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TUBERCULOSIS AND RESPIRATORY MEDICINE


TUBERCULOSIS AND RESPIRATORY MEDICINE ​

​​1:-Alpha 1 anti trypsine deficiency is caused by mutation in the gene
A:-SERPINA1
B:-ACVRL1
C:-SFTPA2
D:-CSF2RA
Ans: A

2:-At the end of a deep breath what percent of lung volume is air ?
A:-60
B:-80
C:-70
D:-90
Ans: B

3:-Fibre types in respiratory muscles that help in sneezing and coughing is
A:-Type I
B:-Type IIa
C:-Type IIb
D:-Type IIx
Ans: D

4:-Most common pattern of ILD in Rheumatoid arthritis is
A:-UIP
B:-COP
C:-NSIP
D:-DIP
Ans: A

5:-Fall in FEV1 in non-smoking adults are at the rate of
A:-15 ml/year
B:-30 ml/year
C:-45ml/year
D:-60ml/year
Ans: B

6:-All are true regarding COPD exacerbations, except
A:-Best predictor of future exacerbations
B:-More common in patients with chronic cough and sputum production
C:-Spirometry during the acute exacerbation is usually helpful in predicting the severity and duration
D:-Many of these eventually resolve without specific treatment
Ans: C

7:-All are causes of exacerbations of asthma, except
A:-Rhino virus
B:-Hemophilus influenza
C:-Chlamydia
D:-Para influenza virus
Ans: B

8:-Anti inflammatory action of theophyllins are mediated through
A:-Phosphodiesterase
B:-Histone deacetylase2
C:-All of the above
D:-None of the above
Ans: B

9:-NSAID well tolerated in Aspirin induced asthma is
A:-Indomethacine
B:-Ketorolac
C:-Piroxicam
D:-Sodium salicylate
Ans: D

10:-Prevalence of exercise induced asthma may be more in the following group
A:-Children
B:-Elite athletes
C:-All of the above
D:-None of the above
Ans: C

11:-The most effective drug in exercise induced asthma is
A:-Beta adrenergic agonists
B:-Chromolin sodium
C:-Theophyllins
D:-Leukotriene antagonists
Ans: A

12:-Pathognomonic of ABPA among the following is
A:-Elevated aspergillus specific IgE
B:-Elevated aspergillus specific IgG
C:-Charcot-Leyden crystals
D:-Hyphae filled mucous plug
Ans: D

13:-Unilateral vocal cord paralysis causes
A:-Variable intrathoracic obstruction
B:-Variable extra thoracic obstruction
C:-Fixed intrathoracic obstruction
D:-Fixed extra thoracic obstruction
Ans: B

14:-Most common type of benign tracheal tumour is
A:-Chondroma
B:-Papilloma
C:-Hemangioma
D:-Hamartoma
Ans: A

15:-All are true in Vocal Cord Dysfunction, except
A:-Stridor/wheeze
B:-Symptoms may remit without treatment
C:-Presence of bronchial hyper responsiveness
D:-Normal alveolar arterial gradient
Ans: C

16:-F508 del mutation in cystic fibrosis results in
A:-Block in processing
B:-Block in regulation
C:-Altered conductance
D:-Reduced synthesis
Ans: A

17:-Risk factors for liver disease in cystic fibrosis are all the following, except
A:-Meconium ileus
B:-PiZ heterozygous state
C:-TGF beta-1 polymorphism
D:-Female sex
Ans: D

18:-Infections with the following organism is associated with development of bronchiectasis.
A:-Streptococcus pneumoniae
B:-Haemophilus influenza
C:-Staphylococcus aureus
D:-Morexella catarrhalis
Ans: C

19:-Most common form of ILD is
A:-Hypersensitivity pneumonitis
B:-Sarcoidosis
C:-CT-ILD
D:-IPF
Ans: D

20:-Differentiating feature between RB-ILD and DIP is
A:-Age of onset
B:-Involvement of alveoli
C:-Smoking score more than 30 pack years
D:-Golden brown pigments in macrophages
Ans: B

21:-Detergent workers disease is caused by
​A:-Cladosporium spp.
B:-Pseudomonas spp.
C:-Aureobasidium spp.
D:-Bacillus subtilis
Ans: D

22:-Shrinking lung syndrome is seen in
​A:-SLE
B:-Emphysema
C:-IPF
D:-Scleroderma
Ans: A

23:-All are true regarding Rheumatoid pleural effusion, except
A:-Low sugar
B:-Leukocytosis
C:-pH more than 7.2
D:-Exudative effusion
Ans: C

24:-Radiologic appearance of PLCH include all, except
A:-Mid and lower zone involvement
B:-Ill defined nodules
C:-Cysts of bizarre shape
D:-Pleural thickening
Ans: A

25:-All are true regarding Alveolar microlithiasis, except
A:-Autosomal recessive disorder
B:-Calcium metabolism disorder
C:-Asymptomatic with abnormal CXR
D:-Mutation in Type II b sodium phosphate cotransporter gene
Ans: B

26:-In which year Robert Koch received Nobel Prize for his contribution in the field of Tuberculosis ?
A:-1888
B:-1905
C:-1912
D:-1886
Ans: B

27:-National Tuberculosis programme was started in India in the year
A:-1906
B:-1956
C:-1978
D:-1962
Ans: D

28:-Swimming pool granuloma is caused by
A:-M.marinum
B:-M.ulcerans
C:-M.avium
D:-M.smegmatis
Ans: A

29:-All are solid culture media in Tuberculosis, except
A:-L-J medium
B:-Loeffler serum slope
C:-Middlebrooks medium
D:-Pawlowskys medium
Ans: C

30:-Most common form of skeletal tuberculosis is
A:-Tuberculosis of hip
B:-Tuberculosis of knee joint
C:-Spinal tuberculosis
D:-Tuberculosis of shoulder joint
Ans: C

31:-Which of the following is unusual in Churg stauss syndrome ?
A:-cANCA
B:-Elevated ESR
C:-Elevated CRP
D:-Elevated Eosinophil Count
Ans: A
​
32:-Which is not true in chylothorax ?
A:-Lymphocyte predominant
B:-Exudate
C:-Elevated LDH
D:-Pleural fluid triglyceride more than 110 mg/dl
Ans: C

33:-Triad of Yellow nail syndrome consists of all, except
A:-Nail changes
B:-Pleural effusion
C:-Bronchiectasis
D:-Lymphedema
Ans: C
​34:-Chronic pleuritic pain is characteristic in
A:-Lung cancer
B:-Pneumoconiosis
C:-Pulmonary embolism
D:-Mesothelioma
Ans: D

35:-Absolute contraindication for argonplasma coagulation is
A:-Implantable defibrillator
B:-`FiO_(2)` less than 0.4
C:-Major airway bleed
D:-Post infectious airway stenosis
Ans: A

36:-Elevated DLCo in asthma is due to
A:-Associated large lung volume
B:-Increased perfusion of well ventilated upper zones
C:-None of the above
D:-both (1) & (2)
Ans: D

37:-Varenicline helps in smoking cessation by a) Being partial agonist of nicotinic cholinergic receptor b) Blocks effects of smoke on nicotine receptor c) As a result of receptor blockade nicotine withdrawal symptoms are relieved d) Desire to smoke is reduced
A:-a, b and c
B:-b, c and d
C:-a, b and d
D:-a, c and d
Ans: C

38:-Which is not true about Pancoast syndrome ?
A:-Most common initial symptom is shoulder pain
B:-Intrinsic muscles of the hand may be involved
C:-Associated with superior sulcus tumour
D:-CT is superior imaging modality
Ans: D

39:-Malignancy commonly associated with airway metastasis is
A:-Prostatic cancer
B:-Colon cancer
C:-Osteogenic sarcoma
D:-Ca. Tongue
Ans: B

40:-Criteria for diagnosing a definite Hereditary Hemorrhagic Telangiectasia include all, except
A:-Recurrent spontaneous nose bleeds
B:-Mucocutaneous telangiectasia
C:-No first degree relative involved
D:-Visceral involvement
Ans: C

41:-Skin manifestation that is specific for sarcoidosis
A:-Erythema nodosum
B:-Lupus pernio
C:-Subcutaneous nodules
D:-Plaques
Ans: B

42:-Not true about Idiopathic Pulmonary Hemosiderosis, from the following is
A:-Predominantly disease of children
B:-Recurrent haemoptysis
C:-Renal involvement is common
D:-Histology of lung shows bland alveolar haemorrhage with hemosiderin accumulation
Ans: C

43:-The commonest type of lung carcinoma seen in women and non-smokers
A:-Adenocarcinoma
B:-Large cell carcinoma
C:-Small cell carcinoma
D:-Squamous cell carcinoma
Ans: A

44:-The commonest malignant tumour seen in asbestos worker
A:-Bronchogenic carcinoma
B:-Gastric carcinoma
C:-Glioblastoma multiforme
D:-Malignant mesothelioma
Ans: A

45:-Cushing syndrome is usually associated with all, except
A:-Carcinoid tumour
B:-Squamous cell carcinoma
C:-Neuroblastoma
D:-Small cell carcinoma
Ans: B

46:-Most common radiological pattern associated with Bronchioloalveolar carcinoma
A:-Multiple nodular lesions
B:-Consolidative pattern
C:-Perihilar opacity with cavitation
D:-Single nodular lesions
Ans: D

47:-The commonest type of emphysema
A:-Irregular
B:-Centriacinar
C:-Panacinar
D:-Paraseptal
Ans: B

48:-The pneumoconiosis which can be seen commonly in tobacco smokers is
A:-Anthrocosis
B:-Byssinosis
C:-Siderosis
D:-Silicosis
Ans: A

49:-The type of pneumoconiosis in which eggshell calcification of hilar lymph nodes is seen in chest X-ray is
A:-Anthracosis
B:-Berylliosis
C:-Coalworkers pneumoconiosis
D:-Silicosis
Ans: D

50:-Bronchial carcinoma can be associated with all except
A:-Acanthosis nigricans
B:-Myesthenia gravis
C:-Hypercalcaemia
D:-SIADH
Ans: B

51:-All are true about asbestosis except
A:-Asteriod bodies are characteristic
B:-Begins in the lower lobe and subpleurally
C:-Marked diffuse pulmonary interstial fibrosis
D:-Pleural plaques most common manifestation
Ans: A

52:-All are true about silicosis except
A:-Most prevalent chronic occupational disease in the world
B:-Quartz is most commonly implicated form
C:-Initial lesions tend to localize in the lower lung zone
D:-There is no known clear association of silica and development of lung cancer
Ans: C

53:-Bedaquiline is not started in MDR TB in all the situations, except
A:-Pyrazinamide and at least 4 second line drugs are not available according to sensitivity tests
B:-Uncontrolled cardiac arrhythmia requiring medication
C:-Prolonged QT interval (more than 450 ms)
​D:-Presence of chorioretinitis
Ans: A
​54:-Most common lung cancer type associated with pleural involvement
A:-Squamous cell carcinoma
B:-Adenocarcinoma
C:-Large cell carcinoma
D:-Small cell carcinoma
Ans: B

55:-All are true regarding pleural effusion associated with mesothelioma, except
A:-Presence of hyaluronic acid is diagnostic
B:-Low pH
C:-Low sugar
D:-LDH concentration greater than that of carcinoma of pleura
Ans: A

56:-Haller index suggesting significant sternal depression in Pectus excavatum is
A:-2.5
B:-More than 3.25
C:-Less than 3.25
D:-Less than 2.5
Ans: B

57:-Chronic mountain sickness is characterized by all the features, except
A:-Dyspnoea on exertion
B:-Extreme polycythemia
C:-Elevated haematocrit
D:-Pulmonary hypertension
Ans: A

58:-EGFR mutations positive lung cancers have all the following features, except
A:-Exclusively in NSCLC
B:-More in women
C:-More in smokers
D:-20-30% Asian lung cancer patients
Ans: C

59:-Carcinoid syndrome is seen in all, except
A:-Carcinoid tumours
B:-Large cell carcinoma
C:-Squamous cell carcinoma
D:-Small cell carcinoma
Ans: C

60:-Hypercalcemia most frequently occur in
A:-Squamous cell cancer
B:-Adenocarcinoma
C:-Small cell lung cancer
D:-Large cell carcinoma
Ans: A

61:-Spherical pneumonia is associated with
A:-Streptococcal pneumonia
B:-Haemophilus influenza
C:-Coxiella burnetti
D:-All of the above
Ans: D

62:-Which is not true about pneumatoceles ?
A:-Seen in young children
B:-Develop late in the course of pneumonia
C:-Thin walled air filled spaces
D:-Disappear in a few months
Ans: B

63:-Liver function abnormalities and clinical hepatitis in atypical pneumonia usually suggest
A:-Qfever
B:-Mycoplasma pneumonia
C:-Legionella pneumonia
D:-Chlamydia pneumonia
Ans: A

64:-Lemmiere syndrome is caused by
A:-M.abscesus
B:-Peptostreptococcus
C:-Prevotella oralis
D:-F.necrophorum
Ans: D

65:-Important infection in post transplant patients, beyond one month post surgery is
A:-CMV
B:-P. jiroveci
C:-A. fumigates
D:-Nocardia asteroides
Ans: A

66:-Mechanism of action of fluoroquinolones is
A:-Inhibition of protein synthesis
B:-Interfere with DNA gyrase/topoisomerase IV leading to cell wall lysis
C:-LPS mediated increased cell wall permeability to antibiotics
D:-Both (a) and (c)
Ans: B

67:-Most common site for aspiration pneumonia is
A:-Superior segment of RLL
B:-Posterior segment of LUL
C:-Medial segment of RML
D:-Superior segment of LLL
Ans: A

68:-Most likely diagnosis in an edentulous patient presenting with a cavitating lesion in CXR in all, except
A:-Bronchial obstruction
B:-Pulmonary embolus
C:-Septic embolus
D:-Lung abscess
Ans: D

69:-Diagnostic threshold for BAL in nosocomial pneumonia is
A:-`10^(5)` CFU/ml
B:- `10^(3)` CFU/ml
C:-`10^(4) ` CFU/ml
D:-` 10^(6) ` CFU/ml
Ans: C

70:-Which of the following mycobacteriae is not associated with human infection ?
A:-M.africanum
B:-M.canettii
C:-M.bovis BCG
D:-M.caprae
Ans: D

71:-Droplet nuclei are not the mode of transmission among the following diseases
A:-Measles
B:-Tuberculosis
C:-Influenza
D:-Varicella
Ans: C

72:-Most common form of extrapulmonary tuberculosis is
A:-Pleural effusion
B:-Spinal tuberculosis
C:-Genitourinary TB
D:-Lymphnode TB
Ans: D

73:-All are true about Xpert-MTB-RIF, except
A:-Nucleic acid amplification test
B:-Sophisticated laboratory needed, not useful in resource poor settings
C:-Simultaneously detects RIF resistance
D:-Specificity 90-100%
Ans: B

74:-Diagnostic test of choice in pneumocystis jerovecii, is
A:-Diff-Quick stain
B:-Induced sputum with direct immunofluorescent staining
C:-Wright's stain
D:-Toluidine blue O
Ans: B

75:-Mechanism of Bleomycin lung toxicity include all, except
A:-Generation of oxygen free radicals
B:-Direct effects on DNA
C:-Absence of enzyme Bleomycin hydrolase
D:-Inhibition of enzyme Bleomycin hydrolase
Ans: D

76:-Which is not correct about omalizumab ?
A:-Recombinant humanised antibody
B:-Dose dependent on serum level of IgE alone
C:-Indicated in moderate to severe allergic asthma
D:-Should not be initiated at acute stage of asthma
Ans: B

77:-IRIS can occur in all the following conditions in a patient with HIV, except
A:-Mycobacterium tuberculosis
B:-Leishmaniasis
C:-Fungal infections
D:-Bacterial pneumonia
Ans: D

78:-Permissive hyper capnoea is used in all the following, except
A:-Acute lung injury
B:-Increased intracerebral pressure
C:-ARDS
D:-Neonatal respiratory failure
Ans: B

79:-Oral bio-availability is maximum for which among the following inhaled steroids ?
A:-Fluticasone
B:-Mometasone
C:-Ciclasonide
D:-Beclomethasone
Ans: D

80:-All are features of chronic eosinophilic pneumonia, except
A:-Elevated eosinophil count in blood and BAL
B:-Reverse pulmonary edema pattern in CXR
C:-Male sex predominance
D:-Presence of interstitial fibrosis pathologic hall mark
​Ans: C
​
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