Tuberculosis and Respiratory Medicine Practice Set

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Practice Set of Tuberculosis and Respiratory Medicine

1. Obese Hypoventilation Syndrome (OHS) is defined by which of the following?
(1) BMI>25kg/m2;PaCO2>45mmHg
(2) BMI>35kg/m2; PaCO2 > 40mmHg
(3) BMI>30kg/m2;PaCO2 >45mmHg
(4) BMI>40kg/m2; PaCO2 > 45mmHeg

2. Which of the following conditions can cause Diaphragmatic palsy?
(1) Sarcoidosis
(2) Tuberculosis
(3) Asthma
(4) Silicosis

3. The predominant immunosuppressive agent used in the induction therapy after lung transplantation is –
(1) Tacrolimus
(2) Basiliximab
(3) Alemtuzumab
(4) Mycophenolate mofetil

4. E-cigarette/Vaping Associated Lung Injury (EVALD, a syndrome of acute respiratory distress is associated with vaping of which of the following toxic chemicals?
(1) Benzo (a) pyrene
(2) β-naphthylamine
(3) delta-9-tetrahydrocannabinol (THC)
(4) Nicotine

5. All of the following are components of Pulmonary rehabilitation, except –
(1) Exercise training
(2) Psychosocial support
(3) Collaborative self-management skills
(4) Emphasis on short-term health enhancing behaviour

6. Cryotherapy used in therapeutic bronchoscopy technique for managing central airway disorders is based on which of the following principles?
(1) Boyle’s Law
(2) Joule Thompson effect
(3) Carnot’s theorem
(4) Avogadro’s law

7. Which of the following statement is false about Bronchial Artery Embolization (BAE)?
(1) BAEcan both localise and embolize bleeding vessels.
(2) Success rate have been reported as high as 85%.
(3) BAE for haemoptysis due to active tuberculosis and aspergilloma may be associated with higher success rates with less recurrence rates.
(4) Adverse effects include subintimal vascular dissection and neurologic defects.

8. All of the following are diagnosed by EBUS-TBNA (transbronchial-needle aspiration), except –
(1) Lymphoma
(2) Tubercular hilar lymphadenopathy
(3) Silicosis
(4) Sarcoidosis

9. Which of the following influenza vaccine is administered through intranasal route?
(1) Trivalent Inactivated Influenza Vaccine (ITV3)
(2) Quadrivalent Inactivated Influenza Vaccine (IIV4)
(3) Quadrivalent Recombinant Influenza Vaccine (RIV4)
(4) Quadrivalent Live Attenuated Influenza Vaccine (LAIV4)

10. Which of the following statement is true?
(1) VATS (Video-Assisted Thoracoscopic Surgery) allows sampling from any tissue confined to anterior and middle mediastinum only.
(2) Cervical mediastinoscopy provides access to lymph nodes in aortopulmonary window.
(3) EBUS-TBNA provides access to posterior subcarinal lymph nodes as well hilar nodes or masses.
(4) VATS can be performed under regional anaesthesia.

11. The cardinal symptom of radiation pneumonitis is –
(1) Cough
(2) Dyspnea
(3) Chest pain
(4) Hemoptysis

12. In which of the following patients presenting with acute dyspnea would a positive D-dimer prompt additional testing for a pulmonary embolus?
(1) A 24-year-old woman with 32 weeks pregnancy.
(2) A 36-year-old woman undergoing breast cancer chemotherapy.
(3) A 48-year-old man with no medical history and presents with calf pain following prolonged air travel with normal alveolar-arterial oxygen gradient.
(4) A 62-year-old man who had an acute myocardial infarction two weeks ago.

13. Which of the following statements regarding diagnostic imaging in pulmonary embolism is true?
(1) A high probability ventilation-perfusion scan is one that has at least one segmental perfusion defect in the setting of normal ventilation.
(2) If a patient has a high probability ventilation-perfusion scan, there is a 90% likelihood that the patient does indeed have a pulmonary embolism.
(3) Magnetic resonance angiography provides excellent resolution for both proximal and smaller segmental pulmonary emboli.
(4) Multidetector-row spiral CT imaging is suboptimal for detecting small peripheral emboli, necessitating the use of invasive pulmonary angiography.

14. All of the following are ANCA-associated vasculitis, except –
(1) Polyarteritis nodosa
(2) Wegener’s syndrome
(3) Microscopic polyangiitis
(4) Churg-Strauss syndrome

15. In which of the following condition the bronchoalveolar lavage typically shows increased T lymphocytes with high helper T cells?
(1) Sarcoidosis
(2) Hypersensitivity pneumonitis
(3) Idiopathic pulmonary fibrosis
(4) Rheumatoid arthritis

16. Which one of the following is not in the diagnostic criteria for tropical pulmonary eosinophilia?
(1) Haemoptysis
(2) Eosinophil counts greater than 3300 cells/mm3
(3) Residence in a filarial endemic area
(4) Clinical improvement and haematological response to diethylcarbamazine

17. In which of the following condition, chest radiograph shows widespread snow-storm appearance from minute calcified mottled shadows?
(1) Alveolar microlithiasis
(2) Miliary carcinomatosis
(3) Talc granulomatosis
(4) Pulmonary alveolar haemorrhage

18. Which of the following statement is correct for HIV-related tuberculosis?
(1) Apical lobe involvement and cavitation is common with low CD, count.
(2) Extra-pulmonary tuberculosis is more common than pulmonary tuberculosis.
(3) Pleural effusion can be seen in both high and low CD, count.
(4) A 3mm induration is considered positive tuberculin test.

19. Which of the following drug can be safely used with Bedaquiline?
(1) Amiodarone
(2) Digoxin
(3) Diltiazem
(4) Procainamide

20. All of the following drugs causes QT prolongation as adverse drug events, except –
(1) Ethionamide
(2) Fluoroquinolone
(3) Clofazimine
(4) Bedaquiline

21. Regarding molecular tests in TB, which of the following is not correct?
(1) Molecular diagnostic tests provide timely results useful for high-quality patient care, low contamination risk and ease of performance and speed.
(2) Diagnostic accuracy is better for respiratory specimens than for non-respiratory specimens
(3) Molecular methods can be used for determining response to treatment
(4) These tests cannot differentiate between live and dead bacilli

22. Parapneumonic pleural effusion with alkalotic pH is caused by –
(1) Enterococci
(2) E.Coli
(3) Pseudomonas
(4) Proteus

23. Lung sliding and comet tail artifacts sign on thoracic ultrasound denotes –
(1) Pneumothorax
(2) Pleural effusion
(3) Pleural thickening
(4) No abnormality

24. Spontaneous pneumothorax in a patient with skin lesions, renal mass and ‘FLCN’ gene mutations is seen in –
(1) Marfan syndrome
(2) Adams-Oliver syndrome
(3) Birt-Hogg-Dube syndrome
(4) Contarini’s syndrome

25. Which one of the following Interleukin (IL) is the primary factor responsible for eosinophilic pleural effusion?
(1) IL-1
(2) IL-3
(3) IL-5
(4) IL-7

26. Hyperbaric oxygen therapy is contraindicated in –
(1) Carbon monoxide poisoning
(2) Airembolism
(3) Necrotizing fasciitis
(4) Untreated tension pneumothorax

27. In which of the following method, removal of large quantity of pleural fluid is possible with minimal risk of re-expansion pulmonary edema?
(1) Intercostal tube drainage system
(2) Thoracoscopic removal with controlled suction
(3) Thoracocentesis via needle aspiration
(4) Thoracocentesis via needle aspiration and controlled suction

28. Following are common hemodynamic profile in both hypovolemic and cardiogenic shock, except –
(1) Decrease mean arterial pressure
(2) Decrease in cardiac output
(3) Decrease in pulmonary arterial wedge pressure
(4) Increase in systemic vascular resistance

29. The main purpose of permissive hypercapnia during mechanical ventilation is to reduce the patients –
(1) pH
(2) Tidal volume
(3) Respiratory rate
(4) Pulmonary pressure

30. Which of the following is not a complication of Positive End Expiratory Pressure (PEEP)?
(1) Decrease venous return and cardiac output
(2) Barotrauma
(3) Decreased intracranial pressure
(4) Alteration in renal function and water metabolism

31. All of the followings are contraindication of non-invasive mechanical ventilation, except –
(1) AIDS with pneumocystis infection
(2) Hemodynamic instability
(3) Inability to protect the airway
(4) Copious respiratory secretions

32. ‘Ragocytes’ in pleural fluid are seen in –
(1) Tuberculosis
(2) Sarcoidosis
(3) Rheumatoid arthritis
(4) Ankylosing spondylitis

33. Which of the following connective tissue disease is not responsive to corticosteroids?
(1) Rheumatoid arthritis
(2) Ankylosing spondylitis
(3) Acute lupus pneumonitis
(4) Scleroderma related lung disease

34. A 30% of greater decrease in airflow lasting atleast 10 seconds and associated with a 4% or greater oxyhemoglobin desaturation is called –
(1) Central apnea
(2) Obstructive apnea
(3) Hypopnea
(4) Respiratory event-related arousal

35. Which of the followings validated questionnaires for screening obstructive sleep apnea is based on three reported symptoms (snoring, feeling tired, having witnessed apneas) and five physical characteristics (hypertension, obesity, age, enlarged neck circumference and male gender) –
(1) Berlin questionnaire
(2) Epworth sleepiness scale
(3) Pittsburgh sleep quality index
(4) STOP-BANG questionnaire

36. Patients with chronic hypoventilation disorders often complain of headache upon wakening. What is the cause of this symptom?
(1) Arousal from sleep
(2) Polycythaemia
(3) Cerebral vasodilation
(4) Nocturnal micro-aspiration and cough

37. In which of the following condition, paradoxical movement of chest wall is seen?
(1) Kyphosis
(2) Flail chest
(3) Pectus excavatum
(4) Ankylosing spondylitis

38. Which of the following technique is based on aim to reduce airway smooth muscle mass in uncontrolled bronchial asthma?
(1) Bronchial thermoplasty
(2) Bronchoscopic thermal vapour ablation
(3) Bronchoscopic electrocautery
(4) Photodynamic therapy

39. A worker in acrylic resin factory presented with dizziness, nausea, rapid breathing followed by vomiting, chest pain and confusion in a rapid manner. On examination there is ‘bitter almonds’ odour breath with no cyanosis and normal oxygen saturation. These features suggest –
(1) Carbon monoxide poisoning
(2) Cyanide poisoning
(3) Paraquat poisoning
(4) Sulfur dioxide poisoning

40. Which of the following pair of tumors constitutes majority of tracheal tumors?
(1) Adenoid cystic carcinoma and adenocarcinoma
(2) Squamous cell carcinoma and mucoepidermoid carcinoma
(3) Squamous cell carcinoma and adenoid cystic carcinoma
(4) Adenoid cystic carcinoma and mucoepidermoid carcinoma

41. The most common cause for hypertension, hyperglycemia, hypokalemic alkalosis and raised ACTH levels among lung cancer is –
(1) Squamous cell carcinoma
(2) Adenocarcinoma
(3) Large cell carcinoma
(4) Small cell carcinoma