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Quantitative Physiology > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

1) A 30yr old man is resting and his sympathetic output increases to maximal values because of extreme fright. Which of the following sets of changes would be expected in response to this increased sympathetic output?

Increase or decrease for each of the following:

1) Resistance to venous return
2) Mean systemic filling pressure
3) Venous return

A

1) INCREASE Resistance to venous return
2) INCREASE Mean systemic filling pressure
3) INCREASE Venous return

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2
Q

2) A balloon catheter is advanced from the superior vena cava into the heart and inflated to increase atrial pressure by 5mmHg. An increase in which of the following would be expected to occur in response to the elevated atrial pressure?

A) atrial natriuretic peptide (high pressure response)
B) angiotensin 2 (reabsorb sodium and such in water)
C) Aldosterone (more water, more blood volume, more pressure?)
D) renal sympathetic nerve activity

A

A) atrial natriuretic peptide

It increases glomerular filtration and renal excretion of sodium and water, because increased sodium levels and pressure increase together, and secreting more water lowers the blood volume

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3
Q

3) Which of the following segments of the circulatory system has the highest velocity of blood flow?

A) Aorta
B) Arteries
C) Capillaries
D) Venules
E) Veins
A

A) Aorta

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4
Q

4) A 22 year old man enters the hospital emergency room after severing a major artery in a motorcycle accident. It is estimated that he has lost approximately 700 millileters of blood. His blood pressure is 90/55 mmHg. Which of the following sets of changes would be expected in response to hemorrhage in this man?

Increase or decrease in:

1) Renal blood flow,
2) parasympathetic nerve activity,
3) total peripheral resistance

A

1) decrease renal blood flow
2) decrease parasympathetic nerve activity
3) INCREASE total peripheral resistance

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5
Q

5) Which of the following conditions would be expected to decrease mean systemic filling pressure?

A) Norepinephrine administration
B) Increased blood volume
C) Increased sympathetic stimulation
D) Increased venous compliance
E) Skeletal muscle contraction
A

5) Increased venous compliance

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6
Q

6) Which of the curves in the figure above has the highest resistance to venous return?

A) the line with mean systemic pressure Psf = 10

B) The line with Psf = 10.5 (flattest slope)

C) The line with Psf = 2.3

D) The line with Psf = 7

A

B) The line with Psf = 10.5

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7
Q

7) Blood flow to a tissue remains relatively constant despite a reduction in arterial pressure (autoregulation). Which of the following would be expected to occur in response to the reduction in
arterial pressure?

A) Decreased conductance
B) Decreased tissue carbon dioxide concentration
C) Increased tissue oxygen concentration
D) Decreased vascular resistance
E) Decreased arteriolar diameter
A

D) Decreased vascular resistance

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8
Q

8) The largest portion of the arterial pressure generated during systole is dissipated at which of the following locations in the vascular tree?

A) aortic arch
B) Aortic-arterial juncture 
C) Arterial-arterolar juncture 
D) Arteriolar-capillary juncture
E) capillary-venular juncture
A

D) Arteriolar-capillary juncture

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9
Q

9) Which of the following conditions usually increases the plateau level of the cardiac output curve?

A) Myocarditis
B) Sever cardiac tamponade
C) Decreased parasympathetic stimulation of the heart
D) Myocardial infarction
E) Mitral stenosis
A

C) Decreased parasympathetic stimulation of the heart

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10
Q

10) An increase in atrial pressure results in which of the following?

A) Decrease in plasma atrial natriuretic peptide
B) Increase in plasma angiotensin 2 concentration
C) Increase in plasma aldosterone concentration
D) Increase in heart rate

A

D) Increase in heart rate

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11
Q

11) Which of the following is filtered most readily by the glomerular capillaries?

A) Albumin in plasma
B) Neutral dextran with a molecular weight of 25,000
C) Polycationic dextran with a molecular weight 25,000
D) Polyanionic dextran with a molecular weight of 25,000
E) Red blood cells

A

C) Polycationic dextran with a molecular weight of 25,000

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12
Q

12) The maximum clearance rate possible for a substance that is totally cleared from the plasma is equal to which of the following?

A) Glomerular filtration rate
B) Filtered load of that substance
C) Urinary excretion rate of that substance
D) Renal Plasma flow
E) Filtration fraction
A

D) Renal Plasma flow

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13
Q

13) Which of the following changes, compared with normal, would you expect to find 3 weeks after a patient ingested a toxin that caused sustained impairment of proximal tubular sodium chloride reabsorption? NO change in diet or electrolytes

Increase, decrease or no change in:

1) GFR
2) Afferent arteriolar resistance
3) Sodium excretion

A

1) Decrease GFR
2) INCREASE afferent arteriolar resistance
3) no change sodium excretion

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14
Q

14) If glomerular filtration rate (GFR) suddenly decreases from 100 ml/min to 50 ml/min and tubular fluid reabsorption simultaneously decreases from 99ml/min to 50ml/min, which of the following changes will occur (assuming that the changes in GFR and tubular fluid reabsorption are maintained)?

A) Urine flow rate will not change
B) Urine flow rate will decrease by 50%
C) Urine flow rate will decrease to 0
D) Urine flow rate will increase by 50%

A

C) Urine flow rate will decrease to 0

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15
Q

15) You begin treating a hypertensive patient with a powerful loop diuretic (e.g., furosemide). Which of the
following changes would you expect to find, compared with pretreatment values, when he returns for a follow-up examination 2 weeks later?

Increase, decrease, or no change in:

1) Urine sodium excretion
2) Extracellular fluid volume
3) Blood pressure
4) Plasma potassium concentration

A

1) no change, urine sodium excretion
2) decrease, extracellular fluid volume
3) decrease, blood pressure
4) decrease, plasma potassium concentration

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16
Q

16) In acidosis, most of the hydrogen ions secreted by the proximal tubule are associated with which of the following processes?

A) Excretion of hydrogen ions
B) Excretion of NH4+
C) Reabsorption of bicarbonate ions
D) Reabsorption of phosphate ions
E) Reabsorption of potassium ions
A

C) Reabsorption of bicarbonate ions

17
Q

17) Two weeks after constricting the renal artery of a sole remaining kidney to initially reduce renal artery pressure by 20 mmHg (100 to 80) which of the following changes would you expect, compared with before constriction of the artery?

A) Large decrease in sodium excretion (>20%)

B) Large increase in renin secretion (more than 2 fold)

C) Return of renal artery pressure to nearly 100mmHg

D) Large decrease in glomerular filtration rate (>20%)

E) Large reduction in reduction in renal blood flow (>20%)

A

C) Return of renal artery pressure to nearly 100mmHg

18
Q

18) Which of the following changes would you expect to find after acute administration of a vasodilator drug that caused a 50% decrease in renal efferent arteriolar resistance and no change in afferent arteriolar resistance or arterial pressure?

Increase, decrease, or no change in:

1) Renal blood flow
2) Glomerular Filtration rate
3) Glomerular capillary hydrostatic pressure
4) Peritubular capillary hydrostatic pressure

A

1) INCREASE renal blood flow
2) decrease GFR
3) decrease glomerular capillary hydrostatic pressure
4) INCREASE peritubular hydrostatic pressure

19
Q

19) Which of the following statements is true?

A) Antidiuretic hormone (ADH) increases water reabsorption from the ascending loop of Henle

B) Water reabsorption from the descending loop of Henle is normally less than that from the ascending loop of Henle

C) Sodium reabsorption from the ascending loop Henle is normally less than that from the descending loop of Henle

D) Osmolarity of fluid in the early distal tubule would be less than 300 mOsm/L in a dehydrated person with normal kidneys and increased ADH levels

E) ADH decreases the urea permeability in the medullary collecting tubes

A

D) Osmolarity of fluid in the early distal tubule would be less than 300 mOsm/L in a dehydrated person with normal kidneys and increased ADH levels

20
Q

20) Which of the following changes would you expect to find in a patient consuming a high-sodium diet (200 mEq/day ) compared with the same patient on a normal-sodium diet (100 mEq/day), assuming steady-state conditions?

A) Increased plasma aldosterone concentration

B) Increased urinary potassium excretion

C) Decreased plasma renin activity

D) Decreased plasma atrial natriuretic peptide

E) An increase in plasma sodium concentration of at least 5 mmol/L

A

C) Decreased plasma renin activity

21
Q

21) A healthy 28 year old woman stands up from supine position. What cardiovascular changes are most likely to occur with respect to:

1) Plasma Renin activity:
2) Renal blood flow:
3) Total peripheral resistance:
4) Venous hydrostatic pressure in legs:
5) Heart rate:

A

1) Plasma Renin activity: INCREASES
2) Renal blood flow: decreases
3) Total peripheral resistance: INCREASES
4) Venous hydrostatic pressure in legs: decreases
5) Heart rate: INCREASES

22
Q

22) Administration of a drug decreases the diameter of arterioles in the muscle bed of an experimental animal. What physiological changes would be expected to occur in response to the decrease in diameter, with respect to:

Vascular conductance:

Capillary filtration:

Blood flow:

A

Vascular conductance: decrease

Capillary filtration: decrease

Blood flow: decrease

23
Q

Ohm’s law vs hemodynamics

What is current, voltage difference, and resistance?

A

Current: Flow rate

Voltage difference: driving pressure gradient

Resistance: Resistance

24
Q

Graph of Stroke work vs End diastolic pressure, showing a positive slope with reduced mycardial contractility going down the slope like a slide:

What fundamental relationship does the graph depict?

A

Starling’s Law

25
Q

What does sympathetic stimulation, increased preload, and increased after load do to the heart work curve?

A

Sympathetic stimulation: widens to the left (increased stroke volume)

Increased Pre-load: widens to the right (increased stroke volume)

Increased After-load: taller (increased left ventricular pressure)

26
Q

What does increased sympathetic innervation, increased mean systemic filling pressure, increased vascular resistance do to venous return and cardiac output?

A

sympathetic innervation: increases cardiac output plateau, and lengthens venous return to right (increases right atrial pressure)

increased mean systemic filling pressure: increases venous return and right atrial pressure

increased vascular resistance: decreases venous return

27
Q

Two mechanisms of renal blood flow autoregulation:

A

Mechanism 1: Myogenic response of preglomerular arterioles
i. This mechanism senses changes in transmural pressure through the stretching of the muscle cells in the arteriole wall to induce contraction of preglomerular arterioles and afferent arterioles

Mechanism 2: tubuloglomerular feedback
i. This feedback senses changes in the concentration of sodium chloride (dependent
on flow rate which relates to glomerular capillary pressure and GFR) through
paracrine signaling in the tubular fluid and adjusts the diameter by contraction or
relaxation of the afferent arteriole to regulate blood flow

Quantitative Physiology (3 decks)

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