2015 end of module exam Flashcards
What affects PH the most?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
A) paco2
What doesn’t change with hypoventilation?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
C) AaDO2
What increases with hypoventilation?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
A) paco2
Which of these parameters is most affected in anemia?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
D) CaO2
What increases in stagnant hypoxia?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
G) AV difference at rest
Which of the following affect the tone of the pulmonary arterioles?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
B) pao2
What is sensed by carotid body?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
B) pao2
Largely depends on the concentration of hb?
A) paco2 B) pao2 C) AaDO2 D) CaO2 E) CvO2 F) PAO2 G) AV difference at rest H) Hb saturation
D) CaO2
Trans-lung pressure (PL) depends on pleural pressure and alveolar pressure. Pleural pressure is 8 less than alveolar pressure, alveolar pressure is like barometric pressure. What is PL?
+8 (PL= 0 – (- 8))
Airway dilatation from the level of the respiratory bronchiole to the alveoli,
predominantly affecting lower zones of the lung?
Pan-acinar emphysema
What Ig plays a role in humoral immunity of the respiratory system?
A) IgA
B) IgM
C) IgD
D) IgE
A) IgA
What is seen in a tumor of the lung?
a) Small calcified nodule
b) Cavitating nodule
c) Nodule that disappears in successive films
b) Cavitating nodule
What characterizes asthma vs emphysema?
a. Expiration in emphysema is worse than in asthma
b. Inspiration of both is equally bad
c. Expiration of both is equally bad
a. Expiration in emphysema is worse than in asthma
A 9-year-old girl was admitted to the hospital with one day of malaise, anorexia, and low-grade fever. Her immunization status was incomplete. On physical examination, she had acute pharyngitis with overlying white adherent membrane. What is the most likely cause?
A) Gram +ve cocci
B) Gram –ve cocci
C) Gram +ve bacilli
D) Gram –ve bacilli
C) Gram +ve bacilli
What produces surfactants?
A) Pnemocyte type I
B) Pnemocyte type II
C) Basal cells
D) Brush cells
B) Pnemocyte type II
Surgery for goiter in anterior triangle of the neck. Patient experienced monotonous voice and unable to increase pitch. Sensation to the vestibule was intact. What nerve was damaged?
A) External laryngeal
B) Recurrent laryngeal
C) Internal laryngeal
A) External laryngeal
Internal laryngeal nerve lesion in a 60 years old patient with lung cancer. What action is lost first?
A) Abduction
B) Adduction
C) Relaxers
D) Tensors
A) Abduction
Right heart border on chest x-ray corresponds to what part of the lung?
Medial border of middle lobe
In allergic bronchial asthma, what do TH2 cells release to activate effector
cells?
A) IL4,5,9,13
B) IL 4, 12, 15, 23
A) IL4,5,9,13
What occurs in allergic bronchial asthma?
A) Upregulation of FCeR1 receptors by IL-4
B) IL-5 preventing eosinophils from exiting bone marrow
C) RANTES
D) MCP 1 causing release of histamine from basophils
A) Upregulation of FCeR1 receptors by IL-4
A 39-year-old female with fever and weight loss and cervical
lymphadenopathy?
A)Node with multiple well-formed epithelioid without necrosis
B) Lysosomal release by leukocytes
C) Induction of class complement
D) Type 4 hypersensitivity
D?
Hypersensitivity lung reaction?
A) Allergic bronchopulmonary aspergillosis (ABPA) B) Aspergilloma C) allergic aspergillus sinusitis D) pulmonary aspergillosis E) invasive pulmonary aspergillosis
A) Allergic bronchopulmonary aspergillosis (ABPA)
Fungal ball in the lung?
A) Allergic bronchopulmonary aspergillosis (ABPA) B) Aspergilloma C) allergic aspergillus sinusitis D) pulmonary aspergillosis E) invasive pulmonary
B) Aspergilloma
Hypersensitivity pneumonitis?
A) IgG precipitin antibodies B) Total serum IgE C) Allergen specific IgE D) Serum tryptase E) Intradermal test F) Eosinophil cationic protein G) Prick to prick test H) Methacholine challenge test
A) IgG precipitin antibodies
Allergic bronchopulmonary aspergillosis (ABPA)?
A) IgG precipitin antibodies B) Total serum IgE C) Allergen specific IgE D) Serum tryptase E) Intradermal test F) Eosinophil cationic protein G) Prick to prick test H) Methacholine challenge test
B) Total serum IgE
What is the guideline for bronchopulmonary segment removal?
Pulmonary vein
What decreases the resistance of airways?
A) Adrenaline
B) Histamine
C) Ach
D) Substance P
A) Adrenaline
What do you measure in anaphylaxis?
Serum tryptase
Older male Patient with inspiratory crackles, chronic dry cough, dyspnea, and clubbing. He stopped smoking 15 years ago, what is the diagnosis?
A) COPD
B) Bronchial asthma
C) Interstitial lung disease
C) Interstitial lung disease
What produces mucus?
A) Pneumocyte type I B) Pneumocyte type II C) Clara cells D) Goblet cells E) Ciliated cells F) Small neuro-endocrine cells
D) Goblet cells
On gross examination, we found dilated near the subpleural area, with mucus
and purulent substance. what is the pathology?
A) Bronchiectasis B) Chronic bronchitis C) Pneumonia D) Central emphysema E) Panacinar emphysema
A) Bronchiectasis
Patient, middle aged male with productive cough for 10 years, smoker, with
hypoventilation (high co2, low o2, ph low) what is the likely diagnosis?
A) Submucosa mucus gland hypertrophy
B) Loss of elastic recoil
A) Submucosa mucus gland hypertrophy
Type of emphysema that leads to pneumothorax?
Paraseptal emphysema
Which of the intercostal spaces is approached in the mid-axillary line with a
needle to drain the costo-diaphragmatic recess?
A) 6th
B) 7th
C) 8th
D) 9th
D) 9th
FV loop of emphysema given: What is the diagnosis? Or what is the underlying
process?
Decreased elastic recoil
What kills MTB?
A) Macrophages
B) NK cells
A) Macrophages
A 6-year-old boy diagnosed with bronchopneumonia, his sputum culture yielded an organism that only grows on chocolate agar. What is the most likely organism?
A) S. pyogenes
B) M. pneumonia
C) H. influenza
C) H. influenza
What is activated in type IV hypersensitivity (or what is activated by TH1 cells in MTB infection?) A) Cytotoxic T cells B) Eosinophils C) Mast cells
A) Cytotoxic T cells
Pancytopenia, Hepatospleenomegaly, ground glass appearance of lung?
Miliary TB
Hepatospleenomegaly, ground glass lung – sample showed epithelioid granulomas. What is the underlying pathological process causing this?
Type IV hypersensitivity
Chest x-ray of a 29 years old male with fever & night chills showed ground glass appearance. Physical examination showed splenomegaly. Blood test showed pancytopenia. Bronchial biopsy showed two epitheloid granuloma. Which of the following organisms is implicated In this pathology?
A) Mycobacterium avium intravellulare
B) k.pneumonia
C) MTB
D) P.argenosa
C) MTB
Which type of cells control MTB in the infected cell? A) Th2 B) Mast cells C) Esinophiols D) CD8+
D) CD8+
What is the gold standard test to diagnose food allergy?
A) Skin prick test for major proteins
B) Intradermal prick test for major proteins
C) Prick to prick test for fresh food
D) Double blinded food challenge test
D) Double blinded food challenge test
A 65-year-old female presented to the ER with cough and fever for 3 days duration. She was diagnosed as a case of lobar pneumonia. What is the most likely causative organism? A) Staph. Aureus B) Strept. Pneumonia C) MTB D) Haemophilus influenzae
B) Strept. Pneumonia
The alveoli should be dry for proper gas diffusion across the respiratory membrane. Which of the following factors play a key role in preventing the net fluid drainage from pulmonary capillaries?
Hydrostatic pressure is low in pulmonary capillaries, thus favors reabsorption of fluid
What allows the expansion of blood vessels in the lung? A) Pulmonary artery B) Pulmonary ligament C) Cervical pleura D) Costal pleura E) Diaphragmatic pleura F) Endothoracic fascia G) Hilum H) Primary bronchus
B) Pulmonary ligament
A 49-year-old man with long standing pulmonary TB is recently discovered to have massive proteinuria associated with ascites and lower limb edema. Lab tests showed marked hypoalbuminemia? A) Systemic amyloidosis B) Miliary TB C) adrenal TB D) pott’s disease
A) Systemic amyloidosis
What tells you about the population size in Kaplan-meyers graph?
a. Size of steps
b. Cumulative incidence of the two groups
c. Median survival rate of the two groups
a. Size of steps