NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2025 COMPLETE
EXAM
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
,NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2025 COMPLETE
EXAM
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)
,NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2025 COMPLETE
EXAM
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)
Vit D --> Hyper Ca
Idiopathic pulmonary fibrosis - ANSWER: *Honeycomb* pattern
loss of Type 1 pneumocytes
*hyperplasia Type II* pneumocytes
Goodpasture - ANSWER: HS II
Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli
Obstructive Lung Disease - ANSWER: DECREASED FEV1, Decreased FVC
increased RV, FRC, TLC
**different shape
, NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2025 COMPLETE
EXAM
COPD - ANSWER: PMN, mo, CD8
*V/Q mismatch:* O2 induced hypercapnia;
physio dead space
Myeloperoxidase causes - ANSWER: Green sputum/pus
Do not give O2 supplement to - ANSWER: COPD patient
Decreased stimulation of
*carotid bodies* = decreased RR
TX COPD with - ANSWER: *Fluticasone* (glucocorticoid)
inhibit cellular reaction
a1-antitrypsin deficiency - ANSWER: Serine protease inhibitor
*LIVER*
*LUNG*: inc PMN elastase --> emphysema
Asthma dx - ANSWER: *Methacholine* (maCh) challenge
= induce bronchoconstriction
to reduce FEV1
+ test = Airways ARE reactive
B2 agonist MOA - ANSWER: B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - ANSWER: inhibit cytokine synthesis
suppress T lymphocyte
mACh Antagonist ("tropium") MOA - ANSWER: *inhibit Vagal* via ACh
--> decreased Ca
OSA causes - ANSWER: pulmonary HTN and RHF
increases EPO which worsens HTN
EPO can do what
on Cardiovascular - ANSWER: worsen HTN
Pulmonary Arterial HTN - ANSWER: *BMPR2*
High *endothelin*, Low NO
AND ANSWERS LATEST 2025 COMPLETE
EXAM
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
,NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2025 COMPLETE
EXAM
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)
,NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2025 COMPLETE
EXAM
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)
Vit D --> Hyper Ca
Idiopathic pulmonary fibrosis - ANSWER: *Honeycomb* pattern
loss of Type 1 pneumocytes
*hyperplasia Type II* pneumocytes
Goodpasture - ANSWER: HS II
Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli
Obstructive Lung Disease - ANSWER: DECREASED FEV1, Decreased FVC
increased RV, FRC, TLC
**different shape
, NBME CBSE REAL EXAM 200 QUESTIONS
AND ANSWERS LATEST 2025 COMPLETE
EXAM
COPD - ANSWER: PMN, mo, CD8
*V/Q mismatch:* O2 induced hypercapnia;
physio dead space
Myeloperoxidase causes - ANSWER: Green sputum/pus
Do not give O2 supplement to - ANSWER: COPD patient
Decreased stimulation of
*carotid bodies* = decreased RR
TX COPD with - ANSWER: *Fluticasone* (glucocorticoid)
inhibit cellular reaction
a1-antitrypsin deficiency - ANSWER: Serine protease inhibitor
*LIVER*
*LUNG*: inc PMN elastase --> emphysema
Asthma dx - ANSWER: *Methacholine* (maCh) challenge
= induce bronchoconstriction
to reduce FEV1
+ test = Airways ARE reactive
B2 agonist MOA - ANSWER: B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - ANSWER: inhibit cytokine synthesis
suppress T lymphocyte
mACh Antagonist ("tropium") MOA - ANSWER: *inhibit Vagal* via ACh
--> decreased Ca
OSA causes - ANSWER: pulmonary HTN and RHF
increases EPO which worsens HTN
EPO can do what
on Cardiovascular - ANSWER: worsen HTN
Pulmonary Arterial HTN - ANSWER: *BMPR2*
High *endothelin*, Low NO
