Physiology FinalA

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PHYSIOLOGY

1. Partial contraction following low rate of nerve impulses a. twitch

b. tetanus c. treppe

d. tone

Answer: D (pp 81 – 82)

2. The mechanism for the perception of sound localization is

a. higher frequency sound waves are heard louder in the ear .near the source of sound

b. lower frequency sound waves are heard are heard farther equally by both ears

c. higher amplitude sound waves arrive in the ear near the source of sound

d. faster time of arrival at the ear farther from the source of sound Answer: C (pp 656 – 657)

3. The flow of endolymph postrotatory from a counterclockwise direction is a. stopped immediately as one stops rotating

b. in opposite direction of rotation in both ears c. continuous in the same direction of rotation d. to the right in right ear but to the left in left ear Answer: C (p 695)

4. Which of the following is true of the conducting system?

a. it contains 550 ml of air

b. it actively participates with gas exchange

c. It is also known as the anatomic dead space

d. it is the area of the respiratory system which is perfused but not ventilated

Answer: C (pp 477-478)

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a. it is higher than atmospheric pressure during expiration b. it is the same as atmospheric pressure during inspiration c. it is the same as intrathoracic pressure during inspiration d. does not change during inspiration and expiration

Answer: A (pp 478 – 479)

6. Which of the following is true of SURFACTANT?

a. its presence decreases the work of breathing b. it is a secretion of the Clara cells of the alveoli

c. it is responsible for the elasticity of the respiratory system d. synthesis is only observed perinatally within 48-72 hrs. Answer: A (pp 479-480)

7. The process of gas exchange in the lungs is by a. simple diffusion

b. facilitated diffusion c. endocytosis d. filtration

Answer: A (pp 506-507)

8. The following have direct effects on the respiratory center in the medulla a. Carbon Dioxide

b. Oxygen

c. Hydrogen ions d. A and C

Answer: D (p 516)

9. True about the Frank-Starling mechanism

a. once the heart rate increases above a critical level, heart strength decreases

b. strong vagal stimulation decreases heart contraction by 20 to 30% c. cardiac output can be increased by sympathetic stimulation

d. greater muscle stretch will result to greater force of contraction

Answer: D (p 111-112)

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a. High protein meals b. Histamine secretion c. Cholinergic stimulation d. Starchy food

Answer: D (pp. 797-798)

11. What increases the absorptive surface of the small intestines by 20X compared to the surface of a smooth tube?

a. Plicae circulares b. Brush borders c. Villi

d. Valvulae conniventes Answer: B (pp. 812-813)

12. What is TRUE regarding the defecation reflex?

a. It is normally initiated by chemical irritation of the rectal mucosa b. The enteric nervous system in the rectum mediates intrinsic

defecation reflexes

c. This reflex is permanently inhibited by keeping the external sphincter contracted

d. Distension of the anus initiates contractions of the rectum Answer: B (pp. 789-790)

13. A patient with impaired cardiac function with ejection fraction 40% is expected to have

a. normal renal blood flow b. increased effective renal blood flow

c. increased renal plasma flow d. decreased GFR

Answer: D (pp 309 – 316)

14. How does the kidney handle bicarbonate?

a. the titrable acidity is equal to the total amount of HCO-3 that is reabsorbed

b. most of filtered HCO-3 is reabsorbed through Na+H+ exchanger in the proximal convoluted tubule

c. reabsorption of filtered HCO-3 in the proximal convoluted tubule contributes to net secreted H+

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d. formation of urinary NH+4 from glutamine leads to conservation of filtered HCO-3

Answer: A (pp 396 – 397)

15. Tubular fluid is isosmotic in which segment of the tubule? a. distal convoluted tubule

b. descending limb of Henle’s loop c. proximal convoluted tubule d. ascending Henle’s loop

Answer: C (pp 332 – 338; 349) 16. The amount of total body water depends on

a. total amount of albumin b. total reabsorbed sodium

c. total amount of extracellular protein d. total reabsorbed potassium

Answer: A (pp 348 – 349)

17. When a patient suffers from metabolic acidosis, which of the following will happen in the kidneys

a. the GFR is increased b. increased HCO3- excretion c. renin is secreted

d. increased new HCO3 production Answer: D (pp 396 – 397)

18. A patient with bronchial asthma in acute exacerbation will have which of the

following acid base problems

a. increased respiratory rate leading to decreased pCO2 b. increased respiratory rate leading to increased pO2 arterial c. relatively decreased renal excretion of [H+]

d. relatively increased renal excretion of [HCO3] Answer: A (pp 796 – 797)

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a. Falicitated diffusion b. Active transport

c. Endocytasis d. Simple diffusion Chapter 4 page 52

20. During the start of skeletal muscle contraction, energy source for ATP production comes from which of the following?

a. Muscle glycogen b. Liver glycogen c. Free fatty acids d. Creatine phosphate Chapter 6 page 72

21. In skeletal muscle contraction, one of the following shortens

a. Actin

b. Myosin c. Sarcomere d. tubule

Chapter 6 page 72

22. In a skelatel muscle contraction and relaxation, the only event that is non-energy requiring is

a. Generation of muscle action potential

b. Release of calcium from sarcoplasmic reticulum c. Shortening of sarcometric length

d. Relaxation of the muscle Chapter 6 page 80

23. The amount of blood leaving the ventricles is 80 ml, cardiac rate is 80/ min arterial pressure is 100 mmHg. The cardiac output is

a. 6.4 L b. 0.80 L c. 8.0 L d. 0.64 L

Chapter 36 page 457

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a. 1-2 hours b. 24-48 hours

c. 12-24 hours d. 48-72 hours Chapter page

25. Which of the following terms best describe the interaction of insulin and glucagons? a. Synergistic b. Permissive c. Antogonistic d. Cooperative Chapter 78 page 961

26. The increased intestinal absorption of a Ca is stimulated directly by:

a. Parathormone

b. 1.25 dihydroxy vitamin D3 c. Calcitonin

d. T3 Chapter 79 page 978

27. Ketoacidosis in untreated diabetes mellitus is due to:

a. Excessive fluid loss

b. Hypoventilation

c. Excessive eating and obesity d. Excessive fat catabolism Chapter 78 page 972

28. Which of the following statements regarding distribution of ventilation in an upright (standing) position is CORRECT?

a. It is greater in the lung apices than in the base b. It is greater in the base than in the apices c. It is equal in the apices and the bases

d. Its rate of increase towards the best is faster than that of perfusion Chapter 37 page 471

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29. The factor that will shift the oxyhemoglobin dissociation curve to the left: a. Increased pH b. Increased PCO2 c. Increased 2,3-DPG d. Increased temperature Chapter 40 page 502

30. The most potent stimulus to the central chemorespiratory center is:

a. Hypixia

b. Hypercapnea c. Acidosis

d. Hypoventilation Chapter 41 page 518

31. What is the hallmark of a restrictive ventilatory impairment? a.  VC

b.  RV c.  TLC d.  ERV

Chapter 37 page 471

32. Which of the following is NOT true regarding an individual with emphysema?

a. Decreased pulmonary compliance b. Increased airway resistance

c. Hyperinflation

d. Decreased elastanse Chapter 42 page 526

33. The amount of air remaining in the lungs at the end-expiratory level is called the a. ERV b. FRC c. RV d. Vt Chapter 42 page 526

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34. Muscle of inspiration do not include the following

a. Diaphragm

b. External intercostal muscle c. Sternocleidomastoid muscle d. Abdominal muscle

Chapter 9 page 103

35. Given this data, what is the net filtration pressure at the glomerulus? Glomerular hydrostatic pressure = 44 mmHg

Bowman’s space hydrostatic pressure = 9 mmHg

Osmotic / Oncotic pressure of glomerular capillary = 28 mmHg Osmotic/ Oncotic pressure of tubular fluid or Bowman’s space = 0 a. – 5mmHg

b. 7mmHg c. 25mmHg d. 62mmHg

Chapter 26 page 307

36. Which of the following solutions, will most likely yeild the highest amount of urine volume? a. Isotonic b. Hypotonic c. Hypertonic d. Osmotic diuretic Chapter 25 page 299

37. Which of the following circumtance would lead to an increase in GFR? a.  colloid osmotic pressure

b.  ultrafiltration coefficient c.  bowmans capsular pressure d.  sympathetic tone

Chapter 26 page 307

38. About 65% of the filtered load of sodium and water is reabsorbed by the a. Proximal tubule

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c. Thick ascending limb of the Loop of Henle d. Distal tubule

Chapter 31 page 402

39. Because of the decreased renal blood flow resulting from decreased cardiac output, which one of the following hormone will the kidneys release? a. Angiotensin b. Bradykinin c. Renin d. Aldosterone Chapter 26 page 307

40. Which of the following factors will NOT AFFECT sodium regulation by the kidneys? a. ADH b. Aldosterone c. ANF d. GFR Chapter 29 page 377

41. The following statement is true of defecation:

a. Immediate relaxation of the external anal sphincter b. Relaxation of the rectum

c. Initiated by sudden distention of rectal walls d. The sigmoid colon becomes quiescent

Chapter 63 page 789

42. Because of the overproduction of ketone bodies (-hydroxybutrate & acetoacetate) blood gases is consistent with

a. Respiratory Acidosis

b. Repiratory Alkalosis c. Metabolic Acidosis d. Metabolic Alkalodis Chapter 42 page 524

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a. increased activity of the renin-angiotensin system b. hyponatremia

c. hypokalemia d. ACTH

Page: 950

44. Rate of diffusion is NOT determined by: a. amount of substance

b. velocity of kinetic motion

c. number and sizes of openings in cell membrane d. energy availability

page: 57-58

45. This adaptation will NOT occur in trained athletes: a. hypertrophy of skeletal muscles

b. enlargement of heart chambers c. increase in heart mass

d. increase in resting cardiac output page: 1063

46. NOT TRUE about the respiratory system in exercise: a. perfusion of all pulmonary capillaries occur b. pulmonary ventilation increases

c. respiratory system is normally the most limiting factor d. blood gases remain nearly normal

page: 1061

47. This is NOT normally found in the urine: a. urea b. sodium c. glucose d. potassium page: 334

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a. aldosterone secretion

b. decreased extracellular fluid potassium concentration c. slow tubular flow rate

d. increased hydrogen ion concentration pages: 336-337

49. The inherent rhythm for respiration appears to be located within the: a. upper pons b. lower pons c. apneustic center d. medulla pages: 514-514

50. When the ventilation-perfusion ratio of a lung unit decreases, the alveoli in that unit develop a:

a. lower pO2 and higher pCO2 b. higher pO2 and lower pCO2 c. lower pN2

d. higher pN2 and higher pO2 pages: 500-501

51. Electrolyte ion responsible for depolarizing the hair cells in the organ of Corti:

a. calcium b. sodium c. potassium d. chloride

Textbook of Medical Physiology by Guyton, 11th_{ed., p. 656}

52. Vascular smooth muscle relaxation is observed in the following conditions, EXCEPT

a. acidosis

b. excess carbon dioxide

c. decreased body temperature d. hypoxemia

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53. In which of the following type of training should the goal is to increase the glycolytic activity of the motor units

a. typing

b. marathon running c. weight lifting

d. 100-meter breaststroke Ref: Guyton, p 79

54. Addition of hypertonic solution to the ECF causes the following except: a. increased plasma osmolality

b. increased intracellular volume c. increased extracellular volume

d. Diffusion of fluid from the cells to the extracellular space Ref: Guyton 10th_{edition page 299}

55. A state of alkalosis will lead to:

a. increased renal excretion of ammonium b. increased renal raebsorption of bicarbonate c. increased renal excretion of titratable acid d. decreased rate of ventilation

Ref: Guyton 10th edition page 397

56. Exercise prolongs life because it a. Reduces HDL

b. Increase LDL

c. Increases the cardiac reserve d. Decrease the pulmonary reserve Ref: Guyton 10th_{Edition page 977}

57. This is a form of blood flow that flows in a steady state wherein the central portionof blood stays at the center of the blood vessel

a. laminar flow b. turbulent flow c. straight flow d. curvilinear flow

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Ref: Guyton page 165

58. The most important means by which substances are transferred between plasma and interstitial fluid is

a. diffusion b. osmosis

c. active transport d. exchange transport Ref: Guyton page 183

59. The blood viscosity of a chronic pulmonary patient with a hematocrit level of 70 vol%

a. Will remain normal

b. Will be higher than normal c. Will be lower than normal

d. Will be lower than normal in circulatory segments with slow blood flow rates but higher than normal in segments with fast blood flow rates

Reference: Textbook of Medical Physiology, 11e (Int'l Ed) by Guyton and Hall p.169

60. The following pulmonary function test are decreased in COPD, EXCEPT: a. timed expiratory volume, FEV1

b. maximum expiratory flow rate c. FEV1/FVC

d. FVC

Reference: Textbook of Medical Physiology, 11e (Int'l Ed) by Guyton and Hall p. 526

61. Which of the following phases of swallowing is voluntary: a. oral phase

b. pharyngeal phase c. esophageal phase d. All of the above

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a. It prevents absorption to occur in the stomach b. It protects autodigestion of the gastric mucosa c. It retards desquamation of gastric epithelium

d. It ensures integrity of absorption of Vitamin B12

Reference: Textbook of Medical Physiology, 11e (Int'l Ed) by Guyton and Hall pp. 820-21

63. Gastric contents are propelled up to the esophagus during vomiting by: a. Forceful contraction of abdominal muscles

b. Sucked up by deep inspiratory movement c. Spastic contraction of gastric walls

d. Forceful expansion of the thorax

64. In paraplegics, defecation is mediated by centers located in the: a. Enteric walls

b. Sacral spinal cord c. Medulla and pons d. Cerebral cortex

65. In endocrine systems, the specificity of communication is determined by: a. hormone chemical structure

b. distance between endocrine gland and target cell c. presence of receptors in target cells

d. anatomic connections between endocrine gland and target cells Reference: Textbook of Medical Physiology, 11e (Int'l Ed) by

Guyton and Hall p. 910

66. The kidney enzyme 1α-hydroxylase catalyzes the conversion of a. cholecalciferol to dehydrocholesterol

b. Vitamin D3 to Vitamin D2

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d. calcium to hydroxyapatite

67. An inhibitor of vasopressin secretion:

a. decreased extracellular fluid volume, ECF b. decreased plasma oncotic pressure c. exercise

d. stress

68. Which of the following is true of diabetes insipidus:

a. Can only be treated by surgical removal of the tumor

b. Urine of patients with low osmolality and high specific gravity c. Cardinal symptoms include polyuria and polydipsia d. Associated with excessive oxytocin secretion

69. The following hormones are hyperglycemic, EXCEPT: a. Insulin

b. Glucagon c. Cortisol d. Epinephrine

70. The enlargement of the thyroid gland in iodine-deficiency goiter is due to: a. Thyroid Releasing Hormone, TRH

b. Thryroid Stimulating Hormone, TSH c. Thryoxine

d. Thyronine

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71. The following effects of hypothyroidism in infants and children are reversible, EXCEPT:

a. mental retardation b. stunting of growth

c. failure of endochondral ossification d. sluggish metabolism

72. If a substance has a urinary excretion rate that is less than its filtration rate, that means that

a. There was net reabsorprtion b. There was net secretion

c. The amount filtered equaled the amount reabsorbed d. The amount filtered equaled the amount secreted

Reference: Textbook of Medical Physiology, 11e (Int'l Ed) by Guyton and Hall p.314

73. The rise in body temperature during the secretory phase of the menstrual cycle is caused by the effect of

a. Estrogen on the anterior pituitary

b. Follicle stimulating hormone on the ovary c. Luteinizing hormone on the anterior pituitary d. Progesterone on the hypothalamus

74. Post-menopausal women are prone to develop bone fractures because lack of estrogen increases

a. osteoclastic activity in bone b. bone matrix

c. parathyroid homone synthesis d. calcitonin synthesis

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75. Which of the following laboratory findings on analysis of semen is the most probably cause of a patient’s infertility?

Sperm count of 120 million per ml pH of 7.35

4 ml of ejaculate per emission

Only three-fourths of the sperms are morphologically normal Reference: Textbook of Medical Physiology, 11e (Int'l Ed) by

Guyton and Hall p. 1001

76. The appropriate stimulus for erythropoiesis is:

a. Increased population of old red cells in circulation b. Tissue hypoxia

c. Infection d. Stress

77. The clinical problem posed by polycythemia is: a. Decreased oxygenation of peripheral tissues b. Increased viscosity of blood

c. Immaturity of red cells in the circulation d. Shortened lifespan of red cells

78. In ABO blood group, the agglutinins are present in the a. serum

b. red blood cells

c. pluripotent stem cells d. interstitial fluid

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