Pulmonology: C R P - C - 1) All of The Following Are The Causes of Clubbing of Fingers, Except

Pulmonology
COMMON R ESPIRATORY PRESENTATIONS .
CLUBBING .
1) All of the following are the causes of clubbing of fingers, except:
A. Subacute bacterial endocarditis
B. Pulmonary abscess
C. Emphysema
D. Hepatic cirrhosis
E. Ulcerative colitis
Answer: C* Emphysema
Description:
COPD (emphysema or chronic bronchitis) is not a known cause of clubbing.
Clubbing is changes in the areas under and around the toenails and fingernails that occur with
some disorders. Causes of clubbing include:
System causes
 cardiac: - Congenital heart defects
- Endocarditis
- Atrial myxoma
 Respiratory: - Lung cancers ( the most common cause of clubbing )
- Bronchiectasis
- Lung abscess
- Cystic fibrosis
- Interstitial lung disease
- Mesothelioma
 Gastrointestinal: - Celiac disease
- Liver cirrhosis
- Liver cancer
- GI cancer
- Inflammatory bowel diseases (UC, Crohn's)
 Thyroid - Thyrotoxicosis
problems: - Graves disease
 Others: - Hodgkin lymphoma
- Aortic aneurism

A. Bronchiectasis
B. Crohn's disease
C. Pulmonary embolism
D. Infective endocarditis
E. Fibrosing alveolitis
Answer: C* Pulmonary embolism

Description:
Pulmonary embolism is not a known cause of clubbing.
Dr Amjad Afeef – 0798843824 – Amman Jo

System causes
- Endocarditis
- Atrial myxoma
- Bronchiectasis
- Lung abscess
- Cystic fibrosis
- Mesothelioma
- Liver cirrhosis
- Liver cancer
- GI cancer
- Aortic aneurism

A. Bronchogenic carcinoma
B. Rheumatoid arthritis
C. Tetralogy of Fallot
D. Lung fibrosis
E. Mesothelioma
Answer: B* Rheumatoid arthritis

Description:
Rheumatoid arthritis is known cause of hand joint deformity, But not clubbing.
System causes
- Endocarditis
- Atrial myxoma
- Bronchiectasis
- Lung abscess
- Cystic fibrosis
- Mesothelioma
- Liver cirrhosis
- Liver cancer
- GI cancer
- Aortic aneurism

4) Finger clubbing is a recognized feature of all the following, except:
A. Bronchiectasis
B. Aortic aneurysm
C. COPD
D. Infective endocarditis
E. Crohn's disease
Answer: C* COPD
Description:
COPD (emphysema or chronic bronchitis) is not a known cause of clubbing.
System causes
- Endocarditis
- Atrial myxoma
- Bronchiectasis
- Lung abscess
- Cystic fibrosis
- Mesothelioma
- Liver cirrhosis
- Liver cancer
- GI cancer
- Aortic aneurism
HEMOPTYSIS .
5) Hemoptysis is commonly associated with all of the following, except:
A. Bronchiectasis
B. Bronchial carcinoma
C. Uncomplicated bronchial asthma
D. Mitral stenosis
E. Pulmonary infarction
Answer: C* Uncomplicated bronchial asthma

Description:
Hemoptysis is coughing up of blood.
Uncomplicated bronchial asthma does not cause hemoptysis,
Causes of hemoptysis include:
- Bronchitis (acute or chronic), the most common cause of coughing up blood.
- Bronchiectasis
- Lung cancer or non-malignant lung tumors
- Use of anticoagulation
- Pneumonia
- Asperogilloma
- asbestosis
- Pulmonary embolism

- Congestive heart failure,
- mitral stenosis
- Tuberculosis
- Inflammatory or autoimmune conditions (lupus, Wegener’s granulomatosis,
microscopic polyangiitis, Churg-Strauss syndrome ,goodpasture syndrome)
- Pulmonary arteriovenous malformations (AVMs)
- Trauma, such as a gunshot wound or motor vehicle accident
6) All of the following can cause hemoptysis, except:

A. Pneumonia
B. Mitral prolapse
C. Tuberculosis
D. Lung trauma
E. Goodpasture's syndrome
Answer: B* Mitral prolapse

Description:
Mitral stenosis, not mitral prolapse is a cause of hemoptysis
- Bronchiectasis
- Pneumonia
- Asperogilloma
- asbestosis
- mitral stenosis
- Tuberculosis
7) Hemoptysis may result from all of the following, except:

A. Pulmonary tuberculosis
B. Aspergilloma
C. Cryptogenic fibrosing alveolitis (idiopathic pulmonary fibrosis)
D. Bronchial adenoma
E. Pulmonary infarction
Answer: C* Cryptogenic fibrosing alveolitis

Description:
IPF idiopathic pulmonary fibrosis may present with SOB, cough, clubbing , but NOT
hemoptysis.
- Bronchiectasis

- Pneumonia
- Asperogilloma
- asbestosis
- mitral stenosis
- Tuberculosis
RESPIRATORY INVESTIGATIONS .
LUNG ANATOMY .
8) Regarding the right main bronchus, all the following are correct, except:
A. It is longer and wider than the left bronchus
B. It extends from the carina down to the origin of middle lobe bronchus
C. Its structure is identical of trachea
D. The right upper lobe bronchus leaves the main bronchus outside the hilum
E. It is more vertical than the left
Answer: A* It is longer and wider than the left bronchus

Description:
Carina is the site at which the trachea divided into right and left main bronchi.
The right main bronchus is wider, shorter (2cm long)and more vertical than the left main
bronchus, the right main bronchus is subdivided into three lobar bronchi, the upper one leave
the main bronchus outside the hilum.
The left main bronchus is smaller in caliber but longer (5cm long) than right main bronchus,
the left main bronchus divides into two lobar bronchi.
The cartilage and mucous membrane in both main bronchi are similar to that in trachea.
CHEST X-R AYS .

9) Regarding chest X-Ray all are true except:
A. Routine CXR is done in A-P view with full inspiration
B. Right dome of diaphragm is seen at the level of 6 th anterior rib
C. Visceral pleura cover the lung
D. Right hilum is usually lower than the left
E. Pneumothorax appears radiolucent
Answer: A* Routine CXR is done in A-P view with full inspiration

Description:
The routine chest x-ray is done in P-A view while A-P view done in the emergency cases or
when the patient can't stand.
Right dome of diaphragm is higher than the left one due to the presence of the liver beneath it
and is seen at level of 6th rib.
Right Hilum is normally lower than the left one.
Pleura has 2 layers , the parietal pleura (outer) and the visceral pleura (inner), the latter covers
the lung . and the pleural space between them contains serous fluid.
Pneumothorax is the presence of air inside the pleural space, air usually appears radiolucent
on x-ray , represented by darker colour.

RESPIRATORY DISEASES .
PNEUMONIA .
10) Rusty sputum is characteristic of:
A. Pneumococcal pneumonia
B. Lung abscess
C. Tuberculosis
D. Coal worker pneumoconiosis
E. Lung cancer
Answer: A* Pneumococcal pneumonia

Description:
pneumococcal pneumonia usually rapid in onset,associated with high fever, Rusty Sputum
and pleuritic chest pain
Lung abscess is associated with foul-smelling sputum production, while TB and Lung cancer
is associated with bloody sputum.
Coal worker pneumoconiosis is associated with dry cough, No sputum.
11) The most common cause of pneumonia is:

A. Staphylococcus aureus
B. Mycoplasma pneumonia
C. Haemophilus influenza
D. Streptococcus pneumonia
E. Influenza A virus
Answer: D* Streptococcus pneumonia

Description:
Pneumonia Defined as Infection of the lung
it can be bacterial , viral ,or fungal infection
Streptococcus pneumonia is a bacteria that cause about 80% of cases of pneumonia, so it
considered the most common cause
12) The most common cause of pneumonia in children is:

A. Adenovirus
B. Staphylococci pneumonia
C. Streptococci pneumonia
D. H. influenza type B
E. Mycoplasma
Answer: C* Streptococci pneumonia

Description:
Pneumonia Defined as Infection of the lung
it can be bacterial , viral ,or fungal infection
Streptococcus pneumonia is a bacteria that cause about 80% of cases of pneumonia, so it
considered the most common cause
13) All of the following conditions may cause aspiration pneumonia, except:
A. Gastroesophageal reflux
B. Achalasia
C. Phrenic nerve palsy
D. Werdnig-Hoffman disease
E. Tracheo-esophageal fistula
Answer: C* Phrenic nerve palsy

Description:
Aspiration pneumonia occur due to passage of GI contents to the trachea, due to abnormality
in motility of the esophagus, abnormal connection between esophagus and trachea, or due to
loss of protective swallowing mechanism.
Werdnig-Hoffman disease, is a rare neuromuscular disorder that affect the motor function and
may lead to weak cough, and affect swallowing reflex which lead to aspiration .
Phrenic nerve palsy will lead to paralysis of the diaphragm and decreased breathing which
may lead to pneumonia, but aspiration is not a feature in this case
14) Clinical signs consistent with lobar pneumonia include all the following, except:
A. Reduced chest movement
B. Whispering pectoriloquy
C. Pleural rub
D. Deviation of the trachea
E. Bronchial breathing
Answer: D* Deviation of the trachea

Description:
Tracheal deviation to the opposite side occur in cases of pneumothorax, Hemothorax, pleural
effusion or mass compressing the trachea, while trachea deviated to the same side in cases of
fibrosis, note that pneumonia will not cause trachea to deviate, it will be central in this case.
Clinical features of pneumonia include:
- Cough with sputum
- Fever
- Chest pain + decreased chest movement
- Dyspnea
- Bronchial breathing ( consolidation )
- Hemoptysis can be a feature
- Pleural rub  if coexistent pleuritis
- Can cause Atrial fibrillation
- Whispering pectoriloquy
15) Regarding viral pneumonia, one of the following is correct:

A. Influenza virus group C can cause epidemics in human
B. Amantadine is an effective medication for swine flue
C. H1N1 virus is transmitted mainly through milk
D. Viral pneumonia is more common than bacterial pneumonia
E. Specific radiological findings is characteristic for viral pneumonia
Answer: A* Influenza virus group C can cause epidemics in human

Description:
Flu due to the type C species is rare compared to types A or B, but can be severe and can
cause local epidemics.
- Amantadine is approved as anti-Parkinson (increase dopamine activity) and antiviral
drug that is effective against, Amantadine is not thought to be effective for the
treatment of swine-origin influenza virus (S-OIV). However, the actual clinical
efficacy of amantadine has not been well documented.
- H1N1 virus is transmitted either by inhaling the virus (infected droplets) or by
touching surfaces contaminated with the virus, then touching the mouth or nose.

- The most common cause of pneumonia is streptococcus pneumonia which is
bacterial, and it is known to be more common than viral pneumonia.
- Viral pneumonia usually present with atypical symptoms and there is no specific
radiological features in CXR.
16) Regarding atypical pneumonia all are true except:

A. The organism is Mycoplasma pneumonia
B. Treatment with clarythromycin
C. Positive cold agglutination test
D. Presence of cell wall responsible for resistance of penicillin
E. More common in school age children
Answer: D* Presence of cell wall responsible for resistance of penicillin

Description:
Mycoplasma pneumonia is the most common cause of atypical pneumonia
This bacteria has no cell wall  so resistant to antibiotics that inhibit cell wall like penicillin
Associated with cold agglutinin hemolytic anemia (intravascular hemolytsis, IgM)
It is ssociated with erythema multiform
Treated by Erythromycin or clarythromycin
EMPYEMA & LUNG ABSCESS.

17) The most common complication of lung abscess is:
A. Pneumothorax
B. Empyema
C. Broncho-pleural fistula
D. Brain abscess
E. Osteomyelitis of a rib
Answer: B* Empyema
Description:
Abscess is defined as "localized collection of pus. Empyema is defined as Pus collection in
the pleural space.
All of the mentioned choices was recorded as complication of lung abscess, with Empyema is
the most common complication
18) All of the following may be causes of empyema, except:

A. Osteomyelitis of rib
B. Pneumonia
C. Perforation of the esophagus
D. Subphrenic abscess
E. Primary
Answer: E* Primary
Description:
Empyema is a collection of pus in the pleural space
The most common cause is pneumonia, and usually it can be caused by spread of bacteria or
pus from another site like infected rib, perforated esophagus, ruptured lung or Subphrenic
abscess, or perforated esophagus , but never be primary.
BRONCHIECTASIS .
19) Any of the following may be commonly found in patients with bronchiectasis,
except:
A. Clubbing of fingers
B. Lung crepitations

C. Absence of sputum
D. Hemoptysis
E. Pulmonary hypertension
Answer: C* Absence of sputum

Description:
Bronchiectasis present with purulent sputum, not absent sputum.
Bronchiectasis is the Dilatation of the airways due to inflammation, usually affects medium-
sized airways, the most common pathogen = Pseudomonas aeruginosa
Symptoms include:
- Purulent sputum
- Hemoptysis
- Clubbing
- Recurrent infections
- Coarse crepitations
CYSTIC FIBROSIS (CF).

20) Routine management in cystic fibrosis (CF) includes all of the following, except:
A. Gluten free diet
B. Pancreatic preparations
C. Regular physiotherapy
D. Vitamins supplementation
E. Low fat diet
Answer: A* Gluten free diet

Description:
Gluten free diet is a part of management of celiac disease not cystic fibrosis.
CF It is a genetic disease of exocrine gland , causing thick secretion of exocrine glands and
thus  obstruction of excretory ducts
CF has no definite treatment, but management include:
- Nutrition : high caloric – low fat diet , pancreatic enzymes , fat soluble vitamins
supplement
- For respiratory manifestations : antibiotics prophylaxis , physiotherapy , mucolytics ,
- Control DM
- Pt. May need IVF for fertility
LUNG TUMORS.
21) The commonest symptom of bronchial carcinoma is:
A. Cough
B. Chest pain
C. Cough and pain
D. Coughing blood
E. Weight loss
Answer: A* Cough
Description:
Cough is not only the most common symptom of bronchial carcinoma, it considered the most
common respiratory symptom at all, all other mentioned choices are known features of
bronchial carcinoma.
22) Concerning carcinoma of bronchus, one of the following is not true:

A. It may lead to recurrent laryngeal nerve palsy

B. Cigarette smoking is predisposing factor
C. Squamous cell carcinoma is the most common type
D. Clubbing is not a feature of bronchial carcinoma
E. Pancoast tumor is a peripheral type occurring at the apex of the lung
Answer: D* Clubbing is not a feature of bronchial carcinoma

Description:
some disorders.
it is a feature of lung cancers and strongly present in Squamous cell carcinoma.
Other causes of clubbing include:
System causes
- Endocarditis
- Atrial myxoma
- Bronchiectasis
- Lung abscess
- Cystic fibrosis
- Mesothelioma
- Liver cirrhosis
- Liver cancer
- GI cancer
- Inflammatory bowel diseases (UC, Crohns)
- Aortic aneurism
23) Pancoast tumor arises in:

A. Apex of the lung
B. Isthmus of the thyroid gland
C. Body of the pancreas
D. Appendix
E. Pituitary gland
Answer: A* Apex of the lung

 Pancost tumor : is a peripheral tumor occur at the apex of lung , spread usually to
adjacent tissue , usually non-small cell lung cancer  usually questioned as a cause of
Horner Syndrome
 Horner syndrome: ptosis + Myosis + anhydrosis, Due to defect in sympathetic nervous
system, can be caused by Pancost tumor.
ASTHMA.
24) One of the following differentiates the asthma from COPD:
A. Hyperreactive airways
B. Variability
C. Wheezes
D. Hyperinflation

E. Cough
Answer: B* Variability
Description:
Variability is the main difference between asthma and COPD. Asthma is reversible and
variable narrowing of the airway while COPD is irreversible and not variable.
Both asthma and COPD has hyperreactive airways and both have cough, wheezing and
hyperinflation on CXR.
25) All of the following are signs of severe asthma, except:

A. Silent chest
B. Low PO2
C. Loud wheezy chest
D. Pulsus paradoxus
E. Cyanosis
Answer: C* Loud wheezy chest

Description:
Despite wheezy chest is a feature of asthma, the question here is about severe asthma.
Silent chest with no breath sound nor additional sounds is a main feature of severe asthma .
Signs of sever / life threatening asthma also include:
- Inability to speak a full sentence
- Severe tachypnea/tachycardia
- respiratory muscle fatigue
- diminished expiratory effort
- cyanosis
- respiratory acidosis
- decreased LOC
- Pulsus paradoxus
- Low PEEP.
26) All of the following are found in patient with bronchial asthma, except:
A. Hyperinflated chest
B. Wheezing
C. Dyspnea
D. Clubbing
E. Cough
Answer: D* Clubbing
Description:
Clubbing is not a feature of asthma nor COPD.
causes of clubbing include:
System causes
- Endocarditis
- Atrial myxoma
- Bronchiectasis
- Lung abscess
- Cystic fibrosis
- Mesothelioma

- Liver cirrhosis
- Liver cancer
- GI cancer
- Inflammatory bowel diseases (UC, Crohns)
- Aortic aneurism
27) All of the following are components of airway obstruction in asthma, except:
A. Mucous plugging
B. Laryngospasm
C. Inflammation of airways
D. Bronchospasm
E. Edema of airways
Answer: B* Laryngospasm
Description:
Laryngospasm is a cause of upper respiratory obstruction and will result in stridor.
Asthma is obstructive lung disease affect the lower respiratory tract.
Pathogenesis as following:
Exposure to allergen  bronchospasm , airway edema ,increased mucus , airway
obstruction  hypoxemia  hyperventilation Decreased PaCO2  respiratory alkalosis
muscle fatigue decreased ventilationincrease co2 + respiratory acidosis + respiratory
failure
28) All the following are typical components of bronchial asthma, except:
A. Bronchospasm
B. Stridor
C. Edema of airways
D. Mucus production
E. Feeling of suffocation
Answer: B* Stridor
Description:
stridor is a caused by upper respiratory obstruction eg: laryngospasm.
Asthma is obstructive lung disease affect the lower respiratory tract, associated with wheezes.
Pathogenesis as following:
failure
29) Acute asthmatic attack may be precipitated by all of the following, except:
A. Exercise
B. Sudden change of air temperature
C. Infection
D. Paracetamol injection
E. Crying

Answer:D * Paracetamol injection
Description:
Asthma is a chronic disease cause inflammation and reversible & variable narrowing of the
airways ,Triggers include: ( dusts, smoking, air pollution , Drugs –NSAID ,Beta-blockers
,exercise ,emotions, sudden changing in air temperature)
Studies shows that high percentage of patients with asthma has also sensitivity reaction to
NSAID's.
Paracetamol is a simple analgesia that can be used safely in patients with asthma.
30) The commonest symptom of bronchial asthma is:

A. Cough
B. Chest pain
C. Coughing blood
D. Chest infection
E. Weight loss
Answer: A* Cough
Description:
Cough is not only the most common symptom of asthma, it `considered the most common
respiratory symptom at all.
31) Typical attack of bronchial asthma consists of each of the following, except:
A. Marked dyspnea
B. Attacks of cough
C. Expiratory wheezes
D. Bradycardia
E. Restlessness
Answer: D* Bradycardia
Description:
Typical asthma attack include tachycardia, not bradycardia
Other symptoms include:
Cough (most common symptom) ,dyspnea, restlessness, wheezing, tachypnea, chest tightness
and Pulsus paradoxus.

A. CO2 retention
B. Silent chest
C. Respiratory alkalosis
D. Pulsus paradoxus
E. Cyanosis
Answer: C* Respiratory alkalosis

Description:
Pathogenesis of asthma is as following:
failure.
Note that in mild early stage of asthma, tachypnea will result in respiratory alkalosis but later
while attack gets severe  respiratory acidosis and respiratory failure will result.
Features of severe asthma include:

- cyanosis
- decreased LOC
- Pulsus paradoxus
- Low PEEP.
33) All of the following are features of severe asthma, except:

A. Tachycardia (more than 130 per min)
B. Pulsus paradoxus (more than 30mm Hg)
C. Hypercapnia
D. Low PEEP (below 100 per min)
E. Pulsus alternans
Answer: E* Pulsus alternans

Description:
Remember that pulsus paradoxus not pulsus alternans is a feature of asthma.

- cyanosis
- decreased LOC
- Pulsus paradoxus
- Low PEEP.

A. Inability to speak
B. Tachycardia more or equal 120 beats per minute
C. Silent chest
D. Pulsus alternans
E. PEEF below 150liters
Answer: D* Pulsus alternans

Description:
Remember that pulsus paradoxus not pulsus alternans is a feature of asthma.

- cyanosis
- decreased LOC
- Pulsus paradoxus
- Low PEEP.

MANAGEMENT OF ASTHMA.
35) The following are useful in the treatment of a severe asthmatic attack, except:
A. IV Aminophyllin
B. Intravenous hydrocortisone
C. Sodium Cromoglycate
D. Oxygen
E. Inhaled Salbutamol
Answer: C* Sodium Cromoglycate

Description:
In exam , you have to be aware if question is about asthma control or acute treatment of
asthma, here the question is about the acute asthma attack, all the mentioned drugs can be
used in asthma exacerbation except sodium Cromoglycate which is used in asthma control.
Drugs that used in asthma control (maintenance treatment):
- step 1 : newly diagnosed asthma  SABA
- step 2:not improved or >3 attacks per week or night symptoms add ICS (low dose)
- step 3  add LTRA
- step 4  add LABA
- step 5  increase low dose ICS to medium dose ICS
- step 6  add oral steroid
Drugs used in treatment of acute asthma:

- Oxygen
- 1st step :SABA (nebulizer of MDI) Q 20 minutes can be repeated upto 3 doses
- 2nd step: SAMA
- 3rd step: Steroid ( oral and IV steroid are equivalent)
- 4th step: Magnesium sulphate iv (1.2-2mg over 20 minutes)
- 5th step: IV Aminophylline ( little evidence to support it)
- 6th step: if no response IV salbutamole
- Intubation and mechanical ventilation can be helpful
*SABA = Short acting Beta agonist (Salbutamol)

*SAMA = Short acting muscarinic antagonist (Ipratropium )
*ICS = inhaled corticosteroid
*LABA = long acting beta agonist (salmertol)
*LTRA – leukotrine receptor antagonist
*Cromoglycate + ketotifen can be used in chronic maintenance therapy , not acute
exacerbation of asthma
36) All of the following medications can be used in first step in the management of
bronchial asthma as a reliever therapy, except:
A. Salbutamol
B. Salmeterol
C. Beclomethasone
D. Fluticasone
E. Leukotriene antagonist
Answer: E* Leukotriene antagonist

Description:

used in asthma exacerbation except Leukotriene antagonist (LTRA) which is used in asthma
control.

- Oxygen
- 2nd step: SAMA

37) Following are considered as controller medications in Bronchial asthma

management, except:
A. Inhaled gluco-corticosteroids
B. Leukotriene modifiers
C. Short-acting inhaled B2-agonists
D. Systemic gluco-corticosteroids
E. Theophylline
Answer: C* Short-acting inhaled B2-agonists

Description:
used in asthma control except SABA which is used in asthma relieve.

- Oxygen
- 2nd step: SAMA


38) All of the following drugs could be used in controlling acute attacks of bronchial
asthma, except:
A. Adrenaline
B. Aminophyllin
C. Ketotifen (Zaditen)
D. Ephedrine sulfate
E. Salbutamol
Answer: C* Ketotifen (Zaditen)

Description:
used in asthma exacerbation except Ketotifen which is an antihistamine than can be used in
asthma control.

- Oxygen
- 2nd step: SAMA


39) Substances thought to normally mediate the bronchospasm in asthma include all of
the following, except:
A. Prostaglandines
B. Histamine
C. Slow reacting substance of anaphylaxis
D. Sodium cromoglycate
E. Eosinophilic chemotactic factor of anaphylaxis
Answer: D* Sodium cromoglycate

Description:
Bronchospasm occur in asthma patient in response to exposure to allergen, this will trigger
some substances that mediate the mechanism of bronchospasm.
Histamine and serotonin considered of primary mediators for bronchospasm, also
leukotrines , prostaglandins, platelet activating factors and cytokines are considered
secondary mediators.
Note that sodium cromoglycate can be used in treatment of asthma and cause bronchodilation
not bronchospasm.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE COPD.

40) Treatment of COPD patient includes all the followings except:
A. Ipratropium bromide
B. Salbutamol
C. Steroid
D. O2 mask 100%
E. Aminophylline
Answer: D* O2 mask 100%

Description:
In normal people, the main driver of respiratory center is CO 2 , the level of it can stimulate
respiratory centre if increased and can suppress the center if decreased.
In COPD patients, CO2 retention makes it not appropriate to drive the respiratory centre, so
Oxygen will me the main driver in this case; so if we use 100% oxygen in COPD patient 
this will lead to suppression of respiratory centre and makes symptoms worse and may cause
respiratory failure.
So in treatment:
- O2 therapy ( O2 sat. target = 88-92% until ABGs available , If no CO 2 retention 
make target 94-98%)
- Don’t use 100% oxygen
41) Total lung capacity is increased in:

A. Asthma
B. Emphysema
C. Congestive failure
D. Cystic fibrosis
E. Respiratory distress syndrome
Answer: B* Emphysema
Description:
Total lung capacity is composed of functional residual capacity + inspiratory capacity.
In emphysema patient air trapping will lead to increased functional residual capacity and this
result in increased Total lung capacity.

42) All of the following complications of chronic obstructive pulmonary disease, except:
A. Cor-pulmonale
B. Polycythemia
C. Respiratory failure
D. Left ventricle failure
E. Bronchogenic carcinoma
Answer: D* left ventricular heart failure

Description:
Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for both the
development of primary lung cancer, as well as poor outcome after lung cancer diagnosis and
treatment.
COPD is a known cause of Cor-pulmonale, which is an alteration of structure and function of
the right side of the heart due to respiratory problem, and this will cause right side heart
failure NOT LEFT SIDE.
Left-sided heart failure is most often caused by high blood pressure or coronary artery
disease. It’s not directly related to COPD. But the two conditions may influence each other.
Respiratory failure is a feature of COPD and patient may need ventilation.
Polycythemia is caused by decreased O2  stimulate more erythropoietin to be secreted 
increased in hemoglobin.
43) All of the following changes occur in COPD, except:

A. Lung inflammation
B. No alveolar wall destruction
C. Loss of elasticity
D. Destruction of pulmonary capillary bed
E. Increase in inflammatory cells macrophages
Answer: B* No alveolar wall destruction

COPD is a type of Obstructive lung disease which is irreversible and invariable.
There are two types of COPD.
- Emphysema: is a disease of the alveoli. The fibers that make up the walls of the
alveoli become damaged, as well as the capillary bed. The damage makes them less
elastic and unable to work when exhalation
- Chronic bronchitis: is an inflammatory process, lead to inflammatory cells to be
increased, fixed obstruction of the airways will give a picture of obstructive lung
disease.

RESPIRATORY FAILURE .
44) Blood gas analysis in type 1 respiratory failure shows:
A. High PCO2 and normal PO2
B. Low PCO2 and normal PO2
C. Normal PCO2 and high PO2
D. High PCO2 and low PO2
E. Normal PCO2 and low PO2
Answer: E* Normal PCO2 and low PO2

Description:
Respiratory failure is a failure of respiratory system to maintain normal blood gases.
There are two types:
- Type I: Hypoxia without Hypercapnia
- Type II: Hypoxia with Hypercapnia
Hypoxia: pO2 <60 mmhg (low PO2)

Hypercapnia: paCO2 >50 mmhg (high PCO2)
45) The usual causes of low arterial oxygen tension (PaO2) include all of the following,
except:
A. Right to left shunt
B. Ventilation perfusion mismatch
C. Impaired diffusion capacity
D. Hyperventilation
E. Hypoventilation
Answer: D* Hyperventilation
Description:
Arterial oxygen tension is dependent on oxygen tension in atmosphere, lung function,
respiratory rate, and presence of normal heart structure and function
Low oxygen tension in atmosphere will lead to decreased oxygen transferred through alveoli
to the blood and then less oxygen tension in the blood.
Ventilation perfusion mismatch, impaired diffusion capacity and hypoventilation will reduce
the oxygen tension in blood.
Deoxygenated blood in the right side of heart if shunted to the left side, it will bypass the lung
and cause less oxygen in the systemic circulation.
Hyperventilation will not lower the oxygen tension in the bloodstream.
46) Signs of Hypercapnia include all of the following, except:

A. Confusion
B. Papilledema
C. Cold extremities
D. A large pulse volume
E. Coma
Answer: C* Cold extremities

Description:
Hypercapnia is an increased PaCO2 to a level of more than normal >50mmhg.
In this case, The cardiac output is usually normal or even moderately raised, and this, together
with the vasodilator effect of hypoxemia and Hypercapnia on the small vessels of the limbs, is
responsible for the warm extremities.

Other symptoms include (flushed skin, large volume pulse, tachypnea, dyspnea,
extrasystoles, muscle twitches, hand flaps, reduced neural activity, and possibly a raised
blood pressure).
Neuronal effect range from mild confusion to coma or may be death.
Frank Papilledema (pseudotumor cerebri) and motor disturbances (Myoclonic jerks, flapping
tremor, and seizures) are signs of acidosis which result from Hypercapnia .
47) The following are signs of respiratory failure, except:

A. Warm hands
B. Flapping tremors
C. Small volume pulse
D. Papilledema
E. Altered level of consciousness
Answer: C* Small volume pulse

Description:
Hypercapnia is an increased PaCO2 to a level of more than normal >50mmhg.
Large volume pulse may be a result of increased cardiac output due to Hypercapnia.
The cardiac output may be normal or even moderately raised, and this, together with the
vasodilator effect of hypoxemia and Hypercapnia on the small vessels of the limbs, is
responsible for the warm extremities.
Other symptoms include (flushed skin, large volume pulse, tachypnea, dyspnea,

extrasystoles, muscle twitches, hand flaps, reduced neural activity, and possibly a raised
blood pressure).
Neuronal effect range from mild confusion to coma or may be death.
Frank Papilledema (pseudotumor cerebri) and motor disturbances (Myoclonic jerks, flapping
tremor, and seizures) are signs of acidosis which result from Hypercapnia .
48) Hyperventilation may be found in all of the following, except:

A. Narcotic overdose
B. Diabetic ketoacidosis
C. Acute attack of bronchial asthma
D. Hysterical reaction
E. Pulmonary embolism
Answer: A* Narcotic overdose

Description:
Narcotics have negative effect on respiration and cause respiratory depression not
hyperventilation.
DKA is a cause of metabolic acidosis which will lead to respiratory hyperventilation to wash
CO2 and compensate the acidosis.
Bronchial asthma, hysterical reaction and pulmonary embolism are a known cause of
hyperventilation and secondary respiratory alkalosis in their early stages.
PULMONARY EMBOLISM.
49) The most common symptoms after major pulmonary embolism is:
A. Cough
B. Hemoptysis
C. Dyspnea
D. Pleural pain
E. Chest pain

Answer: C* Dyspnea
Description:
PE is an occlusion of pulmonary artery or its branches by embolus.
DVT (usually proximal) , migration of clot  lodge in pulmonary artery.
Symptoms and signs of PE include:
- Sudden dyspnea (Most common symptom in the major pulmonary embolism)
- Chest pain (typically pleuritic)
- Fever (low grade)
- Low Oxygen saturation /hypoxia
- Tachypnea
- Tachycardia
50) All of the following clinical findings are seen in patients with pulmonary embolism,
except:
A. Hypoxia
B. Right heart failure
C. Cyanosis
D. Deep vein thrombosis
E. Bradycardia
Answer: E* Bradycardia
Description:
Tachycardia not bradycardia is a feature of PE.
PE results in ventilation perfusion mismatch and hypoxia, tachypnea and tachycardia is a
compensatory mechanisms to compensate this reduction of oxygen.
Right ventricular strain and right ventricular heart failure may be a feature of massive PE.
Note that bradycardia can present rarely in massive PE due to Vagal stimulation. But here is
another poor question in JMC exams in which all answers are kind of true.
Also Hypercapnia and cyanosis are very rare but can be present.
51) All of the following are clinical evidence of pulmonary embolism, except:
A. Hypoxia
B. Pleural friction rub
C. Hypercapnia
D. Right ventricular failure
E. Deep venous thrombosis
Answer: C* Hypercapnia
Description:
PE will provoke hyperventilation and cause CO2 wash (hypocapnia),
Hypercapnia is a very rare feature of PE and usually not present
All other features are common in PE and this will make the answer C is the most likely
answer.
52) The following are characteristics of pulmonary embolus, except:

A. Normal or low PCO2
B. Hypoxia
C. Collapsing pulse

D. Pleuritic chest pain
E. Raised jugular venous pressure
Answer: C* Collapsing pulse

Description:
This will lead to ventilation perfusion mismatch and hypoxia, hypoventilation here will
manifest as compensatory mechanism and cause hypocapnia (but CO2 may still normal),
clinical symptoms include dyspnea and pleuritic chest pain
JVP will be high If PE was massive and cause right side heart failure.
Collapsing pulse is not a feature of PE, but can be a feature of:

- aortic regurgitation
- patent ductus arteriosus
- hyperkinetic (anaemia, thyrotoxic, fever, exercise/pregnancy)
53) The definitive diagnosis of pulmonary embolism is best made by:

A. Arterial blood gas analysis
B. Chest X-ray
C. ECG
D. Lung scan
E. Pulmonary arteriography
Answer: E* Pulmonary arteriography

Description:
CTPA (CT pulmonary angiography) unless contraindicated, is the most accurate test for
diagnosis of PE,
ABG's will show respiratory alkalosis, but it is not that specific.
Chest X-Ray will be mostly normal
ECG: Sinus tachycardia is most common ECG changes other changes include: S1,Q3,T3 ,
right ventricular strain , RBBB, right axis deviation and S1,S2,S3.
Lung perfusion scan can be used if CTPA is contraindicated, but CTPA is more accurate.
PNEUMOTHORAX .
54) A 3 years old boy with staphylococcal pneumonia suddenly develops increasing
respiratory distress. The possible diagnosis requiring urgent action is:
A. Pneumatocele formation
B. Pleural effusion
C. Tension pneumothorax
D. Progression of pneumonia
E. Lung abscess formation
Answer: C* Tension pneumothorax

Description:
Here the question is directed toward the most urgent case of the mentioned complications,
Tension pneumothorax is the most urgent, due to its compression on the lungs, heart and
major vessels. And this will cause immediate death if not treated urgently.
The first step will be "needle decompression" with large pore needle inserted to the second
intercostal space at mid-clavicular line.

55) In patient who is receiving assisted ventilation with positive end expiratory pressure
(PEEP). The sudden occurrence of hypotension most likely caused by:
A. Hypovolemia
B. Acute congestive cardiac failure
C. Hemothorax
D. Massive atelectasis
E. Tension pneumothorax
Answer: E* Tension pneumothorax

Description:
surgical emergency in which cause lung and cardiac function impairment
Usually due to trauma  lung laceration  creation of one-way-valve
Can be due to ventilation with high pressure.
High pressure ventilation can cause rupture and leak of air into the pleural space and rapid
collection of air will result in tension pneumothorax.
Hemothorax and Hypovolemia requires blood vessel injury with blood or body fluid injury to
occur and this is not a complication of PEEP.
Acute CHF and atelectasis again is not a complication of PEEP ventilation.
PLEURAL EFFUSIONS .
56) The following conditions may cause Transudate type of pleural effusion, except:
A. Nephrotic syndrome
B. Hypothyroidism
C. Liver cirrhosis
D. Congestive cardiac failure
E. Empyema
Answer: E* Empyema
Description:
In pleural effusion, pleural fluid should be aspirated for diagnostic purpose to determine the
cause . Transudates V.S exudates fluid determined by:
 If >30g/l  exudates
 If < 20g/l  Transudates
 If 20-30 g/l  apply lights criteria
Modified Light's criteria:

- Pleural/serum protein ratio >0.5
- Pleural/serum LDH ratio >0.6
- Pleural LDH >0.45 of upper limit of normal serum LDH
- If one of the above criteria fond  exudates
Now the differential diagnosis as following:

 Transudative Pleural effusion :
- CHF
- Liver cirrhosis
- Nephrotic syndrome
- Pulmonary embolism (But can cause exudates More often)
- Hypothyroidism
 Exudative Pleural effusion

- Infection
- Empyema

- Pulmonary embolism (can cause exudates More often)
- Malignancy
- Inflammation
- Trauma
- Oesophageal perforation
- Meig's Syndrome (Associated with ovarian or pelvic tumour)
In the above question, Empyema is the only choice that is listed among exudates causes.
57) An Exudative pleural effusion may be due to all of the following, except:
A. Pulmonary tuberculosis
B. Congestive cardiac failure
C. Bronchogenic carcinoma
D. Acute pancreatitis
E. Mesothelioma
Answer: B* Congestive cardiac failure

Description:
In pleural effusion, pleural fluid should be aspirated for diagnostic purpose to determine the
cause . Transudates V.S exudates fluid determined by:
 If >30g/l  exudates
 If < 20g/l  Transudates
 If 20-30 g/l  apply lights criteria
Modified Light's criteria:

- Pleural/serum protein ratio >0.5
- Pleural/serum LDH ratio >0.6
- Pleural LDH >0.45 of upper limit of normal serum LDH
- If one of the above criteria fond  exudates
Now the differential diagnosis as following:

 Transudative Pleural effusion :
- CHF
- Liver cirrhosis
- Nephrotic syndrome
- Pulmonary embolism (But can cause exudates More often)
- Hypothyroidism
 Exudative Pleural effusion

- Infection
- Empyema
- Pulmonary embolism (can cause exudates More often)
- Malignancy
- Inflammation
- Trauma
- Esophageal perforation
- Meig's Syndrome (Associated with ovarian or pelvic tumour)
In the above question, CHF is the only choice that is listed among transudates causes.
58) Signs of pleural effusion include all of the following, except:

A. Stony dullness on percussion
B. Diminished or absent breath sound
C. Deviation of trachea to opposite side

D. Increased tactile vocal fremitus
E. Bronchial breathing above effusion
Answer: D* Increased tactile vocal fremitus

Description:
Pleural effusion is collection of fluids within the pleural space.
Tactile vocal fremitus (TVF) describe the amount of vibratory waves comes from the chest of
the patient when speaking to the examiners hand,
If there is pleural fluid collection it will minimize the transmitted sound and its vibrations.
Pleural effusion Can be asymptomatic if little amount or can be associated with Dyspnea ,
chest pain Stony Dullness to percussion and trachea will be shifted away from the diseased
side, Decreased or absent breath sounds and bronchial breathing above the effusion are a
feature , as well as the signs and symptoms of the cause.
59) One of the following is aspirated from the pleural cavity in Chylothorax:
A. Fresh blood
B. Lymph
C. Serous fluid
D. Saliva
E. Bile
Answer: B* Lymph
Description:
There are several fluids or air that can abnormally accumulate in the pleural space and each
condition is named according to the material accumulated:
- Pneumothorax: Air in the pleural space
- Hemothorax: Blood in the pleural space
- Hemopneumothorax: Air and blood in pleural space
- Chylothorax: lymphatic fluid in pleural space
- Empyema: Pus in pleural space
SARCOIDOSIS .
60) 40 years old woman presented with 2 months history of dry cough, nasal blockage,
low grade fever, the CXR showed enlarged both right and left hilum. All of the
following are in favor of the sarcoidosis diagnosis, except:
A. Presence of right paratracheal lymphadenopathy
B. Increased lymphocytes by bronchoscopic bronchioalveolar lavage
C. Disappearance of the radiological findings after 3 months without treatment
D. Presence of deforming arthritis
E. Negative PPD test
Answer: D* Presence of deforming arthritis

Description:
Here is a simple case question in which the examiner provided you the diagnosis of
sarcoidosis with bilateral hilar lymphadenopathy (BHL)  stage 1 sarcoidosis.
Stage I and II sarcoidosis usually spontaneously resolve with disappearance of radiological
findings within 3 months (choice c).
Paratracheal lymphadenopathy (Choice A) is a known feature of sarcoidosis
Diagnosis include ACE level (not specific, not sensitive) , and increased lymphocytes in
Bronchioalveolar lavage (Choice B), and PPD test will be negative (Choice E)
Arthritis is a feature of sarcoidosis but it is usually non-deforming, so the best answer to
choose here is (Choice D).

61) All of the following are features of sarcoidosis, except:
A. Hypocalcemia
B. Lupus pernio
C. Erythema nodosum
D. Anterior uveitis
E. Hepatosplenomegaly
Answer: A* Hypocalcemia
Description:
Sarcoidosis is a multi-system disease, characterized with non-caseating granuloma.
It could be asymptomatic But cough, fever, chest pain may present
Hypercalcaemia not Hypocalcemia occur, since the macrophages inside the granulomas cause
an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol)
which cause hypercalcaemia.
Other features include:

- Erythema nodosum (Good prognosis)
- Lupus pernio
- Anterior uveitis
- Hepatosplenomegaly
- Non-deforming arthritis
62) All of the following are features of sarcoidosis, except:

A. Erythema multiforme
B. Lupus pernio
C. Bilateral hilar lymphadenopathy
D. Uveitis
E. Hypercalcemia
Answer: A* Erythema multiforme

Description:
Sarcoidosis is a multi-system disease, characterized with non-caseating granuloma.
Erythema nodosum is a feature not erythema multifor, and it is considered a good prognostic
feature of sarcoidosis.
Other features include:

- Hypercalcaemia
- Lupus pernio
- Anterior uveitis
- Hepatosplenomegaly
- Non-deforming arthritis
63) All of the following about sarcoidosis are true, except:

A. It is a granulomatous condition
B. Causes bilateral hilar lymphadenopathy
C. Steroid therapy is helpful in the treatment
D. Hypercalcemia is a feature

E. Tuberculin test is usually positive
Answer: E* Tuberculin test is usually positive

Description:
In sarcoidosis the PPD test (Choice E) will be negative, and it will be positive in TB.
Sarcoidosis is a multi-system disease, characterized with non-caseating granuloma (Choice A)
(granulomatous disease).
Bilateral hilar lymphadenopathy (Choice B) is a feature of stage 1 and stage 2 of the disease.
Steroid (Choice C) indicated If:
- stages >2 with progressive symptoms
- hypercalcaemia (Choice D)
- eye-heart-or CNS involvement
64) In sarcoidosis all are true, except:

A. Hepatomegaly is a feature
B. There is usually a hypergammaglobulinemia
C. Bilateral hilar lymphadenopathy is a feature
D. Steroid therapy is helpful in the treatment
E. It is common in those over 60 years of age
Answer: E* It is common in those over 60 years of age

Description:
Sarcoidosis is a multi-system disease, characterized with non-caseating granuloma, it is more
common in young adults and in people of African descent
in pulmonary sarcoidosis the lung is an important site of immunoglobulin production, and
activated lung T lymphocytes play an important role in modulating this local production of
antibody, and thus are likely to modulate the polyclonal hyperglobulinemia (Choice B)
observed in these individuals.
BHL (Choice C) is a feature of stage I and II of sarcoidosis.
Steroid (Choice D) indicated If:
- hypercalcaemia
65) In sarcoidosis which of the following is true:

A. It is commonest in those over 60 years of age
B. It should always be treated with steroids
C. It is presenting with erythema nodosum has good prognosis
D. Tuberculin test is usually positive
E. It is usually responds to antituberculous therapy
Answer: C* it is presenting with erythema nodosum has good prognosis

Description:
Sarcoidosis is a multi-system disease, characterized with non-caseating granuloma, it is more
common in young adults and in people of African descent.
Erythema nodosum is a feature (Choice C), and it is considered a good prognostic feature of
sarcoidosis.
Steroid is only indicated If: (note that steroids are not always indicated)
- hypercalcaemia

tuberculin test (PPD) is always negative in sarcoidosis, and it is not responsive to
antituberculous therapy
INTERSTITIAL LUNG DISEASE .

66) All the following are associated with decreased diffusion lung carbon monoxide
except:
A. Pulmonary edema
B. Pulmonary hemorrhage
C. Pulmonary resection
D. Anemia
E. Interstitial lung disease
Answer: B* Pulmonary hemorrhage

Description:
The transfer factor describes the rate at which a gas will diffuse from alveoli into blood.
 Causes of increased DLCO:
- Asthma
- Polycythemia
- pulmonary hemorrhage (Choice B)
 causes of decreased DLCO:
- fibrosis and other interstitial lung diseases
- pneumonia
- PE
- Anemia
- Emphysema
EXTRINSIC ALLERGIC ALVEOLITIS .

67) A large round mass in a chest X-ray might be due to all of the following, except:
A. Hydatid cyst
B. Bronchogenic carcinoma
C. Tuberculoma
D. Bronchogenic cyst
E. Extrinsic allergic alveolitis
Answer: E* Extrinsic allergic alveolitis

Description:
EAA Also known as (hypersensitivity pneumonitis), occur by Inhalation of organic substance
 destruction of alveoli  fibrosis
There is no mass or cystic lesion in this disease.
Chest x-ray will show fibrosis usually in the upper zone on the lungs.
Other listed choices can cause either cystic or mass lesion which will appear as round mass in
chest x-ray
OBSTRUCTIVE SLEEP APNEA SYNDROME.

68) All of the following are provocative factors for obstructive sleep apnea, except:
A. Sleep deprivation
B. Alcohol use
C. Tobacco abuse
D. CNS depressant medications
E. Diuretic use

Answer: E* Diuretic use
Description:
Obstructive sleep apnea (OSA) results in apnea during sleep due to obstruction of upper
airways, this will lead to distorted sleeping, snoring and daytime sleepiness and Hypertension
Alcohol and CNS depressant medications results in decreased muscle tone, tobacco and sleep
deprivation as well as can worsen the symptoms.
OSA can result in HTN, so diuretics can be used as a treatment of HTN.
69) Features of the Pickwickian syndrome may include all of the following, except:
A. Obesity
B. Somnolence
C. Hypocapnia
D. Polycythemia
E. Hypoxia
Answer: C* Hypocapnia
Description:
Also known as obesity hypoventilation syndrome, it is a condition in which severely
overweight people fail to maintain normal adequate breathing.
Obesity is the main
Pickwickian syndrome is defined as:
- combination of obesity (BMI above 30 kg/m2) (Choice A)
- hypoxemia during sleep (Choice E)
- hypercapnia during the day, resulting from hypoventilation
Hypercapnia will increased secretion of erythropoietin hormone which results in
Polycythemia (Choice D)
Daytime Somnolence results as the patient cant sleep at night because of snoring and
recurrent apnea

Pulmonology: C R P - C - 1) All of The Following Are The Causes of Clubbing of Fingers, Except

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Pulmonology

COMMON R ESPIRATORY PRESENTATIONS .

2) All of the following are the causes of clubbing of fingers, except:

Answer: C* Pulmonary embolism

Dr Amjad Afeef – 0798843824 – Amman Jo

3) All of the following are the causes of clubbing of fingers, except:

Answer: B* Rheumatoid arthritis

Dr Amjad Afeef – 0798843824 – Amman Jo

Answer: C* Uncomplicated bronchial asthma

Dr Amjad Afeef – 0798843824 – Amman Jo

6) All of the following can cause hemoptysis, except:

Answer: B* Mitral prolapse

7) Hemoptysis may result from all of the following, except:

Answer: C* Cryptogenic fibrosing alveolitis

Dr Amjad Afeef – 0798843824 – Amman Jo

Answer: A* It is longer and wider than the left bronchus

CHEST X-R AYS .

Answer: A* Routine CXR is done in A-P view with full inspiration

Dr Amjad Afeef – 0798843824 – Amman Jo

Answer: A* Pneumococcal pneumonia

11) The most common cause of pneumonia is:

Answer: D* Streptococcus pneumonia

12) The most common cause of pneumonia in children is:

Answer: C* Streptococci pneumonia

Answer: C* Phrenic nerve palsy

Dr Amjad Afeef – 0798843824 – Amman Jo

Answer: D* Deviation of the trachea

15) Regarding viral pneumonia, one of the following is correct:

Answer: A* Influenza virus group C can cause epidemics in human

Dr Amjad Afeef – 0798843824 – Amman Jo

16) Regarding atypical pneumonia all are true except:

Answer: D* Presence of cell wall responsible for resistance of penicillin

EMPYEMA & LUNG ABSCESS.

18) All of the following may be causes of empyema, except:

Dr Amjad Afeef – 0798843824 – Amman Jo

Answer: C* Absence of sputum

CYSTIC FIBROSIS (CF).

Answer: A* Gluten free diet

22) Concerning carcinoma of bronchus, one of the following is not true:

Dr Amjad Afeef – 0798843824 – Amman Jo

Answer: D* Clubbing is not a feature of bronchial carcinoma

23) Pancoast tumor arises in:

Answer: A* Apex of the lung

Dr Amjad Afeef – 0798843824 – Amman Jo

25) All of the following are signs of severe asthma, except:

Answer: C* Loud wheezy chest

Dr Amjad Afeef – 0798843824 – Amman Jo

Dr Amjad Afeef – 0798843824 – Amman Jo

30) The commonest symptom of bronchial asthma is:

32) All of the following are signs of severe asthma, except:

Answer: C* Respiratory alkalosis

Dr Amjad Afeef – 0798843824 – Amman Jo

33) All of the following are features of severe asthma, except:

Answer: E* Pulsus alternans

Signs of sever / life threatening asthma also include:

34) All of the following are signs of severe asthma, except:

Answer: D* Pulsus alternans

Signs of sever / life threatening asthma also include:

Dr Amjad Afeef – 0798843824 – Amman Jo

Answer: C* Sodium Cromoglycate

Drugs used in treatment of acute asthma:

*SABA = Short acting Beta agonist (Salbutamol)

Answer: E* Leukotriene antagonist