Tuberculosis and Respiratory Medicine Quiz

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Quiz on Tuberculosis and Respiratory Medicine

1. Interstitial lung disease with ‘Gottron’s papules’ is seen in –
(1) Systemic sclerosis
(2) Sjogren’s syndrome
(3) Dermatomyositis
(4) Sarcoidosis

2. All of the following statements are correct for asbestosis related pleural involvement, except –
(1) Diffuse pleural thickening is not specific for asbestos exposure.
(2) Trapped lung in asbestosis may lead to restriction of lung function and respiratory insufficiency/failure.
(3) Rounded atelectasis results from visceral pleural fibrosis that has been drawn back into the lung and is called Blesovsky’s syndrome.
(4) Pleural plaques represent parietal pleura involvement that are associated with pleural adhesions and cause significant pulmonary function impairment.

3. All of the following are pulmonary manifestations of systemic lupus erythematosus, except –
(1) Cavitary lung nodules
(2) Pleuritis
(3) Pulmonary haemorrhage
(4) Pulmonary vascular disease

4. All of the following anti-tuberculosis drugs are implicated in drug induced Systemic Lupus Erythematous, except –
(1) Streptomycin
(2) Isoniazid
(3) Rifampicin
(4) Para-aminosalicylic acid

5. At which of the following points does the maximum flow volume curve crosses the volume axis?
(1) Expiratory reserve volume and FVC
(2) Residual volume and TLC
(3) FRC and FVC
(4) Maximum inspiratory and expiratory flow

6. Which is the most common immunodeficiency associated with bronchiectasis?
(1) Combined Variable Immunodeficiency (CVID)
(2) Chronic granulomatous disease
(3) Hyper IgE syndrome
(4) Severe Combined Immunodeficiency (SCID)

7. Which of the following is false regarding bronchial challenge test in asthma?
(1) Fall in FEV1 from baseline >15% with standard doses of methacholine.
(2) Airway hyperresponsiveness is also seen in COPD, BPD, allergic rhinitis.
(3) Challenge agents include inhaled methacholine, histamine, exercise.
(4) Positive challenge test doesn’t mean patient has asthma.

8. Which of the following is the earliest radiographic finding of cystic fibrosis?
(1) hyperinflation of lungs
(2) enlargement of pulmonary artery
(3) peribronchial thickening
(4) cystic lesions

9. p53 and RB gene mutation are related with which carcinoma lung?
(1) Adenocarcinoma
(2) Small cell lung carcinoma
(3) Large cell carcinoma
(4) Squamous cell carcinoma

10. First line treatment in advanced non-small cell lung carcinoma without EGFR/ALK alternations with PD-L1 expression less than 50% –
(1) Pembrolizumab with platinum chemotherapy agents
(2) Atezolizumab with platinum chemotherapy agents
(3) Durvalumab with platinum chemotherapy agents
(4) Nivolumab with platinum chemotherapy agents

11. Which of the following is not seen in Heerfordt syndrome?
(1) Uveitis
(2) Parotitis
(3) Erythema nodosum
(4) Fever

12. Shaver’s disease is associated with exposure to which agent?
(1) Silica
(2) Beryllium
(3) Aluminium
(4) Asbestos

13. Which of the following is of highest value for the diagnosis of Hypersensitivity Pneumonitis?
(1) Exposure to a known offending antigen
(2) Eosinophils in Bronchoalveolar Lavage (BAL)
(3) Serum precipitins
(4) Delayed respond to corticosteroids

14. Migratory shadows are not found in which of the following?
(1) Allergic Bronchopulmonary Aspergillosis
(2) Cryptogenic Organizing Pneumonia
(3) Chronic Eosinophilic Pneumonia
(4) Hypersensitivity Pneumonia

15. Shrinking lung syndrome is associated with –
(1) Systemic Lupus Erythematous
(2) Rheumatoid Arthritis
(3) Systemic Sclerosis
(4) Sjogren’s Syndrome

16. Which of the following is false regarding Hermansky-Pudlak Syndrome?
(1) It is autosomal dominant disorder.
(2) Associated with oculocutaneous albinism, bleeding diathesis, granulomatous colitis.
(3) Subtypes HPS-1, 2, 4 are associated with pulmonary fibrosis.
(4) HPS related pulmonary fibrosis share the UIP pattern.

17. Which of the following is false regarding silicosis?
(1) Silicosis has been linked with ANCA antibody positivity and vasculitis.
(2) Egg shell calcification is pathognomonic of silicosis.
(3) Silicotic nodule range from 3 to 10 mm in diameter.
(4) Silicotic nodules are symmetrically distributed and tend to involve upper zone first.

18. Which of the following is not correct regarding second-hand smoke?
(1) It contains respiratory irritants like SO2, Ammonia, acrolein.
(2) SHS exposure is a cause of asthma exacerbation in both children and adults.
(3) Exposure to SHS does not cause respiratory symptoms in non asthmatic individual.
(4) SHS increases the risk of exacerbation in COPD patients.

19. Which of the following is not an absolute contraindication for anticoagulation in pulmonary thromboembolism?
(1) Difficult to control active bleeding
(2) Platelet count < 25,000/mL
(3) Intracranial bleeding in last 30 days.
(4) Active GIT bleeding in the last 7 days.

20. Which of the following is not a cause of Pulmonary Artery Hypertension?
(1) HIV infection
(2) Sarcoidosis
(3) Schistosomiasis
(4) Congenital heart disease

21. Which of the following air pollutant does not cause pulmonary toxicity?
(1) Sulphur dioxide
(2) Nitrogen dioxide
(3) Ozone
(4) Carbon monoxide

22. Which of the following is false regarding Acute Eosinophilic Pneumonia (AEP)?
(1) Acute onset with febrile respiratory manifestation
(2) Bilateral diffuse opacities on imaging
(3) PaQ2/FiO2 < 300 mm Hg
(4) BAL eosinophilia > 40%

23. Which of the following initial treatment is appropriate in granulomatosis with polyangiitis life threatening disease?
(1) Methotrexate
(2) Azathioprine and Prednisolone
(3) Cyclophosphamide and prednisolone
(4) Mycophenolate and prednisolone

24. With of the following is false regarding Diffuse Alveolar Haemorrhage (DAH)?
(1) Classical presentation includes dyspnea, hemoptysis and anemia.
(2) Hemoptysis may not be present in 50 percent of cases.
(3) BAL shows sequential increase in red blood cells count.
(4) Most common cause is systemic vasculitis.

25. Which of the following is the most common presentation in Autoimmune Pulmonary Alveolar Proteinosis?
(1) Dyspnea
(2) Cough
(3) Sputum production
(4) Chest pain

26. The Tuberculosis Unit in Sub-district Level under NTEP scheme covers which of the following?
(1) One TB unit per 1.5-2.5 lakh for rural and urban population
(2) One TB unit per 0.5-0.75 lakh for rural and urban population
(3) One TB unit per 1-2 lakh for rural and urban population
(4) One TB unit per 0.75-1.25 lakh for rural and urban population

27. Which of the following statement about Isoniazid Preventive Therapy (IPT) is false?
(1) The dose of Isoniazid for preventive therapy is 10 mg/kg body weight administered daily for a period of 6 months.
(2) Isoniazid preventive therapy is given to children below 6 years of age who are close contacts of a TB patient.
(3) INH preventive therapy is not recommended for children (who had close contact with TB) who are already BCG vaccinated.
(4) INH preventive therapy is given to a child born to mother with TB in pregnancy.

28. Which of the following anti-TB drugs causes pseudomembranous colitis?
(1) Pyrazinamide
(2) Rifampicin
(3) Isoniazid
(4) Ethambutol

29. Which of following statement is false?
(1) Bedaquiline, newer anti-TB drug targets ATP synthase enzyme of mycobacterium tuberculosis.
(2) The half life of Delamanid is 5.5 months.
(3) Bedaquiline or Delamanid can be used on patients aged > 6 years of age.
(4) Bedaquiline/Delamanid should not be used in pregnant and lactating mothers.

30. Which of the following statement about miliary Tuberculosis is false?
(1) In miliary TB, acid-fast bacilli are more likely to be found in hard tubercles.
(2) Pleural and pericardial involvement is common with bilateral pleural effusions.
(3) In miliary TB, giant cells are not found in the TB granulomas.
(4) The treatment of miliary TB may extend up to one year.

31. All of the following Non-Tb Mycobacteria (NTM) can cause chronic pulmonary infection, except –
(1) M. Kansasii
(2) M. Avium Complex
(3) M. Marinum
(4) M. Xenopi

32. Which of the following statement about thymoma is false?
(1) Thymoma is most common neoplasm arising in anterior mediastinum.
(2) In PET scan, thymoma show high uptake of FDG.
(3) The most common systemic syndrome associated with thymoma is myasthenia gravis.
(4) The mainstay treatment for thymoma is surgical resection.

33. Which malignancy is the leading cause of chylothorax?
(1) Lymphoma
(2) Lung cancer
(3) CLL
(4) Metastatic cancer

34. Which of the following is not associated with primary spontaneous pneumothorax?
(1) Cystic fibrosis
(2) Marfan syndrome
(3) Ehlers-Danlos syndrome
(4) Alpha-1 antitrypsin deficiency

35. Which of the following drugs does not cause pleural effusion?
(1) Nitrofurantoin
(2) Dantrolene
(3) Amiodarone
(4) Mycophenolate mofetil

36. Which of the following statement regarding ventilator strategy in ARDS is true?
(1) Vt setting should start at 6 mL/kg ideal body weight and I:E setting is 1:2 to 1:4.
(2) Vt setting should start at 7 mL/kg ideal body weight and I:E setting is 1:1 to 1:3.
(3) Vt setting should start at 8 mL/kg ideal body weight and Pplat do not exceed 30 cm H20.
(4) Vt setting should start at 6 mL/kg and Pplat do not exceed beyond 40cm H20.

37. Which of the following is a contraindication for Non-invasive ventilation?
(1) Mild ARDS
(2) Severe ARDS
(3) Neuromuscular disease
(4) Community acquired pneumonia

38. Which of the following statement is true?
(1) APACHE II score is the widely used score to predict NIV failure.
(2) In HACOR score, a score greater than 5 at 2 hour of NIV predicts failure in hypoxemic patients.
(3) In HACOR score, PaO2/FiO2 ratio of < 200 is given a point of 6.
(4) AHACOR score greater than 5 at 1 hour of NIV predicts failure in hypoxemic patients.

39. BiPAP is most commonly delivered with which of the following modes of ventilation?
(1) PSV plus PEEP
(2) Neurally adjusted ventilation
(3) Volume targeted ventilation
(4) Negative pressure ventilation

40. Which of the following statement about the variables of positive pressure breath types in mechanical ventilation is true?
(1) In pressure support, the pressure and minimal flow is set, whereas the breath is patient triggered.
(2) In volume control, pressure and flow is set, whereas breath is machine triggered.
(3) In pressure control, the pressure and Ti is set, whereas breath is patient triggered.
(4) In volume assist, the flow and volume is set, whereas the breath is machine triggered.

41. Extra-pulmonary complication of Guillain Barre syndrome is seen in pneumonia caused by –
(1) H. Influenzae
(2) Pseudomonas aeruginosa
(3) Mycoplasma pneumoniae
(4) Streptococcus pneumoniae

42. Regarding Lymphangioleiomyomatosis (LAM) which of the following is not correct?
(1) It usually manifests during the reproductive years in female.
(2) Lung volume does not remain preserved.
(3) Renal cysts are occasionally presents.
(4) Pneumothorax in LAM has high recurrence rate.

43. Which of the following statement regarding non-REM sleep is true?
(1) non-REM sleep is characterised by low-voltage slow wave EEG activity.
(2) non-REM sleep is characterised by high voltage slow wave EEG activity.
(3) non-REM sleep is characterised by low voltage fast wave EEG activity.
(4) non-REM sleep is characterised by high voltage fast wave EEG activity.

44. Which of the following statement about Obstructive Sleep Apnea (OSA) is false?
(1) Upper airway resistance is increased during sleep.
(2) Apnea, hypopneas and respiratory effort-related arousals are found.
(3) Sympathetic activity is increased both during wakefulness and sleep.
(4) Hypoxia attenuates the effects of increased sympathetic tone.

45. Which of the following statements regarding Polysomnography (PSG) is true?
(1) In PSG, Level 1 sleep testing measures only oximetry and airflow yielding less information compared to other levels.
(2) Level 2 in PSG is the in-laboratory technologist attendant overnight sleep testing level
(3) Level 3 is the level that acquires respiratory flow, respiratory effort, oximetry, snoring and body position.
(4) Level 4 involves a Full PSG performed in an unattended non-laboratory setting which has been used in population based studies.