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BOARD REVIEW > PHYSIOLOGY > Flashcards

PHYSIOLOGY Flashcards

1
Q

An increase in the heart rate increases the force of contraction generated by the myocardial cells with each heartbeat refers to

A

Treppe phenomenon

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2
Q

What phases are NOT present in the SA node action potential?

A

Phases 1 and 2

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3
Q

The rapid diffusion of ions that result in propagation of the action potential in cardiac muscle fibers is due to the presence of

A

Gap junctions

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4
Q

A carotid pulse called pulsus parvus et tardus is seen in what disease?

A

Aortic stenosis

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5
Q

What ion is responsible for the self-excitation of the sinus nodal fibers?

A

Sodium

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6
Q

An accentuated decrease in systolic arterial pressure of >10 mmHg during inspiration

A

Pulsus paradoxus

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7
Q

Wide, fixed splitting of the second heart sound is characteristically seen in what condition

A

Atrial septal defect

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8
Q

Pt: ventricular tachycardia
PE: hyperkeratosis of his hands and feet and that he had thick, wool-like hair.

A

Naxos disease

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9
Q

infero-posterior infarction and hypotension. What reflex?

A

Bezold- Jarish reflex

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10
Q

In what phase of the cardiac volume-pressure curve are the atrioventricular valves open while the semilunar valves are closed?

A

Period of filling

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11
Q

A beat to beat alternation of one or more components of the ECG signal, together with sinus tachycardia is a relatively specific sign of what condition

A

Pericardial effusion with tamponade

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12
Q

What ions are responsible for the plateau phase in the ventricular action potential

A

Calcium

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13
Q

Brain waves found in those who are awake (eyes closed)

A

Alpha waves
8-12 Hz

(Awake and relaxed)

<4- delta
<8 - theta
>12 - beta

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14
Q

Brain waves found in those who are awake (eyes open)

A

Beta waves
>12 Hz

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15
Q

Brain waves found in those who are alert

A

Beta wave

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16
Q

Brain waves found in those who are awake and relaxed

A

Alpha wave

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17
Q

Brain waves found in those who are soundly sleeping

A

Delta/ slow waves
Deep sleep

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18
Q

Brain waves found in those who have hepatic/ uremic encephalopathy

A

Delta / slow waves

(Requirement on those who have hepatic encephalopathy + asterixis/negative myoclonus)

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19
Q

Brain waves found in those who are in REM sleep

A

Beta wave

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20
Q

Brain waves found in those who are in stage 4 slow wave sleep

A

Delta wave

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21
Q

Brain waves that are strong and of low frequency

Most sleep during each night

A

Slow wave or non REM Sleep

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22
Q

Eyes undergo rapid movements even though the person is still asleep

25% of sleep time
Recurs about every 90 mins

A

Rapid eye movement (REM Sleep)

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23
Q

Not so restful
Associated with vivid dreams?
REM or Non REM?

A

REM sleep

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24
Q

Deep, restful sleep during first hour of sleep after having been awake for many hours

A

Non-REM sleep

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25
Q

Paradoxical, desynchronized sleep

A

REM Sleep

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26
Q

Raphe nuclei produce what neurotransmitter?

A

Serotonin

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27
Q

Lesion in raphe nuclei
Bilateral lesion in the medial rostral suprachiasmal area in the anterior hypothalamus

A

high state of wakefullness

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28
Q

Important neurons in arousal and wakefulness

A

Orexin neuron/ hypocretin
Produced in the hypothalamus

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29
Q

Loss or destruction of Orexin Producing neurons cause?

A

Narcolepsy

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30
Q

Weight of kidney

A

150 g

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31
Q

Most common injured organs in blunt abdominal trauma

A

Liver and spleen

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32
Q

Position of kidneys

A

Retroperitoneal
Right kidneys more CAUDAL

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33
Q

What is the most common kidney chosen for renal transplant?

A

LEFT kidney

Left renal vein in Longer

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34
Q

All chronic kidney disease has atrophied kidney except?

A

HIV
DM nephropathy
Amyloidosis

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35
Q

Functional unit of kidney

A

Nephron

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36
Q

Juxtaglomerular apparatus (3)

A

JG cells
Macula densa
Mesangial cells

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37
Q

Cell that secretes Renin

A

JG cells

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38
Q

Senses changes in volume and decrease in NaCl concentration

“Na sensor”

A

Macula densa

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39
Q

Basic renal processes

A

Glomerular Filtration
Tubular Reabsorption
Tubular Secretion

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40
Q

Normal protein content of urine

A

Zero

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41
Q

Usual daily urine output

A

720 - 1440mL
(700-1500)

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42
Q

Bladder muscle responsible for urination

A

Detrusor muscle

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43
Q

Effect of sympathetic nervous system in the bladder

A

Fill the bladder

(Sympathy is Feeling)

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44
Q

Effect of parasympathetic nervous system in the bladder

A

Emptying of bladder

(No pera - empty)

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45
Q

Erection
Para or sympa?

A

Parasympathetic
(point)

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46
Q

Ejaculation
Para or sympa?

A

Sympathetic
(Shoot)

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47
Q

Parasite that causes urinary bladder cancer

A

Schistosoma haematobium

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48
Q

Chemical notorious for causing urinary bladder cancer

A

Aniline dye

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49
Q

Chemical notorious for causing hemorrhagic cystitis

Toxin?

A

Cyclophosphamide/ ifosphamide

Toxin: acrolein

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50
Q

First urge to void is felt at a bladder volume of about?

A

150 mL

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51
Q

Marked fullness of bladder at about?

A

400 mL

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52
Q

Normal capacity of adult urinary bladder

A

500 mL

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53
Q

Rx for post-op urinary retention

A

Bethanecol

Parasympathetic effect = emptying

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54
Q

Effect of parasympathetic nervous system on the cardiovascular system

A

Inhibit

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55
Q

Substance secreted in response to changes in Bp by the JG cells of the afferent arteriole

A

Renin

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56
Q

Action of renin?

A

Converts angiotensinogen (from liver) to angiotensin I

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57
Q

Angiotensin I
vasodilator or vasoconstrictor?

A

Potent vasoconstrictor

Angiotensin II is a more potent vasoconstrictor than angiotensin I

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58
Q

Hormone that promotes WATER REABSORPTION in distal collecting ducts

Location?

A

Vasopressin/ ADH

Supraoptic nuclei of posterior pituitary gland

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59
Q

Drug used to treat bipolar disorder that causes nephrogenic Diabetes Insipidus

A

Lithium carbonate

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60
Q

Hormone produced by the adrenal cortex (z. Glomerulosa); promotes NA REABSORPTION in the collecting ducts

A

Aldosterone

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61
Q

Drug used to treat volume overload in liver cirrhosis of congestive heart failure which is an aldosterone antagonist

A

Spirinolactone

Side effect: gynecomastia and small balls

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62
Q

Produced by atrial cardiac cells and promote NA EXCRETION in the collecting ducts

A

Natriuretic peptides (NPs)

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63
Q

Action of parathyroid hormone

A

Phosphate EXcretion
Calcium reAbsorption
Vit D Production

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64
Q

Hormone that will decrease calcium

A

Calcitonin from C cells of thyroid

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65
Q

Thyroid cancer that is calcitonin producing

A

Medullary thyroid CA
(Bad prognosis)

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66
Q

Where is erythropoietin (EPO) produced

A

Peritubular capillaries of the kidney

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67
Q

Two erythropoietin Vit B

A

Vitamin B9 (folic acid) and B12 (cyanocobalamin)

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68
Q

Strict vegetarians

A

Vit B12 (cyanocobalamin)

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69
Q

Recently underwent a gastrectomy

A

Intrinsic factor deficiency
—-Removal of parietal cells

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70
Q

Promotes Calcium and Phosphate Absorption from the gut as a principal action

A

Vitamin D
1, 25 dihydroxycholecalciferol (active)

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71
Q

Enzyme present in kidney that converts Vit D to its active form

A

1 alpha hydroxylase

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72
Q

Case:
- infant
- hypogonadism
- syndactyly
- (-) 7 dehydrocholesterol reductase

Dx?

A

Smith Lemli Opitz Syndrome (SLOS)

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73
Q

Vitamin D deficiency in children

A

Rickets

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74
Q

Vitamin D deficiency in adults

A

Osteomalacia

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75
Q

High permeability of the Thin Descending limb to WATER is because of?

A

Aquaporin 1 channels

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76
Q

Specific action of ADH on the kidney

A

Causes insertion of aquaporin/ water channels on the distal tubules

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77
Q

Where is aldosterone produced specifically?

A

Zona glomerulosa of adrenal cortex

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78
Q

Clearance of this substance is used to estimate renal blood flow and renal plasma flow

A

Para aminohipuric acid (PAH)

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79
Q

Clearance of this substance is used to estimate GFR

A

Inulin

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80
Q

Renal threshold for glucose

A

180 ml/dL

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81
Q

3 urinary buffers

A

NaHCO3 - sodium bicarbonate
NaHPO4 - sodium phosphate
NH4 - ammonium

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82
Q

Most important ECF buffer

A

Bicarbonate buffers

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83
Q

Most powerful buffer because pK of proteins (amino acids)

A

Protein buffer

84
Q

Causes of normal anion gap metabolic acidosis (NAGMA)

A

Diarrhea or
Renal tubular acidosis

“USEDCAR”
Ureteral diversion
Saline infusion
Exogenous acid
Diarrhea
Carbonic anhydrase inhibitors
Adrenal insufficiency
Renal tubular acidosis

85
Q

Carbonic anhydrase inhibitor that is used to treat glaucoma, hydrocephalus and acute mountain sickness

A

Acetazolamide

86
Q

Cofactor for carbonic anhydrase

A

Zinc

87
Q

Mammary myoepithelial cells are contractile epithelial cells that express _____________________

A

Smooth muscle a-actin (ACTA2)

88
Q

The primary function of mammary myoepithelial cells is to contract in response to _________ release by posterior pituitary gland upon sucking of nipple

A

Oxytocin

89
Q

Milk letdown reflex
Milk ejection reflex
Uterine contraction

A

Oxytocin

90
Q

Specific part of hypothalamus that synthesizes oxytocin

A

Paraventricular or magnocellular nuclei

91
Q

Galactorrhea causes

A

Nipple stimulation
Prolactinoma of anterior pituitary
Drugs (anti-psychotic, anti-depressant, digitalis, reserpine, estrogen, dopamine 2, methyldopa)

92
Q

Pressure of the fluid in the pleural space; slightly negative

A

Pleural pressure

93
Q

Major muscle of inspiration

A

Diaphragm

—-phrenic nerve

94
Q

Air pressure inside alveoli

A

Alveolar pressure

95
Q

Difference between alveolar and pleural pressure

A

Transpulmonary pressure

96
Q

Measures lung DISTENSIBILITY

A

Compliance

“Compliant lungs are easy to distend”

97
Q

Property of matter to resist DEFORMATION

A

Elastance

“Highly elastic structures are difficult to deform”

98
Q

Compliance work is ____ in emphysema (obstructive) and ____ in lung fibrosis (restrictive)

A

Compliance work is INCREASED in emphysema and REDUCED in lung fibrosis

99
Q

Obstructive lung diseases

  • destruction of lung tissue and the loss of elastin and collagen
A

Emphysema
Asthma
Normal aging lung

100
Q

Restrictive lung diseases

A

Pulmonary fibrosis
Alveolar edema
Atelectasis
Increased surface tension

101
Q

Created by attractive forces between water molecules

Produces a collapsing pressure

A

Surface tension

102
Q

Decreases alveolar surface tension to decrease the work of breathing

A

Surfactant

103
Q

Collapsing pressure = 2(surface tension)/ alveolar radius

A

Law of laplace

104
Q

ARDS in newborn due to

A

Prematurity

(-) surfactant

105
Q

ARDS in adult due to

A

Sepsis/ infection

Diffuse Alveolar Damage (DAD)

106
Q

Air Flow Resistance = (air viscosity)(airway length)/ airway radius

A

Poiseuille’s Equation

107
Q

Volume inspired or expired with each normal breath

A

Tidal volume
500ml

108
Q

Extra volume that can be Inspired over and above the tidal volume

A

Inspiratory Reserve Volume (IRV)
3000ml

109
Q

Maximum extra volume that can be Expired by forceful expiration after the end of a normal tidal expiration

A

Expiratory Reserve Volume (ERV)
1100ml

110
Q

Volume that Remains in the lungs after maximal expiration

A

Residual Volume (RV)
1200ml

111
Q

TV + IRV = ?

A

Inspiratory Capacity
TV + IRV = IC
500 + 3000 = 3500ml

112
Q

ERV + RV = ?

A

Functional Residual Volume (FRV)
1100 + 1200 = 2300 ml

113
Q

TV + IRV + ERV =

A

Vital Capacity (VC)
500 + 3000 + 1100 = 4600ml

114
Q

TV + IRV + ERV + RV =

A

Total Lung Capacity (TLC)
500 + 3000 + 1100 + 1200 = 5800ml

115
Q

Lung Volumes
___ in RESTRICTIVE
___ in OBSTRUCTIVE

A

DECREASE in RESTRICTIVE disease
INCREASE in OBSTRUCTIVE disease

116
Q

Total Lung Capacity
___ in RESTRICTIVE
___ in OBSTRUCTIVE

A

DECREASED in RESTRICTIVE
INCREASED in OBSTRUCTIVE

117
Q

Maximum amount of air that can be exhaled in 1 sec after a maximal inspiration

A

Forced Expiratory Volume (FEV1)

118
Q

FEV1/FVC Ratio

___ in RESTRICTIVE
___ in OBSTRUCTIVE

A

0.8

Normal or increased in RESTRICTIVE
Decreased in OBSTRUCTIVE

119
Q

Reversibility is demonstrated….

A

12% and 200ml increase in FEV1 15mins after an inhaled Beta 2 agonist

Or

2-4 week trial of oral corticosteroids (OCS) (Prednisolone or Prednisone 30-40mg daily)

120
Q

Portions of the lungs that are VENTILATED but in which NO GAS EXCHANGE occurs

A

Pulmonary Dead Space

121
Q

Volume of conducting airways NOT involved in gas exchange
(Approx. 150ml)

A

Anatomic dead space

122
Q

Ventilated alveoli that are NOT PERFUSED
Negligible amount

A

Alveolar dead space

123
Q

SUM of anatomic and alveolar dead spaces

A

Physiologic dead space

124
Q

Increases anatomic dead space

A

Mechanical ventilator (extra tubes)

125
Q

Respiratory centers of the brain

A

Pons and Medulla

126
Q

Controls basic RHYTHM of respiration

A

Dorsal Respiratory Group of Medulla

127
Q

Stimulates EXPIRATORY MUSCLES as in forced expiration

A

Ventral Respiratory Group of Medulla

128
Q

INHIBITS INSPIRATION thus decreasing lung filling and increases respiratory rate

A

Pneumotaxic of Pons

129
Q

INCREASES DURATION of inspiration thus increases lung filling and decreases respiratory rate

A

Apneustic of Pons

130
Q

Lung overinflation stimulates stretch receptors and transmits signal through vagus nerve to the Dorsal Respiratory Group switching off inspiration

Tidal volume 3x normal (>1.5L)

A

Hering-Breuer Inflation Reflex

131
Q

Lung overinflation stimulates the Dorsal Respiratory Group switching off inspiration

VT 3x normal (>1.5L)

A
132
Q

Best oxygenated (ventilated) lung zone

A

Zone 1 - apices
No blood flow during cardiac cycle

133
Q

Best perfused lung zone

A

Zone 3 - bases
Continues with cardiac cycle

134
Q

Maximum amount of O2 that can combine with Hemoglobin of the blood

A

1g Hgb + 1.34ml of O2

135
Q

Major form of CO2 in the blood

A

Bicarbonate

136
Q

Phenomenon where bicarbonate ions diffuse from RBC into plasma and chloride ions diffuse into RBC to take their place

A

Chloride shift

137
Q

Phenomenon associated with unloading of carbon dioxide secondary to increased OXYGEN

A

Haldane effect

138
Q

Phenomenon associted with unloading of oxygen secondary to increased H+

A

Bohr effect

139
Q

Major forms of CO2 transported as..

A

Bicarbonate (*)
Carbaminohemoglobin
Dissolved CO2

140
Q

Nerve supply for the anterior 2/3 of the tongue

A

CN 7 - facial nerve

141
Q

Diseases that presents ectopia lentis (2)

A

Marfans
Homocystinuria

142
Q

Transparent and avascular part of the eye

Only human tissue that can be transplanted without fear of rejection

A

Cornea

143
Q

Findings of cornea with wilsons disease?

Tx?

A

Keyser fleischer rings

Penicillamine

144
Q

Layer of the retina converts 11-cis retinal to all-trans retinal

A

Pigment epithelial cells
- to absorb stray light and prevent scatter of light

145
Q

Vitamin necessary for the regeneration of 11-cis retinal

A

Vitamin A

Earliest manifestation: Nyctalopia (night blindness)

146
Q

Allow dim light vision and peripheral vision

Rods or cones?

A

Rods

147
Q

Area of the retina which only has cones

A

Fovea centralis

148
Q

Day vision
High visual aCuity
Color vision
Will adapt first

Rods or cones?

A

Cones

149
Q

Unit of measure of the refractive power of a lens

A

Diopters

150
Q

Normal and correct focus
Normal vision

A

Emmetropia

151
Q

Farsighted
Light focus BEHIND retina
CONVEX lens correction

A

Hyperopia

152
Q

Nearsighted
Light focus in FRONT of retina
BiCONCAVE LENS

A

Myopia

153
Q

Curvature of lens not uniform
CYLINDRICAL LENS

A

Astigmatism

154
Q

Condition with increase intraocular pressure?

Gold standard to diagnose?

Rx?

A

Glaucoma

Tonometry

Acetazolamide, timolol, pilocarpine, bimatoprost

155
Q

Mast cell stabilizer used in a form of eyedrops

For conjunctivitis

A

Ketotifen

156
Q

Loss of accomodation power of lens (aging)
CONCAVE LENS

A

Presbyopia

157
Q

Pie in the sky lesion

A

Meyer’s loop

158
Q

If cut, will result to homonymous hemianopia with macular sparing

A

Geniculocalcarine tract

159
Q

Free nerve ending

A

Pain
Cold
Warmth

160
Q

Pacinian corpuscles

A

Pressure

161
Q

Meissner’s corpuscles

A

Touch

162
Q

Muscle Spindle

A

Stretch

163
Q

Golgi tendon receptor

A

Tension

164
Q

Simultaneous neuronal discharge

A

Summation

165
Q

Summation by activating multiple terminals on widely-spaced areas

A

Spatial

166
Q

Rapidly successive discharges from a single presynaptic terminal

Increasing the frequency of nerve impulse in each fiber

A

Temporal

167
Q

Occurs when membrane potential is NEARER TO TRESHOLD FOR FIRING than normal but is not yet at the firing level

A

Facilitation

168
Q

Potential that OPPOSES MOVEMENT of an ion

A

Nernst potential

169
Q

Receptor: pain and temperature

A

Free nerve ending

170
Q

Receptor: light touch

A

Merkel’s tactile disks

171
Q

Receptor: fine touch

A

Meissner corpuscles

172
Q

Receptor: Pressure and vibration

A

Pacinian corpuscles

173
Q

Receptor: cold temp

A

Krause’s corpuscles

174
Q

Receptor: warm temp

A

Ruffini’s endings

175
Q

Receptor: muscle Tension

A

Golgi Tendon organs

176
Q

Receptor: muscle Length

A

Muscle Spindle

177
Q

Bending of light rays at angulated interface

A

Refraction

178
Q

Ratio of velocity of light in air to the velocity in the substance

A

Refractive index

179
Q

Optics of the eye (3)

A

Lens
Pupil
Retina

180
Q

Emmetropia

A

Normal eye

181
Q

Eyeball that is too short or lens too weak
Corrected with Concave lens

A

Hyperopia

182
Q

Eyeball that is too long or lens that is too strong
Corrected by convex lens

A

Myopia

183
Q

Refractive errorthat causes visual image one plane to focus at a different distance from that of the plane at right angles

Corrected with SPHERICAL LENS & CYLINDRICAL LENS

A

Astigmatism

184
Q

The ability to determine distance of an object from the eye

A

Depth perception

185
Q

Interneurons that help analyze visual signals before leaving the retina

A

Amacrine cells

186
Q

Cell type for fine details and color vision

A

Parvocellular

187
Q

Cell type for rapidly moving visual signals and low-contrast stimuli

A

Magnocellular

188
Q

Area lack of rods and cones in the retina over the area of the optic disk 15°lateral to the central point of vision°

A

Blind spot

189
Q

Rapid jerk-like “jumping” movement of the eyes to shift the focus on a visual scene

A

Saccades

190
Q

Rapid smooth movement of the eye

A

Pursuit movement

191
Q

Responsible for rapid head and eye turning movements

A

Superior colliculi

192
Q

Refers to lack of fusion of the eyes

A

Strabismus

193
Q

Total body water measurement

A

Antipyrine

194
Q

Clearance of this substance used to estimate GFR

A

Inulin

195
Q

Plasma or Intravascular volume measured

A

Evan’s blue dye

196
Q

Most important ECF buffers

A

Bicarbonate buffer

197
Q

Most powerful buffer because pK of proteins (amino acids)

A

Protein buffer

198
Q

Clearance of substance is used to estimate Renal Blood Flow and Renal Plasma Flow

A

PAH / Paraaminohippuric

199
Q

Highest % of glomerular filgrate reabsorption occurs in

A

Proximal tubules at brush border and microvilli

200
Q

Filling nerve

A

Sympathetic nerve

201
Q

Will cause emptying of bladder

A

Parasympathetic

202
Q

Normal protein content of urine

A

0 (zero)

203
Q

Usual daily urine output

A

720-1440mL

204
Q

Bladder muscle responsible for urination

A

Detrussor muscle

205
Q

Urinary buffers

A

Sodium bicarb (NaHCO3)
Sodium phosphate (NaHPO4)
Ammonium (NH4)

206
Q

Cofactor of carbonic anhydrase

A

Zinc

BOARD REVIEW (19 decks)

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