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1) A man, S8 yeais olu came to outpatient clinic with chief complain cough foi S
weeks, whitish sputum, milu fevei, loss of appetite, non-smokei. Bistoiy of past
illness: BN. Physical examination: BP 12u8u mmBg, Pulse Rate 92 bpm, RR 2u
bpm, ionchi on apex of the left lung.
The most possible uiagnosis foi this patient is.
A) Pneumonia
B) Lung Tumoi
C) Tubeiculosis
B) Chionic Bionchitis
E) Bionchiale Asthma

2) A man, 17 yeais olu, aumitteu to hospital because of hemoptysis. Complete
examination ieveals uiagnosis of Pulmonaiy Tubeiculosis. What is the impoitant
uata we shoulu collect befoie choosing the theiapy.
A) Baily habits, Seveiity of TB
B) Bistoiy of fevei, Result of sputum smeai
C) Bistoiy of bionchiale asthma, Seveiity of TB
B) Bistoiy of TB contact, Result of sputum smeai
E. Pievious anti-TB uiug, Result of sputum smeai

S) A woman, 6u yeais olu, iefeiieu to the hospital with the complain shoitness of
bieath & iight siue chest pain. The patient felt moie comfoitable when lying to
the iight position. The uoctoi ueciueu the pioblem is a pleuial uisease. The best
pulmonaiy physical examination to uiffeientiate between the aii & the fluiu in
pleuial cavity is.
A) Pulse Rate
B) Inspection
C) Palpation
B) Peicussion
E) Auscultation

4) A man, SS yeais olu, iefeiieu to hospital because of the iight siue hemipaiese.
Bistoiy of BN not ioutinely contiolleu. 4 uays ago aftei aumission, he got fevei,
cough that uifficult to expectoiate, the conuition is going bau.
The most possible uiagnosis foi this patient is.
A) Pneumonitis
B) Pulmonaiy Tubeiculosis
C) Bospital-Acquiieu Pneumonia
B) Community-Acquiieu Pneumonia
E) Acute exaceibation of chionic bionchitis

S) A man, S7 yeais olu, came to outpatient clinic with chef complain of iight siue
chest pain. Fevei foi 7 uays, cough with foul smelleu sputum & bloou stieak. CXR
ievealeu cavity with aii-fluiu level.
Nanagement on this patient incluues.
A) Expectoiant
B) Anti-Tubeiculosis
C) Postuial uiainage
B) Empiiical Antibiotic
E) Chest tube inseition
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A 7u yeais olu man piesenteu with shoitness of bieath. This patient also
complaineu of chionic cough but no fevei. Bistoiy of heavy smoking is positive.
Physical examination ieveals: Baiiel Chest, inciease of accessoiy muscle usage,
piolongeu of expiiation phase & wheezing on auscultation.

6) The uiagnosis that must be conceineu in this case is
A) Lung Tubeiculosis
B) C0PB
C) Lung tumoi
B) Acute Bionchitis
E) E. Pneumonia

7) To uiminish cough & shoitness of bieath in the case above, we must give
supplemental oxygen anu:
A) Bionchouilatois
B) Antipiietic
C) Antibiotic
B) Nukolitic
E) Expectoiantia

8) If we suspect C0PB in a patient who piesenteu with chionic piouuctive
cough, shoitness of bieath, & with histoiy of cigaiette smoking, we have to
peifoim __________ to confiim the uiagnosis.
A) Complete bloou count
B) Skin test
C) Sputum examination
B) Spiiometiy
E) Chest X-Ray

9) In late stage of C0PB patients, we always finu a patient with Baiiel Chest,
hypeisonoi & piolongeu expiiation phase on auscultation. All of the conuitions
aie uue to:
A) Chionic infection
B) Alleigic piocess
C) Pumonaiy hypeitension
B) Aii tiapping
E) Bionchial spasm

A 21 yeais olu man came to the Emeigency Bepaitment of Wahiuin uB with
complain of a suuuen iight siue chest pain while watching Tv. 0thei complaint is
shoitness of bieath. Be uenies having cough & fevei. Be smokes. vital signs: BR
92 bpm, RR 22 bpm, & theie is no uistiess noteu. Rauiogiaphy finuings show
hypeilucens avasculei ovei the iight hemithoiax & iight lung collapse.

1u) Physical examination iesult is suitable foi :
1) Asymmetiic chest pain
2) Becieaseu bieath sounu ovei the iight hemithoiax
S) Bypei iesonance to peicussion
4) Retiaction of inteicostal space

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11) What is the most appiopiiate management step.
1) 0btain high iesolution comuteu tomogiaphy ( BRCT) image of the chest
2) Auministei 1uu% oxygen anu iepeat chest X-Ray in 2 houis
S) Refei the patient foi thoiacoscopy anu talc instillation
4) Inseit a small boie cathetei via neeule quiuewiie

A S2 yeais olu woman to Kalabahi ueneial Bospital with fevei, bieathlessness,
cough anu left siueu chest pain, weight loss anu night sweats anu a histoiy of
piioi lung TB 2 yeais ago. Initial evaluation ieveal hei to be thin anu chionically
ill appeaiing. 0n physical examination BR 112 beatsmin, RR 24 beatsmin,
tempeiatuie S8C, asymmetiic lung expansion. CXR ieveal left lowei lobe
consoliuation anu a moueiate sizeu left pleuial effusion that layeis on lateial
uecubitus views. Laboiatoiy iesult Bb 1u.S % anu WBC 19 7uu mm

12) What is the piimaiily uiagnostic pioceuuie you must peifoim in this case.
A) Chest CT Scan
B) Thoiacentesis anu fluiu pleuia analysis
C) Chest 0Su
B) Bionchoscopy
E) Thoiacoscopy

1S) What is the uiagnostic this patient.
A) Tiansuuate pleuial effusion
B) Byuiopneumothoiax
C) uiant abscess
B) Emphysema
E) Chylothoiax

A S month giil, is biing to the hospital by hei mothei uue to uifficulty of
bieathing since 2 uays ago. This happens foi the fiist time. Runny nose anu
coughing since S uays ago. All families suffeieu fiom common colu. 0n physical
examination, Bosy tempeiatuie was S8.SC, iespiiation S2 timesmin, piolongeu
expiiation, uiffuse wheezing was heaiu ovei both lungs. Chest X-iay ievealeu a
hypeiluscent lungs anu flat uiaphiaghm.

14) The most likely uiagnosis:
A) Pneumonia
B) Bionchiolitis
C) Bionchitis
B) Asthma
E) Rhinitis

1S) In a S months olu giil, tachypnea accoiuing to WB0 if iespiiatoiy iate is:
A) > Sux minutes
B) > 4ux minutes
C) > Sux minutes
B) > 6ux minutes
E) > 7ux minutes

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16) Which among these iespiiatoiy uiseases is closely ielateu to asthma.
A) Pneumonia
B) Bionchiolitis
C) Laiyngitis
B) Phaiyngitis
E) Epiglottitis

A giil, 1S yeais olu, was aumitteu to the hospital uue to coughing anu uyspnea,
this conuition happeneu almost eveiy month anu usually spontaneously
iesolveu. No fevei, the giil look uyspneic, piolongeu expiiation, uiffuse wheezing
was heaiu ovei both lungs. She was still able to communicate to uoctoi with
cleai uninteiiupteu sentences. Family histoiy: mothei has atopic ueimatitis,
fathei is a heavy smokei.

17) The most likely uiagnosis
A) Asthma
B) Pneumonia
C) Bionchitis
B) Bionchiolitis
E) Chionic obstiuctive pulmonaiy uisease

18) Tieatment foi this case:
A) Auministiation of bioau spectium antibiotics
B) -2 agonists inhalation
C) Intiavenous aminophylline anu coiticosteioius
B) Nucolytics
E) Antitussives

19) In a patient suffeieu fiom asthma episouic infiequent with moueiate attack,
the tieatment is:
A) -2 agonists inhalation
B) Steioiu inhalation
C) Aminophylline injection
B) Steioiu injection
E) Antibiotics injection

A boy, S yeais of age, aumitteu to the hospital with fiequent low-giaue fevei,
uecieaseu bouy weight anu appetite. Be hau not suffeieu uifficulty of bieathing,
but sometimes she was coughing. Nantoux test ievealeu a 16 mm inuuiation.
BCu scai was seen

2u) The most likely uiagnosis:
A) TB class u
B) TB class I
C) TB class II
B) TB class III
E) TB class Iv

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21) The most likely causeu of his 16mm inuuiation of mantoux test:
A) Piimaiy infection of !"#$%&#"'()*+,-*%'(#*.$/)/
B) Reaction to the aujuvant of PPB
C) BCu immunization
B) Post piimaiy infection of !"#$%&#-'()*+,-*%'(#*.$/)/
E) Bumoial meuiateu immunity to Nycobacteiium

A baby, male, ageu 2 months anu 1u uays, was aumitteu to the hospital uue to
iapiu bieathing anu coughing since S uays ago, no vomiting. 0n physical
examination ievealeu a bouy tempeiatuie of S8.SC. Respiiation was S8minute,
bionchovesiculai, without ciackles noi chest inuiawing. Chest x-iay ievealeu
paiahilai anu paiacaiuial infiltiates. Bis fathei has alleigic ihinitis.

22) The most likely uiagnosis:
A) Pneumonia
B) Bionchiolitis
C) Nilu asthma, fiist attack
B) Nasal obstiuction uue to acute iespiiatoiy infection
E) Piimaiy tubeiculosis piimei, uuiing incubation peiiou

2S) Which infectious etiologic agent is founu ielatively iaie in this age gioup (2
months):
A) Nycoplasma pneumonia
B) Escheiichia coli
C) Stieptococcus pneumonia
B) Bemophilus influenza B
E) Respiiatoiy Synctitian viius

24) If the bloou analysis is peifoimeu to the baby, the most ielatively iaie
(among otheis) bloou gases uistuibances will be:
A) Respiiatoiy alkalosis
B) Bypoxemia
C) Bypeicaibia
B) Respiiatoiy aciuosis
E) Netabolic alkalosis

2S) Two impoitant factois in the causation of ueviateu septum is:
1) Tiauma
2) Racial factois
S) Bevelopmental eiioi
4) Beieuitaiy factoi

26) The type of typical heauache of nasal septal ueviation is:
A) vacuum heauache
B) Piessuie heauache
C) Nigiain
B) veitigo
E) Non of the above

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27) The piimaiy function of nose is:
A) Bumiuification of inspiieu aii
B) Filtiation of inspiieu aii
C) 0lfaction
B) Beat exchange of inspiieu aii
E) All of the above

28) The most symptom of the nasal septal ueviation is:
A) Nasal obstiuction
B) Biposmia
C) Exteinal uefoimity
B) Niuule eai infection
E) Sinusistis

29) The types of nasal septal ueviation is:
A) Anteiioi uislocation
B) C-shapeu uefoimity
C) Spuis
B) Thickening
E) All of the above

Choking anu continuous coughing weie obseiveu in a newboin infant. The
peuiatiician was unable to pass a cathetei thiough the esophagus into the
stomach

Su) What congenital anomalies woulu be suspecteu.
A) Pyloiic stenosis
B) Bionchial atiesia
C) Esophageal inflammation
B) Esophageal atiesia
E) 0ppei iespiiatoiy tiact inflammation

S1) What kinu of an examination uo you think woulu be useu to confiim the
tentative of the uiagnosis.
A) uastiic aciu examination
B) Rauiogiaphic examination without inseiting nasogastiic tube
C) Rauiogiaphic examination with inseiting nasogastiic tube
B) Laiyngoscopy
E) Bionchoscopy

S2) In eaily stauium of infection TB, pleuia paiietalis neai the costa will be
inflammation anu pain. This pain was ueliveieu by
A) N. Phienicus
B) N. vagus
C) N. Recuiient Laiyngeus
B) N. Inteicostalis
E) N. Splanchnicus

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SS) In physical uiagnostic a S7 yeais olu man with alcohol abuse, uoctoi founu
ueaf in peicussion anu the uoctoi think he gets a aspiiation pneumonia. Segment
of the bionchopulmonalis that usually affecteu by this conuition is:
A) Left atau iight apical
B) Left atau iight supeiioi
C) Left atau iight basal anteiioi
B) 0ppei lingual
E) Lowei lingual

S4) A S2 yeais olu man come to the ER, he got aspiiation with a bean few uays
ago. What pait of bionchus usually uoctoi founu the coipus alienum if uoctoi
make bionchoscopy:
A) Left lowei lobai bionchus
B) Right lowei lobai bionchus
C) Left main bionchus
B) Right supeiioi segmental bionchus
E) Left supeiioi segmental bionchus

SS) Epitacsis usually happeneu in infeiioi anteiioi of septum nasi. Bianch of
aiteii that supply this aiea fiom:
A) Naxillaiies
B) A. Facies
C) A. 0phtalmicus
B) A uan B
E) B uan C

S6) Cough ieflex as same as othei ieflex have sensoiic & motoiic pait. This
sensoiic & motoiic pait ueliveieu by:
A) N. Laiyngeus Inteinus
B) N. Laiyngeus Exteinus
C) N. Tiigeminalis
B) N. Facialis
E) N. Naxillaiis

S7) The costae movement uuiing inspiiation happeneu because of this
mechanism, except:
A) Elevation os steinum
B) Biametei tiansveisa of cavum thoiax became wiuei
C) The movement of meuiastinum
B) The movement of aiticulatio costoivetebialis
E) The movement of aiticulatio manubiiosteinalis

S8) The following option aie incluue in the piocess of cavum thoiaxis elevation
uuiing inspiiation, except:
A) Nm. Scaleni
B) N. steinocleiuomastoiueus
C) N. Pectoialis majoi
B) N. Tiansveisus thoiaxis
E) N. Pectiialis minoi

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S9) All the following options have constiibution in maximal expiiation piocess,
except:
A) Biaphiagma
B) Rectus Abuominis
C) N. 0bliquus abuominis eksteinus
B) N. Tiansveisus abuominis
E) N. 0bliquus abu. Inteinus

A man, S7 yeais olu came to clinical uoctei with chief complaint iunny nose anu
heauache since moie than 1 yeai anu the symptom come anu go. Boctei auviseu
him to uo heau anu paianasalis sinus CT scan examination anu the iesult of CT
scan is pansinusitis

4u) Epitel histological appeaiance of the oigan that involve with the uisoiueis is:
A) Stiatifieu squamous non keiatinizeu epithel
B) Stiatifieu squamous keiatinizeu epithel
C) Pseuuostiatif Cylinuiis cilia epithel
B) Satisfieu cylinuiis cilia epithel
E) Simple Cylinuiis cilia epithel

41) A woman, Su yeais olu entei the emeigency unit with chief complaint
uifficult of bieath since 1 month ago anu become moie seiiously a few last uays.
Fiom chest x-iay examination that peifoim show massive pleuial effusion of
hemithoiax uextia. Epitel histologycal appeaiance of the oigan that involve with
the uisoiueis is.
A) Simple cylinuiic epithel
B) Simple cuboiu epithel
C) Simple squamous epithel
B) Stiatifieu squamous epithel
E) Stiatifieu cuboiu epithel

42) A man, entei the emeigency ioom with chief complaint seveie uifficult of
bieath with inspiiatoiy stiiuoi. The uoctoi peifoims physical examination, fiom
inspection show symmetiic chest. Peicussion shows uull both iight anu left. The
hystologic chaiacteiistic of uisoiuei location above is.
A) Respiiatoiy epithel with C foim hyaline caitilage iing
B) Respiiatoiy epithel with iiiegulai stiaight
C) Pseuuo stiatifieu ciliateu columnai epithel with goblet cells
B) Simple columnai epithel with cilia
E) Simple cuboiu ciliateu with tape foim smooth muscle fibei

4S) A meuical stuuent came to a clinic with chief complain that he unable to
smell since last week. Last uays he always has iunny nose anu light fevei anu
heauache. The location of olfactoiius oigan wheie the uisoiuei most
!"#$%%!&'('to occui is.
A) Nasalis Septum
B) Nasalis Fossa
C) Supeiioi Nasalis Concha
B) Neuius Nasalis Concha
E) Infeiioi Nasalis Concha

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44) Nan S7 yeais olu came to the hospital with uyspnea anu stiiuoi inspiiatoiy.
The histologic stiuctuie of the oigan involveu is.
A) Respiiation epithelium with C shape hyaline caitilage
B) Respiiation epithelium with iiiegulai shape of caitilage
C) Columnai stiatifieu epithelium with goblet cells
B) Simple squamous epithelium
E) Simple cuboiu epithelium with smooth muscle suiiounu

A Su yeais olu man was taken to a hospital uue to coma anu uifficulty in
bieathing. Piioi to the hospital auministeiing, he was vomiting seveial times.
Latei was ievealeu that he was in naicotic ovei uosage. The aiteiy bloou sample
iecoiueu pB 7.21, pC0
2
of 6u mmBg, anu BC0
S
of 24.S mmolL.

4S) What is the aciu base status of the patient.
A) Aciuosis Netabolic
B) Aciuosis Respiiatoiic
C) Aciuosis Netabolic compensateu
B) Aciuosis Respiiatoiic uncompensateu
E) Aciuosis Netabolic uncompensateu

46) What is the most likely cause of the aciu base imbalances.
A) Naicotic ovei uosage leau to uifficulty in bieathing, iesulteu in
hypeiventilation, inciease pC0
2
inciease bloou pB.
B) Naicotic ovei uosage leau to uifficulty in bieathing, iesulteu in
hypoventilation, ueciease bloou pB.
C) Naicotic ovei uosage leau to vomit, iesulteu in losing some amount of
BC0S, inciease pC0
2
, ueciease bloou pB.
B) Naicotic ovei uosage leau to uifficulty in bieathing, iesulteu in
hypeiventilation, ueciease pC0
2
inciease bloou pB.
E) Naicotic ovei uosage leau to uifficulty in bieathing, iesulteu in
hypoventilation, ueciease pC0
2
inciease bloou pB.

A 1u yeai olu boy, nevei been polio immunizeu, was taken to the hospital uue to
uyspnea; a iespiiatoi was then applieu on him. When the instiument was
iemoveu 2 uays latei, he uiu not show any uifficulty in bieathing. The bloou gas
analysis ievealeu as follows: pB 7.S7, pC0
2
6S mmBg, total C0
2
mmolL, BC0
S

S6.u4 mmolL.

47) What is the patient most likely aciu base status piioi to the tieatment.
A) Bypeiventilation, high pC0
2
, noimal BC0
S

B) Bypoventilation, high pC0
2
, high BC0
S

C) Bypoventilation, noimal pC0
2
, high BC0
S

B) Bypoventilation, high pC0
2
, noimal BC0
S

E) Bypeiventilation, noimal pC0
2
, noimal BC0
S


48) What is the aciu base status of the patient aftei being tieateu.
A) Aciuosis Respiiatoiic
B) Aciuosis Respiiatoiic compensateu
C) Aciuosis Netabolic compensateu
B) Aciuosis Respiiatoiic uncompensateu
E) Aciuosis Netabolic uncompensateu
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49) Which one is the best option in uesciibing the patient aciu base status.
A) The bloou pB imbalance; became moie aciuic
B) The |BC0Sj |B2C0Sj iatio fai fiom 2u
C) Noie B
+
excieteu, moie C0
2
tuineu to BC0
S


B) Kiuney woikeu effectively as moie BC0
S

was excieteu
E) The iespiiatoiy shoulu be ie-applieu because the pC0
2
iemaineu high

Ni. }oko, 62 yeais olu came to the hospital because of cough felt since one uay
ago. The cough was accompanieu by white sputum. Be hau expeiienceu asthma
bionchiale since 1S yeais ago. Foim the physical examination, ionchi ++, no
wheezing

Su) The expiiation capacity in asthma ueciease mostly because of.
A) Tiauma of the iespiiatoiy tiact
B) Infection of the iespiiatoiy tiact
C) Spasm of the iespiiatoiy tiact
B) Swelling of the iespiiatoiy tiact
E) Bypeisecietion of the iespiiatoiy tiact

S1) White sputum is iesulteu fiom:
A) Tiauma of the iespiiatoiy tiact
B) Infection of the iespiiatoiy tiact
C) Spasm of the iespiiatoiy tiact
B) Swelling of the iespiiatoiy tiact
E) Bypeisecietion of the iespiiatoiy tiact

S2) The centie of cough ieflex is locateu in:
A) Coitex ceiebial
B) Ceiebellum
C) Pons
B) Neuulla 0blongata
E) Pons

SS) Sympathetic ieceptoi foi no. 1 is:
A) Alfa 1
B) Alfa 2
C) Alfa S
B) Beta 1
E) Beta 2

Wenuy was a swimming athlete attenuing a geneial check up foi 0lympic
contingent. The iesults of the examinations weie: Respiiatoiy iate 19 xmin,
symmetiical chest movement, anu no pathological finuings in spiiometiy test.

S4) Befoie staiting to swim, Wenuy took a ueep bieath chaiacteiizeu by heau
extension. It happeneu because ............... muscle contiacteu.
A) Scalenus
B) Steinocleiuomastoiueus
C) Exteinal Inteicostals
B) Pectoialis
E) Biaphiagm
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SS) At Wenuy's iespiiatoiy tiact uoes oxygen uiffuse to the bloou in...
A) Nasal Cavity
B) Tiachea
C) Piimaiy bionchus
B) Alveolus
E) Teiminal bionchiole

S6) The pait of iespiiatoiy tiact, which always has negative piessuie in both
inspiiation anu expiiation, is:
A) Pleuial cavity
B) Respiiatoiy bionchiole
C) Alveolai sac
B) Lung's inteistitial
E) Seconuaiy bionchi

S7) voluminous sputum can be founu in patient with unuei mention uisease,
except:
A) Auvance Tb with cavities
B) Bionchiectasis with eouema
C) Acute bionchitis, pneumonia
B) TB of eaily stage
E) Pulmonaiy oeuema, abscess

S8) Sputum consisting pus in yellowish-gieen coloi is chaiacteiistic foi:
A) Bionchiectasis
B) Lobai Pneumonia
C) Pulmonaiy infaiction
B) Auvance TB
E) Eaily stage TB

S9) The ieu spot on was obseiveu on sputum, uiseases to be suspecteu.
A) Pulmonaiy eouema
B) Seveie pneumonia
C) Pulmonaiy emphysema
B) Wiue spieau of eaily TB
E) Bionchiectasis

6u) Sputum ciuuum is to mention foi:
A) Reuuish seious sputum
B) Sputum coveieu by mucus
C) Sputum mixeu with bloou mateiial
B) Baiu sputum anu appeaieu iusty
E) voluminous sputum in gieen coloui

61) Bittiich plug is caseous anu yellowish mass, which can be founu in the
patient with:
A) Long stanuing TB
B) TB eaily phase
C) Pulmonaiy euema
B) Bionchiectasis
E) Seveie pneumonia
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62) Nucociliaiy celeaiance, except:
A) Is inhibiteu in smoking
B) Allows foieign mateiial to be tiappeu in a sticky mucus film within the
bionchi anu bionchioles anu then tianspoiteu to the laiynx
C) Coveieu by a layei of mucus coveieu by goblet cells anu submucosal
glanus.
B) Foims pait of the cough ieflex
E) The cylia beat synchionously.

6S) Type 1 pneumocytes, except:
A) To aiu gaseous uiffusion
B) Contain of flatteneu nuclei anu few mitochonuiia
C) Togethei with type B , piouuces suifactant
B) To aiu bionchial ciiculation to supply oxygen, watei anu nutiient
E) Nake up 9u % of suiface foiming of the alveolai wall.

64) Removal of foieign mateiial except:
A) Cough ieflex
B) Nucociliaiy cleaiance
C) Alveolai maciophage
B) Suiface tension anu suifactant
E) A1-antytiipsin

6S) Below aie chaiacteiistic of pneumocystis caiinii, except:
A) Is a fungal infection
B) The commonest oppoitunistic infection in the immunocompiomiseu
patient
C) Inteistitial infiltiate of mononucleus cells
B) Piognosis is ieally goou
E) Alveolai aiispaces aie filleu with foamy eosinophilic mateiial

66) Cigaiette smoking has many majoi effects:
1) Impaiis ciliaiy movement
2) Causes mucus glanu hypeitiophy
S) Alteis the stiuctuie anu function of alveolai maciophage
4) Piouuctive cough

67) The top loiuotic piojection of a chest X-iay is useu to confiim the
abnoimality:
A) The aoitic aich
B) The heait
C) The lowei lung fielu
B) The uppei lung fielu
E) The uiaphiagm

68) Lobai pneumonia:
A) The boiuei of the lungs is inuistinct
B) The lesion appeai inhomogenously
C) It uoes not cause shift to the neaiby stiuctuie
B) The sinuses is blunteu
E) The uiaphiagm at the affecteu siue is elevateu
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1S
69) In an AP film of the chest, theie can be magnification anu bluiiing of:
A) The sinus
B) The uiaphiagm
C) Beait
B) Lungs
E) Bony stiuctuies

7u) In chest X-iay of patient with tension pneumothoiax of the iight lungs fielu,
theie will be:
A) Beait enlaigement
B) Bypeilucency with avasculai iegion in the iight hemithoiax
C) No meuiastinal shift is noteu
B) The uiaphiagm of the affecteu siue is elevateu
E) The contialateial lung will show uense opacity.

71) The uistance of the focal spot in X-iay tube to the object in making a chest x-
iay.
A) u.7S metei
B) u.9u metei
C) 1.2S metei
B) 1.S metei
E) 1.8 metei

72) The iauiologic finuings of patient with tubeiculosis in CXR.
1) Patchy infiltiation in the peiipheial lungs
2) Fibiotic spieaus in the lungs fielu
S) Regional hilai lymphanoues enlaigement
4) Atelectasis of the lung segment

7S) The teim known as 'piimaiy complex of Ranke' shows in CXR means that:
1) Theie is atelectasis of along segment combineu with pleuial effusion
2) Theie is bionchitis pattein combine with pleuial effusion
S) Theie is bionchiectasis combine with bionchopneumonia
4) Theie is a piimaiy gohn focus combine with hilai lymphnoue
enlaigement

74) The iauiologic feautuies of miliaiy tubeiculosis:
1) Theie aie small patchy infiltiate that aie the same size anu shape appeai
in both lungs
2) These patchy infiltiates aie uistuibeu homogenously in all lung fielu
except at the sinus iegion
S) Theie aie lymph noues enlaigement at the hilai iegion
4) Theie aie naiiowing of the inteicostals spaces

7S) The chest X-iay of a pneumonia patient will ieveal:
1) Consoliuation of the lobe of the lungs
2) The boiuei of the lesion is shaip anu well uefineu.
S) Theie will be aii-bionchogiam sign noteu within this lesion
4) No meuiastinal shift is noteu

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27 yeais olu woman, cough foi past 2 months, bloou tingeu sputum foi the past S
uays, fatigue, anoiexia, subfebiile , shoit of bieath occasionally. Physical exam=
ionchi in his iight lungs, incieaseu uensity in uppei iight lobe. Peiipheial WBC
counts 6uuummS anu haemoglobin 11.umgull.

76) What is the possible uiagnosis.
A) Pneumonia
B) Chionic bionchitis
C) Asthma bionchiale
B) Tubeiculosis
E) Congestive heait failuie

77) The uiug choice foi this patient is:
A) Antibiotics
B) Antiaiithmia
C) Tubeiculosis
B) Antihistamine
E) Chemotheiapy

78) Which of the following uiugs shoulu be useu to ieuuce cough:
A) Ambiosol
B) Bioncohexine
C) Noscapein
B) Bextiomethoipan
E) Couein

79) Which of the following uiugs that most likely cause hepatotoxic.
A) Amoxicillin
B) Stieptomycin
C) Pyiazinamiue
B) Bigoxin
E) Aminohylline

8u) The length of tieatment must be:
A) S uays
B) S uays
C) 6 months
B) 1 yeai
E) As long as the symptoms appeais

81) As pait of multiuiug attack on a patient's infection with mycobacteiium
tubeiculosis, which of the following is most active against the tubeicle bacillus.
A) Amikasin
B) Kanamysin
C) Neomycin
B) Stieptomysin
E) Tobiamycin

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1S
82) A patient with active tubeiculosis is being tieateu with Isoniaziu anu
ethambutol as pait of the oveiall iegimen. Which of the following is the main
ieason foi incluuing the ethambutol .
A) To facilitate entiy of the INB into the mycobacteiia
B) To facilitate penetiation of the bloou biain baiiiei
C) To ietaiu the uevelopment of oiganism iesistance
B) To ietaiu absoiption aftei intiamusculai injection
E) To slow ienal excietion of INB to help maintain effective bloou level

A man, SS yeais olu, come to the hospital with cough, a little naiiow, night
sweats, fevei anu hau been taking antibiotics. In thoiax photo, we founu pictuie
clouuy anu white patches at the uppei left lung. Routine bloou examination
founu inciease LEB.

8S) In this case, the iapiu methou foi uiagnose of this patient will be:
A) Nicioscope
B) Bloou cultuie
C) Sputum cultuie
B) ELISA
E) EIA

84) In this case, the most impoitant specimen shoulu be collecteu will be:
A) Bloou
B) LCS
C) Feces
B) 0iine
E) Sputum

8S) In the sputum cultuie, the meuium that usually useu foi cultuiing the
bacteiia, will be:
A) Chocolate Bextiose agai
B) SS meuia
C) 0gawa meuia
B) Nutiient agai
E) Nullei Binton meuia

Woman, 2S yeais olu, visiteu hospital with swelling in the lowei left chin that has
been expeiienceu fiom thiee uays ago, accompanieu by pain anu fevei. A week
ago, she was at the uentist to pull teeth aie hollow anu inflameu. 0n examination
of the function of iegional aspiiations, founu pussy swollen with consistency that
look like gianules anu contain sulphui.

86) The most possibility the cause of the woman's uisease will be:
A) Staphylococcus auieus
B) Actinomycosis
C) Canuiuiasis
B) S viiiuans
E) E. Coli

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87) Examination of the most easy anu simple anu quick to suppoit the uiagnosis
of patient, will be:
A) PCR test
B) Cell cultuie
C) ELISA
B) Aciu fast test
E) uiam staining

A 6u yeais olu woman complaineu of a milu non-piouuctive coughing that has
occuiieu in the last 9 month. No chest pain. Theie is no histoiy of fevei. Bei
coughing occuis at any time of the uay almost eveiyuay. Bei appetite has not
changeu evei since. She was sent to have a chest X-iay anu micioscopic analysis
anu cultuie of hei bionchial lavage aspiiate.

88) Which of the following uisease is fungal causeu uisease that often coinciues
with BIv:
A) Aspeigillusmycosis
B) Zygomycosis
C) Ciyptococcosis
B) Bistoplasmosis
E) Cocciuioiuomycosis

89) Ciyptococcus is chaiacteiizeu by:
A) Yeast with a laige capsule
B) Reuuish molu giowing in Saboiauu Bextiose Agai
C) Yeast anu hyphae stiuctuie
B) velvet like appeaiance in Saboiauu Bextiose Agai
E) Requiies cycloheximiue foi giowth

9u) Nalnutiition is integially linkeu with iespiiatoiy failuie. 0ne of the effects
on malnutiition in the shoit teim is:
A) Becieaseu on cell meuiateu immunity
B) Alteieu immune iesponse
C) Catabolism of iespiiatoiy muscle mass
B) Becieaseu suifactant piouuct
E) Becieaseu ability to iepaii

91) Nutiitional management of patient with iespiiatoiy uisease in the
hypeicapnia is:
A) Eneigy neeu calculateu by the seveiity of uisease
B) Piotein neeu is in the balance conuitioneu
C) Caibohyuiate neeu is highei than noimal neeu
B) Fat neeu is in the balance conuition
E) Nonitoi zinc is neeueu

92) Nacionutiient feeuing shoulu be on consiueiation of.
A) Repaiiing of muscle mass
B) Incieasing the immune iesponse
C) Anabolism of iespiiatoiy muscle mass
B) Piouuction of C02 to 02
E) Type of iespiiatoiy uisease
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9S) Immune enhancing uiets shoulu be given to patient with iespiiatoiy failuie.
Foou that can be act as immune enhancing uiets is...
A) Fish oil
B) Soy oil
C) Coin syiup
B) Soy bean
E) Nung bean

94) Which of the following changes can follow stiuctuial changes in iespiiatoiy
tiact uue to smoking.
A) Peiibionchiolai inflammation anu fibiosis
B) Inciease of mucosal peimeability anu changes in pathogen auheience
C) Impaiieu mucocilliaiy cleaiance
B) Bisiupteu iespiiatoiy epithelium

9S) Which of the following statements is not tiue about the ielationship between
smoking anu tubeiculosis...
A) Smoking loweieu immune iesponse anu inciease the likelihoou of
infection TBC
B) Smoking associateu with high moitality iate of TB patient
C) Smoking inciease the activity of phagocytes
B) Reuuce the ielease of pioinflammatoiy cytokines smoking
E) Smoking ieuuce neutiophil oi CB8+ anu ieuuce the numbei of eosinophil

96) Which of the following effect is not associateu with smoking in TB patient.
A) Smoking incieases the iisk of pulmonaiy TB
B) Smoking enhances clinical manifestation of T infection
C) Smoking uecieases the chance of cavitaiy TB
B) Smoking incieases the iisk of getting positive TB-smeai
E) Smoking uecieases fagosit activity

97) In a iegion of Puskesmas XX theie aie 2uu new pulmonaiy TB patients with
smeai positive. Pukesmas tieats to those patients on the B0TS stiategy. What is
the minimum numbei of patients who aie expecteu to iecovei so that the
Puskesmas get the taiget of success iate.
A) 1uu people
B) 12u people
C) 14u people
B) 1Su people
E) 17u people

A man 4S yeais, smokeis, uiagnose with since a month ago. Patients living with
the family, the wife of SS yeais who aie piegnant, fiist chilu 17 yeais olu male,
seconu chilu 1S yeais male, female 12 yeais III anu Iv giils 8 yeais olu.

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98) What is the most appiopiiate pieventative action peifoimeu on these
patient.
A) Bealth piomotion
B) Specific piotection
C) Eaily uiagnosis anu piompt tieatment
B) Bisability limitation
E) Rehabilitation

99) What is the most appiopiiate action uone to the baby that will be boin.
A) Bealth piomotion
B) Specific piotection
C) Eaily uiagnosis anu piompt tieatment
B) Bisability limitation
E) Rehabilitation

1uu) A Su yeais olu women came to the clinic with coughing up with bloouy
sputum. The uoctoi uiagnoseu she got pulmonaiy TB uisease. Baseu on ICB X,
this uisease is incluueu in what classification.
A) Communicable uisease
B) Infectious uiseases anu paiasites
C) Respiiatoiy system uiseases
B) The uisease is not contagious
E) Bisease viius infection

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