NBME CBSE Study Guide Exam With Complete All Questions And Accurate Answers.

Type II pneumocytes - correct answer surfactant (*lecithin*) Proliferate after injury Type I progenitors *Neonatal Respiratory Distress Syndrome* Polio live v killed vaccine - correct answer Killed = Salk = IgG Live = Sabin = IgG + IgA - can be shed in feces Neonatal Respiratory Distress: Etiology + Tx - correct answer Maternal DM (*high insulin*) or C-section (*low cortisol*) TX: *dexamethasone* before birth Lung maturity determined with - correct answer Amniocentesis of Phospholipids (*type II pneumocytes) L >> S Type I pneumocytes - correct answer Squamous gas diffusion Elastase in lungs - correct answer macrophage: *lysosomes* PMN: *azuronphilic granules* Elastin stretches and recoils due to - correct answer Lysine interchain crosslinks air pressure and intrapleural pressure at FRC - correct answer Air pressure = 0 Intrapleural pressure = -5 Pulm Vasc Resistance is lowest during - correct answer Exhale of Tidal Volume Lung Compliance is decreased by - correct answer LHF, pulmonary edema, pulmonary fibrosis Lung Compliance is increased by - correct answer emphysema, age Obesity affects ERV and FRC - correct answer DECREASE ERV & FRC Blood flow/min (pulmonary v systemic) - correct answer pulmonary = systemic Anatomic pulmonary shunting - correct answer Bronchial circulation causes *decreased PO2 in LA/LV* than in pulmonary capillaries More ventilation is at the - correct answer BASE O2-Hgb dissociation LEFT shift - correct answer basic, cold, low 2,3 BPG low pO2 (compensatory erythrocytosis) O2-Hgb dissociation RIGHT shift - correct answer low pH, high 2,3BPG, high T HOT, ACIDIC CO2 transport to lungs - correct answer *carbonic anhydrase* Cl shift *Haldane*: CO2 released to lung (*Bohr*: O2 release to tissue) CO poisoning causes - correct answer carboxyhemoglobin no affect on PaO2 Cyanide poisoning causes - correct answer lactic acidosis How to treat cyanide poisoning - correct answer *Amyl nitrite* --> Methemoglobin THEN *Thiosulfate* (hydroxycobalamin) Normal A-a gradient - correct answer 5-15 Hypoventilation: Heroin OD or high altitude Increased A-a gradient - correct answer *Diffusion impairment* (fibrosis) *R-L shunt* (aspiration, ARDS) *V/Q mismatch* (pulmonary edema AT --> AT II where and how - correct answer ACE (- high in sarcoidosis) In small pulmonary bV C5a induces what - correct answer PMN influx (ie: in lungs) Korotkoff sound - correct answer BP cuff - appear and disappear in inflation/deflation Pulsus Paradoxus - correct answer 10mmHg difference in Korotkoff sound Pulsus Paradoxus occurs in - correct answer Cardiac Tamponade Kussmaul sign - correct answer JVP rises *during inspiration* Constrictive Pericardiditis Restrictive/Interstitial Lung Disease: A-a, FVC, FEV1, EFR - correct answer Airway widening due to *radial traction* from fibrosis *increase Aa* decreased FVC & FEV1 *Increased EFR* Sarcoidosis - correct answer *Th1 *noncaseating granulmona bilateral hilar adenopathy increased *ACE* increased IL2, IFNg 1-a-hydroxylase in macrophages: vit D --> *HyperCa* Hyper Ca causes - correct answer stones, thrones, groans, psych overtones 1-a-hydroxylase in macrophages - correct answer PTH independent conversion of Calcifediol to *calcitriol* (bioactive Vit D) Vit D --> Hyper Ca Idiopathic pulmonary fibrosis - correct answer *Honeycomb* pattern loss of Type 1 pneumocytes *hyperplasia Type II* pneumocytes Goodpasture - correct answer HS II Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli Obstructive Lung Disease - correct answer DECREASED FEV1, Decreased FVC increased RV, FRC, TLC **different shape COPD - correct answer PMN, mo, CD8 *V/Q mismatch:* O2 induced hypercapnia; physio dead space Myeloperoxidase causes - correct answer Green sputum/pus Do not give O2 supplement to - correct answer COPD patient Decreased stimulation of *carotid bodies* = decreased RR TX COPD with - correct answer *Fluticasone* (glucocorticoid) inhibit cellular reaction a1-antitrypsin deficiency - correct answer Serine protease inhibitor *LIVER* *LUNG*: inc PMN elastase --> emphysema Asthma dx - correct answer *Methacholine* (maCh) challenge = induce bronchoconstriction to reduce FEV1 + test = Airways ARE reactive B2 agonist MOA - correct answer B2 (Gs) --> AC --> increase *cAMP* Corticosteroid MOA - correct answer inhibit cytokine synthesis suppress T lymphocyte mACh Antagonist ("tropium") MOA - correct answer *inhibit Vagal* via ACh --> decreased Ca OSA causes - correct answer pulmonary HTN and RHF increases EPO which worsens HTN EPO can do what on Cardiovascular - correct answer worsen HTN Pulmonary Arterial HTN - correct answer *BMPR2* High *endothelin*, Low NO SMC hypertophy, fibrosis, narrow lumen *P2 louder* than A2 When is P2 louder than A2 - correct answer Pulmonary Artherial Hypertension TX pulmonary arterial hypertension - correct answer Endothelin-R antagonist: - Bo*sentan*, Ambi*sentan* PGEi (inc cGMP): - Silden*afil* Pulmonary Embolism - correct answer *perfusion defect* (V/Q mismatch) sudden SOB + calf swelling Hypoxemia --> *Hyperventilate * --> *Respiratory Alkalosis * --> Metabolic compensation in 2 days dx pulmonary embolism - correct answer *D-dimer* test CT angiogram Lines of Zahn *Homan's sign* (DVT calf pain on dorsiflex)