NBME CBSE EXAM Questions and Answers
Latest Update 2025 GRADED A+ FOR
SUCCESS
B2 agonist MOA - CORRECT ANSWERS B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - CORRECT ANSWERS inhibit cytokine synthesis
suppress T lymphocyte
mACh Antagonist ("tropium") MOA - CORRECT ANSWERS *inhibit Vagal* via
ACh
--> decreased Ca
OSA causes - CORRECT ANSWERS pulmonary HTN and RHF
increases EPO which worsens HTN
EPO can do what
on Cardiovascular - CORRECT ANSWERS worsen HTN
Pulmonary Arterial HTN - CORRECT ANSWERS *BMPR2*
High *endothelin*, Low NO
SMC hypertophy, fibrosis, narrow lumen
*P2 louder* than A2
,When is P2 louder than A2 - CORRECT ANSWERS Pulmonary Artherial
Hypertension
TX pulmonary arterial hypertension - CORRECT ANSWERS Endothelin-R
antagonist:
- Bo*sentan*, Ambi*sentan*
PGEi (inc cGMP):
- Silden*afil*
Pulmonary Embolism - CORRECT ANSWERS *perfusion defect* (V/Q
mismatch)
sudden SOB + calf swelling
Hypoxemia --> *Hyperventilate *
--> *Respiratory Alkalosis *
--> Metabolic compensation in 2 days
dx pulmonary embolism - CORRECT ANSWERS *D-dimer* test
CT angiogram
Lines of Zahn
*Homan's sign* (DVT calf pain on dorsiflex)
TX pulmonary embolism - CORRECT ANSWERS Heparin/LMWH
THEN
Warfarin
Fat embolism syndrome - CORRECT ANSWERS Long bone/pelvic fracture
--> neuro, hypoxemia, rash
,Fat microglobules in *pulmonary arterioles*
Spontaenous pneumothorax - CORRECT ANSWERS nontraumatic* rupture of
subpleural blebs*
**20 yo thin TALL man who smokes
*DECREASED PRELOAD*
Tension pneumothorax - CORRECT ANSWERS Treachea deviates
REQUIRES INTUBATION
ARDS - CORRECT ANSWERS bilateral infiltrate
**PANCREATITIS RISK
1. *EXUDATIVE* (capillary permeability)
2. *Proliferative* (collagen)
3. *Fibrotic* (pulmonary fiborsis + HTN)
What are the risks from ARDS - CORRECT ANSWERS Sepsis
Pancreatitis
Pneumo
cystic fibrosis genetics - CORRECT ANSWERS *dF508 frameshift*
CFT protein - post-tln
HypoNa
Cystic Fibrosis complications - CORRECT ANSWERS Dec *Vit A* --> Pancreatic
(squamous metaplasia)
, Def *Vit E* --> Neuromuscular, hemolytic anemia
Def *Vit K *--> Intracranial hemorrhage
Meconium Ileus; No Vas deferns; Digital clubbing
DEATH FROM PNEUMO
Hemorrhagic infarct is what color and why - CORRECT ANSWERS RED
Dual blood supply
Empyema - CORRECT ANSWERS Infected *exudative* pleural effusion
Meniscus opacity
Increased LDH
COMPLICATES PNEUMO
Lobar pneumonia - CORRECT ANSWERS *consolidation*
Ex: strep, legionella
--> Red (3-4 d)
--> Grey hepatization (5-7d)
--> Resolution (*Type II regen* in 8 d)
Broncho Pneumonia - CORRECT ANSWERS *Patchy*
ex: Staph, Strep, Kleb, H flu
Interstitial Pneumonia - CORRECT ANSWERS Alveolar walls
Ex: Mycoplasma, Chlamydia,
Legionella,
RSV/CMV/flu/adeno
Latest Update 2025 GRADED A+ FOR
SUCCESS
B2 agonist MOA - CORRECT ANSWERS B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - CORRECT ANSWERS inhibit cytokine synthesis
suppress T lymphocyte
mACh Antagonist ("tropium") MOA - CORRECT ANSWERS *inhibit Vagal* via
ACh
--> decreased Ca
OSA causes - CORRECT ANSWERS pulmonary HTN and RHF
increases EPO which worsens HTN
EPO can do what
on Cardiovascular - CORRECT ANSWERS worsen HTN
Pulmonary Arterial HTN - CORRECT ANSWERS *BMPR2*
High *endothelin*, Low NO
SMC hypertophy, fibrosis, narrow lumen
*P2 louder* than A2
,When is P2 louder than A2 - CORRECT ANSWERS Pulmonary Artherial
Hypertension
TX pulmonary arterial hypertension - CORRECT ANSWERS Endothelin-R
antagonist:
- Bo*sentan*, Ambi*sentan*
PGEi (inc cGMP):
- Silden*afil*
Pulmonary Embolism - CORRECT ANSWERS *perfusion defect* (V/Q
mismatch)
sudden SOB + calf swelling
Hypoxemia --> *Hyperventilate *
--> *Respiratory Alkalosis *
--> Metabolic compensation in 2 days
dx pulmonary embolism - CORRECT ANSWERS *D-dimer* test
CT angiogram
Lines of Zahn
*Homan's sign* (DVT calf pain on dorsiflex)
TX pulmonary embolism - CORRECT ANSWERS Heparin/LMWH
THEN
Warfarin
Fat embolism syndrome - CORRECT ANSWERS Long bone/pelvic fracture
--> neuro, hypoxemia, rash
,Fat microglobules in *pulmonary arterioles*
Spontaenous pneumothorax - CORRECT ANSWERS nontraumatic* rupture of
subpleural blebs*
**20 yo thin TALL man who smokes
*DECREASED PRELOAD*
Tension pneumothorax - CORRECT ANSWERS Treachea deviates
REQUIRES INTUBATION
ARDS - CORRECT ANSWERS bilateral infiltrate
**PANCREATITIS RISK
1. *EXUDATIVE* (capillary permeability)
2. *Proliferative* (collagen)
3. *Fibrotic* (pulmonary fiborsis + HTN)
What are the risks from ARDS - CORRECT ANSWERS Sepsis
Pancreatitis
Pneumo
cystic fibrosis genetics - CORRECT ANSWERS *dF508 frameshift*
CFT protein - post-tln
HypoNa
Cystic Fibrosis complications - CORRECT ANSWERS Dec *Vit A* --> Pancreatic
(squamous metaplasia)
, Def *Vit E* --> Neuromuscular, hemolytic anemia
Def *Vit K *--> Intracranial hemorrhage
Meconium Ileus; No Vas deferns; Digital clubbing
DEATH FROM PNEUMO
Hemorrhagic infarct is what color and why - CORRECT ANSWERS RED
Dual blood supply
Empyema - CORRECT ANSWERS Infected *exudative* pleural effusion
Meniscus opacity
Increased LDH
COMPLICATES PNEUMO
Lobar pneumonia - CORRECT ANSWERS *consolidation*
Ex: strep, legionella
--> Red (3-4 d)
--> Grey hepatization (5-7d)
--> Resolution (*Type II regen* in 8 d)
Broncho Pneumonia - CORRECT ANSWERS *Patchy*
ex: Staph, Strep, Kleb, H flu
Interstitial Pneumonia - CORRECT ANSWERS Alveolar walls
Ex: Mycoplasma, Chlamydia,
Legionella,
RSV/CMV/flu/adeno
