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Exam (elaborations)

NBME CBSE EXAM 2024/2025 EITH 100% ACCURATE SOLUTIONS

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  • NBME CBSE
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NBME CBSE EXAM 2024/2025 EITH 100% ACCURATE SOLUTIONS

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  • September 10, 2024
  • 228
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NBME CBSE
  • NBME CBSE
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YANCHY
NBME CBSE EXAM 2024/2025 EITH 100%
ACCURATE SOLUTIONS
Type II pneumocytes - Precise Answer ✔✔surfactant (*lecithin*)

Proliferate after injury

Type I progenitors

*Neonatal Respiratory Distress Syndrome*



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



Live = Sabin = IgG + IgA

- can be shed in feces



Neonatal Respiratory Distress:

Etiology + Tx - Precise Answer ✔✔Maternal DM (*high insulin*)

or C-section (*low cortisol*)

TX: *dexamethasone* before birth



Lung maturity determined with - Precise Answer ✔✔Amniocentesis of Phospholipids (*type II
pneumocytes)

L >> S



Type I pneumocytes - Precise Answer ✔✔Squamous gas diffusion



Elastase in lungs - Precise Answer ✔✔macrophage: *lysosomes*

PMN: *azuronphilic granules*



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

,air pressure and

intrapleural pressure at FRC - Precise Answer ✔✔Air pressure = 0

Intrapleural pressure = -5



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



Lung Compliance is decreased by - Precise Answer ✔✔LHF, pulmonary edema,

pulmonary fibrosis



Lung Compliance is increased by - Precise Answer ✔✔emphysema, age



Obesity affects ERV and FRC - Precise Answer ✔✔DECREASE

ERV & FRC



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



Anatomic pulmonary shunting - Precise Answer ✔✔Bronchial circulation causes

*decreased PO2 in LA/LV*

than in pulmonary capillaries



More ventilation is at the - Precise Answer ✔✔BASE



O2-Hgb dissociation LEFT shift - Precise Answer ✔✔basic, cold, low 2,3 BPG

low pO2 (compensatory erythrocytosis)



O2-Hgb dissociation RIGHT shift - Precise Answer ✔✔low pH, high 2,3BPG, high T

HOT, ACIDIC

,CO2 transport to lungs - Precise Answer ✔✔*carbonic anhydrase*

Cl shift

*Haldane*: CO2 released to lung

(*Bohr*: O2 release to tissue)



CO poisoning causes - Precise Answer ✔✔carboxyhemoglobin

no affect on PaO2



Cyanide poisoning causes - Precise Answer ✔✔lactic acidosis



How to treat cyanide poisoning - Precise Answer ✔✔*Amyl nitrite* --> Methemoglobin

THEN *Thiosulfate* (hydroxycobalamin)



Normal A-a gradient - Precise Answer ✔✔5-15



Hypoventilation: Heroin OD or high altitude



Increased A-a gradient - Precise Answer ✔✔*Diffusion impairment* (fibrosis)

*R-L shunt* (aspiration, ARDS)

*V/Q mismatch* (pulmonary edema



AT --> AT II

where and how - Precise Answer ✔✔ACE

(- high in sarcoidosis)

In small pulmonary bV



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



Korotkoff sound - Precise Answer ✔✔BP cuff - appear and disappear

, in inflation/deflation



Pulsus Paradoxus - Precise Answer ✔✔10mmHg difference in

Korotkoff sound



Pulsus Paradoxus occurs in - Precise Answer ✔✔Cardiac Tamponade



Kussmaul sign - Precise Answer ✔✔JVP rises *during inspiration*

Constrictive Pericardiditis



Restrictive/Interstitial Lung Disease:

A-a, FVC, FEV1, EFR - Precise Answer ✔✔Airway widening due to *radial traction* from fibrosis

*increase Aa*

decreased FVC & FEV1

*Increased EFR*



Sarcoidosis - Precise Answer ✔✔*Th1 *noncaseating granulmona

bilateral hilar adenopathy

increased *ACE*

increased IL2, IFNg

1-a-hydroxylase in macrophages: vit D --> *HyperCa*



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



1-a-hydroxylase in macrophages - Precise Answer ✔✔PTH independent conversion of

Calcifediol to *calcitriol* (bioactive Vit D)



Vit D --> Hyper Ca

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