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NBME CBSE EXAM STUDY GUIDE.

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©THESTAR EXAM SOLUTIONS 2024/2025 ALL RIGHTS RESERVED. 1 | P a g e NBME CBSE EXAM STUDY GUIDE. Type II pneumocytes - answersurfactant (*lecithin*) Proliferate after injury Type I progenitors *Neonatal Respiratory Distress Syndrome* Polio live v killed vaccine - answerKilled = Salk = IgG L...

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NBME CBSE EXAM STUDY GUIDE.

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

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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

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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

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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

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