Practice Questions Flashcards
What are the direct manifestations of right ventricular dysfunction?
Elevated systemic venous pressure
Elevated right atrial pressure
What are the direct manifestations of left ventricular dysfunction?
Pulmonary edema
Insufficient cardiac output
Elevated diastolic pressures
What is the most common cause of right-sided heart failure due to right ventricular dysfunction?
Left-sided heart failure due to left ventricular function. This is a result of pulmonary hypertension from left-ventricular dysfunction.
Which of the following is NOT a direct manifestation of left ventricular dysfunction?
a. Pulmonary edema
b. Insufficient cardiac output
c. Elevated diastolic pressures
d. Elevated systemic venous pressure
d. Elevated systemic venous pressure
Which of the following is the outer-most layer of the pericardium?
a. Parietal pericardium
b. Fibrous pericardium
c. Epicardium
D. Visceral pericardium
b. Fibrous pericardium
What are the layers of the pericardium and cardiac muscle from outermost to innermost?
The layers of the pericardium and cardiac muscle are as follows:
Pericardium consists of 3 layers (from outer to inner):
- Fibrous pericardium
- Parietal pericardium
(pericardial space/cavity)
- Epicardium (includes visceral pericardium and the adipose layer)
Layers of cardiac muscle (from outer to inner):
- Myocardium
- Endocardium
Which step of the cardiac cycle results in the semilunar valves opening and blood being ejected into the arteries?
a. First phase of ventricular systole
b. Second phase of ventricular systole
c. Late phase of ventricular diastole
d. Atrial systole
b. Second phase of ventricular systole
What steps compose the cardiac cycle?
Steps composing the cardiac cycle:
Atrial systole beginning,
atrial systole ending,
first phase of ventricular systole,
second phase of ventricular systole,
early phase of ventricular diastole and
late phase of ventricular diastole.
What occurs during the first phase of ventricular systole?
Ventricular contraction results in the closing of the AV valves, but does not create enough pressure to open the semilunar valves.
What occurs during the second phase of ventricular systole?
Enough ventricular pressure is generated to open the semilunar valves and eject blood into the arteries.
What characteristic of the cardiac muscle links the myocytes together and results in coordinated muscle contraction?
a. Gap junctions
b. Desmosomes
c. Intercalated discs
D. Fascia adherent
c. Intercalated discs
What are intercalated discs?
The unique structures that define the myocyte borders and facilitate cell-to-cell communication necessary for synchronization of contraction.
What characteristics of cardiac muscle are found in intercalated discs?
Desmosomes, gap junctions and the fascia adherens are found within intercalated discs.
BioGenQ Which of the following nutrients is NOT a primary source of energy for cardiac muscles?
a. Fatty acids
b. Amino acids
c. Lactate
d. Glucose
b. Amino acids
What do cardiac muscle cells primarily use as energy sources?
They primarily use fatty acids (60-80%), glucose (20-40%) and lactate as energy sources.
Why do cardiac muscle cells rely on aerobic metabolism to produce ATP?
Cardiac muscle cells contain many mitochondria and little glycogen.
What percent of ATP within cardiac muscle cells is generated by oxidation?
98%
What percent of ATP within cardiac muscle cells is generated through glycolysis?
2%
The deficiency of which endocrine hormone results in hypotension and hyponatremia among patients with primary adrenal insufficiency?
a. Aldosterone
b. Cortisol
c. Norepinephrine
d. DHEA
a. Aldosterone
What happens to the zona glomerulosa in primary adrenal insufficiency?
It stops producing aldosterone.
What does aldosterone do?
Increases the synthesis of sodium-potassium ATPase channels in the distal convoluted tubule of the nephron leading to an increase of potassium excretion and reabsorption of sodium and chloride.
What does aldosterone deficiency lead to?
It leads to decreased sodium and water reabsorption. This results in hyponatremia and hypotension.
Select the zone that is matched correctly with the endocrine hormone it synthesizes and its major function.
a. Zona glomerulosa produces epinephrine (stress hormone release)
b. Zona fasciculata produces aldosterone (salt regulation)
c. Zona reticularis produces DHEA (sex hormone release)
d. Zona medullaris produces cortisol (blood sugar regulation)
c. Zona reticularis produces DHEA (sex hormone release)
What endocrine hormone does the zona glomerulosa synthesize and what is its major function?
Produces aldosterone and functions to regulate salt.
What endocrine hormone does the zona fasciculata synthesize and what is its major function?
Produces cortisol and functions to regulate blood sugar.
What endocrine hormone does the zona reticularis synthesize and what is its major function?
Produces DHEA and releases sex hormones.
What endocrine hormone does the zona medullaris synthesize and what is its major function?
Produces catecholamines (dopamine, norepinephrine and epinephrine) and releases stress hormones.
The adrenal cortex and the adrenal medulla have the same embryonic origin.
a. False
b. True
a. False
What is the embryonic origin of the adrenal cortex?
Intermediate mesoderm, which also produces the urogenital system.
What is the embryonic origin of the urogenital system?
Intermediate mesoderm, which also produces the adrenal cortex.
Which of the following arteries supply blood to the adrenal glands?
a. Left and right renal arteries
b. Left and right inferior suprarenal arteries
c. Left and right inferior phrenic arteries
d. All of the above
d. All of the above
- Left and right renal arteries
- Left and right inferior suprarenal arteries
- Left and right inferior phrenic arteries
What is the blood supply of the adrenal gland?
It is directly supplied by the superior suprarenal arteries, middle suprarenal arteries and inferior suprarenal arteries bilaterally.
From where do the superior suprarenal arteries branch off of?
The inferior phrenic arteries
From where do the inferior suprarenal arteries branch off of?
The renal arteries
Where do the left and right renal arteries, left and right inferior suprarenal arteries, and the left and right inferior phrenic arteries originate?
The abdominal aorta
What is the rate-limiting step in the biochemical synthesis of catecholamines?
a. The catalyst of phenylalanine to L-tyrosine by phenylalanine hydroxylase
b. The catalysis of dopa to dopamine by dopa decarboxylase
c. The catalysis of dopamine to norepinephrine by dopamine B-hydroxylase
d. The catalysis of L-tyrosine to dopa by tyrosine hydroxylase
d. The catalysis of L-tyrosine to dopa by tyrosine hydroxylase
What is the rate limiting step during the synthesis of catecholamines?
The hydroxylation of L-tyrosine ring by tyrosine hydroxylase to form dihydroxyphenylalanine (dopa).
What cofactors are required by tyrosine hydroxylase?
tetrahydrobiopterine (BH4) and iron
How is tetrahydrobiopterine (BH4) used by tyrosine hydroxylase?
BH4 is used as a reducing agent for aromatic amino acids.
Which of the following morphologic alterations might occur with celiac disease?
a. Epithelial proliferation with crypt elongation
b. Increased intraepithelial lymphocytes
c. Villous atrophy
d. All of the above
d. All of the above
- Epithelial proliferation with crypt elongation
- Increased intraepithelial lymphocytes
- Villous atrophy
What is celiac disease?
It is an autoimmune condition that results in an immune reaction to gliadin peptides at the lamina propria.
What is the effect of celiac disease?
This reaction causes severe inflammation locally, resulting in intraepithelial lymphocyte accumulation, villous atrophy and crypt elongation.
Which of the following gastrointestinal hormones results in the increased secretion of gastric acid and growth of gastric mucosa?
a. Secretin
b. Cholecystokinin (CCK)
c. Gastrin
D. Gastric inhibitory peptide (GIP)
c. Gastrin
Which cells secrete gastrin?
G cells of the stomach
What stimulates the secretion of gastrin?
Ingestion of small peptides and amino acids
Distension of the stomach
Vagal stimulation
What does the secretion of gastrin result in?
Increased gastric acid secretion
Stimulation of gastric mucosa growth
Which cells secrete cholecystokinin (CCK)?
I cells of the duodenum and jejunum
What stimulates the secretion of cholecystokinin (CCK)?
The ingestion of small peptides, amino acids and fatty acids
What does the secretion of cholecystokinin (CCK) result in?
Increased pancreatic enzyme and bicarbonate secretion
contraction of the gallbladder
relaxation of the sphincter of Oddi
growth stimulation of exocrine pancreas and gallbladder
inhibition of gastric emptying
Which cells secrete secretin?
The S cell of the duodenum
What stimulates secretion of secretin?
Gastric acid and fatty acids in the duodenum
What does the secretion of secretin result in?
Increased pancreatic and biliary bicarbonate secretion
decreased gastric acid secretion
Inhibition of the trophic effect of gastrin on the gastric mucosa
What secretes gastric inhibitory peptide (GIP)?
The duodenum and jejunum
What stimulates secretion of gastric inhibitory peptide (GIP)?
Ingestion of fatty acids, amino acids, and glucose
What does the secretion of gastric inhibitory peptide (GIP) result in?
Increased insulin secretion and decreased gastric acid secretion
BioGenQ Which of the following is correct in regard to glucose utilization in specific tissues?
a. Brain cells use glucose anaerobically as fuel.
b. Liver cells use glucose to produce fatty acids, which are then secreted as VLDLs.
c. Adipocytes convert glucose to glycogen for storage.
d. Red blood cells use glucose aerobically as fuel.
b. Liver cells use glucose to produce fatty acids, which are then secreted as VLDLs.
For what purposes does the liver uptake glucose?
To synthesize fatty acids to be secreted as VLDLs in the blood stream
OR
To store it as glycogen
For what purposes do adipocytes uptake glucose?
To store it as triglycerides
For what purposes do brain tissues uptake glucose?
As fuel, aerobically
For what purposes do red blood cells uptake glucose?
As fuel, anaerobically
AnatQ Which of the following is NOT present in the lamina propria of the intestinal mucosa?
a. Myofibroblasts
b. Blood vessels
c. Dense connective tissue
d. Lymphocytes
c. Dense connective tissue
What composes the lamina propria of the intestinal mucosa?
Loose connective tissues
Blood
Lymphatic vessels
Lymphocytes
Myofibroblasts
Nerve endings
Where is dense connective tissue of the intestinal mucosa found?
In the submucosa layer of the intestines
What is the intestinal mucosa composed of?
Epithelium
Lamina propria
Muscularis mucosae
What is the intestinal submucosa composed of?
Submucosal glands
Blood vessels
Nerve plexus
What is the muscularis layer of the intestinal mucosa composed of?
Inner circular layer
myenteric nerve plexus
Other longitudinal layer
What is the outermost layer of the intestinal lining?
Serosa
AnatQ Which of the following muscles does NOT reside in the posterior abdominal wall?
a. Quadratus lumborum
b. Transversus abdominis
c. Psoas
d. Iliacus
b. Transversus abdominis
What muscles make up the posterior abdominal wall?
Quadratus lumborum
Psoas
Iliacus
Diaphragm muscles
AnatQ Which of the following structures does NOT pass through the diaphragm?
a. Inferior vena cava
b. Abdominal aorta
c. Superior vena cava
d. Esophagus
c. Superior vena cava
What passes through the diaphragm at the level of T12?
The abdominal aorta
What passes through the diaphragm at the level of T8?
The inferior vena cava
What passes through the diaphragm at the level of T10?
Esophagus
PathQ Which of the following is characteristic of iron deficiency anemia?
a. Microcytic hypochromic red blood cells
b. Normocytic normochromic red blood cells
c. Macrocytic normochromic red blood cells
d. None of the above
a. Microcytic hypochromic red blood cells
What are microcytic hypochromic red blood cells characteristic of?
Iron deficiency anemia
Lead poisoning
Anemia of chronic disease
Thalassemia
What are normocytic normochromic red blood cells characteristic of?
Hemolytic anemia (including sickle cell anemia)
Acute or chronic blood loss
Leukemia
Aplastic anemia
Systemic Chronic diseases (including kidney and liver disease)
What are macrocytic normochromic red blood cells characteristic of?
B-12 or folate deficiency
Copper deficiency
Pernicious anemia
PhysioQ Which protein binds free iron in order to transport it in the blood?
a. Ceruloplasmin
b. Hemosiderin
c. Ferritin
d. Transferrin
d. Transferrin
Where is transferrin, the iron-binding transfer protein, mainly synthesized?
The liver
What does transferrin do?
Each protein can transfer two Fe3+ molecules and binds to the transferrin cell receptors to be internalized with iron into the cell.
Which protein is the intracellular iron storage protein?
Ferritin
