1.	The following cells are found in the respiratory bronchioles:

A.	Clara cells.
B.	Chondrocytes.
C.	Ciliated epithelial cells.
D.	Type I pneumocytes.
E.	Type II pneumocytes.

2.	Subjects in these situations are more likely to have hyperplastic carotid bodies than is an ordinary person living at sea level:

A.	Inhabitants of the Peruvian Andes.
B.	People with Pickwickian syndrome.
C.	People with acute allergic asthma.
D.	People with kyphoscoliosis.
E.	Olympic marathon runners.

3.	The following respiratory function tests usually have reduced values in asthmatic subjects:

A.	Peak expiratory flow rate (PEFR).
B.	Vital capacity (VC).
C.	Carbon monoxide transfer (TCO).
D.	Forced expiratory ratio (FEV1/VC).
E.	Forced expiratory ratio in 1 second (FEV1).

4.	The following factors predispose to infections of the respiratory tract:

A.	Coma.
B.	Immotile cilia syndromes.
C.	Congenital hypogammaglobulinaemia.
D.	Pulmonary edema.
E.	Cystic fibrosis.

1.	The following cells are found in the respiratory bronchioles:

A.	True. Clara cells secrete a proteinaceous fluid.
B.	False. There is no cartilage in bronchioles. 
C.	True. Ciliated epithelial cells line the bronchioles.
D.	False. Type I pneumocytes are found in the alveoli.
E.	False. Type II pneumocytes are found also in the alveoli where they secrete surfactant and are the stem cells for type I pneumocytes.

2.	Subjects in these situations are more likely to have hyperplastic carotid bodies than is an ordinary person living at sea level:

A.	True. 
B.	True. 
C.	False.
D.	True.
E.	False.

3.	The following respiratory function tests usually have reduced values in asthmatic subjects:

A.	True.
B.	False.
C.	False.
D.	True.
E.	True.

4.	The following factors predispose to infections of the respiratory tract:

A.	True.
B.	True.
C.	True.
D.	True.
E.	True.

5.	Lung abscess:

A.	A common pathogen is staphylococci.
B.	They are usually found in the basal regions.
C.	Aspiration abscesses are more common on the left.
D.	Brain abscess is a complication.
E.	Rheumatic fever is a risk factor.

6.	SARS:

A.	Stands for syndrome of acute respiratory syndrome.
B.	The causative agent is a coronavirus.
C.	Fever of more than 38.5C is a defining symptom.
D.	Causes death by acute respiratory failure.
E.	Is thought to have originated from avian virus in China.

7.	Atypical pneumonia:

A.	Characterized by inflammation of alveolar septa.
B.	Consolidation is absent.
C.	Rhinitis and pharynigitis are prominent symptoms.
D.	Usually result in acute respiratory distress syndrome.
E.	Formation of hyaline membranes is pathognomic of diffuse alveolar damage.

8.	Adult respiratory distress syndrome:

A.	Is a manifestation of diffuse alveolar damage leading to widespread systemic metabolic derangements.
B.	Progression of disease is mediated by systemic release of cytokines.
C.	Raised intracranial pressure is a common cause.
D.	Mortality rate is about 60 – 70%.
E.	There is usually no sequelae in survivors.

5.	Lung abscess:

A.	True.
B.	False.
C.	False. They are more common on the right.
D.	True.
E.	True.

6.	SARS:

A.	True.
B.	True.
C.	False.
D.	True.
E.	True.

7.	Atypical pneumonia:

A.	True.
B.	True.
C.	True.
D.	False.
E.	True.

8.	Adult respiratory distress syndrome:

A.	True.
B.	True.
C.	True.
D.	True.
E.	False. 20% have some permanent lung dysfunction.

9.	Carcinoma of the larynx:

A.	Is usually of the adenocarcinoma type.
B.	Is commoner in men than in women.
C.	Is associated with exposure to tobacco smoke.
D.	Has a treated 5-year survival rate of about 50%.
E.	May be complicated by lung infections.

10.	Malignant mesothelioma of the pleura:

A.	In Europe, is related to asbestos exposure in about 20% of cases.
B.	Is associated with cigarette smoking.
C.	Has been decreasing in incidence in Britain during the 1980s.
D.	Often has a biphasic epithelial / sarcomatous pattern of differentiation on histological examination.
E.	Usually contains asbestos bodies.

11.	Lobar pneumonia:

A.	Affects females more commonly than males.
B.	Is common in infancy and old age.
C.	Is usually due to Streptococcus pneumoniae.
D.	Passes through the stage of gray hepatization before red hepatization.
E.	Is rarely associated with sputum production.

12.	Pneumocystis carinii pneumonia:

A.	Usually occurs in immunocompetent subjects.
B.	Gives a histological picture of a foamy pink alveolar exudate.
C.	May be diagnosed by cytological examination of bronchoalveolar lavage.
D.	Is rarely life-threatening.
E.	May be associated with other respiratory infections. 
9.	Carcinoma of the larynx:

A.	False. 95% show squamous cell differentiation.
B.	True.
C.	True.
D.	True.
E.	True. Ulcerated tumors of the larynx are a potent source of infected debris in the distal airways.

10.	Malignant mesothelioma of the pleura:

A.	False.
B.	False.
C.	False.
D.	True.
E.	False.

11.	Lobar pneumonia:

A.	False. Males are more commonly affected.
B.	False. Lobar pneumonia occurs most commonly in adults between the ages of 30 and 50 years.
C.	True.
D.	False.
E.	True. Sputum is often plentiful and may have a rusty color due to flecks of blood.

12.	Pneumocystis carinii pneumonia:

A.	False.
B.	True.
C.	True. Silver impregnation stains make identification of the organism relatively easy in cytological preparations.
D.	False. It is a common terminal event in AIDS.
E.	True.

13.	Adult respiratory distress syndrome (ARDS):

A.	May be caused by ingestion of paraquat.
B.	May be caused by high concentrations of inspired oxygen.
C.	Can lead to an interstitial fibrosis.
D.	Produces hyaline membranes which line the alveoli.
E.	May lead to proliferation of type I pneumocytes.

14.	Bronchiectasis:

A.	Usually affects the upper lobes of the lungs.
B.	Is associated with cystic fibrosis.
C.	Is characterized by constriction of bronchi.
D.	Is associated with Kartagener’s syndrome.
E.	May complicate infection with the measles virus.

15.	Carcinoid tumors of the bronchus:

A.	Contain dense-core granules on electron microscopic examination.
B.	Usually occur in the periphery of the lung.
C.	May produce 5-hydroxytryptamine.
D.	Characteristically grow along the alveolar septa.
E.	May cause hemoptysis.

16.	Exposures to the following materials have a proven positive association with carcinoma of the lung:

A.	Asbestos.
B.	Cigar smoke.
C.	Cigarette smoke.
D.	Uranium.
E.	Radon.

13.	Adult respiratory distress syndrome (ARDS):

A.	True.
B.	True.
C.	True.
D.	True.
E.	False.

14.	Bronchiectasis:

A.	False.
B.	False.
C.	False.
D.	True.
E.	False.

15.	Carcinoid tumors of the bronchus:

A.	True.
B.	False.
C.	True.
D.	True.
E.	True.

16.	Exposures to the following materials have a proven positive association with carcinoma of the lung:

A.	False.
B.	True.
C.	True.
D.	False.
E.	False.

17.	Silicosis:

A.	May affect gold miners.
B.	Is caused by silica particles greater than 50m in diameter.
C.	Is associated with tuberculosis.
D.	May cause right ventricular hypertrophy.
E.	May cause malignant mesothelioma of the pleura.

18.	Chronic bronchitis:

A.	Is usually defined as a persistent productive cough for at least 3 consecutive months in at least 2 consecutive years.
B.	Rarely co-exists with emphysema.
C.	Is not associated with cigarette smoking.
D.	Is associated with hypoplasia of mucin-secreting glands.
E.	Is associated with infection by Haemophilus influenzae.

19.	The following conditions can cause pulmonary hypertension:

A.	Wegener’s granulomatosis.
B.	Multiple pulmonary emboli.
C.	A right-to-left ventricular intracardiac shunt.
D.	Residence at a high altitude.
E.	Transposition of the great vessels.

20.	Squamous cell carcinoma of the lung:

A.	Is commoner in females than in males.
B.	Is usually situated in the periphery of the lung.
C.	Rarely metastasizes.
D.	Has a 5-year survival rate of about 60%.
E.	Contains cytoplasmic mucin globules.

17.	Silicosis:

A.	True.
B.	False.
C.	True. Some 10 – 80% of subjects with silicosis have concomitant tuberculosis.
D.	True.
E.	False.

18.	Chronic bronchitis:

A.	True.
B.	False. Chronic bronchitis and emphysema are co-existent in the vast majority of subjects.
C.	False. 
D.	False.
E.	True. Other commonly isolated organisms are coagulase-positive staphylococci.

19.	The following conditions can cause pulmonary hypertension:

A.	True.
B.	True. Multiple pulmonary emboli obstruct the flow of blood through the lungs.
C.	False.
D.	True.
E.	True. In this anomaly there is increased blood flow through the lungs. 

20.	Squamous cell carcinoma of the lung:

A.	False. It is commoner in males.
B.	False. It usually arise centrally in a major bronchus.
C.	False.
D.	False.
E.	False. Adenocarcinomas contain intracytoplasmic mucin. Squamous cell carcinomas reveal their differentiation by production of keratin and intercellular bridges.

21.	A false-negative reaction to the tuberculin test may occur in the following circumstances:

A.	Cyclosporin therapy.
B.	Malignant lymphoma.
C.	Viral infections.
D.	Malnutrition.
E.	Active tuberculosis.

22.	Hyaline membrane disease (HMD) in neonates (infantile respiratory distress syndrome) is associated with:

A.	Postmaturity.
B.	Delivery by caesarean section.
C.	Birthweight of more than 4.5 kg.
D.	A deficiency of pulmonary surfactant.
E.	Maternal diabetes mellitus.

23.	Pulmonary adenochrondroma:

A.	Is regarded as an autonomous neoplasm.
B.	May present as a ‘coin’ lesion on chest radiograph.
C.	Has poorly-defined borders.
D.	Is usually a central lesion.
E.	Must always be surgically removed.

24.	The following are viruses which commonly cause rhinitis:

A.	Coronaviruses.
B.	Rhinoviruses.
C.	Cytomegalovirus.
D.	Haemophilus influenzae.
E.	Echoviruses.