I n t e r n a L medicine questions Bank

All of the following statements are true regarding avian influenza except :

1. 
   H5N1 is the killing type.
   
2. 
   The mortality rate is around 50% .
   
3. 
   Tamiflu is an effective treatment if given early.
   
4. 
   Spread from human to human was documented in some cases. e - R-t PCR is a specific test for the disease .
   

11. 
    In patients with idiopathic pulmonary fibrosis (usual interstitial pneumonia) all of the followings are expected physiological changes except :
    

6. 
   Low DLCO .
   
7. 
   Decreased FEV1/FVC .
   
8. 
   Severe O2 desaturation on exercise.
   
9. 
   Reduced vital capacity and total lung capacity .
   
10. 
    Increased pulmonary artery pressure .
    

11. 
    Broncuiolitis obliterans characterized by all of the following conditions except a- Obstructive changes by spirometry .
    

b Can complicate bone marrow transplant . c- Good response to systemic corticosteroid .

4. 
   HRCT scan of the chest typically shows mosaic appearance of air trapping . e- Transbronchial lung biopsy is in adequate for the diagnosis in most of cases .
   

11. 
    All of the followings may improve obstructive sleep apnea except : a- Dental extraction .
    

2. 
   Weight Reduction .
   
3. 
   Decrease alcohol consumption . d- Nasal CPAP
   

e- Tracheostomy .

11. 
    Nasl CPAP/BiPAP can be used to treate all of the following conditions except :
    

1. 
   Myasthnia gravis
   
2. 
   Acute pulmonary edema . c- Obstructive sleep apnea .
   
3. 
   Respiratory failure due to severe kyphoscoliosis . e- Narcolepsy .
   

11. 
    All of the following statement regarding lung cancer are true except :
    

6. 
   Smoking is a known risk factor for all types of bronchogenic carcinoma .
   
7. 
   Adenocarcinoma usually is a peripheral lung tumor .
   
8. 
   Adenocarcinoma in some cases is difficult to be differentiated from mesothelioma .
   
9. 
   Thromboembolic disease can be the first manifestation of the disease.
   
10. 
    Surgery can be curative for early diagnosed cases .
    

14. 
    ONE of the following drugs is LEAST used in treatment of acute sever asthma. a- nebulized B2 agonist
    

2. 
   i.v hydrocortisone
   
3. 
   epinephrine (adrenaline) d- oxygen
   

e- i.v . aminophylline

14. 
    Hypoxia (decreased PaO2) and decreased Pa CO2 is found in all the following Except. a- left ventricular failure
    

b- massive pulmonary embolism c- acute sever asthma
d- acute exacerbation of COPD e- pneumonia

ONE of the following drugs is most appropriate in treatment of pneumocystis carinii pneumonia. a- clarithromycin

2. 
   ethambutol
   
3. 
   azithromycin
   
4. 
   Trimethoprim-Sulphamethoxazole e- INH and rifampicine
   

27. 
    All the following are true about Bronchiectasis Except. a- chronic cough with whitish sputum.
    

2. 
   May be caused by cystic fibrosis
   
3. 
   Clubbing of fingers d- Hemoptysis
   

e- Bronchial dilation and wall thicking is shown by high resolution chest CT scan.

27. 
    All the following are true about sarcoidosis Except. a- raised serum level of angiotensin converting enzymes b- Negative tubercline skin test
    

c- Normochromic normocytic anemia d- Hypercalcemia
e- Pulmonary caseating granuloma
37.ONE of the following statements is true about treatment of pulmonary tuberculosis. a- pyrazinamide may precipitate hyperurecmic gout.

2. 
   INH can cause optic neuritis
   
3. 
   renal impairment with rifampicine
   
4. 
   streptomycin is causing reversible damage to vestibular nerve e- hepatitis is usually caused by ehambutol
   

51. 20-year old woman presents with a week history of fever, rigor and productive rusty cough. The chest X-ray shows left lower lobe consolidation.

Which ONE of the following is most appropriate treatment? a- clarithramycin

2. 
   gentamycin
   
3. 
   Cotrimoxazole d- Benzypenicillin e- Flucloxacillin
   

69. 
    A pleural effusion analysis results: ratio of concentration of total protein in pleural fluid to serum of 0. 38 , latate dehydrogenase LDH level of 125 IU, and ratio of LDH in pleural fluid to serum of 0. 45.
    

Which of the following ONE disease is the most likely the cause for this pleural effusion. a- uremia

2. 
   pulmonary embolism
   
3. 
   sarcoidosis d- SLE
   

e- Congestive heart failure

69. 
    All the following criteria indicate sever asthma Except. a- silent chest
    

b- respiratory rate of 20/ min. c- hypercapnia
d- throracoabdominal respiration e- confusion

82. Which ONE of the following Arterial Blood Gases is most likely to be found in a 60-year-old heavy smoker man, He has chronic bronchitis, peripheral odema and cyanosis?

a- PH 7.50, PO2 75, PCO2 28
b- PH 7.15, PO2 78, PCO2 92
c- PH 7.06, PO2 36, PCO2 95
d- PH 7.06, PO2 108, PCO2 13
f- PH 7.39, PO2 48, PCO2 54

87. 
    All of the following associations between conditions and mechanisms of hypoxia are true, except:
    
    1. 
       COPD and V/Q mismatch (The principal contributor to hypoxemia in COPD patients is ventilation/perfusion (V/Q) mismatch resulting from progressive airflow limitation)
       
    2. 
       ARDS and pulmonary shunt (edema in patients with ALI/ARDS is impaired gas exchange with intrapulmonary shunt,)
       
    3. 
       Multiple rib fractures and hypoventilation
       
    4. 
       Hepatopulmonary syndrome and V/Q mismatch (The hepatopulmonary syndrome is characterized by a defect in arterial oxygenation induced by pulmonary vascular dilatation in the setting of liver disease1) (Dyspnea and hypoxemia are worse in the upright position (which is called platypnea and orthodeoxia, respectively)
       
    5. 
       Motor neuron disease and hypoventilation
       

87. 
    IN patients with sarcoidosis, all of the following are associated with good prognosis, except:
    
    1. 
       Fever
       
    2. 
       Erythema nodosum
       
    3. 
       Age less than 40 years
       
    4. 
       Black race
       
    5. 
       Presence of polyarthritis
       
88. 
    Regarding the pathogenesis of bronchial asthma, one of the following is specific for the disease:Air flow limitation
    
    1. 
       Airway hyper-responsiveness
       
    2. 
       Inflammation of the mucosa
       
    3. 
       Peak flow variability
       
    4. 
       Brochioalevolar eosinophils
       
89. 
    The most common organism responsible for severe community pneumonia needing ICU care is:
    
    1. 
       Strep. pnuemonia
       
    2. 
       Legionella
       
    3. 
       H. influenza
       
    4. 
       Gram negative bacilli
       
    5. 
       Mycoplasama pneumonia
       

2. 
   Which one of the following arterial blood gas sets on room air is compatable with completely compensated metabolic acidosis?
   

	A	B	C	D	E
PH	7.44	7.38	7.60	7.36	7.56
PaC02 mmHg	26	25	25	95	40
Bicarb. MEq	18	15	24	49	34
B. Excess	-4.0	-10	+4	+15	+11