module 13 week 4 question
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MODULE 13: RESPIRATORY SYSTEM
QMU 2011-2012 (BATCH 2010-2016)
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NAME :
MODULE : RESPIRATORY SYSTEM (MODULE 13)
WEEK : 4
DURATION :
TREATMENT OF BRONCHIAL ASTHMA 2
1. Choose the correct answer about the theophylline
A. It provides mild or moderate bronchodilation in patient with asthma
B. It is a non-selective phosphodiesterase inhibitor
C. It produces minimal to no effect on the airway reactivity
D. All of the above
2. All of the following factors will increases the plasma level of theophylline except
A. Rapid intravenous injection
B. Febrile illness
C. Heart failure
D. Concomitant use of theophylline with contraceptive pills
3. Choose the incorrect statement about the sustained-release oral theophylline
A. Mild to moderate bronchodilator
B. It produces a low plasma level over a prolonged period of time
C. It has a wide therapeutic indexD. Can be used for treatment of nocturnal asthma
4. Which of the following answer is the systemic effect which is caused by atropine?
A. Tachycardia
B. Urine retention
C. Glaucoma
D. All of the above
5. All of the following answers are true about the iatropium bromide except
A. It has high bioavailabilityB. May be used as alternative bronchodilator for COPD patients who do not tolerate SABA
C. It can only be given by inhalation
D. It is a short acting anticholinergic drug
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MODULE 13: RESPIRATORY SYSTEM
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VENTILATION/PERFUSION RELATIONSHIP (V/Q)
6. The V/Q ratio in the ideal lung is
A. 0.8
B. 0.6
C. 3.3
D. 0.2
7. The following statements are true EXCEPT
A. Apical alveoli are more perfused than ventilated
B. The base of the lung represents a physiological shunt
C. There is more perfusion than ventilation at the base of lung
D. Low volume dead space can be found at the apex of lung
8. Which of the following is TRUE regarding to bronchial constriction?
I. There is increase in PACO2
II. PO2 and PCO2 in alveoli and capillary are the same
III. V/Q ratio= infinity
IV. The ventilation is zero
A. I, II and III
B. I, II and IV
C. I, III and IV
D. II, III and IV
9. During exercise, there is increase in perfusion at the apex of the lung
A. True
B. False
10.Choose the true statements regarding ventilation/perfusion ratio
I. Mismatch between ventilation and perfusion can cause CO2 retention and hypoxia
II. The V/Q ratio in thrombosis is zero
III. The V/Q ratio at the apex is more than at the base
IV. There is almost equal in V/Q ratio between apex and base of lung during rest
A. I and II
B. I and III
C. II and III
D. III and IV
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MODULE 13: RESPIRATORY SYSTEM
QMU 2011-2012 (BATCH 2010-2016)
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PNEUMONIA AND LUNG ABSCESS
11.All the following are true regarding the community-acquired acute pneumonia except:
A. Most cases are bacterial in origin
B. Commonly, the infection follows a viral upper respiratory tract infection
C. Its most common cause is Pneumococcus
D. Originates by aspiration of pharyngeal flora
12.The correct sequence of phases of inflammatory response of pneumococcal lobar pattern is:
A. Gray hepatization stage -> Congestion stage -> Red hepatization stage -> Resolution stage
B. Red hepatization stage -> Gray hepatization stage ->Congestion stage-> Resolution stage
C. Resolution stage -> Gray hepatization stage ->Red hepatization stage -> Congestion stage
D. Congestion stage -> Red hepatization stage -> Gray hepatization stage-> Resolution stage
13.Choose the false fate and prognosis for bronchopneumonic pattern:
A. Carnification
B. Pleural empyema
C. Death especially in type 3 pneumococci infection
D. Complicated by bacterial superinfection
14.The morphology of viral or mycoplasmal pneumonia is the following except:
A. Inflammatory reaction may be patchy, or may involve whole lobes bilaterally or unilaterally
B. Grossly, the affected areas appear congested,subcrepitant with consolidation
C. Microscopically it is termed interstitial pneumonitis
D. Alveolar spaces are free of cellular exudates hence it is termed atypical pneumonia
15.Choose the false type of lung abscess:
A. Postpneumonic and postbronchiectatic lung abscess
B. Postobstructive lung abscess
C. Nosocomial lung abscess
D. Primary cryptogenic lung abscess
MICROBIOLOGY TUBERCULOSIS
16.The following are true EXCEPT
A. Saprophytic mycobacteria which are found in soil are atypical
B. Myolic acid in mycobateria cell wall makes them acid and alcohol fast
C. Ziehl Neelsen stain can be used to stain mycobacterium tuberculosis
D. Lowenstein Jensen glycerol medium is inhibitory to mycobacterium tuberculosis
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MODULE 13: RESPIRATORY SYSTEM
QMU 2011-2012 (BATCH 2010-2016)
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17.The following are true EXCEPT
A. Pasteurization renders milk safe because mycobacteria are killed by dry heat at 60C fo 15-20
min
B. Tubercle Bacilliresist acid and alkali and has more resistance to malachite green and penicillin
compared to other bacteria
C. Paranitrobenzoic acid (PNBA) medium does not promote the growth ofM.Bovis
D. Human are one of the main source of infection of tuberculosis
18.Choose the correct statements
I. Spreading oftubercle bacilliin the host is by direct extension, through blood and lymphatics
II. Gohns complex is the feature of primary tuberculosis
III. Intramuscular test of tuberculin is used to detect state of hypersensitivity to tubercle bacilli
IV. A positive tuberculin test always implies that active disease is present
A. I & II
B. II & III
C. III & IV
D. II & IV
19.Choose the correct statements
I. Old tuberculin and purified protein derivative are used as material in Tuberculin test
II. Specimen for lab diagnosis of pulmonary tuberculosis : late night sputum
III. Polymerase chain reaction is one of the rapid technique used to detect mycobacterial antigen
IV. M. Kansasiicause tuberculosis-like disease of the lung
A. I & II
B. I & IV
C. II & III
D. II & IV
20.The following are atypical mycobacterium EXCEPT
A. M. SmegmatisB. M. KansasiiC. M. AviumD. M. IntracellulareE. M. Bovis
PATHOLOGY TUBERCULOSIS
21.Tuberculosis is one of infective disease because it can transmit disease through:
A. Ingestion of milk
B. Inoculation of skin
C. Droplet transmission
D. All of above
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22.What is the difference primary and secondary TB?
A. Primary TB develops in a person who was not previously exposed to the tubercle bacilli and is
therefore are sensitized.
B. Secondary TB regional lymph node are less prominently involved.
C. Primary TB have complications of fibrocaseous TB with cavitation.
D. None of above.
23.In the pathogenicity of TB, the center of granuloma undergoes caseation possibly due to :
I. Vascularity of lesion
II. Lack of blood supply
III. Response to mediators produced by activated macrophage and activated CD4+ lymphocytes
IV. Dystrophic calcification
A. I AND III
B. I AND IV
C. II AND III
D. III AND IV
24.Fate of pulmonary TB depends on virulence of organism and dose of infection:
A. True
B. False
25.Healing by fibrosis and calcification occurs when the organism is high virulence and patients
resistance is low :
A. True
B. False
PHARMACOLOGY (CONTROLLER MEDICATION)
26.Which of the following is about theophylline ?
I. Aminophylline is administered to treat of asthma exacerbations
II. Increasing theophylline plasma level above 20 g/ml leads to GIT disturbance, arrhythmia, and
headache
III. Pregnancy and concomitant use of anti-tuberculosis medication decrease theophylline plasma
level
IV. Rapid IV theophylline injection may cause cardiac and CNS side effects
A. I and III
B. II and IV
C. I, II and IV
D. All of the above
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27.All of the following is CORRECT regarding antimuscarinic bronchodilators and magnesium sulfate
EXCEPT
A. Cardiac arrest may occur in some cases treated with magnesium sulfate
B. Tiotropium bromide can be given to COPD patients
C. Ipratropium bromide is approved for use in nocturnal asthma
D. Systemic side effect of atropine make its use proved to be not suitable
28.All of the following is TRUE regarding to glucocorticoids EXCEPT
A. Corticosteroids suppress recruitment of airways inflammatory cell
B. Systemic steroids are indicated to mild, moderate or severe persistent asthma
C. Inhaled steroids have lower bioavailability than oral systemic corticosteroids
D. Adverse effects of inhaled steroids are voice hoarseness, oropharyngeal candidiasis, dermal
thinning, bruises and linear growth delay in children
29.Regarding to controller medication, choose INCORRECT statement:
A. Montelukast can be given in exercise induced asthma and aspirin-sensitive individuals
B. Omalizumab may lead to anaphylactic reactions
C. Liver toxicity has been found in some subjects receiving zileuton
D. Cromones are administered only oral administration
30.Which of the following drugs are given in severe persistent asthma?
I. Inhaled corticosteroid
II. Cromones
III. Omalizumab
IV. Aspirin
V. Beta- blocker
A. I and III
B. II and IV
C. I, II and III
D. All of the above
PHARMACOLOGY TUBERCULOSIS
31.Choose the correct answer about the antimicrobial action of pyrazinamide:
I- The drug is taken by macrophages and exert its action intracellularly
II- Is a prodrug converted to pyrazinoic acid by the enzyme found in mycobact. tuberculosis
III- Destroys the bacterium by inactivates vital enzyme in fatty acid synthesis of mycobacterium
IV- It is bacteristatic to semidormant bacteria
A. I & II Only
B. I, II, & III
C. III & IV
D. All of the above
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32.The following are the advantages of the use of pyrazanamide in treatment of Tuberculosis EXCEPT:
A. The resistance are not easy to develop
B. It is highly effective during the first two months
C. It can be use in severe life-threatening tuberculosis
D. It shortened the duration of therapy to six months
33.All of the following are incorrect about the indications for usage of streptomycin EXCEPT:
A. It is included in the short course of multiple drug therapy
B. To prevent recurrence of infection in immunodefficient individuals
C. To shortened the duration of therapy to six months
D. It is including in multidrug treatment of mild tuberculosis
34.A 45-year old males comes to an outpatient complaining of cough with bloody sputum. The patient
experience weight loss with night sweat. Chest X-ray revealed cavitation at the apical region of the
lung. You suspect the patient having pulmonary TB. Which of the following drug are suitable to treat
the patient while waiting for the microbiologic testing?
A. Isoniazid and Fluoroquinolones
B. Isoniazid and rifampin
C. Amikacin and Fluoroquinolones
D. Strepromycin rifapentine
35.Choose the correct regimens exist in treatment of tuberculosis:
I- Initial treatment with reduced number of drug and continue with increasing number of drug
II- The combination theraphy of isoniazid-rifampin-pyrazinamide reduced the total duration of
therapy without loss of efficacy
III- The continuation phase of short course therapy aim to eliminate the persisters
IV- During the initial phase of administration, the majority of tubercle bacilli are killed but the
still infectious
A. I & II only
B. II & III only
C. III & IV only
D. All of the above
OXYGEN TRANSPORT 1
36.Which of the following is TRUE regarding the value of Oxygen pressure starting from atmospheric air
till reaching pulmonary artery? (mmHg)
A. 160>150> 100>95>40
B. 159>150>100>95>40
C. 150>100>40
D. 159>150>100>40
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37.Choose the CORRECT statements regarding dissolved form of Oxygen in the blood.
I. Its about 3% of total Oxygen in the blood
II. 0.3ml/100ml in arterial blood & 0.13/100ml in venous blood
III. It determines direction and rate of flow of RBCs
IV. Determine chemical combination with Hb
A. I,II,III
B. I,II,IV
C. III,IV
D.All of the above
38.Choose the FALSE statements regarding Oxygen in chemical combination
I. 97% of Oxygen in the blood is in this form
II. Its about 20ml/100ml blood
III. The combination consist of 4haem fractions with 4 iron atom in ferric state each bind to 1
oxygen molecule
IV. The binding of Hb with Oxygen is by oxidation
A. I,II
B. II,III
C. III,IV
D. I,IV
39.Which of the following is FALSE regarding chemical combination of the blood?
A. Tense configuration of Hb increases the affinity of the molecule for oxygen
B. Relaxed configuration exposed more binding site for more oxygen binding
C. Oxygen contents in blood depends on Hb concentration and oxygen tension
D. 15g/d.L of Hb is needed to carry oxygen in chemical combination form
40.Choose the CORRECT answers regarding Oxygen-Hb dissociation curve
I. Changes of pressure of Oxygen has great effect on the % saturation of Hb with Oxygen
II. The flat upper part represent loading zone, it represent lung side
III. The steep lower part represent dissociation zone,it represent tissue side
IV. During muscular exercise,the saturation of Hb with the oxygen is increases
A. I,II
B. II,III
C. I,II,IV
D. All of the above
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MODULE 13: RESPIRATORY SYSTEM
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ANTITUBERCULOUS DRUG 2
41.Which of the following is not true about Pyrazinamide?
A. Included in first-choice combination regimen drug
B. Resistance to Pyrazinamide is easily required
C. At neutral ph, pyrazinamide is inactive
D. At ph 5.5, pyrazinamide inhibits tubercle bacilli
42.All of the following are the adverse effects of pyrazinamide except?
A. Hyperuricemia
B. Arthralgia
C. Optic neuritis
D. Hepatitis
43.Which of the following is not true about Streptomycin?
A. it is an aminoglycosides
B. Most action on intracellular tubercle bacilli
C. Penetration to CSF increase when the meninges are inflamed
D. Most action on extracellular tubercle bacilli
44.Which drug causes the patients suffering from gouty arthritis?
A. Pyrazinamide
B. Rifampicin
C. Streptomycin
D. Ethambutol
45.Which drug causes injury to 8th nerve ?
A. Rifampicin
B. Isoniazid
C. Streptomycin
D. Ethambutol
PHYSIOLOGY (O2 TRANSPORT 2)
46.Below are all factors affecting oxygen-Hb dissociation curve EXCEPT
A. Increased acidity
B. Increase temperature
C. Increase 2-3 diphosphoclycerate
D. Fetal Hb
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True [A] or False [B]
47.P50 determines the position of oxygen-Hb dissociation curve
48.Chronic hypoxia will increase 2-3DPG synthesis
49.Choose the correct statement regarding myoglobin
I. High affinity to oxygen
II. Important in preventing muscle from getting hypoxia at rest
III. Give out oxygen only when the pressure is very low
IV. Found in cardiac muscle
A. I, III
B. II, IV
C. I, II, III
D. II, III ,IV
50.All of the statement regarding the above gas are true EXCEPT
A. Has 200-250 affinity higher than oxygen
B. Have a significant effect on PO2 and oxygen content
C. Interfere with oxygen transport function of blood
D. Smoking causes 14% of Hb turn inti HbCO
ILA 2: TUBERCULOSIS
PATHOLOGY
51.All the following are important points during history taking for tuberculosis EXCEPT
I- Debilitating disease
II- History of contact with active tuberculosis patients
III- Immunocompromised patients
IV- Previously history of tuberculosis
A. I & II
B. II & III
C. III & IV
D. None of the above
Carbon Monoxide
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MODULE 13: RESPIRATORY SYSTEM
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52.Which of the following are fates of secondary tuberculosis?
I- Miliary TB
II- Healing by fibrosis with dystrophic calcification
III- Fibrocaesous TB
IV- Resolution
A. I, II, III
B. I, III, IV
C. II, III, IV
D. All the above
53.All the following are characteristics of primary TB except
A. Gohns focus at upper part of upper lobe or lower part of lower lobe
B. Lymphadenitis of tracheobronchial lymph nodes
C. Lymphangitis
D. Healing by fibrosis is the most common fate
MICROBIOLOGY
54.All the following are rapid diagnosis for tuberculosis and their reasons for usage EXCEPT
A. PCR detect Mycobacteria DNA
B. Bacter radiometric technique detect labeled palmitic acid to show growth of Mycobacteria
C. EIA detect Mycobacteria antigen
D. NA probe detect Mycobacteria rRNA rapidly due to high copies per cell; 10 000 copies
55.All the following are the reason to conduct Tuberculin test EXCEPT
A. Prior vaccination
B. To exclude TB in respiratory diseases diagnosis
C. Can detect active TB patients
D. To conduct epidemiological study
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MODULE 13: RESPIRATORY SYSTEM
QMU 2011-2012 (BATCH 2010-2016)
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beyond their greatest
failure.Napoleon Hill quotes(American author, 1883-1970)
ANSWERS:
1.D (pg.233) 17.A 33.A 49.A
2.B (pg.234) 18.A 34.B 50.B
3.C (pg.233) 19.B 35.B 51.D
4.D (PG.234) 20.E 36.B 52.A
5.A(PG.234) 21.D 37.B 53.A
6.A 22.B 38.C 54.B
7.B 23.C 39.A 55.C8.B 24.A 40.B
9.A 25.B 41.B
10.B 26.D 42.C
11.B 27.C 43.B
12.D 28.B 44.A
13.D 29.D 45.C
14.B 30.A 46.D
15.C 31.B 47.B
16.D 32.C 48.A
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