[MCQ] Disorders of the Pleura and Mediastinum- Part 1

I. Start the exam by click the “Start” button

Disorders of the Pleura and Mediastinum- Part 1

Please wait while the activity loads.
If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.

If loading fails, click here to try again

Start

Congratulations - you have completed Disorders of the Pleura and Mediastinum- Part 1. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

In healthy adults, pleural space contains how much of pleural fluid ?

A	5 to 10 mL
B	25 to 50 mL
C	50 to 100 mL
D	100 to 150 mL

Question 1 Explanation:

In healthy adults, pleural space contains ~ 5 to 10 mL of pleural fluid (0.1 mg/kg body weight)

Question 2

Which of the following is not related to pleural effusion ?

A	Skodaic resonance
B	Calots triangle
C	Grocco triangle
D	Garland triangle

Question 2 Explanation:

Skodaic resonance (area of hyperresonance above a pleural effusion), Succussion splash (splashing sound produced by violently shaking patients with hydropneumothorax), Grocco triangle (rightangle triangle of dullness found over posterior region of chest opposite a large pleural effusion), Garland triangle (small area of resonance next to spine in patients with large unilateral pleural effusions).

Question 3

Contralateral tracheal or mediastinal shift occurs when the size of pleural effusion is ?

A	300 - 500 mL
B	500 - 750 mL
C	750 - 1000 mL
D	> 1,500 mL

Question 3 Explanation:

Physical findings are normal if <300 mL of fluid is present. Large effusions (>1500 mL) is associated with significant asymmetry of chest expansion, contralateral tracheal or mediastinal shift and bulging of intercostal spaces.

Question 4

What quantity of pleural fluid must be present to be detected by physical examination ?

A	100 mL
B	150 mL
C	350 mL
D	500 mL

Question 4 Explanation:

At least 500 mL of fluid must be present to be detected an effusion by physical examination

Question 5

Which of the following statements is false ?

A	Normally, fluid enters pleural space from capillaries in parietal pleura
B	Normally, fluid is removed via lymphatics situated in parietal pleura
C	Fluid can also enter pleural space from peritoneal cavity
D	Lymphatics have the capacity to absorb 2 times more fluid than is normally formed in pleural spaces

Question 5 Explanation:

Lymphatics have a capacity to absorb 20 times more fluid than is normally formed

Question 6

Which of the following is true for exudative pleural effusions ?

A	Pleural fluid protein / serum protein >0.5
B	Pleural fluid LDH / serum LDH >0.6
C	Pleural fluid LDH > two-thirds normal upper limit for serum
D	All of the above

Question 7

Which of the following is true for transudative pleural effusions ?

A	Pleural fluid protein / serum protein >0.5
B	Pleural fluid LDH / serum LDH >0.6
C	Pleural fluid LDH > two-thirds normal upper limit for serum
D	None of the above

Question 7 Explanation:

Light’s criteria - Out of the following, exudative pleural effusions meet at least one, whereas transudative pleural effusions meet none. Pleural fluid protein/serum protein >0.5, pleural fluid LDH/ serum LDH >0.6 and pleural fluid LDH more than two-thirds normal upper limit for serum. Still, if clinically transudative effusion is strongly suspected, difference between albumin levels in serum and pleural fluid is estimated. If this difference is >3.1 g/dL, pleural effusion is transudative.

Question 8

Most common cause of pleural effusion is ?

A	Left ventricular failure
B	Bacterial pneumonia
C	Cirrhosis liver
D	Viral infection

Question 8 Explanation:

Most common cause of pleural effusion is LVF. Isolated right-sided pleural effusions are more common than left-sided effusions in heart failure.

Question 9

Which of the following test is virtually diagnostic of pleural effusion secondary to congestive heart failure ?

A	Pleural fluid LDH
B	Pleural fluid N-terminal pro-brain natriuretic peptide
C	Pleural fluid sodium
D	Pleural fluid osmolality

Question 9 Explanation:

Pleural fluid NT-proBNP >1500 pg/mL is virtually diagnostic of an effusion secondary to CHF.

Question 10

Which of the following is false for ‘Hepatic Hydrothorax’ ?

A	Occur in ~5% of patients with cirrhosis & ascites
B	Due to direct movement of peritoneal fluid through small holes in diaphragm into pleural space
C	Effusion is usually left-sided
D	Transjugular intrahepatic portal systemic shunt helpful

Question 10 Explanation:

Hepatic Hydrothorax is usually “right-sided”

Question 11

Parapneumonic effusions are associated with ?

A	Bacterial pneumonia
B	Lung abscess
C	Bronchiectasis
D	All of the above

Question 11 Explanation:

Parapneumonic effusions are associated with bacterial pneumonia, lung abscess, or bronchiectasis. Grossly purulent effusion is termed Empyema

Question 12

Which of the following is the likely pathogen in pneumonia presenting with a subacute illness, weight loss, brisk leukocytosis and possibility of aspiration ?

A	Bacterial infection
B	Anaerobic infection
C	Fungal infection
D	Viral infection

Question 12 Explanation:

Patients with “anaerobic infections” present with a subacute illness, weight loss, brisk leukocytosis, mild anemia, & predisposition for aspiration.

Question 13

Therapeutic thoracentesis is indicated if pleural free fluid separates lung from chest wall by ?

A	> 5 mm
B	> 10 mm
C	> 15 mm
D	> 20 mm

Question 13 Explanation:

If pleural free fluid separates lung from the chest wall by >10 mm, a therapeutic thoracentesis should be performed

Question 14

Factors indicating the likely need for a procedure more invasive than a thoracentesis are all except ?

A	Loculated pleural fluid
B	Pleural fluid pH < 7.40
C	Pleural fluid glucose <60 mg/dL
D	Positive Gram stain or culture of pleural fluid

Question 14 Explanation:

Positive Gram stain or culture of pleural fluid

Question 15

Which out of the following is the commonest cause of malignant pleural effusion ?

A	Hepatoma
B	Ca. Pancreas
C	Ca. Thyroid
D	Lymphoma

Question 16

Which out of the following is the commonest cause of malignant pleural effusion ?

A	Hepatoma
B	Leukemia
C	Mesotheliomas
D	Ca. Breast

Question 16 Explanation:

lung carcinoma, breast carcinoma & lymphoma are the cause of ~75% of all malignant pleural effusions

Question 17

The only symptom that can be attributed to the malignant pleural effusion itself is ?

A	Dyspnea
B	Pain
C	Cough
D	Hemoptysis

Question 17 Explanation:

Only symptom that can be attributed to pleural effusion itself is dyspnea. Dyspnea is frequently out of proportion to the size of pleural effusion.

Question 18

Which of the following about malignant pleural effusion is false ?

A	To be treated symptomatically
B	Indicates disseminated disease
C	Most malignancies associated with PE are not curable
D	None of the above

Question 18 Explanation:

Patients with malignant pleural effusion are treated symptomatically as presence of effusion indicates disseminated disease & most malignancies associated with pleural effusion are not curable with chemotherapy

Question 19

Most malignant mesotheliomas are related to exposure to ?

A	Silica
B	Asbestos
C	Benzene
D	Carbon

Question 19 Explanation:

Malignant mesotheliomas are primary tumors that arise from the mesothelial cells that line the pleural cavities. Most are related to asbestos exposure.

Question 20

Chest radiograph of patients with mesothelioma reveals ?

A	Pleural effusion
B	Generalized pleural thickening
C	Shrunken hemithorax
D	All of the above

Question 20 Explanation:

Chest radiograph in patients with mesothelioma reveals a pleural effusion, generalized pleural thickening, and a shrunken hemithorax

Question 21

Shortness of breath in mesothelioma should be treated with ?

A	Bronchodilators
B	Glucocorticoids
C	Opiates
D	ACE inhibitors

Question 21 Explanation:

Shortness of breath in mesothelioma is treated with oxygen and/or opiates.

Question 22

The diagnosis most commonly overlooked in differential diagnosis of an undiagnosed pleural effusion is ?

A	Pulmonary embolism
B	Left ventricular failure
C	Malignancy
D	AIDS

Question 22 Explanation:

Diagnosis most commonly overlooked in differential diagnosis of an undiagnosed pleural effusion is pulmonary embolism.

Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results

There are 22 questions to complete.

←

List

→

Return

Shaded items are complete.

1	2	3	4	5
6	7	8	9	10
11	12	13	14	15
16	17	18	19	20
21	22	End

Return

See all quizzes of Disorders of the Pleura and Mediastinum at here:

1.In healthy adults, pleural space contains how much of pleural fluid ?
A. 5 to 10 mL
B. 25 to 50 mL
C. 50 to 100 mL
D. 100 to 150 mL

2. Which of the following is not related to pleural effusion ?
A. Skodaic resonance
B. Calots triangle
C. Grocco triangle
D. Garland triangle

3. Contralateral tracheal or mediastinal shift occurs when the size of pleural effusion is ?
A. 300 – 500 mL
B. 500 – 750 mL
C. 750 – 1000 mL
D. > 1,500 mL

4. What quantity of pleural fluid must be present to be detected by physical examination ?

A. 100 mL
B. 150 mL
C. 350 mL
D. 500 mL

5. Which of the following statements is false ?
A. Normally, fluid enters pleural space from capillaries in
parietal pleura

B. Normally, fluid is removed via lymphatics situated in
parietal pleura
C. Fluid can also enter pleural space from peritoneal cavity
D. Lymphatics have the capacity to absorb 2 times more fluid
than is normally formed in pleural spaces

6. Which of the following is true for exudative pleural effusions ?
A. Pleural fluid protein / serum protein >0.5
B. Pleural fluid LDH / serum LDH >0.6
C. Pleural fluid LDH > two-thirds normal upper limit for serum
D. All of the above
7. Which of the following is true for transudative pleural
effusions ?
A. Pleural fluid protein / serum protein >0.5
B. Pleural fluid LDH / serum LDH >0.6
C. Pleural fluid LDH > two-thirds normal upper limit for serum
D. None of the above

8. Most common cause of pleural effusion is ?
A. Left ventricular failure
B. Bacterial pneumonia
C. Cirrhosis liver
D. Viral infection

9. Which of the following test is virtually diagnostic of pleural
effusion secondary to congestive heart failure ?
A. Pleural fluid LDH
B. Pleural fluid N-terminal pro-brain natriuretic peptide
C. Pleural fluid sodium
D. Pleural fluid osmolality

1/. Which of the following is false for ‘Hepatic Hydrothorax’ ?
A. Occur in ~5% of patients with cirrhosis & ascites
B. Due to direct movement of peritoneal fluid through small
holes in diaphragm into pleural space
C. Effusion is usually left-sided
D. Transjugular intrahepatic portal systemic shunt helpful

11. Parapneumonic effusions are associated with ?
A. Bacterial pneumonia

B. Lung abscess
C. Bronchiectasis
D. All of the above

12. Which of the following is the likely pathogen in pneumonia
presenting with a subacute illness, weight loss, brisk
leukocytosis and possibility of aspiration ?
A. Bacterial infection
B. Anaerobic infection
C. Fungal infection
D. Viral infection
13. Therapeutic thoracentesis is indicated if pleural free fluid
separates lung from chest wall by ?
A. > 5 mm
B. > 10 mm
C. > 15 mm
D. > 20 mm

14. Factors indicating the likely need for a procedure more invasive
than a thoracentesis are all except ?
A. Loculated pleural fluid
B. Pleural fluid pH < 7.40
C. Pleural fluid glucose <60 mg/dL
D. Positive Gram stain or culture of pleural fluid

15. Which out of the following is the commonest cause of
malignant pleural effusion ?
A. Hepatoma
B. Ca. Pancreas
C. Ca. Thyroid
D. Lymphoma
16. Which out of the following is the commonest cause of
malignant pleural effusion ?
A. Hepatoma
B. Leukemia
C. Mesotheliomas
D. Ca. Breast

17. The only symptom that can be attributed to the malignant
pleural effusion itself is ?

A. Dyspnea
B. Pain
C. Cough
D. Hemoptysis

18. Which of the following about malignant pleural effusion is
false ?
A. To be treated symptomatically
B. Indicates disseminated disease
C. Most malignancies associated with PE are not curable
D. None of the above

19. Most malignant mesotheliomas are related to exposure to ?
A. Silica
B. Asbestos
C. Benzene
D. Carbon

2/. Chest radiograph of patients with mesothelioma reveals ?
A. Pleural effusion
B. Generalized pleural thickening
C. Shrunken hemithorax
D. All of the above

21. Shortness of breath in mesothelioma should be treated with ?
A. Bronchodilators
B. Glucocorticoids
C. Opiates
D. ACE inhibitors

22. The diagnosis most commonly overlooked in differential
diagnosis of an undiagnosed pleural effusion is ?
A. Pulmonary embolism
B. Left ventricular failure
C. Malignancy
D. AIDS

Disorders of the Pleura and Mediastinum

[MCQ] Disorders of the Pleura and Mediastinum- Part 1

I. Start the exam by click the “Start” button

Disorders of the Pleura and Mediastinum- Part 1

Share this:

Related

[MCQ] Interstitial Lung Diseases- Part 3

[MCQ] Disorders of the Pleura and Mediastinum- Part 2

You may also like

Leave a Comment Cancel Reply