Sr. NoQuestionABCDECorrect AnswerExplanation
1%age of arterial oxygenation at high altitude like k24035105025The correct answer is: 40the 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
2mesothelioma is associated with exposure toberylliumCarbon dustasbestosMg exposuresiliconThe correct answer is: asbestosMalignant mesiothelioma is associated with the long term exposure to the asbestos
3Diagnostic test for dry mouth dry eyes isAnti IgsAnti SMAAnti dsDNAAnti SSAAnti TNFThe correct answer is: Anti SSAFeatures are suggestive of the Sjogren syndrome and investigation of choice is Anti SSA
4How much amount of air needed for air embolism2cc50cc100cc150cc10 ccThe correct answer is: 100ccA 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.
5Ghon complexes are characteristic ofprimary TBsecondary focus of TBChronic bronchitisPneumoniaSarcoidosisThe correct answer is: secondary focus of TBGhon focus is due to primary lesion of the TB while Ghon complexes with advanced lymphadenopathy are characteristics of the secondary TB
6Leg vein thrombus will lodge inbrain vesselsposterior vesselspulmonary veinsleft atriumright ventricleThe correct answer is: pulmonary veinsThis venous thrombus goes to the heart and this to the pulmonary veins by pulmonary circulation
7investigation of choice for cystic fibrosis isgenotypingLFTssweat Cl testCBCbronchoscopyThe correct answer is: sweat Cl testInvestigation of choice for cystic fibrosis is the sweat chloride test
8A patient has H/O recurrent respiratory infections,eczema and his platelet count is 10,000/cmm.This is due toPneumoniaDICSepsisWiskott-Aldrich syndromeHematogenous infectionThe correct answer is: Wiskott-Aldrich syndromeWiskott–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).
9All of these are true about bronchial asthma exceptAllergens play significant role in pathogenesisLeukotriene antagonists are not helpful in the treatmentRegular inhaled steroids casuse growth retardation in childrenSymptoms are worse at nightCromolyns are very effective for exercise induced asthmaThe correct answer is: Leukotriene antagonists are not helpful in the treatmentLeukotrienes are the inflammatory mediators. Their antagonist reduce the inflamation and can be used in asthma.
10In chronic smoker, SOB after hyperbaric O2 for longer time, Dx..?spontaneous pneumothoraxpneumothoraxdysplasiafibrolental hyperplasiahemothoraxThe correct answer is: spontaneous pneumothoraxA chronic smoker (COPD), when in O2 therapy for prolonged time is at risk of spontaneous pneumothorax leading to dyspnea
11emphysematous changes are due to deficiency offibronectinfibrinα1 anti trypsinALPElastinThe correct answer is: α1 anti trypsinTwo types of Emphysema are:Centriacinar—associated with smoking.Panacinar—associated with α1-antitrypsin deficiency.
12ectopic parathyroid is produced by which tumorBCCmelanomaCMLlymphomaSCCThe correct answer is: SCCSquamous cell carcinoma: Hilar mass arising from bronchus; Cavitation; Associated with Cigarettes; hyperCalcemia (produces PTHrP)
13In an acute state of status asthmaticus, The most important PFTs which will be abnormaltidal volumeinspiratory reserve volumeFEV1expiratory resrve volumeresidual volumeThe correct answer is: FEV1Bronchial 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%
14non casseating granuloma is associated withSarcoidosissyphilisasthmalung cancerTBThe correct answer is: SarcoidosisAmong the features of the Sarcoidosis, non casseating granuloma with asteroid bodies are the characteristic
15A male working in plastic factory is at risk of tumor ofCA tonguescabiesCA lungskin lesionsCA bladderThe correct answer is: CA bladderPlastic factory contains the hydrocarbons that are causitive agents of the CA bladder
16A parasite comes from nose of a child, it isE. histolyticaW. BancroftiA DudenaleAscaristrypanasomaThe correct answer is: AscarisA worm affecting both the GIT and respiratory tract is the Ascaris lumbricoids
17In 15 years old boy, the most important sign of ARDS is hypoxia it iscorrected by CO2affect red membraneepithelial damagealways infectivecorrected by O2The correct answer is: corrected by O2ACUTE 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)
18A smoker has interstitial lung disease and pleural plaque, most common cause is ?asbestosisbyssinosissilicosispneumoconiosisanthracosisThe correct answer is: asbestosisAsbestosis: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
19A 58 year old male with Patient of COPD present with breathlessness. pH shows acidosis. His electrolytes test will showhyperkalemiahypernatremiahypoglycemiahypokalemiahypocalcemiaThe correct answer is: hyperkalemiaIn any case of acidosis, if there is derranged K level than it will be hyperkalemia resulted from outward shift of K.
2065 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 frompulmonary embolism involving large sized arterydue to paradoxical embolismpulmonary artery thrombosispulmonary embolism involving medium sized arteryPE in small sized arteryThe correct answer is: PE in small sized arteryafter 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.
21In a 23 year old male patient, parasite related to lung infectionChlonorchisT. soliumS. hematobiumascarisS. mansoniThe correct answer is: ascarisAscaris lumbricoides :(giant roundworm)Transmitted by Fecal-oral; eggs visible in feces under microscopeIntestinal and lung infection
22An 8 year old boy with Cystic fibrosis typical signs and symptoms and having recurrent pseudomonas infections, these infections can cause:atypical PneumoniaeLobar PneumoniaeBronchectasisChronic bronchitisAcute bronchitisThe correct answer is: BronchectasisComplications 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).
23A patient has pyogenic lung abscess.The responsible organism isProteusstaph aureusH influenzastrep PneumoniaebacteriodsThe correct answer is: staph aureusThe most common cause of the pyogenic lung abscess is the staph aureus.
24A 43 year old male with history of coal worker presents with cough, weight loss and montoux positive, Cause..?Silicosisberryliumhydrocarbonsorganic dustasbestosisThe correct answer is: SilicosisSilicosis: 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.
25Regarding hemodynamics, most common cause of increased pulmonary artery pressurehypoxiaintake of nitroglycerineexerciseessential hypertensionsympathetic stimulationThe correct answer is: hypoxiahypoxia results in constriction of pulmonary vusculature resulting in increased pressure. Chronic hypoxia may leads to pulmonary hypertension.
26Primary TB is characterized by theghon focuscoughskin lesionsghon complexlymphadenopathyThe correct answer is: ghon complexGhon complexes are seen in primary TB while Ghon focus in secondary one
27A 47 year old female on vent. has greenish sputum, organismklebsellastaph aureusPseudomonasspirocheteActinomycetesThe correct answer is: PseudomonasPseudomonas 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).
28Caplan"s syndrome usually occurs amongradar assembly workertextile workercoal workerarc welderhay farmerThe correct answer is: coal workerlung fibrosis along with rheumatoid arthritis is known as caplan syndrome. It is most common among coal workers.
29What type of CA lung that causes clubbing, in non smokersoat cell CAAdeno CAlarge cell CAsmall cell CASCCThe correct answer is: Adeno CAMost common lung cancer in nonsmokers and overall (except for metastases). Activating mutations include k-ras, EGFR, and ALK. Associated with hypertrophic osteoarthropathy (clubbing).
30A male gardener develops cough and his chest X-ray reveals a rounded opacity in right lobe of lung. Diagnosis istuberculosisSarcoidosisblastomycosisActinomycosisaspergillosisThe correct answer is: aspergillosisfindings are characteristics of the aspergillosis and formers are most affected by it
3158 year old man presented with cushing syndrome. CT chest shows a lesion in lung.. Most likely diagnosis ismetastatic carcinoma of lungsquamous cell carcinomaadenocarcinoma of lungmesotheliomasmall cell carcinomaThe correct answer is: small cell carcinomasmall cell carcinoma is a neuroendocrine tumor produces ACTH causing uncontrolled release of cortisol resulting in cushing syndrome. It also causes SIADH
32While regarding respiratory physiology, deficiency of surfactant causesasthmainc. alveolar resistancedec. airway calberpneumoniadec. alveolar resistanceThe correct answer is: inc. alveolar resistancepulmonary surfactant decreases the alveolar surface tension and prevention of alveolar collapse (atelectasis).
33In a atopic asthamatic patient, the allergen inhaled rapidly interacts in the bronchi with?mucosal mast cellsmooth muscleT-lymphocytesalveolar epithelial cellseosinophillsThe correct answer is: mucosal mast cellin 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.
34Histopathology LNs of a young female revealed granuloma. A definite diagnosis of TB in this case requirespresence of caseation necrosisevidence of lung involvement by Xraypresence of langherhan giant cells.demonstration of AFBmantoux testThe correct answer is: demonstration of AFBgold standard test for the diagnosis of TB is the presence of acid fast bacillus
35Investiagtion of choice for severity of asthma?FEVCO2 clearanceRVFVCO2 saturationThe correct answer is: FVCObstruction of air flow resulting in air trapping in the lungs. Airways close prematurely .Patient have highlung volumes, increased RV and decreased FVC.
36A mine worker is suffering from mesiothelioma due tocarbonMgsiliconasbestoshydrogenThe correct answer is: asbestosAsbestosis is the leading cause of the Mesothelioma in mine workers.
37A 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 isSarcoidosisTuberculosisAlveolar proteinosisSilicosCarcinomatosisThe correct answer is: SarcoidosisSarcoidosis is the Granulomatous disorder characterized by Non-Caseating granuloma and hilar lymphadenopathy.
38In an old 57 year male, Oat cell CA causes whatcushing syndromeDown syndromeasthmaCarcinoidSarcoidosisThe correct answer is: cushing syndromeSmall 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).
39A 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 isAcute Respiratory acidosiscompensated respiratry acidosisRespiratory alkalosis and metabolic acidosismixed respiratory acidosis & metabolic acidosismetabolic acidosisThe correct answer is: Acute Respiratory acidosislabs 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.
40A patient with lung infiltrates and non casseating granulomachurg StraussTBpneumoniaSarcoidosissyphilisThe correct answer is: Sarcoidosispulmonary infiltrates with dry cough and hilar lymphadenopathy and non casseating granuloma are the features of the Sarcoidosis
41Patient has no cough, but diffuse fibrosis on chest X-ray, causeinorganic dustasbestoshydrocarbonberryliumsiliconThe correct answer is: inorganic dustPneumoconioses. These environmental diseases are caused by inhalation of inorganic dust particles. Chronic exposure causes diffused bilalteral lung fibrosis.
42A 32 old female with low grade fever, hypercalcemia stones with B/L lymphadenopathy\ histopathological findings will be?GranulomaCassiusFibrinoidGranuloma with asteroid bodiesabscessThe correct answer is: Granuloma with asteroid bodiesSarcoidosis 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.
43True about the pulmonary embolism islong bone fracturepregnancyinc. V/Qhypoxiadec. V/QThe correct answer is: inc. V/QIn pulmonary embolism, the V/Q is increased due to decreased perfusion and normal ventilation
44Eosinophilia on sputum is due toworm infestationviral infectionasthmaSarcoidosisfungal infectionThe correct answer is: asthmaIn sputum of the asthmatics, the eosinophilic count is increased.
45Dead space is increased inemphysemapulmonary infarctpulmonary embolismboth asthma and emphysemaasthmaThe correct answer is: both asthma and emphysemadead 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.
46A pt with pain radiating to backand rustling sound on auscultation hasmyocarditispleural fluidpleural effusionpneumoniapericarditisThe correct answer is: pericarditisPericardial rub or the russling sounds over auscultation are due to the pericarditis
476 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 becitamin B12 assayjejunal biopsychloride sweat testfat absoption testserum immunoglobulin levelThe correct answer is: chloride sweat testpatient 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.
48which of the following is the effect of asthmaalveolar sacstracheaalveolar ductsalveolibroncheolesThe correct answer is: broncheolesReversible 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
49A 35 years old woman is unconcious, BP unrecordable, thready pulse. Aortic and carotid feedback is increased, Dx..?dec. pO2dec. CO2inc. O2inc. Nadec. HThe correct answer is: dec. pO2Chemoreceptors 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).
50Familial emphysema is associated most closely withParaneoplastic syndromeChronic bronchitisSilicosisSmokingAlpha- anti-trypsin deficiencyThe correct answer is: Alpha- anti-trypsin deficiencyFamilial 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.
51A 21 years old died after 5 days of femor fracture, causesepsishypovolumic shockfat embolismspinal shockabscessThe correct answer is: fat embolismFat 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
52Among the following, which is true about pulmonary Thromboembolismsec. resistancecollapseV/Q mismatchinc. resistancedec. surfactantThe correct answer is: V/Q mismatchPulmonary emboli:V/Q mismatch causes hypoxemia and leading to respiratory alkalosis. Sudden-onset dyspnea, chest pain, tachypnea. May present as sudden death
53In 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 illnessPycoplasma pneumoniaeStaphylococcus aureusHaemophilus influenaeKlebsiella pneumoniaestreptococcus pneumoniaeThe correct answer is: Staphylococcus aureusCystic 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.
54An old patient has COPD from 6 months. ABGs show pH 7.37(normal) PCO2 48( normal below 47) HCO3 30( normal below 29). Diagnosis isalkalosiscompensated respiratory acidosiscompensated metabolic acidosisacidosisdiabetic acidosisThe correct answer is: compensated respiratory acidosisThe acid base disturbance is toward the acidosis, but mild derranged CO2 and HCO are characteristics of the compensated disturbance.
55A 54 year old male Patient with cough and bronchial spasm, causeIgGIgEIgMIgAIgDThe correct answer is: IgEIgE: 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
56Which organ is least likely to be affected by infarctionintestineliverpancreasspleenkidneysThe correct answer is: liverliver is supplied by dual blood supply. Thrombosis in one artery is least likely to cause infarction in liver. Lungs also doesnot infarct with thrombosis
57Among the following, most imp. factor in maintaining pressure in pleural cavity isosmotic pressureCO2 concentrationhydrostatic pressurevenous drainagelymphatic drainageThe correct answer is: lymphatic drainagelymphatic drainage is the most important factor for maintaining pressure in pleural cavity.
58A smoker is diagnosed case of lung carcinoma.Now he presented with frank hemoptysis. The likely cause of hemoptysis iserosion of bronchial vesselsinvasion of pulmonary veinconsolidation of lungserosion of bronchitumor necrosisThe correct answer is: erosion of bronchial vesselstumors invading the bronchial vessels results in massive hemoptysis.
59V/Q is increased inasbestosisCOPDasthmaTBpulmonary embolismThe correct answer is: pulmonary embolismIn pulmonary embolism, the perfusion is decreased without affecting the ventilation
60In an RTA patient with chest trauma, chest tube is inserted in which space7th4th5th3rd6thThe correct answer is: 5thA 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
61A patient has emphysema. What would be the acid-base imbalance present in him?alkalosisretained HCO3anemiahypoxiaacidosisThe correct answer is: acidosisemphysema causes CO2 retention and hence causes acidosis
62Rock crusher can be affected by which disease?AsbestosisSarcoidosismesiotheliomapneumoconiosisSilicosisThe correct answer is: SilicosisRock contains silicon and chronic exposure can cause Silicosis
63A 57 year old male Factory worker presented in opd with progressive peripheral motor disfunction and anemia. Cause can beLead poisoningB1 deficiencyVitamin C deficiencyFolate deficiencyB3 deficiencyThe correct answer is: Lead poisoningLead 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.
64dull percusion over the chest is characteristic ofemphysemapleural effusiontemponadepericarditispneumoniaThe correct answer is: pleural effusionRegarding the physical examination of the respiratory system, dull percusion note is associated with the pleural effusion
65Granuloma with asteroid bodies is inchurg Straussdystrophic calcificationTBaspergillosisSarcoidosisThe correct answer is: SarcoidosisNon cassious granuloma with asteroid bodies is the characteristic of the Sarcoidosis
66A man with sudden onset of respiratory distress but ECG and CXR normal, he died of..?emphysemaasthmachronic bronchitisMIpulmonary embolismThe correct answer is: pulmonary embolismSudden onset of respiratory distress and no findings on ECG and chest X-ray is consistent with the pulmonary embolism
67paraneoplastic syndrome is associated withoverian CAsmall cell CA lunggastric CApancreatic CAlarge cell CA lungThe correct answer is: small cell CA lungParaneoplastic syndrome is associated with the small cell CA of the lungs
68Patient has dyspnoea on lying supine but normal CVS examination.It is due toCKDCCFMIretrosternal goitreasthmaThe correct answer is: retrosternal goitrePatient has SOB on lying down but has normal CVS is due to the retrosternal goiter.
6911 days menstruation after every 15 days isBicornuate Utruspoly myalgiamenorrhogiapolymenorrheaPIDThe correct answer is: polymenorrheaBoth the increased frequency the duration of the menstruation is called the polymennorrhea and increased amount is called the menorrhogia
70New born with recurrent URTI for the last 3 months and diarrhea, family Hx positive, how to confirm diagnosis?sweat Cl testplasma proteinjejunal biopsygenetic analysismarrow biopsyThe correct answer is: sweat Cl testDIAGNOSIS: 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.
71Joint pain associated with metabolism oflipidspyrimidinecarbohydratespurineproteinsThe correct answer is: purineend product of purine metabolism is the uric acid and increased uric acid causes the gout
72A 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 iiinessHemphilus influenzaeKlebsiella pneumoniaeStreptococcus pneumorniaePseudomonas aeruginosaMycoplasma pneumoniaeThe correct answer is: Pseudomonas aeruginosaPseudomonas is one of the most common bacteria to cause infection in CF. It is gram negative fructose non-fermenting that forms green colonies.
73Most common cause of fat embolism is frature ofsternumhumerusfibulatibiafemorThe correct answer is: femorFat 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.
74A 43 year old male with Diabetes and smoker came with papillary construction and ptosis, Diagnosis?cervical spinel lesionptosishorner syndromeWPS syndromemisosisThe correct answer is: horner syndromeHorner 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).
75Hilar lymph node is most commonly associated with asteriod bodies in histologyemphysemaSarcoidosisasthmaRSVTBThe correct answer is: SarcoidosisSarcoidosis is characterized by chronic cough with lymphadenopathy and asteriod bodies on Histopathology
76What is the drug of choice for acute severe asthma?N/S nebulizationSalbutamol nebulizationOral steroidsAntihistamineInhalational steroidsThe correct answer is: Salbutamol nebulizationThe first line treatment of acute severe asthma is bronchodilators either inhalational or I/V.
77An 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 ofparadoxical embolismpulmonary embolism involving large sized arteryPE in small sized arterypulmonary artery thrombosisPE in medium sized arteryThe correct answer is: PE in small sized arteryafter 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.
78A rock crusher developed lymphadenopathy and bireferengence on biopsy, Dx..?byssinosisanthracosisasbestosissilicosispneumoconiosisThe correct answer is: silicosisRock crush is associated with silicosis exposure.
79A 28 year old female with previous TB now presented with fever, pericardial effusion and thick sputum, Dx..?Chronic bronchitisasthmaatelectasisBronchiectasisacute bronchitisThe correct answer is: BronchiectasisBronchiectasis is Associated with bronchial obstruction, chronic infection like TB, poor ciliary motility (smoking), Kartagener syndrome, cystic fibrosis, allergic bronchopulmonary aspergillosis.
80V/Q inc inasthmapulmonary infarctPulmonary embolismemphysemaCOPDThe correct answer is: Pulmonary embolismIncreasing 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.
81On 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 diseseSacoidosisleprosyTyberculosisSyphilisThe correct answer is: leprosyMycobacterium Laprae is an AFB that causes Leprosy in which there are lion facies, glove and stocking loss of sensation & non-Caseating Granuloma.
82In a patient with chronic cough and pleural plaques on CXR, diagnosis isaspergillomaasbestosismesothiomaSilicosismycetomaThe correct answer is: asbestosispleural plaques with dry cough are the features of the asbestosis
83Which cells are increased in bronchial asthma?monocytesEisinophilsBasophilslymphocytesleukocytesThe correct answer is: EisinophilsAsthma 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.
84Dry cough and hilar lymphadenopathy are seen inSilicosisCA lungSarcoidosisasbestosisTBThe correct answer is: SarcoidosisBoth the dry cough and hilar lymphadenopathy are suggestive of the Sarcoidosis
85most common cause of pulmonary embolismATTimmobilizationCOPDinjuryastmaThe correct answer is: immobilizationRisk factors for the Thromboembolic phenomenon are given by Virchow"s triad: Immobilization, Hypercoagulable state and endothelial injury.
86A patient has SOB on lying down but normal CVS and otherwise normal respiratory examination. Diagnosis will beCLDCKDretrosternal goiterrespiratory distressheart failureThe correct answer is: retrosternal goiterAs the CVS and respiratory system of the patient is normal so the SOB is due to the retrosternal goiter.
87A young lady with hemoptysis one week after delivery. There is no fever. ECG shows S1 Q3 T3 pattern. The most appropriate investigation would beCPKGallium ScanLDHX-Ray ChestSGOTThe correct answer is: Gallium Scanpatient is likely suffering from pulmonary infarction due to thromboembolic process. Best diagnostic test is CT angiography or gallium Scan.
88Medullary CA is associated with theCA 13myosinkeratincalcitoninactinThe correct answer is: calcitoninCalcitonin is the tumor marker of the Medullary carcinoma of thyroid
89A pteint has generalized anasarca and his renal biopsy shows Amylodosis. What is the reason of edema?Increased hydrostatic pressureIncreased salt retentionIncreased water retentionHypoproteinemiaIncrease AmyloidThe correct answer is: HypoproteinemiaPatient has renal amyloidosis, it is secondary due to pulmonary tuberculosis i.e. chronic inflammatory disorder. Renal amyloidosis results in proteinuria and Nephrotic syndrome.
90In hypothyroidism what will increase?cholesterolcarbohydratesproteinsLDLchylomicronsThe correct answer is: cholesterolIn hypothyroidism, cholesterol level is increased due to increased lipoprotein receptors
91A boy with reccurent chest infections and salty sweat, test..?sweat Cl testmarrow examinationRFTsESRserum electrolytesThe correct answer is: sweat Cl testAll the features given in scenario are characteristics of the cystic fibrosis, and test to perform is the sweat chloride test
92lung cancer spread throughdirect invasionnerve plexuslymphaticschemokinesHematogenousThe correct answer is: lymphaticsIn 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).
93A 45 years old African-American female presented to medical OPD with shortness of breath.You are suspecting sarcoidosis.Cause of hypercalcemia in sarcoidosis isprimary HPTHmalignancyvitanim D excessrenal failurevit A excessThe correct answer is: vitanim D excessin sardoidosis there is excess of vitamin D, due to increase activity of 25- dehydrogenase enzyme inside the macrophages.
94A Young female with respiratory distress has no CVS or respiratory issue but has proptosisretrosternal goiterasthmalymphomaCCFCOPDThe correct answer is: retrosternal goiterProptosis is pointing to thyroid disease and respiratory distress is due to retrosternal goiter compresses over the trachea
95Chest pain not related to respiration is due topleurapericardiumepicardiummesocardiummyocardiumThe correct answer is: myocardiumChest pain not related to respiration is due to disease of the myocardium.
96In a 48 year old man with Small cell lung cancer is related toThyroiditisglacttorhiahyperthyroidismhyperparathyroidismCushing syndromeThe correct answer is: Cushing syndromeSmall 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.
97best investigation for pneumonia isbronchoscopyESRCTCXRsuputum cultureThe correct answer is: suputum cultureFor the diagnosis of the Pneumonia, best investigation is the suputum culture to see the causitive organism
98In a 36 year old female, common site of DVT in vein atabdominalthighpulmonarybelow kneeneckThe correct answer is: below kneePathologic 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.
99An old smoker with H/O fever, weight loss and worker in hydrocarbons factory presents to you.What is the diagnosis?asthmahemangiomatuberculosispneumoniabronchogenic CAThe correct answer is: bronchogenic CAAll the features given in the scenario are characteristics of the lung cancer.
100A 24 year old male for suspicion of pneumonia Dx, sample takensputum cultureBloodurine samplenose swabserum cultureThe correct answer is: sputum cultureConsolidation (lobar pneumonia)Bronchial breath sounds; late inspiratory crackles. Confirmed by suputum culture.
101R/R control is a function ofNone of thesePO2HCO3PHPCO2The correct answer is: PCO2Increase PCO2 stimulates central chemoreceptors in medulla which in result increases respiratory rate to get rid of CO2 from body.
102Surfactant production starts during intrauterine life at32weeks36 weeks28 weeksBoth A and B34 weeksThe correct answer is: 28 weeksSurfactants production start at 28 weeks but maturation is achieved uptill 35 weeks.
103atmospheric pressure is 700mmhg, what will be gases contentPaO² 47, CO² 53PaO² 153, paCO² 147PaO2 will be 147 and Nitrogen will be 553 mmHgPaO² 147, Pa N 253PaO² 147, pa N 153The correct answer is: PaO2 will be 147 and Nitrogen will be 553 mmHgO2 percentage in air is 21, so 700 x 21/100=147Nitrogen percentage is 79, so 700 x 79/100=553
104What is the effect of low Hb on aleolar ventillation in an old aged male person?Remains the sameDecreasesIncreasesIncreases than decreasesDecreases than increasesThe correct answer is: IncreasesDecrease oxygen content will increase R.R for comensation so incresase in R.R will increase alveolar ventilation.
105in fetus pulmonary resistance is increased because ofsickle cell anemiavasoconstrictionmethylated HbanemiaHemolytic anemiaThe correct answer is: vasoconstrictionFetal 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
106Diffusion of CO2 from blood into ?livervenuleslungscapillariesbloodThe correct answer is: lungsLungs are the organs that have large surface area and are main place for the gaseous exchange (O2 & CO2).
107What is ture of hypoxia in lung vessels?dec. CO2dec. CO2sec. COInc. O2dec. pO2The correct answer is: dec. pO2Whenever there is decrease level of O2 content (dec. PO2) in pulmonary vessels, it leads to pulmonary Hypoxia
108Surfactant has following features EXCEPT:Increase surface tension in alveolar lumenIs important at the time of birthIs decreased in the lungs of cigarette smokersIs produced by type 2 alveolar epithelial cellsDeficiency is also associated with patchy atelactesisThe correct answer is: Increase surface tension in alveolar lumenSurfactants 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.
109Ventilation is more than perfusion inAnatomic dead spaceNone of theseNormal responseDead spaceShuntThe correct answer is: Dead spaceVentilation > perfusion i.e. air is present but not equal amount of blood is present to get oxygenatied which forms dead space.
110Focal length is 0.25m. Power will beplus 4 dioptorminus 4 dioptorminus 1 dioptorplus 1 dioptorplus 2 diopterThe correct answer is: plus 4 dioptorPower is defined as the reciprocal of the of focal length taken in meterhence Power = 1/ (0.25m)= 4 Dioptor
111what is dec. in emphysema?alveolivolumespacesurface areaplaquesThe correct answer is: surface areain emphysema, the surface area decreases but the lung volume increases
112If Phrenic nerve damages, it will result intotilting headrespiratory distresstorticulustachycardiarespiratory lossThe correct answer is: respiratory distressPhrenic nerve supplies the diaphragm and its lesion causes respiratory depression.
113A young smoker was playing soccer when he suddenly became breathless with deep pain in chest.Reason for SOBAlveolar capillary blockDepression of respiratory centreVentilation perfusion mismatchLow blood countLow o2 tension/pressureThe correct answer is: Ventilation perfusion mismatchSmoking 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.
114Why pO2 in arteries is less than in pulmonary blood?surface areadiffusionpressure gradientmembrane thicknessactive transportThe correct answer is: pressure gradientPresence 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.
115On reaching mount everest a man developed severe dyspnea, reason.?toxemiaanemiapolycythemiapulmonary edemahypoxiaThe correct answer is: pulmonary edemaAcute 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
116In med E/R a man is given oxygen for 22hrs. he is likely to develop?tension Pneumothoraxblindnessopen pneumothoraxspontaneous pneumothoraxfibrolental hyperplasiaThe correct answer is: spontaneous pneumothoraxA 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.
117Respiratory centre is activated during hypoxia viaDirectly acting on medullaActing on central chemoreceptorNone of theseStimulating peripheral chemoreceptorBoth B and CThe correct answer is: Stimulating peripheral chemoreceptorCentral 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+.
118hyperventilation is accompanied by tetanic spasm. why?dec. O2fatiguelactic acidosisdec. pHCa squestrationThe correct answer is: Ca squestrationIn 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)
119Hypoxemia is improved by O2 supplementation in all EXCEPTImpairement of diffusionRight to left shuntsAlveolar hypoventilationNone of thesePoorly ventilated lungThe correct answer is: Right to left shuntsIn right to left shunt, there is continuous mixing of blood between right and left side so increased O2 administration does not improve hypoxemia.
120Result of sympathetic activation isBronchosonstricionNone of theseIncrease GIT motilityBronchodilationVasodilation in skinThe correct answer is: BronchodilationSympathetic stimulation causes bronchodilation via B2 receptors, vasoconstriction in skin and decreases GIT motility.
121Labor breathing flared nostrils is associated withacessary musclesTBasthmaemphysematype 2 respiratory failureThe correct answer is: acessary musclesDifficult breathing is associated with the use of the acessary muscles of respiration
122Respiratory centre feature isNone of theseBasic rhythm lies in dorsal medullaApneumotaxic centre changes inspirationMedullary chemoreceptors directly respond to hypoxiaPneumotaxic centre lengmens inspirationThe correct answer is: Basic rhythm lies in dorsal medullaDorsal 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.
123Surfactant deacreases alveolar tension. It is secreted fromTerminal bronchiolesType I pneumocytesBoth B and CLung endotheliumType II pneumocytesThe correct answer is: Type II pneumocytesLumellar bodies are found in type II pneumocytes and secrete surfactant.
124Peanut inhaled will get lodged inright upper bronchusright lower bronchusleft lower bronchusright middle segmentleft upper bronchusThe correct answer is: right lower bronchuswhile standing, the penut will go to the right lower bronchus and while supine, it will go to the right middle bronchus
125pCO2=25, O2=50, Ph=7, HCO3=1.1 are findings on an ABGs report.Diagnosis will beNone of theseAspirin toxicityCOPDHaemothoraxMorphine overdoseThe correct answer is: Aspirin toxicityAspirin/ salicyclate toxicity leasds to respiratory alkalosis due to direct stimulation of respiratory center causing hyperventilation. This is an example of partially compensated respiratory alkalosis.
126upon bedside examination a female has left shifted trachea and resonant note on right side.Diagnosis?Right pneumothoraxNone of thesePleural effusionLeft pneumothoraxConsolidationThe correct answer is: Right pneumothoraxOnly pneumothorax gives resonant note, while effusion and consolidation give dull note and pneumothorax shift trachea to opposite side that’s why right sided.
127Regarding surfactant, what statement is true in your opinion?Decrease lung complianceSlow turnoverSecreted by type 1 pnuemocytesProduction decreases as the size of alveoli decreaseForms macromolecular layer on fluidThe correct answer is: Forms macromolecular layer on fluidSurfactants are macromolecutes consisting 70-80% of phospholipids aminly (DPPL), 10% surface profeins and 10% neutral lipids (cholestrol mainly).
128Quite inspiration is the function ofScalenius posteriorDiaphragmIntercostal muacleNone of theseSternocladomastoidThe correct answer is: DiaphragmMain muscle responsible for quite inspiration is diaphragm, other are accessory.
129Function of Pneumotaxic centercontrol expirationcontrol respirationcause apnealimit inspirationcontrol apneaThe correct answer is: limit inspirationA 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.
130what change will be seen in lung compliance if surface tension is decreased?shift to leftincreasedecreaseshift to rightbecome zeroThe correct answer is: increaseCompliance—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
131Physological shunt is associated withVentilation is zeroBoth A and CPerfusion is zeroVentilation is infinityNone of theseThe correct answer is: Ventilation is zeroWhen 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.
132Prolonged O2 therapy for 24 hours can causefibroplasiaretrosternal fibrosisspontaneous pneumothoraxangiomatosisangiogenesisThe correct answer is: spontaneous pneumothoraxHigh flow O2 therapy for prolonged time is the leading cause of spontaneous pneumothorax.
133Pulmonary artery embolism lead toNone of theseAlveolar pO2 increasedAlveolar pCO2 increasedPumonary artery pCO2 decreasedPulmonary artery pCO2 increasedThe correct answer is: Pumonary artery pCO2 decreasedPatient of pulmonary embolism becomes tachypncic, exholes CO2, decreased pulmonary artery pCO2.
134Reason for pulmonary O2 toxicityProlong O2 therapyIn under waterAt high altitudeIncrease PCO2None of theseThe correct answer is: Prolong O2 therapyProlonged exposure to increased O2 levels at normal pressure can cause oxidative damage to cell membranes, collapse of alveoli in the lungs causing O2 tonicily.
135If oxygen dissociation curve is dissociated towards right, T50 would be:None of these26183520The correct answer is: 26T50 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.
136Before waking cortisol levels are at its peak in body. Cause?circannualdeep sleepcircadian rhythmmorning stressstressThe correct answer is: circadian rhythmGlucocorticoid 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).
137Lung has metabolic actions in addition to breathing. One of these isInactivation of bradykininInactivation of serotoninMetabolism of basic drugs by cytochrome P450 systemConversion of angiotensin I to angiotensin IINone of theseThe correct answer is: Conversion of angiotensin I to angiotensin IIIn 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.
138surfactant is secreted byalveolialveolar sacsalveolar ductstype 2 pneumocytestype 1 pneumocytesThe correct answer is: type 2 pneumocytesSurfactant is secreted by the type 2 pneumocytes of the respiratory tract
139Which of the following has maxmimum value upon standing at the apex of lung?dec. V/Q valueincreased Ventilationincreased profusioninc. V/Q valuedecreased perfusionThe correct answer is: inc. V/Q valueIdeally, 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
140When a person becomes apneic for a minute only, the value of rise in pCO2 is6 mmHg/min10 mmHg/min8 mmHg/min4 mmHg/min2 mmHg/minThe correct answer is: 10 mmHg/minPaCO2 increases during first minute to apnea by 10 mmHg and 3 mmHg for each minue afterwards.
141by which week surfactant begins to appear?1216181426The correct answer is: 26Surfactant synthesis begins around week 26 of gestation, but mature levels are not achieved until around week 35
142Pleural rupture results inInward collapse and inward chest wall springInward collapse and outward chest wall springOutward collapse and outward chest wall springNone of theseOutward collapse and inward chest wall springThe correct answer is: Inward collapse and outward chest wall springIf 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.
143The central chemoreceptors in the medulla are sensitive toNone of theseH+All of theseCO2O2The correct answer is: CO2Central chemoreceptors respond to increase CO2 and increase H+ both but more sensitive to CO2.
144left shift in Hb-O2 curve is result of?dec. Nadec. Kincreased pHdec. O2dec. pHThe correct answer is: dec. pHAn 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.
145Bluish discoloration of skin or cyanosis results fromBoth A and BIncreased myoglobin in bloodIncreased CO2 in bloodIncreased deoxy hemoglobin in bloodDecreased PO2 in bloodThe correct answer is: Increased deoxy hemoglobin in bloodDeoxy Hb absorbs most of the red light and reflects blue light so > 5 g/dl deoxy Hb cause peripheral cyanosis.
146Drop in arterial o2 saturation is seen without drop in arterial O2 tension inCarbon monoxide poisoningLow v/qAnemiaBoth A and BNone of theseThe correct answer is: Carbon monoxide poisoningIn 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.
147In pulmonary fibrosis spirometry shows low values of all BUT:Vital capacityTotal lung capacityResidual volumeFEV1 to FVCNone of theseThe correct answer is: FEV1 to FVCIn pulmonary fibrosis FEV1 and FVC both decrease but FVC decrease more than FEV1 that’s why FEV1/FVC ration is > 0.8.
148Pulmonary edema without any cardiac cause is due to?emphysemapulmonary embolismasthmaARDSpulmonary edemaThe correct answer is: ARDSAcute 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)
149Surfactant is released by pneumocytes andHas a low tumover rateNone of theseDecrease complianceDecreases whtn alveolar size decreasedDecreases compliance workThe correct answer is: Decreases compliance workSurfactants greatly reduce surface tension, increasing compliance allowing lungs to inflate much more easily, thereby reducing the work of breathing.
150what phenomenon is carried out at dead space?ventilationconvectionradiationperfusionconductionThe correct answer is: ventilationphysiologic 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.
151In hypermetropia, image is formedat lensin front of retinaat retinalateral to retinabehind the retinaThe correct answer is: behind the retinaHypermetropia or the farsightedness is defined as focusing defect when image is formed behind the retina.
152dead space remains unchanged inventilatormaskshallow breathingoropharangeal airwaytracheostomyThe correct answer is: shallow breathingAmong the given list of features, the least likely change in dead space is by the shallow breathing.
153Exchange of gas from alveoli to blood is byactive transportcarrier mediatedsimple diffusionosmosisfacilitated diffusionThe correct answer is: simple diffusionIn lungs, the gases are exchanged by the simple diffusion
154Pulmonary vsoconstriction during low oxygen levels in blood is accompanied byDecreas PCO2Decrease PO2Increase PCO2None of theseIncrease PO2The correct answer is: Increase PCO2Hypoxia (decrease pO2) causes pulmonary vasoconstriction which is accentuated by increased PCO2 (hypercarbia).
155Dependant on diffusionO2O2 during exerciseAll fo theseN2OCo2The correct answer is: O2 during exerciseGuses 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.
156Aqueous humor is produced bycilliary processArachnoid villiBruch"s membranecilliary bodyArachnoid granulationThe correct answer is: cilliary processaqueous humor is produced by the ciliary process and it is collectes to medial canthus through blinking and drains to NL duct.
157Role of pneumotaxic centercontrol hypoxialimits inspirationexpiration centerinc. respirationlimits expirationThe correct answer is: limits inspirationA 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
158O2 tension normal but O2 saturation is declined because ofsec. alveolidec. surfactantdec. plasmadec. RBCinc. plasmaThe correct answer is: inc. plasmaIn case of increased plasma volume but no increase in hemoglobin (relative anemia) leads to decreased O2 saturation.
159A patient has been on supplemental O2 therapy for more than 24 hours and later develops difficulty in breathing.Diagnosis ishypoxemiaO2 toxicityspontaneous pneumothoraxoptic atrophyfibrolental hyperplasiaThe correct answer is: spontaneous pneumothoraxProlong O2 therapy is associated with the development of the spontaneous pneumothorax
160O2 is transmitted through alveoli byosmosispinocytosisactive transportactive diffusionpassive diffusionThe correct answer is: passive diffusionPassive diffusion is the most common and effective method of O2 transport in the lungs.
161Considering chronic respiratory acidosis, for every 10mmHg increase in pCO2, there is rise in HCO3 of15 mEq7 mEq3 mEq1 mEq10 mEqThe correct answer is: 3 mEq1 mm rise in CO2 = 0.35 mEq HCO3, 10 jmm rise in CO2 = 3.5 mEq, 20 mm rise in CO2 = 7 mEq HCO3.
162Transport of CO2 from alveoli to blood in lungs is viaActive transportOsmosisFaciliated diffusionDiffusionSecondary active transportThe correct answer is: DiffusionExchange 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.
163Physiologically highest partial pressure of oxygen is seen inPulmonary capillariesNone of thesePulmonary arteriesAortaPulmonary veinsThe correct answer is: Pulmonary veinsAs pulmonary capillaries are continuous exchanging CO2 with O2 and pulmonary veins receive only oxygenated blood so pO2 in pulmonary veins is highest.
164How R/R is affected by rising blood CO2?IncreasesDecreasesNo changeStopsFirst increases then decreasesThe correct answer is: IncreasesIncreased 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.
165In last trimester what changes are mostly found regarding respiration.dec. CO2dec. O2dec. HCO3dec. COdec. KThe correct answer is: dec. O2In 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.
166cut off for the metabolic alkalosis isHCO3 less than 32CO2 more than 32HCO3 more than 24HCO3 less than 20more CO2The correct answer is: HCO3 more than 24among the given list, the level of HCO3 more than 24 is associated with the metabolic alkalosis
167measure of the physiological dead space isair conductionalveoliemphysemabronchustracheaThe correct answer is: air conductionDead space is the part of air way that participates only in air conduction but not in gases exchange
168surfactant is produced byMast cellspleurapneumocytes IIpneumocytes IalveoliThe correct answer is: pneumocytes IISurfactant is secreted by the type II pneumocytes
169Max. inspiration + normal expiration is equivalent toexpiratory capacityexpiratory volumeresidual volumeinspiratory capacitytotal capacityThe correct answer is: inspiratory capacityMaximum inspiration with normal expiration is used to measure the inspiratory capacity.
170The Normal quiet expiration results from action of:None of theseElastic tissue in thoracic and lung wallAbdominal musclesSternocleidomastoidDiaphragmThe correct answer is: Elastic tissue in thoracic and lung wallNormal expiration is brought about by recoil of elastic tissue and in thoracic and lung wall, when expiration is a passive process.
171Which of the following vein has arterialization of blood?Intenal juglar veinVeins on dorsum of a warm handAnticubetal veinFemoral veinSubclavian veinThe correct answer is: Veins on dorsum of a warm handThis is due to the fact that in warm hand more blood is supplied than need for heat exchange. This causes arterilization of venous blood.
172Active thyroid released in blood isTRHT2T3T1TSHThe correct answer is: T3Active form of the thyroid hormone is the T3 while abundant is the T4
173O2 dissociation curve shifts to the left due to risingNone of theseTemperaturePartial pressure of CO22-3 DPG concentrationOxygen affinity of haemoglobinThe correct answer is: Oxygen affinity of haemoglobinIncrease in oxygen affinity of Hb (as in fetal Hb) causes the curve shift towards left i.e. decrease O2 release in tissue.
174Which test is most relevant for pulmonar function to check obstructve vs restrictive diseasesventilationRCFEV1/ FVCRVFVCThe correct answer is: FEV1/ FVCObstructive 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),
175Gaseous exchange through lungs is dependant onSurface area available for gas exchangeAll fo theseSolubility and molecular weight fo the gasesDiffusion distancePartial pressure difference of the gasesThe correct answer is: All fo theseAll these given factors are responsible for determining exchange through lungs wall, enlargement of air space and increase in compliance.
176Stem related to normal Hb and there is decrease oxygen saturation:acidosisCO2 excessSuffocationNO2 excessCO poisoningThe correct answer is: CO poisoningThe 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.
177Condition causing respiratory acidosis isEmphysemaIngestion of excess amount of sodium bicarbonateVomitingHyperventilationStarvationThe correct answer is: EmphysemaIn 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.
178Low arterial O2 tension results fromHypoventilationNone of theseCO poisoningAnemiaModerate exerciseThe correct answer is: HypoventilationIn hypoventilation, there is CO2 retention and decreased O2 tension while in all other scnerios O2 tension is unchanged and saturation is decreased.
179Maximal vasodilatory effect of CO2 is seen inHeartKidneyBoth A and BLiverBrainThe correct answer is: BrainOf all ranges, brain is the most sensitive to increase pCO2.
180The Lowest PO2 is observed inMaternal uterine veinUmbilical arteryMaternal femoral veinMaternal arteryUmbilical veinThe correct answer is: Umbilical arteryUmblical artery carries all the deoxygenated blood from fetus to mother that’s why has fewest PO2.
181respiration is directly proportional tosurfactantalveoli surface areaalveolialveolar ductsalveoli sacThe correct answer is: alveoli surface areaDiffusion: 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.
182Blood supply to lungs in L/min during rest5322.56The correct answer is: 5Lungs 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.
183V/Q ratio is maximum at upper part of lung becauseBlood flow is decreased considerably more than ventilationDirect connection with tracheaNone of theseBlood flow is increased considerably more than ventilationBase of lund has high ventilation in relation to blood flowThe correct answer is: Blood flow is decreased considerably more than ventilationVentilation 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.
184Respiration will be stopped centrally if following structure is damagedMidbrainPonsMedullaNone of theseCerebellumThe correct answer is: MedullaRespiratory centre is present in medulla which has basic rhythm of respiration, its damage will lead to central cessation of breathing
185inc. in thoracic vol during quiet inspiration is due toexternal intercostalinternal intercostalexternal obliquequadratus LumborumdiaphragmThe correct answer is: diaphragmIntra thoracic volume is increased by the movements of the diaphragm
186decrease in surfactant in lungs will result in?dec. complienceinc. compliencecause Hypoxiainc. O2 affinitydec. CO affinityThe correct answer is: dec. complienceSurfactant 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.
187Mark the true narrative regarding peripheral chemoreceptors:Respond to PO2 less than 40 mmhgNone of theseDetect increased CO2/PHHave increased O2 consumptionRespond on PO2 less than 60 mmhgThe correct answer is: Respond on PO2 less than 60 mmhgPO2 must decrease to < 60 mmgh before breathing is stimulated.
188Diffusion rate of CO2 is raised through alveolar membrane because ofNone of theseBoth A and BIncreased solubilityIncrease density of CO2Increased diffusion co-efficientThe correct answer is: Increased diffusion co-efficientCO2 is the gas with maximum diffusion co-efficient in body.
189A patient’s blood shows PO2 70 mmHg. What kind of hypoxia is he suffering from?hypoxic hypoxiadilutional hypoxiaanemic Hypoxiaanoxic hypoxiatoxic HypoxiaThe correct answer is: hypoxic hypoxiaIn all the cases of the hypoxia, the saturation is normal except for the hypoxic hypoxia
190dead space minus from tidal volume times breathing rate, isalveolar ventilationventilationbreathinggaseous exchangeventilation rateThe correct answer is: alveolar ventilationAlveolar ventilation is defined as dead space minus from tidal volume times breathing rate.
191mechanism of CO2 transport from tissues to lungsuptake of HCO3uptake of HCO3 in exchange of Cluptake of HCO3 in exchange of Kuptake of K in exchange forClexchange of KThe correct answer is: uptake of HCO3 in exchange of ClHCO3- 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.
192Keeping in mind physiology of vital capacity, true isNone of theseBoth A and CMeasured directly by spirometryIs the sum of Tidal Volume+ERV+IRVIs decreased in some lung diseasesThe correct answer is: Is the sum of Tidal Volume+ERV+IRVVital capacity is maximum volume of air that can be expelled from the lungs after taking the deepest possible breath, VC = TV + IRV + ERV.
193stony dull percusion is character ofair in plueral cavityfluid in pleural cavityfibrosisPneumoniaeCOPDThe correct answer is: fluid in pleural cavityWhenever 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.
194After forced expiration amount of RV in ml isNone of these1200 ml1000 ml2400 ml500 mlThe correct answer is: 1200 mlRV = 1200 ml , TV = 500 ml , dead space =150 ml.
195V/Q scan is important for diagnosis ofPneumoniaEmphysemaPulmonary embolismInterstitial lung diseaseNone of theseThe correct answer is: Pulmonary embolismIn pulmonary embolism, Q = O, V/Q = infinity
196what changes hb dissociation curve to extreme leftNO3CO2SO2N2OCOThe correct answer is: COIn addition, binding of CO to hemoglobin increases the affinity of remaining sites for O2, causing a shift of the curve to the left
197At rest, transverse diameter of chest is increased bydiaphragmexternal intercostalinternal obliqueinternal intercostalquadratus LumborumThe correct answer is: external intercostaltransverse diameter of the chest is increased by the external intercostal muscles
198Which volume is inhaled maximum than exhaled?residual capacityinspiratory capacityTLCvital capacityresidual volumeThe correct answer is: vital capacityVital capacity is defined as the volume of air that is maximally exhaled after deep inspiration