NBME CBSE EXAM FINAL STUDY
GUIDE 2026 COMPLETE QUESTIONS
AND SOLUTIONS
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*
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
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*
GUIDE 2026 COMPLETE QUESTIONS
AND SOLUTIONS
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*
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
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*
