis
Answer E
Answer E
Answer E
Answer E
5.(02) (0 points) Which of the following x-ray changes best supports the diagnosis of this patient:
A. Bilateral pulmonary emphysema with a narrow cardiac shadow and prominent pulmonary artery segments
B. Large dense inflammatory shadows with cavities are seen in the left lower lung
C. Disturbed honeycomb changes of the texture of the left lower lung field, with a small fluid plane visible
D. loss of texture in the outer bands of the left lung field, with a pneumothorax line
E. multiple round or oval shadows with slender borders and no inflammatory infiltrate
A. bilateral pulmonary emphysema with narrow cardiac shadows and prominent pulmonary artery segments B. large dense inflammatory shadows in the left lower lung, with cavities C. disorganized honeycomb change of the texture in the left lower lung field, with a small plane of fluid D. loss of texture in the outer bands of the left lung field, with a pneumothorax line E. multiple round or oval shadows with slender borders and no inflammatory infiltrates
Answer C
6.(03) (0 points) The antibiotic of choice for anti-infective therapy in this patient is:
A. macrolides
B. a second-generation cephalosporin
C. vancomycin
D. an antibiotic against Pseudomonas
E. all of these. >
E. None of the above
A. macrolides B. second-generation cephalosporins C. vancomycin D. antipseudomonas antibiotics E. None of the above
ANSWER D
A 68-year-old man with a recurrent cough and coughing up sputum for 20 years, aggravated by exposure to the cold a week ago, with marked shortness of breath and cyanosis, bilateral lower extremity edema, and drowsiness. Blood gas analysis: Ph7.26, PaO240mmHg, PaCO80mmHg. HCO3-18mmol/L. ECG: Rv1+Sv5=1.15mv.
7.(01) (0 points) Which of the following should be the diagnosis for this patient:
A. Chronic bronchitis with obstructive emphysema
B. Chronic pulmonary heart failure
B. Chronic pulmonary heart failure
B. Chronic pulmonary heart failure
B. Chronic pulmonary heart failure
B. Chronic pulmonary heart failure
B. Chronic pulmonary heart failure
Coughing. Chronic pulmonary heart failure
C. Chronic pulmonary heart disease with pulmonary infection
D. Chronic pulmonary heart disease with pulmonary encephalopathy
E. Chronic pulmonary heart disease with coronary heart disease
A. Chronic bronchitis with obstructive emphysema B. Chronic pulmonary heart failure C. Chronic pulmonary heart disease with pulmonary infection D. Chronic pulmonary heart disease with pulmonary encephalopathy E. Chronic pulmonary heart disease with coronary heart disease
A. Chronic bronchitis with obstructive emphysema B. Chronic pulmonary heart failure C. Chronic pulmonary heart disease with pulmonary infection D. Chronic pulmonary heart disease with pulmonary encephalopathy E. Chronic pulmonary heart disease with coronary heart disease Coronary artery disease
Answer D
8.(02) (0 pts) The above blood gas analysis suggests which type of acid-base imbalance:
A. uncompensated respiratory acidosis
B. uncompensated metabolic acidosis
C. compensated respiratory acidosis
D. respiratory acidosis combined with metabolic alkalosis
E. respiratory acidosis combined with metabolic alkalosis
D. respiratory acidosis combined with metabolic alkalosis
E. respiratory acidosis combined with metabolic alkalosis
E. Respiratory Acidosis Combined with Metabolic Acidosis
A. Uncompensated Respiratory Acidosis B. Uncompensated Metabolic Acidosis C. Compensated Respiratory Acidosis D. Respiratory Acidosis Combined with Metabolic Alkalosis E. Respiratory Acidosis Combined with Metabolic Acidosis
ANSWER E
9. (03) (0 pts.) The most critical current management measures is:
A. tracheotomy
B. sodium bicarbonate supplementation
C. hyperbaric oxygen
D. expectoration
E. control of the infection
A. tracheotomy B. sodium bicarbonate supplementation C. hyperbaric oxygen D. expectoration E. control of the infection
ANSWER E
10. (0 points) Control of the infection by Infection control, expectoration and oxygenation via continuous low-flow for 14 hours with respiratory stimulants have not resulted in any significant change in condition, which emergency treatment should be the next step:
A. Ultrasonic nebulization
B. Increase the dosage of respiratory stimulants
C. Tracheotomy with assisted respiration
D. Increase the dosage of antibiotics
E . . fibrinoscopic aspiration
A. ultrasonic nebulization B. increase the dosage of respiratory stimulants C. tracheotomy plus assisted ventilation D. increase the dosage of antibiotics E. fibrinoscopic aspiration
Answer C
Female, 23 years old, has been coughing mildly for the past two months with blood in the sputum, and has had fever of the palms and feet in the afternoon. Night sweats and palpitations have been treated with antibiotics for a week with poor results, and a chest radiograph now shows cloudy flocculent shadows above the third anterior rib of the right upper lung.
11.(01) (0 points) You think the most likely diagnosis is:
A. right upper lung cancer
B. chronic fibrocavitary lesion secondary to tuberculosis
C. infiltrative foci of secondary tuberculosis
D. right lung abscess
E. right upper pneumonia
A. right upper lung cancer B. secondary tuberculosis
A. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer B. right upper lung cancer Tuberculosis chronic fibrous cavitary lesion C. Secondary tuberculosis infiltrative lesion D. Right lung abscess E. Right upper pneumonia
Answer C
12.(02) (0 pts) Which of the following tests would be the most significant in making a definitive diagnosis:
A. Accelerated rate of hemosedimentation
B. Sputum looking for antacid bacilli is positive
C. Routine blood tests show mild Anemia
D. Negative sputum bacterial culture
E. Chest CT shows a patchy exudative shadow in the right upper lung
A. Accelerated sedimentation rate B. Positive sputum search for antacid bacilli C. Mild anemia on routine blood tests D. Negative sputum bacterial culture E. Chest CT shows a patchy exudative shadow in the right upper lung
ANSWER B
13.(03) (0 points) If a PPD test is given to a patient at this time and the skin nodules are <5 mm in diameter after 48 hours, do you think it is most likely that:
A. it is a normal reaction
B. tuberculosis is ruled out
C. it may be combined with the application of immune-enhancing medications
D. the time has been too short for the body to develop an allergic reaction
E. it may be combined with the presence of an immunosuppressive disease
E. the presence of an immunosuppressive disease
E. it may be combined with cellular Immunosuppressive diseases are present
A. Normal reaction B. Tuberculosis is ruled out C. Possible combination of immune-enhancing drugs D. Too short a period of time and the body does not develop an allergic reaction E. Possible combination of cellular immune-suppressive diseases are present
Answer E
14. (0 pts) Which is the patient's first choice of treatment:
A. Antiinfective treatment
B. short course chemotherapy based on INH, RFP, PZA
C. short course chemotherapy based on INH, EMB, PZA
D. short course chemotherapy based on INH, SM, PZA
E. short course chemotherapy based on INH. RFP, PZA-based short-course chemotherapy C. INH, EMB, PZA-based short-course chemotherapy D. INH, SM, PZA-based short-course chemotherapy E. INH.SM, EMB-based short-course chemotherapy
ANSWER B
Male, 68 years old, smoked for years, 30 cigarettes per day. 10 years ago coughing with progressively increasing dyspnea . He has been hospitalized for the past 5 days with bedriddenness, low urine output, and lower extremity edema. Physical examination: barrel chest, low respiratory sounds in both lungs. ECG showed pulmonary P waves.
15.(01) (0 pts) The most likely diagnosis is:
A. Chronic bronchitis with coronary artery disease
B. Wheezing chronic bronchitis
C. Chronic pulmonogenic heart disease
D. Chronic bronchitis with emphysema
E. Chronic bronchitis, emphysema, and pulmonary artery disease with loss of compensations
A. Chronic bronchitis with coronary artery disease B. Wheezing chronic bronchitis with pulmonary artery disease Coronary artery disease B. Wheezing chronic bronchitis C. Chronic pulmonogenic heart disease D. Chronic bronchitis with emphysema E. Chronic bronchitis, emphysema, and decompensated pulmonary heart disease
Answer E
16.(02) (0 points) Which of the following is the most important treatment:
A. Respiratory stimulants
B. Diuretics
C. Cardiotonics
D. Control of infections
E. Diuretics
C. Cardiotonic agents
E. Expectorant expectorant
A. Respiratory stimulants B. Diuretics C. Cardiotonic agents D. Infection control E. Expectorant expectorant
Answer D
A 49-year-old male with a recurrent cough for 14 years, intermittent hemoptysis, and a history of penicillin, streptomycin, and INH during the course of the illness. Chest X-ray: multiple cavities in the right upper lung with more striated shadows around them, right hilar elevation, and rightward shift of the trachea.
17.(01) (0 points) The most likely diagnosis is:
A. Central lung cancer
B. Chronic lung abscess
C. Bronchiectasis
D. Infiltrative tuberculosis
E. Chronic fibrocavitary tuberculosis
A. Central lung cancer B. Chronic lung abscess C. Bronchiectasis D . . invasive tuberculosis E. chronic fibrous cavernous tuberculosis
Answer E
18.(02) (0 points) Do you think that the main reason for the patient's recurrent exacerbations of the disease is:
A. older age of onset of the disease
B. severity of the disease
C. primary infection with a drug-resistant organism
D. substandard treatment
E. combination of other diseases
E . . comorbidities
A. older age of onset B. severe disease C. primary drug-resistant bacterial infection D. substandard treatment E. comorbidities
Answer D
19.(03) (0 pts) The next step in the treatment is:
A. anti-infective treatment
B. formal anti-tuberculosis chemotherapy
C. surgical treatment
D. Artificial pneumothorax therapy
E. Nutritional support therapy
A. Anti-infective therapy B. Formal anti-tuberculosis chemotherapy C. Surgery D. Artificial pneumothorax therapy E. Nutritional support therapy
Answer B
A male, 60 years of age, of normal build, was hospitalized for congestive heart failure, during which he breathed normally during the day, and then, as soon as he went to sleep at night. As soon as he fell asleep at night, his spontaneous respiratory rate gradually decreased or even stopped, and he often woke up with suffocation or sat up suddenly, feeling panic and chest tightness and discomfort in the precordial area.
20.(01) (0 points) Which test is preferred for definitive diagnosis:
A. arterial blood gas analysis
B. pulmonary function
C. polysomnography
D. cranial computed tomography (CT)
E. electrocardiogram
A. arterial blood gas analysis B. pulmonary function C. polysomnography D. cranial CT E. electrocardiogram
Answer C
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