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
e- None of the above
4- The most common cause of hospital
acquired pneumonia in US
a- G-ve bacilli
b- S.pneumonia
c- S.aureus
d- S.viridans
e- None of the above
5- Hypercalemia related to paraneoplastic
changes include which of the following
cancers
a- mixed tumors
b- squamous lung carcinoma
c- Carcinoid
d- Adenocarcinoma
e- None of the above
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
e- None of the above
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
e- None of the above
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
e- None of the above
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
e- None of the above
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
e- none 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
e- None of the above
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
e- None of the above
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
e- none of the above
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
a- Chemotherapy then surgery.
b- Surgery then chemotherapy
c- Chemotherapy alone
d- Targeted chemotherapy
e- Surgery alone
37- Adenocarcinoma is treated by
a- Chemotherapy then surgery.
b- Surgery then chemotherapy
c- Chemotherapy alone
d- Targeted chemotherapy
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
e- None of the above
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
e- none of the above
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
e- None 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
e- None of the above
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
e- None of the above
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
e- None of the above
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
e- None of the above
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
e- None of the above
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
e- None of the above
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
e- None of the above
39- which one is a spherule ?
a- coccidioides immits
b- paracoccidioidis brasiliensis
c- Cryptococcus neoformans
d- P.carinin
e- None of the above
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
e- None 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
e- None of the above
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
e- None of the above
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