NBME CBSE ACTUAL EXAM|VERIFIED QUESTIONS AND CORRECT DETAILED
ANSWERS|RATED AND GRADED A+ NEW UPDATE| 2026/2027
II pneumocytes - ANSWER✔ surfactant (*lecithin*)
Proliferate after injury
Type I progenitors
*Neonatal Respiratory Distress Syndrome*
Polio live v killed vaccine - ANSWER✔ Killed = Salk = IgG
Live = Sabin = IgG + IgA
- can be shed in feces
Neonatal Respiratory Distress:
Etiology + Tx - ANSWER✔ Maternal DM (*high insulin*)
or C-section (*low cortisol*)
TX: *dexamethasone* before birth
Lung maturity determined with - ANSWER✔ Amniocentesis of Phospholipids (*type II pneumocytes)
L >> S
Type I pneumocytes - ANSWER✔ Squamous gas diffusion
Elastase in lungs - ANSWER✔ macrophage: *lysosomes*
PMN: *azuronphilic granules*
Elastin stretches and recoils due to - ANSWER✔ Lysine interchain crosslinks
,air pressure and
intrapleural pressure at FRC - ANSWER✔ Air pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - ANSWER✔ Exhale of Tidal Volume
Lung Compliance is decreased by - ANSWER✔ LHF, pulmonary edema,
pulmonary fibrosis
Lung Compliance is increased by - ANSWER✔ emphysema, age
Obesity affects ERV and FRC - ANSWER✔ DECREASE
ERV & FRC
Blood flow/min (pulmonary v systemic) - ANSWER✔ pulmonary = systemic
Anatomic pulmonary shunting - ANSWER✔ Bronchial circulation causes
*decreased PO2 in LA/LV*
than in pulmonary capillaries
More ventilation is at the - ANSWER✔ BASE
O2-Hgb dissociation LEFT shift - ANSWER✔ basic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - ANSWER✔ low pH, high 2,3BPG, high T
HOT, ACIDIC
,CO2 transport to lungs - ANSWER✔ *carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - ANSWER✔ carboxyhemoglobin
no affect on PaO2
Cyanide poisoning causes - ANSWER✔ lactic acidosis
How to treat cyanide poisoning - ANSWER✔ *Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - ANSWER✔ 5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - ANSWER✔ *Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
*V/Q mismatch* (pulmonary edema
AT --> AT II
where and how - ANSWER✔ ACE
(- high in sarcoidosis)
In small pulmonary bV
C5a induces what - ANSWER✔ PMN influx (ie: in lungs)
, Korotkoff sound - ANSWER✔ BP cuff - appear and disappear
in inflation/deflation
Pulsus Paradoxus - ANSWER✔ 10mmHg difference in
Korotkoff sound
Pulsus Paradoxus occurs in - ANSWER✔ Cardiac Tamponade
Kussmaul sign - ANSWER✔ JVP rises *during inspiration*
Constrictive Pericardiditis
Restrictive/Interstitial Lung Disease:
A-a, FVC, FEV1, EFR - ANSWER✔ Airway widening due to *radial traction* from fibrosis
*increase Aa*
decreased FVC & FEV1
*Increased EFR*
Sarcoidosis - ANSWER✔ *Th1 *noncaseating granulmona
bilateral hilar adenopathy
increased *ACE*
increased IL2, IFNg
1-a-hydroxylase in macrophages: vit D --> *HyperCa*
Hyper Ca causes - ANSWER✔ stones, thrones, groans, psych overtones
1-a-hydroxylase in macrophages - ANSWER✔ PTH independent conversion of
Calcifediol to *calcitriol* (bioactive Vit D)
ANSWERS|RATED AND GRADED A+ NEW UPDATE| 2026/2027
II pneumocytes - ANSWER✔ surfactant (*lecithin*)
Proliferate after injury
Type I progenitors
*Neonatal Respiratory Distress Syndrome*
Polio live v killed vaccine - ANSWER✔ Killed = Salk = IgG
Live = Sabin = IgG + IgA
- can be shed in feces
Neonatal Respiratory Distress:
Etiology + Tx - ANSWER✔ Maternal DM (*high insulin*)
or C-section (*low cortisol*)
TX: *dexamethasone* before birth
Lung maturity determined with - ANSWER✔ Amniocentesis of Phospholipids (*type II pneumocytes)
L >> S
Type I pneumocytes - ANSWER✔ Squamous gas diffusion
Elastase in lungs - ANSWER✔ macrophage: *lysosomes*
PMN: *azuronphilic granules*
Elastin stretches and recoils due to - ANSWER✔ Lysine interchain crosslinks
,air pressure and
intrapleural pressure at FRC - ANSWER✔ Air pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - ANSWER✔ Exhale of Tidal Volume
Lung Compliance is decreased by - ANSWER✔ LHF, pulmonary edema,
pulmonary fibrosis
Lung Compliance is increased by - ANSWER✔ emphysema, age
Obesity affects ERV and FRC - ANSWER✔ DECREASE
ERV & FRC
Blood flow/min (pulmonary v systemic) - ANSWER✔ pulmonary = systemic
Anatomic pulmonary shunting - ANSWER✔ Bronchial circulation causes
*decreased PO2 in LA/LV*
than in pulmonary capillaries
More ventilation is at the - ANSWER✔ BASE
O2-Hgb dissociation LEFT shift - ANSWER✔ basic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - ANSWER✔ low pH, high 2,3BPG, high T
HOT, ACIDIC
,CO2 transport to lungs - ANSWER✔ *carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - ANSWER✔ carboxyhemoglobin
no affect on PaO2
Cyanide poisoning causes - ANSWER✔ lactic acidosis
How to treat cyanide poisoning - ANSWER✔ *Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - ANSWER✔ 5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - ANSWER✔ *Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
*V/Q mismatch* (pulmonary edema
AT --> AT II
where and how - ANSWER✔ ACE
(- high in sarcoidosis)
In small pulmonary bV
C5a induces what - ANSWER✔ PMN influx (ie: in lungs)
, Korotkoff sound - ANSWER✔ BP cuff - appear and disappear
in inflation/deflation
Pulsus Paradoxus - ANSWER✔ 10mmHg difference in
Korotkoff sound
Pulsus Paradoxus occurs in - ANSWER✔ Cardiac Tamponade
Kussmaul sign - ANSWER✔ JVP rises *during inspiration*
Constrictive Pericardiditis
Restrictive/Interstitial Lung Disease:
A-a, FVC, FEV1, EFR - ANSWER✔ Airway widening due to *radial traction* from fibrosis
*increase Aa*
decreased FVC & FEV1
*Increased EFR*
Sarcoidosis - ANSWER✔ *Th1 *noncaseating granulmona
bilateral hilar adenopathy
increased *ACE*
increased IL2, IFNg
1-a-hydroxylase in macrophages: vit D --> *HyperCa*
Hyper Ca causes - ANSWER✔ stones, thrones, groans, psych overtones
1-a-hydroxylase in macrophages - ANSWER✔ PTH independent conversion of
Calcifediol to *calcitriol* (bioactive Vit D)
