Download Tests Pulmonology

1.
A.
B.
C.*
D.
E.
2.
A.
B.*
C.
D.
E.
3.
A.*
B.
C.
D.
E.
4.
The following drug is licensed for the management of COPD:
montelukast
nedocromil sodium
salbutamol
cromolyn sodium
none of above
The following clinical features are common in COPD:
Symptoms under age 35
chronic productive cough
night time wakening with breathlessness and wheeze
significant diurnal or day to day variability of symptoms
all of above
Which laboratory results are consistent with longterm COPD?
Erythrocytosis
Erythrocytopenia
Hypocapnia
Leukopenia
Hyperglycemia
A patient has COPD and a barrel chest. Which finding would the physician expect when assessing the chest?
A.
B.
C.*
D.
E.
5.
A.
B.
C.
D.*
E.
6.
Paradoxical chest movement
Presence of a friction rub
Decreased respiratory excursion
Absent breath sounds
None of above
Which would be an expected effect of resistive breathing training in a patient with COPD?
Energy conservation
Increased oxygen saturation
Decreased hypercarbia
Increased respiratory muscle strength
None of above
An elderly patient is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary
disease. The physician would suggest a spacer to
A.
B.
C.*
D.
E.
7.
A.
B.
C.*
D.
E.
enhance the administration of the medication
increase patient compliance
improve aerosol delivery in patients who are not able to coordinate the MDI
prevent exacerbation of COPD
none of above
What is the most common cause of chronic obstructive pulmonary disease (COPD)?
Bronchiectasis
Chronic bronchitis
Cigarette smoking
Emphysema
Asthma
8.
A.
Alpha, -antitrypsin deficiency is associated with:
bronchial asthma
B.
C.*
D.
E.
9.
A.
B.
C.*
D.
E.
10.
A.
B.
C.*
D.
E.
11.
A.
B.
C.*
D.
E.
12.
A.
B.
C.
D.
E.*
13.
A.
B.
C.
D.*
E.
14.
A.
B.
C.*
D.
E.
15.
A.*
B.
C.
D.
E.
16.
a late onset of dyspnea upon exertion
COPD
pneumonia
gastrointestinal malabsorption
In which of the following conditions can central cyanosis be detected?
methemoglobinemia
ventilation-perfusion mismatch
pulmonary arteriovenous fistula
general overcooling
heavy physical exercise
Characteristics of mediastinal emphysema include all EXCEPT:
marked suprasternal pulsation
Hamman's sign (a crackling sound synchronous with cardiac systole)
pain in the throat
gas under the diaphragm
cyanosis
Characteristics of mediastinal emphysema include all EXCEPT:
marked suprasternal pulsation
Hamman's sign (a crackling sound synchronous with cardiac systole)
arterial hypertension
gas under the diaphragm
cyanosis
The side effects of corticosteroids include all EXCEPT:
arterial hypertension
cataract
ostheoporosis
hyperglycemia
cachexy
Recognized cause of recurrent pneumonia include:
chronic alcoholism
multiple myeloma
anemia
esophageal lesions and aspiration of its content
silicosis
Klebsiella-pneumonia:
is usually mild
is frequently associated with a collapse of the upper lobe
frequently causes lung abscesses
despite therapy the mortality is 50%
most commonly develops in youngsters
Bilateral pleural effusion is observed in all states EXCEPT:
left-sided pneumonia
sytemic lupus erythematosus
miliary tuberculosis
carcinomatous lymphangitis
chronic cardiac failure
Bilateral pleural effusion is observed in all states EXCEPT:
A.*
B.
C.
D.
E.
17.
A.
B.
C.*
D.
E.
18.
A.
B.
C.*
D.
E.
19.
A.
B.
C.*
D.
E.
20.
A.
B.
C.
D.
E.*
21.
A.*
B.
C.
D.
E.
22.
A.
B.
C.*
D.
E.
23.
A.
B.
C.
D.*
monolobar pneumonia
sytemic lupus erythematosus
miliary tuberculosis
severe kidney insufficiency
chronic cardiac failure
Clubbing of the fingers is observed in which of the following conditions?
viral pneumonia
rheumatoid arthritis
bronchiectasis
trombemboly of pulmonary artery
status asthmaticus
Clubbing of the fingers is observed in which of the following conditions?
fungal pneumonia
rheumatoid arthritis
chronic bronchitis
trombemboly of pulmonary artery
status asthmaticus
Characteristic physical symptoms of pneumothorax include all EXCEPT:
percussion over the affected side reveals bang-box sound
auscultation over the affected side reveals weaker respiratory
sounds
end-respiratory crepitations are detected
the mediastinum is shifted towards the opposite side
there are decreased respiratory movements on the affected side
Adequate procedures in the treatment of asthmatic crisis include:
the inhalation of 40% oxygen if the PaC02 is elevated
sedation if the patient is agitated
the intravenous administration of hydrocortisone
salbutamol inhalation
plasmaphorhesis
Choose the false answer: COPD is a disease:
characterized by reversible airways obstruction
which rarely occurs in patients under the age of 35
in which symptoms rarely vary between days
which is linked to a chronic productive cough
All answers are false
Choose the false answer: When the diagnosis of COPD is considered the patient should also be questioned
about:
occupational
history
dyspnoea
defecation
ankle swelling
All answers are false
Choose the false answer: Possible differential diagnosis considered when diagnosing COPD are:
lung cancer
bronchial asthma
heart failure
cystic fibrosis
E.
24.
A.
B.
C.*
D.
E.
All answers are false
Choose the false answer: Patients with severe COPD:
may have type II respiratory failure
should be managed with a combination of inhaled corticosteroid and long acting beta agonist
will often be managed in hospital
are maintained on long term oxygen therapy for more thanhours a day
All answers are false
25.
A.
B.
C.*
D.
E.
26.
A.
B.*
C.
D.
E.
27.
A.
B.
C.*
D.
E.
28.
A.
B.
C.
D.
E.*
29.
A.
B.
C.
D.
E.*
30.
A.
B.
C.
D.
E.*
31.
A.*
Choose the false answer: Smoking cessation:
in patients with COPD will return the patients FEV1 to normal for their age
in patients with COPD will return the rate of decline in FEV1 to normal
in patients with COPD will have no effect on lung function
is the most beneficial intervention for all patients with COPD
All answers are false
Choose the false answer: For management of patients with COPD it is necessary:
at severe exacerbation of COPD should be prescribed inhaled corticosteroids
admitted to hospital with an exacerbation of COPD should be scribed high dosages of oral corticosteroids
should be referred pulmonary rehabilitation if they think that they functionally disabled by the disease
All answers are true
All answers are false
Choose the false answer: In the management of COPD it is recommended:
the use of as required short acting inhaled beta agonists
the use of anticholinergics
the use of ipratropium and tiotropium together
the use of combination inhalers in moderate to severe disease
All answers are false
Patients with COPD should only be prescribed:
inhaled corticosteroids if they have demonstrable reversibility
corticosteroids in an exacerbation if they have had a steroid trial
ipratropium if a short acting beta agonist has shown no benefit
a long acting beta agonist if they are also receiving an inhaled corticosteroid
All answers are false
Patients with COPD demonstrate no increase in quality of life:
when prescribed inhaled corticosteroids unless they demonstrate sensibility
when prescribed tiotropium rather than ipratropium
unless their FEV1 is also increased
when prescribed a combination of inhaled corticosteroids and long-acting beta agonists
All answers are false
Patients with COPD who are prescribed long term oxygen therapy at home should:
be encouraged to stop smoking
use antibiotics at the phase of exacerbation
should avoid overcooling
should use a compressor and air to drive any nebulised medicines
All answers are true
Choose the wrong answer: Patients with COPD:
should have their nebulised drugs delivered by a nebuliser driven by oxygen
B.
C.
D.
E.
should have their nebulised drugs delivered by a nebuliser driven by air
which is severe should be prescribed a combination of an inhaled corticosteroid and long acting beta agonist
which is moderate to severe should be prescribed tiotropium
All answers are wrong
32.
A.
B.*
C.
D.
E.
33.
A.
B.*
C.
D.
E.
34.
Other therapies which have shown usefulness in the management of COPD include all exept:
mucolytics
diuretics
theophylline
adrenomimetics
All answers are true
One of the assessment criteria which does not favour home management of exacerbations of COPD is that
the
doespatient:
not currently receive home oxygen therapy
severe breathlessness
has an oxygen saturation above 80%
mild breathlessness
All answers are true
All answers are true except: Abrupt withdrawal of prednisolone following management of an exacerbation of
COPD:
A.
B.
C.
D.*
E.
may precipitate a further exacerbation of COPD
is acceptable if the patient has been on a high dose for less than 21 days
can be undertaken if the patient is not on a maintenance dose of corticosteroids
cannot be undertaken if the patient is on high dose inhaled corticosteroids
All answers are true
35.
A.
B.
C.
D.*
E.
36.
A.
B.
C.
D.*
E.
37.
A.
B.*
C.
D.
E.
Choose the false answer: An infective exacerbation is characterized by:
an increased volume of sputum and a cough
an increased volume of sputum and increased purulence of sputum
an increased volume of sputum and increased breathlessness
an increased volume of sputum and increased FEV1
an increased temperature
The most common causative organisms of infective exacerbations of COPD are all except:
Staphylococcus aureus
Streptococcus pneumonia
Haemophilus influenzae
All answers are false
All answers are true
An appropriate antibacterial for the management of an exacerbation of COPD are all except:
amoxicillin 500mg three times a day for a non-penicillin allergic patient
amoxicillin 3g twice a day for non-penicillin allergic patients
clarithromycin 500mg twice a day for a penicillin allergic patient
All answers are false
All answers are true
38.
A.
B.
C.*
D.
E.
39.
A.
B.
C.
D.*
E.
40.
A.*
B.
C.
D.
E.
41.
A criterion for the diagnosis of asthma.
5% reversibility
10% reversibility
15% reversibility
Changes of vital capacity
Changes of FVC
The substance released by the mast cell activation and causes bronchospasm.
IgA
IgG
Creatinine
Histamine
IgM
This parameter of respiratory function is usually unaffected in asthma.
Vital capacity
PEFR
FVC
FEV1
RV
Found more commonly in sputum of patients with asthma.
A.
B.*
C.
D.
E.
42.
A.
B.
C.
D.
E.*
43.
A.*
B.
C.
D.
E.
44.
A.
B.
C.
D.
E.*
45.
A.*
B.
C.
D.
E.
46.
A.
B.*
C.
D.
E.
47.
A.
B.
C.*
D.
E.
48.
A.
B.
C.
D.
E.*
T cells
Eosinophils
Mast cells
Neutrophils
Erythrocytes
Blocking these can worsen the asthma.
Alpha receptors
Cholinoreceptors
Mast cells
Eosinophils
Beta 2 receptors
Choose the single most characteristic lung function test picture for exacerbation of asthma.
FEV/FVC-58%, 25% to bronchodilators, normal transfer factor
FEV/FVC ratio—90%, TLC reduced by 30%
Normal PFTs
FEV/FVC-89%
FEV/FVC—62%, no bronchodilators, gas trapping, and reduced transfer factor
Choose the single most characteristic lung function test picture for emphysema.
FEV/FVC-58%, 25% to bronchodilators, normal transfer factor
FEV/FVC ratio—90%, TLC reduced by 30%
Normal PFTs
FEV/FVC-89%
FEV/FVC—62%, no bronchodilators, gas trapping, and reduced transfer factor
Choose the single most characteristic lung function test picture for pneumonectomy.
Spirometry, lung volumes and incorrected transfer factor predicted.
FEV/FVC ratio—90%, TLC reduced by 30%
Normal PFTs
FEV/FVC-58%, 25% to bronchodilators, normal transfer factor
FEV/FVC—62%, no bronchodilators, gas trapping, and reduced transfer factor
Choose the single most characteristic lung function test picture for interstitial lung disease.
FEV/FVC-58%, 25% to bronchodilators, normal transfer factor
FEV/FVC ratio—90%, TLC reduced by 30%
Normal PFTs
FEV/FVC-89%
FEV/FVC—62%, no bronchodilators, gas trapping, and reduced transfer factor
Choose the false answer: In the management of COPD it is recommended:
the use of as required short acting inhaled beta agonists
the use of anticholinergics
the use of ipratropium and tiotropium together
the use of combination inhalers in moderate to severe disease
All answers are false
Patients with COPD should only be prescribed:
inhaled corticosteroids if they have demonstrable reversibility
corticosteroids in an exacerbation if they have had a steroid trial
ipratropium if a short acting beta agonist has shown no benefit
a long acting beta agonist if they are also receiving an inhaled corticosteroid
All answers are false
49.
A.
B.
C.
D.
E.*
50.
A.
B.
C.
D.
E.*
51.
A.*
B.
C.
D.
E.
Patients with COPD demonstrate no increase in quality of life:
when prescribed inhaled corticosteroids unless they demonstrate sensibility
when prescribed tiotropium rather than ipratropium
unless their FEV1 is also increased
when prescribed a combination of inhaled corticosteroids and long-acting beta agonists
All answers are false
Patients with COPD who are prescribed long term oxygen therapy at home should:
be encouraged to stop smoking
use antibiotics at the phase of exacerbation
should avoid overcooling
should use a compressor and air to drive any nebulised medicines
All answers are true
Choose the wrong answer: Patients with COPD:
should have their nebulised drugs delivered by a nebuliser driven by oxygen
should have their nebulised drugs delivered by a nebuliser driven by air
which is severe should be prescribed a combination of an inhaled corticosteroid and long acting beta agonist
which is moderate to severe should be prescribed tiotropium
All answers are wrong
52.
A.
B.*
C.
D.
E.
53.
A.
B.*
C.
D.
E.
54.
A.
B.
C.
D.*
E.
55.
A.
B.
C.
D.*
E.
56.
A.
B.
C.
Other therapies which have shown usefulness in the management of COPD include all exept:
mucolytics
diuretics
theophylline
adrenomimetics
All answers are true
One of the assessment criteria which does not favour home management of exacerbations of COPD is that
the patient:
does
not currently receive home oxygen therapy
severe breathlessness
has an oxygen saturation above 80%
mild breathlessness
All answers are true
All answers are true except: Abrupt withdrawal of prednisolone following management of an exacerbation of
COPD:
may
precipitate a further exacerbation of COPD
is acceptable if the patient has been on a high dose for less than 21 days
can be undertaken if the patient is not on a maintenance dose of corticosteroids
cannot be undertaken if the patient is on high dose inhaled corticosteroids
All answers are true
Choose the false answer: An infective exacerbation is characterised by:
an increased volume of sputum and a cough
an increased volume of sputum and increased purulence of sputum
an increased volume of sputum and increased breathlessness
an increased volume of sputum and increased FEV1
an increased temperature
The most common causative organisms of infective exacerbations of COPD are all except:
Staphylococcus aureus
Streptococcus pneumonia
Haemophilus influenzae
D.*
E.
57.
A.
B.*
C.
D.
E.
58.
All answers are false
All answers are true
An appropriate antibacterial for the management of an exacerbation of COPD are all except:
amoxicillin 500mg three times a day for a non-penicillin allergic patient
amoxicillin 3g twice a day for non-penicillin allergic patients
clarithromycin 500mg twice a day for a penicillin allergic patient
All answers are false
All answers are true
Match one of the options of antimicrobial agents to such clinical situation as the agent of choice: Severe
community acquired pneumonia
A.
B.
C.*
D.
E.
59.
Trimethoprim
Fluconazole
Cefotaxime and clarithromycin
Aciclovir
Penicillin V
Match one of the antimicrobial agents to such clinical situation as the agent of choice: A simple bacterial
infection of upper respiratory tract.
A.*
B.
C.
D.
E.
60.
A.
B.
C.*
D.
E.
61.
A.
B.
C.*
D.
E.
62.
A.
B.
C.*
D.
E.
63.
A.
B.*
C.
D.
E.
Ciprofloxacin
Fluconazole
Aciclovir
Cefuroxime and metronidazole
Vancomycin
Match one of the antimicrobial agents to such clinical situation as the agent of choice: Hospital-acquired
pneumonia
Penicillin
V due to multi-resistant Staphylococcus aureus.
Fluconazole
Vancomycin
Metronidazole
Aciclovir
How does antibiotic therapy increase the risk for infection?
Most intravenous antibiotics contain high concentrations of glucose, providing an ideal medium for bacterial
proliferation.
The
associated diarrhea causes ulcerations to form in the intestinal tract, creating a new portal of entry.
Antibiotic therapy also kills off normal floras, which provide a means of protection from infection.
The resulting dead bacteria provide a rich culture medium for viruses.
None of above
Which blood gas value indicates that the patient is experiencing hypercarbia?
pH = 7.33
Bicarbonate = 20 mEq/L
PaCO2 = 60 mm Hg
PaO2 = 80 mm Hg
Non of above
What is the physiologic consequences of CO2 narcosis?
Excessive sleepiness in the patient with hypercarbia
Failure of rising blood levels of CO2 to trigger more rapid and deeper respirations
A change in the ventilation-perfusion ratio, in which ventilation exceeds perfusion
Increase in the percentage of oxygen delivered to the patient does not result in an increasedPaO2
None of above
64.
A.
B.*
C.
D.
E.
65.
A.
B.
C.
D.*
E.
66.
A.
B.
C.*
D.
E.
67.
A.*
B.
C.
D.
E.
68.
A.
B.
C.
D.*
E.
69.
A.*
B.
C.
D.
E.
70.
A.*
B.
C.
D.
E.
71.
A.*
B.
C.
D.
What is the major difference in pathophysiology between asthma and COPD?
Asthma is a restrictive disorder and COPD is an obstructive disorder.
COPD results in permanent airflow obstruction and asthma is a condition of reversible airflow obstruction.
COPD is caused by chronic exposure to inhalation irritants and the major cause of asthma is cigarette
smoking.is the result of an inflammatory process and COPD is a result of inflammatory, infectious, and
Asthma
hyperresponsiveness
processes.
None
of above
What part of the pulmonary system is most affected by asthma?
Alveoli
Larynx
Pharynx
Airways
None of above
Which drug is more commonly used as therapy for COPD than as therapy for asthma?
Theophylline (Theo-Dur)
Montelukast (Singulair)
Guaifenesin (Organidin)
Salmeterol (Serevent)
None of above
Which assessment finding should you expect in the patient with COPD?
Decreased vocal fremitus
Grossly bloody sputum
Loss of the gag reflex
Tracheal deviation
None of above
Which disorder is an example of a "restrictive" pulmonary disease?
Asthma
Bronchitis
Lung cancer
Pulmonary fibrosis
None of above
How does the drug oseltamivir (Tamiflu) prevent influenza or shorten the duration of illness?
Preventing the virus from entering respiratory cells
Boosting the patient’s immune system
Inhibiting the virus from multiplying
Directly killing the virus
None of above
Which set of arterial blood gas values indicates early pneumonia as the respiratory problem?
pH 7.35, HCO3– 22 mEq/L, PCO2 45 mm Hg, PO2 86 mm Hg
pH 7.30, HCO3– 22 mEq/L, PCO2 60 mm Hg, PO2 92 mm Hg
pH 7.32, HCO3– 17 mEq/L, PCO2 25 mm Hg, PO2 98 mm Hg
pH 7.30, HCO3– 28 mEq/L, PCO2 65 mm Hg, PO2 75 mm Hg
None of above
What is the role of surfactant in pulmonary function?
Reduces alveolar surface tension, improving gas exchange
Increases alveolar surface tension, improving gas exchange
Dilates pulmonary blood vessels, decreasing pulmonary vascular resistance
Relaxes bronchial smooth muscle, decreasing pulmonary vascular resistance
E.
72.
A.
B.*
C.
D.
E.
73.
A.
B.*
C.
D.
E.
74.
A.
B.
C.*
D.
E.
75.
A.
B.*
C.
D.
E.
76.
A.
B.
C.*
D.
E.
77.
A.
B.*
C.
D.
E.
78.
A.*
B.
C.
D.
E.
79.
A.
B.
C.*
None of above
All of the following features are seen in the viral pneumonia except:
Presence of interstitial inflammation.
Predominance of alveolar exudates.
Bronchiolitis.
Multinucleate giant cells in the bronchiolar wall.
All features are present
Pulmonary surfactant is secreted by:
Type I pneumocytes.
Type II pneumocytes.
Clara cells.
Bronchial epithelial cells.
Tracheal epithelial cells.
With which of the following theophylline has an antagonistic interaction?
Histamine receptors.
Bradykinin receptors.
Adenosine receptors.
Imidazoline receptors.
Beta-adrenoreceptors
Which patient is at greatest risk for acute respiratory distress syndrome?
The 62-year-old with COPD who has pneumonia
The 22-year-old who received 10 units of blood after a motor vehicle crash
The 78-year-old with chronic congestive heart failure and pulmonary edema
The 24-year-old with asthma who has not taken any of her asthma medications for 2 weeks
None of above
What is the most important intervention for the patient with acute respiratory distress syndrome?
Antibiotic therapy
Bronchodilators
Oxygen therapy
Diuretic therapy
None of above
Which patient is at greatest risk for developing a “community-acquired” pneumonia?
The 40-year-old first-grade teacher
The 60-year-old smoker who is also an alcoholic
The 75-year-old with exercise-induced wheezing
The 35-year-old aerobics instructor who skips meals and eats only vegetables
None of above
Which patient is a greatest risk for developing nosocomial pneumonia?
The 60-year-old patient receiving mechanical ventilation
The 40-year-old patient receiving antibiotics for a surgical wound infection
The 60-year-old patient in traction for a fractured femur who also has a cold
The 40-year-old patient with type 2 diabetes who has a 50 pack-year smoking history
None of above
Which clinical manifestation in an older patient with pneumonia indicates that the disease is responding to
the therapeutic
The
patient doesregimen?
not have a cough.
Urine output is 900 mL for the day.
Pulse oximetry shows an oxygen saturation of 90%.
D.
E.
80.
A.
B.*
C.
D.
E.
81.
A.
B.
C.*
D.
E.
82.
A.
B.
C.*
D.
E.
83.
A.
B.
C.
D.*
E.
84.
A.
B.*
C.
D.
E.
85.
A.
B.
C.
D.
E.*
86.
A.
B.
C.*
D.
E.
Tactile fremitus is increased over the affected lung fields.
None of above
Which clinical change indicates the patient's COPD is becoming worse?
Pulse pressure has increased from 35 mm HG to 40 mm Hg,Alveoli
The patient has had an unplanned weight loss of 15 pounds.
The patient's average respiratory rate has decreased from 34 to 33.
The patient's PaCO2 is 58 mm Hg this month compared with 64 mm Hg last month.
None of above
The following drug is licensed for the management of COPD:
atenolol
nedocromil sodium
salbutamol
cromolyn sodium
all of the above
A criterion for the diagnosis of asthma.
2% reversibility
5% reversibility
15% reversibility
Changes of vital capacity
10 % reversibility
The substance released by the mast cell activation and causes bronchospasm.
IgA
IgG
Urea
Histamine
Thyroxin
Found more commonly in sputum of patients with asthma.
Leucocytes
Eosinophils
Mast cells
All of the above
Erythrocytes
Blocking these can worsen the asthma.
Alpha 1 receptors
Cholinoreceptors
Alpha 2 receptors
T-cells
Beta 2 receptors
The following drug is licensed for the management of COPD:
propranolol
nedocromil sodium
salbutamol
cromolyn sodium
nothing of the above
1.
is:
A drug is to be delivered by a nebuliser. The size of a droplet for its humidification (in mcm)
A. *less than 5
B. 5-10
C. 10-15
D. 15-20
E. All of the above
2.
According recommendations of WHO daily dose of inhaled glucocortisteroids in the case of
mild persistant bronchial asthma is:
A. *200-500 mkg
B. 150-300 mkg
C. 800-2000 mkg
D. More than 2000 mkg
E. Glucocorticosteroids are not recommended
3.
All medicines listed below are used in bronchial asthma, except:
A. *Morphine
B. Salbutamol
C. Aminophylline
D. Steroids
E. Ipratropium
4.
All of the following are useful for treating acute bronchial asthma except:
A. *Sodium chromoglycate inhalation
B. 100% Oxygen
C. Hydrocortisone infusion
D. IV aminophylline
E. All of the above
5.
All of the following drugs useful in the treatment of a patient with acute bronchial asthma
except:
A. *Montelukast
B. Ipratropium
C. Salbutamol
D. Hydrocortisone
E. All of the above
6.
All of the following drugs useful in the treatment of a patient with acute bronchial asthma
except:
A. *Nifedipine
B. Ipratropium
C. Salbutamol
D. Hydrocortisone
E. All of the above
7.
All of the following drugs useful in the treatment of a patient with acute bronchial asthma
except:
A. *Atenolol
B. Ipratropium
C. Salbutamol
D. Hydrocortisone
E. All of the above
8.
All of the following drugs useful in the treatment of a patient with acute bronchial asthma
except:
A. *Propranolol
B. Ipratropium
C. Salbutamol
D. Hydrocortisone
E. All of the above
9.
All of the following statements about Leukotriene modifiers in the management of bronchial
asthma are true except:
A. *May be used for acute asthma
B. May be used for exercise induced asthma
C. Zileuton is Leukotriene modifier
D. May uncover Churg Strauss syndrome
E. All of the above
10. Aspirin sensitive asthma is associated with :
A. *Nasal polyps
B. Extrinsic asthma
C. Urticaria
D. Obesity
E. All of the above
11. Aspirin-sensitive asthma is associated with:
A. *Nasal polyp
B. Obesity
C. Urticaria
D. Extrinsic asthma
E. Nothing of the above
12. Asthma is precipitated by all except:
A. *Gold
B. Aspirin
C. Alcohol
D. Suxamethonium
E. Nothing of the above
13. Attack of bronchial asthma differs from heart asthma by such sign
A. *By expiration dyspnea
B. By sudden development of attack
C. By orthostatic position of the patient
D. By duration of the attack
E. By inspiration dyspnea
14. Blocking these can worsen the asthma
A. *β2 -adrenoreceptors
B. α-adrenoreceptors
C. Mast cells
D. Neutrophils
E. Eosinophils
15. Bronchial asthma is associated with raised levels of
A. *Leukotrienes
B. Thromboxane
C. Antinuclear antibodies
D. Corticosteroids
E. All of the above
16. Bronchial asthma patient on artificial ventilation requires :
A. *An IE ratio 1: 2.5
B. A low inspiratory flow
C. An equal IE ratio of 1:1
D. An inverese ratio ventilation
E. Nothing of the above
17. Bronchodylation activity is specific for
A. *Berotec
B. Anuzol
C. Inderal
D. Paracetamol
E. Azafen
18. Drug of choice for inhalation in acute asthma not responding to salbutamol is:
A. *Ipratropium bromide
B. Atropine sulfate
C. Isopropamide
D. Hyoscine methyl bromide
E. All of the above
19. Consider the following statement: Early onset of extrinsic episodic asthma is characterized by:
1. Family history of eczema or rhinitis 2. Development of an early and late asthmatic reaction
mediated by mast cells 3. T lymphocytes that release cytokine like interleukin-4. Which of these
statements are correct ?
A. *1,2 and 3
B. 1 and 2
C. 2 and 3
D. 1 and 3
E. Nothing of the above
20. Consider the following statements: Life threatening features of acute-severe asthma in
children include: 1. Altered sensorium 2. Pulsus paradoxus 3. Audible wheeze in both inspiration
and expiration 4. Oxygen saturation 92-95%. Which of these statements is/are correct?
A. *1 and 2
B. 1 only
C. 2 and 4
D. 1, 2, 3 and 4
E. Nothing of the above
21. Contraindication for glucocorticosteroid therapy of bronchial asthma is:
A. *Bleeding from gastric ulcer
B. Chronic persistant hepatitis
C. Exacerbation of respiratory-heart failure
D. Emphysema of lungs
E. Respiratory failure
22. Sharko-Leiden crystals are seen in:
A. *Bronchial asthma
B. Bronchiectasis
C. Chronic bronchitis
D. Wegners granulomatosis
E. All of the above
23. Curschmann's spirals in sputum are seen in:
A. *Bronchial asthma
B. Bronchiectasis
C. Chronic bronchitis
D. Wegners granulomatosis
E. All of the above
24. Curshmann's spirals in sputum is seen in:
A. *Asthma
B. Tuberculosis
C. Bronchitis
D. Bronchiectasis
E. Pneumonia
25. Decreased maximum mid-expiratory flow rate indicates obstruction in:
A. *Small airways
B. Trachea
C. Large airways
D. Trachea & bronchi both
E. Nothing of the above
26. Drug of choice in asthma with heart disease is
A. *Ipratropium
B. Rimiterol
C. Terbutaline
D. Cromolyn sodium
E. All of the above
27. Exercise induced asthma is not precipitated by :
A. *Swimming in hot water
B. High altitude climb and exercises
C. Cycling in cold weather
D. Swimming in cold water
E. All of the above
28. FEV1/FVC is reduced in case of:
A. *Asthma
B. Pleural effusion
C. Lung fibrosis
D. All of the above
E. Nothing of the above
29. Find common changes in spirography for patients with bronchial asthma
A. *FEV1, FVC, Typhno index are low
B. FEV1, FVC, Typhno index are high
C. FEV1, FVC, Typhno index are normal
D. FEV1, FVC are high, Typhno index is low
E. FEV1, FVC are low, Typhno index is high
30. Find common changes in sputum for patients with asthma
A. *Eosinophils
B. T cells
C. Mast cells
D. Neutrophils
E. IgM
31. How does antibiotic therapy increase the risk of infection?
A. *Antibiotic therapy also kills off normal flora, which provide a means of protection from
infection
B. The associated diarrhea causes ulcerations to form in the intestinal tract, creating a new portal of
entry
C. Most intravenous antibiotics contain high concentrations of glucose, providing an ideal medium
for bacterial proliferation
D. The resulting dead bacteria provide a rich culture medium for viruses
E. All of the above
32. How many stages of severity of bronchial asthma do you know?
A. *4
B. 1
C. 2
D. 3
E. There are no stages of severity
33. In bronchial asthma glucocorticoids
A. *Reduce airway inflammation
B. Act as potent bronchodilators
C. Inhibit degranulation of mast cells
D. Block the action of humoral mediators
E. Nothing of the above
34. In patient K. 21 years old was diagnosed persistent bronchial asthma. Prophylaxis of attacks
of dyspnea can be provided with:
A. *Beclomethasone
B. Theophillin
C. Nedokromil sodium
D. Antihystamine medicines
E. Atrovent
35. In severe bronchial asthma, it is present:
A. *Hyperresonant chest with prolonged expiration
B. Infrequent rhonchi and absent breath sounds
C. Increased fremitus and crackles
D. Decreased fremitus and crepitation
E. All of the above
36. In the time of attack of bronchial asthma in lungs are heard
A. *Dry loud wheezes
B. Moist loud wheezes
C. Moist soundless wheezes
D. Voice of pleural friction
E. Crepitation
37. In what specific way does the respiratory system function contribute to acid-base balance?
A. Prevents excessive loss of hydrogen ions by evaporation
B. Increases the potassium ion content in bronchial secretions
C. *Removes carbon dioxide generated as a result of metabolism
D. Maintains body water levels through mucous membrane function
E. Non of above
38. In which patient with chronic airflow limitation would you expect to find dependent edema?
A. 25-year-old with cold-induced asthma
B. 65-year-old with exercise-induced asthma
C. *55- year-old with chronic bronchitis
D. 45-year-old with moderate emphysema
E. Non of above
39. What is the most necessary in order to diagnose bronchial asthma:
A. *To notice the asthmatic attack of dyspnea
B. To find allergic antibodies
C. To find the presence of expiration dyspnea
D. To find the presence of signs of obstructive respiratory failure
E. To find the presence of eosinophylia in blood
40. One of the following is not an indicator of the severity of asthma:
A. *Systolic hypertension
B. Use of accessory muscles
C. Pulsus paradoxus
D. Cyanosis
E. All of the above
41. Patient`s diagnosis is “bronchial asthma, persistent form of moderate severity”. What
medicine would you give advantage for the planned treatment of disease?
A. *Budesonid-forte
B. Intal
C. Euphylline orally
D. Salbutamol
E. Berotec
42. Poor prognostic indicators in acute severe asthma include all of the following EXCEPT:
A. *PEFR less than 20% of previous value
B. Pulsus paradoxus
C. Hypocarbia
D. Use of accessory respiratory muscles
E. Nothing of above
43. Primary prophylaxis of bronchial asthma has to be provided:
A. *In case of bronchial asthma in relatives
B. For all healthy people
C. In case of any allergic diseases
D. In case of chronic non-obstructive bronchitis
E. In case of frequent colds
44. Pulmonary surfactant is secreted by:
A. Type I pneumocytes
B. *Type II pneumocytes
C. Lymphocytes
D. Bronchial epithelial cells
E. Tracheal epithelial cells
45. Silent chest is seen in
A. *Very severe asthma
B. Chronic bronchitis
C. Emphysema
D. Bronchiectasis
E. All of the above
46. Spirals of Kurshman in patients with bronchial asthma may be found at the laboratory test of:
A. *Sputum
B. Urine
C. Biopsy of pulmonary tissue
D. Gastric juice
E. Pleural exudates
47. Steroid inhalation side effect include:
A. *Oropharyngeal candidiasis
B. Retention of fluid
C. Sedation
D. Palpitations
E. Nothing of the above
48. The FEV1 is the volume of:
A. *air forcefully expired during the first second after a full breath and normally comprises > 75%
of the VC
B. air normally expired during the first second after a full breath and normally comprises > 75% of
the VC
C. air forcefully expired during the first minute after a full breath and normally comprises > 75%
of the VC
D. air normally expired during the first minute after a full breath and normally comprises > 75% of
the VC
E. air forcefully expired during the second minute after a full breath and normally comprises >
75% of the VC
49. The most predictive and dangerous side effect of propranolol that makes it to be avoided in
known patient of COPD is induction of:
A. *Acute asthmatic attack
B. Respiratory failure
C. Glaucoma
D. Pleural effusion
E. All of the above
50. The patient diagnosed with moderate stage of COPD says there is no sense in stopping
smoking now because the damage is done. Which response is the best rationale for encouraging this
patient to stop smoking?
A. “The damage will be reversed.”
B. *“The COPD will progress more slowly.”
C. “Your risk for asthma development, which would further reduce your lung function, will be
decreased.”
D. “You will be less likely to lose excessive amounts of weight and will have a more normal
appearance.”
E. Non of above
51. The patient with manifestations of a respiratory infection is suspected of having SARS. In
addition to standard precautions, what other infection control precautions should the physician use
until the diagnosis is certain?
A. Airborne precautions
B. Droplet precautions
C. *Airborne precautions and contact precautions
D. Droplet precautions and contact precautions
E. Non of above
52. The substance released by the mast cell activation and causes bronchospasm.
A. *Histamine
B. Leukotrienes
C. IgM
D. IgG
E. IgE
53. This parameter of respiratory function is usually unaffected in asthma.
A. *Vital capacity
B. PEFR
C. FVC
D. FEV1
E. FEV1/FVC
54. Use of disodium cromoglycate as a preventive measure has been found to be of value in :
A. *Exercise induced asthma
B. Pneumonia
C. Chronic bronchitis
D. Fanner's lung
E. Nothing of the above
55. What is not specific for severe persistent bronchial asthma?
A. *Severe vomiting
B. Long duration of attacks
C. Development of status asthmaticus
D. Development of acute heart failure
E. Necessarity of usage of glucocorticosteroids
56. What is the main purpose of a negative-pressure ventilator?
A. Healing diseased lung tissue
B. Relieving hypoxemia by opening obstructed airways
C. *Assisting ventilation to healthy lungs by mimicking normal chest pressures
D. Delivering an individualized preset tidal volume to the lower respiratory tract
E. Non of above
57. What is the major difference in pathophysiology between asthma and COPD?
A. Asthma is a restrictive disorder and COPD is an obstructive disorder
B. Asthma is the result of an inflammatory process and COPD is a result of inflammatory,
infectious, and hyperresponsiveness processes
C. COPD is caused by chronic exposure to inhalation irritants and the major cause of asthma is
cigarette smoking
D. *COPD results in permanent airflow obstruction and asthma is a condition of reversible airflow
obstruction
E. All of the above
58. What is the most important intervention for the patient with acute respiratory distress
syndrome?
A. Antibiotic therapy
B. Bronchodilators
C. *Oxygen therapy
D. Diuretic therapy
E. Non of above
59. What is the role of surfactant in pulmonary function?
A. Dilates pulmonary blood vessels, decreasing pulmonary vascular resistance
B. Increases alveolar surface tension, improving gas exchange
C. *Reduces alveolar surface tension, improving gas exchange
D. Relaxes bronchial smooth muscle, decreasing pulmonary vascular resistance
E. All of the above
60. Which assessment finding in a patient who has been medicated during an asthma attack
indicates to you that the therapy should be modified?
A. Peak expiratory rate flow 10% below expected value
B. Presence of bilateral tactile fremitus
C. *Suprasternal retraction on inhalation
D. Trachea at the midline
E. Non of above
61. Which assessment finding in a patient with severe dyspnea indicates to you that the
respiratory problem is chronic?
A. Wheezing on exhalation
B. Productive cough
C. *Clubbed fingers
D. Cyanosis
E. Non of above
62. Which assessment finding should you expect in the patient with COPD?
A. *Decreased vocal fremitus
B. Grossly bloody sputum
C. Loss of the gag reflex
D. Tracheal deviation
E. Non of above
63. Which β2-agonist is not given for acute bronchial asthma?
A. *Salmeterol
B. Salbutamol
C. Terbutaline
D. Methyl xanthine
E. All of the above
64. Which blood gas value indicates that the patient is experiencing hypercarbia?
A. pH = 7.33
B. Bicarbonate = 20 mEq/L
C. *PaCO2 = 60 mm Hg
D. PaO2 = 80 mm Hg
E. Non of above
65. Which clinical change indicates the patient's COPD is becoming worse?
A. *The patient has had an unplanned weight loss of 15 pounds
B. Pulse pressure has increased from 35 mm Hg to 40 mm Hg
C. The patient's average respiratory rate has decreased from 34 to 33
D. The patient's PaCO2 is 58 mm Hg this month compared with 64 mm Hg last month
E. All of the above
66. Which clinical manifestation alerts you to the presence of hypoventilation when you are
monitoring a patient with chronic lung disease and hypercarbia who is receiving oxygen therapy?
A. Coarse crackles and wheezes on auscultation
B. *Slow, shallow respirations
C. Pulse oximetry of 90%
D. Clubbing of the fingers
E. Non of above
67. Which clinical manifestation in a patient with chronic bronchitis indicates to you a worsening
of the patient's respiratory condition?
A. Fatigue
B. Cachexia
C. *Confusion
D. Slow capillary refill
E. Non of above
68. Which clinical manifestation in a patient with long-standing COPD alerts you to the
possibility of cor pulmonale?
A. Pursed-lip breathing occurs when the patient is at rest
B. The patient's neck muscles are enlarged and prominent
C. The patient's ECG shows tall, peaked T waves and an absent U wave
D. *Jugular venous distention is present when the patient is in a sitting position
E. Non of above
69. Which laboratory value indicates to you that the patient may have allergic asthma?
A. *Eosinophil count of 13%
B. Total white blood cell count of 100%
C. Total absence of macrophages in the differential white blood cell count
D. Band neutrophil count of 32% and a segmented neutrophil count of 22%
E. Non of above
70. Which manifestations in a patient receiving oxygen therapy at 60% for more than 24 hours
alerts you to the possibility of oxygen toxicity?
A. *Increased dyspnea
B. Decreased rate and depth of respiration
C. Wheezing on inhalation and exhalation
D. Increased excretion of thick, white, frothy sputum
E. Non of above
71. Which of the following patients could be expected to require mechanical ventilation longterm?
A. 27-year-old with status asthmaticus
B. 45-year-old with morphine overdose
C. *24-year-old with muscular dystrophy
D. 65-year-old with bilateral bacterial pneumonia
E. Non of above
72. Which patient is a greatest risk for contracting SARS?
A. *The 30-year-old physician providing direct care to patients with SARS
B. The 50-year-old farmer working directly with cows and pigs
C. The 60-year-old patient with type 2 diabetes mellitus and renal insufficiency
D. The 70-year-old patient residing in an assisted living environment
E. Non of above
73. Which set of arterial blood gas values indicates early pneumonia as the respiratory problem?
A. *pH 7.35, HCO3– 22 mEq/L, PCO2 45 mm Hg, PO2 86 mm Hg
B. pH 7.30, HCO3– 22 mEq/L, PCO2 60 mm Hg, PO2 92 mm Hg
C. pH 7.32, HCO3– 17 mEq/L, PCO2 25 mm Hg, PO2 98 mm Hg
D. pH 7.30, HCO3– 28 mEq/L, PCO2 65 mm Hg, PO2 75 mm Hg
E. Non of above
74. Which type of acid-base imbalance is most common among patients with COPD?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. *Respiratory acidosis
E. All of the above
75. With which of the following theophylline has an antagonistic interaction?
A. Histamine receptors.
B. Bradykinin receptors.
C. *Adenosine receptors.
D. Alpha-adrenoreceptors.
E. Beta-adrenoreceptors
76. According recommendations of WHO daily dose of inhaled glucocortisteroids in the case of
mild persistant bronchial asthma is:
A. *200-500 mkg
B. 50-150 mkg
C. 800-2000 mkg
D. More than 2000 mkg
E. Glucocorticosteroids are not recommended
77. All the following statements are true about chronic obstructive lung disease except:
A. *Decreased diffusion capacity
B. Decreased FEV1
C. Decreased MEFR
D. Increased RV
E. Nothing of the above
78. All the following lung volumes can be measured by a simple spirometer except:
A. *Residual volume
B. Vital capacity
C. Tidal volume
D. Forced vital capacity
E. Nothing of the above
79. Alveolar-arterial tension gradient increases in all states except:
A. *Hypoventilation
B. Diffusion defects
C. R-L shunt
D. Ventilation perfusion abnormality
E. All of the above
80. Alveolar-arterial tension gradient increases in all states except:
A. *Hypoventilation
B. Diffusion defects
C. R-L shunt
D. Ventilation perfusion abnormality
E. Nothing of the above
81. Bronchodylation activity is specific for
A. *Berotec
B. Anuzol
C. Inderal
D. Paracetamol
E. Azafen
82. Decreased maximum mid-expiratory flow rate indicates obstruction in:
A. *Small airways
B. Trachea
C. Large airways
D. Trachea & Bronchi both
E. Nothing of the above
83. False about COPD is that it can be characterized by:
A. *Decreased diffusion capacity
B. Decreased FEV1
C. Decreased midexpiratory peaks flow rate
D. Increased residual capacity
E. Nothing of the above
84. In chronic obstructive disease the following pulmonary function abnormalities are present
except:
A. *Decreased diffusing capacity
B. Decreased FEV1
C. Decreased maximum expiratory flow rate
D. Increased residual volume
E. Nothing of the above
85. Obstructive type of insufficiency of pulmonary ventilation is caused by:
A. *Narrowing of bronchi
B. Decreasing of diaphragm mobility
C. Arrising of pleuritis
D. Decreasing of breathing muscles strength
E. Violation of perfusion
86. Poor prognostic indicators in acute severe asthma include all of the following EXCEPT
A. *PEFR less than 20% of previous value
B. Pulsus paradoxus
C. Hypocarbia
D. Use of accessory muscles of respiration
E. Nothing of the above
87. The hall mark of generalised obstructive lung disease is
A. *Reduced timed vital capacity
B. Reduced tidal volume
C. Reduced residual volume
D. Reduced vital capacity
E. Non of above
88. The most predictive and dangerous side effect of atenolol that makes it to be avoided in
known patient of COPD is induction of :
A. *Acute asthmatic attack
B. Respiratory failure
C. Glaucoma
D. Pleural effusion
E. All of the above
89. The severity of COPD and the potential response to bronchodilator can be adequately assessed
by:
A. *Simple spirometry (± flow-volume loop) before and after inhalation of bronchodilator
B. X-ray examination
C. Bronchscopy
D. Simple spirometry (± flow-volume loop) after inhalation of bronchodilator
E. All of the above
90. This parameter of respiratory function is usually unaffected in asthma:
A. *Vital capacity
B. PEFR
C. FVC
D. FEV1
E. FEV1/FVC
91. Which manifestations in a patient receiving oxygen therapy at 60% for more than 24 hours
alerts you to the possibility of oxygen toxicity?
A. *Increased dyspnea
B. Decreased rate and depth of respiration
C. Wheezing on inhalation and exhalation
D. Increased excretion of thick, white, frothy sputum
E. Non of above
92. Breath sounds are decreased in following except:
A. *Lobar pneumonia
B. Pneumothorax
C. Pleural effusion
D. Atelectasis
E. Nothing of the above
93. Bulging fissure sign is characteristic of pneumonia due to
A. *Klebsiella
B. Anaerobic bacteria
C. Mycoplasma
D. Pseudomonas
E. Nothing of the above
94. Most common sign of aspiration pneumonia:
A. *Tachypnoe
B. Bronchospasm
C. Cyanosis
D. Crepitations
E. All of the above
95. Mycoplasma infection simulates:
A. *Viral pneumonia
B. Pnemuococcal pneumonia
C. Pulmonary oedema
D. Pulmonary infarction
E. All of the above
96. Paradoxical breathing is charateristic of:
A. *Pneumonia
B. Pneumothorax
C. Atelectasis
D. Pleurisy
E. None of above
97. Primary atypical pneumonia is caused by:
A. *Mycoplasma
B. Mycobaterium kansaii
C. Photochromogens
D. Pneumocystis carinii
E. All of the above
98. Virus causing pneumonia are all except:
A. *Mumps
B. Cytomegalovirus
C. Measles
D. Retrovirus
E. Nothing of the above
99. Which clinical manifestation in a patient with long-standing COPD alerts you to the
possibility of cor pulmonale?
A. Pursed-lip breathing occurs when the patient is at rest
B. The patient's neck muscles are enlarged and prominent
C. The patient's ECG shows tall, peaked T waves and an absent U wave
D. *Jugular venous distention is present when the patient is in a sitting position
E. All of the above
100. Acute respiratory failure does not happen due to:
A. *Pb poisoning
B. Porphyria
C. Myasthenia gravis
D. Polio
E. Nothing of the above
101. Cyanosis is seen if :
A. Reduced HB 5 gm %
B. SulfHB0.5gm%
C. Meth HB 1.5 gm %
D. *All of the above
E. Nothing of the above
102. False statement about type I respiratory failure
A. *Normal A-a gradient
B. Decreased Pa O2
C. Decreased Pa CO2
D. Normal Pa CO2
E. All of the above
103. In type - II respiratory failure, there is:
A. *Low pO2 and high pCO2
B. Low pO2 and low pCO2
C. Normal pO2 and high pCO2
D. Low pO2 and normal pCO2
E. All of the above
104. In what specific way does the respiratory system function contribute to acid-base balance?
A. Prevents excessive loss of hydrogen ions by evaporation
B. Increases the potassium ion content in bronchial secretions
C. *Removes carbon dioxide generated as a result of metabolism
D. Maintains body water levels through mucous membrane function
E. Non of above
105. In which patient with chronic airflow limitation would you expect to find dependent edema?
A. 25-year-old with cold-induced asthma
B. 65-year-old with exercise-induced asthma
C. *55- year-old with chronic bronchitis
D. 45-year-old with moderate emphysema
E. Non of above
106. Lung abscess is least likely complication of:
A. *Bronchopneumonia
B. Lobar pneumonia
C. Malignancy
D. Bronchiectasis
E. All of the above
107. Respiratory failure type I consists of
A. *Low Pa O2, normal or low Pa CO2
B. Raised Pa CO2, low Pa O2
C. Pa O2, low Pa O2
D. Pa O2 and PaCO2- high
E. All of the above
108. The most frequent cause of peripheral cyanosis is:
A. *Slowed circulation through the skin
B. Interatrial septal defect
C. Methaemoglobinaemia
D. Interstitial pulmonary fibrosis
E. All of the above
109. Type II respiratory failure is seen in :
A. *COPD with cor pulmonale
B. Chronic renal failure
C. Adult repiratory distress syndrome
D. Pulmonary fibrosing alveolitis
E. Nothing of the above
110. What onset is typical for pleuropneumonia?
A. *Acute
B. Latent
C. Fulminant
D. Gradual
E. All of the above
111. What onset is typical for bronchopneumonia?
A. Acute
B. Latent
C. Fulminant
D. *Gradual
E. All of the above
112. Which clinical manifestation in an older patient with pneumonia indicates that the disease is
responding to the therapeutic regimen?
A. *Pulse oximetry shows an oxygen saturation of 90%
B. The patient does not have a cough
C. Urine output is 900 ml for the day
D. Tactile fremitus is increased over the affected lung fields
E. All of above
113. Which patient is at greatest risk for developing a “community-acquired” pneumonia?
A. *The 60-year-old smoker who is also an alcoholic
B. The 40-year-old first-grade teacher
C. The 75-year-old with exercise-induced wheezing
D. The 35-year-old aerobics instructor who skips meals and eats only vegetables
E. All of above
114. A person who has high fever, tachycardia, haemoptysis and a lobar consolidation on CXR has:
A. Pleurisy
B. Pulmonary oedema
C. *Lobar pneumonia
D. Pulmonary infarction
E. None of the above
115. Patient L., 25 years old, has persistent bronchial asthma. Prophylaxis of attacks of dyspnea
can be provided with:
A. *Fluticasone
B. Theophylline
C. Salbutamol
D. Antihystamine medicines
E. Atrovent
116. Patient of 52 has severe attack of expiratory dyspnea, with severe dry cough, distant wheezes,
palpitations. What medicine is the best one for the first aid?
A. *Salbutamol
B. Digoxin
C. Lasolvan
D. Atrovent
E. Prednisone
117. Patient with mild persistent bronchial asthma developed exacerbation. Your
recommendations?
A. *To increase dose of inhaled glucocorticosteroid, β2-agonist of short action
B. To increase dose of β2-agonist of short action, do not change dose of inhaled glucocorticosteroid
C. To provide test with bronchodylator, and then to increase dose of inhaled glucocorticosteroid
and β2-agonist
D. To provide provocative test with hystamine, and then to increase the dose of inhaled
glucocorticosteroid and β2-agonist
E. To increase dose of inhaled glucocorticosteroid, β2-agonist, and then to provide provocational
test with hystamine
118. If FEV1, is 1.3 L and FVC is 3.1 L in an adult man it suggests diagnosis of
A. *Obstructive lung disease
B. Normal lung function
C. Restrictive lung disease
D. None of the above
E. All of the above
119. Patient K., 20 years old, has persistent bronchial asthma. Prophylaxis of attacks of dyspnea
can be provided with:
A. *Fluticasoni
B. Nifedipine
C. Salbutamol
D. Antihystaminic medicines
E. Atrovent
120. Patient A., 47 years old, has severe attack of expiration dyspnea, with severe dry cough with
heared on distance wheezes, palpitation. What preparation is the best one for the first aid?
A. *Salbutamol
B. Strofantin
C. Lasolvan
D. Atrovent
E. Nifedipine
121. Patient of 40 years old has pneumonia. On his chest X-ray film there is local shadow in some
segments of right lower lobe. What data at percussion and auscultation may be founded in this area?
A. *Shortened percussion sound, moist rales
B. Band-box percussion sound, vesicular breathing
C. Percussion sound is not changed. Dry wheezes
D. Tympanic sound. Amphoric breathing
E. Percussion sound is not changed. Vesicular breathing
122. Man, 48 y.o., has severe attack of expiratory dyspnea, with intensive dry cough, distance
wheezes, palpitations. What medicine is the best one for the first aid?
A. *Salbutamol
B. Theophyllin
C. Lasolvan
D. Atrovent
E. Prednisone
123. Man, 44 y.o., has severe attack of expiratory dyspnea, with intensive dry cough, distance
wheezes, palpitations. What medicine is the conrindicated in this situation?
A. * Atenolol
B. Theophyllin
C. Salbutamol
D. Atrovent
E. Prednisone
124. Your patient with asthma is receiving aminophylline intravenously. Which manifestation
alerts you to the possibility of aminophylline toxicity?
A. Pulse oximetry of 93%
B. *Increased restlessness
C. Hourly urine output of 45 ml
D. Heart rate increase from 72 to 84 beats per minute
E. All of the above
125. The 82-year-old patient has a pulmonary infection. Which action addresses the age-related
change of increased vascular resistance to blood flow through pulmonary vasculature in this
patient?
A. Encouraging the patient to turn, cough, and deep breathe every hour
B. *Assessing the patient's level of consciousness
C. Raising the head of the bed
D. Humidifying the oxygen
E. All of the above
126. Silent chest is seen in
A. *Very severe asthma
B. Chronic bronchitis
C. Emphysema
D. Chronic laryngitis
E. Nothing of the above
127. Spirals of Kurshman in patients with bronchial asthma may be found at the laboratory test of:
A. *Sputum
B. Urine
C. Blood
D. Gastric juice
E. Excrement
128. What onset is typical for pleuropneumonia?
A. *Acute
B. Latent
C. Fulminant
D. Gradual
E. None of the above
129. How many stages of severity of bronchial asthma do you know?
A. *4
B. 1
C. 2
D. 3
E. 5
130. In patient K. 27 years old was diagnosed persistent bronchial asthma. Prophylaxis of attacks
of dyspnea can be provided with:
A. *Beclomethasone
B. Theophillin
C. Euphyllin
D. Antihystamine medicines
E. Nifedipine