Samplex 2015 Set B Flashcards
1
Q
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
A
E
2
Q
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
A
B
3
Q
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
A
B
4
Q
Function of respiratory system which is most reflected by PaO2 values:
a. Ventilation
b. Gas exchange
c. Metabolism
d. defense
A
B
5
Q
Function of respiratory system which is most reflected by PaCO2 values:
a. Ventilation
b. Gas exchange
c. Metabolism
d. defense
A
A
6
Q
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
A
D
7
Q
Which of the following causes hypoxemia
a. Hypoventilation
b. Shunt
c. V/Q mismatch
d. All of the above
A
D
8
Q
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
A
9
Q
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
A
E
10
Q
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
A
11
Q
During which phase of lung development does congenital diaphragmatic hernia develop?
a. embryonic
b. pseudoglandular
c. canalicular
d. saccular
e. alveola
A
B
12
Q
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
A
13
Q
The earliest indicator of alveolar hypoventilation is:
a. PaO2
b. PaCO2
c. PA aO2
d. HCO3
A
NA
14
Q
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
A
15
Q
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
A
B
16
Q
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
A
D
17
Q
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
A
C
18
Q
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
A
19
Q
Which of the ff is the least acceptable equivalent of dyspnea?
a. SOB
b. Breathlessness
c. Tachypnea
d. Not getting all the air down
A
C
20
Q
Which of the ff signs collaborate with dyspnea?
a. alar flaring
b. slow breathing
c. stammering speech
d. flushed face
A
A
21
Q
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
A
22
Q
All of the following situations induce breathlessness EXCEPT
a. heightened ventilatory command
b. respiratory muscle abnormalities
c. abnormal ventilatory impedance
d. metabolic alkalosis
A
D
23
Q
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
A
24
Q
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
A
B
25
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
26
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
27
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
28
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
29
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
30
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
31
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
32
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
33
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
34
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
35
Polysomnography monitors the ff:
a. arterial blood gases
b. Hgb, Hct
c. O2 saturation, EEG
d. Pulmonary Artery pressure
C
36
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
37
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
38
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
39
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
40
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
41
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
42
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
43
Agua, a 5 year old female from Palawan was brought to the emergency room for difficulty of breathing. Hx revealed that she had cough and fever for 3 days duration. Your PE showed respiratory distress . She had cyanotic oral mucosa and tongue, and suprasternal retractions. On the right hemithorax, there was dullness in percussion, decreased breath sounds and increased tactile and vocal fremiti.
In the pediatric patient, the ff are true of cyanosis:
a. Cyanosis is a normal occurrence and will often spontaneously resolve
b. Peripheral cyanosis is a more reliable indicator of severe hypoxemia than central cyanosis
c. Central cyanosis is only apparent oxygen saturation of hemoglobin (SaO2) drops below 75%
d. Peripheral cyanosis is definitely related to any underlying pathological disorder.
NA
44
Agua, a 5 year old female from Palawan was brought to the emergency room for difficulty of breathing. Hx revealed that she had cough and fever for 3 days duration. Your PE showed respiratory distress . She had cyanotic oral mucosa and tongue, and suprasternal retractions. On the right hemithorax, there was dullness in percussion, decreased breath sounds and increased tactile and vocal fremiti.
The ff are possible causes of decreased breath sounds:
a. atelectasis
b. pleural effusion
c. pneumothorax
d. consolidation
e. AOTA
E
45
Agua, a 5 year old female from Palawan was brought to the emergency room for difficulty of breathing. Hx revealed that she had cough and fever for 3 days duration. Your PE showed respiratory distress . She had cyanotic oral mucosa and tongue, and suprasternal retractions. On the right hemithorax, there was dullness in percussion, decreased breath sounds and increased tactile and vocal fremiti.
The following are possible causes of dullness on percussion EXCEPT:
a. atelectasis
b. pleural effusion
c. pneumothorax
d. consolidation
e. all of the above cause dullness on percussion
C
46
Agua, a 5 year old female from Palawan was brought to the emergency room for difficulty of breathing. Hx revealed that she had cough and fever for 3 days duration. Your PE showed respiratory distress . She had cyanotic oral mucosa and tongue, and suprasternal retractions. On the right hemithorax, there was dullness in percussion, decreased breath sounds and increased tactile and vocal fremiti.
What is Agua’s most likely clinical impression?
a. atelectasis
b. pleural effusion
c. pneumothorax
d. consolidation
e. all of the above cause dullness on percussion
B
47
The PA projection is the routine chest x-ray examination of choice because:
a. it provides better visualization of the retrocardiac space
b. there is no magnification of the cardiac shadow
c. it accentuates the pulmonary vasculature
d. the scapulae are superimposed on the lung fields
B
48
The apicolordotic view is used to assess:
a. lung bases
b. upper lobes
c. hilar structures
d. clavicles
B
49
What is the modality of choice for a guided aspiration biopsy of a peripheral pulmonary mass?
a. CT scan
b. fluruoscopy
c. ultrasound
d. MRI
A
50
A common radiologic finding in viral pneumonia:
a. bronchiectasis
b. pneumothorax
c. lobar consolidation
d. hyperaerated lungs
D
51
Which statement is true?
a. in the frontal projection, the radiolucency of the lung decreases from superior to inferior
b. The complete hemidiaphragm in the chest lateral view is the left hemidiaphragm
c. in the lateral projection, the retrocardiac space is radiopaque
d. In the lateral view of the chest, the trachea lies posterior to the esophagus
A
52
what is the most common way for microorganisms to gain access to the lower respiratory tract?
a. inhalation of contaminated droplets
b. contiguous extension from an infected pleural or mediastinal space
c. aspiration from the oropharynx
d. hematogenous spread
e. all of the above
C
53
The following are true regarding mechanical factors in host defense:
a. hair and turbinates of the nares catch both large and small particles before they reach the lower respiratory tract
b. branching architecture of the tracheobronchial tree traps particles on the airway lining
c. mucociliary clearance and local antibacterial factors kill the potential pathogen
d. gag reflex provides critical protection from aspiration
e. all of the above
E
54
The following host inflammatory response trigger the clinical syndrome of pneumonia, except:
a. interleukin 1
b. interleukin 6
c. tumor necrosis factor
d. interleukin 8
e. granulocyte colony stimulating factor
B
55
Which of the following are the common viral pathogen in acute laryngitis?
a. parainfluenza
b. rhinovirus
c. coxsackie
d. coronavirus
e. all of the above
E
56
which of the following regarding the pattern of bonchiectasis is true?
a. the involved bronchi in cylindrical bronchiectasis appear uniformly dilated and end abruptly at the point where medium sized bronchi are obstructed by secretions
b. In varicose bronchiectasis, the affected bronchi have an irregular or ballooned patern of dilatation
c. In saccular bronchiectasis, the bronchi end in blind sacs without recognizable bronchial structures distal to the sacs
d. in cystic bronchiectasis, the bronchi have a ballooned appearance at the periphery.
e. all of the above
E
57
The following are pathophysiologic events following an inflammatory response, EXCEPT:
a. bacterial pathogens interfere with the hypoxic vasoconstriction that can result in severe hypoxemia
b. increased respiratory drive in the systemic inflammatory response syndrome (SIRS) leads to metabolic acidosis
c. decreased compliance lead to dyspnea
d. reduction in volume and compliance and the pulmonary shunting of blood may cause the patient’s death
B
58
The following are differential diagnosis for exudative pleural effusion, EXCEPT:
a. Tuberculosis
b. Uremia
d. Urinothorax
e. Esophageal perforation
D
59
What is the most common cause of lung abscess?
a. esophageal dysmotility
b. aspiration
c. seizure disorder
d. bulbar dysfunction
B
60
What is the duration of treatment of lung abscess?
a. 1-2 weeks
b. 2-4 weeks
c. 4-6 weeks
d. 8-12 weeks
e. NOTA
C
61
Apart from Hemophilus influenza, the predominant organism found in the sputum of the patients with bronchiectasis?
a. Streptococcus pneumoniae
b. Mycoplasma pneumoniae
c. Staphylococcus aureus
d. Pseudomonas aeroginosa
C
62
The diagnsos of lung abscess is based on which of the following?
a. clinical symptoms
b. identification of predisposing conditions
c. chest radiographic findings
d. AOTA
e. NOTA
D
63
Which of the following medical illnesses affect host defenses?
a. Diabetes mellitus
b. congestive heart failure
c. aspergillus infection
d. AOTA
e. NOTA
D
64
Which of the following laboratory results indicate the likely need for a procedure more invasive than a thoracentesis?
a. pleural fluid pH > 7.0
b. pleural fluid glucose
B, D
65
A 5 year old male developed high grade fever and sore throat. A few hours after the patient appeared toxic with difficulty in swallowing and labored breathing. Physical examination revealed a patient in respiratory distress who is seen sitting upright and leaning forward. He was noted to have stridor and drooling.
Your immediate impression for the above case should be:
a. Laryngomalacia
b. Bacterial tracheitis
c. Acute epiglotittis
d. Acute laryngotracheobronchitis
C
66
A 5 year old male developed high grade fever and sore throat. A few hours after the patient appeared toxic with difficulty in swallowing and labored breathing. Physical examination revealed a patient in respiratory distress who is seen sitting upright and leaning forward. He was noted to have stridor and drooling.
The attending physician of the above patient requested for Neck STL. What radiographic finding should you look for in this case?
a. Steeple sign
b. Thumb sign
c. Silhouette Sign
d. Sail sign
B
67
The most common infectious cause of acute upper airway obstruction in children is:
a. Rhinitis
b. Tonsillopharyngitis
c. laryngotracheobronchitis
d. epiglotittis
C
68
The “Steeple sign” is most commonly associated with:
a. Rhinitis
b. tonsillopharyngitis
c. laryngotracheobronchitis
d. epiglotittis
C
69
The physical examination finding that is most sensitive and specific for pneumonia in children is:
a. retractions
b. tachypnea
c. rales
d. wheezing
B
70
A 3 year old boy with a two-day history of high grade fever and cough was brought to the ER due to respiratory distress. He had a hoarse voice, noisy fast breathing and barking cough productive of copious purulent sputum. Chest x-ray showed subglottic narrowing and irregular tracheal border. The most likely diagnosis is:
a. epiglotittis
b. spasmodic croup
c. laryngotracheobronchitis
d. bacterial treacheitis
e. retropharyngeal abscess
B
71
Which of the following signs and symptoms point to the diagnosis of pneumonia in children?
a. cough
b. fever
c. tachypnea
d. crackles
e. cyanosis
f. AOTA
g. A,B,C,D only
NA
72
Which laboratory study would be most helpful to confirm the diagnosis of pneumonia in children?
a. CBC
b. CXR
c. blood culture
d. sputum Gram stain and culture
e. throat swab culture
B
73
What is the most important factor you should consider in determining the etiology of pneumonia in children?
a. severity of illness
b. age
c. crackles
d. nasopharyngeal colonization
e. radiologic findings
B
74
A child had been diagnosed with acute pharyngotonsillitis had been having persistent fever for several days now. On the day of consultation, he has high grade fever (40.5oC), severe throat pain and trismus and refuses to swallow or speak. Speech is characterized as “hot potato” voice.
The most likely diagnosis in this case is:
a. chronic pharyngotonsillitis
b. peritonsillar abscess
c. retropharyngeal abscess
d. acute epiglotitis
e. acute laryngotracheobronchitis
B
75
A 25-year-old medical student consults for cough and fever for 2 days. He has chills up to 40oC and cough productive of yellow phlegm. On physical findings, he was noted to have crackles at the right lower lung. His vital signs were: T 38, BP 100/70, HR88, RR20.
This patient can best be described to have:
a. low risk community acquired pneumonia (CAP)
b. moderate risk CAP
c. high risk CAP
d. nosocomial pneumonia
e. health care associated-pneumonia
NA
76
A 78-year-old malewas found under the LRT unconscious and thus brought to the PGH-ER. He was found to have a palpating BP and needed to be intubated. Upon intubation, copious amount of yellow green respiratory secretions were sunctioned. Chest radiograph showed multilobar pneumonia.
This case can be best described to have
a. low risk community acquired pneumonia (CAP)
b. moderate risk CAP
c. high risk CAP
d. nosocomial pneumonia
e. health care associated-pneumonia
NA
77
A 62-year-old male admitted for complicated acute pancreatitis. His initial CXR was normal. On the 5th HD, he develops fever and increase in yellowish respiratory secretions, CXR now showed lung infiltrates in both bases. He rapidly deteriorates and needed to be on mechanical ventilation.
This case can be described as
a. low risk community acquired pneumonia (CAP)
b. moderate risk CAP
c. high risk CAP
d. nosocomial pneumonia
e. ventilator-assocciated pneumonia
D
78
The sputum studies is a clinical part of diagnostic armamentarium for pneumonia.What are the minimum requirement for a good sputum specimen?
a. it must be colored (yellow, green, etc)
b. it must be 1st specimen in the morning
c. Gram stain must have >25 PMN cells and
C
79
Which of the following fungal infection of the lungs that is characterized by growth of fungal mycelia within the pre-existing lung cavities?
a. Histoplasmosis
b. Aspergillosis
c. Cryptococcosis
d. Mucormycosis
e. Candidiasis
B
80
Type of emphysema associated with prolonged cigarette smoking
a. Panacinar emphysema
b. Centilobular emphysema
c. Focal emphysema
d. Distal acinar emphysema
e. NOTA
B
81
The Reid Index is increased in this disease, usually in proportion to the severity and duration of the disease:
a. bronchiectasis
b. bronchial asthma
c. emphysema
d. chronic bronchitis
e. NOTA
D
82
Obstruction and infection are the predisposing factors in the development of which of the following:
a. emphysema
b. adult respiratory distress syndrome
c. bronchiectasis
d. NOTA
C
83
the following viruses may be associated with cytopathic effect of the bronchial epithelium
a. herpes simplex
b. varicella zoster
c. adenovirus
d. cytomegalovirus
e. all of the above
D
84
treatment for TB meningitis
a. 2HR/7-10 HRZE
b. 2HRZE/7-10 HR
c. 2HRZES/1HRZE/5HRE
d. 2HRZE/4HR
B
85
the criteria for the diagnosis of sputum negative PTB are the following except:
a. sputum culture negative for M tuberculosis
b. at least 2 negative sputum smears (including at least 1 early morning specimen)
c. lack of response to trial of broad spectrum antimicrobial agents
d. CXR findings consistent with TB
C
86
a 50 year old male, vendor, cigarette smoker consulted at the OPD clinic with a chief complaint of productive cough of 3 weeks duratino associated with night sweats and intermittent fever. Patient has no known comorbidities, and claimed to have no previous history of PTB treatment.
PE: (+) bilateral supraclavicular lymphadenopathies
C/L: SCE, rales on both lung fields prominent in the apices
LABS: CXR- PA – hyperaerated lung fields, apicolordotic view suggested
AFB 1,2,3- (+)1/(-)/(+)
the above patient can be classified as:
a. smear negative pulmonary TB
b. new, smear positive PTB
c. extrapulmonary TB
d. possible MDR-TB
B
87
a 50 year old male, vendor, cigarette smoker consulted at the OPD clinic with a chief complaint of productive cough of 3 weeks duratino associated with night sweats and intermittent fever. Patient has no known comorbidities, and claimed to have no previous history of PTB treatment.
PE: (+) bilateral supraclavicular lymphadenopathies
C/L: SCE, rales on both lung fields prominent in the apices
LABS: CXR- PA – hyperaerated lung fields, apicolordotic view suggested
AFB 1,2,3- (+)1/(-)/(+)
The above patient would warrant what treatment regimen?
a. 2HRZES/1HRZE/5HRE
b. 2HRZE/4HR
c. 4HRZE/2HR
d. 2HRZE/4HRE
B
88
a 50 year old male, vendor, cigarette smoker consulted at the OPD clinic with a chief complaint of productive cough of 3 weeks duratino associated with night sweats and intermittent fever. Patient has no known comorbidities, and claimed to have no previous history of PTB treatment.
PE: (+) bilateral supraclavicular lymphadenopathies
C/L: SCE, rales on both lung fields prominent in the apices
LABS: CXR- PA – hyperaerated lung fields, apicolordotic view suggested
AFB 1,2,3- (+)1/(-)/(+)
The best way to monitor the patient’s response would be to?
a. Request for sputum smear at 2nd and 4th month of treatment
b. Repeat CXR at the end of 6 months
c. Assess clinically at the end of 6 months
d. Do FNAB of lymph nodes at the end of treatment
A
89
The following is/are true re: the PPD skin test except?
a. It should be positive in patients with TB infection
b. It should be positive in patients with TB exposure
c. It should be positive in patients with TB disease
d. It should be positive in patients after successful treatment of TB disease
no antibodies yet until you actually get infected and produce immune response
B
90
Which of the following treatment regimens is/are appropriate?
a. INH for 6 months as primary prophylaxis
b. INH for 6 months as secondary prophylaxis
c. INH for 9 months as secondary prophylaxis
d. INH and Rifampicin for 6 months as treatment for pulmonary TB
Issues in pediatric TB trans
C
91
The diagnosis of TB disease can be ascertained for the following cases except?
a. Fine needle aspiration biopsy of patient’s cervical lymph node positive for Langhans giant cells
b. Mother recently diagnosed to have sputum AFB + smear
c. Patient with positive gastric aspirate AFB smear
d. PPD positive result in an adolescent patient with apical cavitary lesion on chest xray
Exposure is not equal to having the disease.
B
92
True re the transmission of TB in pediatric patients except
a. An adolescent or adult household member with untreated disease is the usual source of the child’s infection
b. The classmate of a preschooler diagnosed to have latent TB infection
c. Amniotic fluid aspirated during delivery to a mother with TB endometritis can cause congenital TB
d. Ingestion of unpasteurized milk can lead to GI TB
B
93
Which of the following is/are true re the classification of TB?
a. A patient with + exposure/ - PPD/ -CXR is defined as having disease
b. A patient with + exposure/ + PPD/ - CXR is defined as having disease
c. A patient with + exposure/ + PPD/ +CXR is defined as having disease
d. All true
C
94
tuberculate macroconidia
```
A. Mucor Sp
B. Coccidioides immites
C. Blastomyces dermatitidis
D. Histoplasma capsulatum
E. Cryptococcus neoformans
```
D
95
encapsulated yeast
```
A. Mucor Sp
B. Coccidioides immites
C. Blastomyces dermatitidis
D. Histoplasma capsulatum
E. Cryptococcus neoformans
```
E
96
broad-based oval budding cells
```
A. Mucor Sp
B. Coccidioides immites
C. Blastomyces dermatitidis
D. Histoplasma capsulatum
E. Cryptococcus neoformans
```
C
97
spherule
```
A. Mucor Sp
B. Coccidioides immites
C. Blastomyces dermatitidis
D. Histoplasma capsulatum
E. Cryptococcus neoformans
```
B
98
```
Strep. Pneumonia is seen in the laboratory as:
A. gram (+) cocci in clusters
B. gram (+) cocci in pairs
C. gram (-) diplococcic
D. gram (-) rods in pairds
```
B
99
The gold standard in the diagnosis of paragonimiasis is:
A. stool exam
B. sputum exam
C. serologic test
D. NOTA
C
100
The following are TRUE statements about the lung fluke EXCEPT :
A. it is a hermaphrodite
B. molluscs are the first intermediate hosts
C. crustaceans are the second intermediate host
D. NOTA
D
101
Pathology in lung fluke infections includes the following EXCEPT :
A. tubercle-like abscesses
B. granuloma formation
C. BOTH A and B
D. NEITHER A nor B
D
102
Lung flukes may invade ANY of the following organs EXCEPT :
A. brain
B. spinal cord
C. peritoneal organs
D. NOTA
D
103
The drug/s of choice for paragonimiasis is/are
A. Praziquantel
B. Triclabendazole
C. EITHER A and B
D. NEITHER A nor B
A
104
Chief complaints of patients with Loeffler’s syndrome may include the following EXCEPT :
A. Difficulty of breathing
B. Cough
C. Chest and/or back pain
D. NOTA
D
105
The following parasitic organisms may manifest with the signs and symptoms of Loeffler’s syndrome EXCEPT :
A. Schistosoma spp.
B. Trichuris spp.
C. Necator spp.
D. Ascaris spp.
B
106
Physical examination findings supporting a diagnosis of Loeffler’s syndrome include the following EXCEPT:
A. Wheezing
B. Rales
C. Increased respiratory rate
D. NOTA
D
107
Tropical pulmonary eosinophilia is seen in :
A. lymphatic filariasis
B. hookworm infection
C. whipworm infection
D. NOTA
A
