PULMONARY MEDICINE
PULMONARY MEDICINE
1:-Which among the following is a marker for Type II alveolar epithelial cells A:-Caveolin 1 B:-Aquaporin 5 C:-Carboxypeptidase M D:-A|ka|ine phosphatase Ans: D
2:-Regarding cervical rib, which among the following is FLASE A:-It is bilateral in 80% of cases B:-Symptom due to compression are more prevalent in males C:-More common on the left side D:-The production of symptoms bears no relation to the size of the rib Ans: B
3:-Which among the following group is least likely to progress to active tuberculosis once infected with tubercle bacilli A:-Patients on TNF alpha inhibitors B:-Si|icosis C:-Postjejunoi|ea| bypass D:-Post renal transplant patients Ans: A
4:-Which among the following antibiotics has got good penetration to respiratory secretions A:-Cephalosporins B:-Vancomycin C:-Macrolides D:-Carbapenems Ans: C
5:-Patients with scoliosis will have significant ventilator impairment if the Cobb angle is more than
A:-60 degrees B:-75 degrees C:-90 degrees D:-100 degrees
Ans: D
6:-All the following are mast cell mediators EXCEPT A:-Tryptase B:-Chymase C:-E|astase D:-Collagenase Ans: D
7:-Difference between the alveolar and pleural pressures is termed as A:-Transthoracic pressure B:-Transpu|monary pressure C:-Trans alveolar pressure D:-Trans bronchial pressure Ans: B
8:-As per the 2019 WHO guidelines on drug resistant Tuberculosis treatment, all the following are highly effective and strongly recommended for inclusion in all oral longer regimens EXCEPT A:-Levofloxacin B:-Bedaquiline C:-Ethionamide D:-Linezo|id
Ans: C
9:-The minute ventilation above which route of airflow switches from predominately nasal to oronasal breathing is A:-10L/min B:-16L/min C:-24L/min D:-30L/min Ans: D
10:-Regarding honeycomb spaces in usual interstitial pneumonia (UIP) all are true EXCEPT A:-Results from parenchymal remodeling with formation of new airspaces B:-Have thickened and irregular wa||s C:-There will be destruction of normal airspaces D:-They have abundant and well collagenized connective tissue Ans: C
11:-Regarding Bedaquiline which is FALSE A:-Belongs to the diarquuinoline class B:-Targets the rpoB gene encoding the subunit c of the ATP synthase of Mycobacterium tuberculosis C:-Binds to the oligomeric and proteolipic subunit c of mycobacterial ATP synthase D:-Bedaquiline is rapidly absorbed orally Ans: B
12:-About Riociguat which is true A:-Stimulator of soluble guanylate cyclase (sGC) B:-Inhibitor of soluble guanylate cyclase (sGC) C:-Stimulator of Cyclic GMP (cGMP) D:-lnhibitor of cyclic GMP (cGMP) Ans: A
13:-SERAPHIN trial is related to management of A:- Lung Cancer B:-|diopathic pulmonary fibrosis C:-COPD D:-pulmonary arterial hypertension Ans: D
14:-"Differentiation syndrome" is an adverse event seen during treatment with A:-Gefitinib B:-All-trans retinoic acid C:-Paclitaxel D:-Docetaxel Ans: B
15:-Searles and Mckendry diagnostic criteria is used to detect pulmonary involvement due to A:-Bleomycin B:-Cyclophosphamide C:-Methotrexate D:-Actinomycin D Ans: C
16:-Predictive postoperative lung function should be estimated for patients with and FEV1 or DLco less than A:-80% of predicted B:-60% of predicted C:-50% of predicted D:-40% of predicted Ans: A
17:-|ntraoperative risk factors associated with the development of postoperative pulmonary complication is least for A:-Hip surgery B:-Head and neck surgery C:-Neurosurgery D:-Thoracic surgery Ans: A
18:-In Tsuboi classification of tumor-bronchus relationship, when the bronchus is compressed, narrowed, and displaced by the tumor, but the bronchial mucosa is intact will be categorized as which pattern
A:-Type l
B:-Type ll
C:-Type lll
D:-Type IV
Ans: C
19:-Flexible fiber optic bronchoscopy was pioneered by A:-Gustav Kilian B:-Ikeda C:-Schieppati D:-Wang Ans: B
20:-In order to maintain procedural competence for medical thoracoscopy, minimum number of procedures to be performed yearly by operator should be A:-2 B:-5 C:-8 D:-10 Ans: D
21:-Anti TB drug which can cause metallic taste A:-Bedaquilline B:-Delamanide C:-Fluroquinolone D:-both A and C Ans: C
22:-Acid fastness is a property of all of the following organisms except A:-Rhodococcos B:-Legionella micadadei C:-Cryptococcus D:-Isospora Ans: C
23:-Treatment of LTBI can reduce the risk of progression to active disease by abou --------% A:-30% B:-60% C:-80% D:-90% Ans: B
24:-The cut off value (confirmed by repeat ECG) of QTcF value above which all the OTC prolonging drugs should be discontinued. A:-440ms B:-470ms C:-500ms D:-520ms Ans: C
25:-TB meningitis should be treated with first line A'l'l' for at least------ months A:-6 B:-9 C:-12 D:-15 Ans: B
26:-Regarding starting DRTB drugs in a HIV infected patient, pick the wrong statement A:-Un|ike drug sensitive pulmonary tuberculosis, ART should be started along with DRTB drugs. B:-HIV infected DRTB patients without the benefit of ART may experience mortality rates exceeding 90% C:-For servere IRIS syndrome prednisolone is the recommended drug. D:-For all new HIV co infected patients recommended ART is FDC of TLE (Tenofovir, Lamivudine and Efavirenz) Ans: A
27:-Pick the incorrect statement regarding tubercular pleural effusion A:-Pleural fluid ADA values less than 40 U/L virtually rules out tuberculosis B:-ADA activity correlates with CD4+ T lymphocyte cell infiltration in the pleura and pleural fluid C:-Haemolysed blood in fluid sample may cause false over estimation of ADA D:-ADA1:ADA2 ratio less than 0.45 is highly suggestive of tuberculosis
Ans: C
28:-The non tubercular mycobacterium proposed to have an etiological relationship with Crohns disease is A:-M.interjectum B:-M.avium subsp. Paratuberculosis C:-M.intracellulare D:-M.chimaera Ans: B
29:-Regarding VAT (ventilator associated tracheobronchitis) pick the wrong statement A:-|t can be associated with fever and purulent tracheal secretions B:-There is absence of new infiltrate on chest X-ray C:-Non antibiotic treatment is recommended D:-Most common organism implicated is pneumococcus Ans: D
30:-Which of the following is a extracellular functioning PRR(Pattern Recognition Receptor) A:-TLR 6 B:-TLR 3 C:-NLR D:-RIG-l Ans: A
31:-The pneumonia which is often associated with bullous myringitis A:-Mycoplasma pneumonia B:-Pneumococcal pneumonia C:-Staphylococcal pneumonia D:-Legionella pneumonia Ans: A
32:-False positive beta-D glucan assay is seen with all except. A:-lntra Venous Immunoglobulin B:-Intra Venous Piperacillin-Tazobactam C:-Pseudomonas bacteraemia D:-Intra Venous Ringer lactate Ans: D
33:-Which of the following is not true regarding Anthrax A:-It is also called Brad Ford disease B:-There is no human to human transmission C:-Causative agent is a large, square ended gram negative bacilli D:-Widening of the mediastinum or prominence of hilar modes is the earliest radiological finding Ans: C
34:-ln cystic fibrosis select the wrong statement A:-The first genetic marker that was found to be linked to cystic fibrosis was Paraoxanase B:-60% of patients have meconium ileus as the initial manifestation C:-In CF pancreatic insufficiency a malabsorption coefficient of > 7% is considered abnormal D:-T5 polymorphism expressed with R117H result in CBAVD Ans: B
35:-All the above are features of Lofgren's syndrome except A:-Erythema nodosum B:-Bilateral hilar adenopathy C:-Polyarthritis D:-Lupus pernio Ans: D
36:-HRCT pattern consistent with idiopathic pulmonary fibrosis are all except A:-Peribronchovascular predominance B:-Subpleural basal predominance C:-Honeycombing D:-Reticular abnormality Ans: A
37:-The drug recommended for the treatment of idiopathic pulmonary fibrosis A:-Corticosteroid B:-Nintedanib C:-N acetyl cysteine
D:-Azathioprine Ans: B
38:-GAP score is used as a mortality predictor in which condition? A:-|diopathic pulmonary fibrosis B:-COPD C:-Asthma D:-None of the above Ans: A
39:-Reversed halo sign is seen in all conditions except A:-Cryptogenic organising pneumonia B:-Mucormycosis C:-ldiopathic pulmonary fibrosis D:-Pulmonary infarction Ans: C
40:-The usual time frame for the development of radiation pneumonitis is A:-1 week to 1 month B:-within 2 weeks C:-6 weeks to 6 months D:-None of the above Ans: C
41:-Causes of acute respiratory distress in SLE patient is A:-Community acquired pneumonia B:-Acute lupus pneumonitis C:-pulmonary embolism D:-Al| of the above Ans: D
42:-Caplan syndrome is seen in A:-Rheumatoid arthritis B:-Systematic lupus erythematosus C:-Systemic sclerosis D:-Polymyositis dermatomyositis Ans: A
43:-The most common lLD pattern in systemic sclerosis is A:-Usua| interstitial pneumonia B:-Non-specific interstitial pneumonia C:-Cryptogenic organising pneumonia D:-Diffuse alveolar damage Ans: B
44:-Birbeck granules is seen in A:-Systemic sclerosis B:-systemic lupus erythematosus C:-Sjogren's syndrome D:-Langerhans cell histiocytosis Ans: D
45:-B|ack pleura sign is seen in A:-Pulmonary alveolar haemorrhage B:-Langerhans cell histiocytosis C:-Lymphangioleiomyomatosis D:-Pulmonary alveolar microlithiasis Ans: D
46:-The most common antimicrobial agent that causes pulmonary fibrosis A:-Azithromycin B:-Ciprofloxacin C:-Nitrofurantoin D:-cefepime Ans: C
47:-Most common genetic mutation seen in cystic fibrosis is
A:-∆F508 B:-R117H
C:-6551D D:-R227H
Ans: A
48:-Oral drug ivacaftor is used in the treatment of
A:-Lymphangioleiomyomatosis B:-Pulmonary alveolar proteinosis C:-Cystic fibrosis D:-Sarcoidosis Ans: C
49:-Vanishing lung syndrome is seen in which condition A:-Systemic sclerosis B:-bullous lung disease C:-diaphragm palsy D:-pulmonary alveolar proteinosis Ans: B
50:-All are used in tobacco smoking cessation except A:-Nicotine replacement therapy B:-Bupropion C:-varenicline D:-e-cigarette Ans: D
2:-Regarding cervical rib, which among the following is FLASE A:-It is bilateral in 80% of cases B:-Symptom due to compression are more prevalent in males C:-More common on the left side D:-The production of symptoms bears no relation to the size of the rib Ans: B
3:-Which among the following group is least likely to progress to active tuberculosis once infected with tubercle bacilli A:-Patients on TNF alpha inhibitors B:-Si|icosis C:-Postjejunoi|ea| bypass D:-Post renal transplant patients Ans: A
4:-Which among the following antibiotics has got good penetration to respiratory secretions A:-Cephalosporins B:-Vancomycin C:-Macrolides D:-Carbapenems Ans: C
5:-Patients with scoliosis will have significant ventilator impairment if the Cobb angle is more than
A:-60 degrees B:-75 degrees C:-90 degrees D:-100 degrees
Ans: D
6:-All the following are mast cell mediators EXCEPT A:-Tryptase B:-Chymase C:-E|astase D:-Collagenase Ans: D
7:-Difference between the alveolar and pleural pressures is termed as A:-Transthoracic pressure B:-Transpu|monary pressure C:-Trans alveolar pressure D:-Trans bronchial pressure Ans: B
8:-As per the 2019 WHO guidelines on drug resistant Tuberculosis treatment, all the following are highly effective and strongly recommended for inclusion in all oral longer regimens EXCEPT A:-Levofloxacin B:-Bedaquiline C:-Ethionamide D:-Linezo|id
Ans: C
9:-The minute ventilation above which route of airflow switches from predominately nasal to oronasal breathing is A:-10L/min B:-16L/min C:-24L/min D:-30L/min Ans: D
10:-Regarding honeycomb spaces in usual interstitial pneumonia (UIP) all are true EXCEPT A:-Results from parenchymal remodeling with formation of new airspaces B:-Have thickened and irregular wa||s C:-There will be destruction of normal airspaces D:-They have abundant and well collagenized connective tissue Ans: C
11:-Regarding Bedaquiline which is FALSE A:-Belongs to the diarquuinoline class B:-Targets the rpoB gene encoding the subunit c of the ATP synthase of Mycobacterium tuberculosis C:-Binds to the oligomeric and proteolipic subunit c of mycobacterial ATP synthase D:-Bedaquiline is rapidly absorbed orally Ans: B
12:-About Riociguat which is true A:-Stimulator of soluble guanylate cyclase (sGC) B:-Inhibitor of soluble guanylate cyclase (sGC) C:-Stimulator of Cyclic GMP (cGMP) D:-lnhibitor of cyclic GMP (cGMP) Ans: A
13:-SERAPHIN trial is related to management of A:- Lung Cancer B:-|diopathic pulmonary fibrosis C:-COPD D:-pulmonary arterial hypertension Ans: D
14:-"Differentiation syndrome" is an adverse event seen during treatment with A:-Gefitinib B:-All-trans retinoic acid C:-Paclitaxel D:-Docetaxel Ans: B
15:-Searles and Mckendry diagnostic criteria is used to detect pulmonary involvement due to A:-Bleomycin B:-Cyclophosphamide C:-Methotrexate D:-Actinomycin D Ans: C
16:-Predictive postoperative lung function should be estimated for patients with and FEV1 or DLco less than A:-80% of predicted B:-60% of predicted C:-50% of predicted D:-40% of predicted Ans: A
17:-|ntraoperative risk factors associated with the development of postoperative pulmonary complication is least for A:-Hip surgery B:-Head and neck surgery C:-Neurosurgery D:-Thoracic surgery Ans: A
18:-In Tsuboi classification of tumor-bronchus relationship, when the bronchus is compressed, narrowed, and displaced by the tumor, but the bronchial mucosa is intact will be categorized as which pattern
A:-Type l
B:-Type ll
C:-Type lll
D:-Type IV
Ans: C
19:-Flexible fiber optic bronchoscopy was pioneered by A:-Gustav Kilian B:-Ikeda C:-Schieppati D:-Wang Ans: B
20:-In order to maintain procedural competence for medical thoracoscopy, minimum number of procedures to be performed yearly by operator should be A:-2 B:-5 C:-8 D:-10 Ans: D
21:-Anti TB drug which can cause metallic taste A:-Bedaquilline B:-Delamanide C:-Fluroquinolone D:-both A and C Ans: C
22:-Acid fastness is a property of all of the following organisms except A:-Rhodococcos B:-Legionella micadadei C:-Cryptococcus D:-Isospora Ans: C
23:-Treatment of LTBI can reduce the risk of progression to active disease by abou --------% A:-30% B:-60% C:-80% D:-90% Ans: B
24:-The cut off value (confirmed by repeat ECG) of QTcF value above which all the OTC prolonging drugs should be discontinued. A:-440ms B:-470ms C:-500ms D:-520ms Ans: C
25:-TB meningitis should be treated with first line A'l'l' for at least------ months A:-6 B:-9 C:-12 D:-15 Ans: B
26:-Regarding starting DRTB drugs in a HIV infected patient, pick the wrong statement A:-Un|ike drug sensitive pulmonary tuberculosis, ART should be started along with DRTB drugs. B:-HIV infected DRTB patients without the benefit of ART may experience mortality rates exceeding 90% C:-For servere IRIS syndrome prednisolone is the recommended drug. D:-For all new HIV co infected patients recommended ART is FDC of TLE (Tenofovir, Lamivudine and Efavirenz) Ans: A
27:-Pick the incorrect statement regarding tubercular pleural effusion A:-Pleural fluid ADA values less than 40 U/L virtually rules out tuberculosis B:-ADA activity correlates with CD4+ T lymphocyte cell infiltration in the pleura and pleural fluid C:-Haemolysed blood in fluid sample may cause false over estimation of ADA D:-ADA1:ADA2 ratio less than 0.45 is highly suggestive of tuberculosis
Ans: C
28:-The non tubercular mycobacterium proposed to have an etiological relationship with Crohns disease is A:-M.interjectum B:-M.avium subsp. Paratuberculosis C:-M.intracellulare D:-M.chimaera Ans: B
29:-Regarding VAT (ventilator associated tracheobronchitis) pick the wrong statement A:-|t can be associated with fever and purulent tracheal secretions B:-There is absence of new infiltrate on chest X-ray C:-Non antibiotic treatment is recommended D:-Most common organism implicated is pneumococcus Ans: D
30:-Which of the following is a extracellular functioning PRR(Pattern Recognition Receptor) A:-TLR 6 B:-TLR 3 C:-NLR D:-RIG-l Ans: A
31:-The pneumonia which is often associated with bullous myringitis A:-Mycoplasma pneumonia B:-Pneumococcal pneumonia C:-Staphylococcal pneumonia D:-Legionella pneumonia Ans: A
32:-False positive beta-D glucan assay is seen with all except. A:-lntra Venous Immunoglobulin B:-Intra Venous Piperacillin-Tazobactam C:-Pseudomonas bacteraemia D:-Intra Venous Ringer lactate Ans: D
33:-Which of the following is not true regarding Anthrax A:-It is also called Brad Ford disease B:-There is no human to human transmission C:-Causative agent is a large, square ended gram negative bacilli D:-Widening of the mediastinum or prominence of hilar modes is the earliest radiological finding Ans: C
34:-ln cystic fibrosis select the wrong statement A:-The first genetic marker that was found to be linked to cystic fibrosis was Paraoxanase B:-60% of patients have meconium ileus as the initial manifestation C:-In CF pancreatic insufficiency a malabsorption coefficient of > 7% is considered abnormal D:-T5 polymorphism expressed with R117H result in CBAVD Ans: B
35:-All the above are features of Lofgren's syndrome except A:-Erythema nodosum B:-Bilateral hilar adenopathy C:-Polyarthritis D:-Lupus pernio Ans: D
36:-HRCT pattern consistent with idiopathic pulmonary fibrosis are all except A:-Peribronchovascular predominance B:-Subpleural basal predominance C:-Honeycombing D:-Reticular abnormality Ans: A
37:-The drug recommended for the treatment of idiopathic pulmonary fibrosis A:-Corticosteroid B:-Nintedanib C:-N acetyl cysteine
D:-Azathioprine Ans: B
38:-GAP score is used as a mortality predictor in which condition? A:-|diopathic pulmonary fibrosis B:-COPD C:-Asthma D:-None of the above Ans: A
39:-Reversed halo sign is seen in all conditions except A:-Cryptogenic organising pneumonia B:-Mucormycosis C:-ldiopathic pulmonary fibrosis D:-Pulmonary infarction Ans: C
40:-The usual time frame for the development of radiation pneumonitis is A:-1 week to 1 month B:-within 2 weeks C:-6 weeks to 6 months D:-None of the above Ans: C
41:-Causes of acute respiratory distress in SLE patient is A:-Community acquired pneumonia B:-Acute lupus pneumonitis C:-pulmonary embolism D:-Al| of the above Ans: D
42:-Caplan syndrome is seen in A:-Rheumatoid arthritis B:-Systematic lupus erythematosus C:-Systemic sclerosis D:-Polymyositis dermatomyositis Ans: A
43:-The most common lLD pattern in systemic sclerosis is A:-Usua| interstitial pneumonia B:-Non-specific interstitial pneumonia C:-Cryptogenic organising pneumonia D:-Diffuse alveolar damage Ans: B
44:-Birbeck granules is seen in A:-Systemic sclerosis B:-systemic lupus erythematosus C:-Sjogren's syndrome D:-Langerhans cell histiocytosis Ans: D
45:-B|ack pleura sign is seen in A:-Pulmonary alveolar haemorrhage B:-Langerhans cell histiocytosis C:-Lymphangioleiomyomatosis D:-Pulmonary alveolar microlithiasis Ans: D
46:-The most common antimicrobial agent that causes pulmonary fibrosis A:-Azithromycin B:-Ciprofloxacin C:-Nitrofurantoin D:-cefepime Ans: C
47:-Most common genetic mutation seen in cystic fibrosis is
A:-∆F508 B:-R117H
C:-6551D D:-R227H
Ans: A
48:-Oral drug ivacaftor is used in the treatment of
A:-Lymphangioleiomyomatosis B:-Pulmonary alveolar proteinosis C:-Cystic fibrosis D:-Sarcoidosis Ans: C
49:-Vanishing lung syndrome is seen in which condition A:-Systemic sclerosis B:-bullous lung disease C:-diaphragm palsy D:-pulmonary alveolar proteinosis Ans: B
50:-All are used in tobacco smoking cessation except A:-Nicotine replacement therapy B:-Bupropion C:-varenicline D:-e-cigarette Ans: D
51:-Empey's index is A:-FEV1:PEFR ratio B:-FEV1/FVC ratio C:-FEV1/MMEF ratio D:-MMEF/FVC ratio Ans: A
52:-As per surviving sepsis campaign, for resuscitation of a patient with septic shock, which of the following recommendation is correct A:-At least 20mL/kg of IV crystalloid fluid be given within the first 4 hours B:-At least 20mL/kg of IV crystalloid fluid be given within the first 3 hours C:-At least 30mL/kg of IV crystalloid fluid be given within the first 4 hours D:-At least 30mL/kg of IV crystalloid fluid be given within the first 3 hours Ans: D
53:-Which of the following feature is not a part of the Well's Score for predicting the probability of Pulmonary Embolism? A:-HR>100 B:-Haemoptysis C:-Age>50 D:-Malignancy Ans: C
54:-Which among the following is not true regarding Pulmonary veno occlusive disease?
A:-Pulmonary Hypertension
B:-Radiographic evidence of pulmonary edema
C:-Raised PAWP
D:-Lymphatic dilatation at the lung bases and pleura
Ans: C
55:-McConnells sign is a sonologic sign diagnostic of :
A:-Lung cancer B:-Pleural effusion C:-Pneumothorax D:-Pulmonary embolism
Ans: D
56:-96:-According to ATS guidelines which among the following is the preferred option for microbiologic diagnosis of VAP
A:-Noninvasive sampling with semiquantitative cultures
B:-lnvasive sampling with quantitative cultures
C:-Noninvasive sampling with quantitative cultures
D:-Mini BAL culture
Ans: A
57:-Curacao diagnostic criteria is used to diagnose which of the following?
A:-Henoch-Schonlein purpura B:-Wegner's granulomatosis C:-Christmas disease D:-Hereditary hemorrhagic telengectasia
Ans: D
58:-A flow volume loop is showing plateauing of the inspiratory loop only. The most likely cause is: A:-Fixed extra-thoracic obstruction B:-Variable extra-thoracic obstruction C:-Fixed intra-thoracic obstruction D:-Variable intra-thoracic obstruction Ans: B
59:-A patient with severe COPD enters a respiratory rehabilitation program. This is most likely to improve: A:-ABG's B:-Survival C:-Exercise tolerance D:-Spirometry Ans: C
60:-Fatal asthma attacks are best predicted by: A:-Onset in childhood B:-Increased bronchodilator use C:-Smoking D:-Atopy Ans: B
61:-According to GOLD Guidelines 2019, Inhaled steroids are not considered beneficial if AEC is less than A:-400 B:-300 C:-200 D:-100 Ans: D
62:-Which of the following parameters would be needed to calculate a patient's BODE index? A:-Pre bronchodilator FEV1% B:-Height C:-Resting Pa02 D:-V02Max Ans: B
63:-Which of the following is likely to be positive in a case of Follicular bronchiolitis? A:-Anticyclic citrullinated peptide antibody B:-Liver-kidney microsomal type 1 (LKM-1) antibody C:-ACE D:-Anti DS antibody Ans: A
64:-ln a case of COPD with pulmonary hypertension (Mean PAP 50 mm Hg), which is the best form of treatment? A:-Sildenafil B:-Bosentran C:-Epoprostenol D:-None Ans: D
65:-Which among the following is the most pathognomic radiologic sign of ABPA? A:-Central bronchiectasis B:-High attenuation mucus C:-G|oved finger sign D:-Fleeting shadows Ans: B
66:-Which among the following pattern of calcification in a SPN is considered to increase likelihood of malignancy? A:-Popcorn B:-Diffuse C:-Stippled D:-Laminated Ans: C
67:-According to current TNM classification of Non Small Cell Ca lung, a tumor of size 6 cm in right upper lobe with a satellite nodule of 1 cm in the same lobe, subcarinal lymph node and pleural fluid cytology positive belongs to which stage? A:-T2N1M1a B:-T3N1M1a C:-T2N2M1b D:-T3N2M1a Ans: D
68:-Which of the following IHC stains is most useful for identifying adenocarcinoma of pulmonary origin from metastatic lesions? A:-Ca|retinin & CK5/6 B:-Synaptophysin & chromogranin C:-Thyroid transcription factor & thyroglobulin D:-P63 Ans: C
69:-Which is the commonest cell type of scar carcinoma?
A:-Squamous cell carcinoma B:-Adeno carcinoma C:-Small cell carcinoma D:-Large cell carcinoma
Ans: B
70:-Positive predictors of response to EGFR targeted therapy in lung cancer include all the following except: A:-Asian ethnicity B:-Never smokers C:-Adenocarcinoma D:-K-ras mutations
Ans: D
71:-Pemberton's sign is used to demonstrate which disease?
A:-Pulmonary embolism B:-Pleural effusion C:-Retrosternal goiter D:-Pancoast tumour Ans: C
72:-Most common location for ectopic parathyroid tumour is
A:-Anterior mediastinum B:-Posterior mediastinum C:-Chest wall D:-None of above Ans: A
73:-Calcification in mediastinal neuroblastoma is
A:-Rare B:-Seen in 50% C:-Seen in 80% D:-Usually do not calcify Ans: C
74:-In castlemans disease HHV 8 is implicated in patho genesis of
A:-Multicentric disease B:-Unicentric disease C:-Both D:-Not associated Ans: A
75:-Which of the following statement about clinical effect of obesity on ARDS is correct?
A:-Risk of developing ARDS is decreased in obese patients
B:-Risk of developing ARDS is increased in obese patients
C:-Mortality from ARDS is increased in obese patients
D:-Obesity has no effect on outcome of ARDS
Ans: B
76:-|n USG assessment of pleural effusion, effusion is assessed as moderate if
A:-Within the area covered by 3.5 MHz curvilinear probe
B:-Between the range of one to two probes
C:-Between the range of one to three probes
D:-Between the range of two to four probes
Ans: B
77:-Which of the following USG finding is a definite sign of pneumothorax A:-Absence lung slide B:-Absence of lung pulse C:-Presence of lung point D:-Presence ofA |ines Ans: C
78:-Recommended dose of talc for pleurodesis in malignant effusion is
A:-2-3 gms B:-3-4 gms C:-4-6 gsm D:-6-7 gsm Ans: C
79:-Which of the following is NOT a preferred recommendation for prevention of ventilator associated pneumonia
A:-Drainage of sub-glottic secretions B:-Elevation of head end of bed
C:-Closed suction of endotracheal tube D:-Early tracheostomy
Ans: D
80:-Explosive pleuritis is
A:-Rupture of an abscess into pleural cavity causing sudden development of pyopneumothorax
B:-Rupture of infected bulla causing sudden development of pyopneumothorax
C:-Rapid development of pleural effusion despite minimal pneumonia in Streptococcus pyogens infection
D:-Rapid development of pleural effusion in miliary tuberculosis
Ans: C
81:-Which among the following is not a feature of nicotine withdrawal
A:-Tachycardia B:-Restlessness C:-Increased appetite or weight gain D:-Difficulty concentrating
Ans: A
82:-Regarding fluid resuscitation in septic shock which of the following statement is correct
A:-Normal saline is the most preferred crystalloid
B:-Colloids like Hydroxyethyl starch is preferred to maintain intravascular volume
C:-Normal saline is preferred over Ringer lactate
D:-When large volume is infused, normal saline may cause renal damage
Ans: D
83:-In patients with acute type 1 respiratory failure, Oxygen flow should be adjusted to maintain Sp02 around
A:-88—92% B:-94-98% C:-90-94% D:-92-95%
Ans: B
84:-Regarding NIV use, which of the following statement is wrong
A:-Fluid overload commonly contributes to NIV failure in patients with OHS
B:-Forced diuresis may be useful to prevent NIV failure in patients with OHS
C:-NIV should not be used in patients with acute asthma exacerbations and AHRF
D:-ln patients with non-CF bronchiectasis with AHRF, NIV should not be tried
Ans: D
85:-Clinical pulmonary infection score is considered to be positive if it is equal to or more than
A:-4 B:-5 C:-6 D:-7
Ans: C
86:-K complex is
A:-Well delineated negative sharp wave followed by a positive component lasting at least 0.5 sec duration
B:-Well delineated negative sharp wave followed by a positive component lasting less than 0.5 sec duration
C:-Well delineated positive sharp wave followed by a negative component lasting at least 0.5 sec duration
D:-Well delineated positive sharp wave followed by a negative component lasting less than 0.5 sec duration
Ans: A
87:-Regarding CPAP titration in OSA, which of the following statement is correct
A:-Optimal titration reduces RDI to <5 per hour for at least 15-min duration and should include supine REM sleep that is not continually interrupt by spontaneous arousals or awakenings
B:-Optimal titration reduced RDI to <5 per hour for at least a 30-min duration and should include supine REM sleep that is not continually interrupted by spontaneous arousals or awakenings
C:-Optimal titration reduced RDI to <5 per hour for at least a 1 hour duration and should include supine REM sleep that is not continually interrupted by spontaneous arousals or awakenings
D:-Optimal titration reduces total respiratory disturbance to less than 10 in 3 hours of sleep and should include supine REM sleep that is not continually interrupted by spontaneous or awakenings
Ans: A
88:-Which one of the following anticoagulant can be used without initial parenteral anticoagulation in pulmonary thromboembolism
A:-Dabigatran B:-Rivaroxaban C:-Vit K antagonists D:-Apixaban Ans: B
89:-As per ACCP guidelines, in patients with a first venous thromboembolism that is an unprovoked proximal DVT of the leg or pulmonary embolism and who have a high bleeding risk, duration of anticoagulation is
A:-3 months B:-6 months C:-12 months D:-24 months
Ans: A
52:-As per surviving sepsis campaign, for resuscitation of a patient with septic shock, which of the following recommendation is correct A:-At least 20mL/kg of IV crystalloid fluid be given within the first 4 hours B:-At least 20mL/kg of IV crystalloid fluid be given within the first 3 hours C:-At least 30mL/kg of IV crystalloid fluid be given within the first 4 hours D:-At least 30mL/kg of IV crystalloid fluid be given within the first 3 hours Ans: D
53:-Which of the following feature is not a part of the Well's Score for predicting the probability of Pulmonary Embolism? A:-HR>100 B:-Haemoptysis C:-Age>50 D:-Malignancy Ans: C
54:-Which among the following is not true regarding Pulmonary veno occlusive disease?
A:-Pulmonary Hypertension
B:-Radiographic evidence of pulmonary edema
C:-Raised PAWP
D:-Lymphatic dilatation at the lung bases and pleura
Ans: C
55:-McConnells sign is a sonologic sign diagnostic of :
A:-Lung cancer B:-Pleural effusion C:-Pneumothorax D:-Pulmonary embolism
Ans: D
56:-96:-According to ATS guidelines which among the following is the preferred option for microbiologic diagnosis of VAP
A:-Noninvasive sampling with semiquantitative cultures
B:-lnvasive sampling with quantitative cultures
C:-Noninvasive sampling with quantitative cultures
D:-Mini BAL culture
Ans: A
57:-Curacao diagnostic criteria is used to diagnose which of the following?
A:-Henoch-Schonlein purpura B:-Wegner's granulomatosis C:-Christmas disease D:-Hereditary hemorrhagic telengectasia
Ans: D
58:-A flow volume loop is showing plateauing of the inspiratory loop only. The most likely cause is: A:-Fixed extra-thoracic obstruction B:-Variable extra-thoracic obstruction C:-Fixed intra-thoracic obstruction D:-Variable intra-thoracic obstruction Ans: B
59:-A patient with severe COPD enters a respiratory rehabilitation program. This is most likely to improve: A:-ABG's B:-Survival C:-Exercise tolerance D:-Spirometry Ans: C
60:-Fatal asthma attacks are best predicted by: A:-Onset in childhood B:-Increased bronchodilator use C:-Smoking D:-Atopy Ans: B
61:-According to GOLD Guidelines 2019, Inhaled steroids are not considered beneficial if AEC is less than A:-400 B:-300 C:-200 D:-100 Ans: D
62:-Which of the following parameters would be needed to calculate a patient's BODE index? A:-Pre bronchodilator FEV1% B:-Height C:-Resting Pa02 D:-V02Max Ans: B
63:-Which of the following is likely to be positive in a case of Follicular bronchiolitis? A:-Anticyclic citrullinated peptide antibody B:-Liver-kidney microsomal type 1 (LKM-1) antibody C:-ACE D:-Anti DS antibody Ans: A
64:-ln a case of COPD with pulmonary hypertension (Mean PAP 50 mm Hg), which is the best form of treatment? A:-Sildenafil B:-Bosentran C:-Epoprostenol D:-None Ans: D
65:-Which among the following is the most pathognomic radiologic sign of ABPA? A:-Central bronchiectasis B:-High attenuation mucus C:-G|oved finger sign D:-Fleeting shadows Ans: B
66:-Which among the following pattern of calcification in a SPN is considered to increase likelihood of malignancy? A:-Popcorn B:-Diffuse C:-Stippled D:-Laminated Ans: C
67:-According to current TNM classification of Non Small Cell Ca lung, a tumor of size 6 cm in right upper lobe with a satellite nodule of 1 cm in the same lobe, subcarinal lymph node and pleural fluid cytology positive belongs to which stage? A:-T2N1M1a B:-T3N1M1a C:-T2N2M1b D:-T3N2M1a Ans: D
68:-Which of the following IHC stains is most useful for identifying adenocarcinoma of pulmonary origin from metastatic lesions? A:-Ca|retinin & CK5/6 B:-Synaptophysin & chromogranin C:-Thyroid transcription factor & thyroglobulin D:-P63 Ans: C
69:-Which is the commonest cell type of scar carcinoma?
A:-Squamous cell carcinoma B:-Adeno carcinoma C:-Small cell carcinoma D:-Large cell carcinoma
Ans: B
70:-Positive predictors of response to EGFR targeted therapy in lung cancer include all the following except: A:-Asian ethnicity B:-Never smokers C:-Adenocarcinoma D:-K-ras mutations
Ans: D
71:-Pemberton's sign is used to demonstrate which disease?
A:-Pulmonary embolism B:-Pleural effusion C:-Retrosternal goiter D:-Pancoast tumour Ans: C
72:-Most common location for ectopic parathyroid tumour is
A:-Anterior mediastinum B:-Posterior mediastinum C:-Chest wall D:-None of above Ans: A
73:-Calcification in mediastinal neuroblastoma is
A:-Rare B:-Seen in 50% C:-Seen in 80% D:-Usually do not calcify Ans: C
74:-In castlemans disease HHV 8 is implicated in patho genesis of
A:-Multicentric disease B:-Unicentric disease C:-Both D:-Not associated Ans: A
75:-Which of the following statement about clinical effect of obesity on ARDS is correct?
A:-Risk of developing ARDS is decreased in obese patients
B:-Risk of developing ARDS is increased in obese patients
C:-Mortality from ARDS is increased in obese patients
D:-Obesity has no effect on outcome of ARDS
Ans: B
76:-|n USG assessment of pleural effusion, effusion is assessed as moderate if
A:-Within the area covered by 3.5 MHz curvilinear probe
B:-Between the range of one to two probes
C:-Between the range of one to three probes
D:-Between the range of two to four probes
Ans: B
77:-Which of the following USG finding is a definite sign of pneumothorax A:-Absence lung slide B:-Absence of lung pulse C:-Presence of lung point D:-Presence ofA |ines Ans: C
78:-Recommended dose of talc for pleurodesis in malignant effusion is
A:-2-3 gms B:-3-4 gms C:-4-6 gsm D:-6-7 gsm Ans: C
79:-Which of the following is NOT a preferred recommendation for prevention of ventilator associated pneumonia
A:-Drainage of sub-glottic secretions B:-Elevation of head end of bed
C:-Closed suction of endotracheal tube D:-Early tracheostomy
Ans: D
80:-Explosive pleuritis is
A:-Rupture of an abscess into pleural cavity causing sudden development of pyopneumothorax
B:-Rupture of infected bulla causing sudden development of pyopneumothorax
C:-Rapid development of pleural effusion despite minimal pneumonia in Streptococcus pyogens infection
D:-Rapid development of pleural effusion in miliary tuberculosis
Ans: C
81:-Which among the following is not a feature of nicotine withdrawal
A:-Tachycardia B:-Restlessness C:-Increased appetite or weight gain D:-Difficulty concentrating
Ans: A
82:-Regarding fluid resuscitation in septic shock which of the following statement is correct
A:-Normal saline is the most preferred crystalloid
B:-Colloids like Hydroxyethyl starch is preferred to maintain intravascular volume
C:-Normal saline is preferred over Ringer lactate
D:-When large volume is infused, normal saline may cause renal damage
Ans: D
83:-In patients with acute type 1 respiratory failure, Oxygen flow should be adjusted to maintain Sp02 around
A:-88—92% B:-94-98% C:-90-94% D:-92-95%
Ans: B
84:-Regarding NIV use, which of the following statement is wrong
A:-Fluid overload commonly contributes to NIV failure in patients with OHS
B:-Forced diuresis may be useful to prevent NIV failure in patients with OHS
C:-NIV should not be used in patients with acute asthma exacerbations and AHRF
D:-ln patients with non-CF bronchiectasis with AHRF, NIV should not be tried
Ans: D
85:-Clinical pulmonary infection score is considered to be positive if it is equal to or more than
A:-4 B:-5 C:-6 D:-7
Ans: C
86:-K complex is
A:-Well delineated negative sharp wave followed by a positive component lasting at least 0.5 sec duration
B:-Well delineated negative sharp wave followed by a positive component lasting less than 0.5 sec duration
C:-Well delineated positive sharp wave followed by a negative component lasting at least 0.5 sec duration
D:-Well delineated positive sharp wave followed by a negative component lasting less than 0.5 sec duration
Ans: A
87:-Regarding CPAP titration in OSA, which of the following statement is correct
A:-Optimal titration reduces RDI to <5 per hour for at least 15-min duration and should include supine REM sleep that is not continually interrupt by spontaneous arousals or awakenings
B:-Optimal titration reduced RDI to <5 per hour for at least a 30-min duration and should include supine REM sleep that is not continually interrupted by spontaneous arousals or awakenings
C:-Optimal titration reduced RDI to <5 per hour for at least a 1 hour duration and should include supine REM sleep that is not continually interrupted by spontaneous arousals or awakenings
D:-Optimal titration reduces total respiratory disturbance to less than 10 in 3 hours of sleep and should include supine REM sleep that is not continually interrupted by spontaneous or awakenings
Ans: A
88:-Which one of the following anticoagulant can be used without initial parenteral anticoagulation in pulmonary thromboembolism
A:-Dabigatran B:-Rivaroxaban C:-Vit K antagonists D:-Apixaban Ans: B
89:-As per ACCP guidelines, in patients with a first venous thromboembolism that is an unprovoked proximal DVT of the leg or pulmonary embolism and who have a high bleeding risk, duration of anticoagulation is
A:-3 months B:-6 months C:-12 months D:-24 months
Ans: A
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