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1) A 50 yr old taxi driver and heavy smoker complains that his feet swell up at the end of the day. He has also noticed increasing shortness of breath. What is the SINGLE next most appropriate step in management?

One answer only.

   Sputum culture

   Pericardial aspiration

   Streptokinase

   Frusemide

   Oxygen therapy

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2) A middle-aged woman complains of a chronic cough and purulent sputum. Recently she has become very wheezy and dyspnoeic. An ECG gives a low voltage trace and a CXR shows a large heart shadow. What is the SINGLE next most appropriate step in management?

One answer only.

   Antibiotics

   Sputum culture

   Pericardial aspiration

   Streptokinase

   Frusemide

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3) An elderly woman complains of acute chest pain, breathlessness and haemoptysis. A month ago she had pain and swelling in the legs but did not go to the doctor with these complaints. What is the SINGLE next most appropriate step in management?

One answer only.

   Antibiotics

   Sputum culture

   Pericardial aspiration

   Streptokinase

   Frusemide

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4) His friends bring in a 48 yr old businessman. He is very distressed, breathless, cold and clammy. He has severe chest pain and he has vomited 3 times. What is the SINGLE next most appropriate step in management?

One answer only.

   Morphine

   Nasal IPPV

   Venesection

   Advise stop smoking

   Beta agonists

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5) A 4 yr old child has severe cough and fever. She appears acutely ill and cyanosed. What is the SINGLE most likely diagnosis?

One answer only.

   Bronchogenic carcinoma

   Parainfluenzae

   Respiratory syncytial virus

   Rhinovirus

   Pleurisy

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6) A 6 yr old child complains of a very sore throat. He has a mild fever and red fauces. What is the SINGLE most likely diagnosis?

One answer only.

   Bronchogenic carcinoma

   Parainfluenzae

   Respiratory syncytial virus

   Rhinovirus

   Pleurisy

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7) A 33 yr old bus driver complains of a persistent cough and blood stained sputum. He does not smoke He has a fever and supraclavicular glands. A CXR shows a dense irregular hilar expansion. What is the SINGLE most likely diagnosis?

One answer only.

   Tuberculosis

   MI

   Asthma

   Meningitis

   Bronchiectasis

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8) A 32 yr old lecturer has had a fever for a week with no cough. Her fever came on suddenly and she says half her department is similarily ill. She has fine rales and a positive chest X-ray. What is the SINGLE most likely diagnosis?

One answer only.

   Parainfluenzae

   Respiratory syncytial virus

   Rhinovirus

   Pleurisy

   Pneumococci

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9) A 40 yr man complains of swollen legs and breathlessness. Examination reveals hepatosplenomegaly. And a chest x-ray shows a normal but dense heart shadow and clear lung fields. What is the SINGLE next most appropriate step in management?

One answer only.

   Pericardia! resection

   Radiotherapy

   Frusemide

   Anti emetics

   Aspirin

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10) A middle aged decorator complains of severe chest pain radiating to the neck. The pain came on after dinner and as he was retiring for the night. What is the SINGLE next most appropriate step in management?

One answer only.

   Diamorphine

   Diazepam

   Combination antibiotics

   Anxiolytics

   Lobectomy