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NBME CBSE Actual Questions and answers | Latest 2024/25 Rated A+
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NBME CBSE Actual Questions and answers | Latest 2024/25 Rated A+
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NBME CBSE Actual Questions andanswers | Latest 2024/25 Rated A+
Type II pneumocytes - surfactant (*lecithin*)
II II II II II II II
Proliferate after injury II II
Type I progenitors II II
*Neonatal Respiratory Distress Syndrome* II II II
Polio live v killed vaccine - Killed = Salk = IgG
II II II II II II II II II II II II II II II
Live = Sabin = IgG + IgAII II II II II II
- can be shed in feces
II II II II II
Neonatal Respiratory Distress:
II II II II II
Etiology + Tx - Maternal DM (*high insulin*) II II II II II II II II II II
or C-section (*low cortisol*)
II II II
TX: *dexamethasone* before birth
II II II
Lung maturity determined with - Amniocentesis of Phospholipids (*type II pneumocytes)
II II II II II II II II II II II II II II
L >> S II II
Type I pneumocytes - Squamous gas diffusion
II II II II II II II II II II
Elastase in lungs - macrophage: *lysosomes*
II II II II II II II II II
PMN: *azuronphilic granules* II II
Elastin stretches and recoils due to - Lysine interchain crosslinks
II II II II II II II II II II II II II
air pressure and
II II II II II
intrapleural pressure at FRC - Air pressure = 0 II II II II II II II II II II
Intrapleural pressure = -5 II II II
Pulm Vasc Resistance is lowest during - Exhale of Tidal Volume
II II II II II II II II II II II II II II
Lung Compliance is decreased by - LHF, pulmonary edema,
II II II II II II II II II II II II II
pulmonary fibrosis II
Lung Compliance is increased by - emphysema, age
II II II II II II II II II II II
Obesity affects ERV and FRC - DECREASE
II II II II II II II II II II II
ERV & FRC II II
Blood flow/min (pulmonary v systemic) - pulmonary = systemic
II II II II II II II II II II II II
, Anatomic pulmonary shunting - Bronchial circulation causes
II II II II II II II II II II II
*decreased PO2 in LA/LV* II II II
than in pulmonary capillaries II II II
More ventilation is at the - BASE
II II II II II II II II II II
O2-Hgb dissociation LEFT shift - basic, cold, low 2,3 BPG
II II II II II II II II II II II II II II
low pO2 (compensatory erythrocytosis)
II II II
O2-Hgb dissociation RIGHT shift - low pH, high 2,3BPG, high T
II II II II II II II II II II II II II II
HOT, ACIDIC II
CO2 transport to lungs - *carbonic anhydrase*
II II II II II II II II II II
Cl shift II
*Haldane*: CO2 released to lung II II II II
(*Bohr*: O2 release to tissue) II II II II
CO poisoning causes - carboxyhemoglobin
II II II II II II II II II
no affect on PaO2 II II II
Cyanide poisoning causes - lactic acidosis
II II II II II II II II II
How to treat cyanide poisoning - *Amyl nitrite* --> Methemoglobin
II II II II II II II II II II II II II
THEN *Thiosulfate* (hydroxycobalamin) II II
Normal A-a gradient - 5-15
II II II II II II II II
Hypoventilation: Heroin OD or high altitude II II II II II
Increased A-a gradient - *Diffusion impairment* (fibrosis)
II II II II II II II II II II
*R-L shunt* (aspiration, ARDS) II II II
*V/Q mismatch* (pulmonary edema II II II
AT --> AT II
II II II II II II
where and how - ACE II II II II II II II
(- high in sarcoidosis)
II II II
In small pulmonary bV
II II II
C5a induces what - PMN influx (ie: in lungs)
II II II II II II II II II II II II
Korotkoff sound - BP cuff - appear and disappear
II II II II II II II II II II II II II
in inflation/deflation
II
Pulsus Paradoxus - 10mmHg difference in
II II II II II II II II II II
Korotkoff sound II
, Pulsus Paradoxus occurs in - Cardiac Tamponade
II II II II II II II II II II
Kussmaul sign - JVP rises *during inspiration*
II II II II II II II II II II
Constrictive Pericardiditis II
Restrictive/Interstitial Lung Disease:
II II II II II
A-a, FVC, FEV1, EFR - Airway widening due to *radial traction* from fibrosis
II II II II II II II II II II II II II II
*increase Aa* II
decreased FVC & FEV1 II II II
*Increased EFR* II
Sarcoidosis - *Th1 *noncaseating granulmona
II II II II II II II II
bilateral hilar adenopathy II II
increased *ACE* II
increased IL2, IFNg II II
1-a-hydroxylase in macrophages: vit D --> *HyperCa* II II II II II II
Hyper Ca causes - stones, thrones, groans, psych overtones
II II II II II II II II II II II II
1-a-hydroxylase in macrophages - PTH independent conversion of
II II II II II II II II II II II II
Calcifediol to *calcitriol* (bioactive Vit D) II II II II II
Vit D --> Hyper Ca
II II II II
Idiopathic pulmonary fibrosis - *Honeycomb* pattern
II II II II II II II II II
loss of Type 1 pneumocytes
II II II II
*hyperplasia Type II* pneumocytes II II II
Goodpasture - HS II
II II II II II II II II
Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli
II II II II II II II II II
Obstructive Lung Disease - DECREASED FEV1, Decreased FVC
II II II II II II II II II II II
increased RV, FRC, TLC II II II
**different shape II
COPD - PMN, mo, CD8
II II II II II II II II
*V/Q mismatch:* O2 induced hypercapnia;
II II II II II
physio dead space II II
Myeloperoxidase causes - Green sputum/pus
II II II II II II II II
Do not give O2 supplement to - COPD patient
II II II II II II II II II II II II
Decreased stimulation of II II II
*carotid bodies* = decreased RR II II II II
, TX COPD with - *Fluticasone* (glucocorticoid)
II II II II II II II II II II
inhibit cellular reaction II II
a1-antitrypsin deficiency - Serine protease inhibitor
II II II II II II II II II
*LIVER* II
*LUNG*: inc PMN elastase --> emphysema II II II II II
Asthma dx - *Methacholine* (maCh) challenge
II II II II II II II II II
= induce bronchoconstriction
II II II
to reduce FEV1II II
+ test = Airways ARE reactive
II II II II II
B2 agonist MOA - B2 (Gs) --> AC --> increase *cAMP*
II II II II II II II II II II II II II II
Corticosteroid MOA - inhibit cytokine synthesis
II II II II II II II II II
suppress T lymphocyte II II
mACh Antagonist ("tropium") MOA - *inhibit Vagal* via ACh
II II II II II II II II II II II II II
--> decreased Ca II II
OSA causes - pulmonary HTN and RHF
II II II II II II II II II II II
increases EPO which worsens HTN II II II II
EPO can do what
II II II II II II
on Cardiovascular - worsen HTN
II II II II II II
Pulmonary Arterial HTN - *BMPR2*
II II II II II II II II
High *endothelin*, Low NO II II II
SMC hypertophy, fibrosis, narrow lumen II II II II
*P2 louder* than A2 II II II
When is P2 louder than A2 - Pulmonary Artherial Hypertension
II II II II II II II II II II II II II
TX pulmonary arterial hypertension - Endothelin-R antagonist:
II II II II II II II II II II II
- Bo*sentan*, Ambi*sentan*
II II
PGEi (inc cGMP): II II II
- Silden*afil*
II
Pulmonary Embolism - *perfusion defect* (V/Q mismatch)
II II II II II II II II II II
sudden SOB + calf swelling II II II II
Hypoxemia --> *Hyperventilate * II II II
--> *Respiratory Alkalosis *
II II II
--> Metabolic compensation in 2 days
II II II II II
dx pulmonary embolism - *D-dimer* test
II II II II II II II II II
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