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Respiratory module Exams > 2012 end of module exam > Flashcards

2012 end of module exam Flashcards

1
Q

What is the main cell infiltrate in Arthur reaction (type III hypersensitivity)?

A
  • Neutrophils
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2
Q

What action of inhaled corticosteroid?

A
  • Inhibit IgE synthesis
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3
Q

Asthmatic lady with bout of coughing, she develops chest pain what best diagnostic method for pain?

A
  • Urgent CT scan
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4
Q

Table with low PaCO2 and at pure oxygen PaO2 is low?

A
  • Abnormal shunt
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5
Q

What’s influence static compliance?

  • Lung volume
  • Ppl
  • Frequencyofbreath
A
  • Lung volume
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6
Q

What Decreases dynamic compliance?

  • deep breath
  • Exercise
  • Increase of Raw
A
  • Increase of Raw
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7
Q

Tb Drug not given to female on oral contraceptives? -

A

Rifampin

*Rifampin is a strong inducer of cyt P450, hence rapid inactivation of oral contraceptives, warfarin, and oral antidiabetics.

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8
Q

Ifshuntedbloodexceeds30%thiswillcauserisein: - PaO2

  • PAO2
  • PaCO2
  • AaDO2
A
  • AaDO2
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9
Q

In which condition the DLCO will increase?

A

Lefttorightshunt

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10
Q

What increases DLCO?

A

Pulmonary hemorrhage

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11
Q

Concentric layers of hyalinized fibrotic?

A
  • Foci in the lung
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12
Q

What is the mechanism in the smooth muscles of the pulmonary vessels that links hypoxia and vasoconstriction?

A
  • Reduced uptake of Ca+ in the sarcoplasmic reticulum
  • Hypoxia –> increased AMP –> activation ofAMPK –> phosphorylation of K+ channels and partial depolarization –> opening of Ca2+ channels. AMPK also phosphorylates cADPR which allow mobilization of Ca2+ into cytoplasm through RyR receptors
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13
Q

What Ig is involved in allergic Reaction?

A

IgE

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14
Q

What is the most common cause of URTIs in Kuwait?

A
  • Viral
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15
Q

A child presented with fever, dyspnea, tachypnea, she didn’t have all her childhood vaccination?

A
  • Epiglottitis
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16
Q

What joint is associated with bucket handle movement?

  • Costovertebral joint (stiff with little space –> slight gliding)
  • Costotransverse joint (at ribs 7-10)
A
  • Costotransverse joint (at ribs 7-10)
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17
Q

What is the cause of damage in AAT deficiency when a pathogen is introduced?

A
  • Increased protease activity
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18
Q

What is the mechanism of alpha1anti-trypsin?

A
  • Suicide substrate
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19
Q

What would happen if SP-D was deficient?

A
  • Impaired innate immunity
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20
Q

What is effect of polyhydrocarbons?

A
  • Formation of DNA adducts
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21
Q

How do nitrogen base analogs cause mutations?

- Mismatch pair

A
  • Mismatch pair
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22
Q

What is the hyaline membrane of ARDS patient composed of?

A

Fibrin and necrotic epithelial cells

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23
Q

Immediate effector cells in allergic reaction?

A
  • mast cells
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24
Q

Late effector cells in allergic reactions?

A

Eosinophils

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25
Q

What is the effect of 2,3BGP?

A

Decrease affinity of hemoglobin to O2

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26
Q

How does RBC’s react in hypoxia?

A

Release of ATP

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27
Q

A woman had interstitial lung disease, bilateral lung involvement, subcutaneous nodules, & salivary gland involvement. Skin biopsy showed non-caesating granuloma & asteroid bodies. Diagnosis?

A

Sarcoidosis

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28
Q

What can directly affect cough receptors in airway epithelium?

A
  • Substance P
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29
Q

It was about diagnosis of obstructive diseases or something like that?

A
  • FEV1 & FVC & their ratios
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30
Q

female non-smoker, fever, cough with rusty sputum, normal lung expansion, dullness in infra-scuplar area, bronchial breathing, fine crackles during inspiration & expiration?

A
  • Pneumonia
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31
Q

What decreases significantly in anemic patients?

A
  • O2 arterial content
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32
Q

Pathophysiology of emphysema?

A

Loss of elastic recoil

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33
Q

What increases Hb affinity to O2?

A
  • Increase intracellular pH
34
Q

A case w/ rusty sputum?

A
  • S. Pneumonia
35
Q

A question about calculating CaO2

A

The equation is (0.03 x PaO2) + (Hb x Saturation x 1.34)

36
Q

What is the most common viral infection in Kuwait?

  • Adenovirus
  • Influenza virus
  • Corona virus
  • Rhinovirus
A
  • Rhinovirus
37
Q

Deficiency in which cell predispose patient to recurrent bacterial infection?

  • B cells
  • Neutrophils
A
  • Neutrophils
38
Q

In which structure does the nasolacrimal duct open?

A
  • Inferior nasal meatus
39
Q

Which structure most commonly infected?

A
  • Maxillary sinus
40
Q

Tooth ache?

A
  • Maxillary sinus
41
Q

Main muscle to increase thoracic cage volume?

A

Diaphragm

42
Q

Which cell develops protection for terminal bronchiole?

A
  • Clara cells
  • Clara cells are nonciliated cells that detoxify noxious inhaled substances (e.g. nitric oxide) and secrete surfactant-like protective material and leukocyte protease inhibitor (anti-inflammatory to protect epithelium).
43
Q

Origin of visceral pleura?

A
  • Splanchnic mesoderm
  • Lateral plate mesoderm divides into somatopleuric mesoderm (forms parietal pleura) and splanchnopleuric mesoderm (forms visceral pleura)
44
Q

Structure pain insensitive?

A

Visceral pleura

45
Q

What structure paralyze when dorsal rami of thoracic spinal nerve is cut?

A
  • Levator costarum
46
Q

Blood-air barrier in alveoli?

A

Type 1 pnemocyte

47
Q

From which structure epithelium of LRT develops?

  • Neural crest
  • Laryngotracheal groove/diverticulum ( –> lung buds)
A
  • Laryngotracheal groove/diverticulum ( –> lung buds)

* Endoderm not mentioned in the choices

48
Q

A life long smoker had a pulmonary function test. What is the
result to confirm that he is COPD?

A
  • Reduced FEV1/FVC ratio
49
Q

A 25 year old man presented with cough and chest pain, initial chest x-ray reveled small plural effusion at the right side, after 3 months follow up while he’s asymptomatic, a chest x-ray showed small opacity on the right apex?

A
  • Secondary TB
50
Q

Anti Tb drug that caused nephrotoxicity and ototoxicity?

A

Streptomycin

51
Q

What is the percentage of smokers that will die from smoking- related disease?

A
  • 50%
52
Q

Which condition has the triad of bronchiectasis, sinusitis, sinus inverses seen in approximately 50% of primary ciliary dyskinesia patients?

  • ARDS
  • Ive(something) syndrome
  • Kartagner syndrome
A

Kartagner syndrome

53
Q

What makes influenza vaccine? - Two A, one B

  • Two B, one A
  • One A, one B, one C
A
  • TwoA, oneB
54
Q

Most common cause of sore throat?

  • Diphtheria
  • H.influenza
  • Pyogenes
A
  • Pyogenes
55
Q

Most common cause of allergies in Kuwait?

  • Cat dander
  • Dog hair
  • Moulds
  • Cockroaches
  • Pollen
A
  • Pollen
56
Q

Arrangement of cilia in respiratory tract?

A
  • 9+2
57
Q

Table with low CO2 , low O2 and high Hb - V/Q mismatch

  • Hypoventilation
  • Anemia
  • Diffusion limitation
  • High altitude for two months
A
  • High altitude for two months
58
Q

What is essential to surfactant in children?

A

*Synthesis of dipalmitoylphosphatidylcholine (DPPC) requires glucose, choline, and palmitic acid, which occurs in type II pneumocytes; amino acids are needed for surfactant proteins.

59
Q

Increase of what causes surfactant to be disrupted in adults?

A

Cholesterol

60
Q

Lack of which SP would cause a decrease in innate immunity?

A
  • SP-A
  • Although the major role of SP-D is to be part of innate immunity, SP-A is the “most abundant surfactant protein” and it has both lipid roles and innate immunity roles, i.e. amount of SP- A is more than 5 times that of SP-D (see pie chart in lecture)
61
Q

Treatment of a 1 year old with otitis media?

A

Amoxicillin

62
Q

Treatment of a child with strep throat who’s allergic to penicillin?

  • Erythromycin (for Corynebacterium)
  • Clindamycin
A

Clindamycin

63
Q

What enzymes do steroids block?

A

Phospholipase A2

64
Q

Causes destructive pulmonary disease?

A
  • M.kanasi
65
Q

Which of these regarding the genotype of AAT deficiency is true?

A

PIss genotype results in formation of a protein with a short half-life that is easily degraded outside the liver

66
Q

If recurrent laryngeal nerve is cut, which muscle is spared?

A 
Cricothyriod muscle (innervated by external branch
of superior laryngeal nerve which is from CNX)
67
Q

What is the result of mutation of the gene responsible for cystic fibrosis?

  • Calcium channels
  • Sodium channels
  • Chloride channels
  • Potassium channels
A
  • Chloride channels
68
Q

Severe asthma (static asmaticus) for long term control

A

LABA + inhaled steroids

69
Q

Which of the following combination in a patient who is recently infected with TB?

A

Refampcin / isonzaid / pyrazinamide / ethambutol

70
Q

What structure has to be identified and carefully isolated in the separation of 2 bronchopulmonary segments from each other?

  • Pulmonary arteries
  • Pulmonary veins
  • Pulmonary lymph nodes
  • Pulmonary lymphatics
  • Pulmonary ligaments
A
  • Pulmonary veins
71
Q

What muscle tenses the vocal folds in high-pitched voice?

A

Cricothyroid

72
Q

What contributes to the development of posterolateral part of the diagram?

A

Pleuriperitoneal membrane

73
Q

What nerve is responsible for sensory innervation of peripheral part of the diaphragm?

A
  • Intercostal nerve
74
Q

A 67 year old man developed ventilator associated pneumonia in the ICU after a colorectal surgery. His tracheoaspirate showed green colonies. What is the causative agent?

A

Pseudomonas aeruginosa

75
Q

What is most affected in ciliary dyskinesia?

A

Trachea

76
Q

What joint has bucket handle movement?

  • Costochondral
  • Costovertebral
  • Costotransverse
A
  • Costovertebral
77
Q

What besides smoking is the most important risk factor for COPD in developing countries?

  • Poor diet
  • Genetics
A
  • Poor diet
78
Q

Old female had nocturnal wheezing. She was asthmatic before puberty. Her doctor changed her diabetes medications one month ago. What causes her wheezing?

  • NSAIDs(shifts arachidonic acid into LTs instead of PGs)
  • ACEI
A

?

79
Q

Patient with cough and confusion. Chest x-ray shows interstitial infiltrates. What is the causative agent?

  • Chlamydia pneumonia
  • Streptococcus pneumonia
A
  • Chlamydia pneumonia
80
Q

A 61 year old had hip replacement surgery then she had hemoptysis. What is the cause?

  • PE
  • Bronchogenic carcinoma
  • Bronchiectasis
A
  • PE
81
Q

What is the effect of 2, 3-BPG?

A

Reduce O2 affinity

82
Q

What causes an increase in AaDO2?

A

?

Respiratory module Exams (10 decks)

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