OnExamination SCE in Respiratory Medicine (Updated Feb 2023)
Supporting you through your SCE in Respiratory Medicine
Are you preparing for the SCE in Respiratory Medicine? Look no further! We have just the resource you need to ace your exam. Our comprehensive question bank will support you throughout your exam preparation journey and ensure you feel confident on the day of the test.
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Our question bank features over 190 carefully crafted questions, written by clinicians who are experts in their specialty. These professionals have a wealth of knowledge and experience with the exam structure, difficulty level, and curriculum. By using our resource, you will be exposed to questions that closely resemble those that you may encounter on the actual exam.
Each question is accompanied by a detailed explanation, helping you understand the underlying concepts and reasoning. This ensures that you not only memorize the correct answers but also fully comprehend the principles behind them. With our in-depth explanations, you will be well-equipped to tackle similar questions that may appear on the exam.
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Here’s a sneak peek into what you can expect from our question bank:
A 68-year-old retired former banker comes to see you for breathing difficulties at rest and exertion, which have been developing over several years. During the examination, you notice that his breathlessness markedly decreases when he lies supine. Based on the provided information, which of the following could be an underlying cause of his breathlessness?
Key Learning Point: Lower lobe predominant lung disease is a cause of breathlessness which improves on lying down (platypnoea). Other causes include Atrial Septal defect, Arterio-venous malformations, Cirrhosis, Autonomic failure, and Supraglottic tumor.
Explanation: This man complains of breathlessness, which improves when he lies flat. The reason, in this case, is due to an intra-pulmonary shunt. Alpha 1 AT deficiency is a lower lobe predominant disease, which means that when standing, the blood gravitates towards the affected lower lobes resulting in poor gas exchange due to a ventilation-perfusion mismatch. On lying flat, the pulmonary circulation is not affected by gravity as much and is able to circulate and exchange gases within the mid and upper lobes of the lung to a greater extent, reducing the ventilation-perfusion mismatch. Alpha-1-antitrypsin deficiency is the correct answer as it explains the breathlessness on lying down most completely. Guillain barre can cause breathlessness, which is relieved by lying down due to autonomic failure, but the history is too long. Langerhans cell histiocytosis typically has an upper lobe predominance, meaning symptoms would improve on standing up compared to lying down. Mesothelioma is a cause of breathlessness due to pleural effusions, but this would not improve with lying down. Ventricular septal defects can cause severe breathlessness, but it is actually atrial septal defects that can vary (and improve) with lying down.
By practicing questions like these, you will be able to identify and understand the various conditions, symptoms, and underlying pathologies associated with respiratory medicine. This will aid you not only in your exam but also in your clinical practice later on. Our question bank is designed to provide you with a comprehensive and interactive learning experience.
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