Pulmonology

Question 1

The factor that mostly effects the prognosis of a COPD patient is:
A) The continuation of smoking
B) The reversibility of obstruction when using steroids
C) The degree of hypoxia
D) The value of FEV1
E) The presence of hypercapnia

Answer 1

D) The value of FEV1

Question 2

In case of suspected chronic obstructive pulmonary disease, the most important examination that can confirm the diagnosis is:
A) The determination of the daily amount of sputum
B) Physical examination
C) Chest radiograph
D) Pulmonary function testing
E) Blood gas analysis

Answer 2

D) Pulmonary function testing

Question 3

From the following symptoms which one is the most typical for bronchiectasis?
A) Cough
B) Large amount of (>50-100 ml/day), often purulent expectoration
C) Hemoptysis
D) Chest pain
E) Dyspnea

Answer 3

B) Large amount of (>50-100 ml/day), often purulent expectoration

Question 4

From the following medication groups which one can significantly inhibit the production of mucus?
A) Theophylline
B) β2-adrenergic receptor agonists
C) Non-selective β2-blockers
D) Anticholinergics
E) Furosemide

Answer 4

C) Non-selective β2-blockers

Question 5

Medications for the rapid treatment of asthma attacks:
A) Sedatives
B) Bronchodilators
C) Antihistamines
D) Corticosteroids
E) Chromoglycate

Answer 5

B) Bronchodilators

Question 6

Which of the following answers is not correct?
A) Regular administration of a short-acting β2-receptor agonist bronchodilator is preferred to administration as needed.
B) Inhaled β2-agonists reach their maximal bronchodilator effect within minutes (in 5-15 minutes).
C) The efficiency of inhalation bronchodilator aerosols can be enhanced, if the patient inhales them through an inhalation piece (nebuhaler).
D) The duration of effect of long-acting inhaled β2-receptor agonist products is between 10-12 hours.
E) The most effective medications in case of bronchoconstriction are β-receptor stimulant bronchodilators.

Answer 6

A) Regular administration of a short-acting β2-receptor agonist bronchodilator is preferred to administration as needed.

Question 7

In case of a 56-year-old, alcoholic, heavy smoker male patient with recurrent fever and cough, followed by large amount of purulent expectoration, weight loss, chest pain and poor general condition has occured. His chest x-ray shows a right upper lobe shadow with fissure formation. The most likely pathogen that caused the pneumonia with above-described clinical picture is:
A) Streptococcus pneumoniae
B) Mycoplasma pneumoniae
C) Staphylococcus aureus
D) Klebsiella pneumoniae
E) Mycobacterium tuberculosis

Answer 7

D) Klebsiella pneumoniae

Question 8

The size of the hyperergic tuberculin reaction among the vaccinated population is (the largest diameter perpendicular to the longitudinal axis of the induration):
A) > 10 mm
B) > 15 mm
C) > 20 mm
D) > 25 mm
E) > 30 mm

Answer 8

B) > 15 mm

Question 9

In case of newly discovered lesion, which is the size of an infant’s palm, inhomogeneous, right apical, clinically considered as TB, but is negative to Mycobacterium with direct sputum test and with PCR, which one is the recommended sufficient drug combination?
A) INH + RAMP + PZA
B) INH + RAMP
C) INH + PZA
D) INH + PZA + RAMP + EMB
E) INH + EMB

Answer 9

A) INH + RAMP + PZA

Question 10

Which antibiotic from the followings is most likely to cause hepatitis?
A) INH
B) PZA
C) RAMP
D) PAS
E) EMB

Answer 10

B) PZA

Question 11

Principles used in the treatment of multidrug-resistant TB patients, except:
A) At least three drugs to which the isolated bacteria are sensitive should be used.
B) First-line antituberculotic treatment should be used primarily.
C) The medication is supplemented with secondary antituberculotics to achieve a combination of four drugs.
D) At least 3-3 microscopic examinations and culture tests should be performed every three months during treatment.
E) A resistance test is need to be performed from the cultures.
F) After bacterial testing came back negative, the treatment must be continued for at least one more year.
G) Surgical solution must be considered.

Answer 11

D) At least 3-3 microscopic examinations and culture tests should be performed every three months during treatment.

Question 12

Which treatment is contraindicated in the treatment of pulmonary embolism during pregnancy?
A) O2 addition
B) bedrest
C) early mobilization
D) administration of Syncumar
E) administration of heparin

Answer 12

D) administration of Syncumar

Question 13

Characteristics of primer pulmonary hypertension, except:
A) progressive disease of young women
B) exertional, then resting dyspnea
C) high pulmonary wegde pressure
D) Raynaud’s phenomenon
E) effort syncope
F) right ventricular failure
G) chest pain

Answer 13

C) high pulmonary wegde pressure

Question 14

Characteristics of acute cor pulmonale, except:
A) consequence of pulmonary embolism
B) consequence of severe acute asthma
C) echocardiography shows dilated, thin walled right ventricle
D) echocardiography shows hypertrophic dilated right ventricle
E) the consequence of acute increase of right ventricular pressure

Answer 14

D) echocardiography shows hypertrophic dilated right ventricle

Question 15

In which condition could ’Birbeck’s granulomas’ be typically detected from bronchoalveolar lavage by electron microscopy or may be the ratio of CD1-positive cells above 3%?
A) alveolar microlithiasis
B) Goodpasture syndrome
C) Hamman-Rich syndrome
D) histiocytosis X
E) alveolar proteionosis

Answer 15

D) histiocytosis X

Question 16

In which condition is pleural exudate most likely expected?
A) heart failure
B) nephrosis
C) cirrhosis hepatis
D) peritoneal dialysis
E) pulmonary embolism

Answer 16

E) pulmonary embolism

Question 17

All of the following conditions may cause mediastinal lymph node enlargement, except:
A) Hodgkin’s disease
B) Non-Hodgkin’s lymphomas
C) Toxoplasma gondii infection
D) Sarcoidosis
E) Pneumonia

Answer 17

E) Pneumonia

Question 18

Symptoms of superior vena cava syndrome, except:
A) swelling of the head
B) cyanosis
C) development of thoracic collateral circulation
D) arrhythmia
E) heavy breathing

Answer 18

D) arrhythmia

Question 19

Characteristic of respiratory failure based on hypoventilation, except:
A) May be a consequence of neuromuscular disease
B) The degree of hypoxia is not similar to the degree of hypercapnia
C) May be caused by chest deformity
D) Ventilation pulmp failure
E) May be a consequence of obesity

Answer 19

B) The degree of hypoxia is not similar to the degree of hypercapnia

Question 20

In the following conditions respiratory failure is predominantly due to diffusion failure, except:
A) fibrotic alveolitis
B) sarcoidosis
C) alveolar cell carcinoma
D) COPD
E) irradiation damage

Answer 20

D) COPD

Question 21

Characteristic of trachea dyskinesis:
A) predispose to barking cough
B) common cause of cough
C) usually curable by surgery
D) precancerosis
E) relieved by antihistamines

Answer 21

A) predispose to barking cough

Question 22

Which one of the following clinical signs is not characteristic of sleep apnea?
A) daytime sleepiness
B) intellectual- and personality changes
C) loud snoring at night
D) elevated blood glucose level
E) hypertonia
F) obesity

Answer 22

D) elevated blood glucose level

Question 23

Tuberculosis infections can occur in the following ways, with one exception. Mark the exception.
A) trough airways
B) alimentary infection (by the consumption of contaminated food)
C) percutaneous (contact with the skin)
D) transplacental (through the placenta)
E) genital contact

Answer 23

D) transplacental (through the placenta)

Question 24

Which one of the following can lead to chronic cor pulmonale?
A) lobar pneumonia
B) pulmonary venous thromboembolism
C) pulmonary edema
D) chronic obstructive pulmonary disease
E) bronchopneumonia

Answer 24

D) chronic obstructive pulmonary disease

Question 25

Symptoms of Goodpasture-syndrome, except:
A) focal glomerulonephritis
B) septic spleen
C) pulmonary fibrosis, induration
D) cutaneous purpura
E) Prussian blue staining in lung parenchyma

Answer 25

B) septic spleen

Question 26

All the followings are possible complications of chronic obstructive pulmonary disease (COPD), except:
A) cor pulmonale
B) polycythaemia
C) respiratory failure
D) left ventricular dysfunction
E) bronchogenic carcinoma

Answer 26

D) left ventricular dysfunction

Question 27

Depending on the pathological changes in the lung, chronic obstructive pulmonary disease (COPD) can manifest as emphysema or bronchitis. Although these two COPD-syndromes rarely manifest as independent diseases, by definition they can be separated based on the clinical features. Which one of the following symptomes is common in both COPD’s bronchitic and emphysematous phenotype?
A) polycythaemia
B) airflow improvement with bronchodilators
C) dyspnoea
D) chronic cough
E) hypercapnia

Answer 27

C) dyspnoea

Question 28

Which statement is not true about the autonomic innervation of the respiratory tract?
A) Parasympathetic nerves control the main mechanisms of bronchoconstriction.
B) Sympathetic nerves control the main mechanisms of bronchodilatation.
C) Acetylcholine is the primary mediator of parasympathetic postganglionic neurons.
D) Noradrenaline is the primary mediator of sympathetic postganglionic neurons.
E) Slightly increased cholinergic resting bronchial tone is physiological.

Answer 28

B) Sympathetic nerves control the main mechanisms of bronchodilatation.

Question 29

Inhalation of non-selective cholinergic antagonists can paradoxically provocate bronchoconstriction. Inhibition of which receptor is responsible for this rare reaction?
A) M1
B) M2
C) M3
D) NA
E) Beta2-adrenergic

Answer 29

B) M2

Question 30

How do anticholinergic bronchodilators exert their bronchial smooth muscle relaxing effect?
A) by facilitating sympathetic neuromuscular transmission
B) by inhibiting sympathetic neuromuscular transmission
C) by facilitating parasympathetic neuromuscular transmission
D) by inhibiting parasympathetic neuromuscular transmission
E) by direct effect

Answer 30

D) by inhibiting parasympathetic neuromuscular transmission

Question 31

Which one of the following function is not characteristic of pulmonary surfactant?
A) stabilizing alveoli and bronchi during exspiration (anti-atelectasis)
B) maintaining the alveolo-bronchial clearance
C) enhancing alveolar macrophage function
D) enhancing the colonisation of particular viruses and bacteria
E) increasing bronchial clearance by reducing the adhesion between sol and gel phase of the fluid covering the bronchial walls

Answer 31

D) enhancing the colonisation of particular viruses and bacteria

Question 32

Which statement is not true?
A) Alveoli can be found on the walls of bronchioles distal to the terminal bronchioles.
B) The terminal bronchiole is divided into two respiratory bronchioles.
C) The third-generation of respiratory bronchioles are divided into alveolar ducts.
D) Alveolar ducts can also originate from first-generation respiratory bronchioles.
E) Airways distal to the terminal bronchioles are called conductive airways.

Answer 32

E) Airways distal to the terminal bronchioles are called conductive airways.

Question 33

Which statement is not true?
A) The average diameter of terminal bronchiole is 0,6 mm.
B) The wall of the bronchioles do not contain cartilage.
C) The lung unit provided by terminal bronchioles is called acinus.
D) The basis diameter of acinus is 0,5–1 cm.
E) The unit provided by the third-generation respiratory bronchioles is the terminal respiratory unit.
F) An acinus contains 8-10 lobules.
G) The average airspace of an acinus is 0,2 ml

Answer 33

F) An acinus contains 8-10 lobules.

Question 34

The main features of cells, which cover airways, except for:
A) Clara cells are secretory cells, which do not contain cilium and are predominantly presented in the terminal bronchioles.
B) Kulchitsky cells produce biogenic amines.
C) Type I pneumocytes produce surfactant.
D) The number of goblet cells in the bronchi decreases towards the periphery.
E) In case of chronic irritation goblet cells may also appear in the bronchioles.

Answer 34

C) Type I pneumocytes produce surfactant.

Question 35

Which statement is not true?
A) The average ventilation/perfusion ratio is 0,8.
B) Ventilation of basal areas is low compared to the perfusion.
C) Perfusion of apical areas is very low compared to the ventilation.
D) The normal alveolar ventilation is 8l.
E) Alveolar hypoventilation is characterized by the elevation of CO2 in the arterial blood.

Answer 35

D) The normal alveolar ventilation is 8l.

Question 36

Which of the following metabolic functions does not occur in the lungs?
A) Production of prostaglandins
B) Production of arylsulphatase-B
C) Production of leukotrienes
D) Hormone production
E) Conversion of angiotensin I to angiotensin II
F) Hypoxaemia-induced erythropoietin production
G) Deamination of serotonine
H) Production of thromboplastin

Answer 36

F) Hypoxaemia-induced erythropoietin production

Question 37

Which of the following cells plays a central role in the pathogenesis of bronchial asthma?
A) neutrophil granulocyte
B) eosinophil granulocyte
C) monocyte
D) histiocyte
E) plasma cell

Answer 37

B) eosinophil granulocyte

Question 38

The most common stimulus which triggers exercise-induced asthma is:
A) running in cold air
B) using stationary bicycle
C) swimming
D) hall football
E) hall aerobic

Answer 38

A) running in cold air

Question 39

Which of the following cells is the most important antigen presenting cell in asthma?
A) T-lymphocyte
B) alveolar macrophage
C) dendritic cell
D) epithel cell
E) endothel cell

Answer 39

C) dendritic cell

Question 40

Which parameter goes first to normal range in case of the adequate treatment of community-acquired pneumonia?
A) fever
B) cough
C) auscultation
D) CRP
E) leukocytosis

Answer 40

D) CRP

Question 41

Which virus can be the cause of pneumonia in transplanted patients and which one of the risk factors of rejection?
A) CMV
B) adenovirus
C) flu virus
D) EBV
E) RSV

Answer 41

A) CMV

Question 42

The features of aspiration pneumonia are:
A) Community-acquired aspiration pneumonia is most commonly caused by aerob bacterias.
B) The clinical manifestation includes pneumonitis, necrotising bronchopneumonia and pulmonary abscess.
C) Leukocytosis is not a characteristic feature.
D) In diagnostic, the hemoculture has a main role because of its good sensitivity and specificity.
E) The first choice is aminoglycoside antibiotic treatment.

Answer 42

B) The clinical manifestation includes pneumonitis, necrotising bronchopneumonia and pulmonary abscess.

Question 43

Which bacteria is NOT the cause of pulmonary gangraena?
A) Klebsiella pneumoniae
B) Anaerob bacterias
C) Mycobacterium marinum
D) Hemophilus influenzae
E) Staphylococcus aureus

Answer 43

C) Mycobacterium marinum

Question 44

Which one of the followings is an exclusion criteria in lung transplantation?
A) idiopathic, non-treated, end-stage pulmonary disease
B) confused psychical status, unsettled severe social status
C) significantly reduced life expectancy without the surgery
D) acceptable nutritional status
E) severe pulmonary arterial hypertension

Answer 44

B) confused psychical status, unsettled severe social status

Question 45

Which one of the followings is NOT the indication of lung transplantation?
A) end-stage pulmonary fibrosis
B) pulmonary sepsis
C) severe emphysema due to α-1 antitrypsin deficiency
D) pulmonary arterial hypertension
E) severe COPD with pulmonary hypertension

Answer 45

B) pulmonary sepsis

Question 46

Which disease is not solved by lung transplantation alone?
A) Eisenmenger-syndrome
B) severe bilateral bronchiectasis with severe symptoms
C) pulmonary arterial hypertension
D) secundery pulmonary hypertension

Answer 46

A) Eisenmenger-syndrome

Question 47

What situation can be an indication for combined heart and lung transplantation, if the adequate severity criteria are present?
A) congenital heart defect combined with Eisenmenger-syndrome
B) cystic fibrosis
C) severe emphysema caused by α-1 antitrypsin deficiency
D) end-stage pulmonary fibrosis
E) pulmonary arterial hypertension

Answer 47

A) congenital heart defect combined with Eisenmenger-syndrome

Question 48

What is the chance of CMV pneumonia among lung transplanted patients without specific drug therapy?
A) 25%
B) 18%
C) 50%
D) 80%
E) 90%

Answer 48

C) 50%

Question 49

When does the bacterial pneumonia occurs the most commonly after lung transplantation?
A) 0–3 months
B) 2–12 weeks
C) 1–3 months
D) 9 days –2 months
E) the first 2 weeks

Answer 49

A) 0–3 months

Question 50

How often do fungal infections occur after a lung transplantation?
A) 30%
B) 10–22%
C) 23–30%
D) less, than 5%
E) 50%

Answer 50

B) 10–22%

Question 51

The most common respiratory symptoms of thyreotoxicosis are the following, except:
A) increased consumption of oxygen and increased production of carbon dioxide
B) decreased vital capacity
C) increased lung compliance
D) the enlarged thyroid compresses the trachea
E) dyspnea

Answer 51

C) increased lung compliance

Question 52

How does hypothyreoidism affects the respiration?
A) It dilates the airways.
B) It decreases the central reaction to hypoxaemia and hypercapnia.
C) It increases the vital capacity.
D) It increases the FEV1.
E) It decreases the diffusing capacity.

Answer 52

B) It decreases the central reaction to hypoxaemia and hypercapnia.

Question 53

The general principles of treating pregnant asthmatic pregnant patients are the following, except:
A) avoiding symptom-tirggers (eg. dust mite, animals, infections, pollen etc.)
B) isolation of the patient from the environment
C) follow-up of symptoms
D) adequate drug treatment
E) monitoring the actual status with peak flow meter

Answer 53

B) isolation of the patient from the environment

Question 54

The following are included in the treatment of status asthmaticus in asthmatic pregnant patients, except:
A) oxygen
B) short acting beta-agonist
C) succinyilcholine
D) methylprednisolone
E) intravenous fluid replacement with magnesium

Answer 54

C) succinyilcholine

Question 55

Doctors notice a 2 cm (diameter) nodule with calcification in the lung of a young woman. What origin could we suspect?
1) tuberculoma
2) metasasis of ovarian cancer
3) hamartoma
4) Echinococcus cyst
5) bronchopneumonia

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 55

C) only the 1. and 3. answers are correct

Question 56

Doctors discover a cavern in the top of the lower lobe during a screening x-ray of a 52 years old man. The previous screening was negative. What can we think of?
1) tuberculotic cavern
2) lung cyst
3) disintegrating lung cancer
4) aspergilloma
5) metastasis of colon carcinoma

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 56

C) only the 1. and 3. answers are correct

Question 57

Unilateral broadening of hilum can be caused by:
1) central lung cancer
2) mediastinal tumor
3) malignant lymphoma
4) lymphangioleiomyomatosis
5) histiocytosis

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 57

A) only the 1., 2. and 3. answers are correct

Question 58

Bilateral broadening of hilum can be caused by:
1) idiopathic interstitial pneumonia
2) sarcoidosis
3) Wegener-granulomatosis with polyangiitis
4) bronchial carcinoma
5) alveolar microlithiasis

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 58

D) only the 2. and 4. answers are correct

Question 59

Which conditions need to co-exist for long-term steroid therapy to be recommended in COPD?
1) A more than 10% increase of FEV1 after two weeks of 24-32mg oral steroid treatment in a period without exacerbations.
2) No significant reversibility while using beta2-agonist.
3) The patient’s overall condition is not satisfactory without steroid.
4) Persistent airway obstruction is present.
5) The patient has theophyllin intolerance.

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 59

C) only the 1. and 3. answers are correct

Question 60

The FEV1 value of a 50-year-old smoker male COPD patient is 30% of the reference value. Immediately after administration of a beta2-agonist it changes to 34%, after 2 weeks of steroid treatment to 39%, while arterial O2 tension is 55 mmHg. What treatment is the most important in increasing the survival?
1) regular administration of a short-acting inhaled beta2-agonist
2) smoking cessation
3) regular administration of an inhaled steroid
4) long-term home O2 therapy
5) long-term oral steroid therapy

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 60

D) only the 2. and 4. answers are correct

Question 61

What are common signs in emphysema and in exercise-induced asthma?
1) Reversible respiratory obstruction to beta2-agonist
2) Dyspnoea shortly after stopping exercise
3) Dyspnoea after 6-10 minutes of exercise
4) Exercise-induced dyspnoea
5) Increasing limitation of exhaled flow during exercise

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 61

E) only the 4. answer is correct

Question 62

The following statements apply to chronic obstructive pulmonary disease (COPD):
1) airway obstruction caused by chronic bronchitis
2) may be accompanied by respiratory hyperreactivity
3) decreased FEV1
4) decreased FIV1
5) seizure-like dyspnoea

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 62

A) only the 1., 2. and 3. answers are correct

Question 63

Medications for the continuous maintenance treatment of chronic asthma in moderate stage (Step 3):
1) use of an inhaled short-acting beta2-agonist as needed
2) continuous administration of inhaled corticosteroids
3) use of long-acting β2- agonist
4) regular administration of antihistamines
5) continuous administration of an oral steroid

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 63

A) only the 1., 2. and 3. answers are correct

Question 64

Which are the right answers?
1) The bronchodilator effect of theophylline application depends on the serum concentration.
2) The duration of the effect of retard theophylline is 10-12 hours.
3) Oral theophylline is used in mild asthma.
4) Therapeutic levels of theophylline in blood are between 5 and 15 µg / ml.
5) The metabolism of the drug shows great individual differences.

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 64

B) only the 1., 2., 4. and 5. answers are correct

Question 65

Effective drugs for the treatment of atypical pneumoniae (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila):
1) macrolides
2) fluoroquinolones
3) oxytetracyclin
4) beta-lactam antibiotics
5) aminoglycosides

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 65

A) only the 1., 2. and 3. answers are correct

Question 66

Which of the following is not a characteristic of pulmonary tuberculosis?
1) cough
2) weight loss
3) higher temperature
4) night sweats
5) bloodstained sputum

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 66

F) all of the answers are correct

Question 67

Which tests can prove the tuberculotic origin of pleuritis exsudativa within 3 days?
1) bacterial detection of punctate by PCR
2) thoracoscopy
3) pleurabiopsy
4) liquid cultures (eg BACTEC)
5) Ziehl-Neelsen’s sputum staining (sputum smear for the demonstration of acid-fast bacilli)

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 67

A) only the 1., 2. and 3. answers are correct

Question 68

In addition to the administration of antituberculotics, which corticosteroid treatment is not indicated?
1) primary tuberculosis complex
2) miliary tuberculosis
3) cervical lymph node tuberculosis
4) pleuritis exsudativa tuberculosa
5) toxic pulmonary tuberculosis

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 68

C) only the 1. and 3. answers are correct

Question 69

Characteristic of tuberculosis associated with HIV infection:
1) faster lymphatic and hematogenous dissemination
2) systemic disease is more common
3) the disease develops predominantly by activation of dormant bacteria and endogenous exacerbation
4) the proportion of extrapulmonary forms increases
5) the rate of false negative tuberculin skin test increases

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 69

B) only the 1., 2., 4. and 5. answers are correct

Question 70

Pulmonary diseases caused by Aspergillus:
1) allergic bronchopulmonary aspergillosis
2) aspergilloma
3) aspergillus asthma
4) chronic necrotizing pulmonary aspergillosis
5) bronchocentric granuloma

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 70

F) all of the answers are correct

Question 71

Treatment of invasive aspergillosis:
1) inhaled Amphotericin B
2) segmental resection
3) hyperbaric oxigen therapy
4) intravenous Amphotericin B
5) cavernostomy

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 71

E) only the 4. answer is correct

Question 72

From the symptoms listed below, which are typical of acute massive pulmonary embolism?
1) severe resting dyspnea
2) syncope
3) cough
4) central chest pain
5) cyanosis

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 72

B) only the 1., 2., 4. and 5. answers are correct

Question 73

Symptoms of pneumothorax (ptx) in general:
1) chest pain on the same side
2) cyanosis
3) dyspnea (maybe only exertional)
4) mediastinum deviating to the side of the ptx
5) wheezing

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 73

C) only the 1. and 3. answers are correct

Question 74

What is conventional therapy for diffuse malignant mesothelioma?
1) pleurodesis
2) chemotherapy
3) symptomatic treatment
4) radiotherapy
5) surgery

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 74

A) only the 1., 2. and 3. answers are correct

Question 75

Indication of mechanical ventilation:
1) NIF (Negative Inspiratory Force) < 20 H2Ocm
2) respiratory rate > 35–40/min
3) vital capacity < 65–70 ml/kg
4) PaCO2 > 55 Hgmm
5) O2-saturation < 90% by FiO2=0.6

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 75

B) only the 1., 2., 4. and 5. answers are correct

Question 76

Acute respiratory failure:
1) is always with CO2 retention
2) it can be the consequence of pneumonia
3) life-threatening acid-base imbalances are rare
4) a common consequence of acute exacerbation of chronic lung disease
5) it can always be well influenced by O2 therapy

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 76

D) only the 2. and 4. answers are correct

Question 77

Chronic respiratory failure:
1) develops over months, years
2) characterised by hypoxia and often hypercapnia
3) common consequence of COPD
4) due to compensationmechanisms, buffer bases are reduced
5) rare in fibrosis

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 77

A) only the 1., 2. and 3. answers are correct

Question 78

Typical for ARDS:
1) PO2/FiO2 < 200
2) always secondary disease
3) elevated pulmonary wedge pressure
4) refractory hypoxemia
5) leading symptom is the dyspnoea

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 78

B) only the 1., 2., 4. and 5. answers are correct

Question 79

Damage caused by smoke inhalation is characterized by:
1) upper airway edema
2) symptoms of CO intoxication
3) respiratory distress may develop after two days
4) immediate respiratory arrest
5) high temperature is the sole cause of symptoms

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 79

A) only the 1., 2. and 3. answers are correct

Question 80

Foreign body aspiration:
1) even the suspicion is a bronchoscopic indication
2) more common in childhood
3) can cause endobronchial granulation
4) requires preventive antibiotic treatment
5) can be excluded by chest CT scan

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 80

A) only the 1., 2. and 3. answers are correct

Question 81

The partial manifestation of Löfgren’s syndrome may be:
1) bilateral hilar lympadenopathy
2) erythema nodosum
3) polyarthralgia
4) pulmonary infiltrate
5) pleural effusion

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 81

A) only the 1., 2. and 3. answers are correct

Question 82

Which of the following can be associated with lung cancer?
1) hypercalcaemia
2) gynaecomastia
3) drumstick fingers
4) Cushing’s syndrome
5) Leukemia-like reaction

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 82

F) all of the answers are correct

Question 83

Can cause lung fibrosis:
1) amiodarone
2) bleomycin
3) nitrofurantoin
4) atrovent
5) colchicin

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 83

A) only the 1., 2. and 3. answers are correct

Question 84

Which of the following is true about sarcoidosis?
1) histologically epitheloid granuloma
2) hypergammaglobulinaemia is common in the active form
3) hilar lymphadenopathy is not always bilateral
4) shows no spontaneous regression
5) tuberculin test is mostly positive

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 84

A) only the 1., 2. and 3. answers are correct

Question 85

Functionally inoperable lung cancer is indicated by:
1) FEV1 <1 l
2) PaO2 <55 Hgmm
3) severe pulmonary hypertension
4) reduced CO-transfer coefficient
5) Increased TLC (total lung capacity)

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) only the 4. answer is correct
F) all of the answers are correct

Answer 85

A) only the 1., 2. and 3. answers are correct

Question 86

An asthmatic attack is accompanied by a characteristic sound phenomenon, (wheezing). The cessation of the acoustic phenomenon (silent lungs) indicates that the obstruction has ceased.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 86

C) The first one is correct in itself, but the second one is incorrect

Question 87

In case of suspected pulmonary embolism, pulmonary scintigraphy is recommended early because of its high information value and low radiation exposure.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 87

A) Both are correct, and there is a causal relationship between them

Question 88

Transthoracic fine needle biopsy is more efficient than bronchoscopy when diagnosing a peripheral pulmonary nodule, because the lesion is in the area of the bronchioles which can not be examined with bronchoscopy.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 88

A) Both are correct, and there is a causal relationship between them

Question 89

Arterialized capillary blood (from earlobe or fingertip) should be used for blood gas analysis when the patient is in shock, because arterial blood sample would show incorrect results due to the failure of circulation.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 89

E) Both are incorrect

Question 90

Acute severe asthma is an asthmatic state resistant to usual bronchodilator therapies, thus it always needs to be treated with mechanical ventilation.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 90

C) The first one is correct in itself, but the second one is incorrect

Question 91

Community-acquired pneumonia is usually caused by atypical pathogens, therefore in most cases community-acquired pneumonia should be treated with amoxicillin.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 91

D) The first one is incorrect, the second one is correct in itself

Question 92

A hyperergic reaction to the tuberculin test proves active tuberculosis, because there is a strong correlation between the size of the induration and the activity and extension of the disease.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 92

E) Both are incorrect

Question 93

In pulmonary hypertension the pulmonary systolic blood pressure is above 30 mmHg, because the hypoxaemic pulmonary vasoconstriction causes an elevated pulmonary vascular resistance.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 93

B) Both are correct but there is no causal relationship between them

Question 94

In type II respiratory failure there is often an urgent need for endotracheal intubation and mechanical ventilation, because the severe hypoxaemia can cause brain damage.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 94

B) Both are correct but there is no causal relationship between them

Question 95

Hypercapnia seldom occurs in chronic respiratory failure, because compensatory mechanisms can get on due to slow progression.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 95

D) The first one is incorrect, the second one is correct in itself

Question 96

Elevated tumor marker readings (higher CEA-, TPA levels) are diagnostic for lung cancer without any radiological findings, because they are very specific parameters.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 96

E) Both are incorrect

Question 97

Heavy smoking causes chronic bronchitis, therefore older patients with chronic bronchitis are expected to have occult lung cancer.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 97

C) The first one is correct in itself, but the second one is incorrect

Question 98

SCLC (small cell lung cancer) is not treated, because there is no treatment option that could improve the overall survival of the patient.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 98

E) Both are incorrect

Question 99

If a patient presents with haemoptysis, but the summation chest X ray is negative, lung cancer is excluded, although haemoptysis can be a sign of lung cancer.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 99

D) The first one is incorrect, the second one is correct in itself

Question 100

48-year-old woman had an operation due to breast cancer 3 years ago, followed by radiotherapy. Her novum pleural effusion might be related to the previous breast cancer.
A) Both are correct, and there is a causal relationship between them
B) Both are correct but there is no causal relationship between them
C) The first one is correct in itself, but the second one is incorrect
D) The first one is incorrect, the second one is correct in itself
E) Both are incorrect

Answer 100

A) Both are correct, and there is a causal relationship between them

Question 101

Which of the following examinations are needed for the diagnosis?
A 37-year-old man presents with symptoms that have persisted for 3 weeks: sore throat, muscle pain, headache, photophobia, severe nonproductive cough, fatigue, loss of apetite, fever. He has a history of spontaneous pneumothorax, recent overseas-travel, 20 years of massive smoking. 3 days ago the same signs and sypmtoms have occured in two of his family members.
1) complete blood count and blood chemistry
2) serologic tests for antibodies
3) ECG
4) chest X-ray
5) bronchoscopy
6) ophthalmic examination
7) echocardiography

A) only the 1., 3. and 5. answers are correct
B) only the 2. and 4. answers are correct
C) only the 5. and 6. answers are correct
D) only the 3., 4. and 7. answers are correct
E) all of the answers are correct

Answer 101

B) only the 2. and 4. answers are correct

Question 102

What is the probable diagnosis?
A 37-year-old man presents with symptoms that have persisted for 3 weeks: sore throat, muscle pain, headache, photophobia, severe nonproductive cough, fatigue, loss of apetite, fever. He has a history of spontaneous pneumothorax, recent overseas-travel, 20 years of massive smoking. 3 days ago the same signs and sypmtoms have occured in two of his family members.
A) tuberculosis
B) aspergillosis
C) myocarditis
D) atypical pneumonia
E) bronchogenic carcinoma

Answer 102

D) atypical pneumonia

Question 103

In case of the right diagnosis which is the recommended therapy?
A 37-year-old man presents with symptoms that have persisted for 3 weeks: sore throat, muscle pain, headache, photophobia, severe nonproductive cough, fatigue, loss of apetite, fever. He has a history of spontaneous pneumothorax, recent overseas-travel, 20 years of massive smoking. 3 days ago the same signs and sypmtoms have occured in two of his family members.
A) chemotherapy
B) antibiotic therapy
C) antifungal therapy
D) immunosuppressive therapy
E) lobectomy

Answer 103

B) antibiotic therapy

Question 104

What is the probable diagnosis?
A man with no history of serious illness presents with a trauma-induced pulmonary haematoma that has been unable to resolve for months. Despite taking several cycles of targeted antibiotics, he still has excessive sputum, tomography shows a soft tissue mass located in a surrounding cavity and the sputum test confirmed the presence of Aspergillus fumigatus repeatedly.
A) aspergilloma
B) allergic bronchopulmonalis aspergillosis
C) invasive aspergillosis
D) bronchiectasis due to Aspergillus-bronchitis
E) allergic alveolitis

Answer 104

A) aspergilloma

Question 105

Diagnostic methods:
A man with no history of serious illness presents with a trauma-induced pulmonary haematoma that has been unable to resolve for months. Despite taking several cycles of targeted antibiotics, he still has excessive sputum, tomography shows a soft tissue mass located in a surrounding cavity and the sputum test confirmed the presence of Aspergillus fumigatus repeatedly.
1) tomography
2) lung scintigraphy
3) determine serum Aspergillus-antibody
4) determine DCO
5) repeated sputum cytology
6) blood gas test
7) examine bronchial offspring using Bactec method

A) only the 2., 4., 6. and 7. answers are correct
B) only the 4., 6. and 7. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 5. answers are correct
E) all of the answers are correct

Answer 105

C) only the 1. and 3. answers are correct

Question 106

Which one is the ideal therapy?
A man with no history of serious illness presents with a trauma-induced pulmonary haematoma that has been unable to resolve for months. Despite taking several cycles of targeted antibiotics, he still has excessive sputum, tomography shows a soft tissue mass located in a surrounding cavity and the sputum test confirmed the presence of Aspergillus fumigatus repeatedly.
A) cavernostomy
B) pleurodesis
C) bronchoplasty
D) pulmonary resection
E) permanent chest drain

Answer 106

D) pulmonary resection

Question 107

Which examinations are mandatory for the diagnosis?
A 56-year-old man with no previous history of serious illness presents with progressive shortness of breath on exertion, that has persisted for 6 weeks. In addition, he has been experiencing non productive cough, but he has no fever. With physical examination mild cyanosis of the lips and extremities can be spotted and auscultation of the lungs shows late inspiratory crepitation at the bases of both lungs. No other diversion can be observed. Spirometry findings show reduced static lung volumes with normal airway resistance. Diffusion capacity is decreased. Immunological tests are negative.
1) electron microscopic analysis of the bronchoalveolar lavage fluid
2) CD4/CD8 ratio of peripheral blood
3) measuring the level of SACE (serum angiotensin-converting enzyme)
4) chest X-ray
5) ANCA (antineutrophil cytoplasmic-antibody) test
6) histologic examination of bioptatum
7) HRCT (high resolution computed tomography)

A) only the 2., 4., 6. and 7. answers are correct
B) only the 4., 6. and 7. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 5. answers are correct
E) all of the answers are correct

Answer 107

B) only the 4., 6. and 7. answers are correct

Question 108

The most subservient diagnostics needed in this case:
A 24-year-old doctor developed a febrile condition and a chest fluid accumulation on the right side. No bacteria were grown from the serous chest fluid and the sediment contained mainly lymphocites.
1) Mycobacterial culture from the pleural fluid
2) Pleural needle biopsy
3) Mantoux test
4) Hemoculture
5) SACE
6) ANA
7) Transbronchial biopsy

A) only the 1., 6. and 7. answers are correct
B) only the 4., 5. and 6. answers are correct
C) only the 1., 2. and 3. answers are correct
D) only the 5. and 7. answers are correct
E) only the 2. and 6. answers are correct

Answer 108

C) only the 1., 2. and 3. answers are correct

Question 109

What is the correct diagnosis?A 24-year-old doctor developed a febrile condition and a chest fluid accumulation on the right side. No bacteria were grown from the serous chest fluid and the sediment contained mainly lymphocites.
A) Parapneumonic pleuritis
B) Empyema thoracis
C) Hydrothorax
D) Pleuritis exsudativa tuberculosa
E) Pleurodynia

Answer 109

D) Pleuritis exsudativa tuberculosa

Question 110

Suggested therapy:
A 24-year-old doctor developed a febrile condition and a chest fluid accumulation on the right side. No bacteria were grown from the serous chest fluid and the sediment contained mainly lymphocites.
A) Combination of antituberculotic drugs
B) Antibiotic treatment + steroid
C) Steroid treatment
D) Chest drainage
E) Irrigation and suction (aspiration) of the pleural space

Answer 110

A) Combination of antituberculotic drugs

Question 111

Which of the following diagnostics are necessary in the case described above?
A 48-year-old female patient has been experiencing fever up to 39 °C in the past two weeks and itching of the skin. Her chest X-ray shows asymmetric tumescence of mediastinal lymph nodes.
1) Gastroscopy
2) Chest CT
3) Spirometry
4) Bronchoscopy
5) ECG
6) Mediastinoscopy
7) Haematological testing

A) only the 2., 4., 6. and 7. answers are correct
B) only the 4., 6. and 7. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 5. answers are correct
E) all of the answers are correct

Answer 111

A) only the 2., 4., 6. and 7. answers are correct

Question 112

Which of the followings are potential diagnoses?
A 48-year-old female patient has been experiencing fever up to 39 °C in the past two weeks and itching of the skin. Her chest X-ray shows asymmetric tumescence of mediastinal lymph nodes.
1) COPD
2) Sarcoidosis
3) Asthma
4) Lymphoma (non-Hodgkin)
5) Pneumonia
6) TB
7) Hodgkin lymphoma

A) only the 2., 4., 6. and 7. answers are correct
B) only the 4., 6. and 7. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 5. answers are correct
E) all of the answers are correct

Answer 112

A) only the 2., 4., 6. and 7. answers are correct

Question 113

Which of the following diagnostics would result in the exact diagnosis?
A 48-year-old female patient has been experiencing fever up to 39 °C in the past two weeks and itching of the skin. Her chest X-ray shows asymmetric tumescence of mediastinal lymph nodes.
A) Histology of the lymph node
B) Chest MRI
C) Sternal puncture
D) Haemogram

Answer 113

A) Histology of the lymph node

Question 114

Which of the following diagnostics can have valuable results in the case described above?
A 35-year-old male patient treated at surgical unit because of acute pancreatitis. He experiences increasing dyspnoea. Physical examination shows severe dyspnoea, tachypnoea, cyanosis, paleness, sweating, tachycardia, hypotonia. ECG shows sinus tachycardia. Decrease in central venous pressure.
1) Serum and urine amylase
2) Chest X-ray
3) Haemogram
4) Perfusion scintigraphy of the lungs
5) Blood gas assessment
6) Echocardiography
7) SGOT, SGPT, LDH, CK

A) only the 2., 4., 6. and 7. answers are correct
B) only the 4., 6. and 7. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 5. answers are correct
E) all of the answers are correct

Answer 114

D) only the 2. and 5. answers are correct

Question 115

What is the probable diagnosis?
A 35-year-old male patient treated at surgical unit because of acute pancreatitis. He experiences increasing dyspnoea. Physical examination shows severe dyspnoea, tachypnoea, cyanosis, paleness, sweating, tachycardia, hypotonia. ECG shows sinus tachycardia. Decrease in central venous pressure.
A) Myocardial infarction
B) Pancreatic abscess
C) ARDS
D) Pulmonary embolism
E) Abdominal haemorrhage

Answer 115

C) ARDS

Question 116

Which therapy is possibly the most effective in case of a correct diagnosis?
A 35-year-old male patient treated at surgical unit because of acute pancreatitis. He experiences increasing dyspnoea. Physical examination shows severe dyspnoea, tachypnoea, cyanosis, paleness, sweating, tachycardia, hypotonia. ECG shows sinus tachycardia. Decrease in central venous pressure.
A) Thrombolysis
B) Antibiotics
C) Parenteral nutrition
D) Continuous positive airway pressure ventilation
E) Transfusion

Answer 116

D) Continuous positive airway pressure ventilation

Question 117

Informative investigations:
After 2 weeks of respiration and tracheotomy due to a suicide experiment, a 44-year-old woman developed dyspnea and inspirational stridor 2 months later.
1) inspiratory lung function parameters
2) carbon monoxide diffusion capacity
3) bronchoscopy
4) echocardiography
5) compliance-testing
6) blood gas test
7) pharmacospirometry

A) only the 2., 4., 6. and 7. answers are correct
B) only the 4., 6. and 7. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 5. answers are correct
E) all of the answers are correct

Answer 117

C) only the 1. and 3. answers are correct

Question 118

Probable diagnosis:
After 2 weeks of respiration and tracheotomy due to a suicide experiment, a 44-year-old woman developed dyspnea and inspirational stridor 2 months later.
A) Trachea cylindrome
B) Postintubatic stenosis
C) Hustenstrang dyskinesis
D) Instability of trachea
E) Asthma bronchiale – intrinsic type

Answer 118

B) Postintubatic stenosis

Question 119

Theoretical therapeutic options:
After 2 weeks of respiration and tracheotomy due to a suicide experiment, a 44-year-old woman developed dyspnea and inspirational stridor 2 months later.
A) Afterloading
B) Inhalational steroid
C) Trachea resection
D) Chemotherapy
E) Conicotomy

Answer 119

C) Trachea resection

Question 120

Which of the following is the correct acid-base imbalance in this case?
A 58-year-old man with known chronic obstructive pulmonary disease and diabetes mellitus has been urgently hospitalized for high fever, cough with massive purulent sputum, dyspnoea and cyanosis. Arterial blood gas result parameters: pO2: 51 Hgmm pCO2: 54 Hgmm pH: 7,26 St. HCO3: 32 mmol/l
A) metabolic acidosis
B) metabolic alkalosis
C) respiratoric acidosis
D) respiratoric alkalosis
E) respiratoric acidosis with renal compensation

Answer 120

C) respiratoric acidosis

Question 121

Underlying diseases are being treated and the patient is also having oxygen therapy receiving 3 liters of O2 per minute through a nasal tube. The result of the repeated blood gas test after 24 hours:
pCO2: 76 Hgmm
pO2: 65 Hgmm
pH: 7,22
St. HCO3: 35 mmol/l
Which of the following therapies do you choose for treatment?
A 58-year-old man with known chronic obstructive pulmonary disease and diabetes mellitus has been urgently hospitalized for high fever, cough with massive purulent sputum, dyspnoea and cyanosis. Arterial blood gas result parameters: pO2: 51 Hgmm pCO2: 54 Hgmm pH: 7,26 St. HCO3: 32 mmol/l
A) Increases the amount of oxygen delivered through the nasal probe
B) Reduce the amount of oxygen delivered through the nose probe
C) Mechanical ventilation, respirator treatment
D) Provide 100% oxygen inhalation
E) Use bicarbonate infusion

Answer 121

C) Mechanical ventilation, respirator treatment

Question 122

Choose from among the examination procedures below those which may be diagnostic of the suspected diagnosis(es).
A 27-year-old female has persistent colds, mainly from spring to autumn. Occasionally, especially at dawn, she wakes up coughing and feels pressure in her chest. These symptoms disappears when she “coughs up”. Sometimes she hears squeezing in her chest while she is cleaning.
1) Skin test
2) Serum-IgE-testing
3) Bronchoscopy
4) Multi-day PEF monitoring
5) Chest x-ray
6) Sputum bacteriology test
7) KCI inhalation provocation test
8) Specific inhalation provocation test

A) only the 1., 2., 4. and 7. answers are correct
B) only the 2., 3., 5. and 7. answers are correct
C) only the 4., 6., 7. and 8. answers are correct
D) all of the answers are correct
E) none of the answers are correct

Answer 122

A) only the 1., 2., 4. and 7. answers are correct

Question 123

Which of the following would you give to the patient to prevent or control her symptoms?
A 27-year-old female has persistent colds, mainly from spring to autumn. Occasionally, especially at dawn, she wakes up coughing and feels pressure in her chest. These symptoms disappears when she “coughs up”. Sometimes she hears squeezing in her chest while she is cleaning.
1) Inhaled (local) steroid
2) Oral antihistamin
3) Na-cromoglycat
4) Cough suppressant
5) Digoxin

A) only the 1., 2. and 3. answers are correct
B) only the 1., 2., 4. and 5. answers are correct
C) only the 1. and 3. answers are correct
D) only the 2. and 4. answers are correct
E) all of the answers are correct

Answer 123

A) only the 1., 2. and 3. answers are correct