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Respiratory Medicine Flashcards

6 cards from real MRCP PART 1 practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 Respiratory Medicine flashcards as text

  1. A patient with COPD has an FEV1/FVC ratio of 0.6 and an FEV1 of 45% predicted. According to GOLD criteria, what severity is this?

    Answer: GOLD 3 (severe)

    GOLD severity is based on FEV1 % predicted (post-bronchodilator): GOLD 1 ≥80%, GOLD 2 50–79%, GOLD 3 30–49%, GOLD 4 <30%. An FEV1 of 45% predicted places this patient in GOLD 3 (severe). The FEV1/FVC <0.7 confirms obstruction.

  2. Which organism is the most common causative pathogen in community-acquired pneumonia (CAP)?

    Answer: Streptococcus pneumoniae

    Streptococcus pneumoniae (pneumococcus) is the most common cause of community-acquired pneumonia in the UK, accounting for approximately 30–40% of cases requiring hospitalisation. It typically causes a lobar pattern of consolidation.

  3. A patient with known asthma has a PEFR of 33% best and cannot complete sentences. What severity of asthma attack is this?

    Answer: Life-threatening asthma

    Life-threatening asthma is defined by any of: PEFR 4.6 kPa), silent chest, poor respiratory effort, cyanosis, bradycardia, confusion, or exhaustion. PEFR 33% with inability to speak indicates life-threatening severity.

  4. A 25-year-old non-smoker presents with progressive dyspnoea and a CXR showing bilateral basal emphysematous changes. What rare condition should be considered?

    Answer: Alpha-1-antitrypsin deficiency

    Alpha-1-antitrypsin (AAT) deficiency should be suspected in young, non-smoking patients with premature emphysema, particularly with a basal distribution (unlike smoking-related emphysema which is upper lobe). Serum AAT levels and phenotyping confirm the diagnosis.

  5. Which of the following pleural fluid findings are most consistent with an exudate using Light's criteria?

    Answer: Pleural protein/serum protein ratio >0.5

    Light's criteria classify an exudate if ANY of: (1) pleural protein/serum protein ratio >0.5, (2) pleural LDH/serum LDH ratio >0.6, or (3) pleural LDH > 2/3 upper limit of normal serum LDH are met. A pleural/serum protein ratio >0.5 alone classifies as an exudate.

  6. What is the most appropriate first-line treatment for a Wells score of 3 and a positive D-dimer in a patient with suspected PE?

    Answer: Request CT pulmonary angiography and treat if confirmed

    A Wells score of 3 represents intermediate (moderate) probability for PE. CTPA is the investigation of choice. Anticoagulation may be started before imaging if there will be a significant delay (>1 hour) and there are no contraindications, but confirmation before committing to long-term therapy is preferred.