Module 13 Week 4 Question

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MODULE 13: RESPIRATORY SYSTEM

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NAME :

MODULE : RESPIRATORY SYSTEM (MODULE 13)

WEEK : 4

DURATION :

TREATMENT OF BRONCHIAL ASTHMA 2

1. Choose the correct answer about the theophylline

A. It provides mild or moderate bronchodilation in patient with asthma

B. It is a non-selective phosphodiesterase inhibitor

C. It produces minimal to no effect on the airway reactivity

D. All of the above

2. All of the following factors will increases the plasma level of theophylline except

A. Rapid intravenous injection

B. Febrile illness

C. Heart failure

D. Concomitant use of theophylline with contraceptive pills

3. Choose the incorrect statement about the sustained-release oral theophylline

A. Mild to moderate bronchodilator

B. It produces a low plasma level over a prolonged period of time

C. It has a wide therapeutic indexD. Can be used for treatment of nocturnal asthma

4. Which of the following answer is the systemic effect which is caused by atropine?

A. Tachycardia

B. Urine retention

C. Glaucoma

D. All of the above

5. All of the following answers are true about the iatropium bromide except

A. It has high bioavailabilityB. May be used as alternative bronchodilator for COPD patients who do not tolerate SABA

C. It can only be given by inhalation

D. It is a short acting anticholinergic drug


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VENTILATION/PERFUSION RELATIONSHIP (V/Q)

6. The V/Q ratio in the ideal lung is

A. 0.8

B. 0.6

C. 3.3

D. 0.2

7. The following statements are true EXCEPT

A. Apical alveoli are more perfused than ventilated

B. The base of the lung represents a physiological shunt

C. There is more perfusion than ventilation at the base of lung

D. Low volume dead space can be found at the apex of lung

8. Which of the following is TRUE regarding to bronchial constriction?

I. There is increase in PACO2

II. PO2 and PCO2 in alveoli and capillary are the same

III. V/Q ratio= infinity

IV. The ventilation is zero

A. I, II and III

B. I, II and IV

C. I, III and IV

D. II, III and IV

9. During exercise, there is increase in perfusion at the apex of the lung

A. True

B. False

10.Choose the true statements regarding ventilation/perfusion ratio

I. Mismatch between ventilation and perfusion can cause CO2 retention and hypoxia

II. The V/Q ratio in thrombosis is zero

III. The V/Q ratio at the apex is more than at the base

IV. There is almost equal in V/Q ratio between apex and base of lung during rest

A. I and II

B. I and III

C. II and III

D. III and IV


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PNEUMONIA AND LUNG ABSCESS

11.All the following are true regarding the community-acquired acute pneumonia except:

A. Most cases are bacterial in origin

B. Commonly, the infection follows a viral upper respiratory tract infection

C. Its most common cause is Pneumococcus

D. Originates by aspiration of pharyngeal flora

12.The correct sequence of phases of inflammatory response of pneumococcal lobar pattern is:

A. Gray hepatization stage -> Congestion stage -> Red hepatization stage -> Resolution stage

B. Red hepatization stage -> Gray hepatization stage ->Congestion stage-> Resolution stage

C. Resolution stage -> Gray hepatization stage ->Red hepatization stage -> Congestion stage

D. Congestion stage -> Red hepatization stage -> Gray hepatization stage-> Resolution stage

13.Choose the false fate and prognosis for bronchopneumonic pattern:

A. Carnification

B. Pleural empyema

C. Death especially in type 3 pneumococci infection

D. Complicated by bacterial superinfection

14.The morphology of viral or mycoplasmal pneumonia is the following except:

A. Inflammatory reaction may be patchy, or may involve whole lobes bilaterally or unilaterally

B. Grossly, the affected areas appear congested,subcrepitant with consolidation

C. Microscopically it is termed interstitial pneumonitis

D. Alveolar spaces are free of cellular exudates hence it is termed atypical pneumonia

15.Choose the false type of lung abscess:

A. Postpneumonic and postbronchiectatic lung abscess

B. Postobstructive lung abscess

C. Nosocomial lung abscess

D. Primary cryptogenic lung abscess

MICROBIOLOGY TUBERCULOSIS

16.The following are true EXCEPT

A. Saprophytic mycobacteria which are found in soil are atypical

B. Myolic acid in mycobateria cell wall makes them acid and alcohol fast

C. Ziehl Neelsen stain can be used to stain mycobacterium tuberculosis

D. Lowenstein Jensen glycerol medium is inhibitory to mycobacterium tuberculosis


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17.The following are true EXCEPT

A. Pasteurization renders milk safe because mycobacteria are killed by dry heat at 60C fo 15-20

min

B. Tubercle Bacilliresist acid and alkali and has more resistance to malachite green and penicillin

compared to other bacteria

C. Paranitrobenzoic acid (PNBA) medium does not promote the growth ofM.Bovis

D. Human are one of the main source of infection of tuberculosis

18.Choose the correct statements

I. Spreading oftubercle bacilliin the host is by direct extension, through blood and lymphatics

II. Gohns complex is the feature of primary tuberculosis

III. Intramuscular test of tuberculin is used to detect state of hypersensitivity to tubercle bacilli

IV. A positive tuberculin test always implies that active disease is present

A. I & II

B. II & III

C. III & IV

D. II & IV

19.Choose the correct statements

I. Old tuberculin and purified protein derivative are used as material in Tuberculin test

II. Specimen for lab diagnosis of pulmonary tuberculosis : late night sputum

III. Polymerase chain reaction is one of the rapid technique used to detect mycobacterial antigen

IV. M. Kansasiicause tuberculosis-like disease of the lung

A. I & II

B. I & IV

C. II & III

D. II & IV

20.The following are atypical mycobacterium EXCEPT

A. M. SmegmatisB. M. KansasiiC. M. AviumD. M. IntracellulareE. M. Bovis

PATHOLOGY TUBERCULOSIS

21.Tuberculosis is one of infective disease because it can transmit disease through:

A. Ingestion of milk

B. Inoculation of skin

C. Droplet transmission

D. All of above


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22.What is the difference primary and secondary TB?

A. Primary TB develops in a person who was not previously exposed to the tubercle bacilli and is

therefore are sensitized.

B. Secondary TB regional lymph node are less prominently involved.

C. Primary TB have complications of fibrocaseous TB with cavitation.

D. None of above.

23.In the pathogenicity of TB, the center of granuloma undergoes caseation possibly due to :

I. Vascularity of lesion

II. Lack of blood supply

III. Response to mediators produced by activated macrophage and activated CD4+ lymphocytes

IV. Dystrophic calcification

A. I AND III

B. I AND IV

C. II AND III

D. III AND IV

24.Fate of pulmonary TB depends on virulence of organism and dose of infection:

A. True

B. False

25.Healing by fibrosis and calcification occurs when the organism is high virulence and patients

resistance is low :

A. True

B. False

PHARMACOLOGY (CONTROLLER MEDICATION)

26.Which of the following is about theophylline ?

I. Aminophylline is administered to treat of asthma exacerbations

II. Increasing theophylline plasma level above 20 g/ml leads to GIT disturbance, arrhythmia, and

headache

III. Pregnancy and concomitant use of anti-tuberculosis medication decrease theophylline plasma

level

IV. Rapid IV theophylline injection may cause cardiac and CNS side effects

A. I and III

B. II and IV

C. I, II and IV

D. All of the above


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27.All of the following is CORRECT regarding antimuscarinic bronchodilators and magnesium sulfate

EXCEPT

A. Cardiac arrest may occur in some cases treated with magnesium sulfate

B. Tiotropium bromide can be given to COPD patients

C. Ipratropium bromide is approved for use in nocturnal asthma

D. Systemic side effect of atropine make its use proved to be not suitable

28.All of the following is TRUE regarding to glucocorticoids EXCEPT

A. Corticosteroids suppress recruitment of airways inflammatory cell

B. Systemic steroids are indicated to mild, moderate or severe persistent asthma

C. Inhaled steroids have lower bioavailability than oral systemic corticosteroids

D. Adverse effects of inhaled steroids are voice hoarseness, oropharyngeal candidiasis, dermal

thinning, bruises and linear growth delay in children

29.Regarding to controller medication, choose INCORRECT statement:

A. Montelukast can be given in exercise induced asthma and aspirin-sensitive individuals

B. Omalizumab may lead to anaphylactic reactions

C. Liver toxicity has been found in some subjects receiving zileuton

D. Cromones are administered only oral administration

30.Which of the following drugs are given in severe persistent asthma?

I. Inhaled corticosteroid

II. Cromones

III. Omalizumab

IV. Aspirin

V. Beta- blocker

A. I and III

B. II and IV

C. I, II and III

D. All of the above

PHARMACOLOGY TUBERCULOSIS

31.Choose the correct answer about the antimicrobial action of pyrazinamide:

I- The drug is taken by macrophages and exert its action intracellularly

II- Is a prodrug converted to pyrazinoic acid by the enzyme found in mycobact. tuberculosis

III- Destroys the bacterium by inactivates vital enzyme in fatty acid synthesis of mycobacterium

IV- It is bacteristatic to semidormant bacteria

A. I & II Only

B. I, II, & III

C. III & IV

D. All of the above


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32.The following are the advantages of the use of pyrazanamide in treatment of Tuberculosis EXCEPT:

A. The resistance are not easy to develop

B. It is highly effective during the first two months

C. It can be use in severe life-threatening tuberculosis

D. It shortened the duration of therapy to six months

33.All of the following are incorrect about the indications for usage of streptomycin EXCEPT:

A. It is included in the short course of multiple drug therapy

B. To prevent recurrence of infection in immunodefficient individuals

C. To shortened the duration of therapy to six months

D. It is including in multidrug treatment of mild tuberculosis

34.A 45-year old males comes to an outpatient complaining of cough with bloody sputum. The patient

experience weight loss with night sweat. Chest X-ray revealed cavitation at the apical region of the

lung. You suspect the patient having pulmonary TB. Which of the following drug are suitable to treat

the patient while waiting for the microbiologic testing?

A. Isoniazid and Fluoroquinolones

B. Isoniazid and rifampin

C. Amikacin and Fluoroquinolones

D. Strepromycin rifapentine

35.Choose the correct regimens exist in treatment of tuberculosis:

I- Initial treatment with reduced number of drug and continue with increasing number of drug

II- The combination theraphy of isoniazid-rifampin-pyrazinamide reduced the total duration of

therapy without loss of efficacy

III- The continuation phase of short course therapy aim to eliminate the persisters

IV- During the initial phase of administration, the majority of tubercle bacilli are killed but the

still infectious

A. I & II only

B. II & III only

C. III & IV only

D. All of the above

OXYGEN TRANSPORT 1

36.Which of the following is TRUE regarding the value of Oxygen pressure starting from atmospheric air

till reaching pulmonary artery? (mmHg)

A. 160>150> 100>95>40

B. 159>150>100>95>40

C. 150>100>40

D. 159>150>100>40


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37.Choose the CORRECT statements regarding dissolved form of Oxygen in the blood.

I. Its about 3% of total Oxygen in the blood

II. 0.3ml/100ml in arterial blood & 0.13/100ml in venous blood

III. It determines direction and rate of flow of RBCs

IV. Determine chemical combination with Hb

A. I,II,III

B. I,II,IV

C. III,IV

D.All of the above

38.Choose the FALSE statements regarding Oxygen in chemical combination

I. 97% of Oxygen in the blood is in this form

II. Its about 20ml/100ml blood

III. The combination consist of 4haem fractions with 4 iron atom in ferric state each bind to 1

oxygen molecule

IV. The binding of Hb with Oxygen is by oxidation

A. I,II

B. II,III

C. III,IV

D. I,IV

39.Which of the following is FALSE regarding chemical combination of the blood?

A. Tense configuration of Hb increases the affinity of the molecule for oxygen

B. Relaxed configuration exposed more binding site for more oxygen binding

C. Oxygen contents in blood depends on Hb concentration and oxygen tension

D. 15g/d.L of Hb is needed to carry oxygen in chemical combination form

40.Choose the CORRECT answers regarding Oxygen-Hb dissociation curve

I. Changes of pressure of Oxygen has great effect on the % saturation of Hb with Oxygen

II. The flat upper part represent loading zone, it represent lung side

III. The steep lower part represent dissociation zone,it represent tissue side

IV. During muscular exercise,the saturation of Hb with the oxygen is increases

A. I,II

B. II,III

C. I,II,IV

D. All of the above


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ANTITUBERCULOUS DRUG 2

41.Which of the following is not true about Pyrazinamide?

A. Included in first-choice combination regimen drug

B. Resistance to Pyrazinamide is easily required

C. At neutral ph, pyrazinamide is inactive

D. At ph 5.5, pyrazinamide inhibits tubercle bacilli

42.All of the following are the adverse effects of pyrazinamide except?

A. Hyperuricemia

B. Arthralgia

C. Optic neuritis

D. Hepatitis

43.Which of the following is not true about Streptomycin?

A. it is an aminoglycosides

B. Most action on intracellular tubercle bacilli

C. Penetration to CSF increase when the meninges are inflamed

D. Most action on extracellular tubercle bacilli

44.Which drug causes the patients suffering from gouty arthritis?

A. Pyrazinamide

B. Rifampicin

C. Streptomycin

D. Ethambutol

45.Which drug causes injury to 8th nerve ?

A. Rifampicin

B. Isoniazid

C. Streptomycin

D. Ethambutol

PHYSIOLOGY (O2 TRANSPORT 2)

46.Below are all factors affecting oxygen-Hb dissociation curve EXCEPT

A. Increased acidity

B. Increase temperature

C. Increase 2-3 diphosphoclycerate

D. Fetal Hb


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True [A] or False [B]

47.P50 determines the position of oxygen-Hb dissociation curve

48.Chronic hypoxia will increase 2-3DPG synthesis

49.Choose the correct statement regarding myoglobin

I. High affinity to oxygen

II. Important in preventing muscle from getting hypoxia at rest

III. Give out oxygen only when the pressure is very low

IV. Found in cardiac muscle

A. I, III

B. II, IV

C. I, II, III

D. II, III ,IV

50.All of the statement regarding the above gas are true EXCEPT

A. Has 200-250 affinity higher than oxygen

B. Have a significant effect on PO2 and oxygen content

C. Interfere with oxygen transport function of blood

D. Smoking causes 14% of Hb turn inti HbCO

ILA 2: TUBERCULOSIS

PATHOLOGY

51.All the following are important points during history taking for tuberculosis EXCEPT

I- Debilitating disease

II- History of contact with active tuberculosis patients

III- Immunocompromised patients

IV- Previously history of tuberculosis

A. I & II

B. II & III

C. III & IV

D. None of the above

Carbon Monoxide


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52.Which of the following are fates of secondary tuberculosis?

I- Miliary TB

II- Healing by fibrosis with dystrophic calcification

III- Fibrocaesous TB

IV- Resolution

A. I, II, III

B. I, III, IV

C. II, III, IV

D. All the above

53.All the following are characteristics of primary TB except

A. Gohns focus at upper part of upper lobe or lower part of lower lobe

B. Lymphadenitis of tracheobronchial lymph nodes

C. Lymphangitis

D. Healing by fibrosis is the most common fate

MICROBIOLOGY

54.All the following are rapid diagnosis for tuberculosis and their reasons for usage EXCEPT

A. PCR detect Mycobacteria DNA

B. Bacter radiometric technique detect labeled palmitic acid to show growth of Mycobacteria

C. EIA detect Mycobacteria antigen

D. NA probe detect Mycobacteria rRNA rapidly due to high copies per cell; 10 000 copies

55.All the following are the reason to conduct Tuberculin test EXCEPT

A. Prior vaccination

B. To exclude TB in respiratory diseases diagnosis

C. Can detect active TB patients

D. To conduct epidemiological study

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beyond their greatest

failure.Napoleon Hill quotes(American author, 1883-1970)

ANSWERS:

1.D (pg.233) 17.A 33.A 49.A

2.B (pg.234) 18.A 34.B 50.B

3.C (pg.233) 19.B 35.B 51.D

4.D (PG.234) 20.E 36.B 52.A

5.A(PG.234) 21.D 37.B 53.A

6.A 22.B 38.C 54.B

7.B 23.C 39.A 55.C8.B 24.A 40.B

9.A 25.B 41.B

10.B 26.D 42.C

11.B 27.C 43.B

12.D 28.B 44.A

13.D 29.D 45.C

14.B 30.A 46.D

15.C 31.B 47.B

16.D 32.C 48.A
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Module 13 Week 4 Question

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