ARDS is best described as: A. Cardiogenic pulmonary oedema with reduced ejection fraction
B. Acute inflammatory lung injury causing hypoxemia and stiff lungs
C. Chronic fibrotic lung disease
D. Obstructive airway disease
E. Pulmonary hypertension due to left heart failure
B
Which cell type is primarily responsible for surfactant production? A. Type I pneumocyte
B. Type II pneumocyte
C. Alveolar macrophage
D. Endothelial cell
E. Clara cell
B
Type I pneumocytes are best described as: A. Cuboidal and surfactant-secreting
B. Mitotic and regenerative
C. Squamous and involved in gas exchange
D. Responsible for immune defense
E. Located only in bronchioles
C
ARDS is classified as non-cardiogenic pulmonary oedema because: A. It occurs only in young patients
B. It has normal pulmonary capillary wedge pressure
C. BNP is always elevated
D. It results from left ventricular failure
E. It causes pleural effusion
B
Which finding excludes ARDS by Berlin definition? A. Bilateral lung opacities
B. PaO₂/FiO₂ ≤ 300
C. Pulmonary oedema due to heart failure
D. Acute onset respiratory failure
E. Hypoxemia
C
According to the Berlin definition, ARDS must develop within: A. 24 hours
B. 72 hours
C. 5 days
D. 7 days
E. 14 days
D
A patient has PaO₂/FiO₂ ratio of 150 on CPAP of 5 cmH₂O. This is classified as: A. Mild ARDS
B. Moderate ARDS
C. Severe ARDS
D. Respiratory failure, not ARDS
E. Chronic lung disease
B
Which PaO₂/FiO₂ ratio defines severe ARDS? A. ≤ 300
B. ≤ 250
C. ≤ 200
D. ≤ 150
E. ≤ 100
E
The Kigali modification differs from the Berlin definition by: A. Requiring invasive ventilation
B. Using chest CT only
C. Using SpO₂/FiO₂ instead of PaO₂/FiO₂
D. Excluding infection-related ARDS
E. Requiring pulmonary artery catheterization
C
The most common risk factor for ARDS in low-income countries is: A. Trauma
B. Malignancy
C. Infection
D. Smoking
E. Cardiovascular surgery
C
Which of the following is a direct lung injury causing ARDS? A. Pancreatitis
B. Sepsis
C. Pneumonia
D. Blood transfusion
E. Drug overdose
C
The earliest pathological phase of ARDS is: A. Fibrotic
B. Proliferative
C. Exudative
D. Resolution
E. Chronic
C
The exudative phase typically occurs during: A. Days 1–7
B. Days 8–14
C. Days 15–30
D. Weeks 4–6
E. Months
A
In the exudative phase, the main pathological event is: A. Fibroblast proliferation
B. Increased capillary permeability
C. Collagen deposition
D. Bronchial dilation
E. Alveolar regeneration
B
The proliferative phase of ARDS is characterized by: A. Rapid worsening hypoxemia
B. Coarse reticular opacities
C. Massive pleural effusion
D. Complete lung collapse
E. Pulmonary embolism
B
A normal chest X-ray in the first 24 hours does NOT exclude ARDS because: A. ARDS is always unilateral initially
B. There is a latent radiographic period
C. Hypoxemia precedes symptoms
D. CT scan is mandatory
E. Pleural effusion masks findings
B
Which radiographic feature favors ARDS over cardiogenic pulmonary oedema? A. Cardiomegaly
B. Pleural effusions
C. Septal lines
D. Peripheral alveolar opacities
E. Rapid resolution with diuretics
D
New lung infiltrates during the stable proliferative phase most likely indicate: A. Natural disease progression
B. Pulmonary fibrosis
C. Superadded infection
D. Heart failure
E. Atelectasis
C
ARDS patients often initially develop which acid–base disturbance? A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
E. Mixed acidosis
C
Which laboratory value helps distinguish ARDS from cardiogenic pulmonary oedema? A. ESR
B. Ferritin
C. BNP
D. Platelet count
E. Creatinine
C
Renal complication commonly seen in ARDS is: A. Acute interstitial nephritis
B. Chronic kidney disease
C. Acute tubular necrosis
D. Nephrotic syndrome
E. Renal artery stenosis
C
Which investigation is most useful for detecting dependent lung consolidation in ARDS? A. Chest X-ray
B. Lung ultrasound
C. Chest CT scan
D. Echocardiography
E. Bronchoscopy
C
Which condition is an important differential diagnosis of ARDS? A. COPD
B. Asthma
C. Pulmonary embolism
D. Tuberculosis
E. Lung cancer
C
