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1.Hyponatremiaa.may increase intracellular fluid volume b.may be seen in SIADHc.may increase the secretion of ANPd.may increase the plasma osmolalitye.of acute onset may be associated with cerebral oedema2.The following statements are true:a.normal plasma osmolarity is in the range of 300-315mosm/L b.one mole of sodium chloride in a litre of water has a concentration of 2osm/Lc.osmolarity refers to osmoles per litre of fluidd.depends on the size of the particles in solutione.total osmotic pressure of plasma is higher than atmospheric pressure3.Siggard-Anderson curve normograma.has pCO
2
on the vertical scale b.has pH on the horizontal scalec.determines standard bicarbonate content after plotting measures pCO
2
and pH of a blood gas sampled.plots base excess on a secondary axise.allows estimation of the buffer base content4.Concerning buffersa.buffers are least efficient when half dissociated b.carbonic anhydrase is an important component of the physiological buffering systemc.phosphate is an important extracellular buffer d.oxygenated haemoglobin is a more powerful physiological buffer thandeoxygenated haemoglobine.the imidazole ring structure of haemoglobin is the site of H
+
exchange for  physiological buffering5.The rate of diffusion of a gasa.is a result of the random movement of the gas molecules b.is proportional to the tension gradientc.depends upon the gas temperatured.is inversely proportional to the square root of the density at constanttemperaturee.CO
2
diffuses more rapidly than oxygen
 Physiology MCQ / April 2009
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6.Physiological dead space:a.includes anatomical dead space b.is unchanged over a two fold range of tidal volumec.accounts for the difference in composition between ‘ideal’ alveolar gasand mixed expired gasd.changes with posturee.is measured by Fowler’s method7.Which of the following is (are) true with respect to increasing oxygen reservesthrough preoxygenation with 100% oxygen:a.It is well reflected by the arterial oxygenation saturation. b.It requires longer when using a Bain circuit.c.It is achieved equally as well with 4 vital capacity breaths or 3 minutes of tidal volume breathing.d.Oxygen reserves are reduced in pregnancy.e.Preoxygenation is essential especially in obese patients during rapidsequence induction8.In calculating the shunt fraction, the following need(s) to be measured or estimated:a.mixed venous oxygen content b.pulmonary end-capillary oxygen contentc.arterial oxygen contentd.alveolar partial pressure of oxygene.haemoglobin concentration9.Surfactant:a.is a mucopolypeptide b.causes a decrease in surface tensionc.results in the same surface tension for different sized alveolid.causes an increase in compliancee.production is reduced after a prolonged reduction in pulmonary blood flow10.CO
2
transport in venous blooda.occurs predominantly by conversion to bicarbonate b.results in an increase in erythrocyte volumec.causes an efflux of hydrogen ions from the erythrocyted.is inhibited by deoxygenation of haemoglobine.can occur by carbamino bonding in plasma
 Physiology MCQ / April 2009
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11.Baroreceptorsa.in the carotid sinus are innervated by vagus nerve b.are stretch receptorsc.reset the threshold for firing in chronic hypertensiond.becomes less sensitive by volatile agentse.also respond to changes in blood pH and PaCO
2
12.Regarding coronary blood flowa.subendocardium is more vulnerable to ischaemia than epicardium b.adenosine and dipyridamole are coronary vasoconstrictorsc.myocardial consumption and coronary blood flow bear a linear relationshipd.coronary blood flow may be improved by increasing the heart rate as thisimproves the cardiac outpute.normal myocardial extraction ratio is 70%13.The following is (are) true about pulmonary capillary wedge pressure (PCWP):a.also known as pulmonary artery occlusion pressure (PAOP) b.position of the pulmonary artery (PA) catheter tip should lie in zone 2 of the lungc.traditionally measured at end of inspirationd.normal value: 6-12mmHge.reflective of left ventricular end-diastolic pressure in the presence of mitralstenosis14.Haemodynamic changes seen following Valsalva manoeuvrea.rise in MAP in phase I due to rise in intrathoracic pressure b.in phase II, decreased venous return is responsible for the drop in MAPc.MAP increases in phase III due to rise in heart rate and vasoconstrictiond.MAP returns to normal in phase IVe.these changes are seen in autonomic dysfunction15.With reference to the normal hearta.The most rapidly conducting fibres in the heart the Purkinje’s fibres b.The last part of the ventricle to be activated is the apexc.The duration of action potential in a ventricular muscle fibre is about thesame as in a skeletal muscle fibred.The T wave of the ECG occurs at the beginning of the absolute refractory period of the ventriclee.Left axis deviation leads to abnormally large R wave in standard limb leadI
 Physiology MCQ / April 2009
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