THE NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS
LATEST 2025 COMPLETE EXAM (USMLE STEP 1)MEDICAL
EXAMINATION.
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*
*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*
LATEST 2025 COMPLETE EXAM (USMLE STEP 1)MEDICAL
EXAMINATION.
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*
*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*
