RESPIRATORY SYSTEM

1. 1-A 65 year old man on the 30th postoperative day after radical
prostatectomy for adenocarcinoma suddenly becomes
extremely dyspneic and diaphoretic, with chest pain,
palpitations, and feeling of panic after being ambulatory. Which
of the following post-operative pulmonary complications has he
most likely developed?
A Pulmonary edema
B Pleural effusion
C Atelectasis
D Thromboembolus
2-60-year-old man developed non-productive cough worsening
over the past 2 months. He also noted the appearance of
blood-streaked sputum. A chest radiograph reveals a 5 cm
mass near the left lung hilum. Sputum cytology reveals the
presence of small clusters of very hyperchromatic, pleomorphic
cells with scant cytoplasm. Which of the following is the most
likely predisposing factor to development of his pulmonary
disease?
A Silicosis
B Radon gas exposure
C Smoking
D Asbestosis
3-66-year-old man with increasing dyspnea for the past one
year. He is retired from the construction business. There are
rales auscultated in both lungs. A chest radiograph reveals
bilateral diaphragmatic pleural plaques with calcification as well
as diffuse interstitial lung disease. A sputum cytology shows no
atypical cells, only ferruginous bodies. These findings are most
likely to suggest prior exposure to which of the following
environmental agents?
A Beryllium
B Silica dust
C Fumes with iron particles

2. D Asbestos crystals
4-35-year-old man has lost 6 kg in 5 months. He has cough
with hemoptysis along with pleuritic chest pain. his temperature
is 37.5°C. A chest x-ray reveals a bilateral and predominantly
upper lobe reticulonodular pattern of infiltrates with cavitation.
Sputum on light microscopic examination shows epithelioid
cells with necrotic debris. Laboratory studies show a WBC
count of 5890/. Which of the following additional histologic
findings is most likely to be present in his sputum?
A Branching, septated hyphae
B Pleomorphic cells with dark, angular nuclei
C Clusters of small RBC-sized cysts staining with GMS
D Acid fast bacilli
5-Following an accident with blood loss leading to prolonged,
severe hypotension, a 30-year-old man is intubated and placed
on a mechanical ventilator. He has progressively decreasing
oxygen saturations. He dies 3 days later. At autopsy, the distal
lungs show pink hyaline membranes, thickened interstitium,
and many macrophages but few neutrophils. Which of the
following pulmonary diseases most likely complicated his
course?
A Bronchopneumonia
B Chronic bronchitis
C Viral pneumonia
D Diffuse alveolar damage
6-What type of lung cancer fits this description? The tumour
cells originate from neuroendocrince (Kulchitsky) cells. It is
associated with smoking and is centrally located along the
bronchial airways. Tumours tend to be at a high stage at the
time of diagnosis. It is treated with chemotherapy as it is usually
not amenable to surgery. There is an association with
paraneoplastic syndromes, for example Cushing’s, SIADH and
Eaton- Lambert syndrome.

3. A Adenocarcinoma In Situ
B Carcinoid tumour
C Small cell carcinoma
D Adenocarcinoma
7-What is the main complication of primary Tuberclosis ?
A Formation of a Ghon complex
B Miliary pulmonary TB
C Tuberculous bronchopneumonia
D Lung Abcess
8-What is the correct order for the gross phases of lobar
pneumonia ?
A Congestion, Red hepatisation, Gray hepatisation,
Resolution
B Gray hepatisation, Red hepatisation, Congestion, Resolution
C Resolution, Gray hepatisation, Red hepatisation,
Congestion
D Red hepatisation, Gray hepatisation, Resolution Congestion
9-Which of the following is the most characteristic change
occuring in chronic bronchitis?
A Columnar metaplasia of the bronchial epithelium
B Decrease in goblet cell number
C Increase in size of the mucous glands
D Increase in smooth muscle thickness
10-Which of the following statements is CORRECT regarding
squamous cell carcinoma of the lung?

4. A Is usually peripheral
B Is commonly associated with cigarette smoking
C Has a 5 year survival of 60%
D Is more common in females