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NBME CBSE USMLE-Questions with Correct Answers/ Verified/ Latest (2024/2025)

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NBME CBSE USMLE-Questions with Correct Answers/ Verified/ Latest (2024/2025)

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  • September 20, 2024
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  • 2024/2025
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MikeHarris
NBME CBSE USMLE-Questions with Correct Answers/ Verified/
Latest (2024/2025)
Type II pneumocytes - ✔✔surfactant (*lecithin*)
Proliferate after injury
Type I progenitors
*Neonatal Respiratory Distress Syndrome*



Polio live v killed vaccine - ✔✔Killed = Salk = IgG


Live = Sabin = IgG + IgA
- can be shed in feces


Neonatal Respiratory Distress:

Etiology + Tx - ✔✔Maternal DM (*high insulin*)
or C-section (*low cortisol*)
TX: *dexamethasone* before birth



Lung maturity determined with - ✔✔Amniocentesis of Phospholipids (*type II pneumocytes)
L >> S



Type I pneumocytes - ✔✔Squamous gas diffusion



Elastase in lungs - ✔✔macrophage: *lysosomes*
PMN: *azuronphilic granules*



Elastin stretches and recoils due to - ✔✔Lysine interchain crosslinks


air pressure and

intrapleural pressure at FRC - ✔✔Air pressure = 0

,Intrapleural pressure = -5



Pulm Vasc Resistance is lowest during - ✔✔Exhale of Tidal Volume



Lung Compliance is decreased by - ✔✔LHF, pulmonary edema,
pulmonary fibrosis



Lung Compliance is increased by - ✔✔emphysema, age



Obesity affects ERV and FRC - ✔✔DECREASE
ERV & FRC



Blood flow/min (pulmonary v systemic) - ✔✔pulmonary = systemic



Anatomic pulmonary shunting - ✔✔Bronchial circulation causes
*decreased PO2 in LA/LV*
than in pulmonary capillaries



More ventilation is at the - ✔✔BASE



O2-Hgb dissociation LEFT shift - ✔✔basic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)



O2-Hgb dissociation RIGHT shift - ✔✔low pH, high 2,3BPG, high T
HOT, ACIDIC



CO2 transport to lungs - ✔✔*carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung

,(*Bohr*: O2 release to tissue)



CO poisoning causes - ✔✔carboxyhemoglobin
no affect on PaO2



Cyanide poisoning causes - ✔✔lactic acidosis



How to treat cyanide poisoning - ✔✔*Amyl nitrite* --> Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)



Normal A-a gradient - ✔✔5-15


Hypoventilation: Heroin OD or high altitude



Increased A-a gradient - ✔✔*Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
*V/Q mismatch* (pulmonary edema


AT --> AT II

where and how - ✔✔ACE
(- high in sarcoidosis)
In small pulmonary bV



C5a induces what - ✔✔PMN influx (ie: in lungs)



Korotkoff sound - ✔✔BP cuff - appear and disappear
in inflation/deflation



Pulsus Paradoxus - ✔✔10mmHg difference in

, Korotkoff sound



Pulsus Paradoxus occurs in - ✔✔Cardiac Tamponade



Kussmaul sign - ✔✔JVP rises *during inspiration*
Constrictive Pericardiditis


Restrictive/Interstitial Lung Disease:

A-a, FVC, FEV1, EFR - ✔✔Airway widening due to *radial traction* from fibrosis
*increase Aa*
decreased FVC & FEV1
*Increased EFR*



Sarcoidosis - ✔✔*Th1 *noncaseating granulmona
bilateral hilar adenopathy
increased *ACE*
increased IL2, IFNg
1-a-hydroxylase in macrophages: vit D --> *HyperCa*



Hyper Ca causes - ✔✔stones, thrones, groans, psych overtones



1-a-hydroxylase in macrophages - ✔✔PTH independent conversion of
Calcifediol to *calcitriol* (bioactive Vit D)


Vit D --> Hyper Ca



Idiopathic pulmonary fibrosis - ✔✔*Honeycomb* pattern
loss of Type 1 pneumocytes
*hyperplasia Type II* pneumocytes

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