| Post Name | Assistant Professor in Pulmonary Medicine |
|---|---|
| Department | Medical Education |
| Question Paper Code | 133/2026/OL |
| Category Code | 689/2025 |
| Date of Test | 21 July 2026 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
Which CPET parameter is most useful for assessing ventilatory eļ¬ciency ?
Answer
C. VE/VCO2 slope
2
Benralizumab induces eosinophil depletion primarily through
Answer
B. Antibody-dependent cellular cytotoxicity (ADCC)
3
In a survival analysis, the Hazard Ratio for death is 0.85 with a 95% CI of 0.60-1.20. The correct interpretation is :
Answer
D. No statistically signiļ¬cant diļ¬erence is demonstrated
4
Which EBUS sonographic feature has the highest speciļ¬city for metastatic nodal involvement in lung cancer ?
Answer
A. Coagulation necrosis sign
5
In a randomized controlled trial evaluating a new antiļ¬brotic drug in idiopathic pulmonary ļ¬brosis, which method best ensures balance of known and unknown confounders between groups
Answer
B. Randomization
6
A 34-year-old lady with severe, uncontrolled asthma is considered for add-on biologic therapy. Her laboratory workup shows a boold eosinophil count of 120 cells/ L and a fractional exhaled nitric oxide (FeNO) level of 15 ppb. Which of the following biologic is most likely to beneļ¬t her ?
Answer
C. Tezepelumab
7
What is the recommended dose of nebulized ensifentrine in COPD ?
Answer
C. 3 mg BD
8
Which of the following is not a feature of nicotine withdrawal ?
Answer
B. Tachycardia
9
Which amongst the following best describes tuberculosis associated COPD ?
Answer
D. COPD-I
10
A 70-year-old male with chronic cough and wheezing performs spirometry for suspected COPD. The spirometry values are as follows : Maneuver 1 : FEV1 = 1.20 L, FVC = 2.50 L (End of forced Expiration plateau achieved at 9 seconds) Maneuver 2 : FEV1 = 1.32 L, FVC = 2.30 L (Maneuver interrupted by a severe coughing ļ¬t at 2 seconds) Maneuver 3 : FEV1 = 1.30 L, FVC = 2.30 L (End of forced expiration plateau achieved at 7 seconds) Maneuver 4 : FEV1 = 1.35 L, FVC = 2.10 L (End of forced expiration plateau achieved at 11 seconds) Which is the most appropriate maneuver used for calculating FEV1/FVC ratio ?
Answer
A. Maneuver 1
11
Non bronchodilator eļ¬ects of Tiotropium includes all except
Answer
C. Activation of M3 receptor
12
which of the following statement is true regarding management of Bronchiectasis ?
Answer
B. In BAT trail there was observed a greater percentage of resistant pathogen by end of treatment period
13
Latest ERS guidelines on Bronchiectasis (Eur Respir J 2025) recommendation are i) All patients newly diagnosed with bronchiectasis should be screened for immunodeļ¬ciency, ABPA and NTM. ii) Not to oļ¬er long term non-macrolide oral antibiotics as ļ¬rst line treatment to adult patients with bronchiectasis and a high risk of exacerbations iii) Not to oļ¬er eradication treatment to patients with a new isolation of P. aeruginosa
Answer
B. i and ii
14
Which of the following statement is false regarding FeNO ? i) There is strong correlation between FeNO and airway hyper-responsiveness ii) Elevated FeNO in infancy can predict childhood Asthma iii) In the EXTRA study biomarker FeNO predicteed response to Benralizumab iv) ATS guidelines suggest the FeNO < 25ppb in adults is a strong indicator of ICS non responsiveness.
Answer
B. iii and iv
15
In Centrilobular Emphysema
Answer
C. Central Dot sign in a classical sign of centrilobular emphysema
16
In Lung Oscillometry
Answer
B. Higher frequencies travel shorter distances while lower frequencies travel deeper into the lung
17
For Symptomatic Central Airway Obstructions Malignant or Non malignant-ACCP guidelines are all, except
Answer
D. Flexible Therapeutic bronchoscopy for interventions
18
A 36 year old female having breathing issues for the past few years, has multiple episodes of ER visits and intubation. She has no improvement with high dose steroids. Her most likely diagnosis is
Answer
C. Vocal cord dysfunction
19
Which of the following statements are true regarding e-cigarettes.
Answer
D. All the above
20
Randomized double blind METREX trial was done with
Answer
B. Mepolizumab
21
According to the ATS/IDSA guidelines, which of the following criteria deļ¬nes Severe Community-Acquired Pneumonia (CAP) requiring ICU admission ?
Answer
B. Three minor criteria OR one major criterion
22
Which of the following NTM species is MOST commonly associated with hot tub lung (Hypersensitivity pneumonitis pattern)
Answer
C. Mycobacterium Avium Complex (MAC)
23
A post-renal transplant patient on tacrolimus and prednisolone presents with headache, fever and visual changes. CSF : opening pressure 320 mmH2O, lymphocytic pleocytosis, low glucose, elevated protein. India ink preparation is positive. Which of the following is the MOST appropriate induction therapy ?
Answer
C. Liposomal amphotericin B + ļ¬ucytosine for at least 2 weeks
24
45-year-old patient, asplenic due to trauma 2 years ago presents for vaccination advice.Which of the following vaccines is contraindicated in this patient ?
Answer
C. Live attenuated oral typhoid vaccine (Ty21a)
25
Mycobacterium tuberculosis evades intracellular killing primarily by which mechanism after phagocytosis by alveolar macrophages ?
Answer
B. Inhibiting phagosome-lysosome fusion by blocking vacuolar ATPase acidiļ¬cation via ESAT-6 and lipoarabinomannan
26
Which of the following radiological patterns is most characteristic of post-primary (reactivation) pulmonary tuberculosis ?
Answer
B. Upper lobe ļ¬brocavitary disease
27
The mechanism by which isoniazid (INH) exerts its anti mycobacterial eļ¬ect is
Answer
B. Inhibition or inhA blocking mycolic acid synthesis
28
Rasmussen's aneurysm involves which vessel ?
Answer
B. Pulmonary artery branch within or adjacent to a cavity
29
All of the following statements are true regarding Bruton agammaglobulinemia except
Answer
D. Children present with recurrent infections within ļ¬rst 4 months of age
30
The principal advantage of Xpert MTB/RIF Ultra over conventional Xpert MTB/ RIF is
Answer
B. Higher sensitivity due to lower limit of detection
31
ANCA associated vasculitis are
Answer
D. All of the above
32
Paget-Schroetter syndrome is a rare condition that can be a predisposing factor of pulmonary embolism aļ¬ecting young, healthy, and physically active individuals is associated with
Answer
D. Deep vein thrombosis of upper limb vessels
33
During the course of three distinct phases of in Eosinophilic Granulomatosis with Polyangiitis- prodromal allergic, eosinophilic and vasculitic phase, the exceedingly rarely seen lung manifestation is
Answer
A. Alveolar haemorrhage
34
Massive haemoptysis due to Vasculitis weakening the walls of the pulmonary arteries, and rupture of the aneurysms into the adjacent airways is seen in
Answer
A. Behcet's Disease
35
Interstitial Lung disease associated with smoking are all except
Answer
C. Cryptogenic Organising Pneumonia (COP)
36
Microscopic polyangiitis (MPA) is a systemic autoimmune disease characterized by small-vessel inļ¬ammation,systemic manifestations include all except
Answer
C. Cavitating Lung nodules
37
Match the Radiological Patterns of lLD with the mostprobable diagnosis Column 1 Column 2 A. Three density sign a. Non-Speciļ¬c Interstitial Pneumonia B. Peri lymphatic Nodules b. Lymphocytic interstitial pneumonia C. Ground-Glass Opacities c. Sarcoidosis D. Cysts d. hypersensitivity pneumonitis
Answer
A. Ad, Bc,Ca, Db
38
Match the Broncho Alveolar Lavage ļ¬ndings in column 1 with the most probable diagnosis in column 2. Column 1 Column 2 A. High CD4/CD8 ratio > 4 a. Alveolar Proteinosis B. Eosinophil diļ¬erential count > 25% b. Alveolar Haemorrhage C. Hemosiderin-laden macrophages c. Sarcoidosis D. Positive for periodic acid-Schiļ¬ staining d. Chronic Eosinophilic Pneumonia
Answer
D. Ac, Bd,Cb, Da
39
L fgren syndrome is an acute form of sarcoidosis presenting with fever and erythema nodosum,characterised by all except
Answer
C. Bad prognosis with less than 10% remission
40
The most common subtype of mesothelioma and generally oļ¬ers the best prognosis to treatment is
Answer
C. Epithelioid Mesothelioma
41
Major ļ¬ndings of MIST-2 ( second Multicentre Intrapleural Sepsis trial) are all except
Answer
A. Streptokinase is not inferior to combination of tPA and DNase
42
Post cardiac injury syndrome is characterised by all except
Answer
B. Characteristically the C Reactive protein level will be low
43
Pulmonary Hypertension due to congenital Heart Disease is categorised under WHO classiļ¬cation as group
Answer
A. 1
44
Wells score includes all except
Answer
C. Alternate diagnosis likely
45
Pulmonary hypertension in COPD is best managed with
Answer
A. Home Oxygen therapy
46
Chronic hypoventilation due to chest wall deformity in a 30 year old man can be managed with all except
Answer
B. Correction of chest deformity to improve lung function
47
All are TRUE regarding D dimer Except
Answer
A. Should be used to rule in pulmonary embolism in patients with high probability of pulmonary embolism
48
Familial pneumothorax can be seen in all except
Answer
D. Rubinstein Taybi syndrome
49
The pharmacological agent which has shown improvement in hemodynamic after balloon pulmonary angioplasty in Chronic Thrombo Embolic Pulmonary Hypertension is
Answer
D. Riociguat
50
Intercostal tube sizes recommended for primary spontaneous pneumothorax by British Thoracic Society guidelines is
Answer
B. 8-14F
51
Which driver mutation is common in lung adenocarcinoma occurring in never smokers
Answer
B. EGFR Mutation
52
Malignant pulmonary nodule shows which pattern of calciļ¬cation
Answer
D. Punctate
53
PET-CT is most useful in evaluating a solitary pulmonary nodule if the diameter is
Answer
C. Greater than or equal to 8 mm
54
SUV max greater than___________ has been considered suspicious of lung malignancy.
Answer
C. 2.5
55
The recommended follow up for lung-RADS category 3 is
Answer
C. LD CT in 6 months
56
In TNM staging system for lung cancer which of the following is classiļ¬ed as M1a disease
Answer
Question Cancelled
57
Tumor marker often elevated in mesothelioma is
Answer
C. SMRP
58
In the Masaoka staging of thymoma microscopic transcapsular invasion corresponds to
Answer
B. Stage llA
59
A monophasic steep decline in pleural manometry during ļ¬uid removal is seen in
Answer
D. Trapped lung
60
A patient with an anterior mediastinal mass and marked elevation of AFP most likely has
Answer
C. Non seminomatous germ cell tumor
61
The mechanisms for post operative atelectasis are i. FRC greater than CC ii. CC exceeds lung volume for part of the time during each tidal breath iii. Reduction in FEV1 iv. CC is greater than FRC
Answer
D. (ii) and (iv)
62
Which is the wrong statement about Carbon monoxide toxicity ?
Answer
B. Oxygenāhemoglobin dissociation curve is shifted to the right
63
Bronchiolitis obliterans is a complication of
Answer
C. All of the above
64
All are absolute contraindications for lung transplantation, except,
Answer
Question Cancelled
65
Increased incidence of postoperative pulmonary complications in patients with COPD is due to
Answer
D. All of the above
66
A 62 year old male with severe congestive heart failure and acute pulmonary oedema is placed on non-invasive positive pressure ventilation (BiPAP) with an IPAP of 16 cm H2O and an EPAP of 6 cm H2O. After 30 minutes, he is sweating and remains extremely anxious. He is spitting up pink, frothy sputum and is repeatedly pulling oļ¬ his BiPAP mask. His vital signs are: Heart rate 118 beats/minute, BP 178/96 mmHg, Respiratory rate 32breaths/minute, and SpO2 82 % on BiPAP with 100% oxygen. What is the most appropriate immediate action ?
Answer
C. Proceed with urgent endotracheal intubation and mechanical ventilation
67
A 58 year old female with a history of liver cirrhosis presents in the emergency room with fever, chills, and a rapidly progressing, painful erythematous lesion on the left leg. On examination, her blood pressure is 80/42 mm and she is diagnosed with sepsis secondary to cellulitis. Her blood is drawn for serum lactate estimation. According to the Surviving Sepsis Campaign guidelines,which among the following is the most appropriate initial ļ¬uid resuscitation strategy ?
Answer
B. Administer balanced crystalloids at 30 ml/kg within the ļ¬rst 3 hours
68
The most common underlying physiological abnormality/disturbance resulting in diļ¬cult weaning in patients with severe COPD is
Answer
D. Respiratory muscle fatigue caused by intrinsic PEEP and high resistive workload
69
Which among the following primary physiological mechanism by which prone positioning improves oxygenation in severe ARDS ?
Answer
C. It recruits collapsed alveoli in the dorsal lung zones and homogenizes ventilation-perfusion (V/Q) matching
70
A patient is on volume control ventilation with a tidal volume of 400 mL, peak inspiratory pressure (PIP) of 35cm H2O, plateau pressure (Pplat) of 26 cm H2O, and PEEP of 10 cm H2O. What is the driving pressure (ā P)?
Answer
A. 16cmH2O
71
Which of the following will decrease cortisol levels most eļ¬ectively and rapidly in patients with severe Cushing syndrome ?
Answer
C. Etomidate
72
Which medication is NOT known to cause or worsen methemoglobinemia ?
Answer
C. Amlodipine
73
A 50-year-old female patient has massive hemoptysis and x-ray chest shows a large cavity in the left apex. Which of the following is advised ?
Answer
C. Selective right mainstem bronchus intubation
74
Which of the following statements is correct for the diagnosis of Guillain-Barre' syndrome ?
Answer
B. Respiratory failure develops in approximately one-third of patients
75
Based on the randomized ECLS-SHOCK trial, which of the following is correct ?
Answer
C. VA-ECMO has no eļ¬ect on survival with substantial increase in bleeding and vascular complications.
76
Which of the following strategies is most likely to reduce risk of central line-associated bloodstream infections (CLABSIs) ?
Answer
B. Use of chlorhexidine-containing dressings
77
Which of the following is a risk factor for multidrug-resistant Ventilator Associated Pneumonia (VAP) ?
Answer
B. Initiation of acute renal replacement therapy prior to VAP onset
78
Which of the following tools is no longer recommended as a single instrument to screen patients with sepsis or septic shock ?
Answer
B. Quick Sequential Organ Failure Assessment (qSOFA)
79
Which of the following treatments for the management of myasthenia gravis (MG) will have the most rapid onset of action?
Answer
A. Plasma exchange
80
A 80 year old man developed rapid onset hypotension after 3 days of a below-knee amputation. He also has coronary artery disease that is medically managed. At present, his BP is 70/50 mm Hg, heart rate of 110/min, and respiratory rate of 20/min with Spo2 of 96% on breathing room air. In spite of transfusing a bolus of normal saline via an existing peripheral IV catheter, he is having persistent hypotension. What is the best route for initial administration of vasopressors in this situation ?
Answer
A. Peripheral venous catheter
81
Which of the following is a clinical sub-group of immotile cilia syndrome ?
Answer
B. Kartagener syndrome
82
Indications for screening for cystic ļ¬brosis in adults include all of the following except
Answer
C. Dextrocardia
83
Cause of neonatal respiratory distress seen exclusively in premature infants
Answer
A. Bronchopulmonary dysplasia
84
Which is the respiratory component of vacteralsyndrome ?
Answer
C. Tracheoesophageal defects
85
Which is a developmental lung abnormality that can present as Diļ¬use Cystic Lung Disease ?
Answer
Question Cancelled
86
A score of 3 or more is indicative of high risk for the diagnosis of Obstructive sleep apnea as per the stop bang screening criteria and it includes the following except
Answer
B. Neck circumference more than 30 cm
87
Pick out the true statements with regards to Auto-Titrated Positive Airway pressure machine (APAP) I. It was originally developed for titration of patients after a home sleep study II. It monitors inspiratory ļ¬ow patterns, detect and respond to changes in upper Air ļ¬ow and resistance in real time III. It is unique in that it can detect and diļ¬erentiate both central and obstructive events and is recommended for both diagnosis and management of OSA IV. It acts as a CPAP which varies over time with pressure range between 4-20 cm of H2O
Answer
C. I, II & IV are correct
88
The false statement about Tirzepatide is
Answer
D. It is a dual GLP-1/GIP antagonist and improves insulin sensitivity and reduces upper airway collapsibility.
89
Profound muscle atonia in Electromyogram (EMG) and low voltage mixed frequencies along with Saw tooth pattern in Electroencephalogram (EEG) are typical of the following sleep stage
Answer
D. REM sleep
90
Choose the incorrect statement from the following :
Answer
B. It has a rare Autosomal recessive inheritance pattern apart from de novo mutants
91
All are true about Narcolepsy except
Answer
D. Type 2 Narcolepsy presents characteristically with cataplexy
92
UARS or upper airway resistance syndrome comprises of
Answer
Question Cancelled
93
All are true about Obesity hypoventilation Syndrome (OHS) except
Answer
A. Typically, the BMI is greater than 25 Kg/ M2
94
CompSAS or Complex Sleep apnea syndrome is except and response should be
Answer
C. not a transient phenomenon in a large majority and hence requires newer modes of PAP therapy
95
Match the following: Breathing pattern Disease condition i) Shallow breathing a) Post stroke patients ii) Cheyne stokes breathing b) Renal failure iii) Kussmauls breathing c) Brain stem lesions iv) Ataxic breathing d) Parkinsonism, Motor neuron
Answer
A. i(d) ii (a) iii (b) iv (c)
96
All are factors associated with development of post operative pulmonary complications except
Answer
B. Gender
97
The following statements about post operative lung function are true except
Answer
D. Vital Capacity falls by 10% after lower abdominal surgery
98
The following statements are true except
Answer
A. Most common hemodynamic derangement inpatients with liver disease is pulmonary hypertension
99
Airway obstruction following acute smoke inhalation can be treated in ICU with
Answer
D. a, b and c
100
Performing CPR in a patient with refractory septic shock complicated by cardiac arrestafter progressive hypo-tension despite maximal therapy is
Answer
D. a, b and c
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