Sr. No | Question | A | B | C | D | E | Correct Answer | Explanation |
---|---|---|---|---|---|---|---|---|
1 | %age of arterial oxygenation at high altitude like k2 | 40 | 35 | 10 | 50 | 25 | The correct answer is: 40 | the arterial oxygenPo2 in the natives at high altitude is only 40 mm Hg,but because of the greater quantity of hemoglobin,the quantity of oxygen in their arterial blood is greaterthan that in the blood of the natives at the lower altitude |
2 | mesothelioma is associated with exposure to | beryllium | Carbon dust | asbestos | Mg exposure | silicon | The correct answer is: asbestos | Malignant mesiothelioma is associated with the long term exposure to the asbestos |
3 | Diagnostic test for dry mouth dry eyes is | Anti Igs | Anti SMA | Anti dsDNA | Anti SSA | Anti TNF | The correct answer is: Anti SSA | Features are suggestive of the Sjogren syndrome and investigation of choice is Anti SSA |
4 | How much amount of air needed for air embolism | 2cc | 50cc | 100cc | 150cc | 10 cc | The correct answer is: 100cc | A larger volume of air, generally more than 100 cc, is necessary to produce a clinical effect in the pulmonary circulation; unless care is taken, this volume of air can be inadvertently introduced during obstetric or laparoscopic procedures, or as a consequence of chest wall injury. |
5 | Ghon complexes are characteristic of | primary TB | secondary focus of TB | Chronic bronchitis | Pneumonia | Sarcoidosis | The correct answer is: secondary focus of TB | Ghon focus is due to primary lesion of the TB while Ghon complexes with advanced lymphadenopathy are characteristics of the secondary TB |
6 | Leg vein thrombus will lodge in | brain vessels | posterior vessels | pulmonary veins | left atrium | right ventricle | The correct answer is: pulmonary veins | This venous thrombus goes to the heart and this to the pulmonary veins by pulmonary circulation |
7 | investigation of choice for cystic fibrosis is | genotyping | LFTs | sweat Cl test | CBC | bronchoscopy | The correct answer is: sweat Cl test | Investigation of choice for cystic fibrosis is the sweat chloride test |
8 | A patient has H/O recurrent respiratory infections,eczema and his platelet count is 10,000/cmm.This is due to | Pneumonia | DIC | Sepsis | Wiskott-Aldrich syndrome | Hematogenous infection | The correct answer is: Wiskott-Aldrich syndrome | Wiskott–Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia (low platelet count), immune deficiency, and bloody diarrhea (secondary to the thrombocytopenia). |
9 | All of these are true about bronchial asthma except | Allergens play significant role in pathogenesis | Leukotriene antagonists are not helpful in the treatment | Regular inhaled steroids casuse growth retardation in children | Symptoms are worse at night | Cromolyns are very effective for exercise induced asthma | The correct answer is: Leukotriene antagonists are not helpful in the treatment | Leukotrienes are the inflammatory mediators. Their antagonist reduce the inflamation and can be used in asthma. |
10 | In chronic smoker, SOB after hyperbaric O2 for longer time, Dx..? | spontaneous pneumothorax | pneumothorax | dysplasia | fibrolental hyperplasia | hemothorax | The correct answer is: spontaneous pneumothorax | A chronic smoker (COPD), when in O2 therapy for prolonged time is at risk of spontaneous pneumothorax leading to dyspnea |
11 | emphysematous changes are due to deficiency of | fibronectin | fibrin | α1 anti trypsin | ALP | Elastin | The correct answer is: α1 anti trypsin | Two types of Emphysema are:Centriacinar—associated with smoking.Panacinar—associated with α1-antitrypsin deficiency. |
12 | ectopic parathyroid is produced by which tumor | BCC | melanoma | CML | lymphoma | SCC | The correct answer is: SCC | Squamous cell carcinoma: Hilar mass arising from bronchus; Cavitation; Associated with Cigarettes; hyperCalcemia (produces PTHrP) |
13 | In an acute state of status asthmaticus, The most important PFTs which will be abnormal | tidal volume | inspiratory reserve volume | FEV1 | expiratory resrve volume | residual volume | The correct answer is: FEV1 | Bronchial asthma is a obstructive lung disease. The most important pulmonary function test for the diagnoses is FEV1 to FVC ratio. That is always less then 70%. Whereas in restrictive lung diseases this ratio is always greater than 80% |
14 | non casseating granuloma is associated with | Sarcoidosis | syphilis | asthma | lung cancer | TB | The correct answer is: Sarcoidosis | Among the features of the Sarcoidosis, non casseating granuloma with asteroid bodies are the characteristic |
15 | A male working in plastic factory is at risk of tumor of | CA tongue | scabies | CA lung | skin lesions | CA bladder | The correct answer is: CA bladder | Plastic factory contains the hydrocarbons that are causitive agents of the CA bladder |
16 | A parasite comes from nose of a child, it is | E. histolytica | W. Bancrofti | A Dudenale | Ascaris | trypanasoma | The correct answer is: Ascaris | A worm affecting both the GIT and respiratory tract is the Ascaris lumbricoids |
17 | In 15 years old boy, the most important sign of ARDS is hypoxia it is | corrected by CO2 | affect red membrane | epithelial damage | always infective | corrected by O2 | The correct answer is: corrected by O2 | ACUTE RESPIRATORY DISTRESS SYNDROME:A. Diffuse damage to the alveolar-capillary interface (diffuse alveolar damage) Plexiform lesion, primary pulmonary hypertension. B. Leakage of protein-rich fluid leads to edema and formation of hyaline membranes in alveoli. Treatment 1. Address underlying cause 2. Ventilation with positive end-expiratory pressure (PEEP) |
18 | A smoker has interstitial lung disease and pleural plaque, most common cause is ? | asbestosis | byssinosis | silicosis | pneumoconiosis | anthracosis | The correct answer is: asbestosis | Asbestosis:Associated with shipbuilding, roofing, and plumbing. “Ivory white,” calcified pleural plaques are pathognomonic of asbestos exposure, but are not precancerous. Associated with an increased incidence of bronchogenic carcinoma and mesothelioma |
19 | A 58 year old male with Patient of COPD present with breathlessness. pH shows acidosis. His electrolytes test will show | hyperkalemia | hypernatremia | hypoglycemia | hypokalemia | hypocalcemia | The correct answer is: hyperkalemia | In any case of acidosis, if there is derranged K level than it will be hyperkalemia resulted from outward shift of K. |
20 | 65 years old male develops respiratory distress after abdominal surgery, A diagnosis of pulmonary infarction was made on the basis of subsequent investigation. This is likely to result from | pulmonary embolism involving large sized artery | due to paradoxical embolism | pulmonary artery thrombosis | pulmonary embolism involving medium sized artery | PE in small sized artery | The correct answer is: PE in small sized artery | after surgery, immobilization of patient causes an increased risk for thrombosis. Thrombi can be dislodged and can block pulmonary vasculature most commonly small sized pulmonary artery causing dyspnea. |
21 | In a 23 year old male patient, parasite related to lung infection | Chlonorchis | T. solium | S. hematobium | ascaris | S. mansoni | The correct answer is: ascaris | Ascaris lumbricoides :(giant roundworm)Transmitted by Fecal-oral; eggs visible in feces under microscopeIntestinal and lung infection |
22 | An 8 year old boy with Cystic fibrosis typical signs and symptoms and having recurrent pseudomonas infections, these infections can cause: | atypical Pneumoniae | Lobar Pneumoniae | Bronchectasis | Chronic bronchitis | Acute bronchitis | The correct answer is: Bronchectasis | Complications of Bronchetasis: Recurrent pulmonary infections (e.g., Pseudomonas), chronic bronchitis and bronchiectasis increased reticulonodular pattern on CXR, pancreatic insufficiency, malabsorption and steatorrhea, nasal polyps, and meconium ileus in newborns. Infertility in males (absence of vas deferens, absent sperm). Fat-soluble vitamin deficiencies (A, D, E, K). |
23 | A patient has pyogenic lung abscess.The responsible organism is | Proteus | staph aureus | H influenza | strep Pneumoniae | bacteriods | The correct answer is: staph aureus | The most common cause of the pyogenic lung abscess is the staph aureus. |
24 | A 43 year old male with history of coal worker presents with cough, weight loss and montoux positive, Cause..? | Silicosis | berrylium | hydrocarbons | organic dust | asbestosis | The correct answer is: Silicosis | Silicosis: Associated with foundries, sandblasting, and mines. Macrophages respond to silica and release fibrogenic factors, leading to fibrosis. It is thought that silica may disrupt phagolysosomes and impair macrophages, increasing susceptibility to TB. |
25 | Regarding hemodynamics, most common cause of increased pulmonary artery pressure | hypoxia | intake of nitroglycerine | exercise | essential hypertension | sympathetic stimulation | The correct answer is: hypoxia | hypoxia results in constriction of pulmonary vusculature resulting in increased pressure. Chronic hypoxia may leads to pulmonary hypertension. |
26 | Primary TB is characterized by the | ghon focus | cough | skin lesions | ghon complex | lymphadenopathy | The correct answer is: ghon complex | Ghon complexes are seen in primary TB while Ghon focus in secondary one |
27 | A 47 year old female on vent. has greenish sputum, organism | klebsella | staph aureus | Pseudomonas | spirochete | Actinomycetes | The correct answer is: Pseudomonas | Pseudomonas aeruginosa:Aerobic gram-negative rod. Non-lactose fermenting, oxidase positive. Produces pyocyanin (blue-green pigment); has a grape-like odor. Water source. Produces endotoxin (fever, shock) and exotoxin (inactivates EF-2). |
28 | Caplan"s syndrome usually occurs among | radar assembly worker | textile worker | coal worker | arc welder | hay farmer | The correct answer is: coal worker | lung fibrosis along with rheumatoid arthritis is known as caplan syndrome. It is most common among coal workers. |
29 | What type of CA lung that causes clubbing, in non smokers | oat cell CA | Adeno CA | large cell CA | small cell CA | SCC | The correct answer is: Adeno CA | Most common lung cancer in nonsmokers and overall (except for metastases). Activating mutations include k-ras, EGFR, and ALK. Associated with hypertrophic osteoarthropathy (clubbing). |
30 | A male gardener develops cough and his chest X-ray reveals a rounded opacity in right lobe of lung. Diagnosis is | tuberculosis | Sarcoidosis | blastomycosis | Actinomycosis | aspergillosis | The correct answer is: aspergillosis | findings are characteristics of the aspergillosis and formers are most affected by it |
31 | 58 year old man presented with cushing syndrome. CT chest shows a lesion in lung.. Most likely diagnosis is | metastatic carcinoma of lung | squamous cell carcinoma | adenocarcinoma of lung | mesothelioma | small cell carcinoma | The correct answer is: small cell carcinoma | small cell carcinoma is a neuroendocrine tumor produces ACTH causing uncontrolled release of cortisol resulting in cushing syndrome. It also causes SIADH |
32 | While regarding respiratory physiology, deficiency of surfactant causes | asthma | inc. alveolar resistance | dec. airway calber | pneumonia | dec. alveolar resistance | The correct answer is: inc. alveolar resistance | pulmonary surfactant decreases the alveolar surface tension and prevention of alveolar collapse (atelectasis). |
33 | In a atopic asthamatic patient, the allergen inhaled rapidly interacts in the bronchi with? | mucosal mast cell | smooth muscle | T-lymphocytes | alveolar epithelial cells | eosinophills | The correct answer is: mucosal mast cell | in asthamatic patients, there are presensitized mast cells. When there is exposure to allergens or cold these mast cells start releasing chemical mediators that cause bronchoconstrictors. |
34 | Histopathology LNs of a young female revealed granuloma. A definite diagnosis of TB in this case requires | presence of caseation necrosis | evidence of lung involvement by Xray | presence of langherhan giant cells. | demonstration of AFB | mantoux test | The correct answer is: demonstration of AFB | gold standard test for the diagnosis of TB is the presence of acid fast bacillus |
35 | Investiagtion of choice for severity of asthma? | FEV | CO2 clearance | RV | FVC | O2 saturation | The correct answer is: FVC | Obstruction of air flow resulting in air trapping in the lungs. Airways close prematurely .Patient have highlung volumes, increased RV and decreased FVC. |
36 | A mine worker is suffering from mesiothelioma due to | carbon | Mg | silicon | asbestos | hydrogen | The correct answer is: asbestos | Asbestosis is the leading cause of the Mesothelioma in mine workers. |
37 | A patient with skin lesion and SOB, his chest X-ray shows diffuse interstitial diease with hilar masses. Biopsy of a skin lesion and a lymph node show granulomas with no necrosis. The most likely diagnosis is | Sarcoidosis | Tuberculosis | Alveolar proteinosis | Silicos | Carcinomatosis | The correct answer is: Sarcoidosis | Sarcoidosis is the Granulomatous disorder characterized by Non-Caseating granuloma and hilar lymphadenopathy. |
38 | In an old 57 year male, Oat cell CA causes what | cushing syndrome | Down syndrome | asthma | Carcinoid | Sarcoidosis | The correct answer is: cushing syndrome | Small cell (oat cell) carcinoma:Central location, Undifferentiated and very aggressive.May produce ACTH (Cushing syndromeg) , ADH, or Antibodies against presynaptic Ca2+ channels (Lambert-Eaton myasthenic syndrome). |
39 | A 55 year old smoker developed cough and SOB. Slightly drowsy his labs showed PCO2 9.5 KPA (4.4-6.1) PO2 6.2 KPA, HCO3 27 MMOL/L, Na 134 MMOL/L, K 3.8 MMOL/L. the mose likely diagnosis is | Acute Respiratory acidosis | compensated respiratry acidosis | Respiratory alkalosis and metabolic acidosis | mixed respiratory acidosis & metabolic acidosis | metabolic acidosis | The correct answer is: Acute Respiratory acidosis | labs shows increased pCO2, and the patients is having acute shortness of breath likely suffering from obstructive disease with long history of smoking. Acute shortness of breath causes retention of CO2 causing respiratory acidosis. |
40 | A patient with lung infiltrates and non casseating granuloma | churg Strauss | TB | pneumonia | Sarcoidosis | syphilis | The correct answer is: Sarcoidosis | pulmonary infiltrates with dry cough and hilar lymphadenopathy and non casseating granuloma are the features of the Sarcoidosis |
41 | Patient has no cough, but diffuse fibrosis on chest X-ray, cause | inorganic dust | asbestos | hydrocarbon | berrylium | silicon | The correct answer is: inorganic dust | Pneumoconioses. These environmental diseases are caused by inhalation of inorganic dust particles. Chronic exposure causes diffused bilalteral lung fibrosis. |
42 | A 32 old female with low grade fever, hypercalcemia stones with B/L lymphadenopathy\ histopathological findings will be? | Granuloma | Cassius | Fibrinoid | Granuloma with asteroid bodies | abscess | The correct answer is: Granuloma with asteroid bodies | Sarcoidosis is Associated with restrictive lung disease (interstitial fibrosis), erythema nodosum, lupus pernio, Bell palsy, epithelioid granulomas containing microscopic Schaumann and asteroid bodies, uveitis, and hypercalcemia (due to increased 1α hydroxylase–mediated vitamin D activation in macrophages). Treatment: steroids. |
43 | True about the pulmonary embolism is | long bone fracture | pregnancy | inc. V/Q | hypoxia | dec. V/Q | The correct answer is: inc. V/Q | In pulmonary embolism, the V/Q is increased due to decreased perfusion and normal ventilation |
44 | Eosinophilia on sputum is due to | worm infestation | viral infection | asthma | Sarcoidosis | fungal infection | The correct answer is: asthma | In sputum of the asthmatics, the eosinophilic count is increased. |
45 | Dead space is increased in | emphysema | pulmonary infarct | pulmonary embolism | both asthma and emphysema | asthma | The correct answer is: both asthma and emphysema | dead space is the volume of air which is inhaled that does not take part in the gas exchange, either because it (1) remains in the conducting airways, or (2) reaches alveoli that are not perfused or poorly perfused. The alveolar deadspace is caused by ventilation/perfusion inequalities at the alveolar level. The commonestcauses of increased alveolardeadspace are airways disease--smoking, bronchitis, emphysema, and asthma. Other causes includepulmonary embolism, pulmonaryhypotension, and ARDS. |
46 | A pt with pain radiating to backand rustling sound on auscultation has | myocarditis | pleural fluid | pleural effusion | pneumonia | pericarditis | The correct answer is: pericarditis | Pericardial rub or the russling sounds over auscultation are due to the pericarditis |
47 | 6 year old boy presented to E/R with recurrent respiratory tract infections and failure to thrive. He also gives history of chronic diarrhea. Family history is positive for such complaints. The most relevant examination in this case to confirm the diagnosis would be | citamin B12 assay | jejunal biopsy | chloride sweat test | fat absoption test | serum immunoglobulin level | The correct answer is: chloride sweat test | patient is most likely suffering from cystic fibrosis. Autosomal recessive defect in CFTR gene on chromosome 7. CFTR encodes an ATP-gated Cl− channel that secretes Cl− in lungs and GI tract, and reabsorbs Cl− in sweat glands. increase Cl− concentration (> 60 mEq/L) in sweat is diagnostic. Recurrent pulmonary infections (eg, S aureus [early infancy], P aeruginosa [adolescence]), chronic bronchitis and bronchiectasis, pancreatic insufficiency. |
48 | which of the following is the effect of asthma | alveolar sacs | trachea | alveolar ducts | alveoli | broncheoles | The correct answer is: broncheoles | Reversible airway bronchoconstriction, most often due to allergic stimuli (type I hypersensitivity) B. Presents in childhood; often associated with allergic rhinitis, eczema, and a family history of atopy |
49 | A 35 years old woman is unconcious, BP unrecordable, thready pulse. Aortic and carotid feedback is increased, Dx..? | dec. pO2 | dec. CO2 | inc. O2 | inc. Na | dec. H | The correct answer is: dec. pO2 | Chemoreceptors in the carotid and aortic bodies■ are located near the bifurcation of the common carotid arteries and along the aortic arch.■ have very high rates of O2 consumption and are very sensitive to decreases in the partial pressure of oxygen (Po2). |
50 | Familial emphysema is associated most closely with | Paraneoplastic syndrome | Chronic bronchitis | Silicosis | Smoking | Alpha- anti-trypsin deficiency | The correct answer is: Alpha- anti-trypsin deficiency | Familial Emphysema is associated with α-1 anti-trypsin deficiency. This enzyme limits the breakdown of Elastin & its deficiency causes excessive breakdown of Elastin leading to damaged airways, collapse and thus emphysema. |
51 | A 21 years old died after 5 days of femor fracture, cause | sepsis | hypovolumic shock | fat embolism | spinal shock | abscess | The correct answer is: fat embolism | Fat embolism: These emboli are particles of bone marrow and other fatty intra osseous tissue that enter the circulation as a result of severe (often multiple) fractures. b. They lodge in the lungs, brain, kidneys, and other organs |
52 | Among the following, which is true about pulmonary Thromboembolism | sec. resistance | collapse | V/Q mismatch | inc. resistance | dec. surfactant | The correct answer is: V/Q mismatch | Pulmonary emboli:V/Q mismatch causes hypoxemia and leading to respiratory alkalosis. Sudden-onset dyspnea, chest pain, tachypnea. May present as sudden death |
53 | In 5 yr old child with cystic fibrosis, is diagnosed to have chest infedtionis suspected clinically, sputum gulture shows large, opaque, Circularcolonies on blood agar which are coagulase positive. which bacteriumis most likely causeing this patient"s illness | Pycoplasma pneumoniae | Staphylococcus aureus | Haemophilus influenae | Klebsiella pneumoniae | streptococcus pneumoniae | The correct answer is: Staphylococcus aureus | Cystic Fibrosis is a genetic disorder in which body secretions become thick. It especially affects the respiratory tree and causes thick mucous and obstruction. 3 microorganisms cause infection S. Aureus, H. influenza & Pseudomonas. Here coagulative necrosis supports the infection by S.Aureus. |
54 | An old patient has COPD from 6 months. ABGs show pH 7.37(normal) PCO2 48( normal below 47) HCO3 30( normal below 29). Diagnosis is | alkalosis | compensated respiratory acidosis | compensated metabolic acidosis | acidosis | diabetic acidosis | The correct answer is: compensated respiratory acidosis | The acid base disturbance is toward the acidosis, but mild derranged CO2 and HCO are characteristics of the compensated disturbance. |
55 | A 54 year old male Patient with cough and bronchial spasm, cause | IgG | IgE | IgM | IgA | IgD | The correct answer is: IgE | IgE: Binds mast cells and basophils; cross-links when exposed to allergen, mediating immediate (type I) hypersensitivity through release of inflammatory mediators such as histamine. Mediates immunity to worms by activating eosinophils. Lowest concentration in serum |
56 | Which organ is least likely to be affected by infarction | intestine | liver | pancreas | spleen | kidneys | The correct answer is: liver | liver is supplied by dual blood supply. Thrombosis in one artery is least likely to cause infarction in liver. Lungs also doesnot infarct with thrombosis |
57 | Among the following, most imp. factor in maintaining pressure in pleural cavity is | osmotic pressure | CO2 concentration | hydrostatic pressure | venous drainage | lymphatic drainage | The correct answer is: lymphatic drainage | lymphatic drainage is the most important factor for maintaining pressure in pleural cavity. |
58 | A smoker is diagnosed case of lung carcinoma.Now he presented with frank hemoptysis. The likely cause of hemoptysis is | erosion of bronchial vessels | invasion of pulmonary vein | consolidation of lungs | erosion of bronchi | tumor necrosis | The correct answer is: erosion of bronchial vessels | tumors invading the bronchial vessels results in massive hemoptysis. |
59 | V/Q is increased in | asbestosis | COPD | asthma | TB | pulmonary embolism | The correct answer is: pulmonary embolism | In pulmonary embolism, the perfusion is decreased without affecting the ventilation |
60 | In an RTA patient with chest trauma, chest tube is inserted in which space | 7th | 4th | 5th | 3rd | 6th | The correct answer is: 5th | A chest drain is inserted into the pleural cavity via an intercostal space, the fi fth space being preferred. After cutting through the overlying skin in the midaxillary line, the remaining insertion is done by blunt dissection into the pleural cavity, at which point the drain is inserted and connected to an underwater seal |
61 | A patient has emphysema. What would be the acid-base imbalance present in him? | alkalosis | retained HCO3 | anemia | hypoxia | acidosis | The correct answer is: acidosis | emphysema causes CO2 retention and hence causes acidosis |
62 | Rock crusher can be affected by which disease? | Asbestosis | Sarcoidosis | mesiothelioma | pneumoconiosis | Silicosis | The correct answer is: Silicosis | Rock contains silicon and chronic exposure can cause Silicosis |
63 | A 57 year old male Factory worker presented in opd with progressive peripheral motor disfunction and anemia. Cause can be | Lead poisoning | B1 deficiency | Vitamin C deficiency | Folate deficiency | B3 deficiency | The correct answer is: Lead poisoning | Lead poisoning:Lead inhibits ferrochelatase and ALA dehydratase dec. heme synthesis and inc. RBC protoporphyrin and dec. B6 leading to neurological problems.Also inhibits rRNA degradation, causing RBCs to retain aggregates of rRNA (basophilic stippling).High risk in old houses with chipped paint and lead factory worker. |
64 | dull percusion over the chest is characteristic of | emphysema | pleural effusion | temponade | pericarditis | pneumonia | The correct answer is: pleural effusion | Regarding the physical examination of the respiratory system, dull percusion note is associated with the pleural effusion |
65 | Granuloma with asteroid bodies is in | churg Strauss | dystrophic calcification | TB | aspergillosis | Sarcoidosis | The correct answer is: Sarcoidosis | Non cassious granuloma with asteroid bodies is the characteristic of the Sarcoidosis |
66 | A man with sudden onset of respiratory distress but ECG and CXR normal, he died of..? | emphysema | asthma | chronic bronchitis | MI | pulmonary embolism | The correct answer is: pulmonary embolism | Sudden onset of respiratory distress and no findings on ECG and chest X-ray is consistent with the pulmonary embolism |
67 | paraneoplastic syndrome is associated with | overian CA | small cell CA lung | gastric CA | pancreatic CA | large cell CA lung | The correct answer is: small cell CA lung | Paraneoplastic syndrome is associated with the small cell CA of the lungs |
68 | Patient has dyspnoea on lying supine but normal CVS examination.It is due to | CKD | CCF | MI | retrosternal goitre | asthma | The correct answer is: retrosternal goitre | Patient has SOB on lying down but has normal CVS is due to the retrosternal goiter. |
69 | 11 days menstruation after every 15 days is | Bicornuate Utrus | poly myalgia | menorrhogia | polymenorrhea | PID | The correct answer is: polymenorrhea | Both the increased frequency the duration of the menstruation is called the polymennorrhea and increased amount is called the menorrhogia |
70 | New born with recurrent URTI for the last 3 months and diarrhea, family Hx positive, how to confirm diagnosis? | sweat Cl test | plasma protein | jejunal biopsy | genetic analysis | marrow biopsy | The correct answer is: sweat Cl test | DIAGNOSIS: Sweat Cl- concentration (>60 mEq/L) in sweat is diagnostic. Can present with contraction alkalosis and hypokalemia (ECF effects analogous to a patient taking a loop diuretic) because of ECF H2O/Na+ losses and concomitant renal K+/H+ wasting. |
71 | Joint pain associated with metabolism of | lipids | pyrimidine | carbohydrates | purine | proteins | The correct answer is: purine | end product of purine metabolism is the uric acid and increased uric acid causes the gout |
72 | A 6 year old boy came to ER lowgrade fever and productive cough for the last 5 days. On physical examination his temperature is 102 F. He is a diagnosed case of cystic fibrosis.A clinical diagnosis of pneumonia is suspected. Sputum culture yielded non-lactose fermenting gram- negative rods with green pigmentation. which bacterium is mostprobably causing his iiiness | Hemphilus influenzae | Klebsiella pneumoniae | Streptococcus pneumorniae | Pseudomonas aeruginosa | Mycoplasma pneumoniae | The correct answer is: Pseudomonas aeruginosa | Pseudomonas is one of the most common bacteria to cause infection in CF. It is gram negative fructose non-fermenting that forms green colonies. |
73 | Most common cause of fat embolism is frature of | sternum | humerus | fibula | tibia | femor | The correct answer is: femor | Fat emboli:a. These emboli are particles of bone marrow and other fatty intra osseous tissue that enter the circulation as a result of severe (often multiple) fractures of long bones. Femor is the most common bone involved, others are the tibia and humerus. |
74 | A 43 year old male with Diabetes and smoker came with papillary construction and ptosis, Diagnosis? | cervical spinel lesion | ptosis | horner syndrome | WPS syndrome | misosis | The correct answer is: horner syndrome | Horner syndrome: Sympathectomy of face:Ptosis (slight drooping of eyelid: superior tarsal muscle)Anhidrosis (absence of sweating) and flushing (rubor) of affected side of faceMiosis (pupil constriction)Associated with lesion of spinal cord above T1 (e.g., Pancoast tumor, Brown-Séquard syndrome [cord hemisection], late-stage syringomyelia). |
75 | Hilar lymph node is most commonly associated with asteriod bodies in histology | emphysema | Sarcoidosis | asthma | RSV | TB | The correct answer is: Sarcoidosis | Sarcoidosis is characterized by chronic cough with lymphadenopathy and asteriod bodies on Histopathology |
76 | What is the drug of choice for acute severe asthma? | N/S nebulization | Salbutamol nebulization | Oral steroids | Antihistamine | Inhalational steroids | The correct answer is: Salbutamol nebulization | The first line treatment of acute severe asthma is bronchodilators either inhalational or I/V. |
77 | An old man developed respiratory distress after abdominal surgery. A diagnosis of pulmonary infarction is made on the basis of subsequent investigations. The infarction is most likely the result of | paradoxical embolism | pulmonary embolism involving large sized artery | PE in small sized artery | pulmonary artery thrombosis | PE in medium sized artery | The correct answer is: PE in small sized artery | after surgery, immobilization of patient causes an increased risk for thrombosis. Thrombi can be dislodged and can block pulmonary vasculature most commonly small sized pulmonary artery causing dyspnea. |
78 | A rock crusher developed lymphadenopathy and bireferengence on biopsy, Dx..? | byssinosis | anthracosis | asbestosis | silicosis | pneumoconiosis | The correct answer is: silicosis | Rock crush is associated with silicosis exposure. |
79 | A 28 year old female with previous TB now presented with fever, pericardial effusion and thick sputum, Dx..? | Chronic bronchitis | asthma | atelectasis | Bronchiectasis | acute bronchitis | The correct answer is: Bronchiectasis | Bronchiectasis is Associated with bronchial obstruction, chronic infection like TB, poor ciliary motility (smoking), Kartagener syndrome, cystic fibrosis, allergic bronchopulmonary aspergillosis. |
80 | V/Q inc in | asthma | pulmonary infarct | Pulmonary embolism | emphysema | COPD | The correct answer is: Pulmonary embolism | Increasing the V/Q ratio to infinity: Mathematically, dividing by zero produces the answer of infinity - so an increase in V/Q to infinity is produced when perfusion goes to zero. In a patient, regions of zero blood flow will result from a pulmonary embolism that blocks the blood flow. |
81 | On examination of 22 yr male with low grade fever, his nasal bridge was distorted and and cervical lymphnodes were plapable. Histology of these lymph nodes is the most probable diagnosis? | Cat scratch disese | Sacoidosis | leprosy | Tyberculosis | Syphilis | The correct answer is: leprosy | Mycobacterium Laprae is an AFB that causes Leprosy in which there are lion facies, glove and stocking loss of sensation & non-Caseating Granuloma. |
82 | In a patient with chronic cough and pleural plaques on CXR, diagnosis is | aspergilloma | asbestosis | mesothioma | Silicosis | mycetoma | The correct answer is: asbestosis | pleural plaques with dry cough are the features of the asbestosis |
83 | Which cells are increased in bronchial asthma? | monocytes | Eisinophils | Basophils | lymphocytes | leukocytes | The correct answer is: Eisinophils | Asthma is a chronic lung disease in which diseased airways are infiltrated by inflammatory cells (and thus thickened) and obstructed by fluid and mucous. .In eosinophilic asthma, the numbers of eosinophils are increased in blood, lung tissue, and mucus is coughed up from the respiratory tract. |
84 | Dry cough and hilar lymphadenopathy are seen in | Silicosis | CA lung | Sarcoidosis | asbestosis | TB | The correct answer is: Sarcoidosis | Both the dry cough and hilar lymphadenopathy are suggestive of the Sarcoidosis |
85 | most common cause of pulmonary embolism | ATT | immobilization | COPD | injury | astma | The correct answer is: immobilization | Risk factors for the Thromboembolic phenomenon are given by Virchow"s triad: Immobilization, Hypercoagulable state and endothelial injury. |
86 | A patient has SOB on lying down but normal CVS and otherwise normal respiratory examination. Diagnosis will be | CLD | CKD | retrosternal goiter | respiratory distress | heart failure | The correct answer is: retrosternal goiter | As the CVS and respiratory system of the patient is normal so the SOB is due to the retrosternal goiter. |
87 | A young lady with hemoptysis one week after delivery. There is no fever. ECG shows S1 Q3 T3 pattern. The most appropriate investigation would be | CPK | Gallium Scan | LDH | X-Ray Chest | SGOT | The correct answer is: Gallium Scan | patient is likely suffering from pulmonary infarction due to thromboembolic process. Best diagnostic test is CT angiography or gallium Scan. |
88 | Medullary CA is associated with the | CA 13 | myosin | keratin | calcitonin | actin | The correct answer is: calcitonin | Calcitonin is the tumor marker of the Medullary carcinoma of thyroid |
89 | A pteint has generalized anasarca and his renal biopsy shows Amylodosis. What is the reason of edema? | Increased hydrostatic pressure | Increased salt retention | Increased water retention | Hypoproteinemia | Increase Amyloid | The correct answer is: Hypoproteinemia | Patient has renal amyloidosis, it is secondary due to pulmonary tuberculosis i.e. chronic inflammatory disorder. Renal amyloidosis results in proteinuria and Nephrotic syndrome. |
90 | In hypothyroidism what will increase? | cholesterol | carbohydrates | proteins | LDL | chylomicrons | The correct answer is: cholesterol | In hypothyroidism, cholesterol level is increased due to increased lipoprotein receptors |
91 | A boy with reccurent chest infections and salty sweat, test..? | sweat Cl test | marrow examination | RFTs | ESR | serum electrolytes | The correct answer is: sweat Cl test | All the features given in scenario are characteristics of the cystic fibrosis, and test to perform is the sweat chloride test |
92 | lung cancer spread through | direct invasion | nerve plexus | lymphatics | chemokines | Hematogenous | The correct answer is: lymphatics | In the lung, metastases (usually multiple lesions) are more common than 1° neoplasms. Most often from breast, colon, prostate, and bladder cancer. Lung cancer metastases through lymphatics to—adrenals, brain, bone (pathologic fracture), liver (jaundice, hepatomegaly). |
93 | A 45 years old African-American female presented to medical OPD with shortness of breath.You are suspecting sarcoidosis.Cause of hypercalcemia in sarcoidosis is | primary HPTH | malignancy | vitanim D excess | renal failure | vit A excess | The correct answer is: vitanim D excess | in sardoidosis there is excess of vitamin D, due to increase activity of 25- dehydrogenase enzyme inside the macrophages. |
94 | A Young female with respiratory distress has no CVS or respiratory issue but has proptosis | retrosternal goiter | asthma | lymphoma | CCF | COPD | The correct answer is: retrosternal goiter | Proptosis is pointing to thyroid disease and respiratory distress is due to retrosternal goiter compresses over the trachea |
95 | Chest pain not related to respiration is due to | pleura | pericardium | epicardium | mesocardium | myocardium | The correct answer is: myocardium | Chest pain not related to respiration is due to disease of the myocardium. |
96 | In a 48 year old man with Small cell lung cancer is related to | Thyroiditis | glacttorhia | hyperthyroidism | hyperparathyroidism | Cushing syndrome | The correct answer is: Cushing syndrome | Small cell (oat cell) carcinoma is Central, Undifferentiated very aggressive.May produce ACTH (Cushing syndrome) , ADH, or Antibodies against presynaptic Ca2+ channels (Lambert-Eaton myasthenic syndrome). Amplification of myc oncogenes common. Inoperable; treat with chemotherapy. |
97 | best investigation for pneumonia is | bronchoscopy | ESR | CT | CXR | suputum culture | The correct answer is: suputum culture | For the diagnosis of the Pneumonia, best investigation is the suputum culture to see the causitive organism |
98 | In a 36 year old female, common site of DVT in vein at | abdominal | thigh | pulmonary | below knee | neck | The correct answer is: below knee | Pathologic formation of an intravascular blood clot (thrombus) 1. Can occur in an artery or vein 2. Most common location is the deep veins (DVT) of the leg below the knee. |
99 | An old smoker with H/O fever, weight loss and worker in hydrocarbons factory presents to you.What is the diagnosis? | asthma | hemangioma | tuberculosis | pneumonia | bronchogenic CA | The correct answer is: bronchogenic CA | All the features given in the scenario are characteristics of the lung cancer. |
100 | A 24 year old male for suspicion of pneumonia Dx, sample taken | sputum culture | Blood | urine sample | nose swab | serum culture | The correct answer is: sputum culture | Consolidation (lobar pneumonia)Bronchial breath sounds; late inspiratory crackles. Confirmed by suputum culture. |
101 | R/R control is a function of | None of these | PO2 | HCO3 | PH | PCO2 | The correct answer is: PCO2 | Increase PCO2 stimulates central chemoreceptors in medulla which in result increases respiratory rate to get rid of CO2 from body. |
102 | Surfactant production starts during intrauterine life at | 32weeks | 36 weeks | 28 weeks | Both A and B | 34 weeks | The correct answer is: 28 weeks | Surfactants production start at 28 weeks but maturation is achieved uptill 35 weeks. |
103 | atmospheric pressure is 700mmhg, what will be gases content | PaO² 47, CO² 53 | PaO² 153, paCO² 147 | PaO2 will be 147 and Nitrogen will be 553 mmHg | PaO² 147, Pa N 253 | PaO² 147, pa N 153 | The correct answer is: PaO2 will be 147 and Nitrogen will be 553 mmHg | O2 percentage in air is 21, so 700 x 21/100=147Nitrogen percentage is 79, so 700 x 79/100=553 |
104 | What is the effect of low Hb on aleolar ventillation in an old aged male person? | Remains the same | Decreases | Increases | Increases than decreases | Decreases than increases | The correct answer is: Increases | Decrease oxygen content will increase R.R for comensation so incresase in R.R will increase alveolar ventilation. |
105 | in fetus pulmonary resistance is increased because of | sickle cell anemia | vasoconstriction | methylated Hb | anemia | Hemolytic anemia | The correct answer is: vasoconstriction | Fetal pulmonary vascular resistance is very high because of generalized hypoxic vasoconstriction; as a result, blood flow through the fetal lungs is low. With the first breath, the alveoli of the neonate are oxygenated, pulmonary vascular resistance decreases, and pulmonary blood flow increases and becomes equal to cardiac output (as occurs in the adult |
106 | Diffusion of CO2 from blood into ? | liver | venules | lungs | capillaries | blood | The correct answer is: lungs | Lungs are the organs that have large surface area and are main place for the gaseous exchange (O2 & CO2). |
107 | What is ture of hypoxia in lung vessels? | dec. CO2 | dec. CO2 | sec. CO | Inc. O2 | dec. pO2 | The correct answer is: dec. pO2 | Whenever there is decrease level of O2 content (dec. PO2) in pulmonary vessels, it leads to pulmonary Hypoxia |
108 | Surfactant has following features EXCEPT: | Increase surface tension in alveolar lumen | Is important at the time of birth | Is decreased in the lungs of cigarette smokers | Is produced by type 2 alveolar epithelial cells | Deficiency is also associated with patchy atelactesis | The correct answer is: Increase surface tension in alveolar lumen | Surfactants reduce surface tension inhibiting collapse of alveoli (i.e. atelactasis) and are important at time of birth to open the alveoli to make lungs functioning. |
109 | Ventilation is more than perfusion in | Anatomic dead space | None of these | Normal response | Dead space | Shunt | The correct answer is: Dead space | Ventilation > perfusion i.e. air is present but not equal amount of blood is present to get oxygenatied which forms dead space. |
110 | Focal length is 0.25m. Power will be | plus 4 dioptor | minus 4 dioptor | minus 1 dioptor | plus 1 dioptor | plus 2 diopter | The correct answer is: plus 4 dioptor | Power is defined as the reciprocal of the of focal length taken in meterhence Power = 1/ (0.25m)= 4 Dioptor |
111 | what is dec. in emphysema? | alveoli | volume | space | surface area | plaques | The correct answer is: surface area | in emphysema, the surface area decreases but the lung volume increases |
112 | If Phrenic nerve damages, it will result into | tilting head | respiratory distress | torticulus | tachycardia | respiratory loss | The correct answer is: respiratory distress | Phrenic nerve supplies the diaphragm and its lesion causes respiratory depression. |
113 | A young smoker was playing soccer when he suddenly became breathless with deep pain in chest.Reason for SOB | Alveolar capillary block | Depression of respiratory centre | Ventilation perfusion mismatch | Low blood count | Low o2 tension/pressure | The correct answer is: Ventilation perfusion mismatch | Smoking causes permanent destruction of alveoli in the lung and irreversible decrease in airflow leading to ventilation perfusion mismatch. This may also be scnerio of dissecting aneurysm causing ventilation perfusion mismatch. |
114 | Why pO2 in arteries is less than in pulmonary blood? | surface area | diffusion | pressure gradient | membrane thickness | active transport | The correct answer is: pressure gradient | Presence of an gas in body is dependent on the pressure gradient in that area and membrane thickness. Pressure gradient of O2 is more in pulmonary blood than in arteries. |
115 | On reaching mount everest a man developed severe dyspnea, reason.? | toxemia | anemia | polycythemia | pulmonary edema | hypoxia | The correct answer is: pulmonary edema | Acute pulmonary edema. The cause of this is stillunknown, but a suggested answer is the following:The severe hypoxia causes the pulmonary arteriolesto constrict potently, but the constriction is muchgreater in some parts of the lungs than in otherparts, so that more and more of the pulmonaryblood flow is forced through fewer and fewer stillunconstricted pulmonary vessels |
116 | In med E/R a man is given oxygen for 22hrs. he is likely to develop? | tension Pneumothorax | blindness | open pneumothorax | spontaneous pneumothorax | fibrolental hyperplasia | The correct answer is: spontaneous pneumothorax | A traumatic pneumothorax requires insertion of a chest drain, in contrast to a spontaneous pneumothorax, which may resolve without intervention that usually follows the high flow O2 therapy. |
117 | Respiratory centre is activated during hypoxia via | Directly acting on medulla | Acting on central chemoreceptor | None of these | Stimulating peripheral chemoreceptor | Both B and C | The correct answer is: Stimulating peripheral chemoreceptor | Central chemoreceptors are sensitive to increase PCO2 and increase H+ while peripheral chemoreceptors are also sensitive to decrease PO2 along with increase PCO2 and increase H+. |
118 | hyperventilation is accompanied by tetanic spasm. why? | dec. O2 | fatigue | lactic acidosis | dec. pH | Ca squestration | The correct answer is: Ca squestration | In hyperventilation, CO2 is washed out leading to respiratory alkalosis. Conc. of H ions decreases and then plasma proteins use Ca for binding in place of H laeding hypocalcemia (and tetanic spasms) |
119 | Hypoxemia is improved by O2 supplementation in all EXCEPT | Impairement of diffusion | Right to left shunts | Alveolar hypoventilation | None of these | Poorly ventilated lung | The correct answer is: Right to left shunts | In right to left shunt, there is continuous mixing of blood between right and left side so increased O2 administration does not improve hypoxemia. |
120 | Result of sympathetic activation is | Bronchosonstricion | None of these | Increase GIT motility | Bronchodilation | Vasodilation in skin | The correct answer is: Bronchodilation | Sympathetic stimulation causes bronchodilation via B2 receptors, vasoconstriction in skin and decreases GIT motility. |
121 | Labor breathing flared nostrils is associated with | acessary muscles | TB | asthma | emphysema | type 2 respiratory failure | The correct answer is: acessary muscles | Difficult breathing is associated with the use of the acessary muscles of respiration |
122 | Respiratory centre feature is | None of these | Basic rhythm lies in dorsal medulla | Apneumotaxic centre changes inspiration | Medullary chemoreceptors directly respond to hypoxia | Pneumotaxic centre lengmens inspiration | The correct answer is: Basic rhythm lies in dorsal medulla | Dorsal respiratory group is primarily responsible for inspiration and generates basic rhythm for breathing. Ventral respiratory group is primarily responsible for expiration ony when its active. |
123 | Surfactant deacreases alveolar tension. It is secreted from | Terminal bronchioles | Type I pneumocytes | Both B and C | Lung endothelium | Type II pneumocytes | The correct answer is: Type II pneumocytes | Lumellar bodies are found in type II pneumocytes and secrete surfactant. |
124 | Peanut inhaled will get lodged in | right upper bronchus | right lower bronchus | left lower bronchus | right middle segment | left upper bronchus | The correct answer is: right lower bronchus | while standing, the penut will go to the right lower bronchus and while supine, it will go to the right middle bronchus |
125 | pCO2=25, O2=50, Ph=7, HCO3=1.1 are findings on an ABGs report.Diagnosis will be | None of these | Aspirin toxicity | COPD | Haemothorax | Morphine overdose | The correct answer is: Aspirin toxicity | Aspirin/ salicyclate toxicity leasds to respiratory alkalosis due to direct stimulation of respiratory center causing hyperventilation. This is an example of partially compensated respiratory alkalosis. |
126 | upon bedside examination a female has left shifted trachea and resonant note on right side.Diagnosis? | Right pneumothorax | None of these | Pleural effusion | Left pneumothorax | Consolidation | The correct answer is: Right pneumothorax | Only pneumothorax gives resonant note, while effusion and consolidation give dull note and pneumothorax shift trachea to opposite side that’s why right sided. |
127 | Regarding surfactant, what statement is true in your opinion? | Decrease lung compliance | Slow turnover | Secreted by type 1 pnuemocytes | Production decreases as the size of alveoli decrease | Forms macromolecular layer on fluid | The correct answer is: Forms macromolecular layer on fluid | Surfactants are macromolecutes consisting 70-80% of phospholipids aminly (DPPL), 10% surface profeins and 10% neutral lipids (cholestrol mainly). |
128 | Quite inspiration is the function of | Scalenius posterior | Diaphragm | Intercostal muacle | None of these | Sternocladomastoid | The correct answer is: Diaphragm | Main muscle responsible for quite inspiration is diaphragm, other are accessory. |
129 | Function of Pneumotaxic center | control expiration | control respiration | cause apnea | limit inspiration | control apnea | The correct answer is: limit inspiration | A Pneumotaxic Center Limits theDuration of Inspiration and Increasesthe Respiratory Rate: A pneumotaxic center, located dorsally in the nucleusparabrachialis of the upper pons, transmits signals tothe inspiratory area. |
130 | what change will be seen in lung compliance if surface tension is decreased? | shift to left | increase | decrease | shift to right | become zero | The correct answer is: increase | Compliance—change in lung volume for a given change in pressure; maintained by surfactant decreased in pulmonary fibrosis, pneumonia, and pulmonary edema and deccreased surfactant; increased in emphysema, increased surfactantand normal aging |
131 | Physological shunt is associated with | Ventilation is zero | Both A and C | Perfusion is zero | Ventilation is infinity | None of these | The correct answer is: Ventilation is zero | When V is zero e.g. in tracheal obstruction. V/Q = zero i.e. on gas exchange in a lung that is perfused but not ventilated, it is called shunt. |
132 | Prolonged O2 therapy for 24 hours can cause | fibroplasia | retrosternal fibrosis | spontaneous pneumothorax | angiomatosis | angiogenesis | The correct answer is: spontaneous pneumothorax | High flow O2 therapy for prolonged time is the leading cause of spontaneous pneumothorax. |
133 | Pulmonary artery embolism lead to | None of these | Alveolar pO2 increased | Alveolar pCO2 increased | Pumonary artery pCO2 decreased | Pulmonary artery pCO2 increased | The correct answer is: Pumonary artery pCO2 decreased | Patient of pulmonary embolism becomes tachypncic, exholes CO2, decreased pulmonary artery pCO2. |
134 | Reason for pulmonary O2 toxicity | Prolong O2 therapy | In under water | At high altitude | Increase PCO2 | None of these | The correct answer is: Prolong O2 therapy | Prolonged exposure to increased O2 levels at normal pressure can cause oxidative damage to cell membranes, collapse of alveoli in the lungs causing O2 tonicily. |
135 | If oxygen dissociation curve is dissociated towards right, T50 would be: | None of these | 26 | 18 | 35 | 20 | The correct answer is: 26 | T50 is the oxygen tension at which Hb is 50% saturated. The normal P50/T50 is 26.7. A rightward shift increases P50 and lowers Hb affinity for O2thus releasing O2 in tissues. |
136 | Before waking cortisol levels are at its peak in body. Cause? | circannual | deep sleep | circadian rhythm | morning stress | stress | The correct answer is: circadian rhythm | Glucocorticoid secretion ■ oscillates with a 24-hour periodicity or circadian rhythm.■ For those who sleep at night, cortisol levels are highest just before waking (ª8 am) and lowest in the evening (≈12 midnight). |
137 | Lung has metabolic actions in addition to breathing. One of these is | Inactivation of bradykinin | Inactivation of serotonin | Metabolism of basic drugs by cytochrome P450 system | Conversion of angiotensin I to angiotensin II | None of these | The correct answer is: Conversion of angiotensin I to angiotensin II | In renin-angiotensin system, renin converts orgiotensinogent to angiotensin I and then angiotensin I is converted to antgiotensin II in lungs. Renin angiotensin pathway is very important in maintaining BP and plasma volume. |
138 | surfactant is secreted by | alveoli | alveolar sacs | alveolar ducts | type 2 pneumocytes | type 1 pneumocytes | The correct answer is: type 2 pneumocytes | Surfactant is secreted by the type 2 pneumocytes of the respiratory tract |
139 | Which of the following has maxmimum value upon standing at the apex of lung? | dec. V/Q value | increased Ventilation | increased profusion | inc. V/Q value | decreased perfusion | The correct answer is: inc. V/Q value | Ideally, ventilation is matched to perfusion (i.e., V/Q = 1) in order for adequate gas exchange.Lung zones:1. Apex of the lung—V/Q = 3 (wasted ventilation)2. Base of the lung—V/Q = 0.6 (wasted perfusion)Both ventilation and perfusion are greater at the base of the lung than at the apex of the lung |
140 | When a person becomes apneic for a minute only, the value of rise in pCO2 is | 6 mmHg/min | 10 mmHg/min | 8 mmHg/min | 4 mmHg/min | 2 mmHg/min | The correct answer is: 10 mmHg/min | PaCO2 increases during first minute to apnea by 10 mmHg and 3 mmHg for each minue afterwards. |
141 | by which week surfactant begins to appear? | 12 | 16 | 18 | 14 | 26 | The correct answer is: 26 | Surfactant synthesis begins around week 26 of gestation, but mature levels are not achieved until around week 35 |
142 | Pleural rupture results in | Inward collapse and inward chest wall spring | Inward collapse and outward chest wall spring | Outward collapse and outward chest wall spring | None of these | Outward collapse and inward chest wall spring | The correct answer is: Inward collapse and outward chest wall spring | If pleura is ruptured, negative intrathoracic pressure is lost and chest wall recoils outwards and lungs collapse which are their normal tendencies inhibited by negative pressure. |
143 | The central chemoreceptors in the medulla are sensitive to | None of these | H+ | All of these | CO2 | O2 | The correct answer is: CO2 | Central chemoreceptors respond to increase CO2 and increase H+ both but more sensitive to CO2. |
144 | left shift in Hb-O2 curve is result of? | dec. Na | dec. K | increased pH | dec. O2 | dec. pH | The correct answer is: dec. pH | An increased in all factors (including H+) causes a shift of the curve to the right.A decreased in all factors (including H+) causes a shift of the curve to the left. |
145 | Bluish discoloration of skin or cyanosis results from | Both A and B | Increased myoglobin in blood | Increased CO2 in blood | Increased deoxy hemoglobin in blood | Decreased PO2 in blood | The correct answer is: Increased deoxy hemoglobin in blood | Deoxy Hb absorbs most of the red light and reflects blue light so > 5 g/dl deoxy Hb cause peripheral cyanosis. |
146 | Drop in arterial o2 saturation is seen without drop in arterial O2 tension in | Carbon monoxide poisoning | Low v/q | Anemia | Both A and B | None of these | The correct answer is: Carbon monoxide poisoning | In CO poisoning arterial O2 content/ tension remains same but Hb has much more affinity for CO so CO birds Hb more than O2 and O2 saturation decreases. |
147 | In pulmonary fibrosis spirometry shows low values of all BUT: | Vital capacity | Total lung capacity | Residual volume | FEV1 to FVC | None of these | The correct answer is: FEV1 to FVC | In pulmonary fibrosis FEV1 and FVC both decrease but FVC decrease more than FEV1 that’s why FEV1/FVC ration is > 0.8. |
148 | Pulmonary edema without any cardiac cause is due to? | emphysema | pulmonary embolism | asthma | ARDS | pulmonary edema | The correct answer is: ARDS | Acute respiratory distress syndrome:May be caused by trauma, sepsis, shock, gastric aspiration, uremia, acute pancreatitis, or amniotic fluid embolism. Diffuse alveolar damage and increased alveolar capillary permeability leading to protein-rich leakage into alveoli and noncardiogenic pulmonary edema (normal PCWP) |
149 | Surfactant is released by pneumocytes and | Has a low tumover rate | None of these | Decrease compliance | Decreases whtn alveolar size decreased | Decreases compliance work | The correct answer is: Decreases compliance work | Surfactants greatly reduce surface tension, increasing compliance allowing lungs to inflate much more easily, thereby reducing the work of breathing. |
150 | what phenomenon is carried out at dead space? | ventilation | convection | radiation | perfusion | conduction | The correct answer is: ventilation | physiologic dead space = anatomic dead space of conducting airways plus functional dead space in alveoli; apex of healthy lung is largest contributor of functional dead space. Volume of inspired air that does not take part in gas exchange. |
151 | In hypermetropia, image is formed | at lens | in front of retina | at retina | lateral to retina | behind the retina | The correct answer is: behind the retina | Hypermetropia or the farsightedness is defined as focusing defect when image is formed behind the retina. |
152 | dead space remains unchanged in | ventilator | mask | shallow breathing | oropharangeal airway | tracheostomy | The correct answer is: shallow breathing | Among the given list of features, the least likely change in dead space is by the shallow breathing. |
153 | Exchange of gas from alveoli to blood is by | active transport | carrier mediated | simple diffusion | osmosis | facilitated diffusion | The correct answer is: simple diffusion | In lungs, the gases are exchanged by the simple diffusion |
154 | Pulmonary vsoconstriction during low oxygen levels in blood is accompanied by | Decreas PCO2 | Decrease PO2 | Increase PCO2 | None of these | Increase PO2 | The correct answer is: Increase PCO2 | Hypoxia (decrease pO2) causes pulmonary vasoconstriction which is accentuated by increased PCO2 (hypercarbia). |
155 | Dependant on diffusion | O2 | O2 during exercise | All fo these | N2O | Co2 | The correct answer is: O2 during exercise | Guses which have diffusion limited exchange are CO and O2 (in emphysema, fibrosis, exerose, more affinity for CO so CO birds Hb more than O2 and O2 saturation decreases. |
156 | Aqueous humor is produced by | cilliary process | Arachnoid villi | Bruch"s membrane | cilliary body | Arachnoid granulation | The correct answer is: cilliary process | aqueous humor is produced by the ciliary process and it is collectes to medial canthus through blinking and drains to NL duct. |
157 | Role of pneumotaxic center | control hypoxia | limits inspiration | expiration center | inc. respiration | limits expiration | The correct answer is: limits inspiration | A pneumotaxic center, located dorsally in the nucleusparabrachialis of the upper pons, transmits signals tothe inspiratory area. The primary effect of this centeris to control the “switch-off” point of the inspiratoryramp, thus controlling the duration of the filling phaseof the lung cycle |
158 | O2 tension normal but O2 saturation is declined because of | sec. alveoli | dec. surfactant | dec. plasma | dec. RBC | inc. plasma | The correct answer is: inc. plasma | In case of increased plasma volume but no increase in hemoglobin (relative anemia) leads to decreased O2 saturation. |
159 | A patient has been on supplemental O2 therapy for more than 24 hours and later develops difficulty in breathing.Diagnosis is | hypoxemia | O2 toxicity | spontaneous pneumothorax | optic atrophy | fibrolental hyperplasia | The correct answer is: spontaneous pneumothorax | Prolong O2 therapy is associated with the development of the spontaneous pneumothorax |
160 | O2 is transmitted through alveoli by | osmosis | pinocytosis | active transport | active diffusion | passive diffusion | The correct answer is: passive diffusion | Passive diffusion is the most common and effective method of O2 transport in the lungs. |
161 | Considering chronic respiratory acidosis, for every 10mmHg increase in pCO2, there is rise in HCO3 of | 15 mEq | 7 mEq | 3 mEq | 1 mEq | 10 mEq | The correct answer is: 3 mEq | 1 mm rise in CO2 = 0.35 mEq HCO3, 10 jmm rise in CO2 = 3.5 mEq, 20 mm rise in CO2 = 7 mEq HCO3. |
162 | Transport of CO2 from alveoli to blood in lungs is via | Active transport | Osmosis | Faciliated diffusion | Diffusion | Secondary active transport | The correct answer is: Diffusion | Exchange of CO2 and O2 both occurs through diffusion which depends on partial pressure difference, permeability of alveolar-pulmonary-capillary barrier, diffusion co-efficient of gas and surface area. Inversely related to thickness of membrane. |
163 | Physiologically highest partial pressure of oxygen is seen in | Pulmonary capillaries | None of these | Pulmonary arteries | Aorta | Pulmonary veins | The correct answer is: Pulmonary veins | As pulmonary capillaries are continuous exchanging CO2 with O2 and pulmonary veins receive only oxygenated blood so pO2 in pulmonary veins is highest. |
164 | How R/R is affected by rising blood CO2? | Increases | Decreases | No change | Stops | First increases then decreases | The correct answer is: Increases | Increased CO2 diffuses from arterial blood to CSF, here it combines with water to release H+, which affects central chemoreceptors resulting in hyerventilation then releases arterial pCO2 towards normal. |
165 | In last trimester what changes are mostly found regarding respiration. | dec. CO2 | dec. O2 | dec. HCO3 | dec. CO | dec. K | The correct answer is: dec. O2 | In 3rd trimester of pregnancy, gravid utrus pushes causes upward push of the diaphragm and decreases tidal volume and hence increases respiratory rate and dec. O2 saturation. |
166 | cut off for the metabolic alkalosis is | HCO3 less than 32 | CO2 more than 32 | HCO3 more than 24 | HCO3 less than 20 | more CO2 | The correct answer is: HCO3 more than 24 | among the given list, the level of HCO3 more than 24 is associated with the metabolic alkalosis |
167 | measure of the physiological dead space is | air conduction | alveoli | emphysema | bronchus | trachea | The correct answer is: air conduction | Dead space is the part of air way that participates only in air conduction but not in gases exchange |
168 | surfactant is produced by | Mast cells | pleura | pneumocytes II | pneumocytes I | alveoli | The correct answer is: pneumocytes II | Surfactant is secreted by the type II pneumocytes |
169 | Max. inspiration + normal expiration is equivalent to | expiratory capacity | expiratory volume | residual volume | inspiratory capacity | total capacity | The correct answer is: inspiratory capacity | Maximum inspiration with normal expiration is used to measure the inspiratory capacity. |
170 | The Normal quiet expiration results from action of: | None of these | Elastic tissue in thoracic and lung wall | Abdominal muscles | Sternocleidomastoid | Diaphragm | The correct answer is: Elastic tissue in thoracic and lung wall | Normal expiration is brought about by recoil of elastic tissue and in thoracic and lung wall, when expiration is a passive process. |
171 | Which of the following vein has arterialization of blood? | Intenal juglar vein | Veins on dorsum of a warm hand | Anticubetal vein | Femoral vein | Subclavian vein | The correct answer is: Veins on dorsum of a warm hand | This is due to the fact that in warm hand more blood is supplied than need for heat exchange. This causes arterilization of venous blood. |
172 | Active thyroid released in blood is | TRH | T2 | T3 | T1 | TSH | The correct answer is: T3 | Active form of the thyroid hormone is the T3 while abundant is the T4 |
173 | O2 dissociation curve shifts to the left due to rising | None of these | Temperature | Partial pressure of CO2 | 2-3 DPG concentration | Oxygen affinity of haemoglobin | The correct answer is: Oxygen affinity of haemoglobin | Increase in oxygen affinity of Hb (as in fetal Hb) causes the curve shift towards left i.e. decrease O2 release in tissue. |
174 | Which test is most relevant for pulmonar function to check obstructve vs restrictive diseases | ventilation | RC | FEV1/ FVC | RV | FVC | The correct answer is: FEV1/ FVC | Obstructive lung diseases:Obstruction of air flow resulting in air trapping in the lungs. Airways close prematurely at high lung volumes inc. RV and dec. FVC. PFTs: decreased FEV1/FVC ratio (hallmark), |
175 | Gaseous exchange through lungs is dependant on | Surface area available for gas exchange | All fo these | Solubility and molecular weight fo the gases | Diffusion distance | Partial pressure difference of the gases | The correct answer is: All fo these | All these given factors are responsible for determining exchange through lungs wall, enlargement of air space and increase in compliance. |
176 | Stem related to normal Hb and there is decrease oxygen saturation: | acidosis | CO2 excess | Suffocation | NO2 excess | CO poisoning | The correct answer is: CO poisoning | The problem with carbon monoxide (CO) is that it inhibits your ability to distribute O2 (oxygen). Hemoglobin, a protein in your red blood cells, binds oxygen in your lungs, and distributes oxygen throughout your body. Hemoglobin has a very high affinity for oxygen. However, it has a HIGHER affinity for CO. |
177 | Condition causing respiratory acidosis is | Emphysema | Ingestion of excess amount of sodium bicarbonate | Vomiting | Hyperventilation | Starvation | The correct answer is: Emphysema | In emphysema inspiration is normal but expiration is impaired due to loss of elastic recoil, lungs cant expire properly which leads to CO2 retention and decrease pH. |
178 | Low arterial O2 tension results from | Hypoventilation | None of these | CO poisoning | Anemia | Moderate exercise | The correct answer is: Hypoventilation | In hypoventilation, there is CO2 retention and decreased O2 tension while in all other scnerios O2 tension is unchanged and saturation is decreased. |
179 | Maximal vasodilatory effect of CO2 is seen in | Heart | Kidney | Both A and B | Liver | Brain | The correct answer is: Brain | Of all ranges, brain is the most sensitive to increase pCO2. |
180 | The Lowest PO2 is observed in | Maternal uterine vein | Umbilical artery | Maternal femoral vein | Maternal artery | Umbilical vein | The correct answer is: Umbilical artery | Umblical artery carries all the deoxygenated blood from fetus to mother that’s why has fewest PO2. |
181 | respiration is directly proportional to | surfactant | alveoli surface area | alveoli | alveolar ducts | alveoli sac | The correct answer is: alveoli surface area | Diffusion: Vgas = A/T × Dk(P1 – P2) where A = area, T = thickness, and Dk(P1 – P2) ≈difference in partial pressures: A dec. in emphysema. T inc. in pulmonary fibrosis. |
182 | Blood supply to lungs in L/min during rest | 5 | 3 | 2 | 2.5 | 6 | The correct answer is: 5 | Lungs receive blood both from right and eft heart so if CO is 5 l/min, lungs also receive 5 l/min of blood at rest. |
183 | V/Q ratio is maximum at upper part of lung because | Blood flow is decreased considerably more than ventilation | Direct connection with trachea | None of these | Blood flow is increased considerably more than ventilation | Base of lund has high ventilation in relation to blood flow | The correct answer is: Blood flow is decreased considerably more than ventilation | Ventilation is lower at apex, higher at base while perfusion is lower at apex and highest at base, so V/Q at apex is higher than V/Q at base. This is due to more gravity effect on perfusion. |
184 | Respiration will be stopped centrally if following structure is damaged | Midbrain | Pons | Medulla | None of these | Cerebellum | The correct answer is: Medulla | Respiratory centre is present in medulla which has basic rhythm of respiration, its damage will lead to central cessation of breathing |
185 | inc. in thoracic vol during quiet inspiration is due to | external intercostal | internal intercostal | external oblique | quadratus Lumborum | diaphragm | The correct answer is: diaphragm | Intra thoracic volume is increased by the movements of the diaphragm |
186 | decrease in surfactant in lungs will result in? | dec. complience | inc. complience | cause Hypoxia | inc. O2 affinity | dec. CO affinity | The correct answer is: dec. complience | Surfactant deficiency inc. surface tension decreases lung compliance and increased chances of alveolar collapse. A lecithin:sphingomyelin ratio < 1.5 in amniotic fluid is predictive of neonatal respiratory distress syndrome. |
187 | Mark the true narrative regarding peripheral chemoreceptors: | Respond to PO2 less than 40 mmhg | None of these | Detect increased CO2/PH | Have increased O2 consumption | Respond on PO2 less than 60 mmhg | The correct answer is: Respond on PO2 less than 60 mmhg | PO2 must decrease to < 60 mmgh before breathing is stimulated. |
188 | Diffusion rate of CO2 is raised through alveolar membrane because of | None of these | Both A and B | Increased solubility | Increase density of CO2 | Increased diffusion co-efficient | The correct answer is: Increased diffusion co-efficient | CO2 is the gas with maximum diffusion co-efficient in body. |
189 | A patient’s blood shows PO2 70 mmHg. What kind of hypoxia is he suffering from? | hypoxic hypoxia | dilutional hypoxia | anemic Hypoxia | anoxic hypoxia | toxic Hypoxia | The correct answer is: hypoxic hypoxia | In all the cases of the hypoxia, the saturation is normal except for the hypoxic hypoxia |
190 | dead space minus from tidal volume times breathing rate, is | alveolar ventilation | ventilation | breathing | gaseous exchange | ventilation rate | The correct answer is: alveolar ventilation | Alveolar ventilation is defined as dead space minus from tidal volume times breathing rate. |
191 | mechanism of CO2 transport from tissues to lungs | uptake of HCO3 | uptake of HCO3 in exchange of Cl | uptake of HCO3 in exchange of K | uptake of K in exchange forCl | exchange of K | The correct answer is: uptake of HCO3 in exchange of Cl | HCO3- leaves the RBCs in exchange for Cl- (chloride shift) and i is transported to the lungs in the plasma. HCO3- is the major form in which CO2 is transported to the lungs. |
192 | Keeping in mind physiology of vital capacity, true is | None of these | Both A and C | Measured directly by spirometry | Is the sum of Tidal Volume+ERV+IRV | Is decreased in some lung diseases | The correct answer is: Is the sum of Tidal Volume+ERV+IRV | Vital capacity is maximum volume of air that can be expelled from the lungs after taking the deepest possible breath, VC = TV + IRV + ERV. |
193 | stony dull percusion is character of | air in plueral cavity | fluid in pleural cavity | fibrosis | Pneumoniae | COPD | The correct answer is: fluid in pleural cavity | Whenever there is a fluid in the the pleural cavity, the percussion note will be dull,normal note is tympanic in presence of normal pleural cavity. |
194 | After forced expiration amount of RV in ml is | None of these | 1200 ml | 1000 ml | 2400 ml | 500 ml | The correct answer is: 1200 ml | RV = 1200 ml , TV = 500 ml , dead space =150 ml. |
195 | V/Q scan is important for diagnosis of | Pneumonia | Emphysema | Pulmonary embolism | Interstitial lung disease | None of these | The correct answer is: Pulmonary embolism | In pulmonary embolism, Q = O, V/Q = infinity |
196 | what changes hb dissociation curve to extreme left | NO3 | CO2 | SO2 | N2O | CO | The correct answer is: CO | In addition, binding of CO to hemoglobin increases the affinity of remaining sites for O2, causing a shift of the curve to the left |
197 | At rest, transverse diameter of chest is increased by | diaphragm | external intercostal | internal oblique | internal intercostal | quadratus Lumborum | The correct answer is: external intercostal | transverse diameter of the chest is increased by the external intercostal muscles |
198 | Which volume is inhaled maximum than exhaled? | residual capacity | inspiratory capacity | TLC | vital capacity | residual volume | The correct answer is: vital capacity | Vital capacity is defined as the volume of air that is maximally exhaled after deep inspiration |