Pulmonology MRE

May 7, 2020
NAME: HERRERA, CHRISTIAN CHAIM Level: I Score:

I. Multiple choice: choose the BEST answer. Write your answer after each number.

B 1. The following disorders categorized as OBSTRUCTIVE lung disease EXCEPT;

A. Asthma
B. Asbestosis
C. Bronchiectasis
D. Bronchiolitis
A 2. What is the first step in doing physical examination among asthmatic patients?
A. Inspection
B. Palpation
C. Percussion
D. Auscultation
A 3. What pulmonary physical examination technique will differentiate pneumonia from IPF or
idiopathic pulmonary fibrosis?
A. Egophony
B. Pectoriloquy
C. Presence of crackles
D. Presence of wheezes

Nos. 4-8. Choices

4. Total Lung Capacity

5. Residual Volume
6. Vital Capacity
7. Expiratory Reserve Volume
8. Functional Residual Capacity
9. Tidal Volume
 8. Vital
4. Tidal volume Capacity

6.Expiratory
reserve
5. Functional Residual Volume

Capacity
7. Residual Volume

10.
A 11. What disorder may commonly manifest the below pulmonary function test result?
TLC 60% FRC 60% RV 60% FVC 60% FEV1 75%
Raw 1.0 DLCO 60%
A. Pulmonary fibrosis
B. Severe emphysema
C. Acute asthma
D. Moderate obesity

B 12. What is the recommended screening procedure for lung cancer among persons who are aged
55–80 years with 30 pack year smoking history and currently smoke or quit within the past 15
years?
A. Serial chest X-ray
B. multidetector CT (MDCT)
C. CT pulmonary angiography (CTPA
D. Positron emission tomographic (PET) scanning
D 13. Physiologic changes during menstruation causing an acute Asthma attack.
A. Increase estrogen
B. Decrease estrogen
C. Increase progesterone
D. Decrease progesterone

C 14. What protein induces the increased release of mucus secretion in goblet cells during asthma
attack?
A. IL-2
B. IL-7
C. IL-13
 D. IL-16
D 15. Which of the following factors decreases the clearance of theophylline in the blood?
A. Rifampicin
B. Tobacco smoking
C. High protein and low carbohydrate diet
D. Ciprofloxacin

D 16. Pathophysiology or mechanisms of corticosteroid-refractory asthma EXCEPT;

A. Increase glucocorticoid receptor (GR)-β
B. Defect in IL-10 production
C. Reduction in HDAC2 activity
D. Increase lymphocytes response

B 17. A 56M, machine operator in an industrial area, with NO known co-morbid developed chronic
cough, episodes of difficulty of breathing, on and off fever. Laboratory work-up showed elevated
eosinophils; sputum AFB & TB gene expert; normal blood chemistry, chest X-ray revealed ill-
defined micronodular opacities. What is/are the common organism(s) causing this
manifestation?
A. Cladosporium species
B. Pseudomonas
C. Aspergillus
D. Isocyanates

D 18. All of the following Infectious Causes a Pulmonary Eosinophilia EXCEPT;

A. Tuberculosis
B. Cysticercosis
C. Ascaris
D. Dengue virus

C 19. A 62M, embalmer, diagnosed with nasopharyngeal cancer and chronic bronchitis. What is the
most likely chemical agent will cause his disease?
A. HNO3
B. Ammonia
C. Formaldehyde
D. Cadmium fumes
B 20. What is the most common form of bronchiectasis?
A. cylindrical
B. tubular
C. varicose
D. cystic
A 21. A 86F, moderate dementia from Alzheimer’s disease, bronchiectasis, bed bound, without
hypertension and diabetes, consulted thru telemedicine due to chronic cough. Caregiver
recalled admission due to pneumonia from aspiration. What is the most important diagnostic
work-up needed for your patient?
A. Bronchoscopy with bronchoalveolar lavage
B. Helical CT scan
C. Swallowing test
D. stains/cultures for acid-fast bacilli and fungi

B 22. According to GOLD criteria for Severity of Airflow Obstruction in COPD, what is the expected
spirometry findings for a moderate stage (II)?
A. FEV1/FVC <0.7 and FEV1 ≥80% predicted
B. FEV1/FVC <0.7 and FEV1 ≥50% but <80%  predicted
C. FEV1/FVC <0.7 and FEV1 ≥30% but <50%  predicted
D. FEV1/FVC <0.7 and FEV1 <30% predicted

C 23. “Air trapping” in COPD defined as

A. Increased total lung capacity
B. Increased total lung capacity and increased ratio of residual volume to expiratory reserve
volume
C. Increased residual volume and increased ratio of residual volume to total lung capacity
D. Decreased vital capacity and increased residual volume

C 24. What medical treatment among COPD in exacerbation can reduces the length of stay, hastens
recovery, and reduces the chance of subsequent exacerbation or relapse?
A. Inhaled β agonists and muscarinic antagonists
B. Broadspectrum antibiotic
C. Systemic glucocorticoids
D. Supplemental Oxygen

A 25. A 22M, with NO co-morbids, non-smoker, consulted at OPD due to chronic cough and gradual
shortness of breath. Pertinent Physical examination showed rales at lung bases and digital
clubbing. Pertinent imaging result of HRCT revealed Bilateral subpleural reticular changes most
prominent in lower, posterior lung zones. What is most likely your diagnosis?
A. Idiopathic pulmonary fibrosis
B. Sarcoidosis
C. nonspecific interstitial pneumonia
D. Systemic sclerosis associated ILD
A 26. Among Interstitial Lung diseases (ILD), which of the following has the poor prognosis?
A. Idiopathic pulmonary fibrosis
B. Sarcoidosis
C. nonspecific interstitial pneumonia
D. Systemic sclerosis associated ILD

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