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Respiratory System 5 Blocks

The document contains links to various USMLE resources and study groups on Telegram, including specific study materials for different USMLE steps. It also includes questions and answers related to medical topics, with explanations for the correct answers. The content appears to be aimed at medical students preparing for the USMLE exams.
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0% found this document useful (0 votes)
23 views949 pages

Respiratory System 5 Blocks

The document contains links to various USMLE resources and study groups on Telegram, including specific study materials for different USMLE steps. It also includes questions and answers related to medical topics, with explanations for the correct answers. The content appears to be aimed at medical students preparing for the USMLE exams.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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USMLE e e r m h nne s

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Question # 1

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=G�����A=B�5B8�F9GD=F5H=CBG�5F9����A=B �*I@G9�CL=A9HFM�CB�FCCA�5=F�G<CKG�5B�CLM;9B�G5HIF5H=CB�C:����
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@IB;�:=9@8G �.F95HA9BH�K=H< <=;<�8CG9 7CBH=BICIG�=B<5@98�5@6IH9FC@ =G�69;IB �.<=G�D5H=9BH�=G�5H�=B7F95G98
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Answer Image

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Hint

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HMD=75@@M�<5J9�GMGH9A=7�9::97HG �"CK9J9F��IG9�C:�7CBH=BICIG�=B<5@98 5@6IH9FC@ :CF�@CB;�D9F=C8G�C:�H=A9
75B�F9GI@H�=B V��A98=5H98 58J9FG9�9::97HG

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Correct Answer

A - Miosis

Explanation Why

V��5;CB=GHG 75IG9 7=@=5FM�AIG7@9 F9@5L5H=CB�=B�H<9 9M9��K<=7<�@958G�HC AM8F=5G=G��BCH A=CG=G �.<9


58A=B=GHF5H=CB�C: V��5;CB=GHG =G�9GD97=5@@M�7CBHF5=B8=75H98�=B�D5H=9BHG�K=H< B5FFCK�5B;@9�;@5I7CA5

B - Hypoglycemia

Explanation Why

V��5;CB=GHG <5J9�5�AI@H=:57HCF=5@�9::97H�CB�;@I7CG9 <CA9CGH5G=G 6M�GH=AI@5H=B; @=J9F ;@M7C;9BC@MG=G


5B8 D5B7F95H=7 =BGI@=B G97F9H=CB��5B8�H<9F96M�DFCACH=B; <MDC;@M79A=5 �"CK9J9F��6975IG9�H<9F9�=G�5
G=AI@H5B9CIG�F9@95G9�C: D5B7F95H=7 ;@I75;CB 5B8�5�897F95G9�=B =BGI@=B G9BG=H=J=HM��H<9�B9H�9::97H�C:
V��A98=5H98�GH=AI@5H=CB�=G <MD9F;@M79A=5

C - Hypokalemia

Explanation But

)H<9F�58J9FG9�9::97HG�C:�7CBH=BICIG 5@6IH9FC@ H<9F5DM�=B7@I89 <MDCA5;B9G9A=5� <MDCD<CGD<5H9A=5�


5B8�=B7F95G9G�=B <95FH�F5H9

Explanation Why

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GH=AI@5H=CB�C:�H<9 (5��%���.*5G9��K<=7<�@958G�HC�5B�=BHF579@@I@5F�%� G<=:H ��88=H=CB5@@M�
V��A98=5H98�GH=AI@5H=CB�C:�H<9 @=J9F 9@9J5H9G 7�'* @9J9@G��H<9F96M�=B7F95G=B; ;@M7C;9BC@MG=G 5B8
<MD9F;@M79A=5 "MD9F;@M79A=5 GH=AI@5H9G =BGI@=B G97F9H=CB��K<=7<�5@GC�57H=J5H9G�H<9 (5��%���.*5G9
5B8�:IFH<9F�DCH9BH=5H9G�H<9�=BHF579@@I@5F�%� G<=:H "MDC?5@9A=5 75B�75IG9 �%! 7<5B;9G��GI7<�5G .
K5J9 :@5HH9B=B;� -.�89DF9GG=CB��5B8 /�K5J9G

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D - Sedation

Explanation Why

V��5;CB=GHG C:H9B�75IG9�=FF=H56=@=HM��5BL=9HM��5B8 HF9ACF��BCH�G985H=CB��H<FCI;<�H<9=F�9::97HG�CB�H<9


79BHF5@�B9FJCIG�GMGH9A 5B8 G?9@9H5@�AIG7@9

E - Urinary frequency

Explanation Why

V�A98=5H98�GH=AI@5H=CB�C:�H<9 6@5889F 75IG9G�F9@5L5H=CB�C:�H<9 89HFIGCF AIG7@9 �.<=G�9::97H�89@5MG�H<9


B998�:CF�A=7HIF=H=CB�5B8�F9GI@HG�=B�897F95G98 IF=B5FM�:F9EI9B7M

F - Bradycardia

Explanation Why

V��5;CB=GHG 75IG9 H57<M75F8=5��BCH 6F58M75F8=5��H<FCI;<�5�7CA6=B5H=CB�C:�8=F97H�V��A98=5H98�75F8=57


GH=AI@5H=CB�5B8 F9:@9L�H57<M75F8=5 :C@@CK=B;�V��A98=5H98�D9F=D<9F5@ J5GC8=@5H=CB ��77CF8=B;@M� V�
5;CB=GHG G<CI@8�69�IG98�K=H<�75IH=CB�=B�D5H=9BHG�K=H<�?BCKB�75F8=CJ5G7I@5F�8=G95G9��9 ; �
<MD9FH9BG=CB� <95FH�:5=@IF9��6975IG9�H<9M�75B�=B8I79�@=:9�H<F95H9B=B; J9BHF=7I@5F�5FF<MH<A=5G

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Question # 2

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@5GH98 ��ACBH<G �"9�<5G�GAC?98 HKC�D57?G�C:�7=;5F9HH9G 85=@M�:CF�H<9�D5GH ���M95FG �*<MG=75@
9L5A=B5H=CB�G<CKG�G75HH9F98�9LD=F5HCFM�K<99N=B;�5B8�F<CB7<=�H<FCI;<CIH�6CH<�@IB;�:=9@8G �'=7FCG7CD=7
9L5A=B5H=CB�C:�5�@IB;�6=CDGM�GD97=A9B�=G�ACGH�@=?9@M�HC�G<CK�K<=7<�C:�H<9�:C@@CK=B;�:=B8=B;G�

Answer Image

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Hint

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6FCB7<=H=G �DFC8I7H=J9 7CI;< :CF�5H�@95GH ��ACBH<G 957<�M95F�:CF�HKC�7CBG97IH=J9�M95FG�

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Correct Answer

A - Increased ciliated epithelial cells

Explanation Why

.<9�BIA69F�C: 7=@=5H98�9D=H<9@=5@�79@@G =G�897F95G98�F5H<9F�H<5B�=B7F95G98�=B�D5H=9BHG�K=H< 7<FCB=7


6FCB7<=H=G ��<FCB=7�9LDCGIF9�HC�HC6577C�GAC?9�=B=H=5@@M�F9GI@HG�=B A9H5D@5G=5 C: 7=@=5H98�9D=H<9@=IA�
K<=7<�=G�H<9B�F9D@5798�K=H< GHF5H=:=98 GEI5ACIG�9D=H<9@=IA �.<9�897F95G98�BIA69F�C: 7=@=5H98�79@@G
=AD5=FG�AI7C7=@=5FM�HF5BGDCFH��7CBHF=6IH=B;�HC�H<9�89J9@CDA9BH�C: 7<FCB=7�6FCB7<=H=G

B - Decreased alveolar macrophages

Explanation Why

#B 7<FCB=7�6FCB7<=H=G��H<9�BIA69F�C: 5@J9C@5F�A57FCD<5;9G =G�=B7F95G98�F5H<9F�H<5B�897F95G98


�<FCB=7�9LDCGIF9�HC�HC6577C�GAC?9�75IG9G DFC@=:9F5H=CB 5B8�57H=J5H=CB�C: A57FCD<5;9G��K<=7<
F9@95G9�=B:@5AA5HCFM�A98=5HCFG�5B8 DFCH95G9G H<5H�85A5;9 @IB; D5F9B7<MA5 5B8�7CBHF=6IH9�HC
7<FCB=7 =B:@5AA5H=CB

C - Increased club cells

Explanation Why

�@I6�79@@G 5F9�:CIB8�=B�H<9 7=@=5H98�9D=H<9@=IA C: 6FCB7<=C@9G 5B8�G97F9H9 ;@M7CG5A=BC;@M75BG 5B8


@MGCNMA9G��K<=7<�<9@D�HC�6F95?�8CKB�AI7IG�5B8�A5=BH5=B�H<9�=BH9;F=HM�C:�H<9�6FCB7<=5@�@=B=B; �#B
7<FCB=7�6FCB7<=H=G��H<9�BIA69F�C: 7@I6�79@@G =G�897F95G98�F5H<9F�H<5B�=B7F95G98

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D - Decreased smooth muscle cells

Explanation Why

#B 7<FCB=7�6FCB7<=H=G��H<9�BIA69F�C: GACCH<�AIG7@9�79@@G =G�=B7F95G98�F5H<9F�H<5B�897F95G98 ��<FCB=7


9LDCGIF9�HC�HC6577C�GAC?9�75IG9G GACCH<�AIG7@9�79@@G HC�DFC8I79�=B:@5AA5HCFM 7MHC?=B9G�
DFCH95G9G��5B8�;FCKH<�:57HCFG �.<=G�@958G�HC�=B7F95G98 DFC@=:9F5H=CB C: GACCH<�AIG7@9�79@@G 5B8
F9AC89@=B;�C:�GA5@@ 5=FK5MG 5B8�J5G7I@5HIF9��7CBHF=6IH=B;�HC�H<9�89J9@CDA9BH�C: DI@ACB5FM
<MD9FH9BG=CB =B�D5H=9BHG�K=H< �)*�

E - Increased goblet cells

Image

Explanation Why

#B7F95G98 ;C6@9H�79@@ DFC@=:9F5H=CB��AI7IG�<MD9FG97F9H=CB��5B8�=AD5=F98�7=@=5FM�:IB7H=CB�5F9


7<5F57H9F=GH=7�:=B8=B;G�=B 7<FCB=7�6FCB7<=H=G��5�GI6HMD9�C: �)*� H<5H�H<=G�D5H=9BH�@=?9@M�<5G

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-I6AI7CG5@ ;C6@9H�79@@ <MD9FD@5G=5 F9GI@HG�:FCA�7<FCB=7�HC6577C�GAC?9�9LDCGIF9�5B8�75B�69
EI5BH=:=98�<=GHC@C;=75@@M�IG=B;�H<9 ,9=8�=B89L��5 F5H=C ��� ��=G�7CBG=GH9BH�K=H< 7<FCB=7�6FCB7<=H=G

F - Increased enterochromaffin cells

Explanation Why

%I@7<=HG?M�79@@G 5F9�B9IFC9B8C7F=B9�6FCB7<=5@�79@@G�5GGC7=5H98�K=H< GA5@@�79@@�@IB;�75B79F �.<=G


D5H=9BH�G�GAC?=B;�<=GHCFM�=B7F95G9G�<=G�F=G?�:CF @IB;�75B79F��5B8�7<FCB=7 7CI;< =B�5�GAC?9F�G<CI@8
5@K5MG�F5=G9�GIGD=7=CB�C: A5@=;B5B7M �"CK9J9F��<9�<5G�BC�9J=89B79�C: <9ACDHMG=G��K9=;<H�@CGG��CF
CH<9F 7CBGH=HIH=CB5@�GMADHCAG H<5H�5F9�GI;;9GH=J9�C:�75B79F

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Question # 3

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5B8�H<=7?�B5G5@�8=G7<5F;9 �-<9 <58�5�GCF9�H<FC5H�5B8�B5G5@�7CB;9GH=CB�H<9�K99?�69:CF9 H<5H�<58�=B=H=5@@M
=ADFCJ98 "9F�H9AD9F5HIF9�=G��� �O������ �O � *<MG=75@�9L5A�G<CKG DIFI@9BH�B5G5@�8F5=B5;9�5B8
H9B89FB9GG�HC�D9F7IGG=CB�CJ9F�H<9�:FCBH5@�G=BIG9G �.<9�B5G5@�HIF6=B5H9G�5F9�9FMH<9A5HCIG�5B8�A=@8@M
GKC@@9B �1<=7<�C:�H<9�:C@@CK=B;�89G7F=69G�H<9�A=7FC6=C@C;=75@�DFCD9FH=9G�C:�H<9�ACGH�@=?9@M�75IG5@
CF;5B=GA�

Answer Image

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Answer Image

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Hint

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Correct Answer

A - Gram-negative, oxidase-positive, maltose-nonfermenting diplococci

Explanation Why

Moraxella catarrhalis �;F5A�B9;5H=J9� CL=85G9�DCG=H=J9��A5@HCG9�BCB:9FA9BH=B; 8=D@C7C77=��=G�5


F9@5H=J9@M�7CAACB�75IG9�C: 57IH9�CH=H=G�A98=5 5B8�H<9�H<=F8�ACGH�7CAACB�75IG9�C:�657H9F=5@
F<=BCG=BIG=H=G Neisseria gonorrhoeae =G�5@GC�5�;F5A�B9;5H=J9� CL=85G9�DCG=H=J9��A5@HCG9�
BCB:9FA9BH=B; 8=D@C7C77= �"CK9J9F��=H�=G�BCH�5�75IG9�C:�57IH9 F<=BCG=BIG=H=G

B - Gram-positive, optochin-sensitive, lancet-shaped diplococci

Image

Explanation But

.<9�G97CB8�ACGH�7CAACB�75IG9�C: 657H9F=5@�F<=BCG=BIG=H=G =G�BCBHMD956@9 Haemophilus influenzae

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.C;9H<9F� Streptococcus pneumoniae 5B8 Haemophilus influenzae 577CIBH�:CF�������C:�5@@�75G9G

Explanation Why

Streptococcus pneumoniae �;F5A�DCG=H=J9� CDHC7<=B�G9BG=H=J9��@5B79H�G<5D98 8=D@C7C77=��=G�H<9�ACGH


7CAACB�75IG9�C:�657H9F=5@ F<=BCG=BIG=H=G ���J=F5@ IDD9F�F9GD=F5HCFM�=B:97H=CB��5G�H<=G�KCA5B�@=?9@M
<58�H<9�K99?�DF=CF��=G�H<9�ACGH�7CAACB�DF98=GDCG=B;�:57HCF�HC�H<9�89J9@CDA9BH�C: 657H9F=5@
F<=BCG=BIG=H=G

C-

Gram-negative, lactose-nonfermenting, blue-green pigment-producing bacilli

Explanation Why

Pseudomonas aeruginosa �;F5A�B9;5H=J9� @57HCG9�BCB:9FA9BH=B;��6@I9�;F99B�D=;A9BH�DFC8I7=B;


657=@@=��=G�5�7CAACB�75IG9�C: BCGC7CA=5@ /.#G 5B8 DB9IACB=5 �#H�75B�75IG9�5 BCGC7CA=5@
F<=BCG=BIG=H=G =B =AAIBC7CADFCA=G98 D5H=9BHG�CF�H<CG9�K=H<�B5G5@�HI69G��= 9 �B5GC;5GHF=7�HI69���6IH
H<=G�KCA5B�8C9G�BCH�<5J9�5BM�C:�H<CG9�DF98=GDCG=B;�:57HCFG

D - Gram-negative, encapsulated, lactose-fermenting bacilli

Explanation Why

Klebsiella pneumoniae �;F5A�B9;5H=J9��9B75DGI@5H98� @57HCG9�:9FA9BH=B; 657=@@=��75B��=B�79FH5=B


7=F7IAGH5B79G��75IG9�5 BCGC7CA=5@ 657H9F=5@�F<=BCG=BIG=H=G �"CK9J9F��H<=G�D5H=9BH�<5G�BCH�699B�HC�H<9
<CGD=H5@�F979BH@M ��88=H=CB5@@M� K. pneumoniae =G�ACF9�HMD=75@@M�H<9�75IG9�C: BCGC7CA=5@ /.#G 5B8
DB9IACB=5

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E - Gram-positive, coagulase-positive, clustered cocci

Image

Explanation Why

Staphylococcus aureus �;F5A�DCG=H=J9� 7C5;I@5G9�DCG=H=J9 7C77= :CIB8�=B�7@IGH9FG��=G�89H97H56@9�=B�H<9


BCGHF=@G�C:�56CIH�����C:�H<9�<95@H<M�DCDI@5H=CB��6IH�=G�5�F5F9�75IG9�C:�657H9F=5@ F<=BCG=BIG=H=G S.
aureus =G�5�7CAACB�75IG9�C: G?=B�=B:97H=CBG �9 ; 79@@I@=H=G� =AD9H=;C� 56G79GG�

F - Gram-positive, anaerobic, non-acid fast branching filamentous bacilli

Explanation Why

�7H=BCAM79G�=GF59@== �;F5A�DCG=H=J9� 5B59FC6=7��BCB�57=8�:5GH 6F5B7<=B;�:=@5A9BHG��=G�5�B5HIF5@


657H9F=5�C:�H<9 CF5@�75J=HM H<5H�75IG9G 56G79GG :CFA5H=CB�5:H9F�HCCH<�9LHF57H=CB� 89BH5@�75F=9G��CF
A5L=@@C:57=5@�HF5IA5 �.<=G�HMD9�C:�657H9F=5�8C9G�BCH�75IG9�57IH9�657H9F=5@ F<=BCG=BIG=H=G

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Question # 4

��A5@9 B9K6CFB 6CFB�5H ���K99?G� ;9GH5H=CB�=G�9J5@I5H98�:CF F5D=8�6F95H<=B;�5B8�<MDCL=5�G<CFH@M�5:H9F


6=FH< �"=G�ACH<9F�<58�BC�DF9B5H5@�75F9 ��5F8=CDI@ACB5FM�9L5A=B5H=CB�G<CKG�BCFA5@�<95FH�GCIB8G�
=BH9F7CGH5@�F9HF57H=CBG��5B8 B5G5@�:@5F=B; ��B L�F5M C:�H<9�7<9GH�G<CKG�@CK�@IB;�JC@IA9G��5=F
6FCB7<C;F5AG��5B8�8=::IG9 ;FCIB8�;@5GG CD57=H=9G �"9�=G�GH5FH98�CB�B5G5@�7CBH=BICIG�DCG=H=J9�5=FK5M
DF9GGIF9 � IFH<9F�9J5@I5H=CB�C:�H<=G�D5H=9BH�=G�ACGH�@=?9@M�HC�G<CK�K<=7<�C:�H<9�:C@@CK=B;�:=B8=B;G�

Answer Image

�=@5H9F5@�D@9IF5@�9::IG=CBG�CB�@IB;

I@HF5GCIB8

�CF?G7F9K�G<5D98�CF;5B=GAG�CB

IA6=@=75@�7CF8�7I@HIF9

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@IB;�6=CDGM

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GI7H=CB=B;

*5H9BH�8I7HIG�5FH9F=CGIG�CB

97<C75F8=C;F5D<M

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Hint

.<=G�DF9A5HIF9 B9K6CFB DF9G9BHG�K=H< <MDCL=5� 5=F�6FCB7<C;F5AG��5B8�8=::IG9 ;FCIB8�;@5GG�CD57=H=9G�


K<=7<�=G�7CBG=GH9BH�K=H< B9CB5H5@�F9GD=F5HCFM�8=GHF9GG�GMB8FCA9 �(,�-�

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Correct Answer

A - Bilateral pleural effusions on lung ultrasound

Explanation Why

�=@5H9F5@ D@9IF5@�9::IG=CBG CB @IB; I@HF5GCIB8 5F9�F5F9@M�G99B�=B B9K6CFBG K=H< (,�- �.<9�DF9G9B79


C: D@9IF5@�9::IG=CBG =G�5�<9@D:I@�K5M�HC�8=GH=B;I=G< (,�- :FCA�95F@M B9CB5H5@�DB9IACB=5 6975IG9
6CH<�DFC79GG9G�A5M�G<CK�5@J9C@5F�89BG=H=9G�K=H< 5=F�6FCB7<C;F5AG CB 7<9GH�L�F5M �)H<9F�75IG9G�C:
D@9IF5@�9::IG=CBG =B�H<9 B9K6CFB =B7@I89 7CB;9GH=J9�<95FH�:5=@IF9 �9 ; ��8I9�HC�7CB;9B=H5@ <95FH
89:97HG�� A97CB=IA�5GD=F5H=CB�GMB8FCA9��5B8 <M8FCDG�:9H5@=G �9 ; � <9AC@MH=7�8=G95G9�C:�H<9
B9K6CFB�

B - Corkscrew-shaped organisms on umbilical cord culture

Explanation But

�5F@M�:95HIF9G�C: 7CB;9B=H5@�GMD<=@=G H<5H�A5M�89J9@CD�K=H<=B�H<9�:=FGH�ACBH<G�5F9�AI7CDIFI@9BH�CF


6@CC8�GH5=B98�B5G5@�8=G7<5F;9� <9D5HCGD@9BCA9;5@M� G?=B @9G=CBG��D9H97<=59���5B8�6CB9�56BCFA5@=H=9G

Explanation Why

�CF?G7F9K�G<5D98�CF;5B=GAG�CB IA6=@=75@�7CF8 7I@HIF9�KCI@8�69�GI;;9GH=J9�C: 7CB;9B=H5@�GMD<=@=G


8I9�HC�5 Treponema pallidum =B:97H=CB �.<=G B9K6CFB�G�ACH<9F�<58�BC DF9B5H5@�75F9��K<=7<�=B7F95G9G
<=G�F=G?�C:�7CB;9B=H5@�=B:97H=CBG �"CK9J9F��=H�=G�5B�IB@=?9@M�75IG9�C:�<=G�DF9G9BH5H=CB� 7CB;9B=H5@
GMD<=@=G =G�ACGH�7CAACB@M�5GMADHCA5H=7�5H 6=FH<��CF�F9GI@HG�=B GH=@@6=FH< 5B8�CF <M8FCDG�:9H5@=G

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C - Hyaline membranes lining the alveoli on lung biopsy

Image

Explanation Why

"M5@=B9�A9A6F5B9G @=B=B;�H<9�5@J9C@=�CB @IB; 6=CDGM =G�7<5F57H9F=GH=7�C: (,�-��K<=7<�F9GI@HG�:FCA


GIF:57H5BH�89:=7=9B7M 5B8�=G�H<9�ACGH�7CAACB�75IG9�C:�895H<�=B DF9A5HIF9�=B:5BHG -IF:57H5BH
89:=7=9B7M 75IG9G�=B7F95G98�5@J9C@5F�GIF:579�H9BG=CB�5B8�5�GI6G9EI9BH�897F95G9�=B @IB; 9LD5BG=CB�
@958=B;�HC�5@J9C@5F�7C@@5DG9� 5H9@97H5G=G� <MDCL9A=5��5B8 <MD9F75DB=5 �.<=G�D5H=9BH�G�7<9GH L�F5M
G<CKG�7@5GG=7�:=B8=B;G�C: (,�-��=B7@I8=B;�@CK @IB;�JC@IA9G� 5=F�6FCB7<C;F5AG��5B8�8=::IG9�;FCIB8�
;@5GG CD57=H=9G

D - Meconium-stained fluid on deep suctioning

Explanation Why

'97CB=IA�GH5=B98�:@I=8�CB�899D�GI7H=CB=B;�=G�7<5F57H9F=GH=7�C: A97CB=IA�5GD=F5H=CB�GMB8FCA9

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�'�-� ��@H<CI;<�F9GD=F5HCFM�8=GHF9GG�5B8 <MDCL=5 5F9�7@=B=75@�:95HIF9G�C: '�-��=H�=G�IB@=?9@M�=B�H<=G
DF9A5HIF9 B9K6CFB��5G '�- IGI5@@M�89J9@CDG�=B H9FA =B:5BHG��F5H<9F�H<5B DF9H9FA�=B:5BHG �#B
588=H=CB��7<9GH L�F5M KCI@8�G<CK�5GMAA9HF=7��D5H7<M CD57=H=9G 5B8 D@9IF5@�9::IG=CBG��K<=7<�=G
=B7CBG=GH9BH�K=H<�H<=G�D5H=9BH�G�:=B8=B;G

E - Patent ductus arteriosus on echocardiography

Explanation Why

� D5H9BH�8I7HIG�5FH9F=CGIG CB 97<C75F8=C;F5D<M =G�<=;<@M�IB@=?9@M�=B�H<=G�D5H=9BH�K=H<�BC�9J=89B79�C:


5 <95FH�AIFAIF �9 ; ��7CBH=BICIG A57<=B9FM�AIFAIF��CB D<MG=75@�9L5A=B5H=CB � IFH<9FACF9��H<9
7<5F57H9F=GH=7�:=B8=B;G�C:�DFCA=B9BH DI@ACB5FM�5FH9FM 5B8 5CFH=7�?BC6 5@CB;�H<9�IDD9F�@9:H <95FH
6CF89F�5F9�@57?=B;�CB�H<=G�D5H=9BH�G�7<9GH L�F5M

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Question # 5

.KC�85MG�5:H9F�IB89F;C=B;�@9:H�<9A=7C@97HCAM�:CF�5�7C@CB=7�A5GG��5 ���M95F�C@8 A5B�89J9@CDG G<CFHB9GG


C:�6F95H< �"=G�H9AD9F5HIF9�=G �� �O� ���� �O ���DI@G9�=G����A=B��F9GD=F5H=CBG�5F9����A=B��5B8�6@CC8
DF9GGIF9�=G �������AA�"; �*I@G9�CL=A9HFM�CB�FCCA�5=F�G<CKG�5B�CLM;9B�G5HIF5H=CB�C:����
�5F8=CDI@ACB5FM�9L5A=B5H=CB�G<CKG�897F95G98�6F95H<�GCIB8G�5B8�897F95G98�:F9A=HIG�5H�6CH<�@IB;
65G9G ��FH9F=5@�6@CC8�;5G�5B5@MG=G�CB�FCCA�5=F�G<CKG�

D" � ��

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@=?9@M�IB89F@M=B;�A97<5B=GA�C:�H<=G�D5H=9BH�G�<MDCL9A=5�

Answer Image

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Answer Image

�97F95G98�7<9GH�K5@@�7CAD@=5B79

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Hint

.<=G�D5H=9BH�G 8MGDB95 5B8�897F95G98�6=@5H9F5@ :F9A=HIG =B�H<9�DCGHCD9F5H=J9�D9F=C8�7CA6=B98�K=H<�5B


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G<CK=B;�7C@@5DG98 @IB;

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Correct Answer

A - Increased anatomic dead space

Explanation Why

�B5HCA=7�8958�GD579 F9:9FG�HC�H<9 DFCDCFH=CB C:�H<9 5=FK5M H<5H�8C9G�BCH�D5FH=7=D5H9�=B ;5G�9L7<5B;9


�9 ; ��B5GCD<5FMBL� HF57<95��9H7� �B5HCA=7�8958�GD579 =G�BCH�5::97H98�6M 5H9@97H5G=G 5B8�KCI@8�BCH
9LD@5=B�H<=G�D5H=9BH�G <MDCL9A=5

B - Decreased hemoglobin oxygen-binding capacity

Explanation Why

��897F95G98 <9AC;@C6=B CLM;9B�6=B8=B;�75D57=HM��9 ; ��8I9�HC 75F6CB�ACBCL=89�DC=GCB=B; CF


A9H<9AC;@C6=B9A=5��75B�75IG9 <MDCL9A=5 �"CK9J9F� 5H9@97H5G=G 8C9G�BCH�5::97H <9AC;@C6=B
CLM;9B�6=B8=B;�75D57=HM

C - Increased tidal volume

Explanation Why

#B7F95G98 H=85@�JC@IA9 KCI@8�F9GI@H�=B�=B7F95G98�J9BH=@5H=CB�5B8�=ADFCJ98�CLM;9B5H=CB��F5H<9F�H<5B


<MDCL9A=5��5G�G99B�=B�H<=G�D5H=9BH ��L9F7=G9G�HC�=B7F95G9 H=85@�JC@IA9 �9 ; ��IG=B;�5B =B79BH=J9
GD=FCA9H9F��5F9�7CAACB@M�IG98�HC�DF9J9BH�5B8�7CFF97H 5H9@97H5G=G

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D - Decreased ratio of ventilated alveoli

Explanation Why

#B�D5H=9BHG�K=H<�6=65G=@5F 5H9@97H5G=G��7C@@5DG98�5@J9C@=�5F9�IB56@9�HC�D5FH=7=D5H9�=B ;5G�9L7<5B;9�


5@@CK=B;�J9BCIG�6@CC8�HC�D5GG�=BHC�H<9�5FH9F=5@�7=F7I@5H=CB�K=H<CIH�697CA=B;�CLM;9B5H98��K<=7<
F9GI@HG�=B�5�F=;<H�HC�@9:H�G<IBH �.<9 5@J9C@5F�5FH9F=5@ ;F58=9BH�=G�=B7F95G98�6975IG9�C:�H<9 J9BH=@5H=CB�
D9F:IG=CB�A=GA5H7<

E - Increased rate of oxygen consumption

Explanation Why

.<9�F5H9�C:�CLM;9B�7CBGIADH=CB�=G�=B7F95G98�=B�GH5H9G�C:�<=;<�9B9F;M�9LD9B8=HIF9��9 ; ��9L9F7=G9�
G9J9F9�=@@B9GG� G9DG=G��5B8�IGI5@@M�@958G�HC�5�7CAD9BG5HCFM�=B7F95G9�=B�J9BH=@5H=CB��9 ; ��=B7F95G9�=B
F9GD=F5HCFM�F5H9 5B8�CF H=85@�JC@IA9��HC�DF9J9BH <MDCL9A=5 �.<=G�D5H=9BH�8C9G�BCH�<5J9�5BM�<=GHCFM�HC
GI;;9GH�=B7F95G98�CLM;9B�7CBGIADH=CB

F - Decreased chest wall compliance

Explanation Why

�97F95G98 7<9GH�K5@@�7CAD@=5B79 �9 ; ��8I9�HC G7C@=CG=G��F9GD=F5HCFM�AIG7@9�D5F5@MG=G��HF5IA5��CF


:F5=@HM��75B�@958�HC <MDCL9A=5 5G�5�F9GI@H�C:�=AD5=F98�J9BH=@5H=CB�5B8�A5M�C77IF�D5F5@@9@�HC
5H9@97H5G=G �"CK9J9F� <MD9F75DB=5 KCI@8�5@GC�69�9LD97H98

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Question # 6

� �����; �� ��@6��A5@9�=B:5BH�=G�89@=J9F98�5H ���K99?G� ;9GH5H=CB�J=5�GDCBH5B9CIG�J5;=B5@�89@=J9FM


*F9;B5B7M�5B8�89@=J9FM�K9F9�IB7CAD@=75H98�6IH�5�DF9B5H5@�I@HF5GCIB8�5H ���K99?G G<CK98�5 89:97H�=B
H<9�D@9IFCD9F=HCB95@�A9A6F5B9 � IFH<9F�9J5@I5H=CB�C:�H<=G�D5H=9BH�=G�ACGH�@=?9@M�HC�G<CK�K<=7<�C:�H<9
:C@@CK=B;�:=B8=B;G�

Answer Image

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Correct Answer

A - Gastric fundus in the thorax

Image

Explanation Why

��89:97H�=B�H<9 D@9IFCD9F=HCB95@�A9A6F5B9 8IF=B; :9H5@�89J9@CDA9BH 75B�@958�HC 7CB;9B=H5@


8=5D<F5;A5H=7�<9FB=5 =B�H<9 B9K6CFB ��975IG9�H<9 @=J9F DFCH97HG�H<9�F=;<H�<9A=8=5D<F5;A�
8=5D<F5;A5H=7 <9FB=5G ACGH�7CAACB@M�C77IF�CB�H<9�@9:H�G=89��F9GI@H=B;�=B�8=GD@579A9BH�C:�H<9 ;5GHF=7
:IB8IG =B�H<9�H<CF5L �CB;9B=H5@�8=5D<F5;A5H=7�<9FB=5G HMD=75@@M�DF9G9BH�K=H<�F9GD=F5HCFM�8=GHF9GG�5H
6=FH<��8I9�HC�8=GD@579A9BH�C:�568CA=B5@�CF;5BG�=BHC�H<9�H<CF5L�5B8�8=GFIDH=CB�C:�BCFA5@ @IB;
89J9@CDA9BH

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B - Pancreatic ring around the duodenum

Explanation Why

��F=B;�C: D5B7F95H=7 H=GGI9�GIFFCIB8=B;�H<9 8IC89BIA =G�7<5F57H9F=GH=7�C:�5B 5BBI@5F�D5B7F95G��K<=7<


C77IFG�8I9�HC�=AD5=F98�:IG=CB�C:�H<9 J9BHF5@ 5B8 8CFG5@ 6I8�C:�H<9 D5B7F95G 8IF=B; :CF9;IH FCH5H=CB
.<9 D@9IFCD9F=HCB95@�A9A6F5B9 =G�BCH�=BJC@J98�=B D5B7F95H=7 89J9@CDA9BH

C - Small and cystic kidneys

Explanation Why

-A5@@�5B8�7MGH=7 ?=8B9MG 5F9�7<5F57H9F=GH=7�C: AI@H=7MGH=7�8MGD@5GH=7�?=8B9MG %=8B9M 89J9@CDA9BH�=G


BCH�5::97H98�6M�H<9 D@9IFCD9F=HCB95@�A9A6F5B9

D - Hypertrophy of the gastric pylorus

Explanation Why

"MD9FHFCD<M C:�H<9�;5GHF=7 DM@CFIG =G�7<5F57H9F=GH=7�C: DM@CF=7�GH9BCG=G��K<=7<�HMD=75@@M�A5B=:9GHG��P�


K99?G�5:H9F 6=FH< K=H<�BCB6=@=CIG� DFC>97H=@9�JCA=H=B; ,=G?�:57HCFG :CF DM@CF=7�GH9BCG=G =B7@I89
GAC?=B;�8IF=B; DF9;B5B7M 5B8 A57FC@=89 IG9��6IH�=H�=G�BCH�5GGC7=5H98�K=H<�5�89:97H�=B�H<9
D@9IFCD9F=HCB95@�A9A6F5B9

E - Cystic masses in the mediastinum

Explanation Why

�MGH=7�A5GG9G�=B�H<9 A98=5GH=BIA 5F9�7<5F57H9F=GH=7�C: 6FCB7<C;9B=7�7MGHG��K<=7<�5F9�75IG98�6M

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56BCFA5@�6I88=B;�C:�H<9 :CF9;IH 8IF=B; 9A6FMCB=7�89J9@CDA9BH �.<9 D@9IFCD9F=HCB95@�A9A6F5B9G
5F9�BCH�=BJC@J98�=B�DI@ACB5FM�89J9@CDA9BH

F - Large bowel in the inguinal canal

Explanation Why

.<9�DF9G9B79�C:�@5F;9�6CK9@�=B�H<9 =B;I=B5@�75B5@ =G�7<5F57H9F=GH=7�C:�5B�=B8=F97H =B;I=B5@�<9FB=5


�CB;9B=H5@ =B;I=B5@�<9FB=5G 5F9�75IG98�6M�=B7CAD@9H9�7@CGIF9�C:�H<9 DFC79GGIG�J5;=B5@=G 5B8�5F9�BCH
F9@5H98�HC�H<9 D@9IFCD9F=HCB95@�A9A6F5B9

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Question # 7

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8=5FF<95��5B8�7CB:IG=CB :CF ��85MG �"9�F979BH@M�F9HIFB98�:FCA�5�7FI=G9�HC�H<9��5F=6695B �"9�<5G�5�<=GHCFM
C:�7<FCB=7�C6GHFI7H=J9�DI@ACB5FM�8=G95G9 �"9�<5G�GAC?98�CB9�D57?�C:�7=;5F9HH9G�85=@M�:CF ���M95FG �"=G
H9AD9F5HIF9�=G �� �O������ �O ���DI@G9�=G����A=B��5B8�6@CC8�DF9GGIF9�=G �������AA�"; �"9�=G�7CB:IG98
5B8�CF=9BH98�CB@M�HC�D9FGCB �*<MG=75@�9L5A=B5H=CB�G<CKG 7C5FG9�7F57?@9G�H<FCI;<CIH�6CH<�@IB;�:=9@8G
"=G�G9FIA GC8=IA�7CB79BHF5H=CB�=G ����A�E�& ��I@HIF9�C:�H<9�ACGH�@=?9@M�75IG5@�CF;5B=GA�KCI@8�F9EI=F9
K<=7<�C:�H<9�:C@@CK=B;�A98=IAG�

Answer Image

� �<5F7C5@�M95GH�9LHF57H�5;5F

� '57�CB?9M�5;5F

� �CG=B�A9H<M@9B9�6@I9�5;5F

� �<C7C@5H9�5;5F

� '5BB=HC@�G5@H�5;5F

�5HCB�5;5F

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Hint

.<=G�D5H=9BH�G F=G?�:57HCFG �5;9��F979BH�HF5J9@�CB�5�7FI=G9�G<=D��<=GHCFM�C:�GAC?=B;��5B8 7<FCB=7�C6GHFI7H=J9


DI@ACB5FM�8=G95G9��5B8�GMADHCAG��:9J9F��F9@5H=J9 6F58M75F8=5��BCBDFC8I7H=J9 7CI;<� 8=5FF<95�
7CB:IG=CB� <MDCB5HF9A=5��5F9�7<5F57H9F=GH=7�C: &9;=CBB5=F9G��8=G95G9��K<=7<�=G�75IG98�6M Legionella
pneumophila.

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Correct Answer

A - Charcoal yeast extract agar

Image

Explanation But

@ICFCEI=BC@CB9G �9 ; � @9JC:@CL57=B��5F9�H<9�:=FGH�@=B9�HF95HA9BH�:CF Legionella =B:97H=CB

Explanation Why

�<5F7C5@�M95GH�9LHF57H�5;5F �6I::9F98�K=H< 7MGH9=B9 5B8 =FCB��=G�H<9�A98=IA�IG98�HC�7I@HIF9�5B8


=89BH=:M Legionella pneumophila��H<9�@=?9@M�75IG9�C:�H<=G�D5H=9BH�G�GMADHCAG �/F=B5FM 5BH=;9B H9GHG
5B8 DC@MA9F5G9�7<5=B�F957H=CB 5F9�588=H=CB5@�A9H<C8G�C:�=89BH=:M=B;�H<9 L. pneumophila D5H<C;9B

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B - MacConkey agar

Explanation Why

'57�CB?9M�5;5F =G�IG98�HC�=89BH=:M Klebsiella pneumoniae� Enterobacter, Serratia, and E. coli


1<=@9�H<9G9�D5H<C;9BG��9GD97=5@@M Klebsiella��75B�75IG9 BCGC7CA=5@�DB9IACB=5 =B:97H=CBG�
DI@ACB5FM�GMADHCAG�KCI@8�BCH�69�G99B�=B�7CB>IB7H=CB�K=H< 8=5FF<95 5B8 <MDCB5HF9A=5

C - Eosin-methylene blue agar

Explanation Why

�CG=B�A9H<M@9B9�6@I9�5;5F =G�IG98�HC�=89BH=:M Escherichia coli �1<=@9 E. coli =B:97H=CB�75B�A5B=:9GH


K=H< 8=5FF<95��=H�8C9G�BCH�HMD=75@@M�75IG9�H<9�F9GD=F5HCFM�GMADHCAG�G99B�=B�H<=G�D5H=9BH

D - Chocolate agar

Explanation Why

�<C7C@5H9�5;5F =G�5�A98=IA�IG98�HC�7I@HIF9�5B8�=89BH=:M Haemophilus influenzae��K<=7<�=G�=B75D56@9


C: <9AC@MG=G CB�=HG�CKB�5B8�H<IG�F9EI=F9G�6@CC8�7CADCB9BHG�:CF�=HG�;FCKH< Haemophilus influenzae
75B�75IG9 DB9IACB=5��6IH 8=5FF<95 5B8 <MDCB5HF9A=5 5F9�BCH�7CAACB�:95HIF9G�C: H. influenza
=B:97H=CB �'CF9CJ9F� H. influenza =B:97H=CB�<5G�697CA9�F5F9�G=B79 J577=B5H=CB 6975A9�FCIH=B9

E - Mannitol salt agar

Explanation Why

'5BB=HC@�G5@H�5;5F =G�IG98�HC�7I@HIF9�;F5A�DCG=H=J9�657H9F=5��GD97=:=75@@M Staphylococcus GD97=9G

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1<=@9 S. aureus 75B�75IG9 DB9IACB=5��=H�ACGH�7CAACB@M�A5B=:9GHG�5G�5�657H9F=5@ GID9F=B:97H=CB
:C@@CK=B;�J=F5@ =B:@I9BN5 =B:97H=CB �=5FF<95 5B8 <MDCB5HF9A=5 5F9�BCH�7CAACB�:95HIF9G�C:�=B:97H=CB
K=H< S. aureus

F - Eaton agar

Explanation Why

�5HCB�5;5F =G�IG98�HC�=89BH=:M Mycoplasma pneumoniae��K<=7<�75B�75IG9�5B 5IHC=AAIB9�<9AC@MH=7


5B9A=5 �7C@8�5;;@IH=B=B�8=G95G9��5B8 5HMD=75@�DB9IACB=5 �"CK9J9F� 8=5FF<95 5B8 <MDCB5HF9A=5 5F9
BCH�7CAACB�:95HIF9G�C: M. pneumoniae =B:97H=CB

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Question # 8

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5B8�BC=GM�6F95H<=B; :CF�H<9�@5GH ��85MG � =J9�85MG�5;C��G<9�<58�5 @CK�;F589 :9J9F�5B8�FIBBM�BCG9 �-<9
5HH9B8G�85M75F9 �"9F�=AAIB=N5H=CBG�5F9 ID�HC�85H9 �"9F�H9AD9F5HIF9�=G �� �O������O � 5B8�F9GD=F5H=CBG
5F9����A=B �*<MG=75@�9L5A=B5H=CB�G<CKG�GIDF57@5J=7I@5F�F9HF57H=CBG �.<9F9�=G�5 <=;<�D=H7<98 GCIB8
DF9G9BH�CB�=BGD=F5H=CB ��L5A=B5H=CB�C:�H<9�H<FC5H�G<CKG�9FMH<9A5�K=H<CIH�9LI85H9G �1<=7<�C:�H<9
:C@@CK=B;�=G�H<9�ACGH�@=?9@M�@C75H=CB�C:�H<9�5B5HCA=7�B5FFCK=B;�75IG=B;�H<=G�D5H=9BH�G�GMADHCAG�

Answer Image

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� �=GH5@�HF57<95

� *<5FMBL

� �D=;@CHH=G

� -I6;@CHH=7�@5FMBL

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Hint

��7<9GH L�F5M C:�H<=G�D5H=9BH�KCI@8�ACGH�@=?9@M�F9J95@�5 GH99D@9�G=;B

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Correct Answer

A - Supraglottic larynx

Explanation Why

(5FFCK=B;�C:�H<9�GIDF5;@CHH=7 @5FMBL =B�7<=@8F9B�=G�HMD=75@@M�8I9�HC @5FMB;CA5@57=5��K<=7<�=G


7<5F57H9F=N98�6M�9L79GG=J9�:@577=8=HM�5B8�7C@@5DG9�C:�H<9�GIDF5;@CHH=7 75FH=@5;9 8IF=B;�=BGD=F5H=CB�H<5H
KCFG9BG�=B�H<9 GID=B9�DCG=H=CB��8IF=B;�7FM=B;�5B8�CF�:998=B; ��@H<CI;<�7<=@8F9B�75B�5@GC�DF9G9BH�K=H<
=BGD=F5HCFM�GHF=8CF��65F?=B; 7CI;< 5B8�G=;BG�C: IDD9F�F9GD=F5HCFM�HF57H�=B:97H=CB KCI@8�BCH�69
9LD97H98 ��@GC� @5FMB;CA5@57=5 HMD=75@@M�A5B=:9GHG�K=H<=B�H<9�:=FGH���ACBH<G�C:�@=:9

B - Distal trachea

Explanation Why

(5FFCK=B;�C:�H<9 8=GH5@ HF57<95 �9 ; ��8I9�HC�5 J5G7I@5F�F=B;��75B�5@GC�DF9G9BH�K=H< =BGD=F5HCFM�GHF=8CF


.<9 HF57<95 =G�7CADCG98�C:�<CFG9�G<C9�G<5D98 75FH=@5;9 F=B;G��K<=7<�5@@CK�H<9�@IA9B�C:�H<9 HF57<95
HC�9LD5B8�=: AI7CG5@ GK9@@=B;�C77IFG �"CK9J9F� HF57<95@ 7CADF9GG=CB�IGI5@@M�F9GI@HG�=B�G9J9F9
8MGDB95 5B8��=B�GCA9�75G9G� 5DB95 5B8 7M5BCG=G��K<=7<�5F9�BCH�DF9G9BH�=B�H<=G�D5H=9BH �"C5FG9B9GG
5B8�5�65F?=B; 7CI;< KCI@8�BCH�69�9LD97H98 �#B�588=H=CB��J5G7I@5F�F=B;G�ACGH�7CAACB@M�A5B=:9GH
K=H<=B�H<9�:=FGH�K99?G�C:�@=:9

C - Pharynx

Explanation Why

#B:@5AA5H=CB C:�H<9 D<5FMBL �9 ; � GHF9D�H<FC5H��HMD=75@@M�DF9G9BHG�K=H< 9FMH<9A5 5B8 9LI85H9G C:�H<9


D<5FMBL 5B8 HCBG=@G �*5H=9BHG�DF=A5F=@M�89J9@CD GCF9�H<FC5H 5B8 8MGD<5;=5 ��9FJ=75@
@MAD<589BCD5H<M =G�5@GC�5�HMD=75@�:=B8=B; �"C5FG9B9GG�5B8�65F?=B; 7CI;< 8C�BCH�C77IF

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D - Epiglottis

Explanation Why

#B:@5AA5H=CB C:�H<9 9D=;@CHH=G �9 ; ��5G�G99B�=B 9D=;@CHH=H=G��75B�5@GC�DF9G9BH�K=H< =BGD=F5HCFM�GHF=8CF


�89A5 C:�H<9�GA5@@�5B8�:@577=8�9D=;@CHH=7 75FH=@5;9 =B�7<=@8F9B�EI=7?@M�F9GI@HG�=B�8FCC@=B;� GCF9�H<FC5H�
8MGD<5;=5��5B8�AI::@98�JC=79��F5H<9F�H<5B�<C5FG9B9GG�5B8�5�65F?=B; 7CI;< ��<=@8F9B�K=H< 9D=;@CHH=H=G
HMD=75@@M�<5J9�5�HCL=7�5DD95F5B79��9 ; ��F9GD=F5HCFM�8=GHF9GG� 7M5BCG=G��=BGD=F5HCFM�F9HF57H=CBG�
F9GH@9GGB9GG��5B8�5F9�5H�<=;<�F=G?�C:�89J9@CD=B;�F9GD=F5HCFM�8=GHF9GG

E - Subglottic larynx

Explanation Why

�FCID��H<9�ACGH�@=?9@M�8=5;BCG=G�=B�H<=G�D5H=9BH��=G�7<5F57H9F=N98�6M =B:@5AA5H=CB 5B8�B5FFCK=B;�C:


H<9 GI6;@CHH=7 D5FH�C:�H<9 @5FMBL �69@CK�H<9 JC75@�:C@8G� �.<9�7F=7C=8 75FH=@5;9 F=B;�C:�H<9 GI6;@CHH=G
75BBCH�9LD5B8 �!=J9B�H<9�GA5@@�G=N9�5B8�:@CDD=B9GG�C:�H<9 @5FMBL 5B8 HF57<95 =B�7<=@8F9B� AI7CG5@
GK9@@=B;�EI=7?@M�75IG9G�<C5FG9B9GG��65F?=B; 7CI;<��5B8 =BGD=F5HCFM�GHF=8CF

F - Bronchioles

Explanation Why

#B:@5AA5H=CB C:�H<9 6FCB7<=C@9G �9 ; � 6FCB7<=C@=H=G��75B�5@GC�DF9G9BH�K=H<�GMADHCAG�C: IDD9F


F9GD=F5HCFM�HF57H�=B:97H=CB �9 ; ��@CK�;F589 :9J9F� F<=BCFF<95� 7CI;<� �(5FFCK=B;�C:�H<9 H9FA=B5@
6FCB7<=C@9G 8I9�HC 989A5 5B8�9L79GG=J9�AI7IG�75IG9G K<99N=B; 5B8 7F57?@9G �"C5FG9B9GG�5B8
=BGD=F5HCFM�GHF=8CF 8C�BCH�C77IF �#B�588=H=CB� 6FCB7<=C@=H=G ACGH�7CAACB@M�5::97HG�7<=@8F9B�����M95FG

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Question # 9

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��,�-��8I9�HC =B:@I9BN5�� �"9�<5G�BC�<=GHCFM�C:�G9F=CIG�=@@B9GG�5B8�8C9G�BCH�GAC?9 ��B L�F5M C:�H<9
7<9GH�G<CKG�8=::IG9�6=@5H9F5@�=B:=@HF5H9G .KC�K99?G @5H9F��<=G�GMADHCAG�<5J9�=ADFCJ98 �*I@ACB5FM
9L5A=B5H=CB�CB�8=G7<5F;9�G<CKG�=BGD=F5HCFM�7F57?@9G�5H�6CH<�@IB;�65G9G �.<=G�D5H=9BH�=G�ACGH�@=?9@M�HC
89J9@CD�K<=7<�C:�H<9�:C@@CK=B; @CB;�H9FA 7CAD@=75H=CB�

Answer Image

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Hint

.MD=75@�7<9GH��.�:=B8=B;G�=B�H<=G�7CB8=H=CB�=B7@I89 ;FCIB8�;@5GG CD57=H=9G�5B8�H<=7?9B=B;�C:�H<9


=BH9F@C6I@5F�G9DH5

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Correct Answer

A - Pulmonary embolism

Explanation Why

*I@ACB5FM�9A6C@=GA 7CAACB@M�89J9@CDG�=B�D5H=9BHG�K=H< �,�- 8IF=B;�H<9�<CGD=H5@=N5H=CB�D9F=C8


#H�=G�DF=A5F=@M�75IG98�6M�=AAC6=@=N5H=CB��GH5G=G�C:�6@CC8��5B8 9B8CH<9@=5@ 85A5;9��K<=7<�75B�57H=J5H9
H<9 7C5;I@5H=CB�75G7589 �"CK9J9F� DI@ACB5FM�9A6C@=GA =G�BCH�7CBG=89F98�5�@CB;�H9FA�7CAD@=75H=CB
C: �,�-

B - Interstitial lung disease

Explanation Why

.<=G�D5H=9BH�K=H< �,�- =G�5H�=B7F95G98�F=G?�:CF =BH9FGH=H=5@�@IB;�8=G95G9 �,�- =G�7<5F57H9F=N98�6M


85A5;9�HC 75D=@@5F=9G 5B8 9D=H<9@=5@ 79@@G�=B�H<9 @IB;G��K<=7<�75IG9G�9LI85H=CB�C:�DFCH9=B�F=7<�:@I=8
=BHC�H<9�5@J9C@5F�GD579�5B8�H<9�:CFA5H=CB�C: <M5@=B9�A9A6F5B9G �.<=G�F9GI@HG�=B�8=::IG9�5@J9C@5F
85A5;9��������K<=7<�=G�F9D5=F98�6M DFC@=:9F5H=CB C: HMD9�##�DB9IAC7MH9G 5B8�=B:=@HF5H=CB�C:
:=6FC6@5GHG��I@H=A5H9@M�@958=B;�HC�DFC;F9GG=J9 =BH9FGH=H=5@ :=6FCG=G 5B8 F9GHF=7H=J9�@IB;�8=G95G9

C - Spontaneous pneumothorax

Explanation Why

#5HFC;9B=7 �BCH�GDCBH5B9CIG� DB9IACH<CF5L A5M�C77IF�57IH9@M�5G�5�7CAD@=75H=CB�C: A97<5B=75@


J9BH=@5H=CB :CF�H<9�HF95HA9BH�C: �,�- 6IH�KCI@8�BCH�69�9LD97H98�HKC�K99?G�5:H9F�HF95HA9BH
-97CB85FM GDCBH5B9CIG�DB9IACH<CF5L C77IFG�ACGH�7CAACB@M�K=H< C6GHFI7H=J9�@IB;�8=G95G9 �9 ; �
9AD<MG9A5�DF98CA=B5BH �)*��

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D - Panacinar emphysema

Explanation Why

*5B57=B5F��D5B@C6I@5F� 9AD<MG9A5 =G�5GGC7=5H98�K=H< T��5BH=HFMDG=B�89:=7=9B7M��K<=7<�=G


7<5F57H9F=N98�6M�89GHFI7H=CB�C:�H<9�9BH=F9�57=BIG T��5BH=HFMDG=B�89:=7=9B7M IGI5@@M�5::97HG�H<9�@CK9F
@C69G�5B8�F9GI@HG�=B�=B7F95G98 DI@ACB5FM�7CAD@=5B79 5B8 C6GHFI7H=J9�@IB;�8=G95G9 �#H�=G�BCH�5
7CAD@=75H=CB�C: �,�-

E - Asthma

Explanation Why

�GH<A5 =G�5�F9J9FG=6@9 C6GHFI7H=J9�@IB;�8=G95G9 H<5H�=G�HF=;;9F98�6M�9LDCGIF9�HC 5@@9F;9BG� !�,��


7C@8�5=F��5B8�9L9F7=G9 �IG7I@H5HCFM :=B8=B;G�=B�D5H=9BHG�K=H< 5GH<A5 HMD=75@@M�=B7@I89�8=::IG9
K<99N=B;�F5H<9F�H<5B�H<9�6=65G=@5F 7F57?@9G G99B�<9F9 �GH<A5 =G�BCH�5�7CAD@=75H=CB�C: �,�-

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Question # 10

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D<MG=7=5B�:CF�5 :C@@CK�ID 9L5A=B5H=CB �"9�<5G B9J9F�GAC?98 �"=G�DI@G9�=G ���A=B��6@CC8�DF9GGIF9�=G
�������AA�";��5B8�F9GD=F5H=CBG�5F9 ���A=B ��L5A=B5H=CB�G<CKG�5B�=B7F95G98�5BH9FCDCGH9F=CF�8=5A9H9F
C:�H<9�7<9GH ��=A=B=G<98�6F95H<�GCIB8G�5B8�K<99N=B;�5F9�<95F8�CB�5IG7I@H5H=CB�C:�H<9�7<9GH ��B L�F5M C:
H<9�7<9GH�G<CKG�K=89B98�=BH9F7CGH5@�GD579G��5�:@5HH9B98�8=5D<F5;A��5B8 65G=@5F�DF98CA=B5BH 6I@@CIG
7<5B;9G�C:�H<9�@IB;G �.<=G�D5H=9BH�=G�5H�=B7F95G98�F=G?�:CF�K<=7<�C:�H<9�:C@@CK=B;�7CAD@=75H=CBG�

Answer Image

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Hint

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D5B@C6I@5F�9AD<MG9A5 �6=@5H9F5@��65G=@5F�<MD9F@I79B7M��5G�CDDCG98�HC 79BHF=@C6I@5F�9AD<MG9A5
�DF98CA=B5BH@M�5::97HG�H<9�IDD9F�@C69G� �.<=G 95F@M�CBG9H 9AD<MG9A5 =G�75IG98�6M�9L79GG=J9�6F95?8CKB
C: 9@5GH=B 6975IG9 DFCH95G9 57H=J=HM�=B�H<9 @IB;G 75BBCH�69�B9IHF5@=N98

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Correct Answer

A - Hepatocellular carcinoma

Explanation Why

�<FCB=7��HCL=7�577IAI@5H=CB�C:�A=G:C@898 5@D<5���5BH=HFMDG=B ���.��DFCH9=B�=B�<9D5H=7�H=GGI9�75IG9G


G=;B=:=75BH @=J9F 85A5;9�5B8 7=FF<CG=G��K<=7<�75B�DFC;F9GG�HC "�� �.<9�F=G?�:CF "�� F9A5=BG
9@9J5H98�9J9B�=B�H<9�56G9B79�C: 7=FF<CG=G &=J9F 8=G95G9�C77IFG�=B�56CIH�����C:�D5H=9BHG�K=H< ��.
89:=7=9B7M

B - Churg-Strauss syndrome

Explanation Why

�<IF;�-HF5IGG�GMB8FCA9 =G�5�GA5@@�J9GG9@� �(���DCG=H=J9 J5G7I@=H=G 5GGC7=5H98�K=H< 5BH=6C8=9G


8=F97H98�5;5=BGH�9=H<9F AM9@CD9FCL=85G9 �'*)��(����CF�DFCH9=B5G9����*,���(��� ��975IG9
5@D<5���5BH=HFMDG=B ���.��=B<=6=HG�*,��57H=J=HM��7IFF9BH�<MDCH<9G9G�GI;;9GH�H<5H�H<9�@57?�C: ��.
@958G�HC�9L79GG=J9�*,��A98=5H98�H=GGI9�89GHFI7H=CB��5B8�=B�HIFB��=G�ACF9�@=?9@M�HC�=B8I79�5B
5IHC=AAIB9�F9GDCBG9 �"CK9J9F��H<9F9�=G�7IFF9BH@M�BC�9J=89B79�HC�GIDDCFH�5B�=B7F95G98�F=G?�C:
89J9@CD=B; �(���DCG=H=J9 J5G7I@=H=G =B ��.�89:=7=9BH�=B8=J=8I5@G

C - Pulmonary fibrosis

Explanation Why

*I@ACB5FM :=6FCG=G �#* ��=G�5B =BH9FGH=H=5@�@IB;�8=G95G9 H<5H�=G�ACGH�7CAACB@M =8=CD5H<=7 =B�CF=;=B


)77ID5H=CB5@�<5N5F8G��9 ; � G=@=7CG=G�� 7<9ACH<9F5D9IH=7�5;9BHG �9 ; � 6@9CAM7=B���GAC?=B;��5B8
=B:97H=CIG�8=G95G9G��9 ; � HI69F7I@CG=G��G=;B=:=75BH@M�=B7F95G9�H<9�F=G?�C:�DFC;F9GG=B;�HC�=FF9J9FG=6@9
:=6FCG=G �"CK9J9F� ��.�89:=7=9B7M =G�BCH�5GGC7=5H98�K=H<�5B�=B7F95G98�F=G?�C: #*

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D - Bronchogenic carcinoma

Explanation Why

��.�89:=7=9B7M 8C9G�BCH�@958�HC�<=;<9F�F5H9G�C: @IB;�75B79F �1<=@9�GCA9�75G9�GHI8=9G�<5J9�GI;;9GH98


H<5H ��.�89:=7=9B7M 7CI@8�69�5GGC7=5H98�K=H<�5�<=;<9F�F=G?�C: @IB;�75B79F��H<9F9�=G�BC�<=;<�EI5@=HM
9J=89B79�C:�GI7<�5B�5GGC7=5H=CB �.<9�65G9@=B9�F=G?�C: @IB;�75B79F =B�H<=G�BCB�GAC?=B;�D5H=9BH�=G�H<IG
7CAD5F56@9�HC�H<9�;9B9F5@�DCDI@5H=CB

E - Bronchiolitis obliterans

Explanation Why

�FCB7<=C@=H=G�C6@=H9F5BG��K<=7<�C77IFG�5G�5�F9GI@H�C:�F9D95H98�7M7@9G�C: =B:@5AA5H=CB 5B8�G75FF=B;�=B


H<9�GA5@@ 5=FK5MG��=G�HMD=75@@M�8I9�HC�=B<5@5H=CB�C:�HCL=7�:IA9G� ;F5:H�J9FGIG�<CGH�8=G95G9 =B @IB;
HF5BGD@5BH D5H=9BHG��CF�7<FCB=7 @IB; =B:97H=CBG �"CK9J9F� ��.�89:=7=9B7M =G�BCH�5GGC7=5H98�K=H<�5B
=B7F95G98�F=G?�C: 6FCB7<=C@=H=G�C6@=H9F5BG

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Question # 11

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G<CFHB9GG�C:�6F95H< CB�9L9FH=CB �.<9F9�=G�BC�:5A=@M�<=GHCFM�C:�G9F=CIG�=@@B9GG �-<9�8C9G�BCH�GAC?9 �-<9
H5?9G 8=9H<M@DFCD=CB HC�7CBHFC@�<9F�5DD9H=H9�5B8��5G�5�F9GI@H��<5G�<58�5 � ��?;�����@6� K9=;<H�@CGG�8IF=B;
H<9�D5GH ��ACBH<G �-<9�=G ����7A����:H���=B� H5@@�5B8�K9=;<G ����?;������@6����'#�=G ���?;�A� �"9F�DI@G9
=G����A=B��5B8�6@CC8�DF9GGIF9�=G �������AA�"; ��5F8=57�9L5A=B5H=CB�G<CKG�5 @CI8�DI@ACB5FM
7CADCB9BH�C:�H<9�-� ��68CA=B5@�9L5A=B5H=CB�G<CKG�BC�56BCFA5@=H=9G �1<=7<�C:�H<9�:C@@CK=B;�=G�H<9
ACGH�@=?9@M�IB89F@M=B;�75IG9�C:�H<=G�D5H=9BH�G G<CFHB9GG�C:�6F95H<�

Answer Image

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� *9FA5B9BH�9B@5F;9A9BH�C:�8=GH5@�5=FGD579G

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Hint

.<=G�D5H=9BH�G�GMADHCAG�5F9�@=?9@M�8I9�HC�5�75H5GHFCD<=7�58J9FG9�9::97H�C:�8=9H<M@DFCD=CB��5
GMAD5H<CA=A9H=7 5DD9H=H9�GIDDF9GG5BH �.<9�5779BHI5H98 DI@ACB5FM�7CADCB9BH�C:�H<9�G97CB8�<95FH
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Correct Answer

A - Hypertrophy of interventricular septum

Explanation Why

"MD9FHFCD<M C:�H<9�=BH9FJ9BHF=7I@5F�G9DHIA�=G�G99B�=B <MD9FHFCD<=7�C6GHFI7H=J9�75F8=CAMCD5H<M


1<=@9�H<=G�7CB8=H=CB�75B�75IG9 G<CFHB9GG�C:�6F95H<��=H�=G�7<5F57H9F=N98�6M�5B�CIH:@CK�C6GHFI7H=CB�=B
H<9 @9:H�J9BHF=7@9��BCH�H<9 F=;<H�J9BHF=7@9 �.<IG��5B�5CFH=7 GMGHC@=7�9>97H=CB AIFAIF CF�D5F58CL=75@ GD@=H
-� KCI@8�69�9LD97H98��BCH�H<9�@CI8�DI@ACB5FM�7CADCB9BH�C: -� G99B�=B�H<=G�D5H=9BH � IFH<9FACF9�
B9=H<9F�5B -� 9LD97H98�C:�5�BCB7CAD@=5BH <MD9FHFCD<=98 J9BHF=7@9�BCF�5 :5A=@M�<=GHCFM C: GI889B
75F8=57�895H< =B�MCIB;�F9@5H=J9G�=G�DF9G9BH�K=H<�H<=G�D5H=9BH

B - Permanent enlargement of distal airspaces

Explanation Why

*9FA5B9BH�9B@5F;9A9BH�C: 8=GH5@ 5=FGD579G�=G�G99B�=B 9AD<MG9A5 �1<=@9 9AD<MG9A5 75B�75IG9


G<CFHB9GG�C:�6F95H< 5B8�A5M�75IG9 DI@ACB5FM�<MD9FH9BG=CB��H<=G�D5H=9BH�8C9G�BCH�<5J9�5BM
9AD<MG9A5 F=G?�:57HCFG��GI7<�5G�9LH9BG=J9�GAC?=B;�<=GHCFM�CF�G=;BG�C: 5@D<5���5BH=HFMDG=B 8=G95G9
�9 ; � <9D5HCA9;5@M�

C - Hyperplasia of pulmonary vascular walls

Explanation Why

"MD9FD@5G=5 5B8 <MD9FHFCD<M C:�DI@ACB5FM�J5G7I@5F�K5@@G�=G�H<9�IB89F@M=B;�75IG9�C: DI@ACB5FM


5FH9F=5@�<MD9FH9BG=CB��K<=7<�75B�F9GI@H�:FCA�HCL=7=HM�75IG98�6M GMAD5H<CA=A9H=7 5DD9H=H9
GIDDF9GG5BHG�5B8�DF9G9BHG�K=H< 8MGDB95 CB�9L9FH=CB �.<=G�D5H=9BH�G <95FH�GCIB8G 5F9�HMD=75@�C:
DI@ACB5FM�<MD9FH9BG=CB��K<=7<�=B=H=5@@M�DF9G9BHG�K=H<�5�DFCA=B9BH�-� �#B7F95G98�F9G=GH5B79�C:�H<9
DI@ACB5FM�J5G7I@5HIF9�=B DI@ACB5FM�5FH9F=5@�<MD9FH9BG=CB @=A=HG F=;<H�J9BHF=7I@5F 75F8=57�CIHDIH��5G�=H
DFC;F9GG9G� F=;<H�J9BHF=7I@5F�:5=@IF9 75B�89J9@CD��9 ; � 7CF�DI@ACB5@9�

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D - Blockade of the right bundle branch

Explanation Why

,=;<H�6IB8@9�6F5B7<�6@C7? �,�����=G�5�75F8=57�7CB8I7H=CB�89:=7=H�H<5H�75B�75IG9�5�K=89@M GD@=H�-�


�@H<CI;< ,��� 75B�A5B=:9GH�K=H< 8MGDB95 8I9�HC�IB89F@M=B;�8=G95G9G��=H�=G�HMD=75@@M�5GMADHCA5H=7

E - Fibrosis of pulmonary interstitium

Explanation Why

=6FCG=G C:�H<9�DI@ACB5FM =BH9FGH=H=IA =G�G99B�=B DI@ACB5FM :=6FCG=G �1<=@9 8MGDB95 5B8�:5H=;I9�5F9


HMD=75@�C:�H<=G�8=G95G9��5�D9FG=GH9BH�8FM 7CI;< KCI@8�5@GC�69�9LD97H98 � IFH<9FACF9��IB@=?9
6@9CAM7=B� A9H<CHF9L5H9��5B8 5A=C85FCB9��8=9H<M@DFCD=CB�=G�BCH�?BCKB�HC�75IG9 DI@ACB5FM :=6FCG=G

F - Calcification of the pulmonary valve

Explanation Why

�5@7=:=75H=CB�C:�H<9 DI@ACB5FM�J5@J9 75B�75IG9 DI@ACB5FM�GH9BCG=G��F9GI@H=B;�=B�:5H=;I9� 8MGDB95��5B8


GD@=HH=B;�C:�-� ��5@7=:=75H=CB�C:�H<9 DI@ACB5FM�J5@J9 =G�F5F9�6IH�75B�C77IF�G97CB85FM�HC�7CB;9B=H5@
<95FH 8=G95G9� 75F7=BC=8�<95FH�8=G95G9��CF�5;9�F9@5H98�7<5B;9G �.<=G�D5H=9BH�=G�BCH�=B�5�<=;<�F=G?�5;9
;FCID�BCF�8C9G�G<9�<5J9�5BM�G=;BG�C:�7CB;9B=H5@�CF 75F7=BC=8�<95FH�8=G95G9 K<=7<�KCI@8�GI;;9GH
75@7=:=75H=CB

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Question # 12

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6F95H< :CF ��85M -<9�<5G�699B�7CI;<=B;�=BH9FA=HH9BH@M��K<=7<�KCFG9BG�H<9�D5=B �-<9�<5G�CGH9CDCFCG=G�
:CF�K<=7<�G<9�H5?9G F5@CL=:9B9 ��FH9F=5@�6@CC8�;5G�5B5@MG=G�CB�FCCA�5=F�G<CKG�

D" � ��

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Answer Image

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Answer Image

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Hint

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Correct Answer

A - Unilateral swelling of the leg

Image

Explanation Why

*<MG=75@�9L5A=B5H=CB =G�ACGH�@=?9@M�HC�G<CK�IB=@5H9F5@�@9;�GK9@@=B;��=B8=75H=B; 899D�J9=B�H<FCA6CG=G


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G<5FD 7<9GH�D5=B 5B8 G<CFHB9GG�C:�6F95H<��5G�G99B�<9F9 �#B *���C77@IG=CB�C:�CB9�CF�ACF9�C:�H<9
DI@ACB5FM�5FH9F=9G @958G�HC�5 J9BH=@5H=CB�D9F:IG=CB�A=GA5H7<��K<=7<�F9GI@HG�=B�5B�=B7F95G98 ��5
;F58=9BH 5B8 <MDCL9A=5 �#B�HIFB� <MDCL9A=5 @958G�HC <MD9FJ9BH=@5H=CB 5B8�GI6G9EI9BH F9GD=F5HCFM
5@?5@CG=G �8I9�HC�@CK *�)� @9J9@G� ��9FH5=B�A98=75H=CBG�=B7@I8=B; F5@CL=:9B9 =B7F95G9�H<9�F=G?�C:
�0. 5B8 *�

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B - Increased anteroposterior diameter of the thorax

Image

Explanation Why

#B7F95G98 5BH9FCDCGH9F=CF�8=5A9H9F C:�H<9�H<CF5L��= 9 � 65FF9@�7<9GH��=G�HMD=75@@M�G99B�=B�58J5B798


7<FCB=7�C6GHFI7H=J9�DI@ACB5FM�8=G95G9 ��)*���8I9�HC 5=F�HF5DD=B; 5B8 9AD<MG9A5 �)*� 75IG9G
F9GD=F5HCFM�57=8CG=G 8I9�HC �)� F9H9BH=CB��BCH F9GD=F5HCFM�5@?5@CG=G

C - Grouped vesicles on the right hemithorax

Explanation Why

!FCID98�J9G=7@9G�CB�H<9�F=;<H�<9A=H<CF5L�75B�69�G99B�=B�D5H=9BHG�K=H< <9FD9G�NCGH9F��K<=7<�HMD=75@@M
DF9G9BHG�K=H<�G<5FD 7<9GH�D5=B �"CK9J9F� <9FD9G�NCGH9F KCI@8�BCH�9LD@5=B�H<=G�D5H=9BH�G G<CFHB9GG�C:
6F95H<��=BH9FA=HH9BH 7CI;<��5B8 5FH9F=5@�6@CC8�;5G 7<5B;9G

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D - Pericardial friction rub

Explanation Why

*9F=75F8=5@�:F=7H=CB�FI6 =G�5�G=;B�C: D9F=75F8=H=G��K<=7<�75B�DF9G9BH�K=H<�G<5FD 7<9GH�D5=B �"CK9J9F�


D9F=75F8=H=G =G�IB@=?9@M�HC�75IG9 5FH9F=5@�6@CC8�;5G 7<5B;9G

E - Absent left radial pulse

Explanation Why

�B�56G9BH�@9:H�F58=5@ DI@G9 75B�69�G99B�=B�75G9G�C: 5CFH=7�8=GG97H=CB DFCL=A5@ HC�H<9 GI67@5J=5B�5FH9FM


�CFH=7�8=GG97H=CB 7@5GG=75@@M�DF9G9BHG�K=H<�GI889B��G9J9F9�7<9GH�CF�657? D5=B �.<=G�7CB8=H=CB�75B�@958
HC�<MDCD9F:IG=CB�5B8��GI6G9EI9BH@M��H=GGI9 <MDCL=5 �.=GGI9 <MDCL=5 F9GI@HG�=B @57H=7�57=8CG=G��K<=7<
75IG9G A9H56C@=7�57=8CG=G �D"���� �����BCH F9GD=F5HCFM�5@?5@CG=G

F - Increased tactile fremitus

Explanation Why

#B7F95G98 H57H=@9�:F9A=HIG =B8=75H9G�7CBGC@=85H=CB��9 ; ��8I9�HC @C65F�DB9IACB=5���K<=7<�75B�75IG9


<MDCL9A=5��5G�G99B�=B�H<=G�D5H=9BH �"CK9J9F� DB9IACB=5 =G�ACF9�@=?9@M�HC�75IG9 F9GD=F5HCFM�57=8CG=G
�F5H<9F�H<5B 5@?5@CG=G��8I9�HC�=B589EI5H9 5@J9C@5F�J9BH=@5H=CB��5G�5@J9C@=�5F9�:=@@98�K=H<�=B:@5AA5HCFM
9LI85H9

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Question # 13

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8=;=H5@�7@I66=B; �*I@ACB5FM�:IB7H=CBG�H9GHG�G<CK�5B �0�� 0��F5H=C C:�����5B8�5�HCH5@�@IB;�75D57=HM�C:
��� ��B L�F5M C:�H<9�7<9GH�G<CKG�GA5@@�6=@5H9F5@�F9H=7I@5F�CD57=H=9G��DF98CA=B5BH@M�=B�H<9 @CK9F�@C69G ��
D<CHCA=7FC;F5D<�C:�5�GD97=A9B�C6H5=B98�CB�@IB;�6=CDGM�=G�G<CKB �.<9�D5H=9BH�ACGH�@=?9@M�KCF?G�=B
K<=7<�C:�H<9�:C@@CK=B;�:=9@8G�

Answer Image

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Answer Image

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Hint

.<9�D5H=9BH�DF9G9BHG�K=H<�7<FCB=7��DFC;F9GG=J9 8MGDB95 5B8�G<CKG�5�F9GHF=7H=J9�D5HH9FB�C: @IB; 8=G95G9�CB


DI@ACB5FM�:IB7H=CB�H9GHG �BCFA5@�HC�=B7F95G98 �0�� 0� F5H=C��897F95G98�.&�� �.<9�D<CHCA=7FC;F5D<
C:�H<9 @IB; 6=CDGM GD97=A9B�G<CKG�G9J9F5@ 8IA669@@�G<5D98 :9FFI;=BCIG�6C8=9G��K<=7<�5F9�7C@@97H=CBG
C: =FCB 5B8�DFCH9=B�7C5H=B; 5G69GHCG :=69FG

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Correct Answer

A - Shipbuilding

Image

Explanation But

�5@7=:=98��=JCFM�K<=H9��CF�:=6FCIG D@9IF5@�D@5EI9G 5F9 D5H<C;BCACB=7 C: 5G69GHCG=G

Explanation Why

-<=D6I=@89FG�A=;<H�69�9LDCG98�HC 5G69GHCG��5G�=H�=G�5�<=;<@M�F9G=@=9BH�A5H9F=5@�H<5H�=G�5B�CDH=A5@
=BGI@5HCF�5B8�K5G�K=89@M�IG98�69:CF9�=HG�85B;9FG�K9F9�?BCKB �)H<9F�D5H=9BHG�5H�<=;<�F=G?�:CF
C77ID5H=CB5@�9LDCGIF9�HC 5G69GHCG =B7@I89�7CBGHFI7H=CB�KCF?9FG��D@IA6=B;��FCC:=B;��=BGI@5H=CB��5B8
:=F9:=;<H9FG��<95H�F9G=GH5BH�7@CH<=B;� �.<9 =B7=89B79 C: 5G69GHCG=G =G�89D9B89BH�CB�7IAI@5H=J9
9LDCGIF9 �1<=@9 5G69GHCG=G IGI5@@M�5::97HG�H<9�@CK9F�@C69G��CH<9F DB9IAC7CB=CG9G �9 ; ��8I9�HC�G=@=75�
7C5@� 69FM@@=IA��H9B8�HC�5::97H�H<9�IDD9F�@C69G�C:�H<9 @IB;G �.<9�ACGH�7CAACB@M�5GGC7=5H98
A5@=;B5B7=9G�C: 5G69GHCG=G 5F9 6FCB7<C;9B=7�75F7=BCA5��:C@@CK98�6M A9GCH<9@=CA5

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B - Aerospace manufacturing

Image

Explanation Why

1CF?9FG�=B�59FCGD579�A5BI:57HIF=B;�5F9�C:H9B�9LDCG98�HC 69FM@@=IA 5@@CMG��K<=7<�75B�75IG9


69FM@@=CG=G 5:H9F�<=;<�;F589�9LDCGIF9 ��@H<CI;< 69FM@@=CG=G 75B�DF9G9BH�K=H<�5�F9GHF=7H=J9�D5HH9FB�CB
DI@ACB5FM�:IB7H=CB�H9GHG��7<9GH L�F5M KCI@8�G<CK�:=B9�BC8I@5F�CD57=H=9G�=B�H<9�IDD9F @IB; NCB9G
F5H<9F�H<5B�H<9�@CK9F @IB;G �'CF9CJ9F� @IB; 6=CDGM KCI@8�F9J95@ BCB�75G95H=B; ;F5BI@CA5G G=A=@5F�HC
H<CG9�G99B�=B G5F7C=8CG=G��BCH :9FFI;=BCIG�6C8=9G

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C - Cattle farming

Image

Explanation Why

�5HH@9�:5FA9FG�5F9�7<FCB=75@@M�9LDCG98�HC�CF;5B=7�8IGH��9 ; ��:FCA AC@8G��5B=A5@ DFCH9=BG��5B8�5F9�5H


F=G?�:CF�7<FCB=7 <MD9FG9BG=H=J=HM DB9IACB=5��K<=7<�=G�7<5F57H9F=N98�6M�G@CK@M�DFC;F9GG=J9 8MGDB95�
6=@5H9F5@ 7F57?@9G��5B8�5�F9GHF=7H=J9�D5HH9FB�CB DI@ACB5FM�:IB7H=CB�H9GHG��K<=7<�=G�5@GC�G99B�<9F9
"CK9J9F��H<9�7<9GH L�F5M KCI@8�G<CK�;FCIB8�;@5GG�CD57=H=9G�K=H< <CB9M7CA6=B; �:=6FCH=7 7<5B;9G�
5B8 @IB; 6=CDGM KCI@8�F9J95@ ;F5BI@CA5HCIG�=B:@5AA5H=CB K=H< @MAD<C7MH9G 5B8�DC@MBI7@95F ;=5BH
79@@G��BCH :9FFI;=BCIG�6C8=9G

D - Sandblasting

Explanation Why

1CF?9FG�9LDCG98�HC�G=@=75�8IGH��9 ; ��=B�G5B86@5GH=B;��A=B=B;��75GH=B;�A9H5@G��5F9�5H�F=G?�:CF G=@=7CG=G�

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K<=7<�IGI5@@M�DF9G9BHG�K=H<�5�A=L98�C6GHFI7H=J9�F9GHF=7H=J9�D5HH9FB�CB DI@ACB5FM�:IB7H=CB�H9GHG 2�
F5M :=B8=B;G�=B G=@=7CG=G HMD=75@@M�=B7@I89�<=@5F 9;;G<9@@�75@7=:=75H=CBG 5B8�BC8I@5F�CD57=H=9G�=B�H<9
IDD9F�@C69G�F5H<9F�H<5B�H<9�@CK9F�@C69G ��:H9F�@CB;�H9FA�9LDCGIF9�HC�G=@=75�8IGH��<=GHCD5H<C@C;=75@
9L5A=B5H=CB�C:�H<9�@IB; HMD=75@@M�G<CKG G=@=7CH=7�BC8I@9G��K<=7<�5F9�7CADCG98�C: 7C@@5;9B�:=69FG
GIFFCIB898�6M A57FCD<5;9G 5B8 @MAD<C7MH9G��5B8��DCGG=6@M��=BHF5��CF�9LHF579@@I@5F 6=F9:F=B;9BH G=@=75
D5FH=7@9G

E - Coal mining

Image

Explanation Why

�C5@�A=B9FG�5F9�5H�=B7F95G98�F=G?�C: 7C5@�KCF?9FG��DB9IAC7CB=CG=G��K<=7<�=G�75IG98�6M�7<FCB=7
C77ID5H=CB5@�9LDCGIF9�HC�75F6CB�8IGH ��@H<CI;<�=H�75B�DF9G9BH�K=H<�5�F9GHF=7H=J9�D5HH9FB�CB DI@ACB5FM
:IB7H=CB�H9GHG��H<9�7<9GH L�F5M KCI@8�G<CK�:=B9�BC8I@5F�CD57=H=9G�=B�H<9�IDD9F @IB; NCB9G�F5H<9F�H<5B
H<9�@CK9F @IB;G � IFH<9FACF9� @IB; 6=CDGM KCI@8�F9J95@ A57FCD<5;9G @589B�K=H<�75F6CB��BCH
=FCB�7C5H98 5G69GHCG :=69FG

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Question # 14

� ���M95F�C@8 A5B�7CA9G�HC�H<9�D<MG=7=5B�6975IG9�C:�5 ��M95F <=GHCFM�C:�DFC;F9GG=J9�G<CFHB9GG�C:�6F95H<


5B8�BCBDFC8I7H=J9�7CI;< �*I@ACB5FM�9L5A=B5H=CB�G<CKG�6=65G=@5F�=BGD=F5HCFM�7F57?@9G ��B L�F5M C:�H<9
7<9GH�G<CKG�AI@H=D@9�BC8I@5F�CD57=H=9G�=B�H<9�IDD9F�@C69G�5B8 75@7=:=98�<=@5F�BC8I@9G �*I@ACB5FM
:IB7H=CBG�H9GHG�G<CK�5B �0�� 0� F5H=C�C:�����5B8�5�G9J9F9@M�897F95G98�8=::IG=B;�75D57=HM�:CF�75F6CB
ACBCL=89 ���6=CDGM�GD97=A9B�C:�5�@IB;�BC8I@9�G<CKG K95?@M�6=F9:F=B;9BH�B998@9G�GIFFCIB898�6M
7CB79BHF=7�@5M9FG�C:�<M5@=B=N98�7C@@5;9B �.<9�D5H=9BH�<5G�ACGH�@=?9@M�699B�9LDCG98�HC�K<=7<�C:�H<9
:C@@CK=B;�

Answer Image

� �9FM@@=IA

� �FMGH5@@=B9�G=@=75

� 'C@8M�<5M

� �5F6CB�8IGH

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Hint

.<9�D5H=9BH�G�KCFG9B=B; 8MGDB95� 7CI;<��5B8�897F95G98 �&�) F5=G9�GIGD=7=CB�:CF�5B =BH9FGH=H=5@�@IB;


8=G95G9 �.<9 6=CDGM :=B8=B;G��HC;9H<9F�K=H<�H<9�IDD9F�@C69�BC8I@5F�CD57=H=9G�5B8�75@7=:=98 <=@5F�@MAD<
BC89G��5F9�7<5F57H9F=GH=7�C:�9LDCGIF9�HC�5�GI6GH5B79�7@5GG=75@@M�5GGC7=5H98�K=H<�<5F8�FC7?�A=B=B;

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Correct Answer

A - Beryllium

Explanation Why

�9FM@@=CG=G =G�HMD=75@@M�G99B�=B�D5H=9BHG�KCF?=B;�=B�<=;<�H97<�G97HCFG��GI7<�5G�H<9�BI7@95F�5B8
59FCGD579�=B8IGHF=9G��K<9F9 69FM@@=IA 5@@CMG�5F9�7CAACB �1<=@9 69FM@@=CG=G 5@GC�5::97HG�H<9�IDD9F
@C69G�5B8�KCI@8�DF9G9BH�G=A=@5F@M�HC�H<=G�D5H=9BH��<=GHC@C;=75@�5B5@MG=G�=G�7<5F57H9F=N98�6M�H<9
DF9G9B79�C: BCB75G95H=B;�;F5BI@CA5G 5B8�5�F9H=7I@5F =BH9FGH=H=5@ D5HH9FB�CB�7<9GH L�F5M G=A=@5F�HC�H<5H
C: G5F7C=8CG=G

B - Crystalline silica

Explanation But

�8J5B798 G=@=7CG=G D5H=9BHG�5F9�5H�D5FH=7I@5F@M�<=;<�F=G?�:CF�89J9@CD=B; HI69F7I@CG=G

Explanation Why

.<=G�D5H=9BH�=G�GI::9F=B;�:FCA�7<FCB=7 G=@=7CG=G 8I9�HC�5B�C77ID5H=CB5@�9LDCGIF9�HC�7FMGH5@@=B9�G=@=75�


5G�9J=89B798�6M�H<9 D5H<C;BCA=7 6=CDGM :=B8=B;G�H<5H�5F9�7CBG=GH9BH�K=H<�5 G=@=7CH=7�BC8I@9
,58=C;F5D<=7�56BCFA5@=H=9G��GI7<�5G�8=::IG9�;FCIB8�;@5GG�CF�BC8I@5F�CD57=H=9G��75B�5F=G9�95F@M�=B�H<9
8=G95G9��HMD=75@@M�H<9�IDD9F�@C69G� �"CK9J9F��CJ9FH�GMADHCAG�75B�H5?9�897589G�C:�9LDCGIF9�HC
89J9@CD��K<=7<�=G�7CBG=GH9BH�K=H<�H<=G�D5H=9BH�G�58J5B798�5;9

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C - Moldy hay

Image

Explanation Why

�LDCGIF9�HC�H<9FACD<=@=7 57H=BCAM79G GDCF9G�=B�AC@8M�<5M�75B�@958�HC�5�HMD9�C: <MD9FG9BG=H=J=HM


DB9IACB=H=G��75@@98 5FA9F�G�@IB; �.<=G�KCI@8�5@GC�DF9G9BH�K=H<�DFC;F9GG=J9 8MGDB95 5B8�7<FCB=7
7CI;<��6IH <=GHC@C;M KCI@8�=BGH958�F9J95@ ;F5BI@CA5HCIG�=B:@5AA5H=CB K=H< @MAD<C7MH9G 5B8
DC@MBI7@95F ;=5BH�79@@G � IFH<9FACF9��7<9GH L�F5M KCI@8�G<CK�;FCIB8�;@5GG�CD57=H=9G�K=H<
<CB9M7CA6=B;��5B8�=B�GCA9�75G9G� 9AD<MG9A5

D - Carbon dust

Explanation Why

�<FCB=7�9LDCGIF9�HC�75F6CB�8IGH�75B�F9GI@H�=B �C5@�KCF?9F�G�DB9IAC7CB=CG=G �-=A=@5F�HC�H<=G�D5H=9BH�G


7CB8=H=CB� 6@57?�@IB; F9GI@HG�=B�GA5@@�BC8I@5F�CD57=H=9G�CB�7<9GH L�F5M��GD97=:=75@@M�=B�H<9�IDD9F @IB;

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:=9@8G �"=GHC@C;=7�5B5@MG=G��<CK9J9F��KCI@8�=BGH958�G<CK�89DCG=H=CB�C:�85F?�D=;A9BH�=B�H<9 =BH9FGH=H=5@
H=GGI9�5B8 <=@5F�@MAD<�BC89G 8I9�HC�75F6CB�577IAI@5H=CB�=B 5@J9C@5F�A57FCD<5;9G

E - Asbestos fibers

Explanation Why

�LDCGIF9�HC 5G69GHCG :=69FG�75B�@958�HC�89J9@CDA9BH�C: 5G69GHCG=G @5H9F�=B�@=:9 �1<=@9 5G69GHCG=G 5@GC


DF9G9BHG�=B8C@9BH@M�K=H< 8MGDB95 5B8�5�7<FCB=7 7CI;<��H<9�7<9GH L�F5M HMD=75@@M�G<CKG�@CK9F�@C69
=BJC@J9A9BH�5B8 D5H<C;BCACB=7 :=B8=B;G�C:�GIDF58=5D<F5;A5H=7�5B8�D@9IF5@�75@7=:=75H=CBG
�=5;BCG=G�=G�5=898�6M�=89BH=:=75H=CB�C:�H<9�;C@89B��695898�5DD95F5B79�C: 5G69GHCG :=69FG�=B GDIHIA�
K<=7<�5F9�7C5H98�K=H< =FCB 5B8 :9FF=H=B �H<IG�75@@98 :9FFI;=BCIG�6C8=9G��5:H9F�69=B; D<5;C7MHCG98 6M
A57FCD<5;9G

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Question # 15

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GK9@@=B;�C:�<=G�@9:H�5FA 5B8�:99@=B;�C:�:I@@B9GG�=B�<=G�<958�H<5H�=G�9L579F65H98�6M�@M=B;�8CKB�5B8�69B8=B;
CJ9F�HC�H=9�<=G�G<C9G �*<MG=75@�9L5A=B5H=CB�G<CKG @9:H�G=898 :57=5@�989A5 5B8 8=GH9BH=CB�C:�GID9F:=7=5@
J9=BG�=B�H<9�B97?�5B8�@9:H�7<9GH�K5@@ �1<=7<�C:�H<9�:C@@CK=B;�=G�H<9�ACGH�@=?9@M�75IG9�C:�H<=G�D5H=9BH�G
GMADHCAG�

Answer Image

� ,=;<H�<95FH�:5=@IF9

� �9FJ=75@�F=6

� �D=75@�@IB;�HIACF

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Answer Image

� '98=5GH=B5@�@MAD<CA5

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Hint

.<=G�D5H=9BH�G�GMADHCAG�C:�:57=5@�GK9@@=B;��5FA�GK9@@=B;��5B8�8=GH9BH=CB�C:�B97?�5B8 7<9GH�K5@@ J9=BG =G


7CB79FB=B;�:CF 6F57<=C79D<5@=7�GMB8FCA9

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Correct Answer

A - Right heart failure

Explanation Why

,=;<H�<95FH�:5=@IF9 75IG9G 657?K5F8�:5=@IF9��@958=B;�HC�GMGH9A=7�J9BCIG�7CB;9GH=CB��=B7F95G98 79BHF5@


J9BCIG�DF9GGIF9� >I;I@5F�J9BCIG�8=GH9BG=CB �$0����5B8�D9F=D<9F5@ D=HH=B;�989A5 ��@H<CI;<�H<=G
D5H=9BH�8C9G�<5J9 $0� 5B8 989A5��H<9 989A5 75IG98�6M F=;<H�<95FH�:5=@IF9 KCI@8�69�6=@5H9F5@�
6975IG9�H<9�F=;<H <95FH F979=J9G�J9BCIG�6@CC8�:FCA�6CH<�G=89G�C:�H<9�6C8M�J=5�H<9 GID9F=CF�J9B5�75J5
.<=G�D5H=9BH�<5G�IB=@5H9F5@ 989A5��GI;;9GH=B;�H<5H J9BCIG�F9HIFB =G�C6GHFI7H98�IDGHF95A�:FCA�H<9
GID9F=CF�J9B5�75J5

B - Cervical rib

Explanation Why

� 79FJ=75@�F=6 =G�IGI5@@M�5GMADHCA5H=7�6IH�75B�75IG9 @CK9F�6F57<=5@�D@9LIG�D5@GM CF�7CADF9GG=CB�C:


H<9�GI67@5J=5B�J9GG9@G��5G�=B H<CF57=7�CIH@9H�GMB8FCA9 ��CADF9GG=CB�C:�H<9�@9:H GI67@5J=5B�J9=B 6M�5
79FJ=75@�F=6 7CI@8�9LD@5=B�H<=G�D5H=9BH�G�@9:H�G=898�IB=@5H9F5@�5FA�GK9@@=B; �"CK9J9F��=H�KCI@8�BCH
9LD@5=B�<=G $0� CF�:57=5@ 989A5��G=B79�H<9 >I;I@5F J9=BG KCI@8�GH=@@�69�56@9�HC�8F5=B�J9BCIG�6@CC8
:FCA�<=G�:579�5B8�B97?�=BHC�H<9 6F57<=C79D<5@=7�J9=B 5B8�H<9B�=BHC�H<9 GID9F=CF�J9B5�75J5 K=H<CIH
C6GHFI7H=CB

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C - Apical lung tumor

Image

Explanation But

*5B7C5GH�HIACFG 75B�5@GC�75IG9 -0��GMB8FCA9 5B8 "CFB9F�GMB8FCA9

Explanation Why

.<=G�D5H=9BH�@=?9@M�<5G 6F57<=C79D<5@=7�GMB8FCA9 8I9�HC�5 *5B7C5GH�HIACF �*F98CA=B5BH@M�75IG98�6M


BCB�GA5@@�79@@�@IB;�75B79F��H<9G9�HIACFG�5F9�@C75H98�=B�H<9�GID9F=CF�GI@7IG�C:�H<9 @IB;��K<9F9
=B:=@HF5H=CB�C:�B95F6M�GHFI7HIF9G�75IG9G�5�F97C;B=N56@9�7CBGH9@@5H=CB�C:�GMADHCAG �.<=G�D5H=9BH�G
IB=@5H9F5@�:57=5@�GK9@@=B;�5B8�<958�:I@@B9GG�5F9�@=?9@M�8I9�HC�>I;I@5F�J9BCIG�7CB;9GH=CB��K<=@9�<=G
IB=@5H9F5@�5FA 989A5 GI;;9GHG�GI67@5J=5B�J9BCIG�7CB;9GH=CB �.<9G9�J9GG9@G�A9F;9�5H�H<9
6F57<=C79D<5@=7�J9=B��A5?=B;�=H�H<9�ACGH�@=?9@M�G=H9�C:�C6GHFI7H=CB

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D - Subclavian steal syndrome

Image

Explanation Why

-I67@5J=5B�GH95@�GMB8FCA9 5F=G9G�8I9�HC�GH9BCG=G�C:�5 GI67@5J=5B�5FH9FM 5B8�A5B=:9GHG�K=H< =G7<9A=7


GMADHCAG��9 ; � D5=B 5B8 D5@@CF��=B�H<9�5FA�CB�H<9�5::97H98�G=89 �#B�GCA9�75G9G��B9IFC@C;=7�GMADHCAG
A5M�C77IF��=B7@I8=B; @=;<H<95898B9GG 75IG98�6M�F9J9FG98�6@CC8�:@CK�=B�H<9 =DG=@5H9F5@ J9FH96F5@
5FH9FM ��@H<CI;<�H<=G�D5H=9BH�<5G�GMADHCAG�5::97H=B;�CB@M�CB9�5FA� 989A5 5B8�J9BCIG�8=GH9BH=CB
=B8=75H9�5�J9BCIG�F5H<9F�H<5B�5FH9F=5@�C6GHFI7H=CB �'CF9CJ9F��<9�8C9G�BCH�<5J9�5BM =G7<9A=7 CF
B9IFC@C;=7�GMADHCAG

E - Mediastinal lymphoma

Explanation Why

'98=5GH=B5@ @MAD<CA5��ACGH�C:H9B "C8;?=B�@MAD<CA5 CF�DF=A5FM A98=5GH=B5@ ��79@@ @MAD<CA5�

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Question # 16

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GDIHIA �"9�=G�5 F9H=F98�89AC@=H=CB�:CF9A5B �.<9F9�=G�8I@@B9GG�HC�D9F7IGG=CB�5B8�897F95G98�6F95H<�GCIB8G
CJ9F�H<9�@9:H�@IB;�65G9 �� �.�G75B C:�H<9�7<9GH�G<CKG�5 @9:H�G=898 D@9IF5@�9::IG=CB�5B8 7=F7IA:9F9BH=5@
D@9IF5@�H<=7?9B=B;�K=H<�75@7=:=75H=CBG CB�H<9�@9:H�<9A=H<CF5L �*5H<C@C;=7�9L5A=B5H=CB�C:�5�6=CDGM
GD97=A9B�C:�H<9�H<=7?9B98�H=GGI9�=G�ACGH�@=?9@M�HC�G<CK�K<=7<�C:�H<9�:C@@CK=B;�:=B8=B;G�

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Answer Image

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Hint

.<=G�A5B��K<CG9�:CFA9F�C77ID5H=CB�75FF=9G�5�<=;<�F=G?�C:�7<FCB=7�=B<5@5H=CB5@�9LDCGIF9�HC 5G69GHCG�
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�.�G75B �.<9�C77ID5H=CB5@�<=GHCFM��GMADHCAG��5B8�:=B8=B;G�5F9�<=;<@M�GI;;9GH=J9�C:�A5@=;B5BH D@9IF5@
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Correct Answer

A-

Synaptophysin-positive dark blue cells with hyperchromatic nuclei and scarce


cytoplasm

Image

Explanation Why

.<9G9�:=B8=B;G�89G7F=69 %I@7<=HG?M�79@@G��K<=7<�5F9�7<5F57H9F=GH=7�C: GA5@@�79@@�@IB;�75F7=BCA5


-MB5DHCD<MG=B =G�5�6=CA5F?9F�:CIB8�=B�HIACFG�K=H<�B9IFC9B8C7F=B9�8=::9F9BH=5H=CB �.<9�56IB85B79
C:�GA5@@��85F?�6@I9�79@@G�K=H< <MD9F7<FCA5H=7 BI7@9= �G5@H�5B8�D9DD9F�5DD95F5B79��5B8�G75F79
7MHCD@5GA =B8=75H9G�F5D=8�;FCKH<�5B8�A9H56C@=7�57H=J=HM �)H<9F =AAIBC<=GHC7<9A=75@ :=B8=B;G�C:
-�&� =B7@I89�5�DCG=H=J9 7<FCAC;F5B=B�� 5B8 B9IFCB�GD97=:=7�9BC@5G9 GH5=B

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B - Calretinin-positive polygonal cells with numerous long surface microvilli

Image

Explanation But

.<9�ACGH�7CAACB A5@=;B5B7M 5GGC7=5H98�K=H< 5G69GHCG=G =G 6FCB7<C;9B=7�75F7=BCA5��BCH


A9GCH<9@=CA5 �"CK9J9F� 6FCB7<C;9B=7�75F7=BCA5 =G�BCH�5G�GD97=:=7�:CF 5G69GHCG=G��G=B79�5@ACGH�5@@
75G9G�C: D@9IF5@�A9GCH<9@=CA5 5F=G9�G97CB85FM�HC 5G69GHCG 9LDCGIF9��IGI5@@M�5:H9F�5�@CB; @5H9B7M
D9F=C8 C:���P���M95FG

Explanation Why

.<9G9�:=B8=B;G�89G7F=69�H<9�<=GHCD5H<C@C;=7�5DD95F5B79�C: A9GCH<9@=CA5 �5@F9H=B=B =G�5�6=CA5F?9F


:CIB8�=B�6CH<�69B=;B�5B8�A5@=;B5BH�H=GGI9�C: A9GCH<9@=5@ CF=;=B '9GCH<9@=5@ 79@@G�5F9�C:H9B
DC@M;CB5@�=B�G<5D9�5B8�<5J9�@CB;��G@9B89F A=7FCJ=@@=��K<=7<�75B�69�G99B�CB 9@97HFCB�A=7FCG7CDM��5B8
DG5AACA5�6C8=9G

C-

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Napsin-positive cells in an acinar growth pattern with intracytoplasmatic
mucin

Image

Explanation Why

.<9G9�:=B8=B;G�89G7F=69�H<9�<=GHCD5H<C@C;=7�5DD95F5B79�C:�K9@@�8=::9F9BH=5H98 @IB;�589BC75F7=BCA5�
5 BCB�GA5@@�79@@�@IB;�75B79F �.<=G HIACF <5G�5�;@5B8I@5F�D5HH9FB�5B8�GH5=BG�DCG=H=J9�:CF AI7=B �)H<9F
6=CA5F?9FG�:CF @IB;�589BC75F7=BCA5 =B7@I89 B5DG=B�� 5B8 .. ��

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D - Keratin-producing large polygonal cells with intercellular bridges

Image

Explanation Why

.<9G9�:=B8=B;G�89G7F=69�H<9�<=GHCD5H<C@C;=7�5DD95F5B79�C: GEI5ACIG�79@@�75F7=BCA5 �-����C:�H<9


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DFC8I79 ?9F5H=B�D95F@G��5�7<5F57H9F=GH=7�<=GHCD5H<C@C;=7�:=B8=B;� ?9F5H=B =G�5�A5F?9F�C:�HIACFG�K=H<
GEI5ACIG 9D=H<9@=5@ 8=::9F9BH=5H=CB �.<9�DF9G9B79�C:�=BH9F79@@I@5F�6F=8;9G��89GACGCA9G��69HK99B
BIA9FCIG�DC@M;CB5@�79@@G�=G�5@GC�7<5F57H9F=GH=7�C:�-��

E-

Large polygonal cells with prominent nucleoli and abundant pale cytoplasm

Explanation Why

.<9G9�:=B8=B;G�89G7F=69�H<9�<=GHCD5H<C@C;=7�5DD95F5B79�C: @5F;9�79@@�75F7=BCA5��5 BCB�GA5@@�79@@�@IB;

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Question # 17

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J9<=7@9�7C@@=G=CB �)B�5FF=J5@��<9�=G�IB7CBG7=CIG�5B8�IBF9GDCBG=J9�HC�D5=B:I@�GH=AI@= �"=G�DI@G9�=G�����
A=B��F9GD=F5H=CBG�5F9����A=B��5B8�<=G�6@CC8�DF9GGIF9�=G ������AA�"; �#B:IG=CB�C: � ���G5@=B9 =G�69;IB�
5B8 =BHI65H=CB�=G�5HH9ADH98�K=H<CIH�GI779GG �*I@G9�CL=A9HFM�CB ���&�A=B C:�CLM;9B�J=5�65;�A5G?�G<CKG
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H<FCI;<�5B�=B7=G=CB�=B�K<=7<�C:�H<9�:C@@CK=B;�GHFI7HIF9G�

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Answer Image

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Hint

#BHI65H=CB <5G�:5=@98�=B�H<=G�=B7F95G=B;@M <MDCL9A=7 D5H=9BH �.<9�B9LH�GH9D�F9EI=F9G�9GH56@=G<=B;�5


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Correct Answer

A - Buccopharyngeal fascia

Explanation Why

#B7=G=CB C:�H<9 6I77CD<5FMB;95@�:5G7=5��K<=7<�9BJ9@CDG�H<9�GID9F=CF�7CBGHF=7HCF�AIG7@9�C:�H<9


DCGH9F=CF D<5FMBL��=G�BCH�D5FH�C:�H<9�DFC798IF9�HC�9GH56@=G<�5B 9A9F;9B7M�GIF;=75@�5=FK5M H<5H�H<=G
D5H=9BH�F9EI=F9G

B - Investing layer of deep cervical fascia

Image

Explanation Why

#B7=G=CB C:�H<9 =BJ9GH=B;�@5M9F C: 899D�79FJ=75@�:5G7=5 =G�B979GG5FM�HC�D9F:CFA�H<9 7F=7CH<MFC=8CHCAM


B99898�HC�9GH56@=G<�5B 5=FK5M =B�H<=G�D5H=9BH �#B�9A9F;9B7M�G=HI5H=CBG�K<9F9�5�D5H=9BH�75BBCH�69

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7F=7CH<MFC=8CHCAM =G�H<9�GIF;=75@�DFC798IF9�C:�7<C=79�HC�F9GHCF9�CLM;9B5H=CB �� 7F=7CH<MFC=8CHCAM =G
D9F:CFA98�6M�J9FH=75@@M�=B7=G=B;�H<9 G?=B �GID9F:=7=5@�79FJ=75@�:5G7=5� =BJ9GH=B;�@5M9F C: 899D�79FJ=75@
:5G7=5��5B8�DF9HF57<95@ :5G7=5��5B8�H<9B�<CF=NCBH5@@M�=B7=G=B;�H<9 7F=7CH<MFC=8 A9A6F5B9

C - Annular ligament

Explanation Why

.<9 5BBI@5F�@=;5A9BHG�C:�H<9�HF57<95��K<=7<�9LH9B8�69HK99B�H<9 HF57<95@ F=B;G�5B8�<C@8�H<9���G<5D98


F=B;G�C: 75FH=@5;9 HC;9H<9F��8C�BCH�F9EI=F9�5B =B7=G=CB HC�9GH56@=G<�5B 5=FK5M =B�H<=G�D5H=9BH #B7=G=CB C:
5B�5BBI@5F @=;5A9BH �5@CB;�K=H<�5 HF57<95@ F=B;��=G�8CB9�=B HF57<9CGHCAM��5�DFC798IF9�H<5H�=G�HMD=75@@M
D9F:CFA98�=B�9@97H=J9�CF�G9A=�9@97H=J9�G=HI5H=CBG�K<9F9�@CB;�H9FA A97<5B=75@�J9BH=@5H=CB =G�F9EI=F98
CF�K<9B�57IH9�IDD9F 5=FK5M C6GHFI7H=CB�C77IFG �.<=G�D5H=9BH�=G�=B�5B�9A9F;9B7M�G=HI5H=CB�H<5H
F9EI=F9G�=AA98=5H9�F9GHCF5H=CB�C:�H<9 5=FK5M 5B8�J9BH=@5H=CB��:CF�K<=7< HF57<9CGHCAM =G�BCH�H<9
DFC798IF9�C:�7<C=79

D - Cricotracheal ligament

Explanation Why

#B7=G=CB C:�H<9 7F=7CHF57<95@�@=;5A9BH��K<=7<�7CBB97HG�H<9�7F=7C=8 75FH=@5;9 HC�H<9�:=FGH HF57<95@ F=B;��=G


BCH�D5FH�C:�H<9�DFC798IF9�HC�9GH56@=G<�5B 9A9F;9B7M�GIF;=75@�5=FK5M H<5H�H<=G�D5H=9BH�F9EI=F9G

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E - Prevertebral layer of deep cervical fascia

Image

Explanation Why

#B7=G=CB C:�H<9 DF9J9FH96F5@�@5M9F C: 899D�79FJ=75@�:5G7=5��K<=7<�FIBG DCGH9F=CF HC�H<9 HF57<95��=G�BCH


D5FH�C:�H<9�DFC798IF9�HC�9GH56@=G<�5B 9A9F;9B7M�GIF;=75@�5=FK5M H<5H�H<=G�D5H=9BH�F9EI=F9G

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F - Thyrohyoid membrane

Image

Explanation Why

#B7=G=CB C:�H<9 H<MFC<MC=8�A9A6F5B9��K<=7<�7CBB97HG�H<9 H<MFC=8 75FH=@5;9 HC�H<9 <MC=8�6CB9��=G�8CB9


=B HF57<9CGHCAM��5�DFC798IF9�H<5H�=G�HMD=75@@M�D9F:CFA98�=B�9@97H=J9�CF�G9A=�9@97H=J9�G=HI5H=CBG�K<9F9
@CB;�H9FA A97<5B=75@�J9BH=@5H=CB =G�F9EI=F98�CF�K<9B�57IH9�IDD9F 5=FK5M C6GHFI7H=CB�C77IFG �.<=G
D5H=9BH�=G�=B�5B�9A9F;9B7M�G=HI5H=CB�H<5H�F9EI=F9G�=AA98=5H9�F9GHCF5H=CB�C:�H<9 5=FK5M 5B8�J9BH=@5H=CB�
:CF�K<=7< HF57<9CGHCAM =G�BCH�H<9�DFC798IF9�C:�7<C=79

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Question # 18

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7CI;< ��B L�F5M C:�H<9�7<9GH�G<CKG�5�F=;<H�@CK9F�@C69�7CBGC@=85H=CB�5B8�5�8=5;BCG=G�C: 5GD=F5H=CB
DB9IACB=5 =G�A589 �.<9�D<MG=7=5B�DF9G7F=69G�5�8FI;�H<5H�6@C7?G�D9DH=89�HF5BG:9F�6M 6=B8=B;�HC�H<9
��-�F=6CGCA5@ GI6IB=H �1<=7<�C:�H<9�:C@@CK=B;�8FI;G�K5G�ACGH�@=?9@M�DF9G7F=698�

Answer Image

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Hint

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Correct Answer

A - Doxycycline

Explanation Why

�CLM7M7@=B9 =G�5 H9HF57M7@=B9 5BH=6=CH=7 H<5H�=B<=6=HG�657H9F=5@ DFCH9=B�GMBH<9G=G 6M�6=B8=B;�HC�H<9


657H9F=5@���-��GA5@@� F=6CGCA5@ GI6IB=H�5B8�DF9J9BH=B;�5HH57<A9BH�C: 55�H,(� �.<=G�8FI;�=G
7CAACB@M�IG98�=B�H<9�HF95HA9BH�C: 7CAAIB=HM�57EI=F98�DB9IACB=5 �9GD97=5@@M 5HMD=75@�DB9IACB=5�
.<=G�D5H=9BH�K5G�DF9G7F=698�5B 5BH=6=CH=7 H<5H�57HG�5H�H<9 ��-�F=6CGCA5@�GI6IB=H

B - Metronidazole

Explanation Why

'9HFCB=85NC@9 =B<=6=HG�657H9F=5@ BI7@9=7�57=8 GMBH<9G=G�6M�DFC8I7=B; :F99�F58=75@G H<5H�75IG9 �(�


GHF5B8�6F95?G ��@H<CI;<�=H�=G�D5FH=7I@5F@M�9::97H=J9�5;5=BGH 5B59FC6=7�657H9F=5��=H�=G�BCH�5�:=FGH�@=B9
HF95HA9BH�:CF 5GD=F5H=CB�DB9IACB=5 5B8�=H�8C9G�BCH�6=B8�HC�H<9 ��-�F=6CGCA5@�GI6IB=H

C - Levofloxacin

Explanation Why

&9JC:@CL57=B =G�5 :@ICFCEI=BC@CB9 5BH=6=CH=7 H<5H�=B<=6=HG�657H9F=5@ HCDC=GCA9F5G9�## ��(��;MF5G9�


&9JC:@CL57=B =G�5B�=ADCFH5BH�7CADCB9BH�C:�=BD5H=9BH�HF95HA9BH�:CF 7CAAIB=HM�57EI=F98�DB9IACB=5
5B8 <CGD=H5@�57EI=F98�DB9IACB=5 5B8�<5G�GCA9 5B59FC6=7 57H=J=HM �.<=G�D5H=9BH�K5G�DF9G7F=698�5B
5BH=6=CH=7 H<5H�57HG�5H�H<9 ��-�F=6CGCA5@�GI6IB=H

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D - Clindamycin

Explanation Why

�@=B85AM7=B =G�5 657H9F=CGH5H=7 5BH=6=CH=7 H<5H�=B<=6=HG�657H9F=5@ DFCH9=B�GMBH<9G=G 6M�DF9J9BH=B;


D9DH=89 HF5BG@C75H=CB�5H�H<9���-��@5F;9� F=6CGCA5@ GI6IB=H �#H�H5F;9HG 5B59FC6=7 CF;5B=GAG�5B8�=G
7CAACB@M�IG98�:CF�H<9�HF95HA9BH�C: 5GD=F5H=CB�DB9IACB=5 5B8 @IB;�56G79GG��K<=7<�5F9�HMD=75@@M
DC@MA=7FC6=5@ Clostridioides difficile 7C@=H=G =G�5�DCH9BH=5@�7CAD@=75H=CB�C: 7@=B85AM7=B

E - Azithromycin

Explanation Why

�N=H<FCAM7=B =G�5 A57FC@=89 5BH=6=CH=7 H<5H�5@GC�=B<=6=HG�657H9F=5@ DFCH9=B�GMBH<9G=G 6M�6@C7?=B;


D9DH=89 HF5BG@C75H=CB�5H�H<9 ��-�F=6CGCA5@�GI6IB=H �1<=@9�=H�=G�7CAACB@M�IG98�=B�H<9�HF95HA9BH�C:
7CAAIB=HM�57EI=F98�DB9IACB=5��=H�=G�BCH�9::97H=J9�5;5=BGH 5B59FC6=7 CF;5B=GAG�5B8�=G��H<9F9:CF9��BCH
IG98�5G�ACBCH<9F5DM�:CF 5GD=F5H=CB�DB9IACB=5

F - Piperacillin with tazobactam

Explanation Why

*=D9F57=@@=B =BH9F:9F9G�K=H< 79@@�K5@@ GMBH<9G=G�6M�6=B8=B;�HC D9B=7=@@=B�6=B8=B;�DFCH9=BG �*�*G��


K<=7<�=B<=6=HG D9DH=8C;@M75B 7FCGG@=B?=B; .5NC657H5A��K<=7<�=G�5 69H5�@57H5A5G9�=B<=6=HCF��=B<=6=HG
657H9F=5@ 69H5�@57H5A5G9 5B8�H<IG�DF9J9BHG�H<9�6F95?8CKB�C: D=D9F57=@@=B �.<=G�7CA6=B5H=CB 5BH=6=CH=7
=G�7CAACB@M�IG98�:CF�=BD5H=9BH�HF95HA9BH�C:�G9J9F9 7CAAIB=HM�57EI=F98�DB9IACB=5 5B8 <CGD=H5@�
57EI=F98�DB9IACB=5��8I9�HC�=HG�57H=J=HM�5;5=BGH Pseudomonas �(9=H<9F�8FI;G�6=B8�HC�H<9 ��-
F=6CGCA5@�GI6IB=H

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G - Ceftriaxone

Explanation Why

�9:HF=5LCB9 =G�5 79D<5@CGDCF=B 5BH=6=CH=7 H<5H�=FF9J9FG=6@M�=B<=6=HG 657H9F=5@�79@@�K5@@ GMBH<9G=G�6M


6=B8=B;�HC D9B=7=@@=B�6=B8=B;�DFCH9=BG 5B8�H<IG�DF9J9BH=B; D9DH=8C;@M75B 7FCGG@=B?=B; ��@H<CI;<�H<=G
8FI;�=G�5�7CAACB�7CADCB9BH�:CF�=BD5H=9BH�HF95HA9BH�C: 7CAAIB=HM�57EI=F98�DB9IACB=5��=H�=G�BCH
9::97H=J9�5;5=BGH 5B59FC69G��K<=7<�5F9�7CAACB�=B 5GD=F5H=CB�DB9IACB=5

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Question # 19

� ���M95F�C@8 A5B�7CA9G�HC�H<9�D<MG=7=5B�6975IG9�C:�5 ��ACBH< <=GHCFM�C:�KCFG9B=B; 9L9FH=CB5@


8MGDB95�5B8�5�D9FG=GH9BH�8FM�7CI;< � CF ���M95FG <9�<5G�KCF?98�=B�5 B5J5@�G<=DM5F8 �"9�<5G�GAC?98
��D57? C:�7=;5F9HH9G�85=@M�:CF�H<9�D5GH ���M95FG �*I@ACB5FM�9L5A=B5H=CB�G<CKG�:=B9�6=65G=@5F
9B8�9LD=F5HCFM 7F57?@9G ��B L�F5M C:�H<9�7<9GH�G<CKG�8=::IG9�6=@5H9F5@�=B:=@HF5H9G�DF98CA=B5BH@M�=B�H<9
@CK9F�@C69G�5B8�D@9IF5@�F9H=7I@CBC8I@5F�CD57=H=9G �� �.�G75B C:�H<9�7<9GH�G<CKG D@9IF5@�D@5EI9G�5B8
GI6D@9IF5@�@=B95F�CD57=H=9G �.<9�D5H=9BH�=G�ACGH�@=?9@M�HC�89J9@CD�K<=7<�C:�H<9�:C@@CK=B;�7CB8=H=CBG�

Answer Image

� �FCB7<C;9B=7�75F7=BCA5

� �GD9F;=@@CA5

� 'M7C657H9F=5@�#B:97H=CB

� '5@=;B5BH�A9GCH<9@=CA5

� -DCBH5B9CIG�DB9IACH<CF5L

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Hint

.<9 L�F5M :=B8=B;G�C:�8=::IG9�6=@5H9F5@�=B:=@HF5H9G�DF98CA=B5BH@M�=B�H<9�@CK9F�@C69G�5B8�D@9IF5@


F9H=7I@CBC8I@5F�CD57=H=9G��5@CB;�K=H<�H<9��.�:=B8=B;�C: D@9IF5@�D@5EI9G��=G�5�7@5GG=7�F58=C;F5D<=7
DF9G9BH5H=CB�C: 5G69GHCG=G

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Correct Answer

A - Bronchogenic carcinoma

Image

Explanation Why

�FCB7<C;9B=7�75F7=BCA5 =G�H<9�ACGH�7CAACB�A5@=;B5BH�DI@ACB5FM HIACF =B�D5H=9BHG�K=H< 5G69GHCG=G


5B8�H<9�G97CB8�ACGH�7CAACB 75F7=BCA5 KCF@8K=89 �.<=G�D5H=9BH�<5G�HKC�=ADCFH5BH F=G?�:57HCFG�
DF=A5F=@M�5�GAC?=B;�<=GHCFM�5B8�5�<=GHCFM�C: 5G69GHCG 9LDCGIF9 �.<9�:=FGH�GMADHCA�C: 6FCB7<C;9B=7
75F7=BCA5 =G�IGI5@@M�5 7CI;<��5@H<CI;< <9ACDHMG=G� 8MGDB95��5B8 7<9GH�D5=B 75B�5@GC�C77IF
�G69GHCG=G =G�H<9�A5=B�75IG9�C: A9GCH<9@=CA5��K<=7<�F5F9@M�C77IFG�K=H<CIH�5�<=GHCFM�C: 5G69GHCG
9LDCGIF9 �"CK9J9F� 6FCB7<C;9B=7�75F7=BCA5 =G�GH=@@�J5GH@M�ACF9�7CAACB�H<5B A9GCH<9@=CA5��9J9B
=B�D9CD@9�K=H<�5�<=GHCFM�C: 5G69GHCG 9LDCGIF9

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B - Aspergilloma

Explanation Why

�GD9F;=@@CA5G 5F9�5�:CFA�C: 7<FCB=7�DI@ACB5FM�5GD9F;=@@CG=G H<5H�75B�C77IF�=B�5�BIA69F�C: @IB;


7CB8=H=CBG��=B7@I8=B; G=@=7CG=G��DI@ACB5FM G5F7C=8CG=G��5B8 HI69F7I@CG=G �#H�=G�BCH�5GGC7=5H98�K=H<
5G69GHCG=G

C - Mycobacterial Infection

Explanation Why

.I69F7I@CG=G C77IFG�ACF9�:F9EI9BH@M�=B�D5H=9BHG�K=H< G=@=7CG=G��K<=7<�DF=A5F=@M�DF9G9BHG�K=H< 8MGDB95


5B8�5 7CI;<��5G�=B�H<=G�D5H=9BH �"CK9J9F� 7<9GH�L�F5M KCI@8�HMD=75@@M�G<CK 9;;G<9@@�75@7=:=75H=CBG 5B8
6=@5H9F5@�8=::IG9 ;FCIB8�;@5GG�CD57=H=9G��K<=7<�5F9�6CH<�56G9BH�<9F9

D - Malignant mesothelioma

Explanation Why

�G69GHCG=G =G�H<9�A5=B�9H=C@C;=75@�:57HCF�C: A9GCH<9@=CA5��K<=7<�F5F9@M�C77IFG�K=H<CIH�5�<=GHCFM�C:


5G69GHCG 9LDCGIF9 ��@H<CI;<�H<9�F=G?�C: A9GCH<9@=CA5 =G�A5F?98@M�=B7F95G98�=B�H<=G�D5H=9BH��5BCH<9F
7CAD@=75H=CB�=G�ACF9�@=?9@M�HC�5F=G9

E - Spontaneous pneumothorax

Explanation Why

�I@@CIG 9AD<MG9A5 @958=B;�HC GDCBH5B9CIG�DB9IACH<CF5L =G�5�?BCKB�7CAD@=75H=CB�C: 5@IA=BCG=G��5

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:CFA�C: DB9IAC7CB=CG=G��K<=7<�F9GI@HG�:FCA�7<FCB=7�=B<5@5H=CB�C:�5@IA=BIA�8IGH��ACGH�C:H9B�=B
K9@89FG �.<=G DB9IAC7CB=CG=G =G�J9FM�F5F9��5B8�K<=@9�=H�A5M�DF9G9BH�K=H< 8MGDB95 CB�9L9FH=CB�5B8
7CI;<��5 �.�G75B C:�H<9�7<9GH�KCI@8�89ACBGHF5H9�GA5@@�7MGH=7�F58=C@I79B7=9G��<CB9M7CA6=B;�

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Question # 20

� ���M95F�C@8 A5B�7CA9G�HC�H<9�D<MG=7=5B�6975IG9�C:�5 ��85M <=GHCFM�C:�:9J9F�5B8�7CI;<�DFC8I7H=J9�C:


:CI@�GA9@@=B;� 85F?�F98��;9@5H=BCIG�GDIHIA �"9�<5G�GAC?98 ��D57? C:�7=;5F9HH9G�85=@M�:CF ���M95FG 5B8
8F=B?G�HKC ���CN 6CHH@9G�C:�699F�85=@M ��B L�F5M C:�H<9�7<9GH�G<CKG�5 75J=HM�K=H< 5=F�:@I=8 @9J9@G =B�H<9
F=;<H�@CK9F�@C69 �-DIHIA�7I@HIF9�;FCKG ;F5A�B9;5H=J9 FC8G �1<=7<�C:�H<9�:C@@CK=B;�J=FI@9B79�:57HCFG�=G
ACGH�@=?9@M�=BJC@J98�=B�H<9�D5H<C;9B9G=G�C:�H<=G�D5H=9BH�G�7CB8=H=CB�

Answer Image

� �LCHCL=B��

� #;��DFCH95G9

� "95H�GH56@9�HCL=B

� *�:=A6F=59

� �5DGI@5F�DC@MG577<5F=89

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Hint

.<=G�D5H=9BH�G GDIHIA 7I@HIF9�K=H< ;F5A�B9;5H=J9 FC8G�5B8�<=GHCFM�C: :CI@�GA9@@=B;��85F?�F98��;9@5H=BCIG


GDIHIA �7IFF5BH�>9@@M�GDIHIA��=G�7CBG=GH9BH�K=H<�5�DI@ACB5FM�=B:97H=CB�75IG98�6M Klebsiella
pneumoniae

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Correct Answer

A - Exotoxin A

Explanation Why

�LCHCL=B�� =G�DFC8I798�6M Pseudomonas aeruginosa��5�;F5A�B9;5H=J9�FC8�H<5H�75B�75IG9�5 @IB;


56G79GG G97CB85FM�HC DB9IACB=5��9GD97=5@@M�=B�D5H=9BHG�K=H< 5@7C<C@�IG9�8=GCF89F �"CK9J9F� @IB;
=B:97H=CB�6M P. aeruginosa =G�HMD=75@@M�5GGC7=5H98�K=H<�;F99B�7C@CF98 GDIHIA��BCH�85F?�F98 GDIHIA�
8I9�HC�H<9�DFC8I7H=CB�C: DMC7M5B=B

B - IgA protease

Explanation Why

#;��DFCH95G9 =G�G97F9H98�6M Haemophilus influenzae �5�;F5A�B9;5H=J9�FC8��5B8 Streptococcus


pneumoniae��6CH<�C:�K<=7<�75B�75IG9�5 @IB;�56G79GG G97CB85FM�HC DB9IACB=5 �"CK9J9F�
Haemophilus influenzae =B:97H=CB�=G�F5F9@M�G99B�=B�89J9@CD98�7CIBHF=9G�G=B79�=BHFC8I7H=CB�C:�H<9 "=6
J577=B5H=CB��5B8 Streptococcus pneumoniae =G�5�;F5A�DCG=H=J9�7C77IG

C - Heat-stable toxin

Explanation Why

"95H�GH56@9�HCL=BG��GI7<�5G�H<9 9BH9FCHCL=BG DFC8I798�6M Staphylococcus aureus��H5F;9H�H<9�=BH9GH=B5@


AI7CG5 5B8�75IG9 :CC8�DC=GCB=B; CF�9BH9F=H=G ��@H<CI;< S. aureus 75B�75IG9 @IB;�56G79GG� <95H�GH56@9
HCL=BG 5F9�BCH�F9GDCBG=6@9�:CF�H<9�D5H<C;9B9G=G�C:�DI@ACB5FM�=B:97H=CBG �#BGH958��CH<9F J=FI@9B79
:57HCFG��GI7<�5G DFCH9=B����5F9�=BJC@J98�=B�H<9�D5H<C;9B9G=G�C: S. aureus DB9IACB=5 �'CF9CJ9F� S.
aureus =G�5�;F5A�DCG=H=J9�7C77IG��BCH�5�;F5A�B9;5H=J9�FC8

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D - P-fimbriae

Explanation Why

*M9@CB9D<F=H=G�5GGC7=5H98 :=A6F=59 �*�:=A6F=59��5F9�DF9G9BH�CB�IFCD5H<C;9B=7 E. coli �5�;F5A�


B9;5H=J9�FC8�H<5H�75IG9G 7MGH=H=G 5B8 DM9@CB9D<F=H=G E. coli 75B�5@GC�75IG9�5 @IB;�56G79GG G97CB85FM
HC DB9IACB=5��6IH E. coli DB9IACB=5 =G�HMD=75@@M�<CGD=H5@�57EI=F98��5B8 *�:=A6F=59 5F9�BCH
F9GDCBG=6@9�:CF�H<9�D5H<C;9B9G=G�C:�DI@ACB5FM�=B:97H=CBG �#BGH958��CH<9F J=FI@9B79�:57HCFG��GI7<�5G�H<9
%�75DGI@9��5F9�=BJC@J98�=B�H<9�D5H<C;9B9G=G�C: E. coli DB9IACB=5

E - Capsular polysaccharide

Explanation Why

Klebsiella pneumoniae DCGG9GG�5�75DGI@5F DC@MG577<5F=89 H<5H�57HG�5G�5B�5BH=D<5;C7MH=7 J=FI@9B79


:57HCF 5B8�5@@CKG�657H9F=5�HC�9J589�<CGH�=AAIB9�89:9BG9G �.<=G�D5H<C;9B�=G�D5FH�C:�H<9�B5HIF5@�:@CF5
C:�H<9 ;5GHFC=BH9GH=B5@�HF57H �#B�D5H=9BHG�K<C�5F9 =AAIBC7CADFCA=G98 5B8�D5H=9BHG�K<C�<5J9�5B
=B7F95G98�F=G?�:CF 5GD=F5H=CB 9J9BHG��9 ; ��8I9�HC�7<FCB=7�5@7C<C@�IG9�� 5GD=F5H=CB C: Klebsiella 75B
@958�HC�89GHFI7H=CB�C:�5@J9C@=��F9GI@H=B;�=B�6@CC8M GDIHIA K=H<�5�7IFF5BH�>9@@M�5DD95F5B79

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Question # 21

� ���M95F�C@8 A5B�K=H< 7<FCB=7�C6GHFI7H=J9�DI@ACB5FM�8=G95G9 5B8�<MD9FH9BG=CB�7CA9G�HC�H<9�D<MG=7=5B


6975IG9�C:�G<CFHB9GG�C:�6F95H< ��85MG 5:H9F�GH5FH=B; DFCDF5BC@C@ �"=G�H9AD9F5HIF9�=G �� �O� ��� �O ��
DI@G9�=G ���A=B��F9GD=F5H=CBG�5F9 ���A=B��5B8�6@CC8�DF9GGIF9�=G �������AA�"; ��IG7I@H5H=CB�C:�H<9�@IB;G
G<CKG 8=::IG9�9LD=F5HCFM�K<99N9G �#B�588=H=CB�HC�8=G7CBH=BI=B;�H<9 DFCDF5BC@C@��K<=7<�C:�H<9�:C@@CK=B;
8FI;G�G<CI@8�69�58A=B=GH9F98�

Answer Image

� -5@A9H9FC@

� �@6IH9FC@

� *F98B=GCB9

� !@I75;CB

� .=CHFCD=IA�6FCA=89

.<9CD<M@@=B9

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Hint

*FCDF5BC@C@ =G�5 BCB�G9@97H=J9 69H5 6@C7?9F �9H5�� 6@C7?589�75B�HF=;;9F�6FCB7<C7CBGHF=7H=CB��D5FH=7I@5F@M


=B�D5H=9BHG�K=H< �)*� CF 5GH<A5

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Correct Answer

A - Salmeterol

Explanation Why

-5@A9H9FC@ =G�5�@CB;�57H=B; 69H5���5;CB=GH IG98�5G�5 A5=BH9B5B79�HF95HA9BH :CF �)*� 5B8 5GH<A5


�@H<CI;<�H<9 69H5���5;CB=GH 9::97HG�C: G5@A9H9FC@ 7CI@8�DCH9BH=5@@M�F9J9FG9 DFCDF5BC@C@�A98=5H98
6FCB7<CGD5GA =B�H<=G�D5H=9BH��H<9�8FI;�=G�BCH�F97CAA9B898�:CF 57IH9�9L579F65H=CBG�C:��)*�

B - Albuterol

Explanation Why

�@6IH9FC@ =G�5�G<CFH�57H=B; 69H5���58F9B9F;=7�5;CB=GH H<5H�=B8I79G�F9@5L5H=CB�C:�6FCB7<=5@ GACCH<


AIG7@9�79@@G ���D5H=9BH�DF9G9BH=B;�K=H<�G=;BG�C: 57IH9�9L579F65H=CB�C:��)*� �9 ; � G<CFHB9GG�C:
6F95H<� H57<MDB95��5B8�9LD=F5HCFM K<99N9G��G<CFH@M�5:H9F�GH5FH=B; DFCDF5BC@C@��ACGH�@=?9@M�<5G�8FI;�
=B8I798 6FCB7<CGD5GA �@6IH9FC@ =G�HMD=75@@M�IG98�5G�5�:=FGH�@=B9 6FCB7<C8=@5HCF =B�D5H=9BHG�K=H<
57IH9�9L579F65H=CB�C:��)*� CF 5GH<A5 5B8�KCI@8�7CIBH9F57H�H<9�9::97H�C: DFCDF5BC@C@ G99B�=B�H<=G
D5H=9BH

C - Prednisone

Explanation Why

*F98B=GCB9 =G�5�GMGH9A=7 7CFH=7CGH9FC=8 H<5H�F98I79G =B:@5AA5H=CB 6M�GIDDF9GG=B;�H<9 =AAIB9


F9GDCBG9 ��@H<CI;< DF98B=GCB9 =G�:F9EI9BH@M�IG98�:CF 57IH9�9L579F65H=CBG�C:��)*���=H�KCI@8�BCH�H<9
:=FGH�@=B9�HF95HA9BH�=B�5�D5H=9BH�K=H<�8FI;�=B8I798 6FCB7<CGD5GA

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D - Glucagon

Explanation Why

!@I75;CB =B7F95G9G�=BHF579@@I@5F 7�'* 6M�57H=J5H=B; 589BM@5H9�7M7@5G9 �#BHF5J9BCIG ;@I75;CB 75B�69


IG98�:CF�H<9�=B=H=5@�HF95HA9BH�C:�D5H=9BHG�K=H<�G9J9F9 6F58M75F8=5 5B8 <MDCH9BG=CB G97CB85FM�HC 69H5
6@C7?9F CJ9F8CG9 ��@H<CI;<�H<=G�D5H=9BH�G�GMADHCAG�5F9�ACGH�@=?9@M�8I9�HC�G=89�9::97HG�C:
DFCDF5BC@C@� ;@I75;CB =G�BCH�IG98�HC�HF95H 57IH9�9L579F65H=CBG�C:��)*�

E - Tiotropium bromide

Explanation Why

.=CHFCD=IA�6FCA=89 =G�5�@CB;�57H=B; 5BH=AIG75F=B=7�5;9BH H<5H 7CAD9H=H=J9@M�=B<=6=HG H<9�57H=CB�C:


579HM@7<C@=B9 =B�6FCB7<=5@ GACCH<�AIG7@9�79@@G��75IG=B;�6FCB7<C8=@5H=CB .=CHFCD=IA�6FCA=89 =G�IG98
5G�5 A5=BH9B5B79�HF95HA9BH :CF �)*� 5B8 5GH<A5��6IH�=H�=G�BCH�IG98�HC�HF95H 57IH9�9L579F65H=CBG�C:
�)*�

F - Theophylline

Explanation Why

.<9CD<M@@=B9 =G�5 D<CGD<C8=9GH9F5G9�=B<=6=HCF K=H<�5BH=�=B:@5AA5HCFM�5B8�6FCB7<C8=@5HCFM�9::97HG


IG98�:CF�H<9�HF95HA9BH�C:�7<FCB=7 �)*� 5B8 5GH<A5 '9H<M@L5BH<=B9G GI7<�5G H<9CD<M@@=B9 5F9�BCH
F97CAA9B898�:CF 57IH9�9L579F65H=CBG�C:��)*� 6975IG9�H<9M�<5J9�5 B5FFCK�H<9F5D9IH=7�=B89L 5B8
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Question # 22

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7CAAIB=HM �"9�GAC?98�CB9�D57?�C:�7=;5F9HH9G�85=@M�:CF ���M95FG 6IH�EI=H ��M95FG 5;C �"9�<5G�5 ���M95F
<=GHCFM�C:�5@7C<C@�56IG9�6IH�<5G�BCH�7CBGIA98�5BM�5@7C<C@�=B�H<9�D5GH ��M95FG �"=G H9AD9F5HIF9�=G �� �O�
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C:�H<9�@IB;�G<CKG�F5@9G�5B8�897F95G98�6F95H<�GCIB8G�CJ9F�H<9�F=;<H�IDD9F�@IB;�:=9@8 ��L5A=B5H=CB�G<CKG
5�F9GH=B;�HF9ACF �&56CF5HCFM�GHI8=9G�G<CK�

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� *5F?=BGCB�8=G95G9

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Hint

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Correct Answer

A - Living in an assisted-living community

Explanation Why

&=J=B;�=B�5B�5GG=GH98�@=J=B;�7CAAIB=HM�=G�5 F=G?�:57HCF :CF DB9IACB=5 6975IG9�C:�H<9�58J5B798�5;9


5B8�F98I798�:IB7H=CB5@�GH5HIG�C:�H<9�=B<56=H5BHG�5G�K9@@�5G�9LDCGIF9�HC�CH<9F�G=7?�7CBH57HG�K=H<=B�H<9
7CAAIB=HM �"CK9J9F��@=J=B;�=B�5B�5GG=GH98�@=J=B;�7CAAIB=HM�8C9G�BCH�DF98=GDCG9�HC 5GD=F5H=CB
DB9IACB=5 GD97=:=75@@M�5B8�H<=G�A5B�<5G�5�ACF9�G=;B=:=75BH F=G?�:57HCF H<5H�G<CI@8�69�7CBG=89F98

B - Tobacco use history

Explanation Why

-AC?=B;�=B7F95G9G�H<9�F=G?�C: DB9IACB=5 6M�K95?9B=B;�DI@ACB5FM�DFCH97H=J9�A97<5B=GAG �#H�5@GC


DF98=GDCG9G�D5H=9BHG�HC 7<FCB=7�C6GHFI7H=J9�DI@ACB5FM�8=G95G9 ��)*����K<=7<�75B�69�5 F=G?�:57HCF :CF
5GD=F5H=CB�DB9IACB=5 �"CK9J9F��H<=G�A5B�=G�BCH�5�7IFF9BH�GAC?9F��5B8�8C9G�BCH�<5J9�CH<9F�:95HIF9G�C:
�)*� GI7<�5G�5�7<FCB=7 7CI;<��K<99N=B;��CF�5 65FF9@�7<9GH��A5?=B;�H<=G�5B�IB@=?9@M�75IG9�C:�<=G
DB9IACB=5

C - Past history of alcohol abuse

Explanation Why

�7H=J9�5@7C<C@�IG9�=G�5 F=G?�:57HCF :CF 5GD=F5H=CB�DB9IACB=5��5G�=H�A5M�@958�HC�5@H9F98�7CBG7=CIGB9GG�


9A9G=G��5B8�GIDDF9GG98 5=FK5M DFCH97H=J9�A97<5B=GAG ��@H<CI;<�H<=G�D5H=9BH�G�D5GH�<=GHCFM�C: 5@7C<C@
56IG9 =B7F95G9G�<=G�F=G?�:CF�A5BM�8=::9F9BH�7CB8=H=CBG��GI7<�5G�<9D5H=7�8MG:IB7H=CB�5B8 79F96F5@
5HFCD<M��=H�8C9G�BCH�=B7F95G9�H<9�F=G?�:CF 5GD=F5H=CB�DB9IACB=5

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D - Gastritis

Explanation Why

!5GHF=H=G 7CAACB@M�DF9G9BHG�K=H<�9D=;5GHF=7�568CA=B5@ D5=B��B5IG95��5B8�JCA=H=B; ��CAD@=75H=CBG�C:


;5GHF=H=G =B7@I89�6@998=B; I@79FG 5B8 ;5GHF=7�75F7=BCA5G �"CK9J9F� ;5GHF=H=G 8C9G�BCH�DF98=GDCG9�HC
5GD=F5H=CB�DB9IACB=5��5G�H<9F9�=G�BC�F9:@IL�5GGC7=5H98�K=H< ;5GHF=H=G

E - Parkinson disease

Explanation But

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5@H9F98�7CBG7=CIGB9GG��9 ; � 5@7C<C@=GA� G9=NIF9G���5DCD@9LM�5B8�B9IFC89;9B9F5H=J9�7CB8=H=CBG��9 ; �
�@N<9=A9F�8=G95G9�� ;5GHFC9GCD<5;95@�F9:@IL�8=G95G9��5B8 9GCD<5;95@�ACH=@=HM�8=GCF89FG

Explanation Why

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7CI;< A97<5B=GA�=B�ID�HC�����C:�H<CG9�K=H<�@5H9�GH5;9�8=G95G9 �GD=F5H=CB =G�ACGH�@=?9@M�HC�C77IF�=B
H<9�89D9B89BH�DCFH=CBG�C:�H<9 @IB; �H<9�GID9F=CF�G9;A9BH�C:�F=;<H�@CK9F�@C69�5B8�H<9 DCGH9F=CF
G9;A9BH�C:�H<9�F=;<H�IDD9F�@C69�K<9B GID=B9 CF�H<9�5D=75@�5B8 DCGH9F=CF F=;<H�@CK9F�@C69�K<9B
IDF=;<H� �.<9G9�5F9�C:H9B�A=L98�=B:97H=CBG�=BJC@J=B;�CF;5B=GAG�:FCA�H<9�CF5@�:@CF5��D5FH=7I@5F@M
5B59FC6=7�657H9F=5 �9 ; � Peptostreptococcus� Fusobacterium, Provetella��CF Bacteroides�

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Question # 23

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GK95HG �-<9�<5G�GAC?98�CB9 D57?�C:�7=;5F9HH9G�85=@M�:CF�H<9�D5GH ���M95FG -<9�5DD95FG�H<=B ��L5A=B5H=CB
C:�H<9�@IB;�G<CKG�5�DFC@CB;98�9LD=F5HCFM�D<5G9�5B8 9B8�9LD=F5HCFM K<99N=B; �-D=FCA9HFM�G<CKG
897F95G98 �0�� 0��F5H=C �������DF98=7H98���897F95G98� �0���5B8�5�HCH5@�@IB;�75D57=HM�C:������C:
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@=?9@M�8=5;BCG=G�

Answer Image

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Hint

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:@5HH9B=B;�C:�H<9�8=5D<F5;A

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Correct Answer

A - Bronchial asthma

Explanation Why

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HC�H<=G�D5H=9BH�G���ACBH<G�C:�DFC;F9GG=J9 8MGDB95 �'CF9CJ9F��K9=;<H�@CGG�KCI@8�BCH�69�9LD97H98��5B8
�&�) KCI@8�69�BCFA5@�CF�A=@8@M�=B7F95G98

B - Bronchiectasis

Explanation Why

�FCB7<=97H5G=G 75B�F9GI@H�=B�DFC;F9GG=J9@M�KCFG9B=B; 8MGDB95� 7CI;<��K<99N=B;��K9=;<H�@CGG��5B8


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KCI@8�<5J9�5�DFC8I7H=J9 7CI;< K=H<�H<=7?��:CI@�GA9@@=B; GDIHIA �8I9�HC 5B59FC6=7 =B:97H=CB��5B8
7C5FG9�=BGD=F5HCFM 7F57?@9G CB 5IG7I@H5H=CB

C - Hypersensitivity pneumonitis

Explanation Why

-I657IH9 <MD9FG9BG=H=J=HM�DB9IACB=H=G 75B�F9GI@H�=B 8MGDB95 H<5H�KCFG9BG�CJ9F�H<9�7CIFG9�C:��


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<MD9FG9BG=H=J=HM�DB9IACB=H=G HMD=75@@M�F9GI@HG�=B�F9GHF=7H=J9��CF�A=L98�F9GHF=7H=J9�C6GHFI7H=J9� @IB;
8=G95G9� :CF798�J=H5@�75D57=HM KCI@8�H<9F9:CF9�69�F98I798 �'CF9CJ9F��D5H=9BHG�K=H< <MD9FG9BG=H=J=HM
DB9IACB=H=G HMD=75@@M�<5J9�6=65G=@5F�=BGD=F5HCFM 7F57?@9G CB 5IG7I@H5H=CB F5H<9F�H<5B�K<99N=B;�5B8�5
<=GHCFM�C:�C77ID5H=CB5@�9LDCGIF9�HC�5B 5@@9F;9B �9 ; ��5B=A5@ DFCH9=BG��AC@8�

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D - Interstitial lung disease

Explanation Why

#BH9FGH=H=5@�@IB;�8=G95G9 �#&���F9GI@HG�=B�DFC;F9GG=J9@M�KCFG9B=B; G<CFHB9GG�C:�6F95H<��5�8FM 7CI;<�


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C775G=CB5@@M �"CK9J9F� #&� F9GI@HG�=B F9GHF=7H=J9�@IB;�8=G95G9 �897F95G98�.&��5B8�BCFA5@�CF
=B7F95G98 �0�� 0�� �'CF9CJ9F��D5H=9BHG�K=H< #&� HMD=75@@M�<5J9�6=65G=@5F�=BGD=F5HCFM 7F57?@9G CB
5IG7I@H5H=CB F5H<9F�H<5B�K<99N=B;

E - Chronic obstructive pulmonary disease

Image

Explanation But

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�)*� G<CI@8�5@GC�F979=J9�H<9 DB9IAC7C775@�J577=B9 9J9FM��P��M95FG�5B8�H<9 =B:@I9BN5�J577=B9
5BBI5@@M

Explanation Why

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DFC;F9GG=J9@M�KCFG9B=B; 8MGDB95��5B�9B8�9LD=F5HCFM�K<99N9��5B8�5�8FM 7CI;<��K<=7<�ACGH�@=?9@M
=B8=75H9G 9AD<MG9A5�DF98CA=B5BH �)*� �#B 9AD<MG9A5��89GHFI7H=CB�C:�H<9�5@J9C@=�F9GI@HG�=B�5
897F95G98�GIF:579�5F95�:CF�5=F�9L7<5B;9� �&�) @9J9@G�5F9�H<9F9:CF9�897F95G98

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Question # 24

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:CF ��M95FG �"9�=G ����7A ���:99H ��=B��H5@@�5B8�K9=;<G ���?;������@6����'#�=G ���?;�A� �*<MG=75@
9L5A=B5H=CB�G<CKG F98I798�6F95H<�GCIB8G�CJ9F�H<9�@9:H�@IB;�:=9@8 �.<9F9�=G <MD9FF9GCB5B79�CB
D9F7IGG=CB�C:�H<9�@9:H�IDD9F�H<CF5L ��B L�F5M C:�H<9�7<9GH�=G�G<CKB �1<=7<�C:�H<9�:C@@CK=B;�7<5B;9G�=G
ACGH�@=?9@M�HC�=AA98=5H9@M�F9GI@H�:FCA�H<=G�D5H=9BH�G�7IFF9BH�7CB8=H=CB�

Answer Image

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Answer Image

� #B7F95G98�=BHF5�5@J9C@5F�DF9GGIF9

� #B7F95G98�D<MG=C@C;=75@�8958�GD579

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Hint

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Correct Answer

A - Increased transpulmonary pressure

Image

Explanation Why

.F5BGDI@ACB5FM�DF9GGIF9 =G�H<9�8=::9F9B79�69HK99B =BHF5�5@J9C@5F�DF9GGIF9 5B8�=BHF5D@9IF5@�DF9GGIF9


#B DB9IACH<CF5L��H<9�DF9GGIF9�=B�H<9 D@9IF5@�GD579 =B7F95G9G�8I9�HC�H<9�DF9G9B79�C:�5=F��@958=B;�HC
8=A=B=G<98��BCH�=B7F95G98� HF5BGDI@ACB5FM�DF9GGIF9

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B - Increased intra-alveolar pressure

Image

Explanation Why

#BHF5�5@J9C@5F�DF9GGIF9 KCI@8�69�IB7<5B;98�CF�9J9B�897F95G98�=B DB9IACH<CF5L ��CB8=H=CBG


=BJC@J=B;�=B7F95G98�=BHF5�5@J9C@5F�DF9GGIF9�=B7@I89 C6GHFI7H=J9�@IB;�8=G95G9G �9 ; � �)*�� 5GH<A5�
5B8 A97<5B=75@�J9BH=@5H=CB K=H<�=B7F95G98�DCG=H=J9�9B8�9LD=F5HCFM�DF9GGIF9��*��*�

C - Increased physiological dead space

Explanation Why

�958�GD579 =B7F95G9G�=B�7CB8=H=CBG�=B�K<=7<�5@J9C@=�5F9�J9BH=@5H98�6IH�BCH D9F:IG98 �9 ; � DI@ACB5FM


9A6C@=GA� �(CFA5@�CF�897F95G98 D<MG=C@C;=75@�8958�GD579 KCI@8�69�9LD97H98�=B DB9IACH<CF5L

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D - Increased pulmonary shunting

Image

Explanation But

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IB56@9�HC�DF9J9BH <MDCL9A=5 =B DB9IACH<CF5L

Explanation Why

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6IH�5F9�GH=@@ D9F:IG98 K=H<�89CLM;9B5H98�6@CC8�:FCA�H<9�F=;<H <95FH *9F:IG=CB C:�H<9�BCBJ9BH=@5H98
5@J9C@=�F9GI@HG�=B�897F95G98�CLM;9B5H=CB�C:�6@CC8�:@CK=B;�HC�H<9�@9:H <95FH �F=;<H�HC�@9:H�DI@ACB5FM
G<IBH=B;��5B8 <MDCL=5

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E - Increased lung compliance

Image

Explanation Why

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DF=A5FM�GDCBH5B9CIG�DB9IACH<CF5L 6975IG9�<9�=G�H5@@��G@=A��5B8�8C9G�BCH�<5J9�9J=89B79�C:
9AD<MG9A5HCIG 7<5B;9G��9 ; ��<MD9F=B:@5H=CB� 6I@@59��=B�H<9�F=;<H @IB; :=9@8 &IB;�7CAD@=5B79 =G�BCH
5::97H98�=B�5�D5H=9BH�K=H< DF=A5FM�GDCBH5B9CIG�DB9IACH<CF5L��K<=7<�=G�BCH�5GGC7=5H98�K=H<
IB89F@M=B; @IB; 8=G95G9

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Question # 25

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IB8=::9F9BH=5H98�79@@G K=H<�BI7@95F�D@9CACFD<=GA�5B8�56IB85BH�A=HCH=7�:=;IF9G �.<9�D5H=9BH�ACGH�@=?9@M
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HF5BGA=GG=CB�

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Hint

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Correct Answer

A - Sexual contact

Explanation Why

�=G95G9�HF5BGA=HH98�J=5�G9LI5@�7CBH57H�=B7@I89 <IA5B�=AAIBC89:=7=9B7M�J=FIG� <IA5B


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G97F9H=CBG��GI;;9GHG�H<9�DCGG=6=@=HM�C:�G9LI5@�HF5BGA=GG=CB���<CK9J9F��H<=G�DCGG=6=@=HM�=G�@9GG�@=?9@M
K<9B�7CAD5F98�HC�ACF9�7CAACB�FCIH9G�C: ��0 HF5BGA=GG=CB

B - Tick bite

Explanation Why

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HF5BGA=GG=CB�C: ��0

C - Transfer of saliva

Explanation Why

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D - Fecal-oral

Explanation Why

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5G75F=5G=G� 9BH9FC6=5G=G�� <9D5H=H=G����5B8 <9D5H=H=G�� ��0 =G�BCH�HF5BGA=HH98 :975@�CF5@@M

E - Blood transfusion

Explanation Why

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5ACB;�GCA9�D5H=9BHG��9 ; � GH9A�79@@ HF5BGD@5BH�F97=D=9BHG���H<=G�F=G?�=G�7CBG=89F56@M�@CK�K<9B
7CAD5F98�HC�CH<9F�ACF9�7CAACB�FCIH9G�C: ��0 HF5BGA=GG=CB

F - Mother to baby

Explanation Why

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=AAIBC89:=7=9B7M�J=FIG� <9D5H=H=G�� J=FIG� !FCID���GHF9DHC7C77IG��5B8 Listeria monocytogenes
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Me est i e s: https://t.me/USMLEMe est

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Question # 26

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Hint

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Correct Answer

A - Bronchiectasis

Explanation Why

�FCB7<=97H5G=G =G�7<5F57H9F=N98�6M�7<FCB=75@@M�8=@5H98 6FCB7<= 5B8�AI7CDIFI@9BH GDIHIA �#H�=G�A5=B@M


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�FCB7<=97H5G=G 7<5F57H9F=GH=75@@M�5DD95FG�5G�QHF5A�HF57?R�@=B9G�CF <CB9M7CA6=B; CB L�F5M��8I9�HC
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=A5;=B;�:=B8=B;G�7CBG=GH9BH�K=H< 6FCB7<=97H5G=G

B - Pneumocystis pneumonia

Explanation Why

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����79@@G�AA� A5?9G�H<=G�8=5;BCG=G�@9GG�@=?9@M

C - Adenocarcinoma in situ

Explanation Why

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D - Tuberculosis

Explanation Why

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8=::9F9BH�8=5;BCG=G �'CF9CJ9F��H<=G�D5H=9BH�G�7<9GH L�F5M @57?G�75J=H5FM�@9G=CBG�7<5F57H9F=GH=7�C: .�
.<9�<5NM�=B:=@HF5H9�=B�H<9�F=;<H�@CK9F @IB; :=9@8�=G�GI;;9GH=J9�C:�5�8=::9F9BH�8=5;BCG=G

E - Aspiration pneumonia

Explanation Why

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DC@MA=7FC6=5@�=B:97H=CB�8CA=B5H98�6M�;F5A�B9;5H=J9��9 ; � Klebsiella pneumoniae��5B8 5B59FC6=7
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Question # 27

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Hint

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Correct Answer

A - Elevated anti-Smith titers

Explanation Why

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7IH5B9CIG J5G7I@=H=G���I@79F5H=CB�C:�H<9�B5G5@ AI7CG5��5B8��F5F9@M��G9DH5@�D9F:CF5H=CB�89:CFA=H=9G
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IGI5@@M�69�DF9G9BH ��@GC��75J=H5H=B;��BC8I@5F�@9G=CBG�CB�5 7<9GH�L�F5M KCI@8�BCH�69�G99B�=B -&�

B - Elevated serum IgA titers

Explanation Why

-9FIA #;� H=H9FG A5M�69�=B7F95G98�=B�D5H=9BHG�K=H< #;��J5G7I@=H=G��K<=7<�75B�5@GC�DF9G9BH�K=H< :9J9F


�DFC8FCA5@���D5@D56@9 DIFDIF5� B9D<F=H=7�GMB8FCA9��5B8��F5F9@M� <9ACDHMG=G �"CK9J9F� #;��J5G7I@=H=G
HMD=75@@M�C77IFG�=B�7<=@8F9B��5B8�=H�KCI@8�BCH�9LD@5=B�H<9�D5H=9BH�G�CH<9F�7@=B=75@�:95HIF9G �#BGH958�
D5H=9BHG�IGI5@@M�<5J9�5�<=GHCFM�C:�7C@=7?M�568CA=B5@ D5=B

C - Elevated p-ANCA titers

Explanation But

#B7F95G98�@9J9@G�C: D��(�� 5F9�5@GC�7CAACB@M�G99B�K=H< 9CG=BCD<=@=7�;F5BI@CA5HCG=G�K=H<


DC@M5B;==H=G ��!*�� �<IF;�-HF5IGG�GMB8FCA9���K<=7<�75B�DF9G9BH�K=H< :9J9F� <9ACDHMG=G� <9A5HIF=5�
5B8 7<FCB=7�F<=BCG=BIG=H=G �5@@9F;=7� �"CK9J9F��G9DH5@�D9F:CF5H=CB�=G�F5F9��5B8�H<=G�D5H=9BH�G�CH<9F
:95HIF9G�KCI@8�BCH�69�G99B �#BGH958��D5H=9BHG�K=H< �!*� HMD=75@@M�DF9G9BH�K=H<�5�<=GHCFM�C: 6FCB7<=5@
5GH<A5��AI@H=:C75@�ACBCB9IFCD5H<M��5B8�CF�9J=89B79�C: 9CG=BCD<=@=5 CB�5 ���

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Explanation Why

.=H9FG C: D��(�� 5F9�=B7F95G98�=B�������C:�D5H=9BHG�K=H< ;F5BI@CA5HCG=G�K=H<�DC@M5B;==H=G �!*��


#BGH958� D��(�� H=H9FG 5F9�7CAACB@M�9@9J5H98�=B�D5H=9BHG�K=H< A=7FCG7CD=7�DC@M5B;==H=G �'*���
K<=7<�75B�DF9G9BH�J9FM�G=A=@5F@M�HC�H<=G�D5H=9BH��K=H<�=BJC@J9A9BH�C:�H<9 @IB;G �<9ACDHMG=G 8I9�HC
DI@ACB5FM J5G7I@=H=G���H<9 ?=8B9MG �;@CA9FI@CB9D<F=H=G���5B8�H<9 G?=B �D5@D56@9 DIFDIF5� �"CK9J9F�
=BJC@J9A9BH�C:�H<9�B5GCD<5FMBL��G9DH5@�D9F:CF5H=CB� G=BIG=H=G��I@79F5H=CB��=G�AI7<�ACF9�7CAACB�=B
!*� ������H<5B�=B '*� ����� �1<=@9 '*� 75BBCH�69�9BH=F9@M�9L7@I898�=B�H<=G�D5H=9BH�K=H<CIH
<=GHCD5H<C@C;=75@�9L5A=B5H=CB��H<9�9LH9BG=J9�IDD9F�F9GD=F5HCFM�HF57H�=BJC@J9A9BH�A5?9G !*� H<9
ACF9�@=?9@M�8=5;BCG=G

D - Positive tuberculin test

Explanation Why

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<9ACDHMG=G��5B8�AI@H=D@9��BC8I@5F��75J=H5H=B;�@9G=CBG�CB�7<9GH L�F5M �,5F9@M��G9DH5@�D9F:CF5H=CB��8I9
HC�89GHFI7H=CB�C:�H<9�G9DH5@ 75FH=@5;9 6M�;F5BI@CA5HCIG�@9G=CBG�� <9A5HIF=5 �8I9�HC ;9B=HCIF=B5FM
HI69F7I@CG=G���5B8�7IH5B9CIG�A5B=:9GH5H=CBG��G7FC:I@C89FA5 CF @IDIG�JI@;5F=G� 75B�5@GC�C77IF
"CK9J9F��H<9�CBG9H�C:�F9GD=F5HCFM�GMADHCAG��9 ; � 7CI;<� :9J9F��=G�IGI5@@M�GI657IH9�HC�7<FCB=7�K=H<
5B�=B8C@9BH�7CIFG9��IB@=?9�H<9�57IH9��9D=GC8=7�DF9G9BH5H=CB�=B�H<=G�D5H=9BH �)H<9F 7CBGH=HIH=CB5@
GMADHCAG GI7<�5G�K9=;<H�@CGG� A5@5=G9��5B8�CF�B=;<H�GK95HG�KCI@8�5@GC�69�DFCA=B9BH � IFH<9FACF9�
D5H=9BHG�K=H<�8=GG9A=B5H98 HI69F7I@CG=G KCI@8�IGI5@@M�<5J9�5�<=GHCFM�C:�=AA=;F5H=CB�:FCA�5B
9B89A=7 F9;=CB��5B8�CF�5B =AAIBC7CADFCA=G98�GH5H9 �9 ; � "#0 =B:97H=CB��H<9F5DM�K=H< 5BH=�.( �T
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E - Elevated c-ANCA titers

Image

Explanation Why

�DDFCL=A5H9@M�����C:�D5H=9BHG�K=H<�57H=J9 !*� 5B8�������C:�D5H=9BHG�K=H<�=B57H=J9 !*� <5J9


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B5GCD<5FMBL��G<CI@8�69�C6H5=B98�HC�7CB:=FA�H<9�8=5;BCG=G��G<CK=B; B97FCH=7��D5FH=5@@M�;F5BI@CA5HCIG
J5G7I@=H=G ��B�=B8=F97H =AAIBC:@ICF9G79B79 C:�H<9 6=CDGM G5AD@9�KCI@8�G<CK 7��(�� 5BH=6C8=9G 5G
5�;F5BI@5F�D5HH9FB�C:�:@ICF9G79B79�@=A=H98�HC�H<9 7MHCD@5GA �<9B79�Q7R��(��� �)J9F�H=A9��B5G5@
75FH=@5;9 89GHFI7H=CB�75B�@958�HC G588@9�BCG9�89:CFA=HM

F - Elevated anti-GBM titers

Explanation Why

�BH=�!�'�5BH=6C8=9G 5F9�G99B�=B !CC8D5GHIF9�GMB8FCA9��K<=7<�75B�5@GC�DF9G9BH�K=H< :9J9F�

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7<9GH L�F5M KCI@8�BCH�69�G99B �#BGH958��D5H=9BHG�<5J9�8=::IG9�=B:=@HF5H=B;�CD57=:=75H=CB�C:�H<9 @IB;
:=9@8G��8I9�HC 8=::IG9�5@J9C@5F�<9ACFF<5;9� � IFH<9FACF9��H<=G�D5H=9BH�G�CH<9F�7@=B=75@�:95HIF9G�5F9�BCH
75IG98�6M !CC8D5GHIF9�GMB8FCA9

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Question # 28

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9LH9B898�B97?�5B8�9L79GG=J9�8FCC@=B; �"9F�JC=79�=G�AI::@98�5B8�H<9F9�=G�=BGD=F5HCFM�GHF=8CF �.<9F9�=G
H9B89F�6=@5H9F5@�79FJ=75@�@MAD<589BCD5H<M�5B8�D5=B�IDCB�D5@D5H=CB�C:�H<9�<MC=8 �&56CF5HCFM�GHI8=9G
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75IG5@�CF;5B=GA�

Answer Image

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� -HF9DHC7C77IG�DMC;9B9G

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Hint

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GIDF5;@CHH=7�B5FFCK=B;��5@GC�?BCKB�5G�5�QH<IA6DF=BH�G=;BR �05F=CIG�8=G95G9G�DF9G9BH�K=H< =BGD=F5HCFM
GHF=8CF 5G�5�A5=B�8=5;BCGH=7�:95HIF9��6IH�CB@M 9D=;@CHH=H=G =G�BCH56@9�:CF�D5=B:I@ GK5@@CK=B;��<958
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Correct Answer

A - Haemophilus influenzae type b

Explanation Why

9J9F��D5=B:I@ GK5@@CK=B;��9L79GG=J9�8FCC@=B;��5�AI::@98�JC=79��5B8�H9B89F�79FJ=75@
@MAD<589BCD5H<M 5F9�GI;;9GH=J9�C: 9D=;@CHH=H=G ��@H<CI;<�H<=G�7CB8=H=CB�=G�ACF9�7CAACB�=B�7<=@8F9B
69HK99B���5B8����M95FG�C:�5;9��=H�75B�C77IF�5H�5BM�5;9 Haemophilus influenzae HMD9�6 �"=6��IG98�HC
69�H<9�ACGH�7CAACB�75IG9�C: 9D=;@CHH=H=G =B�H<9�/-��6IH�G=B79�H<9�=BHFC8I7H=CB�C:�H<9 "=6�J577=B9�
CH<9F�657H9F=5��S. pyogenes� S. pneumoniae� S. aureus��5F9�5@GC�7CAACB�=B�D98=5HF=7�75G9G �"CK9J9F�
"=6 =G�GH=@@�H<9�ACGH�7CAACB�75IG9�C: 9D=;@CHH=H=G =B�58I@HG������C:�75G9G���H<9�A5>CF=HM�C:�K<=7<
<5J9�BCH�M9H�F979=J98 J577=B5H=CB

B - Streptococcus pyogenes

Explanation Why

Streptococcus pyogenes =G�5�7CAACB�75IG9�C:�57IH9�657H9F=5@ HCBG=@@=H=G ��J9B�H<CI;< 57IH9�HCBG=@@=H=G


5@GC�<5G�5�GI889B�CBG9H�C: :9J9F� 8MGD<5;=5�C8MBCD<5;=5��5B8�H9B89F��79FJ=75@ @MAD<�BC89G��=H�8C9G
BCH�75IG9 =BGD=F5HCFM�GHF=8CF 5B8�5�AI::@98�JC=79 �#B�588=H=CB� 57IH9�657H9F=5@�HCBG=@@=H=G KCI@8�G<CK
F98��GKC@@9B HCBG=@G K=H<�DCGG=6@9 9LI85H9G

C - Adenovirus

Explanation Why

�89BCJ=FIG =G�5�7CAACB�75IG9�C: 57IH9�J=F5@�HCBG=@@=H=G ��J9B�H<CI;< 57IH9�HCBG=@@=H=G 5@GC�<5G�5


GI889B�CBG9H�C: :9J9F� 8MGD<5;=5�C8MBCD<5;=5��5B8�H9B89F��79FJ=75@ @MAD<�BC89G��=H�8C9G�BCH�75IG9
=BGD=F5HCFM�GHF=8CF 5B8�5�AI::@98�JC=79 �#B�588=H=CB� J=F5@�HCBG=@@=H=G KCI@8�G<CK�F98��GKC@@9B HCBG=@G
K=H<�DCGG=6@9 9LI85H9 5B8�H<9�7CB8=H=CB�=G�IGI5@@M�577CAD5B=98�6M <95857<9��95F D5=B��5B8�CF�B5G5@
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D - Corynebacterium diphtheriae

Explanation Why

Corynebacterium diphtheriae =G�H<9�75IG9�C: @5FMB;95@�8=D<H<9F=5��K<=7<�=G�5B�=ADCFH5BH�8=::9F9BH=5@


8=5;BCG=G�=B�D5H=9BHG�K=H< =BGD=F5HCFM�GHF=8CF� C8MBCD<5;=5��5B8�79FJ=75@ @MAD<589BCD5H<M �"CK9J9F�
IB@=?9�H<=G�D5H=9BH��D5H=9BHG�K=H< @5FMB;95@�8=D<H<9F=5 HMD=75@@M�DF9G9BH�K=H< 7CI;<��5�<C5FG9�F5H<9F
H<5B�5�AI::@98�JC=79��5B8�5�AI7<�G@CK9F�CBG9H�C:�GMADHCAG���P��85MG�

E - Parainfluenza virus

Explanation Why

*5F5=B:@I9BN5�J=FIG =G�H<9�ACGH�7CAACB�75IG9�C: 7FCID��K<=7<�=G�5B�=ADCFH5BH�8=::9F9BH=5@�8=5;BCG=G


=B�5�D5H=9BH�K=H< =BGD=F5HCFM�GHF=8CF �"CK9J9F� 7FCID HMD=75@@M�DF9G9BHG�K=H<�5 7CI;<��5�<C5FG9�F5H<9F
H<5B�AI::@98�JC=79��5B8�BC C8MBCD<5;=5 � IFH<9FACF9��5@ACGH�5@K5MG�C77IFG�=B�7<=@8F9B

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Question # 29

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C775G=CB5@@M�5B8�8C9G�BCH�8F=B?�5@7C<C@ �*<MG=75@�9L5A=B5H=CB�G<CKG 7@I66=B;�C:�H<9�:=B;9FG
�B8�=BGD=F5HCFM 7F57?@9G�5F9�<95F8�=B�6CH<�@CK9F�@IB;�:=9@8G ��B L�F5M C:�H<9�7<9GH�G<CKG�6=@5H9F5@
F9H=7I@CBC8I@5F�89BG=H=9G K=H<�=BH9FGH=H=5@�:=6FCG=G �'=7FCG7CD=7�9L5A=B5H=CB�C:�5�@IB;�6=CDGM�GD97=A9B
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A97<5B=GA�C:�H<=G�D5H=9BH�G�7CB8=H=CB�

Answer Image

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Answer Image

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Hint

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Correct Answer

A - Aspergillus-induced eosinophil release

Explanation Why

�7H=J5H=CB�C:�H<9 =AAIB9�GMGH9A 6M Aspergillus =G�G99B�=B�5@@�:CFAG�C: 5GD9F;=@@CG=G ��*�


F9G9A6@9G 5GH<A5 7@=B=75@@M��5B8�7CI@8�5@GC�75IG9 8MGDB95 5B8 7CI;<��5G�G99B�=B�H<=G�D5H=9BH 2�F5MG
C:�D5H=9BHG�K=H< 5GD9F;=@@CG=G 5F9�C:H9B�7<5F57H9F=N98�6M D5F9B7<MA5@ CD57=H=9G����*���CF�BC8I@9G
�7<FCB=7�DI@ACB5FM�5GD9F;=@@CG=G� �"CK9J9F� 5GD9F;=@@CG=G =G�ACF9�7CAACB@M�G99B�=B�D5H=9BHG�K<C
5F9 =AAIBC7CADFCA=G98 CF�<5J9�IB89F@M=B; @IB; 8=G95G9��IB@=?9@M�;=J9B�H<=G�D5H=9BH�G�<=GHCFM��5B8
=G�BCH�HMD=75@@M�5GGC7=5H98�K=H< ;F5BI@CA5 :CFA5H=CB

B - Silica-induced macrophage activation

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Explanation Why

�<FCB=7�=B<5@5H=CB�C:�G=@=75�;9B9F5H9G�CLM;9B :F99�F58=75@G H<5H�=B8I79 =B:@5AA5H=CB 5B8�57H=J5H=CB�C:


5@J9C@5F�A57FCD<5;9G �)J9F�H=A9��H<=G�75B�@958�HC :=6FCG=G��K<=7<�<5G�5�J9FM�G=A=@5F�5DD95F5B79�CB L�
F5M HC�K<5H�=G�G99B�=B�H<=G�D5H=9BH �"CK9J9F� G=@=7CG=G =G�BCH�5�;F5BI@CA5HCIG�8=G95G9�5B8�=G�ACF9
7CAACB@M�G99B�=B�7C5@�KCF?9FG�F5H<9F�H<5B�:5FA9FG

C - IgG-mediated immune complex deposition

Image

Explanation Why

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=G�ACGH�7CAACB@M�C6G9FJ98�=B�D5H=9BHG�K=H<�DFC@CB;98�9LDCGIF9�HC�GD97=:=7�8=G95G9�DF97=D=H5H=B;
5BH=;9BG��GI7<�5G�H<9�:IB;5@�GDCF9G�5B8�H<9FACD<=@=7 57H=BCAM79H9G :CIB8�=B�AC@8M�<5M �.<=G
9LDCGIF9�=B8I79G�5�A=L98 HMD9�###�<MD9FG9BG=H=J=HM�HMD9�#0�<MD9FG9BG=H=J=HM F957H=CB�H<5H�A5B=:9GHG
K=H< #;!�5BH=6C8M�5BH=;9B 7CAD@9L�89DCG=H=CB�=B�H<9 @IB; D5F9B7<MA5 5B8�J9GG9@�K5@@G�5B8
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D - IgE-mediated histamine release

Explanation Why

#;��A98=5H98 <=GH5A=B9 F9@95G9�=G�5�89:=B=B;�:95HIF9�C: 5HCD=7 7CB8=H=CBG�GI7<�5G 5@@9F;=7�F<=B=H=G�


5HCD=7�89FA5H=H=G��5B8 5GH<A5 �&=?9�H<=G�D5H=9BH��D5H=9BHG�K=H< 5GH<A5 A5M�DF9G9BH�K=H<�KCFG9B=B;
7CI;< 5B8 G<CFHB9GG�C:�6F95H< �"CK9J9F� 5GH<A5 8C9G�BCH�75IG9 8=;=H5@�7@I66=B;��DI@ACB5FM :=6FCG=G�
CF BCB75G95H=B;�;F5BI@CA5G

E - Elastase-mediated parenchymal destruction

Explanation Why

�L79GG=J9 9@5GH5G9 57H=J=HM�75IG9G�H<9 D5F9B7<MA5@ 89GHFI7H=CB�5B8�@CGG�C: 9@5GH=7�F97C=@


7<5F57H9F=GH=75@@M�G99B�=B T��5BH=HFMDG=B�89:=7=9B7M �&=?9�H<=G�D5H=9BH� T��5BH=HFMDG=B�89:=7=9B7M 75B
5@GC�DF9G9BH�K=H<�5�7<FCB=7 7CI;< 5B8�KCFG9B=B; G<CFHB9GG�C:�6F95H< �"CK9J9F��9LD97H98 L�F5M
:=B8=B;G�KCI@8�=B7@I89 @IB; <MD9F=B:@5H=CB�5B8�=B7F95G98�@I79B7M��F5H<9F�H<5B�H<9 :=6FCH=7 7<5B;9G
G99B�<9F9

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Question # 30

� ���M95F�C@8 A5B�=G�6FCI;<H�HC�H<9�9A9F;9B7M�89D5FHA9BH�6975IG9�C:�5�:9J9F��7CI;<��D@9IF=H=7�7<9GH
D5=B��5B8�8MGDB95 �.KC�85MG�5;C��<9�F9HIFB98�:FCA�5�7CBGHFI7H=CB�G=H9�5@CB;�H<9 '=GG=GG=DD=�,=J9F
�68CA=B5@�9L5A=B5H=CB�G<CKG�5�D5@D56@9�GD@99B ��B L�F5M C:�H<9�7<9GH�G<CKG�8=::IG9�F9H=7I@CBC8I@5F
=B:=@HF5H9G �.<9F5DM�K=H<�5 8FI;�H<5H�6=B8G�9F;CGH9FC@ =G�=B=H=5H98 �.<=G�D5H=9BH�=G�ACGH�@=?9@M�HC�9LD9F=9B79
K<=7<�C:�H<9�:C@@CK=B;�58J9FG9�9::97HG�

Answer Image

� "MDCA5;B9G9A=5

� "=GH5A=B9�F9@95G9

� &9I?CD9B=5

� �MG;9IG=5

� �MHC7<FCA9�*����=B8I7H=CB

!MB97CA5GH=5

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Hint

.<=G�D5H=9BH�G�DF9G9BH5H=CB�C: DB9IACB=5 5B8 GD@9BCA9;5@M =B�H<9�G9HH=B;�C:�F979BH�HF5J9@�HC�H<9


'=GG=GG=DD=�,=J9F�05@@9M�GI;;9GHG�=B:97H=CB�K=H< <=GHCD@5GACG=G �AD<CH9F=7=B����5B 5BH=:IB;5@ 8FI;�H<5H
6=B8G�HC 9F;CGH9FC@ =B�H<9�:IB;5@ 79@@�A9A6F5B9 5B8�H<9F96M�8=GFIDHG�=H��=G�H<9�HF95HA9BH�C:�7<C=79�:CF
D5H=9BHG�K=H<�G9J9F9 <=GHCD@5GACG=G

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Correct Answer

A - Hypomagnesemia

Explanation But

�M�75IG=B;�=B7F95G98�F956GCFDH=CB�C:�"� =CBG� 5AD<CH9F=7=B�� HF95HA9BH�75B�9J9BHI5@@M�@958�HC HMD9��


F9B5@�HI6I@5F�57=8CG=G

Explanation Why

"MDCA5;B9G9A=5 =G�5�G=89�9::97H�C: 5AD<CH9F=7=B�� �$IGH�5G�=H�6=B8G�HC 9F;CGH9FC@ =B�:IB;5@ 79@@


A9A6F5B9G� 5AD<CH9F=7=B�� 75B�5@GC�6=B8�HC 7<C@9GH9FC@ =B�<IA5B�79@@G �.<=G�G=89�9::97H�75B�C77IF�=B
F9B5@�HI6I@5F�79@@G��K=H<�5�F9GI@H=B;�=B7F95G9�=B�A9A6F5B9�D9FA956=@=HM�H<5H�@958G�HC�=B7F95G98
8=::IG=CB C:�"� =CBG�:FCA�H<9 IF=B9 657?�=BHC�H<9�79@@G �.<=G�"� =CB�ACJ9A9BH�7F95H9G�5�:5JCF56@9
7CB79BHF5H=CB�;F58=9BH�:CF 8=::IG=CB C: A5;B9G=IA :FCA�H<9�F9B5@�HI6I@5F�79@@G�HC�H<9�HI6I@5F�@IA9B�
H<9F96M�@958=B;�HC�=B7F95G98 A5;B9G=IA 9L7F9H=CB�=B�H<9 IF=B9

B - Histamine release

Explanation Why

"=GH5A=B9 F9@95G9�=G�5�G=89�9::97H�C: 97<=BC75B8=BG 5B8�@958G�HC�F5G<� <MDCH9BG=CB��5B8 5B;=C989A5


�7<=BC75B8=BG =B<=6=H�H<9�GMBH<9G=G�C: V�;@I75B��5�7CADCB9BH�C:�H<9�:IB;5@ 79@@�K5@@ �"CK9J9F��H<9M
8C�BCH�6=B8 9F;CGH9FC@ "=GH5A=B9 F9@95G9�=G�BCH�5�G=89�9::97H�C: 5AD<CH9F=7=B��

C - Leukopenia

Explanation Why

&9I?CD9B=5 75B�C77IF�=B 6CB9�A5FFCK�GIDDF9GG=CB��K<=7<�=G�5�G=89�9::97H�C:�H<9 5BH=:IB;5@


:@I7MHCG=B9 @I7MHCG=B9 9BH9FG�:IB;5@�79@@G��K<9F9�:IB;5@ 7MHCG=B9�895A=B5G9 7CBJ9FHG�H<9�8FI;�HC
��:@ICFCIF57=@ �� / H<9B�=B<=6=HG�:IB;5@ �(� 5B8 ,(� GMBH<9G=G �"CK9J9F� :@I7MHCG=B9 8C9G�BCH

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6=B8 9F;CGH9FC@ &9I?CD9B=5 =G�BCH�5�G=89�9::97H�C: 5AD<CH9F=7=B��

D - Dysgeusia

Explanation Why

�MG;9IG=5 =G�5�G=89�9::97H�C:�H<9 5BH=:IB;5@ H9F6=B5:=B9 �1<=@9 H9F6=B5:=B9 897F95G9G 9F;CGH9FC@


GMBH<9G=G�H<FCI;<�=B<=6=H=CB�C:�H<9�:IB;5@�9BNMA9 GEI5@9B9�9DCL=85G9��=H�8C9G�BCH�8=F97H@M�6=B8
9F;CGH9FC@ �MG;9IG=5 =G�BCH�5�G=89�9::97H�C: 5AD<CH9F=7=B��

E - Cytochrome P450 induction

Explanation Why

�MHC7<FCA9�*��� =B8I7H=CB�8C9G�BCH�C77IF�K=H< 5AD<CH9F=7=B�� 6IH�=G�5�G=89�9::97H�C:�H<9 5BH=:IB;5@


;F=G9C:I@J=B��K<=7<�KCF?G�6M�=BH9F:9F=B;�K=H< A=7FCHI6I@9 :IB7H=CB��H<9F96M�8=GFIDH=B;�:IB;5@
A=HCG=G !F=G9C:I@J=B 8C9G�BCH�6=B8�HC 9F;CGH9FC@

F - Gynecomastia

Explanation But

�MHC7<FCA9�*����=B<=6=H=CB =G�5BCH<9F�=ADCFH5BH�G=89�9::97H�C: ?9HC7CB5NC@9

Explanation Why

!MB97CA5GH=5 C77IFG�G97CB85FM�HC�=B<=6=H=CB�C: 5B8FC;9B GMBH<9G=G�5B8�H<9�F9GI@H=B;�=B7F95G9�=B�H<9


9GHF58=C@�H9GHCGH9FCB9 F5H=C �-I7<�5B�=B7F95G9�C77IFG�5G�5�G=89�9::97H�C: ?9HC7CB5NC@9 HF95HA9BH �1<=@9
?9HC7CB5NC@9 75B�897F95G9 9F;CGH9FC@ GMBH<9G=G��=H�8C9G�BCH�6=B8�HC 9F;CGH9FC@ =B�H<9�:IB;5@ 79@@
A9A6F5B9 !MB97CA5GH=5 =G�BCH�5�G=89�9::97H�C: 5AD<CH9F=7=B��

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Question # 31

�B ��M95F�C@8 6CM�=G�6FCI;<H�HC�H<9�9A9F;9B7M�89D5FHA9BH�6975IG9�C: G<CFHB9GG�C:�6F95H<�5B8�8FM�7CI;<


:CF ��85MG �"=G�GMADHCAG�69;5B�5:H9F�<9�<9@D98�<=G�:5H<9F 7@95B�H<9�65G9A9BH �"9�=G 5@@9F;=7�HC�G<9@@:=G<
,9GD=F5H=CBG�5F9����A=B �*<MG=75@�9L5A=B5H=CB�G<CKG�8=::IG9 9B8�9LD=F5HCFM K<99N=B;�5B8�897F95G98
=BGD=F5HCFM�HC�9LD=F5HCFM F5H=C �.<=G�D5H=9BH�G�GMADHCAG�5F9�ACGH�@=?9@M�69=B;�75IG98�6M�=B:@5AA5H=CB�C:
K<=7<�C:�H<9�:C@@CK=B;�GHFI7HIF9G�

Answer Image

� *@9IF5@�75J=HM

� �@J9C@=

� ,9GD=F5HCFM�6FCB7<=C@9G

� �=GH5@�HF57<95

� .9FA=B5@�6FCB7<=C@9G

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Hint

#B�5�D5H=9BH�K=H<�5�<=GHCFM�C: 5HCDM��K<99N=B;�5B8�DFC@CB;98�9LD=F5HCFM�D<5G9�5:H9F�9LDCGIF9�HC 5@@9F;9BG


�AC@8�GDCF9G��5F9�ACGH�@=?9@M�G=;BG�C: 5GH<A5

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Correct Answer

A - Pleural cavity

Explanation Why

�GH<A5 HMD=75@@M�<5G�BC�9::97H�CB�H<9 D@9IF5@�75J=HM #B:@5AA5H=CB =B�H<9 D@9IF5@�75J=HM 75B�69�8I9�HC


5B 9ADM9A5��K<=7<�HMD=75@@M�DF9G9BHG�K=H< :9J9F� D@9IF=H=7�7<9GH�D5=B��5B8 8MGDB95��K<=7<�=G
=B7CBG=GH9BH�K=H<�H<9�D5H=9BH�G�DF9G9BH5H=CB

B - Alveoli

Explanation Why

�975IG9�5@J9C@=�5F9�GC�H<=B�K5@@98�5B8�@57? GACCH<�AIG7@9��H<9M�8C�BCH�7CBHF=6IH9�G=;B=:=75BH@M�HC
H<9 6FCB7<CGD5GA H<5H�75IG9G�ACGH�C:�H<9�GMADHCAG�=B 5GH<A5 #B:@5AA5H=CB 5H�H<9�5@J9C@IG�=G
7CAACB�=B <MD9FG9BG=H=J=HM�DB9IACB=H=G��K<=7<�IGI5@@M�F9GI@HG�:FCA�9LDCGIF9�HC�6=F8G�CF�AC@8M
D@5BH�A5HH9F �.<CI;<�H<=G�D5H=9BH�<5G�5�F979BH�AC@8�9LDCGIF9��<=G�DF9G9BH5H=CB�=G�BCH�HMD=75@�C:
<MD9FG9BG=H=J=HM�DB9IACB=H=G��K<=7<�IGI5@@M�DF9G9BHG�K=H< :@I�@=?9�GMADHCAG� 8MGDB95 K=H<CIH
K<99N=B;��5B8 F5@9G CB 5IG7I@H5H=CB

C - Respiratory bronchioles

Explanation Why

1<=@9 =B:@5AA5H=CB C:�H<9 F9GD=F5HCFM�6FCB7<=C@9G 75B�C77IF�=B 5GH<A5��=H�8C9G�BCH�7CBHF=6IH9


G=;B=:=75BH@M�HC�H<9�CBG9H�C:�GMADHCAG ,9GD=F5HCFM�6FCB7<=C@9G 8CB�H�<5J9�7CB79BHF=7 GACCH<
AIG7@9��5G�H<9F9�5F9�;5DG�=B�H<9=F�K5@@G�K<9F9�5@J9C@=�6F5B7<�CIH ��975IG9�C:�H<=G� F9GD=F5HCFM
6FCB7<=C@9G 5F9�BCH�H<9�ACGH�@=?9@M�@C75H=CB�C: 6FCB7<C7CBGHF=7H=CB 5B8 5=FK5M C6GHFI7H=CB

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D - Distal trachea

Explanation Why

.<9 8=GH5@ HF57<95 <5G 75FH=@5;=BCIG F=B;G�HC�?99D�H<9 5=FK5M D5H9BH��5B8�5G�5�F9GI@H��8C9G�BCH


7CBHF=6IH9�G=;B=:=75BH@M�HC�H<9 6FCB7<CGD5GA H<5H�75IG9G�ACGH�C:�H<9�GMADHCAG�C: 5GH<A5
#B:@5AA5H=CB C:�H<9 HF57<95 =G�7CAACB�=B 7FCID��5�8=G95G9�H<5H�HMD=75@@M�DF9G9BHG�K=H<�5�65F?=B;
7CI;< :C@@CK=B;�5 /,#�@=?9 DFC8FCA9

E - Terminal bronchioles

Explanation Why

.<9�GMADHCAG�C: 5GH<A5 5F9�DF=A5F=@M�75IG98�6M =B:@5AA5H=CB C:�H<9 H9FA=B5@�6FCB7<=C@9G .9FA=B5@


6FCB7<=C@9G 5F9�@=B98�K=H< GACCH<�AIG7@9 6IH�@57?�H<9 75FH=@5;9 :CIB8�=B�@5F;9F 5=FK5MG �1<9B�5B
5@@9F;9B HF=;;9FG�5 <MD9FG9BG=H=J=HM�F957H=CB H<9F9�=G�6FCB7<=5@ GI6AI7CG5@ 989A5 5B8 GACCH<�AIG7@9
7CBHF57H=CB�5B8�H<9 5=FK5MG 7C@@5DG9��5G�H<9M�8CB�H�<5J9�H<9�GIDDCFH�C: 75FH=@5;9 �.<=G�7C@@5DG9�@958G
HC�H<9�GMADHCAG�C: 5GH<A5

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Question # 32

��DF9J=CIG@M�<95@H<M ���M95F�C@8 KCA5B�7CA9G�HC�H<9�D<MG=7=5B�K=H<�5 CB9�K99? <=GHCFM�C:�DFC8I7H=J9


7CI;<�5B8�:5H=;I9 �.KC�K99?G�5;C��G<9�<58�:9J9F��B5G5@�7CB;9GH=CB��F<=BCFF<95��5B8�AM5@;=5G�H<5H
F9GC@J98�K=H<�GIDDCFH=J9�75F9 �-<9�<5G�BCH�HF5J9@98�CIH�C:�H<9�/B=H98�-H5H9G �*I@ACB5FM�9L5A=B5H=CB
G<CKG 8I@@B9GG�HC�D9F7IGG=CB�5B8�=B7F95G98�:F9A=HIG 5H�H<9�F=;<H�A=88@9�@C69 ��B L�F5M C:�H<9�7<9GH�=G
G<CKB ���GDIHIA�G5AD@9�=G�ACGH�@=?9@M�HC�G<CK�K<=7<�C:�H<9�:C@@CK=B;�:=B8=B;G�

Answer Image

� !F5A�DCG=H=J9��75H5@5G9�DCG=H=J9�7C77=

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Answer Image

� -=@J9F�GH5=B=B;��;F5A�B9;5H=J9�657=@@=

� !F5A�=B89H9FA=B5H9��57=8�:5GH�657H9F=5

� !F5A�DCG=H=J9��69H5�<9AC@MH=7�7C77=�=B�7<5=BG

� -9DH5H9��57IH9�6F5B7<=B;�<MD<59

�B75DGI@5H98��;F5A�B9;5H=J9�7C77C657=@@=

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Hint

.<=G�D5H=9BH�G�7<9GH L�F5M G<CKG�5�@5F;9�=FF9;I@5F@M�FCIB898�75J=HM�K=H<�5B 5=F�:@I=8 @9J9@�=B�H<9�F=;<H


A=88@9�@C69��=B8=75H=B;�5 @IB;�56G79GG

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Correct Answer

A - Gram-positive, catalase-positive cocci

Explanation Why

� GDIHIA G5AD@9�=G�ACGH�@=?9@M�HC�G<CK Staphylococcus aureus��K<=7<�75B�75IG9 @IB;�56G79GG9G�


9GD97=5@@M�=B�75G9G�C:�F979BH�CF�7IFF9BH =B:@I9BN5�J=FIG =B:97H=CB��5G�=G�@=?9@M�H<=G�75G9�=B�H<=G�D5H=9BH�
)H<9F�D5H<C;9BG�=AD@=75H98�=B�ACBCA=7FC6=5@ @IB;�56G79GG9G =B7@I89 Klebsiella pneumoniae��5B8
Streptococcus anginosus �'I@H=A=7FC6=5@�=B:97H=CB�K=H< 5B59FC6=7�657H9F=5 H<5H�7C@CB=N9�H<9 CF5@
75J=HM =G�ACF9�7CAACB

B - Silver-staining, gram-negative bacilli

Image

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Explanation Why

-=@J9F�GH5=B=B;��;F5A�B9;5H=J9 657=@@= =B�7CA6=B5H=CB�K=H< 7CI;< 5B8 :9J9F KCI@8�F5=G9�GIGD=7=CB�C:


Legionella DB9IACB=5 75IG98�6M Legionella pneumophila &9;=CB9@@CG=G 8C9G�BCH�7CAACB@M�75IG9
56G79GG :CFA5H=CB��6IH�F5H<9F 5HMD=75@�DB9IACB=5 ��LD97H98�7<9GH L�F5M :=B8=B;G�=B�D5H=9BHG�K=H<
5HMD=75@�DB9IACB=5 KCI@8�=B7@I89�8=::IG9��DI@ACB5FM =BH9FGH=H=5@ =B:=@HF5H9G

C - Gram-indeterminate, acid-fast bacteria

Explanation Why

Mycobacterium tuberculosis =G�5�;F5A�=BH9FA98=5H9� 57=8�:5GH 657H9F=5�K<=7<�75IG9G HI69F7I@CG=G


.<=G�D5H=9BH�<5G�BC�<=GHCFM�C:�F979BH�HF5J9@��7CBH57H�K=H<�=B:97H98�D5H=9BHG��=B75F79F5H=CB��BIFG=B;
<CA9G�� "#0 =B:97H=CB��CF�CH<9F F=G?�:57HCFG HC�GI;;9GH HI69F7I@CG=G

D - Gram-positive, beta-hemolytic cocci in chains

Explanation Why

.<9�DF9G9B79�C:�;F5A�DCG=H=J9� 69H5�<9AC@MH=7 7C77= KCI@8�GI;;9GH�=B:97H=CB�K=H< ;FCID��


GHF9DHC7C77= �9 ; � Streptococcus pyogenes� ��@H<CI;< ;FCID���GHF9DHC7C77= 75B�75IG9 IDD9F
F9GD=F5HCFM�=B:97H=CBG �9 ; � D<5FMB;=H=G� G75F@9H�:9J9F��5B8 G?=B�=B:97H=CBG �9 ; � =AD9H=;C�� DB9IACB=5
5B8 @IB;�56G79GG =B�5�DF9J=CIG@M�<95@H<M�D5H=9BH�KCI@8�69�J9FM�IBIGI5@ �.<=G�D5H=9BH�G�F979BH
GMADHCAG�C:�5B =B:@I9BN5 =B:97H=CB�A5?9�5�8=::9F9BH�D5H<C;9B�ACF9�@=?9@M

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E - Septate, acute-branching hyphae

Image

Explanation Why

-9DH5H9��57IH9�6F5B7<=B; <MD<59 KCI@8�69�=B8=75H=J9�C:�=B:97H=CB�K=H< Aspergillus fumigatus��K<=7<


75B�C77IF�=B�DF9�9L=GH=B; @IB; 75J=H=9G��9 ; ��:FCA �)*� CF 9AD<MG9A5� �#H�A5M�5@GC�75IG9 =BJ5G=J9
5GD9F;=@@CG=G =B =AAIBC7CADFCA=G98 D5H=9BHG��K<=7<�7@5GG=75@@M�DF9G9BHG�K=H<�DI@ACB5FM�BC8I@9G
5B8�CF�5B 5=F�7F9G79BH�G=;B �GD9F;=@@CG=G =G�BCH�5�7CAACB�75IG9�C: @IB;�56G79GG

F - Encapsulated, gram-negative coccobacilli

Explanation Why

Haemophilus influenzae =G�5B�9B75DGI@5H98��;F5A�B9;5H=J9�7C77C657=@@IG ��@H<CI;< Hemophilus


influenzae =G�5�7CAACB�75IG9�C: CH=H=G�A98=5 =B�7<=@8F9B�5B8 DB9IACB=5 =B�H<9�9@89F@M��=H�=G�BCH�5
7CAACB�75IG9�C: @IB;�56G79GG

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Question # 33

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Answer Image

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Hint

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Correct Answer

A - 2nd left intercostal space along the midclavicular line

Explanation But

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897CADF9GG=CB�C:�5 H9BG=CB�DB9IACH<CF5L =B�58I@HG �.<=G�@C75H=CB�=G�5GGC7=5H98�K=H<�<=;<�:5=@IF9
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=BH9F7CGH5@�GD579 5@CB;�H<9 A=85L=@@5FM�@=B9 =G�DF9:9F56@9

Explanation Why

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<MDCH9BG=CB 5B8 H57<M75F8=5��GC�H<9 DB9IACH<CF5L G<CI@8�69�897CADF9GG98�5G�EI=7?@M�5G�DCGG=6@9
-=B79�H<9�B9IFCJ5G7I@5F�6IB8@9�FIBG�69@CK�957< F=6��H<9�IDD9F�98;9�C:�H<9 F=6 =G�H<9�DF9:9FF98
DIB7HIF9�G=H9�HC�<9@D�A=H=;5H9�H<9�F=G?�C:�9L79GG=J9�6@998=B;�5B8�B9FJ9�85A5;9 ��A9F;9B7M B998@9
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A=85L=@@5FM�@=B9

B - 5th left intercostal space along the midaxillary line

Explanation Why

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7<=@8F9B

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C - 8th left intercostal space along the posterior axillary line

Explanation Why

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5@GC�DF9G9BHG�K=H<�57IH9�F9GD=F5HCFM�8=GHF9GG��F98I798 =DG=@5H9F5@ 7<9GH�9LD5BG=CB��5B8 7CBHF5@5H9F5@
HF57<95@�89J=5H=CB 5G�G99B�<9F9��=H�75IG9G�8I@@B9GG�HC�D9F7IGG=CB��BCH�<MD9FF9GCB5B79

D - Subxiphoid space in the left sternocostal margin

Explanation Why

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D9F=75F8=C79BH9G=G .57<M75F8=5� <MDCH9BG=CB��5B8�8=GH9B898�B97? J9=BG 75B�5@GC�69�G99B�=B
D9F=75F8=5@�H5ADCB589 �"CK9J9F��897F95G98�6F95H<�GCIB8G�5B8�<MD9FF9GCB5B79�CB�D9F7IGG=CB�C:�H<9
@9:H @IB; 5F9�BCH�:95HIF9G�C: D9F=75F8=5@�H5ADCB589

E - 5th left intercostal space along the midclavicular line

Explanation Why

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=BG9FH=CB�5H�H<=G�G=H9�8C9G�BCH�DFCJ=89�897CADF9GG=CB�C:�5 H9BG=CB�DB9IACH<CF5L

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Question # 34

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6@CC8�H=B;98 GDIHIA �"=G�H9AD9F5HIF9�=G �� �O������ �O � 5B8�F9GD=F5H=CBG�5F9 ���A=B �*<MG=75@
9L5A=B5H=CB�G<CKG�7C5FG9�=BGD=F5HCFM�7F57?@9G�CJ9F�H<9�F=;<H�@IB;�:=9@8 �-DIHIA�7I@HIF9G�;FCK
;F5A�B9;5H=J9��9B75DGI@5H98�657=@@=�H<5H�5F9�F9G=GH5BH�HC�5ACL=7=@@=B��79:HF=5LCB9��5B8�5NHF9CB5A �1<=7<
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CF;5B=GA�HC�CH<9F�D5H=9BHG�=B�H<9�<CGD=H5@�

Answer Image

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Hint

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Correct Answer

A - Require all staff and visitors to wear droplet masks

Explanation Why

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F9GD=F5HCFM�G97F9H=CBG �.<9G9�=B7@I89 Neisseria meningitidis� =B:@I9BN5� Bordetella pertussis��5B8
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=B�H<=G�D5H=9BH

B - Transfer patient to a positive pressure room

Explanation Why

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69=B;�8F5KB�=BHC�H<9�FCCA �.<=G�=G�BCH�=B8=75H98�=B�H<=G�D5H=9BH�5G�<9�=G�BCH =AAIBC7CADFCA=G98�
5B8�=H�KCI@8�BCH�<9@D�F98I79�HF5BGA=GG=CB�C: �-�&

C - Require autoclave sterilization of all medical instruments

Explanation Why

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D - Isolate patient to a single-occupancy room

Explanation Why

'I@H=8FI;�F9G=GH5BH�GHF5=BG�C:�657H9F=5��GI7<�5G �-�&��5F9�5�;F95H9F�DI6@=7�<95@H<�<5N5F8�H<5B�5�HMD=75@
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DF975IH=CBG 5B8�GHF=7H�<5B8�<M;=9B9��D5H=9BHG�G<CI@8�69�=GC@5H98�=B�G=B;@9�C77ID5B7M�FCCAG

E - Transfer patient to a negative pressure room

Explanation Why

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5@@CK=B;�5=F�HC�:@CK�=BHC�5B8�DF9J9BH=B;�5=F�:FCA�:@CK=B;�CIH�C:�H<9�FCCA �'CJ=B;�H<9�D5H=9BH�HC�5
B9;5H=J9�DF9GGIF9�FCCA�=G�BCH�B979GG5FM�HC�DF9J9BH�HF5BGA=GG=CB�C: �-�&

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Question # 35

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G=HH=B;�DCG=H=CB ��:H9F =B<5@=B;�5 K5H9F�GC@I6@9 ;5G�H<5H�F5D=8@M�7CA6=B9G�K=H<�<9AC;@C6=B��H<9
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Answer Image

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Hint

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Correct Answer

A - Entering a cold chamber

Explanation Why

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8=::IG=CB 57FCGG�H<9�5@J9C@5F�A9A6F5B9 ��C@8�5=F�5@GC�=B8I79G�6FCB7<C7CBGHF=7H=CB��:IFH<9F�F98I7=B;
H<9�JC@IA9�C:�;5G�F957<=B;�H<9�5@J9C@5F�A9A6F5B9

B - Deep exhalation

Explanation Why

�=::IG=CB�75D57=HM 7<5B;9G�8IF=B;�H<9�=B<5@5H=CB�9L<5@5H=CB�7M7@9�5G�5�F9GI@H�C:�7<5B;=B;�GIF:579
5F95 �.<9�=B7F95G98�JC@IA9�8IF=B;�=B<5@5H=CB�=B7F95G9G�H<9�5J5=@56@9�GIF:579�5F95�5B8�H<IG�5@GC�H<9
8=::IG=CB F5H9��K<=@9�H<9�897F95G98�JC@IA9�8IF=B;�899D�9L<5@5H=CB�897F95G9G�H<9 8=::IG=CB�75D57=HM

C - Standing straight

Explanation Why

�@CC8�:@CK�HC�H<9 @IB;G =G�5::97H98�6M�;F5J=HM �&M=B; GID=B9 F9GI@HG�=B�5�IB=:CFA�8=GHF=6IH=CB�C:�6@CC8


H<FCI;<CIH�H<9 @IB;G��D9FA=HH=B;�CDH=A5@ 8=::IG=CB =B�H<9�IDD9F�@C69G�5H�H<9�G5A9�F5H9�5G�H<9�@CK9F
@C69G �#B�7CBHF5GH��GH5B8=B;�D9FA=HG�CDH=A5@ 8=::IG=CB CB@M�=B�H<9�@CK9F�@C69G��897F95G=B;�CJ9F5@@
5@J9C@5F D9F:IG=CB 5B8�GI6G9EI9BH@M�F98I7=B; 8=::IG=CB�75D57=HM

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D - Performing Valsalva maneuver

Explanation Why

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5@J9C@5F�65FF=9F �.<=G�897F95G9G�H<9 8=::IG=CB C:�H<9�;5G�57FCGG�H<9�5@J9C@5F�A9A6F5B9

E - Treadmill exercise

Explanation But

.<9�89GHFI7H=CB�C:�5@J9C@5F�K5@@G�=B 9AD<MG9A5 ;F95H@M�F98I79G�H<9�GIF:579�5F95�5J5=@56@9�:CF ;5G


9L7<5B;9 =B�H<9 @IB;G��G=;B=:=75BH@M�@CK9F=B; 8=::IG=CB�75D57=HM

Explanation Why

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F - Assuming a hunched position

Explanation Why

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K=H<�5�G9J9F9 ?MD<CG=G <5J9�F98I798 8=::IG=CB�75D57=HM J=5�H<9�G5A9�A97<5B=GA

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Question # 36

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Hint

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Correct Answer

A - Smoking cessation

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Explanation Why

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B - Breathing exercises

Explanation Why

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C - Salmeterol therapy

Explanation Why

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D - Fluticasone therapy

Explanation Why

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E - Alpha-1 antitrypsin therapy

Explanation Why

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Question # 37

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Correct Answer

A - Increased pulmonary vascular resistance

Explanation Why

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8=J=898�6M�H<9�F5H9�C:�6@CC8�:@CK��75F8=57�CIHDIH��HF5J9@=B;�H<FCI;<�H<=G�7=F7I=H ��L9F7=G9�=B7F95G9G
75F8=57�CIHDIH :FCA�H<9 F=;<H�J9BHF=7@9 5B8�F97FI=HG�DF9J=CIG@M�IBD9F:IG98�DI@ACB5FM�J9GG9@G �.<9
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DI@ACB5FM�J5G7I@5F�F9G=GH5B79

B - Decreased physiologic dead space

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Explanation Why

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C - Decreased alveolar-arterial oxygen gradient

Explanation Why

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D - Increased arterial partial pressure of oxygen

Explanation Why

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E - Increased apical ventilation-perfusion ratio

Explanation Why

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Question # 38

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Correct Answer

A - Increased apical ventilation with normal perfusion bilaterally

Explanation Why

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B - Normal ventilation with multiple, bilateral perfusion defects

Explanation Why

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C - Matched ventilation and perfusion bilaterally

Explanation Why

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5@J9C@=�5B8�H<9 75D=@@5FM�698 �)H<9F�DCGG=6=@=H=9G�=B7@I89�H<9�7CA6=B5H=CB�C:�HKC�G9D5F5H9�7CB8=H=CBG�
C:�K<=7<�CB9�75IG9G�5@J9C@5F <MDCJ9BH=@5H=CB �9 ; � CD=C=8�=BHCL=75H=CB��5B8�H<9�CH<9F�75IG9G
DI@ACB5FM�<MDCD9F:IG=CB��9 ; � F=;<H�G=898�<95FH�:5=@IF9��G9J9F9 <MDCH9BG=CB� �.<=G�D5H=9BH�G<CKG
G=;BG�C: DI@ACB5FM�989A5��K<=7<�KCI@8�DF9G9BH�K=H<�8=::9F9BH�:=B8=B;G

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D - Normal perfusion with bilateral ventilation defects

Image

Explanation But

)H<9F�7CB8=H=CBG�H<5H�75B�F9GI@H�=B J9BH=@5H=CB�D9F:IG=CB�A=GA5H7< =B7@I89 DB9IACB=5 �=AD5=F98


J9BH=@5H=CB��5B8 DI@ACB5FM�9A6C@=GA �=AD5=F98 D9F:IG=CB�

Explanation Why

�F95G�K=H<�BCFA5@ D9F:IG=CB 5B8�BC�J9BH=@5H=CB��J9BH=@5H=CB�D9F:IG=CB�A=GA5H7<��5F9�G99B�=B�D5H=9BHG


K=H<�75F8=C;9B=7 DI@ACB5FM�989A5 ��@9J5H98�DI@ACB5FM�J9BCIG�DF9GGIF9G��G97CB85FM�HC�897F95G98
@9:H�J9BHF=7I@5F :IB7H=CB��F9GI@HG�=B�=B7F95G98�5ACIBHG�C:�=BHF5�5@J9C@5F�:@I=8��K<=7<�@958G�HC�=AD5=F98
5@J9C@5F�J9BH=@5H=CB �#BGI::=7=9BH@M�CLM;9B5H98�6@CC8�:FCA�D5FHG�C:�H<9 @IB;G H<5H�5F9�BCH�J9BH=@5H98
A=L9G�K=H<�CLM;9B5H98�6@CC8�:FCA�J9BH=@5H98�D5FHG�C:�H<9 @IB;G��F9GI@H=B;�=B�5B�CJ9F5@@�897F95G9�=B
*5)���=B7F95G98 ��5�;F58=9BH��5B8�GMGH9A=7 <MDCL9A=5

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E - Normal perfusion with decreased ventilation at the right base

Explanation Why

(CFA5@ D9F:IG=CB K=H<�:C75@�5F95G�C:�897F95G98�J9BH=@5H=CB�75B�69�75IG98�6M�@C75@=N98�=B:@5AA5HCFM


DFC79GG9G��GI7<�5G DB9IACB=5��6FCB7<=5@�C6GHFI7H=CB��CF A5@=;B5B7M �*5H=9BHG�K=H< DB9IACB=5 <5J9
=B7F95G98�=BHF5�5@J9C@5F�:@I=8�=B�GCA9�D5FHG�C:�H<9 @IB;G��75IG=B;�5�897F95G98�J9BH=@5H=CB�C:�H<CG9
5F95G �.<=G�D5H=9BH�G 8MGDB95 7CI@8�69�5�G=;B�C: DB9IACB=5 6IH�<=G L�F5M :=B8=B;G�5B8�H<9�<=GHCFM�C:�5
F979BH AMC75F8=5@�=B:5F7H=CB GI;;9GH DI@ACB5FM�989A5

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Question # 39

� ���M95F�C@8 A5B�K=H<�"#0�7CA9G�HC�H<9�D<MG=7=5B�6975IG9�C:�5�BCBDFC8I7H=J9�7CI;<�5B8�G<CFHB9GG�C:
6F95H<�:CF ��K99?G �"9�:99@G�H=F98�5:H9F�K5@?=B;�ID�5�:@=;<H�C:�GH5=FG�5B8�5:H9F�@CB;�7CBJ9FG5H=CBG�CB�H<9
D<CB9 �"9�5DD95FG�7<FCB=75@@M�=@@ �"=G�H9AD9F5HIF9�=G �� �O������ �O ���5B8�DI@G9�=G�����A=B �*I@G9
CL=A9HFM�CB�FCCA�5=F�G<CKG�5B�CLM;9B�G5HIF5H=CB�C:���� �/DCB�K5@?=B;��<=G CLM;9B�G5HIF5H=CB
897F95G9G�HC���� ��5F8=CDI@ACB5FM�9L5A=B5H=CB�=G�BCFA5@ �&56CF5HCFM�GHI8=9G�G<CK�5
�����.�@MAD<C7MH9 7CIBH�C: ����AA� �,9GI@HG�C:�IF=B9 Legionella 5BH=;9B�H9GH=B;�5F9�B9;5H=J9 ��
�.�G75B C:�H<9�7<9GH�G<CKG 8=::IG9��6=@5H9F5@ ;FCIB8�;@5GG CD57=H=9G �'=7FCG7CD=7�9L5A=B5H=CB�C:�:@I=8
C6H5=B98�:FCA�6FCB7<C5@J9C@5F�@5J5;9�K=@@�ACGH�@=?9@M�G<CK�K<=7<�C:�H<9�:C@@CK=B;�:=B8=B;G�

Answer Image

� !F5A�DCG=H=J9��75H5@5G9�DCG=H=J9�7C77=

� -=@J9F�GH5=B=B;��8=G7�G<5D98�7MGHG

� #BHF579@@I@5F��57=8�:5GH�657H9F=5

� -9DH5H9��57IH9�6F5B7<=B;�<MD<59

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� -=@J9F�GH5=B=B;��;F5A�B9;5H=J9�657=@@=

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Hint

.<=G =AAIBCGIDDF9GG98 D5H=9BH�DF9G9BHG�K=H<�=B8C@9BH�DFC;F9GG=CB�C:�BCBDFC8I7H=J9 7CI;<� 8MGDB95 CB


9L9FH=CB� :9J9F��5�BCFA5@ @IB;�9L5A=B5H=CB��5B8�6=@5H9F5@ ;FCIB8�;@5GG CD57=H=9G�CB�7<9GH �.�G75B��5@@�C:
K<=7<�GI;;9GH�5�8=5;BCG=G�C: Pneumocystis jirovecii DB9IACB=5

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Correct Answer

A - Gram-positive, catalase-positive cocci

Explanation Why

!F5A�DCG=H=J9� 75H5@5G9�DCG=H=J9 7C77= CB�A=7FCG7CD=7�9L5A=B5H=CB�C:�F9GD=F5HCFM�G97F9H=CBG�5F9


7<5F57H9F=GH=7�C: Staphylococcus aureus Staphylococcus aureus 75B�75IG9�:I@A=B5BH DB9IACB=5 ACGH
7CAACB@M�:C@@CK=B; =B:@I9BN5�J=FIG =B:97H=CB �#H�DF9G9BHG�K=H<�5�F5D=8@M�DFC;F9GG=J9�7CIFG9�C: G<C7?�
B9IHFCD9B=5� @IB; B97FCG=G��5B8�<=;< ACFH5@=HM 89GD=H9�5DDFCDF=5H9 5BH=6=CH=7�H<9F5DM �.�G75B C:�H<9
7<9GH�=B�D5H=9BHG�K=H< Staphylococcus DB9IACB=5 G<CKG�G=;BG�C:�7CBGC@=85H=CB�5B8�@=EI9:57H=CB�K=H<
CF�K=H<CIH�75J=H5H=CB��F5H<9F�H<5B�6=@5H9F5@�;FCIB8�;@5GG CD57=H=9G��5G�G99B�=B�H<=G�D5H=9BH

B - Silver-staining, disc-shaped cysts

Image

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Explanation But

�FI;G�IG98�:CF�H<9�HF95HA9BH�C: Pneumocystis jirovecii pneumonia =B7@I89 HF=A9H<CDF=A�


GI@:5A9H<CL5NC@9 �.'*�-'2�� D9BH5A=8=B9��5B8 5HCJ5EICB9 �#B8=J=8I5@G�K=H<�5 ���� .�
@MAD<C7MH9 7CIBH�������AA� G<CI@8�69�GH5FH98�CB�DFCD<M@5L=G��9 ; � .'*�-'2�

Explanation Why

-=@J9F�GH5=B=B;��8=G7�G<5D98�7MGHG�CB�A=7FCG7CD=7�9L5A=B5H=CB�C: 6FCB7<C5@J9C@5F�@5J5;9 :@I=8


=B8=75H9 Pneumocystis jirovecii��5 M95GH�@=?9�:IB;IG�H<5H�75IG9G CDDCFHIB=GH=7�=B:97H=CB =B
=AAIBC7CADFCA=G98 D5H=9BHG��D5FH=7I@5F@M�H<CG9�K=H< "#0��#�- 5B8�5 ���� 7CIBH�69@CK����
79@@G�AA� Pneumocystis DB9IACB=5 ;9B9F5@@M�A5B=:9GHG�K=H<�5B�=B8C@9BH�DFC;F9GG=CB�C:�F9GD=F5HCFM
GMADHCAG��BCFA5@ @IB;�9L5A=B5H=CB �9GD97=5@@M�95F@M�=B�H<9�7CIFG9�C:�H<9�8=G95G9���@CK CLM;9B
G5HIF5H=CB H<5H�KCFG9BG�K=H<�9L9FH=CB��5B8�6=@5H9F5@��8=::IG9� =BH9FGH=H=5@ =B:=@HF5H9G��;FCIB8�;@5GG
CD57=H=9G� CB�F58=C;F5D<=7�=A5;=B;�C:�H<9�7<9GH��5G�G99B�=B�H<=G�D5H=9BH

C - Intracellular, acid-fast bacteria

Explanation Why

#BHF579@@I@5F� 57=8�:5GH�657H9F=5 CB 6FCB7<C5@J9C@5F�@5J5;9 9L5A=B5H=CB�=G�7<5F57H9F=GH=7�C:


Mycobacterium avium-intracellulare��5B �#�-�89:=B=B;�7CB8=H=CB H<5H�7CAACB@M�A5B=:9GHG�K=H<
=B8C@9BH�DFC;F9GG=CB�C: :9J9F 5B8 7CI;< �"CK9J9F��H<=G�7CB8=H=CB�A5=B@M�DF9G9BHG�=B�D5H=9BHG�K=H<�5
���� 7CIBH�69@CK����79@@G�AA� �)LM;9B�89G5HIF5H=CB�CB�9L9FH=CB�5B8�8=::IG9��6=@5H9F5@�;FCIB8�
;@5GG�CD57=H=9G�CB�7<9GH �.�G75B KCI@8�5@GC�BCH�69�9LD97H98 �'CF9CJ9F��H<=G�D5H=9BH�@57?G�CH<9F
:95HIF9G�C: M. avium =B:97H=CB��GI7<�5G�B=;<H�GK95HG��K9=;<H�@CGG� <9ACDHMG=G��5B8 @MAD<589BCD5H<M

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D - Septate, acute-branching hyphae

Image

Explanation Why

-9DH5H9��57IH9�6F5B7<=B; <MD<59 CB 6FCB7<C5@J9C@5F�@5J5;9 :@I=8�=G�7<5F57H9F=GH=7�C: Aspergillus


fumigatus��5�ACBCACFD<=7�:IB;IG�H<5H�75B�75IG9 =BJ5G=J9�5GD9F;=@@CG=G =B =AAIBC7CADFCA=G98
D5H=9BHG��9 ; ��8I9�HC �#�-� ��@H<CI;<�H<=G�7CB8=H=CB�A5M�DF9G9BH�K=H< :9J9F 5B8 7CI;<� <9ACDHMG=G�
D@9IF=H=7 D5=B��5B8�K<99N=B;�CB @IB;�9L5A=B5H=CB KCI@8�69�9LD97H98 �'CF9CJ9F� =BJ5G=J9
5GD9F;=@@CG=G A5=B@M�C77IFG�=B�D5H=9BHG�K=H<�5 ���� 7CIBH�69@CK�����79@@G�AA� �&5GH@M��G=B;@9�CF
AI@H=D@9�BC8I@9G�K=H<�CF�K=H<CIH�75J=H5H=CB�KCI@8�69�G99B�5�7<9GH �.�G75B��F5H<9F�H<5B�8=::IG9�
6=@5H9F5@�;FCIB8�;@5GG CD57=H=9G

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E - Silver-staining, gram-negative bacilli

Explanation Why

-=@J9F�GH5=B=B;��;F5A�B9;5H=J9 657=@@= CB�A=7FCG7CD=7�9L5A=B5H=CB�C:�F9GD=F5HCFM�G97F9H=CBG�=B8=75H9


Legionella pneumophila &9;=CBB5=F9G�8=G95G9 =G�7<5F57H9F=N98�6M 5HMD=75@�DB9IACB=5� K<=7<�5@GC
A5B=:9GHG�K=H<�BCBDFC8I7H=J9 7CI;< 5B8 8MGDB95 CB�9L9FH=CB �"CK9J9F��D5H=9BHG�7<5F57H9F=GH=75@@M
<5J9�<=;< :9J9F �IGI5@@M�����O���5B8�7<=@@G��C:H9B�577CAD5B=98�6M 8=5FF<95 5B8�7CB:IG=CB��8I9�HC
<MDCB5HF9A=5� 2�F5M :=B8=B;G�5F9�J5F=56@9�6IH�IGI5@@M�G<CK�D5H7<M�IB=@5H9F5@�5B8�@C65F�=B:=@HF5H9G
H<5H�DFC;F9GG�HC�7CBGC@=85H=CB�F5H<9F�H<5B�5�8=::IG9��6=@5H9F5@ =BH9FGH=H=5@ =B:=@HF5H9 �&5GH@M��H<=G�D5H=9BH�G
IF=B5FM 5BH=;9B H9GH�:CF Legionella =G�B9;5H=J9

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USMLE e e r m h nne s
Me est i e s: https://t.me/USMLEMe est

K p n ssr m i e s: https://t.me/USMLEK p n

USMLE i e s Step : https://t.me/USMLE Step

e ker i e s: https://t.me/USMLE e ker

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r s e n i e s Step K: https://t.me/USMLE r sAn e n Step K

Ph se i e s: https://t.me/USMLEPh se

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P th m i e s: https://t.me/USMLEP th m

nA i s i h it : https://t.me/USMLE nA i s

Am ss r p: https://t.me/USMLEAm ss

Le t ri nk: https://t.me/USMLELe t ri

En p int P s: https://t.me/USMLEEn p int

USMLE MEs: https://t.me/USMLE ME

L E Me E : https://t.me/USMLE n ineMe E

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Question # 40

� ���M95F�C@8 KCA5B�7CA9G�HC�H<9�D<MG=7=5B�6975IG9�C: KCFG9B=B;�G<CFHB9GG�C:�6F95H<�5B8�F97IFF9BH


DI@ACB5FM�=B:97H=CBG CJ9F�H<9�D5GH ��M95FG �-<9�<5G GAC?98 ��D57?G C:�7=;5F9HH9G�85=@M�:CF�H<9�D5GH
���M95FG �*I@G9�CL=A9HFM�CB�FCCA�5=F�G<CKG�5B�CLM;9B�G5HIF5H=CB�C:���� ��L5A=B5H=CB�G<CKG�G75HH9F98
9LD=F5HCFM�K<99N=B; 5B8�F<CB7<=�6=@5H9F5@@M 2�F5MG C:�H<9�7<9GH�5F9�G<CKB �*I@ACB5FM�:IB7H=CB�H9GH=B;
=G�ACGH�@=?9@M�HC�G<CK�K<=7<�C:�H<9�:C@@CK=B;�G9HG�C:�:=B8=B;G�

FEV1 FEV1/FVC TLC RV

A �97F95G98 897F95G98 =B7F95G98 =B7F95G98

B �97F95G98 =B7F95G98 897F95G98 897F95G98

C (CFA5@ BCFA5@ BCFA5@ BCFA5@

D �97F95G98 897F95G98 BCFA5@ =B7F95G98

E �97F95G98 BCFA5@ 897F95G98 BCFA5@

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Answer Image

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Hint

.C;9H<9F�K=H<�5�G=;B=:=75BH�GAC?=B;�<=GHCFM��H<=G�D5H=9BH�G�GMADHCAG�5B8 L�F5M :=B8=B;G��<MD9F=B:@5H=CB�


:@5HH9B98�8=5D<F5;A��=B7F95G98 G5;=HH5@ H<CF57=7�8=5A9H9F��5F9�7CBG=GH9BH�K=H< 9AD<MG9A5��5�?9M
7CADCB9BH�C: 7<FCB=7�C6GHFI7H=J9�DI@ACB5FM�8=G95G9

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Correct Answer

A-A

Explanation Why

�<FCB=7 =B:@5AA5H=CB C:�H<9 5=FK5MG 8I9�HC�=B<5@98�HCL=BG��GAC?=B;��@958G�HC�DFC;F9GG=J9


89GHFI7H=CB�C: @IB; D5F9B7<MA5 8=GH5@ HC�H<9 H9FA=B5@�6FCB7<=C@9G ��6BCFA5@��D9FA5B9BH�8=@5H=CB�C:
H<9�5=F�GD579G��9AD<MG9A5��75IG98�6M�@CGG�C:�9@5GH=7�H=GGI9�5B8 5=F�HF5DD=B; 69<=B8�7C@@5DG98�CF
C6GHFI7H98 6FCB7<=C@9G =B7F95G9G F9G=8I5@�JC@IA9 �,0��5B8 HCH5@�@IB;�75D57=HM �.&�� �(5FFCK=B;�C:
H<9 5=FK5MG��K<=7<�=G�G99B�=B�D5H=9BHG�K=H< �)*���=B7F95G9G�H<9�F9G=GH5B79�HC�5=F�:@CK�5B8
7CBG9EI9BH@M�897F95G9G :CF798�9LD=F5HCFM�JC@IA9 � �0���5B8�H<9 .=::9B95I�*=B9@@= =B89L
� �0�� 0�� ��5A5;9�HC�H<9�5@J9C@5F�K5@@G�:IFH<9FACF9�F9GI@HG�=B�897F95G98 �&�) 6975IG9�H<9
GIF:579�5F95�:CF�;5G9CIG�9L7<5B;9�=G�8=A=B=G<98

B-B

Image

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Explanation Why

.<=G�G9H�C:�:=B8=B;G�=G�7CBG=GH9BH�K=H< F9GHF=7H=J9�@IB;�8=G95G9 �9 ; ��8I9�HC =BH9FGH=H=5@�@IB;�8=G95G9�


�@@ @IB;�JC@IA9G 5B8�75D57=H=9G�5F9�9EI5@@M�897F95G98�5G�5�F9GI@H�C:�H<9 @IB;G��=AD5=F98�56=@=HM�HC
9LD5B8��U�7CAD@=5B79� �.<9 �0�� 0��F5H=C =G�HMD=75@@M�=B7F95G98����������6975IG9 0�
5DDFC57<9G �0� 5G�5�F9GI@H�C:�<=;<9F @IB; 9@5GH=7=HM �*5H=9BHG�K=H< F9GHF=7H=J9�@IB;�8=G95G9 IGI5@@M
DF9G9BH�K=H< 8MGDB95 5B8�897F95G98 CLM;9B�G5HIF5H=CB��6CH<�C:�K<=7<�5F9�G99B�<9F9 �"CK9J9F��5B L�
F5M KCI@8�G<CK�F9H=7I@5F�CD57=H=9G�5G�5�G=;B�C: :=6FCG=G 5B8�6=65G=@5F�=BGD=F5HCFM 7F57?@9G CF F5@9G
KCI@8�69�<95F8�CB 5IG7I@H5H=CB ��@H<CI;<�GAC?=B;�=G�5 F=G?�:57HCF :CF =8=CD5H<=7�DI@ACB5FM�:=6FCG=G�
=H�=G�ACF9�7CAACB@M�5GGC7=5H98�K=H< C6GHFI7H=J9�@IB;�8=G95G9

C-C

Explanation Why

(CFA5@�GD=FCA9HF=7�:=B8=B;G�=B�5�D5H=9BH�K=H< G<CFHB9GG�C:�6F95H< 5B8�897F95G98 CLM;9B�G5HIF5H=CB


=B8=75H9�5B�9LHF5DI@ACB5FM�75IG9�C: <MDCL=5 �9 ; � 5B9A=5 CF�75F8=CJ5G7I@5F�8=G95G9� �"CK9J9F��H<=G
D5H=9BH�G L�F5M 5B8 5IG7I@H5HCFM :=B8=B;G�5F9�7CBG=GH9BH�K=H<�58J5B798 7<FCB=7�C6GHFI7H=J9�DI@ACB5FM
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Hint

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Correct Answer

A - Inspiratory capacity

Explanation Why

"?DA:C2E@CJ�42A24:EJ :D�E96�>2I:>F>�G@=F>6�@7�82D�E92E�42?�36�:?92=65�27E6C�2�?@C>2=�6IA:C2E:@?��: 6 �
E96�5:776C6?46�36EH66? E@E2=�=F?8�42A24:EJ 2?5�E96�G@=F>6�@7�82D�E92E�C6>2:?D�:?�E96 =F?8D 2E�E96�6?5
@7�2�?@C>2=�6IA:C2E:@?� ,@E2=�=F?8�42A24:EJ :D�C6AC6D6?E65�3J�E96 =F?8 G@=F>6�2E�>2I:>F>
EC2?DAF=>@?2CJ�AC6DDFC6 @7�E96�4@>3:?65 =F?8�E9@C2I�DJDE6> �,9FD� :?DA:C2E@CJ�42A24:EJ @?�E96
8C2A9�:D�E96�G6CE:42=�5:DE2?46�36EH66?�E9:D =F?8 G@=F>6�2?5�E96�5@EE65�=:?6

B - Vital capacity

Explanation Why

.:E2=�42A24:EJ :D�E96�=2C86DE�G@=F>6�@7�82D�E92E�42?�36�6I92=65�27E6C�2�>2I:>2=�:?DA:C2E:@?��: 6 ��E96


5:776C6?46�36EH66? E@E2=�=F?8�42A24:EJ 2?5 C6D:5F2=�G@=F>6� ,@E2=�=F?8�42A24:EJ :D�C6AC6D6?E65�3J�E96
=F?8 G@=F>6�2E�>2I:>F> EC2?DAF=>@?2CJ�AC6DDFC6 @7�E96�4@>3:?65 =F?8�E9@C2I�DJDE6> *6D:5F2=
G@=F>6 :D�C6AC6D6?E65�3J�E96 =F?8 G@=F>6�2E�>:?:>F> EC2?DAF=>@?2CJ�AC6DDFC6 @7�E96�4@>3:?65
=F?8�E9@C2I�DJDE6> �,9FD� G:E2=�42A24:EJ @?�E96�8C2A9�:D�E96�G6CE:42=�5:DE2?46�36EH66?�E96�9:896DE�2?5
=@H6DE�A@:?ED�@7�E96�4@>3:?65 =F?8�E9@C2I�DJDE6>�4FCG6

C - Tidal volume

Explanation Why

,:52=�G@=F>6 :D�E96�G@=F>6�@7�82D�:?92=65�:?E@�E96 =F?8D 5FC:?8�2�?@C>2=�C6DE:?8�3C62E9 �,96�5@EE65


=:?6�:D�E96�G@=F>6�@7�82D�E92E�C6>2:?D�:?�E96 =F?8D 2E�E96�6?5�@7�2�?@C>2=�6IA:C2E:@? �,9FD� E:52=
G@=F>6 @?�E96�8C2A9�:D�C6AC6D6?E65�3J�E96�G6CE:42=�5:DE2?46�36EH66? =F?8 G@=F>6�27E6C�2�?@C>2=
:?92=2E:@?�2?5�E96�5@EE65�=:?6

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D - Functional residual capacity

Explanation Why

�7E6C�2�?@C>2=�6IA:C2E:@?��E96�4@>3:?65 EC2?DAF=>@?2CJ�AC6DDFC6 @7�E96 =F?8D 2?5�E9@C2I�:D�K6C@


�: 6 � 2E>@DA96C:4�AC6DDFC6��3642FD6�E96�E6?56?4J�@7�E96 =F?8 E@�4@==2AD6�:?H2C5��5F6�E@�A@D:E:G6
EC2?DAF=>@?2CJ�AC6DDFC6��:D�6BF2=�:?�>28?:EF56�E@�E96�E6?56?4J�@7�E96�E9@C2I�E@�>@G6�@FEH2C5��5F6
E@�?682E:G6 EC2?DAF=>@?2CJ�AC6DDFC6� �,9FD��E96 =F?8 G@=F>6�2E�E96�A@:?E�H96C6�E96�4@>3:?65
=F?8�E9@C2I�DJDE6>�6I6CED�?@ EC2?DAF=>@?2CJ�AC6DDFC6 �: 6 ����4>�!�'��:D�E96 7F?4E:@?2=�C6D:5F2=
42A24:EJ �: 6 ��E96�G@=F>6�@7�82D�E92E�C6>2:?D�:?�E96 =F?8D 27E6C�2�?@C>2=�6IA:C2E:@?�

E - Total lung capacity

Explanation Why

,@E2=�=F?8�42A24:EJ :D�E96�=2C86DE�G@=F>6�@7�82D�E92E�42?�36�96=5�:?�E96 =F?8D 27E6C�2�>2I:>2=


:?DA:C2E:@?��H9:49�:D�E96 =F?8 G@=F>6�2E�>2I:>F> EC2?DAF=>@?2CJ�AC6DDFC6 @7�E96�4@>3:?65
=F?8�E9@C2I�DJDE6>

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Question # 2

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4:82C6EE6D�52:=J�7@C ���J62CD 3FE�BF:E ��J62CD 28@ �(9JD:42=�6I2>:?2E:@?�D9@HD�2?�:?4C62D65
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Hint

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Correct Answer

A - Fluticasone

Explanation Why

"?92=65�8=F4@4@CE:4@:5D =:<6 7=FE:42D@?6 :?9:3:E�E96�DJ?E96D:D�@7�D6G6C2= 4JE@<:?6D 2?5�E9FD�C6DF=E�:?�2?


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H9:49�?@C>2==J�:?5F46D�E96�AC@5F4E:@?�@7�:?7=2>>2E@CJ�286?ED��6 8 � ,&��Q� ��=E9@F89�:?92=65
8=F4@4@CE:4@:5D 2C6�A2CE�@7�E96�>F=E:5CF8�C68:>6?�E@�EC62E 49C@?:4�@3DECF4E:G6�AF=>@?2CJ�5:D62D6�
E96J�5@�?@E�2?E28@?:K6�E96�67764ED�@7 G282= DE:>F=2E:@?�@?�E96 2:CH2JD

B - Montelukast

Explanation Why

�?E:=6F<@EC:6?6D�=:<6 >@?E6=F<2DE 2C6�2?E:�:?7=2>>2E@CJ�286?ED�E92E�3=@4< =6F<@EC:6?6 C646AE@CD


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�44@C5:?8=J��3=@4<:?8 =6F<@EC:6?6 C646AE@CD�=625D�E@�3C@?49@5:=2E:@? ��=E9@F89 >@?E6=F<2DE C6=:6G6D
2:CH2J :?7=2>>2E:@?��:E�:D�?@E�:?5:42E65�E@�EC62E 49C@?:4�@3DECF4E:G6�AF=>@?2CJ�5:D62D6 �,9:D
>65:42E:@?�:D�EJA:42==J�FD65�E@�EC62E 2DE9>2 2?5�92D�366?�D9@H?�E@�C65F46�E96�?F>36C�@7 24FE6
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2:CH2JD

C - Albuterol

Explanation Why

�=3FE6C@= :D�2?�:?92=65 S��28@?:DE E92E�5:C64E=J�:?5F46D�3C@?49@5:=2E:@? ��642FD6�:E�:D�2�D9@CE�24E:?8


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FD65�2D�A2CE�@7�49C@?:4 >2:?E6?2?46�E96C2AJ �%@C6@G6C� 2=3FE6C@= 5@6D�?@E�2?E28@?:K6�E96�67764ED�@7
G282= DE:>F=2E:@?�@?�E96 2:CH2JD

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D - Tiotropium

Explanation Why

,:@EC@A:F> :D�2? 2?E:>FD42C:?:4�286?E FD65�E@�EC62E 49C@?:4�@3DECF4E:G6�AF=>@?2CJ�5:D62D6 ��'(��


2?5 2DE9>2 �,9:D�A2E:6?E�92D�2�9:DE@CJ�@7�E@3244@�FD6��AC6D6?ED�H:E9�49C@?:4�AC@5F4E:G6 4@F89��2?5
92D�2?�:?4C62D65�2?E6C@A@DE6C:@C�496DE�5:2>6E6C�H:E9�4@2CD6 4C24<=6D @?�6I2>:?2E:@? �,@86E96C��E96D6
762EFC6D�DEC@?8=J�DF886DE�2 5:28?@D:D�@7��'(� ,:@EC@A:F> �2?5�@E96C�=@?8�24E:?8
A2C2DJ>A2E9@=JE:4D��4@>A6E:E:G6=J�3:?5D�E@ >FD42C:?:4�C646AE@CD��H9:49�DF3D6BF6?E=J�C65F46D
A2C2DJ>A2E96E:4 E@?6�@?�E96 3C@?49:@=6D��3=@4<:?8�3C@?49@4@?DEC:4E:@? �,96D6�67764ED�C65F46�E96
DJ>AE@>D�@7 2:CH2J @3DECF4E:@?�2?5�:>AC@G6�AF=>@?2CJ�7F?4E:@?2=:EJ

E - Theophylline

Explanation Why

,96@A9J==:?6 :D�2�>:=5 3C@?49@5:=2E@C E92E�:D�FD65�2D�2?�25;F?4E:G6�E96C2AJ�:?�E96�>2?286>6?E�@7


49C@?:4�@3DECF4E:G6�AF=>@?2CJ�5:D62D6 �"E�:?9:3:ED A9@DA9@5:6DE6C2D6 2?5�:?4C62D6D�:?EC246==F=2C
4�%( 4@?46?EC2E:@?D�E@�564C62D6�3C@?49@4@?DEC:4E:@? �,9:D�5CF8�:D�C2C6=J�FD65�3642FD6�:E�92D�2
?2CC@H�E96C2A6FE:4�:?56I 2?5�:D�2DD@4:2E65�H:E9�D:8?:7:42?E�E@I:4:EJ��?2FD62��G@>:E:?8� D6:KFC6D��2?5
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E96 2:CH2JD

F - Cromolyn

Explanation Why

%2DE�46==�DE23:=:K6CD =:<6 4C@>@=J? 2C6�2?E:2==6C8:4�286?ED�E92E�AC6G6?E >2DE�46== 568C2?F=2E:@? 2?5


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>2DE�46==D A=2J�2�C@=6�:?�E96�A2E9@86?6D:D�@7 49C@?:4�@3DECF4E:G6�AF=>@?2CJ�5:D62D6� >2DE�46==
DE23:=:K6CD 2C6�?@E�FD65�:?�E96�EC62E>6?E�@7�E9:D�4@?5:E:@? �%@C6@G6C��E96J�5@�?@E�2?E28@?:K6�E96
67764ED�@7 G282= DE:>F=2E:@?�@?�E96 2:CH2JD

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Question # 3

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Hint

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Correct Answer

A - Increasing the respiratory rate

Explanation Why

"?4C62D:?8�E96 C6DA:C2E@CJ�C2E6 :?4C62D6D�3@E9 >:?FE6�G6?E:=2E:@? 2?5 2=G6@=2C�G6?E:=2E:@? �!@H6G6C�


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G6?E:=2E:@?

B - Increasing the partial pressure of inhaled oxygen

Explanation Why

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AC6DDFC6 E@�2C62D�@7�=@H A2CE:2=�AC6DDFC6��2�8C62E6C�AC6DDFC6�5:776C6?46�4C62E6D�2�DEC@?8�8C25:6?E�7@C
@IJ86?�E@�5:77FD6�24C@DD�E96�3=@@5�2:C�32CC:6C�:?E@�E96�3=@@5 �,96 A2CE:2=�AC6DDFC6 @7�:?92=65�@IJ86?
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C - Decreasing the physiologic dead space

Image

Explanation But

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:?4C62D65 2=G6@=2C�5625�DA246 G6?E:=2E:@?

Explanation Why

,96 A9JD:@=@8:4�5625�DA246 4@?D:DED�@7�E96�G@=F>6�@7�2:C�:?�E96�4@?5F4E:?8 2:CH2JD �: 6 � 2?2E@>:4


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2=G6@=2C�5625�DA246� ��64C62D:?8�E96 A9JD:@=@8:4�5625�DA246 C65F46D�E96�5:776C6?46�36EH66? >:?FE6
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D - Decreasing the affinity of hemoglobin for oxygen

Explanation Why

�64C62D:?8�E96 277:?:EJ @7 96>@8=@3:? 7@C�@IJ86?��: 6 ��2�C:89E�D9:7E�@7�E96 @IJ86?�5:DD@4:2E:@?�4FCG6


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@IJ86?2E:@? �"E�5@6D�?@E�27764E�G6?E:=2E:@?�@C�G@=F>6�A2C2>6E6CD

E - Increasing the respiratory depth

Explanation Why

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Question # 4

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Hint

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Correct Answer

A - Increased lung compliance

Explanation But

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9JA6C42A?:2 2?5 9JA@I:2

Explanation Why

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B - Increased vital capacity

Explanation Why

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C - Decreased residual volume

Explanation Why

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D - Decreased total lung capacity

Explanation Why

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E - Increased chest wall compliance

Explanation Why

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F - Decreased A-a gradient

Explanation Why

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Question # 5

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Correct Answer

A - Chronic obstructive pulmonary disease

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Explanation Why

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B - Idiopathic pulmonary fibrosis

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Explanation Why

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C - Endotracheal neoplasm

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Explanation Why

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D - Neuromuscular weakness

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Explanation Why

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E - Chronic asthma

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Explanation Why

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F - Unilateral mainstem obstruction

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Explanation Why

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Question # 6

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Hint

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Correct Answer

A - Mycobacterium tuberculosis

Image

Explanation Why

Mycobacterium tuberculosis :D�2?�:>A@CE2?E�42FD6�@7�4@>>F?:EJ�24BF:C65 A?6F>@?:2 :?�56G6=@A:?8


4@F?EC:6D �!@H6G6C��E9:D�A2E:6?E�:D�2E�=@H�C:D<�7@C EF36C4F=@D:D 2D�96�=24<D�2�9:DE@CJ�@7�EC2G6=�E@�2?
6?56>:4 2C62�@C�@E96C C:D<�724E@CD 7@C�:?764E:@?��6 8 � :>>F?@DFAAC6DD:@?��:?42C46C2E:@?��".�5CF8�FD6�
EC62E>6?E�H:E9 ,&��Q :?9:3:E@CD���2?5�96�92D�?@?6�@7�E96�EJA:42=�762EFC6D�@7�24E:G6�AF=>@?2CJ
EF36C4F=@D:D �6 8 ��H6:89E�=@DD��?:89E�DH62ED��2?5 96>@AEJD:D� ��FCE96C>@C6��2�496DE I�C2J @7�2�A2E:6?E
H:E9��C624E:G2E65� EF36C4F=@D:D H@F=5�D9@H�FAA6C�=@36�42G:E2CJ =F?8 =6D:@?D��?@E�=@32C�4@?D@=:52E:@?

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B - Pseudomonas aeruginosa

Explanation Why

Pseudomonas aeruginosa :D�@?6�@7�E96�>@DE�4@>>@?�42FD6D�@7�3@E9�9@DA:E2=�24BF:C65�2?5


G6?E:=2E@C�2DD@4:2E65 A?6F>@?:2��3FE�C2C6=J�42FD6D�4@>>F?:EJ�24BF:C65 A?6F>@?:2 :?
:>>F?@4@>A6E6?E�9@DED ��FCE96C>@C6��E9:D�A2E:6?E�92D�?@?6�@7�E96�EJA:42= C:D<�724E@CD 7@C�:?764E:@?
H:E9�E9:D�A2E9@86?��:?4=F5:?8 3C@?49:64E2D:D��DECF4EFC2= =F?8 23?@C>2=:E:6D��2?5 :>>F?@DFAAC6DD:@?
�6 8 � !". :?764E:@?��EC62E>6?E�H:E9 :>>F?@DFAAC6DD2?ED�

C - Fusobacterium nucleatum

Image

Explanation Why

Fusobacterium nucleatum :D�2? 2?26C@3:4 A2E9@86?�2DD@4:2E65�H:E9 2DA:C2E:@?�A?6F>@?:2 2?5 =F?8


23D46DD *:D<�724E@CD�7@C�2DA:C2E:@? :?4=F56�C65F465 =6G6=D�@7�4@?D4:@FD?6DD �6 8 ��5F6�E@ 962GJ

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5C:?<:?8 @C 56>6?E:2��2?5 5JDA928:2 �5F6�E@�@3DECF4E:@?�@C�:>A2:C65 A6C:DE2=D:D���7@C�H9:49�E96C6�2C6
?@�D:8?D�:?�E9:D�A2E:6?E �%@C6@G6C� 2DA:C2E:@?�A?6F>@?:2 EJA:42==J�AC6D6?ED�H:E9�2�>@C6�:?5@=6?E
4@FCD6�@7 76G6C 2?5 5JDA?62��7@F=�D>6==:?8 DAFEF>��2?5�2�496DE I�C2J D9@H:?8�:?764E:@?�:?�2
56A6?56?E�2C62�@7�E96 =F?8 �>@DE�4@>>@?=J�E96�DFA6C:@C�D68>6?E�@7�E96�C:89E�=@H6C�=@36�

D - Mycoplasma pneumoniae

Explanation Why

Mycoplasma pneumoniae :D�E96�>@DE�4@>>@?�42FD6�@7 2EJA:42=�A?6F>@?:2 �"?�4@?EC2DE�E@�E9:D


A2E:6?E�D�DF556?�@?D6E�@7�5:D62D6� 2EJA:42=�A?6F>@?:2 EJA:42==J�E2<6D�2?�:?5@=6?E�4@FCD6�H:E9�>:=56C
DJ>AE@>D�DF49�2D�=@H�8C256 76G6C��?@?AC@5F4E:G6��5CJ 4@F89��2?5�6IEC2AF=>@?2CJ�>2?:76DE2E:@?D
�6 8 � 96252496D� >J2=8:2��C2D9���2?5�AC6D6?ED�H:E9�3:=2E6C2= :?E6CDE:E:2= @A24:E:6D�@?�496DE I�C2J

E - Legionella pneumophila

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Explanation Why

Legionella pneumophila 42?�42FD6 $68:@??2:C6D��5:D62D6��2�7@C>�@7 2EJA:42=�A?6F>@?:2 �,JA:42=


DJ>AE@>D�:?4=F56 76G6C� >2=2:D6��2?5 4@F89��H9:49�2C6�2=D@�D66?�96C6 �!@H6G6C��AC6D6?E2E:@?�:D
FDF2==J�DF324FE6�2?5�2�496DE I�C2J H@F=5�=:<6=J�D9@H�A2E49J�F?:=@32C�:?7:=EC2E6D �%@C6@G6C��4@>>@?
6IEC2AF=>@?2CJ�7:?5:?8D�@7 $68:@??2:C6D��5:D62D6� DF49�2D 5:2CC962��2?5�?6FC@=@8:4�23?@C>2=:E:6D
�6DA �4@?7FD:@?��2C6�23D6?E�:?�E9:D�A2E:6?E Legionella 324E6C:2�2C6�EJA:42==J�EC2?D>:EE65�G:2�:?92=2E:@?
@7�26C@D@=D�56C:G65�7C@>�4@?E2>:?2E65�H2E6C �'FE3C62<D�@7E6?�@44FC�:?�724:=:E:6D�H:E9�4@>A=6I�H2E6C
DJDE6>D��6 8 ��2:C�4@?5:E:@?:?8��9@E�H2E6C�E2?<D��DF49�2D�9@E6=D��9@DA:E2=D��2?5�?FCD:?8�9@>6D

F - Staphylococcus aureus

Explanation Why

Staphylococcus aureus :D�E96�>@DE�4@>>@?�42FD2=�A2E9@86?�@7�9@DA:E2=�24BF:C65 A?6F>@?:2 2?5


>2J�42FD6�D64@?52CJ�324E6C:2= A?6F>@?:2 :?�A2E:6?ED�C64@G6C:?8�7C@> :?7=F6?K2 �: 6 ��A@DE�:?7=F6?K2
A?6F>@?:2� �"E�:D�?@E��9@H6G6C��4@>>@?=J�2DD@4:2E65�H:E9�4@>>F?:EJ�24BF:C65 A?6F>@?:2��H9:49
E9:D�A2E:6?E�92D

G - Streptococcus pyogenes

Explanation Why

Streptococcus pyogenes :D�2�4@>>@?�42FD2=�A2E9@86?�@7 324E6C:2=�A92CJ?8:E:D��E@?D:==:E:D��2D�H6==�2D


D<:?�2?5�D@7E�E:DDF6�:?764E:@?D �!@H6G6C��:E�C2C6=J�42FD6D A?6F>@?:2 �/96?�:E�5@6D�@44FC� S. pyogenes
A?6F>@?:2 EJA:42==J�7@==@HD�G:C2=�:?764E:@?D��6 8 � :?7=F6?K2��2?5�>2?:76DED�H:E9�7F=>:?2?E�5:D62D6
2?5�62C=J�6>AJ6>2�7@C>2E:@?��?@?6�@7�H9:49�2C6�D66?�96C6

H - Haemophilus influenzae

Explanation Why

(?6F>@?:2 42FD65�3J Haemophilus influenzae 42?�AC6D6?E�H:E9�24FE6�@?D6E 76G6C��AC@5F4E:G6 4@F89�

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2?5�2�496DE I�C2J D9@H:?8�=@32C�4@?D@=:52E:@?��2==�@7�H9:49�2C6�D66?�:?�E9:D�A2E:6?E �!@H6G6C��:E�:D�?@E
E96�>@DE�4@>>@?�42FD6�@7�4@>>F?:EJ�24BF:C65 =@32C�A?6F>@?:2 2?5�:D�>@C6�=:<6=J�E@�36�7@F?5�:?�2
A2E:6?E�H:E9�2?�F?56C=J:?8 =F?8 5:D@C56C�DF49�2D �'(�

I - Histoplasma capsulatum

Image

Explanation Why

Histoplasma capsulatum :D�2�42FD6�@7�7F?82= A?6F>@?:2 ��7764E65�A2E:6?ED�>2J�36�2DJ>AE@>2E:4�@C


AC6D6?E�H:E9�24FE6�@?D6E 76G6C� >2=2:D6��2?5�AC@5F4E:G6 4@F89��2D�D66?�96C6 �!@H6G6C��2�496DE I�C2J
EJA:42==J�D9@HD�A2E49J�@C�?@5F=2C�:?7:=EC2E6D�2?5�9:=2C =J>A9256?@A2E9J��?@E�=@32C�4@?D@=:52E:@?
%@C6@G6C��E9:D�A2E:6?E�=24<D C:D<�724E@CD 7@C 9:DE@A=2D>@D:D��DF49�2D�6IA@DFC6�E@�D@:=�4@?E2>:?2E65
H:E9�3:C5�@C�32E�5C@AA:?8D��6 8��:?�49:4<6?�4@@AD���C6D:56?46�:?�2�9:89=J 6?56>:4 2C62��6 8 ��'9:@�2?5
%:DD:DD:AA:�*:G6C�.2==6JD���@C :>>F?@DFAAC6DD:@?

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J - Streptococcus pneumoniae

Image

Explanation Why

,9:D�A2E:6?E�D�24FE6�@?D6E�@7 >2=2:D6� 76G6C��2?5�49:==D��AC@5F4E:G6 4@F89��2?5 E249JA?62 :?


4@>3:?2E:@?�H:E9�E96 A9JD:42=�6I2>:?2E:@? 7:?5:?8D��:?4C62D65 7C6>:EFD��3C@?49:2=�3C62E9�D@F?5D�
2?5�E96�496DE I�C2J D9@H:?8�=@32C�4@?D@=:52E:@?�:D�:?5:42E:G6�@7 EJA:42=�A?6F>@?:2 Streptococcus
pneumoniae :D�E96�>@DE�4@>>@?�42FD2=�A2E9@86?

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Question # 7

� ���J62C�@=5 >2?�4@>6D�E@�E96�A9JD:4:2?�3642FD6�@7�AC@8C6DD:G6�D9@CE?6DD�@7�3C62E9�2?5�2�H@CD6?:?8
4@F89�7@C�E96�A2DE�>@?E9 �!6�2=D@�C6A@CED�@442D:@?2=�3=@@5J�DAFEF> �!6�92D�=@DE�23@FE ��<8 ��� ��=3��@7
H6:89E�@G6C�E96�A2DE ��>@?E9D 56DA:E6�92G:?8�?@�492?86�:?�2AA6E:E6 �!6�92D�D>@<65 ��A24<D @7�4:82C6EE6D
52:=J�7@C ���J62CD 3FE�DE@AA65�D>@<:?8�2E�E96�286�@7��� �(9JD:42=�6I2>:?2E:@?�D9@HD�C65F465�3C62E9
D@F?5D�E9C@F89@FE�3@E9�=F?8D ��? I�C2J @7�E96�496DE :D�D9@H? �/9:49�@7�E96�7@==@H:?8�:D�E96�>@DE�=:<6=J
42FD6�@7�E96�A2E:6?E�D�DJ>AE@>D�

Answer Image

� +BF2>@FD�46==�=F?8�42C4:?@>2

� +>2==�46==�=F?8�42?46C

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Answer Image

� $F?8�256?@42C4:?@>2

� (F=>@?2CJ�>6E2DE2D6D

� (=6FC2=�>6D@E96=:@>2

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Hint

,96�A2E:6?E�D 496DE�I�C2J D9@HD�?F>6C@FD�C@F?5� H6==�4:C4F>D4C:365 AF=>@?2CJ�=6D:@?D

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Correct Answer

A - Squamous cell lung carcinoma

Explanation Why

+BF2>@FD�46==�=F?8�42C4:?@>2 42?�>2?:76DE�H:E9�AC@8C6DD:G6 5JDA?62� 4@F89� 96>@AEJD:D��2?5


H6:89E�=@DD��2==�@7�H9:49�2C6�D66?�:?�E9:D�A2E:6?E �%@C6@G6C��E9:D�EJA6�@7�AC:>2CJ =F?8�42?46C :D
DEC@?8=J�2DD@4:2E65�H:E9�D>@<:?8 �!@H6G6C��2 496DE�I�C2J H@F=5�EJA:42==J�D9@H�2�9:=2C�>2DD�2?5
42G:E2E:@?�C2E96C�E92?�E96�>F=E:A=6��3:=2E6C2=�=6D:@?D�D66?�96C6

B - Small cell lung cancer

Explanation Why

+>2==�46==�=F?8�42?46C �+�$���42?�>2?:76DE�H:E9�AC@8C6DD:G6 5JDA?62� 4@F89� 96>@AEJD:D��2?5


H6:89E�=@DD��2==�@7�H9:49�2C6�D66?�:?�E9:D�A2E:6?E �%@C6@G6C��E9:D�EJA6�@7�AC:>2CJ =F?8�42?46C :D
DEC@?8=J�2DD@4:2E65�H:E9�D>@<:?8 �!@H6G6C��2 496DE�I�C2J H@F=5�EJA:42==J�D9@H�2�D:?8=6�46?EC2=
?@5F=6�C2E96C�E92?�E96�>F=E:A=6��3:=2E6C2=�=6D:@?D�D66?�96C6 �"?�255:E:@?� +�$� :D�4@>>@?=J
244@>A2?:65�3J A2C2?6@A=2DE:4�DJ?5C@>6D �6 8 � DJ?5C@>6�@7�:?2AAC@AC:2E6�2?E:5:FC6E:4�9@C>@?6
D64C6E:@?� �FD9:?8�DJ?5C@>6���H9:49�E9:D�A2E:6?E�5@6D�?@E�92G6

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C - Lung adenocarcinoma

Image

Explanation Why

$F?8�256?@42C4:?@>2��H9:49�:D�E96�>@DE�4@>>@?�EJA6�@7�AC:>2CJ =F?8�42?46C��42?�>2?:76DE�H:E9
AC@8C6DD:G6 5JDA?62� 4@F89� 96>@AEJD:D��2?5�H6:89E�=@DD��2==�@7�H9:49�2C6�D66?�:?�E9:D�A2E:6?E
!@H6G6C��2 496DE�I�C2J H@F=5�EJA:42==J�D9@H�2�D:?8=6�A6C:A96C2=�?@5F=6�C2E96C�E92?�E96�>F=E:A=6�
3:=2E6C2=�=6D:@?D�D66?�96C6

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D - Pulmonary metastases

Image

Explanation Why

*@F?5�?@5F=6D�@7�G2CJ:?8�D:K6D�D42EE6C65�E9C@F89@FE�E96 =F?8D �O42??@?32==�=6D:@?DP��DF886DE


AF=>@?2CJ�>6E2DE2D6D �%@C6@G6C��E9:D�A2E:6?E�C6A@CED�E92E�DJDE6>:4�DJ>AE@>D��: 6 ��H6:89E�=@DD�
AC646565�E96�@?D6E�@7�AF=>@?2CJ�DJ>AE@>D��5JDA?62� 4@F89� 96>@AEJD:D��3J�D6G6C2=�>@?E9D��H9:49
D9@F=5�C2:D6�DFDA:4:@?�7@C�2�AC:>2CJ�6IEC2E9@C24:4 >2=:8?2?4J $F?8�>6E2DE2D6D @44FC�:?�FA�E@����
@7�42?46C�A2E:6?ED��H:E9 3C62DE��4@=@C64E2=��2?5�C6?2= 42C4:?@>2D 2>@?8�E96�>@DE�4@>>@?�AC:>2CJ
EF>@CD�:?�25F=ED ��?�6IE6?D:G6�5:28?@DE:4�H@C<FA��6 8 ��:>28:?8� 3:@ADJ H:E9 9:DE@=@8J 2?5
:>>F?@9:DE@496>:DECJ��D9@F=5�36�:?:E:2E65�E@�:56?E:7J�E9:D�A2E:6?E�D�AC:>2CJ >2=:8?2?4J

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E - Pleural mesothelioma

Image

Explanation Why

(=6FC2=�>6D@E96=:@>2 42?�>2?:76DE�H:E9�AC@8C6DD:G6 5JDA?62� 4@F89��2?5�H6:89E�=@DD��2==�@7�H9:49


2C6�D66?�:?�E9:D�A2E:6?E �!@H6G6C��E9:D�EJA6�@7 >2=:8?2?4J 2=>@DE�6I4=FD:G6=J�@44FCD�5F6�E@
:?92=2E:@?2= 2D36DE@D 6IA@DFC6��H9:49�E9:D�A2E:6?E�92D�?@E�C6A@CE65 �%@C6@G6C��2 496DE�I�C2J H@F=5
EJA:42==J�D9@H A=6FC2=�A=2BF6D 2?5�@C�42=4:7:42E:@?D�2?5�F?:=2E6C2= A=6FC2=�677FD:@? C2E96C�E92?�E96
>F=E:A=6�AF=>@?2CJ�=6D:@?D�D66?�96C6

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Question # 8

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E96�=24C:>2=�AF?4EF> �,96�A9JD:4:2?�4@?4=F56D�E92E�E96�>@DE�=:<6=J�42FD6�@7�E96�A2E:6?E�D�DJ>AE@>D�:D
E96 4@?86?:E2=�@3DECF4E:@?�@7�2�5F4E �,96�5F4E�E92E�:D�>@DE�=:<6=J�@3DECF4E65�:?�E9:D�A2E:6?E�5C2:?D�:?E@
H9:49�@7�E96�7@==@H:?8�DECF4EFC6D�

Answer Image

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� +A96?@6E9>@:52=�C646DD

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Hint

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Correct Answer

A - Inferior nasal meatus

Image

Explanation Why

,96 ?2D@=24C:>2=�5F4E 5C2:?D�E96 =24C:>2=�D24 :?E@�E96 :?76C:@C�?2D2=�>62EFD��H9:49�:D�=@42E65�36EH66?


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524CJ@DE6?@D:D @44FCD�:?������@7 ?6H3@C?D 2?5�>2?:76DED�H:E9�A6CD:DE6?E�E62C:?8 �(2=A2E:@?�@7�E96
=24C:>2=�D24 @7E6?�C6DF=ED�:?�E62C:?8�2E�E96 =24C:>2=�AF?4EF>��2D�D66?�:?�E9:D�A2E:6?E �%@DE�42D6D
C6D@=G6�DA@?E2?6@FD=J�3J���>@?E9D�@7�286�H:E9�@?=J 4@?D6CG2E:G6�>2?286>6?E �6 8 � =24C:>2=�D24
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B - Sphenoethmoidal recess

Explanation Why

,96 DA96?@6E9>@:52=�C646DD��H9:49�:D�=@42E65�23@G6�E96 DFA6C:@C�?2D2=�4@?4926��C646:G6D�5C2:?286


7C@>�E96 DA96?@:5�D:?FD6D �"E�5@6D�?@E�5C2:?�E96 ?2D@=24C:>2=�5F4E

C - Pharyngeal recess

Explanation Why

,96 A92CJ?862=�C646DD :D�2�H6==�56>2C42E65�8C@@G6�:?�E96 =2E6C2= 2DA64E�@7�E96�?2D@A92CJ?I��=@42E65


369:?5�E96 E@CFD�EF32C:FD �,9:D�DECF4EFC6�5@6D�?@E�C646:G6�2?J�5C2:?286

D - Middle nasal meatus

Explanation Why

,96 >:55=6�?2D2=�>62EFD C646:G6D�5C2:?286�7C@>�E96 2?E6C:@C 2?5�>:55=6 6E9>@:52=�46==D� >2I:==2CJ


D:?FD6D��2?5 7C@?E2=�D:?FD6D �"E�:D�=@42E65�36EH66?�E96 :?76C:@C�?2D2=�4@?4926 2?5�E96 >:55=6�?2D2=
4@?4926 �"E�5@6D�?@E�5C2:?�E96 ?2D@=24C:>2=�5F4E

E - Semilunar hiatus

Explanation Why

,96 D6>:=F?2C�9:2EFD :D�2?�@A6?:?8�=@42E65�:?�E96 >:55=6�?2D2=�>62EFD E92E�C646:G6D�5C2:?286�7C@>


E96 7C@?E2=�D:?FD6D �G:2�E96 7C@?E@?2D2=�5F4E�� >2I:==2CJ�D:?FD6D��2?5 2?E6C:@C 6E9>@:52=�46==D �"E�5@6D
?@E�5C2:?�E96 ?2D@=24C:>2=�5F4E

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F - Superior nasal meatus

Explanation Why

,96 DFA6C:@C�?2D2=�>62EFD C646:G6D�5C2:?286�>2:?=J�7C@>�E96 A@DE6C:@C 6E9>@:52=�2:C�46==D �"E�:D


=@42E65�36EH66?�E96 DFA6C:@C�?2D2=�4@?4926 2?5�E96 >:55=6�?2D2=�4@?4926 �"E�5@6D�?@E�5C2:?�E96
?2D@=24C:>2=�5F4E

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Question # 9

� ���J62C�@=5 >2?�:D�25>:EE65�E@�E96�9@DA:E2=�7@C�6G2=F2E:@?�@7�2 ��52J 9:DE@CJ�@7�5:77:4F=EJ�3C62E9:?8


!6�92D�925�H@CD6?:?8�4@F89�2?5�5JDA?62�7@C�E96�A2DE�>@?E9�3FE�C67FD65�E@�D66�2�A9JD:4:2? �,H@�52JD
27E6C�25>:DD:@?��96�56G6=@AD C6DA:C2E@CJ�:?DF77:4:6?4J ��6DA:E6�2AAC@AC:2E6�42C6��96�5:6D�2�76H�52JD�=2E6C
,96�8C@DD�2AA62C2?46�@7�E96 =F?8�2E�2FE@ADJ�:D�D9@H? �,96�A2E:6?E�D�AF=>@?2CJ�7:?5:?8D�2C6�>@DE�=:<6=J
42FD65�3J�H9:49�@7�E96�7@==@H:?8�

Answer Image

� *646?E�:>>@3:=:K2E:@?

� �D36DE@D�6IA@DFC6

� % �EF36C4F=@D:D�:?764E:@?

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Answer Image

� 2DEC:4�4@?E6?E�2DA:C2E:@?

� �9C@?:4�4:82C6EE6�D>@<:?8

� &@?�42D62E:?8�8C2?F=@>2�7@C>2E:@?

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Hint

,96�:>286�D9@HD�2�=2C86�>2DD�:?�E96�FAA6C�=@36�@7�E96 =F?8 H:E9�46?EC2=�42G:E2E:@?��H9:49�:D�4@?D:DE6?E


H:E9�2 DBF2>@FD�46==�42C4:?@>2

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Correct Answer

A - Recent immobilization

Explanation Why

*646?E�:>>@3:=:K2E:@?�:D�2 C:D<�724E@C 7@C AF=>@?2CJ�6>3@=:D> �(2E9@=@8:4�7:?5:?8D�@7 AF=>@?2CJ


6>3@=:D> 2C6 =F?8 96>@CC9286�2?5 6>3@=: :?�E96�AF=>@?2CJ�G6DD6=D �"7 AF=>@?2CJ�:?72C4E:@? @44FCD�
:E�:D�=:<6=J�E@�36�:?�E96�=@H6C�=@36D�@7�E96 =F?8D��2D�@AA@D65�E@�E96�FAA6C�=@36�=6D:@?�:?�E9:D�A2E:6?E
,96�492C24E6C:DE:4�A2E9@=@8:4�7:?5:?8�@7 AF=>@?2CJ�:?72C4E:@? :D�2�H6586�H:E9�E96�32D6�2E�E96 =F?8
A6C:A96CJ �"E�EJA:42==J�2AA62CD�96>@CC928:4�2?5�92D�2�A=6FC2=�7:3C:?@FD 6IF52E6��F?=:<6�E96�42G:E2E:?8
=6D:@?�:?�E96�FAA6C�=@36�D66?�:?�E9:D�A2E:6?E

B - Asbestos exposure

Explanation Why

�9C@?:4 2D36DE@D 6IA@DFC6�42?�42FD6 2D36DE@D:D 2?5�:?4C62D6D�E96�C:D<�@7 3C@?49@86?:4�42C4:?@>2�


H9:49�42?�92G6�2�8C@DD�2AA62C2?46�D:>:=2C�E@�E92E�@7�E9:D�A2E:6?E�D =F?8 �!@H6G6C� =F?8�42?46C 5F6�E@
2D36DE@D 6IA@DFC6�:D�>F49�=6DD�4@>>@?�E92?�C@FE:?6 =F?8�42?46C �"?�255:E:@?��A2E:6?ED�H:E9
2D36DE@D:D EJA:42==J�92G6�3:=2E6C2=�5:77FD6 =F?8 :?7:=EC2E6D�>2:?=J�:?�E96�=@H6C�=@36D� A=6FC2=�A=2BF6D�
2?5 :?E6CDE:E:2= 7:3C@D:D H:E9�2 9@?6J4@>3:?8 A2EE6C?��:?�25G2?465�DE286D���?@?6�@7�H9:49�:D�D66?�:?
E9:D�A2E:6?E

C - M. tuberculosis infection

Explanation Why

�4E:G6�AC:>2CJ % �EF36C4F=@D:D :?764E:@?�@?=J�>2<6D�FA��N���@7 AC:>2CJ�EF36C4F=@D:D �,���42D6D


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,� :?764E:@?�2C6 =F?8 :?7=2>>2E:@?��9:=2C =J>A9256?@A2E9J��2?5 A=6FC2=�677FD:@?D��E96�42G:E2E:@?
D66?�:?�E9:D�A2E:6?E�:D�F?4@>>@? �*624E:G2E65 % �EF36C4F=@D:D :?764E:@?��D64@?52CJ�:?764E:@?��42?
56G6=@A�>@?E9D�@C�J62CD�7@==@H:?8�2�=2E6?E AC:>2CJ�,� :?764E:@? ��=E9@F89�FAA6C�=@36�42G:E2CJ =F?8
=6D:@?D�2C6�A2E9@=@8:4�7:?5:?8D�@7�C624E:G2E65 ,���=6D:@?D�2C6�492C24E6C:DE:42==J�=@42E65�H:E9:?�E96

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2A6I�@7�@?6�@C�3@E9�FAA6C�=@36D�C2E96C�E92?�46?EC2==J�:?�2?�FAA6C�=@36

D - Gastric content aspiration

Explanation Why

2DEC:4�4@?E6?E 2DA:C2E:@? :D�2 C:D<�724E@C 7@C 2DA:C2E:@?�A?6F>@?:2 2?5 =F?8�23D46DD �,96�>2:?


A2E9@=@8:4�7:?5:?8�@7�2 =F?8�23D46DD :D�2�4@==64E:@?�@7 AFD 2?5 ?64C@E:4 E:DDF6��?@E�E96�=2C86�42G:E2E:?8
>2DD�D66?�:?�E9:D�A2E:6?E

E - Chronic cigarette smoking

Explanation Why

,9:D�A2E:6?E�D�9:DE@CJ�@7�H@CD6?:?8 4@F89 2?5 5JDA?62 DE2CE:?8�2�>@?E9�28@�E@86E96C�H:E9�E96�2FE@ADJ


7:?5:?8D�2C6�9:89=J�DF886DE:G6�@7 =F?8�42?46C��7@C�H9:49�49C@?:4 4:82C6EE6�D>@<:?8 :D�E96�>@DE
:>A@CE2?E C:D<�724E@C $F?8�42?46C C:D<�:?4C62D6D�2D�E96�4:82C6EE6 A24<�J62CD :?4C62D6 �,96�EJA6D�@7
=F?8�42?46C >@DE�DEC@?8=J�4@CC6=2E65�H:E9 4:82C6EE6�D>@<:?8 2C6 DBF2>@FD�46==�42C4:?@>2 �+����2?5
D>2==�46==�=F?8�42?46C �+�$����3@E9�@7�H9:49�2C6�2DD@4:2E65�H:E9�2�>@C6�46?EC2=�=@42E:@?�:?�E96 =F?8
�2G:E2CJ�=6D:@?D��2D�D66?�:?�E9:D�A2E:6?E�D�2FE@AD:65 =F?8��2C6�4@>>@?�:?�+�� �'E96C C:D<�724E@CD 7@C
E96�56G6=@A>6?E�@7 =F?8�42?46C :?4=F56�@44FA2E:@?2=�2?5�6?G:C@?>6?E2=�6IA@DFC6�E@ 42C4:?@86?D
�A2DD:G6�D>@<:?8� 2D36DE@D� 2CD6?:4� C25@?��2?5�FC2?:F>�� 72>:=J�9:DE@CJ��2?5 D42C E:DDF6�:?�E96 =F?8D
�6 8 ��AF=>@?2CJ 7:3C@D:D��9:DE@CJ�@7 EF36C4F=@D:D�

F - Non-caseating granuloma formation

Explanation Why

&@?�42D62E:?8 8C2?F=@>2 7@C>2E:@?�:D�2�4@>>@?�>:4C@D4@A:4�7:?5:?8�@7 D2C4@:5@D:D �%24C@D4@A:4


6I2>:?2E:@?�@7�E96�=F?8D 4@>>@?=J�D9@HD�?@�=6D:@?D�:? D2C4@:5@D:D��2?5 3:=2E6C2=�9:=2C
=J>A9256?@A2E9J H@F=5�36�6IA64E65 �"?�25G2?465 D2C4@:5@D:D���N�4> ?@?�42D62E:?8 2?5�?@?�
42G:E2E65�?@5F=6D�2=@?8�E96 =J>A92E:4D 2?5 =F?8 7:3C@D:D 42?�36�D66?��C2E96C�E92?�2�=2C86�>2DD�:?�E96
FAA6C�=@36

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Question # 10

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G6?E:=2E65�H:E9�DFAA=6>6?E2=�@IJ86? �!6�92D 49C@?:4�@3DECF4E:G6�AF=>@?2CJ�5:D62D6�2?5�92D�D>@<65�@?6
A24<�@7�4:82C6EE6D�52:=J 7@C ���J62CD �!:D�E6>A6C2EFC6�:D��� �M����� �M����AF=D6�:D����>:?� C6DA:C2E:@?D
2C6����>:?�2?5�D92==@H��2?5�3=@@5�AC6DDFC6�:D �������>>�!8 �(F=D6�@I:>6ECJ�D9@HD�2? @IJ86?
D2EFC2E:@?�@7���� ��I2>:?2E:@?�D9@HD C65F465�3C62E9�D@F?5D�2?5�23D6?E�E24E:=6�7C6>:EFD @G6C�E96�=67E
96>:E9@C2I ��? I�C2J @7�E96�496DE�D9@HD =@DD�@7�=F?8�G@=F>6��2�>@56C2E6�>65:2DE:?2=�D9:7E�E@�E96�=67E�
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6IA=2:?D�E9:D�A2E:6?E�D�AF=>@?2CJ�7:?5:?8D�

Answer Image

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� ,6?D:@?�A?6F>@E9@C2I

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Hint

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Correct Answer

A - Simple pneumothorax

Explanation Why

��D:>A=6 A?6F>@E9@C2I 42?�@44FC�:?�>6492?:42==J�G6?E:=2E65�A2E:6?ED�2?5�>2?:76DE�H:E9�5:77:4F=EJ


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!@H6G6C��496DE I�C2J H@F=5�?@E�D9@H�2�H6586�D92A65�@A24:EJ��2D�D66?�96C6��3FE�C2E96C�C65F465�@C
23D6?E =F?8 >2C<:?8D�36J@?5�2�A=6FC2=�=:?6 ��:?2==J� A?6F>@E9@C246D :?�>6492?:42==J�G6?E:=2E65
A2E:6?ED�2C6�@7E6?�42FD65�3J 32C@EC2F>2 7C@>�9:89 (��(��D@�E9:D�A2E:6?E�D�:>AC@G6>6?E�27E6C
:?4C62D:?8 (��( H@F=5�?@E�36�4@?D:DE6?E�H:E9�E9:D�4@?5:E:@?

B - Tension pneumothorax

Explanation Why

,6?D:@?�A?6F>@E9@C2I >2?:76DED�H:E9�5:77:4F=EJ�3C62E9:?8� 9JA@I6>:2��C65F465�3C62E9�D@F?5D��2?5


23D6?E E24E:=6�7C6>:EFD @?�E96�27764E65�D:56�:?�A2E:6?ED�H9@�2C6�>6492?:42==J�G6?E:=2E65 �!@H6G6C�
255:E:@?2=�DJ>AE@>D�@7 E6?D:@?�A?6F>@E9@C2I DF49�2D E249J42C5:2� 9JA@E6?D:@?� ;F8F=2C�G6?@FD
5:DE6?D:@?��2?5 4@?EC2=2E6C2= 56G:2E:@?�@7�E96�EC24962 2C6�23D6?E�:?�E9:D�A2E:6?E �%@C6@G6C��2�496DE I�
C2J H@F=5�D9@H�C65F465�@C�23D6?E =F?8 >2C<:?8D�H:E9�2 >65:2DE:?2= D9:7E�E@�E96 4@?EC2=2E6C2= C2E96C
E92?�E96�27764E65�D:56 ��:?2==J� A?6F>@E9@C246D :?�>6492?:42==J�G6?E:=2E65�A2E:6?ED�2C6�@7E6?�42FD65
3J 32C@EC2F>2 7C@>�9:89 (��(��D@�E9:D�A2E:6?E�D�:>AC@G6>6?E�27E6C�:?4C62D:?8 (��( :D�:?4@?D:DE6?E
H:E9�E9:D�5:28?@D:D

C - Pneumonia

Explanation Why

(?6F>@?:2 :D�2�4@>>@?�A@DE@A6C2E:G6�4@>A=:42E:@?�E92E�>2?:76DED�H:E9�5:77:4F=EJ�3C62E9:?8�2?5
9JA@I6>:2 (?6F>@?:2 H:==�2AA62C�2D�2?�@A24:EJ�@?�496DE I�C2J��2?5��:7�E96�4@?D@=:52E:@?�@3DECF4ED�2
D>2== 2:CH2J��42?�6G6?�D9@H�6G:56?46�@7�G@=F>6�=@DD��2D�D66?�96C6 �!@H6G6C� 76G6C� 4C24<=6D��2?5
:?4C62D65�C2E96C�E92?�23D6?E E24E:=6�7C6>:EFD H@F=5�36�6IA64E65�:?�2�A2E:6?E�AC6D6?E:?8�H:E9

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A?6F>@?:2 ��:?2==J��:?4C62D65 (��( :D�?@E�2�EC62E>6?E�7@C A?6F>@?:2 2?5�>2J�6G6?�H@CD6?
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D - Atelectasis

Explanation But

'E96C�EJA6D�@7 2E6=64E2D:D :?4=F56�?@?@3DECF4E:G6�2?5�C@F?565

Explanation Why

,9:D�A2E:6?E�D 9JA@I6>:2��5F==?6DD�E@�A6C4FDD:@?��2?5�23D6?E E24E:=6�7C6>:EFD :?�4@>3:?2E:@?�H:E9


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G:DF2=:K65�3J�E96�?@C>2=�496DE I�C2J 52JD�27E6C�:?4C62D:?8 (��(��7FCE96C�DFAA@CED�E9:D�5:28?@D:D
(@DE@A6C2E:G6 A2:? 42?�:?E6C76C6�H:E9�DA@?E2?6@FD�566A�3C62E9:?8�2?5 4@F89:?8��H9:49�42?�=625�E@
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=625D�E@�C6D@CAE:@?�@7�82D�3J�AF=>@?2CJ 42A:==2C:6D��H9:49�42?�42FD6�E96�4@==2AD6�@7�?@?G6?E:=2E65
2=G6@=: 5:DE2= E@�E96�3C@?49:2=�@44=FD:@?��: 6 � C6D@CAE:G6�2E6=64E2D:D� �!@H6G6C��:?4C62D65�A@D:E:G6
AC6DDFC6�42?�C6@A6?�E96�4@==2AD65�2=G6@=:�3J DE6?E:?8 @A6?�E96 2:CH2JD��AC@G:5:?8�E96 =F?8 6IA2?D:@?
E92E�E96�A2E:6?E�:D�F?23=6�E@�249:6G6�3J�E96>D6=7 �(2E:6?ED�H9@�D>@<6�2?5�@C�92G6 �'(���=:<6�E9:D
A2E:6?E��2C6�A2CE:4F=2C=J�2E�C:D<�7@C A@DE@A6C2E:G6�2E6=64E2D:D �(C6@A6C2E:G6�D>@<:?8�46DD2E:@?�2?5
>65:42=�@AE:>:K2E:@?�2C6�<6J�E@�AC6G6?E:@?

E - Pleural effusion

Explanation Why

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F - Pulmonary embolism

Explanation Why

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A2:? �%@C6@G6C��564C62D65�3C62E9�D@F?5D�2?5�564C62D65 E24E:=6�7C6>:EFD 2C6�?@E�4@>>@?�762EFC6D�@7
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Question # 11

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:?�E96�A6C:A96CJ�@7�E96�=67E�=@H6C�=@36�2D�2�C6DF=E�@7�C6D:5F2=�D42C�E:DDF6 �,96�A2E:6?E�:D�4@?46C?65�23@FE
A@DD:3=6�=@?8�E6C>�4@>A=:42E:@?D�7C@>�E96 =F?8�D42C �,9:D�A2E:6?E�:D�2E�8C62E6DE�C:D<�7@C�56G6=@A:?8�2
AF=>@?2CJ�>2=:8?2?4J�4@>AC:D65�@7�H9:49�@7�E96�7@==@H:?8�EJA6D�@7�46==D�

Answer Image

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Answer Image

� +BF2>@FD�EF>@C�46==D

� =2?5F=2C�EF>@C�46==D

� (=6@>@CA9:4�8:2?E�46==D

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Hint

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Correct Answer

A - Anaplastic small-blue-round cells

Image

Explanation Why

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D>2==�46==�=F?8�42?46C EJA:42==J�92D�2�46?EC2=�=@42E:@?�:?�E96 =F?8 2?5�:D�DEC@?8=J�2DD@4:2E65�H:E9
D>@<:?8

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B - Serotonergic neuroendocrine cells

Image

Explanation Why

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C - Squamous tumor cells

Image

Explanation Why

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D - Glandular tumor cells

Image

Explanation But

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2D�2 7:3C@E:4 =6D:@?

Explanation Why

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:?�=@42E:@?��2D�5@6D 256?@42C4:?@>2�@7�E96�=F?8 �+42CC:?8�7C@> EF36C4F=@D:D :D�E96�>@DE�4@>>@? C:D<
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E - Pleomorphic giant cells

Image

Explanation Why

(=6@>@CA9:4 8:2?E�46==D 2C6�D66?�:? =2C86�46==�42C4:?@>2��H9:49�EJA:42==J�92D�2�A6C:A96C2=�=@42E:@?�:?


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9:DE@=@8:4�EJA6�@7 =F?8 D42C 42C4:?@>2

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Question # 12

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Answer Image

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Hint

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Correct Answer

A - Skeletal myocytes

Explanation Why

,96�7@C>2E:@?�@7�?6H�D<6=6E2= >J@4JE6D �2=D@�<?@H?�2D�>J@7:36CD��7C@>�E96�>6D@56C>2=�=2J6C


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2?5�H:5E9�G:2 9JA6CEC@A9J 3FE�E96�?F>36C�@7�46==D�C6>2:?D�E96�D2>6

B - Nephrons

Explanation Why

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H66<D� 86DE2E:@? ��C@>�E9:D�A@:?E�@?H2C5��C6?2=�7F?4E:@?�4@?E:?F6D�E@�:?4C62D6�G:2 ?6A9C@?
9JA6CEC@A9J��H9:49�:D�:?5F465�3J�96>@5J?2>:4�DEC6DD

C - Brown adipocytes

Explanation Why

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25F=E9@@5��E96J�2C6�FDF2==J�4@?46?EC2E65�@?=J�2C@F?5�E96 G6CE63C2� 4=2G:4=6� >65:2DE:?F>��2?5�=2C86
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D - Alveoli

Image

Explanation Why

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E - Oocytes

Image

Explanation Why

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564=:?6�:?�E96�E@E2=�?F>36C�@7�AC:>2CJ @@4JE6D 6249�>@?E9 �-A@?�C6249:?8 AF36CEJ��@?=J�2AAC@I
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