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Respiratory module Exams > 2017 end of module exam > Flashcards

2017 end of module exam Flashcards

1
Q

Which of the following receptors is strongly associated with a coughing reflex due to an object irritating the respiratory tract?

A- C-fiber receptors

B- Alpha/Gamma receptors

C- Rapidly adapting receptors

D- Strong cough mechanoreceptors

A

-

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2
Q

56 yr old Indian woman presented with chronic cough, night sweets, and weight loss (for four months *not sure*) she took isoniazid only but here condition relapse

  1. S. Pneumonia
  2. M. Pneumonia
  3. MTB
A
  1. MTB
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3
Q

Of those with LITB (non-HIV) what is the % that they will get the disease again

A

-

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4
Q

What is the source of infection with MTB among older people in developing countries?

A) Activation of latent TB

B) Crowded household and workplace

C) Living with a patient with TB

D) Unavailability of anti-TB drugs

A

-B) Crowded household and workplace

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5
Q

Which lipoxygenase requires flap for its activity?

  1. -lipoxinA4
  2. -leukotrien
  3. -5-Lipoxygenase
A
  1. -5-Lipoxygenase
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6
Q

low o2 low co2 dlco 22 (predicted 28)

  1. hypoventilation
  2. diffusion limitation
  3. shunt
  4. v/q
A
  1. diffusion limitation
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7
Q

Which of the following nucleic base is mostly affected with the exposure of aromatic hydrocarbons

A- Adenine

B- Guanine

C- thymine

D- cytosine

A

B- Guanine

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8
Q

A 45 yr old female asian origin non smoker with peripheral mass on x ray. Fine need aspirate indicates adenocarcinoma. Which mutation determines the response to tyrosine kinase inhibitors?

  1. EGFR
  2. P53
  3. KRAS
A
  1. EGFR
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9
Q

A 5 year old boy with symptoms of epiglottitis. Gram stain shows gram negative cocobacilli. What is the causative agent?

  1. S. Pneumoniae
  2. H. Influenzae
  3. Neisseria meningitis
A
  1. H. Influenzae

S. pneumonia is gram +ve, lancet shaped

N. meningitis is gram -ve, coccus

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10
Q

What is the final phase in the pathophysiology of interstitial lung disease?

A) accumulation of WBS in the interstitial space

B) accumulation of protein rich fluid in the interstitial space

C) accumulation of macrophages in the interstitial space

D) destruction of alveolar septum

E) diffuse interstitial fibrosis leading to honeycomb appearance

A

D) destruction of alveolar septum

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11
Q

Which drug class causes adrenal suppression in children?

A. Xanthine derivatives

B. Corticosteroids

C. Anti-leukotrienes

D. B2 adrenoreceptor agonists

E. Muscuranic receptor antagonists

A

B. Corticosteroids

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12
Q

A 5 year old came to the ER with epiglottitis and lab investigations were done and came back with gram negative cocobacilli what is the causative agent?

A- streptococcus agalactiae

B- neisseria gonorrhoeae

C-streptococcus pneumoniae

D- haemophilus influenzae

A

D- haemophilus influenzae

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13
Q

What is the action of antihistamine in treatment of acute urticaria?

B. Block release of histamine from mast cells

C.block vascular permeability

A

C.block vascular permeability

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14
Q

Subpleural pulmonary lesion and associated enlarged hilar lymph node that underwent calcification in a person with tb

  1. ghons focus
  2. Ghons complex
  3. Simon focus
  4. Ranke complex
A
  1. Ranke complex
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15
Q

What’s the component of surfactant that plays a major role in reduce the Surface tension?

A

DPPC ( dipalmitoylphosphatidylcholine )

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16
Q

Drug of choice in a Pt with strep pharyngitis who is allergic to penicillin

A. Acyclovir

B. Cefotaxime

C. Ampicillin

D. Erythromycin

A

C. Ampicillin

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17
Q

what is the most appropriate drug to treat motion sickness ?

A diphenhydramine

B doxylamine

C laratidine

A

A
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18
Q

Which nerve innervates the peripheral part of the diaphragm?

  1. Vagus
  2. Intercostal
  3. Phrenic
A
  1. Intercostal
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19
Q

70 year old healthy man with progressive dyspnea for last few months. On Xray he had diffuse reticular pattern. What is the proper investigation to do ?

  1. Positron emission limited
  2. Ultra-scan chest
  3. HRCT scan
  4. V/Q nuclear study
A
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20
Q

Which muscle elevate the larynx?

A

Mylohyoid

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21
Q

In cardiopulmonary test ; as hr increases oxygen pulse and vo2 increase, in which case does a rapid increase in hr happen with very slight increase in vo2 and oxygen pulse?

  1. Anxiety
  2. Low sv
  3. Something related to ventilation
A
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22
Q

A 23 year old male presented with 6 months of intermittent symptoms of coughing, wheezing, and chest tightness. There was no fever or weight loss. He smokes 20 ciggs per day since the age of 17. His chest radiograph was normal. Physical examination revealed bilateral prolonged expiratory phase with wheezing. What is the next best step in diagnosis?

A) Pre and Post Spirometry

B) Methacholine challenge test

C) measurement of lung volumes

D) DLCO measurement

A
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23
Q

What happens to the blood gases when living in high altitude for a long period of time

  1. High CO2 high HCO3
  2. No change
  3. Low CO2 low CO3
  4. Low CO2 high CO3
A
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24
Q

In the supressive action of cough, why is dextromethorphan better than codeine?

A. It can be taken orally

B. It also has an expectorant effect

C. It also has analgesic effects

D. It doesn’t inhibit ciliary activity

E. It doesn’t penetrate the CNS

A
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25
Q

What is the diagnostic feature of biopsy of middle aged man with progressive chronic bronchitis?

A

Hyperplasia of mucus gland in bronchial wall

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26
Q

if perfusion was almost zero, and ventilation is preserved, what happens to PAO2?

A) close to atmospheric oxygen

B) close to zero

A
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27
Q

20 year old female, persistent cough and hemoptysis. Bronchoscopy showed round mass protruding into the bronchi. Biopsy showed monomorphic cells with salt and pepper chromatin. What other morphological feature would you expect

  1. High mucin content
  2. High keratin
  3. Collagen
  4. Adenoid tissue
  5. Neuro secretory granules
A
  1. Neuro secretory granules
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28
Q

Which structure is mainly affected in emphysema?

  1. Primary bronchi
  2. Secondary bronchi
  3. Bronchioles
  4. Alveoli
A
  1. Alveoli
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29
Q

Which nerve carries general sensation of periphral diaghragm ?

  1. Lower intercostal
  2. Vagus nerve
  3. Upper limb nerve
  4. Phrenic nerve
A
  1. Lower intercostal
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30
Q

In which respiratory disease does the diffusing capacity of carbon monoxide DLCO often increases

  1. ideopathic pulmonary fibrosis
  2. chronic bronchitis
  3. asthma
  4. compression of the pulmonary artery
A
  1. asthma
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31
Q

Which of the following play a role in preventing net fluid drainage from pulmonary capillaries?

A

High oncotic pressure

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32
Q

Why is it more common for abcesses to form in the right lung

  1. Recieves less blood flow
  2. Right main bronchus is more vertical
  3. has 2 lobes
  4. has less branches from bronchus
A

2, Right main bronchus is more vertical

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33
Q

Which one of these nerves supply the bronchi?

  1. Vagus nerve
  2. Phrenic nerve
  3. Intercostal nerve
A
  1. Vagus nerve
34
Q

Last stage in ILD

A

Fibrosis

35
Q

Which receptor doesn’t cause mast cell degranulation?

  1. H2
  2. C5a
  3. C3a
A
  1. H2
36
Q

non caseating granuloma + asteroid bodies

  1. Sarcoidosis
  2. Berylliosis
A
  1. Sarcoidosis
37
Q

what stains pneumocystis jirovici?

  1. grammucurine oil
  2. red omasson
  3. trichrome
  4. gomori methanamine silver
A

gomori methanamine silver

38
Q

A 2 year old was diagnosed with brochopneumonia. Sputum culture should growth only on chocolate agar.

  1. A. Streprococcus pneumoniae
  2. B. Hemophillus influenzae
  3. C. Chlamydia pneumoniae
  4. D. Pseudomonas aeruginosa
A

B. Hemophillus influenzae

39
Q

What is the best lung parameter to measure/identify restrictive lung disease ?

  1. TLC
  2. FEV1
  3. FEV1/FVC ratio
  4. DLCO
A
  1. TLC
40
Q

Which of the clinical scenario is “Centri-acinar emphysema” commonly seen ?

  1. Chronic heavy tobacco smoking
  2. Alpha-1 antitrypsin deficiency
  3. Severe childhood asthma
  4. History of drug abuse
A
  1. Chronic heavy tobacco smoking
41
Q

A (60 yr old ?) woman came to the ED with 3 months of fever and cough. Gram stain showed gram positive dipococci. What is the causative organism?

  1. S. Pneumonia
  2. H. Influenzae
  3. S. Aureus
A
  1. S. Pneumonia
42
Q

Which laryngeal muscle is affected when the external laryngeal nerve is damaged?

  1. Cricothyroid
  2. Posterior cricoarytenoid
  3. Lateral cricoarytenoid
A
  1. Cricothyroid
43
Q

A 15 year old boy was diagnosed with pneumonia caused by Mycoplasma Pneumoniae, what antibiotic should be given?

  1. ampicillin
  2. amikacin
  3. erythromycin
  4. vancomycin
A
  1. erythromycin
44
Q

Which of the following causes hypoxia with AaDO2 almost near zero?

  1. hypoventilation
  2. right to left shunt
  3. diffusion impairment
  4. V/Q mismatch
A
45
Q

What stage of lobar pneumonia is characterized by progressive disintegration of red blood and persistence of fibirno-suppurative exudate?

  1. congestion
  2. red hepatization
  3. gray hepatization
  4. resolution
A
  1. gray hepatization
46
Q

Which of the following is released by T-regs

  1. IL-2
  2. IL-3
  3. IL-8
  4. IL-10
A
  1. IL-10
47
Q

Which type of Tcell is involved in innate immunity?

  1. alpha beta
  2. gamma delta
  3. Treg
  4. CD8+
A
  1. gamma delta
48
Q

what condition causes air in the stomach of an infant?

A

Tracheoesophageal fistula

49
Q

Which condition cause pleural pressure to be positive :

  1. A- end of inspiration at TLC
  2. B- during inspiration at FRC
  3. C- end of forced expiration at RV
  4. D- during forced expiration at FRC
A
50
Q

What is the genetic cause of PCD that causes defected ciliary clearance and mislocated axonoemal structure?

A

CCDC40

51
Q

What is the function of the proximal histidine ?

  1. Attached to heme
  2. Attached to o2
  3. Critical for the attachment of the tetramer subunits
A
  1. Attached to heme
52
Q

A 45 year old female, with normal vital capacity (VC). What is the most likely diagnosis from this diagram?

  1. fixed Intrathoracic obstruction
  2. variable Intrathoracic obstruction
  3. fixed extrathoracic obstruction
A
53
Q

Which afferent fibers work to terminate inspiration during breathing?)

  1. c-fibers nociceptors
  2. a-delta nociceptors
  3. slowly adapting receptors
A
54
Q

What dimension is changed by the pump movement?

  1. 1- transverse
  2. 2- anterioposterior
  3. 3- vertical
  4. 4- certcal-transvers
A

1- transverse

55
Q

A 50-year old male presented with massive hemoptysis. Chest X-ray revealed a thick walled cavity lesions in the apex of the right lung. What are the possible factors responsible for the tissue destruction?

  1. antimicrobial peptides
  2. inducable nitric oxide synthase
  3. tumor necrosis factors
A
56
Q

Which of these drugs is associated with optic neuritis?

A

Ethambutol

57
Q

Which group of drugs causes adrenal insufficiency in children?

A

Corticosteroids

58
Q

What is the origin of inferior phrenic artery?

  1. Thoracic aorta
  2. abdominal aorta
  3. subcostal artery
A
  1. abdominal aorta
59
Q

In a rat brain, If the pons and vagus nerve is cut, what will happen to breathing pattern

  1. Breathing stops
  2. Breathing maintained but irregular
  3. Breathing prlonged
  4. Breathing is normal
A
60
Q

Best lung function parameter to determine obstructive lung disease?

  1. TLC
  2. FVC
  3. FEV1/FVC
  4. DLCO
A
  1. FEV1/FVC
61
Q

Best lung function parameter to determine restrictive lung disease?

  1. TLC
  2. FVC
  3. FEV1/FVC
  4. DLCO
A
  1. FVC
62
Q

When a child understands that death is functional and irreversible ?

1) 5 years
2) 8 years
3) 10 years
4) 14 years

A

3) 10 years

63
Q

A 65 y/o male with lung cancer; has ptosis, myosis, & anhydrosis. What is the location of his tumor?

  1. Upper part of lower lobe
  2. Right main bronchus
  3. Lower part of upper lobe
  4. Apex
A
  1. Apex
64
Q

A 15 months old boy presented with tachpnea, dyspnea, low grade fever, sneezing, the chest radiograph revealed hyperinflation.

  1. Adenovirus
  2. Influenza
  3. RSV
A

RSV

65
Q

What is the main structure affected in bronchial asthma?

  1. Prim bronchus
  2. Sec bronchus
  3. Bronchioles
  4. Alveoli
A
  1. Bronchioles
66
Q

What is true about fetal Hg?

  1. It has high binding affinity for 2,3 BGP compared to A Hg
  2. It facilitates the transport from maternal to fetal
  3. it has decreased …?
A
  1. It facilitates the transport from maternal to fetal
67
Q

A patient is infected with Pneumocystis jirovecii, what special stain is used?

A

Gomori methenamine silver (GMS) stain

68
Q

Which cell is involved in mediating the innate immune response in TB?

    • T regs
    • CD8
    • aplha-beta
    • delta gamma
A
    • delta gamma
69
Q

Patient with lung cancer or carcimoma “not sure” has miosis, ptosis enhydrosis. Which part of lung cancer affect?

  1. -Lower part of upper lobe
  2. -Apex of lung
  3. -Upper part of lower lobe
A
  1. -Apex of lung
70
Q

which if these produced by 5-LOX has anti- inflammatory effect?

  1. leukotrien A4
  2. lipoxin A4
  3. prostaglandin
  4. thromboxane
A
  1. lipoxin A4
71
Q

What is multi-drug resistant mycrobacterium TB?

A

does not respond to at least isoniazid and rifampicin

72
Q

Physio question: what is shown on the graph (a flow-volume loop) the answers were

  1. variable extrathoracic
  2. variable intrathoracic
  3. Normal
A

1- Variable Extrathoracic

73
Q

What is the mechanism of hypoxic vasoconstriction

  1. variable extrathoracic
  2. variable intrathoracic
  3. Normal
A

1- Variable Extrathoracic

74
Q

What is the mechanism of hypoxic vasoconstriction”
A) decrease Ca conduction
B) decrease K conduction

A

B) decrease K conduction

75
Q

Where would you see hyaline formation in the lungs?

A

Viral Infections - ARDS

76
Q

Which of these is an example of delayed type hypersensitivity reaction?

  1. Contact dermatitis
  2. Anaphylaxis
A

Contact dermatitis

77
Q

Military spread limited to the lungs can occur following erosion of a vessel wall by tuberculous lung lesions.which of the following vessels is most likely to be involved ?

  1. Pulmonary veins
  2. Pulmonary arteries
  3. Systemic veins
  4. Systemic lymphatics
A
78
Q

56 yr old Indian woman presented with chronic cough, night sweets, and weight loss (for four months *not sure*) she took isoniazid only but here condition relapse ?

  1. S. Pneumonia
  2. C. Pneumonia
  3. MTB
A

MTB

79
Q

27) What percentage of long-term smokers die from smoking-related diseases?

  1. 5%
  2. 10%
  3. 25%
  4. 50%
  5. 75%
A
  1. 50%
80
Q

Which one is anti inflammatory

  1. LipoxinA4
  2. Lleukotrien
A

LipoxinA4

81
Q
A

Respiratory module Exams (10 decks)

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