2012 end of module exam Flashcards
1
Q
What is the main cell infiltrate in Arthur reaction (type III hypersensitivity)?
A
- Neutrophils
2
Q
What action of inhaled corticosteroid?
A
- Inhibit IgE synthesis
3
Q
Asthmatic lady with bout of coughing, she develops chest pain what best diagnostic method for pain?
A
- Urgent CT scan
4
Q
Table with low PaCO2 and at pure oxygen PaO2 is low?
A
- Abnormal shunt
5
Q
What’s influence static compliance?
- Lung volume
- Ppl
- Frequencyofbreath
A
- Lung volume
6
Q
What Decreases dynamic compliance?
- deep breath
- Exercise
- Increase of Raw
A
- Increase of Raw
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.
8
Q
Ifshuntedbloodexceeds30%thiswillcauserisein: - PaO2
- PAO2
- PaCO2
- AaDO2
A
- AaDO2
9
Q
In which condition the DLCO will increase?
A
Lefttorightshunt
10
Q
What increases DLCO?
A
Pulmonary hemorrhage
11
Q
Concentric layers of hyalinized fibrotic?
A
- Foci in the lung
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
13
Q
What Ig is involved in allergic Reaction?
A
IgE
14
Q
What is the most common cause of URTIs in Kuwait?
A
- Viral
15
Q
A child presented with fever, dyspnea, tachypnea, she didn’t have all her childhood vaccination?
A
- Epiglottitis
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)
17
Q
What is the cause of damage in AAT deficiency when a pathogen is introduced?
A
- Increased protease activity
18
Q
What is the mechanism of alpha1anti-trypsin?
A
- Suicide substrate
19
Q
What would happen if SP-D was deficient?
A
- Impaired innate immunity
20
Q
What is effect of polyhydrocarbons?
A
- Formation of DNA adducts
21
Q
How do nitrogen base analogs cause mutations?
- Mismatch pair
A
- Mismatch pair
22
Q
What is the hyaline membrane of ARDS patient composed of?
A
Fibrin and necrotic epithelial cells
23
Q
Immediate effector cells in allergic reaction?
A
- mast cells
24
Q
Late effector cells in allergic reactions?
A
Eosinophils
25
What is the effect of 2,3BGP?
Decrease affinity of hemoglobin to O2
26
How does RBC's react in hypoxia?
Release of ATP
27
A woman had interstitial lung disease, bilateral lung involvement, subcutaneous nodules, & salivary gland involvement. Skin biopsy showed non-caesating granuloma & asteroid bodies. Diagnosis?
Sarcoidosis
28
What can directly affect cough receptors in airway epithelium?
- Substance P
29
It was about diagnosis of obstructive diseases or something like that?
- FEV1 & FVC & their ratios
30
female non-smoker, fever, cough with rusty sputum, normal lung expansion, dullness in infra-scuplar area, bronchial breathing, fine crackles during inspiration & expiration?
- Pneumonia
31
What decreases significantly in anemic patients?
- O2 arterial content
32
Pathophysiology of emphysema?
Loss of elastic recoil
33
What increases Hb affinity to O2?
- Increase intracellular pH
34
A case w/ rusty sputum?
- S. Pneumonia
35
A question about calculating CaO2
The equation is (0.03 x PaO2) + (Hb x Saturation x 1.34)
36
What is the most common viral infection in Kuwait?
- Adenovirus
- Influenza virus
- Corona virus
- Rhinovirus
- Rhinovirus
37
Deficiency in which cell predispose patient to recurrent bacterial infection?
- B cells
- Neutrophils
- Neutrophils
38
In which structure does the nasolacrimal duct open?
- Inferior nasal meatus
39
Which structure most commonly infected?
- Maxillary sinus
40
Tooth ache?
- Maxillary sinus
41
Main muscle to increase thoracic cage volume?
Diaphragm
42
Which cell develops protection for terminal bronchiole?
- 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
Origin of visceral pleura?
- Splanchnic mesoderm
* Lateral plate mesoderm divides into somatopleuric mesoderm (forms parietal pleura) and splanchnopleuric mesoderm (forms visceral pleura)
44
Structure pain insensitive?
Visceral pleura
45
What structure paralyze when dorsal rami of thoracic spinal nerve is cut?
- Levator costarum
46
Blood-air barrier in alveoli?
Type 1 pnemocyte
47
From which structure epithelium of LRT develops?
- Neural crest
- Laryngotracheal groove/diverticulum ( --> lung buds)
- Laryngotracheal groove/diverticulum ( --> lung buds)
| * Endoderm not mentioned in the choices
48
A life long smoker had a pulmonary function test. What is the
result to confirm that he is COPD?
- Reduced FEV1/FVC ratio
49
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?
- Secondary TB
50
Anti Tb drug that caused nephrotoxicity and ototoxicity?
Streptomycin
51
What is the percentage of smokers that will die from smoking- related disease?
- 50%
52
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
Kartagner syndrome
53
What makes influenza vaccine? - Two A, one B
- Two B, one A
- One A, one B, one C
- TwoA, oneB
54
Most common cause of sore throat?
- Diphtheria
- H.influenza
- Pyogenes
- Pyogenes
55
Most common cause of allergies in Kuwait?
- Cat dander
- Dog hair
- Moulds
- Cockroaches
- Pollen
- Pollen
56
Arrangement of cilia in respiratory tract?
- 9+2
57
Table with low CO2 , low O2 and high Hb - V/Q mismatch
- Hypoventilation
- Anemia
- Diffusion limitation
- High altitude for two months
- High altitude for two months
58
What is essential to surfactant in children?
*Synthesis of dipalmitoylphosphatidylcholine (DPPC) requires glucose, choline, and palmitic acid, which occurs in type II pneumocytes; amino acids are needed for surfactant proteins.
59
Increase of what causes surfactant to be disrupted in adults?
Cholesterol
60
Lack of which SP would cause a decrease in innate immunity?
- 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
Treatment of a 1 year old with otitis media?
Amoxicillin
62
Treatment of a child with strep throat who's allergic to penicillin?
- Erythromycin (for Corynebacterium)
- Clindamycin
Clindamycin
63
What enzymes do steroids block?
Phospholipase A2
64
Causes destructive pulmonary disease?
- M.kanasi
65
Which of these regarding the genotype of AAT deficiency is true?
PIss genotype results in formation of a protein with a short half-life that is easily degraded outside the liver
66
If recurrent laryngeal nerve is cut, which muscle is spared?
```
Cricothyriod muscle (innervated by external branch
of superior laryngeal nerve which is from CNX)
```
67
What is the result of mutation of the gene responsible for cystic fibrosis?
- Calcium channels
- Sodium channels
- Chloride channels
- Potassium channels
- Chloride channels
68
Severe asthma (static asmaticus) for long term control
LABA + inhaled steroids
69
Which of the following combination in a patient who is recently infected with TB?
Refampcin / isonzaid / pyrazinamide / ethambutol
70
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
- Pulmonary veins
71
What muscle tenses the vocal folds in high-pitched voice?
Cricothyroid
72
What contributes to the development of posterolateral part of the diagram?
Pleuriperitoneal membrane
73
What nerve is responsible for sensory innervation of peripheral part of the diaphragm?
- Intercostal nerve
74
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?
Pseudomonas aeruginosa
75
What is most affected in ciliary dyskinesia?
Trachea
76
What joint has bucket handle movement?
- Costochondral
- Costovertebral
- Costotransverse
- Costovertebral
77
What besides smoking is the most important risk factor for COPD in developing countries?
- Poor diet
- Genetics
- Poor diet
78
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
?
79
Patient with cough and confusion. Chest x-ray shows interstitial infiltrates. What is the causative agent?
- Chlamydia pneumonia
- Streptococcus pneumonia
- Chlamydia pneumonia
80
A 61 year old had hip replacement surgery then she had hemoptysis. What is the cause?
- PE
- Bronchogenic carcinoma
- Bronchiectasis
- PE
81
What is the effect of 2, 3-BPG?
Reduce O2 affinity
82
What causes an increase in AaDO2?
?
