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Patho, L4, COPD

 L4 , COPD,patho

Lecture video 


MCQ 

1. Source of pulmonary surfactant is: 

 A. Alveolar macrophages 

 B. Type I pneumocytes 

 C. Type II pneumocytes 

 D. Capillary basement membrane


2. The basic defect in neonatal hyaline membrane disease is: 

 A Shock due to sepsis 

 B. Deficient production of surfactant 

 C. Inhalation of toxins 

 D. Aspiration pneumonitis


3. Adult respiratory distress syndrome occurs from the following causes except: 

 A. Pancreatitis 

 B. Oxygen toxicity 

 C. Deficiency of surfactant 

 D. Diffuse pulmonary infections


4. Primary atelectasis is defined as: 

 A. Incomplete expansion of a previously unexpanded lung 

 B. Reduction in size of a previously expanded lung due to 

 compression 

 C. Reduction in size of a lung due to obstruction 

 D. Reduction in lung size due to contraction


5. Pulmonary hypertension is defined as  systolic blood pressure in the pulmonary arterial circulation above the following cut off figure: 

 A. 120 mmHg

 B. 90 mmHg 

 C. 60 mmHg 

 D. 30 mmHg


6. Bronchopneumonia is grossly characterized by: 

 A. Diffuse consolidation of a lobe or lobes of one or both lungs 

 B. Diffuse consolidation of a lobe of one lung 

 C. Diffuse consolidation of a lobe of both lungs 

 D. Patchy consolidation of a lobe or lobes of one or both lungs



7. The most common causative organism for lobar pneumonia is: 

 A. Staphylococci 

 B. Streptococci 

 C. Pneumococci 

 D. Haemophilus


8. Viral pneumonias are characterised by the following features except: 

 A. Presence of interstitial inflammation 

 B. Presence of alveolar exudate 

 C. Necrotising bronchiolitis 

 D. Multinucleate giant cells in the bronchiolar wall


9. The organism in Pneumocystis carinii pneumonia is: 

 A. Mycoplasma 

 B. Fungus 

 C. Protozoa 

 D. Chlamydia


10. Lung abscess secondary to aspiration pneumonia develops more often in: 

 A. Lower lobe of right lung 

 B. Lower lobe of left lung 

 C. Upper lobe of either lung 

 D. Middle lobe of right lung


11. Reid index used as a criteria of quantitation in chronic bronchitis is the ratio of thickness of: 

 A. Bronchial mucosa to that of bronchial wall 

 B. Submucosal glands to that of bronchial wall 

 C. Bronchial cartilage to that of bronchial wall 

 D. Inflammatory infiltrate to that of bronchial wall


12. The most fibrogenic dust in pneumoconiosis is: 

 A. Coal 

 B. Asbestos 

 C. Silica 

 D. Beryllium





13. Classic a-I antitrypsin deficiency in emphysema has the following phenotype of protease inhibitor: 

 A. PiMM 

 B. PiZZ 

 C. PiMZ 

 D. PiMO

14. The extent of damage to pulmonary parenchyma is severest in the following type of emphysema: 

 A. Centriacinar 

 B. Panacinar 

 C. Distal acinar 

 D. Irregular 

15. Emphysema associated most often with (I antitrypsin deficiency is: 

 A. Panacinar 

 B. Centriacinar 

 C. Distal acinar 

 D. Irregular 

16. Serum lgE levels are elevated in: 

 A. Intrinsic bronchial asthma 

 B. Extrinsic bronchial asthma 

 C. Predominant chronic bronchitis 

 D. Predominant emphysema 

17. Bronchiectasis commonly develops in the following microanatomic zone of bronchial tree: 

 A. Acini beyond respiratory bronchioles 

 B. Acini beyond terminal bronchioles 

 C. Terminal bronchioles less than 2 mm diameter 

 D. Bronchioles more than 2 mm diameter

18. The following histologic types of bronchogenic carcinoma have strong association with cigarette smoking except: 

 A. Squamous cell carcinoma 

 B. Small cell carcinoma 

 C. Large cell carcinoma 

 D. Adenocarcinoma 


19. The following type of bronchogenic carcinoma has worst prognosis: 

 A. Squamous cell carcinoma 

 B. Small cell carcinoma 

 C. Large cell carcinoma 

 D. Adenocarcinoma 

20. Bronchial carcinoid arises from: 

 A. Columnar ciliated epithelium 

 B. Goblet cells 

 C. Kulchitsky cells 

 D. Alveolar lining cells 

21. The following tumour does not have association with occupational exposure to asbestosis: 

 A. Benign mesothelioma 

 B. Malignant mesothelioma 

 C. Bronchogenic carcinoma 

 D. Laryngeal carcinoma 


22. Macrophage-derived fibrogenic cytokine is: 

 A. IL-I 

 B. IL-8 

 C. TNF 

 D. TGF ( 

23. The most important mutation in small cell carcinoma is in the following gene: 

 A. RB gene 

 B. MYC gene 

 C. CDK gene 

 D. RAS gene

24. Hamman-Rich syndrome is: 

 A. Bronchopulmonary dysplasia 

 B. Desquamative interstitial pneumonia 

 C. Diffuse fibrosing alveolitis 

 D. ARDS





25. Most common etiologic factor implicated in chronic bronchitis is: 

 A. Atmospheric pollution 

 B. Cotton mills 

 C. Mycoplasma infection 

 D. Cigarette smoking 

26. Which type of asthma occurs in late adult life: 

 A. Atopic asthma 

 B. Intrinsic asthma 

 C. Mixed asthma 

 D. Allergic asthma 

27. Asbestos exposure results in all of the following changes except: 

 A. Interstitial pneumonia 

 B. Pleural effusion 

 C. Malignant mesothelioma 

 D. Pleural fibrosis 

28. All are types of allergic pneumonitis except: 

 A. Bagassosis 

 B. Byssinosis 

 C. Berryliosis 

 D. Farmer's lung 

29. Which of the following mutation is being used to develop targeted molecular therapy in non-small cell cancer of lung: 

 A. EGFR mutation 

 B. p53 mutation 

 C. K-RAS mutation 

 D. p16 mutation

30. Which of the following statements is true about Mikulicz cells: 

 a) These are macrophages with deeply eosinophillic cytoplasmic staining 

 b) They are characteristic cells seen in lobar pneumonia. gray hepatization stage 

 c) They are most commonly seen in the nasal mucosa in cases of atrophic rhinitis 

 d) They are the pathognomonic cells of scleroma 

 e) They are commonly seen in the middle ear in cases of chronic otitis media 



31. Which of the following statements is not true about tonsilitis? 

 a) it may predispose to rheumatic fever 

 b) It may predispose to glomerulonephritis 

 c) It may predispose to carcinoma of the tonsils 

 d) It may be complicated by quinzy 

 e) it may be complicated by otitis media

32. Which of the following statements is true about nasopharyngeal carcinoma: 

 a) It may affect young adults, 15-25 years of age 

 b) It may be predisposed to be Ebstein-Barr virus infection 

 c) It may be cured by radiotherapy 

 d) All of the above 

 e) None of the above 

33. Which of the following lesions does not affect the vocal cords: 

 a) Juvenille papilloma 

 b) Adult papilloma 

 c) Singer's nodule 

 d) Squamous cell carcinoma 

 e) Basal cell carcinoma

34. Which of the following is not a cause of epistaxis: 

 a) Scleroma 

 b) Nasopharyngeal fibroma 

 c) Vitamin D deficiency 

 d) Leukemia

 e) Fevers

35. Which of the following conditions is not associated with nasal or nasopharyngeal obstruction: 

 a) Atrophic rhinitis 

 b) Nasal polyp

 c) Adenoids

 d) Scleroma

 e) Nasopharyngeal fibroma




36. Which of the following conditions is not true about bronchiectasis: 

 a) This is septic persistent dilatation of the bronchi 

 b) It is often a unilateral disease affecting the right lung 

 c) It may be complicated by amyloidosis 

 d) Some cases may be complicated by right sided heart failure 

 e) Bronchiectasis can be a complication of septic bronchopneumonia 


37. Which of the following conditions is true about lobar pneumonia: 

 a) This is suppurative inflammation Of one or more lung lobes 

 b) The condition is commonly complicated by bronchiectasis 

 c) Consolidation(hepatization) of the affected lobes does not occur before 9 days 

 d) All of the above

 e) None of the above


38. Which of the following conditions is a complication of septic bronchopneumonia 

 a) Lung abscess 

 b) Brochogenic carcinoma 

 c) Obstruction of large bronchi 

 d) All of the above 

 e) None of the above 


39. Which of the following is an obstructive lung disease: 

 a) Chronic bronchitis 

 b) Bronchial asthma 

 c) Emphysema 

 d) All of the above 

 e) None of the above 


40. Which of the following is a restrictive lung disease: 

 a) Adult respiratory distress syndrome 

 b) Senile emphysema 

 c) Carcinoid tumor 

 d) All of the above

 e) None of the above





41. Which of the following is not a suppurative disease

 A) Empyema 

 b) Bronchiectasis 

 c) Postpneumonic abscess 

 d) Lobar pneumonia 

 e) Septic bronchopneumnla 


42. AIpha I antitrypsin deficiency leads to emphysema because

 a) It leads to deficient formation of pulmonary elastic tissue 

 b) It leads to excessive destruction of elastic tissue by elastase enzyme 

 c) It predisposes to bronchial inflammation and obstruction 

 d) All of the above 

 e) Noneof the above 


43. Emphysematous lungs are characterized by all of the following except: 

 a) They rapidly collapse on opening the chest 

 b) They show air bullae 

 c) They are pale and dry 

 d) They may show indentations at sites of ribs 

 e) They may cover the heart 


44. Which of the following is a complication of emphysema: 

 a) Empyema 

 b) Cor pulmonale 

 c) Left sided heart failure 

 d) All of the above 

 e) None of the above


45. Which of the following is true about centriacinar emphysema: 

 a) It affects the alveoli and spares the bronchioles 

 b) It is the main type occuring in smokers 

 c) It is reversible 

 d) All of the above 

 e) None of the above 





46. Which of the following is true about bronchogenic carcinoma: 

 a) chronic lung abscess is a predisposing factor 

 b) It arises from the peripheral brnchi in 85% of of cases 

 c) Adenocarcinoma is the most common microscopic type and is related to smoking 

 d) All of the above 

 e) None of the above 


47. All of the following conditions can cause atelectasis except: 

 a) Compression of bronchi by enlarged lymph nodes 

 b) Pneumothorax 

 c) Alpha I antitrypsin deficiency 

 d) Bronchial tumors 

 e) Empyema


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