1) Which of the following is NOT recommended in the first instance in the treatment of severe

asthma exacerbation?
a) Oxygen
b) Ipratropium inhaler
c) Salbutamol inhaler
d) Methylprednisolone injection
e) Injectable aminophylline

2) Which of the following is the recommended antibiotic for a patient with a primary lung
abscess?
a) Ciprofloxacin
b) Amoxicillin clavulanate
c) Moxifloxacin
d) Clarithromycin
e) Vancomycin

3) Which of the following indicates the need for pleural drainage in the tube?
a) A 1.5 cm pneumothorax measured at the hilum
b) A pleural effusion occupying the right cost diaphragmatic sinus
c) A 6 cm posttraumatic pneumothorax measured at the pulmonary apex
d) Hydrothorax occupying the lower 1/3 of a lung field, in a patient with heart failure
and Sa02 95 % in the ambient
e) Air minimal parapneumonic pleurisy in a patient with good evolution on day 2 of
antibiotic treatment

4) Which of the following statements about the treatment of microcellular lung carcinoma is
TRUE?
a) Curative surgery is first-line
b) Neo-adjuvant chemotherapy is routinely recommended
c) Adjuvant Radio-chemotherapy is routinely administered
d) First-line chemotherapy consists of combining a platinum derivative with toposide
e) Prophylactic chest irradiation is routinely recommended

5) Which of the following conditions is a contraindication for non-invasive ventilation?

a) Cardiogenic pulmonary edema
b) Hypoventilation obesity syndrome
c) COPD exacerbation
d) Hypoxemic respiratory failure in immunocompromised patients
e) Non-respiratory organ failure

6) Which of the following is a factor favouring pneumonia associated with mechanical

ventilation?
a) history of pneumonia in the last 3 months
b) Administration of low molecular weight heparin
c) Treatment with systemic corticosteroids
d) Renal replacement therapy
e) Oropharyngeal colonization with pathogenic bacteria
7) Which of the following is the preferred empirical treatment in chronic cough secondary to
chronic rhinosinusitis?
a) Salbutamol inhaler as needed
b) Budesonide inhaler
c) Pseudoephedrine and chlorpheniramine oral
d) Montelukast oral
e) Theophylline oral

8) Which of the following is the most appropriate way to evaluate the initial response to
antibiotic treatment in community-acquired pneumonia?
a) At 24h: vital signs, general condition
b) At 48-72h: vital signs, general condition
c) At 48-72h: vital signs, bacterial eradication in sputum
d) At 48-72h: vital signs, radiological improvement
e) At 8-10 days: vital signs, radiological resolution

9) Which of the following investigations represents the best method in establishing the
diagnosis of pulmonary thromboembolism?
a) Pulmonary radiography
b) Arterial gases
c) Cardiac ultrasound
d) Pulmonary angiography CT O
e) Spirometry

10) Which of the following is the main effect of long-term bronchodilator treatment in COPD?
a) An improvement in lung function
b) Relief of symptoms
c) Reduction in decline in lung function
d) Reversal of systemic effects
e) Reduction in mortality

11) Which of the following therapeutic methods for correcting gasometric abnormalities is
correctly applied?
a) Oxygen therapy in case of hypercapnia not associated with respiratory acidosis
b) Invasive or non-invasive ventilation in case of hypercapnia and respiratory acidosis
c) Oxygen therapy if Pa02> 60mmHg and / or Sp02> 90%
d) Non-invasive ventilation if PaCO2 <45mmHg and pH> 7.35
e) Oxygen therapy with a SpO2 target of 94-98% in patients at risk of hypercapnia

12) The differential diagnosis of lung abscess is made with:

a) Excavated lung neoplasm
b) Miliary tuberculosis
c) silicosis
d) Hypersensitivity pneumonitis
e) All of the above
13) Your patient comes with a 10-episode polysomnographic recording of obstructive sleep
apnea / hour, but has no symptoms suggestive of obstructive sleep apnea syndrome. Each
of the following conditions, if present, would support the diagnosis of obstructive sleep
apnea syndrome, EXCEPT:
a) Systemic hypertension
b) Ischemic heart disease
c) Cerebral vascular stroke
d) Morbid obesity
e) Type 2 diabetes

14) Which of the following statements about the diagnosis of diffuse interstitial pneumonia is
true?
a) The definite diagnosis of hypersensitivity pneumonias is based on the detection of
antibodies against the glomerular basement membrane and / or ANCA
b) Lymphocytic inflammation and the presence of granulomas without central necrosis
can be found in idiopathic pulmonary fibrosis and post-irradiation pneumonitis
c) Atypical LAM-type cells (similar to smooth vascular muscle cells)
d) The characteristic histological appearance in idiopathic pulmonary fibrosis is of usual
interstitial pneumonitis (PIU)
e) Sarcoidosis has typical clinical and imaging presentation, so no biopsy is needed to
establish the diagnosis

15) Which of the following statements about post-capillary PH is true?

a) It is characterized by an average pulmonary artery pressure (PAP) ≥ 25mmHg and
pulmonary capillary pressure (PCP) ≤ 15mmHg
b) It is secondary to left heart disease
c) It is a rare form of PH
d) It can be associated with portal hypertension or HIV infection
e) Its main mechanism is vasoconstriction by endothelial dysfunction

16) The evolution of idiopathic pulmonary fibrosis is characterized by:

a) Complete remission, spontaneous or under antifibrotic treatment
b) Slow or rapid worsening, sometimes associating exacerbations of interstitial
syndrome or complications
c) Progressive bronchial obstruction, which responds to bronchodilators
d) Very good response to treatment with systemic corticosteroids
e) Extension of fibrosis to all organs or systems

17) Blind pleural biopsy has an increased diagnostic yield in:

a) A pleurisy secondary to nosocomial pneumonia
b) Pleural mesothelioma
c) Secondary neoplastic pleurisy
d) Spontaneous pneumothorax
e) Tuberculous pleurisy
18) The recommended treatment for a patient with obstructive sleep apnea syndromeis:
a) Oxygen therapy and weight loss
b) BPAP and oxygen therapy
c) CPAP and oxygen therapy
d) Oxygen therapy and theophylline
e) CPAP and weight loss

19) COPD stage GOLD 2 is defined by:

a) FEV1 <30% predicted
b) 30% ≤ FEV <50% predicted
c) 50% ≤ FEV <80% predicted
d) FEV1 ≥ 80% predicted
e) GOLD stage classification is not based on FEV1

20) An asthma patient claims the onset of asthmatic symptoms by the factors below.
Consequently you advise him to avoid all these do EXCEPTION:
a) House dust
b) Cat
c) Aspirin
d) Physical effort
e) Passive smoking

21) Which of the following conditions is a risk factor for PE?

a) Atrial fibrillation
b) Neoplasm
c) Varicose veins of the lower limbs
d) Asthma
e) Anticoagulant medication

22) Which of the following is a contraindication for curative surgery in lung cancer?
a) COPD GOLD Stage I
b) Persistent haemoptysis
c) Endobronchial tumor located at <2 cm from carina
d) Lung node in the same lobe as the primary tumor
e) Hilar adenopathy with a diameter> 2 cm

23) Which of the following interventions are useful in diffuse interstitial pneumonia?
a) Quitting smoking improves or slows the progression of the disease in
pulmonary histiocytosis with Langerhans cells
b) Estrogen preparations should be avoided in lymphangioleiomyomatosis.
c) Discontinuation of sensitizing agent exposure is required in hypersensitivity
pneumonia.
d) Respiratory rehabilitation helps to increase exercise tolerance
e) All of the above
24) Normal Spirometry in a Patient with Dyspnoea Excludes Diagnosis of:
a) Interstitial Lung Disease
b) COPD
c) Asthma
d) Pulmonary Hypertension
e) Cannot rule out any lung disease

25) Which of the following is the most effective treatment for preventing asthma
symptoms and exacerbations (i.e. controlling asthma)?
a) Salbutamol inhaler
b) Budesonide inhaler
c) Montelukast oral
d) theophylline oral
e) Omalizumab s.c.

26) What is the most probable etiology for community-acquired pneumonias requiring
hospitalization (according to severity criteria) in a pulmonology department:
a) Mycoplasma pneumoniae, Gram-negative bacilli, Staphylococcus aureus
b) Legionella, Gram-negative bacilli, Staphylococcus aureus
c) Chlamydia pneumoniae, anaerobes, Streptococcus
d) Streptococcus pneumoniae, Hemophilus influenzae, Legionella
e) Streptococcus pneumoniae, anaerobes, Staphylococcus aureus

27) Which of the following is the most common cause of chronic non-smoking cough
with normal lung radiography and no chronic treatment?
a) Chronic rhinosinusitis
b) Asthma
c) Chronic bronchitis
d) Non-asthmatic eosinophilic bronchitis
e) Gastroesophageal reflux

28) Which of the following classes of drugs is NOT recommended in the treatment of
pulmonary arterial hypertension (PAH) group 1?
a) Beta-blockers (metoprolol, nebivolol, bisoprolol)
b) Calcium channel blockers (nifedipine, diltiazem)
c) Prostacycline analogues (epoprostenol, iloprost, treprostinil)
d) Endothelin receptor antagonists
e) Phosphodiesterase inhibitors (sildenafil, tadalafil)

29) Which of the following is the specific difference between an episode of central apnea
and one of obstructive sleep apnea?
a) Absence of snoring
b) Decreased amplitude of nasal airflow by more than 50%
c) Absence of thoraco-abdominal respiratory movements during apnea
d) Absence of significant desaturation (i.e. over 3%)
e) None of the above
30) What is the most suitable place of care for a patient with community-acquired
pneumonia and acute hypoxemic respiratory failure, without signs of sepsis, without
intense respiratory labor (does not use respiratory accessory muscles)?
a) At home
b) On the conventional ward
c) On the intermediate therapy ward
d) On the intensive care ward
e) In the guard room / UPU

31) Which of the following statements about imaging in diffuse interstitial pneumopathy
is true?
a) Idiopathic pulmonary fibrosis is accompanied by images, in ground glass
b) Hypersensitivity pneumonias often have cystic images
c) Patients with sarcoidosis over time suffer a worsening from radiological type I
to type IV
d) Diffuse reticular opacities have a nonspecific appearance, being found in
many diffuse interstitial pneumopathies
e) In patients with autoimmune systemic diseases the most common lung
damage is bronchiectasis

32) Decreased alveolo-capillary diffusion is found in the following situations, EXCEPT:

a) Diffuse interstitial pneumonia
b) Emphysema
c) Asthma
d) Pulmonary vasculitis
e) Pulmonary hypertension

33) Female 75-year-old patient, hypertensive and with permanent atrial fibrillation, goes
to the emergency room for dyspnea at low exertion, palpitations and fever for 3
days. Pulmonary radiography shows a right pleural effusion, and examination of the
extracted pleural fluid shows: protein 3.2 g / L, LDH 100 IU / L, glucose 110 mg / dL.
Serum values: protein 7 g / L, LDH 400 IU / L (normal values 150-350 IU / L), glucose
130 mg / dL. What is the most likely cause of pleural effusion?
a) Underlying community-acquired pneumonia
b) Neoplasm
c) Viral pleurisy
d) Heart failure
e) There is not enough information to decide

34) In which of the following diffuse interstitial pneumonias can bronchial obstruction be
found?
a) Idiopathic pulmonary fibrosis
b) Sarcoidosis
c) Pulmonary vasculitis
d) Carcinomatous lymphangitis
e) Bronchial obstruction excludes a condition of the pulmonary interstitium
35) Which of the following statements regarding functional diagnosis in respiratory
pathology is CORRECT?
a) Interpretation of spirometry begins with analysis of test correctness
b) Obstruction is diagnosed if FEV1 (FEV1) is low
c) Restriction is accompanied by decreased FEV1 / CVF (FEV1 / FVC) ratio
(<lower than normal limit)
d) The bronchodilator response is significant if the CVF (FVC) increases by at
least 15%
e) Restriction and obstruction cannot be associated

36) **. the risk of malignancy of a solitary lung nodule, EXCEPT:

a) Family history of lung cancer
b) Significant history of smoking
c) Location in the lower lobe
d) Association with COPD
e) Spiky margins

37) Which of the following is an indication for long-term oxygen therapy in patients with
COPD?
a) Severe dyspnea at rest
b) FEV < 30% predicted
c) Paco2 > 50mmHg
d) Pa02 < 60 mmHg and associated anemia
e) Pa02 < 50 mmHg

38) Which of the following is a predisposing factor for bronchiectasis?

a) Male
b) Closed thoracic trauma
c) Uncontrolled diabetes
d) Recurrent lung infections
e) Asthma with adult onset

39) Which of the following statements about the assessment of severity and the
treatment of pulmonary thromboembolism is true?
a) Severity assessment is based exclusively on echocardiography
b) Systemic hypotension (TAS <90 or TAd <60mmHg) is associated with an
intermediate risk of death
c) Thrombolysis is reserved only for patients with massive pulmonary embolism
d) Anticoagulant therapy is indicated only in patients with moderate to high risk
of death
e) The duration of anticoagulant treatment is 6 km***
40) The true statement about the treatment of sarcoidosis is:
a) Oral corticosteroid therapy is recommended in most patients with
sarcoidosis.
b) Methotrexate or azathioprine are more effective in sarcoidosis and easier to
tolerate than corticosteroids.
c) Forms of sarcoidosis with functional or vital risk require rapid treatment with
high doses of systemic corticosteroids
d) Topical corticosteroids (inhaler, intraocular) are not used in the treatment of
sarcoidosis.
e) Oral corticosteroid therapy should be discontinued as soon as possible after
initiation (maximum 7 days).

41) Which of the following is an indication for antibiotic treatment in exacerbating

COPD?
a) Increase in sputum purulence
b) Severe dyspnea at rest
c) PEF < 33% predicted
d) Pa02 < 60 mm Hg
e) PaCO2 > 45 mm Hg

42) What is the first-line treatment for a patient with community-acquired pneumonia
whose severity score is CURB 65?
a) Oral ciprofloxacin
b) Oral gentamicin iv
c) Oral amoxicillin
d) Oral biseptol
e) Oral ceftriaxone

43) The following germs colonize the airways in patients with cystic fibrosis, EXCEPT:
a) Streptococcus pneumoniae
b) Haemophilus influenzae
c) Staphylococcus aureus
d) Pseudomonas aeruginosa
e) Burkholderia cepacia
44) The reference standard in the diagnosis of PH is:
a) Pulmonary angiography MRI
b) Pulmonary scintigraphy of ventilation and perfusion
c) Pulmonary angiography CT
d) Cardiac catheterization
e) Echocardiography
45) The most common pattern encountered in the pulmonary auscultation of a patient
with asthma is:
a) Normal
b) Diffuse wheezing
c) Diffuse snoring
d) Subcurrent diffuse
e) Prolonged expiration