Qmu Week 5 Respi

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WEEK: 5 (3-6 JUNE 2012)

MODULE: 13 (RESPIRATORY SYSTEM)

YEAR: 2 (2011/2012)

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MYCOPLASMA AND CHLAMYDIA

1. Choose the incorrect statement about the characteristics of mycoplasmaA. They lack a rigid cell wallB. They cannot reproduce in cell-free mediaC. They are completely resistant to penicillinD. They are inhibited by tetracycline or erythromycin

2. Which of the following is false about the general properties of chlamydia?A. It is obligate intracellular parasiteB. Sensitive to sulphonamideC. Lacks mechanism for production of metabolic energyD. It does not contain cell wall

3. Choose the correct answer about the cultural and growth characteristics of the mycoplasmaA. They have a typical fried-egg appearanceB. They grow aerobicallyC. They require about 30% of serum in the agar or brothD. All of the above

4. All of the following test can be used to detect specific antibodies against mycoplasmapneumonia except

A. Immunofluorescent testB. ELISAC. Cold agglutination testD. Passive haemagglutination test

5.

Choose the correct statement about the chlamydia trachomatisA. It is sexually transmitted from male to femaleB. About 10-20% of infants exposed to chlamydia trachomatis at birth may develop diffuse

interstitial pneumonia

C. Chlamydia trachomatis pneumonitis in adult is infrequentD. All of the above


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CARBON DIOXIDE TRANSPORT

6. Choose the false statement:A. Carbon dioxide is transported as physically dissolved CO2 and chemically combined CO2B. 95% of CO2 is chemically combined in red blood cellsC. Carbamino compounds is the major form by which CO2 is transported in bloodD. Physically dissolved CO2 is responsible for CO2 tension in arterial and venous blood

7. All the following are true regarding chloride shift and its changes at the tissues except:A. Small amount of CO2 is hydrated forming carbonic acid which dissociates into hydrogen

ions and bicarbonate

B. In plasma the hydration reaction is faster than inside RBCs due to the presence ofcarbonic anhydrase enzyme

C. Chloride ions enter the RBCs from the plasma to maintain the electrical neutralitiesD. Chloride ions content in RBCs in venous blood is greater than that in arterial blood

8. The following statements are true regarding carbon dioxide dissociation curve except:A. This curve shows the relation between PCO2 in the blood and the total CO2 content/100

ml of blood

B. O2 dissociation curve is more linear than carbon dioxide dissociation curveC. CO2 content depends on the degree of de-saturation of HB from oxygenD. Physiological CO2 dissociation curve represents the changes in PCO2 and CO2 content

that occur in the systemic blood

9. All the following are true regarding Haldane effect except:A. It is the binding of oxygen with haemoglobin tends to displace CO2 from bloodB. It is important in promoting CO2 transport at the lungsC. The combination of O2 with Hb in the lungs causes the Hb to become stronger alkaliD. More highly acidic Hb has less tendency to combine with CO2 to form carbamino Hb

10.Choose the true statement:A. The hydrogen ion that is released after dissociation of H2CO3 is buffered in the RBCs by

plasma proteins

B. Deoxygenated Hb is less acidic than oxygenated Hb and is a better H+ acceptorC. Haematocrit value of venous blood is normally 5% greater than arterial bloodD. Protein of Hb is quantitatively more important than plasma protein in binding with CO2

because blood contain less Hb

BRONCHIECTASIS & BRONCHIAL ASTHMA

11.All of the following are included in the definition of bronchiectasis EXCEPTA. Permenant abnormal dilatation of small bronchi and bronchiolesB. Due to destruction of their muscles and elastic tissueC. Resulting from chronic necrotizing infectionD. Associated with small bronchi and bronchioles obstruction


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12.Regarding to bronchiectasis, which of the following is the CORRECT statementA. Predisposing factors are bronchial obstruction, hereditary condition and meningitisB. Pathogenesis : obstruction and acute infectionC. Usually lower lobes of lungsD. Microscopically, lining epithelium and submucosa show desquamation, ulceration or

squamous metaplasia

E. Even in moderate case, fibrosis and lung abscess can be seen13.Regarding to bronchial asthma, all of the following is TRUE EXCEPT

A. Characterized by episodic reversible bronchospasmB. Shows the morphology of Curschmann spiralsC. Cannot be considered as a chronic inflammatory disorder of airwaysD. Non-immunologic asthma mostly triggered by respiratory tract infections, chemical

irritants, air pollution, aspirin, cold, exercise and psychogenic factor

14.Bronchiectasis and bronchial asthma have same clinical features which areI. Status asthmaticus

II. DyspneaIII. Attacks of coughIV. WheezingV. Clubbing of fingerA. II and IIIB. II, III and IVC. I, IV and VD. All of the above

15.What are the complications for both bronchiectasis and bronchial asthma?I. Emphysema

II. BronchopneumiaIII. Squamous metaplasiaIV. Cor pulmonaleV. Brain abscessA. I and IIB. I and IVC. I, II an IVD. All of the above


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NERVE OF THORAX

16. Choose the correct statement regarding right vagus nervesI Right vagus nerve enter thorax by passing behind first part of subclavian artery

II Then it will formed cardiac plexusIII Right vagus at the end will form posterior gastric nerve

IV It enter abdomen by passing through oesophaeal opening

A. I,II,IIIB. II,III,IVC. III, IVD. I, II

True [A] or False [B]

17.Left vagus enter thorax by descending between left common carotid artery and leftsubclavian artery.

18.Then it descend to give right posterior pulmonary plexus19.Cardiac plexus consist of deep and superficial plexus20.Coronary plexus, pulmonary plexus and oesophageal plexus have branches from cardiac

plexus that forming them

REGULATION OF RESPIRATION 1

21. Respiratory basic rhythm is generated mainly by

I. Dorsal respiratory group

II. Ventral respiratory group

III. Pre-BOtzinger complex

IV. Apneustic center

A. I and II

B. I and III

C. II and III

D. III and IV

22. The respiratory center that can be found in nucleus parabrachialis is

A. Dorsal respiratory group

B. Pre-BOtzinger complex

C. Pneumotaxic centerD. Apneustic center


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23. Choose the TRUE statements regarding the ventral respiratory group

I. Groups of inspiratory neurons

II. Have both inspiratory and expiratory neurons

III. Important during muscular exerciseIV. Located between nucleus ambiguous and lateral reticular nucleus in medullaA. I and III

B. II and III

C. III and IV

D. I and IV

24. The above statements are related to:

A. Apneustic center

B. Pre-BOtzinger complex

C. Ventral respiratory group

D. Pneumotaxic center

25. The characters of central chemoreceptors are

I. The sensitivity reduced during sleep

II. In normal condition, they will always stimulated

III. Respond to CO2 excess slower than peripheral chemoreceptors

IV. Do not affected by H+ in blood

A. I, II and IVB. I, III and IV

C. II, III and IV

D. I, II, III and IV

VIRUSES CAUSING RTI

26. Choose the correct morphology of the following virus:

I- Rhinovirus: Naked IcosahedralII- Adenovirus : ds-DNA, naked icosahedralIII- Paramyxovirus: Small envelopedIV- Orthomyxovirus: Helical nucleocapsid, non-segmented

A. I onlyB. I & IIC. I, II, & IIID. All of the above

Producing prolonged inspiration when

stimulated

Inhibited by impulses from vagus nerve


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27. Choose the correct statement about the virus causing respiratory tract infection:

A. Adenovirus has special affinity to mucousB. Paramyxovirus antigen changes continually and undergoes mutabilityC. Rhonivirus replicates mostly in the noseD. Orthomyxovirus replication limited to respiratory epithelia

28. The following are the correct statement regarding the influenza virus, EXCEPT:

A. It is the most important cause of Lower respiratory tract illness in infants and young childrenB. There are at least 9 antigenic types of neuraminidase spikes and they facilitate budding and

self aggregation of virions

C. Antigenic drift occur as a result of single mutation in viral DNAD. Major antigenic changes occurs at a longer period 10-40 years in influenza A strains

29. Choose the correct answer regarding the paramyxovirus:

I- Carries 2 types of glycoprotein spikes: Haemagluttinin spikes (HA) and Neuraminidase spikes(NA)

II- RSV lacks haemagluttinin and neuraminidase activity and it replicates in epithelial cell ofnasopharynx

III- Paramyxovirus replication is limited to respiratory epithelia in Parainfluenza & RSV butdisseminated in measles & mumps

IV- HN and F spikes are the key factor for its infection and pathogenesisA. I onlyB. I, II & IIIC. II, III & IVD. All of the above

30. The following are INCORRECT regarding the laboratory diagnosis of the virus causing respiratory

tract infections EXCEPT:

A. Microscopic examination using gram stainB. Use enzyme immunoassay technique to detect adenovirus antigenC. Tuberculin test to detect the state of hypersensitivity to the virus antigenD. Haemagluttinin inhibition and neutralization test can be used to detect specific antibodies

following adenovirus infection

REGULATION OF RESPIRATION

31. Choose the CORRECT statements regarding regulation of respiration

I. Based on integration of the sensors, central controllers and effectorsII. Consists of three systems(neural, chemical & non chemical)III. Neural regulation responsible for automatic control onlyIV. Voluntary system can always over-ride involuntary system for a long time


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A. I,IIB. II,IIIC. I,II,IVD. All of the above

32. Which of the following is FALSE regarding neural regulation of respiration?

A. Voluntary system can over-ride involuntary system for a short timeB. Involuntary system is driven by group of pacemaker cells at medullaC. Consist of medullary, pontine and higher centersD. Composed of several neurons located bilaterally in medullaoblongata and pons

33. Choose the CORRECT statements regarding involuntary regulation of respiration

I. DRG continuously send excitatory impulse to the contralateral inspiratory muscleII. VRG is important during heavy expiration as in muscular exerciseIII. Pre-BOTC is found nucleus ambiguous(rostrally) and nucleus retroambiguus( caudally)IV. Pre-BOTC act as generator neurons for the respiratory rhythmA. I,IIB. II,IIIC. I,II,IVD. All of the above

34. All of the following are TRUE regarding 'Ramp'' signal.EXCEPT

A. Nervous signal that transmitted to inspiratory muscles is due to instantaneous burst ofaction potentials

B. In normal respiration, it begins weakly and increase steadily in 2 secondsC. The signal ceases abruptly for the next 3 secondsD. The man advantage is to prevent inspiratory gasp

35. Choose the CORRECT pair regarding pontine centers

I. Acts as modifier of rhythmic discharge released by medullary centersII. Apneustic center lead to prolonged inspiration and decrease inspiratory rateIII. Pneumotaxic center centers are inhibited by Apneustic centersIV. Pneumotaxic centers prolonged the inspiration and cause over inflationA. I,IIB. II,IIIC. I,IIID. I,IV

MICROBIOLOGY VIRUS 2

36. The following are true about Corona viruses EXCEPT

A. Show tropism to epithelial cells of respiratory tractB. They are SS RNA viruses with linear segmented genomeC. Cause infections mainly in the upper respiratory tract


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37.The following are correct matches for laboratory diagnosis of the following viruses EXCEPT

A. Corona virus-PCRB. SARS CoV-isolationC. Adenovirus-neutralizationD. Corona virus-isolation

38. The following are true EXCEPT

A. Humans are affected by group I and II of the three major serogroup of Corona VirusB. SARS CoV can be grown on tissue culture cells such as Vero monkey cells resulting in

cytopathic effect

C. Severe lower respiratory tract diseases in human can be caused by corona virus infectionD. Infection by SARS CoV is untreatable with only control measures to stop the spread of

infection

39. The following are false EXCEPT

A. Corona virus causes 20-35% of respiratory illness in adults during winter monthsB. Spread of SARS CoV from a person to another is through feco-oral routeC. Latest antiviral drugs are proven to cause effective stoppage of SARS CoV spreadD. Serology test such as immnoflurescence can be used to detect antibodies against SARS CoV

40. The following are correct matches for treatment and control measures in handling the following

viruses EXCEPT

A. Ribavirin-oralRespiratory syncytial virusB. Zanamivir-inhalation Influenza virusC. Amantadine Hydrochloride- influenza virusD. Isolation of patient- SARS CoV

RESTRICTIVE LUNG DISEASES

41. All the following are true regarding Restrictive Lung Diseases except:

A. A group of diseases having similar clinical signs, symptoms, radiologic alterations andpathologic changes

B. They are identified by a reduced timed vital capacity, lung volumes and lung complianceC. Restrictive defect may be due to extra pulmonary chest wall disorderD. Restrictive defect is due to parenchymal causes in the lung itself

42. Pathogenesis of parenchymal restrictive lung diseases are the following except:

A. Interstitial pneumonitis occurs in almost all casesB. Characterized by accumulation of inflammatory cells and immune effector cells in the

alveolar wall and interstitium

C. Release of chemical mediators causes injury to the endothelial cells of the capillaries onlyD. The final result is an end stage fibrotic lung known as stiff lung


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43. Choose the false statement regarding the clinical features and complications of parenchymal

restrictive lung diseases:

A. Patients have dyspnea,tachypnea, and cyanosis without wheezingB. The cause of dyspnea is the stiffness of the lung which reduces the lung complianceC. Chest radiographs show diffuse infiltration by small nodules or smooth glass shadowsD. Restrictive lung diseases may end in severe hypoxia and respiratory failure

44. Which statement is not true regarding the acute restrictive lung diseases?

A. The best example is infant respiratory distress syndromeB. The causes are infection, physical injury, inhaled irritants and chemical injuryC. Grossly the lungs are dark red, firm, airless, and heavy in early stageD. Microscopically sistended alveolar ducts are lined by a hyaline membrane

45. Choose the false type of pneumoconiosis:

A. AnthracosisB. SilicosisC. AsbestosisD. Narcosis

HYPOXIA AND CYANOSIS

46. What is hypoxia?

A. Mild pain causes hypoxiaB. Bluish discoloration of skinC. Oxygen deficiency at tissue levelD. None of above

47. Which of following NOT the causes of hypoxic hypoxia :

A. Intracardiac shuntB. Paralysis of respiratory muscleC. EmphysemaD. Increase partial pressure of oxygen

48. Which of following are correct matches?

I. Hypoxic hypoxia blood flow to tissues is slowII. Anaemic hypoxia reduced amount of Hb that carries oxygenIII. Stagnant hypoxia amount of oxygen delivered to tissues is inadequateIV. Histotoxic hypoxia tissue become unable to utilize oxygenA. I AND IIB. II AND IIIC. I,II AND IIID. II, III AND IV


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49. Effectiveness of oxygen therapy is guaranteed on treatment of hypoxic hypoxia only :

A. TrueB. False

50. Cyanosis is:

A. Cherry red discoloration of skinB. Threshold of cyanosis is 5gm reduced Hb/100 ml of bloodC. Total amount of Hb in blood is decreasedD. All of above

TBL PHYSIOLOGY 1: EFFECTS OF DECREASED BAROMETRIC PRESSURE (HIGH ALTITUDE)

51. All the following are the acclimatization to low PO2 EXCEPT

A. Hyperventilation due to increase PCO2B. Respiratory alkalosis due to wash out of CO2C. Increase excretion of bicarbonate from blood and CSF by kidneyD. Adaptation of central chemoreceptors to low levels of CO2 due to hyperventilation

52. All the following is true regarding polycythemia due to decrease PaO2 level EXCEPT

A. Erythropoietin hormone stimulate bone marrow to increase formation of RBCsB. Erythropoietin secretion increases 4 days after exposure to low atmospheric pressureC. Polycythemia sustained as long as the individual remains at high altitudeD. It increases blood viscosity

53. All the following are true regarding carbon dioxide in low atmospheric pressure EXCEPT

A. It has the same percentage from total air composition as at the sea levelB. Its partial pressure is decreasedC. It leads to hyperventilation by stimulating central chemoreceptorsD. Its density is decreased

54. Which of the following is WRONG upon effects of decreased barometric pressure?

A. Increased cardiac outputB. Increased arterial blood pressureC. Increased heart rateD. Vasodilatation of pulmonary arteryE. Shifting of O2-Hb dissociation curve from left at the beginning to the right later on

55. Which of the following is TRUE regarding effects that increase oxygenation of tissues EXCEPT

A. Increased lung volume which increase surface area of respiratory membraneB. Opening of the previously closed capillaries and increase their diameterC. Angiogenesis to increase blood flow the tissueD. Increased 2-3 diphosphoglycerate (DPG)E. Increase certain cellular oxidative enzymes


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TBL 3: EFFECTS OF INCREASED BAROMETRIC PRESSURE

56. What is the value of atmospheric pressure at depth of 132 feets?

A. 3 atmB. 4 atmC. 5 atmD. 6 atm

57. Increase in depth will cause:

I. Compression of gases to bigger and bigger volumeII. Increase density of gases

III. Decrease work of breathingIV. Atmospheric pressure is higher

A. I and IIIB. II and IVC. I,III and IvD. II, III and IV

58. Manifestation of N2 narcosis are the following EXCEPT

A. DrowsinessB. DepressionC. Impaired performancesD. Loss of coordination

59. Pressure does not equalize in middle ear through Eustachian tube causing

A. Mild painB. Otitis mediaC. Ear drum ruptureD. Water enters inner ear

60. Helium is more desirable from N2 for diver because

A. It has more narcotic effectB. It is more soluble in body fluidsC. It produces low quantity of bubblesD. Its molecule cannot diffuse out of tissues easily.


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ANSWERS

1 B 161 11 D 198 21 B 118 31 A 41 B 201 51 A

2 D 163 12 C 198 22 C 119 32 C 42 C 201 52 B

3 D 161 13 C 200 23 B 117 33 C 43 C 202 53 C

4 C 162 14 A 199 24 A 119 34 A 44 A 202 54 D5 D 164 15 B 199 25 D 120 35 A 45 D 203 55 E

6 C 110 16 C 26 B 169 36 B 46 C 56 C

7 B 111 17 A 27 C 167 37 D 47 D 57 B 134

8 B 113 18 B 28 A 169 38 C 48 D 58 B 135

9 C 114 19 A 29 C 167 39 D 49 A 59 C

10 B 112 20 A 30 D 166 40 A 50 B 60 C 135

VERY OFTEN A CHANGE OF SELF IS NEEDED MORE THAN A CHANGE OF SCENE

Qmu Week 5 Respi

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