Physiology 1-50 Flashcards

1
Q

Para-amino-hippuric acid is used as a measure of renal plasma flow because ____________.
A. It is only filtered by the renal glomerulus.
B. It is both filtered and secreted.
C. It is both filtered and reabsorbed.
D. It is both reabsorbed and secreted.
E. It is filtered, reabsorbed, and secreted

A

B.
Theoretically, if a substance is completely cleared from the plasma, the clearance rate of that substance is
equal to the total renal plasma flow. A substance that is completely cleared from the plasma must be both filtered and secreted and not reabsorbed. PAH is about 90% cleared from the plasma and can be used as a easure of renal plasma flow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
The threshold for drinking is reached by an increase in sodium concentration of as little as: 
A. 1 mEq/L 
B. 2 mEq/L 
C. 3 mEq/L 
D. 4 mEq/L 
E. 5 mE/q/L
A

B.
When the sodium concentration increases only about 2 mEq/L above normal, the thirst mechanism is activated, causing a desire to drink water.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
Corrective lenses for near-sighted persons consist of \_\_\_\_\_\_\_\_ lenses because these lenses \_\_\_\_\_\_\_\_ light rays so that these are focused on the retina. 
A. Convex, converge 
B. Convex, diverge 
C. Concave, converge 
D. Concave, diverge 
E. Cylindrical lenses, converge
A

D.
In myopia, the image falls in front of the retina. Corrective lenses should therefore be concave so that light rays diverge and fall on the retina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
In a person eating a pure carbohydrate diet, the respiratory exchange ratio is expected to be: 
A. 1.0 
B. 0.85 
C. 0.7 
D. 0.5 
E. 0.25
A

A.
Respiratory exchange ratio is the ratio of carbon dioxide released with oxygen consumed. The normal ratio is 0.825.
However, in a pure carbohydrate diet, much more carbon dioxide is released which increases the ratio to 1.0. When
oxygen is metabolized with carbohydrates, one molecule of CO2 is formed for each molecule of O2 consumed. When oxygen reacts with fats, a large share of the oxygen combines with hydrogen atoms from the fats to form water instead of CO2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
Which part of the heart is first to repolarize? 
A. Base 
B. Septum 
C. Apex 
D. Right atria 
E. Right ventricle
A
C.
The first part of the ventricles to 
become depolarized is the left 
endocardial surface of the septum. The 
last part of the heart to become 
depolarized is the outer walls of the 
ventricles near the base of the heart. 
The greatest portion of ventricular 
muscle mass to repolarize first is the 
entire outer surface of the ventricles, 
especially near the apex of the heart. 
The endocardial areas, conversely, 
normally repolarize last. **So 
confusing!**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
Which glucose transporter is insulindependent? 
A. SGLT-1 
B. SGLT-2 
C. GLUT-1 
D. GLUT-2 
E. GLUT-3
A

D.
Sodium-glucose transporters are secondary active co-transport systems that depends on the sodium gradient.
GLUT-1 and GLUT-3, both present in the brain, does not depend on insulin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When a nerve action potential reaches a muscle membrane, which of the following events take place in chronological order?
A. Opening of sodium channels ? Depolarization ? Power stroke ? Calcium release from SR
B. Depolarization ? Opening of sodium channels ? Calcium release from SR ? Power stroke
C. Opening of sodium channels ? Depolarization ? Calcium release from SR ? Power stroke
D. Depolarization ? Opening of sodium channels ? Power stroke ? Calcium release from SR
E. None of the above

A
C.
The opening of sodium channels causes 
more inward positive current. This 
causes the depolarization of the muscle 
membrane.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The latch mechanism of smooth muscles serves to:
A. Increase the number of cross-bridges between actin and myosin
B. Increase the power of muscle contraction
C. Allow a prolonged relaxed state
D. Avoid muscle fatigue
E. Maintain prolonged tonic contraction

A

E.
Once smooth muscle has developed full contraction, the amount of continuing excitation usually can be reduced to far less than the initial level, yet the muscle maintains its full force of contraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
Which is NOT a diabetogenic hormone? 
A. Growth hormone 
B. Epinephrine 
C. Cortisol 
D. Thyroid hormone 
E. Glucagon
A

D.
The effects of thyroid hormone on carbohydrate metabolism are both
anabolic and catabolic as thyroid hormones cause an overall increase in cellular metabolic enzymes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
Spatial summation results from action potentials that are: 
A. Simultaneous 
B. Successive 
C. Alternating
D. Decremental 
E. Inadequate
A

A.

Temporal summation results when action potential are successive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
Sounds of high frequency stimulate basilar fibers located near the oval window because in this location, the basilar fibers are: 
A. Short and stiff 
B. Short and limber 
C. Long and limber 
D. Long and stiff 
E. None of the above
A

A.
The lengths of the basilar fibers increase progressively beginning at the oval window and going from the base of the cochlea to the apex. The diameters of the fibers, however, decrease from the oval window to the helicotrema, so that their overall stiffness decreases more than 100-fold. As a result, the stiff, short fibers near the oval window vibrate best at a very high frequency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
At the base of the lungs, there is relatively more perfusion than ventilation. This is: 
A. Physiologic dead space 
B. Physiologic shunt 
C. Anatomic dead space 
D. Anatomic shunt
E.    None of the above
A

B.

At the apex, there is relatively more ventilation than perfusion. This is physiologic dead space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
Which waste product plays a crucial role in maintaining the hyperosmolarity of the renal interstitium? 
A. Hydrogen ion 
B. Urea 
C. Carbon dioxide 
D. Glucose 
E. Water
A

B.
Urea is passively reabsorbed from the medullary collecting tubules to maintain a hyperosmolar renal interstitium. This promotes water reabsorption, thus, leading to the formation of a concentrated urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
Cushing's syndrome is ACTH-independent if the lesion occurs in the: 
A. Adrenal 
B. Pituitary 
C. Hypothalamus 
D. Ectopic sites 
E. All of the above
A

A.
The hypercortisolism from an adrenal cause of Cushing’s syndrome is not due to an increased ACTH. These patients have, in fact, low or undetectable levels of ACTH. Hence, it is ACTHindependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
Which GI hormone receptor belongs in the CCK family of receptors? 
A. Gastrin 
B. Secretin 
C. Histamine 
D. Pepsin 
E. Insulin
A

A.

CCKB is the receptor for gastrin. CCKA is for cholecystokinin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
The Edinger-Westphal nucleus of the oculomotor nerve serves \_\_\_\_\_\_\_ functions. 
A. Sensory 
B. Motor – sympathetic 
C. Motor – parasympathetic 
D. Both sensory and motor 
E. Neither sensory nor motor
A

C.
This nucleus functions in
accommodation of the eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which is a correct statement regarding acetylcholine?
A. It binds both to nicotinic and adrenergic receptors.
B. It is usually the hormone released by post-synaptic sympathetic neurons.
C. It is rapidly degraded by pseudocholinesterases.
D. Its receptors located in the muscle membrane are of the nicotinic type.
E. It functions only in the parasympathetic system.

A

D.
Acetylcholine functions both in the parasympathetic and sympathetic systems. It is degraded by acetylcholinesterase. Receptors for acetylcholine are of the nicotinic and muscarinic types.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
In blood vessels, compliance is a function of: 
A. Pressure and viscosity of blood 
B. Pressure and volume 
C. Volume and length of vessel 
D. Pressure and length of vessel
E. Volume and viscosity of blood
A

B.

A blood vessel is compliant if its volume increases with a corresponding increase in pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
Which hormone accounts for the increase in basal body temperature noted around the time of ovulation? 
A. FSH 
B. LH C. Estrogen 
D. Progesterone 
E. Prolactin
A

D.

This is the thermogenic effect of progesterone. The increase in temperature is about 0.5 degree Fahrenheit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
Capacitation of the spermatozoon occurs in the: 
A. Testes 
B. Epididymis 
C. Vas deferens 
D. Spongy urethra 
E. Female genital tract
A

E.
Capacitation refers to the collective changes that activate the sperm upon coming in contact with the fluids of the female genital tract. These changes make it possible for the sperm to penetrate the ovum. Maturation occurs in the epididymis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
which of the following will cause hypokalemia secondary to stimulation of potassium uptake by a cell? 
A. DM type 1 
B. 15 km Marathon 
C. Propanolol intake 
D. Thiazide intake 
E. all of the above
A

D.
Factors that cause shift of K into the cell are the following: Insulin administration, aldosterone, Beta adrenergic stimulation, alkalosis. Thiazide causes metabolic alkalosis.

22
Q
Cross section of the sarcomere through the H zone will reveal what structures? 
A. Actin and myosin 
B. Myosin only C. Actin only 
D. Actin myosin and troponin 
E. None of the above
A

B.

H zone is the center region of the sarcomere bilaterally adjacent to the M line. It compose of myosin only.

23
Q

A lung cancer patient presents to a neurologist compaining of inability to walk after waking up secondary to bilateral leg weakness. He noted that ambulation improves throughout the day. which of the following is the most likely mechanism of the weakness ?
A. antibodies to the Ach receptor
B. antibodies to the presynaptic vesicular transporters
C. antibodies to the presynaptic voltage gated channel
D. antibodies to the Acetylcholinesterase
E. none of the above.

A

C.
The patient is most likely suffering from Lambert Eaton Myasthenic syndrome. This is a common paraneoplastic syndrome associated with small cell lung carcinoma. It attacks the presynaptic voltage gated calcium channels causing decrease release of ach in the synaptic junction. accumulation of ach throughout the day will cause improvement in the motor strength.

24
Q
what is the most important controller of coronary arterial blood flow?
A. Prostaglandin 
B. Carbon dioxide 
C. Lactate
D. Adenosine
E.  All of the above
A

D.
SIMILAR TO PREVIOUS BOARD EXAM
CONCEPT/PRINCIPLE. Guyton 11th ed
pp 250-251

25
Q
the largest percentage of blood volume is contain in which of the following part of the circulation? 
A. capillaries 
B. arteries 
C. veins 
D. lungs 
E. All have the same blood volume
A

C.

veins are also known as capacitance vessel. It contains as much as 2/3 of the blood volume

26
Q
In which type of shock is associated with increased cardiac output? 
A. Neurogenic shock 
B. Septic shock 
C. Anaphylactic shock 
D. Hypovolumic shock 
E. All of the above
A

B.
during septic shock, there is an overall high basal metabolic rate resulting to compensatory vasodilatation of systemic arterioles this leads to dramatic decrease in afterload leading to increase cardiac output. All the other choices are associated with decrease CO

27
Q

Which of the following is true regarding EEG wave forms ?
A. Delta waves are seen during stage 4 sleep
B. Alpha waves is seen during awake,active and during periods of sympathetic surge
C. Beta waves are regular waves seen during quiscent state
D. REM sleep show prominence of sleep spindles an K complexes
E. all of the above

A

A.
Alpha waves - awake, quiscent state, beta waves - awake, heightened activity, alert. REM sleep- beta waves. Sleep spindles and K complex are seen during Stage II sleep. Delta waves are prominent during Stage III and IV sleep.

28
Q
these concept states the specificity of a specific sensory nerve fiber to transmit only one sensory modality? 
A. Labeled line principle 
B. Convergence principle 
C. Frequency coding principle 
D. Specificity coding principle 
E. None of the above
A

A. Guyton 11th ed pp 572-573

29
Q
which of the following factors will increase the PR interval in the ECG?
A. increased epinephrine   
B. Increased K permeability   
C. Increased calcium conductance 
D. decrease acetylcholine 
E.  Increase sodium conductance
A

B.
increase in K conductance will result in the hyperpolarization of AV node leading increase in PR interval. Increase sodium, calcium, epinephrine,norepinephrine and decrease parasympathetic will result to an opposite outcome.

30
Q
which of the following taste sensation will have the lowest threshold for stimulation? 
A. sweet 
B. salty 
C. Sour 
D. None of the above 
E. Both a and b
A

D.

bitter is the most sensitive taste sensation as an adaptation to prevention of toxin ingestion.

31
Q
which of the following will adjust the basic respiratory rhythm by decrease the duration of inspiration and increase the respiratory rate? 
A. Ventral respiratory group 
B. pneumotaxic 
C. apneustic 
D. Dorsal respiratory group 
E. None of the above
A

B.
the Dorsal group sets off the basic rhythm of respiration. During periods of exertion and exertion, there is overflow of stimulation to the ventral respiratory group such that it will cause tachypnea and set up a higher respiratory rhythm. The apneustic center found in pons causes an increase in inspiratory duration and lowers the respiratory rate. pneumotaxic center seen also in the pons provide signal to DRG to set off the rhythm.

32
Q
which of the following will decrease the excretion of potassium at the cortical collecting tubule? 
A. Uncompensated metabolic alkalosis 
B. hypernatremia 
C. Acetazolamide intake 
D. Spirinolactone 
E. All of the above
A

D.
spirinolactone is an aldosterone antagonist. The action of the aldosterone is to increase excretion of potassium while promoting sodium retention.therefore blocking this action will lead to opposite result. Hypernatremia will cause increae Na and fluid load in the tubules leading to further increase in K secretion. same is true in giving an acetazolamide which is acts on proximal tubule to inhibit absorption of Na. In acute alkalosis, a decrease in hydrogen will have a lesser inhibitory effect on the Na K pump. therefore, more K is in the extracellular compartment and will be transported to the tubules.

33
Q
What zone of pulmonary perfusion does the lung apices belong if the patient is in upright still position ? 
A. Zone 1 
B. Zone 2 
C. Zone 3 
D. Zone 4 
E. Zone 5
A

B.
the apices of the lung is zone 2, while the mid and basal lung regions are zone 3. Zone 2 states that only during systole that there would be pulmonary perfusion since at that time it will exceed the alveolar pressure. Zone 3 means there is a continuous blood flow since the alveolar capillary pressure is always greater than alveolar pressure regardless on what phase of cardiac cycle. Zone 1 happens only if the patient is having severe blood loss or in a positive pressure ventilation.

34
Q
at 20th week of gestation, what is predominant site of RBC production? 
A. Yolk sac 
B. liver 
C. Bone marrow 
D. spleen 
E. Both A and B
A

B.
during first trimester, the yolk sac is the predominant site of RBC production, it gradually involutes and by the time of 2nd trimester, the liver will take over with the hematopoeisis. It is only during the third trimester does the marrow will provide the majority of RBC production.

35
Q
Digestion of which substances/macronutrien ts occurs exclusively in the small intestine? 
A. Triglycerides 
B. Proteins
C. Cellulose 
D. Starch 
E. None of the above
A

E.
the start of digestion of fats occurs primarily in the intestine because it needs bile for it to be acted upon by pancreatic lipase. There is no enzyme of physiologic significance is found proximal to the duodenum that can digest fats. Sugars are first acted upon by contact with ptyalin. while proteins are initially digested at the stomach. cellulose is indigestible. CORRECTION: actual answer is E, not A. Lingual Lipase begins digestion of fats in the stomach. Stomach also causes mechanical digestion of fats.

36
Q
A 32 y/o male was using the threadmill machine for about an hour already, which of the following organs will have no significant decrease in the blood flow parameter? 
A. Small intestine 
B. brain 
C. kidney 
D. Forearm muscle 
E. None of the above
A

B.
among the organs of the body, the brain and the heart will have widest range of autoregulation. Blood flow in these two organs will be constant even if the person is in strenuous exercise. Visceral organs including the kidneys will have a significant decrease in blood flow at this time as well as the non exercising muscle such as the forearm.

37
Q
which of the following condition will result to a right axis deviation in the ECG? 
A. Central obesity 
B. Chronic bronchitis 
C. Aortic regurgitation 
D. Aortic stenosis 
E. Atrial fibrillation
A

B.
central obesity can mechanically translate the heart superolaterally leading to left axis deviation. Aortic regurgitation and aortic stenosis will result to volume and pressure overload respectively causing also left axis deviation. Atrial fibrillation presents with absence of P waves and irregularly irregular rhythm. chronic bronchitis is in a prolonged state of hypoxia resulting to pulmonary vasoconstriction. this will lead to increase pulmonary overload and as a compensatory, there would right ventricular hypertrophy.

38
Q

what nephron segment is the primary site of magnesium reabsorption?
A. Proximal convoluted tubule 1st portion
B. Descending limb of henle.
C. Distal cortical collecting tubule
D. Ascending limb of henle
E. Proximal convoluted tubule straight portion

A
D.
unlike other electrolytes wherein 
majority are absorbed at the first 
portion of the PCT. Magnesium 
absorption primarily occurs at 
ascending limb of henle with a 
percentage of approximately 65%
39
Q
In Melzack and Wall Gate Control theory, inhibition of pain signal transmission is due to stimulation of which nerve fiber type?
A. A alpha 
B. Golgi tendon organ  
C. A beta   
D. A delta   
E. Type B fibers
A
C.
according to the gate control theory, A 
beta fibers responsible for tactile 
stimulations tends to close the 
transmission of a delta and C fibers at 
the level of substantia gelatinosa
40
Q
growth hormone promotes catabolism of which metabolic substrate? 
A. protein 
B. Glucose 
C. Fats 
D. All of the above 
E. A and B only
A
C.
growth hormone promotes oxidation of 
fatty acids while decreasing the 
catabolism of sugars and proteins. 
SIMILAR TO PREVIOUS BOARD EXAM 
CONCEPT/PRINCIPLE.
41
Q

Which of the following conditions could potentially lead to a coagulation defect in both extrinsic and intrinsic pathways?
A. a heritable defect involving von willebrand’s factor
B. a mutation in the genes coding for platelet Gp1B receptor
C. a mutation in the genes coding for platelet Gp2B3A receptor
D. a blockage in bile flow
E. an x linked disorder leading to factor 8 deficiency

A
D.
SIMILAR TO PREVIOUS BOARD EXAM 
CONCEPT/PRINCIPLE, blockage to bile 
flow leads to decreased vit K 
absorption leading to alteration in both 
extrinsic and intrinsic pathways 
involving factor 7, 9
42
Q

A 65 year old male patient with long standing hypertension, occasional intermittent chest heaviness, with month long history of bilateral pedal edema more prominent during the afternoon. He uses 3 pillows at night during sleep. 5 hrs PTC, patient developed chest heaviness not releaved by rest and medications, he suddenly developed dyspnea and was rushed to the hospital. On initial observation, patient was noted to have distended neck veins and bilateral crackles were heard on both lungs. The primary pathophysiologic mechanism causing his dyspnea is
A. increased glomerular hydrostatic pressure
B. increased interstitial oncotic pressure
C. increased capillary hydrostatic pressure
D. increased capillary oncotic pressure
E. increased interstitial hydrostatic pressure

A

C.
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, know the starling forces and understand them by heart, patient has heart failure, increased capillary hydrostatic pressure from fluid overload pushes fluid out into interstitium causing pulmonary edema, causing dyspnea

43
Q

A 15 year old male patient presents at the clinic saying that he was diagnosed with klinefelter’s syndrome which of the following physical findings is expected to be found on examination?
A. breast development, sparse body and facial hair and grossly male external genitalia
B. short stature, swelling, broad chest, low hairline, low-set ears, and webbed necks
C. male phenotype with ambiguous genitalia
D. female phenotype with ambiguous genitalia
E. small chin, slanted eyes, poor muscle tone, a flat nasal bridge, single palmar crease

A

A.
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, grossly male genitalia with female secondary sexual characteristics is klinefelter, E is down’s syndrome, B is turners, C and D pseudohermaphroditism

44
Q
Which of the following lung volumes or capacities might be increased in severe asthma? 
A. IC inspiratory capacity 
B. FEV forced expiratory volume 
C. IRV inspiratory reserve volume 
D. TV tidal volume 
E. RV residual volume
A

E.
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, residual volume is increased due to air trapping, the rest are decreased

45
Q
Which of the following lung regions are most susceptible to barotrauma from over ventilation? 
A. apical region 
B. upper lobe 
C. middle lobe 
D. lower lobe 
E. all of the above
A

A.
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, apical alveoli are already partially distended to begin with, further increase in air pressure may promote barotrauma in these regions first before the other regions of the lung

46
Q

Comparing the cardiac output of the right and left heart, which of the following is true?
A. cardiac output is higher in the left side due to increased systemic vascular resistance
B. cardiac output is lower in the right side due to decreased pulmonary vascular resistance
C. cardiac output in the right side of the heart is the same as the left side
D. cardiac output in the left side of the heart is doubled due to higher pressure in the aorta
E. cardiac output in the right side of the heart is less due to the lower pressure in the pulmonary circulation

A

C.

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, cardiac output in the left and right heart are the same

47
Q
Which of the following conditions suppress the secretion of growth hormone? 
A. decreased serum cortisol levels 
B. increased dopamine secretion 
C. decreased thyroid hormone levels 
D. increased serum glucose 
E. decreased food intake or starvation
A

D.

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, increased glucose levels inhibit growth hormone secretion

48
Q
A 1 year old male was rushed to the hospital due to bouts of persistent watery diarrhea, patient looks dry and was lethargic, which of the following fluids when infused would not increase extracellular fluid volume? 
A. Plain normal saline solution 
B. Plain lactated ringers solution 
C. D5W 
D. D5LR 
E. D5NSS
A

C.
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, D5W is a hypotonic solution with tendency to go inside of the dehydrated cells, it will not replete so much the ECF volume or intravascular volume

49
Q
A 50 year old male patient was rushed to the ER due to dull crampy generalized vague abdominal pain, patient had absence of bowel movement for 3 days already with minimal flatus accompanied by vomiting and anorexia, patient had a previous appendectomy. The abdominal pain felt by the patient is most likely conducted by which nerve fibers? 
A. A alpha nerve fibers 
B. AB nerve fibers 
C. A delta nerve fibers 
D. B fibers 
E. C fibers
A

E.
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, slow vague visceral pain is transmitted by unmyelinated C fibers in contrast to A delta myelinated fibers which transmit fast localized somatic pain, B is preganglionic autonomic, A AB are motor fibers

50
Q
17 year old female patient noted to have heavy menses was noted to be pale with easy fatigability, this may be brought about by decreased oxygen carrying capacity of the blood, one knows that for every 1g of Hgb can carry how much oxygen?
A. 2.56mL  
B. 1.34mL   
C. 100 mL  
D.  50 mL  
E.  5.35 mL
A

B.

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE