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2024 NBME CBSE EXAM WITH CORRECT ANSWERS
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2024 NBME CBSE EXAM WITH CORRECT ANSWERS
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2024 NBME CBSE EXAM WITHCORRECT ANSWERS
Down Syndrome - CORRECT-ANSWERStri 21
Flat face
protruding tongue
Small ears
Duodenal atresia (double bubble)
umbilical hernia
Cause of Down Syndrome - CORRECT-ANSWERSMeiotic Nondisjuncition
Translocation *t(14;21)*
Mosaicism
Type II pneumocytes - CORRECT-ANSWERSsurfactant (*lecithin*)
Proliferate after injury
Type I progenitors
*Neonatal Respiratory Distress Syndrome*
Polio live v killed vaccine - CORRECT-ANSWERSKilled = Salk = IgG
Live = Sabin = IgG + IgA
- can be shed in feces
What should you give a child who is breastfed - CORRECT-ANSWERSVit D
Biliary Emesis (2 causes) - CORRECT-ANSWERS1. Midgut *Malrotation around
SMA*
--> fibrous bands
= intestinal obstruction below duodenum
2. *Intestinal atresia* of jej or ileum
Necrotizing Entercolitis - CORRECT-ANSWERS*pre-me *
air in bowel
- (lucency parallels lumen)
Bloody stool
Hirschsprung - CORRECT-ANSWERS*failed NCC migration *
*rectum *always involved
cannot pass meconium
,O2 supplementation can cause what in infant - CORRECT-ANSWERSabnormal
retinal vascularization
Patau - CORRECT-ANSWERStri 13
CL/P
Omphalocele
Rockerbottom
Edwards - CORRECT-ANSWERS*Tri 18*
Low ears
Small mandible
Neonatal Respiratory Distress:
Etiology + Tx - CORRECT-ANSWERSMaternal DM (*high insulin*)
or C-section (*low cortisol*)
TX: *dexamethasone* before birth
Lung maturity determined with - CORRECT-ANSWERSAmniocentesis of
Phospholipids (*type II pneumocytes)
L >> S
Type I pneumocytes - CORRECT-ANSWERSSquamous gas diffusion
Elastase in lungs - CORRECT-ANSWERSmacrophage: *lysosomes*
PMN: *azuronphilic granules*
Elastin stretches and recoils due to - CORRECT-ANSWERSLysine interchain
crosslinks
air pressure and
intrapleural pressure at FRC - CORRECT-ANSWERSAir pressure = 0
Intrapleural pressure = -5
Pulm Vasc Resistance is lowest during - CORRECT-ANSWERSExhale of Tidal
Volume
Lung Compliance is decreased by - CORRECT-ANSWERSLHF, pulmonary
edema,
pulmonary fibrosis
Lung Compliance is increased by - CORRECT-ANSWERSemphysema, age
Obesity affects ERV and FRC - CORRECT-ANSWERSDECREASE
ERV & FRC
,Blood flow/min (pulmonary v systemic) - CORRECT-ANSWERSpulmonary =
systemic
Anatomic pulmonary shunting - CORRECT-ANSWERSBronchial circulation
causes
*decreased PO2 in LA/LV*
than in pulmonary capillaries
More ventilation is at the - CORRECT-ANSWERSBASE
O2-Hgb dissociation LEFT shift - CORRECT-ANSWERSbasic, cold, low 2,3 BPG
low pO2 (compensatory erythrocytosis)
O2-Hgb dissociation RIGHT shift - CORRECT-ANSWERSlow pH, high 2,3BPG,
high T
HOT, ACIDIC
CO2 transport to lungs - CORRECT-ANSWERS*carbonic anhydrase*
Cl shift
*Haldane*: CO2 released to lung
(*Bohr*: O2 release to tissue)
CO poisoning causes - CORRECT-ANSWERScarboxyhemoglobin
no affect on PaO2
Cyanide poisoning causes - CORRECT-ANSWERSlactic acidosis
How to treat cyanide poisoning - CORRECT-ANSWERS*Amyl nitrite* -->
Methemoglobin
THEN *Thiosulfate* (hydroxycobalamin)
Normal A-a gradient - CORRECT-ANSWERS5-15
Hypoventilation: Heroin OD or high altitude
Increased A-a gradient - CORRECT-ANSWERS*Diffusion impairment* (fibrosis)
*R-L shunt* (aspiration, ARDS)
*V/Q mismatch* (pulmonary edema
AT --> AT II
where and how - CORRECT-ANSWERSACE
(- high in sarcoidosis)
In small pulmonary bV
C5a induces what - CORRECT-ANSWERSPMN influx (ie: in lungs)
, Korotkoff sound - CORRECT-ANSWERSBP cuff - appear and disappear
in inflation/deflation
Pulsus Paradoxus - CORRECT-ANSWERS10mmHg difference in
Korotkoff sound
Pulsus Paradoxus occurs in - CORRECT-ANSWERSCardiac Tamponade
Kussmaul sign - CORRECT-ANSWERSJVP rises *during inspiration*
Constrictive Pericardiditis
Restrictive/Interstitial Lung Disease:
A-a, FVC, FEV1, EFR - CORRECT-ANSWERSAirway widening due to *radial
traction* from fibrosis
*increase Aa*
decreased FVC & FEV1
*Increased EFR*
Sarcoidosis - CORRECT-ANSWERS*Th1 *noncaseating granulmona
bilateral hilar adenopathy
increased *ACE*
increased IL2, IFNg
1-a-hydroxylase in macrophages: vit D --> *HyperCa*
Hyper Ca causes - CORRECT-ANSWERSstones, thrones, groans, psych
overtones
1-a-hydroxylase in macrophages - CORRECT-ANSWERSPTH independent
conversion of
Calcifediol to *calcitriol* (bioactive Vit D)
Vit D --> Hyper Ca
Idiopathic pulmonary fibrosis - CORRECT-ANSWERS*Honeycomb* pattern
loss of Type 1 pneumocytes
*hyperplasia Type II* pneumocytes
Goodpasture - CORRECT-ANSWERSHS II
Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli
Obstructive Lung Disease - CORRECT-ANSWERSDECREASED FEV1,
Decreased FVC
increased RV, FRC, TLC
**different shape
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