Q.1 Which of the following is the most common cause of community-acquired pneumonia?
Streptococcus pneumoniae
Mycoplasma pneumoniae
Legionella pneumophila
Chlamydia pneumoniae
Explanation - Streptococcus pneumoniae is the leading cause of community-acquired pneumonia worldwide, especially in adults.
Correct answer is: Streptococcus pneumoniae
Q.2 A patient presents with chronic productive cough for more than 3 months in 2 consecutive years. What is the most likely diagnosis?
Bronchial asthma
Chronic bronchitis
Bronchiectasis
Pulmonary fibrosis
Explanation - Chronic bronchitis is defined clinically by productive cough lasting for at least 3 months in 2 successive years.
Correct answer is: Chronic bronchitis
Q.3 Which lung cancer subtype is most strongly associated with smoking?
Adenocarcinoma
Small cell carcinoma
Large cell carcinoma
Bronchioalveolar carcinoma
Explanation - Small cell carcinoma has the strongest association with smoking and is highly aggressive.
Correct answer is: Small cell carcinoma
Q.4 A patient with asthma uses an inhaler for acute symptom relief. Which drug is most likely in the inhaler?
Salmeterol
Formoterol
Albuterol
Ipratropium
Explanation - Short-acting beta-2 agonists like Albuterol are used as rescue therapy in asthma.
Correct answer is: Albuterol
Q.5 Which of the following is a hallmark feature of obstructive lung disease?
Decreased FEV1/FVC ratio
Increased FEV1/FVC ratio
Normal FEV1/FVC ratio
Restrictive pattern on spirometry
Explanation - Obstructive lung diseases such as COPD and asthma are characterized by a reduced FEV1/FVC ratio.
Correct answer is: Decreased FEV1/FVC ratio
Q.6 Which organism is classically associated with pneumonia in alcoholics and produces a 'currant jelly sputum'?
Streptococcus pneumoniae
Klebsiella pneumoniae
Pseudomonas aeruginosa
Haemophilus influenzae
Explanation - Klebsiella pneumoniae commonly affects alcoholics and produces thick, blood-tinged sputum.
Correct answer is: Klebsiella pneumoniae
Q.7 A 65-year-old smoker presents with hemoptysis and weight loss. Chest X-ray shows a central lung mass. What is the most likely diagnosis?
Adenocarcinoma
Small cell carcinoma
Large cell carcinoma
Bronchial carcinoid tumor
Explanation - Small cell carcinoma commonly presents as a central mass in smokers and is associated with paraneoplastic syndromes.
Correct answer is: Small cell carcinoma
Q.8 Which of the following conditions is characterized by a barrel-shaped chest?
Asthma
Emphysema
Pulmonary fibrosis
Pleural effusion
Explanation - Emphysema causes hyperinflation of lungs, resulting in a barrel-shaped chest.
Correct answer is: Emphysema
Q.9 Which of the following is the gold standard investigation for pulmonary embolism?
Chest X-ray
CT pulmonary angiography
Ventilation-perfusion scan
D-dimer test
Explanation - CT pulmonary angiography is the diagnostic gold standard for pulmonary embolism.
Correct answer is: CT pulmonary angiography
Q.10 Which of the following is an example of a restrictive lung disease?
Asthma
Emphysema
Idiopathic pulmonary fibrosis
Chronic bronchitis
Explanation - Restrictive diseases such as idiopathic pulmonary fibrosis reduce lung compliance and total lung capacity.
Correct answer is: Idiopathic pulmonary fibrosis
Q.11 Which of the following is the most common cause of lung abscess?
Staphylococcus aureus
Anaerobic bacteria
Klebsiella pneumoniae
Pseudomonas aeruginosa
Explanation - Lung abscesses are most commonly caused by aspiration of anaerobic bacteria from the oropharynx.
Correct answer is: Anaerobic bacteria
Q.12 A 25-year-old asthmatic experiences worsening symptoms at night. This worsening is due to:
Increased parasympathetic activity at night
Increased sympathetic activity at night
Hypoventilation during sleep
Air pollution exposure
Explanation - Asthma symptoms worsen at night due to increased vagal tone and airway hyperresponsiveness.
Correct answer is: Increased parasympathetic activity at night
Q.13 Which of the following drugs is contraindicated in asthma?
Beta blockers
Inhaled corticosteroids
Leukotriene inhibitors
Short-acting beta agonists
Explanation - Non-selective beta blockers can cause bronchospasm and are contraindicated in asthma.
Correct answer is: Beta blockers
Q.14 In a patient with COPD, the primary drive to breathe is due to:
Hypoxemia
Hypercapnia
Metabolic acidosis
Hyperventilation
Explanation - In COPD patients, chronic CO2 retention makes hypoxemia the main respiratory drive (hypoxic drive).
Correct answer is: Hypoxemia
Q.15 Which imaging finding is most characteristic of bronchiectasis?
Ground-glass opacities
Honeycombing
Dilated airways with thickened walls
Pleural effusion
Explanation - Bronchiectasis shows permanently dilated bronchi with thickened walls on imaging.
Correct answer is: Dilated airways with thickened walls
Q.16 Which of the following is a common side effect of long-term inhaled corticosteroid use in asthma?
Oral candidiasis
Hypertension
Hypoglycemia
Pulmonary fibrosis
Explanation - Inhaled corticosteroids can suppress local immunity leading to oral thrush if mouth rinsing is not done.
Correct answer is: Oral candidiasis
Q.17 In pulmonary tuberculosis, the most common initial site of infection is:
Upper lobe
Middle lobe
Lower lobe
Lingula
Explanation - Primary TB usually starts in the lower lobe, while reactivation commonly involves the apical upper lobe.
Correct answer is: Lower lobe
Q.18 Which genetic condition is associated with bronchiectasis due to abnormal mucus secretion?
Alpha-1 antitrypsin deficiency
Cystic fibrosis
Kartagener syndrome
Marfan syndrome
Explanation - Cystic fibrosis causes thickened secretions leading to recurrent infections and bronchiectasis.
Correct answer is: Cystic fibrosis
Q.19 Which occupational exposure is associated with mesothelioma?
Silica
Asbestos
Coal dust
Beryllium
Explanation - Asbestos exposure is strongly linked to mesothelioma and pleural plaques.
Correct answer is: Asbestos
Q.20 Which type of hypersensitivity reaction is asthma primarily classified as?
Type I
Type II
Type III
Type IV
Explanation - Asthma is an IgE-mediated Type I hypersensitivity reaction.
Correct answer is: Type I
Q.21 Which sign is classically seen in pleural effusion on physical examination?
Hyperresonance on percussion
Tracheal deviation towards lesion
Stony dullness on percussion
Increased tactile fremitus
Explanation - Pleural effusion produces stony dullness on percussion due to fluid accumulation.
Correct answer is: Stony dullness on percussion
Q.22 What is the most common cause of secondary spontaneous pneumothorax?
Asthma
Tuberculosis
COPD
Cystic fibrosis
Explanation - COPD is the leading cause of secondary spontaneous pneumothorax due to ruptured bullae.
Correct answer is: COPD
Q.23 In sarcoidosis, which radiological finding is most characteristic?
Bilateral hilar lymphadenopathy
Honeycomb lung
Solitary pulmonary nodule
Pleural plaques
Explanation - Sarcoidosis typically presents with bilateral hilar lymphadenopathy on chest X-ray.
Correct answer is: Bilateral hilar lymphadenopathy
Q.24 Which test is most useful to confirm the diagnosis of obstructive sleep apnea?
Spirometry
Polysomnography
Chest CT
Arterial blood gas analysis
Explanation - Polysomnography (sleep study) is the gold standard for diagnosing sleep apnea.
Correct answer is: Polysomnography
Q.25 Which of the following is NOT a component of the classic triad of asthma?
Airway inflammation
Airway hyperresponsiveness
Airway remodeling
Pulmonary fibrosis
Explanation - Asthma involves inflammation, hyperresponsiveness, and remodeling, but not pulmonary fibrosis.
Correct answer is: Pulmonary fibrosis