1|Page
NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS LATEST
2025 COMPLETE EXAM (USMLE STEP 1)MEDICAL EXAMINATION
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
1-a-hydroxylase in macrophages: vit D --> *HyperCa*
,2|Page
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
,3|Page
Decreased stimulation of
*carotid bodies* = decreased RR
TX COPD with - ANSWER-*Fluticasone* (glucocorticoid)
inhibit cellular reaction
a1-antitrypsin deficiency - ANSWER-Serine protease inhibitor
*LIVER*
*LUNG*: inc PMN elastase --> emphysema
Asthma dx - ANSWER-*Methacholine* (maCh) challenge
= induce bronchoconstriction
to reduce FEV1
+ test = Airways ARE reactive
B2 agonist MOA - ANSWER-B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - ANSWER-inhibit cytokine synthesis
suppress T lymphocyte
mACh Antagonist ("tropium") MOA - ANSWER-*inhibit Vagal* via ACh
--> decreased Ca
OSA causes - ANSWER-pulmonary HTN and RHF
increases EPO which worsens HTN
, 4|Page
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*
NBME CBSE REAL EXAM 200 QUESTIONS AND ANSWERS LATEST
2025 COMPLETE EXAM (USMLE STEP 1)MEDICAL EXAMINATION
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
1-a-hydroxylase in macrophages: vit D --> *HyperCa*
,2|Page
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
,3|Page
Decreased stimulation of
*carotid bodies* = decreased RR
TX COPD with - ANSWER-*Fluticasone* (glucocorticoid)
inhibit cellular reaction
a1-antitrypsin deficiency - ANSWER-Serine protease inhibitor
*LIVER*
*LUNG*: inc PMN elastase --> emphysema
Asthma dx - ANSWER-*Methacholine* (maCh) challenge
= induce bronchoconstriction
to reduce FEV1
+ test = Airways ARE reactive
B2 agonist MOA - ANSWER-B2 (Gs) --> AC --> increase *cAMP*
Corticosteroid MOA - ANSWER-inhibit cytokine synthesis
suppress T lymphocyte
mACh Antagonist ("tropium") MOA - ANSWER-*inhibit Vagal* via ACh
--> decreased Ca
OSA causes - ANSWER-pulmonary HTN and RHF
increases EPO which worsens HTN
, 4|Page
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*
