Obstructive Lung Diseases
1. Which of the following is the primary cause of Chronic Obstructive Pulmonary Disease (COPD)?
A. Smoking
B. Occupational exposure to dust
C. Genetic mutations
D. Viral infections
Answer: A
Explanation: Smoking is the leading cause of COPD, leading to chronic inflammation, airway narrowing, and alveolar destruction.
2. Which test is most useful in distinguishing asthma from COPD?
A. Diffusion capacity (DLCO)
B. Methacholine challenge test
C. Chest X-ray
D. Arterial blood gas (ABG)
Answer: B
Explanation: The Methacholine challenge test is used to diagnose asthma by assessing airway hyperreactivity. COPD does not typically respond to this test.
A. Diffusion capacity (DLCO)
B. Methacholine challenge test
C. Chest X-ray
D. Arterial blood gas (ABG)
Answer: B
Explanation: The Methacholine challenge test is used to diagnose asthma by assessing airway hyperreactivity. COPD does not typically respond to this test.
3. Bronchiectasis is characterized by:
A. Progressive alveolar destruction
B. Reversible airway obstruction
C. Permanent bronchial dilation
D. Decreased lung compliance
Answer: C
Explanation: Bronchiectasis is irreversible dilation of the bronchi, usually due to chronic infections or conditions like cystic fibrosis.
B. Reversible airway obstruction
C. Permanent bronchial dilation
D. Decreased lung compliance
Answer: C
Explanation: Bronchiectasis is irreversible dilation of the bronchi, usually due to chronic infections or conditions like cystic fibrosis.
4. Which is a hallmark symptom of asthma?
A. Productive cough
B. Persistent wheezing
C. Digital clubbing
D. Weight loss
Answer: B
Explanation: Wheezing, especially with episodes of dyspnea and chest tightness, is a key feature of asthma due to airway hyperresponsiveness.
A. Productive cough
B. Persistent wheezing
C. Digital clubbing
D. Weight loss
Answer: B
Explanation: Wheezing, especially with episodes of dyspnea and chest tightness, is a key feature of asthma due to airway hyperresponsiveness.
5. In COPD, which pulmonary function test result is most commonly decreased?
A. Total lung capacity (TLC)
B. Residual volume (RV)
C. Forced expiratory volume in 1 second (FEV₁)
D. Diffusing capacity of carbon monoxide (DLCO)
Answer: C
Explanation: FEV₁ is reduced in COPD due to airflow obstruction and loss of elastic recoil.
B. Residual volume (RV)
C. Forced expiratory volume in 1 second (FEV₁)
D. Diffusing capacity of carbon monoxide (DLCO)
Answer: C
Explanation: FEV₁ is reduced in COPD due to airflow obstruction and loss of elastic recoil.
6. Which of the following is considered an irreversible component of COPD?
A. Airway inflammation
B. Mucus hypersecretion
C. Alveolar destruction
D. Bronchial hyperresponsiveness
Answer: C
Explanation: Alveolar destruction, leading to emphysema, is irreversible and results in permanent loss of gas-exchange surface area.
A. Airway inflammation
B. Mucus hypersecretion
C. Alveolar destruction
D. Bronchial hyperresponsiveness
Answer: C
Explanation: Alveolar destruction, leading to emphysema, is irreversible and results in permanent loss of gas-exchange surface area.
7. Which statement about asthma is TRUE?
A. It is primarily a restrictive lung disease.
B. Airflow limitation is fully reversible.
C. It is characterized by chronic bronchial infection.
D. It does not respond to bronchodilators.
Answer: B
Explanation: Asthma is an obstructive lung disease with reversible airway constriction that improves with bronchodilator therapy.
A. It is primarily a restrictive lung disease.
B. Airflow limitation is fully reversible.
C. It is characterized by chronic bronchial infection.
D. It does not respond to bronchodilators.
Answer: B
Explanation: Asthma is an obstructive lung disease with reversible airway constriction that improves with bronchodilator therapy.
8. What is the typical FEV₁/FVC ratio in patients with obstructive lung disease?
A. >90%
B. 80–85%
C. 70–75%
D. <70%
Answer: D
Explanation: A FEV₁/FVC ratio <70% indicates airflow obstruction, seen in COPD and asthma.
B. 80–85%
C. 70–75%
D. <70%
Answer: D
Explanation: A FEV₁/FVC ratio <70% indicates airflow obstruction, seen in COPD and asthma.
Restrictive Lung Diseases
9. Which of the following is a restrictive lung disease?
A. Emphysema
B. Asthma
C. Pulmonary fibrosis
D. Chronic bronchitis
Answer: C
Explanation: Pulmonary fibrosis causes stiff, non-compliant lungs with reduced lung volumes, characteristic of restrictive lung disease.
A. Emphysema
B. Asthma
C. Pulmonary fibrosis
D. Chronic bronchitis
Answer: C
Explanation: Pulmonary fibrosis causes stiff, non-compliant lungs with reduced lung volumes, characteristic of restrictive lung disease.
10. Pulmonary fibrosis primarily affects which part of the lungs?
A. Bronchi
B. Pleura
C. Alveolar interstitium
D. Large airways
Answer: C
Explanation: Pulmonary fibrosis involves scarring of the alveolar interstitium, reducing gas exchange efficiency.
A. Bronchi
B. Pleura
C. Alveolar interstitium
D. Large airways
Answer: C
Explanation: Pulmonary fibrosis involves scarring of the alveolar interstitium, reducing gas exchange efficiency.
11. Which environmental exposure is associated with pneumoconiosis?
A. Mold spores
B. Carbon monoxide
C. Tobacco smoke
D. Silica dust
Answer: B
Explanation: Silica dust, as seen in mining and construction work, leads to silicosis, a type of pneumoconiosis.
B. Carbon monoxide
C. Tobacco smoke
D. Silica dust
Answer: B
Explanation: Silica dust, as seen in mining and construction work, leads to silicosis, a type of pneumoconiosis.
12. Which restrictive lung disease is characterized by non-caseating granulomas?
A. Tuberculosis
B. Sarcoidosis
C. Pulmonary edema
D. Bronchiectasis
Answer: B
Explanation: Sarcoidosis is an inflammatory disease causing non-caseating granulomas in the lungs and other organs.
A. Tuberculosis
B. Sarcoidosis
C. Pulmonary edema
D. Bronchiectasis
Answer: B
Explanation: Sarcoidosis is an inflammatory disease causing non-caseating granulomas in the lungs and other organs.
13. A patient with asbestosis is at increased risk of developing:
A. Mesothelioma
B. Asthma
C. Pulmonary embolism
D. Bronchiolitis
Answer: A
Explanation: Asbestosis is strongly associated with mesothelioma, a rare pleural cancer.
A. Mesothelioma
B. Asthma
C. Pulmonary embolism
D. Bronchiolitis
Answer: A
Explanation: Asbestosis is strongly associated with mesothelioma, a rare pleural cancer.
14. Which lung function parameter is most commonly reduced in restrictive lung diseases?
A. Forced expiratory volume in 1 second (FEV₁)
B. Total lung capacity (TLC)
C. Residual volume (RV)
D. Inspiratory reserve volume (IRV)
Answer: B
Explanation: TLC is significantly reduced in restrictive lung diseases due to decreased lung compliance and expansion.
B. Total lung capacity (TLC)
C. Residual volume (RV)
D. Inspiratory reserve volume (IRV)
Answer: B
Explanation: TLC is significantly reduced in restrictive lung diseases due to decreased lung compliance and expansion.
15. Which occupational exposure increases the risk of developing coal worker’s pneumoconiosis?
A. Asbestos
B. Silica
C. Coal dust
D. Cotton fibers
Answer: C
Explanation: Coal worker’s pneumoconiosis is caused by coal dust inhalation, leading to lung fibrosis.
A. Asbestos
B. Silica
C. Coal dust
D. Cotton fibers
Answer: C
Explanation: Coal worker’s pneumoconiosis is caused by coal dust inhalation, leading to lung fibrosis.
16. Which cytokine is most involved in the fibrosis of idiopathic pulmonary fibrosis (IPF)?
A. Tumor necrosis factor-alpha (TNF-α)
B. Interleukin-6 (IL-6)
C. Transforming growth factor-beta (TGF-β)
D. Interleukin-1 (IL-1)
Answer: C
Explanation: TGF-β promotes fibrosis by stimulating collagen production, leading to lung scarring in IPF.
A. Tumor necrosis factor-alpha (TNF-α)
B. Interleukin-6 (IL-6)
C. Transforming growth factor-beta (TGF-β)
D. Interleukin-1 (IL-1)
Answer: C
Explanation: TGF-β promotes fibrosis by stimulating collagen production, leading to lung scarring in IPF.
Infectious Lung Diseases
17. The most common cause of bacterial pneumonia in adults is:
A. Mycoplasma pneumoniae
B. Haemophilus influenzae
C. Legionella pneumophila
D. Streptococcus pneumoniae
Answer: D
Explanation: Streptococcus pneumoniae is the leading cause of community-acquired pneumonia in adults.
A. Mycoplasma pneumoniae
B. Haemophilus influenzae
C. Legionella pneumophila
D. Streptococcus pneumoniae
Answer: D
Explanation: Streptococcus pneumoniae is the leading cause of community-acquired pneumonia in adults.
18. What is the classic radiographic finding in tuberculosis?
A. Ground-glass opacity
B. Honeycombing
C. Upper lobe cavitation
D. Pleural effusion
Answer: C
Explanation: TB typically presents with upper lobe cavitary lesions due to caseous necrosis.
A. Ground-glass opacity
B. Honeycombing
C. Upper lobe cavitation
D. Pleural effusion
Answer: C
Explanation: TB typically presents with upper lobe cavitary lesions due to caseous necrosis.
19. Which symptom is most commonly associated with acute bronchitis?
A. Hemoptysis
B. Dry, hacking cough
C. Night sweats
D. Weight loss
Answer: B
Explanation: Acute bronchitis is characterized by a persistent dry cough that later becomes productive.
C. Night sweats
D. Weight loss
Answer: B
Explanation: Acute bronchitis is characterized by a persistent dry cough that later becomes productive.
20. Pneumonia that develops after 48 hours of hospital admission is classified as:
A. Community-acquired pneumonia
B. Healthcare-associated pneumonia
C. Hospital-acquired pneumonia
D. Aspiration pneumonia
Answer: C
Explanation: Hospital-acquired pneumonia (HAP) occurs ≥48 hours after hospital admission and is often due to drug-resistant bacteria.
B. Healthcare-associated pneumonia
C. Hospital-acquired pneumonia
D. Aspiration pneumonia
Answer: C
Explanation: Hospital-acquired pneumonia (HAP) occurs ≥48 hours after hospital admission and is often due to drug-resistant bacteria.
21. Which test is most commonly used to confirm tuberculosis?
A. Sputum culture
B. Chest X-ray
C. Mantoux (PPD) test
D. Bronchoscopy
Answer: A
Explanation: Sputum culture for Mycobacterium tuberculosis is the gold standard for TB diagnosis.
B. Chest X-ray
C. Mantoux (PPD) test
D. Bronchoscopy
Answer: A
Explanation: Sputum culture for Mycobacterium tuberculosis is the gold standard for TB diagnosis.
22. Which of the following is a key symptom of pulmonary tuberculosis?
A. Sudden onset of pleuritic chest pain
B. Productive cough with hemoptysis
C. Acute respiratory distress
D. High fever with chills
Answer: B
Explanation: Pulmonary tuberculosis (TB) often presents with chronic cough, hemoptysis, weight loss, and night sweats.
A. Sudden onset of pleuritic chest pain
B. Productive cough with hemoptysis
C. Acute respiratory distress
D. High fever with chills
Answer: B
Explanation: Pulmonary tuberculosis (TB) often presents with chronic cough, hemoptysis, weight loss, and night sweats.
23. What is the most appropriate first-line antibiotic regimen for community-acquired pneumonia?
A. Vancomycin + Clindamycin
B. Oseltamivir
C. Isoniazid + Rifampin
D. Azithromycin or Amoxicillin
Answer: D
Explanation: Azithromycin or Amoxicillin are first-line treatments for community-acquired pneumonia, targeting common bacteria like Streptococcus pneumoniae.
B. Oseltamivir
C. Isoniazid + Rifampin
D. Azithromycin or Amoxicillin
Answer: D
Explanation: Azithromycin or Amoxicillin are first-line treatments for community-acquired pneumonia, targeting common bacteria like Streptococcus pneumoniae.
Pulmonary Vascular Diseases
24. A pulmonary embolism is most commonly caused by a clot originating from:
A. The heart
B. The lungs
C. The deep veins of the legs
D. The carotid artery
Answer: C
Explanation: Deep vein thrombosis (DVT) is the most common source of pulmonary embolism.
A. The heart
B. The lungs
C. The deep veins of the legs
D. The carotid artery
Answer: C
Explanation: Deep vein thrombosis (DVT) is the most common source of pulmonary embolism.
25. Which imaging test is most sensitive for detecting pulmonary embolism?
A. Chest X-ray
B. CT Pulmonary Angiography (CTPA)
C. Ventilation-perfusion (V/Q) scan
D. Echocardiogram
Answer: B
Explanation: CT Pulmonary Angiography (CTPA) is the gold standard for diagnosing pulmonary embolism.
A. Chest X-ray
B. CT Pulmonary Angiography (CTPA)
C. Ventilation-perfusion (V/Q) scan
D. Echocardiogram
Answer: B
Explanation: CT Pulmonary Angiography (CTPA) is the gold standard for diagnosing pulmonary embolism.
26. Which is a major risk factor for pulmonary hypertension?
A. Smoking
B. Obstructive sleep apnea
C. Left heart disease
D. All of the above
Answer: D
Explanation: Pulmonary hypertension can be caused by lung diseases, sleep apnea, and left-sided heart failure.
B. Obstructive sleep apnea
C. Left heart disease
D. All of the above
Answer: D
Explanation: Pulmonary hypertension can be caused by lung diseases, sleep apnea, and left-sided heart failure.
27. What is the first-line treatment for acute pulmonary embolism?
A. Bronchodilators
B. Antibiotics
C. Anticoagulants
D. Diuretics
Answer: C
Explanation: Anticoagulation therapy (e.g., heparin, warfarin) is the primary treatment for PE.
A. Bronchodilators
B. Antibiotics
C. Anticoagulants
D. Diuretics
Answer: C
Explanation: Anticoagulation therapy (e.g., heparin, warfarin) is the primary treatment for PE.
28. Which heart sound is commonly associated with pulmonary hypertension?
A. S1 accentuation
B. Loud P2 component of S2
C. S3 gallop
D. Diastolic murmur
Answer: B
Explanation: A loud P2 (pulmonic component of S2) suggests increased pulmonary artery pressure.
A. S1 accentuation
B. Loud P2 component of S2
C. S3 gallop
D. Diastolic murmur
Answer: B
Explanation: A loud P2 (pulmonic component of S2) suggests increased pulmonary artery pressure.
29. Which clinical sign is most specific for a massive pulmonary embolism (PE)?
A. Sudden onset of dyspnea and chest pain
B. Slow progressive cough
C. Bilateral lung wheezing
D. Clubbing of the fingers
Answer: A
Explanation: Pulmonary embolism presents with sudden dyspnea, pleuritic chest pain, and tachycardia due to obstruction of pulmonary arteries.
B. Slow progressive cough
C. Bilateral lung wheezing
D. Clubbing of the fingers
Answer: A
Explanation: Pulmonary embolism presents with sudden dyspnea, pleuritic chest pain, and tachycardia due to obstruction of pulmonary arteries.
30. Which medication is used for long-term management of pulmonary arterial hypertension (PAH)?
A. Beta-blockers
B. Calcium channel blockers
C. Endothelin receptor antagonists (e.g., Bosentan)
D. Corticosteroids
Answer: C
Explanation: Endothelin receptor antagonists reduce pulmonary artery pressure and are used for long-term treatment of PAH.
A. Beta-blockers
B. Calcium channel blockers
C. Endothelin receptor antagonists (e.g., Bosentan)
D. Corticosteroids
Answer: C
Explanation: Endothelin receptor antagonists reduce pulmonary artery pressure and are used for long-term treatment of PAH.