,NBME CBSE Actual exam
COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS 2025
Type II pneumocytes - CORRECT ANS:surfactant (*lecithin*)
Proliferate after injury
Type I progenitor*Neonatal Respiratory Distress Syndrome*
Polio live v killed vaccine - CORRECT ANS:Killed = Salk = IgG
Live = Sabin = IgG + IgA
- can be shed in feces
Neonatal Respiratory Distress:
Etiology + Tx - CORRECT ANS:Maternal DM (*high insulin*)
or C-section (*low cortisol*)
TX: *dexamethasone* before birth
Lung maturity determined with - CORRECT ANS:Amniocentesis of Phospholipids (*type II pneumocytes)
L >> S
Type I pneumocytes - CORRECT ANS:Squamous gas diffusion
Elastase in lungs - CORRECT ANS:macrophage: *lysosomes*
PMN: *azuronphilic granules*
,Elastin stretches and recoils due to - CORRECT ANS:Lysine interchain crosslinks
air pressure and
intrapleural pressure at FRC - CORRECT ANS:Air pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - CORRECT ANS:Exhale of Tidal Volume
Lung Compliance is decreased by - CORRECT ANS:LHF, pulmonary edema,
pulmonary fibrosis
Lung Compliance is increased by - CORRECT ANS:emphysema, age
Obesity affects ERV and FRC - CORRECT ANS:DECREASE
ERV & FRC
Blood flow/min (pulmonary v systemic) - CORRECT ANS:pulmonary = systemic
Anatomic pulmonary shunting - CORRECT ANS:Bronchial circulation causes
*decreased PO2 in LA/LV*
than in pulmonary capillaries
More ventilation is at the - CORRECT ANS:BASE
, O2-Hgb dissociation LEFT shift - CORRECT ANS:basic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - CORRECT ANS:low pH, high 2,3BPG, high T
HOT, ACIDIC
CO2 transport to lungs - CORRECT ANS:*carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - CORRECT ANS:carboxyhemoglobin
no affect on PaO2
Cyanide poisoning causes - CORRECT ANS:lactic acidosis
How to treat cyanide poisoning - CORRECT ANS:*Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - CORRECT ANS:5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - CORRECT ANS:*Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS 2025
Type II pneumocytes - CORRECT ANS:surfactant (*lecithin*)
Proliferate after injury
Type I progenitor*Neonatal Respiratory Distress Syndrome*
Polio live v killed vaccine - CORRECT ANS:Killed = Salk = IgG
Live = Sabin = IgG + IgA
- can be shed in feces
Neonatal Respiratory Distress:
Etiology + Tx - CORRECT ANS:Maternal DM (*high insulin*)
or C-section (*low cortisol*)
TX: *dexamethasone* before birth
Lung maturity determined with - CORRECT ANS:Amniocentesis of Phospholipids (*type II pneumocytes)
L >> S
Type I pneumocytes - CORRECT ANS:Squamous gas diffusion
Elastase in lungs - CORRECT ANS:macrophage: *lysosomes*
PMN: *azuronphilic granules*
,Elastin stretches and recoils due to - CORRECT ANS:Lysine interchain crosslinks
air pressure and
intrapleural pressure at FRC - CORRECT ANS:Air pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - CORRECT ANS:Exhale of Tidal Volume
Lung Compliance is decreased by - CORRECT ANS:LHF, pulmonary edema,
pulmonary fibrosis
Lung Compliance is increased by - CORRECT ANS:emphysema, age
Obesity affects ERV and FRC - CORRECT ANS:DECREASE
ERV & FRC
Blood flow/min (pulmonary v systemic) - CORRECT ANS:pulmonary = systemic
Anatomic pulmonary shunting - CORRECT ANS:Bronchial circulation causes
*decreased PO2 in LA/LV*
than in pulmonary capillaries
More ventilation is at the - CORRECT ANS:BASE
, O2-Hgb dissociation LEFT shift - CORRECT ANS:basic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - CORRECT ANS:low pH, high 2,3BPG, high T
HOT, ACIDIC
CO2 transport to lungs - CORRECT ANS:*carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - CORRECT ANS:carboxyhemoglobin
no affect on PaO2
Cyanide poisoning causes - CORRECT ANS:lactic acidosis
How to treat cyanide poisoning - CORRECT ANS:*Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - CORRECT ANS:5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - CORRECT ANS:*Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
