[MCQ] Bronchiectasis and Lung Abscess- Part 2

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Bronchiectasis and Lung Abscess- Part 2

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Question 1

Which of the following is related to bronchiectasis ?

A	Tram tracks
B	Signet-ring sign
C	“Tree-in-bud” pattern
D	All of the above

Question 1 Explanation:

In chest radiographs, presence of “tram tracks” indicate dilated airways and is consistent with bronchiectasis. Chest CT findings include airway dilation that is detected as parallel “tram tracks” or as “signet-ring sign” i.e. a cross-sectional area of the airway with a diameter at least 1.5 times that of the adjacent vessel, lack of bronchial tapering (including the presence of tubular structures within 1 cm from the pleural surface), bronchial wall thickening in dilated airways, inspissated secretions (e.g., the “tree-in-bud” pattern), or cysts emanating from the bronchial wall (especially pronounced in cystic bronchiectasis

Question 2

“Tram tracks” and “ring shadows” are chest radiological signs seen in ?

A	Bronchopneumonia
B	Bronchiectasis
C	Bronchogenic carcinoma
D	Aspergillosis

Question 2 Explanation:

Dilated airways with thickened walls due to peribronchial inflammation are often crowded together in parallel. When seen longitudinally, they appear as “tram tracks”, when seen in cross-section, they produce “ring shadows”.

Question 3

Nodular bronchiectasis is suggestive of ?

A	Infection with Mycobacterium avium complex
B	ABPA
C	Cystic fibrosis
D	Cystic fibrosis

Question 3 Explanation:

Presence of multiple small pulmonary nodules (nodular bronchiectasis) suggests infection with M. avium complex

Question 4

FEV1 declines by how much per year in healthy individuals ?

A	10 - 20 mL
B	20 - 30 mL
C	30 - 40 mL
D	40 - 50 m

Question 4 Explanation:

Forced expiratory volume in 1 second (FEV1) declines by 20 - 30 mL per year in healthy subjects.

Question 5

Which of the following is not a feature of ‘Yellow nail syndrome’ ?

A	Lymphedema
B	Pleural effusion
C	Mediastinal lymphadenopathy
D	Yellow discoloration of nails

Question 5 Explanation:

Yellow nail syndrome is due to hypoplastic lymphatics. The triad of lymphedema, pleural effusion and yellow discoloration of nails is accompanied by bronchiectasis in ~40% of patients.

Question 6

Which lobe of lung is involved in “Dry” bronchiectasis ?

A	Upper lobe
B	Middle lobe
C	Lower lobe
D	Any of the above

Question 6 Explanation:

Bronchiectasis with upper lobe involvement may be suggestive of either tuberculosis or ABPA

Question 7

Multiple small pulmonary abscesses in contiguous areas of lung is called ?

A	Lung chancre
B	Lung carbuncle
C	Lung gangrene
D	Lung pemphigus

Question 7 Explanation:

Lung abscess refers to microbial infection of lung resulting in necrosis of pulmonary parenchyma. Necrotizing pneumonia or lung gangrene refers to multiple small pulmonary abscesses in contiguous areas of the lung, usually resulting from a more virulent infection.

Question 8

Most common cause of lung abscess is ?

A	Aspiration
B	Periodontal disease
C	Alcoholism
D	Immunoglobulin deficiency

Question 8 Explanation:

Aspiration is the most common cause of lung abscess.

Question 9

Most common causative organisms for lung abscess is ?

A	Anaerobic bacteria
B	S. aureus
C	Klebsiella pneumoniae
D	M. tuberculosis

Question 9 Explanation:

Anaerobic bacteria are the most common causative organisms for lung abscess

Question 10

Of the following, which is the most common pulmonary site of lung abscess ?

A	Anterior segments of upper lobes
B	Posterior segments of lower lobes
C	Right middle lobe
D	None of the above

Question 10 Explanation:

Dependent areas of lung, particularly upper lobes & posterior segments of lower lobes are the most common pulmonary site of lung abscess.

Question 11

Acute lung abscess in a healthy young patient, along with influenza, is likely to be due to ?

A	Klebsiella pneumoniae
B	Staphylococcus aureus
C	M. tuberculosis
D	All of the above

Question 11 Explanation:

Acute lung abscess in a healthy young patient, especially in conjunction with influenza, is likely to be due to Staphylococcus aureus. Other bacteria include S. milleri, K. pneumoniae, Group A Streptococcus, Gemella, Legionella, and Actinomyces spp. Parasites include Entamoeba histolytica, Paragonimus westermani, Strongyloides stercoralis.

Question 12

Which of the following agent is found almost exclusively in patients with defective cell-mediated immunity ?

A	Nocardia asteroides
B	Burkholderia pseudomallei
C	Paragonimus westermani
D	S. milleri

Question 12 Explanation:

Agents that are found almost exclusively in patients with defective cell-mediated immunity are Nocardia asteroides and Rhodococcus equi. Other agents include M. tuberculosis, Legionella spp., P. aeruginosa, Enterobacteriaceae (Klebsiella pneumoniae), Aspergillus spp., Cryptococcus spp.

Question 13

Lemierre’s disease best relates to ?

A	Strongyloides stercoralis
B	Blastomyces
C	Fusobacterium necrophorum
D	Gemella

Question 14

Which of the following clinical features of nonspecific lung abscess is uncommon ?

A	Fatigue
B	Cough
C	Sputum production
D	Fever with chills

Question 14 Explanation:

Chills are uncommon

Question 15

Foul odor of sputum is due to the organisms’ production of ?

A	Short-chain fatty acids
B	Medium-chain fatty acids
C	Long-chain fatty acids
D	All of the above

Question 15 Explanation:

Foul odor of sputum is due to the organisms’ production of short-chain fatty acids, such as butyric or succinic acid

Question 16

Which of the following is uncommon in lung abscess ?

A	Fever with chills
B	Lymphadenopathy
C	Anaerobic bacteria in expectorated sputum cultures
D	All of the above

Question 16 Explanation:

Lymphadenopathy is not associated with bacterial lung abscess and suggests an alternative diagnosis. Anaerobic bacteria, the most common causes of primary lung abscess, are not detected in expectorated sputum cultures.

Question 17

Which of the following in lung abscess indicates anaerobic infection ?

A	Putrid breath
B	Sputum
C	Empyema fluid
D	All of the above

Question 18

Which of the following drugs is now standard therapy for lung abscess ?

A	Penicillin
B	Clindamycin
C	Metronidazole
D	TMP-SMZ

Question 18 Explanation:

Penicillin “was” the mainstay of empiric antibiotic therapy for lung abscess. Due to frequent - lactamase producing organisms, clindamycin is now standard therapy.

Question 19

Which of the following should not be used for pulmonary infections ?

A	Linezolid
B	Daptomycin
C	Aerosolized colistin
D	Aminoglycosides

Question 19 Explanation:

Daptomycin should not be used for pulmonary infections.

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See all quizzes of Bronchiectasis and Lung Abscess at here:

Bronchiectasis and Lung Abscess- Part 1 | Bronchiectasis and Lung Abscess- Part 2

1.Which of the following is related to bronchiectasis ?
A. Tram tracks
B. Signet-ring sign
C. “Tree-in-bud” pattern
D. All of the above
2. “Tram tracks” and “ring shadows” are chest radiological signs seen in ?
A. Bronchopneumonia
B. Bronchiectasis
C. Bronchogenic carcinoma
D. Aspergillosis

3. Nodular bronchiectasis is suggestive of ?
A. Infection with Mycobacterium avium complex
B. ABPA
C. Cystic fibrosis
D. P. aeruginosa infection

4. FEV1 declines by how much per year in healthy individuals ?
A. 10 – 20 mL
B. 20 – 30 mL
C. 30 – 40 mL
D. 40 – 50 mL

5. Which of the following is not a feature of ‘Yellow nail syndrome’ ?
A. Lymphedema
B. Pleural effusion
C. Mediastinal lymphadenopathy
D. Yellow discoloration of nails

6. Which lobe of lung is involved in “Dry” bronchiectasis ?
A. Upper lobe
B. Middle lobe
C. Lower lobe

D. Any of the above

7. Multiple small pulmonary abscesses in contiguous areas of lung is called ?
A. Lung chancre
B. Lung carbuncle
C. Lung gangrene
D. Lung pemphigus

8. Most common cause of lung abscess is ?
A. Aspiration
B. Periodontal disease
C. Alcoholism
D. Immunoglobulin deficiency

9. Most common causative organisms for lung abscess is ?
A. Anaerobic bacteria
B. S. aureus
C. Klebsiella pneumoniae
D. M. tuberculosis

10. Of the following, which is the most common pulmonary site of lung abscess ?
A. Anterior segments of upper lobes
B. Posterior segments of lower lobes
C. Right middle lobe
D. None of the above

11. Acute lung abscess in a healthy young patient, along with influenza, is likely to be due to ?
A. Klebsiella pneumoniae
B. Staphylococcus aureus
C. M. tuberculosis
D. All of the above

12. Which of the following agent is found almost exclusively in patients with defective cell-mediated immunity ?
A. Nocardia asteroides

B. Burkholderia pseudomallei
C. Paragonimus westermani
D. S. milleri

13. Lemierre’s disease best relates to ?
A. Strongyloides stercoralis
B. Blastomyces
C. Fusobacterium necrophorum
D. Gemella
14. Which of the following clinical features of nonspecific lung abscess is uncommon ?
A. Fatigue
B. Cough
C. Sputum production
D. Fever with chills
Chills are uncommon.
15. Foul odor of sputum is due to the organisms’ production of ?
A. Short-chain fatty acids
B. Medium-chain fatty acids
C. Long-chain fatty acids
D. All of the above

16. Which of the following is uncommon in lung abscess ?
A. Fever with chills
B. Lymphadenopathy
C. Anaerobic bacteria in expectorated sputum cultures
D. All of the above

17. Which of the following in lung abscess indicates anaerobic infection ?
A. Putrid breath
B. Sputum
C. Empyema fluid
D. All of the above

18. Which of the following drugs is now standard therapy for lung abscess ?
A. Penicillin
B. Clindamycin

C. Metronidazole
D. TMP-SMZ

19. Which of the following should not be used for pulmonary infections ?
A. Linezolid
B. Daptomycin
C. Aerosolized colistin
D. Aminoglycosides

Bronchiectasis and Lung Abscess

[MCQ] Bronchiectasis and Lung Abscess- Part 2

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Bronchiectasis and Lung Abscess- Part 2

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