2013 physiology final!

1. At the hospital, you meet the patient with diagnosed aortic insuffienciency(blood flows backward), Which statement correctly characterized this pathology?(67)

   1. It increases aortic pulse and diastolic pressure

   2. In decreases aortic pulse and diastolic pressure

   3. It increases pulse pressure and decreases diastolic pressure

   4. It is similar to vasoconstriction in that it decreases pulse pressure and increases diastolic pressure.

   5. It is similar to vasodilation in that it decreases pulse pressure and increases diastolic pressure

1. A 16-year-old girl experiences fainting episodes before exams or in other stressful circumstances. Very probably reason of such symtoms is(46)

   1. Vasovagal syncope because of massive parasympathetic activation

   2. Vasovagal syncope being the effect of massive sympathetic activation

   3. Herring_breuer reflex

   4. Sudden increase of cardiac output

   5. Paroxysmal tachycardia being an effect of parasympathetic stimulation

2. The ph of a tubular fluid in the distal nephron can be lower than that in the proximal tubule, because? (47)

   1. A greater sodium gradient can be established across the wall of distal nephron than accross the wall in distal tubule

   2. The tight junction of the distal nephron are less leaky to solute than those in the proximal tubule

   3. More bugger is present in the tubular fluid of the distal nephron than in the proximal tubule

   4. More hydrogen ion is secreted in to the distal nephron than into the proximal tuble

   5. The brush border of distal nephron contains more carbonic anhydrase than that in the proximal tubule

3. A drug is administred to the a patient and found to have a no effect on his recalcification plasma clothing time or one-stage prothrobin time tub does increase his bleeding time. Which of the following statements is the most likely explanation of his action? This drug (48)

   1. Inhibits rouleau formation

   2. Inhibits fibrin polymerization

   3. Inhibits the action of thrombin

   4. Inhibits platelet aggregation

   5. Facilitates this activation of facto X

4. Which of the following statements best describes water and electrolytes in the GI tract?(49)

   1. Most water and electrolytes come from ingested fluids

   2. The small intestine and colon have similar water electrolyte absorptive capacities

   3. The majority of absorption of water and electrolytes occurs in the jejunum(real its in the ileum)

   4. Osmotic equilibration of chime occurs in stomach

   5. Water absorption is independent of NA+ absorption

5. Simple and facilitated diffusion are alike in that both (50)

   1. Can be blocked by specific inhibitors

   2. Display saturation kinetics

   3. Can transport material against concentration gradient

   4. Require some sort of carrier mechanism for transport

   5. Can work in the absence of ATP

6. Which of the following is least contributor to osmotic pressure of interstitial ***?(58)

   1. Albumin

   2. Sodium

   3. Glucose

   4. Chloride

   5. They all have comparable influence on this value

7. A 62-year old patient has been diagnosed with pulmonary fibrosis. Compared with a health person of the same age, his lungs would?(59)

   1. Have lower-elestic recoil

   2. Have greater airway resistance

   3. Be more compliant

   4. Be easier to diflate

   5. C and D

8. When excess amounts of carbohydrates are consumed, they are stored in the body as(60)

   1. Cholesterol

   2. Triglycerides

   3. Glucose

   4. Glycogen

   5. Proteins

9. Blood flow in vessels is laminar( occurs when a fluid flows in parallel layers, with no disruption between the layers), and(61)

   1. All layers flow with the same velocity

   2. The layer of blood adjacent to the vessel wall flows fastest (slowest)

   3. Is the reason of axial accumulation of RBCs…….

   4. Laminar flow never chan…….

   5. Is audible……..

10. Which organ has the biggest blood flow per 1 g of tissue/

    1. Kidney

    2. Brain

    3. ***

    4. Liver

11. D****-sparring (99)

12. (video) A patient was diagnosed to PTH…..

    1. Tonic-clonic contraction of muscles, fever and tackycardia

    2. Tetany and hyperphosphatemia

    3. Weakness, abdominal ache and muscle pulsy

    4. Bone demineralization and hyperphosphoturia

    5. Bone demineralization and hypercalcuria

69. Which of the listed respiratory volumes reaches the biggest value in one individual?

1. Tidal volume

2. Vital capacity

3. Resting minute ventilation

4. Maximal ventilation during heaving exercise

5. Maximal voluntary ventilation

70. Which plasma protein is synthesized in the liver and dedicated to transport iron in the blood?

1. Hemosiderin

2. Apoferritin

3. Apotransferrin

4. Ceruloplasmin

5. Lactoferrin

71. Which characteristic differs between thyroid and steroid hormones?

1. Type of membrane receptor

2. Amount stored in the body

3. The way of transport in plasma

4. Mechanism of action

5. Postsecretory modifications

72. A middle-age man suffers from severe viral hepatitis. In these circumstances, in his blood plasma w might expect to observe which of the following?

1. Hypertrombinemia

2. Hyperglobulinemia

3. Hyperalbuminemia

4. Hyperprotrombinemia

5. Hyperbilirubinemia

78. What happen when the ventilation perfusion ratio of a lung unit decreases?

1. Lower PN₂

2. Higher PO₂

3. Higher PCO₂

4. Higher PO₂ and lower PCO₂

5. Higher PN₂ and higher PO₂

79. A physician notes that when taking a patient’s blood pressure using a sphygmomanometer cuff, although the sound over the artery becomes muffled that a cuff pressure of 70 mmHg, it does not disappear as the cuff pressure returns to 0 mmHg. What conclusion is most likely drawn from these data? The patient

1. Has a diastolic pressure at or near 0 mmHg

2. Has a patent ductus arteriosus

3. Probably has a weakened heart

4. Has an aortic stenosis

5. Has a low hematocrit

80. Which of the following changes in the blood of the right atrium is most likely to be seen in anemia as compared with a healthy subject?

1. An increase in O₂ carrying capacity

2. An increase in O₂ content

3. A and B

4. A decrease in hemoglobin oxygen saturation

5. An increase in PO₂

81. A 36-year-old male patient with a recent head injury complains of polyuria and polydypsia. You suspect central diabetes insipidus. How could you confirm the diagnosis?

1. Restrict water intake and treat with unsulin and see if urinary volume is decreased

2. Restrict water intake and treat with arginine vasopressin (AVP) and see if urinary volume declines

3. Restrict water intake and treat with aniotensin II and see if urinary volume is decreased

4. Restrict water intake and treat with a loop diuretic to determine if urinary flow rates decrease

5. Compare urinary production rates following consumption of 3L of water and 3L of isotonic saline to determine whether they differ

82. Glucose in the cells is stored in the

Answer: Glycogen, because lower osomarlity

83 can’t see

84. Which organ has the biggest blood flow for 1g of tissue?

1. Kidney

2. Stomach

3. Brain

4. Liver

5. Heart

30. the following data were collected from a normal patient before an …

a. a high dietary intake of potassium

b. administration of loop diuretics…

c. administration of aldosterone …

d. administration of vasopressin …

e. transfusion of 2L isotonic….

41. in the course of so-called “crash syndrome” we are dealing with injury of skeletal muscle fibers. What changes in blood plasma composition might we expect?

a. HCO3- concentration > 35 mmol/L

b. K+ concentration > 4.5 mmol/L

c. Na+ concentration > 160 mmol/L

d. K+ concentration < 3.5 mmol/L

e. Cl- K+ concentration > 104 mmol/L

(The normal intracellular concentration of potassium is about 150 mM while theextracellular concentration is typically about 5 mM. Despite this large difference in)

42. amount of nitrogen excreted in urine

a. increases when a person changes diet 

b. is independent from the diet 

c. is lowest when a person is starving

d. is lowest when a person is on protein-free diet

e. does not influence the pH of the urine 

43. on the record from an experiment you may follow the potentials recorded from different parts of the isolated mammalian heart showing no spontaneous activity. Electrodes are inserted into the heart with identical distances between them. After applying the single electric stimulus on the SA node, the shortest time-lapse you should notice between recordings obtained from two consecutive electrodes

a. in the Purkinje fibers

b. in the ventricular myocardium

c. in the right and left atrium

d. between S-A node and atrial muscle 

e. between atrial muscle and A-V node

44. a middle-aged man demonstrates gradual coarsening of facial features and a progressive protrusion of the brows in the 2-decades period. Upon questioning the patient reports to change his shoes to the larger size than he used to wear as a young man. Which of the following pair of hormones normally regulates the hormone that is responsible for the described changes?

a. Dopamine and norepinephrine

b. LH and hCG

c. Prolactin and FSH

d. TSH and ACTH

e. Somatostatin and GHRH

45. in emphysema, there is an increase tendency of bronchioles to collapse during a forced expiration. This is due to 

a. decreased elasticivity of the lungs

b an increased elasticity of the lungs

c. a failure of bronchiolar chondroblasts

d. excessive tone in the …

e. ….

1. In a neonate (a newborn baby)

   1. The intrapleural pressure during inspiration is always more negative in normal than premature born bay

   2. Body weigh is unchanging for about a week

   3. The levels of circulating bilirubin are lower than in adults

   4. Sympathetic stimulation of brown fat metabolism plays a significant role in temperature regulation

   5. Active immunoprotection is provided by maternal immunoglobulins

2. Salutatory conduction in myelinated axons results from the fact that

   1. Salt concentration is increased beneath the myelin segments

   2. Nongated ion channels are present beneaththe segment of myelin(open, leakage)

   3. Capacitance is decreased at the nodes of Ranvier

   4. Membrane resistance is decreased beneath the segments of myelin

   5. Voltage-gated sodium channels are concentration at the nodes of Ranvier

3. Cardiac muscle cells

   1. Are highly dependent on glucose as a nutrient

   2. Are highly dependent on anerobic metabolism

   3. Are electrically isolated from one another

   4. Have prolonged action potentials partly because they demonstrate the voltage-activated Ca2+ current

   5. Are elongated, spindle-shape, striated single cells

4. In a monitored dog, 50mL of saline was rapidly injected into the carotid artery. What happended as the effect of this injection?(you will have increased right atrial pressure to the increased venous return)

   1. Increased in vasomotor sympathetic nerves activity

   2. Decreased stroke volume(Elevated afterload (commonly measured as the aortic pressure during systole) reduces stroke volume.)

   3. Reflex bradycardia

   4. Drop of coronary blood flow

   5. Increase in systemic resistsance

5. A 35 year old soldier after contusive injury of abdominal cavity without intraperitoneal bleeding is not defecating and has low blood pressure and dry mucosa. In such circumstance , you can suspect

   1. Extracellular fluid volume bigger than 30% of body mass

   2. Increase of transcellular body fluid because of GIT motility paralysis

   3. Decrease of intracellular fluid volume because of intestinal edema

   4. Stimulation of sympathetic nervous system decreasing heart rate and saliva production

   5. Sudden decrease of transcellular fluid because of water accumulation in the lumen of GIT

6. (#16 on test) which of the following statements

   1. Denervation of the small intestine (i.e. cutting of its vegetative and sensory nerve fibers) causes a disappearance of segmentation

   2. Stimulation of parasympathetic neurons increases the frequency of peristaltic waves in the small intestine

   3. A and B

   4. Denervation of the small intestine causes a disappeperance of peristalsis

   5. B and D

7. (#15 on test) patient of age 46 was diagnosed with stenosis of mitral valve. This results in reduction of the flow through this valve, as confirmed in the UKG examination…which of the following statements matches the consequences

   1. Left ventricular preload increases

   2. Left atrial pressure diminishes

   3. Right ventricular end-diastololic pressure decreases

   4. Central venous pressure decrease

   5. Exercise can induce acute pulmonary edema

8. (#14 on test) a 55-year-old lady with severe bilateral pneumonia reports subjective breath and in physical examination doctor finds acrocyanosis. The cause of the symptoms is

   1. Hyperventilation

   2. Decreased excitatbility of peripheral chemoreceptors as the consequence

   3. Thickening of the diffusion barrier because of inflammation

   4. Increased functional pulmonary shunt

   5. Inflammatory injury of the respiratory injury of the respiratory center

9. (#13 on test) in the kidney producing urine with an osmolality of 1200 mOsm//kg H20 the osmolality of fluid collected from the end of cortical duct is about

   1. 100 mOsm/kg H20

   2. 300 mOsm/kg H20

   3. 900 mOsm/kg H20

   4. 1200 mOsm/kg H20

10. (#12 on test) which of the following IS NOT an important ….mechanism for increasing the blood flow to activate skeletal muscle during exercise?….

    1. The action of metabolites on skeletal muslce

    2. An increased cardiac output

    3. An increased concentration of epinephrine in the vicinity of the blood vessels of active skeletal muscle

    4. An increased concentration of acetylcholine in the vicinity of the blood vessels of active skeletal muscle

    5. An increased concentration of norepinephrine in the vicinity of the blood vessels of active skeletal muscle

11. (#6) which of the following is

    1. Intact brain stem, where the barrington center is located

    2. Intact thoracic segments of spinal cord that controls the abdominal

    3. A and B

    4. Intact sacral segments of spinal cord

    5. At least 300 mL of urine in the urinary bladder

12. (#7) which of the following

    1. The secretion of saliva is essential for

    2. It is primary under hormonal control

    3. It is the only hypotonic gastrointestinal secretion

    4. It may promote decalcification of the teeth

    5. It is a basic solution that begins the digestive of protein in the mouth

13. (#8) six months after castration (removal of testes), an adult man will manifest

    1. Atrophy of the prostate gland

    2. A decreased secretion of LH

    3. Complete hair loss

    4. An increased pitch of the voice

    5. Breast enlargement

14. (9) antigen-presenting cells include all of the listed ones, EXCEPT

    1. Dendritic cells

    2. Macrophages

    3. Langerhans dendritic cells

    4. Langerhans islets cells

    5. B cells

15. (10) what is the most efficient method for the asthmatic to use during respiration

    1. Hyperventalation

    2. Higher respiratory rate and lower tidal volume than the healthy subject

    3. A respiratory rate and tidal volume comparable to that of a healthy

    4. Lower respiratory rate and higher tidal volume than the healthy subject

    5. A respiratory rate and tidal volume comparable to that of a person with a reduced lung compliance

16. (11) the highest blood flow per gram of …

    1. At the beginning of diastole

    2. When aortic flow is highest

    3. When aortic pressure is highest

    4. When left ventricular pressure is highest

    5. At the beginning of isovolumetric contraction

17. Increasing

    1. it activates neural mechanism that remove acid from the

    2. it makes hemoglobin a stronger acid

    3. it increases PO2 of the blood

    4. the increased muscle work of increase breathing generates more CO2

    5. it decreases PCO2 in the alveolar

18. which of the following hormones manifests action antagonist…

    1. Glucagon

    2. Growth hormone

    3. Thyroxin

    4. All

    5. None

19. If the venous return to the right atrium should …

    1. An increase in atrial and end-diastolic ventricular pressure with decreased stroke volume

    2. An increase in atrial volume and end-diastrolic ventricular pressure with increased stroke volume

    3. A decrease in atrial and end-diastrolic ventricular pressure with decrease contractility

    4. Bradycardia and cardiac shock

    5. Bradycardia and very low end-diastolic pressure of the right ventricle

20. The end-plate potential of

    1. A local reversal of charge originating at the end plate

    2. A reversal of charge originating at the end plate

    3. A local decrease

    4. A decrease of the negative value of….propagated throughout the cell

    5. A local decrease of the negative value … associated with little or not increase

21. Resection of the stomach was performed…

    1. Vitamin B12

    2. Vitamin B12

    3. Vitamin K

    4. Vitamin E

    5. None

22. (24) a 25 year old woman complains…weight gain over the past 6 months..physical examination revels…puffiness, a symmetrically…relaxation phase of deep…lower extremities. Which set…shown below would you expect

    1. Low serum thyroxine…

    2. ?

    3. ?

    4. ?

    5. ?

56. a patient was diagnosed to have PTH

a. ionic-clonic contractility

b. tetany and hyperphosphetemia

c. weakness, abdominal ache and …

d. bone demineralization and hyperphosphoturia

e. bone deminerzalization and hypercalcemia

57. which of the following LEAST contribute …..fluid?

a. sodium

b. glucose

c. Albumin

d. Chloride

e. they all have comparable influence on this

54. A student who passed PHYSIO exam drinks for 3 days and here urine flow increases from 1ml to 10ml which of the following have the highest clearance:

1. Creatinine

2. Sodium

3. Glucose

4. Urea

5. Phosphate