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PHYSIOLOGY Module 1 NONE General Concepts I

Module 2 General Concepts II PHYSIOLOGY > Exams > 2005 Phys P4 Exam (#1-30) PHYSIOLOGY > Exams > 2004 Phys P4 Exam (#1-30) PHYSIOLOGY > Exams > 2003 Phys P1 Exam (#1-30) Module 3 Cardiovascular/Respiratory PHYSIOLOGY > Exams > 2005 Phys P4 Exam (#31-60 [cardio.]) PHYSIOLOGY > Exams > 2004 Phys P4 Exam (#31-60 [cardio.]) PHYSIOLOGY > Exams > 2003 Phys P1 Exam (#31-60 [cardio.]) PHYSIOLOGY > Exams > 2005 Phys P5 Exam (#1-20, 50 [resp.]) PHYSIOLOGY > Exams > 2004 Phys P2 Exam (#1-20 [resp.]) PHYSIOLOGY > Exams > 2003 Phys P2 Exam (#1-20 [resp.]) Module 4 Gastrointestinal/Renal PHYSIOLOGY > Exams > 2005 Phys P5 Exam (#21-49 [renal]) PHYSIOLOGY > Exams > 2004 Phys P2 Exam (#21-50 [renal]) PHYSIOLOGY > Exams > 2003 Phys P2 Exam (#21-50 [renal]) PHYSIOLOGY > Exams > 2005 Phys P6 Exam (#1-20 [GI]) PHYSIOLOGY > Exams > 2004 Phys P3 Exam (#21-45 [GI]) PHYSIOLOGY > Exams > 2003 Phys P3 Exam (#1-10 [GI]) Module 5 Endocrine/Reproductive PHYSIOLOGY > Exams > 2005 Phys P6 Exam (#21-45 [endo.]) PHYSIOLOGY > Exams > 2004 Phys P3 Exam (#1-20 [endo.]) PHYSIOLOGY > Exams > 2003 Phys P3 Exam (#11-45 [endo. + repro.]) Module 6 NONE Module 7 NONE Musculoskeletal

Neuroscience

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0 2.3L). 6 4.5. The respective alveolar ventilation rates are (quiet breathing. 4 3. _______3. This is associated with a.5L. Compare the alveolar ventilation rate of a patient breathing quietly at 10/minute. _______2. inspiratory reserve volume = 2L. e. the concentration of He at the end of quiet expiration was 5%. 5. Spirometry reveals tidal volume = 0. An elderly patient has emphysema and his physician decides to characterize his lung volumes and capacities. e.5 3. b. d. 5. b. 5. decreased work of breathing. increased numbers of Type I cells in alveoli.2L and vital capacity of 3L. all of the above. rapid breathing) in L/minute: a.0. b. c.0. While alternative answers may be partially correct. 4. Directions: Choose the single best answer. (tidal volume 0. Respiratory distress syndrome (RDS) in prematurely delivered infants is characterized by progressive collapse of alveoli and respiratory failure. with that of the same individual breathing rapidly at 20/minute (tidal volume 0. e. expiratory reserve volume = 1.5L.0 none of the above. c. From these measurements his vital capacity (VC) and total lung capacity (TLC) in liters are (respectively): a. _______1. The primary deficiency is a lack of surfactant production. The patient then quietly breathes gas from a spirometer (volume 3L) which contains helium (He) at an initial concentration of 10%. After 3 minutes of breathing. d. 5. only one is fully correct. d. This individual has a physiologic dead space of 0.0. 4. 6 1. 3 3. increased surface tension forces at he air/liquid interface in alveoli.5 5.DIRECTIONS: Choose the single best answer. overproduction of phosphatidylglycerol (PG) by Type II epithelial cells of the alveoli.5L).5. c. 2 54 .0.

greater than PB during all phases of quiet breathing. This pressure in such an individual is a. 55 . d. b. only one is fully correct. with positive flow = exhalation and negative flow = inhalation. b. equal to PB at the end of the quiet inspiration. always less than atmospheric pressure (PB). Maximum rate of flow during exhalation is attained at low lung volumes. less than PB at the end of quiet expiration. Directions: Choose the single best answer. ³B¶ represents a region in which air flow is limited by airway collapse. Point ³C´ represents an effort-independent region of the breathing cycle. e. c. The figure shows the relation between rate of flow of air and lung volume. EFGHA is the path of exhalation from maximum lung volume. rather than high lung volumes. Intrapleural pressure plays a central role in breathing in a healthy individual. Which of the following statements is correct? a. _______5. _______4. greater than (more positive value) alveolar pressure (PA) at the peak of inspiration.DIRECTIONS: Choose the single best answer. Point ³D´ represents a region in which rate of airflow is effortindependent. While alternative answers may be partially correct. c. e. d.

e. less of the inhaled gas goes to alveoli at the apex of the lung than to alveoli at the base of the lung b. All of the above muscles are activated. b. If she has an FRC of 2L. alveoli at the base of the lung are more compliant than those at the apex of the lung. b. since expiration is a passive process. In advanced stages of chronic obstructive pulmonary disease such as emphysema a.DIRECTIONS: Choose the single best answer. _______9. c.02 _______8. c. alveoli at the base of the lung are smaller than those of the apex of the lung. No muscles are activated. Rectus abdominus muscle is activated. 10 1. For such a breath a.0 0. Directions: Choose the single best answer. Transverse abdominus muscle is activated. A healthy individual breathes out forcefully. e. _______7. at the end of quiet inspiration.1 0. c. e. _______6. c. lung compliance is increased. the specific compliance of her lungs is (in CM H2O ±1) a. Internal intercostal muscles are activated. b. 56 . A healthy individual quietly inhales starting at functional residual capacity (FRC). When a healthy individual inhales 2L of air starting from the FRC. d. only one is fully correct. her pleural pressure decreases from ±4cm H2O to ±14cm H2O. e. all of the above occur. the equal pressure point moves along the airways towards the alveoli. alveolar and capillary walls are progressively destroyed. d. alveoli having large time constants (X = RC) will fill more slowly than those having small time constants.2 0. d. While alternative answers may be partially correct. Which of the following statements is correct? a. total lung capacity is increased. all of the above are correct. d.

only one is fully correct. b. d. PA02 decreases. is laminar. c. ______12. She measures the diffusing capacity of the patient¶s lungs (DL) using inhalation of carbon monoxide (CO) gas. pH increases. 57 . will not provide any breath sounds on a stethoscope. While alternative answers may be partially correct. CO is used rather than O2 because a. CO has low solubility in blood. Directions: Choose the single best answer. b. d. d. c. e. c. is accurately described by all of the above.DIRECTIONS: Choose the single best answer. e. A clinician suspects that a patient may have a diffusion problem in the lungs due to fibrosis. it is probable that. is associated with a Reynolds number less than 2000. a. provides little (less than 20%) of the total resistance to airflow due to frictional forces. the rate of CO equilibration across the alveolar /capillary boundary is very rapid. PAC02 decreases. The flow of air in small airways (respiratory bronchioles) during usual breathing. e. runners frequently do not breathe for the approximately 10 second duration of the race. In a 100-meter race. during such a race a. ______11. the PO2 of alveolar gas cannot be measured. VA increases. the Pco of capillary blood remains close to zero since CO doesn¶t dissolve easily in capillary membranes. ______10. all of the above occur. Given the fact that such vigorous exercise greatly increases metabolic rate. the only limitation for CO diffusion is the equilibration of CO with alveolar gas when air is inhaled. b.

is accurately described by all of the above. CO has greater affinity for Hb than does O2 . results in a lowering of the AaD02 i. The VA/Q ratio is greatest at the base of the lungs.e. b. Exercise increases the differences in VA/Q ratio between base and apex of lungs. only one is fully correct. is an example of a ³left-to-right´ shunt b. d. Which of the following statements is incorrect? a. Fetal hemoglobin (Hb) has a greater affinity for O2 than does adult Hb. e. the difference in P02 between alveoli and arterial blood is decreased. Decreased temperature and increased pH result in increased affinity of Hb for O2 (i. c. b. occurs when some mixed venous blood by passes the alveoli and goes directly into oxygenated arterial blood. c. e. a shift of the Hb ± PO2 curve to the left). While alternative answers may be partially correct. ______13. c. ______15. d. Directions: Choose the single best answer. can be fully corrected clinically by administering 100% oxygen o the patient. The affinity of Hb for O2 is increased by the presence of carbon monoxide (CO). The VA/Q ratio is uniformly equal to 1. The ventilation is greater at the apex than at the base of the lungs. d. ______14. Ventilation/Perfusion inequalities may contribute significantly to differences in alveolar/arterial oxygen (AaD02).e. e. Both ventilation and perfusion are greater at the base than at the apex of the lungs. 58 .0 throughout the lungs. The concentration of Hb in the blood greatly affects the P02 of that blood. A ³anatomical shunt´ in the lungs a.DIRECTIONS: Choose the single best answer. In a healthy individual standing upright a.

e. c. since CO2 is 20 times more soluble in plasma than is O2. will change more rapidly (i. mainly in the form of CO2 dissolved in plasma. increased blood pH. d. Directions: Choose the single best answer. ______17. ______16. increases if PaC02 decreases in the presence of constant Pa02. e. mainly provide direct inhibitory input to centers located in the pons. ______18. Ventilation rate a.e. are most sensitive to changes in arterial P02 in usual quiet breathing. is more sensitive to change in Pa02 if Pa C02 is elevated. only one is fully correct. e. c. c. in the presence of constant PaC02. provide sensory input to the same group of neurons that receive sensory input from the vagal stretch receptors and pneumotaxic center. b. at lower values of partial pressure in arterial blood than is O2.DIRECTIONS: Choose the single best answer. all of the above. independently of the values of PC02 of arterial and venous blood. CO2 is transported in the blood a. decreased VC02. c. in smaller amounts than is O2 b. is usually more sensitive to changes in Pa02 than to changes in Pa C02. While alternative answers may be partially correct. if Pa02 increases. d. is accurately described by all of the above. is more sensitive) in response to changes in PaC02. provide direct excitatory input to centers located in the medulla. 59 . d. b. increased arterial P C02 increased arterial P02. e. Peripheral and central chemoreceptors of the pulmonary system a. ______19. d. Sustained exercise at an intensity beyond the anaerobic threshold results in a. increases if Pa02 increases. b. are activated by stretch receptors located in large airways.

c. He is given 50% supplemental oxygen to breathe using a facemask. What is clearance of X? a. 20 ml/min 100 ml/min 120 ml/min 200 ml/min 220 ml/min 60 . and the concentration of X in the urine is 100 mg/ml. c. If urine volume is 2 ml/min. d. Which of the following is true? a. Directions: Choose the single best answer. d. He is lying down quietly on a bed and has steady measured rates of oxygen consumption (V02) and carbon dioxide production (VC02) of 250 ml/min and 250 ml/min respectively. 7 mms Hg) PAC02 = partial pressure of C02 in alveolar air (40 mms Hg). A patient with pneumonia has a difference in alveolar/arterial oxygen (AaD02 = PA02 ±Pa02) of 30 mms Hg. Alveolar air equation: PA02 = F I02 (PB-PH20) ± PAC02/ R. b. e. 30 mms Hg 230 mms Hg 350 mms Hg 100 mms Hg 10 mms Hg X is freely filtered and secreted. b. Use the alveolar air equation (given below) to calculate what his new AaD02 is following the supplemental O2 therapy.DIRECTIONS: Choose the single best answer. his AaD02 is a. While alternative answers may be partially correct. b.5). c. The filtered load of X is 120 mg/min. ______21. Cx = Cin Cx = CPAH Cx < CPAH Cx = 0 Cx < Cin ______22. Atmospheric pressure is 747 mms Hg. e. d. If 50% of X binds to plasma protein during circulation. PH20 = partial pressure of saturated water vapor at body temperature. R = Respiratory Exchange Ratio (VC02/V02) On the basis of these measurements. given that arterial blood sampling reveals a Pa02 = 80 mms Hg. e. and GFR is 120 ml/min. ______20. Where FI02 = fraction of O2 in inspired gas (0. only one is fully correct.

increases. increased ______25. only one is fully correct. no change. increased increased. more. Congential diseases resulting in formation of glomerular basal lamina that have few negatively charged proteoglycans forming this meshwork results in all of the following except ______________.DIRECTIONS: Choose the single best answer. less. less. no change increased. proteinuria a relative increase in medium sized (6-8 nm) neutral proteins in the urine a decrease in peritubular oncotic pressure increase in the oncotic pressure of urine increase in urinary flow rate 61 . b. b. While alternative answers may be partially correct. c. d. e. d. d. ______23. decreased. Contraction of the afferent arteriole will do all of the following except __________. e. e. d. b. Which of the following is critical to creation of the hyperosmotic medulla? a. decreases. decreased decreased. decreases. Active NaCl reabsorption at the TAL ADH passive urea reabsorption at the collecting duct counter current flow in the vasa recta all of the above are necessary ______26. his plasma osmolarity will initially be ___________ resulting in _____________ ADH release followed by __________ in urine osmolarity and ___________ urine flow rate (urine volume per time). He is constantly drinking water. a. decrease RPF increase oncotic pressure in the peritubular capillary decrease GFR increase mean arterial pressure ______24. more. decreased. After drinking lots of water. decreased decreased. c. c. c. a. Directions: Choose the single best answer. b. Pete has polydipsia: a psychosis associated with uncontrolled intake of pure water. no change in. a.

b. c. While alternative answers may be partially correct. ______27. What would happen to Pcr (compared to Pcr in the disease stater) if Sally was given a drug that reversed all adverse effects of her renal failure. e. Pcr would rise Pcr would decrease Pcr would not change Pcr would stop decreasing and stay stable Pcr would stop increasing and stay stable ______28. e. a. c. Directions: Choose the single best answer. respectively. Bill¶s filtration fraction is 0. c. His Ccreatinine = 100 ml/min. acid-base balance secretion of organic anions production of ammonium in the proximal tubule regeneration of bicarbonate by the proximal tubule all of the above ______29. b. d. Her doctors have been following plasma creatinine levels as an indication of her decreasing GFR. 10 mg/min 600 mg/min 805 mg/min 1050 mg/min cannot determine 62 .16. Glutamine metabolism in the kidney plays an essential role in __________________. His urine volume and urinary PAH concentration are 2 ml/min and 625 mg/ml. Sally has chronic renal failure with progressive loss of functional renal capacity. b.DIRECTIONS: Choose the single best answer. a. d. only one is fully correct. d. e. What is Bill¶s PAH secretion rate? a.

C.4 and he has a pCO2 < 40 mmHg. acidosis alkalosis both neither cannot determine 63 . B. and CH2O = free water clearance): A. Which answer best describes a person that has diabetes mellitus (saturation of glucose reabsorption in the PT)? ______32.DIRECTIONS: Choose the single best answer. Which answer best describes a person that has central diabetes insipudus (not making ADH)? ______33. b. D. While alternative answers may be partially correct. Directions: Choose the single best answer. E. c. V = COsm V > COsm COsm = 0 CH2O < 0 COsm = CH2O Which answer choice best describes a person taking a loop diuretic? ______30. which scenario would decrease plasma volume the greatest? If Jake¶s plasma pH is 7. d. e. a. ______35. For questions 30-35 use the following answer choices (where V = urine volume/time. Which person is responding to dehydration? ______34. Which of the above relationships A-E can never happen? If V is equal under all conditions. Jake must have? ______36. only one is fully correct. ______31. COsm = osmolar clearance.

47 7.26 7. E. e. e. c. B. Betty is given an experimental drug that decreases Cx but has no affect on Cin. decreases GFR increases GFR block reabsorption of X increase reabsorption of X decrease RPF ______38. b.4 7. e.5 Paul¶s pCO2 is 16. d. only one is fully correct.26 7. c. What is his pH? a. b. Substance X is freely filtered and not bound to plasma protein and completely reabsorbed. b. Na+ organic anions glucose inulin bicarbonate 64 . ______37. d. While alternative answers may be partially correct. Which patient has respiratory alkalosis? [HCO3-] PCO2 15 40 14 20 24 40 26 60 30 40 PH 7. Which of the following is secreted in to the proximal tubule: a. patient A.2 cannot determine ______40. d. 6. c.2 7. C. D.DIRECTIONS: Choose the single best answer. Directions: Choose the single best answer.7 mmHg and his [HCO3-] is 10 mM.4 8. What does this experimental drug do? a.2 7. ______39.

Directions: Choose the single best answer. Dubya has congestive heart failure. Jake¶s osmolar and free water clearances are 4 and ±2 L/min. d. decrease increase not change all of the above ______43. Dubya has a heart attack and dies. c. b.DIRECTIONS: Choose the single best answer. Ms. While alternative answers may be partially correct. An increase in filtration fraction will _____________ Na+ reabsorption at the proximal tubule. b. d. Shortly after administering this second diuretic in addition to the first diuretic and K supplement. e. b. his inulin clearance was 120 ml/min. a.0 mg/ml. Ms. e. Calculate his inulin excretion rate. c. only one is fully correct. She has pulmonary edema and has been treated with a loop diruetic that blocks the tri-transporter and a K supplement. respectively. c. d. After setting his plasma inulin levels to 1. What type of diuretic did Dr. Dubya another diuretic in addition to her other medications. 1 mg/min 6 mg/min 10 mg/min 60 mg/min 120 mg/min ______42. Bob most likely and inappropriately add to Ms. ______41. Bob comes along and decides to give Ms. Dubya¶ therapy? a. a carbonic anhydrase inhibitor mannitol a Na/Cl cotransporter inhibitor an inhibitor of the Na channel in the collecting duct cannot say 65 . Dr. a.

Which patient is excreting the most free water? POsm (mOsm/kg) 300 300 300 300 300 ______47. b.DIRECTIONS: Choose the single best answer. Which patient might have a liver disease that washes out the medullary hyperosmotic gradient due to aberrant protein metabolism? 66 . d. While alternative answers may be partially correct. c. Which vascular element in the kidney presents the majority of resistance to blood flow? a. c. the kidney vasculature includes two capillary beds in series the vasa recta system runs in counter-current the glomerular capillary is surrounded by two contractile arterioles the glomerular capillary is made by fenestrated endothelial cells all of the above ______45. ______44. d. ______49. b. vasa recta afferent arteriole efferent arteriole glomerular capillary b and c For questions 46 ± 49 use the following data set: patient Urine flow UOsm (ml/min) (mOsm/kg) A 6 100 B 6 200 C 6 300 D 0. e. Which of the following anatomical arrangements of the renal vasculature make the kidney unique? a.5 600 E 2 1200 ______46. Directions: Choose the single best answer. only one is fully correct. e. Which patient is most likely taking a diuretic that blocks the ADH receptor? Which patient has the highest osmolar clearance? ______48.

b.DIRECTIONS: Choose the single best answer. only one is fully correct. e. Glomerulotubular balance happens because? a. RPF sets oncotic pressure plasma protein levels set oncotic pressure filtration at the glomerulus concentrates plasma proteins filtration is isoosmotic all of the above 67 . d. c. While alternative answers may be partially correct. Directions: Choose the single best answer. ______50.

5. 18. 34. 41. 49. 11. 46. 21. 3. 2. 14. 31. 24. 6. 4. 29. 2004 1. 10. 30. 17. 33. 50. 48. 40. 19. 25. 27. 12. 44. 35. 38. 15. 37. B A E C E E C D E E B A E D B B D A C B C D B E E B B 28. MEDICAL PHYSIOLOGY PHASE 2 EXAMINATION KEY APRIL 12. 47. 20. 32. 13. 8. 7. 9. E D A A B D C D C C B C B E B D E E A A E C C 68 . 26. 39. 22. 43.DIRECTIONS: Choose the single best answer. 45. 42. 36. 16. 23.

are always distributed symmetrically across the bi-lipid layer. there will be an increase in volume of the intracellular compartment there will be a decrease in volume of the vascular compartment. j. are usually linked to carbohydrate molecules as glycoproteins on the inner face (intracellular side) of the membrane. no sarcomeres. may be removed from membranes by solubilizing them using detergents. _______2. g. are accurately described by all of the above. the volume of the vascular compartment will be unchanged.DIRECTIONS: Choose the single best answer. g. j. g. assuming all of this fluid is still in his body: f. only one is fully correct. While alternative answers may be partially correct. smooth muscle cells have f. i. Directions: Choose the single best answer. An individual drinks 500ml of hypertonic saline. Within a short time (say 20 minutes). _______3. less concentration of actin molecules all of the above. h. _______1. h. Intrinsic membrane proteins f. more troponin molecules. j. 69 . h. i. the volume of the interstitial fluid compartment will be unchanged. higher myosin concentration. i. In comparison with skeletal muscle fibers. are usually held in place in the membrane by means of charge interactions with lipid molecules. there will be increased volume of the extracellular fluid compartment.

g. Shortening of the active muscle under load A will be greater than that under load E. the diffusion coefficient is directly proportional to the square of the molecular weight of the molecule.DIRECTIONS: Choose the single best answer. the path of the contraction is given by XpY1p Bp A. the rate of diffusion is directly proportional to the distance traveled. Sarcomere Length The diagram above was obtained from a single muscle fiber and represents the passive and active tensions the fiber is capable of generating at particular sarcomere lengths. h. Diffusion is an effective process for the movement of nutrients and other molecules only over small distances because f. g. Under isometric conditions. Directions: Choose the single best answer. 70 . only one is fully correct. _______4. While alternative answers may be partially correct. _______5. Under after-loaded isotonic conditions (load: E) the path of the contraction would be XpF. j. i. Which of the following statements is correct for a muscle which is stimulated to contract starting at the sarcomere length given by point D? f. Under afterloaded isotonic conditions (load given by: A) the path is XpY1p Zp C. Under eccentric conditions of contraction the path would be XpY2pZ.

290 osmoles/liter) are placed in a solution of particles X. Directions: Choose the single best answer. j. f. From these facts. if molecules X can freely penetrate the cell membranes. the rate of transport of L-glucose into muscle cells is not affected by the presence of metabolic inhibitors. only one is fully correct. as defined by the Van¶t Hoff equation.DIRECTIONS: Choose the single best answer. It is known that D±glucose is transported into muscle cells by facilitated diffusion. is proportional to the molar concentration of the solute. The cells will not change in volume if the molecules X are able to freely penetrate the cell membranes. The cells will increase in volume in the steady state. While alternative answers may be partially correct. j. Which of the following statements is true? f. h. h. is proportional to the osmotic coefficient (*). The cells will shrink in volume in the steady state if X easily penetrates cell membranes. The cells will increase in volume if molecules X cannot penetrate cell membranes. 71 . The osmolarity of a solution. by primary active transport. g. i. j. we may conclude that L± glucose movement across muscle cell membranes is f. i. The solution of molecules X is hypo-osmotic in comparison with the intracellular contents of the cells i. by secondary active transport.4 osmoles/liter. having an osmotic pressure of 0. g. depends upon the degree of dissociation of the solute. large molecules only move small distances by diffusion. _______8. g. _______6. the time of diffusion increases as the square of the distance over which the diffusion takes place. h. is not affected by competitive inhibition from other molecules of similar structure and does not exhibit saturation kinetics. is accurately described by all of the above. L-glucose exhibits movement characteristics across muscle cell membranes which are very different from those of D±glucose. _______7. Red blood cells (having an osmolarity of 0. is independent of temperature. the diffusion coefficient is proportional to distance. For example.

occurring by facilitated diffusion. j. probably by simple diffusion. 72 . probably much faster than that of D-glucose. i. h.DIRECTIONS: Choose the single best answer.

determines if X+ will move to a region where the potential energy is different. When these agents are present: f.ATP-ase pump system will be inhibited. is directly proportional to the concentration of X+. of X+ increases. growth factors and mitogens. g. there will be increased outflux of Na+ from cells. g. i. hydrophilic amino acids against their own concentration gradient. is correctly described by all of the above. would be enhanced by increasing extracellular Na+ concentration. are leaky to glucose and neutral amino acids. and extracellular Na+ is exchanged for intracellular H+. the intracellular ?H+A concentration will increase. when the pH decreases. utilizes the energy of the Na+ concentration gradient.H+ exchange transport protein protects cells from acidification because affinity of the protein for H+ increases. While alternative answers may be partially correct. are impermeable to water and water-soluble molecules. i.DIRECTIONS: Choose the single best answer. j. h. h. h. h. 73 . g. will decrease if the electrical charge. permit the movement of Na+ / K+ -ATP-ase molecules from the basolateral to the brush border membranes of the cells. ______11. are leaky to water. is an example of secondary active transport. _______9. This transport mechanism: f. is independent of the concentration of X+. The electrochemical potential energy (Qx) of a charged molecule X+ in solution f. would be inhibited by agents which decrease cellular metabolism. or valence. j. i. A similar increased affinity of the protein for H+ is induced by tumor promoters. there will be a net outflux of ?H+A ions from the cells. contain the transport proteins responsible for facilitated diffusion of glucose across the epithelial cells. ______12. j. j. Many cells import neutral. Directions: Choose the single best answer. The tight junctions joining the epithelial cells of the small intestine and proximal tubule of the kidney f. ______10. intracellular pH will decrease the Na+/ K+ . i. is accurately described by all of the above. small water-soluble molecules and ions. The Na+ . g. only one is fully correct.

ions.is in equilibrium across the membrane. Directions: Choose the single best answer. A voltage of ±60mV is maintained across the membrane. equal to the cellular membrane potential. There will be a net movement of X. the transmembrane voltage difference required to produce an electrical force equal and opposite to the chemical concentration force for Xacross the cell membrane. i.from B to A.across the membrane in either direction. There will be a net movement of X. The two compartments A and B are separated by a membrane permeable only to X.DIRECTIONS: Choose the single best answer.is f. The electrical energy gradient is less than the chemical energy gradient. While alternative answers may be partially correct. g. equal to the balance of cell-ions across the membrane.2 rC: f. Use the Nernst equation to select the correct answer. i. h. The equilibrium potential for X. only one is fully correct. j.in this situation is ±100mV. X.which balances osmotic forces across the membrane. the chemical concentration of X. The equilibrium potential of X. h. 74 . j. ______14. assuming the temperature is held at 29. the potential at which there is no movement of X. g. ______13.from A to B.

decreases K+ conductance (gK). g. i. If this drug is added to muscle cells in vivo: f. increased Na+ conductance. no change in membrane potential. Adding this drug to the fluid surrounding nerve fibers will. the resting membrane potential will be depolarized. depolarization of the membrane potential. g. increases the number of Na+ channels open at a given time. only one is fully correct. 75 . The muscle membranes will exhibit increased excitability. ______15. decreased K+ conductance. affects both Na+ and K+ channels. i. If extracellular K+ concentration is increased in the fluid surrounding nerve and muscle fibers f. all of the above will occur. the magnitude (size) of subsequent action potentials will be decreased.ATP-ase. i. h. according to the Chord Conductance equation. All of the above will occur. The drug digitalis inhibits the cell membrane Na +/ K+ . The process of accommodation in nerve and muscle fibers: f. g. Directions: Choose the single best answer. h. There will be a depolarization of the resting membrane potential. cause: f. While alternative answers may be partially correct. the membrane potential will be hyperpolarized. h. ______18.DIRECTIONS: Choose the single best answer. j. i. g. The drug TTX (tetrodotoxin) specifically blocks Na+ channels. h. renders the cell membranes hyper excitable. j. occurs in response to a rapid depolarization. hyperpolarization of the membrane potential. j. j. the nerve and muscle fibers will be more easily excitable. There will be increased intracellular concentration of Na+ ions. There will be decreased intracellular concentration of K+ ions. ______16. ______17.

______21. are also the channels through which the movement of Na+ and K+ occurs across the post-synaptic muscle membrane. i. increased Na+ membrane conductance. i. only one is fully correct. The relative refactory period of the action potential is associated with f. j. g. i. In the Lambert-Eaton syndrome. is accurately described by all of the above. decreases the capacitance of the axon. is the consequence of the opening of voltage-gated channels present in the muscle membrane of the synaptic cleft. h. enables generation of the action potential to occur at any point along the axon. f. ______19. c. mainly hyperpolarization of the cell membrane. are present in the motor nerve terminals of the nerve-muscle junction. increases the intracellular electrical resistance along the axon. ______22. g. are directly responsible for the effects of anti-cholinesterase drugs. patients exhibit muscle weakness because they produce anti-bodies against membrane Ca++ channels. The end plate potential (EPP) of the nerve-muscle junction f. increases the diameter of the axon. d. h. j. results in the generation of muscle fiber action potentials within the synaptic cleft. h.DIRECTIONS: Choose the single best answer. e. The increased speed of conduction of action potentials along myelinated nerve fibers occurs in part because myelin: b. These channels f. While alternative answers may be partially correct. ______20. are located in the post-synaptic muscle membrane. Directions: Choose the single best answer. j. are necessary for the outflow of Ca++ from nerve terminals which causes the release of vesicles of acetyl choline from the terminals. decreased K+ membrane conductance. occurs because of the opening of ligand-gated channels in the muscle membrane of the synaptic cleft. g. 76 . mainly inactivation of Na+ channels. occurs because the action of acetyl choline is to open K+ channels only in the synaptic cleft of the post synaptic membrane. decreases the length constant (P) of the axon. depolarization of the cell membrane.

contain many sarcomeres in parallel. e. c. have a very large (> 100Qm) fiber diameter.DIRECTIONS: Choose the single best answer. contain many sarcomeres in series be classified as a Type I fiber. as in the case of muscles of the eye. Increased skeletal muscle performance can be obtained in vivo by the process of summation. activity of the DHPR receptors (of the transverse tubules) and RYR receptors (of the sarcoplasmic reticulum) is decreased below resting values. if the unit contains fast. c. d. In this process a. Directions: Choose the single best answer. only one is fully correct. such as fast (type 2) and slow (Type 1) fibers. would be recruited first. maximum tetanic contraction is obtained via low frequency stimulation when the muscle is routinely activated under usual daily conditions. e. contain many myofibrils in parallel. intracellular Ca++ levels are rapidly decreased by increasing the speed of the sarcoplasmic reticulum Ca++/ATP-ase pumps. ______24. is accurately described by all of the above. can contain fibers of several different types. A motor unit of a skeletal muscle a. there is increased binding of Ca++ ions to thick filaments. b. 2000 fibers) if the unit is necessary for fine (or precise) control of movement. would be expected to contain many muscle fibers (say. intracellular Ca++ levels are sustained at a high level as a consequence of repetitive stimulation. would be expected to a. While alternative answers may be partially correct. e. 77 . A skeletal muscle fiber which is required to shorten rapidly over large distances but not required to develop large active tensions. ______23. b. consists of a motor nerve and all of the muscle fibers it innervates. b. ______25. d. d. c. fatigable (type 2B) fibers.

c. patients exhibit severe muscle contractions and rigidity in response to administration of anesthetics such as halothane and ether. ______28. j.DIRECTIONS: Choose the single best answer. greater if the fiber is undergoing an eccentric contraction than when undergoing a lightly-loaded after loaded isotonic contraction. uncontrolled release of Ca++ ions from the sarcoplasmic reticulum (SR) into the sarcoplasm. g. This situation may be caused by a. sustained activation of the RYR channel of the SR. b. c. b. 78 . not accurately described by any of the above. associated with greatly reduced pH (about 6. i. determined mainly by the speed of the myosin ATP-ase of that fiber. h. determined mainly by the number of myofibrils in parallel rather than in series in that fiber. associated with greatly reduced levels of intracellular ATP. most often associated with failure of the Type I muscle fibers to continue contracting. accurately described by all of the above. often associated with increased inorganic phosphate ions in the sarcoplasm (to almost 20 times the resting level in working muscles). Fatigue of skeletal muscle fibers is f. While alternative answers may be partially correct. all of the above. e. ______27. The speed of contraction of a skeletal muscle fiber is a. only one is fully correct. sustained activation of the DHPR receptor of the transverse tubule. d. independent of the load on that fiber. Directions: Choose the single best answer. d. e. In malignant hyperthermia (MH). ______26. inability of the SR Ca++ ATP-ase pumps to remove elevated levels of Ca++ from the sarcoplasm.0) during repetitive exercise of low intensity.

Ca++ concentration increases. d. Ca++ ions are not removed from the sarcoplasm in smooth muscle cells by the action of Ca++/ATP-ase pumps. ATP. c. crossbridge cycling is much slower in active smooth muscles than in active skeletal muscles. This is because f. Directions: Choose the single best answer. While alternative answers may be partially correct. This occurs when a. Crossbridge cycling in smooth muscle cells decreases when the crossbridges are dephosphorylated.hydrolysis occurs in order for Ca++ bind to troponin. only one is fully correct. b. myosin phosphatase dephosphorylates the myosin light chain.ATP-ase pump restores the balance of Na+ and K+ across the cell membrane.DIRECTIONS: Choose the single best answer. all of the above are correct. phosphorylation of myosin light chains is necessary to activate the sliding filament mechanism in smooth muscles but not in skeletal muscles. The energy cost of contraction is much less in smooth muscles than in skeletal muscles. h. the Na+/K+. g. all of the above occur. e. ______29. j. i. ______30. but not for Ca++ binding to calmodulin. 79 . myosin light chain kinase (MLCK) becomes active.

the common cardiovascular variables are represented by the following abbreviations: Heart Rate: HR Stroke Volume: SV Cardiac Output: CO Mean Arterial Pressure: MAP Total Peripheral Resistance: TPR 80 . In the following cardiovascular questions (#31-60).DIRECTIONS: Choose the single best answer.

TPR did not change. In a recumbent person with a normal cardiovascular system. Decreases when arteriolar radii increases. c. which of the following about blood pressure is true? a. b. TPR increased by about 3 mmHg/L/min. d. SL open. b. The blood pressure difference between the large arteries and the right atrium is virtually the same across most organs of the systemic circulation. Using the end of ventricular diastole as the starting time. 81 . Question cannot be answered from the given information. AV open. SL close. While alternative answers may be partially correct. AV close. e. The largest pressure drop in a systemic organ circulation is usually across the veins. Both b and c. Before an experimental intervention a patient¶s HR = 67 bpm. d. only one is fully correct. SL close. what is the correct open/close sequence of the atrioventricular (AV) and semilumar (SL) valves during a heart beat? a. b. SL close. TPR decreased by about 20 mmHg/L/min. AV close. AV close. SL close. d. e. AV close. Mean blood pressures in the major arteries of the systemic and pulmonary circulations are identical. SV = 75 ml and MAP = 90 mmHg. ______33. SL open. ______31. b. In response to the intervention. SL open. Both a and c. Decreases when arteriolar smooth muscle tone increases. c. Blood flow through an organ in the systemic circulation: a. Increases when organ vascular resistance increases.DIRECTIONS: Choose the single best answer. how did TPR change to maintain MAP at 90 mmHg? a. e. c. SL close. AV open. AV open. ______34. Is caused by mean arterial pressure being greater than right atrial pressure. Directions: Choose the single best answer. ______32. AV open. AV open. SL open. MAP = TPR ÷ CO. SL open. e. AV close. c. The intervention caused HR to increase to 100 bpm without a change in either SV or MAP. TPR decreased by about 6 mmHg/L/min. d.

only one is fully correct.DIRECTIONS: Choose the single best answer. Directions: Choose the single best answer. conduction of an action potential to an adjacent fiber: a. e. In cardiac muscle. Occurs in part because of pathways with low electrical resistance in the intercalated disk regions. Occurs at a higher velocity in the atrioventricular node than in the Purkinje fibers. Is due primarily to stimulation of ß-adrenergic receptors in the gap junction regions of the adjacent fiber. While alternative answers may be partially correct. b. ______35. d. Occurs most readily when the Na+-channel inactivation mechanism is completely ³turned off´ in the adjacent fiber. c. Both a and c. 82 .

While alternative answers may be partially correct. The resting membrane potential between E and A2 is about -90 mv because Na+-channel conductance is much higher than K+-channel conductance. j. Between D and E the predominant activity of the sarcoplasmic reticulum is release of Ca++ into the cytosol. Drawn below is a recording of two successive ³fast response´ ventricular action potentials in a normal heart. 83 . ______37. only one is fully correct. Inward Ca++ flux (current) is much higher between E and A2 than at C. Directions: Choose the single best answer. Which mechanisms and events are correctly associated with these membrane potential changes? f. +30 C 0 Membrane Potential (mv) ‡ ‡B ‡A 0 150 -50 ‡D E ‡ B2 ‡ ‡ A2 450 600 750 -100 300 Time (msec) ______36. The sarcolemma is in its absolute refractory period between D and A2. h. j. Between E and A2 an action potential was generated in the sinoatrial node. K+-channel conductance at C is much higher than at A. Use this drawing to answer questions 36 and 37. Identify the true statement about mechanisms underlying this membrane potential recording: f. i. The Na+-channel inactivation mechanism is ³turning off´ between D and E. h. g.DIRECTIONS: Choose the single best answer. The maximum contractile tension generated by the first action potential occurs around B2. The P-wave of the electrocardiogram is produced by the depolarization at B. The rapid depolarization at B is due primarily to a rapid increase in ³slow channel´ conductance. i. g.

Is due in part to gradual increase in K+-channel conductance. Increase in frequency in response to increased stimulation of muscarinic cholinergic receptors. Ca++ release from the sarcoplasmic reticulum is triggered by the Na+ influx during an action potential. Have a rapid depolarization phase (phase 0) that is caused primarily by increased conductance of fast Na+-channels. b. The recovery of cytosolic [Ca++] after its initial increase is due primarily to diffusion of Ca++ from cytosol to extracellular fluid. h. d. While alternative answers may be partially correct. c. Action potentials in sinoatrial node fibers: f. Are not conducted to adjacent atrial fibers. Normally occurs in atrial fibers also. b. The diastolic (phase 4) depolarization between action potentials in sinoatrial node fibers: a. 84 . j. only one is fully correct. e. i.DIRECTIONS: Choose the single best answer. Normally occur at a lower frequency than heart rate. Is due in part to a gradual increase in Ca++ influx. Which statement about Ca++ during a heart beat is true? a. The sarcolemmal Ca++ influx during an action potential is normally sufficient to fully saturate the Ca++-binding sites on troponin C. Normally occurs at a slower rate than in atrioventricular node fibers. ______40. Normally occur before those in the right and left bundle branches during a heart beat. The increase in cytosolic [Ca++] in response to an action potential is enhanced when sarcolemmal ß-adrenergic receptors are stimulated. ______39. e. The increase in cytosolic [Ca++] produces contraction only after Ca++ binds to calmodulin. g. d. Is caused by stimulation of ß-adrenergic receptors by norepinephrine. Directions: Choose the single best answer. ______38. c.

The second heart sound begins at D.DIRECTIONS: Choose the single best answer. The mitral and aortic valves are both closed between C and D. g. F ‡ ‡ ‡D B E Left Ventricular Pressure (mmHg) A ‡ ‡ ‡C Left Ventricular Volume (ml) f. j. The mitral and aortic valves are both open between F and A. Using the left ventricular pressure-volume loop for one cardiac cycle drawn below. Left atrial systole accounts for the volume increase between A and B. By definition. i. ventricular end-systolic volume is the ventricular volume at E. While alternative answers may be partially correct. only one is fully correct. ______41. 85 . identify the correct statement about the cardiac cycle. Directions: Choose the single best answer. h.

i. MAP is between 85-95 mmHg. j. i. By definition.DIRECTIONS: Choose the single best answer. Which is true about aortic blood pressure as shown above and the events associated with it? f. 120 C E ‡ ‡‡ D F Arterial 80 ress re (mm g) 40 A ‡‡ B ‡ 0 0 ime (sec) ______42. aortic diastolic blood pressure is the value at D. ______43. Left ventricular pressure reaches its highest level between E and F. Use this drawing to answer questions 42 and 43. h. g. Blood flow through the downstream arterioles is occurring between A and D. The aortic valve opens at D. f. h. Drawn below is aortic blood pressure associated with 3 successive heart beats. but not between D and F. Directions: Choose the single best answer. The left ventricle is filling at C. While alternative answers may be partially correct. only one is fully correct. The first heart sound begins between A and B. g. The period of left ventricular ejection is from C to E. Which cardiac event is correctly associated with these aortic pressure tracings? e. Aortic pulse pressure is about 120 mmHg. The rise in aortic pressure between B and C is due to smooth muscle contraction in the aorta and its major branches. 86 .

Increased Na+ influx through ³funny´ channels during phase 4. Which mechanism normally contributes to the increase in HR produced by increased sympathetic nerve stimulation in the sinoatrial node? f. Is produced normally by a reduction in Ca++-binding to troponin C. Both a and c. The Frank-Starling mechanism that controls SV: f. Increased rate of rise of the phase 4 depolarization. Is related to the intrinsic ventricular muscle mechanism that increases contractile fiber shortening when preload is increased. Requires stimulation of cardiac ß-adrenergic receptors to increase SV. Will tend to decrease SV when venous return becomes greater than CO. Both b and c. ______46. Is due in part to a change in the extent of interfering overlap of actin filaments in a sarcomere when ventricular end-diastolic fiber length is changed. j. Directions: Choose the single best answer. Increases the peak pressure generated by an isvolumetrically contracting ventricle from a given end-diastolic fiber length. h. e. Is the cause of a fall in SV when ventricular afterload increases. g. Change in the membrane potential threshold for action potentials to a more negative value. 87 . only one is fully correct. j. i. h. ______45. ______44. g. d.DIRECTIONS: Choose the single best answer. i. Reduces myocardial O2 consumption. c. b. An increase in ventricular contractility in the normal heart: a. Decreased Ca++-channel conductance during phase 4. While alternative answers may be partially correct. Causes SV to fall when it occurs without a simultaneous change in ventricular preload and afterload.

respectively. ventricular end-diastolic volume is not altered. Both b and c.DIRECTIONS: Choose the single best answer. Directions: Choose the single best answer. d. b. Is normally less than 10 mmHg. 88 . Declines when SV increases. Declines during hemorrhage. only one is fully correct. e. by definition. However. While alternative answers may be partially correct. the cytosolic concentration of the Ca++-calmodulin complex decreases. c. an increase in E-adrenergic receptor stimulation increases the cytosolic concentration of inositol triphosphate (IP3). c. membrane hyperpolarization reduces Ca++-channel conductance. an increase in endothelial release of nitric oxide increases cytosolic [cGMP]. Which point (a-e) represents the new end-systolic volume? LV Pressure (mmHg) ‡a ‡ ‡2 c‡ ‡ ‡e b d ‡1 LV Volume (ml) ______48. e. Decreases with age because major artery compliance increases. b. d. Pulse pressure in the major arteries of the systemic circulation: a. The tone of arteriolar smooth muscle increases when: a. ______49. Is. equal to (systolic blood pressure + diastolic blood pressure). Drawn below is the left ventricular pressure-volume loop during a cardiac cycle with end-diastolic volume and end-systolic volume labeled by 1 and 2. Cardiac sympathetic nerve stimulation accompanies a fall in arterial blood pressure in response to a cardiovascular challenge. ______47.

e. Decreased action potential frequency in sympathetic vasoconstrictor fibers. Both a and d. h. j. b. g. Each of the following could have been a cause of this increase in blood flow through a direct action on arterioles EXCEPT: a. Causes coronary blood flow to fall when heart rate increases. Is the most important controller of blood flow through the cerebral circulation 89 . The metabolic mechanism that controls arteriolar resistance: f. e. Increased release of prostaglandins E2 and I2 from endothelial cells. Is mediated primarily by release of epinephrine from postganglionic nerve terminals. Changes organ blood flow in direct proportion to action potential frequency. d. An event increased blood flow through an organ in the systemic circulation even though there were no changes in MAP and right atrial pressure. The sympathetic vasoconstrictor fiber control of arteriolar resistance: a. c. Directions: Choose the single best answer. Involves a vasodilator influence of metabolites in the interstitial fluid on arteriolar smooth muscle tone. c. Primarily involves ß2-adrenergic receptor stimulation in arteriolar smooth muscle. Causes arteriolar vascular resistance to increase in an organ when its O2 demand increases above the initial O2 supply. b. i. ______50. ______52. Is one cause of reactive hyperemia following release of blood flow occlusion. Is an important moment-to-moment controller of TPR. ______51. d. Increased plasma concentration of angiotensin II. Increased histamine release from mast cells.DIRECTIONS: Choose the single best answer. only one is fully correct. Increased nitric oxide release from endothelial cells. While alternative answers may be partially correct.

only one is fully correct. Subsequently. Both b and c. The following values are measured: Average capillary blood pressure (Pc): 28 mmHg Plasma colloid osmotic pressure ( p): 24 mmHg Interstitial fluid colloid osmotic pressure ( if): 5 mmHg In this organ: a. d. Causes organ blood flow to increase in direct proportion to the increase in MAP. there is initially no net fluid movement across the capillary walls. Interstitial fluid hydrostatic pressure (Pif) is less than 9 mmHg. ______54. c. c. a perturbation increases average arm capillary blood pressure without any change in plasma protein concentration. Interstitial fluid volume is decreasing. Is due in part to a myogenic relaxation of arteriolar smooth muscle when the arteriolar vessel wall is stretched. in turn. but lymph flow is less than the net filtration rate. Both c and d. ______53. If the capillary filtration coefficient is not 0. Capillary filtration coefficient = 0. The net absorptive force due to proteins = 0. e. e. Both a and c. 90 . Reduce interstitial fluid hydrostatic pressure (Pif). d. Initially change net transcapillary fluid movement to filtration. ______55. this perturbation will: a. Directions: Choose the single best answer. c. In a patient¶s arm with surgically eliminated lymph outflow. Decrease interstitial fluid volume. e. Requires stimulation of sensory receptors in that organ which. An organ¶s autoregulation of its steady state blood flow when MAP is elevated: a. b. While alternative answers may be partially correct. Is accomplished through local mechanisms that increase arteriolar resistance. d. b. Produce a continuous net filtration in the new steady state. Net capillary filtration is occurring in an organ.DIRECTIONS: Choose the single best answer. determines the activity of sympathetic vasoconstrictor fibers. b.

d. Directions: Choose the single best answer. An increase in sympathetic nerve activity to venous smooth muscle. Both a and b. b. 91 . c. c. a hemorrhaging individual with falling MAP has: a. d. b. b. an elevated action potential frequency in arterial baroreceptor nerve fibers. an increased kidney (renal) blood flow. An atrial receptor-sensed fall in atrial volume will reflexly increase sympathetic nerve activity to cardiovascular effectors. a decreased sympathetic vasoconstrictor nerve activity to skin. Atrial baroreceptor nerve activity increases when atrial blood volume decreases. c. e. ______56. Reduce E-adrenergic stimulation of arteriolar smooth muscle. Reflexly cause a further increase in MAP. b. d. While alternative answers may be partially correct. an increased TPR. c. e. ______57. only one is fully correct. Reduce cardiac vagal nerve nerve activity. ______58. which event in the veins will initially make venous return greater than CO? a. Which is true about the atrial baroreceptors and the reflex they initiate? a. The atrial baroreceptor reflex has no cardiovascular role during hemorrhage. All of the above. In response to a sudden increase in MAP. If the total blood flow entering the systemic veins of an intact circulation is equal to CO in a person that is lying down. an increased SV due to the Frank-Starling mechanism. The atrial baroreceptor reflex is the most important mechanism in long-term regulation of MAP. Increase ventricular contractility.DIRECTIONS: Choose the single best answer. An increase in venous blood pressure due to arteriolar vasodilation. The atrial baroreceptors are the sensors of the arterial baroreceptor reflex. An increase in leg venous blood volume caused by standing up. e. d. the arterial baroreceptor reflex will: a. ______59. Relative to the pre-stimulus (control) level. Increase HR. e.

reduces coronary blood flow by elevating sympathetic vasoconstrictor nerve activity. 92 . c.DIRECTIONS: Choose the single best answer. d. dynamic exercise: a. While alternative answers may be partially correct. Relative to rest. e. increases HR but not CO. increases active skeletal muscle blood flow primarily by reducing sympathetic vasconstrictor nerve activity. increases gastrointestinal blood flow by reducing sympathetic vasoconstrictor nerve activity. b. only one is fully correct. Directions: Choose the single best answer. ______60. increases ventricular contractility by elevating cardiac sympathetic nerve activity.

54. 8. 52. 42. 41. 28. 56. 11. 53. 37.1. 15. 6. 32. 14. 60. 25. 21. 18. 57. 30. 47. 17. 22. 58. 3. 5. 48. 51. 59. 13. 40. b e e c e d d e e a d a B&C e d e a c b e a a b c a e c c c c e b d e 36. 43. 12. 23. 27. 39. a 2. 9. 10. 45. 19. 31. e b b a d b a c e e a c b c e d c c b a a c c e d . 49. 20. 46. 29. 44. 7. 4. 50. 34. 38. 24. 55. 26. 16. 33. 35.

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