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SLP in medical physiology

Faculty of medicine
Second exam : 40 minutes
24/03/2015

40 MCQs = 40 marks

Choose the best answer:


1- The slowest conducting velocity is:
A) The atrial pathways

B) The AV node

C) The Bundle of His

D) The purkinje system

E) The ventricular muscle

2- Vulnerable period:
A) A period in which the excitability is below the normal

B) It may lead to ventricular fibrillation

C) It coincides in time with the early half of diastole

D) It is occuring mainly in the skeletal muscle

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E) It occurs at +20 mv

3- During isovoumetric contraction:


A) The aortic valve is opened

B) The AV valves are opened

C) The pressure inside the ventricles is less than the atria

D) The ventricular volume is constant

E) Non of the above

4- Positive intropism refers to:


A) Decreased stroke volume

B) Decreased EDV

C) Increased contractility of the heart

D) Repolarization of SAN

E) Non of the above

5- Myocardial contractility is increased by the following,


except:
A) Catecholamines

B) Increase in end diastolic volume

C) Increase in heart rate

D) Calcium ions

E) Non of the above

6- All regarding the first heart sound is right, except:

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A) A high pitched sound with frequency 50 HZ

B) The tricuspid component is heard at the lower end of the sternum

C) The bicuspid component is heard better at the apex of the heart

D) It sounds like the word " LUB "

E) Caused by sudden closure of mitral and tricuspid

7- Murmurs:
A) Blood flow is laminar and non turbulent up to a critical velocity

B) Laminar flow is silent but turbulent flow creates sound

C) Its major cause is a valvular disease

D) All of the above

E) Non of the above

8- Regarding Resting membrane potential:


A) Is about -65 mv in ordinary cardiac cells

B) Potassium is the main cytoplasmic cation

C) Equilibrium potential for Na is established at -64 mv

D) Equilibrium potential for K is established at +98 mv

E) Inward rectifying K current drives the cell away from the RMP

9- Amount of blood pumped by each ventricle per minute


is:
A) Stroke volume

B) Cardiac output

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C) End diastolic volume

D) End systolic volume

E) Cardiac index

10- Cardiac output can be measured using:


A) Direct fick method

B) Thermodilution technique

C) Indicator dilution technique

D) Doppler combined with Echocardiography

E) All of the above

11- The Resting membrane potential:


A) IRK inactivates with time

B) Potassium plays no role in RMP

C) IRK conducts inward current better than outward current

D) There is no role of Na-K pump

E) The membrane is primarily permeable to potassium

12- All the following regarding the afterload, except:


A) Stroke volume is increased when ESV increased

B) ESV coincides with the shortening length of the isolated muscle fiber

C) SV = EDV - ESV

D) ESP represents afterload that nearly equals the mean arterial pressure

E) All of the above

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13- Delayed rectifying potassium channels are:
A) Ligand gated activated at -40 mv during depolarization

B) Voltage gated activated at -75 mv during depolarization

C) Ligand gated deactivated at -40 mv during repolarization

D) Voltage gated deactivated at -40 mv during depolarization

E) Conduct outward current responsible for repolarization

14- All of the following are positive inotropics, except:


A) Activation of sympathetic nerve

B) Xanthines

C) Glucagon

D) Digitalis

E) Calcium antagonists such as Dihydro pyridine drug

15- All about the Cardiac reserve is correct, except:


A) Maximum percentage that COP can increase above normal

B) In normal young adult , it's about 300-400 %

C) It's increased in a patient with heart failure

D) It's increased in an athletically trained person up to 600%

E) It may be decreased in elderly person to 200%

16- During isovolumetric ventricular contraction:


A) Rapid filling of the ventricles occur

B) No blood enters or leaves the ventricles

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C) The maximum rate of ejection occurs

D) The maximum volume of the blood is ejected

E) Non of the above

17- All regarding Excitation contraction coupling is right ,


except:
A) Calcium release process is recovered by Na-K pump before next
contraction

B) Is an example of Calcium induced Calcium released ( CICR )

C) Contraction is initiated when enough calcium is bound to troponin C

D) Dihydro pyridine drug has a positive inotropic effect

E) Calcium binding to Calmodulin leads to contraction

18- The SAN is the pacemaker for the heart because it:
A) has the most stable RMP

B) Is the most richly innervated structure in the heart

C) has the highest rate of autonomic discharge

D) Is the only structure in the heart capable of generating AP

E) Is the cardiac cell least sensitive to catecholamines

19- In a resting adult, the ventricular ejection fraction is:


A) 20%

B) 40%

C) 60%

D) 80%

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E) 30%

20- The following are associated with a decrease in the


cardiac output:
A) Venous obstruction

B) Increased end diastolic volume

C) Increased blood volume

D) Blood pressure of 160/100

E) Non of the above

21- The L-type Calcium channels:


A) Are neglected in the cardiac muscle.

B) A ligand gated calcium channel

C) Is activated by dihydropyridine (DHP)

D) Terminal part of plateau is prolonged by outward current through Ca-Na


exchanger

E) Are the main Calcium channels in all cardiac muscles

22- The absolute refractory period of the cardiac muscle:


A) A period in which the cardiac muscle can be excited with a strong
stimulus

B) It coincides with phases 0-2 and half of phase3 ONLY

C) During which an early premature contraction might occur

D) Stimulation of the heart during ARP may produce ventricular fibrillation

E) Is shorter in the ventricular action potential than that of the Skeletal


muscle

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23- Mean arterial pressure:
A) Is the average arterial pressure over a cardiac cycle

B) Can be calculated from 1/2 ( Systolic minus diastolic pressure )

C) Can be calculated from diastolic pressure + 1/3 (pulse pressure)

D) Can be calculated from Cardiac output X total peripheral resistance

E) Both a & c are correct

24- If the end diastolic volume is increased:


A) The stroke volume would be increased

B) The cardiac output would be decreased

C) The force of cardiac contraction would be decreased

D) The heart rate would be increased

E) Non of the above

25- Concerning the ventricular action potential:


A) Fast rapid depolarization is caused by influx of sodium

B) The upstroke terminates at + 10 mv

C) Rapid repolarization is caused by Influx of potassium and Efflux of


Chloride

D) Long plateau prevents premature reactivation

E) DRK channels conduct inward current responsible for repolarization

26- Regarding ventricular action potential, which phase has


the highest K permeability?
A) Phase 0

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B) Phase 1

C) Phase 2

D) Phase 3

E) Phase 4

27- Which of the following is not a part of the specialized


self-excitable conductive system of the heart?
A) SA node

B) AV node

C) Papillary muscle

D) Bundle of His

E) Purkinjie fibers

28- Type ll pneumocytes:


A) Produces a detergent like substance which allows the collapse of the
alveoli

B) Are very flat and particularly devoid of any organelles

C) Are a part of both Conducting and respiratory zones

D) Also called Type l pneumocytes

E) Are a part of the respiratory zone

29- Which of the following could NOT be part of the


conducting zone
A) Trachea

B) Primary bronchi

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C) Terminal bronchioles

D) Respiratory bronchioles

E) Tertiary bronchi

30- All of the following regarding surfactant is right,


except:
A) It allows facilitation of lung expansion

B) It prevents pulmonary oedema

C) It allows alveolar collapse during expiration

D) It is produced by type ll pneumocytes

E) Non of the above

31- Surfactant deficiency can occur in the following


conditions :
A) Respiratory distress syndrome

B) Cigarette smoking

C) Hypothyroidisn

D) Hypocorticism

E) Hyperinsulinism

32- All of the following regarding Respiratory zone is right,


except:
A) Alveolar structure facilitates diffusion of gases between blood and air

B) Type l pneumocytes are the main cells of the alveolus wall

C) The capillary wall and alveolar wall form the respiratory membrane

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D) It consists of the respiratory bronchioles ONLY

E) Type ll pneumocytes produce a detergent like substance named as


Surfactant

33- The residual volume:


A) Cannot be measured directly with spirometer

B) Is part of vital capacity

C) Represents the resting volume of lung

D) Is the volume at which the lungs tend to recoil outwards

E) Is part of the expratory reserve volume

34- Bronchodilatation can be occured by :


A) Release of acetyl choline

B) Release of histamine

C) Stimulation of arterial receptors

D) Blockage of beta 2 adrenergic receptors

E) Sympathetic stimulation

35- The residual volume:


A) Is a part of vital capacity

B) Is a part of expiratory reserve volume

C) Can not be measured directly with a spirometer

D) Represents the resting volume of the lung

E) Is the volume of air that moves into and out of the lung during single
breath

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36- Which of the following cells produce surfactant in lung
alveoli?
A) Endothelial cells

B) Goblet cells

C) Type l alveolar cells

D) Type ll alveolar cells

E) Dust cells

37- Concerning distribution of ventilation and perfusion:


A) Gradient of change in ventilation is greater than that of perfusion

B) Ventilation increases as we go up the lung

C) Perfusion increases as we go uo the lung

D) VA/Q ratio at apex is greater than at base

E) Non of the above

38- Dead space:


A) Normally alveolar dead space = physiological dead space

B) Equals to 1200 ml in a normal adult

C) It increases in volume at TLC

D) All of the above

E) Non of the above

39- Lung compliance:


A) Is increased by aging

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B) Is decreased in emphysema

C) Is a measure of lung elasticity

D) Is less than compliance of combined lung and chest wall

E) Non of the above

40- Intrapleural pressure:


A) Is more negative by increasing surfactant

B) Is more negative at RV than at TLC

C) Is more negative by straining

D) Is equal to intraesophageal pressure

E) Non of the above

Best wishes

Special thanks

To

Dr/ Abdelrahman essam & Dr/ Abdelrahman mohsen

SLP in medical physiology

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