CBSE TEST QUESTIONS AND ANSWERS(Quiz bank with all the correct answers)

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CBSE Type II pneumocytes Correct Answer: surfactant (*lecithin*) Proliferate after injury Type I progenitors *Neonatal Respiratory Distress Syndrome* Polio live v killed vaccine Correct Answer... : Killed = Salk = IgG Live = Sabin = IgG + IgA - can be shed in feces Neonatal Respiratory Distress: Etiology + Tx Correct Answer: Maternal DM (*high insulin*) or C-section (*low cortisol*) TX: *dexamethasone* before birth Lung maturity determined with Correct Answer: Amniocentesis of Phospholipids (*type II pneumocytes) L >> S Type I pneumocytes Correct Answer: Squamous gas diffusion Elastase in lungs Correct Answer: macrophage: *lysosomes* PMN: *azuronphilic granules* Elastin stretches and recoils due to Correct Answer: Lysine interchain crosslinks air pressure and intrapleural pressure at FRC Correct Answer: Air pressure = 0 Intrapleural pressure = -5 Pulm Vasc Resistance is lowest during Correct Answer: Exhale of Tidal Volume Lung Compliance is decreased by Correct Answer: LHF, pulmonary edema, pulmonary fibrosis Lung Compliance is increased by Correct Answer: emphysema, age Obesity affects ERV and FRC Correct Answer: DECREASE ERV & FRC Blood flow/min (pulmonary v systemic) Correct Answer: pulmonary = systemic Anatomic pulmonary shunting Correct Answer: Bronchial circulation causes *decreased PO2 in LA/LV* than in pulmonary capillaries More ventilation is at the Correct Answer: BASE O2-Hgb dissociation LEFT shift Correct Answer: basic, cold, low 2,3 BPG low pO2 (compensatory erythrocytosis) O2-Hgb dissociation RIGHT shift Correct Answer: low pH, high 2,3BPG, high T HOT, ACIDIC CO2 transport to lungs Correct Answer: *carbonic anhydrase* Cl shift *Haldane*: CO2 released to lung (*Bohr*: O2 release to tissue) CO poisoning causes Correct Answer: carboxyhemoglobin no affect on PaO2 Cyanide poisoning causes Correct Answer: lactic acidosis How to treat cyanide poisoning Correct Answer: *Amyl nitrite* --> Methemoglobin THEN *Thiosulfate* (hydroxycobalamin) Normal A-a gradient Correct Answer: 5-15 Hypoventilation: Heroin OD or high altitude Increased A-a gradient Correct Answer: *Diffusion impairment* (fibrosis) *R-L shunt* (aspiration, ARDS) *V/Q mismatch* (pulmonary edema AT --> AT II where and how Correct Answer: ACE (- high in sarcoidosis) In small pulmonary bV C5a induces what Correct Answer: PMN influx (ie: in lungs) Korotkoff sound Correct Answer: BP cuff - appear and disappear in inflation/deflation Pulsus Paradoxus Correct Answer: 10mmHg difference in Korotkoff sound Pulsus Paradoxus occurs in Correct Answer: Cardiac Tamponade Kussmaul sign Correct Answer: JVP rises *during inspiration* Constrictive Pericardiditis Restrictive/Interstitial Lung Disease: A-a, FVC, FEV1, EFR Correct Answer: Airway widening due to *radial traction* from fibrosis *increase Aa* decreased FVC & FEV1 *Increased EFR* Sarcoidosis Correct Answer: *Th1 *noncaseating granulmona bilateral hilar adenopathy increased *ACE* increased IL2, IFNg 1-a-hydroxylase in macrophages: vit D --> *HyperCa* Hyper Ca causes Correct Answer: stones, thrones, groans, psych overtones 1-a-hydroxylase in macrophages Correct Answer: PTH independent conversion of Calcifediol to *calcitriol* (bioactive Vit D) Vit D --> Hyper Ca Idiopathic pulmonary fibrosis Correct Answer: *Honeycomb* pattern loss of Type 1 pneumocytes *hyperplasia Type II* pneumocytes Goodpasture Correct Answer: HS II Auto-Ab against BM destroys lung alveoli (*restrictive*) and renal glomeruli Obstructive Lung Disease Correct Answer: DECREASED FEV1, Decreased FVC increased RV, FRC, TLC **different shape COPD Correct Answer: PMN, mo, CD8 *V/Q mismatch:* O2 induced hypercapnia; physio dead space Myeloperoxidase causes Correct Answer: Green sputum/pus Do not give O2 supplement to Correct Answer: COPD patient Decreased stimulation of *carotid bodies* = decreased RR TX COPD with Correct Answer: *Fluticasone* (glucocorticoid) inhibit cellular reaction a1-antitrypsin deficiency Correct Answer: Serine protease inhibitor *LIVER* *LUNG*: inc PMN elastase --> emphysema Asthma dx Correct Answer: *Methacholine* (maCh) challenge = induce bronchoconstriction to reduce FEV1 + test = Airways ARE reactive B2 agonist MOA Correct Answer: B2 (Gs) --> AC --> increase *cAMP* Corticosteroid MOA Correct Answer: inhibit cytokine synthesis suppress T lymphocyte mACh Antagonist ("tropium") MOA Correct Answer: *inhibit Vagal* via ACh --> decreased Ca OSA causes Correct Answer: pulmonary HTN and RHF increases EPO which worsens HTN EPO can do what on Cardiovascular Correct Answer: worsen HTN Pulmonary Arterial HTN Correct Answer: *BMPR2* High *endothelin*, Low NO SMC hypertophy, fibrosis, narrow lumen *P2 louder* than A2 When is P2 louder than A2 Correct Answer: Pulmonary Artherial Hypertension TX pulmonary arterial hypertension Correct Answer: Endothelin-R antagonist: - Bo*sentan*, Ambi*sentan* PGEi (inc cGMP): - Silden*afil* Pulmonary Embolism Correct Answer: *perfusion defect* (V/Q mismatch) sudden SOB + calf swelling Hypoxemia --> *Hyperventilate * --> *Respiratory Alkalosis * --> Metabolic compensation in 2 days dx pulmonary embolism Correct Answer: *D-dimer* test CT angiogram Lines of Zahn *Homan's sign* (DVT calf pain on dorsiflex) TX pulmonary embolism Correct Answer: Heparin/LMWH THEN Warfarin Fat embolism syndrome Correct Answer: Long bone/pelvic fracture --> neuro, hypoxemia, rash Fat microglobules in *pulmonary arterioles* Spontaenous pneumothorax Correct Answer: nontraumatic* rupture of subpleural blebs* **20 yo thin TALL man who smokes *DECREASED PRELOAD* Tension pneumothorax Correct Answer: Treachea deviates REQUIRES INTUBATION ARDS Correct Answer: bilateral infiltrate **PANCREATITIS RISK 1. *EXUDATIVE* (capillary permeability) 2. *Proliferative* (collagen) 3. *Fibrotic* (pulmonary fiborsis + HTN) What are the risks from ARDS Correct [Show More]

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