2010 end of module exam Flashcards
1
Q
Which of the following best describes asthma? (EMQ)
A
mainly stimulated by atopy and allergens
2
Q
COPD is mainly defined as what?
A
irreversible airway obstruction
3
Q
which of following side effect of 2nd generation antihistamines?
A
prolonged Q wave
4
Q
antihistamine drug that's used for urticaria works on which receptor ? H1 H1 and H2/ H2/H3 H4
A
H1
5
Q
which of the following causes behavioral addiction?
A
Disruption of motivation hierarchy
6
Q
EMQ: which of the following is found in a patient with cystic fibrosis ?
A
abnormal dilatation of bronchi
7
Q
which of the following best describes obstructive sleep apnea?
A
upper airway obstruction during inspiration
8
Q
a patient presented with wheezing, disturbed sleeping and hypertension, how to diagnose him ?
A
Sleep study test
9
Q
in which condition you will find increase in PaCO2 but AaDO2 doasnt change ?
A
hypoventilation
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
?
11
Q
how RBCs respong to hypoxia?
A
Release ATP
12
Q
a patient presented with necrotizing Granuloma in Lymph Node?
TB
sarcaidosis
A
TB
13
Q
which of the following drurgs binds to A site in tRNA ?
A
tetracycline
14
Q
internal laryngeal nerve passes through which membrane?
A
Thyrohyoid membrane
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
16
Q
which of the following sensory nerves innervates Peripheral parts of diaphragm ?
A
innervated by T6-T12
17
Q
which of the following causes the Clinical symptoms of asthma?
A
IgE cross linkage on the surface of mast cells
18
Q
which of the following leads to desensitization of allergy ?
A
injecting allergin specific
19
Q
which of the following cells mediate allergic reaction
A
tH2
20
Q
which of the following is the exact AAT mechanism of action ?
A
inactivation of protease and forming complex
21
Q
what happens in AAT deficiency ?
A
- prolonged activation of elastase After inflamatory process
22
Q
which of the following causes aggregation of platelets ?
A
TXA2
23
Q
which lipid mediator has anti inflamatory response ?
A
LX4
24
Q
which of the following is Insensitive to aspirin ?
A
LA4
25
what type of damage is caused by nitrosamine/aldehyde ?
DNA adduct
26
which of the following is insensitive to pain ?
viceral pluera
27
which of the following is injured in a stap to apex ?
cervical pluera
28
which of the following is affected in a patient with broken 3 ribs ?
elastic recoil of chest affected
29
which of the following is affected in emphysema ?
elastic recoil of lung
30
which of the following is affected LHF ?
intrapulmonary veins
31
upon examinationa patient was found to have stony dull percusion and reduced breathing sounds, what test would use to diagnose him ?
ultrasound
32
what isthe MOA of inhaled corticosteroids ?
inhibit trascription of infl mediators
33
what added sound is heard with whispring pectoriloquy ?
Bronchial breathing
34
Upon examination patient presented with dullnes and abcense of breathing sounds.
collapse lower right lobe
35
A patient presented with high Pco2 , high Hco3 , low PH(sorry we dont remember the exact numbers)
chronic resp acidosis partial compensated
36
Spirometry test showed reduced PEF also reduced FEF 50%, TLC and FVC was normal, what is most likely would be the diagnosis ?
Large airways obstruction
37
What is the mechanism of action of cisplatin ?
forms intra inter cross linkage of DNA
38
from which structure does the laryngeal endothelium develop ?
laryngeal groove
39
55yr old smoker of 50 pack yrs, has progressive dyspnea over the last 4 wks associated w/morning cough of mucoid sputum on examination
Chronic Bronchitis
40
What are the consequences of ventilation perfusion mismatch?
AaDO2 increase
41
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. hyaline membrane
42
What of the following triggers inflammatory reactions ?
IL 4
43
a 35 indonesian maid presented with dysnea, nausea and occaitional vomiting, CXR showed bilateral tiny diffused opacities, what is the diagnosis ?
milliary TB
44
which of the following inhibit glycopeptide ?
Vancomyosin
45
what is the mechanism of action of ipratropium ?
Block acetylcholine receptors
46
which of the following drugs inhibits mycolic acid synthesis ?
isonizoid
47
which if the following is a characterstic of surfactant ?
monolayer of lipid
48
a patient presented with subpleural infiltration with hilar lymph involvement on CXR ?
ghons complex
49
a 65 male patient presented with peripheral tumor an gland formation, what is most likely would be the diagnosis ?
adenocarcinoma
50
a patient presented with diffused bilatral discrete lesions on CXR, what is most likely would be the diagnosis ?
metastasized cancer
51
a patient presented with cushinoid symptoms, what would be her diagnosis ?
carcinoid tumor
52
A biopsy from a patient showed a collection of epithelioid cells surrounded by lymphcytes?
granuloma
53
What does CFTR gene code for?
Cl channels
54
Which of the following structures mostly affected by immotile cillia syndrome?
primary bronchus
55
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
because she stopped taking medications?
56
If the left phrenic nerve was injured, What causes elevation of the left diaphragmatic dome during inspiration?
-increased intra abdominal pressure
57
What part forms the posterolateral part of the diaphragm?
The pleuroperitoneal membrane
58
A patient presented with fever, pharyngitis, and pseudomembrane. What is the causative agent?
c. Diphtheria
59
Blood culture from patient showed G+ve cocci in clusters. What is the causative organism?
Staph auerus
60
What is the most common infected sinus?
Maxillary sinus
61
Which of the following will cause molar toothache when it is infected?
maxillary sinus
62
Which of the following stimulates cough?
Substance P
63
inspired volume was 3, initial esophageal pressure 12 then 6, what's the compliance?
0.5
64
which mycobacterium is associated with lymphadenitis?
M.avium
65
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?
0.00667
66
What antibiotic prevent peptidoglycan synthesis?
Cefotaxine
67
How is histamine stored in mast cells?
Stored in intracellular granules with heparin
68
What is a characteristic of fetal Hb?
Low affinity to 2,3-BPG
69
What is the mechanism of action of Disodium cromoglycate?
Stabilizing mast cells
70
What causes inhibition of phosphdiesterases?
theophiline
71
Neurovascular bundle is located in front of which muscle?
Inner most
72
Which of the following muscles depress the ribs during forced expiration ?
Internal intercostal muscles
73
Which area is best to cut for performing surgeries ?
Endothracic fasia
74
Which of the following best drives ventilation?
High PaCO2
75
Which of the following inhibits transpeptidation?
Chloramphenicol
76
Which of the following membranes its upper margin forms the vocal ligament?
Conus elasticus
77
Which of the following muscles leads to formation of kite shaped rima glottidis during forced respiration?
Posterior cricoarytenoid muscle
78
Which of the following muscles tense the vocal folds?
Cricothyroid
79
Which of the following drugs interferers with the ribosomal subunit?
Linezolid
80
A 67 years old man presented with a soft gray whitish ensheath on the left lung, biopsy showed biphasic malignancy?
Mesothelioma
81
-How does CO lowers O2 levels in the tissues?
By increasing Hb affinity to O2
82
A patient has just returned back from Asia presented with high fever, productive cough with green sputum. What is the causative organism?
Pseudomonas areugnosa
83
Which type of lung cancers is characterized by keratin and intercellular bridges?
Sqaumous cells carcinoma
84
Patient on percussion was normal apart from the 5th ICS in right side showed dullness. What is the cause?
Due to liver
85
What causes high upper airway obstruction?
Laryngeal atresia
86
Which of the following drugs inhibit folate synthesis?
Co-trimoxazole
87
Which of the following protects B-lactam rings?
Calvulinic acid
88
What is the most important cytokine in immune response against TB?
IFN-gamma
89
EBM question about RRR
20-25%
90
What is typically seen in patients with consilidation and fever , cough with sputum in the chest x- ray?
Aleovlar exudate
91
what structure is commonly compressed by the cervical rib that causes outlet syndrome ?
Subclavian
92
how dies alfatoxin B1 causes lung cancer ?
By converting to alfatoxin M1
93
the lowest airway resistance in ?
TLC
94
what pressure mainly changes in acute heart attack ?
Pulmonary venous pressure
95
which type of lung cancer has the least 5-year survival interval ?
Small cell carcinoma
96
A researcher wanted to asses the effect of a new drug vs standard drug, what is the best study design he can use ?
RCT
97
a patients spirometry results showed: low TLC , normal FEV1/FVC , low FVC , what is the diagnosis ?
Restrictive lung disease
98
a patient presented with dysnea on exertion while climbing stairs, what is the first diagnostic test should be done ?
X-ray
ECG
ECG?
99
which of the following is a gram +ve diplococci obtochin senstive alfa hemolytic bacteria ?
S. pnuemonia
100
what is the importance of secretary component of IgA ?
Prevent degredation
101
contraction of which muscle increases the vertical diameter of the thoracic cavity ?
Diaphragm
102
which of the following is a characterstic of chronic bronchitis ?
Hypertrophy of mucus glands
103
which of the following cells lines the alveolar wall ?
Pneumocyte type 1
