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  1. Infection that may help to differentiated condition from sinusitis is : a. Rhinorrheas b. Cough c. Post nasal drip d. Fever e. Snoring 2. Peritonsilar abses (quincy) is a collection of pus the peritonsilar space withlies between the capsul of tonsil and : a. The interior constrictor muscle b. The superior constrictor muscle c. The medial constrictor muscle d. The pterygoid muscle e. The palatoglossus muscle 3. The most common infecting organism of acute tonsillitis is : a. Haemolytic strep. b. Strept. Pneumonia c. Haemophylus influinzae d. Moraxella catharralis e. Stap. aureus 4. An accepted and important function of the paranasal sinus is : a. Regulation intranasal space b. Lightening of the skull c. Humidifying inspired air d. Increasing surface inspired air e. Secretion of mucus 5. Increased incidence of paranasal sinus infection is usually observed when a. Mucus viscosity increase b. Mucus viscosity decrease c. Mucus volume decrease d. Mucus volume decrease e. Mucus transport decrease 6. Woman, 60 years old referred to hospital with complain : shortness of breath, right side chest pain, she felt more comfortable when lying to right position. The doctor decided the problem is pleural disease. The best pulmonary pemfis do differentiate between the air and the fluid in the pleural cavity? a. pulse rate d. percussion b. inspection e. auscultation c. palpation 7. a man 37 y.o come to clinic with a chief complaint : cough for 3 weeks whity sputum , mild fever, lost of appetite nosmoker history of past illness. Diabetes mellitus , physical exam : BP 120/80 mmHg, pulse 92x/minute , respiratory rate 20x , ronchi on apex of left lung. The most possibility diagnose for this patient ? a. pneumonia d. chronic bronchitis b. lung tumor e. bronchial asthma c. tuberculosis 8. a man, 17 years old, admitted to hospital due to hemoptysis. complete examination reveals the diagnosis of Pulmonary Tuberculosis. what is the important  data that should be collected before choosing the therapy? 1. daily habits, severity of TB 2. history of fever, result of sputum smear 3. history of bronchiale asthma, severity of TB 4. history of TB contact, result of sputum smear 5. previous anti-TB drug, result of sputum smear 9. A man 55 y’o referred to hospital because of the right side hemiparise. History of DM not routinely control, 4 days ago after admission he got fever, cough that difficult to expectorate, the condition is going bad. The most possible diagnosis: a. pneumonitis b. pulmonary TB c. hospital  –  acquired pneumonia d. community  –  acquired pneumonia e. acute axacerbation of chronic bronchitis 10. A man 57 y’o come to outpatient clinic/ chief complaint of right side chest pain, fever for 7 days, cough w/ foul smell sputum & blood streak. CXR revealed cavity with air fluid level. Management on this patient, include: 1. expectorane 2. anti TB 3. postural drainage 4. empirical antibiotic 5. chest tube insertion  A 70 y’o man presented of SOB. This  patient also complain of chronic cough but no fever. History of heavu smoking was positive. Pemfis reveals: barrel chest, increase of accessory muscle useage, prolonged of expiration fase & wheezing on auscultation. 11. The diagnosis must be concern in this case: a. lung TB b. COPD c. lung tumor d. acute bronchitis e. pneumonia 12. to diminish cough & SOB in this case above, we must give supplemental o2 and: a. bronchodilators b. anti piretic c. antibiotic d. mucolytic d. expectorantia 13. if we suspect COPD in a patient who presented w/ chronic productive cough, SOB, & history of cigarette smoking, we have to perform: a. complete blood count b. skin test c. sputum examination d. spirometry e.chest x-ray 14. in late stage COPD patient, we always find a patient with barrel chest, hypersonor & prolonged expiration on auscultation. All the condition due to a. chronic infection e. bronchial spasm  b. allergic process c. pulmonary hypertension d. air tapping  A 21 y’o man came to Emergency hospital w/ complain a sudden right side chest pain while watching tv. Other complain is SOB. He denies having cough & fever. He smoke. Vital sign: HR 92 bpm, RR 22bpm & there is no distress noted. Radiography findings show hyperlucens avascular over the hemithorax & right lung collapse 15. Physical exam result suitable: 1. Asymetric chest pain 2. Decreased breath sound over the right hemithorax 3. Hyper resonance to percussion 4. Retraction of intercostal space 16. What is the most appropriate management step? 1. Obtain high resulotion comuted tomography (HRCT) image of the chest 2. Administer 100% O2 and repeat chest x-ray in 2 hours 3. Refer the patient thoracoscopy and talc instillation 4. insert a small bore catheter via needle quidewire  A 32 y’o woman to Kalabahi General Hospital w/ fever, breathlessness, cough and left sided chest pain, weight loss and nighr sweats and history of prior lung TB 2 years ago. Initial evaluation reveal her to be thin and chronically ill appearing. On pemfis HR 112 beat/min RR 24 beats/min temperature 38’ . Asymetric lung expantion CXR reveal left lower lobe consuladation and moderate size left pleural effusion that layers on lateral decubitus views. Laboratory result Hb 10.5%, WBC 19700/mm 17. What is primary diagnostic procuders u must perform? a. chest CT  –  scan b. thoracosintesis and fluid pleura analysis c. chest USG d. bronchoscopy e. thoracoscopy 18. what is the diagnostic? a. transudate pleural effusion b. hydropneumothorax c. giant abses d. emphysema e. chylothorax  A 5 months girl is bringing to hospital because difficulty of breathing since 2 days ago. This happens for the first time, runny nose and coughing since 5 days ago. All families suffered fro m common cold. On pemfis temperature 38.5’ respiration 52 times/min, prolonged expiration, difuse wheezing was heard over both lungs. CXR reveal a hyperlucent lung and flat diaphragm 19. the most diagnosis: a. Pneumonia e. Rhinitis b. Bronchiolitis c. Bronchitis d. Asthma  20. in a 5 moths old girl takipneu according to WHO if respiratory rate: a. > 30x/min b. > 40x/min c. > 50x/min d. > 60x/min e. > 70x/min 21. Which among these respiratory disease is closely related to asthma ?  A. Pneumonia B. Bronchiolitis C. Laryngitis D. Pharyngitis E. Epiglotitis  A girl 15 y’o was admitted to the hospital due to coughing and dyspnea. This condition happened almost every month and usually spontaneously resolve. No fever, the girl look dyspneic prolonged expiration, difuse wheezing was heard over both lungs. She was still able to communicate to doctor with clear uninterrupted sentences. Family history mother has atopic dermatitis, father is a heavy smoker. 22. the most likely diagnosis: a. asthma b. pneumonia c. bronchitis d. bronchiolitis e. chronic obstructive pulmonary disease 23. Treatment for this case: a. administration of broad spectrum antibiotic b. Beta  –  2 agonis inhalation c. IV aminofilin and corticosteroid d. Mucolytics e. Antitussives 24. In patient suffered asthma episodic in frequent w/ moderate attack, the trearment is: a. beta  –  2 agons inhalation b. steroid inhalation c. aminofilin injection d. steroid injection e. antibiotic injection a boy 3 years old of age admitted to hospital w/ frequent low grade fever, decrease body weight and appetite. He had no suffered difficulty of breathing, but sometimes he was coughing. Mantoux test revealed a 16 mm induration BCG scar was seen. 25. the most likely diagnosis: a. TB class 0 e. TB class IV b. TB class I c. TB class II d. TB class III 26. the most likely causes of his 16 mm in duration of mantoux test: a. primary infection of Mycobacterium TB b. Reaction to the adjuvant of PPD
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