Respiration Flashcards

1
Q

Diabetic pt. draining abscess from jaw, finding on microscopy?

A

granuloma with abscess

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2
Q

How sarcoidosis is differentiated from TB?

A

symmetrical B/L lymphadenopathy

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3
Q

A boy from Afghanistan with discharging sinus in the lateral neck with nigh sweats and fever. Culture shows no growth. Next confirmatory test to be done?

A

Biopsy > ZN staining

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4
Q

AFB is non-resistance, non-encapsulated due to?

A

Cell wall glycoprotein

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5
Q

Initial test to detect microorganism of leprosy?

A

Nasal scraping test

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6
Q

Pt with low grade fever, night sweats, hematuria, urine R/E shows 25 RBC/HPF, ultrasound unremarkable, cause?

A

Renal TB

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7
Q

Antibodies in TB are bound to?

A

cell

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8
Q

Pt took ATT drugs for 2 months, presented with moderately elevated ESR, due to?

A

superimposed acute bacterial infection

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9
Q

Most likely cause of negative Mantoux test in pt. with TB is?

A

Immunosuppressive therapy

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10
Q

Location of pulmonary TB in lungs?

A

posterior segment of upper lobe lung

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11
Q

Isoniazid induced hepatic injury increased by?

A

N-acetyl cysteine deficiency

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12
Q

Female pt. on ATT using OCP still conceive, which drug is responsible?

A

Rifampicin

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13
Q

Pt. with history of cough with sputum, O/E right lung expiratory wheeze. CXR perihilar lymph node involvement. Biopsy shows squamous cell Ca., cause?

A

Radon gas

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14
Q

A smoker patient with interstitial lung disease and pleural plaques, cause?

A

Asbestosis

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15
Q

A man with silicosis presented with pulmonary nodules. Mechanism of formation of nodules is?

A

Giant cell formation

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16
Q

A man with weightloss and lesion in the lung, present with hemoptysis and histology shows small cell clusters (morphology of neoplastic cells), causative agent?

A

Smoking

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17
Q

41yrs old woman with 1yr history of episodic dyspnea. O/E expiratory wheeze. CXR shows few small perihilar nodules. Lab shows elevated IgE with esinophillia. Sputum sample shows eosinophils, finding most likely present in her bronchi?

A

non-invasive aspergillosis

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18
Q

Rhinosinusitis reports invasion of lamina media, extensive endothelial damage and thrombosis, diagnosis?

A

Mucormycosis

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19
Q
  1. Main cause of farmers lung is due to micro-organism?
  2. most common micro-organism?
A
  1. Micropolyspora faeni
  2. Aspergillosis
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20
Q

The finding of pleura ruptured in pneumothorax is?

A

Inward lung collapse and outward chest wall spring

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21
Q

COPD patient, O2 pressure at 10cm of water PEEP for 24hrs would cause?

A

Pneumothorax

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22
Q

What happens to V/Q in pulmonary embolism?

A

increase V/Q

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23
Q

Which type of infarction occurs in thromboembolism in lungs?

A

Hemorrhagic infarction

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24
Q

Pale infarcts occurs in which condition?

A

Embolic/Ischemic stroke

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25
Q

55yrs old female with known case of hematological disease admitted to hospital with history of sudden onset of dyspnea, ECHO shows severe pulmonary hypertension. Best possible cause associated with her condition?

A

Repeated pulmonary embolism

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26
Q

The most common feature of pulmonary embolism?

A

Clinically silent

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27
Q

Capnometer is used to measure pCO2, what else can it be used for?

A

Air embolism

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28
Q

A 30 weeks pregnant lady has SOB and dies after 5 days, cause?

A

pulmonary embolism (since nothing specified in stem, choose this answer)

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29
Q
A
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30
Q

A 32yrs old G4 para 2 admitted in antenatal ward at 32weeks. History of right leg swelling for 3 days. Doppler confirms DVT. Most important factor responsible for thromboembolic disease?

A

Venous stasis

31
Q

A 55yrs old lady with swelling of both legs and B/L pleural effusion, with AST 263, ALT 223, LDH 760, CK 150. no fever or other symptoms, diagnosis?

A

Recurrent thromboembolism

32
Q

Absolute contraindication of OCP?

A

Hx of stroke

33
Q

The most common physiologic cause of hypoxemia is?

A

Ventilation-perfusion inequality

34
Q

Inspiratory ramp signals are produced from the dorsal respiratory neurons, their rate increases in response to impulses from?

A

Pneumotaxic center

35
Q

ABGs show pCO2 70, pO2 90, HCO3 raised, this picture is due to which mechanism?

A

due to stimulation of central chemoreceptors

36
Q

A patient on ventilation support was given 60% oxygen and 40% nitrogen, after taking the ventilator off, there were brief episodes of apnea before getting back to normal. this is due to?

A

low arterial O2 suppressing peripheral chemoreceptors

37
Q

Increase respiration during exercise occurs due to?

A

due to increase PCO2

38
Q

Hypoxic pulmonary vasoconstriction is accentuated by?

A

increase PCO2

39
Q

During the first minute of apnea, the pCO2 rises upto?

A

8mmHg

40
Q

A person doing regular exercise. What factor in this condition increases his respiratory rate?

A

proprioceptors

41
Q

Herring Breuer reflex will lead to inhibition of what in central respiration?

A

Dorsal neuron of central respiration

42
Q

Alveolar ventilation is decreased by?

A

Hering-Breuer reflex

43
Q

What is important regarding dead space?

A

conditioning of inhaled air

44
Q

What is Meigs syndrome?

A

ascites+hydrothorax+ovarian tumour

45
Q

Best site for pleural tap/ thoracocentesis?

A

Lower border of 9th intercostal space mid axillary line

46
Q

When the respiratory muscles are relaxed the lungs are at?

A

FRC

47
Q

Contraction of diaphragm causes what affect on the lung volume?

A

Increases lung volume

48
Q

Man on ventilator what will happen if you give positive expiratory force?

A

Gas redistribution

49
Q

Asthma involves what part of lung?

A

Medium sized bronchioles

50
Q

Vital capacity less than 80% occurs in?

A

Restrictive lung diseases

51
Q

Parameter that doesn’t change in restrictive disease?

A

FEV1/FVC ratio

52
Q

A 28 weeks pregnant lady with premature labour delivers baby who develops respiratory distress and put on ventilator. CXR shows diffuse pulmonary opacities. finding in the lung tissue?

A

decrease lamellar cells in type 2 pneumocytes

53
Q

Hypoxic pulmonary vasoconstriction in alveoli is through which channels?

A

O2 sensing K channels

54
Q

Pulmonary vasoconstriction occurs due to reduced systemic?

A

reduced systemic PO2

55
Q

Stagnant hypoxia caused by heart failure causes?

A

polycythemia

56
Q

Hypoventilation causes hypoxia due to?

A

low PO2 in blood

57
Q

Hypoxia associated with decreased PO2 and increased A-a gradient?

A

right to left shunt

58
Q

Earliest symptom of acute anoxic anoxia?

A

lassitude

59
Q

Methemoglobinemia causes what type of hypoxia?

A

Anemic hypoxia

60
Q

Pulmonary fibrosis causes what type of hypoxia?

A

Stagnant hypoxia

61
Q

When is erythropoietin always raised?

A

Secondary polycythemia

62
Q

A 40yrs old non-smoker presents with splenomegaly and congested face, feature that best supports diagnosis of polycythemia?

A

increased red cell mass

63
Q

Old person presented with weakness and lethargy. Blood show increase RBC, WBC and platelet count. Bone marrow shows hyperplasia. diagnosis?

A

myeloproliferative disorder

64
Q

EPO is inhibited by?

A

theophylline

65
Q

Pt with raise BP, EPO decreased, raised creatinine, defect in which cells?

A

Juxtaglomerular cells

66
Q

In right shift of the curve the atmospheric pressure will be?

A

35mmHg

67
Q

Left shift of curve due to low PCO2 is known as?

A

Haldane effect

68
Q

The effect of oxygenation on carboxyhemoglobin is by?

A

Le chatelier

69
Q

During pregnancy, dyspnea due to progesterone, finding will be?

A

Min. ventilation increases

70
Q

A pregnant lady develops pain after few hours of delivery. ECG shows s1, Q3, T3. What is the most appropriate test for diagnosis?

A

Gallium scan

71
Q

A pregnant lady presents with hyperemesis gravidum and alkalosis. Electrolyte abnormality?

A

Hypokalemia

72
Q

Cervical ectropion occurs in?

A

Normal physiology

73
Q

Difference between carb metabolism in pregnant and non-pregnant lady?

A

Postprandial hyperglycemia

74
Q

An epileptic lady currently on phenytoin becomes pregnant. She is concerned about medication. What to do?

A

replace with barbiturate