Respiratory System — UPSC CMS MCQs (Medicine)

Question 1

The volume of air remaining in the lungs after a normal expiration is called

Accepted Answer

B. functional residual capacity

Answer

expiratory residual volume

Answer

residual volume

Answer

vital capacity

Question 2

A decline in total lung capacity to less than 80% of patient’s predictive value is an indication of

Accepted Answer

A. restrictive lung disease

Answer

obstructive lung disease

Answer

pulmonary artery hypertension

Answer

pulmonary embolism

Question 3

The most frequent symptom of respiratory diseases?

Accepted Answer

D. Cough

Answer

Breathlessness

Answer

Chest pain

Answer

Hemoptysis

Question 4

Consider the following statements with regard to respiratory examination:
1. Change in note when patient phonates “EEE” (Egophony) is characteristic of interstitial fibrosis
2. Whispered pectoriloquy is characteristic of lung consolidation
3. Monophonic wheeze is characteristic of asthma
4. Hyper-resonant note on percussion is characteristic of pneumothorax
Select the correct answer using the code:

Accepted Answer

B. 2 and 4 only

Answer

1 and 3

Answer

1, 2 and 4

Answer

2, 3 and 4

Question 5

Consider the following statements regarding respiratory function in old age:
I. There is increasing ventilation-perfusion mismatch
II. There is increased ventilatory response to hypoxia and hypercapnia
III. There is a decline in maximum oxygen uptake leading to reduction in cardiorespiratory reserve
IV. There is decline in the FEV1/FVC ratio by around 0.2% per year after the forties
Select the correct answer using the code:

Accepted Answer

D. I, III and IV

Answer

I, II and III

Answer

I, II and IV

Answer

II, III and IV

Question 6

Which of the following are categorized under obstructive lung disease?
1. Bronchial asthma
2. Bronchiectasis
3. Bronchiolitis
4. Pulmonary sarcoidosis
Select the correct answer using the code:

Accepted Answer

A. 1, 2 and 3

Answer

1, 2 and 4

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 7

Which of the following are correct regarding Idiopathic Pulmonary Fibrosis?
1. Radiological pattern of usual interstitial pneumonia
2. Finger clubbing
3. More common in elderly
Select the correct answer using the code:

Accepted Answer

D. 1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 8

The most common cause of chronic type II respiratory failure is:

Accepted Answer

B. Severe COPD

Answer

Severe pneumonia

Answer

Severe bronchial asthma

Answer

Severe pulmonary thromboembolism

Question 9

Which one of the following is not a usual cause of Type-2 respiratory failure?

Accepted Answer

C. Pulmonary embolism

Answer

Guillain-Barré syndrome

Answer

Upper airway obstruction

Answer

Flail chest

Question 10

Peri-operative respiratory failure is an example of

Accepted Answer

C. Type III respiratory failure

Answer

Type I respiratory failure

Answer

Type II respiratory failure

Answer

Type IV respiratory failure

Question 11

Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it is:

Accepted Answer

D. Very severe persistent

Answer

Mild persistent

Answer

Moderate persistent

Answer

Severe persistent

Question 12

Which one of the following is not an aim of asthma therapy?

Accepted Answer

C. Minimal use of inhaled corticosteroid

Answer

Peak expiratory flow circadian variation < 20%

Answer

No emergency visits

Answer

Minimal use of beta-2-agonists

Question 13

Which of the following are Controller Therapies in the management of acute asthma?
1. Anticholinergics
2. Systemic glucocorticoids
3. Inhaled glucocorticoids
4. Omalizumab
Select the correct answer using the code:

Accepted Answer

D. 2, 3 and 4

Answer

1, 2 and 3

Answer

1, 2 and 4

Answer

1, 3 and 4

Question 14

Diagnostic work-up for a case of suspected Bronchial asthma should reveal which of the following abnormalities?
1. Reduced FEV1/FVC
2. Increased functional residual volume
3. Reduced diffusion capacity
4. Increment in FEV1 in response to inhaled bronchodilators
Select the correct answer using the code:

Accepted Answer

B. 1, 2 and 4

Answer

1, 2 and 3

Answer

1 and 4 only

Answer

2, 3 and 4

Question 15

Which of the following drugs should be avoided in laboring women with bronchial asthma?
1. Opioid analgesics
2. Prostaglandin F2α
3. Prostaglandin E1
4. Ergometrine
Select the correct answer using the code:

Accepted Answer

B. 1, 2 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

2, 3 and 4

Question 16

Consider the following steps for using a metered dose inhaler (MDI):
I. Incline the head backward to minimize oropharyngeal deposition
II. Remove the cap and shake the inhaler
III. Breathe out gently and place the mouthpiece into the mouth
IV. Hold the breath for 10 seconds
V. Simultaneously, begin a slow deep inspiration, depress the canister and continue to inhale
Which one of the following is the correct sequence of using MDI?

Accepted Answer

C. II, III, I, V, IV

Answer

III, II, I, V, IV

Answer

II, I, IV, III, V

Answer

III, I, II, IV, V

Question 17

Under the Stepwise Approach to the management of Bronchial Asthma, which one of the following is the correct initial treatment at Step 1 for a patient diagnosed with Asthma?

Accepted Answer

A. Low dose inhaled corticosteroid only

Answer

Low dose inhaled corticosteroid plus oral corticosteroid

Answer

Low dose inhaled corticosteroid plus long acting anti-muscarinic agents

Answer

Low dose inhaled corticosteroid plus leukotriene antagonist

Question 18

A 62-year old male chronic smoker has been diagnosed with COPD. On pulmonary function testing, the FEV1/FVC ratio was 0.6 and FEV1 was 70% of predicted. What is the severity of airflow obstruction in this patient as per GOLD criteria?

Accepted Answer

B. Stage II – Moderate

Answer

Stage I – Mild

Answer

Stage III – Severe

Answer

Stage IV – Very severe

Question 19

A 65-year-old female, a stone-cutter by occupation had multiple well circumscribed nodular opacities in upper and middle zones of a chest X-ray along with mediastinal lymph nodes showing egg-shell calcification. Which one of the following is the most likely etiology?

Accepted Answer

B. Silicosis

Answer

Byssinosis

Answer

Berylliosis

Answer

Siderosis

Question 20

Raju is 30 years of age. He has been working in the ceramic and pottery industry for the last 10 years. Which one of the following conditions should he be screened for?

Accepted Answer

A. Silicosis

Answer

Anthracosis

Answer

Byssinosis

Answer

Asbestosis

Question 21

On a chest radiograph, which of the following occupational diseases is most likely to be mistaken as a case of tuberculosis of lungs?

Accepted Answer

B. Silicosis

Answer

Anthracosis

Answer

Siderosis

Answer

Byssinosis

Question 22

Who among the following has two general phases — first, simple pneumoconiosis and a second phase characterized by progressive massive fibrosis (PMF)?

Accepted Answer

A. Anthracosis

Answer

Bagassosis

Answer

Byssinosis

Answer

Siderosis

Question 23

As per the Gell and Coombs classification, Farmer’s lung is which type of hypersensitivity disease?

Accepted Answer

C. Type-III

Answer

Type-I

Answer

Type-II

Answer

Type-IV

Question 24

The following table shows some pneumoconiosis diseases with their most implicated causative agents. Which represent the correct combinations of disease and causative agent?
1. Anthracosis — Coal dust
2. Bagassosis — Silica dust
3. Byssinosis — Cotton dust
4. Siderosis — Asbestos
Select the correct answer using the code:

Accepted Answer

B. 1 and 3

Answer

1 and 2

Answer

2 and 3

Answer

2 and 4

Question 25

With which variety of asbestos, Mesothelioma has been shown to have a strong association?

Accepted Answer

C. Crocidolite

Answer

Amosite

Answer

Anthrophyllite

Answer

Chrysolite

Question 26

A young primigravida with 11 weeks pregnancy presents with sudden onset pain and swelling of left lower limb. Homan’s sign is positive. Duplex ultrasonogram shows non-compressibility of veins in the affected region, with absent flow. The drug of choice for treatment is:

Accepted Answer

A. Enoxaparin

Answer

Amoxycillin–Clavulanic acid

Answer

Warfarin

Answer

Limb elevation only

Question 27

A malnourished 60-year-old man underwent emergency surgery for strangulated sigmoid volvulus. After resection of the sigmoid colon, a colostomy was fashioned. The postoperative period was stormy, and he developed a painful calf swelling in the right lower limb. The most probable diagnosis is:

Accepted Answer

D. Deep vein thrombosis

Answer

Hypoproteinemia

Answer

Edema of renal failure

Answer

Myocardial failure due to fluid overload

Question 28

A 50-year-old lady underwent uneventful bariatric surgery for morbid obesity. On the third postoperative day, she develops breathlessness, and pulmonary embolism is suspected. The next investigation to confirm the diagnosis will be:

Accepted Answer

C. CT pulmonary angiography

Answer

Echocardiography

Answer

Duplex venography

Answer

MR angiography

Question 29

A 60-year-old lady underwent total abdominal hysterectomy. On the 3rd post-operative day, she suddenly became breathless while returning from the washroom. Her blood pressure recorded was 80/50 mm of Hg. The most probable diagnosis is

Accepted Answer

C. Thromboembolism

Answer

Postural hypotension

Answer

Secondary haemorrhage

Answer

Transient ischemic attack

Question 30

Consider the following statements with regard to pulmonary embolism:
1. Unexplained breathlessness is the most common symptom.
2. When congestive heart failure or pneumonia fail to improve despite standard medical treatment, occult pulmonary embolism should be considered.
3. Patients with high clinical likelihood of venous thromboembolism should first undergo D-dimer testing alone without obligatory imaging tests.
Select the correct answer using the code:

Accepted Answer

A. 1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Answer

1, 2 and 3

Question 31

All of the following predispose to Acute Respiratory Distress Syndrome EXCEPT:

Accepted Answer

D. Severe Bronchial asthma

Answer

Acute Pancreatitis

Answer

Toxic gas inhalation

Answer

Aspiration of gastric contents

Question 32

Consider the following statements regarding acute respiratory distress syndrome (ARDS):
1. Exudative phase lasts from day 7 to day 21 after exposure to a precipitating risk factor.
2. Proliferative phase is characterized by proliferation of type II pneumocytes.
3. Low tidal volume ventilation (6 mL/kg body weight) has significantly lower mortality compared to high tidal volume ventilation (12 mL/kg body weight).
4. PaO2/FiO2 ≤ 100 mm Hg is classified as severe ARDS.
Select the correct answer using the code:

Accepted Answer

B. 2, 3 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Answer

1, 2 and 4

Question 33

Which of the following conditions are contraindications for noninvasive positive-pressure ventilation in patients with respiratory failure?
I. Craniofacial abnormalities
II. Significant burns
III. Respiratory failure with PaCO2 of 60 mm Hg
IV. Cardiovascular instability
Select the correct answer using the code:

Accepted Answer

B. I, II and IV

Answer

I, II and III

Answer

I, III and IV

Answer

II, III and IV

Q1. The volume of air remaining in the lungs after a normal expiration is called

Q2. A decline in total lung capacity to less than 80% of patient’s predictive value is an indication of

Q3. The most frequent symptom of respiratory diseases?

Q6. Which of the following are categorized under obstructive lung disease? 1. Bronchial asthma 2. Bronchiectasis 3. Bronchiolitis 4. Pulmonary sarcoidosis Select the correct answer using the code:

Q7. Which of the following are correct regarding Idiopathic Pulmonary Fibrosis? 1. Radiological pattern of usual interstitial pneumonia 2. Finger clubbing 3. More common in elderly Select the correct answer using the code:

Q8. The most common cause of chronic type II respiratory failure is:

Q9. Which one of the following is not a usual cause of Type-2 respiratory failure?

Q10. Peri-operative respiratory failure is an example of

Q11. Oral corticosteroids are best introduced in the treatment of chronic bronchial asthma when it is:

Q12. Which one of the following is not an aim of asthma therapy?

Q13. Which of the following are Controller Therapies in the management of acute asthma? 1. Anticholinergics 2. Systemic glucocorticoids 3. Inhaled glucocorticoids 4. Omalizumab Select the correct answer using the code:

Q15. Which of the following drugs should be avoided in laboring women with bronchial asthma? 1. Opioid analgesics 2. Prostaglandin F2α 3. Prostaglandin E1 4. Ergometrine Select the correct answer using the code:

Q17. Under the Stepwise Approach to the management of Bronchial Asthma, which one of the following is the correct initial treatment at Step 1 for a patient diagnosed with Asthma?

Q18. A 62-year old male chronic smoker has been diagnosed with COPD. On pulmonary function testing, the FEV1/FVC ratio was 0.6 and FEV1 was 70% of predicted. What is the severity of airflow obstruction in this patient as per GOLD criteria?

Q19. A 65-year-old female, a stone-cutter by occupation had multiple well circumscribed nodular opacities in upper and middle zones of a chest X-ray along with mediastinal lymph nodes showing egg-shell calcification. Which one of the following is the most likely etiology?

Q20. Raju is 30 years of age. He has been working in the ceramic and pottery industry for the last 10 years. Which one of the following conditions should he be screened for?

Q21. On a chest radiograph, which of the following occupational diseases is most likely to be mistaken as a case of tuberculosis of lungs?

Q22. Who among the following has two general phases — first, simple pneumoconiosis and a second phase characterized by progressive massive fibrosis (PMF)?

Q23. As per the Gell and Coombs classification, Farmer’s lung is which type of hypersensitivity disease?

Q25. With which variety of asbestos, Mesothelioma has been shown to have a strong association?

Q26. A young primigravida with 11 weeks pregnancy presents with sudden onset pain and swelling of left lower limb. Homan’s sign is positive. Duplex ultrasonogram shows non-compressibility of veins in the affected region, with absent flow. The drug of choice for treatment is:

Q27. A malnourished 60-year-old man underwent emergency surgery for strangulated sigmoid volvulus. After resection of the sigmoid colon, a colostomy was fashioned. The postoperative period was stormy, and he developed a painful calf swelling in the right lower limb. The most probable diagnosis is:

Q28. A 50-year-old lady underwent uneventful bariatric surgery for morbid obesity. On the third postoperative day, she develops breathlessness, and pulmonary embolism is suspected. The next investigation to confirm the diagnosis will be:

Q29. A 60-year-old lady underwent total abdominal hysterectomy. On the 3rd post-operative day, she suddenly became breathless while returning from the washroom. Her blood pressure recorded was 80/50 mm of Hg. The most probable diagnosis is

Q31. All of the following predispose to Acute Respiratory Distress Syndrome EXCEPT: