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Physiology > 2nd Semester Physiology Finals (Batches 2024 and 2025) > Flashcards

2nd Semester Physiology Finals (Batches 2024 and 2025) Flashcards

1
Q

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

A

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.

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2
Q

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

A

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.

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3
Q

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

A

B.Strenuous exercise

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4
Q

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

A

B.Normal inspiration

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5
Q
  1. 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
A

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.

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6
Q

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

A

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

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7
Q

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

A

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.

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8
Q
  1. 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
A

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.

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9
Q

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

A

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.

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10
Q

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

A

B.Reduction of vagal tone and enhancement of sympathetic tone

Temporary answer (RECHECK)

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11
Q

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

A

C.Infusion of norepinephrine

Temporary answer (RECHECK)

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12
Q

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

A

Increasing the barometric pressure

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13
Q

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

A

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

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14
Q
  1. 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
A

D.Increased contractility

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15
Q

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.

A

Constitutive activation can drive a pathway in a regulated manner.

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16
Q

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.

A

Protection against hypoglycemia.

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17
Q

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

A

Insulin: glucagon ratio

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18
Q

54.Parvocellular neurons secretes which hormone?
ACTH

TRH

PRL

FSH

A

TRH

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19
Q

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

TSH

Ghrelin

VIP

IGF-I

A

IGF-I

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20
Q

56.Actions of cortisol include?

Increases adrenergic receptor production.

Inhibits phospholipase A2.

Increase the function of the reproductive axis.

Decrease bone resorption.

A

Inhibits phospholipase A2.

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21
Q

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

A

Exert protein catabolic effect on muscles

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22
Q

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

A

Mobilizes fatty acids during the fasting state

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23
Q

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

Stress

Hyperglycemia

Infection

Diurnal rhythms

A

Hyperglycemia

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24
Q

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

A

K=H x P/HP

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25
Q
  1. What is the most common cause of hypothyroidism worldwide?

Congenital anomaly

Iodine deficiency

Ectopic thyroid

Hypopituitary

A

Iodine deficiency

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26
Q
  1. 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

A

Increases

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27
Q

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

A

3,5,3,5’ tetraiodothyronine*

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28
Q

64.What process is the ability to trap and incorporate iodine into thyroglobulin?

Iodination

Acidification

Incorporation

Organification

A

Organification

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29
Q

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

A

High TSH, both T3 and T4 are low

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30
Q

66.What hormone decreases serum calcium?

Calcitriol

Calcitonin

Cholecalciferol
1,2-hydroxyvitamin D

A

Calcitonin

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31
Q

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

A

hypocalcemia results to tetany

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32
Q
  1. 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

A

200 mg

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33
Q

69.What regulates the level of PTH?

Intracellular Ca++ level

Ca++ resorption in the kidneys

Amount of dietary Ca++

Ca++ in ECF level

A

Ca++ in ECF level

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34
Q
  1. 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

A

Renal excretion

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35
Q

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

A

Vas deferens

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36
Q

72.What cells in the male gonad express androgen receptors and FSH receptors?

Sertoli Cells

Sperm cells

Leydig cells

Basal Cells

A

Sertoli Cells

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37
Q

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

A

Sebum formation

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38
Q

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

A

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

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39
Q

75.Which cell in the ovary produces LDH,HDL and LH receptors?

Mural granulosa cells

Cumulus cells

Theca cells

Preantral follicle

A

Theca cells

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40
Q

76.Which of the following structures provide most of the refractive power of the eye?

Lens

Cornea

Aqueous humor

Vitreous Humor

A

Cornea

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41
Q

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

A

c. Dioptric media

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42
Q
  1. Which of the following structures is responsible for adjusting the optical focus of the eye?
    a. Lens
    b. Cornea
    c. Pupils
    d. Iris
A

a. Lens

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43
Q

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

A

b. superior oblique

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44
Q

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

A

b. closely resembles cerebrospinal fluid

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45
Q

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

A

d. Anterograde Axonal Transport

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46
Q
  1. Which of the following structures regulate the microenvironment of the CNS?
    a. Astrocytes
    b. Oligodendrocytes
    c. Microglia
    d. Ependymal Cells
A

a. Astrocytes

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47
Q

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

A

b. Autonomic Motor Pathway

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48
Q

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

A

d. Lateral Spinothalamic Tract

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49
Q

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

A

c. Anterior Spinothalamic Tract

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50
Q

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

A

c. Blood Retinal Barrier

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51
Q
  1. 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
A

c. Nucleus cuneatus

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52
Q

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

A

b. contralateral loss of fine somatosensory discriminatory abilities

53
Q

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

A

a. Spinothalamic tract

54
Q

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

A

b. Referred pain

55
Q

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

A

Broca’s area

56
Q

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

A

All of the choices are correct

57
Q

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

A

discrete movements of contralateral muscles

58
Q

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

A

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

59
Q

95.Spinal cord tracts controlling movement includes

Pyramidal tracts

Extrapyramidal tracts

Both pyramidal and extrapyramidal tracts

None of the choices are correct

A

Both pyramidal and extrapyramidal tracts

60
Q

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

A

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

61
Q

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

A

indirect pathway

62
Q

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

A

always inhibitory in nature

63
Q

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

Vestibulocerebellum

Archicerebellum

Spinocerebellum

Pontocerebellum

A

Pontocerebellum

64
Q

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

Spinocerebellum

Cerebrocerebellum

Pontocerebellum

Vestibulocerebellum

A

Vestibulocerebellum

65
Q
  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
A

a. Keep hormones in the active
state

66
Q
  1. 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
A

a. All anterior pituitary
hormones

67
Q
  1. “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
A

a. Negative feedback

68
Q
  1. 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
A

d. Downregulation of receptors

69
Q
  1. Stimulation and release of posterior pituitary hormones are through?
    a. Releasing hormones
    b. Neuronal reflexes
    c. Plasma levels
    d. Inhibiting hormones
A

c. Plasma levels

70
Q
  1. Renin is released by:
    a. Increased blood pressure
    b. Increase blood volume
    c. Sympathetic activation
    d. Increased NaCl load
A

b. Increase blood volume

71
Q
  1. The effect of Addison’s disease includes?
    a. Increase serum Na+
    b. Serum K+retention
    c. Hypertension
    d. Alkalosis
A

b. Serum K+retention

72
Q
  1. Actions of epinephrine include? a. Increase gut motility
    b. Decrease arterial
    vasodilation
    c. Increase glucagon secretion d. Decrease cardiac contractility
A

a. Increase gut motility

73
Q
  1. 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
A

c. Bidirectional transport of
glucose in liver cells

74
Q
  1. Inhibitory factors for glucagon secretion:
    a. Low plasma glucose
    b. Increase levels of proteins,
    fatty acids
    c. Stress, exercise
    d. Sympathetic nervous activity
A

a. Low plasma glucose

75
Q
  1. 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
A

a. Increases

76
Q
  1. 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
A

b. Type 2 deiodinase

77
Q
  1. 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
A

c. Low TSH, high T3 and low T4

78
Q
  1. What hormone decreases serum calcium?
    a. Calcitriol
    b. Calcitonin
    c. Cholecalciferol
    d. 1,2-hydroxyvitamin D
A

b. Calcitonin

79
Q
  1. 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
A

c. Tetany

80
Q
  1. 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
A

a. 200mg

81
Q
  1. 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
A

a. Renal excretion

82
Q
  1. 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
A

c. Vas deferens

83
Q
  1. What cells in the male gonad express androgen receptors and FSH receptors?
    a. Sertoli cells
    b. Sperm cells
    c. Leydig cells
    d. Basal cells
A

a. Sertoli cells

84
Q
  1. 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
A

c. Sebum formation

85
Q
  1. 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
A

b. Decline in FSH

86
Q
  1. 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
A

c. Affecting rate of gene
transcription

87
Q
  1. 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
A

d. Decreases frequency and
intensity of myometrial contractions

88
Q
  1. 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
A

d. Decreases frequency and
intensity of myometrial

89
Q
  1. This is a requirement for ovulation to occur:
    a. LH surge
    b. Decline in estrogen
    c. Rise in FSH
    d. Decline in progesterone
A

a. LH surge

90
Q
  1. 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
A

a. A right homonymous
hemianopsia

91
Q
  1. 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
A

c. High refractive power of the
lens system

92
Q
  1. 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
A

c. Corrected by bifocal lens

93
Q
  1. 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
A

c. Optic nerve

94
Q
  1. 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
A

c. Cerebellum

95
Q
  1. 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
A

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

96
Q
  1. 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
A

c. Contralateral to affected side above the medulla

97
Q
  1. 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
A

c. Pacinian

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.

98
Q
  1. 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
A

b. Homunculus

99
Q
  1. 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
A

a. Shingles

100
Q
  1. 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
A

b. Contralateral loss of fine
somatosensory
discriminatory abilities

101
Q
  1. 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
A

b. Referred pain

102
Q
  1. 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
A

c. Nucleus cuneatus

103
Q
  1. 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
A

d. Lateral spinothalamic tract

104
Q
  1. 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
A

c. Anterior spinothalamic tract

105
Q
  1. 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
A

. Cerebrocerebellum
(Neocerebellum)

106
Q
  1. 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
A

b. Spasticity

107
Q
  1. 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
A

b. Basal ganglia and thalamus

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.

108
Q
  1. 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
A

b. Initiation of movement

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).

109
Q
  1. 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
A

b. Substantia nigra

110
Q
  1. 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
A

a. Conscious memory of
personal experiences

111
Q
  1. 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
A

d. Tonically inhibit target nuclei in the thalamus

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.

112
Q
  1. 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
A

c. Suppress the direct pathway and facilitate the indirect

(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.

113
Q
  1. 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
A

a. Learning and controlling
novel movement patterns

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.

114
Q
  1. 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
A

d. Pre-motor cortex

115
Q

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

A

A.Diaphragm

116
Q

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

A

A.Expiratory reserve volume

117
Q

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

A

C.Residual volume

118
Q
  1. Deficiency of surfactant increases work of breathing by increasing work:
    A.Airway resistance
    B.Compliance
    C.Tissue resistance
    D.All of these
A

B.Compliance

119
Q

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

A

B.Radius of airway

120
Q

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

A

Vital capacity + residual volume

121
Q

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

A

B.Dorsal respiratory group

122
Q

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

A

D.Send inspiratory signals to dorsal respiratory group of neurons

123
Q

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

A

B.CO2

124
Q

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

A

C.PaO2

125
Q
  1. Exercise is associated with an increase in
    A.Alveolar ventilation
    B.Arterial CO2 pressure
    C.Arterial pH
    Arterial O2 pressure
A

A.Alveolar ventilation

126
Q

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

A

B.Red blood cell mass

127
Q

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

A

A.Central chemoreceptors by hypercapnea

128
Q

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

A

Formation of free radicals that oxidize cell membranes

129
Q

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

A

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

Physiology (20 decks)

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