3q: all of the following are parasomnias except ?
a. somnambulism
b. bruxism
c. sleep terror
d. nocturnal myoclonus
answer: d . nocturnal myoclonus .
Parasomnias are disorders of partial arousal or disorders that interfere with sleep stage transitions. Parasomnias are often attributed to stress, depression, or other psychological and medical conditions. There are four classifications:
Arousal disorders: are disorders of partial arousal which include: confusional arousals, sleepwalking (aka somnambulism: engaging in activities that are normally associated with wakefulness (such as eating or dressing), which may include walking, without the conscious knowledge of the subject), and sleep terrors (aka Pavor nocturnus or sleep terror disorder: abrupt awakening from sleep with behavior consistent with terror).
Sleep-wake transition disorders: interfere with sleep stage transitions. Common examples include: rhythmic movement disorder, sleep starts, sleeptalking, and nocturnal leg cramps.
Other parasomnias: common sleep disorders such as sleep bruxism (teeth grinding), sleep enuresis (bedwetting), snoring, infant sleep apnea, and sudden infant death syndrome (SIDS), sleep paralysis (conscious paralysis upon waking or falling asleep), partial seizures.
Parasomnias usually associated with REM. These include: nightmares, sleep paralysis, and REM sleep behavior disorder, REM behavior disorder (RBD): acting out violent or dramatic dreams while in REM sleep.
Sunday, February 8, 2009
152 - NIMS MEDICINE february 2009 mcqs - 2
2q: a non small cell cancer of lung with malignant pleural effusion is graded as ?
a. T3
b. T2
c. T4
d. M1
answer: c . T 4 . see the staging of non small cell lung cancer below .
TX
Primary tumour cannot be assessed, or tumour proven by the presence of malignant cells in sputum or
bronchial washings but not visualised by imaging or bronchoscopy
T0
No evidence of primary tumour
T1
Tumour 3 cm or less in greatest dimension, surrounded by lung or visceral pleura, without
bronchoscopic evidence of invasion more proximal than lobar bronchus (i.e., not in the main bronchus)
T2
Tumour with any of the following features of size or extent.
• More than 3 cm in greatest dimension
• Involving main bronchus, 2 cm or more distal to the carina.
• Invading the visceral pleura.
• Associated with atliectasis or obstructive pneumonitis that extends to the hilar region but does not
involve the whole lung
T3
• Tumour of any size that directly invades the chest wall (including superior sulcus tumours),
diaphragm, mediastinal pleura, phrenic nerve or parietal pericardium
• Tumours in the main bronchus less than 2 cm distal to the carina but without involvement of carina.
• Associated ateliectasis or obstructive pneumonitis of the entire lung
T4
• Tumour of any size, which invades the mediastinum, heart, great vessels, trachea, oesophagus,
vertebral body or carina
• Tumour with a MALIGNANT PLEURAL EFFUSION
• Secondary nodules in the same lobe of the lung
Regional Lymph Nodes
NX
Regional nodes cannot be assessed
N0
No regional node metastasis
N1
Ipsilateral peribronchial and/or ipsilateral hilar nodes including direct extension
N2
Ipsilateral mediastinal and/or subcarinal nodes
N3
Ipsilateral scalene, contralateral mediastinal, hilar, scalene or supraclavicular nodes
Distant Metastasis
MX
Presence of metastasis cannot be assessed
M0
No distant metastasis
M1
Distant metastasis present; secondary nodules in a different lobe of the lung other than that of primary
a. T3
b. T2
c. T4
d. M1
answer: c . T 4 . see the staging of non small cell lung cancer below .
TX
Primary tumour cannot be assessed, or tumour proven by the presence of malignant cells in sputum or
bronchial washings but not visualised by imaging or bronchoscopy
T0
No evidence of primary tumour
T1
Tumour 3 cm or less in greatest dimension, surrounded by lung or visceral pleura, without
bronchoscopic evidence of invasion more proximal than lobar bronchus (i.e., not in the main bronchus)
T2
Tumour with any of the following features of size or extent.
• More than 3 cm in greatest dimension
• Involving main bronchus, 2 cm or more distal to the carina.
• Invading the visceral pleura.
• Associated with atliectasis or obstructive pneumonitis that extends to the hilar region but does not
involve the whole lung
T3
• Tumour of any size that directly invades the chest wall (including superior sulcus tumours),
diaphragm, mediastinal pleura, phrenic nerve or parietal pericardium
• Tumours in the main bronchus less than 2 cm distal to the carina but without involvement of carina.
• Associated ateliectasis or obstructive pneumonitis of the entire lung
T4
• Tumour of any size, which invades the mediastinum, heart, great vessels, trachea, oesophagus,
vertebral body or carina
• Tumour with a MALIGNANT PLEURAL EFFUSION
• Secondary nodules in the same lobe of the lung
Regional Lymph Nodes
NX
Regional nodes cannot be assessed
N0
No regional node metastasis
N1
Ipsilateral peribronchial and/or ipsilateral hilar nodes including direct extension
N2
Ipsilateral mediastinal and/or subcarinal nodes
N3
Ipsilateral scalene, contralateral mediastinal, hilar, scalene or supraclavicular nodes
Distant Metastasis
MX
Presence of metastasis cannot be assessed
M0
No distant metastasis
M1
Distant metastasis present; secondary nodules in a different lobe of the lung other than that of primary
151 - NIMS MEDICINE february 2009 mcqs
1q: antineutrophilic cytoplasmic ( ANCA ) antibodies are seen in all except ?
a. churg strauss syndrome
b. wegener's granulomatosis
c. microscopic polyangitis
d. polyarteritis nodosa
answer: d . polyarteritis nodosa .
antineutrophilic cytoplasmic antibodies are of two types
1. P - ANCA = perinuclear antineutrophilic cytoplasmic antibodies and
2. C - ANCA = antineutrophilic cytoplasmic antibodies directed against cytoplasmic proteinase-3
the causes of P - ANCA are
a. microscopic polyangitis ( microscopic PAN )
b. churg strauss syndrome
c. cresentric glomerulonephritis
d. good pasture syndrome
e. rarely seen in classic PAN
the causes of C - ANCA are
a. wegener's granulomatosis .
a. churg strauss syndrome
b. wegener's granulomatosis
c. microscopic polyangitis
d. polyarteritis nodosa
answer: d . polyarteritis nodosa .
antineutrophilic cytoplasmic antibodies are of two types
1. P - ANCA = perinuclear antineutrophilic cytoplasmic antibodies and
2. C - ANCA = antineutrophilic cytoplasmic antibodies directed against cytoplasmic proteinase-3
the causes of P - ANCA are
a. microscopic polyangitis ( microscopic PAN )
b. churg strauss syndrome
c. cresentric glomerulonephritis
d. good pasture syndrome
e. rarely seen in classic PAN
the causes of C - ANCA are
a. wegener's granulomatosis .
Tuesday, February 3, 2009
150 - respiratory system mcqs - part 9
71q: which one of the following is not correct regarding silicosis ?
a. egg shell calcification is seen on chest X ray
b. it is more marked in the lower zone
c. may lead to progressive massive fibrosis
d. the disease may progress even after the exposure has ceased
answer: b .
72q: a person who has high fever,tachycardia,hemoptysis and a lobar consolidation on CXR has ?
a. bronchopneumonia
b. lobar pneumonia
c. pulmonary edema
d. pulmonary infarction
answer: b . lobar pneumonia .
73q: which one of the following organisms causes pneumatocele ?
a. klebsiella
b. hemophilus influenza
c. staphylococcus aureus
d. streptococcus pneumoniae
answer: c . staphylococcus aureus .
74q: kartagener's syndrome is not associated with ?
a. situs inversus
b. subluxation of lens
c. bronchiectasis
d. sinusitis
answer: b .
75q: with reference to cystic fibrosis , which one of the following statement is not correct ?
a. gene is located in the long arm of chromosome 7
b. lung function is grossly impaired at birth
c. pseudomonas infection is very common
d. diabetes is more commonly encountered than in normal population
answer: b . lung function is not actually grossly impaired at birth and hence b is the wrong statement .
76q: cystic fibrosis characteristically has all of the following features except ?
a. low levels of sodium and chloride in sweat
b. pancreatic insufficiency
c. biliary cirrhosis
d. bronchial obstruction
answer: a .
77q: a patient presents with breathlessness . he has bilateral basal crepitations. lung function tests reveal decrease in total lung capacity and vital capacity with normal FEV1/VC ratio. the most likely diagnosis is ?
a. chronic bronchitis
b. idiopathic pulmonary fibrosis
c. cystic fibrosis
d. allergic bronchopulmonary aspergillosis
answer: b . idiopathic pulmonary fibrosis .
78q: interstitial pulmonary fibrosis is associated with the following except ?
a. sarcoidosis
b. asbestosis
c. carcinoid lung
d. radiation exposure
answer: c . carcinoid lung .
79q: all the following are features of alveolitis ( interstitial lung disease ) except ?
a. exertional dyspnea
b. early productive cough
c. digital clubbing
d. coarse crepitations during inspiration
answer: b . early productive cough .
80q: pleural effusion in rheumatoid arthritis is typically associated with the following features except ?
a. glucose greater than 60 mg/dl
b. protein greater than 3gm/ml
c. pleural fluid to serum protein ratio greater than 0.6
d. pleural fluid to serum LDH ratio greater than 0.6
answer: a. rheumatoid arthritis is one of the causes of conditions with low glucose , other causes of pleural fluid low in glucose are mesothelioma ,empyema,malignant pleural effusion . tuberculosis and dressler syndrome are conditions with high glucose in pleural fluid .
a. egg shell calcification is seen on chest X ray
b. it is more marked in the lower zone
c. may lead to progressive massive fibrosis
d. the disease may progress even after the exposure has ceased
answer: b .
72q: a person who has high fever,tachycardia,hemoptysis and a lobar consolidation on CXR has ?
a. bronchopneumonia
b. lobar pneumonia
c. pulmonary edema
d. pulmonary infarction
answer: b . lobar pneumonia .
73q: which one of the following organisms causes pneumatocele ?
a. klebsiella
b. hemophilus influenza
c. staphylococcus aureus
d. streptococcus pneumoniae
answer: c . staphylococcus aureus .
74q: kartagener's syndrome is not associated with ?
a. situs inversus
b. subluxation of lens
c. bronchiectasis
d. sinusitis
answer: b .
75q: with reference to cystic fibrosis , which one of the following statement is not correct ?
a. gene is located in the long arm of chromosome 7
b. lung function is grossly impaired at birth
c. pseudomonas infection is very common
d. diabetes is more commonly encountered than in normal population
answer: b . lung function is not actually grossly impaired at birth and hence b is the wrong statement .
76q: cystic fibrosis characteristically has all of the following features except ?
a. low levels of sodium and chloride in sweat
b. pancreatic insufficiency
c. biliary cirrhosis
d. bronchial obstruction
answer: a .
77q: a patient presents with breathlessness . he has bilateral basal crepitations. lung function tests reveal decrease in total lung capacity and vital capacity with normal FEV1/VC ratio. the most likely diagnosis is ?
a. chronic bronchitis
b. idiopathic pulmonary fibrosis
c. cystic fibrosis
d. allergic bronchopulmonary aspergillosis
answer: b . idiopathic pulmonary fibrosis .
78q: interstitial pulmonary fibrosis is associated with the following except ?
a. sarcoidosis
b. asbestosis
c. carcinoid lung
d. radiation exposure
answer: c . carcinoid lung .
79q: all the following are features of alveolitis ( interstitial lung disease ) except ?
a. exertional dyspnea
b. early productive cough
c. digital clubbing
d. coarse crepitations during inspiration
answer: b . early productive cough .
80q: pleural effusion in rheumatoid arthritis is typically associated with the following features except ?
a. glucose greater than 60 mg/dl
b. protein greater than 3gm/ml
c. pleural fluid to serum protein ratio greater than 0.6
d. pleural fluid to serum LDH ratio greater than 0.6
answer: a. rheumatoid arthritis is one of the causes of conditions with low glucose , other causes of pleural fluid low in glucose are mesothelioma ,empyema,malignant pleural effusion . tuberculosis and dressler syndrome are conditions with high glucose in pleural fluid .
149 - respiratory system mcqs - part 8
66q: use of disodium cromoglycate as a preventive measure has been found to be useful in ?
a. intrinsic asthma
b. exercise induced asthma
c. chronic bronchitis
d. farmer's lung
answer: both a and b .
67q: in bronchial asthma glucocorticoids
a. act as potent bronchodilators
b. reduce airway inflammation
c. inhibit degranulation of mast cells
d. block the action of humoral mediators
answer: b . reduce airway inflammation .
68q: farmer's lung is caused by exposure to ?
answer: thermophilic actinomyces .
69q: the diagnostic criteria for allergic bronchopulmonary aspergillosis would include all of the following except ?
a. peripheral eosinophilia
b. central bronchiectasis
c. bronchial asthma
d. culture of aspergillus fumigatus from the sputum
answer: d . culture of aspergillus fumigatus from the sputum is not a diagnostic criteria .
70q: recognised features of asbestosis does not include ?
a. calcification of pleura
b. egg shell calcification of hilar lymph nodes
c. clubbing of features
d. restrictive pattern of ventilatory defect shown by pulmonary function
answer: c . clubbing of fingers .
a. intrinsic asthma
b. exercise induced asthma
c. chronic bronchitis
d. farmer's lung
answer: both a and b .
67q: in bronchial asthma glucocorticoids
a. act as potent bronchodilators
b. reduce airway inflammation
c. inhibit degranulation of mast cells
d. block the action of humoral mediators
answer: b . reduce airway inflammation .
68q: farmer's lung is caused by exposure to ?
answer: thermophilic actinomyces .
69q: the diagnostic criteria for allergic bronchopulmonary aspergillosis would include all of the following except ?
a. peripheral eosinophilia
b. central bronchiectasis
c. bronchial asthma
d. culture of aspergillus fumigatus from the sputum
answer: d . culture of aspergillus fumigatus from the sputum is not a diagnostic criteria .
70q: recognised features of asbestosis does not include ?
a. calcification of pleura
b. egg shell calcification of hilar lymph nodes
c. clubbing of features
d. restrictive pattern of ventilatory defect shown by pulmonary function
answer: c . clubbing of fingers .
148 - respiratory system mcqs - part 7
61q: study the results of the pulmonary function tests shown below ?
predicted FEV1 of 3.5-4.3 but actual FEV1 is 1.2
predicted FVC of 4.6-5.4 but the actual FVC is 4.1
predicted FEV1/FVC is 72-80 % but the actual value is 29 %
predicted PEF is 440-540 but the actual value is 80
the above results are consistent with the disease of ?
a. chronic bronchitis
b. interstitial lung disease
c. pneumonia
d. pneumothorax
answer: a . chronic bronchitis . the parameters indicate that the disease is an obstructive disease and so the answer is chronic bronchitis .
62q: a previously healthy factory worker was found unresponsive in his workplace .he is afebrile anicteric , tachypnoiec , drowsy and blue all over with
clear lung field and hyperdynamic cardiovascular findings.his ABG with 100 % oxygen after intubation was
pH = 7.30
pO2 = 80 mm of Hg
pCO2 = 30 mm of Hg
SaO2 = 50 %
what is the most likely diagnosis
a. methhemoglobinemia
b. adult respiratory distress
c. carbon monoxide poisoning
d. organophosphorous poisoning
answer: c . carbon monoxide poisoning . ( can anyone explain this - please post in comments ) .
63q: consider the following statements . life threatening features of acute severe asthma in children include
1. altered sensorium
2. pulsus paradoxus
3. audible wheeze in both inspiration and expiration
4. oxygen saturation 92-95 %
a. 1 is only correct
b. 1 and 2 are correct
c. 2 and 4 are correct
d. all are correct
answer: b . altered sensorium and pulsus paradoxus .
64q: poor prognostic indicators in acute severe asthma include all of the following except ?
a. pulsus paradoxus
b. hypocarbia
c. use of accessory muscles of respiration
d. PEFR less than 20 % of previous value
answer: b . hypocarbia .
65q: consider the following statements :
early onset extrinsic episodic asthma is characterised by ?
1. family history of eczema or rhinitis
2. development of an early and late asthamtic reaction mediated by mast cells
3. T lymphocytes that release cytokine like interleukin-4
which of the above statements are ture
a. 1,2 and 3 are true
b. 1 and 2 are true
c. 2 and 3 are true
d. 1 and 3 are true
answer: a . all the three statements are true .
predicted FEV1 of 3.5-4.3 but actual FEV1 is 1.2
predicted FVC of 4.6-5.4 but the actual FVC is 4.1
predicted FEV1/FVC is 72-80 % but the actual value is 29 %
predicted PEF is 440-540 but the actual value is 80
the above results are consistent with the disease of ?
a. chronic bronchitis
b. interstitial lung disease
c. pneumonia
d. pneumothorax
answer: a . chronic bronchitis . the parameters indicate that the disease is an obstructive disease and so the answer is chronic bronchitis .
62q: a previously healthy factory worker was found unresponsive in his workplace .he is afebrile anicteric , tachypnoiec , drowsy and blue all over with
clear lung field and hyperdynamic cardiovascular findings.his ABG with 100 % oxygen after intubation was
pH = 7.30
pO2 = 80 mm of Hg
pCO2 = 30 mm of Hg
SaO2 = 50 %
what is the most likely diagnosis
a. methhemoglobinemia
b. adult respiratory distress
c. carbon monoxide poisoning
d. organophosphorous poisoning
answer: c . carbon monoxide poisoning . ( can anyone explain this - please post in comments ) .
63q: consider the following statements . life threatening features of acute severe asthma in children include
1. altered sensorium
2. pulsus paradoxus
3. audible wheeze in both inspiration and expiration
4. oxygen saturation 92-95 %
a. 1 is only correct
b. 1 and 2 are correct
c. 2 and 4 are correct
d. all are correct
answer: b . altered sensorium and pulsus paradoxus .
64q: poor prognostic indicators in acute severe asthma include all of the following except ?
a. pulsus paradoxus
b. hypocarbia
c. use of accessory muscles of respiration
d. PEFR less than 20 % of previous value
answer: b . hypocarbia .
65q: consider the following statements :
early onset extrinsic episodic asthma is characterised by ?
1. family history of eczema or rhinitis
2. development of an early and late asthamtic reaction mediated by mast cells
3. T lymphocytes that release cytokine like interleukin-4
which of the above statements are ture
a. 1,2 and 3 are true
b. 1 and 2 are true
c. 2 and 3 are true
d. 1 and 3 are true
answer: a . all the three statements are true .
147 - respiratory system mcqs - part 6
51q: FEV1/FVC ratio is decreased in all except ?
a. bronchiectasis
b. emphysema
c. chronic bronchitis
d. tuberculosis
answer: d . tuberculosis .
52q: drug of choice in asthma with heart disease ?
a. rimiterol
b. terbutaline
c. ipratropium
d. cromolyn sodium
answer: c . ipratropium .
53q: an exacerbation of farmer's lung ?
a. is commoner in summer
b. is characterised by intense wheeze
c. produces eosinophilia in the peripheral blood
d. is excluded by the absence of precipitating antibodies
e. disseminated intravascular coagulation
answer: ( if u know the answer please post in comments )
54q: sino bronchial infection is most commonly seen in ?
a. pneumoconiosis
b. kartagener's syndrome
c. uremia
d. down's syndrome
answer: b . kartagener's syndrome .
55q: features of fibrocystic disease include all except ?
a. meconium ileus
b. obstructive emphysema
c. pancreatic insufficiency
d. decreased Na and Cl in sweat
answer: d .
56q: chronic fibrosing mediastinitis is seen in all except ?
a. tuberculosis
b. histoplasmosis
c. plague
d. sarcoidosis
answer: c . plague .
57q: transudative type of pleural effusion is a feature of ?
a. variceal sclerotherapy
b. coronary artery bypass
c. radiation
d. peritoneal dialysis
answer: d . peritoneal dialysis .
other causes of the transudative pleural effusion are congestive heart failure, cirrhosis, nephrotic syndrome , meig's syndrome and hydronephrosis .
58q: external cardiac massage is usually done in ?
a. lower one third of sternum
b. xiphisternum
c. middle of sternum
d. manubrium
answer: a. lower one third of sternum .
59q: pulmonary edema due to narcotic overdose is mostly seen with ?
a. cocaine
b. heroin
c. morphine
d. methadone
answer: b . heroin .
60q: tubular breathing is seen in ?
a. pleural effusion
b. consolidation
c. pleurisy
d. tuberculous cavity
answer: b . consolidation .
146 - respiratory system mcqs - part 5
41q: hemoptysis is an important symptom in all except ?
a. idiopathic hemosiderosis
b. bronchial adenoma
c. alpha antitrypsin deficiency
d. pulmonary tuberculosis
answer: c . alpha antitrypsin deficiency .
42q: finger clubbing is not a usual feature with ?
a. mesothelioma
b. bronchiectasis
c. tropical eosinophilia
d. fibrosing alveolitis
answer: c . tropical eosinophilia .
43q: bulging fissure sign is characteristic of pneuomonia due to ?
a. anaerobic bacteria
b. mycoplasma
c. pseudomonas
d. klebsiella
answer: d . klebsiella .
44q: miliary mottling of the lung is seen in all except ?
a. silicosis
b. aspergillosis
c. hemosiderosis
d. tuberculosis
answer: b . aspergillosis .
45q: best position to reveal small pleural effusions on chest X ray is ?
a. AP view
b. PA view
c. lateral view
d. lateral decubitus view
answer: d . lateral decubitus view .
46q: stony dull note on percussion is charateristic of ?
a. pleural effusion
b. consolidation
c. pleurisy
d. tuberculous cavity
answer: a . pleural effusion .
47q: total minute volume of the normal lung is ?
a. 2 litres
b. 4 liters
c. 4.5 liters
d. 7 liters
answer: d . 7 liters .
48q: FEV1/VC is decreased in all except ?
a. bronchiectasis
b. emphysema
c. chronic bronchitis
d. interstitial lung disease
answer: d. FEV1/VC is normally decreased in obstructive lung diseases , in the options given only d is not an example of obstructive lung disease .
49q: in chronic obstructive pulmonary disease all are seen except ?
a. low FEV1
b. increased FEV1/VC ratio
c. smoking strongly associated
d. partially reversible with bronchodilator therapy
answer: b .
50q: bronchial asthma is associated with raised levels of ?
a. leukotrienes
b. PGI2
c. PGI1
d. thromboxane
answer: a . leukotrienes .
a. idiopathic hemosiderosis
b. bronchial adenoma
c. alpha antitrypsin deficiency
d. pulmonary tuberculosis
answer: c . alpha antitrypsin deficiency .
42q: finger clubbing is not a usual feature with ?
a. mesothelioma
b. bronchiectasis
c. tropical eosinophilia
d. fibrosing alveolitis
answer: c . tropical eosinophilia .
43q: bulging fissure sign is characteristic of pneuomonia due to ?
a. anaerobic bacteria
b. mycoplasma
c. pseudomonas
d. klebsiella
answer: d . klebsiella .
44q: miliary mottling of the lung is seen in all except ?
a. silicosis
b. aspergillosis
c. hemosiderosis
d. tuberculosis
answer: b . aspergillosis .
45q: best position to reveal small pleural effusions on chest X ray is ?
a. AP view
b. PA view
c. lateral view
d. lateral decubitus view
answer: d . lateral decubitus view .
46q: stony dull note on percussion is charateristic of ?
a. pleural effusion
b. consolidation
c. pleurisy
d. tuberculous cavity
answer: a . pleural effusion .
47q: total minute volume of the normal lung is ?
a. 2 litres
b. 4 liters
c. 4.5 liters
d. 7 liters
answer: d . 7 liters .
48q: FEV1/VC is decreased in all except ?
a. bronchiectasis
b. emphysema
c. chronic bronchitis
d. interstitial lung disease
answer: d. FEV1/VC is normally decreased in obstructive lung diseases , in the options given only d is not an example of obstructive lung disease .
49q: in chronic obstructive pulmonary disease all are seen except ?
a. low FEV1
b. increased FEV1/VC ratio
c. smoking strongly associated
d. partially reversible with bronchodilator therapy
answer: b .
50q: bronchial asthma is associated with raised levels of ?
a. leukotrienes
b. PGI2
c. PGI1
d. thromboxane
answer: a . leukotrienes .
145 - respiratory system mcqs - part 4
31q: a patient with spontaneous pneumothorax involving more than 50 % of the hemithorax is best treated with ?
a. needle aspiration
b. closed drainage by tube in underwater seal
c. let spontaneous remission occur
d. open thoracotomy
answer: b . closed drainage by tube in underwater seal .
32q: hamman's crunch is seen in ?
a. caries tooth
b. fracture mandible
c. mediastinal emphysema
d. niemann-pick's disease
answer: c . mediastinal emphysema.
33q: the organism most frequently related to mediastinal fibrosis ?
a. actinomyces
b. histoplasma
c. hansen bacillus
d. staphylococcus
answer: b . histoplasma .
34q: hypercapnea at rest is most indicative of ?
a. hypoventilation
b. right to left shunt
c. impaired diffusion
d. CO poisoning
answer: a . hypoventilation .
35q: about systemic inflammatory response syndrome ( SIRS ) all are true except ?
a. leukopenia
b. hyperthermia
c. hypoxia
d. tachycardia
answer: c . hypoxia .
36q: lung abscesses are least likely to be caused by ?
a. histoplasma
b. staphylococcus
c. metastatic malignancy
d. primary carcinoma
answer: c . metastatic malignancy .
37q: primary disease causing raised PCO2 manifests as ?
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic acidosis
d. metabolic alkalosis
answer: a . respiratory acidosis .
38q: the following are CNS findings of CO2 narcosis except ?
a. excitement
b. increased pH of CSF
c. decreased pH of CSF
d. papilloedema
answer: b . acidosis results due to CO2 narcosis therefore decreasing the pH .
39q: respiratory acidosis is seen with ?
a. DKA
b. pneumonia
c. emphysema
d. phenytoin
answer: c . emphysema .
40q: respiratory acidosis is seen with ?
a. starvation
b. hyperventilation
c. muscular dystrophy
d. vomiting
answer: c . muscular dystrophy .
a. needle aspiration
b. closed drainage by tube in underwater seal
c. let spontaneous remission occur
d. open thoracotomy
answer: b . closed drainage by tube in underwater seal .
32q: hamman's crunch is seen in ?
a. caries tooth
b. fracture mandible
c. mediastinal emphysema
d. niemann-pick's disease
answer: c . mediastinal emphysema.
33q: the organism most frequently related to mediastinal fibrosis ?
a. actinomyces
b. histoplasma
c. hansen bacillus
d. staphylococcus
answer: b . histoplasma .
34q: hypercapnea at rest is most indicative of ?
a. hypoventilation
b. right to left shunt
c. impaired diffusion
d. CO poisoning
answer: a . hypoventilation .
35q: about systemic inflammatory response syndrome ( SIRS ) all are true except ?
a. leukopenia
b. hyperthermia
c. hypoxia
d. tachycardia
answer: c . hypoxia .
36q: lung abscesses are least likely to be caused by ?
a. histoplasma
b. staphylococcus
c. metastatic malignancy
d. primary carcinoma
answer: c . metastatic malignancy .
37q: primary disease causing raised PCO2 manifests as ?
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic acidosis
d. metabolic alkalosis
answer: a . respiratory acidosis .
38q: the following are CNS findings of CO2 narcosis except ?
a. excitement
b. increased pH of CSF
c. decreased pH of CSF
d. papilloedema
answer: b . acidosis results due to CO2 narcosis therefore decreasing the pH .
39q: respiratory acidosis is seen with ?
a. DKA
b. pneumonia
c. emphysema
d. phenytoin
answer: c . emphysema .
40q: respiratory acidosis is seen with ?
a. starvation
b. hyperventilation
c. muscular dystrophy
d. vomiting
answer: c . muscular dystrophy .
Monday, February 2, 2009
144 - respiratory system mcqs - part 3
21q: which of the following is not a feature of kartagener's syndrome ?
a. bronchiectasis
b. pancreatic insufficiency
c. sinusitis
d. situs inversus
answer: b . pancreatic insufficiency .
22q: complication of bronchiectasis are all except ?
a. cerebral abscess
b. lung abscess
c. amyloidosis
d. bronchogenic carcinoma
answer: d . bronchogenic carcinoma is not a complication of bronchiectasis.
23q: what is the histological landmark of langerhan's cells ?
a. dendritic cell processes
b. giant mitochondria
c. birbeck granules
d. increased serum alkaline phosphatase
answer: c . birbeck granules .
24q: pulmonary embolism causes all except ?
a. bradycardia
b. decreased cardiac output
c. arterial hypoxemia
d. acute right ventricular strain
answer: a . bradycardia .
25q: in acute pulmonary embolism, the most frequent ECG finding is?
a. S1Q3T3 pattern
b. P. pulmonale
c. sinus tachycardia
d. right axis deviation
answer: c . sinus tachycardia .
26q: which of the following is characteristic of pulmonary embolism ?
a. respiratory alkalosis
b. right axis deviatioin
c. normal A-a gradient
d. left ventricular strain
answer: b . right axis deviation .
27q: pleural fluid low in glucose is seen in all except ?
a. rheumatoid arthritis
b. tuberculosis
c. mesothelioma
d. empyema
answer: b. tuberculosis .
28q: cause of hemorrhagic pleural effusion are all except ?
a. pulmonary infarction
b. mesothelioma
c. bronchial adenoma
d. tuberculosis
answer: c . bronchial adenoma .
29q: all of the following are causes of hemorrhagic pleural effusion except ?
a. pulmonary embolism
b. rheumatoid arthritis
c. pancreatitis
d. TB
answer: c . pancreatitis .
30q: most unlikely cause of pleural effusion is ?
a. thyroid tumors
b. bronchial carcinoma
c. carcinoma breast
d. lymphoma
answer: a . thyroid tumors .
143 - respiratory system mcqs - part 2
11q: causes of hypersensitivity pneumonitis is/are ?
a. silicosis
b. farmer's lung
c. anthracosis
d. asbestosis
answer: b. farmer's lung caused by thermophilic actinomycetes .
12q: the following does not occur with asbestosis ?
a. pneumoconiosis
b. pleural mesothelioma
c. pleural calcification
d. methhaemoglobinemia
answer: d . methhaemoglobinemia .
13q: asbestosis causes which of the following ?
a. apical nodular fibrosis
b. coin shadow
c. hilar lymphadenopathy
d. basal peribronchal fibrosis
answer: a . apical nodular fibrosis .
14q: which of the following disease coexists with silicosis ?
a. sarcoidosis
b. tuberculosis
c. lymphoma
d. rheumatoid arthritis
answer: b . tuberculosis .
15q: which feature is most characteristic of silicosis ?
a. apical nodular fibrosis
b. coin shadow
c. hilar lymphadenopathy
d. basal peribronchal fibrosis
answer: a . apical nodular fibrosis .
16q: what is true regarding byssinosis ?
a. dyspnea and other respiratory symptoms on day 5
b. similar to chronic bronchitis and emphysema
c. presents as interstitial lung disease
d. eosinophils are prominent in lavage fluid
answer: c . presents as intersititial lung disease .
17q: monday dyspnea is seen in ?
a. byssinosis
b. pulmonary eosinophilia
c. malingering
d. chronic bronchitis
answer: a . byssinosis .
18q: cotton dust causes one of the following occupational lung disease ?
a. byssinosis
b. berylliosis
c. bagassosis
d. silicosis
answer: a . byssinosis .
19q: mycoplasma infection simulates
a. pneumococcal pneumonia
b. viral pneumonia
c. pulmonary oedema
d. pulmonary infarction
answer: b . viral pneumonia .
20q: ultrastructural abnormalities reported in defective cilia in immotile cilia syndrome are ?
a. dyenin arm deficiency
b. absence of radial spokes
c. absence of central microtubule
d. all of the above
answer: d . all of the above .
142 - respiratory system mcqs - part 1
1q: volume of air taken into the lungs in normal respiration is known as ?
a. vital capacity
b. timed vital capacity
c. tidal volume
d. inspiratory reserve volume
answer: c . tidal volume .
2q: for diagnosis of obstructive airway disease which of the following measurement is usual ?
a. vital capacity
b. timed vital capacity
c. tidal volume
d. blood gas analysis
answer: b . timed vital capacity .
3q: in cryptogenic fibrosing alveolitis which of the following is not seen ?
a. decreased lung capacity
b. decreased diffusing capacity
c. decreased arteriolar oxygen tension
d. decreased FEV1/FVC ratio
answer: d . decreased FEV1/FVC ratio . cryptogenic means a disease of obscure or unknown origin .
4q: if FEV1 is 1.3 litres and FVC is 3.1 litres in an adult man , the pattern is suggestive of ?
a. normal lung function
b. restrictive lung disease
c. obstructive lung disease
d. none of the above
answer: c . obstructive lung disease .
5q: the hallmark of generalised obstructive lung disease is ?
a. reduced tidal volume
b. reduced residual volume
c. reduced timed vital capacity
d. reduced vital capacity
answer: c . reduced timed vital capacity .
6q: idiopathic pulmonary fibrosis , features include all except ?
a. decreased TLC
b. decreased RV
c. decreased diffusion capacity
d. decreased FEV1
e. decreased FEV1/FVC
answer: e . decreased FEV1 /FVC .
7q: nasal allergy is most often due to ?
a. pollen grains
b. animal dust
c. house dust
d. automobile dust
answer: a . pollen grains .
8q: curshmann's spirals in sputum is seen in ?
a. asthma
b. tuberculous cavity
c. bronchitis
d. bronchiectasis
answer: a . asthma .
9q: exercise induced asthma is not precipitated by ?
a. high altitude climb and exercises
b. cycling in cold water
c. swimming in hot water
d. swimming in cold water
answer: c . swimming in hot water .
10q: one of the following is not an indicator of the severity of asthma ?
a. use of accesory muscles
b. pulsus paradoxus
c. cyanosis
d. systolic hypertension
answer: d . systolic hypertension .
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