2009 end of module exam Flashcards
1
Q
Which area is the best to cut for performing surgeries ?
A
endothoracic fascia
2
Q
Patient with stony dullness , what should we do first?
A
Chest X-ray
3
Q
Where can we get the withdrawl of fluid from the lung ?
A
- 9th intercostal space
4
Q
Which muscle tenses the vocal cord during the hight pitch sound ?
A
- Crecothyroid muscle
5
Q
What controls the appearance of Kyte-Shaped rima glottidis during forsed respiration ?
A
- Posterior arytenoid
6
Q
Which structure causes deviation of nasal septum ?
- Vomer
- nasal bone
A
Vomer
7
Q
Which is the deepest layer to put anesthesia ?
- Innermost layer
- parital pluera
- endothoracic fascia
- internal IC
A
- Innermost layer
8
Q
When do you see the most negative pleural pressure ?
A
Total lung Capacity
9
Q
At expiratory flow rate of 0.5 L/sec , esophageal balloon pressure was 7 cm H2O and at 6 months 8 cm H2O . R ?
A
- 1 cm H2O / L / sec
10
Q
What does the fibrocalcific scar indicate in case of TB ?
- Healing in secodary TB
- broncho pneumonia
- ghon complex
A
- Healing in secodary TB
11
Q
In which volume/capacity we find the lowest Raw
A
- TLC
12
Q
A 7-yr old healthy boy has alveolar pressure on expiration = +1 . What is the alveolar pressure when inspiration ?
A
- -1
13
Q
What is the most common cancer in men and women ?
A
- Men : lung Women : breast
14
Q
What causes vasoconstriction in the lung ?
- high PCO2
- low PCO2
- blockage of Ca+ channels
A
- high PCO2
15
Q
A patient with emphesima has 30% O2 by mask , PCO2 40 , PaO2 70 . What
is AaDO2
A
- 164
16
Q
Tutorial Question
A
- abnormal shunt
17
Q
Patient on percussion was normal apart from the 6th ICS in right side
showed dullness . What is the cause ?
A
- Due to liver
18
Q
Where are people with asthma affected ?
A
- Bronchioles
19
Q
Which of the following drug is known to cause cough as side effect ?
A
- ACE inhibitor
20
Q
What is the most common risk factor for reactivation of TB
- HIV
- old age
A
- HIV
21
Q
TLC = 2.1 , FEV/FVC = 81% What does this indicate ?
A
Restrictive disease
22
Q
What is the function of alpha antitrypsin ?
A
- prevent tissue damage caused by elastase
23
Q
old man with long smoking history and squamas cell metaplasia
A
- chronic bronchitis
24
Q
What is seen in biopsy in chronic bronchitis ?
A
- hyperplasia and hypertrophy pf mucus cells
25
Alveolar Ventilation = 5L , F = 10 , TV = 0.7
* dead space Volume = 2
26
Dissolved O2 = 21 , Hb = 150 , saturation = 90
* CO2 = 183
27
in which condition you see granuloma ?
* Pulmonary Sarcoidosis
28
What is mechanism of action of phenylephrine ?
* alpha agonist
29
What is mechanism of resistance to rifampicine ?
* mutation in the affinity to RNA polymerase
30
What causes high upper respiratory airway obstruction ?
* Laryngeal atresia
31
What is the main adverse effect of first generation anti histamin ?
* Sedation
32
What changes indicate active TB in chest X-ray ?
- thick cavity with infiltrates
- thin cavity without infiltrates
?
33
Most secondary generation antihistamines fight urticardia by ?
- decreasing vascular permeability
- inhibit release of histamine
* decreasing vascular permeability
34
What is the main function of ipratropium ?
*Muscorenic antagonist
35
What antibiotic that inhibits folate synthesis ?
cotrimoxazole
36
What protect B-lactams ?
Calvulinic Acid
37
Which anti TB drug affect synthesis of proteins ?
* capreomycin
38
What is the characteristic of ARDS ( acute respiratory distress syndrome )
* Hyaline membrane
39
What is the most protective cytokine in TB ?
* IF gamma
40
Whivh of the theraputic agents need to be activated by P450 in liver ?
* cyclophosphamide
41
Neclear medicine imaging tests are best effective in the diagnosis of ?
* bronchioectasis
42
What is the most cancer related to the release of hormone like substance ?
- small cell
- adenocarcinoma
- small cell
43
What is the function of secretory component of IgA ?
* protect against enzymatic degredation
44
What mediates bronchospasm ?
* Ca++
45
What is the role of surfactact in alveoli ?
* reduce surface tension
46
what surfactant protein causes innate immunity ?
* SP A
47
what causes inhibition of phosphodiesterase ?
Theophilline
48
What causes somatic withdrawal ?
- decrease CNS readjustment
- psychological addiction
- neuroadaptive changes
* decrease CNS readjustment
49
During winter, patient suffered from cough , wheezing, malaise . What is the likely cause ?
- Mild upper respiratory infection
- Non steroidal anti inflammatory
*Mild upper respiratory infection
50
Whispering sound heard on examination of the right lower lobe with high pitch with hollow quality ?
* bronchial breathing
51
A 21-yr old athlete male checked his FEV/FVC ratio before practising
80%
52
What is the function of 2 3 bisphosphoglycerate ?
*reduce affinity of O2 to Hb
53
patient with fever , dyspnea , stony dullness over right lung ?
* pneumonia with right plural effusion
54
how many percentage of smoking people ( long term ) develop smoking related lung diseases ?
* 50%
55
patient with massive plural effusion shows ?
* opacity with contralateral mediastinal shift
56
PH = 7.35 , CO2 = 35 , HCO3- = 18
*matabolic acidosis
57
patient with fever cough and dullness on percussion . what is the most likely diagnosis ?
*S pneumoniae
58
a boy presentedd with fever , cough , malaise , dyspnea . He raises pigons , symptoms appeared hours after exposure . What is the mechanism ?
Immune-complex mediated reaction in lung
59
patient with cough , fever , high blood pressure he had high JVC ( jugular vein) ?
* cor pulmonale
60
A 60-yr old man presented with sputum with keratin & bridges ?
*squamous cell carcinoma
61
X-ray of a guy showed ipsilateral infiltration and hilar lymphoadenopathy . He was asymptomatic for 3 months then returned to hospital with small opacities
- TB
- sarcoidosis
* TB
62
the Dr wants to listen to posterior upper right lung and want to get as lateral as possible between intercostal muscle – second vertebrae ?
* right hand on left shoulder
63
patient on percussion with stony dullness ?
* plueral effusion
64
What is typically seen in patients with consilidation and fever , cough with sputum in the chest X-ray ?
- Alveolar Exudate
- hyperemia of alveoli / congestion
*Alveolar Exudate
65
A 50-yr old chronoc smoker male seeks an advice about smoking cassation before getting an appointment with counsler who examined his chest & found expanding limitation with deep inspiration . He also had resonant percussion below 6th ICS in right side
*hyperinflation
66
66- question aboutthe Clinical arithmetic sound
* We don’t know the answer
67
why is the thoracic aorta not affected by contraction of diaghragm ?
*it lies posterior to it
68
what is the main cause og infant respiratoty distress syndrome ?
*under development of type 2 pneumocytes
69
A 40-yr old patient with dry cough , dyspnea , reduced chest expansion & fine crackles
*idiopathic pulmonary fibrosis
70
patient with fever , cough , dyspnea , headaches and vomitting showed bilateral consilidation
*mycoplasma pneumonia
71
we want to check the risk factor of ( something ) and we followed people for 5 years . What study ?
* cohort
72
question about calculating the relative risk reduction ?
*56-66%
73
50-yr old truck driver with hypertension , developed nocturnal choking and migrane headache , had 3 previous car accidents
* obstructive sleep apnea
74
a question with big graph , 30-yr old male . 17- cm with flow rate of 492 . what is his percentage ?
*75%
75
patient with fever & cough for 10 days , dyspnea for 3 months , Xray showed diffused snowy storm infiltrates
* millary TB
76
Newly senthesized mediators secreted by activated mast cells ?
* TNF alpha
77
patient with 2 months history of cough , night sweats , and weight loss of 4 Kg . also suffered from coughing blood
*mycobacteriam Tuberculosis
78
3-yr old child with cough & inflammation of epiglottis
*hemophilic influenza
79
which place is injured when stapping above the clavicle ?
*Cervical pleura
80
which is pain sensitive part ?
- costal
- diaghragmatic
- viscaral
?
81
inferior margin will form laryngeal vestibule
* Quadrangular membrane
82
lies above vocal cord ligamint ?
*conus elasticus
83
What TB drug inhibits nuclic acid synthasis ?
*Isoniazid
84
which drug is contraindicated with streptomycin due to toxicity ?
*capreomyocin
85
low PaO2
*Anemia
86
abnormal AaDO2
* ventilation perfusion mismatch
87
which structure develops the parietal pleura ?
- somatopleuric mesoderm
- pericardial peritoneal membrane
*pericardial peritoneal membrane
88
endothelium of lower respiratory tract comes from
laryngotracheal groove
89
which drug affects alpha 1 agonist ?
*pseudoepidrine
90
which drug treats cough without removal of bronchial secretion ?
- Codeine
- dextromethorphan
dextromethorphan
91
focal exudates with alveolar septum destruction ?
- abscess
- interstitial pneumonia
* abscess
92
diffused patch infiltrate in the lungs ?
*bronchopneumonia
93
smoker with periphral tumor with gland formation ?
adenocarcinoma
94
cancer that mimics lobar pneumonia ?
bronchoalveolar carcinoma
95
PCO2 = 35 , PH = 7.35 , calculate HCO3-
*19
96
96-PH=7.49 .Whatis[H+]
*32
97
60-yr old male with chronic bronchitis can see
* 0.9 read index
98
what produces surfactant ?
*tyoe 2 pneumocytes
99
what is compnent of air bloof barrier ?
*type 1 pneumocyte
100
what is innervated by dorsal rami pf spinal nerve ?
* levator costarum
101
what causes rigidity of muscles during inspiration ?
* external intercostal
102
a patient with alpha 1 antitrypsin defeciency ?
* uniformal enlagement of acini
103
what is the first thing to do when suspecting allergic rhino sinusitis ?
* physical examination & history
104
a test , we should stop taking medication for it , to do it properly for allergic rhino sinusitis ?
*skin prick test for IgE
105
sub pleural lesion with lymph node involvement
* primary complex
106
endothelial cells surrounded by lymphatic tissue ?
* granuloma
107
diffused infiltrates in the lung less than 2 mm
millary TB
108
what changes with PAO2 or PaO2 changes ?
*AaDO2
109
What does not change on ............ ?
* PAO2
110
What causes major change in CSF ?
PCO2
111
Chronic inflammation with involvement of eosinophils
* hypersensitivity Pneumonitis
112
low O2 due to shock ?
* adult respiratory distress syndrome
113
found in fetal hemoglobin but not adults ?
* gamma globin
114
reversibly controls HB concentration
* 2 3 bisphosphoglycerate
115
cysteinyl leukotriene
LTE4
116
Which mediator is not released when damage to endothelium occurs ?
- Prostacyclin
- thromboxane
* Prostacyclin
117
patient with high fever , cough , dyspnea , with consolidation on percussion with distress . what is the most likely diagnosis ?
*S pneumonia
118
circulatory defects to cutaneous vessels ?
* peripheral cyanosis
