Samplex 2015 Set B Flashcards
The following statements are true regarding airway wall structure EXCEPT
a. Epithelial layer gradually becomes reduced from stratified to cuboidal and to squamous
b. Smooth muscle layer disappears in the alveoli
c. Fibrous coat contains cartilage only in bronchi
d. Fibrous coat gradually becomes thinner as the alveolus is approached
e. None of the above
E
Increase in PaCO2 in patients with a shunt is mainly due to:
a. Central hypoventilation
b. Increase in dead space ventilation
c. Decrease in tidal volume
d. Increase in residual volume
B
The following statements are true regarding bronchial epithelium EXCEPT
a. Ciliated cells dominate bronchioles
b. Clara cells progressively decrease distally along the airways
c. Goblet cells and serous cells decrease distally and are absent in terminal bronchioles
d. Basal cells and especially Kutchitsky cells are uncommon in distal airways
e. None of the above
B
Function of respiratory system which is most reflected by PaO2 values:
a. Ventilation
b. Gas exchange
c. Metabolism
d. defense
B
Function of respiratory system which is most reflected by PaCO2 values:
a. Ventilation
b. Gas exchange
c. Metabolism
d. defense
A
The following are true regarding the anatomy of the pleura
a. The pleural membranes include both visceral and parietal pleura
b. The pleural space occupies 18 to 20cm width
c. The pleural is composed of 3 layers
d. A and C only
D
Which of the following causes hypoxemia
a. Hypoventilation
b. Shunt
c. V/Q mismatch
d. All of the above
D
Which stage of development is characterized by ventral outpouching from the foregut:
a. Embryonic phase
b. Pseudoglandular phase
c. Canalicular phase
d. Saccular phase
e. Alveolar phase
A
The following are true of lung development:
a. The first 28 weeks of gestation is characterized by anatomical lung development
b. Lung maturation consists of functional as well as biochemical development
c. All alveoli are present at birth so that postnatal growth is characterized only by an increase in the lumen size of these alveoli
d. All of the above are true
e. Only a and b are true
E
The type of lung development where there is absence of the mainstem bronchus and lung tissue is called:
a. Lung agenesis
b. Lung aplasia
c. Lung hypoplasia
d. Lung dysplasia
e. Lung dysgenesis
A
During which phase of lung development does congenital diaphragmatic hernia develop?
a. embryonic
b. pseudoglandular
c. canalicular
d. saccular
e. alveola
B
The following are characteristics of mature alveolus:
a. It is connected to the alveolar duct
b. It is lined with type 2 cells in intimate contact with a capillary
c. Each capillary is exposed to 5 alveoli
d. The type 1 cells produce adequate surfactant
e. All of the above
A
The earliest indicator of alveolar hypoventilation is:
a. PaO2
b. PaCO2
c. PA aO2
d. HCO3
NA
Hypoxemia can be elicited in diffusion impairment abnormalities by:
a. giving oxygen supplement
b. giving metacholine challenge test
c. having patient perform exercise
d. having patient hyperventilate
A
According to 2009 Smoking Statistics, the mean age of smoking initiation in the Phil is:
a. 20-25
b. 17-19
c. 13-15
d. 25-30
B
Which phase in the process of cough is characterized by rapid rise in subglottic pressure?
a. Inspiratory
b. Expiratory
c. Recovery
d. Compressive
e. Glottic Closure
D
The afferent limb of the cough reflex includes receptors within the sensory distribution of the following nerves except:
a. Trigeminal
b. Glossopharyngeal
c. Spinal Motor
d. Vagus
e. Superior laringeal
C
30yo teacher, nonsmoker consults you for on and off again cough production of white, occasionally yellow phlegm, 6mos ago. Occurs night and early in them orning. 3 days PTC, cough has become bothersome, noted blood-streaking in sputum. She previously consulted their school physician twice and was told she had bronchitis. She was given antibiotics and salbutamol-guaifenesin tablets which provided temporary relief. She recalled cough became worse when she had to write on the board with chalk. She has no other complaints except for chest tightness. The erst of her Hx and PE is unremarkable. CXR done 1month ago was normal.
Basing your clinical decision on the chronic cough algorithm, what willl be your next step?
a. Start empiric inhaled steroid beta agonist combination
b. Repeat CXR
c. Do sputum AFB smears
d. Start empiric antibiotic with atypical coverage
e. Start empiric antihistamine and decongestant
A
Which of the ff is the least acceptable equivalent of dyspnea?
a. SOB
b. Breathlessness
c. Tachypnea
d. Not getting all the air down
C
Which of the ff signs collaborate with dyspnea?
a. alar flaring
b. slow breathing
c. stammering speech
d. flushed face
A
The sense of respiratory effort is believed to arise from a signal transmitted from the motor cortex to the structure coincidentally with the outgoing motor command to the ventilatory muscles.
a. sensory cortex
b. medulla
c. cerebellum
d. anterior horn cells of the spinal cord
A
All of the following situations induce breathlessness EXCEPT
a. heightened ventilatory command
b. respiratory muscle abnormalities
c. abnormal ventilatory impedance
d. metabolic alkalosis
D
Which of the following breathing patterns is expected in lung fibrosis
a. rapid shallow breathing
b. rapid, deep breathing
c. slow, shallow breathing
d. slow, deep breathing
A
Which of the following breathing patterns is characteristic of severe metabolic acidosis?
a. CHeyne- stokes breathing
b. Kussmaul breathing
c. Apneustic breathing
d. Biot’s breathing
B
Which of the following indicates true cyanosis?
a. Hypoxemia
b. Reduced Hb of >3 or 4 g/dL
c. Alterial blood desaturation
d. sluggish peripheral circulation
B
Which of the ff is TRUE regarding central cyanosis?
a. Central cyanosis + dyspneal = respiratory of CVS disease
b. Central cyanosis with no dyspnea rules out respiratory or CVS disease
c. Central and peripheral cyanosis cannot occur simultaneously
d. Central cyanosis + clubbing indicates catastrophic onset illness
A
Scanner with digital computer creates a cross sxnal image or slices of diff organs of the body. It has the ability to image a combination of soft tissue, bone, and BVs, making it possible to detect disease earlier than with a regular xray.
a. CXR
b. PET scan
c. UTZ
d. CT scan
D
Situations in which the PFTs may be contraindicated
a. COPD
b. broncohial asthma
c. chest pain, recent heart attach or unstable CV status
d. pre-operative evaluation
C
Exudative peripheral effusions meet at least one of the ff criteria (light’s Criteria)
a. Pleural fluid pattern divided by serum protein >0.5
b. Pleural fluid protein divided by serum LDH
A
Pleural fluid analysis shows the ff: LDH 300 IU/L, total protein 40g/dL, glucose 216 mg/dL, Serum analysis shows: LDH: 400 IU/L, Total protein 50g/dL, glucose 300mg/dL. The pleural fluid is best described as:
a. exudate
b. transudate
c. malignant
d. indeterminate
A
First imaging test used to help diagnose symptoms such as shortness of breath, a bad or persistent cough, chest pain or injury or fever.
a. Spritometry b. Chest Xray c. Bronchoscopy d. Ultrasound
B
Uses a transducer that sends out ultrasonic sound waves. The transducer picks up the reflected waves, which are then converted into an electronic picture of an organ.
a. MRI b. Thoracocentesis c. UTZ d. PET scan
C
Diagnostic uses of bronchoscopy
a. evaluate pleural based lesions b. evaluate pleural fluid aspirated c. assess alveolar sacs d. investigate unexplained hemoptysis, stridor or localized wheeze
D
Uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures.
a. MRI b. CT Scan c. PET Scan d. UTZ
A
Polysomnography monitors the ff:
a. arterial blood gases b. Hgb, Hct c. O2 saturation, EEG d. Pulmonary Artery pressure
C
Should be the 1st diagnostic test when confronted with a patient in whom there is a clinical suspicion of TB.
a. Chest Xray b. Sputum TB culture c. Sputum exam for AFB d. CT Scan of chest
C
JB, 35, M, taxi driver, heavy smoker, sought consult due to cough.
Pertinent Hx: 1 month episode of cough with yellowish phlegm and occasional low grade fever. Self-medicated with ibuprofen and ambroxol which provided only temporary relief of symptoms.
2 weeks before consult, cough was persistent and quite progressive associated with some episodes of dyspnea. Took terbutaline tablets wc provided temporary relief. His wife noted some weight loss and easy fatigability on walking two flights of stairs.
PE: BP 140/90; RR=24, HR=88 note of 1x1 cm movable node at ( R) supraclavicular area, use of neck accessory muscles Lungs: decreased BS over ( R) base Heart: Regular rhythm, no murmur Soft abdomen, NABS Full pulses
With the given Hx and PE, one might consider the ff pulmonary dx as main impression except,
a. Pneumonia b. TB c. Malignancy d. COPD e. NOTA
E
JB, 35, M, taxi driver, heavy smoker, sought consult due to cough.
Pertinent Hx: 1 month episode of cough with yellowish phlegm and occasional low grade fever. Self-medicated with ibuprofen and ambroxol which provided only temporary relief of symptoms.
2 weeks before consult, cough was persistent and quite progressive associated with some episodes of dyspnea. Took terbutaline tablets wc provided temporary relief. His wife noted some weight loss and easy fatigability on walking two flights of stairs.
PE: BP 140/90; RR=24, HR=88 note of 1x1 cm movable node at ( R) supraclavicular area, use of neck accessory muscles Lungs: decreased BS over ( R) base Heart: Regular rhythm, no murmur Soft abdomen, NABS Full pulses
Additional PE maneuvers were done revealing dullness on percussion over the (R ) base and no adventitious sounds noted. One may consider the ff except,
a. pneumothorax b. pleural effusion c. pneumonia d. empyema
A
JB, 35, M, taxi driver, heavy smoker, sought consult due to cough.
Pertinent Hx: 1 month episode of cough with yellowish phlegm and occasional low grade fever. Self-medicated with ibuprofen and ambroxol which provided only temporary relief of symptoms.
2 weeks before consult, cough was persistent and quite progressive associated with some episodes of dyspnea. Took terbutaline tablets wc provided temporary relief. His wife noted some weight loss and easy fatigability on walking two flights of stairs.
PE: BP 140/90; RR=24, HR=88 note of 1x1 cm movable node at ( R) supraclavicular area, use of neck accessory muscles Lungs: decreased BS over ( R) base Heart: Regular rhythm, no murmur Soft abdomen, NABS Full pulses
Egophony may be appreciated over the (R ) mid lung field in case of the following except:
a. pleural effusion b. consolidation c. pulmonary mass d. loculated pneumothorax
D
A chest radiograph was done revealing a dense opacification of the (R ) basal lung field area. This finding in addition to the above PE data may strengthen the diagnosis of the ff except,
a. pneumothorax b. lobar pnuemonia c. pulmonary mass d. pleural effusion
A
On a right lateral decubitus film, the noted opacification was noted to layer at the lateral aspect of the right hemithorax. This may make one consider:
a. pleural fluid b. empyema c. airway secretions d. pulmonary mass e. A and B only
E
The following are commonly found in extrathoracic obstructive lung disorders:
a. inspiratory stridor b. increased lung volume/hyperinflation in chest radiographs c. prolonged expiratory phase d. expiratory wheeze e. AOTA
E
