SEAT NUMBER: ……….… ROOM:..……………….

FAMILY NAME:………….....………………………….
This question paper must be returned.
OTHER NAMES:……..…….…………………..……..
Candidates are not permitted to remove any part
of it from the examination room.
STUDENT NUMBER:…..…….………..……………..

FORMAL EXAMINATION PERIOD: SESSION 1, JUNE 2019

Unit Code: BIOL376

Unit Name: Advanced Human Physiology

Duration of Exam
(including reading time if applicable):
3 hours plus 10 minutes reading time
Part A; 40 multiple choice questions
Total No. of Questions: Part B; 8 short answer questions
Part C; 8 short answer questions
Total No. of Pages
(including this cover sheet):
Ten (10)

GENERAL INSTRUCTIONS TO STUDENTS:

• Students are required to follow directions given by the Final Examination Supervisor and must refrain from communicating in any way with another student once they have entered
the final examination venue.
• Students may not write or mark the exam materials in any way during reading time.
• Students may only access authorised materials during this examination. A list of authorised material is available on this cover sheet.
• All watches must be removed and placed at the top of the exam desk and must remain there for the duration of the exam. All alarms, notifications and alerts must be switched off.
• Students are not permitted to leave the exam room during the first hour (excluding reading time) and during the last 15 minutes of the examination.
• If it is alleged you have breached these rules at any time during the examination, the matter may be reported to a University Discipline Committee for determination.

EXAMINATION INSTRUCTIONS:

Answer all three parts.

Part A: For each of the multiple choice questions select the letter (a, b, c, d or e) representing the one
correct answer and shade the corresponding oval on the Multiple Choice Answer Sheet with a 2 B pencil.
To correct a mistake, rub out the incorrect answer completely.
Each multiple choice question is worth 0.5% of the total mark.

Total marks for section A: 20

Parts B and C should be answered in separate books

Part B: Short answer questions.

There are eight (8) short answer questions
Answer four (4) out of the eight (8) questions
All questions are worth 5 marks each

Total mark for section B: 20

Part C: Short answer questions.

There are eight (8) short answer questions
Answer four (4) out of the eight (8) questions
All questions are worth 5 marks each

Total mark for part C: 20

Exam total: 60 marks

AIDS AND MATERIALS PERMITTED/NOT PERMITTED:

Dictionaries: No dictionaries permitted
Calculators: Non-programmable calculators that do not have text retrieval capacity permitted
Other: Closed book – No notes or textbooks permitted
 BIOL 376 Part A. Multiple Choice Questions

Marks will not be deducted for wrong answers. Suggested time 60 minutes.

1. Local control of blood flow

a. prevents vasoconstriction due to sympathetic input in exercising muscle.
b. depends on the action of the sympathetic nerves.
c. does not regulate blood flow to the brain.
d. depends on the action of hormones.
e. is the result of pressure natriuresis and diuresis.

2. Sympathetic nerves increase cardiac output by all but one of the following mechanisms.
a. increasing heart rate
b. increasing the strength of ventricular contraction
c. increasing uptake of Ca2+ by the sarcoplasmic reticulum
d. increasing Ca2+ concentration in ventricular muscle cells during contraction
e. increasing total peripheral resistance

3. Which statement concerning the effect of aldosterone on the late distal tubule and collecting
duct is correct? Adosterone
a. binds to a receptor on the basolateral membrane.
b. causes preformed Na+ channels to be inserted into the luminal membrane.
c. increases the reabsorption of K+.
d. acts on nuclear DNA to increase the production of Na+ and K+ channels.
e. inhibits the function of the Na+/K+ exchange pump

4. When blood pressure is low the physiological response would include a decrease in
a. sympathetic input to the kidney.
b. plasma levels of antidiuretic hormone (ADH).
c. plasma levels of renin.
d. plasma levels of aldosterone.
e. plasma levels of atrial natriuretic peptide (ANP).

5. Angiotensin converting enzyme (ACE) inhibitors increase

a. blood pressure.
b. the plasma angiotensin II concentration.
c. the excretion of sodium and water.
d. systemic vasoconstriction.
e. atherosclerosis.

6. The greatest risk factor for death due to cardiovascular disease is

a. high blood pressure.
b. high blood cholesterol levels.
c. diet rich in saturated fats
d. high body mass index (BMI).
e. low physical activity.

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7. In exercising muscle which system provides ATP most rapidly?
a. anaerobic glycolysis
b. mitochondrial respiration
c. conversion of ADP to ATP by phosphocreatine
d. oxidation of free fatty acids
e. glycogenolysis

8. Under anaerobic conditions pyruvate the end product of glycolysis is converted to

a. glucose-6-phosphate.
b. acetyl coA.
c. lactate.
d. free fatty acids.
e. ketones.

9. Type 1 muscle fibres

a. contract quickly.
b. use mainly anaerobic glycolysis for ATP production.
c. fatigue quickly.
d. are describes as white fibres.
e. have high mitochondrial and capillary density

10. During intense whole body exercise there can be a fivefold increase in cardiac output. Almost all
of the extra blood flows through the exercising muscle because of
a. vasodilation of the arterioles in the exercising muscle.
b. vasoconstriction of the arterioles in the abdominal organs including the intestine and
kidney.
c. resetting of the baroreceptors to see a higher blood pressure as normal.
d. activation of the muscle pump.
e. Both a and b are true.

11. Blood flow to the muscle increases as soon as exercise commences due to feed forward
regulation. Which of the following are capable of feed forward control of blood flow?
a. local control
b. central command
c. metaboreceptor reflex
d. baroreceptor reflex
e. mechanoreceptor reflex

12. If they were all at the same concentration which of these would have the highest buffering
capacity in urine with a pH of 5.0?
a. NH4+ (pKa = 9.2)
b. HPO42- (pKa = 6.8).
c. urate (pKa = 5.8),
d. creatinine (pKa = 5)
e. beta-hydroxybutyrate (a ketone; pKa = 4.5)

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13. In the acid base balance practical, a normal subject with a urinary pH of 7.5 drank 400 mL of
9.35 mmol ammonium chloride (NH4Cl). Which one of the following changes in the urine did
drinking NH4Cl produce?
a. pH was increased.
b. Urine flow rate fell.
c. Excretion of buffer bound H+ (titratable buffers) was reduced.
d. Bicarbonate excretion rate was very low.
e. The rate of excretion of free H+ ions was greater than that of buffer bound H+.

14. If a person had an arterial pH of 7.31, HCO3- concentration of 16 mM and a pCO2 of 33 mmHg
you would describe their acid base state as
a. respiratory acidosis.
b. metabolic acidosis.
c. respiratory alkalosis.
d. metabolic alkalosis.
e. in acid base balance.

15. Patient Y has a PCO2 of 25 mmHg and a plasma bicarbonate concentration of 16 mmol/L. What
is his/her arterial pH?
a. 7.75
b. 7.56
c. 7.49
d. 7.43
e. 7.36

16. Which one of the following hormones is derived from tyrosine and described as a
catecholamine?
a. somatomedin
b. adrenaline
c. insulin
d. thyroid hormone T3
e. insulin-like growth factor

17. Which one of the following hormones travels in the blood attached to a binding protein?
a. somatomedin
b. adrenaline
c. insulin
d. thyroid hormone T3
e. insulin-like growth factor

18. Which one of the following opens Ca2+ channels in the sarcoplasmic/endoplasmic reticulum?
a. IP3 (inositol triphosphate)
b. phospholipase C
c. PIP2 (phosphatidylinositol-4,5-bisphosphate)
d. DAG (diacylglycerol)
e. calmodulin

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19. The ability of the Na+/K+ exchange pumps of muscle cells to import K+ from the extra cellular
solution (ECF) is increased by all but one of the following.
a. high plasma levels of K+ in the ECF
b. insulin
c. adrenaline
d. aldosterone
e. angiotensin II

20. When K+ levels in the diet are high, the kidney excretes the extra K+ without altering the rate of
Na+ excretion by
a. increased reabsorption of K+ in the proximal tubule.
b. a higher rate of conversion of angiotensin II to aldosterone.
c. stimulation of the NCC transporter (Na+ Cl- cotransport) in the luminal membrane of the
distal tubule.
d. fewer ENaC and ROMK channels in the luminal membrane of the distal tubule and
collecting duct.
e. regulation of Na+ and K+ transport in the proximal tubule by the WNKs system.

21. Appropriate levels of activated vitamin D3 in the plasma do not depend upon
a. sunlight on the skin.
b. presence of vitamin D binding protein.
c. parathyroid hormone (PTH).
d. calcitonin
e. conversion to the active form by an enzyme in the kidneys.

22. Which one of the following decreases the levels of free Ca2+ in the plasma?
a. high PTH concentration in the plasma
b. high levels of activated vitamin D3 in the plasma
c. increased Ca2+ reabsorption in the kidney
d. increased phosphate concentration in the plasma
e. activation of osteoclasts by RANKL

23. Calcitonin
a. is very important in fish but has no role in humans.
b. is produced in the parafollicluar cells of the parathyroid gland.
c. limits demineralization of bone in lactating mothers.
d. stimulates resorption of Ca2+ from the mother’s bone to provide Ca2+ for breast milk.
e. is essential in humans for the production of the mineral component of bone

24. Which one of the following statements about growth hormone is true?
a. The release of growth hormone releasing hormone (GRH) is stimulated by high plasma
glucose levels.
b. GRH is released directly into the capillaries of the anterior pituitary.
c. Growth hormone (GH) is produced in the liver.
d. GRH is a tropic hormone but GH is not.
e. GH causes the release of insulin-like growth factors (somatomedins) from the liver.

5
25. The corpus luteum
a. contains the ovum (oocyte).
b. produces oestrogen and progesterone.
c. produces nutrients required by the ovum to develop.
d. degenerates as soon as ovulation occurs.
e. increases the secretion of gonadotropin releasing hormone by positive feedback to the
hypothalamus.

26. Which of the following inhibits the release of insulin?

a. adrenaline
b. acetylcholine
c. plasma glucose levels greater than 5.6 mM
d. increased levels of fatty acids and certain amino acids in the plasma
e. peptide hormones produced in the small intestine (the incretins)

27. Insulin causes the rapid removal of excess plasma glucose following a meal by acting on liver
cells to perform all but one of these functions.
a. increasing glucose uptake by the liver cells
b. increased glycolysis
c. increased glycogen production
d. increased production of triglycerides from glucose
e. storage of triglycerides in the liver

28. Gluconeogenesis
a. is the conversion of free fatty acids to ketone bodies.
b. is the conversion of free fatty acids to glucose.
c. is the breakdown of glycogen to glucose.
d. occurs in the adipose cells.
e. provides glucose for the brain during fasting.

29. Which one of the following is not considered to be a stress hormone?

a. insulin
b. cortisol
c. adrenaline
d. growth hormone
e. glucagon

30. An important function of cortisol is

a. the rapid initiation of the fight or flight response.
b. to increase the number of cells of the immune system in the blood.
c. to enhance the activity of insulin.
d. to break down energy stores and transfer the resulting nutrients from cells to the plasma.
e. to increase the uptake of plasma glucose by muscle cells.

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31. A high body mass index (BMI) increases the risk of developing several chronic diseases. Which
one of the following is most closely associated with high BMI?
a. type 2 diabetes
b. gall stones
c. hypertension
d. coronary heart disease
e. obstructive sleep apnea

32. When cell ATP levels are low, AMP-activated protein kinase (AMPK) acts to decrease
a. glucose uptake by cells.
b. glycogen synthesis.
c. glycolysis.
d. fatty acid uptake by cells.
e. the breakdown of triglycerides to produce free fatty acids (lipolysis).

33. Increasing levels of ………………………… act on cells in the hypothalamus to increase appetite.
a. leptin
b. insulin
c. cholecystokinin (CCK)
d. PYY
e. ghrelin

34. Melanocyte stimulating hormone (α-MSH)

a. is produced from the agouti related peptide (AgRP).
b. activates orexigenic neurones in the lateral hypothalamus.
c. binds to melanocortin receptors (MCR3 and MCR4) in the paraventricular nucleus (PVN) of
the hypothalamus.
d. causes the release of orexins.
e. is released when body energy levels are low.

35. In the reward system, the area in the hypothalamus that receives the majority of the
dopaminergic neurons from the ventral tegmental area (VTA) is the
a. orbitofrontal cortex
b. amygdala
c. hippocampus
d. arcuate nucleus
e. nucleus accumbens

36. The sensations caused when we eat (e.g., smell, taste) and our emotional memory related to a
particular food are both important in determining the reward value of a particular food. Which
nucleus in the limbic system is associated with emotional memory?
a. ventral tegmental area
b. nucleus accumbens
c. amygdala
d. hippocampus
e. orbitofrontal cortex

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37. Which statement concerning the Fat Mass and Obesity Associated Gene Region (FTO) is correct.
Changes in a single nucleotide in the FTO increases the likelihood of
a. morbid obesity.
b. a moderate increase in BMI.
c. an inability to produce leptin.
d. an inability to produce melanocortin receptor (MC4R).
e. an increase in the number of beige fat cells.

38. Lactase persistence into adulthood

a. was the natural state before domestication of animals for milk production.
b. provided an increased chance of surviving to adulthood when milk from domesticated
animals was available.
c. is particularly prevalent among Asian communities.
d. allows for lactose digestion/fermentation by the bacteria of the large intestine.
e. increase the production of hydrogen in the body.

39. Which statement concerning protein in the diet is incorrect?

a. High protein diets are not sustainable because protein production uses more resources
than the other macronutrients.
b. High protein diets have been shown to cause kidney disease.
c. Protein contributes ~14% of the energy in the normal western diet.
d. Low protein levels in the foods that make up the diet will tend to increase the total energy
consumption.
e. Energy expenditure due to digestion and utilization of protein is greater than for fats or
carbohydrates.

40. Which of the following statements about the microbiome is incorrect?

a. The number of different bacterial phyla and species differs between individuals.
b. The variety of our bacterial phyla has decrease compared to that of our hunter-gather
ancestors
c. Obese individuals have a higher number of bacteria in the Fermicutes phyla and a lower
number of the Bacteriodetes phyla compared to lean individuals.
d. The kjoules (mainly in the form of fatty acids) transferred from the gut biome to the blood
stream varies between individuals.
e. The composition of an individual’s microbiome depends on diet, genetics, BMI and
antibiotic use.

8
 Part B. Short Answer Questions
Four (4) of the following eight (8) questions must be answered. Suggested time 60 minutes. Point
form and diagrams are accepted.

1. Explain the short term control of blood pressure in a resting individual and also during exercise.
What are the main differences in blood pressure control in these two different situations?

2. If a normal individual adopts a salt (NaCl) free diet, their blood pressure will fall but will be
returned to normal over the next few days.
a. Give the reason for the initial fall in blood pressure.
b. Explain how the interaction of the RAAS system and pressure natriuresis/diuresis
returns their blood pressure to normal.

3. Discuss the possible causes and consequences of essential hypertension.

4. Both aerobic and anaerobic metabolic processes supply exercising muscle with ATP and the
contribution of each depends on the intensity and duration of the exercise.
a. Describe the anaerobic processes of ATP production.
b. Describe the aerobic processes of ATP production.
c. Give the rates and endurance of ATP production of each process.

5. if a normal human subject was to drink 400 mL of a solution of ammonium chloride (as in the
acid/base balance practical)
a. What would be the initial effect of the ammonium chloride on the pH of their
extracellular fluid?
b. Why would the ammonium chloride have this effect?
c. How would the kidney return the pH and composition of the extracellular fluid back to
normal over the next three hours?

6. Concerning a patient who has had an overdose of heroin that has inhibited breathing
a. Give normal ranges of the values of the partial pressure of carbon dioxide, the
bicarbonate concentration and pH in the arterial blood.
b. Using the Henderson Hasselbalch equation, explain how inhibited breathing would
cause a change the arterial pH.
c. How would you describe this change?
d. Using the same equation, explain how the body would minimise the change in pH while
the breathing is still inhibited (compensation).
e. How could you return the acid/base balance in this patient to normal (correction). Give
three alternative measures.

7. Describe the role of hormones, the skin, the digestive system, the kidney and the bones in
maintaining normal plasma calcium level.

8. The plasma potassium concentration is held in a very narrow range. How is this achieved during
and immediately after a meal and in the long term.

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 Part C. Short Answer Questions

Four (4) of the following eight (8) questions must be answered. Suggested time 60 minutes.
Point form and diagrams are accepted

1. Explain how hormones act on the liver, skeletal muscle and adipose tissue to maintain normal
blood glucose levels between meals.

2. Describe the mechanism of release of cortisol into the plasma, the function of cortisol in the
response to stress, and the consequences of the long-term use of high doses of cortisol-based
pharmaceuticals.

3. Homeostatic control of appetite and energy usage is mediated by neuronal systems that
originate in the arcuate nucleus (first order neurons) that connect with the second order neurons
in the hypothalamus (paraventricular nucleus and lateral hypothalamus). Describe how these
systems function to control appetite and energy balance.

4. Chose three different hormones involved the homeostatic control of appetite and energy usage
and describe the
a. factors that cause the release of each hormone.
b. release site of each hormone.
c. target cells of each hormone.
d. function of each hormone.

5. Name the areas in the brain that are part of the mesocorticolimbic dopaminergic system and
explain their functions in reward-driven eating.

6. Compare the contributions of monogenetic effects (silencing of a single gene) and polygenetic
effects (combined effects of many small variations in the genome) on the observed increase in
BMI in the community.

7. Explain what is meant by the protein leverage hypothesis and describe two studies using humans
that support this hypothesis.

8. Health in adulthood can be influenced by low birth weight due to epigenetic changes that occur
in the developing foetus. Discuss.

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