Class of 2017 Respiratory System

1. Which of the following agents is a common aetiological agent of atypical pneumonia?

a) Chlamydia pneumoniae
b) Streptococcus pneumoniae
c) Klebsiella pneumoniae
d) Pseudomonas aeruginosa

2. Cyanosis is indicated by a higher than normal blood concentration of which of the following
compounds?
a) Carbon monoxide
b) Deoxyhemoglobin
c) Carbon dioxide
d) Hydrogen ions

3. Which of the following cell types are NOT included in the epithelium of the mucosa lining
the respiratory segment of the nasal cavity?
a) Goblet Cells
b) Brush Cells
c) Basal Cells
d) Basket Cells

4. All of the following activities are metabolic processes of the lung except
a) removal of serotonin
b) conversion of angiotensin 1 to andgiotensin 2
c) inavtivation of bradykinin
d) production of erythropoietin

5. Which of the following CANNOT be measured using a simple spirometer and stop watch?
a) FRC
b) VT
c) VC

6. In which of the following entities is Human Papilloma Virus (HPV) casually related.

a) Sinonasal adenocarcinoma
b) Juvenile Laryngeal Papillomatosis
c) Esthesioneuroblastoma

7. Which of the following factors does NOT cause an increase in airway resistance?
a) Breathing cigarette smoke
b) Reducing lung volume below FRC
c) Diving to great depth
d) Increased sympathetic stimulation of airway smooth muscles
8. The larynx extends from:
a) C2 - C4
b) C3 - C6
c) C5 - C6
d) C6 - T1

9.
What type of epithelium lines the luminal surface of the true vocal cord?
a) Columnar Epithelium
b) Squamous Epithelium
c) Stratified Squamous Epithelium
d) Stratified Squamous Non Keratinized Epithelium

10. Which of the following statments about diffusion capacity of the lungs is not true?

a) It is measured with carbon monoxide as this gas diffuses very slowly through the blood
air barrier.
b) Diffusion limitation of oxygen is most likely during exercise at high altitude.
c) It is decreased due to pulmonary fibrosis which causes thickening of the blood air
barrier.
d) It decreases if one lung is removed.

11. What levels of the bronchiopulmonary tree are said to be respiratory?

a) 0 – 8
b) 0 – 16
c) 17 – 23
d) 8 – 16

12. What is the embryological origin of the respiratory diverticulum?

a) Ectoderm
b) Endoderm
c) Mesoderm
d) Mesenchyme

13. At what vertebral level does the trachea begin?

a) C6
b) C3
c) T1
d) C4

14. What is the cranial nerve to the second pharyngeal arch?

a) Mandibular
b) Maxilary
c) Facial
d) Glossopharyngeal
15. Which tumor carries the worst prognosis?
a) Small cell carcinoma
b) Large cell carcinoma
c) Squamous cell carcinoma
d) Adenoma

16. Patient PaO2 of 300mmHg what is the most common diagnosis

a) Ventilation/perfusion abnormality
b) High altitude ventilation

17. Which cough suppressant acts by inhibiting cough reflexes

a) Guanefisin
b) Bromohexine
c) Licorice

18. Whichis true about leukotrienes?

a) Zileuton is given daily as an inhalant
b) LTB4 is significantly antagonized by Montelukast
c) Montelukast is primarily decreasing circulatory leukotriene circulation
d) Zafirlukast potentiates the action of phenytoin

19. What is the epithelial lining of terminal bronchiole

a) Simple Columnar with cilia
b) Simple Cuboidal with cilia
c) Simple Columnar
d) Simple Cuboidal

20. At what level does the conducting portion of the respiratory system end
a) Respiratory bronchiole
b) Terminal bronchiole
c) Tertiary Bronchus

21. What is NOT true about the Hering-Breuer Reflex?

a) May help to inflate the neonatal lung
b) Stimulates inspiration when the lung is already inflated
c) Inflates the deflated lung
d) Stimulates deflation of the inflated lung

22. Which is true about the Oxygen-Haemoglobin dissociation curve?

a) It is shifted to the left by high temperatures
b) It is shifted to the left by increased concentrations of 2,3-DPG
c) It is shifted to the right by increased pH
d) It is Shifted to the right by increased tissue CO2 concentrations

23. Asteroid bodies are characteristic of

 a) Tuberculosis
b) Sarcoidosis
c) Berylliosis
d) Leprosy

24. Bronchodialator effect of salbutamol isproduced by :

a) Inhibiton of β 2 receptors – bronchial smooth muscle
b) Inhibition of M 3 receptors - bronchial smooth muscle
c) Stimulation of β 2 receptors – bronchial smooth muscle
d) Stimulation of M 3 receptors - bronchial smooth muscle

25. Oxygen dissociation curve is shifted to the right

a) 2,3 biphosphoglycerate
b) decreased PCO2
c) decreased body temp
d) plasma pH

26. Which of the following concerning laryngeal papillomas is correct?

a) Hard and firm tumour 4-5 cm in diameter
b) Commonly found in supraglottic region of the larynx
c) Juvenille LP regresses at puberty
d) Juvenille LP causally associated with HPV types 33 and 45

27. Stridor is associated with supraglottis is usually

a) Inspiration
b) best heard at rest
c) Associated with hoarseness
d) due to laminar air flow

28. Epistaxis most commonly originated from:

a) Inferior turbinate
b) nasopharynx
c) Middle turbinate
d) Little’s area

29. Which of the foll is not a type of cell found in resp epi
a) goblet cells
b) brush cells
c) basal cell
d) basket cell

30. Ofactory cells are a type of

 a) unipolar neurone
b) bipolar neurone
c) pseudounipolar

31. Which if the foll is true regarding peripheral chemoreceptors. It is stimulated most by
a) PO2
b) PCO2
c) H+

32. After visiting a cave and being exposed to bat droppings, the patient has developed
a) Saroidosis
b) TB
c) Histoplasmosis
d) Wegener Granumalotosis

33. Which is the most common etiological agent of atypical pneumonia?

a) Klebsiella pneumoniae
b) Coxiella burnetti
c) Mycoplasma pneumoniae
d) Pneumocystis carinii

34. What is the average resting alveolar ventilation rate for a young male?
a) 7,500 ml/min
b) 5,250 ml/min
c) 500 ml/min
d) 250 ml/min

35. Which one of the following best describes the preferred site for a tracheostomy?
a) First and second rings
b) Second and third rings
c) Fourth and fifth rings
d) Fifth and sixth rings

36. Sensitivity of peripheral chemoreceptors:

a) PO2 > H+ > PCO2
 b) H+ > PCO2 > PO2
c) PO2 > PCO2 > H+
d) PCO2 > H+ > PO2

37. All of the following are characteristics of asthma except:

a) chronic inflammation of airways
b) Cushprungs spirals
c) Charcot-Layden crystals

38. Which of the following is not a cause of stridor?

a) foreign body in the trachea
b) bilateral vocal cord palsy
c) choanal atresia
d) vocal cord nodules

39. Which of the following in regards to hypoxia is correct?

a) Hypoxic hypoxia occurs at low altitudes
b) Stagnant hypoxia may result from reduced Hb in the blood
c) Anemic hypoxia can occur in carbon monoxide exposure
d) Histotoxic hypoxia occurs in cyanide poisoning

40. Which of the following cells produce surfactant in lung alveoli?

a) Endothelial cells
b) Clara cells
c) Type I cells
d) Type II cells

41. When the inspiratory muscles contract:

a) The diameter of the thoracic cavity increases
b) The length of the thoracic cavity increases
c) The volume of the thoracic cavity is decreased
d) The diameter and length of the thoracic cavity both increase

42. Which is incorrect with regards to pharyngeal arch development?

a) First cleft will give auditory tube
b) First cleft will give inner membrane of eardrum
c) Second cleft will give tonsillar fossa.
d) 5th cleft will give lung bud

43. What is not included in the functional unit of the respiratory system?
a) Trachea
 b) Alveoli surface
c) Capillary
d) Pulmonary ???

44. Which part of the nasal cavity that is the vomer?

a) anterior superior
b) posterior superior
c) posterior inferior
d) anterior inferior

45. Helium oxygen mixtures are more used than nitrogen oxygen mixtures (with the same
oxygen concentration) in deep sea diving because it causes
a) reduced risk of oxygen toxicity
b) reduced risk of decompression sickness
c) increased work in breathing

46. Which of the following statments about diffusion capacity of the lungs is not true?

a) It is measured with carbon monoxide as this gas diffuses very slowly through the blood
air barrier.
b) Diffusion limitation of oxygen is most likely during exercise at high altitude.
c) It is decreased due to pulmonary fibrosis which causes thickening of the blood air
barrier.
d) It decreases if one lung is removed.

47. Which of the following is not a metabolic function of the lung?

a) Removing serotonin
b) Converting angiotensin I to angiotensin II.
c) .inactivating bradykinin.
d) Production of EPO

48. Outbreak of respiratory infection in nursery. What virus is a common cause of respiratory
infection in infants?

a) Parainfluenza
b) Influenza
c) Adenovirus
d) Respiratory Syncytial virus.

49. Medical student got influenza vaccine when he was in the 1st year of the program. Now he's
in 3rd year, how frequently should he get an influenza vaccine?

a) Once daily
 b) Every 5 years
c) Every 10 years
d) Annually

OSPE

Questions 1-3 Spirometry

1. Calculate the Inspiratory Capacity

a. 3.4
b. 4
c. 2.2
d. 6

2. What is the Vital Capcity

a. 4
b. 5
c. 3
d. 6

3. What Is the Functional residual volume?

a. 4
 b. 5
c. 3.2
d. 2.8

Questions 4-8 : Vitallograph

3.5

2.5
Volume (mL)

1.5

0.5

0
0 1 2 3 4 5 6 7 8
Time (Sec)

4. What is the time at RV?

a. 3.1
b. 3
c. 4
d. 5

5. What is RV
a. 3
b. 4
c. 5
d. Cannot be calculated

6. What is FVC
a. 3
b. 2
c. 4
d. 5
Questions 9-11

Plated organism is on blood agar and sensitive to bacitran

9. One would expect to see this in a mouth containing

a. Normal flora
b. Normal flora with alpha hemolysis
c. Normal flora with beta hemolysis

10. What is the agent

a. Streptococcus Pyogens
b. Streptococcus pneumonia
c. H. Influenzae
d. Diptheria

11. What is the drug of choice to be used against this agent?

a. Cefazidine
b. Cotrimoxazolle
c. Erythromycin
d. Penicillin

Questions 12-14 Elek Test

 12. What does this test?
a. Enzyme immunoassay
b. Precipitation in gel
c. Agglutination
d. Neutrophil antigen assay

13. What is the agent?

a. Diphtheria
b. Staphylococcus aureus
c. Chlamydia
d. Pertussis

14. Property of the agent tested?

a) Toxigen Production
b) Nutrient Requirement
c) Presence of a Capsule
d) Growth on media
 15. Blood agar with positive catalase and coagulase test. What is the agent?
a. Streptococcus pyogens
b. Staphylococcus aureus
c. Streptococcus pneumonia
d. Klebisella

16. What is the agent tested below?

a. Pertussis
b. Diptheria
c. Klebsiella
d. Candida Albicans

17. Classify the gram stain shown by the agent

a. Gram negative bacilli
b. Gram negative coccobacilli
c. Gram positive coccobacilli
d. Gram positive bacilli
 18. What is the agent tested?
19. What is the drug treatment for this organism?
a. Comination of drugs for 6 months
b. Penecillin in 10 days
c. Gentamicin in 2 weeks
d. 3rd generation cephalosporin

Picture on the right is?

Picture on the left is?