Pulmonary Medicine Practice Set

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Practice Set of Pulmonary Medicine

1. Chronic Cor pulmonale is seen in all EXCEPT :
(1) Massive pulmonary embolization
(2) COPD
(3) Cystic fibrosis
(4) Primary pulmonary hypertension

2. Most common cause of lung abscess in comatose patient
(1) Staph aureus
(2) Oral anaerobes
(3) Klebsiella
(4) Tuberculosis

3. Which of the following is most likely to be associated with bronchiectasis of the main bronchi ?
(1) Allergic bronchopulmonary aspergillosis
(2) Endobronchial tuberculosis
(3) Measles
(4) Chronic bronchitis

4. Most likely precursor to bronchiectasis is :
(1) Tuberculosis
(2) Carcinoma
(3) Bronchial adenoma
(4) Necrotising pneumonia

5. Ultrastructural abnormalities reported in immotile cilia syndrome are :
(1) Dynein in arm deficiency
(2) Absence of radial spokes
(3) Absence of central microtubule
(4) All of the above

6. Nota CT finding in bronchiectasis
(1) Tree in bud appearance
(2) Crazy paving appearance
(3) Signet ring appearance
(4) Traction bronchiectasis with lung fibrosis

7. Most common presentation in cystic fibrosis :
(1) Lung infections
(2) Meconium ileus
(3) Malabsorbtion
(4) Infertility

8. An infant has a positive newborn screening test for cystic fibrosis. What cut off of sweat chloride confirms cystic fibrosis ?
(1) Sweat Chloride > 30 meq/dL
(2) Sweat Chloride > 40 meq/dL
(3) Sweat Chloride > 50 meq/dL
(4) Sweat Chloride > 60 meq/dL

9. Which one of the following is not likely to be associated with pulmonary fibrosis ?
(1) Coal Miner’s Lung
(2) Primary biliary cirrhosis
(3) Asbestosis
(4) Ankylosing spondylitis

10. Conglomerate nodule are found in
(1) Pulmonary Lymphangioleio-myomatosis
(2) Round pneumonia
(3) Silicosis
(4) Hypersensitivity pneumonitis

11. Klebsiella pneumonia has the following characteristics EXCEPT :
(1) Upper lobes are frequently involved
(2) Pneumatocoele may occur commonly
(3) Empyema is much more common
(4) Lung abscess formation is very uncommon

12. CURB 65 criteria includes all EXCEPT :
(1) Age more than or equal to 65 years
(2) Respiratory rate more than 30/min
(3) Systolic blood pressure is more than 90 mmhg
(4) BUN level is more than >7 mmol/L

13. All of the following features are seen Lt in the viral pneumonia EXCEPT :
(1) Presence of interstitial inflammation
(2) Predominance of alveolar exudates
(3) Bronchiolitis
(4) Multinucleate giant cells in the bronchiolar wall

14. All of the following statements about pneumocystis Jiroveci are true EXCEPT :
(1) Usually associated with CMV infection
(2) May be associated with pneumatocele
(3) Usually diagnosed by sputum examination
(4) Causes disease only in the immunocompromised host

15. Patient diagnosed with HIV and Tuberculosis. How to start ATT and c-A.R.T. ?
(1) Start ATT first
(2) Start cART first
(3) Start both simultaneously
(4) Start cART only

16. False-negative tuberculin test is seen in all EXCEPT :
(1) After 4-6 weeks of measles attack
(2) Immunodeficiency state
(3) Miliary tuberculosis
(4) Atypical mycobacterial infection

17. All of the following criteria are required for diagnosis of obesity hypoventilation syndrome EXCEPT
(1) Hypertension
(2) Sleep disorder breathing
(3) BMI > 30 kg/m2
(4) PaCO2 > 45 mmHg

18. 40-year old smoker, obese, hypertension patient is having loud snoring. On sleep study patient had > 5 episodes of apnea per hour of sleep at night. After control of BP and quitting smoking what is the next best management for improvement of symptoms of the patient ?
(1) CPAP
(2) Uvulopalatoplasty
(3) Weight reduction and diet control
(4) Mandibular reposition surgery

19. ARDS includes all EXCEPT :
(1) Hypoxia
(2) Hypercapnia
(3) Non-cardiogenic pulmonary edema
(4) Normal P.C.W.P.

20. The following are features of adult respiratory distress syndrome EXCEPT :
(1) Hypoxia
(2) Hypocapnia
(3) Low protein pulmonary edema
(4) Stiff lungs

21. Common symptom of Obstructive sleep apnea (OSA) EXCEPT :
(1) Heavy Snoring
(2) Witnessed Apnoea
(3) Daytime Sleepiness
(4) Chest Pain

22. Associated Disease with OSA EXCEPT :
(1) Hypertension
(2) Stroke
(3) Hypothyroidism
(4) Congenital Heart disease

23. Prevalence of OSA with sex distribution is true
(1) Male suffers more than female
(2) Female suffers more than male
(3) Male and female prevalence is equal
(4) Not clearly defined

24. Best Modality for treatment of OSA
(1) Oral appliances
(2) Surgical treatment
(3) Continuous positive airway pressure treatment
(4) Weight reduction

25. “Velcro Crackels in IPF of heard in :
(1) End inspiration
(2) Mid inspiration
(3) Early inspiration
(4) End expiration

26. Median survival of IPF is about :
(1) One years
(2) Two years
(3) Four years
(4) Six years

27. Drugs known to cause interstitial Lung disease are all EXCEPT :
(1) Gold
(2) Methotrexate
(3) Ethambutol
(4) Rifampicin

28. In Rheumatoid associated ILD surgical Lung biopsy show more common pattern of
(1) Non specific interstitial
(2) Usual Interstitial (UIP)
(3) Organizing Pneumonia
(4) Lymphocytic Interstitial Pneumonia (LIP)

29. In drugs induced ILD conventional pattern on Histopathology will be all EXCEPT :
(1) Hypersensitivity Pneumonia
(2) Non specific interstitial Pneumonia
(3) Usual Interstitial Pneumonia
(4) Lymphocytic Interstitial Pneumonia

30. Major diagnostic criteria for IPF 14 include all EXCEPT :
(1) Exclusion of other known cause of ILD
(2) Abnormal pulmonary function
(3) Bibasilar reticular abnormalities on HRCT & No feature to support alternative diagnosis with TBLB/BAL
(4) Bibasilar inspiratory crackles (“Velcro” type)

31. Which of the following associations correctly pairs clinical scenarios and community-acquired pneumonia (CAP) pathogens ?
(1) Aspiration pneumonia : Streptococcus pyogenes
(2) Heavy alcohol use : atypical pathogens and staphylococcus aureus
(3) Poor dental hygiene : Chalmydia pneumonia, Klebsiella pneumoniae
(4) Structural lung disease : Pseudomonas aeruginosa, S. aureus

32. Which of the following conditions would be expected to increase the residual volume (RV) of the Lung ?
(1) Bacterial pneumonia
(2) Cryptogenic organizing pneumonia
(3) Emphysema
(4) Obesity

33. The most common cause of a pleural effusion is
(1) Cirrhosis
(2) Left ventricular failure
(3) Malignancy
(4) Hypoprotenemia

34. A 25 year old woman has a moderately severe pulmonary embolism while on oral contraceptive pills. Which of the following is the most likely predisposing factor ?
(1) Abnormal factor V
(2) Abnormal protein C
(3) Diminished protein C level
(4) Diminished protein S level

35. In the first year after lung transplant, which of the following is the most common cause of mortality ?
(1) Acute rejection
(2) Bronchiolitis obliterans
(3) Infection
(4) Primary graft failure

36. Which of the following is the most | common underlying medical condition of patients undergoing lung transplantation ?
(1) Chronic obstructive pulmonary disease (COPD)
(2) Cystic fibrosis
(3) Idiopathic pulmonary fibrosis (IPF)
(4) Pulmonary hypertension

37. Second hand tobacco smoke has been associated with which of the following ?
(1) Increased risk of lung cancer
(2) Increased prevalence of respiratory illness
(3) Excess cardiac mortality
(4) All of the above

38. Which of the following represents a rare but serious extrapulmonary complication of influenza infection ?
(1) Diffuse eczematous rash
(2) Myositis
(3) Oligoarthritis
(4) Secondary bacterial pneumonia caused by Staphylococcus aureus

39. Chest radiographic finding sarcoidosis stage 3 is:
(1) Bilateral hilar adenopathy, often with right paratracheal adenopathy
(2) Pulmonary infilterate without adenopathy
(3) Stage 1+ Pulmonary infilterate
(4) Advanced Parenchymal Lung disease like fibrosis, honley, combing, cyst, bullal etc.

40. In Sarcoidosis hyper calcemia has been reported to occur in between :
(1) 2% to 63% of patients
(2) 90% of patients
(3) 1 to 80% of patients
(4) Almost in all patients

41. Kveim test in sarcoidosis will be interpreted in :
(1) 2 wks
(2) 3 wks
(3) 4-6 wks
(4) At 72 hrs.

42. All drug can cause cosinophilic lung disease EXCEPT :
(1) PAS
(2) Sulphonamides
(3) Methotrexate
(4) Amidarone

43. Exposure to nitrogen dioxide (NO2) can lead to all EXCEPT :
(1) Excerbation of Asthma
(2) Increased susceptibility to respiratory infection
(3) Airway inflammation
(4) Idiopathic pulmonary fibrosis

44. Short term exposure to outdoor air pollution can cause all EXCEPT :
(1) Work absenteeism
(2) Acute respiratory symptom
(3) Physiologic changes in lung function
(4) Incidence of Asthma and COPD

45. Preexisting Lung disease can be effected at high altitude EXCEPT :
(1) COPD
(2) Breast asthma
(3) Interstitial Lung disease
(4) Bronchogenic Carcinoma