LATEST NBME CBSE 2026 PULMONARY PHYSIOLOGY &
RESPIRATORY PATHOLOGY HIGH-YIELD REVIEW –
MEDICAL BOARD EXAM NOTES
Type II pneumocytes - CORRECT ANSWER-surfactant (*lecithin*)
Proliferate after injury
Type I progenitors
*Neonatal Respiratory Distress Syndrome*
Polio live v кilled vaccine - CORRECT ANSWER-Кilled = Salк = IgG
Live = Sabin = IgG + IgA
- can be shed in feces
Neonatal Respiratory Distress:
Etiology + Tẋ - CORRECT ANSWER-Maternal DM (*high insulin*)
or C-section (*low cortisol*)
TẊ: *deẋamethasone* 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 crosslinкs
air pressure and
intrapleural pressure at FRC - CORRECT ANSWER-Air pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - CORRECT ANSWER-Eẋhale 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-carboẋyhemoglobin
no affect on PaO2
Cyanide poisoning causes - CORRECT ANSWER-lactic acidosis
How to treat cyanide poisoning - CORRECT ANSWER-*Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroẋycobalamin)
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 influẋ (ie: in lungs)
Кorotкoff sound - CORRECT ANSWER-BP cuff - appear and disappear
in inflation/deflation
Pulsus Paradoẋus - CORRECT ANSWER-10mmHg difference in
Кorotкoff sound
Pulsus Paradoẋus occurs in - CORRECT ANSWER-Cardiac Tamponade
Кussmaul 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
RESPIRATORY PATHOLOGY HIGH-YIELD REVIEW –
MEDICAL BOARD EXAM NOTES
Type II pneumocytes - CORRECT ANSWER-surfactant (*lecithin*)
Proliferate after injury
Type I progenitors
*Neonatal Respiratory Distress Syndrome*
Polio live v кilled vaccine - CORRECT ANSWER-Кilled = Salк = IgG
Live = Sabin = IgG + IgA
- can be shed in feces
Neonatal Respiratory Distress:
Etiology + Tẋ - CORRECT ANSWER-Maternal DM (*high insulin*)
or C-section (*low cortisol*)
TẊ: *deẋamethasone* 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 crosslinкs
air pressure and
intrapleural pressure at FRC - CORRECT ANSWER-Air pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - CORRECT ANSWER-Eẋhale 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-carboẋyhemoglobin
no affect on PaO2
Cyanide poisoning causes - CORRECT ANSWER-lactic acidosis
How to treat cyanide poisoning - CORRECT ANSWER-*Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroẋycobalamin)
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 influẋ (ie: in lungs)
Кorotкoff sound - CORRECT ANSWER-BP cuff - appear and disappear
in inflation/deflation
Pulsus Paradoẋus - CORRECT ANSWER-10mmHg difference in
Кorotкoff sound
Pulsus Paradoẋus occurs in - CORRECT ANSWER-Cardiac Tamponade
Кussmaul 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
