NBME CBSE LATEST UPDATED
EXAM QUESTIONS AND ANSWERS
More ventilation is at the - BASE
O2-Hgb dissociation LEFT shift - basic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - low pH, high 2,3BPG, high T
HOT, ACIDIC
CO2 transport to lungs - *carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - carboxyhemoglobin
no affect on PaO2
Cyanide poisoning causes - lactic acidosis
,How to treat cyanide poisoning - *Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - 5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - *Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
*V/Q mismatch* (pulmonary edema
AT --> AT II
where and how - ACE
(- high in sarcoidosis)
In small pulmonary bV
C5a induces what - PMN influx (ie: in lungs)
Korotkoff sound - BP cuff - appear and disappear
in inflation/deflation
Pulsus Paradoxus - 10mmHg difference in
Korotkoff sound
Pulsus Paradoxus occurs in - Cardiac Tamponade
Kussmaul sign - JVP rises *during inspiration*
Constrictive Pericardiditis
,Restrictive/Interstitial Lung Disease:
A-a, FVC, FEV1, EFR - Airway widening due to *radial traction* from fibrosis
*increase Aa*
decreased FVC & FEV1
*Increased EFR*
Sarcoidosis - *Th1 *noncaseating granulmona
bilateral hilar adenopathy
increased *ACE*
increased IL2, IFNg
1-a-hydroxylase in macrophages: vit D --> *HyperCa*
Hyper Ca causes - stones, thrones, groans, psych overtones
1-a-hydroxylase in macrophages - PTH independent conversion of
Calcifediol to *calcitriol* (bioactive Vit D)
Vit D --> Hyper Ca
Idiopathic pulmonary fibrosis - *Honeycomb* pattern
loss of Type 1 pneumocytes
*hyperplasia Type II* pneumocytes
Goodpasture - HS II
Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli
Obstructive Lung Disease - DECREASED FEV1, Decreased FVC
increased RV, FRC, TLC
**different shape
, COPD - PMN, mo, CD8
*V/Q mismatch:* O2 induced hypercapnia;
physio dead space
Myeloperoxidase causes - Green sputum/pus
Do not give O2 supplement to - COPD patient
Decreased stimulation of
*carotid bodies* = decreased RR
TX COPD with - *Fluticasone* (glucocorticoid)
inhibit cellular reaction
a1-antitrypsin deficiency - Serine protease inhibitor
*LIVER*
*LUNG*: inc PMN elastase --> emphysema
Asthma dx - *Methacholine* (maCh) challenge
= induce bronchoconstriction
to reduce FEV1
+ test = Airways ARE reactive
B2 agonist MOA - B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - inhibit cytokine synthesis
suppress T lymphocyte
EXAM QUESTIONS AND ANSWERS
More ventilation is at the - BASE
O2-Hgb dissociation LEFT shift - basic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - low pH, high 2,3BPG, high T
HOT, ACIDIC
CO2 transport to lungs - *carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - carboxyhemoglobin
no affect on PaO2
Cyanide poisoning causes - lactic acidosis
,How to treat cyanide poisoning - *Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - 5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - *Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
*V/Q mismatch* (pulmonary edema
AT --> AT II
where and how - ACE
(- high in sarcoidosis)
In small pulmonary bV
C5a induces what - PMN influx (ie: in lungs)
Korotkoff sound - BP cuff - appear and disappear
in inflation/deflation
Pulsus Paradoxus - 10mmHg difference in
Korotkoff sound
Pulsus Paradoxus occurs in - Cardiac Tamponade
Kussmaul sign - JVP rises *during inspiration*
Constrictive Pericardiditis
,Restrictive/Interstitial Lung Disease:
A-a, FVC, FEV1, EFR - Airway widening due to *radial traction* from fibrosis
*increase Aa*
decreased FVC & FEV1
*Increased EFR*
Sarcoidosis - *Th1 *noncaseating granulmona
bilateral hilar adenopathy
increased *ACE*
increased IL2, IFNg
1-a-hydroxylase in macrophages: vit D --> *HyperCa*
Hyper Ca causes - stones, thrones, groans, psych overtones
1-a-hydroxylase in macrophages - PTH independent conversion of
Calcifediol to *calcitriol* (bioactive Vit D)
Vit D --> Hyper Ca
Idiopathic pulmonary fibrosis - *Honeycomb* pattern
loss of Type 1 pneumocytes
*hyperplasia Type II* pneumocytes
Goodpasture - HS II
Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli
Obstructive Lung Disease - DECREASED FEV1, Decreased FVC
increased RV, FRC, TLC
**different shape
, COPD - PMN, mo, CD8
*V/Q mismatch:* O2 induced hypercapnia;
physio dead space
Myeloperoxidase causes - Green sputum/pus
Do not give O2 supplement to - COPD patient
Decreased stimulation of
*carotid bodies* = decreased RR
TX COPD with - *Fluticasone* (glucocorticoid)
inhibit cellular reaction
a1-antitrypsin deficiency - Serine protease inhibitor
*LIVER*
*LUNG*: inc PMN elastase --> emphysema
Asthma dx - *Methacholine* (maCh) challenge
= induce bronchoconstriction
to reduce FEV1
+ test = Airways ARE reactive
B2 agonist MOA - B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - inhibit cytokine synthesis
suppress T lymphocyte
