2nd Semester Physiology Finals (Batches 2024 and 2025)

Question 1

11.A 55-year old male has COPD. He complains that he easily gets tired when walking. Which of the following would be an effective way to increase alveolar ventilation in this patient?
A.Increase residual volume
B.Increase respiratory rate
C.Increase minute ventilation
D.Increase tidal volume

Answer 1

C.Increase minute ventilation

Temporary answer (RECHECK)

COPD (chronic obstructive pulmonary disease) is a condition characterized by airflow limitation that makes breathing difficult. In this scenario, the patient complains of easily getting tired while walking, which suggests that their breathing may be insufficient to meet their oxygen demand.

To increase alveolar ventilation in this patient, the most effective option would be to increase their minute ventilation, which is the total volume of air that moves in and out of their lungs per minute. Increasing the respiratory rate alone may not be effective because it can cause air trapping, which can worsen the patient’s condition. Likewise, increasing tidal volume may also be ineffective because the lungs of COPD patients may not be able to accommodate larger volumes of air. Increasing residual volume is also not a viable option because it represents the volume of air remaining in the lungs after maximal expiration and cannot be easily increased.

Therefore, option C - Increase minute ventilation would be the best choice to help the patient increase their alveolar ventilation. This can be achieved by a combination of increasing both respiratory rate and tidal volume, but it should be done with caution and under medical supervision to avoid worsening the patient’s condition.

Question 2

12.A 55-year old male has COPD. He complains that he easily gets tired when walking. Which of the following conditions would explain the increase in work of breathing in this patient?
A.Physiologic dead space is increased
B.Anatomic dead space is increased
C.Decreased total volume of gas in each breath that does not participate in gas
D.Physiologic dead space becomes as large as anatomic dead space

Answer 2

A.Physiologic dead space is increased

Temporary answer (RECHECK)

The work of breathing refers to the energy required to move air in and out of the lungs during breathing. In patients with COPD, the work of breathing is often increased due to various factors related to the disease process.

In this scenario, the patient complains of easily getting tired while walking, which suggests that their work of breathing may be increased. Among the given options, the most likely condition that would explain the increase in the work of breathing in this patient is option A - Physiologic dead space is increased.

Physiologic dead space refers to the volume of air in the respiratory tract that does not participate in gas exchange because it does not reach the alveoli. In patients with COPD, the airways are often obstructed, which increases physiologic dead space and reduces the efficiency of gas exchange. This means that more air needs to be moved in and out of the lungs to achieve the same level of oxygenation, resulting in an increased work of breathing.

Anatomic dead space, on the other hand, refers to the volume of air in the respiratory tract that does not participate in gas exchange because it remains in the conducting airways (trachea, bronchi, etc.). This is a fixed volume and does not change significantly in patients with COPD.

Option C - Decreased total volume of gas in each breath that does not participate in gas exchange may not necessarily lead to an increase in the work of breathing. Option D - Physiologic dead space becomes as large as anatomic dead space is incorrect as it implies that anatomic dead space increases, which is not the case in COPD.

Therefore, option A - Physiologic dead space is increased would best explain the increase in the work of breathing in this patient.

Question 3

13.Which of the following conditions would shift the oxygen dissociation curve to the right?
A.Fetal haemoglobin (HbF)
B.Strenuous exercise
C.Decreased 2,3-diphosphoglycerate (DPG) concentration
D.Increased pH

Answer 3

B.Strenuous exercise

Question 4

15.Which of the following conditions will increase output?
A.Hypertension
B.Normal inspiration
C.Severe hypoxemia
D.Supraventricular tachycardia

Answer 4

B.Normal inspiration

Question 5

16. Which of the following components is expected to decrease when administering a positive inotropic agent?
    A.Cardiac output
    B.End-systolic volume
    C.Stroke volume
    D.Heart rate

Answer 5

B.End-systolic volume

Temporary answer (RECHECK)

A positive inotropic agent is a medication or substance that increases the contractility of the heart muscle, resulting in an increase in the force of cardiac contraction. This increase in contractility can have several effects on various cardiac parameters. Among the given options, the component that is expected to decrease when administering a positive inotropic agent is option B - End-systolic volume.

End-systolic volume (ESV) is the volume of blood remaining in the ventricle at the end of systole, after the heart has contracted. It is one of the determinants of stroke volume (SV), which is the volume of blood ejected by the ventricle during each cardiac cycle. The other determinant of SV is end-diastolic volume (EDV), which is the volume of blood in the ventricle at the end of diastole, before the heart contracts.

When a positive inotropic agent is administered, it increases the contractility of the heart muscle, allowing the ventricles to eject more blood with each contraction. This results in an increase in stroke volume. As a result, the end-systolic volume decreases because more blood is ejected from the ventricles, leaving less blood in the ventricles at the end of systole. This decrease in ESV is due to the increased force of contraction and the resulting more complete ejection of blood from the heart, which is a beneficial effect.

Therefore, the correct option is B - End-systolic volume.

Question 6

17.Which of the following is correct of perfusion limited gases?
A.Chemically combine with proteins in blood
B.Involves gases that have as slow rate of air-to-blood equilibration
C.Equilibration occurs in prolonged capillary transit time
D.Limited only by the amount of blood perfusing the alveolus

Answer 6

D.Limited only by the amount of blood perfusing the alveolus

Question 7

18.Which of the following parameters is NOT expected during moderate exercise?
A.Increase in total peripheral resistance
B.Increase in cardiac output
C.Increase in heart rate
D.Increase in pulse pressure

Answer 7

A.Increase in total peripheral resistance

Temporary answer (RECHECK)

During exercise, the body undergoes various physiological changes to meet the increased metabolic demand. Among the given options, the parameter that is NOT expected during moderate exercise is option A - Increase in total peripheral resistance.

Total peripheral resistance (TPR) is the resistance to blood flow offered by the systemic circulation, excluding the pulmonary circulation. It is determined by the tone of the arterioles, which are the small blood vessels that regulate blood flow to the capillary beds in various organs and tissues.

During exercise, the metabolic demand of the muscles increases, leading to an increase in cardiac output (CO), which is the amount of blood pumped by the heart per minute. This increase in CO is achieved by an increase in heart rate (HR) and stroke volume (SV), which is the volume of blood ejected by the ventricle with each heartbeat. As a result, option B, C, and D are expected during moderate exercise.

However, the increase in CO during exercise is typically associated with a decrease in TPR. This is because the arterioles in the muscles dilate to allow more blood flow, while the arterioles in other organs constrict to maintain blood pressure. This redistribution of blood flow to the working muscles and away from other organs is an important mechanism that allows the body to meet the increased metabolic demand during exercise.

Therefore, the correct option is A - Increase in total peripheral resistance.

Question 8

19. Which of the following variables can be used interchangeably to label the x-axis in the cardiac-vascular curve?
    A.Pulse pressure
    B.Mean systemic filling pressure
    C.End-systolic volume
    D.End-diastolic volume

Answer 8

B.Mean systemic filling pressure

Temporary answer (RECHECK)

The cardiac-vascular curve is a graphical representation of the relationship between cardiac output (CO) and mean systemic pressure (Pms) in the circulation. It is a useful tool to understand the factors that determine blood flow and pressure in the circulation. Among the given options, the variable that can be used interchangeably to label the x-axis in the cardiac-vascular curve is option B - Mean systemic filling pressure (Pms).

Mean systemic filling pressure (Pms) is the pressure in the circulation when the blood flow is zero, and the circulatory system is at equilibrium. It represents the balance between the cardiac output and the resistance to blood flow in the circulation. The cardiac output, on the other hand, is the volume of blood pumped by the heart per unit time.

In the cardiac-vascular curve, Pms is plotted on the x-axis, while CO is plotted on the y-axis. The curve represents the relationship between these two variables under various physiological conditions. The slope of the curve represents the resistance to blood flow in the circulation, while the position of the curve on the x-axis represents the Pms.

Therefore, the correct option is B - Mean systemic filling pressure (Pms). The other options, pulse pressure, end-systolic volume, and end-diastolic volume, are not typically used to label the x-axis in the cardiac-vascular curve.

Question 9

20.Which of the following causes of hypoxia would have a normal alveolar-arterial difference for oxygen?
A.Hypoventilation
B.Low ventilation/perfusion ratio
C.Anatomic shunt
D.Diffusion abnormality

Answer 9

A.Hypoventilation

Temporary answer (RECHECK)

The alveolar-arterial difference for oxygen (A-a gradient) is a measure of the difference in the partial pressure of oxygen (PO2) between the alveoli and arterial blood. It is an important diagnostic tool to evaluate the cause of hypoxemia. Among the given options, the cause of hypoxia that would have a normal A-a gradient is option A - Hypoventilation.

Hypoventilation is a condition in which the rate or depth of breathing is decreased, leading to an increase in the partial pressure of carbon dioxide (PCO2) and a decrease in the partial pressure of oxygen (PO2) in the alveoli. This decrease in alveolar PO2 leads to a decrease in the PO2 of arterial blood, causing hypoxemia.

However, in hypoventilation, the A-a gradient is typically normal because the decrease in PO2 in the alveoli and arterial blood occurs proportionately. That is, the partial pressure of oxygen in the alveoli and arterial blood both decrease, leading to a normal A-a gradient.

Question 10

21.Which of the following statements best describe the compensatory mechanisms during an acute blood loss?
A.Direction of the secondary changes in pressure is toward the direction of the initiating change
B.Reduction of vagal tone and enhancement of sympathetic tone
C.Threshold for stimulation of baroreceptors is at an arterial pressure of 40 mmHg.
D.NaCl and water excretion is increased

Answer 10

B.Reduction of vagal tone and enhancement of sympathetic tone

Temporary answer (RECHECK)

Question 11

22.Which of the following conditions would increase myocardial contractility?
A.Severe hypoxia
B.Cholinergic stimulation
C.Infusion of norepinephrine
D.inspiration

Answer 11

C.Infusion of norepinephrine

Temporary answer (RECHECK)

Question 12

23.Which of the following conditions would increase tension in inspired ambient air?
A.Increasing the fraction of inspired O2 in air
B.Increasing minute ventilation
C.Increasing volume of inspired air
Increasing the barometric pressure

Answer 12

Increasing the barometric pressure

Question 13

24.An asthmatic patient (obstructive disease) is experiencing an acute exacerbation. The following results were obtained from his arterial blood gas: PaO2 is 65 mmHg and PaCO2 is 30 mmHg. Which of the following statements would be correct?
A.Residual volume is decreased
B.PaO2 is higher than normal because of inadequate gas exchange
C.PaCO2 is lower than normal because of hyperventilation
D.Ventilation/perfusion is increased

Answer 13

B.PaO2 is higher than normal because of inadequate gas exchange

Question 14

25. Which of the following factors will cause the upward shift as seen in the cardiac function curve?
    A.Increased in total peripheral resistance
    B.Increased mean systemic filling pressure
    C.Increased blood volume
    D.Increased contractility

Answer 14

D.Increased contractility

Question 15

51.Signal transduction pathways whose outcomes were cellular response are characterized by the following, except?

Constitutive activation can drive a pathway in a regulated manner.

Amplification is achieved when a hormone binds to a small percentage of receptors.

One hormone- receptor event may activate multiple pathways.

Antagonism by constitutive and regulated negative feedback reactions.

Answer 15

Constitutive activation can drive a pathway in a regulated manner.

Question 16

52.Insulin secretion is acted upon by sympathetic autonomic regulation through α-adrenergic receptors which functions as:

Protection against hypoglycemia.

Promotes insulin secretion.

Oppose the action of insulin in metabolism.

May increase hyperglycemia in diabetics.

Answer 16

Protection against hypoglycemia.

Question 17

53.Which of the following determines the net effect of metabolic pathways in the blood ?

Inhibition/ stimulation of insulin by glucagon

Increase/ decrease in blood glucose

Insulin: glucagon ratio

Sympathetic autonomic regulation

Answer 17

Insulin: glucagon ratio

Question 18

54.Parvocellular neurons secretes which hormone?
ACTH

TRH

PRL

FSH

Answer 18

TRH

Question 19

55.The primary negative feedback on Somatotropin is exerted by:

TSH

Ghrelin

VIP

IGF-I

Answer 19

IGF-I

Question 20

56.Actions of cortisol include?

Increases adrenergic receptor production.

Inhibits phospholipase A2.

Increase the function of the reproductive axis.

Decrease bone resorption.

Answer 20

Inhibits phospholipase A2.

Question 21

57.The following are metabolic effects of testosterone, except:

Promotes deposition of abdominal adipose tissue

Decrease High Density Lipoprotein

Increase rbc production

Exert protein catabolic effect on muscles

Answer 21

Exert protein catabolic effect on muscles

Question 22

58.Actions of GH includes:

Induces nitrogen breakdown during the fed state

Increase urea production during the fed state

Mobilizes fatty acids during the fasting state

Inactivation of adipocyte lipases during the fasting state

Answer 22

Mobilizes fatty acids during the fasting state

Question 23

59.Which of the following does not regulate the release of TRH?

Stress

Hyperglycemia

Infection

Diurnal rhythms

Answer 23

Hyperglycemia

Question 24

60.The relationship of transport proteins (P), free hormone (H) and bound hormone (HP), are expressed in which of the following?

K=P x H/HP

K=H x P/HP

K=HP x H/P

K= H x HP/P

Answer 24

K=H x P/HP

Question 25

61. What is the most common cause of hypothyroidism worldwide?   Congenital anomaly   Iodine deficiency   Ectopic thyroid   Hypopituitary

Answer 25

Iodine deficiency

Question 26

62. What is the effect of T3 to the cardiac output to ensure sufficient delivery of O2 to the tissues?   Increases   Decreases   No effect   Has limiting effect

Answer 26

Increases

Question 27

63.What is the major (90%) iodothyronine produces by the thyroid gland?   3,5,3’ triiodothyronine   3,3,5’ triiodothyronine   3,5,3,5’ tetraiodothyronine*   5,3,5,3’ tetraiodothyronine

Answer 27

3,5,3,5’ tetraiodothyronine*

Question 28

64.What process is the ability to trap and incorporate iodine into thyroglobulin?   Iodination   Acidification   Incorporation   Organification

Answer 28

Organification

Question 29

65.A patient came in with facial and pedal edema, coarse skin, brittle nails and noted to be constipated. You suspect a primary hypothyroidism and expect her thyroid work-up to be   Low TSH , both T3 and T4 are low   High TSH, both T3 and T4 are low   Low TSH, high T3 and low T4   High TSH, low T3 and high T4

Answer 29

High TSH, both T3 and T4 are low

Question 30

66.What hormone decreases serum calcium?   Calcitriol   Calcitonin   Cholecalciferol 1,2-hydroxyvitamin D

Answer 30

Calcitonin

Question 31

67.Which of the following statements regarding calcium is a fact?   hypercalcemia results to tetany   hypocalcemia results to decreased neuromuscular activity   hypocalcemia results to tetany   hypercalcemia increases excitability of nerves

Answer 31

hypocalcemia results to tetany

Question 32

68. An average adult ingests 1500mg of calcium daily and 200 mg will be absorbed which will be used in bone formation and metabolic processes. How much calcium will be excreted in the kidney in relation to the absorbed calcium?   200 mg   500 mg   1000 mg   1500 mg

Answer 32

200 mg

Question 33

69.What regulates the level of PTH?   Intracellular Ca++ level   Ca++ resorption in the kidneys   Amount of dietary Ca++   Ca++ in ECF level

Answer 33

Ca++ in ECF level

Question 34

70. Aside from bone formation, what is the other primary route of removal of Ca and Pi from the blood?   Renal excretion   Intestinal excretion   Liver conjugation   Osteoclastic activity

Answer 34

Renal excretion

Question 35

71.Aside from the tail of epididymis, where else can viable sperms can be stored for months?   Rete testis   Body of epididymis   Vas deferens   Seminal vesicles

Answer 35

Vas deferens

Question 36

72.What cells in the male gonad express androgen receptors and FSH receptors?   Sertoli Cells   Sperm cells   Leydig cells   Basal Cells

Answer 36

Sertoli Cells

Question 37

73.What is the effect of Dihydrotestosterone?   Increase in VLDL in the liver   Deposition of Visceral fat   Sebum formation   Lowering of tone in male voice

Answer 37

Sebum formation

Question 38

74.Which IS NOT true regarding Corpus luteum?   Programmed to live for only around 28 days unless hCG sustains it   After ovulation, remnant of the antral cavity   Regression changes it to corpus albicans   Regression is due to rise in prostaglandins in response to declining progesterone at the 2nd week of luteal phase

Answer 38

Programmed to live for only around 28 days unless hCG sustains it

Question 39

75.Which cell in the ovary produces LDH,HDL and LH receptors?   Mural granulosa cells   Cumulus cells   Theca cells   Preantral follicle

Answer 39

Theca cells

Question 40

76.Which of the following structures provide most of the refractive power of the eye?   Lens   Cornea   Aqueous humor   Vitreous Humor

Answer 40

Cornea

Question 41

77.The structures of the eye through which light passes are collectively known as? a. Refractive media b. Transparent media c. Dioptric media d. Translucent media

Answer 41

c. Dioptric media

Question 42

78. Which of the following structures is responsible for adjusting the optical focus of the eye? a. Lens b. Cornea c. Pupils d. Iris

Answer 42

a. Lens

Question 43

79.Which of the following muscles is innervated by cranial nerve IV? a. inferior oblique b. superior oblique c. lateral rectus c. medial rectus

Answer 43

b. superior oblique

Question 44

80.Which of the following pertains to the perilymph? a. located in the scala media b. closely resembles cerebrospinal fluid c. contains high K+and low Na+ d. resembles intracellular fluid

Answer 44

b. closely resembles cerebrospinal fluid

Question 45

81.Which of the following transports requires kinesin? a. Fast Axonal Transport b. Slow Axonal Transport c. Retrograde Axonal Transport d. Anterograde Axonal Transport

Answer 45

d. Anterograde Axonal Transport

Question 46

82. Which of the following structures regulate the microenvironment of the CNS? a. Astrocytes b. Oligodendrocytes c. Microglia d. Ependymal Cells

Answer 46

a. Astrocytes

Question 47

83.Which of the following pathways is responsible for controlling the functioning of organs, smooth muscle, and glands? a. Somatic Motor Neuron Pathway b. Autonomic Motor Pathway c. Spinocerebellar Pathway d. Dorsal Column–Medial Lemniscus Pathway

Answer 47

b. Autonomic Motor Pathway

Question 48

84.Which of the following tracts is involved in the sensation of temperature and pain? a. Lateral Corticospinal Tract b. Posterolateral Tract c. Anterior Spinothalamic Tract d. Lateral Spinothalamic Tract

Answer 48

d. Lateral Spinothalamic Tract

Question 49

85.Which of the following tracts is involved in the sensation of crude touch and pressure? a. Lateral Corticospinal Tract b. Posterolateral Tract c. Anterior Spinothalamic Tract d. Lateral Spinothalamic Tract

Answer 49

c. Anterior Spinothalamic Tract

Question 50

86.Which of the following prevents solutes in the circulating blood from non-selectively crossing into the ECF of the CNS? a. Choroid Plexus b. Blood Brain Barrier c. Blood Retinal Barrier d. Blood Cerebrospinal Fluid Barrier

Answer 50

c. Blood Retinal Barrier

Question 51

87. Which of the following nuclei in the DC-ML pathway receives information from the upper part of the body and arm? a. Nucleus gracilis b. Internal Arcuate fibers c. Nucleus cuneatus d. Medial Lemniscus

Answer 51

c. Nucleus cuneatus

Question 52

88.Which of the following abilities would be lost if damage to DC-ML pathway is located above the dorsal column nuclei in the medulla? a. ipsilateral loss of fine somatosensory discriminatory abilities b. contralateral loss of fine somatosensory discriminatory abilities c. ipsilateral loss of pain and temperature d. contralateral loss of pain and temperature somatosensory discriminatory abilities

Answer 52

b. contralateral loss of fine somatosensory discriminatory abilities

Question 53

89.Which of the following pathways is the most important sensory pathway for somatic pain and thermal sensations from the body? a. Spinothalamic tract b. Spinoreticular tract c. Spinomesenphalic tract d. Corticospinal tract

Answer 53

a. Spinothalamic tract

Question 54

90.Which of the following pain sensations is a phenomenon that occurs when the brain misidentifies the source of the pain? a. Neuropathic pain b. Referred pain c. Phantom limb pain d. Radiating pain

Answer 54

b. Referred pain

Question 55

91.Difficulty piecing together words to produce speech would indicate involvement of which of the following?   Right hemisphere   Wernicke's area   Broca's area   Cingulate Motor Area

Answer 55

Broca's area

Question 56

92.True about development of memories?   Memories lasting for days to weeks but then are forgotten result from temporary cortical chemical and/or structural changes,   All of the choices are correct   Short-term memories last for seconds or minutes unless they are converted into longer-term memories   Formation of stable memory tracts result in long term memory.   Memory tracts are facilitated pathways for signal transmission important in formation of memories

Answer 56

All of the choices are correct

Question 57

93.Stimulation of the primary motor cortex results in   complex, patterned movements   discrete movements of ipsilateral muscles   Coordinated contraction of anterior and posterior trunk muscles to maintain posture   discrete movements of contralateral muscles

Answer 57

discrete movements of contralateral muscles

Question 58

94.True statement/s about neurologic structures controlling voluntary movement   All of the choices are correct   The basal ganglia and thalamus then grant "permission" for the planned movement.   A specific motor plan is "selected" from the premotor cortex   The thought of performing the movement arises from the motor cortex

Answer 58

The basal ganglia and thalamus then grant "permission" for the planned movement.

Question 59

95.Spinal cord tracts controlling movement includes   Pyramidal tracts   Extrapyramidal tracts   Both pyramidal and extrapyramidal tracts   None of the choices are correct

Answer 59

Both pyramidal and extrapyramidal tracts

Question 60

96.True statement about the direct pathway of the basal ganglia   the output is always inhibitory thus resulting in inhibition of the motor thalamus   Results in indirect inhibition of basal ganglia output to the motor thalamus   Is activated by binding of dopamine to D1 receptors in the striatum   allows inhibitory thalamocortical projections to stimulate the motor cortex to promote movement

Answer 60

Is activated by binding of dopamine to D1 receptors in the striatum

Question 61

97.This pathway results in inhibition of the motor nucleus resulting in inhibition of movement.   None of the choices is correct   both indirect and direct pathways   direct pathway   indirect pathway

Answer 61

indirect pathway

Question 62

98.True about the effect of the basal ganglia on the motor nucleus   always stimulatory in nature   becomes stimulatory when stimulated by the indirect pathway   always inhibitory in nature   all of the choices are correct

Answer 62

always inhibitory in nature

Question 63

99.Highly developed area of the cerebellar hemispheres crucial to the planning and timing of sequential motor movements   Vestibulocerebellum   Archicerebellum   Spinocerebellum   Pontocerebellum

Answer 63

Pontocerebellum

Question 64

100.Which of the following, when intact, controls posture, equilibrium, and control of eye movements?   Spinocerebellum   Cerebrocerebellum   Pontocerebellum   Vestibulocerebellum

Answer 64

Vestibulocerebellum

Question 65

1. Hormones are bound to transport proteins in order to: a. Keep hormones in the active state b. Act as a reservoir c. Allow unrestricted passage into the urine d. Slow the liver to transform into an active form

Answer 65

a. Keep hormones in the active state

Question 66

2. Which of the following hormones are released through the initiation of hypothalamic releasing hormones? a. All anterior pituitary hormones b. Catecholamines c. Hypothalamic hormones d. Posterior pituitary hormones

Answer 66

a. All anterior pituitary hormones

Question 67

3. “Estrogen acts on the anterior pituitary and then LH stimulates the cells of the ovaries” is an example of? a. Negative feedback b. Positive feedback c. Physiologic response feedback d. Endocrine axis feedback

Answer 67

a. Negative feedback

Question 68

4. High levels of insulin causes removal of receptors from the cell membrane? a. Negative feedback b. Positive feedback c. Upregulation of receptors d. Downregulation of receptors

Answer 68

d. Downregulation of receptors

Question 69

5. Stimulation and release of posterior pituitary hormones are through? a. Releasing hormones b. Neuronal reflexes c. Plasma levels d. Inhibiting hormones

Answer 69

c. Plasma levels

Question 70

6. Renin is released by: a. Increased blood pressure b. Increase blood volume c. Sympathetic activation d. Increased NaCl load

Answer 70

b. Increase blood volume

Question 71

7. The effect of Addison’s disease includes? a. Increase serum Na+ b. Serum K+retention c. Hypertension d. Alkalosis

Answer 71

b. Serum K+retention

Question 72

8. Actions of epinephrine include? a. Increase gut motility b. Decrease arterial vasodilation c. Increase glucagon secretion d. Decrease cardiac contractility

Answer 72

a. Increase gut motility

Question 73

9. Insulin regulates cellular glucose transport by: a. Active transport of glucose into intestinal epithelium b. Secondary transport of glucose into renal tubular cells c. Bidirectional transport of glucose in liver cells d. Unidirectional transport of glucose in muscle cells

Answer 73

c. Bidirectional transport of glucose in liver cells

Question 74

10. Inhibitory factors for glucagon secretion: a. Low plasma glucose b. Increase levels of proteins, fatty acids c. Stress, exercise d. Sympathetic nervous activity

Answer 74

a. Low plasma glucose

Question 75

11. What is the effect of T3 to the cardiac output to ensure sufficient delivery of O2to the tissues? a. Increases b. Decreases c. No effect d. Has limiting effec

Answer 75

a. Increases

Question 76

12. What enzyme is produced in the glial cells in the CNS and thyrotropes of the pituitary which acts as a “thyroid axis sensor”? a. Type 1 deiodinase b. Type 2 deiodinase c. Type 3 deiodinase d. Type 4 deiodinase

Answer 76

b. Type 2 deiodinase

Question 77

13. A patient came in with facial and pedal edema, coarse skin, brittle nails and noted to be constipated. You suspect hypothyroidism, what do you expect her thyroid work-up to be? a. Low TSH, both T3 and T4 are low b. High TSH, both T3 and T4 are low c. Low TSH, high T3 and low T4 d. High TSH, low T3 and high T4

Answer 77

c. Low TSH, high T3 and low T4

Question 78

14. What hormone decreases serum calcium? a. Calcitriol b. Calcitonin c. Cholecalciferol d. 1,2-hydroxyvitamin D

Answer 78

b. Calcitonin

Question 79

15. A patient has significantly low serum calcium level, which among the following conditions will the patient exhibit? a. Flaccid paralysis b. Decreased neuromuscular activity c. Tetany d. Increased excitability of nerves

Answer 79

c. Tetany

Question 80

16. An average adult ingests 1500mg of calcium daily and 200mg will be absorbed which will be used in bone formation and metabolic processes. How much calcium will be excreted in the kidney in relation to the absorbed calcium? a. 200mg b. 500mg c. 1000mg d. 1500mg

Answer 80

a. 200mg

Question 81

17. Aside from bone formation, what is the other primary route of removal of Ca and Pi from the blood? a. Renal excretion b. Intestinal excretion c. Liver conjugation d. Osteoclastic activity

Answer 81

a. Renal excretion

Question 82

18. Aside from the tail of epididymis, where else can viable sperms be stored for months? a. Rete testis b. Body of epididymis c. Vas deferens d. Seminal vesicles

Answer 82

c. Vas deferens

Question 83

19. What cells in the male gonad express androgen receptors and FSH receptors? a. Sertoli cells b. Sperm cells c. Leydig cells d. Basal cells

Answer 83

a. Sertoli cells

Question 84

20. What is the effect of Dihydrotestosterone? a. Increase in VLDL in the lover b. Deposition of visceral fat c. Sebum formation d. Lowering of tone in male voice

Answer 84

c. Sebum formation

Question 85

21. This process helps select the dominant follicle from the crop of recruited antral follicles: a. Decline in estrogen b. Decline in FSH c. Decline in LH d. Increase in progesterone

Answer 85

b. Decline in FSH

Question 86

22. The mechanism of action of gonadal hormones such as Estrogen and Testosterone by which they exert their biological effects in the target cells is by: a. Activating adenylate cyclase b. Activating guanylate cyclase c. Affecting rate of gene transcription d. Conversion to 17-ketosteroids

Answer 86

c. Affecting rate of gene transcription

Question 87

23. The cause of the regression and death of the corpus luteum after 14 days in the absence of a pregnancy is a DECREASE in: a. Estrogen b. FSH c. LH d. Progesterone

Answer 87

d. Decreases frequency and intensity of myometrial contractions

Question 88

24. Which of the following is an effect of Progesterone? a. Causes proliferative changes in the endometrium b. Major ovarian hormone in the first half of the menstrual cycle c. Promotes development of ductal system of the breasts d. Decreases frequency and intensity of myometrial contractions

Answer 88

d. Decreases frequency and intensity of myometrial

Question 89

25. This is a requirement for ovulation to occur: a. LH surge b. Decline in estrogen c. Rise in FSH d. Decline in progesterone

Answer 89

a. LH surge

Question 90

26. A 35 year old complains of visual disturbances. The attending physician requested for a cranial MRI and noted a tumor at the area of the left optic tract. Which visual field disturbance is the patient likely experiencing? a. A right homonymous hemianopsia b. Left quadrantic hemianopsia c. Left homonymous hemianopsia d. Bitemporal hemianopsia

Answer 90

a. A right homonymous hemianopsia

Question 91

27. A 15 year old female complains of seeing nearby objects as blurry, but can see distant objects clearly. Which of the following is true of her condition? a. Near-sightedness b. Too long eyeball c. High refractive power of the lens system d. Corrected with the use of concave lens

Answer 91

c. High refractive power of the lens system

Question 92

28. A 55 year old male is complaining of difficulty focusing on nearby objects. Which of the following statements is true of his condition? a. It is due to increased elasticity of the lens b. There is increased ability of the lens to bend light c. Corrected by bifocal lens d. Lens becomes thinner

Answer 92

c. Corrected by bifocal lens

Question 93

29. A 45 y/o female who was involved in a vehicular accident suddenly complains of blindness in the right. Which of the following structures is likely to be transected? a. Optic chiasm b. Optic tract c. Optic nerve d. Lateral geniculate nucleus

Answer 93

c. Optic nerve

Question 94

30. A 65 y/o male complains of dizziness and difficulty walking for the past days. On examinations, she has difficulty turning her hands over repeatedly. Where is the lesion most likely located? a. Motor cortex b. Medulla c. Cerebellum d. Spinal cord

Answer 94

c. Cerebellum

Question 95

31. A 22 y/0 male had a vehicular accident. On examination, you suspect that the patient has transection of the spinal cord at T4. Which of the following signs would prove your suspicion? a. Loss of conscious proprioception b. Loss of voluntary control of movement above the lesion c. Loss of proprioception on the contralateral side below the lesion d. Loss of proprioception on the ipsilateral side above the lesion

Answer 95

c. Loss of proprioception on the contralateral side below the lesion

Question 96

32. A 72 y/o female complains of weakness of the upper and lower extremity. The attending physician is considering a stroke. Where is the lesion most likely to be located? a. Ipsilateral to affected side below the medulla b. Ipsilateral to affected side of the medulla c. Contralateral to affected side above the medulla d. Contralateral to the affected side of the medulla

Answer 96

c. Contralateral to affected side above the medulla

Question 97

33. While holding your cellular phone, you receive a message and it starts to vibrate. Which of the following receptors is being triggered? a. Merkel b. Ruffini c. Pacinian d. Meissner

Answer 97

c. Pacinian ## Footnote The other options listed, Merkel, Ruffini, and Meissner, are all types of mechanoreceptors that are sensitive to different types of touch and pressure but are not typically involved in detecting the vibrations caused by a cell phone.

Question 98

34. You are locating a lesion in the primary somatosensory cortex and note the following findings. Stimulation of the ventral part of S1 caused sensations on the face. Moving up, the patient felt sensations in the hand, head, and leg. Stimulating the dorsal S1, resulted in the patient feeling sensations in the foot. What cortical map tracing did you use to determine the location of the lesion? a. Dermatome b. Homunculus c. Tonotopic map d. Connectome of the brain

Answer 98

b. Homunculus

Question 99

35. A 35 y/o woman complains of painful lesion on her chest. You note that the lesions are vesicular and follow a unilateral single dermatomal distribution. Which of the following is the most likely initial impression? a. Shingles b. Impetigo c. Dermatitis d. Candida

Answer 99

a. Shingles

Question 100

36. Which of the following abilities would be lost if the DC-ML pathway transected above the dorsal column nuclei in the medulla? a. Ipsilateral loss of fine somatosensory discriminatory abilities b. Contralateral loss of fine somatosensory discriminatory abilities c. Ipsilateral loss of pain and temperature d. Contralateral loss of pain and temperature

Answer 100

b. Contralateral loss of fine somatosensory discriminatory abilities

Question 101

37. A 34 y/o female is complaining of pain in the left arm. After evaluation she is diagnosed to have a myocardial infarction. Which of the following would explain the symptom of the patient? a. Neuropathic pain b. Referred pain c. Phantom limb pain d. Radiating pain

Answer 101

b. Referred pain

Question 102

38. A 25 y/o male complains of loss of discriminatory abilities in the right upper arm. Which of the following locations do you expect the lesion to be found? a. Nucleus gracilis b. Internal arcuate fibers c. Nucleus cuneatus d. Medial lemniscus

Answer 102

c. Nucleus cuneatus

Question 103

39. A 21 y/o female complains of loss of sensation to temperature and touch of the left hand. Which of the following tracts is likely involved in her condition? a. Lateral corticospinal tract b. Posterolateral tract c. Anterior spinothalamic tract d. Lateral spinothalamic tract

Answer 103

d. Lateral spinothalamic tract

Question 104

40. A 21 y/o male complains of decreasing sensation to crude touch and pressure. Which of the following tracts is likely to involved? a. Lateral corticospinal tract b. Posterolateral tract c. Anterior spinothalamic tract d. Lateral spinothalamic tract

Answer 104

c. Anterior spinothalamic tract

Question 105

41. A 34 y/o woman has lack of coordination and cerebellar ataxia secondary to the medication pheytoin. Which of the cerebellum is responsible for planning and initiation of movement? a. Vestibulocerebellum b. Spinocerebellum c. Cerebrocerebellum (Neocerebellum) d. Flocculonodular lobe

Answer 105

. Cerebrocerebellum (Neocerebellum)

Question 106

42. Which of the ff observations would suggest that an upper motor neuron lesion rather that a lower moor neuron lesion is present? a. Hyporeflexia b. Spasticity c. Profound muscle wasting d. Profound muscle weakness

Answer 106

b. Spasticity

Question 107

43. Interaction between these two structures regulate the nervous stimulation related to initiation of movement? a. Substantia nigra and pre-motor cortex b. Basal ganglia and thalamus c. Corpus callosum and primary motor cortex d. Cerebellum and cerebrum

Answer 107

b. Basal ganglia and thalamus ## Footnote The basal ganglia and thalamus are two structures in the brain that are involved in regulating movement. The basal ganglia are a group of nuclei located deep within the cerebral hemispheres, and they play an important role in the initiation and control of voluntary movement. The thalamus is a relay center in the brain that receives sensory information and relays it to the cerebral cortex. The basal ganglia and thalamus interact with each other to regulate the flow of information related to movement. The basal ganglia receive input from the cortex and send output to the thalamus, which then relays the information back to the cortex. This loop is involved in selecting and initiating movement, as well as inhibiting unwanted movement. The other options listed are also involved in regulating movement, but they do not specifically interact with each other to regulate nervous stimulation related to the initiation of movement. The substantia nigra and pre-motor cortex are both involved in motor planning and execution. The corpus callosum connects the two hemispheres of the brain and allows for communication between them, but it is not specifically involved in regulating movement. The cerebellum is important for motor coordination and balance, and it communicates with the cerebrum, but it does not specifically interact with it to regulate the initiation of movement.

Question 108

44. Dopaminergic activation of the basal ganglia leads to which of the ff responses? a. Toning down of the motor activity b. Initiation of movement c. Coordinated motor activity d. Inhibition of movement

Answer 108

b. Initiation of movement ## Footnote Dopaminergic activation of the basal ganglia is known to be involved in the initiation of movement. The basal ganglia are a group of nuclei located deep within the cerebral hemispheres, and they play an important role in the control of voluntary movement. Dopamine is a neurotransmitter that is involved in modulating the activity of the basal ganglia. When dopamine levels in the basal ganglia are low, as is the case in Parkinson's disease, movement initiation is impaired. This can result in symptoms such as bradykinesia (slowness of movement), akinesia (difficulty initiating movement), and rigidity (stiffness of movement).

Question 109

45. A 63 y/o man presents with muscle rigidity, resting tremor, and difficulty walking, consistent with Parkinson disease. The involved nervous structure resulting in the patient’s difficulty in initiating movement is in the: a. Thalamus b. Substantia nigra c. Pre-motor cortex d. Cerebral cortex

Answer 109

b. Substantia nigra

Question 110

46. In mental status examination, a 72 y/o woman is noted to have some difficulty with explicit (declarative) memory. This type of memory includes which of the ff? a. Conscious memory of personal experiences b. Neural alterations underlying new skills c. Unconscious memory of food-induced illness d. Habituation

Answer 110

a. Conscious memory of personal experiences

Question 111

47. True statement about the output neurons for both pathways in the globus pallidus and substantia nigra a. Are usually active at low frequency b. The indirect pathway has Dopamine 1 receptors c. Excitation is a result of direct inhibition of the thalamus d. Tonically inhibit target nuclei in the thalamus

Answer 111

d. Tonically inhibit target nuclei in the thalamus ## Footnote Option (a) is incorrect because the output neurons for both pathways are actually tonically active, meaning they fire at a low frequency even in the absence of input. Option (b) is incorrect because Dopamine 1 receptors are actually found on the direct pathway neurons, not the indirect pathway neurons. Option (c) is incorrect because excitation of the thalamus is not a direct result of inhibition by the output neurons of the globus pallidus and substantia nigra. Instead, the inhibition of the thalamus by the output neurons leads to disinhibition of the cortex, which then activates thalamic neurons through a positive feedback loop.

Question 112

48. A 62 y/o nursing home patient is brought into the emergency department for evaluation of altered mental status. Magnetic resonance imaging indicates degeneration of dopamine-containing neurons in the substantia nigra. This loss is most likely to do which of the ff? a. Decrease activity in basal ganglia output nuclei b. Produce dyskinesias such as chorea c. Suppress the direct pathway and facilitate the indirect pathway from the striatum to the basal ganglia d. Suppress activity in the subthalamic nucleus

Answer 112

c. Suppress the direct pathway and facilitate the indirect ## Footnote (c) Suppress the direct pathway and facilitate the indirect pathway from the striatum to the basal ganglia. Option (a) is incorrect because the loss of dopamine-containing neurons in the substantia nigra leads to increased activity in the basal ganglia output nuclei due to the relative overactivity of the indirect pathway. Option (b) is incorrect because dyskinesias such as chorea are associated with overactivity of the direct pathway, which is suppressed in Parkinson's disease. Option (d) is incorrect because the loss of dopamine-containing neurons in the substantia nigra leads to increased activity in the subthalamic nucleus, due to decreased inhibition by the direct pathway.

Question 113

49. Major functions of cerebellar cortex include which of the ff? a. Learning and controlling novel movement patterns b. Generating motor patterns that subserve the scratch reflex c. Recognizing emotionally potent stimuli d. Directly exciting alpha motor neurons

Answer 113

a. Learning and controlling novel movement patterns ## Footnote The cerebellum is a region of the brain that is involved in the coordination and control of movement. The cerebellar cortex is the outer layer of the cerebellum and plays a critical role in this process. One of the major functions of the cerebellar cortex is to learn and control novel movement patterns. This includes the ability to adapt and refine movements based on feedback and experience. The cerebellar cortex is also involved in the timing and coordination of movements, ensuring that different muscle groups work together smoothly and efficiently.

Question 114

50. The thought of performing a particular movement arises from which are of the brain? a. Motor cortex basal ganglia b. Basal ganglia c. Thalamus d. Pre-motor cortex

Answer 114

d. Pre-motor cortex

Question 115

11.Respiratory muscle that pulls the ribs upward and outward is A.Diaphragm B.External intercostal C.External oblique Internal intercosta

Answer 115

A.Diaphragm

Question 116

12.Functional residual capacity increases when there is INCREASED A.Expiratory reserve volume B.Inspiratory reserve volume C.Tidal volume All of these

Answer 116

A.Expiratory reserve volume

Question 117

13.One of these is high in restrictive lung disease A.Elastic recoil B.Lung compliance C.Residual volume Total lung capacity

Answer 117

C.Residual volume

Question 118

14. Deficiency of surfactant increases work of breathing by increasing work: A.Airway resistance B.Compliance C.Tissue resistance D.All of these

Answer 118

B.Compliance

Question 119

15.Airway resistance increases when there is DECREASED A.Length of airway B.Radius of airway C.Temperature of air D.Viscosity of air

Answer 119

B.Radius of airway

Question 120

16.Total lung capacity is equal to A.Expiratory reserve volume + inspiratory reserve volume + residual volume B.Functional residual capacity + tidal volume C.Inspiratory capacity + residual volume Vital capacity + residual volume

Answer 120

Vital capacity + residual volume

Question 121

17.Respiratory group of neurons that control rate and volume of breathing is A.Apneustic center B.Dorsal respiratory group C.Pneumotaxic center Ventral respiratory group

Answer 121

B.Dorsal respiratory group

Question 122

18.Role of ventral respiratory group of neurons is to A.Control limiting point at which ramp stops B.Participate in basic rhythmical oscillation of respiration C.Provide powerful expiratory signals to abdominal muscles D.Send inspiratory signals to dorsal respiratory group of neurons

Answer 122

D.Send inspiratory signals to dorsal respiratory group of neurons

Question 123

19.One of these has direct effect on central chemoreceptor A.HCO3- B.CO2 C.H+ D.O2

Answer 123

B.CO2

Question 124

20.An increase in one of these has the greatest increase in alveolar ventilation A.Arterial pH B.PaCO2 C.PaO2 Serum H+

Answer 124

C.PaO2

Question 125

21. Exercise is associated with an increase in A.Alveolar ventilation B.Arterial CO2 pressure C.Arterial pH Arterial O2 pressure

Answer 125

A.Alveolar ventilation

Question 126

22.One of these is decreased in chronic mountain sickness A.Pulmonary arterial pressure B.Red blood cell mass C.Right ventricular diameter D.Systemic arterial pressure

Answer 126

B.Red blood cell mass

Question 127

23.Increased alveolar ventilation during rapid ascent is due to stimulation of: A.Central chemoreceptors by hypercapnea B.Central chemoreceptors by hypoxemia C.Peripheral chemoreceptors by hypercapnea Peripheral chemoreceptors by hypoxemia

Answer 127

A.Central chemoreceptors by hypercapnea

Question 128

24.O2 toxicity associated with deep sea diving is due to A.Inhibition of central chemoreceptors that depress respiratory center B.Inhibition of peripheral chemoreceptors that depress respiratory center C.Formation of gas bubbles that block blood vessels D.Formation of free radicals that oxidize cell membranes

Answer 128

Formation of free radicals that oxidize cell membranes

Question 129

25.Divers will experience decompression in one of these conditions A.Ascent to sea level with high gas pressure outside body B.Ascent to sea level with high gas pressure inside body C.Descent to underwater with low gas pressure outside body Descent to underwater with low gas pressure inside body

Answer 129

B.Ascent to sea level with high gas pressure inside body