2010 end of module exam Flashcards

1
Q

Which of the following best describes asthma? (EMQ)

A

mainly stimulated by atopy and allergens

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2
Q

COPD is mainly defined as what?

A

irreversible airway obstruction

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3
Q

which of following side effect of 2nd generation antihistamines?

A

prolonged Q wave

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4
Q
antihistamine drug that's used for urticaria works on which receptor ? 
H1
H1 and H2/
H2/H3
H4
A

H1

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5
Q

which of the following causes behavioral addiction?

A

Disruption of motivation hierarchy

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6
Q

EMQ: which of the following is found in a patient with cystic fibrosis ?

A

abnormal dilatation of bronchi

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7
Q

which of the following best describes obstructive sleep apnea?

A

upper airway obstruction during inspiration

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8
Q

a patient presented with wheezing, disturbed sleeping and hypertension, how to diagnose him ?

A

Sleep study test

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9
Q

in which condition you will find increase in PaCO2 but AaDO2 doasnt change ?

A

hypoventilation

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10
Q

low PO2 and PCO2, normal pH, what is the cause of the change in CO2?
Ventilation perfusion mismatch/ increase minute ventilation/ increase shunt/ increase alveolar ventilation

A

?

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11
Q

how RBCs respong to hypoxia?

A

Release ATP

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12
Q

a patient presented with necrotizing Granuloma in Lymph Node?
TB
sarcaidosis

A

TB

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13
Q

which of the following drurgs binds to A site in tRNA ?

A

tetracycline

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14
Q

internal laryngeal nerve passes through which membrane?

A

Thyrohyoid membrane

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15
Q
large figure (found in week 4 booklet station 2 figure 8)
60 year old male 160cm height presented with asthma what do you expect his peak expiratory flow ?
A

<510

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16
Q

which of the following sensory nerves innervates Peripheral parts of diaphragm ?

A

innervated by T6-T12

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17
Q

which of the following causes the Clinical symptoms of asthma?

A

IgE cross linkage on the surface of mast cells

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18
Q

which of the following leads to desensitization of allergy ?

A

injecting allergin specific

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19
Q

which of the following cells mediate allergic reaction

A

tH2

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20
Q

which of the following is the exact AAT mechanism of action ?

A

inactivation of protease and forming complex

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21
Q

what happens in AAT deficiency ?

A
  • prolonged activation of elastase After inflamatory process
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22
Q

which of the following causes aggregation of platelets ?

A

TXA2

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23
Q

which lipid mediator has anti inflamatory response ?

A

LX4

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24
Q

which of the following is Insensitive to aspirin ?

A

LA4

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25
Q

what type of damage is caused by nitrosamine/aldehyde ?

A

DNA adduct

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26
Q

which of the following is insensitive to pain ?

A

viceral pluera

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27
Q

which of the following is injured in a stap to apex ?

A

cervical pluera

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28
Q

which of the following is affected in a patient with broken 3 ribs ?

A

elastic recoil of chest affected

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29
Q

which of the following is affected in emphysema ?

A

elastic recoil of lung

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30
Q

which of the following is affected LHF ?

A

intrapulmonary veins

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31
Q

upon examinationa patient was found to have stony dull percusion and reduced breathing sounds, what test would use to diagnose him ?

A

ultrasound

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32
Q

what isthe MOA of inhaled corticosteroids ?

A

inhibit trascription of infl mediators

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33
Q

what added sound is heard with whispring pectoriloquy ?

A

Bronchial breathing

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34
Q

Upon examination patient presented with dullnes and abcense of breathing sounds.

A

collapse lower right lobe

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35
Q

A patient presented with high Pco2 , high Hco3 , low PH(sorry we dont remember the exact numbers)

A

chronic resp acidosis partial compensated

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36
Q

Spirometry test showed reduced PEF also reduced FEF 50%, TLC and FVC was normal, what is most likely would be the diagnosis ?

A

Large airways obstruction

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37
Q

What is the mechanism of action of cisplatin ?

A

forms intra inter cross linkage of DNA

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38
Q

from which structure does the laryngeal endothelium develop ?

A

laryngeal groove

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39
Q

55yr old smoker of 50 pack yrs, has progressive dyspnea over the last 4 wks associated w/morning cough of mucoid sputum on examination

A

Chronic Bronchitis

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40
Q

What are the consequences of ventilation perfusion mismatch?

A

AaDO2 increase

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41
Q

what is the characteristic microscopic feature for patients w/ ARDS (Adult Respiratory Distress Syndrome) ??

a. hyaline membrane
b. honeycomb fibrosis
c. bronchiolitis
d. neutrophil
e. interstitial lymphocyte infiltrate

A

a. hyaline membrane

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42
Q

What of the following triggers inflammatory reactions ?

A

IL 4

43
Q

a 35 indonesian maid presented with dysnea, nausea and occaitional vomiting, CXR showed bilateral tiny diffused opacities, what is the diagnosis ?

A

milliary TB

44
Q

which of the following inhibit glycopeptide ?

A

Vancomyosin

45
Q

what is the mechanism of action of ipratropium ?

A

Block acetylcholine receptors

46
Q

which of the following drugs inhibits mycolic acid synthesis ?

A

isonizoid

47
Q

which if the following is a characterstic of surfactant ?

A

monolayer of lipid

48
Q

a patient presented with subpleural infiltration with hilar lymph involvement on CXR ?

A

ghons complex

49
Q

a 65 male patient presented with peripheral tumor an gland formation, what is most likely would be the diagnosis ?

A

adenocarcinoma

50
Q

a patient presented with diffused bilatral discrete lesions on CXR, what is most likely would be the diagnosis ?

A

metastasized cancer

51
Q

a patient presented with cushinoid symptoms, what would be her diagnosis ?

A

carcinoid tumor

52
Q

A biopsy from a patient showed a collection of epithelioid cells surrounded by lymphcytes?

A

granuloma

53
Q

What does CFTR gene code for?

A

Cl channels

54
Q

Which of the following structures mostly affected by immotile cillia syndrome?

A

primary bronchus

55
Q

A teacher who has a history of asthma was suffering from asthamtic attack in the past, she was using medications but she stopped using them when she felt better 6 months ago. She started developing asthma symptoms when she moved to a new flat in the downtown 3 weeks ago. What most likely would be the cause of her symptoms?

  • increase air pollutants in the city
  • because she stopped taking medications
A

because she stopped taking medications?

56
Q

If the left phrenic nerve was injured, What causes elevation of the left diaphragmatic dome during inspiration?

A

-increased intra abdominal pressure

57
Q

What part forms the posterolateral part of the diaphragm?

A

The pleuroperitoneal membrane

58
Q

A patient presented with fever, pharyngitis, and pseudomembrane. What is the causative agent?

A

c. Diphtheria

59
Q

Blood culture from patient showed G+ve cocci in clusters. What is the causative organism?

A

Staph auerus

60
Q

What is the most common infected sinus?

A

Maxillary sinus

61
Q

Which of the following will cause molar toothache when it is infected?

A

maxillary sinus

62
Q

Which of the following stimulates cough?

A

Substance P

63
Q

inspired volume was 3, initial esophageal pressure 12 then 6, what’s the compliance?

A

0.5

64
Q

which mycobacterium is associated with lymphadenitis?

A

M.avium

65
Q

the mother has an infected brother and the father with unknown history. 1 out of 25 of the population are carriers. What is the probability of delivering an infected child?

A

0.00667

66
Q

What antibiotic prevent peptidoglycan synthesis?

A

Cefotaxine

67
Q

How is histamine stored in mast cells?

A

Stored in intracellular granules with heparin

68
Q

What is a characteristic of fetal Hb?

A

Low affinity to 2,3-BPG

69
Q

What is the mechanism of action of Disodium cromoglycate?

A

Stabilizing mast cells

70
Q

What causes inhibition of phosphdiesterases?

A

theophiline

71
Q

Neurovascular bundle is located in front of which muscle?

A

Inner most

72
Q

Which of the following muscles depress the ribs during forced expiration ?

A

Internal intercostal muscles

73
Q

Which area is best to cut for performing surgeries ?

A

Endothracic fasia

74
Q

Which of the following best drives ventilation?

A

High PaCO2

75
Q

Which of the following inhibits transpeptidation?

A

Chloramphenicol

76
Q

Which of the following membranes its upper margin forms the vocal ligament?

A

Conus elasticus

77
Q

Which of the following muscles leads to formation of kite shaped rima glottidis during forced respiration?

A

Posterior cricoarytenoid muscle

78
Q

Which of the following muscles tense the vocal folds?

A

Cricothyroid

79
Q

Which of the following drugs interferers with the ribosomal subunit?

A

Linezolid

80
Q

A 67 years old man presented with a soft gray whitish ensheath on the left lung, biopsy showed biphasic malignancy?

A

Mesothelioma

81
Q

-How does CO lowers O2 levels in the tissues?

A

By increasing Hb affinity to O2

82
Q

A patient has just returned back from Asia presented with high fever, productive cough with green sputum. What is the causative organism?

A

Pseudomonas areugnosa

83
Q

Which type of lung cancers is characterized by keratin and intercellular bridges?

A

Sqaumous cells carcinoma

84
Q

Patient on percussion was normal apart from the 5th ICS in right side showed dullness. What is the cause?

A

Due to liver

85
Q

What causes high upper airway obstruction?

A

Laryngeal atresia

86
Q

Which of the following drugs inhibit folate synthesis?

A

Co-trimoxazole

87
Q

Which of the following protects B-lactam rings?

A

Calvulinic acid

88
Q

What is the most important cytokine in immune response against TB?

A

IFN-gamma

89
Q

EBM question about RRR

A

20-25%

90
Q

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

A

Aleovlar exudate

91
Q

what structure is commonly compressed by the cervical rib that causes outlet syndrome ?

A

Subclavian

92
Q

how dies alfatoxin B1 causes lung cancer ?

A

By converting to alfatoxin M1

93
Q

the lowest airway resistance in ?

A

TLC

94
Q

what pressure mainly changes in acute heart attack ?

A

Pulmonary venous pressure

95
Q

which type of lung cancer has the least 5-year survival interval ?

A

Small cell carcinoma

96
Q

A researcher wanted to asses the effect of a new drug vs standard drug, what is the best study design he can use ?

A

RCT

97
Q

a patients spirometry results showed: low TLC , normal FEV1/FVC , low FVC , what is the diagnosis ?

A

Restrictive lung disease

98
Q

a patient presented with dysnea on exertion while climbing stairs, what is the first diagnostic test should be done ?
X-ray
ECG

A

ECG?

99
Q

which of the following is a gram +ve diplococci obtochin senstive alfa hemolytic bacteria ?

A

S. pnuemonia

100
Q

what is the importance of secretary component of IgA ?

A

Prevent degredation

101
Q

contraction of which muscle increases the vertical diameter of the thoracic cavity ?

A

Diaphragm

102
Q

which of the following is a characterstic of chronic bronchitis ?

A

Hypertrophy of mucus glands

103
Q

which of the following cells lines the alveolar wall ?

A

Pneumocyte type 1