1.
Pulmonary disease is almost entirely:
Correct Answer
A. Environmental
Explanation
Pulmonary disease being almost entirely environmental means that the development and occurrence of these diseases are mainly influenced by external factors such as air pollution, smoking, occupational hazards, and exposure to certain substances. Genetic factors may play a role in some cases, but the majority of pulmonary diseases are caused by environmental factors rather than inherited traits or genetic predisposition.
2.
Gas exchange depends on:
Correct Answer
A. Compliance (stretchability) of the lungs
Explanation
Gas exchange in the lungs depends on the compliance or stretchability of the lungs. Compliance refers to the ability of the lungs to expand and contract easily. When the lungs are compliant, they can easily fill with air during inhalation and expel air during exhalation. This allows for efficient gas exchange between the alveoli and the blood vessels in the lungs. If the lungs are not compliant, it can lead to difficulties in breathing and impaired gas exchange. Therefore, the compliance of the lungs is crucial for effective gas exchange.
3.
What is a mechanism of cyanosis?
Correct Answer
A. Perfused but not ventilated alveoli
Explanation
Cyanosis is a condition characterized by a bluish discoloration of the skin and mucous membranes, which occurs due to a decrease in the oxygen saturation of the blood. In the given options, the mechanism of cyanosis is described as "perfused but not ventilated alveoli." This means that the blood is being adequately perfused (flowing through the capillaries) but not being properly ventilated (oxygenated) in the alveoli of the lungs. This can occur in conditions such as pneumonia, where the alveoli are filled with fluid or pus, preventing proper oxygenation of the blood.
4.
What type of of genetic mutation is present in COPD?
Correct Answer
A. AlpHa 1- AT deficiency
Explanation
COPD (Chronic Obstructive Pulmonary Disease) is often associated with alpha 1-antitrypsin (AT) deficiency, which is a genetic mutation. Alpha 1-AT deficiency is an inherited condition that affects the lungs and liver, causing a deficiency in the production of a protein called alpha 1-antitrypsin. This protein helps protect the lungs from damage caused by enzymes released by white blood cells. When there is a deficiency of alpha 1-AT, these enzymes can cause damage to the lung tissue, leading to the development of COPD.
5.
If left untreated, emphysema is most likely to progress to this acid/base disturbance:
Correct Answer
C. Respiratory acidosis
Explanation
Emphysema is a chronic lung disease characterized by damage to the air sacs in the lungs, resulting in difficulty breathing. As the disease progresses, the damaged air sacs lose their elasticity, making it harder for the lungs to expel carbon dioxide. This leads to a buildup of carbon dioxide in the bloodstream, causing respiratory acidosis. In respiratory acidosis, the pH of the blood decreases, indicating an excess of carbon dioxide and a decrease in oxygen levels. Therefore, if left untreated, emphysema is most likely to progress to respiratory acidosis.
6.
What is the cause most common cause of bacterial pneumonia?
Correct Answer
D. Pneumococcal
Explanation
Pneumococcal bacteria are the most common cause of bacterial pneumonia. These bacteria can infect the lungs and cause inflammation, leading to pneumonia. Pneumococcal pneumonia can be severe, especially in young children, older adults, and individuals with weakened immune systems. It is important to note that other bacteria, such as streptococcal and staphylococcal, can also cause pneumonia, but pneumococcal bacteria are the most common.
7.
Pulmonary tuberculosis is an infection caused by inhalation of
Correct Answer
A. Mycobacterium tuberculosis
Explanation
Pulmonary tuberculosis is an infection caused by the inhalation of mycobacterium tuberculosis. This bacterium is responsible for causing tuberculosis in the lungs. It is transmitted through the air when an infected person coughs or sneezes, and then another person inhales the bacteria. Mycoplasma tuberculosis and tuberculococcus are not the correct terms for the bacteria that cause tuberculosis, hence they are not the correct answers.
8.
Which of the following characteristics will lean you towards tuberculosis diagnosis?
Correct Answer
A. Caseous necrosis
Explanation
Caseous necrosis is a characteristic feature of tuberculosis. It is a type of necrosis that results in the formation of a cheese-like, soft, and friable material in the affected tissue. In tuberculosis, caseous necrosis occurs due to the immune system's attempt to contain and destroy the mycobacteria causing the infection. The necrotic material consists of dead cells, debris, and the mycobacteria themselves. Therefore, the presence of caseous necrosis is highly suggestive of tuberculosis and can aid in the diagnosis of the disease.
9.
A lung abscess is more common in
Correct Answer
A. Right
Explanation
A lung abscess is more common in the right lung because the right lung has three lobes compared to the left lung which has only two lobes. The additional lobe in the right lung provides more surface area for infection to occur. Additionally, the right main bronchus is wider and more vertical than the left, making it easier for bacteria to enter and infect the right lung.
10.
70% of mesothelioma pts have exposure to what
Correct Answer
A. Asbestos
Explanation
Mesothelioma is a type of cancer that primarily affects the lining of the lungs, abdomen, or heart. It is strongly associated with exposure to asbestos, a mineral fiber commonly used in construction materials. Studies have shown that approximately 70% of mesothelioma patients have a history of asbestos exposure. Asbestos fibers, when inhaled or ingested, can cause chronic inflammation and scarring, leading to the development of cancerous cells over time. Other factors such as cigarette smoking, secondhand smoke, and family history may contribute to the risk of developing mesothelioma but are not as strongly linked as asbestos exposure.
11.
Which is more common
Correct Answer
A. Pulmonary metastases
Explanation
Pulmonary metastases refer to the spread of cancer from another part of the body to the lungs, whereas primary lung neoplasms are tumors that originate in the lung itself. The given answer suggests that pulmonary metastases are more common than primary lung neoplasms. This could be because cancer often spreads to the lungs from other organs, such as breast, colon, or prostate, making pulmonary metastases more prevalent. On the other hand, primary lung neoplasms are less common as they only originate within the lung tissue.
12.
Which of the following are considered first-line drugs for TB?
Correct Answer
B. Ethambutol and isoniazid
Explanation
Ethambutol and isoniazid are considered first-line drugs for TB because they are commonly used as the initial treatment for tuberculosis. Ethambutol is effective against actively growing bacteria, while isoniazid is effective against both actively growing and dormant bacteria. These drugs are often used in combination with other first-line drugs, such as rifampin and pyrazinamide, to ensure effective treatment and prevent the development of drug resistance.
13.
Difficulty breathing, unilateral stabbing chest pain and a productive cough is most suggestive of...
Correct Answer
A. Pneumonia
Explanation
Difficulty breathing, unilateral stabbing chest pain, and a productive cough are classic symptoms of pneumonia. Pneumonia is an infection that causes inflammation in the lungs, leading to symptoms such as shortness of breath, chest pain, and coughing up phlegm. These symptoms are not typically associated with myocardial infarction (heart attack), asthma exacerbation, or COPD (chronic obstructive pulmonary disease). Therefore, pneumonia is the most likely explanation for the given symptoms.
14.
Which of the following is used to stage the severity of COPD
Correct Answer
A. FEV1
Explanation
FEV1 (Forced Expiratory Volume in 1 second) is used to stage the severity of COPD (Chronic Obstructive Pulmonary Disease). FEV1 measures the amount of air a person can forcefully exhale in one second after taking a deep breath. In COPD, the airways become narrowed, making it difficult to exhale fully. The FEV1 value is used to determine the severity of airflow limitation and classify COPD into different stages, such as mild, moderate, severe, or very severe. A lower FEV1 value indicates more severe airflow limitation and a higher stage of COPD.
15.
Which of the following would be normal in a restrictive condition?
Correct Answer
A. FEV1/FVC
Explanation
FEV1/FVC would be normal in a restrictive condition because in restrictive lung diseases, such as pulmonary fibrosis or chest wall deformities, the lung tissue becomes stiff and less compliant, leading to a decrease in both FEV1 (forced expiratory volume in 1 second) and FVC (forced vital capacity). However, the ratio of FEV1 to FVC remains normal or even increased because both values decrease proportionally. Therefore, a normal FEV1/FVC ratio is indicative of a restrictive lung condition.
16.
Which of the following is NOT an obstructive condition?
Correct Answer
A. Fibrosis
Explanation
Fibrosis is not an obstructive condition because it refers to the formation of excess fibrous connective tissue in an organ or tissue, which can result in scarring and impaired function. However, it does not directly obstruct the airways or restrict airflow, which is characteristic of obstructive conditions such as asthma, COPD, and bronchiectasis. These conditions involve inflammation, narrowing, and obstruction of the airways, leading to difficulty in breathing.
17.
Wheezing is the hallmark symptom of
Correct Answer
A. Asthma
Explanation
Wheezing is a characteristic symptom of asthma. Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to difficulty in breathing. Wheezing occurs when the airways become narrowed and constricted, resulting in a high-pitched whistling sound during exhalation. While wheezing can also occur in other respiratory conditions like COPD, cystic fibrosis, and lung cancer, it is considered the hallmark symptom of asthma due to its consistent presence in asthma patients.
18.
Consolidation on a chest XRay most likely points to
Correct Answer
A. Pneumonia
Explanation
Consolidation on a chest X-ray refers to an area in the lung that appears denser or more solid than the surrounding lung tissue. This can be caused by various conditions, but pneumonia is the most likely explanation in this case. Pneumonia is an infection that causes inflammation and fluid buildup in the air sacs of the lungs, leading to consolidation. COPD, asthma, and lung cancer may also cause changes on a chest X-ray, but pneumonia is the most common cause of consolidation.
19.
Tree in bud findings and cysts on a high resolution chest CT scan are indicative of
Correct Answer
A. Bronchietasis
Explanation
Tree in bud findings and cysts on a high resolution chest CT scan are commonly seen in patients with bronchiectasis. Bronchiectasis is a chronic condition characterized by the permanent dilation of the bronchi, leading to recurrent infections and inflammation. The tree in bud appearance refers to the presence of small branching opacities, representing dilated and impacted bronchioles filled with mucus and inflammatory debris. These findings are not typically associated with COPD, asthma, or lung cancer.
20.
A pneumothorax refers to
Correct Answer
A. A collection of air in the pleural cavity of the chest
Explanation
A pneumothorax refers to a collection of air in the pleural cavity of the chest. This condition occurs when air leaks into the space between the lung and the chest wall, causing the lung to collapse partially or completely. It can be caused by trauma, lung diseases, or medical procedures. Symptoms may include sudden chest pain, shortness of breath, and decreased breath sounds. Treatment options include removing the air from the pleural cavity and addressing the underlying cause of the pneumothorax.
21.
Which of the following is NOT true about mesothelioma?
Correct Answer
A. It is associated with smoking
Explanation
Mesothelioma is a form of cancer that affects the lining of the lungs, abdomen, or heart. It is primarily caused by exposure to asbestos and is not associated with smoking. Smoking is a risk factor for other types of lung cancer, but it is not a risk factor for mesothelioma.
22.
Intracranial pressure is the pressure of: (3)
Correct Answer(s)
A. Brain
B. Cerebrospinal fluid
C. Brain's blood supply
Explanation
The correct answer is brain, cerebrospinal fluid, and brain's blood supply. Intracranial pressure refers to the pressure exerted inside the skull. It is primarily determined by the brain, which occupies most of the intracranial space. Cerebrospinal fluid, a clear fluid that surrounds and cushions the brain and spinal cord, also contributes to intracranial pressure. Additionally, the brain's blood supply, which includes the arteries and veins that deliver oxygen and nutrients, can affect intracranial pressure.
23.
What ICP value will cause fatality if prolonged
Correct Answer
A. 25-30
Explanation
Prolonged ICP (Intracranial Pressure) values ranging from 25-30 can lead to fatality. This suggests that if the pressure within the skull, specifically in the brain, remains elevated within this range for an extended period, it can result in fatal consequences. It is important to monitor and manage ICP levels to prevent severe complications and potential fatalities.
24.
What is the most common cause of elevated ICP?
Correct Answer
A. The brain swells
Explanation
The most common cause of elevated ICP is when the brain swells. When the brain experiences inflammation or injury, it can lead to an increase in intracranial pressure. This can occur due to various reasons such as trauma, infection, tumors, or certain medical conditions. When the brain swells, it takes up more space within the skull, leading to an increase in pressure. This can be a serious condition that requires immediate medical attention to prevent further damage to the brain.
25.
How would you diagnose elevated ICP if pt is markedly obese
Correct Answer
A. CT scan
Explanation
CT scan is the correct answer because it is a non-invasive imaging technique that can provide detailed images of the brain and help diagnose elevated intracranial pressure (ICP). It is particularly suitable for a markedly obese patient as it does not require the patient to fit into a confined space, unlike an MRI. CT scan can quickly detect any abnormalities or signs of increased pressure within the brain, such as swelling or bleeding. Lumbar puncture may not be suitable for an obese patient due to technical difficulties, and brain scan ultrasound may not provide sufficient detail for an accurate diagnosis.
26.
Lumbar puncture 18 g needle is inserted where
Correct Answer
A. L4-L5
Explanation
The lumbar puncture procedure involves inserting a needle into the spinal canal to collect cerebrospinal fluid for diagnostic purposes. The needle is typically inserted between the lumbar vertebrae, which are numbered from L1 to L5. In this case, the correct answer is L4-L5, indicating that the needle is inserted between the fourth and fifth lumbar vertebrae.
27.
What is a normal opening pressure for lumbar puncture
Correct Answer
A. 60-80 mm of H20
Explanation
The normal opening pressure for a lumbar puncture is typically between 60-80 mm of H20. This range is considered normal and indicates a healthy cerebrospinal fluid pressure in the spinal column.
28.
What is a borderline elevated opening pressure of lumbar puncture
Correct Answer
A. 180-210 mm of H20
Explanation
The correct answer is 180-210 mm of H20. This range represents the borderline elevated opening pressure of a lumbar puncture. Lumbar puncture is a procedure used to measure the pressure of cerebrospinal fluid in the spinal canal. An opening pressure above 180 mm of H20 is considered borderline elevated, indicating increased pressure within the central nervous system. This may be a sign of conditions such as meningitis, intracranial hypertension, or brain tumor.
29.
When will you need to surgically decompress an elevated ICP?
Correct Answer
A. High risk of herniation
Explanation
High risk of herniation is a condition where there is increased pressure inside the skull, known as intracranial pressure (ICP), which poses a risk of the brain tissue being forced out of its normal position. Surgically decompressing an elevated ICP is necessary in this situation to relieve the pressure and prevent herniation, which can lead to severe brain damage or death. This procedure involves removing a portion of the skull to allow the brain to expand and reduce the pressure inside the skull.
30.
________ is the most common cause of intracerebral hemmorhage
Correct Answer
hypertension
Explanation
Hypertension, or high blood pressure, is the most common cause of intracerebral hemorrhage. When blood pressure is consistently high, it can weaken the blood vessels in the brain, making them more susceptible to rupture and causing bleeding within the brain tissue. This can lead to a sudden and severe form of stroke known as intracerebral hemorrhage. Therefore, hypertension is the most likely underlying cause of this condition.
31.
What is an unmodifiable risk factor of stroke
Correct Answer
A. Low birth weight
Explanation
Low birth weight is an unmodifiable risk factor for stroke because it is a characteristic that a person is born with and cannot be changed. Low birth weight refers to babies who weigh less than 5.5 pounds at birth, and it has been associated with an increased risk of developing various health conditions later in life, including stroke. Factors such as genetics and prenatal conditions can contribute to low birth weight, making it unmodifiable.
32.
Stroke symptoms are:
Correct Answer
A. Sudden
Explanation
The answer "sudden" is correct because stroke symptoms typically occur suddenly and without warning. Unlike other medical conditions that may have delayed or gradual symptoms, a stroke often presents with a sudden onset of symptoms such as weakness or numbness on one side of the body, difficulty speaking or understanding speech, and severe headache. It is important to recognize these sudden symptoms and seek immediate medical attention as prompt treatment can greatly improve the outcome for individuals experiencing a stroke.
33.
What are pathologies where anti-coagulants need to be avoided
Correct Answer
A. Alcoholics
Explanation
Alcoholics are at a higher risk of bleeding due to liver damage and impaired blood clotting mechanisms. Therefore, anti-coagulants should be avoided in alcoholics to prevent further bleeding complications.
34.
What is the cause of concussions
Correct Answer
A. Shearing of axons
Explanation
Concussions are typically caused by the shearing of axons, which are the long, slender projections of nerve cells that transmit electrical impulses. When the head experiences a sudden impact or acceleration/deceleration, the brain can move within the skull, causing the axons to stretch or tear. This disruption in the normal functioning of axons can lead to various symptoms associated with concussions, such as headaches, dizziness, confusion, and memory problems. Shearing of brain vessels, structural lesions, and hemorrhages can also occur as a result of a concussion, but the primary cause is the shearing of axons.
35.
Most serious complication of head injury:
Correct Answer
A. Epidural hematoma
Explanation
An epidural hematoma is the most serious complication of a head injury. It occurs when there is bleeding between the skull and the outermost layer of the brain, known as the dura mater. This bleeding can result in the buildup of blood, causing increased pressure on the brain. If not promptly treated, an epidural hematoma can lead to severe brain damage or even death. Therefore, it is crucial to recognize the signs and symptoms of this condition, such as a rapidly deteriorating level of consciousness, and seek immediate medical attention.
36.
What artery is most commonly involved in epidural hematoma?
Correct Answer
A. Middle meningeal
Explanation
The middle meningeal artery is the most commonly involved artery in epidural hematoma. Epidural hematoma occurs when there is bleeding between the dura mater (outermost layer of the meninges) and the skull. The middle meningeal artery is a branch of the maxillary artery and runs between the dura mater and the skull. Trauma to the head can cause a rupture or tear in the middle meningeal artery, leading to bleeding and the formation of an epidural hematoma. This can result in increased pressure on the brain and potentially life-threatening complications if not promptly treated.
37.
What regions is most commonly involved in epidural hematoma
Correct Answer
A. Temporoparietal
Explanation
The temporoparietal region is most commonly involved in epidural hematoma. This region refers to the area where the temporal and parietal bones of the skull meet. Epidural hematomas are usually caused by trauma to the head, which can result in bleeding between the skull and the outermost layer of the brain called the dura mater. The temporoparietal region is particularly vulnerable to injury due to its proximity to major blood vessels, such as the middle meningeal artery, which can be damaged and lead to bleeding in this area.
38.
Subarachnoid hemorrhage is usually caused by
Correct Answer
A. Ruptured intracranial aneurysm
Explanation
A subarachnoid hemorrhage is typically caused by a ruptured intracranial aneurysm. An aneurysm is a weakened area in the blood vessel wall that balloons out and can eventually burst, leading to bleeding in the subarachnoid space. This type of hemorrhage is a medical emergency and can result in severe complications, including brain damage or death. Other potential causes listed, such as idiopathic (unknown cause), sickle cell disease, or dural sinus thrombosis, are less commonly associated with subarachnoid hemorrhage.
39.
Most common cause of viral meningitis
Correct Answer
A. Enterovirus
Explanation
coxsackies/echovirus