PHYSIOLOGY FINAL EXAMS

JULY 8, 2020

Which of the following constitutes the molecular basis for the axonal action potential? *
Na efflux followed by K influx
K influx followed by Na efflux
K efflux followed by Na influx
Na influx followed by K efflux

Which of the following is true regarding the function of cell organelles? *

RER is the site of protein synthesis
SER is the site of lipid synthesis
The Golgi apparatus is the site of post-translational modification
The mitochondrion is the site of ATP synthesis
All of the above

Which of the following nitrogenous bases are found in both DNA and RNA? *
Adenine
Thymine
Uracil
All of the above

Which of the following is the major cation of the extracellular fluid compartment? *
Bicarbonate
Chloride
Potassium
Sodium

Which of the following is a shared characteristic of simple diffusion and facilitated

diffusion? *
Dependent on concentration gradient
Exhibits substrate specificity
Dependent on ATP concentration
Exhibits saturation kinetics

An athlete is doing bicep curls as part of his weight training. He is lifting a 10-kg free
weight from full elbow extension to full elbow flexion. Which of the following is present
in this isotonic contraction? *
Active tension
Active shortening
Afterload
All of the above
In contrast to a chemical synapse, an electrical synapse is characterized by which of
the following features? *
Transmitter substance
Vesicular fusion
Bi-directional flow
Synaptic delay

Smooth muscle contraction is initiated by increased intracellular calcium in response

to: *
Autonomic nerves
Hormones
Local factors
All of the above

The following are true regarding cross-bridge cycling in skeletal muscle, EXCEPT: *
Chemical energy is converted to mechanical action in the power stroke
Initiated by the influx of extracellular calcium via voltage-gated calcium channels
ATP is necessary to break the cross-link between actin and myosin
Results in the sliding of actin and myosin filaments past one another

Muscular tetany results from which of the following conditions? *

Summing up of forces from multiple fibers
Prolongation of refractory period of the motor neuron action potential
Accumulation of intracellular free calcium
Recruitment of motor units

Which of the following will induce umami taste? *

Sucrose
Acids
Sodium
Glutamate

Total blindness of the left eye will result from cutting which of the following
structures? *
Left optic nerve
Left geniculocalcarine tract
Left optic tract
Optic chiasm

Which of the following sensations is transmitted by the anterolateral spinothalamic

system? *
Propioception
Pain
Fine touch
All of the above

Which of the following is true regarding the olfactory receptor cell? *

A neuron
Axon forms C.N. I
Ciliated
All of the above

Which hearing test uses a tuning fork to compare the bone conduction of the patient
with that of a normal subject? *
Audiometry
Rinne
Weber
Schwabach

What type of EEG wave is common to both the awake, attentive state and REM
sleep? *
Delta
Theta
Beta
Alpha

Which of the following statements is true regarding the basal ganglia pathway? *
Dopamine is excitatory on the direct pathway
Dopamine is excitatory on the indirect pathway
The indirect pathway is overall excitatory
All of the above

What spinal tract carries information for fine, skilled movements of the distal limbs? *
Lateral corticospinal tract
Reticulospinal tract
Anterior corticospinal tract
Vestibulospinal tract

In the patellar tendon reflex, the contraction of the quadriceps femoris is initiated by
stimulation of which reflex arc component? *
Golgi tendon organ
Alpha motor neuron
Dorsal root ganglion
Muscle spindle

Which of the following is true regarding the parasympathetic nervous system? *

Ganglion contains adrenergic receptors
Post-ganglionic nerve axon is long
Effector organ contains muscarinic receptors
Pre-ganglionic nerve axon is short

Which of the following is the greatest contributor to the resistance to blood flow in a
normal, healthy individual? *
Radius of the capillaries
Radius of the veins
Radius of the arterioles
Radius of the aorta

In the diagram below, which segment corresponds to ventricular depolarization? *

C
A
D
B

A 20 y/o male is actively bleeding at the scene of a vehicular accident. Initial vital
signs were BP: 100/70 and HR: 80 bpm. When paramedics arrive 20 minutes later, the
vital signs observed were BP: 70/50 and HR: 140 bpm. Which of the following is
expected to occur in response to this situation? *
Decrease in sympathetic output to JG apparatus
Decrease in sodium and water excretion
Decrease in secretion of vasopressin
Decrease in arteriolar resistance

Regarding the ventricular action potential, which of the following matched pairs is
CORRECT? *
Phase 4: Closure of Cl channels
Phase 1 : Na influx via fast channels
Phase 2 : K efflux via ungated channels
Phase 3 : Closure of K slow channels
Which of the following events is associated with closure of the AV valves? *
End of ventricular filling phase
Start of isovolumetric contraction
S1
All of the above
A and B only

The following are true regarding active immunity, EXCEPT: *

Induced after exposure to foreign antigens
Acquired by receiving preformed antibodies from another host
Slow onset
Long-lasting protection

If a patient has type O blood, what type of blood can he receive without risk of a
transfusion reaction? *
A
B
AB
O
All of the above

Which of the following will cause the hemoglobin-oxygen dissociation curve to shift to
the right? *
Increase in PCO2
Increase in 2,3-DPG
Increase in temperature
All of the above

T helper cells recognize antigens attached to which type of MHC protein? *

Class II
Class III
Class I
Class IV

Which of the following represents an immature form of RBC? *

Granulocyte
Reticulocyte
Megakaryocyte
Plasma cell

Which of the following statements is true regarding caisson disease (the bends)? *
Results from slow, chronic decompression
Associated with nitrogen emboli in the blood stream and tissues
Requires prolonged breathing of high-pressure oxygen
Best prevented by a rapid, precipitous ascent

The migration of neutrophils from the blood to the inflamed tissue involves the
following steps in which correct sequence? *
Margination  rolling  migration diapedesis
Rolling  margination  diapedesis  migration
Margination  migration  rolling  diapedesis
Rolling diapedesis  margination  migration

Which energy system is most likely in use during a 100-meter dash? *

Anaerobic glycolysis
Aerobic glycolysis
ATP-PC System
β-oxidation

Which type of immunoglobulin is associated with the primary response of humoral

immunity? *
IgE
IgM
IgG
IgA

The following clotting factors require vitamin K-dependent ϒ-carboxylation, EXCEPT: *

VII
VIII
IX
X

Which of the following cell types secrete surfactant? *

Type III pneumocytes
Type II pneumocytes
Type I pneumocytes
Type IV pneumocytes

Which lung volume/capacity is defined as the maximum amount of air that can be
maximally expelled after a maximum inspiration? *
Inspiratory capacity
Tidal volume
Residual volume
Vital capacity

Which muscle acts as the major muscle of inspiration? *

Serratus anterior
Diaphragm
Intercostals
Rectus abdominis

Which of the following respiratory centers is primarily responsible for stimulating

inspiration during normal quiet breathing? *
Ventral medullary group
Apneustic center
Pneumotaxic center
Dorsal medullary group

Which of the following conditions is consistent with a V/Q below normal? *

Physiologic dead space
Dissociation shift
Physiologic shunt
Decreased DLCO

Which of the following would tend to increase the GFR? *

Increase in renal blood flow
Increase in Bowman’s capsule hydrostatic pressure
Vasoconstriction of afferent arteriole
Increase in glomerular capillary oncotic pressure

The following processes are functions of the kidneys, EXCEPT: *

Erythrocyte destruction
Hormone secretion
Water and electrolyte balance
Waste excretion

Which of the following parameters is used as the index of renal function? *

Filtered load of glucose
Glomerular filtration rate
PAH clearance
Renal plasma flow

Which segment of the nephron is responsible for the reabsorption of most of the
filtered sodium and water? *
Medullary collecting ducts
Distal convoluted tubule
Proximal tubule
Thick ascending loop of Henle

Which of the following mechanisms creates the conditions necessary to produce

concentrated urine? *
Autoregulation
Macula densa feedback
Countercurrent multiplier
Tubuloglomerular feedback

Which component of the nephron is most sensitive to changes in the NaCl

concentration? *
Afferent arteriole
Podocytes
Glomerulus
Macula densa

Which of the following is true regarding the renal control of acid-base balance? *
The loop of Henle serves as the primary site for H+ reabsorption
In chronic acidosis, a new HCO3 is generated and added to the blood for each NH4 excreted
In metabolic alkalosis, the kidneys provide the major compensatory measures to correct the pH
The kidneys regulate ECF H+ through reabsorption of H+ and secretion of HCO3

Which diagram corresponds to the gain of hypotonic fluid in a patient with SIADH? *

D
A
C
B

A 20 y/0 female came into the ER anxious and distraught. Vital signs are as follows:
BP 120/80, PR 90 bpm, RR 30 breaths/min, Temperture 37 C. Arterial blood gas was
requested, and results are as follows: pH: 7.45, HCO3: 20 mEq/L, PCO2: 35 mmHg.
What is the most likely acid-base disorder? *
Respiratory acidosis with renal compensation
Respiratory alkalosis with renal compensation
Metabolic alkalosis with respiratory compensation
Metabolic acidosis with respiratory compensation

Which figure below demonstrates the diffusion of water resulting in the dilution of the
ICF? *

A
B
C
None of the above

Which of the following factors is true regarding the concentration of ions in the saliva
during maximal salivation? *
The concentration of chloride ions is one tenth its concentration in plasma
The concentration of sodium ions is one seventh its concentration in plasma
The concentration of potassium ions is four times that of plasma
The concentration of bicarbonate ions is 2 to 3 times that of plasma

A mother calls the pediatrician because she is concerned that her infant defecates
after every meal. Which of the following reflexes casuses this normal bowel movement
in a newborn? *
Gastrocolic reflex
Defecation reflex
Peristaltic rushes
Gastroileal reflex
Intestino-intestinal reflex

Which of the following conditions may result from the elimination of pancreatic
secretions in the small intestine? *
A. Fat malabsorption
B. Ulceration of the duodenum
C. Increased gastric emptying
All of the above
A and B only

Which of the following factors does NOT influence the rate of gastric emptying? *
Carbohydrate in gastric contents
Acidity of chyme entering the duodenum
Osmolarity of duodenal contents
Distention of the duodenum

Which of the following structures is critical in determining whether a bolus of food is

small enough to be swallowed? *
Upper esophageal sphincter
Palatopharyngeal folds
Epiglottis
Soft palate
Larynx

Which of the following initiates the defecation reflex? *

Distention of the rectal wall
Contraction of internal anal sphincter
Stimulation of sympathetic nerves
Inhibition of parasympathetic nerves
Presence of chyme in the cecum

Most of the energy for strenuous exercise that lasts for more than 5-10 seconds but
less than 1-2 minutes comes from which of the following sources? *
ATP
Oxidation of carbohydrates
Conversion of lactic acid to pyruvic acid
Oxidation of lactic acid
Anaerobic glycolysis

A student ate a heavy meal before taking an exam. Around 30 minutes after eating,
the student felt a strong urge to defecate but managed to hold it until the end of the
examination. This is possible because of which of the following events? *
Relaxation of internal anal sphincter, contraction of external anal sphincter, contraction of rectum
Relaxation of internal anal sphincter, relaxation of external anal sphincter, relaxation of rectum
Contraction of internal anal sphincter, contraction of external anal sphincter, contraction of rectum
Contraction of internal anal sphincter, relaxation of external anal sphincter, relaxation of rectum

A 69-year-old woman has a 30-year history of alcoholism and was previously

diagnosed with liver disease, She is currently at her physician's clinic due to swelling
in the abdomen. Which of the following, if increased, will most likely cause ascites? *
Hepatic vein pressure
Portal vein pressure
Plasma albumin concentration
Hepatic artery pressure
Hydrostatic pressure of peritoneal fluid

Which of the following reflexes refers to the complete cessation of intestinal motility
that may be caused by large distention of the intestines, by injury to the intestinal wall,
or by various intestinal bacterial infections? *
Peristaltic rush
Gastrocolic reflex
Intestino-intestinal reflex
Gastroileal reflex
Defecation reflex

In the summer, a man decided to swim in his pool. The water temperature was 105 F
at noon time. Which of the following heat loss mechanisms is effective for this man? *
Conduction
Convection
Evaporation
Radiation
None of the above

Which of the following statements is true regarding bilirubin formation and excretion? *
Bilirubin is phagocytized by tissue macrophages
Urobilinogen is oxidized to stercobilin in the urine
Biliverdin is formed within the macrophages
Conjugated bilirubin combines with plasma albumin in plasma

Which of the following mechanisms causes heat loss from a normal person when the
environmental temperature is 106 degrees Fahrenheit and the relative humidity is less
than 10%? *
Conduction
Radiation
Evaporation
Convection
Which of the following is correct regarding the functions of the liver in fat
metabolism? *
Synthesis of large quantities of cholesterol, phospholipids, and most lipoproteins
Synthesis of carbohydrates from fats
Oxidation of amino acids to supply energy for body functions
All of the above

Which of the following accounts for the largest component of daily energy expenditure
in a sedentary individual? *
Maintaining body posture
Basal metabolic rate
Thermic effect of food
Non-shivering thermogenesis

Which of the following is true regarding animal protein and vegetable/grain protein? *
Partial proteins do not necessarily increase the daily protein requirement
Vegetable/grain sources provide adequate quantities of essential amino acids and are sufficient
sources of the proteins needed by the body
Proteins sourced from animal foodstuffs are complete proteins
Both animal and vegetable proteins are sufficient sources for the protein requirements of the
body

Which of the following hypothalamic structures serves as the satiety center of the
body? *
Arcuate nuclei
Ventromedial nuclei
Lateral nuclei
Paraventricular nuclei

True or false: Body mass index is a very good estimate of adiposity, as it takes into
account the large muscle mass of certain individuals. *
False
True

True or false: Both carbohydrates and fats act as "protein sparers" primarily during
starvation. *
True
False

Which of the following mechanisms contributes to the short-term regulation of food

intake? *
Blood glucose concentration
Gastrointestinal filling
Feedback signals from the adipose tissue
Temperature regulation

A lesion in which of the following structures causes voracious eating that leads to
obesity? *
Ventrolateral nuclei
Dorsomedial nuclei
Arcuate nuclei
Ventromedial nuclei

Which of the following vitamins is part of the coenzyme that operates as a hydrogen
carrier in oxidative activities in mitochondria? *
Thiamine
Cobalamin
Riboflavin
Niacin

71. Leptin decreases fat storage by which of the following mechanisms? *

Increasing NPY and AGRP
Decreasing insulin secretion
Inhibiting the release of α-MSH
Decreasing CRH

Which of the following conditions result from ascorbic acid deficiency? *

A. Failure of wound healing
B. Failure of ovum maturation
C. Cessation of bone growth
A and B
A and C

Which of the following vitamins is a component of Coenzyme A? *

Pantothenic acid
Pyridoxine
Niacin
Ascorbic acid

Which of the following chemical messengers are secreted by cells into the ECF and
affect neighboring target cells of a different type? *
Cytokines
Neurotransmitters
Endocrine hormones
Paracrines

Which of the following hormones is a 191-amino acid protein with a pulsatile secretion
that may be influenced by ghrelin levels in the circulation? *
Growth hormone
Thyroid hormones
Luteinizing hormone
Prolactin

Which of the following refers to the feedback control of hormone secretion that
prevents over-secretion of a hormone or its overactivity at the target tissue, thus
ensuring the proper level of hormone activity at the target tissue? *
Positive feedback
Negative feedback
Both
Neither

The following statements on the mechanism of action of hormones are correct,

EXCEPT: *
Cells that lack receptors for the hormones do not respond
The first step of a hormone’s action is to bind to specific receptors at the target cell
The binding of a hormone to its receptor initiates a cascade of cellular reactions
Specific hormone receptors are located only on the cell membrane of the target cells

Which of the following structures acts as the functional link between the hypothalamus
and the pituitary gland and is the site from which hypothalamic regulatory hormones
are released? *
Hypophyseal vein
Hypophyseal artery
Hypothalamic neurons
Median eminence

Page 18

Which of the following is a manifestation of hypothyroidism that involves fluid retention

due to deposition of increased quantities of hyaluronic acid and chondroitin sulfate in
the interstitial spaces? *
Cretinism
Myxedema
Pitting edema
All of the above

Which of the following is the only anterior pituitary hormone that does NOT exert its
main effects by stimulating target glands? *
Luteinizing hormone
Adrenocorticotropic hormone
Growth hormone
Thyroid hormones
Which of the following is the thyroid hormone with the greatest metabolic activity but
with much smaller plasma concentrations? *
Diiodotyrosine
Triiodothyronine
Thyroxine
Monoiodotyrosine

Which of the following is the most abundant mineral ion in the body and plays a key
role in many physiological processes including bone formation and turnover, neuronal
cell excitability, muscle contractility, and blood clotting? *
Potassium
Calcium
Sodium
Magnesium

Which of the following is the most active metabolite of Vitamin D? *

Ergocalciferol
Cholecalciferol
25-Dihydroxyvitamin D
1,25-Dihydroxyvitamin D

Page 19

Which of the following are cells break down the bone matrix (bone absorption) and
release calcium and phosphorous into the blood stream? *
A. Osteoclasts
B. Osteoblasts
C. Osteocytes
A and B

Which of the following confirms the diagnosis of diabetes mellitus (DM)? *

Random blood sugar of > 126mg/dl
2-hour oral glucose tolerance test of > 126 mg/dl
Fasting blood glucose of > 126 mg/dl
Fasting blood glucose of > 200mg/dl

Which of the following is the most important regulator of the extracellular calcium
concentration? *
Calmodulin
Parathyroid hormone
Vitamin D
Calcitonin
Which of the following proteins is secreted in equimolar amounts with insulin and is
measured to determine how much natural insulin is produced by DM patients treated
with exogenous insulin? *
Glucagon
Amylin
C-peptide
Pancreatic polypeptide

What is the renal threshold for glucose? *

200 mg/dl
140 mg/dl
180 mg/dl
160 mg/dl

Page 20

Which of the following is the primordia of the fallopian tubes, uterus, and upper two-
thirds of the vagina? *
Wolffian duct
Mullerian duct
Germ cell
Mesonephric duct

Up to how many weeks of gestation do male and female fetuses display identical
reproductive tracts consisting of bilateral Wolffian and Mullerian ducts and of neutral
external genitalia? *
8 weeks
12 weeks
6 weeks
10 weeks

Which layer of the adrenal cortex secretes dehydroepiandrosterone, androstenedione,

small amounts of estrogen, and glucocorticoids? *
Zona glomerulosa
Zona fasciculata
Zona reticularis
Medulla

Which of the following is the most potent mineralocorticoid that accounts for about
90% of all mineralocorticoid activity? *
Aldosterone
Deoxycorticosterone
Cortisol
Corticosterone

Which of the following refers to the process in which the primordial gonad is
committed to development as either a testis or an ovary? *
Gonadal sex
Sex determination
Sex identification
Sex differentiation