The document contains questions and answers related to pulmonary and respiratory diseases. It covers topics like Goodpasture's syndrome, pulmonary hypertension, obstructive sleep apnea, asbestosis, silicosis, pulmonary embolism, tuberculosis screening and treatment. Diseases, their signs and symptoms, diagnostic tests and best treatment approaches are discussed in the multiple choice questions.

1. 29. Pulmonary feature most commonly seen in patients with Goodpasture’s syndrome?
(HPIM p. 2169)
a. Pneumonia
b. Pulmonary hemorrhage
c. Plurds
d. Pleural effusion
31. One cause of acute cor pulmonale? (HPIM p. 1914)
a. Obstructive sleep anea (OSAHS)
b. Large left-to-right shunt
c. Atrial arrhythmia
d. Massive pulmonary embolism
32. Pulmonary vasoconstriction leading to pulmonary hypertension can be due to? (HPIM p.
1914)
a. Hypercabia- induced respiratory acidosis
b. Respiratory alkalosis due to low CO₂
c. Metabolic alkalosis due to decreased HCO₃
d. Metabolic acidosis due to increased CO₂

2. 34. In giving diuretics to patients with PV failure, which of the following must be avoided? (HPIM p.
1915)
a. Metabolic acidosis
b. Contraction alkalosis
c. Hyperkalemia
d. Respiratory alkalosis
35. OSAHS is defined as the coexistence of unexplained excessive daytime sleepiness with at least how
many obstructed breathing events (apnea or hypopnea) per hour of sleep? HPIM p. 2186
a. 2
b. 5
c. 10
d. 15
36. Clinical effects of OSAHS? (HPIM p. 2187)
a. Hypertension
b. Hypoglycemia
c. Hepatitis
d. Increased libido

3. 37. Best evidence-based therapy for OSAHS? (HPIM p. 2188)
a. Oxygen
b. Tracheostomy
c. Modafinal
d. Mandibular repositioning splint
38. Most common cancer associated with asbestos exposure? (HPIM p. 2123)
a. Mesothelioma
b. Lung cancer
c. Nasopharyngeal carcinoma
d. Thymoma
39. “Crazy paving” HRCT pattern is seen in? (HPIM p. 2124)
a. Asbetosis
b. Silicosis
c. Drug induced fibrosis
d. Coal worker’s pneumonconiosis

4. 40. Patients with silicosis are at a greater risk of acquiring with lung infection? (HPIM p.
2125)
a. Streptecoccus pneumoniae
b. Legionella sp.
c. Pneumocystis carinii
d. Mycobacterium tuberculosis
41.
a.
b.
c.
d.
42. The principal imaging test for the diagnosis of pulmonary embolism ? (HPIM p. 2173)
a. Lung nucleur scanning
b. Computed tomography of the chest
c. Chest X-ray
d. MRI

5. 43. Best known indirect sign of PE on transthoracic echocardiography ? (HPIM p. 2174)
a. Pallas sign
b. RV heav sign
c. McConell’s sign
d. Eggshell sign
44. The major advantage of unfractionated heparin is? (HPIM p. 2175)
a. Predictable PTT response
b. PT PA can be measured instead of PTT
c. Greater bioavailability
d. Short half-life
45. Highest risk factor for active TB among persons who have been infected with TB
bacili? (HPIM p. 1342)
a. Recent infection
b. Diabetus melitus
c. Tobacco smoking
d. Jejunoileal bypass

6. 46. Which among these TB patients are most infectious? (HPIM p. 1342)
a. Those who have reactivation of TB
b. Those with cavitary pulmonary disease
c. Those with co-existing extrapulmonary TB
d. Those with co-existing COPD
47. The greatest limitation of PPD is? (HPIM p. 1351)
a. Deterioration of the product
b. Variation of response due to race
c. Lack of mycobacterial species specificity
d. Batch to batch variation
48. Which of the following is recommended for latent TB infections (LTBI)? (HPIM p.
1357)
a. INH for 9 months
b. Rifampicin and Pyrazinamide for 2 months
c. INH and ethambutol for 6 months
d. Rifampicin for 6 months

7. 1. A 65-year-old COPD patient with exacerbation was admitted at the ICU for
ventilator support. The patient was stable but suddenly developed difficulty of
breathing despite respirator support. Breath sounds on the right were absent.
Peak airway pressure was elevated. Management of this patient is (HPIM p. 2181)
a. Reintubation
b. Ambubagging
c. Insert needle at 2nd intercostal space
d. Decrease tidal volume
2. A 45-year old office worker consulted because of low grade afternoon fever and
weight loss. Her chest X-ray showed densities at the apical posterior area of the
right lung . Her past history was unremarkable. Her white cell count was normal.
PPD test measured 18mm. Recommended treatment for this patient to be given
for two months pending sputum studies is? (HPIM p. 1352):
a. HRE
b. HR
c. HRZ
d. HRZES

8. 3. A 67-year-old female diabetic patient was admitted to the hospital because of 3
days duration of fever, cough and difficulty of breathing. On PE she was awake and
conscious, BP 130/80, HR 104, RR 30, T 38.0. Fine rales were noted at the right
base. Lab exam showed WBC at 15,000 with 0.92 segmenters. BUN was 6 mmol/L .
Creatinine was normal and RBS was 185 mmol/L. Your initial antibiotic treatment
is (HPIM p. 2135)
a. IV azithromycin + cefepime