2017 end of module exam Flashcards by Hessa Al Salem

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

A- C-fiber receptors

B- Alpha/Gamma receptors

C- Rapidly adapting receptors

D- Strong cough mechanoreceptors

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

S. Pneumonia
M. Pneumonia
MTB

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

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

A) Activation of latent TB

B) Crowded household and workplace

C) Living with a patient with TB

D) Unavailability of anti-TB drugs

-B) Crowded household and workplace

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Which lipoxygenase requires flap for its activity?

-lipoxinA4
-leukotrien
-5-Lipoxygenase

-5-Lipoxygenase

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low o2 low co2 dlco 22 (predicted 28)

hypoventilation
diffusion limitation
shunt
v/q

diffusion limitation

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

A- Adenine

B- Guanine

C- thymine

D- cytosine

B- Guanine

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

EGFR
P53
KRAS

EGFR

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

S. Pneumoniae
H. Influenzae
Neisseria meningitis

H. Influenzae

S. pneumonia is gram +ve, lancet shaped

N. meningitis is gram -ve, coccus

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

A) accumulation of WBS in the interstitial space

B) accumulation of protein rich fluid in the interstitial space

C) accumulation of macrophages in the interstitial space

D) destruction of alveolar septum

E) diffuse interstitial fibrosis leading to honeycomb appearance

D) destruction of alveolar septum

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Which drug class causes adrenal suppression in children?

A. Xanthine derivatives

B. Corticosteroids

C. Anti-leukotrienes

D. B2 adrenoreceptor agonists

E. Muscuranic receptor antagonists

B. Corticosteroids

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

A- streptococcus agalactiae

B- neisseria gonorrhoeae

C-streptococcus pneumoniae

D- haemophilus influenzae

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

B. Block release of histamine from mast cells

C.block vascular permeability

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

ghons focus
Ghons complex
Simon focus
Ranke complex

Ranke complex

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

DPPC ( dipalmitoylphosphatidylcholine )

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

A. Acyclovir

B. Cefotaxime

C. Ampicillin

D. Erythromycin

C. Ampicillin

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what is the most appropriate drug to treat motion sickness ?

A diphenhydramine

B doxylamine

C laratidine

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Which nerve innervates the peripheral part of the diaphragm?

Vagus
Intercostal
Phrenic

Intercostal

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

Positron emission limited
Ultra-scan chest
HRCT scan
V/Q nuclear study

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Which muscle elevate the larynx?

Mylohyoid

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

Anxiety
Low sv
Something related to ventilation

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

A) Pre and Post Spirometry

B) Methacholine challenge test

C) measurement of lung volumes

D) DLCO measurement

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

High CO2 high HCO3
No change
Low CO2 low CO3
Low CO2 high CO3

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

A. It can be taken orally

B. It also has an expectorant effect

C. It also has analgesic effects

D. It doesn’t inhibit ciliary activity

E. It doesn’t penetrate the CNS

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

Hyperplasia of mucus gland in bronchial wall

if perfusion was almost zero, and ventilation is preserved, what happens to PAO2? A) close to atmospheric oxygen B) close to zero

20 year old female, persistent cough and hemoptysis. Bronchoscopy showed round mass protruding into the bronchi. Biopsy showed monomorphic cells with salt and pepper chromatin. What other morphological feature would you expect 1. High mucin content 2. High keratin 3. Collagen 4. Adenoid tissue 5. Neuro secretory granules

5. Neuro secretory granules

Which structure is mainly affected in emphysema? 1. Primary bronchi 2. Secondary bronchi 3. Bronchioles 4. Alveoli

4. Alveoli

Which nerve carries general sensation of periphral diaghragm ? 1. Lower intercostal 2. Vagus nerve 3. Upper limb nerve 4. Phrenic nerve

1. Lower intercostal

In which respiratory disease does the diffusing capacity of carbon monoxide DLCO often increases 1. ideopathic pulmonary fibrosis 2. chronic bronchitis 3. asthma 4. compression of the pulmonary artery

3. asthma

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

High oncotic pressure

Why is it more common for abcesses to form in the right lung 1. Recieves less blood flow 2. Right main bronchus is more vertical 3. has 2 lobes 4. has less branches from bronchus

2, Right main bronchus is more vertical

Which one of these nerves supply the bronchi? 1. Vagus nerve 2. Phrenic nerve 3. Intercostal nerve

1. Vagus nerve

Last stage in ILD

Fibrosis

Which receptor doesn’t cause mast cell degranulation? 1. H2 2. C5a 3. C3a

1. H2

non caseating granuloma + asteroid bodies 1. Sarcoidosis 2. Berylliosis

1. Sarcoidosis

what stains pneumocystis jirovici? 1. grammucurine oil 2. red omasson 3. trichrome 4. gomori methanamine silver

gomori methanamine silver

A 2 year old was diagnosed with brochopneumonia. Sputum culture should growth only on chocolate agar. 1. A. Streprococcus pneumoniae 2. B. Hemophillus influenzae 3. C. Chlamydia pneumoniae 4. D. Pseudomonas aeruginosa

B. Hemophillus influenzae

What is the best lung parameter to measure/identify restrictive lung disease ? 1. TLC 2. FEV1 3. FEV1/FVC ratio 4. DLCO

1. TLC

Which of the clinical scenario is “Centri-acinar emphysema” commonly seen ? 1. Chronic heavy tobacco smoking 2. Alpha-1 antitrypsin deficiency 3. Severe childhood asthma 4. History of drug abuse

1. Chronic heavy tobacco smoking

A (60 yr old ?) woman came to the ED with 3 months of fever and cough. Gram stain showed gram positive dipococci. What is the causative organism? 1. S. Pneumonia 2. H. Influenzae 3. S. Aureus

1. S. Pneumonia

Which laryngeal muscle is affected when the external laryngeal nerve is damaged? 1. Cricothyroid 2. Posterior cricoarytenoid 3. Lateral cricoarytenoid

1. Cricothyroid

A 15 year old boy was diagnosed with pneumonia caused by Mycoplasma Pneumoniae, what antibiotic should be given? 1. ampicillin 2. amikacin 3. erythromycin 4. vancomycin

3. erythromycin

Which of the following causes hypoxia with AaDO2 almost near zero? 1. hypoventilation 2. right to left shunt 3. diffusion impairment 4. V/Q mismatch

What stage of lobar pneumonia is characterized by progressive disintegration of red blood and persistence of fibirno-suppurative exudate? 1. congestion 2. red hepatization 3. gray hepatization 4. resolution

3. gray hepatization

Which of the following is released by T-regs 1. IL-2 2. IL-3 3. IL-8 4. IL-10

4. IL-10

Which type of Tcell is involved in innate immunity? 1. alpha beta 2. gamma delta 3. Treg 4. CD8+

2. gamma delta

what condition causes air in the stomach of an infant?

Tracheoesophageal fistula

Which condition cause pleural pressure to be positive : 1. A- end of inspiration at TLC 2. B- during inspiration at FRC 3. C- end of forced expiration at RV 4. D- during forced expiration at FRC

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

CCDC40

What is the function of the proximal histidine ? 1. Attached to heme 2. Attached to o2 3. Critical for the attachment of the tetramer subunits

1. Attached to heme

A 45 year old female, with normal vital capacity (VC). What is the most likely diagnosis from this diagram? 1. fixed Intrathoracic obstruction 2. variable Intrathoracic obstruction 3. fixed extrathoracic obstruction

Which afferent fibers work to terminate inspiration during breathing?) 1. c-fibers nociceptors 2. a-delta nociceptors 3. slowly adapting receptors

What dimension is changed by the pump movement? 1. 1- transverse 2. 2- anterioposterior 3. 3- vertical 4. 4- certcal-transvers

1- transverse

A 50-year old male presented with massive hemoptysis. Chest X-ray revealed a thick walled cavity lesions in the apex of the right lung. What are the possible factors responsible for the tissue destruction? 1. antimicrobial peptides 2. inducable nitric oxide synthase 3. tumor necrosis factors

Which of these drugs is associated with optic neuritis?

Ethambutol

Which group of drugs causes adrenal insufficiency in children?

Corticosteroids

What is the origin of inferior phrenic artery? 1. Thoracic aorta 2. abdominal aorta 3. subcostal artery

2. abdominal aorta

In a rat brain, If the pons and vagus nerve is cut, what will happen to breathing pattern 1. Breathing stops 2. Breathing maintained but irregular 3. Breathing prlonged 4. Breathing is normal

Best lung function parameter to determine obstructive lung disease? 1. TLC 2. FVC 3. FEV1/FVC 4. DLCO

3. FEV1/FVC

Best lung function parameter to determine restrictive lung disease? 1. TLC 2. FVC 3. FEV1/FVC 4. DLCO

2. FVC

When a child understands that death is functional and irreversible ? 1) 5 years 2) 8 years 3) 10 years 4) 14 years

3) 10 years

A 65 y/o male with lung cancer; has ptosis, myosis, & anhydrosis. What is the location of his tumor? 1. Upper part of lower lobe 2. Right main bronchus 3. Lower part of upper lobe 4. Apex

4. Apex

A 15 months old boy presented with tachpnea, dyspnea, low grade fever, sneezing, the chest radiograph revealed hyperinflation. 1. Adenovirus 2. Influenza 3. RSV

RSV

What is the main structure affected in bronchial asthma? 1. Prim bronchus 2. Sec bronchus 3. Bronchioles 4. Alveoli

3. Bronchioles

What is true about fetal Hg? 1. It has high binding affinity for 2,3 BGP compared to A Hg 2. It facilitates the transport from maternal to fetal 3. it has decreased ...?

2. It facilitates the transport from maternal to fetal

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

Gomori methenamine silver (GMS) stain

Which cell is involved in mediating the innate immune response in TB? 1. - T regs 2. - CD8 3. - aplha-beta 4. - delta gamma

4. - delta gamma

Patient with lung cancer or carcimoma “not sure” has miosis, ptosis enhydrosis. Which part of lung cancer affect? 1. -Lower part of upper lobe 2. -Apex of lung 3. -Upper part of lower lobe

2. -Apex of lung

which if these produced by 5-LOX has anti- inflammatory effect? 1. leukotrien A4 2. lipoxin A4 3. prostaglandin 4. thromboxane

2. lipoxin A4

What is multi-drug resistant mycrobacterium TB?

does not respond to at least isoniazid and rifampicin

Physio question: what is shown on the graph (a flow-volume loop) the answers were 1. variable extrathoracic 2. variable intrathoracic 3. Normal

1- Variable Extrathoracic

What is the mechanism of hypoxic vasoconstriction 1. variable extrathoracic 2. variable intrathoracic 3. Normal

1- Variable Extrathoracic

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

B) decrease K conduction

Where would you see hyaline formation in the lungs?

Viral Infections - ARDS

Which of these is an example of delayed type hypersensitivity reaction? 1. Contact dermatitis 2. Anaphylaxis

Contact dermatitis

Military spread limited to the lungs can occur following erosion of a vessel wall by tuberculous lung lesions.which of the following vessels is most likely to be involved ? 1. Pulmonary veins 2. Pulmonary arteries 3. Systemic veins 4. Systemic lymphatics

56 yr old Indian woman presented with chronic cough, night sweets, and weight loss (for four months \*not sure\*) she took isoniazid only but here condition relapse ? 1. S. Pneumonia 2. C. Pneumonia 3. MTB

MTB

27) What percentage of long-term smokers die from smoking-related diseases? 1. 5% 2. 10% 3. 25% 4. 50% 5. 75%

4. 50%

Which one is anti inflammatory 1. LipoxinA4 2. Lleukotrien

LipoxinA4

2017 end of module exam Flashcards

(81 cards)