PAO2 = 570 - pCO2/R (GT-87 Q-26)

FRM Slow to Rapid MPH(miles per hour): • Slowly adapting tactile receptors : Free nerve endings Ruffini's receptors Merkels disc [So FRM (From) Slow to] • Rapidly adapting tactile receptors Meissner's corpuscles Paccinians corpuscles Hair end organs. (So Rapid Mph)

• Hippocampus- storage of immediate and recent memories. It is inappropriately activated dring a deja vu experience. • Repetative stimulation of a skeletal muscle fiber cause an increase in contractile streangth because repeatative stimulation causes an increase in the *duration of cross bridge cycling. Reapeatative firing increases the amount of SEC(Series Elastic Component) stretch by maintaining cross-bridge cycling for a longer period of time. • Ammonia is produced from aa in the cells of the renal tubules (mainly proximal tubules), and it's rate of production increases during acidosis. This is important in acidosis because it increases the total amount of H+ ion that can be excreted in a given volume of urine. The ammonia freely diffuses into the tubular lumen, and because of the high pKa(9.2) of the reaction, essentially all of it combines with H+ to form NH4+ ion. This maintains the driving force for more ammonia to passively diffuse into the lumen. The NH4+ that is formed gets trapped in the tubules and excreted because the tubules are impermeable to this cation. • Funny channel- Called funny because unlike most Na channels which open when cell is depolarised this channel is activated when cell is polarised. It therefore opens at the end of the previous AP, allowing Na* to flow through the cell membrane and produce Phase-4 depolarisation. • In addition to light, circadian rhythm is also affected by 'zeitgebers' (timing of meals etc...) though to a lesser extent. Q. The actin rich cell cortex is involved in which of the following cell functions1. Cytokines is----------------------------------ans 2. Bidirectional transport of vescicles 3. Fast axoplasmic transport 4. Chromosomal movements Explnation- GT 87 Q-284 The cells cortex is an area of the cell immediately underneath the plasma membrane and is rich in actin, which is required for cytokinesis. Although movement of vescicles along filaments is regulated by minimyos ins (myosin 1), movement of vescicles and organelles is predoinently a function of microtubules (answers b and c) under the influence of unidirectional motors kinesin and dynein. The movements of chromosomes (answer d) as well as cilia and flagella (answer e) are driven by dynein, and chromosomal movement occur thrugh microtubular kinetics.

Titin is a large protein that located between the Z-line at the end of the sarcomere to the M-line in the middle of the sarcomere. The tinin in cardiac muscle is much than in the skeletal muscle, so it is moe difficult to stretch cardiac muscle than skeletal. • Somatostatin(GH i.e. smatotrophin release inhibitory factor)- produced by D-cells in pancreatic islets. Inhibits secretion of insulin, glucagon, and pancreatic polypeptide. It leads to dyspepsia d/t slow gastric emptying and and decreased gastric acid secretion, and gallstone formation which are precipitated by decreased gallbladder contraction(d/t inhibition of CCK secretion). • PCT has maximum mitochondia per cell. Albinos congenital inability to synthesize melanin

Piebaldism characterized by patches of skin that lack melanin as a result of congenital defects in the migration of pigment cell precursors from the neural crest during embryonic development. Not only the condition but also the precise pattern of the loss is passed from one generation to the next. Vitiligo involves a similar patchy loss of melanin as above, but the loss develops progressively after birth secondary to an autoimmune process that targets melanocytes.

Temperature control(cerebral regions: Mnem-->AC Heavy Hai)Anterior Cooling Heating Posterior [Hypothalamus] (Anterior hypothalamus cools the body in response to heat, while Posterior heats the body in response to cold....) v Super ORS has aa--> increases carrier transport

Glucagon stimulates* insulin secretion Insulin inhibits glucagons secretion v Altitude insomnia- Sleep disturbance that is a common consequence of exposure to high altitude. Periodic breathing of Chynes-Stokes type occurs during NREM sleep about half the time at high altitude, with restoration of a regular breathing pattern during REM sleep. Both hypoxia and hypercapnia are thought to be involved in the development of periodic breathing. Frequent awakenings and poor quality sleep characterise altitude insomnia. RxAcetazolamide v An action potential is normally an all-or-none response; that is it’s magnitude is independent of the stimulus strength. The magnitude of the action potential is reduced during the relative refractory period or when the membrane is depolarised by an abnormally high extracellular potassium concentration. Q. Muscle of expiration during tidal respiration1. Rect. Abdominis 2. Internal intercostal 3. Airway resistance 4. Surface tension elasticity---------ans(expiration is passive) Discussion- In emphysema compliance increases-->decrease in inspiratory energy consumption-->but expiratory work done is also increases(which was free d/t elastic recoil earlier) 3. Work done of breathing is mostly due to1. Tissue elasticiy 2. Viscous resistance 3. Airway resistance 4. Surface tension elasticity------------ans 4. In exersice work done of breathing is increased mainly due to1. Increase in airway resistance 2. Increase in elastic work 3. Increase in viscous work done-------------ans 4. None Q. Jaundice in which of the following congenital conditions characteristically increases with fasting1. Crigler Najar syndrome 2. Gilberts syndrome-------------------ans 3. Rotor syndrome 4. Dubin Johnson syndrome 5. In rapid, shallow breathing1. Pulmonary ventilation more than alveolar ventilation----------ans

2. Pulmonary ventilation less than alveolar ventilation 3. Both equal 4. Data insufficient Discussion- PV>AV(always) Best indicator for ventilation-->AV Asthemics-->Tell them to take slow and deep breathing 7. Which of the folowing statements is true1. PEFR & MEFR are both effort dependent 2. PEFR & MEFR are both independent 3. Only PEFR is effort independent 4. Only MEFR is effort independent-----------ans DiscusisonMid expiratory flow rate-->most sensitive indicator for asthma 8. The given flow volume curve shows-

1. 2. 3. 4.

Restrictive lung disease COPD------------------------------ans Extrathoracic obstruction Fixed airway obstruction


12.''Inflation of lungs induces further inflation”is explained by 1. Hering-Breuer inflation reflex 2. Hering – Breuer deflation reflex 3. Heads paradoxial reflex------------------ans 4. J-reflex Discussion- Afferents by vagus-->Newborn at birth takes first breadth-->stimulation till all alveoli open 15. Cutting the vagi with section above pons leads to1. Hyper ventilation----------ans 2. Hypo ventilation 3. Apneus is 4. None Discussion- Supplement AA-303

• • •

Pons-->Pneumotaxic centre-->inhibits-->apneustic(inspiratory) centre Medulla- Pacemaker for respiration- Prebottzinger Center Medulla-->(important for expiration) Dorsal inhibitory neuron VRG

18. The blood pressure measured sphygmomanometer by is1. Lower than intraarterial pressure 2. Higher than intraarterial pressure-----------ans 3. Same as the intraarterial pressure 4. The same with different cuff size Discussion- Cannulation measurement is best-->next best is continuous monitoring • Cuff (not instrument) should be at the heart level 20. After amputation of one limb the total resistance is1. Increased ------------ans 2. Decreased 3. No effect

4. Cannot be determined Discussion- In body all resistances are in parallel. So if you remove a parallel resistence overall resistance increases. 24. Occlusion of common carotid artery on both sides leads to1. Increases in HR & BP----------------ans 2. Increases BP & decrease in HR 3. Decrease in HR & BP 4. NO effect on BP & HR Discussion- Baro-receptor don't get blood-->no inhibition 25. Fick's principle is used for measuring1. Blood pressure 2. Pulse pressure 3. Lung volumes 4. Cardiac output----------ans Discusison: Fick's principle- The amount of substance taken up by an organ(or by the whole body) per unit of time is equal to the arterial level of the substance minus the venous level(A-V difference) times the blood flow. 26. QSART is used for assessing1. Nodal tissue of heart 2. autonomic functions---------ans(Quantitative pseudomotor response testing) 3. nerve conditions 4. pulmonary functions 27. In 1. 2. 3. 4. aVR all waves are opposite becausepolarity of electrodes is reversed the electrodes are placed perpendicular to each other the lead axis is -150*----------ans none

Discussion29. What happens when there is efferent arteriolar constriction1. inc.RPF,inc.GFR 2. dec.RPF,dec.GFR 3. inc.RPF,dec.GFR 4. dec.RPF,inc.GFR---------------ans Discussion- Blood flow decreases whether you constrict afferent of efferent • With afferent constriction--> decreased RBF, decreased GFR

With efferent constriction--> decreased RBF, increased GFR

30. In the presence of vasopressin the greatest fraction of filtrated water is re-absorbed in which part of the nephron1. Proximal tubule-------ans 2. Distal tubule 3. Loop of Henle 4. Collecting duct 33. Transport maximum(Tm) is1. Renal threshold x GFR------------ans 2. UV/GFR 3. Renal threshold/GFR 4. UV xGFR 34. Calculate clearance if U=5mg/ml,V=1ml/min & P=1mg%1. 5ml/min 2. 50ml/min 3. 500ml/min-------------ans 4. data insufficient Discussion- Cl=UV/P 35. The renal plasma flow (RPF) of a patient was to be estimated through the measurement of Para Amino Hippuric acid (PAH) clearance. The technician observed the procedures correctly but due to an error in the weighing inadvertently used thrice the recommended dose of PAH. RPF estimated is likely to be1. False-high 2. False -low -----------------------ans 3. False-high or false -low depending on the GFR 4. Correct and is unaffected by the PAH overdose Discussion- PAH is also secreted in addition to GFR 36. Inducible buffer system in kidney is1. Bicarbonate buffer 2. Phosphate buffer 3. Ammonia buffer-----------ans 4. None Discussion- At 4.5 pH(limiting pH) kidneys can not secrete acid further 46. Action potential generates in axon hillock due to1. It has least threshold 2. Neurotransmitters produced 3. Unmyelinated 4. Has more Ion channels----------ans 47. RMP is mainly due to which ion1. Na+ 2. K+ ------------------ans(ROAMS P=70) 3. Ca2+ 4. Cl48. Neuron is least excitable during1. Depolarization--------------------ans 2. After Depolarisation 3. Latent period 4. After Hyperpolarisation

50. Synaptic conduction is mostly orthodromic because1. Dentrities cannot be depolarised 2. Once repolarised, an area cannot be depolarised 3. The strength of antidromic impulse is less 4. Chemical mediator is located only in the presynaptic terminal----------ans 51. Which of the following is not a Sarcolemmal protein1. Perlecan-------------ans 2. Dystrophin 3. Dystroglycan 4. Sarcoglycan Discussion• Actinin--> connects Actin to Z-line • Tinin--> connects Myosin to Z-line(tinin dtermines the normal stiffness of ventricular muscle) • Desmin--> connects Z-line to Sarcolemma 53. Regarding Golgi tendon organ true is1. Senses dynamic length of muscle 2. Involved in reciprocal innervation 3. Alpha-motor neuron stimulation 4. Senses muscle tension--------------------ans Discussion- Clasp knife rigidity(actually spasticity)--> occurs d/t golgi tendon organ 54. Which is true about presynaptic inhibition1. Occurs due to hyperpolarization of presynaptic membrane----------------ans 2. Occurs due to inhibition of release of neurotransmitter from presynaptic terminal 3. Produces action potential 4. Produces EPSP Discussion- Presynaptic inhibition occurs by axo-axonic transmission leading to inhibition of a stimulatory neuron before it synapses, by inhibiting Ca2+ entry and blocking downstream processes, preventing neurotransmitter release, and therefore preventing the neuron from generating EPSP post-synaptically. Picrotoxin acts by blocking it. Local anesthesia and Strychnine do not affect presynaptic inhibition. 55. vSnare protein is1. Snaptobrevin------------ans 2. Syntaxin 3. SNAP 25 4. None DiscussionvSnare--> Synaptobrevin--> blocked by tetanus tSnare--> Syntaxin/SNAP 25--> Botulinim-->used in reduction of wrinkles/Achalasia cardia 58. Damage to categorical hemisphere in temporal region is usually leads to1. Normal speech 2. Increased speech 3. Decreased speech 4. Senseless,fluent speech--------------------ans Discussion- Wernicke's area--> Superior temporal gyrus 59. Papez circuit in limbic system involves1. Anterior thalamic nuclei--------ans 2. Pulvinar nuclei 3. Anterior hypothalamic nuclei 4. Interlaminar nuclei DiscussionPapez circuit-

• •

Amygdala: Emotion/fear Pre-frontal cortex: Sham-rage(fearless)

61. Which of the following is involved in REM sleep1. amygdala 2. Locus ceruleus-----------ans 3. Tectal nucleus 4. Fornix 64. b wave of ERG is due to which cells1. Rods 2. Muller cells---------------ans 3. Ganglionic cells 4. Bipolar cells

Discussion: a-wave (negative) is produced by the photoreceptors 65. Amacrine cells are seen in1. Retina---------------------ans 2. Skin in the axilla 3. Inner ear 4. Blood Discussion- Amacrine cells are interneurons in the retina. Amacrine cells are responsible for 70% of input to retinal ganglion cells. Bipolar cells, which are responsible for the other 30% of input to retinal ganglia, are regulated by amacrine cells. Amacrine cells don't have axon and cause lateral inhibition. 67. Destruction of sensory area 1 of brain leads to loss of which sensations1. Pain 2. Touch 3. Stereognosis gone but 2 point discrimination retained 4. Stereognosis & 2 point discrimination----------------------------------------------ans Discussion- Remember perception is possible even with destruction of cortex Sensory cortex injury (loss in following sequence): 1. Fine touch 2. Pressure vibration 3. Pain Recovery(in following sequence): 1. Pain 2. Pressure vibration 3. Fine touch 68. Mirror neurons are predominately found in1. Frontal lobe 2. Parietal lobe-----------------------ans 3. Temporal lobe 4. Occipital lobe

70. Principle neurons found in nucleus accumbens are1. Medium spiney neurons--------ans 2. Pyramidal neurons 3. Golgi neurons


Basket cells

71. Leptin acts by increasing the activity of1. AgRP 2. Neuropeptide Y 3. alpha-MSH--------------ans 4. Ghrelin Discussion- Adipose tissue-->Leptin hormone-->Satiety centre(VMN)-->Depressed Increased Appetite(GONA-M) Ghrelin Orexin NpY AgRP Melanin Concentrating Hormone Decreased Appetite(COLA-G) CCK-PZ Oxyntomodulin Leptin Alpha-MSH GCR-1

72. Lesion of which of the following structure leads to Kluver-Bucy syndrome1. Parahippocampus 2. Hippocampus 3. Hypothalamus 4. Temporal lobes--------------ans DiscussionKluver-bucy syndrome features(Man becomes animal like)• Fearless • Hyperphagia • Visual agonia • Rage • Loss of emotion 73. Phineas Gage was a worker who had personality disorder following a iron rod injury to his brain .Which part of his brain was involved1. temporal lobe 2. frontal lobe----------------------ans 3. parietal lobe 4. limbic cortex DiscussionFunctions of frontal lobe• Personality • Social behaviour • Motor idea (willinness to do something) • Emotional control • Higher functions • Memory

Micturition centre (other in spinal cord)

74. Fast axonal transport is by all except1. Dynenin 2. Kines in 3. Microtubule---------------ans 4. Neurofilament DiscussionSlow Microtubule(0.2-4 mm/d)--> anterograde Fast Antero-->Kines in Retro-->Dynenin Neurofilaments 75. MMCs are related to1. Motilin---------ans 2. CCK-PZ 3. secretin 4. GIP Discussion- Motilin is released during the interdigestive period and is believed to be involved in the initiation of the migrating motor complex. MMC occurs at every 90 min during inter-digestive period Basal Electrical Rhythm: Stomach--> 4/min (Interstitial cells of Cajal-->pacemaker in GIT) Duodenum--> 12/min Ileum--> 9/min Sigmoid colon--> *16/min 78. TRUE about secretin includes all of the following except1. It increases the acidity of biliary and pancreatic secretions----------ans 2. It decreases gastric acid secretion 3. It decreases gastric secretion and gastric emptying 4. Increases flow and velocity of bile 81. Secondary Peristalsis of oesophagus is d/t1. vagus 2. pacemaker of peristalsis 3. local distension---------ans 4. LES relaxation Discussion: • Primary --> Option 2 • Secondary esophageal peristalsis- Esphageal peristalsis and lower esophageal relaxation a/w distension or irritation of the smooth muscle portion of esophageal body. The event is limited to the smooth muscle component of the esophagus and is the result of activation of enteric nerves. Initiation of secondary peristalsis does not involve extrinsic neural reflexes and thus is not accompanied by the oral-pharyngeal phase of swallowing. 82. GRP (Gastrin Releasing Peptide) secretion is brought about by1. Acidic chime 2. Vagus-----------ans 3. Gastrin 4. Local distension 83. Receptive relaxation is seen in-

1. Oeophagus 2. Duodenum 3. Ileum 4. Stomach--------------ans(also colon) Discussion• Important points1. Proximal stomach- Accomodation* 2. Distal stomach- Peristalsis(grinding), Retropulsion(mixing) 3. SI- Segmentation 84. As the rate of salivary secretion increses1. decrease K+ 2. increase Na+ 3. hypotonic saliva-----------ans 4. all 85. In 1. 2. 3. 4. GTT glucose is given orally not i.v. becauseIncreased insulin release in oral administration--------ans(incretin effect) slower absorption orally rapid metabolism in case of i.v.glucose all

90. Most of the testosterone secreted by the testes exists in plasma in the form of1. testosterone bound to sex-steroid binding globulin-----ans (92% ; dihydrotestesterone formes at target organ) 2. free dihydrotestoterone 3. free testosterone 4. testosterone bound to albumin 94. Osteoclasts are characterized by1. TRAP and cathepsin K----------ans 2. TRAP and cathepsin S 3. Only TRAP 4. cathepsin K and cathepsin S DiscussionOsteoclasts1. TRAP 2. Cathepsin(A-L) 99. NE increases all except1. HR------------------ans 2. SBP 3. DBP 4. PP DiscussionNorEpinephrine* Vasoconstriction in all organs Increased DBP (Causes relex bradycardia similar to cushing's reflex) 100. Glucocorticoids decrease all except1. basophils 2. eosinophils 3. lymphocytes Epinephrine Vasodilatation in musle and liver Decreased DBP


monocytes------------ans(LEB low)

12. C-Wave in JVP indicates1. Atrial contraction 2. Bulging of tricuspid valve--------------ans 3. Ventricle systole 4. Rapid ventricular filling Discussion-

In JVP (Normal JVP--> 8 cm of blood): "a" wave corresponds to Atrial contraction "v" wave corresponds to Ventricular contraction X dsescent for Atrial relaXation Y descent for Ventricular relaXation

Abdominojugular refl ux– rise in JVP during 10 sec of mid abdominal co mpression followed by a rap id drop in pressure of 4 cm of blood in release of the compression*. It indicates incip ient right-sided heart failure

14. Which of the following is true about S4 heart sound1. Heard during ventricular filling--------------------------ans 2. Heardby unaided ear 3. Heard during ventricular ejection phase 4. More than 20 Hz DISCUSSIONS- S4--> Also known as presystolic or atrial gallop. It is produced by emptying of the atrium into non complant ventricle. It is associated with effective atrial contraction and hence absent in patients with atrial fibrillation*. 63. In cerebellum only excitatory neuron is1. purkinje 2. golgi 3. basket 4. granule-----------ans Discussion- purkinje cells- only output from erebellar cortex and they exert inhibitory influence.


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