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Resp module 3rd year > 2009 end of module exam > Flashcards

2009 end of module exam Flashcards

1
Q

Which area is the best to cut for performing surgeries ?

A

endothoracic fascia

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2
Q

Patient with stony dullness , what should we do first?

A

Chest X-ray

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3
Q

Where can we get the withdrawl of fluid from the lung ?

A
  • 9th intercostal space
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4
Q

Which muscle tenses the vocal cord during the hight pitch sound ?

A
  • Crecothyroid muscle
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5
Q

What controls the appearance of Kyte-Shaped rima glottidis during forsed respiration ?

A
  • Posterior arytenoid
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6
Q

Which structure causes deviation of nasal septum ?

  • Vomer
  • nasal bone
A

Vomer

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7
Q

Which is the deepest layer to put anesthesia ?

  • Innermost layer
  • parital pluera
  • endothoracic fascia
  • internal IC
A
  • Innermost layer
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8
Q

When do you see the most negative pleural pressure ?

A

Total lung Capacity

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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
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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
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11
Q

In which volume/capacity we find the lowest Raw

A
  • TLC
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12
Q

A 7-yr old healthy boy has alveolar pressure on expiration = +1 . What is the alveolar pressure when inspiration ?

A
  • -1
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13
Q

What is the most common cancer in men and women ?

A
  • Men : lung Women : breast
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14
Q

What causes vasoconstriction in the lung ?

  • high PCO2
  • low PCO2
  • blockage of Ca+ channels
A
  • high PCO2
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15
Q

A patient with emphesima has 30% O2 by mask , PCO2 40 , PaO2 70 . What
is AaDO2

A
  • 164
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16
Q

Tutorial Question

A
  • abnormal shunt
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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
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18
Q

Where are people with asthma affected ?

A
  • Bronchioles
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19
Q

Which of the following drug is known to cause cough as side effect ?

A
  • ACE inhibitor
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20
Q

What is the most common risk factor for reactivation of TB

  • HIV
  • old age
A
  • HIV
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21
Q

TLC = 2.1 , FEV/FVC = 81% What does this indicate ?

A

Restrictive disease

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22
Q

What is the function of alpha antitrypsin ?

A
  • prevent tissue damage caused by elastase
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23
Q

old man with long smoking history and squamas cell metaplasia

A
  • chronic bronchitis
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24
Q

What is seen in biopsy in chronic bronchitis ?

A
  • hyperplasia and hypertrophy pf mucus cells
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25
Q

Alveolar Ventilation = 5L , F = 10 , TV = 0.7

A
  • dead space Volume = 2
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26
Q

Dissolved O2 = 21 , Hb = 150 , saturation = 90

A
  • CO2 = 183
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27
Q

in which condition you see granuloma ?

A
  • Pulmonary Sarcoidosis
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28
Q

What is mechanism of action of phenylephrine ?

A
  • alpha agonist
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29
Q

What is mechanism of resistance to rifampicine ?

A
  • mutation in the affinity to RNA polymerase
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30
Q

What causes high upper respiratory airway obstruction ?

A
  • Laryngeal atresia
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31
Q

What is the main adverse effect of first generation anti histamin ?

A
  • Sedation
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32
Q

What changes indicate active TB in chest X-ray ?

  • thick cavity with infiltrates
  • thin cavity without infiltrates
A

?

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33
Q

Most secondary generation antihistamines fight urticardia by ?

  • decreasing vascular permeability
  • inhibit release of histamine
A
  • decreasing vascular permeability
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34
Q

What is the main function of ipratropium ?

A

*Muscorenic antagonist

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35
Q

What antibiotic that inhibits folate synthesis ?

A

cotrimoxazole

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36
Q

What protect B-lactams ?

A

Calvulinic Acid

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37
Q

Which anti TB drug affect synthesis of proteins ?

A
  • capreomycin
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38
Q

What is the characteristic of ARDS ( acute respiratory distress syndrome )

A
  • Hyaline membrane
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39
Q

What is the most protective cytokine in TB ?

A
  • IF gamma
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40
Q

Whivh of the theraputic agents need to be activated by P450 in liver ?

A
  • cyclophosphamide
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41
Q

Neclear medicine imaging tests are best effective in the diagnosis of ?

A
  • bronchioectasis
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42
Q

What is the most cancer related to the release of hormone like substance ?

  • small cell
  • adenocarcinoma
A
  • small cell
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43
Q

What is the function of secretory component of IgA ?

A
  • protect against enzymatic degredation
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44
Q

What mediates bronchospasm ?

A
  • Ca++
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45
Q

What is the role of surfactact in alveoli ?

A
  • reduce surface tension
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46
Q

what surfactant protein causes innate immunity ?

A
  • SP A
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47
Q

what causes inhibition of phosphodiesterase ?

A

Theophilline

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48
Q

What causes somatic withdrawal ?

  • decrease CNS readjustment
  • psychological addiction
  • neuroadaptive changes
A
  • decrease CNS readjustment
49
Q

During winter, patient suffered from cough , wheezing, malaise . What is the likely cause ?

  • Mild upper respiratory infection
  • Non steroidal anti inflammatory
A

*Mild upper respiratory infection

50
Q

Whispering sound heard on examination of the right lower lobe with high pitch with hollow quality ?

A
  • bronchial breathing
51
Q

A 21-yr old athlete male checked his FEV/FVC ratio before practising

A

80%

52
Q

What is the function of 2 3 bisphosphoglycerate ?

A

*reduce affinity of O2 to Hb

53
Q

patient with fever , dyspnea , stony dullness over right lung ?

A
  • pneumonia with right plural effusion
54
Q

how many percentage of smoking people ( long term ) develop smoking related lung diseases ?

A
  • 50%
55
Q

patient with massive plural effusion shows ?

A
  • opacity with contralateral mediastinal shift
56
Q

PH = 7.35 , CO2 = 35 , HCO3- = 18

A

*matabolic acidosis

57
Q

patient with fever cough and dullness on percussion . what is the most likely diagnosis ?

A

*S pneumoniae

58
Q

a boy presentedd with fever , cough , malaise , dyspnea . He raises pigons , symptoms appeared hours after exposure . What is the mechanism ?

A

Immune-complex mediated reaction in lung

59
Q

patient with cough , fever , high blood pressure he had high JVC ( jugular vein) ?

A
  • cor pulmonale
60
Q

A 60-yr old man presented with sputum with keratin & bridges ?

A

*squamous cell carcinoma

61
Q

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
A
  • TB
62
Q

the Dr wants to listen to posterior upper right lung and want to get as lateral as possible between intercostal muscle – second vertebrae ?

A
  • right hand on left shoulder
63
Q

patient on percussion with stony dullness ?

A
  • plueral effusion
64
Q

What is typically seen in patients with consilidation and fever , cough with sputum in the chest X-ray ?

  • Alveolar Exudate
  • hyperemia of alveoli / congestion
A

*Alveolar Exudate

65
Q

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

A

*hyperinflation

66
Q

66- question aboutthe Clinical arithmetic sound

A
  • We don’t know the answer
67
Q

why is the thoracic aorta not affected by contraction of diaghragm ?

A

*it lies posterior to it

68
Q

what is the main cause og infant respiratoty distress syndrome ?

A

*under development of type 2 pneumocytes

69
Q

A 40-yr old patient with dry cough , dyspnea , reduced chest expansion & fine crackles

A

*idiopathic pulmonary fibrosis

70
Q

patient with fever , cough , dyspnea , headaches and vomitting showed bilateral consilidation

A

*mycoplasma pneumonia

71
Q

we want to check the risk factor of ( something ) and we followed people for 5 years . What study ?

A
  • cohort
72
Q

question about calculating the relative risk reduction ?

A

*56-66%

73
Q

50-yr old truck driver with hypertension , developed nocturnal choking and migrane headache , had 3 previous car accidents

A
  • obstructive sleep apnea
74
Q

a question with big graph , 30-yr old male . 17- cm with flow rate of 492 . what is his percentage ?

A

*75%

75
Q

patient with fever & cough for 10 days , dyspnea for 3 months , Xray showed diffused snowy storm infiltrates

A
  • millary TB
76
Q

Newly senthesized mediators secreted by activated mast cells ?

A
  • TNF alpha
77
Q

patient with 2 months history of cough , night sweats , and weight loss of 4 Kg . also suffered from coughing blood

A

*mycobacteriam Tuberculosis

78
Q

3-yr old child with cough & inflammation of epiglottis

A

*hemophilic influenza

79
Q

which place is injured when stapping above the clavicle ?

A

*Cervical pleura

80
Q

which is pain sensitive part ?

  • costal
  • diaghragmatic
  • viscaral
A

?

81
Q

inferior margin will form laryngeal vestibule

A
  • Quadrangular membrane
82
Q

lies above vocal cord ligamint ?

A

*conus elasticus

83
Q

What TB drug inhibits nuclic acid synthasis ?

A

*Isoniazid

84
Q

which drug is contraindicated with streptomycin due to toxicity ?

A

*capreomyocin

85
Q

low PaO2

A

*Anemia

86
Q

abnormal AaDO2

A
  • ventilation perfusion mismatch
87
Q

which structure develops the parietal pleura ?

  • somatopleuric mesoderm
  • pericardial peritoneal membrane
A

*pericardial peritoneal membrane

88
Q

endothelium of lower respiratory tract comes from

A

laryngotracheal groove

89
Q

which drug affects alpha 1 agonist ?

A

*pseudoepidrine

90
Q

which drug treats cough without removal of bronchial secretion ?

  • Codeine
  • dextromethorphan
A

dextromethorphan

91
Q

focal exudates with alveolar septum destruction ?

  • abscess
  • interstitial pneumonia
A
  • abscess
92
Q

diffused patch infiltrate in the lungs ?

A

*bronchopneumonia

93
Q

smoker with periphral tumor with gland formation ?

A

adenocarcinoma

94
Q

cancer that mimics lobar pneumonia ?

A

bronchoalveolar carcinoma

95
Q

PCO2 = 35 , PH = 7.35 , calculate HCO3-

A

*19

96
Q

96-PH=7.49 .Whatis[H+]

A

*32

97
Q

60-yr old male with chronic bronchitis can see

A
  • 0.9 read index
98
Q

what produces surfactant ?

A

*tyoe 2 pneumocytes

99
Q

what is compnent of air bloof barrier ?

A

*type 1 pneumocyte

100
Q

what is innervated by dorsal rami pf spinal nerve ?

A
  • levator costarum
101
Q

what causes rigidity of muscles during inspiration ?

A
  • external intercostal
102
Q

a patient with alpha 1 antitrypsin defeciency ?

A
  • uniformal enlagement of acini
103
Q

what is the first thing to do when suspecting allergic rhino sinusitis ?

A
  • physical examination & history
104
Q

a test , we should stop taking medication for it , to do it properly for allergic rhino sinusitis ?

A

*skin prick test for IgE

105
Q

sub pleural lesion with lymph node involvement

A
  • primary complex
106
Q

endothelial cells surrounded by lymphatic tissue ?

A
  • granuloma
107
Q

diffused infiltrates in the lung less than 2 mm

A

millary TB

108
Q

what changes with PAO2 or PaO2 changes ?

A

*AaDO2

109
Q

What does not change on ………… ?

A
  • PAO2
110
Q

What causes major change in CSF ?

A

PCO2

111
Q

Chronic inflammation with involvement of eosinophils

A
  • hypersensitivity Pneumonitis
112
Q

low O2 due to shock ?

A
  • adult respiratory distress syndrome
113
Q

found in fetal hemoglobin but not adults ?

A
  • gamma globin
114
Q

reversibly controls HB concentration

A
  • 2 3 bisphosphoglycerate
115
Q

cysteinyl leukotriene

A

LTE4

116
Q

Which mediator is not released when damage to endothelium occurs ?

  • Prostacyclin
  • thromboxane
A
  • Prostacyclin
117
Q

patient with high fever , cough , dyspnea , with consolidation on percussion with distress . what is the most likely diagnosis ?

A

*S pneumonia

118
Q

circulatory defects to cutaneous vessels ?

A
  • peripheral cyanosis

Resp module 3rd year (8 decks)

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