NBME CBSE LATEST EXAM 2024/2025 QUESTIONS AND
VERIFIED CORRECT ANSWERS/ ALREADY GRADED A++
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
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*
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*
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
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
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
VERIFIED CORRECT ANSWERS/ ALREADY GRADED A++
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
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*
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*
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
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
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
