Medicine Final RS 2020

LAB 1) Name the green pointed bone A- Lacrimal bone B- perpendicular plate of palatine bone C- ethmoidal bone D- lateral pterygoid plate of sphenoid 2) which of the following passes through the opening A- Inferior laryngeal artery B- External laryngeal nerve C- Internal laryngeal nerve D-Superior thyroid artery 3) A stupid dentist drops sth into your mouth while you are sitting, where it will go A A- A B- B C- C D- D D B C 4) The pointed structure A- Pulmonary vein B- Pulmonary artery C- Ep arterial bronchus D- Hyp arterial bronchus 5) The green surface is supplied by which nerve A- Intercostal nerves B- Phrenic nerve C- pulmonary plexus 6) Which of the following isn’t found in this fossa A- Maxillary nerve B- Pterygopalatine ganglia C- Sphenopalatine nerv D- First part of the maxillary artery 7) The pointed opening A- Sphenoid Air sinus B- Bulla ethmoidalis C- Eustachian tube D- Middle meatus 8) Wrong about pointed structure A- It has a smooth muscle B- no blood vessels C- no lymph drainage D- it is lined by oral epithelium 9) This section was taken from A- Trachea B- Primary bronchus C- Secondary bronchus D- Tertiary bronchus 10) The green arrowed cell represents? A- Type I pneumocyte B- Type II pneumocyte C- Endothelial cell D- none of the above 11) The blue arrow represents A- Mesothelium B- Hyaline cartilage C- Elastic fibers D- Endothelium 12) Which of the following doesn’t exist in this picture A- Loose connective tissue B- pseudostratified ciliated columnar C- Goblet cells D- hyaline cartilage 13) Wrong about spirometry A- If possible, take the age, name, gender, ethnicity B- Take detailed medical history C- Make sure the patient is sitting straight upright, legs not crossed. D- You must repeat the test 3 times E- Make a good seal with the mouth piece 14) You did a spirometry test to a patient, the test was reproducible and acceptable and it is done 3 times, what is next to do , there was a table with numbers FEV1/FVC=90%, FVC of predicted= 72% A- Repeat the test again B- It is normal C- give bronchodilator and repeat D- Do methacholine challenge test E- Complete pulmonary function test is needed 15) Which of the following is an appropriate media for all fungi A- SDA B- plz choose A C- Chrom Agar 16) sensitive for bacitracin A- Enterococcus B- Strep agalactiae C- Strep pneumonia D- strep pyogenes 17) These clear structures are present in? ARDS 18) True about this pathological section? A- Diagnosed by exclusion B- Macroscopic shows cobbelstones appearance C- Caused mainly by occupational hazard D- You can’t know the origin of the disease 19) This section shows A- severe restrictive abnormality B- Moderate restrictive abnormality C- Mild restrictive abnormality D- Peripheral eosinophilia 20) Smoker for 15 years, choose the right answer about this case  1 2 3 4 5 6 7 8 9 10 A C C B B D C A C A 11 12 13 14 15 16 17 18 19 20 C D A E A D  D C  PBL (Very very easy) 1) Typical description for ARDS and choose the main cause? lack of surfactant 2) How to treat ARDS? Steroids 3) Wheezing and Family history of the same disease with other allergies? ASTHMA 4) Barking cough with steeple sign? CROUP ANATOMY +HISTO+ EMBRYO 1) All of the following is lined by Pseudostratified columnar epithelium with goblet except? A- Olfactory region B- Terminal bronchiole C- posterior surface of epiglottis D- False vocal cord 2) Which of the following is not found in the RS membrane A- Surfactant layer B- Type II pneumocyte C- Type 1 pneumocyte D- Endothelial cell E- Fused basal lamina 3) A needle in the left ninth intercostal space at mid axillary line wouldn’t affect A- diaphragm B- spleen C- Lung D- Pleura E- peritoneum 4) pulmonary embolus most likely originates from? A- femoral vein B- Pulmonary vein C- Cardiac veins D- bronchial veins E- bronchial arteries 5) An X-ray of a day-old neonate shows opaque regions on the periphery of lungs, this means? A- surfactant deficiency B- Pleural effusion C- it is normal since peripheral alveoli take several days to fully expand 6) Oligohydramnios is associated with? A- Ectopic lung lobes B- Lung hypoplasia C- Lung agenesis D- ARDS 7) Wrong about ARDS A- Thyroxine is the most important stimulator B- Causes collapsing of the alveoli C- Accounts for 2% of death in neonates 1 2 3 4 5 6 7 B B C A C B C Pharma 1) a very long question about smoking patient with RS problems, he came to the hospital for treatment, which of the following isn’t right to do Counsel and advise him to quit smoking only while he is in the hospital 2) Which of the following is right drug-drug interaction A- Aspirin decreases levels of zafirlukast B- Erythromycin has no effect on leukotriene antagonist C- Phenytoin increases theophylline concentration D- Varenicline has a lot on drug-drug interaction E- Bupropion decreases tamoxifen levels 3) Which of the following drugs is contraindicated in asthmatic patients A- Inhaled corticosteroids B- LAMA C- LABA D- Riflumilast E- Xanthines 4) Wrong about steroids It decreases the decline in FEV1 5) Rifabutin is used instead of Rifampin because? A- it is not affected by CYP P450 B- It causes more side effects of protease inhibitors C- Rifampin decreases antiviral activity 6) Which of the following drugs is used as a prophylaxis for Meningococcal meningitis A- Isoniazid B- Ethambutol C- Rifampin D- Beclomethasone 7) Antitussive drugs are used for? A- Bronchial asthma B- Cystic fibrosis C- Nonproductive dry cough D- Pneumonia 8) Choose the wrong matching Lemon oil --- Increases lysosomal activity 1 2 3 4 5 6 7 8  E D  C C C  Patho 1) Correct about TB A- Primary TB is infective B- Regional lymph nodes are less involved in secondary TB C- 80% of primary TB become secondary 2) Correct about TB A- Secondary TB is localized in lower lobes B- Mycobacterium bovis causes oropharyngeal tuberculosis C- Mycobacterium avium complex causes disease in 3% of AIDS 3) True about pulmonary embolism A- The more peripheral the embolic occlusion, the lower the risk for infarction B- 40% of them are silent C- Consequences are only determined by size of the embolus D- Small emboli causes alveolar hemorrhage 4) True about Goodpasture syndrome A- Autoimmune disease affects only the Lung B- IgG granular deposition in lung are diagnostic C- Results in necrotizing hemorrhagic interstitial pneumonitis D- Predominance in females 5) Choose the true sentence A- Hyalinized collagen fibers are found around silicosis B- Asbestos bodies are golden brown rounded structures C- Pleural plaques contains Ca++ and iron 6) A mass that contains large cells, with large nuclei and prominent nucleoli, and show no glandular or squamous differentiation, what is the diagnosis? A- Squamous cell carcinoma B- Large cell carcinoma C- Carcinoid D- Small cell carcinoma 7) True about sarcoidosis A- Higher prevalence in smokers B- Mainly occupational disease C- In liver it manifests as granulomas surrounding central veins D- In more than 50%, it causes granuloma in spleen 8) True about sarcoidosis A- Schaumann and asteroid bodies are diagnostic B- It affects old people C- 50% of cases turn to end stage honey cumb lung D- It is usually a symptomatic 9) True about adenocarcinoma A- Form large masses B- Centrally located C- It has a wide range of metastasis in a short time 10) True about lung tumors A- They have good prognoses B- Adenocarcinoma is the most common in smokers C- women are more susceptible to carcinogens in tobacco than men 11) Long case that begins centrally in a localized area and spread widely to the pleura (pleural cell proliferation), this case is associated with? A- distant metastasis B- Adenocarcinoma C- Extensive pleural fibrosis 12) Intraalveolar fibrosis with patchy air space consolidation A- Cryptogenic Organizing pneumonia B- Carcinoid syndrome C- Nonspecific interstitial pneumonia 13) True sentence that coal worker's pneumoconiosis is found in the upper lobes of the lung, so are silicosis nodules 14) True sentence that Adenocarcinoma is the most common lung tumor 1missed 1 2 3 4 5 6 7 8 9 10 11 12 13 14 B B D C A B D D C C C A   MICRO 1) The most common cause of Rhinosinusitis is A- Enveloped single stranded RNA B- Naked Double stranded RNA C- Enveloped double stranded DNA D- Naked single stranded RNA 2) The appropriate treatment for Rhinitis is A- Antiviral drugs B- Antibiotic C- supportive treatment 3) Which of the following causes severe respiratory infection A- SARS B- OC43 C- 229E 4) The most common cause of bronchiolitis is A- Adenovirus B- parainfluenza C- Coxsackie A D- RSV 5) Croup and steeple is caused by Laryngotrachiobronchitis 6) Wrong about avian influenza A- Both high and low pathogenic can infect humans B- Effective human-human transmission C- Can cause severe lower respiratory infection 7) True about antigenic drift A- happens only in type A influenza B- Caused by frameshift mutation in the DNA C- Caused by exchange of genetic segments D- Results in a new subtype with time 8) Which of the following toxins can cause scarlet fever A- DNAse B- Sterptolysin S C- Hyalinase D- C5a protease E- Erythrogenic toxin 9) All of the following are true about S.pyogenes except A- Can’t be diagnosed by smear B- Available vaccine against its capsule C- Treated by penicillin with no resistance D- the capsule is an important virulence factor 10) In H.influenza, we use ceftriaxone as the drug of choice because? A- 80% break the penicillin by changing its binding site B- 20% have B lactamases C- A lot of cases are penicillin allergic D- it is given by IV injection 11) True about PCV 13 (PREVNAR) A- given to children between 2-20 years old B- Given to adults C- given after 2 months until 60 months of birth and to immunocompromised 12) Long case about oral membrane that bleeds profusely when touching it, what is the cause A- Gram negative bacteria non encapsulated B- Gram positive bacteria anaerobe C- Gram negative bacteria encapsulated D- Gram positive bacteria aerobe 13) True about IRGA A- It is the main and goal standard diagnostic method B- it substitutes tuberculin skin test for screening of latent TB C- it can distinguish active TB from latent D- sth about DNA 14) Mycoplasma bacteria is diagnosed by? A- Culture sputum B- Blood culture C- Gram staining 15)Legionella is transmitted by? A- Direct human-human B- Droplets C- Aquatic bodies (sth water) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 D C A D  B D E B B C D B C C