NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2023-2024 (usmle step
1)MEDICAL EXAMINATION
Type 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
AND ANSWERS LATEST 2023-2024 (usmle step
1)MEDICAL EXAMINATION
Type 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
