Introduction to Diagnosis II Past Paper PDF

Introduction to diagnosis - midterm 1. In patient with community acquired pneumonia , tactile fremitus ….. A) Increases B) Decreases C) Absent D) doesn’t change Answer : A 2. Detection of which additive auscultatory findings suggests the diagnosis of COPD in smoker patient ? A) Fine crackles B) S...

Introduction to diagnosis - midterm 1. In patient with community acquired pneumonia , tactile fremitus ….. A) Increases B) Decreases C) Absent D) doesn’t change Answer : A 2. Detection of which additive auscultatory findings suggests the diagnosis of COPD in smoker patient ? A) Fine crackles B) Stridor C) Wheezing D) Vesicular sound Answer : C 3. Which of the following is the earliest symptom of pulmonary embolism ? A) Hemoptysis B) Chest pain C) Cough D) Shortness of breath Answer : D 4. Which one of the following isn’t a risk factor for pulmonary embolism development ? A) Stasis B) Hypercoagulation C) Endothelial injury D) Hypoalbuminemia Answer : D 5. Which component doesn’t take part in the generation of S1 sound ? A) Closure of mitral valve B) Closure of aortic valve C) Opening of pulmonary valve D) Closure of tricuspid valve Answer : B 6. Detection of which of the following heart sounds is never normal finding ? A) S4 B) S3 C) S2 D) S1 Answer : A 7. Which of the following is the most characteristic of congestive heart failure ? A) Cyanosis B) Distended jugular vein C) Clubbing Answer : B 8. Where is S2 sound best heard ? A) On the apex of the heart B) On the base of the heart C) On the tricuspid area D) On the right mid-axillary line , 5th intercostal space Answer : B 9. Your patient with congestive heart failure has developed right-sided pleural effusion , which of the following is expected to be present in that patient on physical examination ? A) Dullness of percussion on the left side of the chest B) Increased tactile fremitus on the right side of the chest C) Diffuse coarse crackles on both sides of the chest including one apex D) Plugging of the right side of the chest during the chest expansion Answer : D 10. What is the most common initial location of thrombus formation in patient with pulmonary embolism ? A) Deep veins of lower extremities B) Superficial veins of lower extremities C) Portal vein D) Jugular vein Answer : A 11. COPD includes the diagnosis of which one of the diseases ? A) Chronic bronchitis B) Emphysema C) Both D) Neither Answer : C 12. All of the following are common symptoms of community acquired pneumonia , EXCEPT : A) Fever B) Bradycardia C) Sputum production D) Signs of consolidation Answer : B 13. Which of the following isn’t a possible cause of hemoptysis ? A) Pulmonary embolism B) Aortic stenosis C) Pneumonia D) Neoplasms Answer : B 14. Which symptom doesn’t include in pulmonary embolism ? A) Chest pain B) Dyspnea C) Night sweats D) Diaphoresis Answer : C 15. Which answer is correct for pulmonary embolism is common ? A) Lung sound -Wheezing B) Pleural friction rub C) Heart sound -“ gallop” D) All of above mention sounds Answer : C 16. Trachea is shifted away from the side of the lesion , its not indicative in which of the following condition ? A) Massive pleural effusion B) Collapse of the lung C) Large-sized pulmonary abscess D) Mediastinal mass formation Answer : B 17. Which of these valve disorders associated with diastolic murmurs ? A) Aortic stenosis and mitral regurgitation B) Pulmonic and mitral regurgitation C) Aortic and tricuspid stenosis D) Mitral stenosis and aortic regurgitation Answer : D 18. Which one of the heart sounds heard in elderly and pathologic in young ? A) S1 B) S2 C) S3 D) S4 Answer : D 19. 49 year old women with history of fever and left sided chest pain for two weeks , examination of respiratory system shows : decreased chest movements , stony dullness on percussion and absence of breath sounds on the left side. which of the following is possible diagnosis ? A) Tumor of the lung B) Fibrosis C) Pleural effusion D) Pneumothorax Answer : C 20. 44 year old lady is hospitalized because of a syncope in the street with history of episodes with chest pain and rheumatic disease. by examination of the heart sounds systolic murmurs are heard on the right sternal border 2nd intercostal space radiating to the neck and carotid arteries , which of the following is possible diagnosis ? A) Aortic stenosis B) Mitral regurgitation C) Pulmonic stenosis D) Mitral stenosis Answer : A 21. What is para-sternal heave ? A) Palpable murmur B) Abnormal pulsation C) Cardial dullness D) Vocal resonance Answer : B 22. Hemoptysis can be found in , EXCEPT : A) Pulmonary fibrosis B) Pneumonia C) Pulmonary embolism D) Tuberculosis Answer : A 23. Systolic murmur of the 5th intercostal space left sided , mid-clavicular can be found in case of ….. A) Mitral stenosis B) Mitral regurgitation C) Tricuspid stenosis D) Aortic stenosis Answer : B 24. In case of one sided large amount of pleural effusion , all are correct , EXCEPT….. A) Auscultatory sound on the affected side is Coarse crackles B) Trachea is shifted to the opposite side of the pleural effusion C) Percussion sound is stony dull D) In auscultation we have absent breath sounds Answer : A 25. Which score is used in prognosis of pneumonia ? A) Well’s score B) Heckling score C) CURB-65 D) BAP-65 Answer : C 26. Physical findings of aortic stenosis is : A) Sustained apical impulse B) Delayed carotid upstroke C) Diminish in intensity of 2nd heart sound D) All of the above Answer : D 27. What is correct , aortic regurgitation murmur is : A) Diastolic , high pitched decrescendo B) Systolic , high pitched decrescendo C) Diastolic , high pitched crescendo D) Whole systolic , high pitched decrescendo Answer : A 28. Which test is more important for patient with pulmonary embolism ? A) Ultrasound B) CT C) Spirometry Answer : B 29. In patient with cough and fever , which finding decreases probability of pneumonia ? A) Normal vital signs B) Tachycardia C) Crackles D) Diminished breath sounds Answer : A 30. Which of the following are signs of consolidation ? A) Percussion -dull B) Crackles C) Bronchial breath sounds D) All answers are correct Answer : D 31. Which individual findings increases probability of COPD ? A) Breath sounds score 16 or more B) Forced expiratory time less than 3 sec C) Early inspiratory crackles D) Diaphragm percussion Answer : C 32. Which individual findings increases probability of pulmonary embolism ? A) Diaphoresis B) Cyanosis C) Unilateral calf pain or swelling D) Chest wall tenderness Answer : C 33. The finding of elevated venous pressure during pre-operative consultation predicts…. A) Post-operative pulmonary edema B) Low left ventricular ejection fraction C) Moderate to severe tricuspid regurgitation Answer : A 34. Small outward movement that begins with S1 and bind mid-systole and then retracts to inward is known as … A) Hyperkientic B) Systolic movement C) Sustained movement D) Retracting movement E) Normal systolic movement Answer : E 35. If the pulse is regular , and S1 intensity varies from beat to beat , the only possible diagnosis ….. A) Atrial flutter B) Atrioventricular dissociation C) Sinus tachycardia D) Ventricular tachycardia Answer : B 36. Early diastolic murmur , loudest on right side of sternum , detects …….. A) Aortic stenosis B) Aortic dissection C) Dilated aortic root or endocarditis D) Mild aortic regurgitation Answer : C 37. Mid to late systolic click in patient with …. A) Mitral stenosis B) Aortic stenosis C) Aortic regurgitation D) Mitral valve prolapse Answer : D 38. What is the definition of interstitial pneumonia ? A) Involves the areas in between the alveoli B) Involves single lobe or segment of the lung C) Affects the lung in patches around the alevoli D) Causes bronchodilation and dry cough Answer : A 39. What are the factors that predispose for pneumonia ? A) Cold rainy weather B) Aspiration of nasopharyngeal or gastric secretions C) DVT D) Chronic cholecystitis Answer : B 40. Jugular vein distension characterstic for : A) Right sided heart failure B) Aortic stenosis C) Mitral stenosis D) Aortic regurgitation Answer : A 41. Barrel chest is more common : A) In patient with asthma B) In patient with aortic stenosis C) In patient with COPD D) In patient with pulmonary embolism Answer : C 42. Medical features of pulmonary embolism are all of the following EXCEPT: A) Sudden onset of pleural chest pain B) Hemoptysis C) Epistaxis Answer : C 43. All principles are correct about systole and diastole , EXCEPT ; A) Systole is shorter than diastole B) 2nd heart sound is produced by the onset of systole Answer : B 44. All are characterstic findings of aortic stenosis , EXCEPT: A) Systolic murmur B) Abnormal cartoid pulse C) Sustaind apical impulse D) Diasolic murmur Answer : D 45. While patient ampulates in the half way of the walker , the nurse will make a priority to … A) Stand on the patient strong side B) Stand behind the patient C) Stand in front of the patient D) Stand on the patient weak side Answer : D 46. Physiological splitting of S2 sound is present …… A) During inspiration B) During expiration C) During inspiration and expiration D) Its always pathological Answer : A 47. When patient uses a cane , to ampulate the patient , the cane will be on the ….. A) Strong side B) Weak side C) Doesn’t matter Answer : A 48. Which of the following is the preferred imaging technique for diagnosing acute PE ? a. V/Q scans b. Duplex ultrasonography c. CT angiography d. Echocardiography Answer: C 49. The pleural space typically contains how much fluid : Answer : 15 ml 50. Bilateral wheezes are characteristic for : a. Lung cancer b. Pulmonary edema c. Asthma d. Tension Pneumothorax Answer: C 51. patient has chronic bronchitis , which of the following isn't correct ? Answer : trachea maybe shifted left or right 52. The cause of the 1st heart sound is : a. The closure of semilunar valves b. The closure of atrioventricular valves c. Rush of the blood from atria to ventricle during rapid filling phase d. Due to atrial systole which cause rapid flow of blood from atria to ventricle Answer: B 53. Hemoptysis is not observed in : a. Lung tuberculosis b. Lung abscess c. Lung cancer d. Asthma Answer: D 54. Which of the valve disorders are associated with systolic murmur ? Answer : aortic stenosis and mitral regurgitation 55. Examination of patient shows diastolic murmur with wide pulse pressure ? Answer : aortic regurgitation 56. Patient is hospitalized with cyanosis and dyspnea. Fever is 38, pulse 110/min, RR 30 lightheadedness, excessive sweating, chest pain, bilateral calf swelling. D-dimer is 50 mg/L. Likely diagnosis is : a. Social acquired pneumonia b. Asthma c. Pulmonary embolism d. Pleural effusion Answer: C Another questions Chest asymmetric tachypnea a. Pleural effusion Trachea is shifted away from side of length is not indicative a. Massive pleural effusion b. Lung collapses c. Lung size pulmonary abscess Answer : B 41-year-old lady was hospitalized by paramedics because of …. With history of chest pain and rheumatic disease. By examination of heart sound, systolic murmur on the second right intercostal space a. Aortic stenosis Which of the following is the appropriate imaging technique for the diagnosis of pulmonary embolism a. CT Hyperresonance may not be present in: a. COPD b. Asthma c. Lung pneumothorax d. Lobal pneumonia Answer : D Examination of a patient shows diastolic murmur with wide pulse pressure. Likely diagnosis is : a. Aortic stenosis b. Aortic regurgitation c. Mitral regurgitation d. Tricuspid regurgitation Answer: B Tactile fremitus is not increased in case of : a. Lobal pneumonia b. Big lung cavity c. Lung emphysema d. Opened pneumothorax Answer: c Which valve has disorders associated in systolic murmurs a. Aortic stenosis and mitral regurgitation Mitral valve opening is heard : a. In early systolic b. In early diastolic c. At the end of systole d. At the end of diastole Answer: b Which among the following is a symptom of coronary artery disease ? a. Shortness of breath b. Weakness and fatigue c. Heaviness, pressure or pain in the chest d. All of the above Answer: d