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Physiology grand quiz

Total questions: 200

Worksheet time: 2hrs 45mins

Name
Class
Date
1.

The term "glycocalyx" refers to:

a)

The negatively charged carbohydrate chains that protrude into the cytosol

b)

The negatively charged carbohydrate layer on the outer cell surface

c)

The layer of anions aligned on the cytosolic surface

d)

The large glycogen stores in fast muscles

e)

A mechanism of cell-cell attachment

2.

Messenger RNA (mRNA):

a)

Carries the genetic code to the cytoplasm

b)

Carries activated amino acids to ribosomes

c)

Is single-stranded RNA that regulates transcription

d)

Forms ribosomes

3.

Which of the following is true for both pinocytosis and phagocytosis?

a)

Involves actin filaments

b)

Occurs spontaneously

c)

Vesicles fuse with ribosomes

d)

Only in macrophages and neutrophils

e)

Does not require ATP

4.

Variation in protein expression reflects:

a)

DNA differences

b)

Gene number variation

c)

Cell-specific gene regulation

d)

Chromosome number differences

e)

Cell age

5.

MicroRNAs (miRNAs):

a)

Formed in cytoplasm and repress mRNA

b)

Processed in cytoplasm by dicer

c)

Double-stranded RNAs

d)

Repress transcription

6.

Deficiency in acid lipase A is linked to which organelle?

a)

Nucleolus

b)

Golgi apparatus

c)

Peroxisomes

d)

Endosomes

e)

Lysosomes

7.

α-mannosidase II mutation affects which organelle?

a)

Agranular ER

b)

Lysosomes

c)

Peroxisomes

d)

Nucleus

e)

Golgi apparatus

8.

Immune role of glycoproteins is linked to:

a)

Microtubules

b)

Cytosol

c)

Endosomes

d)

Lysosomes

e)

Glycocalyx

9.

Protein packaging occurs in the:

a)

Lysosomes

b)

Peroxisomes

c)

Endosomes

d)

Golgi apparatus

e)

Cytosol

10.

Gene transcription takes place in the:

a)

Golgi apparatus

b)

Endoplasmic reticulum

c)

Nucleus

d)

Cytosol

e)

Mitochondria

11.

Genetic code redundancy occurs during:

a)

DNA replication

b)

Transcription

c)

Post-transcriptional modification

d)

Translation

e)

Glycosylation

12.

Not directly involved in transcription:

a)

Helicase

b)

RNA polymerase

c)

Chain-terminating sequence

d)

Activated RNA

e)

Promoter

13.

Product of a proto-oncogene:

a)

Growth factor receptor

b)

Cytoskeletal protein

c)

Na+ channel

d)

Ca++-ATPase

e)

Myosin light chain

14.

Not part of mitosis:

a)

Chromosome condensation

b)

Genome replication

c)

Nuclear envelope fragmentation

d)

Chromatid alignment

e)

Chromatid separation

15.

Cholesterol affects membrane:

a)

Thickness

b)

Ion permeability

c)

Fluidity

d)

Glycosylation

e)

Hydrophobicity

16.

Unique feature of eukaryotic cells:

a)

DNA

b)

RNA

c)

Membranes

d)

Protein

e)

Nucleus

17.

Feedback gain with correction of 25 mmHg and error 25 mmHg:

a)

−1.0

b)

−2.0

c)

0.0

d)

+1.0

e)

+2.0

18.

Equilibrium potential for Cl⁻ (11 inside / 110 outside):

a)

0 mV

b)

122 mV

c)

−61 mV

d)

61 mV

e)

−122 mV

19.

Which solution is hyperosmotic to 1 mM NaCl?

a)

1 mM CaCl₂

b)

1 mM glucose

c)

1 mM KCl

d)

1 mM sucrose

e)

1.5 mM glucose

20.

A 25-year-old man with blood loss of 800 ml has a MAP of 65 mmHg. Which plasma change triggers the greatest chemoreceptor activation?

a)

Increased O₂

b)

Increased pH

c)

Increased HCO₃⁻

d)

Increased CO₂

e)

Decreased glucose

21.

Which vessel change increases lymph flow?

a)

Increased plasma colloid osmotic pressure

b)

Increased arteriolar resistance

c)

Increased hydraulic conductivity

d)

Decreased capillary hydrostatic pressure

e)

A and C

22.

Main determinant of skeletal muscle blood flow under normal physiology:

a)

Sympathetic tone

b)

Vasopressin

c)

Angiotensin II

d)

Metabolic needs

e)

Capillary osmotic pressure

23.

Major contributor to plasma colloid osmotic pressure:

a)

NaCl

b)

Glucose

c)

Albumin

d)

Cholesterol

e)

K⁺

24.

What increases most in skeletal muscle during exercise?

a)

Vascular conductance

b)

CO₂

c)

Blood flow

d)

Arteriolar diameter

e)

All of the above

25.

Which vessel has the highest resistance (given flow and pressure gradient)?

a)

1000 mL/min, 100 mmHg

b)

1200 mL/min, 60 mmHg

c)

1400 mL/min, 20 mmHg

d)

1600 mL/min, 80 mmHg

e)

1800 mL/min, 40 mmHg

26.

Most effective stimulus for angiogenesis in a tumor:

a)

Growth hormone

b)

Glucose deficiency

c)

Angiostatin

d)

VEGF

e)

Tissue O₂ reduction

27.

A 35-year-old woman has aortic regurgitation. Expected change?

a)

↑ diastolic pressure, ↓ systolic pressure

b)

↓ pulse pressure

c)

↑ end-diastolic volume

d)

↓ stroke volume

e)

↑ ejection fraction

28.

What happens when you stand from supine?

a)

↓ HR, ↓ TPR

b)

↑ HR, ↓ TPR

c)

↑ HR, ↑ TPR

d)

↓ HR, ↑ TPR

e)

No change

29.

What change increases mean systemic filling pressure (MSFP)?

a)

Venous dilation

b)

↓ blood volume

c)

↑ sympathetic stimulation

30.

What change increases mean systemic filling pressure (MSFP)?

a)

Venous dilation

b)

↓ blood volume

c)

↑ sympathetic stimulation

d)

AV shunt

e)

Arterial dilation

31.

What causes a left shift in cardiac output curve?

a)

Positive-pressure ventilation

b)

Exercise

c)

Cardiac tamponade

d)

Hyperthyroidism

e)

Blood transfusion

32.

What elevates the plateau of the cardiac output curve?

a)

Sympathetic stimulation

b)

Vagal stimulation

c)

Cardiac tamponade

d)

Open chest

e)

Severe anemia

33.

What most decreases venous return?

a)

Increased venous compliance

b)

Increased blood volume

c)

Decreased venous pressure

d)

Sympathetic activation

e)

Vasoconstriction

34.

What causes coronary vasodilation?

a)

Bradykinin

b)

NO

c)

Histamine

d)

Adenosine

e)

CO₂

35.

Increased extracellular K⁺ in ischemia leads to:

a)

Hyperpolarization

b)

Decreased arrhythmia risk

c)

↓ contractility

d)

↑ excitability and fibrillation risk

e)

No effect

36.

What happens to pulmonary vascular resistance with low alveolar PO₂?

a)

Decreases

b)

No change

c)

Increases

d)

Increases then decreases

e)

Becomes zero

37.

What part of the lung gets more blood during upright posture?

a)

Apex

b)

Base

c)

Equally distributed

d)

Left lung

e)

Right lung

38.

Main controller of coronary blood flow:

a)

O₂ tension

b)

NO

c)

Sympathetic tone

d)

Adenosine

e)

Histamine

39.

Which structure generates basic respiratory rhythm?

a)

Apneustic center

b)

Pneumotaxic center

c)

Dorsal respiratory group

d)

Ventral respiratory group

e)

Hypoglossal nucleus

40.

A patient breathes into a paper bag. What drives increased ventilation?

a)

Increased O₂

b)

Decreased PCO₂

c)

Decreased pH

d)

Increased PCO₂

e)

Increased HCO₃⁻

41.

A 26-year-old with RER of 0.8 transports how much gas (ml/100 ml blood)?

a)

5 O₂, 4 CO₂

b)

4 O₂, 4 CO₂

c)

5 O₂, 3 CO₂

d)

5 O₂, 5 CO₂

e)

6 O₂, 3 CO₂

42.

Compared to arterial RBCs, venous RBCs have:

a)

↓ chloride, ↓ volume

b)

↓ chloride, ↑ volume

c)

↑ chloride, ↑ volume

d)

No change in either

43.

What limits inspiration and increases RR?

a)

Apneustic center

b)

Dorsal respiratory group

c)

Nucleus tractus solitarius

d)

Pneumotaxic center

e)

Ventral respiratory group

44.

Ventral respiratory group neurons become active when:

a)

Quiet breathing begins

b)

Respiratory drive increases above normal

c)

Sleep starts

d)

CO₂ decreases

45.

Hering-Breuer reflex limits:

a)

Lung inflation; receptors in alveoli

b)

Inspiration; stretch receptors in bronchi

c)

Expiration; pulmonary capillaries

46.

Rebreathing into a paper bag increases ventilation due to:

a)

↑ Alveolar PO₂

b)

↑ Alveolar PCO₂

c)

↓ Arterial PCO₂

d)

↑ pH

47.

What occurs with CO inhalation?

a)

Large change in PO₂

b)

↑ RR via chemoreceptors

c)

No change in PCO₂

d)

No change in PO₂ but oxygen delivery impaired

48.

Ventilation vs PCO₂ curve from 35-75 mm Hg is best represented by:

a)

Linear

b)

Logarithmic

c)

Steep exponential

49.

Which diagram shows response to acute PO₂ change (0-160 mmHg)?

4 lines
50.

Which curve shows fetal hemoglobin vs adult?

(a)  

51.

A person with anemia uses 12 ml O₂/dL blood. What is mixed venous PO₂?

a)

0 mmHg

b)

10 mmHg

c)

20 mmHg

d)

40 mmHg

e)

100 mmHg

52.

Main CO₂ transport in blood is via:

a)

Dissolved

b)

Bicarbonate

c)

Carbamino compounds

53.

Which has the lowest osmolarity in diabetes insipidus?

a)

Proximal tubule

b)

Loop of Henle

c)

Early distal tubule

d)

Collecting duct

54.

What stimulates thirst most?

a)

↑ Plasma glucose

b)

↓ Plasma volume

c)

↑ Angiotensin II

d)

↑ Plasma osmolarity

55.

A loop diuretic would:

a)

↓ Na⁺ reabsorption in PCT

b)

↓ Na⁺ reabsorption in thick ascending limb

c)

↓ Na⁺ in collecting duct

56.

Syndrome of inappropriate ADH leads to:

a)

Hypernatremia

b)

Normal serum osmolarity

c)

↓ Plasma osmolarity, ↑ urine osmolarity

57.

Renal artery stenosis in a single kidney causes:

a)

↑ Renin

b)

↓ Renin

c)

Normal BP

58.

Maximum expiratory effort is independent in:

a)

TLC

b)

RV

c)

Descending part of flow-volume curve

59.

In obstructive disease, MEFV curve shows:

a)

Shift left, "scooped" curve

b)

Shift right, steep curve

c)

↓ FVC, ↑ flow

60.

A woman with aortic stenosis shows:

a)

↑ Systolic pressure

b)

↓ Ejection fraction

c)

↑ LV pressure, ↓ stroke volume

61.

A patient visits his dentist, who notices a sore on the patient’s lip. There is no pain or drainage. Later, the patient is admitted with a violent shaking chill. Labs: Hct 30%, platelets 400,000/μl, WBC 4200/μl, 68% lymphocytes, 20% neutrophils. What is the diagnosis?

a)

A mild, nontreatable infection

b)

Agranulocytosis

c)

Aplastic anemia

d)

Acute leukemia

62.

A 9-year-old girl gets nasal discharge and itchy eyes every spring. An allergist performs a grass pollen skin test; she develops a red swollen spot. What is the most likely cause of this reaction?

a)

Antigen–antibody complexes in blood vessels

b)

Neutrophil activation

c)

Activation of CD4 helper cells → antibody generation

d)

Activation of cytotoxic T cells

63.

A 62-year-old female has itching in her hands, headaches, vertigo. CBC: RBCs 8.2 million/μl, WBCs 37,000/μl, platelets 640,000/μl. Low erythropoietin. What is the diagnosis?

a)

Thrombocytopenia

b)

Relative polycythemia

c)

Secondary polycythemia

d)

Polycythemia vera

e)

Myeloid leukemia

64.

A 40-year-old woman recently treated for infection presents with fatigue. Labs: RBC 1.8M/μl, Hb 5.2 g/dL, Hct 15%, WBC 7.6K/μl, platelets 320K/μl, MCV 92 fL, reticulocytes 24%. Most likely diagnosis?

a)

Aplastic anemia

b)

Hemolytic anemia

c)

Hereditary spherocytosis

d)

B12 deficiency

65.

A 34-year-old man with schizophrenia refuses vegetables for a year. Labs: Hb 9.1, MCV 122, normal WBC. Likely diagnosis?

a)

Acute blood loss

b)

Sickle cell

c)

Aplastic anemia

d)

Hemolytic anemia

e)

Folic acid deficiency

66.

A 24-year-old African-American man presents with back/chest pain while skiing. Hb 11, WBC 22,000, reticulocyte 25%. What is the diagnosis?

a)

Acute blood loss

b)

Sickle cell anemia

c)

Anemia of chronic disease

d)

End-stage renal disease

67.

A 62-year-old man with red complexion and splenomegaly. Labs: Hct 58%, WBC 13,300, platelets 600K, O₂ saturation 97%. Treatment of choice?

a)

Chemotherapy

b)

Phlebotomy

c)

Iron supplement

d)

Inhaled oxygen therapy

68.

An 82-year-old woman with abdominal pain and stool blood is on NSAIDs. Endoscopy shows patchy gastritis. H. pylori negative. What lab response would be lower than expected?

a)

Duodenal mucosal growth

b)

Gastric acid secretion

c)

Gastrin secretion

d)

Pancreatic enzyme secretion

e)

Pancreatic growth

69.

A 68-year-old woman with hematemesis and ulcer has H. pylori infection. What damages the mucosa?

a)

Ammonium

b)

Bile salts

c)

Gastrin

d)

NSAIDs

e)

Pepsin

70.

A 65-year-old man experiences cardiopulmonary arrest. Arterial blood shows: • pH = 7.12 • PCO₂ = 60 mmHg • HCO₃⁻ = 19 mEq/L. What is the acid-base disorder?

a)

Respiratory acidosis with partial renal compensation

b)

Metabolic acidosis with partial respiratory compensation

c)

Mixed acidosis (metabolic + respiratory)

d)

Mixed alkalosis

71.

A 54-year-old man collapses on a hot summer day with 106°F fever and HR 160 bpm. Which of the following physiological changes is most likely in this man?

a)

Vasoconstriction, ↓ CO, ↓ sweating

b)

Vasodilation, ↑ HR, ↑ sweating

c)

↓ Vasodilation, ↑ BP, ↓ TPR

d)

Vasoconstriction, ↑ catecholamines, ↓ sweating

e)

↓ HR, ↑ vagal tone, ↑ blood pressure

72.

A 26-year-old develops glomerulonephritis. GFR drops by 50%. Which substance will increase most in plasma concentration?

a)

Glucose

b)

K⁺

c)

Phosphate

d)

H⁺

e)

Creatinine

73.

A patient on sodium bicarbonate for acidosis sees a pH increase to 7.34 and drop in ionized calcium from 2.8 to 2.3 mmol/L. What explains the calcium drop?

a)

Parathyroid inhibition

b)

Osteoblast activation

c)

↑ binding of Ca²⁺ to albumin due to alkalosis

d)

Loss of bone calcium

74.

A 22-year-old man has lost 700 mL of blood (BP = 90/55 mmHg). What plasma change activates the chemoreceptor reflex the most?

a)

↓ PO₂

b)

↑ PCO₂

c)

↓ pH

d)

↓ HCO₃⁻

e)

↓ glucose

75.

A 20-year-old woman has no menstrual cycles. Progesterone is minimal. Explanation?

a)

↑ LH secretion

b)

No corpus luteum present

c)

↑ inhibin levels

d)

↓ FSH

e)

Early menopause

76.

A woman in 3rd trimester experiences RUQ pain post-meal. Normal bilirubin and WBC. Most likely diagnosis?

a)

Hepatitis

b)

Pancreatitis

c)

Constipation

d)

Peritonitis

e)

Cholelithiasis

77.

A 10-year-old boy with type 1 diabetes has glucose = 300 mg/dL. What changes are expected?

a)

↑ filtered load of glucose, ↑ water excretion

b)

↓ GFR, ↓ insulin

c)

↓ osmolarity, ↓ plasma volume

d)

Normal tubular glucose reabsorption

78.

A patient with Conn’s syndrome (↑ aldosterone). Which changes are expected?

a)

↑ Na⁺ reabsorption, ↑ K⁺ secretion, metabolic alkalosis

b)

↑ Na⁺ reabsorption, ↓ plasma volume, acidosis

c)

↓ Na⁺, ↑ K⁺, normal pH

d)

↑ aldosterone, ↓ Na⁺ reabsorption, hyperkalemia

79.

A patient with severe diarrhea. What fluid replacement is best?

a)

Plasma

b)

Pure water

c)

Balanced electrolyte solution

d)

Glucose-only IV

e)

Bicarbonate solution

80.

A 25-year-old man loses ~800 ml of blood in a farm accident. MAP is 65 mmHg. Which change in plasma concentration triggers the greatest chemoreceptor activation?

a)

↓ O₂

b)

↓ Glucose

c)

↓ pH

d)

↑ CO₂

81.

A 50-year-old hypertensive man complains of fatigue and cramps. Labs show primary hyperaldosteronism. What is expected?

a)

↓ Aldosterone, ↑ Plasma K⁺

b)

↑ Aldosterone, ↑ Na⁺ reabsorption, ↓ K⁺

c)

↓ Aldosterone, ↑ K⁺ secretion

d)

Normal aldosterone, ↑ urine Na⁺

82.

A woman delivers a newborn diagnosed with patent ductus arteriosus. What hemodynamic changes occur in this newborn?

4 lines
83.

A medical student constricts the carotid artery in a physiology experiment. Which reflex is triggered?

a)

↓ HR, ↓ SNS

b)

↓ BP, ↑ renin

c)

↑ SNS, ↑ HR, ↑ TPR

d)

↓ vagal tone

84.

A patient has renal artery stenosis post-transplant; GFR falls to 25%. What happens to creatinine levels?

a)

Halved

b)

Doubled

c)

Tripled

d)

Quadrupled

85.

A hypertensive patient is diagnosed with a renin-secreting tumor. What hormonal change is expected?

a)

↓ Renin, ↑ Aldosterone

b)

↑ Renin, ↓ ANP

c)

↑ Renin, ↑ Aldosterone, ↑ BP

d)

Normal renin, ↑ Angiotensin II

86.

A man is given compound X (causes ↓ metabolic rate, ↑ thyroid size). What is compound X?

a)

TSH

b)

T4

c)

Placebo

d)

TRH

87.

A woman has aortic stenosis. What change is expected?

a)

↑ Systolic pressure

b)

↓ Aortic pressure, ↑ LV pressure

c)

↓ Ejection fraction

d)

↑ Stroke volume

88.

A man collapses in summer with fever 106°F and HR 160. What is the most likely physiologic change?

a)

Vasoconstriction, ↓ CO

b)

Vasodilation, ↑ HR, ↑ sweating

c)

↓ TPR, ↓ BP, ↓ sweating

89.

A patient has nephrogenic diabetes insipidus. What is the osmolarity pattern?

a)

↑ Plasma osmolarity, ↑ urine flow

b)

↓ Plasma osmolarity, ↑ ADH

c)

↑ Plasma volume, ↑ ADH

90.

A man is on a low sodium diet. Expected plasma aldosterone levels?

a)

Decreased

b)

Normal

c)

Increased

d)

Fluctuating

91.

A person has Conn’s syndrome. What electrolyte change is expected?

a)

↑ Na⁺, ↓ K⁺

b)

↓ Na⁺, ↑ K⁺

c)

Normal Na⁺, ↓ Aldosterone

92.

A man is infused with 3% NaCl. What fluid compartment changes occur?

a)

↑ ECF, ↓ ICF, ↑ total body water

b)

↑ ECF, ↑ ICF, ↑ total

c)

↓ ECF, ↑ ICF

93.

A patient with acute renal failure due to mushroom poisoning. What is most likely?

a)

Metabolic alkalosis

b)

↓ plasma K⁺

c)

↓ BUN

d)

Metabolic acidosis

94.

A woman suffers blood loss in a car crash. Labs show hypotension and low hematocrit. Immediate compensation involves:

a)

↓ Renin

b)

↑ Sympathetic tone

c)

↓ Vasopressin

d)

↑ Vagal output

95.

A man has plasma osmolarity of 295 mOsm/kg and low urine output. What hormonal profile is expected?

a)

↑ ADH

b)

↓ ADH

c)

↑ Aldosterone

d)

↓ Renin

96.

A woman’s capillary pressures are: Pcap = 25 mmHg, πcap = 25, πint = 10, Pint = –5. What is net filtration rate if Kf = 10 ml/min/mmHg?

a)

0

b)

50 ml/min

c)

100 ml/min

d)

150 ml/min

97.

A young woman has moderate aortic regurgitation. Which changes are expected?

a)

↑ Systolic BP, ↓ Diastolic BP

b)

↓ End-diastolic volume

c)

↓ Stroke volume

d)

↓ Pulse pressure

98.

A 35-year-old woman has aortic stenosis. Which cardiac change occurs?

a)

↑ Stroke volume

b)

↑ Left ventricular pressure

c)

↑ Ejection fraction

d)

↓ End-diastolic volume

99.

A drug constricts arterioles in skeletal muscle. What change follows?

a)

↓ Resistance

b)

↑ Capillary pressure

c)

↓ Blood flow

100.

A premature baby presents with respiratory distress. What is the most likely cause of stiff lungs?

a)

Decreased alveolar surface area

b)

Decreased airway diameter

c)

Increased surface tension

d)

Increased surfactant production

101.

A 22-year-old man loses 700 mL blood. Which compensatory changes are expected?

a)

↓ HR, ↓ TPR, ↓ renin

b)

↑ HR, ↑ TPR, ↑ renin

c)

↓ HR, ↑ TPR, ↓ renin

d)

↑ HR, ↓ TPR, ↑ renin

102.

A man runs in hot weather and drinks only water. Final plasma state?

a)

↑ Plasma osmolarity

b)

↓ Plasma osmolarity

c)

Normal osmolarity

d)

Hypernatremia

103.

A newborn with Hirschsprung disease has constipation. Where is the obstruction?

a)

Ascending colon

b)

Transverse colon

c)

Descending colon

d)

Sigmoid colon

104.

A patient with hyperaldosteronism is evaluated. Expected findings?

a)

Hypotension, hyperkalemia

b)

Hypertension, hypokalemia, hypernatremia

c)

Hypertension, hyperkalemia

d)

Hypotension, hyponatremia

105.

A woman eats and later feels urge to defecate. Which reflex is activated?

a)

Enterogastric

b)

Gastroileal

c)

Gastrocolic

d)

Intestino-intestinal

106.

A woman with ulcers is diagnosed with H. pylori. Which is the best target for treatment?

a)

Gastrin receptor

b)

Ammonium transport

c)

Proton pump

d)

Somatostatin

107.

A patient breathes into a paper bag. Which stimulates ventilation?

a)

Decreased PO₂

b)

Increased PCO₂

c)

Increased HCO₃⁻

d)

Decreased temperature

108.

Patient with CO poisoning has normal PO₂. What causes low O₂ delivery?

a)

Hb not saturated with O₂

b)

Low HCO₃⁻

c)

Inhibited mitochondria

d)

Low pulmonary compliance

109.

A diabetic with glucose = 400 mg/dL and GFR = 150 ml/min. Approximate glucose excretion rate?

a)

50 mg/min

b)

100 mg/min

c)

175 mg/min

d)

225 mg/min

110.

A patient has cystic fibrosis. Which ion transport is impaired?

a)

Na⁺

b)

K⁺

c)

Cl⁻

d)

Ca²⁺

111.

Newborn fails to pass meconium. Likely pathology?

a)

Pyloric atresia

b)

Biliary atresia

c)

Rectal prolapse

d)

Ganglionic loss in sigmoid colon

112.

A man exercises intensely. What happens to venous PCO₂?

a)

Increases

b)

Decreases

c)

No change

d)

Initially falls, then rises

113.

A diabetic man has K⁺ = 5.9 mmol/L. Which hormone shifts K⁺ into cells?

a)

Cortisol

b)

Glucagon

c)

GH

d)

Insulin

114.

Man loses blood from trauma. What autonomic response occurs?

a)

↑ Sympathetic, ↑ TPR

b)

↓ Sympathetic, ↓ TPR

c)

↑ Parasympathetic, ↓ HR

d)

↑ Vagal tone, ↓ HR

115.

A woman on loop diuretic has cramps. Likely electrolyte issue?

a)

Hypernatremia

b)

Hypokalemia

c)

Hypocalcemia

d)

Hyperkalemia

116.

A patient has a urine flow rate of 1 ml/min, a urine inulin concentration of 100 mg/ml, and a plasma inulin concentration of 2 mg/ml. What is the glomerular filtration rate (GFR)?

a)

25 ml/min

b)

50 ml/min

c)

100 ml/min

d)

125 ml/min

117.

If plasma urea is 2.5 mg/ml and urine urea is 50 mg/ml (urine flow is 1 ml/min), what is the rate of urea reabsorption?

a)

0 mg/min

b)

25 mg/min

c)

50 mg/min

d)

75 mg/min

118.

A patient has a plasma glucose of 400 mg/100 ml, a GFR of 150 ml/min, and a glucose transport maximum (Tm) of 300 mg/min. What is the rate of glucose excretion in urine?

a)

0 mg/min

b)

100 mg/min

c)

150 mg/min

d)

225 mg/min

119.

A patient has a urine flow of 2 ml/min, a urine inulin concentration of 60 mg/ml, and plasma inulin is 2 mg/ml. What is the GFR?

a)

30 ml/min

b)

60 ml/min

c)

75 ml/min

d)

120 ml/min

120.

If urine potassium is 20 µmol/ml, urine flow is 2 ml/min, plasma potassium is 4 µmol/ml, and GFR is 60 ml/min, what is the potassium reabsorption rate?

a)

0 µmol/min

b)

20 µmol/min

c)

60 µmol/min

d)

200 µmol/min

121.

Urine osmolality is 150 mOsm/L, plasma osmolality is 300 mOsm/L, and urine flow is 2 ml/min. What is the free water clearance?

a)

+1 ml/min

b)

+2 ml/min

c)

−1 ml/min

d)

−2 ml/min

122.

A patient’s arterial blood gas shows: pH = 7.12, PCO₂ = 60 mmHg, HCO₃⁻ = 19 mEq/L. What is the acid–base status?

a)

Respiratory acidosis

b)

Metabolic acidosis

c)

Mixed acidosis

d)

Mixed alkalosis

123.

A patient has the following pressures: glomerular capillary hydrostatic pressure (Pgc) = 50 mmHg, Bowman’s space pressure (Pbs) = 15 mmHg, glomerular oncotic pressure (πgc) = 30 mmHg, and Kf = 12 ml/min/mmHg. Renal plasma flow is 400 ml/min. What is the filtration fraction?

a)

0.15

b)

0.20

c)

0.25

d)

0.30

124.

If creatinine clearance is 90 ml/min, urine flow is 1 ml/min, and urine potassium is 60 mEq/L, what is the rate of potassium excretion?

a)

0.06 mEq/min

b)

0.3 mEq/min

c)

0.36 mEq/min

d)

3.6 mEq/min

125.

A patient has serum creatinine = 4 mg/dL, urine creatinine = 32 mg/dL, and urine volume = 3600 ml/24 h. What is the GFR?

a)

10 ml/min

b)

20 ml/min

c)

30 ml/min

d)

40 ml/min

126.

If plasma potassium = 5 mmol/L, urine potassium = 10 mmol/L, urine flow = 2.5 ml/min, and GFR = 20 ml/min, what is the potassium reabsorption rate?

a)

1.05 mmol/min

b)

0.10 mmol/min

c)

0.037 mmol/min

d)

0.075 mmol/min

127.

A patient has pH = 7.04, HCO₃⁻ = 13 mEq/L, PCO₂ = 30 mmHg, Cl⁻ = 120 mmol/L. What is the likely cause of metabolic acidosis?

a)

Emphysema

b)

Methanol ingestion

c)

Salicylate poisoning

d)

Diarrhea

128.

A patient’s blood gas shows: pH = 7.28, HCO₃⁻ = 32 mEq/L, PCO₂ = 70 mmHg. What is the most likely diagnosis?

a)

Acute respiratory acidosis

b)

Respiratory acidosis with partial renal compensation

c)

Metabolic acidosis

129.

A patient has a 24-hour urine volume of 600 ml, urine osmolality = 150 mOsm/L, plasma osmolality = 300 mOsm/L. What is the free water clearance?

a)

+5.0 ml/min

b)

+2.5 ml/min

c)

0.0 ml/min

d)

−2.5 ml/min

130.

A 60 kg man has total body water = 36 L. After infusion of 2 L 3% NaCl (855 mOsm), estimate his new plasma osmolarity (initial 260 mOsm/L).

a)

273 mOsm/L

b)

286 mOsm/L

c)

300 mOsm/L

d)

326 mOsm/L

131.

In the above case, what is the new estimated ECF volume?

a)

15.1 L

b)

17.2 L

c)

19.8 L

d)

21.2 L

132.

Inulin concentration in the tubule is 40 mg/100ml; plasma inulin is 2 mg/100ml. What percent of filtered water remains in the tubule?

a)

0%

b)

2%

c)

5%

d)

10%

133.

If a-v oxygen difference = 20 ml/100 ml and O₂ uptake = 240 ml/min, what is the cardiac output?

a)

2 L/min

b)

5 L/min

c)

6 L/min

d)

12 L/min

134.

In a 60 kg person, total water = 57%, and ECF = 20%. What is the intracellular fluid (ICF) volume?

a)

17.1 L

b)

19.6 L

c)

21.4 L

d)

23.5 L

135.

A patient has a renal blood flow of 1 L/min and hematocrit = 0.45. What is the renal plasma flow (RPF)?

a)

450 ml/min

b)

550 ml/min

c)

600 ml/min

d)

750 ml/min

136.

Which of the following is the major factor contributing to plasma colloid osmotic pressure?

a)

Sodium chloride

b)

Glucose

c)

Albumin

d)

Cholesterol

137.

What determines the resting potential of a myelinated nerve fiber?

a)

Calcium

b)

Chloride

c)

Bicarbonate

d)

Potassium

138.

Which muscle type contracts in response to stretch?

a)

Skeletal

b)

Cardiac

c)

Visceral smooth

d)

Multiunit smooth

139.

Which of the following substances requires facilitated diffusion to enter skeletal muscle?

a)

Oxygen

b)

Sodium

c)

Glucose

d)

Carbon dioxide

140.

Which hormone increases calcium excretion in urine?

a)

Parathyroid hormone

b)

Aldosterone

c)

Calcitonin

d)

ADH

141.

Which cell structure synthesizes proteins for secretion?

a)

Golgi apparatus

b)

Mitochondria

c)

Granular ER

d)

Lysosome

142.

The oxygen-hemoglobin dissociation curve shifts right due to:

a)

Alkalosis

b)

Hypothermia

c)

Increased CO₂

d)

Low temperature

143.

Primary active transport requires:

a)

No energy

b)

Glucose

c)

Carrier protein and ATP

d)

Concentration gradient only

144.

Which structure controls basic respiratory rhythm?

a)

Apneustic center

b)

Pneumotaxic center

c)

Medulla

d)

Hypothalamus

145.

Which hormone regulates sodium reabsorption in the kidney?

a)

ADH

b)

Cortisol

c)

Aldosterone

d)

PTH

146.

The majority of carbon dioxide is transported in the blood as:

a)

Dissolved CO₂

b)

Carbaminohemoglobin

c)

Bicarbonate

d)

Carbon monoxide

147.

Which ion causes depolarization in skeletal muscle?

a)

Potassium

b)

Chloride

c)

Sodium

d)

Calcium

148.

Where is glucose absorbed in the nephron?

a)

Loop of Henle

b)

Proximal tubule

c)

Distal tubule

d)

Collecting duct

149.

Which is a secondary active transporter in renal tubules?

a)

Na+/K+ ATPase

b)

Na+/glucose co-transporter

c)

H+ pump

d)

Aquaporin

150.

Which of the following increases venous return?

a)

Increased afterload

b)

Increased venous tone

c)

Decreased blood volume

d)

Standing

151.

What is the primary function of the sarcoplasmic reticulum in muscle?

a)

Store glycogen

b)

Produce ATP

c)

Store calcium

d)

Transmit action potential

152.

Which substance causes vasoconstriction?

a)

Nitric oxide

b)

Angiotensin II

c)

Histamine

d)

Prostacyclin

153.

In cardiac muscle, calcium enters during which phase?

a)

Phase 0

b)

Phase 1

c)

Phase 2 (plateau)

d)

Phase 3

154.

The hormone primarily responsible for milk ejection is:

a)

Prolactin

b)

Estrogen

c)

Progesterone

d)

Oxytocin

155.

Which hormone decreases plasma calcium?

a)

Calcitonin

b)

PTH

c)

Vitamin D

d)

Aldosterone

156.

What is the basic unit of skeletal muscle contraction?

a)

Myofibril

b)

Sarcolemma

c)

Sarcomere

d)

T-tubule

157.

Which gland releases cortisol?

a)

Pituitary

b)

Thyroid

c)

Adrenal cortex

d)

Adrenal medulla

158.

Which cell secretes insulin?

a)

Alpha cell

b)

Beta cell

c)

Delta cell

d)

F cell

159.

Where is ADH synthesized?

a)

Pituitary

b)

Kidney

c)

Hypothalamus

d)

Adrenal gland

160.

The first heart sound corresponds to closure of:

a)

Aortic and pulmonary valves

b)

Mitral and tricuspid valves

c)

AV valves only

d)

Semilunar valves only

161.

Which structure delays the cardiac impulse?

a)

SA node

b)

AV node

c)

Bundle of His

d)

Purkinje fibers

162.

What is the normal resting membrane potential of a neuron?

a)

+20 mV

b)

0 mV

c)

−70 mV

d)

−30 mV

163.

What maintains the resting membrane potential?

a)

Sodium leak

b)

Calcium channel

c)

Na⁺/K⁺ ATPase

d)

Cl⁻ channel

164.

Which hormone causes uterine contractions?

a)

Progesterone

b)

Estrogen

c)

Oxytocin

d)

FSH

165.

Which blood cell lacks a nucleus?

a)

Neutrophil

b)

Eosinophil

c)

Platelet

d)

Red blood cell

166.

What is the primary buffer in plasma?

a)

Phosphate

b)

Bicarbonate

c)

Proteins

d)

Ammonia

167.

Where is bile produced?

a)

Gallbladder

b)

Pancreas

c)

Liver

d)

Small intestine

168.

What stimulates gastric acid secretion?

a)

CCK

b)

Gastrin

c)

Secretin

d)

Somatostatin

169.

Which nerve innervates the diaphragm?

a)

Vagus

b)

Phrenic

c)

Intercostal

d)

Accessory

170.

The Bohr effect describes:

a)

O₂ binding to hemoglobin

b)

Shift of O₂ curve with pH

c)

CO₂ transport

d)

RBC formation

171.

Which hormone regulates water reabsorption?

a)

Aldosterone

b)

ADH

c)

Renin

d)

Cortisol

172.

What is the site of action of loop diuretics?

a)

Distal tubule

b)

Collecting duct

c)

Proximal tubule

d)

Thick ascending limb

173.

Which enzyme converts angiotensin I to II?

a)

Renin

b)

ACE

c)

Aldosterone

d)

ADH

174.

Which cell produces surfactant?

a)

Type I pneumocyte

b)

Type II pneumocyte

c)

Alveolar macrophage

d)

Clara cell

175.

What stimulates erythropoietin production?

a)

High PO₂

b)

Hypoxia

c)

Hypercalcemia

d)

Hypercapnia

176.

Which of the following proteins is most likely to be the product of a proto-oncogene?

a)

Growth factor receptor

b)

Cytoskeletal protein

c)

Na+ channel

d)

Ca++-ATPase

e)

Myosin light chain

177.

Which of the following events does not occur during the process of mitosis?

a)

Condensation of the chromosomes

b)

Replication of the genome

c)

Fragmentation of the nuclear envelope

d)

Alignment of the chromatids along the equatorial plate

e)

Separation of the chromatids into two sets of 46 “daughter” chromosomes

178.

Which of the following characteristics of a biological membrane is most influenced by its cholesterol content?

a)

Thickness

b)

Ion permeability

c)

Fluidity

d)

Glycosylation

e)

Hydrophobicity

179.

The appearance of which of the following distinguishes eukaryotic cells from lower units of life?

a)

DNA

b)

RNA

c)

Membranes

d)

Protein

e)

Nucleus

180.

The feedback “gain” of arterial baroreceptors is approximately −1.0 in a case study. What does this indicate?

a)

Positive feedback mechanism

b)

No feedback system

c)

A highly efficient control system

d)

A negative feedback control system

e)

Baroreceptors are non-functional

181.

What is the equilibrium potential for K+ when intracellular [K+] = 140 mM and extracellular [K+] = 14 mM?

a)

0 mV

b)

122 mV

c)

−122 mV

d)

61 mV

e)

−61 mV

182.

If the membrane potential of this cell is −80 mV, the driving force is greatest for which ion?

a)

Ca++

b)

Cl−

c)

K+

d)

Na+

183.

Why is the tension development maximal between points B and C on the sarcomere length–tension curve?

a)

Actin filaments are overlapping each other

b)

Myosin filaments are overlapping each other

c)

The myosin filament is at its minimal length

d)

The Z discs abut the ends of the myosin filament

e)

There is optimal overlap between the actin and myosin filaments

184.

Which process does not require ATP?

a)

Simple diffusion

b)

Primary active transport

c)

Secondary active transport

d)

Na+/K+ ATPase

e)

Endocytosis

185.

Excitation–contraction coupling in skeletal muscle involves all of the following EXCEPT:

a)

ATP hydrolysis

b)

Binding of Ca++ to calmodulin

c)

Conformational change in dihydropyridine receptor

d)

Depolarization of the transverse tubule (T tubule) membrane

e)

Increased Na+ conductance of sarcolemma

186.

What causes the excess muscle mass in the average male compared to a female?

a)

Increased testosterone secreted in the male

b)

Increased estrogen secreted by the female

c)

Higher exercise levels in the male

d)

Greater glycogen deposition by males

187.

What is the definition of the strength of a muscle?

a)

Maximum weight it can lift

b)

Force required to stretch it after it has contracted

c)

Work that the muscle can perform per unit of time

d)

How long a muscle can lift a given amount of weight

188.

Which type of muscle fiber has more mitochondria?

a)

Slow-twitch

b)

Fast-twitch

c)

Both equally

d)

None of the above

189.

What occurs during training that causes increased mitochondrial enzymes and stored triglycerides?

a)

Aerobic training

b)

Fast weight loss

c)

Short-term fasting

d)

High sodium intake

190.

What effect does smoking have on pulmonary ventilation?

a)

Increased airflow resistance

b)

Enhanced gas exchange

c)

Improved ciliary motion

d)

Decreased fluid secretion

191.

What adverse cardiovascular effect is associated with anabolic steroid use?

a)

Decreased low-density lipoproteins

b)

Decreased risk of stroke

c)

Increased hypertension

d)

Increased sperm production

192.

Which dietary plan allows the longest time to exhaustion during exercise?

a)

High-fat diet

b)

High-protein diet

c)

High-carbohydrate diet

d)

Mixed protein-fat diet

193.

What factor contributes most to the metabolic rate increase during exercise?

a)

Increased blood pressure

b)

Increased O₂ consumption

c)

Increased core temperature

d)

Enhanced reflexes

194.

What causes muscle strength to increase with resistance training?

a)

Decreased mitochondria

b)

Increased myofibrils and enzymes

c)

Reduced triglycerides

d)

Increased muscle length

195.

What part of the pulmonary system is paralyzed by smoking?

a)

Terminal bronchioles

b)

Diaphragm

c)

Cilia on epithelial cells

d)

Alveolar sacs

196.

What happens to stroke volume in Olympic athletes at rest?

a)

Increases significantly

b)

Slightly increases (~5%)

c)

Decreases

d)

No change

197.

Which respiratory parameter increases most in athletes compared to untrained individuals?

a)

Tidal volume

b)

Residual volume

c)

Oxygen diffusing capacity

d)

Dead space

198.

Which muscle fiber type has more myoglobin?

a)

Slow-twitch

b)

Fast-twitch

c)

Both equally

d)

None

199.

How does testosterone affect muscle mass?

a)

Inhibits hypertrophy

b)

Promotes lipid breakdown

c)

Stimulates protein synthesis and hypertrophy

d)

Reduces satellite cell function

200.

Why does anabolic steroid use decrease sperm production?

a)

Overstimulation of FSH

b)

Pituitary hyperplasia

c)

Inhibition of GnRH

d)

Increase in luteinizing hormone

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