Questions - Pneumology and phthisiology

1. Multidrug-resistant tuberculosis is known as resistance to:

a) rifampicin + etambutol+ streptomycine

b) isoniazid + streptomycine

c) rifampicin + isoniazid + PAS

d) streptomycine + rifampicine + etambutol

2. Mycobacterium tuberculosis was discovered in:

a) 1990

b) 1890

c) 1882

d) 2000

3.Which risk factors are applied in the development of carcinoma of the lung ?

a) professional pollutants

b)tobacco smoking

c)scars after overcoming lung infections

d) interaction of multiple risk factors, especially tobacco smoking

4. Tobacco smoking is important risk factor for the following types of lung cancer:

a) adenocarcinoma

b) large cell carcinoma

c) for all types

d) especially for squamous cell and small cell carcinoma

5.Which of the symptoms will be manifested at first in case of lung carcinoma?

a)dry irritating cough

b)dyspnea

c) chest pain

d)hemoptysis

6. Which two tests are the most important before starting the therapy in lung cancer patients?

a) bronchoscopic examination with brushing of a lesion for cytologic and/or histologic examination and chest CT

b)ultrasonography and chest CT

c) PET and bronchoscopy

d) chest X-ray and chest CT

7. What examination weshould be decided in case of localized peripheral lung cancer?

a) video-assisted thoracoscopy (VATS)

b) pleural puncture

c) bronchoscopy

d) chest CT

8. What is a paraneoplastic syndrome?

a)manifestation is caused by direct invasion of the tumor

b) manifestation is caused by direct invasion of the metastases

c) reaction to the presence of tumor

d) right is a and b too

9. Which is an essential therapeutic modality in the treatment of small cell carcinoma of the lung (small cell lung carcinoma-SCLC) ?

a) lung resection

b)chemotherapy and radiotherapy

b) biological treatment

c) symptomatic treatment

10. In which morphological type is indicated prophylactic cranial irradiation?

a) in complete remission of SCLC after chemotherapy

b) non-SCLC - IV. stage

c) non-SCLC -I.stage

d) end stage of SCLC

11. What is the sensitivity in SCLC to chemotherapy and radiotherapy?

a) chemosensitive and radio-resistant

b)chemoresistant and radio-resistant

c) chemosensitive and radio-sensitive

d) chemoresistant and radio-sensitive

12. Which therapeutic modality is applied first in non-SCLC in stage I.II.IIa. ?

a) lung resection

b) biological treatment

c) chemotherapy

d) chemotherapy and radiotherapy

13. What is Meig´s syndrome?

a)pleural effusion and ascites with benign ovarian fibroma

b)pleural effusion in breast tumor

c) pleural effusion in lung cancer

d)pleural effusion in the cardiac decompensation

14. USG examination of the pleural cavity reveals effusions in case ?

a) empyema thoracis

b) greater than 500ml

c) smaller than 300 ml

d) all

15. Before drainage of suspected thoracic empyema isnecessary:

a) chest X-ray

b) PET examination

c) chest X-ray, chest CT, chest sonography

d) physical examination of the chest – percussion, auscultation

16. What is therapeutic approach in case of confirmed thoracic empyema?

a) broad spectrum antibiotics and flushing the cavity through the drain

b) weapply broad spectrum antibiotics

c) only drainage without antibiotic coverage

d) choose surgery

17. Which pneumothorax is particularly dangerous ?

a) pallial

b) valve

c) open

d) iatrogenic

18. Is the aetiology of sarcoidosis is clarified ?

a) not clear

b) disease hascancer etiology

c) disease is caused by Mycobacterium tuberculosis

d) regards environmental disease

19. Which organs are affected in sarcoidosis?

a) only lungs and lymph nodes

b) lung, skin, eyes, bones, CNS, but also other organs

c) only lymph nodes

d) affects only the eyes

20. When is applied pharmacological therapy in patients with sarcoidosis?

a) even in case of small signs

b) we treat patients with hilar lymphadenopathy

c) treatment beginsas soon as the disease is confirmed

d) treat patients with impaired lung function

21. External respiration involves:

a) ventilation (exchange between ambient air and alveolar spaces)

b) diffusion through the alveolo-capillary membrane

c)lung perfusion

d) all of these processes

22. Static lung volumes and capacities are:

a)vital capacity (VC), total lung capacity (TLC)

b) forced expiratory volume in 1st second (FEV1)

c) diffusion capacity of the lung (DL)

d) forced expiratory volume in the first third seconds (FEV3)

23. FEV1/VC determines whether the patient has:

a) restrictive ventilatory defect

b) obstructive ventilatory disease

c) impairment of lung perfusion

d) does not inform about ventilation

24. Obstructive diseases of the respiratory tract include?

a) silicosis

b) pneumonias

c) bronchial asthma

d) cryptogenic fibrosing alveolitis

25.Restrictive ventilation disorders arise in:

a) myasthenia gravis

b) pneumonias

c) kyphoscoliosis

d) all of the above

26. Hypoxemia is caused by:

a) decreased tension of oxygen in the inspired air

b) hypoventilation and shunt

c) ventilation-perfusion imbalance

d) all of the above

27. When we can identify obstructive ventilatory defect?

a) VC is < 80% of reference value

b) FEV1/VC is< 65%

c) FEV1/VC is 80% to 90%

d) diffusion capacity is < 70% of reference value

28. Risk factors for chronic obstructive pulmonary disease are:

a) tobacco smoking

b) some environmental and professional exposures

c) alpha 1 – trypsin deficiency

d) all of the above

29. Main clinical symptoms of COPD are :

a) dyspnea induced by exercise and expectoration

b) chest pain

c) interrupted sleep

d) sore throat

30. Which of the following bronchodilator drug has 12-hour effect?

a) salmeterol

b) salbutamol

c) terbutalin

d) fenoterol

31. Most effective way to stop the progression of COPD is for cigarettes smokers is:

a) bronchodilator therapy

b) mucolytic therapy

c) influenza vaccination against flu or pneumococcal infection

d) quit smoking

32. Which of the following lung disease has the worst prognosis?

a) hypersensitivity pneumonitis

b) systematic sclerosis

c) cryptogenic fibrosing alveolitis

d) rheumatoid arthritis

33.The most effective therapy for asthma is application of:

a) combination oflong-acting β2 – agonists and inhaled glucocorticoids

b)methylxynthines and mucolytics

c) antibiotics and anticholinergic agents

d) cromolyn, nedocromil and anticholinergics

34. Pacient with newly detected positive tuberculosisis treated with administration of antituberculousdrugs:

a) atleast 1 month

b) 6-8 month

c) > 12 month

d) > 18 month

35. Obstructive sleep apneoa syndrome is defined as aoccurance of 10-second apnea pause in 1 hour during sleep at least

a) 3 times

b) 5 times

c) 8 times

d) 10 times

36. Diagnose of the asthma involves

a) history of episodic wheezing, cough, dyspnea

b) wheezing

c) reversible airway obstruction which was documented by pulmonary function tests

d) all of the above

37. Reversible airway obstruction can be demonstrated after administration of the effective bronchodilator or after 7 -10 days applications of glucocorticoids by:

a) improvement in forced expiratory volume in 1st second (FEV1) > 15% compared to reference value

b) improvement in forced expiratory volume in1st second (FEV1)> 15% compared to baseline value

c) improvement in forced expiratory volume1st second (FEV1) > 10% compared with the reference value

d) increase in vital capacity of 15% compared to baseline value

38. Clinical application of pulse oximetry has the following advantages:

a) reveals hyperoxia

b) does not requires arterial puncture and allows continuous monitor hemoglobin saturation oxygen

c) provides information on CO2 elimination

d) provides information about the acid-base balance

39.The most frequent stimuli inducing bronchoconstriction in asthmatic patients are:

a) inhaled allergens and inhaled irritants

b) respiratory infections

c) load

d) all of the above

40. Normal static and dynamic lung volumes depend on the patient´s:

a) height

b) age

c) gender

d) all listed above

41. Normal partial pressure of O2 in arterial blood (PaO2 ) depending on the age and altitude that are within the range:

a) 11,3 -13,3 kPa( 85-100 mmHg)

b) 9,31-10,6 kPa (70-80 mmHg)

c) 9,3 -8,0 kPa (70-60 mmHg)

d) 8,0-6,7 kPa (60-50 mmHg)

42.Hypoxemic respiratory failure without hypercapnia is when PaO2 at the breathing of atmospheric air at see level:

a)< 11,3 kPa (100 mmHg)

b) < 10,6 kPa (80 mmHg)

c) < 10, 0 kPa (75 mmHg)

d) <8,0 kPa(60 mmHg)

43. Hypercapnic respiratory insufficiency is diagnosed when:

a) PaCO2 > 5,3 kPa (40 mmHg) PaO2: 8,0 kPa (60 mmHg)

b) PaCO2 > 5,9 kPa (43 mmHg) PaO2: 8,0 kPa (60 mmHg)

c) PaCO2 > 6,0 kPa (45 mmHg) PaO2: 8,0 kPa (60mmHg)

d) PaCO2 > 6,7 kPa (50 mmHg) PaO2: 8,0 kPa (60mmHg)

44. Restrictive ventilatory defect is considered when:

a) VC, TLC < 80% of reference value

b) FEV1/VC < 90% of reference value

c) inspiratory reserve volume (IRV) > 80% of reference value

d) RV> 80% of reference value

45. Restrictive ventilatory defect occurs in these disease processes :

a) bronchial asthma

b) after lung resection

c) chronic obstructive pulmonary disease

d) bronchiectasis, cystic fibrosis

46.Diffusion lung capacity is in normal range for the following diseases:

a) emphysema

b) bronchial asthma

c) interstitial lung disease

d) pulmonary vascular disease

47. Sample for investigation of arterial blood gas is obtained by puncturing:

a)a.radialis

b) a.femoralis

c) „arterialization“ of capillary blood from fingertip, ear lobe

d) all of the above

48.Lung biopsy specimens canbe received by:

a) flexible bronchoscopy

b) percutaneous needle aspiration and/or biopsy

c) video-thoracoscopy and opensurgical procedure

d) all of the above

49. Lung functiontests provide information about:

a) ventilation alveolar spaces

b) gas diffusion

c) blood oxygenation

d) all of the above

50. Which static and dynamic lung volumes and capacities cannotbe measured by spirometry and other methods are required( plethysmografy, dilutionofhelium,nitrogenwashoutby oxygen):

a )vitalcapacity (VC)

b) residual volume (RV), functionalresidualcapacity (FRC)

c) inspiratoryreserve volume (IRV)

d) expiratory reserve volume (ERV)

51. Criterion of airway obstruction is achange ofindicator when:

a) VC < 80% of reference value

b) TLC < 85% of reference value

c) FEV1/VC< 90% of reference value or <70-75% of absolute value

d) RV > 125% of reference value

52. Conventional chest radiographs are necessery in 2 projections: posterior-anterior and lateral for theaim:

a) detection of disease severity

b) determination of disease progression

c) localization of pathologic finding

d) aetiologic determination of process

53. Flexiblebronchoscopy helps:

a) visualization of the airways

b) obtaining samples for microbiological, cytological, histological examination

c) sunction of the secretions

d) all the above

54. Tracheobronchial secretions can be obtained by:

a) expectoration of sputum

b) transtracheal puncture and aspiration

c) flexibile bronchoscopy

d) all of the above

55. Clubbing occurs at following respiratory diseases:

a) interstitial pulmonary diseases

b) lung cancer (or mesothelioma of pleura)

c) chronic pulmonary infection

d) in all above diseases

56. Chronic obstructive pulmonary disease (COPD) is adisorder of the respiratory system with impairment of expiratory flow and has symptoms:

a) chronic bronchitis

b) emphysema

c) chronic bronchitis and emphysema

d) any not listed above

57. Clinical symptoms and signs of respiratory insufficiency canbe:

a) dyspnea after small exercise, speaking, dressing

b) headache, sleepiness (inverse sleep), agitation, disorder of consciousness, fatigue

c) disorders of consciousness, unconsciousness, tachycardia, heart arhytmia

d) all of the above

58. Löffler ´s syndrome is

a) migratory pulmonary infiltrates with eosinophilia

b) migratory lung infiltrates without eosinophilia

c) pneumonia not requiring therapy

d) bronchial asthma with vasculitis

59. Exudative pleural effusionis usually caused by:

a) left heart failure

b) inflammation (tuberculosis or other bacterial infectins)

c) liver cirhosis

d)nephrotic syndrome

60. Tobacco smoking is the most evident risk factorfor:

a) 15 respiratory and cardiovascular disease

b) 30 respiratory and cardiovascular disease

c) 40respiratory and otherdisease

d) 50 diseases of the human body