You are a medical student on attachment in ICU. The arterial blood gas (ABG) machine in A&E is currently broken so staff are coming up from A&E to use your machine. You read one set of results as follows:

pH: 7.2
pCO2: 5kPa
pO2: 12 kPa
HCO3-: 18

Which of the following clinical scenarios best fits the ABG results presented above?

A) Aspirin overdose.
B) Opiate overdose.
C) COPD.
D) Panic attack.
E) Pneumonia.

Which of the following accurately describes the current screening test used in the UK to check for TB exposure?

A) Blood culture.
B) Chest CT.
C) Chest x-ray.
D) A circle of needles punctures the forearm through which tuberculin is injected.
E) A quantity of tuberculin is injected intradermally.

A patient is found to have a pleural effusion, a sample of the fluid is taken and sent to the laboratory for testing. The report states the patient has an exudate fluid [over 30g/L of protein], which is the most likely cause of this patients pleural effusion?

A) Left ventricular failure.
B) Metastatic breast cancer.
C) Superior vena cava obstruction.
D) Liver cirrhosis.
E) Hypothyroidism.

A young man developed sudden shortness of breath and a sharp pain during inspiration while playing basketball. He presented to A&E and the above chest x-ray was taken. What is the most likely diagnosis?

A) Tension pneumothorax.
B) Acute asthma attack.
C) Pulmonary embolus.
D) Spontaneous pneumothorax.
E) Hyperventilation secondary to panic attack.

This is a PA chest x-ray is of a 19 year old female, showing extensive abnormalities of the lung parenchyma, most pronounced by the central tram-track opacities. Apart from respiratory symptoms, what else is she likely to present with?

A) Obesity.
B) Diarrhoea.
C) Hypertension.
D) Tremor.
E) Recurrent epistaxis. 

Which of the following is not seen on this chest x-ray?

A) Right sided pneumothorax.
B) Left sided pleural effusion.
C) Obliteration of left hilum.
D) Breast shadow.
E) Patient is rotated to the right.

Which of the following types of malignancy is least likely to metastasise to the lung?

A) Breast
B) Bone
C) Thyroid
D) Renal
E) Hepatic

A 16 year old boy presents to A&E with a tight feeling in his chest and a bilateral wheeze. He is a known asthmatic and reports that he usually takes a blue inhaler, he can't remember the name, as and when he needs it. However today, his inhaler did not relieve his symptoms.

What is the single best treatment option for this patient once this acute attack has been treated?
A) Switch to Salbutamol P.R.N inhaler with spacer.
B) Switch to Salmeterol inhaler twice a day.
C) Add Beclometasone inhaler once a day.
D) Add Salmeterol inhaler twice a day.
E) Add oral Prednisolone, 5mg every other day.

Which of the following spirometry results would indicate COPD?

A) FEV1 = 4.3, FVC = 5.0, ratio = 86%
B) FEV1 = 2.8, FVC = 3.1, ratio = 90%
C) FEV1 = 3.8, FVC = 3.8, ratio = 100%
D) FEV1 = 3.3, FVC = 4.3, ratio = 76%
E) FEV1 = 1.8, FVC = 3.1, ratio = 60%

Which of the following findings is the strongest predictive factor for pulmonary embolus?

A) Dyspnoea

B) Fever

C) Haemoptysis

D) Heart rate over 100 beats per minute

E) Known malignancy