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4. Lobar pneumonia
a. Is more common in the young and the elderly
b. Involves morphological changes of red to grey hepatisation <- correct
c. Not usually associated with a productive cough – it is
d. Is associated with immunosuppression
e. Rarely caused by streptococcus – S. pneumoniae is the most common cause of community
acquired
10. In emphysema
a. A deficiency of alpha 1 antitryptin is protective
b. Centriacinar destruction leads to obstructive overinflation -?
c. The protease-antiprotease mechanism is the most plausible explanation of the disease <- true
d. Smokers have an increased number of macrophages in the bronchi -? In the bronchi
e. Elastase activity is unaffected by oxygen free radicals
15. Comparing the pulmonary oedema of CCF with ARDS, a defining characteristic of ARDS is:
a. Spontaneous resolution within 48 hours
b. Formation of hyaline membranes <- characteristic
c. A deficiency of surfactant
d. A distinct lobar pattern of consolidation
e. High pulmonary wedge pressures
24. All of the following are neoplastic syndromes associated with lung cancer EXCEPT:
a. Cushings syndrome
b. Syndrome of inappropriate ADH secretion
c. Hypocalcaemia – this is not a syndrome, but caused by calcitonin
d. Carcinoid syndrome
e. Hypertrophic osteoarthropathy – this is not due to a hormone (and paraneoplastic syndromes are
hormone or cytokine mediated)?
25. Which of the following is not a paraneoplastic syndrome associated with lung carcinoma?
a. Ectopic ADH secretion - true
b. Dermatomyositis - ?
c. Migratory thrombophlebitis - ?
d. Eaton-Lambert (myasthenic) syndrome – this is associated, but not paraneoplastic syndrome!
e. Thrombocytosis - ?
31. The most common type of emphysema associated with cigarette smoking is
a. Centrilobular <= i.e. centriacinar
b. Panacinar
c. Paraseptal
d. Irregular
e. Compensatory
43. emphysema
a. is defined clinically as persistent cough with sputum production for at least three months in at least
two consecutive years
b. is defined morphologically as the abnormal enlargement of air spaces proximal to the terminal
bronchioles
c. is a restrictive lung disease
d. has airway dilation and scarring as its major pathological change
e. develops earlier in smokers with an alpha 1 antitrypsin deficiency