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B5:Respiratory System MID TERM Past Questions

Total questions: 40

Worksheet time: 10hrs 0mins

Name
Class
Date
1.

John is 60 years old man with Chronie Obstructive Pulmonary Disease. He was tested by Pulmonary Faction Test and showed that his FEVI/EVC< 70%, and FEVI is 60% of predicted value with persistent symptom. What is his severity?

a)

I Mild

b)

II Moderate

c)

III Severe

d)

III Very severe

2.

Sammy is 70 years old woman with Chronic Obstructive Pulmonary Disease. She was tested by Pulmonary Function Test and showed as follow:

How much %change in FEV1?

a)

3

b)

4

c)

5

d)

6

3.

When does anaerobic threshold occur?

a)

When energy demands of the resting muscles exceed the body's ability to produce energy by aerobic metabolism

b)

When energy demands of the exercising muscles exceed the body's ability to produce energy by

aerobic metabolism.

c)

When energy demands of the exercising muscles exceed the body's ability to produce energy by anaerobic metabolism

d)

When energy demands of the resting muscles exceed the body's ability to produce energy by anaerobic metabolism

4.

What of the following is the primary indication for performing exercise tests?

a)

 Hypercapnia on an arterial blood gas

b)

Dyspnea on exertion

c)

Pain associated with myocarditis

d)

Recent diagnosis of obstructive sleep apnea

5.

Where did the nasal septum develop from?

a)

Medial nasal prominences

b)

 Lateral nasal prominences

c)

Maxillary prominence

d)

Mandibular prominence

6.

 Where did the parietal pleura develop from?

a)

 Paraxial mesoderm

b)

Intermediate mesoderm

c)

Somatic mesoderm

d)

Splanchnic mesoderm

7.

 Where did the Nasal sac develop from?

a)

Mesoderm

b)

Endoderm

c)

Oral Ectoderm

d)

Surface Ectoderm

8.

Where did the epithelium of trachea develop from?

a)

Mesoderm

b)

Endoderm

c)

Oral Ectoderm

d)

Surface Ectoderm

9.

The opening of paranasal sinuses, which is incorrect?

a)

Sphenoid sinus → superior meatus

b)

Ethmoid sinus → superior and middle meatus

c)

Frontal sinus →middle meatus

d)

Maxillary sinus →middle meatus

10.

 Which of the following movements does not match the muscle contraction?

a)

 Tense vocal fold - cricothyroid muscle

b)

Open rima glottidis - lateral cricoarytenoid muscle

c)

Loose vocal fold - thyroarytenoid muscle

d)

Close rima glottidis -* transverse arytenoid muscle

11.

Which of the following muscle is not innervation by recurrent laryngeal nerve?

a)

Thyroarytenoid muscle

b)

Cricothyroid muscle

c)

Transverse arytenoid

d)

Lateral cricoarytenoid muscle

12.

Which of the following statement is not correct?

a)

The impression of aortic arch is on the left lung

b)

 The number of lobes is 2 on the left and 3 on the right lung

c)

Lingula on the left lung is the impression of heart

d)

Right primary bronchus is thicker and shorter than the left one

13.

Which of the following will increase alveolar POs?

a)

increase in metabolism and no change in alveolar ventilation

b)

breathing air with 15% oxygen at sea level

c)

 increase in alveolar ventilation matched by an increase in metabolism

d)

increased alveolar ventilation with no change in metabolism

14.

Which of the following will cause the largest increase in systemic arterial oxygen saturation in the blood?

a)

an increase in red cell concentration (hematocrit) of 20%

b)

breathing 100% Oz in a healthy subject at sea level

c)

an increase in arterial PO, from 40 to 60 mmHg

d)

hyperventilation in a healthy subject at sea level

15.

 in arterial blood with a PO, of 60 mmHg, which of the following situations will result in the lowest blood oxygen saturation?

a)

 decreased DPG with normal body temperature and blood pH

b)

increased body temperature, acidosis, and increased DPG

c)

decreased body temperature, alkalosis, and increased DG

d)

 normal body temperature with alkalosis

16.

The rhythmic control of breathing is produced by the activity of inspiratory and expiratory neurons in

a)

 the medulla oblongata.

b)

 the apneustic center of the pons.

c)

the pneumotaxic center of the pons.

d)

the cerebral cortex.

17.

 John Snow's investigation of cholera is considered a model for epidemiology field investigations because it included a _____Which is the following statement is false?

a)

Biologically plausible hypothesis

b)

Comparison of a health outcome among exposed and unexposed groups

c)

 Multivariate statistical model

d)

Recommendation for public health action

18.

A study in which children are randomly assigned to receive either a newly formulated vaccine or the currently available vaccine, and are followed to monitor for side effects and effectiveness of each vaccine , is an example of which type of study?

a)

Experimental

b)

Observational

c)

Cohort

d)

Case-control

19.

Which of the following is NOT a vaccine-preventable disease?

a)

Polio

b)

Hepatitis B

c)

Asthma

d)

Measles

20.

Which disease mainly affects children under 5 and remain as endemic in only 2 countries

a)

Rubella

b)

Polio

c)

Measles

d)

Tetanus

21.

A 23-year-old woman is using an albuterol  inhaler for frequent acute  episodes of asthma and complains of symptoms that she ascribes to the albuterol. Which of the following is not a recognized action of albuterol?

a)

Diuretic effect

b)

Positive inotropic effect

c)

Skeletal muscle tremor

d)

mooth muscle relaxation

22.

Which of the following in its parenteral form is life-saving in severe status asthmaticus and acts, at least in part, by inhibiting phospholipase A2?

a)

Aminophylline

b)

Prednisone

c)

Salmeterol

d)

 Zafirlukast

23.

Which of the below is a bronchodilator?

a)

Beta 1 agonists

b)

Beta 1 antagonists

c)

Beta 2 agonists

d)

Beta 2 antagonists

24.

Which of the below is an anti-IgE mAb drug?

a)

Omalizumab

b)

Budesonide

c)

Mometasone

d)

Ciclesonide

25.

Which of the below are inhaled corticosteroids?

a)

Acetylcysteine

b)

 Beclomethasone

c)

Benzonatate

d)

Glycopyrronium

26.

Which one is a muscarinic receptor antagonist for the treatment of asthma?

a)

Fenoterol

b)

Ipratropium

c)

 Theophylline

d)

Montelukast

27.

Which of the following description is wrong?

a)

Pneumoconioses encompass a group of chronic fibrosing diseases of the lung

b)

Pulmonary alveolar macrophages play a central role in the pathogenesis of lung injury by promoting inflammation and producing reactive oxygen species and fibrogenic cytokines.

c)

Coal dust-induced disease is the most common pneumoconiosis in the world

d)

Asbestos exposure is linked with parenchymal interstitial fibrosis and recurrent pleural effusions

28.

Which of the following descriptions is wrong?

a)

Sarcoidosis is a multisystem disease of unknown etiology

b)

Almost all large pulmonary artery thrombi are embolic in origin

c)

H. influenzae is the most common cause of community-acquired acute pneumonia

d)

Lobar pneumonias evolve through four stages: congestion, red hepatization, gray hepatization. and resolution,

29.

Which of the following description is wrong?

a)

Lung abscess is often caused by mixed infections and frequently occur in debilitated individuals following aspiration of oral flora.

b)

Smoking is the most important risk factor for lung cancer

c)

Precursor lesions of lung cancer include squamous dysplasia for squamous cancer and atypical adenomatous hyperplasia for adenocarcinomas

d)

Lung  cancers unusual cause paraneoplastic syndromes

30.

Which of the following descriptions is wrong?

a)

Rhinitis can be infectious or allergie in nature

b)

Pharyngitis and tonsillitis are common upper respiratory tract viral infections typically caused by rhinoviruses, echoviruses, and adenoviruses

c)

Nasopharyngeal carcinoma is most often associated with HPV

d)

Laryngitis can be caused by a host of etiologies, including allergic, viral, bacterial, and chemical insults

31.

A 25-year-old previously well woman presents to your office with complaints of episodic shortness of breath and chest tightness. She has had the symptoms on and off for about 2 years but states that they have worsened lately, occurring two or three times a month. She notes that the symptoms are worse during the spring months. She has no exercise-induced or nocturnal symptoms. The family history is notable for a father with asthma. She is single and works as an administrative assistant in a high-tech firm. She lives with a roommate, who moved in approximately 2 months ago. The roommate has a cat. The patient smokes occasionally when out with friends and drinks socially, but has no history of illicit drug use. Examination is notable for mild end-expiratory wheezing. The history and physical examination are consistent with a diagnosis of Pulmonary function tests are ordered to confirm the diagnosis.

a)

Asthma

b)

Chronic Obstructive Pulmonary Disease (COPD)

c)

Pulmonary Edema

d)

 Interstitial Pulmonary Fibrosis

32.

Which disorder is NOT a metabolic acidosis?

a)

Acute vomiting (10 minutes after vomiting)

b)

Acute methanol ingestion

c)

 Diarrhea

d)

Accidental hypoventilation of a patient on a mechanical ventilator for 10 minutes

33.

A 57-year-old man undergoes total knee replacement for severe degenerative joint disease. Four days after surgery, he develops an acute onset of shortness of breath and right-sided pleuritic chest pain. He is now in moderate respiratory distress with a respiratory rate of 28/min, heart rate of 120 bpm, and blood pressure of 110/70 mm Hg. Oxygen saturation is 90% on room air, Lung examination is normal. Cardiac examination reveals tachycardia but is otherwise unremarkable.

The right lower extremity is postsurgical, healing well, with 2+ pitting edema, calf tenderness, erythema, and warmth; the left leg is normal. He has a positive Homan sign on the right. What disease is suspected in the 57-year-old man?

a)

Chronic Obstructive Pulmonary Disease (COPD)

b)

noncardiogenic pulmonary edema

c)

Asthma

d)

Acute Pulmonary Embolism

34.

Which statement of Cystic fibrosis is true?

a)

People with cystic fibrosis often do not get the nutrition they need to grow normally due to the thick mucus blocks ducts in the pancreas

b)

People with cystic fibrosis inherit a defective gene on chromosome 7 called CFTR (cystic fibrosis transmembrane conductance regulator)

c)

The level of trypsinogen protein is higher than normal in people with cystic fibrosis

d)

All of the above

35.

Which is not the factor that accounts for almost all cases of pulmonary edema?

a)

an increase in vascular endothelial cell and/or alveolar epithelial cell permeability (noncardiogenic pulmonary edema)

b)

a decrease in the oncotic pressure gradient (usually owing to a low plasma protein content)

c)

Impaired lymphatic drainage either from physical lymphatic obstruction or from lymphatic obliteration, which can occur in the setting of radiation treatment.

d)

a decrease in the hydrostatic pressure gradient (cardiogenic pulmonary edema)

36.

Which disease will cause the abnormality of impaired perfusion of blood into lungs?

a)

Right-to-left shunts of great vessels

b)

Pulmonary embolism and pulmonary infarction

c)

Selected lung cancers

d)

All of above

37.

In comparing uncompensated respiratory acidosis and uncompensated metabolic acidosis which one of the following is true?

a)

Plasma pH change is always greater in uncompensated respiratory acidosis compared to uncompensated metabolic acidosis.

b)

There are no compensation mechanisms for respiratory acidosis, whereas there is respiratory compensation for metabolic acidosis.

c)

Uncompensated respiratory acidosis involves changes in plasma HCO3-], whereas plasma HC03- is unchanged in uncompensated metabolic acidosis

d)

 Uncompensated respiratory acidosis is associated with a change in Pco2, whereas in uncompensated metabolic acidosis Pco2 is constant.

38.

A 68-year-old man presents to the clinic with a complaint of shortness of breath. He states that he has become progressively more short of breath over the last 2 months, such that he is now short of breath with walking one block. In addition, he has noted a nonproductive cough. He denies fever, chills, night sweats, chest pain, orthopnea, and paroxysmal nocturnal dyspnea. He has noted no lower extremity edema. The medical history is unremarkable. Physical examination reveals a respiratory rate of 19/min and fine, dry inspiratory crackles heard throughout both lung fields.

Digital clubbing is present. A diagnosis of

_______is made.

a)

pulmonary embolism

b)

Acute Respiratory Distress Syndrome (ARDS)

c)

 Chronic Obstructive Pulmonary Disease (COPD)

d)

Interstitial Pulmonary Fibrosis

39.

Which of the following sentences about Fluorine-18 Fluorodeoxyglucose (F-18 FDG) is correct?

a)

F-18 FDG is a glucose analog that is taken into the cell and phosphorylated by the same mechanism as glucose

b)

 The primary route of F-18 FDG excretion occurs by the kidneys, although F-18 FDG excretion also takes place through the bowel.

c)

Serum glucose actively competes with F-18 FDG uptake.

d)

All of the above

40.

Which of the following sentences about lung nodule survey is wrong?

a)

F-18 FDG PET/CT may be considered if the sizes of the solid lung nodules are larger than 8mm.

b)

F-18 FDG PET/CT shows acceptable accuracy for ground-glass opacity nodules.

c)

Nodules caused by cancer have specific traits such as spiculations, fast-growing and not likely to have calcium buildup

d)

During chest CT follow-up, increases in size or density, or a change in shape may be a sign of cancer.