Fellowship Entrance Test
BAF Academy
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1. Which of the following is true regarding administration of mRNA COVID-19 vaccines?
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They are contraindicated in individuals withprior vaccine anaphylaxis.
Observation time is 15 minutes for allindividuals.
Observation time is 15 minutes for allindividuals.
Anaphylactic reactions occur morecommonly with the second dose.
2. Systemic corticosteroids provide dramaticclinical improvement for patients with severe atopic dermatitis. However, amongthe many side effects, the major concern with their use is which of thefollowing?
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Hepatoxicity
Rebound flares seen after cessation
Acne/folliculitis
Conjunctivitis
3. Which is most specific for airflowobstruction?
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FEV1
FVC
FEV1/FVC
TLC
4. Which of the following, when used beforethe onset of symptoms, prevents the development of chronic obstructive pulmonary disease?
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β-agonists
Anticholinergics
Inhaled corticosteroids
Smoking cessation
5. Which of the following pulmonary functiontest results are seen in both chronic obstructive pulmonary disease andinterstitial lung disease?
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High FEV1/FVC
High total lung capacity
Low diffusion capacity
Low residual volume
6. Which drug is least likely to causeaspirin-exacerbated respiratory disease (AERD)?
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Acetaminophen
Celecoxib
Ibuprofen
Naproxen
7. Which of the following radiographicfeatures are typical of acute hypersensitivity pneumonitis?
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Mosaic attenuation
Ground glass lung infiltrates
Hilar adenopathy
Lobar infiltrates
8. A 32-year-old man presents to your officewith symptoms of itchy, intermittent hives for the past 8 weeks. He reportsthat the hives last for a few hours and resolve but recur a few days later. Hedenies using any new medications but notes development of a sinus infection afew days before the hives started. No bruising occurs when the hives resolve.What laboratory testing should you order after his first visit with you?
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No labs are advised at present
Complete blood count with differential
C4, C1 inhibitor level, and C1 inhibitorfunction
Tryptase level
9. For the same 32-year-old man whopresented to your clinic with symptoms of itchy, intermittent hives for the past8 weeks, what treatment regimen would you suggest at this initial consultation?
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Omalizumab 300 mg every 4 weeks
Avil (Pheneramine) 25 mg as needed
Fexofenadine 180 mg daily
Plaquenil 200 mg daily
10. With regard to the public health impactof ozone and particulate matter standards, which of the following statements ismost accurate?
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Exposure to ozone is strongly associated withdevelopment of new allergy
Long-term reduction in air pollutants has shown clearlyto reduce the occurrence of asthma and bronchitis in the population
Use of prophylactic medications has shown toprotect against the effect of particulate matter on airway disease
Pollution control is most important in thewinter to reduce ozone levels in the morning
11. Which of the following drugs is mostlikely to cause a hypersensitivity reaction?
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Penicillin
Trimethoprim sulfamethoxazole
Ciprofloxacin
Aspirin
12. A 26-year-old physical therapist withepisodes of wheezing 3 days each week. She awakens out of sleep once everyother week with wheezing and cough. Her only medication is albuterol inhaler,which she requires at least 3 days per week. She had a hospitalization at age18 years for asthma requiring intensive care unit management. Her physicalexamination results are normal, and spirometry is normal: (Forced expiratory volume (FEV1) = 88%predicted, forced vital capacity (FVC) = 94% predicted). How would you categorizethe severity of her asthma?
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Intermittent
Mild persistent
Moderate persistent
Severe persistent
13. Which of the following drugs is mostlikely to cause a hypersensitivity reaction?
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Penicillin
Trimethoprim sulfamethoxazole
Ciprofloxacin
Aspirin
14. A 26-year-old seasonal allergic rhino-conjunctivitisassociated complains of progressive irritation in her right eye over the past 2days. There is no history of nausea, vomiting, fever or myalgia. Her right eyeinitially had a ropy white discharge. Now she has noticed that her eyelidsappear to be more sticky in the morning when she wakes up. On examination, anopaque yellowish mucus strand is noted on the eyelid, with moderate injectionof the conjunctiva. The other eye has only mild injection. Which of thefollowing is not recommended?
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Topical mast cell stabilizing agent
Lubricants
Cold compresses
Topical antibiotic/steroid agent
15. A 24-year-old man without any pastmedical history reports nasal congestion, fatigue and yellow nasal drainage forthe past 6 days. He has no fever. What is the best option?
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Supportive care
Short course of oral steroids
10-day course of oral antibiotics
Antihistamines
LongEssay
(15 Marks)
A 30 year old recently promoted executive in a global multinational company movedto Bangalore and has since then c/o persistent cough with wheezing on and off.He is up coughing most nights. He has failed antibiotic courses. He has a normalchest X-Ray. Describe any additional questions that you would ask on history? What is your diagnosis, differentialdiagnosis, severity classification, investigations and long- term management ofthis patient.
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Short Questions
CaseHistory (10 Marks Each)
1. A 35 year old developed severe urticarial rash, wheezing, throat tightness aftereating at a sea food restaurant. Her BP in the emergency room was 70/50.Describe your diagnosis, differential diagnosis and immediate management of thepatient in the emergency room.
2. A 15 year old student presents to you clinic with constant colds, sneezing anditchy nose. She is studying for her 10th standard exams. She isalways indoors, wakes up with severe nasal symptoms and has constant headachesespecially in the afternoon. Her mother has given her home remedies andparacetamol. What is the most likely diagnosis? Outline your management plans.
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