pathology 6- which of the following is not a risk factorcells , or any atypical cells. most probable...

Pathology

1- Lung cancer involving cavitation :

a- Squamous cell carcinoma

b- Small cell lung carcinoma

c- Carcinoid tumor

d- Adenocarcinoma

e- None of the above

2- Earliest genetic abnormality in lung cancers

a- K-RAS

b- EGFR

c- P53

d- 3P

e- All of the above

3- The most common cause of hospital

acquired pneumonia

a- G-ve bacilli

b- S.pneumonia

c- S.aureus

d- S.viridans


4- The most common cause of hospital

acquired pneumonia in US

a- G-ve bacilli

b- S.pneumonia

c- S.aureus

d- S.viridans


5- Hypercalemia related to paraneoplastic

changes include which of the following

cancers

a- mixed tumors

b- squamous lung carcinoma

c- Carcinoid

d- Adenocarcinoma


6- Which of the following is not a risk factor

for aspiration pneumonia

a- Coma

b- Anesthesia

c- Endotracheal intubation

d- Seizure

e- Antibiotics

7- Regarding the genetic aspect of lung cancer

.. which of the following is incorrect:

a- 3p deletion may found in normal tissue

or benign masses

b- RB mutation can be found in the cases

of SCLC

c- p16/ CDKN2A mutation can be found in

cases of NSCLC

d- ( EGFR & K-ras & ALK & MET) found in

adenocarcinoma

e- EGFR mutation is seen in

adenocarcinomas, more in smoker

Female

8- One of the Following is wrong regarding

lung cancer :

a- SCLC may cause cavitation

b- Squamous cell carcinoma might be

associated with hypercalcemia

c- Adenocarcinoma is the commonest in

females

d- Large anaplastic carcinoma carries a

poor prognosis


9- All are true about squamous cell carcinoma

except :

a- keratin formation

b- centrally located

c- shows cavitation

d- better prognosis than small cell

carcinoma

e- none of the above

10- Red heavy lung, with alveolar exudate, high

neutrophil count, watery sputum and high

concentration of bacteria in sputum is

which phase:

a- Grey hepatization

b- Congestion

c- Red hepatization

d- Resolution


11- All of these can cause pulmonary

granuloma except

a- Hypersensitivity pneumonitis

b- TB

c- CMV pneumonitis

d- Histoplasmosis

e- Blastomycosis

12- Reid index is used in confirming the

diagnosis of

a- Chronic Bronchitis

b- Asthma

c- Bronchiectasis.

d- chronic bronchiolitis

e- Emphysema

13- Which of the following related to (EBV) :

a- Laryngeal carcinoma

b- Laryngeal squamous cell cancer

c- Malignant mesothelioma

d- Nasopharyngeal carcinoma

e- Non-small cell lung cancer

14- Pink frothy sputum is associated with

a- Tuberculosis

b- Sarcoidosis

c- Asbestosis

d- P.jiroveci


15- All are true about secondary TB except

a- Apical location

b- Sputum is positive for bacilli

c- Forms cavitation

d- Infection in sensitized person

e- Predominant enlarged lymph nodes

16- Which of the following associations is

wrong :

a- TB salpingitis : sterility

b- Cervical lymph nodes TB :

Scrofuloderma

c- Adrenal glands TB : Addison disease

d- TB meningitis : Potts disease


17- All are true about Hydatid disease except

a- Mainly affect the liver

b- Caused by fungal infection

c- Forms unilocular cyst lined by

easonophilic laminated membrane

d- May be infected or ruptured

e- May be accompanied by eosinophilia

18- One of the following disease cause the

damage to acini :

a- Emphysema

b- Chronic bronchitis

c- Asthma

d- A and B

e- B and C

19- A 53 old patient with a history of fever and

dyspnea . In physical examination

temperature is normal with enlarged hilar

lymph nodes . After culturing the sputum it

was negative for acid fast bacilli , viral

inclusions ,cultural growth , inflammatory

cells , Or any atypical cells. Most probable

diagnosis is :

a- Sarcoidosis

b- Tuberculosis

c- Silicosis

d- Asbestosis

e- Usual interstitial pneumonitis

20- Knowing the structure of the lung is

important for its diagnosis which of the

following is not true:

a- The acinus starts from terminal

bronchiole

b- There are salivary glands in the

respiratory tract

c- The conducting channel starts from

below the trachea

d- all of the above


21- For diagnosing Usual interstitial pneumonia

,what will we do

a- Pulmonary function tests

b- Chest X ray

c- CT

d- Biopsy

e- MRI

22- Which one from these disease has a

fibrosing pattern:

a- Hypersensitivity pneumonia

b- Sacroidosis

c- Pneuomoconiosis

d- Desquamative interstitial pneumonia

e- Respiratory bronchiolitis

23- Which of the restrictive diseases doesn't

include fibrosis

a- Sarcoidosis

b- Usual interstitial pneumonia

c- Non-specific interstitial pneumonia

d- Cryptogenic organizing pneumonia

e- Pneumoconiosis

24- What is INCORRECT regarding restrictive

lung diseases

a- Macrophages do play a major role in

interstitial lung diseases

b- Many of the conditions end with fibrosis

c- The alveoli are mainly affected

d- The problem in restrictive lung disease

is in expiration

e- Principally involves the alveolar walls

25- false about primary TB immunocompetent

patient

a- In 95% healing in 3 weeks

b- Caseation , surrounded by chronic

inflammatory cells

c- Commonly lymphatic spread

d- Enlarged hilar LNs with caseation


26- secondary TB

a- Has less effect on LN

b- In a previously non-sensitized host

c- Reinfection with a non-virulent strain

d- Sputum is negative for TB bacilli in most

cases

e- Cavitation is uncommon

27- small cell carcinoma ?

a- Synaptophysin and chromogranin

positive

b- Probably poorly differentiated

Squamous Cell CA or Adenocarcinoma

c- Growth along alveolar walls without

destruction

d- Mucin positive


28- which of the following is OLD

a- Usual interstitial pneumonia

b- Pneumoconiosis

c- small airway disease bronchiolitis

d- Hypersensitivity pneumonia

e- Sarcoidosis

29- Not a chronic pneumonia

a- TB

b- Histoplasmosis

c- Blastomycosis

d- Coccioidomycosis

e- Cryptococcosis

30- Ghon complex :

a- Subpleural caseating granuloma

b- Subpleural caseating granuloma with

enlarged hilar LN

c- Fibrosis calcification

d- Tuberculous salpingitis & endometritis

e- Tuberculous lymphadenitis

31- Not involved in collagen vascular disease ?

a- Eosinophilic pneumonia

b- Rheumatoid arthritis

c- Systemic lupus erythematosus

d- Progressive Systemic Sclerosis

e- Any interstitial pattern

32- An occupational disease has similar

pathology to chronic bronchitis ?

a- silicosis

b- occupational asthma

c- asbestosis

d- bayiisnosis


33- Laryngeal carcinoma one is false ?

a- Highly related to HPV 40%

b- supraglottis is common

c- glottis is the most common type

d- associated with smoking

e- more in males

34- most common cancer to metastasize to

lungs is

a- breast cancer

b- prostate cancer

c- colon cancer

d- gastric cancer

e- laryngeal cancer

35- Small Cell Carcinoma (SCLC) is treated by

a- Chemotherapy then surgery.

b- Surgery then chemotherapy

c- Chemotherapy alone

d- Targeted chemotherapy

e- Surgery alone

36- Non-Small Cell Carcinoma (NSCLC) is

treated by





e- Surgery alone

37- Adenocarcinoma is treated by





e- Surgery alone

38- The best way to diagnose lung cancers and

interstitial lung diseases

a- Transcutaneous needle biopsy

b- Bronchial biopsy

c- Chest X ray & other radiological

techniques

d- Open lung biopsy

e- Sputum Cytology & bronchial wash

39- Cigarette smoking increases the risk of lung

cancer by

a- 10 times

b- 60 times

c- 11 times

d- 6 times

e- 66 times

40- Occupational hazards increase the risk of

lung cancer by

a- 10 times

b- 60 times

c- 11 times

d- 6 times

e- 66 times

41- Asbestos and smoking increase the risk of

lung cancer by

a- 10 times

b- 60 times

c- 11 times

d- 6 times

e- 66 times

42- Mucin can be seen in cases of

adenocarcinoma by

a- PAS stain

b- Congo red stain

c- India ink stain

d- Immunoperoxidase


43- abnormal (malformation) of cells

a- hamartoma

b- teratoma

c- leiomyoma

d- adenoma

e- hyperplasia

44- What is the difference between

hemorrhagic hydrothorax and hemothorax

a- Hemorrhagic hydrothorax is fluid with

some RBCs

b- Hemothorax is pure blood in the pleural

cavity

c- Hemorrhagic hydrothorax is fluid with

high hemosiderin

d- Hemothorax is hydrothorax is fluid with

some RBCs

e- A and B

45- Which one of these microorganisms is the

causative agent of tuberculosis: a- Staphylococcus aureus

b- mycobacterium tuberculosis c- pseudomonas aeruginosa

d- streptococcus pneumoniae e- none of the above

46- In the pathogenesis of tuberculosis, which

one of these agents is considered the most crucial for the immunity responses a- Macrophages b- TNF c- Interferon gamma d- Nitric oxide e- None of the above

47- The type of necrosis presented in tuberculosis is: a- Coagulative necrosis b- Caseous necrosis c- Fibrinoid necrosis d- Fat necrosis e- Liquefactive necrosis

48- Which of the following will affect the PPD

test results a- anemia

b- chagas disease c- Hodgkin's disease

d- Polymyositis e- None of the above

49- We can diagnose hydatid disease by:

a- MRI b- CT scan c- Chest X ray d- A+B e- None of the above

50- Which of the following pairs are related to

each other a- Spinal TB – Scrofula b- Adrenal TB – Addison Disease c- Renal Infection – Potts Disease d- Lymphadenitis - Tuberculous

bronchopneumonia e- None of the above

51- Which of the following microorganisms is the most common cause of atypical TB in

immunosuppressed patients a- Mycobacterium tuberculosis

b- Mycobacterium bovis c- Mycobacterium gordonae d- Mycobacterium avium e- None of the above

52- Which of these infections does cause sterility

a- Tuberculous Meningitis b- Tuberculous Chronic Pyelonephritis

c- Tuberculous Salpingitis d- Lymphadenitis e- Tuberculous bronchopneumonia

53- Ghon focus is characterized by a- A combination of parenchymal lesion

and lymph node involvement. b- A 1-1.5 cm of gray-white region of

inflammation in lung. c- A region of inflammation with caseous

necrosis. d- A fibrous and calcified parenchymal

lesion. e- Involved lymph nodes that caseate

54- Secondary TB arises in apex of lung because of :

a- High oxygen tension in lung apex. b- Relatively low lymphatic drainage of

lung apex. c- All of the above. d- None of the abovee.

55- Most common systemic complication of

Secondary TB is : a- Meningitis b- Pott’s disease c- Sterile Pyuria d- Cervical lymph node involvement

56 LEAST COMMON primary TB complication

include :

a- Induction of hypersensitivity and increased resistance.

b- Reactivation into secondary TB c- Leading to progressive primary TB

d- Formation of a cavitary focus of caseous necrosis

Physiology

1- Which of the following changes is most

consistent with traumatic pneumothorax a- Decreased lung volume , decreased

pleural cavity volume b- Increased lung volume , increased

pleural cavity volume

c- Increased lung volume , decreased pleural cavity volume

d- Decreased lung volume , increased pleural cavity volume

e- Normal lung volume , normal pleural cavity volume

2- Loss of hemoglobin due to bleeding that results into a decline in hemoglobin concentration from 15 to 12 , which of the following will decrease a- Plasma partial pressure of oxygen

b- Plasma pH c- Oxygen carrying capacity

d- Lung compliance e- Tidal volume

3- Which causes increased zone I in the lungs a- Polycythemia

b- Sympathetic overstimulation c- Fluid retention

d- Blood loss e- Orthostatic hypotension

4- Blood flow hypoxia

a- Blood flow in the base is better than the

apex b- Blood flow in the apex is better than the

base c- Ventilation is equal throughout the lung

parenchyma d- Cessation of pulmonary blood flow

during systole e- None of the above

5- Before the inspiration intra-alveolar

pressure was 0 and the intra-pleural pressure was -5 at the end of inspiration

while glottis is open , what will be the intra-alveolar and the intra-pleural pressures

respectively

a- 0 and +8 b- 0 and -8

c- Both are zero d- -8 and zero

e- +8 and zero

6- Calculate the decrement in the diffusion if we double the distance and reduce the surface area to the half a- 75% b- 25% c- 50%

d- 12.5% e- 5%

7- Calculate the diffusion if we double the distance and reduce the surface area to the

half a- 75%

b- 25% c- 50%

d- 12.5% e- 5%

8- If a subject inspired 600 ml of air , and his glottis is open ,the IPP was measured to be -4 , and after inspiration it was -10 , what is the compliance a- 150

b- 60 c- 2.5 d- 100 e- 40

9- Increased CO will lead to

a- low HB saturation b- increased pO2 in the arterial blood c- decreased oxygen content in blood d- no effect on blood hemoglobin

e- increased metabolic rate

10- Bleeding person will have a- physiological dead space because of

increment in zone 3 b- anatomic dead space because of

hemothorax c- physiological dead space because of

increment in zone 1 d- physiological dead space because of

increment in zone 2


11- How much the amount of O2 consumed in the body if the PaO2 is 18 ml/dl and in

venous 13ml/dl , and there is 6 liters of blood in the body ?

a- 100 ml b- 600 ml

c- 300 ml d- 500 ml e- can’t be measured

12- If the respiratory rate is 10 and the tidal volume = 600 and dead space is 200 what is the pulmonary ventilation rate AND

alveolar ventilation rate respectively a- 4 and 6 L b- 4 and 8 L c- 6 and 6 L d- 6 and 4 L

e- 4 and 4 L

13- The pressure in pleural space : a- less than atmospheric pressure

b- positive in valvular pneumothorax c- supra-atmospheric during inspiration d- more subatmospheric during expiration e- a and b

14- Dorsal respiratory group is responsible for a- inspiration

b- expiration c- inspiration & expiration d- forceful inspiration e- breathing rhythm

15- surfactant effect on alveoli...

a- Effect is constant in all alveoli b- increased in inspiration c- decreased in expiration

d- Doesn't change during breathing e- small effect in small alveoli

16- in normal inspiration which of the following

is true: a- diaphragm relaxation b- accessory muscles should be relaxed c- intrapleural pressure less negative d- transpulmonary pressure is more

negative e- glottis is always closed

17- capillary perfusion with no ventilation will result in:

a- increasing alveolar pCo2 b- increase physiological dead space c- decreasing alveolar pCo2

d- increasing alveolar pO2 e- none of the choices is correct

18- which of the following is correct about blood flow in zone 3 :

a- during systolic phase only b- during diastolic phase only

c- during systolic and diastolic phases d- intermittent blood flow e- no blood flow

19- what are the pulmonary ventilation rate

and the alveolar ventilation rate if the RR = 20/min , Tidal volume =300 and the dead space = 150 ,respectively : a- 4 - 3 b- 5 - 7 c- 6 - 3 d- 3 – 6 e- None of the above

20- during inspiration , a person inspired 3.5 L

and let his glottis open and his intraplueral pressure was -10 and then his glottis is

closed and he relaxed his diaphragm and now his intraplueral pressure is -1 , what is

the intralveolar pressure : a- ( +2 ) b- ( -2 ) c- ( 0 ) d- ( +9 ) e- Can’t be measured

21- in normal expiration:______ thoracic and lung volume_______ intrapulmonary

pressure: a- increase, decrease b- increase, INCREASE c- decrease, increase d- decrease , decrease e- increase, of no change

22- nerve signals from peripheral

chemoreceptors are decreased when: a- arterial blood pressure increase b- arterial PO2 decreases c- oxygen in blood increases d- decrease in PH e- none of the above

23- A 9th old boy is breathing from a bag then his friend notice that the boy become

hyperventilated ... The reason for hyperventilation is:

a- increased arterial pCo2 b- decreased arterial pO2 c- increased blood pH

d- decreased arterial pCo2 e- none of the above

24- The center that is responsible for producing

rhythmic breathing a- dorsal neural vagus center

b- ventral respiratory center c- pneumotaxic center

d- pre-botzinger complex e- apneustic center

25- WHAT'S THE STRONGEST STIMULATION FOR HYPERVENTILATION a- Increased pO2 b- Decrease pO2

c- Increases pCO2 d- Decreased pCO2

e- Increased pH

26- By compressing the rectus abdoimnus which one of the following will take place a- Increased lung recoil b- Decreased IPP c- Increased TPP d- Decreased FRC e- Increased TLC

27- AFTER NORMAL INSPIRATION AND THE GLOTTIS IS OPEN

a- IAP is negative and IPP is atmospheric b- IAP is zero and IPP is subatmospheric c- IAP is subatmospheric and IPP is zero

d- IAP is atmospheric and IPP is atmospheric

e- Can’t be expected

28- A DECREASE IN THE ACTIVITY OF WHICH OF THE FOLLOWING WILL RESULT IN A DIFFICULTY IN BREATHING

a- Surface tension b- Apneustic center c- Type II alveolar cells d- Airway resistance e- None of the above

29- ALL OF THE FOLLOWING STATEMENTS ARE

CORRECT EXCEPT a- If pulmonary blood flow is increased 3

times there will be no change in the diffusion of gases

b- The ideal ventilation to perfusion ratio is found in the middle portion of the lung

c- If pulmonary blood flow is increased 3 times, pulmonary blood pressure will be

affected much d- All of the above


30- WHICH OF THE FOLLOWING HAS THE HIGHEST AFFINITY TO HB a- O2 b- CO2 c- CO d- 2,3-BPG e- H+

31- THE CENTRAL CHEMORECEPTORS ARE

SENSITIVE TO a- CO2 directly and H+ indirectly

b- CO2 directly and O2 indirectly c- H+ directly and CO2 indirectly

d- H+ directly and O2 indirectly e- CO2 directly and pH indirectly

32- WHICH OF THE FOLLOWING STATEMENTS ABOUT PERIPHERAL CHEMORECEPTORS IS

INCORRECT? a- They are sensitive to a decrease in O2

concentration b- They are sensitive to H+ ions

c- They are sensitive to CO2 ions d- They are found in the bifurcation of the

carotid arteries and the aorta

e- Less sensitive but faster than the central ones

33- Vascular congestion and pulmonary edema gives sensation of dyspnea due to

stimulation of : a- stretch receptors b- chemoreceptors c- J-receptors d- Proprioceptors e- None of the above

34- A shift in O2 dissociation curve to the right

means : a- O2 saturation is 100%.

b- O2 saturation is 50%. c- P50 is less than 26

d- Hb bind O2 with low affinity e- None of the above

35- Where does the stretching reflex Hering

Breuer can be found a- Heart b- Arch of aorta & carotid bodies c- Carotid bodies d- Lung

e- Kidneys

36- Can’t be measured by spirometer a- TV b- ERV c- IRV d- FRC e- None of the above

37- The absence pulmonary surfactant in the

alveoli produces:

a- collapse of the large alveoli in the small alveoli

b- increase the lung compliance c- increase the work of breathing

d- Two answers are correct e- None of the above

38- A person has normal arterial PO9

and percent oxyhemoglobin saturation, yet still does not have adequate delivery of oxygen to the tissues, which of the following may account for this:

a- Carbon monoxide poisoning

b- Hypoventilation c- Hyperventilation d- Carbon dioxide poisoning e- Anemia

39- Most of carbon dioxide in the blood is

carried: a- Dissolved in plasma b- Carried to hemoglobin c- In the form of carbonic acid and

bicarbonate d- Bound to plasma protein


40- A normal subject at resting condition

inspired 3 liters of air. At that point, his glottis still opened. If his intra-pleural

pressure was (-8) mmHg, then his intra-alveolar pressure is equal to

a- 8 mmHg b- -8 mmHg

c- 4 m Hg d- Atmospheric

e- Can’t be calculated

41- A normal subject at resting condition inspired 2 liters of air. At that point, his

glottis still opened. If his intra-pleural pressure was (-9) mmHg. Now he closed his

glottis and relaxed his chest muscle. If the intra-pulmonary pressure is (-2)mmHg, then his intra-alveolar pressure is a- Atmospheric b- Subatmospheric c- + 11 d- + 7

e- Can’t be calculated

42- A normal subject at resting condition inspired 3 liters of air. At that point, his glottis still opened. If his intra-pleural pressure was (-8) mmHg, then he inspired another 1 liter and the glottis is still

opened, now his intra-pleural pressure is a- More sub-atmospheric than the first

step b- Less sub-atmospheric than the first step c- The same as in the first step d- Atmospheric e- Can’t be calculated

43- In the absence of lung surfactant, the surface tension of alveoli would

a- Increase during inhalation b- Increase during exhalation

c- Decrease during exhalation d- Will not be affected by breathing


44- Total lung capacity – inspiratory capacity =

a- ERV b- FRC c- TV d- IRV e- None

45- Diffusion of O2 is slower than diffusion of CO2 because:

a- O2 has a lower molecular weight b- O2has high affinity to HB than co2

c- O2 is less soluble than CO2 d- The amount of CO2 in blood is more

than the amount of O2 e- O2 has lower pressure gradient

46- The absence of pulmonary surfactant in alveoli produces:

a- Collapse of large alveoli in to small alveoli

b- an increase in lung compliance c- an increase in arterial O2 d- an increase of work of breathing

e- a and b

47- Regarding regulation of respiration, select the correct statement

a- the peripheral chemoreceptors are in

sensitive to increased arterial H concentration

b- the ventilatory response to hypoxia is decreased by presence of hypercapnia

c- Stimulation of pneumotaxic centre during inspiration causes prolongation of inspiratory activity

d- cutting of the vagus nerves and removing the effect of pneumotaxic centre produces apnea

e- the hearing-breuer reflex acts to terminate inspiration

48- less ventilation to a lung unit causes low

aleveolar…………….which produses local

……… a- p o2 vasoconstriction

b- p o2 vasodilation c- p co2 vasoconstriction

d- p co2 bronchoconsriction e- p co2 bronchodilation

49- FRC for a person measured by helium dilution method original helium concentration in the container is 5% and the final concentration is 4%(after equilibrium) the container volume at the

beginning and at the end of the test was 10.0 liters what is the FRC?

a- 1.5 liters b- 2.0 liters

c- 3 liters d- 3.5 liters e- FRC cannot be determined since

insufficient information is supplied

50- If small emboli were to break loose from a deep vein obstructing small pulmonary

artery this will lead to:

a- A decrease in V\Q in the portion of the lung with clots

b- A decrease in pulmonary arterial blood pressure

c- Sympathetic nerve fiber stimulation

leading to pulmonary vasoconstriction d- A decrease in pulmonary vascular

resistance e- Generalized parasympathetic

stimulation and pulmonary vasodilation

51- the adequate stimulus for hering-breure reflex in the lung is the:

a- stretching of alveoli b- decreased p o2 in alveoli

c- increased p o2 in alveoli d- o2 content of blood bathing the carotid

bodies e- carbon dioxide content of blood

bathing the respiratory center

52- Compared with the base of upright lung the

apex of upright lung has: a- more blood flow b- more ventilation c- less ventilation\ perfusion ratio d- high p o2 of blood leaving the apex

(pulmonary vein) e- high p o2 of blood supplying the apex

(pulmonary artery).

53- which of the following statements is

correct? a- V\Q ration for the whole lung is about 1

b- in normal alveoli the partial pressure of p o2 and p o2 are similar to that of blood in pulmonary arteries

c- there is no gas exchange in the conducting zone of airways because

they are supplied by bronchial circulation

d- alveoli with high V\Q ratio cannot compensate for hypoxia developed

in alveoli with low V\Q ratio.

e- Lung units with high v\Q ratios increase the physiologic dead space.

54- what is wrong about surfactant?

a- contain phospholipids and proteins b- provide constant surface tension c- produced by alveolar type 2 cells d- decreased in patients who breath pure

o2 for long time

e- presents with decreased amount in patients with RDS

Microbiology

1- All of these have vaccines except

a- Streptococcus pneumonia b- H.influenzae c- C.Diphtheria

d- Perussis e- Steptococcus pyogenes

2- Pneumocystis jirovecii

a- Fungus b- Protozoan c- Parasite d- Bacteria e- Virus

3- All of following are true except :

a- Streptolysin O is oxygen labile b- Streptolysin O is immunogenic c- Streptolysin S is oxygen stable d- streptolysin S in non immunogenic e- Streptolysin is a major spreading factor

4- The causative agent of Pontiac fever is a- M.pneumonia

b- L.pneumophila c- C.trachomatis d- C.psittaci e- None of the above

5- All are related to MTB , except

a- Granuloma

b- Caseation c- Scrofula

d- fish fancier’s finger e- none of the above

6- Nocardia , All of these are correct about Nocardia asteroids except ? a- Gram positive b- highly Fastidious M. O c- Weak acid fast d- Pleomorphic


7- Drug that doesn't have an anti-pseudomonal activity ?

a- gentamycin b- imipinem

c- vancomycin

d- ceftzidime e- none of the above

8- Which one of the following associations is

wrong: a- Haemophilus Influenzae - waxy thick

wall b- Streptococcus Pneumonia -

polysaccharide capsule.

c- Diphteriae - exotoxin d- Bacillus anthracis - polypeptide capsule

e- Streptosoccus Pyogenes - Hyaluronic acid capsule

9- The most common cause for CAP is a- C. Pneumoniae b- M. Pneumoniae c- S. Pneumoniae d- S.pyogenes e- Influenza virus

10- which of the following we do blood culture for diagnosis a- epiglottitis b- pneumonia c- pharyngitis

d- tonsillitis e- dental caries

11- All are true regarding diphtheria toxin

except : a- B subunit is required for binding

b- A subunit causes inhibition of protein synthesis in host cell

c- all biotypes are potenially toxigenic e- needs lysogenic conversion e- molonoy test is used to detect the

toxoginicity of diphtheria

12- All of the following are clinical picture of Paracoccidioides brasiliensis except:

a- Edentulous mouth b- white plaques in buccal mucosa

c- Cervical lymphadenopathy d- rhinocerebral e- Pulmonary lesions which mimic TB

lesions

13- Clinical features of Scarlet fever are all except a- Bull neck b- Strawberry tongue c- Sandpaper rash d- Cirumoral pallor e- Erythema

14- All are human pathogens except a- S.pneumonia

b- C-psittaci c- P.aeruoginosa

d- Erysipelothrix rhusiopathiae e- Cryptococcus neoformans

15- All maybe associated with mycoplasm

pneumonia , except : a- cold aggulitnation

b- Stevens johnoson syndrome c- patients usually don’t appear seriously

ill d- colonies with medusa head appearance

e- abnormal chest signs

16- For which of the following uses is bacitracin

susceptibility test used ? a- For the determination if a person is

susceptible to infection by Streptococcus Pyogenes

b- For the diagnosis of patients with Streptococcus Pyogenes

c- For the determination if a person is susceptible to infection by

Streptococcus Pneumoniae d- For the diagnosis of patients with

Streptococcus Pneumoniae


17- The most common cause of rheumatic fever a- H.influenza b- P.aurogenosa c- S.Pneumoniae d- Streptococcus pyogenes

e- Influenza virus

18- Influenza virus has more than 18 different genes, most are present in:

a- Birds b- Pigs

c- Humans d- Horses

e- Cows

19- Aschoff nodules found in ? a- Scarlet fever b- Toxic shock syndrome c- Kawasaki syndrome d- Acute rheumatic fever


20- The serotype of Avian Flu : a- H5N1 b- H1N1 c- H3N1 d- H2N1 e- H1N5

21- Which of the following is false concerning

the antigenic shift and antigenic drift in influenza viruses?

a- Antigenic drift is due to mutations in the RNA that leads to changes in the antigenic

character of the H and N molecules. b- Antigenic drift involves subtle changes that

may cause epidemics but not pandemics. c- Antigenic drift is due to rearrangement of

different segments of the viral genome that produces major changes in the antigenic character of the H and N molecules.

d- Antigenic shift usually occurs in animal

hosts and is responsible for producing both epidemics and pandemics.

e- Antigenic drift is the major changes in the

viral genes leading to a virtually complete change in the virus with no cross reactive antibodies present.

22- False regarding bacillus anthracis a- Non fastidious growth b- Obligate anaerobe c- Spore-forming bacilli d- Gram positive bacilli e- Human is accidental host

23- False regarding edema factor of bacillus

anthracis exotoxin a- calmodulin-dependent

b- adenylate cyclase c- responsible for tissue necrosis

d- causes elevation of intracellular cAMP e- responsible for the severe edema

24- mediates cell entry of edema factor and lethal toxin

a- calmodulin b- adenylate cyclase c- protective antigen d- cyclic AMP e- Tissue necrosis

25- Anthrax is primarily a disease of a- herbivorous animals

b- human c- birds

d- pigs e- none of the above

26- Anthrax is most commonly transmitted by

a- Inhalation b- Ingestion

c- Indirect contact with animals

d- herbivorous animals

e- direct contact with animal products

27- At increased risk of anthrax

a- Vets b- Agricultural workers c- Farmers d- None of the above e- All of the above

28- Wool sorter’s disease a- Anthrax b- Scarlet fever

c- Kawaski d- Pontiac fever


29- DOC for anthrax a- Erythromycin b- Chloramphenicol c- Doxycycline d- Penicillin e- Imipinem

30- Prophylactic against anthrax a- Erythromycin b- Chloramphenicol c- Doxycycline d- Penicillin e- Imipinem

31- Anthrax vaccine is used with

a- Laboratory workers b- Employees of mills handling goat hair

c- Active duty military members d- Potentially entire populace of U.S. for

herd immunity e- All of the above

32- The vast majority of anthrax cases in human are

a- Pneumonic b- Cutaneous

c- Pharyngeal d- Gastrointestinal e- Cerebral

33- the most effective medication for treatment of whooping cough a- Erythromycin b- Chloramphenicol c- Doxycycline

d- Penicillin e- Imipinem

34- Bordetella pertussis reservoir

a- Pigs b- Birds c- Bats d- Human e- Cats

35- Bordetella pertussis transmission a- Airborne

b- Ingestion c- Direct contact

d- Indirect contact

e- Blood-borne

36- the major virulence factor of B. pertussis a- Fimbriae b- Adenylate cyclase toxin c- Pertussis toxin (PT) d- Filamentous hemagglutinin e- Tracheal cytotoxin

37- attachment to the ciliated epithelial cells by

Bordetella pertussis is done by

a- Fimbriae

b- Pertussis toxin (PT)

c- Filamentous hemagglutinin

d- Tracheal cytotoxin

e- A and C

38- The preferred media for pertussis

a- Chocolate agar

b- Saboraoud dextrose agar

c- Bordet-Gengou medium

d- McConkey agar


39- which one is a spherule ?

a- coccidioides immits

b- paracoccidioidis brasiliensis

c- Cryptococcus neoformans

d- P.carinin


Biochemistry

1- The most damaging free radical

a- Hydrogen peroxide

b- Superoxide anion

c- Hydroxyl radical

d- Water

e- Molecular oxygen

2- The terminal oxygen acceptor in electron

transport chain is

a- Cytochrome

b- Water

c- Oxygen

d- FAD+

e- NAD+

3- Mutation in NADPH oxidase will result in

a- Leukocyte adhesion deficiency

b- Chediak-Hegashi syndrome

c- Chronic granulomatous disease

d- Specific IgA deficiency

e- Wiskott Aldrich syndrome

4- Antidote for acetaminophen intoxication is

a- Flumazinel

b- Pralidoxime

c- Glucagon

d- N-acetylcysteine

e- Naloxone

5- Vitamin A

a- Beta carotene

b- Alpha tocopherol

c- Ascorbic acid

d- Hydroxycalciferol

e- Biotin

6- Terminate chain reaction

a- Beta carotene

b- Alpha tocopherol

c- Ascorbic acid

d- Hydroxycalciferol

e- Biotin

7- Vitamin E deficiency will cause all except

a- Anemia

b- Neuropathy

c- Scurvy

d- Retinopathy

e- Excessive chain reaction

8- Which of the following vitamins or enzymes

is unable to protect the cell against free

radical damage

a- Vitamin C

b- Glutathione peroxidase

c- Xanthine oxidase

d- Superoxide dismutase

e- Vitamin E

9- NADPH Oxidase catalyzes:

a- the formation of nitric oxide (NO).

b- the conversion of superoxide to

hydrogen peroxide.

c- the regeneration of reduced glutathione

d- the reduction of hydrogen peroxide to

water.

e- the transfer of an electron from NADPH

to oxygen to form superoxide.

10- Which is the most reactive of the reactive

oxygen species?

a- Hypochlorous acid.

b- Superoxide radical.

c- Oxygen.

d- Hydrogen peroxide.

e- Hydroxyl radical.

11- Which of the following antioxidants has the

primary role as a chain-breaking antioxidant

in cell membrane

a- Vitamin E

b- Glutathione

c- Catalase

d- Nitric oxide

e- Cholesterol

12- Which ONE of the following is considered

an important source of hydroxyl radicals in

the cell?

a- The Fenton reaction

b- Coenzyme Q

c- Myeloperoxidase

d- Lipofuscin

e- Superoxide dismutase

13- Which of the following gives the correct

sequence of intermediates and products for

the reduction of oxygen by four one-

electron steps?

a- Oxygen, Hydrogen peroxide,

Superoxide, Hydroxyl radical, Water

b- Oxygen, Hydroxyl radical, Hydrogen

peroxide, Superoxide, Water

c- Oxygen, Superoxide, Hydroxyl radical,

Hydrogen peroxide, Water

d- Oxygen, Superoxide, Hydrogen

peroxide, Hydroxyl radical, Water

e- Oxygen, Hydroxyl radical, Superoxide,

Hydrogen peroxide, Water

14- Ceruloplasmin is responsible for

a- Iron storage

b- Iron transport

c- Copper storage

d- Copper transport

e- All of the above

15- True regarding superoxide dismutase

a- Catalyzes the transformation of

superoxide anion into hydrogen

peroxide

b- Copper zinc SOD present in cytosol

c- Manganese SOD in mitochondria

d- All of the above


16- The main pathology due to ingestion of CCl4

a- Fatty liver

b- Renal failure

c- Black urine

d- Chain reaction

e- Lipid peroxidation

17- Vitamin C is needed to

a- Convert tyrosine to DOPA

b- Convert DOPA to dopamine

c- Convert dopamine to norepinephrine

d- Convert norepinephrine to epinephrine


18- True about alkaptonuria

a- Accumulation homogenistic acid

b- Black urine and arthritis

c- Blockade of homogenistic acid oxidase

d- Can be treated by vitamin C

e- All of the mentioned

19- The most important buffer system

a- Carbonic acid / bicarbonate

b- Phosphate

c- Protein

d- Hemoglobin


20- All are causes of respiratory acidosis except

a- Hypoventilation

b- Damage to respiratory center

c- Obstruction of the airways

d- Asthma

e- Diabetes mellitus

21- Fill in the blankets , if the case is respiratory

acidosis

pH H+ PCO2 HCO3-

↓ ↑

a- ↑↑ , ↑↑

b- ↑ , ↑↑

c- ↑↑ , ↑

d- ↑↑ , ↓

e- ↓↓ , ↓

22- Fill in the blankets , if the case is respiratory

alkalosis

pH H+ PCO2 HCO3-

↑ ↓

a- ↑↑ , ↑↑

b- ↑ , ↑↑

c- ↑↑ , ↑

d- ↑↑ , ↓

e- ↓↓ , ↓

23- Fill in the blankets , if the case is metabolic

acidosis

pH H+ PCO2 HCO3-

↓ ↑

a- ↑↑ , ↑↑

b- ↑ , ↑↑

c- ↓, ↓↓

d- ↑↑ , ↓

e- ↓↓ , ↓

24- Fill in the blankets , if the case is metabolic

alkalosis

pH H+ PCO2 HCO3-

↑ ↓

a- ↑↑ , ↑↑

b- ↑ , ↑↑

c- ↓, ↓↓

d- ↑↑ , ↓

e- ↓↓ , ↓

25- Someone is suffering from slow

breathing, you measured the pH and it

was low, PCO2 ↑, bicarbonate is normal

and PO2↓, what is the most correct

diagnosis of the acid base disturbance?

a- Respiratory acidosis with full kidney

compensation

b- Respiratory acidosis without kidney

compensation.

c- Respiratory alkalosis.

d- Metabolic acidosis.

e- Metabolic alkalosis.

26- Someone is suffering from rapid

breathing, you measured the pH and it

was high , PCO2 ↓ , bicarbonate is

decreased , what is the most correct

diagnosis of the acid base disturbance?

a- Respiratory acidosis with full kidney

compensation

b- Respiratory acidosis without kidney

compensation

c- Respiratory alkalosis with kidney

compensation

d- Respiratory alkalosis without kidney

compensation

a- None of the above

27- All shifts the hemoglobin dissociation curve

to the right except

a- H+

b- CO2

c- 2,3-BPG

d- Low pH

e- CO

28- False regarding CO binding to hemoglobin

a- binds tightly to the hemoglobin iron

b- hemoglobin shifts to the relaxed

conformation

c- hemoglobin to bind oxygen with lower

affinity

d- shifts curve to the left

e- Hemoglobin is unable to release oxygen

to the tissues

29- Physiologic changes due to prolonged

exposure to high altitude include:

a- Increase in the number of red cells

b- Increase in the concentration of Hb

c- Increase in the concentration of BPG

d- None of the above

e- All of the above

30- False regarding 2,3-BPG

a- synthesized from an intermediate of the

glycolytic pathway

b- decreases the oxygen affinity of

hemoglobin by binding to

oxyhemoglobin but not to

deoxyhemoglobin

c- binds to a pocket, formed by the two β-

globin chains

d- shifts the oxygen-dissociation curve to

the right

e- The concentration of 2,3-BPG increases

in chronic hypoxia, pulmonary

emphysema, at high altitudes and in

chronic anemia

pathology 6- which of the following is not a risk factorcells , or any atypical cells. most probable...

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