Respiratory Medicine Solve Respiratory Medicine - NEXT Total Question: 65 (Updating) 1. Which of the following ions is involved in peripheral oxygen sensing chemoreceptors? Calcium Potassium Sodium Chlorine None 2. A preterm baby who was delivered at 28 weeks developed respiratory distress syndrome. Which of the following is true about surface tension and compliance in this baby? Surface tension - increased; Compliance - decreased Both surface tension and compliance decreased Surface tension - decreased; Compliance - increased Both surface tension and compliane increased None 3. Respiratory distress syndrome is due to the deficiency of Dipalmitoyl Phosphatidylcholine Phosphatidylethanolamine Phosphatidylserine Phosphatidylinosito None 4. A chronic smoker who worked in a cement factory for the past 20 years developed mesothelioma. The association is likely to be due to Silicosis Coal workers' pneumoconiosis Asbestosis Bagassosis None 5. Which of the following effects is governed by the Gibbs-Donnan effect? Chloride shift Bohr Effect Haldane Effect None of the above None 6. A 30-year-old woman with a long history of dyspnea, chronic cough with sputum, and wheezing died of respiratory failure following a bout of lobar pneumonia. She was not a smoker or an alcoholic. The lung at autopsy is shown in the image below. Which of the following is most likely to cause the pathological changes shown? Cystic fibrosis Alpha-1-antitrypsin deficiency Mutation in dynein arms Antibodies against type-IV collagen None 7. The lining epithelium of the respiratory tract of a middle-aged man who is a chronic smoker shows a change from columnar to stratified squamous epithelium, as depicted in the image below. The change is called: Metaplasia Atrophy Hypertrophy Dysplasia None 8. In which of the following conditions is oxygen therapy not useful? Acute myocardial infarction Asthma Central respiratory depression Pulmonary edema None 9. A chronic smoker was on nicotine replacement therapy and clonidine tablets for smoking de-addiction. He stopped taking clonidine tablets and now presents with a headache. What is the reason behind this condition? Postural hypotension Rebound hypertension Receptor upregulation Receptor hypersensitivity None 10. An elderly male who is a known smoker presented with chronic cough, significant weight loss, and fatigue. Serum calcium level is raised. A lung biopsy was done, and it showed large atypical cells with hyperchromasia. What is the probable diagnosis? Small cell carcinoma Large cell neuroendocrine tumor Adenocarcinoma Squamous cell carcinoma None 11. Which of the following statements about the Haldane Effect is not true? Binding of Oxygen to Hb makes it more acidic Binding of Oxygen to Hb reduces its affinity for CO2 Deoxygenated Hb binds more H+ Decrease in blood pH results in a lower affinity of Hb for oxygen None 12. A 56-year-old man was diagnosed with COVID-19 and was put on mechanical ventilation. He passed away after a week. What is the likely post-mortem change seen in the lungs? Acute and chronic alveolar hemorrhage Thick layer of fibrin lining the alveoli Pulmonary artery hypertrophy with increased resistance Perivascular cuffing None 13. A patient was transfused 4 units of blood 2 hours ago, and now she complains of chest discomfort. X-ray shows bilateral fissural thickening. Which of the following is the most probable cause? Fluid overload ABO incompatibility reactions Graft-versus-host disease Hypocalcemia None 14. A tuberculosis patient on anti-tubercular treatment presents with a tingling sensation and paresthesia in the lower limbs. He is not a diabetic and occasionally consumes alcohol. Which of the following vitamins must be supplemented to this patient? Vitamin B2 Vitamin B6 Vitamin B3 Vitamin B12 None 15. Identify the marked blue region in the given spirometry. Tidal volume Functional residual capacity Expiratory reserve volume Expiratory capacity None 16. A 70-year-old patient presented with cough, fatiguability, and weight loss. He was diagnosed with squamous cell carcinoma (SCC) on bronchoscopy. The resected specimen had a hilar lymph node that was 1cm in size and showed a black pigment. What is the black pigment likely to be? Melanin Anthracotic pigment Lipochrome Hemosiderin None 17. Functional residual capacity is: Volume that remains after forced expiration Volume expired after normal inspiration Expiratory reserve volume + residual volume Tidal volume + inspiratory reserve volume None 18. Which of the following breathing patterns does the figure on the right most accurately depict? Normal Biot's Kussmaul's Cheyne Stokes None 19. Respiratory distress syndrome is due to defective Type 1 pneumocytes Type 2 pneumocytes Alveolar capillary endothelial cells Bronchial mucosal epithelial cells None 20. What is the maximum duration for TRALI to occur after blood transfusion? 48 hours 24 hours 12 hours 6 hours None 21. Va/Q = infinity means CO2 alone equilibrates with the venous blood Partial pressure of 02 becomes zero Partial pressure of both CO2 and 02 remain normal No exchange of O2 & CO2 None 22. Which of the following neurons predominantly fire during forceful expiration? Dorsal group of neurons Ventral group of neurons Pneumotaxic center Chemoreceptors None 23. If the lung is allowed to undergo elastic recoil without the chest wall, the resultant volume of the lung would be? Functional residual capacity Zero Residual volume Minimum volume None 24. Single breath nitrogen method is used for measuring Functional Residual Capacity Dead space volume Diffusion capacity Tidal volume None 25. Determine the respiratory quotient (RQ) in a patient with 50kg body weight, if the CO2 exhaled is 200ml/min and 02 consumed is 250 ml/min. 1 0.8 1.25 1.5 None 26. All of the following cause a right shift of the oxygen-hemoglobin dissociation curve, except Acidosis Increased Fetal hemoglobin Raised 2,3 Bisphosphoglyceric acid Increased CO2 None 27. After reaching an equilibrium state during exercising, it was found that the body was consuming oxygen at the rate of 1500 ml/min. Calculate the MET score if the baseline oxygen consumption at rest is 250 ml/min. 6 5 ⅙ ⅕ None 28. The extracellular concentration of chloride is 100mmol/L and the intracellular concentration is 10 mmol/L. What is the equilibrium potential of chloride? -10 mV +10 mV -60 mV +60 mV None 29. Sodium iodide symporter is present in all of the following except: Placenta Thyroid gland Salivary gland Pituitary gland None 30. 2,3-Bisphosphoglycerate causes the unloading of oxygen to tissues by Decreasing ATP production Binding to the beta subunit of Hb Inhibiting a taut structure Increasing ATP production None 31. What does the zero pressure indicate in the pressure-volume curve? Functional residual capacity Residual volume Inspiratory reserve volume Tidal volume None 32. Which among the following organs has the least arteriovenous oxygen difference? Kidney Brain Liver Skin None 33. The graph below shows oxygen dissociation curves. What does the curve marked as '1' indicate? Methemoglobin Carboxyhemoglobinemia Fetal hemoglobin Myoglobin None 34. The parents notice that their child is tired and that he has shortness of breath on climbing stairs and while lying down. What is the first investigation that you would do? Chest x-ray Echocardiogram Spirometry MRI to rule out enlarged heart None 35. If the pH is reduced from 7.4 to 7.3 with the PO2 being constant at 100 mmHg, which line would PCO2 follow? B C D A None 36. What dose of epinephrine is used in anaphylactic shock? 1:10000 I.V - 10 ml 1:1000 I.M - 0.5 ml 1:1000 I.V - 0.5 ml 1:1000 I.M - 1 ml None 37. A known asthmatic patient with fever and sore throat was prescribed an antibiotic. Two days later he presents with a maculopapular rash. Which of the following drugs might have caused this? Fexofenadine Salbutamol Prednisolone Amoxicillin None 38. The response on stimulation of muscarinic receptor is: Ejaculation Erection Increased myocardial contractility Bronchodilation None 39. What is the mechanism of action of remdesevir? RNA-dependent RNA polymerase inhibition RNA-dependent DNA polymerase inhibition Entry inhibition Fusion inhibition None 40. A 60-year-old man was brought to the hospital with complaints of dizziness and breathlessness. During his physical examination, you notice the following discoloration over his face. He is presently being treated with amiodarone, metoprolol, verapamil, lisinopril, and amlodipine. Which of the following drugs is most likely responsible? Amlodipine Amiodarone Verapamil Metoprolol None 41. Which of the following is the most effective drug in smoking cessation? Buspirone SR Varenicline Rimonabant Nicotine gum None 42. A patient was diagnosed with pulmonary tuberculosis and was started on first-line antitubercular drugs. Which of the following drug acts by inhibiting the synthesis of mycolic acid layer? Rifampicin Isoniazid Pyrazinamide Ethambutol None 43. A 62-year-old HIV-positive man presented with fever and breathlessness for 2 weeks. Imaging shows dense infiltration in the lower lobe and the lung biopsy showed the following finding. What is the diagnosis? CMV-associated organizing pneumonia Cryptococcal pneumonia Small-cell lung cancer Tuberculosis None 44. A patient working in a factory presented with lung fibrosis and thickening of pleura. Biopsy was done. Diagnosis from the histopathology picture is: Asbestosis Silicosis Tuberculosis Mesothelioma None 45. A person working in an industry for a long time developed progressive breathlessness. The histopathological image of his lung biopsy is given below. What industry was he most likely working in? Coal dust Silica Cotton Asbestos None 46. A chronic smoker with a smoking history of 24 packs presents with breathlessness and chest pain. Further investigations revealed the presence of a lung tumor. On staining, cells are positive for chromogranin. What is the diagnosis? Squamous cell carcinoma Small cell carcinoma Large cell carcinoma Adenocarcinoma None 47. A 60-year-old woman presents with complaints of fatigue and dyspnea for 2 weeks. On examination, pallor was seen and hemoglobin was found to be 6 gm/dL. That finding will be seen on the peripheral smear? Target cell Microcytic hypochromic cells Poikilocytes Macrocytic cells None 48. A patient complained of fever with chills. A throat examination reveals swollen glands and a thick, whitish membrane over his tonsils. Albert staining is to be done. What are the constituents of Albert's stain? Carbol fuschin and methylene blue Toluidine and methylene blue Toluidine and malachite green Carbol fuschin and malachite green None 49. A hospital has reported an outbreak of MRSA infection. On investigation, it was found that a staff nurse had nasal carriage of MRSA. Which of the following drugs helps in the removal of colonization of bacteria? Topical mupirocin Inhaled colistin Inj. cephalosporin Oral vancomycin None 50. A hospital has reported an outbreak of MRSA infection. On investigation, it was found that a staff nurse had nasal carriage of MRSA. Which of the following drugs helps in the removal of colonization of bacteria? Topical mupirocin Inhaled colistin Inj. cephalosporin Oral vancomycin None 51. Which cell is involved in type 4/delayed type hypersensitivity? Neutrophil Cytotoxic T cell Macrophage Dendritic cell None 52. A 6-year-old boy complains of cough and throat pain. On examination of the oral cavity, a white pseudomembrane was visualized. A swab was taken from it and stained as given in the image below. What is the procedure for the following staining? Acetone Albert's stain- I Acid Alcohol Crystal violet Carbol fuschin Methylene blue Safranin Gram's iodine 4, 8, 1, 7 1, 2, 5, 0 5, 6, 7, 8 3, 2, 4, 1 None 53. A 40-year-old male chronic smoker presents to the AIIMS OPD with fever, fatigue, yellow-colored urine, and clay-colored stools. For the past few days, he has developed an aversion to cigarette smoking. On examination icterus was present. What investigations would you advise to rule out acute viral hepatitis? Liver function test results are given below: Total Bilirubin - 18.5 Direct Bilirubin - 7.5 SGOT - 723 SGPT 812 AntiHAV, HBsAg, IgM antiHBc, AntiHCV HBsAg, IgM antiHBC, AntiHCV, AntiHEV HBsAg, IgM antiHBc, AntiHDV, AntiHCV, Anti HEV AntiHAV, IgM antiHBc, AntiHCV, AntiHEV None 54. What is the most likely causative organism of ventilator-associated pneumonia among the following? Klebsiella Clostridium Hemophilus Acinetobacter None 55. What is the most common pulmonary manifestation of SLE? Pleuritis Shrinking lung syndrome Intra alveolar hemorrhage Interstitial inflammation None 56. All of the following characteristics are found in the pleural effusion fluid of a rheumatoid arthritis patient except: High glucose RA factor Cholesterol crystals High LDH None 57. An intubated patient in the ICU had a chest X-ray taken to evaluate for fever spikes over the last 24-48 hours. The radiograph is shown below. What is the next best step in the management of this patient? Chest physiotherapy twice daily Suction the ET tube Start antibiotics and send samples for culture Ultrasound-guided aspiration None 58. A 35-year-old female patient with class Il pulmonary hypertension presents with a negative vasoreactivity test. Which of the following is used in the next step of management? Ambrisentan Iloprost Epoprostenol Nifedipine None 59. A chronic smoker presented with shortness of breath, bilateral pitting pedal edema, and abdominal distension. On examination, jugular venous pulse was found to be elevated and liver was palpable 8 cm below the costal margin. An abnormality in which of the following structures is responsible for the patient's symptoms? 1. Right Atrium2. Right Ventricle3. Left Atrium4. Left Ventricle 1 2 3 4 None 60. During the discharge of a COVID patient who was treated with steroids and remdesivir, which of the following will you inform him about? Repeat RT-PCR after 7 days of discharge Watch for the persistence of Anosmia Watch for Headache and nasal discharge Monitor glucose levels Watch for Sinusitis like symptoms 2, 3 and 4 1, 3 and 4 1, 2, 3, 4 and 5 3, 4 and 5 None 61. The patient has a fever, cough, and cold. The chest x-ray is given below. What will be the examination finding in the infrascapular region? Coarse crackles Hyperresonance on percussion Stridor Dull note on percussion None 62. A 65-year-old female patient weighing 60 kg is on mechanical ventilation for ARDS secondary to urosepsis. The respiratory parameters are as follows: tidal volume- 360 mL; frequency-30 breaths/min; PEEP-5 cm of H20; and FiO2-90%. The arterial blood gas findings are as follows: pa02- 50 mmHg; paCO2- 38 mmHg; and pH-7.38. What is the next step? Increase tidal volume Reduce FiO2 Increase PEEP Increase respiratory rate None 63. A patient, who is a known case of HIV with a CD4 count of 200 cells/cu.mm, presents with 5 days of cough and high-grade fever without chills and rigors. There is no history of diarrhea, vomiting, or nuchal rigidity. Chest x-ray is normal. What treatment will you give? Amoxicillin-clavulanic acid + Azithromycin Co-trimoxazole + steroids Co-trimoxazole only Antitubercular treatment None 64. A 25-year-old patient with a respiratory volume of 500 mL. The intrapleural pressure measured -4 before inspiration and -8 at the end of inspiration. The pulmonary compliance of the patient will be 150 ml/cm H20 50 ml/cm H2O 125 ml/cm H2O 62.5 ml/cm H2O None 65. What is the oxygen-carrying capacity of a 16-year-old boy with hemoglobin of 14g/dl? 16 22 18 14 None 1 out of 65 Time's up
