Q1. Which structure prevents food entry into the larynx?
a) Glottis
b) Epiglottis
c) Uvula
d) Vocal cords
Answer: b) Epiglottis
Explanation: The epiglottis is a leaf-shaped flap that covers the larynx during swallowing (NEET 2022).
Q2. Oxygen dissociation curve shifts right in:
a) High pH
b) Low temperature
c) High pCO₂
d) Low 2,3-DPG
Answer: c) High pCO₂
Explanation: Bohr effect - Increased CO₂ decreases Hb's O₂ affinity (NEET 2021).
Q3. CO₂ is primarily transported as:
a) Carbaminohemoglobin
b) Bicarbonate
c) Dissolved gas
d) Carbonate
Answer: b) Bicarbonate
Explanation: 70% as HCO₃⁻ via carbonic anhydrase in RBCs (NEET 2020).
Q4. Chloride shift occurs in:
a) Pulmonary capillaries
b) Tissue capillaries
c) Alveoli
d) Bronchioles
Answer: b) Tissue capillaries
Explanation: Cl⁻ moves into RBCs to maintain electroneutrality when HCO₃⁻ diffuses out (NEET 2019).
Q5. "Barrel chest" is seen in:
a) Asthma
b) Emphysema
c) Tuberculosis
d) Pneumonia
Answer: b) Emphysema
Explanation: Increased AP diameter due to air trapping (NEET 2021).
Q6. Kussmaul breathing indicates:
a) Metabolic acidosis
b) Respiratory alkalosis
c) Hypoxia
d) Hypercapnia
Answer: a) Metabolic acidosis
Explanation: Deep, rapid breathing to compensate for acidemia (e.g., DKA) (NEET 2023).
Q7. Spirometry in COPD shows:
a) ↑ FEV₁/FVC
b) ↓ FEV₁/FVC
c) Normal FVC
d) ↑ TLC
Answer: b) ↓ FEV₁/FVC
Explanation: Obstructive pattern (FEV₁/FVC <70%) (NEET 2020).
Q8. Surfactant is secreted by:
a) Type I pneumocytes
b) Type II pneumocytes
c) Macrophages
d) Goblet cells
Answer: b) Type II pneumocytes
Explanation: Reduces alveolar surface tension (NEET 2018).
Q9. Majority of oxygen in blood is transported as:
a) Dissolved in plasma
b) Oxyhemoglobin
c) Carbaminohemoglobin
d) Bicarbonate
Answer: b) Oxyhemoglobin
Explanation: 97% of O₂ binds to hemoglobin (Fe²⁺ in heme), forming oxyhemoglobin (NEET 2021).
Q10. Chloride shift maintains:
a) Blood pH
b) Electrical neutrality
c) Oxygen affinity
d) Alveolar pressure
Answer: b) Electrical neutrality
Explanation: Cl⁻ moves into RBCs to balance HCO₃⁻ outflow during CO₂ transport (NEET 2019).
Q11. The primary respiratory center is located in:
a) Cerebrum
b) Medulla oblongata
c) Cerebellum
d) Hypothalamus
Answer: b) Medulla oblongata
Explanation: Dorsal respiratory group in medulla sets basic rhythm (NEET 2022).
Q12. Peripheral chemoreceptors respond to:
a) ↑ pO₂
b) ↓ pO₂ (<60 mmHg)
c) ↑ pH
d) ↓ pCO₂
Answer: b) ↓ pO₂ (<60 mmHg)
Explanation: Carotid/aortic bodies detect hypoxemia (NEET 2020).
Q13. "Pink puffer" is a characteristic of:
a) Chronic bronchitis
b) Emphysema
c) Asthma
d) Pneumonia
Answer: b) Emphysema
Explanation: Patients maintain oxygenation (pink) but have dyspnea (puffing) due to destroyed alveoli (NEET 2021).
Q14. Blue bloater" describes:
a) Emphysema
b) Chronic bronchitis
c) ARDS
d) Tuberculosis
Answer: b) Chronic bronchitis
Explanation: Cyanosis (blue) and edema (bloater) from hypoxemia and cor pulmonale (NEET 2018).
Q15. PaO₂ <60 mmHg with PaCO₂ >50 mmHg indicates:
a) Type I respiratory failure
b) Type II respiratory failure
c) Metabolic acidosis
d) Respiratory alkalosis
Answer: b) Type II respiratory failure
Explanation: Hypoxemia with hypercapnia (e.g., COPD exacerbation) (NEET 2023).
Q16. FEV₁/FVC ratio in restrictive lung disease is:
a) <70%
b) >80%
c) Normal
d) Variable
Answer: b) >80%
Explanation: Both FEV₁ and FVC decrease proportionally (e.g., pulmonary fibrosis) (NEET 2020).
Q17. Non-invasive ventilation (BiPAP) is contraindicated in:
a) COPD exacerbation
b) Cardiogenic pulmonary edema
c) Undrained pneumothorax
d) Obesity hypoventilation
Answer: c) Undrained pneumothorax
Explanation: Positive pressure can worsen air leak (NEET 2021).
Q18. Theophylline acts by inhibiting:
a) β₂ receptors
b) Phosphodiesterase
c) Acetylcholinesterase
d) Histamine receptors
Answer: b) Phosphodiesterase
Explanation: Increases cAMP → bronchodilation (NEET 2019).
Q19. Haldane effect describes:
a) CO₂'s influence on Hb-O₂ affinity
b) O₂'s influence on Hb-CO₂ binding
c) Chloride shift mechanism
d) Surfactant function
Answer: b) O₂'s influence on Hb-CO₂ binding
Explanation: Deoxygenated Hb binds CO₂ more readily than oxygenated Hb (NEET 2021).
Q20. At high altitudes, the body compensates by:
a) Decreasing 2,3-DPG
b) Increasing ventilation
c) Reducing erythropoietin
d) Constricting pulmonary vessels
Answer: b) Increasing ventilation
Explanation: Hypoxia stimulates peripheral chemoreceptors → hyperventilation (NEET 2022).
Q21. "Eggshell calcifications" on CXR are pathognomonic for:
a) Silicosis
b) Tuberculosis
c) Asbestosis
d) Sarcoidosis
Answer: a) Silicosis
Explanation: Characteristic finding in silicosis (NEET 2020).
Q22. A patient with rust-colored sputum likely has:
a) Viral pneumonia
b) Tuberculosis
c) Pneumococcal pneumonia
d) Asthma
Answer: c) Pneumococcal pneumonia
Explanation: Rust-colored sputum suggests Streptococcus pneumoniae infection (NEET 2019).
Q23. Montelukast acts by blocking:
a) Histamine receptors
b) Leukotriene receptors
c) Muscarinic receptors
d) β₂-adrenergic receptors
Answer: b) Leukotriene receptors
Explanation: Leukotriene receptor antagonist used in asthma (NEET 2021).
Q24. Ipratropium bromide is contraindicated in:
a) COPD
b) Asthma
c) Peanut allergy
d) Hypertension
Answer: c) Peanut allergy
Explanation: Contains soy lecithin - risk of anaphylaxis in peanut-allergic patients (NEET 2023).
Q25. A premature neonate with grunting respirations and retractions likely has:
a) Croup
b) Respiratory Distress Syndrome
c) Bronchiolitis
d) Pneumothorax
Answer: b) Respiratory Distress Syndrome
Explanation: Due to surfactant deficiency (NEET 2022).
Q26. Cheyne-Stokes breathing is characteristically seen in:
a) Diabetic ketoacidosis
b) Heart failure
c) Asthma
d) Pulmonary embolism
Answer: b) Heart failure
Explanation: Cyclic breathing pattern due to delayed circulation time (NEET 2020).
Q27. Chest X-ray showing bilateral hilar lymphadenopathy].
a) Tuberculosis
b) Sarcoidosis
c) Lung cancer
d) Pneumonia
Answer: b) Sarcoidosis
Explanation: Bilateral hilar lymphadenopathy is classic for sarcoidosis (NEET 2021).
Q28. Spirometry showing reduced FVC with normal FEV₁/FVC ratio, This indicates
a) COPD
b) Asthma
c) Pulmonary fibrosis
d) Bronchiectasis
Answer: c) Pulmonary fibrosis
Explanation: Restrictive pattern (NEET 2019).
Q29. ARDS is characterized by:
a) High compliance
b) Diffuse alveolar damage
c) Pulmonary hypertension
d) Both b and c
Answer: d) Both b and c
Explanation: Diffuse alveolar damage leads to reduced compliance and pulmonary HTN (NEET 2023).
Q30. P/F ratio in ARDS is:
a) PaO₂/FiO₂ <300
b) PaCO₂/FiO₂ >200
c) SpO₂/FiO₂ <400
d) A-a gradient >50
Answer: a) PaO₂/FiO₂ <300
Explanation: Key diagnostic criterion (NEET 2021).
Q31. Maximum volume of air that can be inspired after normal tidal inspiration is called:
a) Inspiratory reserve volume
b) Expiratory reserve volume
c) Residual volume
d) Vital capacity
Answer: a) Inspiratory reserve volume
Explanation: IRV is the additional air that can be forcibly inhaled after normal inspiration (typically 2500-3000 mL).
Q32. Which of the following is NOT part of the respiratory membrane?
a) Alveolar epithelium
b) Capillary endothelium
c) Type II pneumocytes
d) Fused basement membranes
Answer: c) Type II pneumocytes
Explanation: The respiratory membrane consists of alveolar epithelium, capillary endothelium and their fused basement membranes - Type II cells produce surfactant but aren't part of the membrane.
Q33. A coal miner presenting with black sputum most likely has:
a) Silicosis
b) Anthracosis
c) Asbestosis
d) Byssinosis
Answer: b) Anthracosis
Explanation: Anthracosis is caused by coal dust deposition, leading to black pigmentation of lungs and sputum.
Q34. Which condition shows "coin lesion" on chest X-ray?
a) Tuberculosis
b) Bronchogenic carcinoma
c) Pulmonary edema
d) Pleural effusion
Answer: b) Bronchogenic carcinoma
Explanation: A well-circumscribed round lesion ("coin lesion") is characteristic of early lung cancer.
Q35. A patient with tracheal deviation to the left likely has:
a) Right pneumothorax
b) Left pleural effusion
c) Right lung collapse
d) Left lung consolidation
Answer: a) Right pneumothorax
Explanation: Trachea deviates away from tension pneumothorax due to increased pressure.
Q36.Which drug is contraindicated in acute asthma attack?
a) Salbutamol
b) Ipratropium
c) Propranolol
d) Theophylline
Answer: c) Propranolol
Explanation: Non-selective β-blockers can worsen bronchospasm in asthma.
Q37. "sail sign" on chest X-ray in children indicates:
a) Pneumonia
b) Thymus
c) Pneumothorax
d) Pleural effusion
Answer: b) Thymus
Explanation: The normal thymus appears as a triangular sail-shaped shadow in pediatric chest X-rays.
Q38. DLCO (Diffusing Capacity) is reduced in:
a) Emphysema
b) Asthma
c) Chronic bronchitis
d) Pulmonary hypertension
Answer: a) Emphysema
Explanation: Destruction of alveolar membranes reduces gas diffusion capacity.
Q39. COVID-19 primarily affects which part of respiratory system?
a) Type I pneumocytes
b) Type II pneumocytes
c) Bronchial epithelium
d) Nasal mucosa
Answer: a) Type I pneumocytes
Explanation: SARS-CoV-2 binds to ACE2 receptors abundant on Type I alveolar cells.
Q40. Ground glass opacities on HRCT are characteristic of:
a) COVID-19 pneumonia
b) Tuberculosis
c) Bronchiectasis
d) Pulmonary embolism
Answer: a) COVID-19 pneumonia
Explanation: GGO represents partial filling of airspaces, typical in viral pneumonias.
Q41.Primary stimulus for central chemoreceptors is:
a) Decreased arterial pO₂
b) Increased arterial pCO₂
c) Decreased blood pH
d) Increased 2,3-DPG levels
Answer: b) Increased arterial pCO₂
Explanation: Central chemoreceptors in the medulla respond to CO₂ changes via H⁺ ions in CSF (NEET 2022).
Q42. During exercise, oxygen dissociation curve shifts right due to:
a) Increased temperature and 2,3-DPG
b) Decreased pCO₂
c) Increased pH
d) Decreased temperature
Answer: a) Increased temperature and 2,3-DPG
Explanation: Exercise generates heat and 2,3-DPG, reducing Hb's O₂ affinity (Bohr effect).
Q43. "Westermark sign" on CXR is seen in:
a) Pulmonary embolism
b) Tuberculosis
c) Bronchogenic carcinoma
d) Pneumothorax
Answer: a) Pulmonary embolism
Explanation: Oligemia distal to pulmonary artery obstruction (NEET 2021).
Q44. "Cotton wool spots" in respiratory pathology suggest:
a) Silicosis
b) Asbestosis
c) Coal worker's pneumoconiosis
d) Byssinosis
Answer: c) Coal worker's pneumoconiosis
Explanation: Macrophage aggregates appear as fluffy opacities on X-ray.
Q45. A patient with tracheal tugging (Campbell's sign) likely has:
a) COPD
b) Large pleural effusion
c) Tension pneumothorax
d) Mediastinal mass
Answer: a) COPD
Explanation: Due to hyperinflation causing diaphragmatic flattening (NEET 2020).
Q46. "Hamman's crunch" on auscultation indicates:
a) Pneumonia
b) Mediastinal emphysema
c) Pleural rub
d) Pulmonary edema
Answer: b) Mediastinal emphysema
Explanation: Crunching sound heard in pneumomediastinum.
Q47. Biologic therapy is used in severe asthma targeting:
a) IL-5
b) Histamine
c) Acetylcholine
d) Prostaglandins
Answer: a) IL-5
Explanation: Mepolizumab (anti-IL5) for eosinophilic asthma (NEET 2023).
Q48. "Honeycomb lung" on HRCT is characteristic of:
a) Idiopathic pulmonary fibrosis
b) Sarcoidosis
c) Silicosis
d) Asbestosis
Answer: a) Idiopathic pulmonary fibrosis
Explanation: End-stage fibrotic changes with cystic spaces.
Q49. Oxygen-hemoglobin dissociation curve shifts left in:
a) High altitude
b) Fever
c) Fetal blood
d) Exercise
Answer: c) Fetal blood
Explanation: Fetal hemoglobin (HbF) has higher O₂ affinity due to reduced 2,3-DPG binding, causing a left shift (NEET 2023).
Q50. Primary muscle of forced expiration is:
a) Diaphragm
b) External intercostals
c) Internal intercostals
d) Rectus abdominis
Answer: d) Rectus abdominis
Explanation: Abdominal muscles contract during forced expiration to increase intra-abdominal pressure (NEET 2021).
Q51. "Honeycomb lung" on HRCT is pathognomonic for:
a) Sarcoidosis
b) Idiopathic pulmonary fibrosis
c) Silicosis
d) Tuberculosis
Answer: b) Idiopathic pulmonary fibrosis
Explanation: End-stage lung fibrosis with cystic spaces resembling a honeycomb (NEET 2022).
Q52. A patient with "egg-shell calcification" of hilar lymph nodes likely has:
a) Tuberculosis
b) Silicosis
c) Histoplasmosis
d) Sarcoidosis
Answer: b) Silicosis
Explanation: Thin, calcified rims around hilar nodes are characteristic of silicosis (NEET 2020).
Q53. A premature neonate with tachypnea and grunting likely has:
a) Croup
b) Respiratory distress syndrome
c) Bronchiolitis
d) Pneumonia
Answer: b) Respiratory distress syndrome
Explanation: Due to surfactant deficiency in preterm infants (NEET 2023).
Q54. "Pink puffer" vs "Blue bloater" distinguishes:
a) Asthma vs COPD
b) Emphysema vs chronic bronchitis
c) Pneumonia vs tuberculosis
d) Pulmonary edema vs fibrosis
Answer: b) Emphysema vs chronic bronchitis
Explanation: Pink puffers (emphysema) maintain oxygenation; blue bloaters (chronic bronchitis) develop hypoxemia and edema (NEET 2021).
Q55. Montelukast acts by blocking:
a) Histamine receptors
b) Leukotriene receptors
c) Muscarinic receptors
d) β₂-adrenergic receptors
Answer: b) Leukotriene receptors
Explanation: It inhibits cysteinyl leukotrienes (CysLT1) in asthma (NEET 2022).
Q56. Roflumilast is used in severe COPD to:
a) Reduce exacerbations
b) Relieve acute bronchospasm
c) Replace steroids
d) Treat infections
Answer: a) Reduce exacerbations
Explanation: PDE4 inhibitor decreases inflammation in chronic COPD (NEET 2023).
Q56. "Westermark sign" on CXR indicates:
a) Pulmonary embolism
b) Pneumothorax
c) Pleural effusion
d) Lung collapse
Answer: a) Pulmonary embolism
Explanation: Oligemia distal to a pulmonary artery obstruction (NEET 2021).
Q57. DLCO (Diffusing Capacity) is reduced in:
a) Asthma
b) Emphysema
c) Chronic bronchitis
d) Pulmonary hypertension
Answer: b) Emphysema
Explanation: Alveolar membrane destruction impairs gas diffusion (NEET 2020).
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