Physiology

INSTRUCTION: Answer the following question with all honesty char! Leave the two spaces for the rationale lecture provided. Thank you and
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QUESTION ANS RATIO
1. Pathogenesis of Alzheimer's disease is believed to
involve the destruction of:

A. Dopamine-secreting cell bodies in the substantia

nigra pars compacta
B. Acetylcholine-producing neurons in many parts
of the brain
C. GABA-producing neurons in caudate nucleus
D. Norepinephrine-secreting neurons in locus
cereleus
2. Cerebral edema is a result of what iatrogenic
phenomenon?

A. Rapid overcorrection of hyponateremia

B. Rapid overcorrection of hypernatremia
C. Rapid overcorrection of hyperkalemia
D. Rapid overcorrection of hypokalemia
E. None of the above
3. Stimulation of the POMC/CART neurons in the
arcuate nucleus of the hypothalams stimulates which
of the following?

A. Increased insulin secretion

B. Increased food intake
C. Increased energy expenditure
D. Both A and B
E. All of the above
4. A 50 year old male patient was rushed to the ER due
to dull crampy generalized vague abdominal pain,
patient had absence of bowel movement for 3 days
already with minimal flatus accompanied by vomiting
and anorexia, patient had a previous appendectomy.
The abdominal pain felt by the patient is most likely
conducted by which nerve fibers?

A. A alpha nerve fibers

B. AB nerve fibers
C. A delta nerve fibers
D. B fibers
E. C fibers
5. Which of the following is true regarding the
sympathetic nervous system?

A. It is responsible for accomodation of vision to near

objects
B. it is responsbile for relaxation of urinary and
gastrointestinal sphincters
C. it has short preganglionic fibers and long post
ganglionic fibers
D. it only utilizes norepinephrine as neurotransmitter
E. the autonomic ganglia are usually embedded
inside the effector organs
6. Which of the following has a much lower
concentration in the CSF than in cerebral capillary
blood?
A. Na+
B. K+
C. Osmolarity
D. Protein
E. Mg2+
7. The activity of the central chemoreceptors is
primarily stimulated by which of the following?

A. A decrease in PO2 of blood flowing through the

brain
B. An increase in the PCO2 of blood flowing through
the brain
C. A decrease in the oxygen content of blood flowing
through the brain
D. A decrease in the metabolic rate of the surrounding
brain tissue
E. An increase in the pH of the CSF
8. Which autonomic receptor is blocked by
hexamethonium at the ganglia, but not at the
neuromuscular junction?

A. Adrenergic α1 receptors
B. Adrenergic β1 receptors
C. Adrenergic β2 receptors
D. Cholinergic muscarinic receptors
E. Cholinergic nicotinic receptors
9. Which of the following responses is mediated by
parasympathetic muscarinic receptors?

A. Dilation of bronchiolar smooth muscle

B. Miosis
C. Ejaculation
D. Constriction of gastrointestinal (GI) sphincters
E. Increased cardiac contractility
10. Which of the following is a feature of the
sympathetic, but not the parasympathetic nervous
system?

A. Ganglia located in the effector organs

B. Long preganglionic neurons
C. Preganglionic neurons release norepinephrine
D. Preganglionic neurons release acetylcholine (ACh)
E. Preganglionic neurons originate in the
thoracolumbar spinal cord
F. Postganglionic neurons synapse on effector organs
G. Postganglionic neurons release epinephrine
H. Postganglionic neurons release ACh
11. Which of the following structures has a primary
function to coordinate rate, range, force, and direction
of movement?

A. Primary motor cortex

B. Premotor cortex and supplementary motor cortex
C. Prefrontal cortex
D. Basal ganglia
E. Cerebellum
12. Which autonomic receptor is activated by low
concentrations of epinephrine released from the
adrenal medulla and causes vasodilation?

A. Adrenergic α1 receptors
B. Adrenergic β1 receptors
C. Adrenergic β2 receptors
D. Cholinergic muscarinic receptors
E. Cholinergic nicotinic receptors
13. Complete transection of the spinal cord at the level
of T1 would most likely result in
A. temporary loss of stretch reflexes below the lesion
B. temporary loss of conscious proprioception below
the lesion
C. permanent loss of voluntary control of movement
above the lesion
D. permanent loss of consciousness above the lesion
14. The association area/s of the central cortex that
provide/s a high level of interpretive meaning from
the surrounding sensory areas is/are the:

A. Corpus callosum
B. Prefrontal association area
C. Parieto-occipitotemporal association area
D. Secondary somatic sensory area
E. All of the above
15. A young college student had nausea, vomiting,
visual disorders, and muscular paralysis after eating
canned tuna fish. The probable diagnosis is botulism,
caused by ingestion of the Clostridium botulinum
toxin. The physiological effect of this toxin is to

A. Bind to and thus inactivate acetylcholine receptors

at myoneural junctions
B. Prevent release of calcium ions from the
sarcoplasmic reticulum, thus inhibiting muscle
contraction
C. Inhibit release of acetylcholine from presynaptic
membranes
D. Inhibit hydrolysis of adenosine triphosphate
during the contraction cycle
16. A 42-year-old woman with a history of
pernicious anemia comes to the physician
complaining of increased anxiety, heart
palpitations, heat intolerance, unexplained
weight loss, and multiple daily bowel
movements. She has not had a period in 4
months. On physical examination, the patient is
found to have a goiter, a thyroid bruit, and mild
exophthalmos. Laboratory studies show
elevated triiodothyronine and free thyroxine
levels, and an undetectable thyroid-stimulating
hormone. Which of the following is the most
likely etiology of this patient’s disease?

A. Autoimmune stimulation of thyroid-stimulating

hormone receptors
B. Idiopathic replacement of thyroid tissue with
fibrous tissue
C. Thyroid adenoma
D. Thyroid hormone-producing ovarian teratoma
E. Viral infection leading to destruction of thyroid
tissue.
17. A 45-year-old man with type 2 diabetes mellitus
undergoes a neurologic examination. The patient
is unable to sense the vibration produced by a
tuning fork placed on his big toe. Which of the
following receptors is most likely affected in this
patient?

A. Krause end bulbs

B. Meissner’s corpuscle
C. Merkel nerve endings
D. Pacinian corpuscle
E. Ruffini corpuscle
18. A 53-year-old woman with newly diagnosed
type 2 diabetes presents to the emergency
 department complaining of vomiting, severe
headache, dizziness, blurry vision, and difficulty
breathing. She says that she had been at a
cocktail party when the symptoms began. Her
skin is notably flushed on physical examination.
Which of the following medications is
responsible for this reaction?

A. Acarbose
B. Glipizide
C. Glyburide
D. Metformin
E. Tolbutamide
F. Troglitazone
19. A 23-year-old man comes to the physician
because of intermittent severe headaches,
anxiety, and heart palpitations. While he has no
significant medical history, his uncle had similar
symptoms. When probed for a deeper family
history, he says that his mother and two cousins
have had their thyroids removed. Which of the
following conditions most likely accounts for the
clinical scenario?

A. Acromegaly
B. ACTH-secreting pituitary adenoma
C. Hyperparathyroidism
D. Nonfunctioning pituitary adenoma
E. Pheochromocytoma
20. A 65-year-old man with small cell lung cancer is
receiving treatment for ectopic production of
ADH. After beginning demeclocycline, he
produces large volumes of dilute urine and
drinks copious amounts of water. The patient is
instructed to not drink any fluid for a 12-hour
period. Despite the hold on fluids, the patient
continues to produce dilute urine. ADH levels
are increased, and serum hyperosmolarity and
hypernatremia are noted. Which of the following
is the most likely diagnosis?

A. Nephrogenic diabetes insipidus secondary to

demeclocycline treatment
B. Neurogenic diabetes insipidus secondary to
metastatic cancer
C. Primary hyperaldosteronism
D. Syndrome of inappropriate ADH secretion
E. Type 2 diabetes mellitus
21. A white, 5-year-old, thin boy is brought to the
physician complaining of recent weight loss ac-
companied by excessive hunger, thirst, and
urination. His urine is positive for high levels of
ketones and glucose. Which of following is the
most likely mechanism and associated findings
in this disease?

A. A deficiency of a brush border enzyme of the

intestinal mucosal cells, causing an inability to
break down all of the normally digested
carbohydrates.
B. An autoimmune process and an association with
human leukocyte antigens DR3 and DR4.
C. An autoimmune process associated with human
leukocyte antigen B27.
D. An increase in the body’s resistance to insulin;
association with obesity.
22. A 54-year-old man with a history of smoking
and lung cancer develops hypercalcemia. He is
enrolled in a research study to assess the
efficacy of a new synthetic agent to treat this
condition. After several days of treatment, he re-
ports persistent numbness and tingling around
his mouth. Physical examination is significant
for facial spasm when the jaw is tapped and
carpal spasm when the blood pressure cuff is
inflated. Which of the following was most likely
used to treat his hypercalcemia?

A. Calcitonin
B. Parathyroid hormone
C. Parathyroid hormone-related peptide
D. Thyroxine
E. Vitamin D
23. An 18-year-old woman is referred to a specialist
because her periods have stopped. She reports
occasional bouts of nausea, vomiting, and
generalized weakness. Her blood pressure is
160/99 mm Hg; laboratory studies show a
serum K+ level of 2.2 mEq/L. This patient
suffers from a condition that affects the
production of two of the three adrenal
hormones, leaving only one functioning
hormone. In which area of the adrenal gland is
this one hormone produced?

A. Capsule
B. Medulla
C. Zona fasciculata
D. Zona glomerulosa
E. Zona reticularis
24. A 22-year-old obese woman presents to her
gynecologist with amenorrhea and hirsutism.
Ultrasonography reveals polycystic ovaries.
Which of the following is a likely
pathophysiologic mechanism of this disorder?

A. Decreased estrogen
B. Decreased testosterone
C. Excess follicle-stimulating hormone
D. Excess luteinizing hormone
E. Excess progesterone
25. In the following graph of changes in endometrial
thickness during a normal 28-day menstrual
cycle, the event designated A corresponds most
closely of which of the following phases?





A. Early Proliferative
B. Menses
C. Mid-luteal phase
D. Ovulation
E. Secretory phase
26. A young couple has been trying to conceive a
baby. The medical director of the fertility center
has advised the woman to take her basal
temperature readings on a daily basis and for
them to have intercourse at the time the woman
appears to be ovulating Once conception takes
place, which of the following must occur in order
for the pregnancy to proceed uneventfully?

A. The corpus luteum must secrete

progesterone to sustain the endometrium.
B. The pituitary must secrete hCG to maintain
the corpus luteum.
C. The pituitary must secrete prolactin to
sustain the placenta.
D. The placenta must secrete FSH to maintain
ovarian function.
E. The placenta must secrete LH to maintain
ovarian function.
27. Which of the following results from the action of
parathyroid hormone (PTH) on the renal tubule?

A. Inhibition of 1α-hydroxylase Stimulation of Ca2+

reabsorption in the distal tubule
B. Stimulation of phosphate reabsorption in the
proximal tubule
C. Interaction with receptors on the luminal
membrane of the proximal tubular cells
D. Decreased urinary excretion of cyclic adenosine
monophosphate (cAMP)
28. Which step in steroid hormone biosynthesis
occurs in the accessory sex target tissues of the
male and is catalyzed by 5α-reductase?
A. Cholesterol →pregnenolone
B. Progesterone → 11-deoxycorticosterone
C. 17-Hydroxypregnenolone →
dehydroepiandrosterone
D. Testosterone → estradiol
E. Testosterone → dihydrotestosterone
29. Which of the following pancreatic secretions has
a receptor with four subunits, two of which have
tyrosine kinase activity?

A. Insulin
B. Glucagon
C. Somatostatin
D. Pancreatic lipase
30. A 16-year-old, seemingly normal female is
diagnosed with androgen insen- sitivity disorder.
She has never had a men- strual cycle and is
found to have a blind- ending vagina; no uterus,
cervix, or ovaries; a 46 XY genotype; and intra-
abdominal testes. Her serum testosterone is
elevated. Which of the following charac- teristics
is caused by lack of androgen receptors?

A. 46 XY genotype
B. Testes
C. Elevated serum testosterone
D. Lack of uterus and cervix
E. Lack of menstrual cycles
31. A 42-year-old woman with severe
pulmonary fibrosis is evaluated by her
physician and has the following
arterial blood gases: pH = 7.48, PaO2 =
55 mm Hg, and PaCO2 = 32 mm Hg. Which
statement best explains the observed value
of PaCO2?

A. The increased pH stimulates breathing via

peripheral chemoreceptors
B. The increased pH stimulates breathing via
central chemoreceptors
C. The decreased PaO2 inhibits breathing via
peripheral chemoreceptors
D. The decreased PaO2 stimulates breathing via
peripheral chemoreceptors
E. The decreased PaO2 stimulates breathing via
central chemoreceptors
32. In which vascular bed does hypoxia cause
vasoconstriction?

A. Coronary
B. Pulmonary
C. Cerebral
D. Muscle
E. Skin
33. An infant born prematurely in gestational
week 25 has neonatal respiratory distress
syndrome. Which of the following would be expected
in this infant?

A. Arterial PO2 of 100 mm Hg

B. Collapse of the small alveoli
C. Increased lung compliance
D. Normal breathing rate
E. Lecithin: sphingomyelin ratio of greater than 2:1
in amniotic fluid
34. Which of the following lung volumes
or capacities can be measured by
spirometry?

A. Functional residual capacity (FRC)

B. Physiologic dead space
C. Residual volume (RV)
D. Total lung capacity (TLC)
E. Vital capacity (VC)
35. When a person is standing, blood flow in
the lungs is:

A. equal at the apex and the base

B. highest at the apex owing to the effects of
gravity on arterial pressure
C. highest at the base because that is where the
difference between arterial and venous pressure
is greatest
D. lowest at the base because that is where
alveolar pressure is greater than arterial
pressure
36. A 35-year-old man has a vital capacity
(VC) of 5 L, a tidal volume (TV) of 0.5 L, an
inspiratory capacity of 3.5 L, and a functional
residual capacity (FRC) of 2.5 L. What is
his expiratory reserve volume (ERV)?

A. 4.5 L
B. 3.9 L
C. 3.6 L
D. 3.0 L
E. 2.5 L
F. 2.0 L
G. 1.5 L
37. Which of the following is the site of highest
airway resistance?

A. Trachea
B. Largest bronchi
C. Medium-sized bronchi
D. Smallest bronchi
E. Alveoli
37. If an area of the lung is not ventilated
because of bronchial obstruction, the pulmonary
capillary blood serving that area will
have a PO2 that is:

A. equal to atmospheric PO2

B. equal to mixed venous PO2
C. equal to normal systemic arterial PO2
D. higher than inspired PO2
E. lower than mixed venous PO2
38. In the transport of CO2 from the tissues
to the lungs, which of the following occurs in
venous blood?

A. Conversion of CO2 and H2O to H+ and

B. HCO3– in the red blood cells (RBCs)
C. Buffering of H+ by oxyhemoglobin
D. Shifting of HCO3– into the RBCs fromplasma in
exchange for Cl–
E. Binding of HCO3– to hemoglobin
F. Alkalinization of the RBCs
40. Which of the following causes of hypoxia
is characterized by a decreased arterial PO2
and an increased A–a gradient?

A. Hypoventilation
B. Right-to-left cardiac shunt
C. Anemia
D. Carbon monoxide poisoning
E. Ascent to high altitude
41. Which of the following changes occurs
during strenuous exercise?
A. Ventilation rate and O2 consumption increase to
the same extent
B. Systemic arterial PO2 decreases to about 70 mm
Hg
C. Systemic arterial PCO2 increases to about 60
mm Hg
D. Systemic venous PCO2 decreases to about 20
mm Hg
E. Pulmonary blood flow decreases at the expense
of systemic blood flow
42. The pH of venous blood is only slightly
more acidic than the pH of arterial blood
because?

A. CO2 is a weak base

B. there is no carbonic anhydrase in venous blood
the H+ generated from CO2 and H2O is buffered
by HCO3– in venous blood
C. the H+ generated from CO2 and H2O isbuffered
by deoxyhemoglobin in venous blood
D. Oxyhemoglobin is a better buffer for H+ than is
deoxyhemoglobin
43. Compared with the apex of the lung, the
base of the lung has

A. a higher pulmonary capillary PO2

B. a higher pulmonary capillary PCO2
C. a higher ventilation/perfusion (V/Q) ratio
D. the same V/Q ratio
44. A person with a ventilation/perfusion
(V/Q) defect has hypoxemia and is treated
with supplemental O2. The supplemental O2
will be most helpful if the person’s predominant
V/Q defect is

A. Dead space
B. Shunt
C. High V/Q
D. Low V/Q
E. V/Q = 0
45. Which person would be expected to have
the largest A–a gradient?

A. Person with pulmonary fibrosis

B. Person who is hypoventilating due to morphine
overdose
C. Person at 12,000 feet above sea level
D. Person with normal lungs breathing 50% O2
E. Person with normal lungs breathing 100% O2
46. A person’s ECG has no P wave but has a normal
QRS complex and a normal T wave. Where is his
pacemaker located?

A. SA node
B. AV node
C. Bundle of His
D. Purkinje fibers
47. The venrticles are completely depolarized during
which isoelectic portion of the ECG?

A. PR interval
B. QRS complex
C. QT interval
D. ST segment
E. T wave

48. In which of the following situations is pulmonary

blood flow greater than aortic blood flow?

A. Normal adult
B. Fetus
C. Left to right ventricular shunt
D. Right to left ventricular shunt
E. Right ventricular failure

49. The tendency for edema to occur will be

increased by:

A. Arteriolar constriction
B. Increased venous pressure
C. Increased plasma protein concentration
D. Muscular activity
50. In the SA and AV nodal cells, phase 0 of the action
potential is caused primarily by

A. Na+ influx through the slow Na+-channels (if

current)
B. Na+ influx through the fast Na+ channels (iNa
current)
C. K+ influx through the inward rectifier K+ channel
(iK1 current)
D. Ca++ influx through the slow Ca++ channels (iCa
current)
51. The strength of contraction of cardiac muscle depends
to a large extent on the availability of:
A. Magnesium ions
B. Potassium ions
C. Sodium Ions
D. Calcium ions

52. All of the following changes will result in edema

formation, EXCEPT:

A. Increased capillary pressure

B. Decreased plasma proteins
C. Lympathic vessel obstruction
D. Decreased capillary membrane permeability

53. Even a stronger than normal stimulus will not

cause a ventricular muscle to develop a propagated
action potential during the effective refractory
period because:

A. The slow Ca++ channels are completely open

B. The membrane’s permeability to K+ is increased
C. All the fast Na+ channels are in an inactivated
state
D. The Na+-K+ ATPase pump is already active

54. The mean arterial pressure of somebody with a

blood pressure of 180/90 mm Hg is approximately:

A. 110
B. 130
C. 100
D.120

55. Vasodilation of the arterioles results from which

of the following?

A. Inhibition of the parasympathetic nervous

system
B. Simultaneous stimulation of both the
sympathetic and parasympathetic nervous systems
C. Inhibition of the sympathetic nervous system.
D. Simultaneous inhibition of both the sympathetic
and parasympathetic nervous systems
56. Which of the following substances is released from
neurons in the GI tract and produces smooth muscle
relaxation?

A. Secretin
B. Gastrin
C. Cholecystokinin (CCK)
D. Vasoactive intestinal peptide (VIP)
E. Gastric inhibitory peptide (GIP)
57. Which of the following is the site of secretion of
intrinsic factor?

A. Gastric antrum
B. Gastric fundus
C. Duodenum
D. Ileum
E. Colon
58. Vibrio cholerae causes diarrhea because it
A. Increases HCO3¯ secretory channels in intestinal
epithelial cells
B. Increases Cl¯ secretory channels in crypt cells
C. Prevents the absorption of glucose and causes
water to be retained in the intestinal lumen
isomotically
D. Inhibits cyclic adenosine monophosphate (cAMP)
production in intestinal epithelial cells
E. Inhibits insoitol 1,4,5-triphosphate (IP3)
production in intestinal epithelial cells
59. Cholecystokinin (CCK) has some gastrin-like
properties because both CCK and gastrin

A. Are released from G cells in the stomach

B. Are released from I cells in the duodenum
C. Are members of the secretin-homologous family
D. Have 5 identical C-terminal amino acids
E. Have 90% homology of their amino acids
60. Which of the following is transported in intestinal
epithelial cells by a Na+- dependent cotransport
process?

A. Fatty acids
B. Triglycerides
C. Fructose
D. Alanine
E. Oligopeptides
61. A 49 year old male patient with severe Chron’s
disease has been unresponsive to drug therapy and
undergoes ileal resection. After the surgery, he will
have steatorrhea because

A. The liver bile acid pool increases

B. Chylomicrons do not form in the intestinal lumen
C. Micells do not form in the intestinal lumen
D. Dietary triglycerides cannot be digested
E. The pancreas do not secrete lipase
62. Cholecystokinin (CCK) inhibits:

A. Gastric emptying
B. Pancreatic HCO3¯ secretion
C. Pancreatic enzyme secretion
D. Contraction of the gallbladder
E. Relaxation of the sphincter of Oddi
63. Which of the following is the site of secretion of
gastrin?

A. Gastric antrum
B. Gastric fundus
C. Duodenum
D. Ileum
E. Colon
64. Micelle formation is necessary for the intestinal
absorption of

A. Glycerol
B. Galactose
C. Leucine
D. Bile Acids
E. Vitamin B12
F. Vitamin D
65. Which of the following is characteristic of saliva?

A. Hypotonicity relative to plasma

B. A lower HCO3¯ concentration than plasma
C. The presence of proteases
D. Secretion rate that is increased by vagotomy
E. Modification by the salivary ductal cells involves
reabsorption of K+ and HCO3
66. Slow waves in small intestinal smooth muscle cells
are

A. Action potentials
B. Phasic contractions
C. Tonic contractions
D. Oscillating resting membrane potentials
E. Oscillating release of cholecystokinin (CCK)
67. Which of the following substances must be further
digested before it can be absorbed by specific carriers
in intestinal cells?

A. Fructose
B. Sucrose
C. Alanine
D. Dipeptides
E. Tripeptides
68. A 24 year old male graduate student participates
in clinical research study on intestinal motility.
Peristalsis of the small intestine

A. Mixes the food blous

B. Is coordinated by the central nervous system
(CNS)
C. Involves contraction of circular smooth muscle
behind and in front of the food bolus
D. Involves contraction of circular smooth muscle
behind the food bolus and relaxation of the
circular smooth muscle in front of the bolus
E. Involves relaxation of circular and longitudinal
smooth muscle simultaneously throughout the small
intestine
69 Which of the following is the site of Na+-bile acid
cotransport?

A. Gastric antrum
B. Gastric fundus
C. Duodenum
D. Ileum
E. Colon
70. A 44 year old woman is diagnosed with Zollinger-
Ellison syndrome. Which of the following findings is
consistent with the diagnosis?

A. Decreased serum gastrin levels

B. Increased serum insulin levels
C. Increased absorption of dietary lipids
D. Decreased parietal cell mass
E. Peptic ulcer disease
72. Which part of the kidney is very sensitive to
changes in blood PO2?

A. Proximal tubule
B. Distal tubule
C. Interstitial Cells of the loop of Henle
D. Collecting duct
E. Macula Densa
73. An 83-year-old woman with a history of
hypertension presents to her family physician’s office
with oliguria. Serum creatinine and BUN are elevated
and a computed tomography (CT) reveals that the
patient’s left kidney is hypoplastic. Renal function
studies are performed to assess the renal handling of
various substances. Substance X is injected into an
arterial line. All of substance X appears in the urine
and none is detected in the renal vein. What do these
findings indicate about the renal handling of
substance X?

A. It must be filtered by the kidney.

B. It must be reabsorbed by the kidney.
C. Its clearance is equal to the GFR.
D. Its clearance is equal to the renal plasma flow
(RPF).
E. Its urinary concentration must be higher than its
plasma concentration.
74. Renin is a component of the RAAS system, which
the body uses to control blood pressure. Which of the
following will lead to an increase in the circulating
levels of renin in the blood?

A. Decreased renal sympathetic nerve activity

B. Increased blood pressure
C. Decreased NaCl delivery to the macula densa
D. All of the above
E. None of the above
75. The transport maximum of the proximal tubules
to
glucose is seen at what level?

A. 200 mg/dL
B. 250 mg/dL
C. 300 mg/dL
D. 350 mg/dL
E. 375 mg/dL
76. What nephron segment is the primary site of
magnesium reabsorption?

A. Proximal convoluted tubule 1st portion

B. Descending limb of henle.
C. Distal cortical collecting tubule
D. Ascending limb of henle
E. Proximal convoluted tubule straight portion
77. In which of the following nephron segments is the
tubular filtrate always hyperosmotic?

A. proximal tubule
B. descending loop of Henle
C. distal tubule
D. medullary collecting duct
78. In a patient with hypovolemic shock, what part of
the kidney is the most susceptible to hypoxia?

A. Collecting duct
B. Loop of henle, descending limb
C. Distal convoluted tubule
D. Proximal convoluted tubule
E. Loop of henle, ascending limb
79. Which of the following would cause an increase in
both glomerular filtration rate (GFR) and renal
plasma flow (RPF)?

A. Hyperproteinemia
B. A ureteral stone
C. Dilation of the afferent arteriole
D. Dilation of the efferent arteriole
E. Constriction of the efferent arteriole
80. Which of the following substances or
combinations of substances could be used to measure
interstitial fluid volume?

A. Mannitol
B. D2O alone
C. Evans blue
D. Inulin and D2O
E. Inulin and radioactive albumin
81. A man presents with hypertension and
hypokalemia. Measurement of his arterial blood gases
reveals a pH of 7.5 and a calculated HCO3 − of 32
mEq/L. His serum cortisol and urinary
vanillylmandelic acid (VMA) are normal, his serum
aldosterone is increased, and his plasma renin activity
is decreased. Which of the following is the most likely
cause of his hypertension?

A. Cushing syndrome
B. Cushing disease
C. Conn syndrome
D. Renal artery stenosis
E. Pheochromocytoma
82. A woman runs a marathon in 90°F weather and
replaces all volume lost in sweat by drinking distilled
water. After the marathon, she will have

A. decreased total body water (TBW)

B. decreased hematocrit
C. decreased intracellular fluid (ICF) volume
D. decreased plasma osmolarity
E. increased intracellular osmolarity
83. Which of the following is a cause of metabolic
alkalosis?

A. Diarrhea
B. Chronic renal failure
C. Ethylene glycol ingestion
D. Treatment with acetazolamide
E. Hyperaldosteronism
F. Salicylate poisoning
84. Secretion of K+ by the distal tubule will be
decreased by

A. metabolic alkalosis
B. a high-K+ diet
C. hyperaldosteronism
D. spironolactone administration
E. thiazide diuretic administration
85. A 45-year-old woman develops severe diarrhea
while on vacation. She has the following arterial blood
values:
pH = 7.25
PCO2 = 24 mm Hg
[HCO3−] = 10 mEq/L
Venous blood samples show decreased blood [K+]
and a normal anion gap. The correct diagnosis for this
patient is

A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis
E. normal acid–base status
85. Which part of the kidney is very sensitive to
changes in blood PO2?

A. Proximal tubule
B. Distal tubule
C. Interstitial Cells of the loop of Henle
D. Collecting duct
E. Macula Densa
86. A 66-year-old man with chronic hypertension is
treated with prazosin by his physician. The treatment
successfully decreases his blood pressure to within
the normal range. What is the mechanism of the drug’s
action?

A. Inhibition of β1 receptors in the sinoatrial (SA)

node
B. Inhibition of β2 receptors in the SA node
C. Stimulation of muscarinic receptors in the SA node
D. Stimulation of nicotinic receptors in the SA node
E. Inhibition of β1 receptors in ventricular muscle
F. Stimulation of β1 receptors in ventricular muscle
G. Inhibition of α1 receptors in ventricular muscle
H. Stimulation of α1 receptors in the SA node
I. Inhibition of α1 receptors in the SA node
J.Inhibition of α1 receptors on vascular smooth
muscle
K. Stimulation of α1 receptors on vascular smooth
muscle
L. Stimulation of α2 receptors on vascular smooth
muscle
87. Which of the following responses is mediated by
parasympathetic muscarinic receptors?

A. Dilation of bronchiolar smooth muscle

B. Miosis
C. Ejaculation
D. Constriction of gastrointestinal (GI) sphincters
E. Increased cardiac contractility
88. Which of the following is a property of C fibers?

A. Have the slowest conduction velocity of any

nerve fiber type
B. Have the largest diameter of any nerve fiber type
C. Are afferent nerves from muscle spindles
D. Are afferent nerves from Golgi tendon organs
E. Are preganglionic autonomic fibers
89. When compared with the cones of the retina, the
rods

A. are more sensitive to low-intensity light

B. adapt to darkness before the cones
C. are most highly concentrated on the fovea
D. are primarily involved in color vision
90. Which of the following statements best describes
the basilar membrane of the organ of Corti?

A. The apex responds better to low frequencies than

the base does
B. The base is wider than the apex
C. The base is more compliant than the apex
D. High frequencies produce maximal displacement
of the basilar membrane near the helicotrema
E. The apex is relatively stiff compared to the base

91. Which of the following is a feature of the

sympathetic, but not the parasympathetic nervous
system?
A. Ganglia located in the effector organs
B. Long preganglionic neurons
C. Preganglionic neurons release norepinephrine
D. Preganglionic neurons release acetylcholine
(ACh)
E. Preganglionic neurons originate in the
thoracolumbar spinal cord
F. Postganglionic neurons synapse on effector
organs
G. Postganglionic neurons release epinephrine
H. Postganglionic neurons release Ach
92. Cutting which structure on the left side causes
total blindness in the left eye?

A. Optic nerve
B. Optic chiasm
C. Optic tract
D. Geniculocalcarine tract
93. The excessive muscle tone produced in
decerebrate rigidity can be reversed by

A. stimulation of group Ia afferents

B. cutting the dorsal roots
C. transection of cerebellar connections to the
lateral vestibular nucleus
D. stimulation of α-motoneurons stimulation of γ-
motoneurons
94. Pathogens that produce fever cause

A. decreased production of interleukin-1 (IL-1)

B.decreased set-point temperature in the
hypothalamus
C. shivering
D. vasodilation of blood vessels in the skin
95. Which of the following statements about the
olfactory system is true?

A. The receptor cells are neurons

B. The receptor cells are sloughed off and are not
replaced
C. Axons of cranial nerve (CN) I are A-delta fibers
D. Axons from receptor cells synapse in the
prepiriform cortex
E. Fractures of the cribriform plate can cause inability
to detect ammonia
96. Which of the following would produce maximum
excitation of the hair cells in the right horizontal
semicircular canal?

A. Hyperpolarization of the hair cells

B. Bending the stereocilia away from the kinocilia
C. Rapid ascent in an elevator
D. Rotating the head to the right
97. Complete transection of the spinal cord at the level
of T1 would most likely result in

A. temporary loss of stretch reflexes below the lesion

B. temporary loss of conscious proprioception below
the lesion
C. permanent loss of voluntary control of movement
above the lesion
D. permanent loss of consciousness above the lesion
98. Sensory receptor potentials

A. are action potentials

B. always bring the membrane potential of a receptor
cell toward threshold
C. always bring the membrane potential of a receptor
cell away from threshold
D. are graded in size, depending on stimulus intensity
E. are all or none
99. Which reflex is responsible for polysynaptic
excitation of contralateral extensors?

A. Stretch reflex (myotatic)

B. Golgi tendon reflex (inverse myotatic)
C. Flexor withdrawal reflex
D. Subliminal occlusion reflex
100. Which of the following is a characteristic of
nuclear bag fibers?

A. They are one type of extrafusal muscle fiber

B. They detect dynamic changes in muscle length
C. They give rise to group Ib afferents
D. They are innervated by α-motoneurons