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Prof En 1 - Physiology

Total questions: 150

Worksheet time: 2hrs 10mins

Name
Class
Date
1.

A 35-year-old patient exhibits muscle weakness with no signs of sensory loss. Nerve conduction velocity is normal. Which of the following is the MOST likely physiological explanation?

a)

Demyelination of peripheral nerves

b)

Inhibition of acetylcholinesterase

c)

Decreased calcium release from the sarcoplasmic reticulum

d)

Damage to the dorsal root ganglia

2.

During high-intensity resistance training, which muscle fiber type undergoes the MOST hypertrophy?

a)

Type I

b)

Type IIa

c)

Type IIb

d)

Type III

3.

Which of the following BEST explains why rigor mortis occurs after death?

a)

Excess calcium is pumped into the SR post-mortem

b)

Lack of ATP prevents detachment of myosin from actin

c)

Increased ATP causes sustained contraction

d)

Inhibition of acetylcholine release at the neuromuscular junction

4.

In a case of muscular dystrophy, what is the PRIMARY pathophysiological mechanism that leads to progressive muscle weakness?

a)

Loss of troponin binding

b)

Overactivation of myosin ATPase

c)

Defective dystrophin protein affects sarcolemma integrity

d)

Excessive accumulation of acetylcholine in the synapse

5.

Which molecular event occurs IMMEDIATELY AFTER the action potential reaches the T-tubule?

a)

Cross-bridge detachment

b)

Opening of ryanodine receptors on the SR

c)

Binding of calcium to troponin C

d)

Release of acetylcholine from the axon terminal

6.

A 45-year-old athlete complains of fatigue during endurance activities. Which enzyme deficiency would MOST likely impair aerobic ATP production in skeletal muscle?

a)

Creatine kinase

b)

Myosin ATPase

c)

Citrate synthase

d)

Lactate dehydrogenase

7.

Which of the following scenarios BEST demonstrates the concept of the length-tension relationship in skeletal muscle?

a)

A muscle contracts more forcefully when overstretched

b)

Maximum force is generated when actin and myosin overlap optimally

c)

Muscle force is independent of initial muscle length

d)

Greater passive tension always leads to greater active tension

8.

A researcher inhibits ATP synthase in a skeletal muscle cell. What is the MOST immediate physiological consequence during contraction?

a)

Increased cross-bridge cycling

b)

Inability to release calcium from the SR

c)

Reduced detachment of myosin from actin

d)

Increased mitochondrial calcium uptake

9.

In isometric contraction, which of the following BEST describes the muscle's behavior?

a)

Muscle length increases while tension remains constant

b)

Muscle length remains constant while tension increases

c)

Muscle shortens without generating force

d)

Muscle produces movement without neural input

10.

A drug that blocks voltage-gated calcium channels at the axon terminal would MOST likely cause which of the following effects on skeletal muscle contraction?

a)

Enhanced acetylcholine release and stronger contractions

b)

No effect on muscle function

c)

Decreased acetylcholine release and weakened contractions

d)

Prolonged depolarization of the muscle fiber

11.

A patient with severe burns presents with fluid loss and electrolyte imbalance. Which function of the skin is MOST directly compromised?

a)

Immune defense

b)

Sensory perception

c)

Thermoregulation

d)

Barrier protection

12.

Which skin layer is primarily responsible for the generation of new keratinocytes?

a)

Stratum corneum

b)

Stratum granulosum

c)

Stratum basale

d)

Stratum lucidum

13.

During wound healing, which phase is characterized by angiogenesis, fibroblast proliferation, and granulation tissue formation?

a)

Inflammatory phase

b)

Proliferative phase

c)

Remodeling phase

d)

Hemostatic phase

14.

A patient is experiencing difficulty with thermoregulation in a hot environment due to impaired sweat gland activity. Which gland is MOST likely dysfunctional?

a)

Sebaceous gland

b)

Apocrine sweat gland

c)

Eccrine sweat gland

d)

Ceruminous gland

15.

Vitamin D synthesis in the skin is primarily initiated in response to which of the following stimuli?

a)

Heat exposure

b)

UVA radiation

c)

UVB radiation

d)

Friction and pressure

16.

Which of the following cells in the epidermis is MOST directly involved in immune surveillance and antigen presentation?

a)

Merkel cells

b)

Keratinocytes

c)

Langerhans cells

d)

Melanocytes

17.

A 65-year-old patient with a history of diabetes presents with a non-healing ulcer. Which physiological impairment MOST likely contributes to delayed wound healing?

a)

Increased fibroblast activity

b)

Enhanced vasodilation

c)

Impaired collagen synthesis

d)

Overproduction of melanin

18.

Which of the following BEST describes the role of melanocytes in the skin?

a)

Synthesize keratin in response to UV exposure

b)

Produce sebum for waterproofing the skin

c)

Generate melanin for UV protection

d)

Regulate epidermal turnover

19.

What is the MAIN role of the arrector pili muscle in thermoregulation?

a)

Enhancing blood flow to skin surface

b)

Increasing sweat secretion

c)

Causing hair to stand and trap heat

d)

Stimulating melanocyte activity

20.

Which of the following skin receptors is MOST sensitive to light touch and is located in the dermal papillae?

a)

Pacinian corpuscle

b)

Ruffini ending

c)

Merkel disc

d)

Meissner corpuscle

21.

A 28-year-old female patient has been non-weight-bearing for 6 weeks due to a tibial fracture. What cellular activity is MOST responsible for the resulting bone density loss?

a)

Increased osteoblast activity

b)

Decreased osteoclast activity

c)

Increased osteoclast activity

d)

Increased chondrocyte proliferation

22.

Parathyroid hormone (PTH) regulates serum calcium by acting on which of the following mechanisms in bone?

a)

Stimulating osteoblasts to form new bone

b)

Inhibiting osteoclast function

c)

Activating osteoblasts to release RANKL

d)

Enhancing collagen cross-linking

23.

Which of the following BEST explains why older adults have a higher risk of fractures despite normal serum calcium levels?

a)

Decreased osteoclast activity

b)

Increased bone mineralization

c)

Impaired osteoblast function and bone remodeling

d)

Overproduction of growth hormone

24.

During endochondral ossification, which of the following events occurs FIRST?

a)

Formation of secondary ossification centers

b)

Calcification of the cartilage matrix

c)

Vascular invasion of the epiphyseal plate

d)

Replacement of cartilage with trabecular bone

25.

Which hormone plays the MOST DIRECT role in increasing intestinal calcium absorption and is produced in the skin, liver, and kidneys in sequence?

a)

Calcitonin

b)

Parathyroid hormone

c)

1,25-dihydroxyvitamin D (calcitriol)

d)

Cortisol

26.

In a child with rickets, what is the PRIMARY physiological abnormality contributing to bone deformities?

a)

Excessive bone resorption

b)

Impaired cartilage formation

c)

Inadequate mineralization of osteoid

d)

Hyperactivity of osteoblasts

27.

A patient has elevated serum alkaline phosphatase levels. Which of the following processes is MOST likely occurring in the skeletal system?

a)

Decreased collagen synthesis

b)

Increased osteoclast-mediated resorption

c)

Active bone formation by osteoblasts

d)

Decreased calcium absorption

28.

Which of the following types of bone cells serves as the long-term calcium reservoir and can become active during periods of calcium demand?

a)

Osteoblasts

b)

Osteoclasts

c)

Osteocytes

d)

Chondrocytes

29.

Mechanical loading and physical activity contribute to bone remodeling primarily through which of the following cellular mechanisms?

a)

Chondrocyte proliferation

b)

Osteocyte mechanotransduction

c)

Osteoclast apoptosis

d)

Inhibition of calcitonin release

30.

Which of the following structural proteins is MOST abundant in the organic matrix of bone and provides tensile strength?

a)

Elastin

b)

Keratin

c)

Type I collagen

d)

Osteocalcin

31.

A patient with multiple sclerosis shows slowed nerve conduction velocity. Which of the following is the PRIMARY physiological cause?

a)

Decreased neurotransmitter release

b)

Inhibition of sodium-potassium pumps

c)

Demyelination of axons

d)

Increased synaptic vesicle degradation

32.

Which ion movement is MOST responsible for the rising phase of the neuronal action potential?

a)

Influx of Na⁺ through voltage-gated channels

b)

Efflux of K⁺ through leak channels

c)

Influx of Cl⁻

d)

Efflux of Ca²⁺

33.

A physical therapist notices that a stroke patient cannot perceive vibration or proprioception on the right lower limb. Which pathway is MOST likely affected?

a)

Spinothalamic tract

b)

Corticospinal tract

c)

Dorsal column-medial lemniscal pathway

d)

Reticulospinal tract

34.

Which of the following glial cells is MOST responsible for maintaining the blood-brain barrier?

a)

Microglia

b)

Astrocytes

c)

Oligodendrocytes

d)

Schwann cells

35.

Inhibitory postsynaptic potentials (IPSPs) are typically caused by which ion movements?

a)

Na⁺ influx or Ca²⁺ influx

b)

K⁺ efflux or Cl⁻ influx

c)

Na⁺ efflux or K⁺ influx

d)

Ca²⁺ efflux or Cl⁻ efflux

36.

Which of the following best explains the concept of temporal summation in a neuron?

a)

Multiple synapses activated simultaneously

b)

Single synapse repeatedly stimulated over time

c)

One presynaptic terminal inhibits multiple neurons

d)

Continuous release of acetylcholine without a stimulus

37.

In the neuromuscular junction, what role does calcium play in neurotransmission?

a)

Blocks Na⁺ channels on the postsynaptic membrane

b)

Facilitates breakdown of acetylcholine

c)

Triggers fusion of synaptic vesicles with the presynaptic membrane

d)

Activates postsynaptic receptors directly

38.

Which brain region is MOST associated with motor planning and the initiation of voluntary movement?

a)

Primary somatosensory cortex

b)

Basal ganglia

c)

Cerebellum

d)

Hippocampus

39.

A patient exhibits flaccid paralysis and diminished reflexes after a spinal cord injury. Which type of motor neuron is MOST likely affected?

a)

Upper motor neuron

b)

Lower motor neuron

c)

Interneuron

d)

Sensory neuron

40.

The cerebellum contributes to motor control by:

a)

Initiating voluntary movement

b)

Modulating reflex arcs

c)

Coordinating timing, precision, and motor learning

d)

Controlling autonomic functions

41.

A patient with untreated hyperthyroidism presents with muscle weakness and heat intolerance. Which of the following best explains the muscle symptoms?

a)

Increased protein synthesis and muscle hypertrophy

b)

Excess cortisol release causing muscle catabolism

c)

Increased basal metabolic rate leading to protein breakdown

d)

Decreased sympathetic nervous system activation

42.

Which hormone has a direct anabolic effect on skeletal muscle and is critical in post-exercise muscle repair?

a)

Cortisol

b)

Insulin

c)

Epinephrine

d)

Thyroxine

43.

Which hormone is MOST responsible for preventing hypoglycemia during prolonged exercise?

a)

Insulin secretion from pancreatic β-cells

b)

Glucagon secretion from pancreatic α-cells

c)

Decreased cortisol release

d)

Decreased growth hormone levels

44.

A postmenopausal woman is diagnosed with osteoporosis. Which hormonal change is MOST responsible for her decreased bone density?

a)

Decreased estrogen

b)

Increased aldosterone

c)

Decreased insulin

d)

Increased melatonin

45.

Which of the following hormones uses intracellular (nuclear) receptors to alter gene transcription?

a)

Epinephrine

b)

Glucagon

c)

Insulin

d)

Cortisol

46.

In a patient with Addison's disease (adrenal insufficiency), which of the following lab findings would MOST likely be present?

a)

Hypernatremia and hypertension

b)

Hyperkalemia and hyponatremia

c)

Hypokalemia and hyperglycemia

d)

Elevated cortisol and low ACTH

47.

Which hormone increases calcium levels by stimulating osteoclast activity and increasing renal reabsorption of calcium?

a)

Calcitonin

b)

Parathyroid hormone

c)

Aldosterone

d)

Growth hormone

48.

A patient presents with acromegaly. Which of the following would be the MOST direct cause of their condition?

a)

Excessive secretion of TSH

b)

Hyposecretion of insulin

c)

Pituitary adenoma secreting growth hormone

d)

Overproduction of cortisol

49.

Which of the following accurately describes a negative feedback loop in endocrine physiology?

a)

ACTH stimulates cortisol release, which enhances further ACTH production

b)

Insulin release lowers blood glucose, which suppresses further insulin release

c)

Estrogen stimulates GnRH release, increasing LH and FSH secretion

d)

Parathyroid hormone increases bone resorption, which inhibits PTH synthesis via positive feedback

50.

During acute stress (fight-or-flight response), which of the following is the PRIMARY immediate endocrine response?

a)

Cortisol release from adrenal cortex

b)

Glucagon release from pancreas

c)

Epinephrine release from adrenal medulla

d)

Growth hormone release from anterior pituitary

51.

During quiet inspiration, which of the following muscles is the PRIMARY contributor to increasing thoracic volume?

a)

External intercostals

b)

Diaphragm

c)

Sternocleidomastoid

d)

Internal intercostals

52.

A patient with restrictive lung disease has a decreased total lung capacity (TLC). Which of the following BEST explains the pathophysiological change?

a)

Increased airway resistance

b)

Decreased lung compliance

c)

Increased surfactant production

d)

Increased alveolar dead space

53.

In which part of the lung is ventilation-perfusion (V/Q) ratio typically HIGHEST in an upright individual?

a)

Apex of the lungs

b)

Base of the lungs

c)

Middle lobes

d)

Diaphragmatic surface

54.

Which of the following would MOST likely shift the oxygen-hemoglobin dissociation curve to the right, enhancing oxygen unloading to tissues?

a)

Decreased temperature

b)

Increased pH

c)

Decreased 2,3-BPG

d)

Increased CO₂ levels

55.

A patient performing aerobic exercise shows increased respiratory rate and depth. What is the PRIMARY stimulus for this ventilatory response?

a)

Low arterial oxygen

b)

Elevated cerebrospinal fluid pH

c)

High arterial CO₂

d)

Increased airway resistance

56.

In a healthy adult, which of the following lung volumes can NEVER be measured directly with spirometry?

a)

Tidal volume

b)

Inspiratory capacity

c)

Vital capacity

d)

Residual volume

57.

A 72-year-old patient with emphysema exhibits increased functional residual capacity (FRC). What is the PRIMARY physiological mechanism?

a)

Decreased surface tension

b)

Air trapping due to loss of elastic recoil

c)

Increased diaphragmatic strength

d)

Enhanced airway clearance

58.

Which of the following BEST describes the role of surfactant in alveolar function?

a)

Increases alveolar surface tension

b)

Facilitates gas exchange by increasing diffusion rate

c)

Prevents alveolar collapse by reducing surface tension

d)

Stimulates alveolar macrophages to clear pathogens

59.

In obstructive lung disease, which spirometric change is MOST characteristic?

a)

Increased FEV₁/FVC ratio

b)

Decreased FEV₁

c)

Increased inspiratory reserve volume

d)

Decreased total lung capacity

60.

Which of the following describes the PRIMARY mode of carbon dioxide transport in blood?

a)

Dissolved in plasma

b)

Bound to hemoglobin as carbaminohemoglobin

c)

As carbonic acid

d)

As bicarbonate ion (HCO₃⁻)

61.

A patient has a resting oxygen consumption of 3.5 mL O₂/kg/min. This value corresponds to:

a)

1 MET

b)

2 METs

c)

3 METs

d)

5 METs

62.

Which of the following cardiovascular changes occurs during moderate-intensity aerobic exercise (4-6 METs)?

a)

Decrease in systolic BP

b)

Decrease in stroke volume

c)

Increase in heart rate and cardiac output

d)

Decrease in mean arterial pressure

63.

A patient performing an activity at 6 METs is consuming how much oxygen?

a)

6 mL O₂/kg/min

b)

21 mL O₂/kg/min

c)

3.5 mL O₂/kg/min

d)

35 mL O₂/kg/min

64.

Which of the following is the PRIMARY determinant of cardiac output during exercise?

a)

Peripheral vascular resistance

b)

Stroke volume × heart rate

c)

Mean arterial pressure

d)

End-diastolic volume × afterload

65.

During prolonged aerobic training, what cardiovascular adaptation is MOST likely to occur?

a)

Increased resting heart rate

b)

Decreased stroke volume

c)

Increased capillary density and stroke volume

d)

Decreased cardiac output at maximal exertion

66.

A 70-year-old patient recovering from MI is cleared for submaximal exercise at 3 METs. Which of the following activities BEST represents this level?

a)

Slow walking (2 km/h)

b)

Sweeping floors or light gardening

c)

Jogging at 8 km/h

d)

Climbing stairs quickly

67.

Which autonomic change supports increased cardiac output during early stages of aerobic exercise?

a)

Decreased sympathetic tone and increased vagal output

b)

Increased parasympathetic activity to the SA node

c)

Increased sympathetic stimulation and reduced vagal tone

d)

Vasoconstriction of skeletal muscle arterioles

68.

During heavy exercise, how is blood flow redistributed to prioritize muscle perfusion?

a)

By increasing coronary and renal blood flow

b)

Through vasoconstriction of arterioles in active muscles

c)

By shunting blood away from skin and toward viscera

d)

Via vasodilation in active skeletal muscle and vasoconstriction in splanchnic beds

69.

A patient with a low functional capacity can only perform activities up to 3 METs. What does this suggest about their aerobic fitness level?

a)

Normal functional capacity

b)

Moderate cardiorespiratory fitness

c)

Severely reduced aerobic capacity

d)

Above-average endurance

70.

In terms of cardiac cycle dynamics, what happens to diastolic time as heart rate increases during exercise?

a)

It increases proportionally

b)

It remains constant

c)

It decreases, reducing coronary perfusion time

d)

It has no effect on myocardial oxygen demand

71.

A patient is dehydrated following intense aerobic exercise. Which renal mechanism is MOST responsible for conserving water?

a)

Decreased aldosterone secretion

b)

Increased glomerular filtration rate (GFR)

c)

Increased antidiuretic hormone (ADH) activity

d)

Reduced sympathetic activity

72.

Which nephron segment is the PRIMARY site for glucose reabsorption?

a)

Distal convoluted tubule

b)

Loop of Henle

c)

Proximal convoluted tubule

d)

Collecting duct

73.

A Physical Therapy patient with chronic hypertension is taking an ACE inhibitor. Which renal hormone pathway is MOST directly affected?

a)

ADH-Vasopressin system

b)

Renin-Angiotensin-Aldosterone System (RAAS)

c)

Erythropoietin synthesis

d)

Natriuretic peptide pathway

74.

Which of the following would be expected to INCREASE glomerular filtration rate (GFR)?

a)

Constriction of the afferent arteriole

b)

Dilation of the efferent arteriole

c)

Increased plasma oncotic pressure

d)

Dilation of the afferent arteriole

75.

A patient in metabolic acidosis has increased renal excretion of hydrogen ions. Which nephron cell type is primarily responsible for this compensation?

a)

Principal cells in the collecting duct

b)

Podocytes in the glomerulus

c)

Intercalated cells in the collecting duct

d)

Macula densa cells in the distal tubule

76.

Which of the following BEST explains the role of the macula densa in tubuloglomerular feedback?

a)

Detects blood pressure in the afferent arteriole

b)

Responds to low sodium levels in the filtrate to increase renin release

c)

Releases aldosterone to regulate potassium excretion

d)

Triggers vasoconstriction of the renal vein during stress

77.

Which of the following substances is filtered but neither reabsorbed nor secreted, making it ideal for measuring GFR?

a)

Glucose

b)

Creatinine

c)

Inulin

d)

Urea

78.

In prolonged endurance exercise, a drop in plasma volume occurs. Which hormone is released to restore sodium and water balance?

a)

Epinephrine

b)

Aldosterone

c)

Glucagon

d)

Insulin

79.

Which of the following BEST describes the kidney's contribution to long-term blood pressure control?

a)

Direct vasodilation of systemic arteries

b)

Regulation of cardiac output

c)

Adjustment of plasma osmolarity via urea

d)

Regulation of extracellular fluid volume through sodium balance

80.

Which renal adaptation is MOST important in maintaining acid-base balance during intense anaerobic exercise?

a)

Decreased bicarbonate reabsorption

b)

Increased ammonia production and H⁺ excretion

c)

Increased sodium secretion

d)

Reduced aldosterone activity

81.

Which hormone secreted by the stomach stimulates gastric acid secretion and motility?

a)

Secretin

b)

Gastrin

c)

Cholecystokinin (CCK)

d)

Motilin

82.

A patient has decreased motility of the colon. Which hormone or neurotransmitter dysfunction could contribute MOST to this symptom?

a)

Excess serotonin

b)

Decreased motilin

c)

Excess somatostatin

d)

Increased acetylcholine

83.

Which layer of the GI tract is primarily responsible for peristalsis?

a)

Mucosa

b)

Submucosa

c)

Circular and longitudinal layers of muscularis externa

d)

Serosa

84.

The hormone cholecystokinin (CCK) plays an important role in:

a)

Stimulating pancreatic enzyme secretion and gallbladder contraction

b)

Increasing gastric acid secretion

c)

Promoting insulin release from the pancreas

d)

Stimulating intestinal sodium absorption

85.

Which hormone is primarily responsible for the development of male secondary sexual characteristics?

a)

Follicle-stimulating hormone (FSH)

b)

Luteinizing hormone (LH)

c)

Testosterone

d)

Estrogen

86.

In the female menstrual cycle, the surge of which hormone triggers ovulation?

a)

Estrogen

b)

Progesterone

c)

Luteinizing hormone (LH)

d)

Follicle-stimulating hormone (FSH)

87.

Which structure in the testes is responsible for sperm production?

a)

Epididymis

b)

Seminiferous tubules

c)

Leydig cells

d)

Vas deferens

88.

During pregnancy, which hormone maintains the uterine lining and prevents menstruation?

a)

Human chorionic gonadotropin (hCG)

b)

Progesterone

c)

Estrogen

d)

Oxytocin

89.

Which hormone primarily stimulates the Sertoli cells to support spermatogenesis?

a)

Testosterone

b)

Luteinizing hormone (LH)

c)

Follicle-stimulating hormone (FSH)

d)

Prolactin

90.

The primary source of estrogen production during the follicular phase of the menstrual cycle is the:

a)

Corpus luteum

b)

Theca cells

c)

Granulosa cells

d)

Hypothalamus

91.

Which hormone causes milk ejection (let-down) during lactation?

a)

Prolactin

b)

Oxytocin

c)

Estrogen

d)

Human placental lactogen

92.

Which part of the brain regulates the release of GnRH (gonadotropin-releasing hormone)?

a)

Medulla oblongata

b)

Hypothalamus

c)

Pituitary gland

d)

Thalamus

93.

In males, Leydig cells primarily produce:

a)

Estrogen

b)

Testosterone

c)

Inhibin

d)

Progesterone

94.

The endometrial changes during the luteal phase are primarily due to increased levels of:

a)

Estrogen

b)

Progesterone

c)

LH

d)

FSH

95.

Which immune cells are primarily responsible for presenting antigens to T lymphocytes?

a)

B cells

b)

Macrophages and dendritic cells

c)

Neutrophils

d)

Natural killer (NK) cells

96.

The major histocompatibility complex (MHC) class I molecules present antigens to which type of immune cells?

a)

CD4+ helper T cells

b)

B cells

c)

CD8+ cytotoxic T cells

d)

Neutrophils

97.

Which of the following is a PRIMARY function of neutrophils during acute inflammation?

a)

Antibody production

b)

Phagocytosis of pathogens

c)

Cytokine secretion to activate B cells

d)

Antigen presentation to T cells

98.

Which cytokine is most involved in promoting fever during systemic infection?

a)

Interleukin-10 (IL-10)

b)

Tumor necrosis factor-alpha (TNF-α)

c)

Interleukin-1 (IL-1)

d)

Interferon-gamma (IFN-γ)

99.

The antibody class primarily involved in mucosal immunity (e.g., respiratory and gastrointestinal tracts) is:

a)

IgG

b)

IgA

c)

IgM

d)

IgE

100.

In the adaptive immune response, memory B cells function to:

a)

Immediately destroy pathogens on first exposure

b)

Produce large amounts of cytokines to recruit neutrophils

c)

Provide a faster and stronger antibody response upon subsequent exposure

d)

Present antigen to cytotoxic T cells

101.

Natural killer (NK) cells kill target cells primarily by:

a)

Producing antibodies

b)

Phagocytosis

c)

Releasing perforin and granzymes to induce apoptosis

d)

Presenting antigen to helper T cells

102.

Which of the following best describes the complement system's role?

a)

Directly producing antibodies

b)

Enhancing phagocytosis and lysing pathogens

c)

Presenting antigen to T cells

d)

Inhibiting neutrophil recruitment

103.

Which cell type secretes histamine and plays a key role in allergic reactions?

a)

Mast cells

b)

Dendritic cells

c)

T regulatory cells

d)

Macrophages

104.

Which immune mechanism is primarily responsible for tissue rejection in organ transplantation?

a)

Autoantibody production

b)

Activation of cytotoxic T cells against foreign MHC molecules

c)

Complement activation only

d)

Neutrophil infiltration

105.

Which fibers are primarily responsible for transmitting fast, sharp, well-localized pain?

a)

C fibers

b)

A-delta fibers

c)

A-beta fibers

d)

Gamma fibers

106.

The gate control theory of pain proposes that:

a)

Pain signals are generated only by damaged tissue

b)

Non-painful input can inhibit pain transmission at the spinal cord level

c)

Pain perception occurs solely in the cerebral cortex

d)

All pain signals bypass the dorsal horn

107.

Which neurotransmitter is primarily involved in the transmission of pain signals in the spinal cord?

a)

Dopamine

b)

Glutamate

c)

Acetylcholine

d)

Serotonin

108.

The descending pain modulatory system primarily uses which neurotransmitter to inhibit pain?

a)

Norepinephrine

b)

Substance P

c)

Gamma-aminobutyric acid (GABA)

d)

Endorphins and serotonin

109.

Central sensitization in chronic pain results from:

a)

Reduced responsiveness of spinal neurons

b)

Increased excitability of dorsal horn neurons leading to amplified pain perception

c)

Complete loss of peripheral nociceptors

d)

Increased inhibitory neurotransmitter release

110.

Which area of the brain is MOST involved in the emotional and motivational aspects of pain?

a)

Primary somatosensory cortex

b)

Amygdala and anterior cingulate cortex

c)

Thalamus

d)

Brainstem

111.

The phenomenon where a normally non-painful stimulus causes pain is called:

a)

Hyperalgesia

b)

Allodynia

c)

Analgesia

d)

Paresthesia

112.

Which endogenous opioid receptor subtype is primarily responsible for analgesia?

a)

Kappa

b)

Delta

c)

Mu

d)

Sigma

113.

Which of the following best describes neuropathic pain?

a)

Pain from tissue damage and inflammation

b)

Pain due to lesion or dysfunction in the somatosensory nervous system

c)

Pain caused by psychological factors only

d)

Pain arising solely from muscle spasms

114.

The "wind-up" phenomenon refers to:

a)

Decreased pain sensitivity after repeated stimuli

b)

Progressive increase in dorsal horn neuron excitability after repetitive stimulation

c)

Inhibition of pain transmission by A-beta fibers

d)

Release of endogenous opioids during stress

115.

The primary function of the Na⁺/K⁺ ATPase pump is to:

a)

Transport sodium and potassium passively

b)

Maintain the resting membrane potential by actively transporting ions

c)

Facilitate endocytosis

d)

Synthesize ATP

116.

Which organelle is responsible for synthesizing most cellular ATP?

a)

Golgi apparatus

b)

Lysosome

c)

Mitochondrion

d)

Ribosome

117.

The phase of the cell cycle where DNA replication occurs is:

a)

G0

b)

G1

c)

S phase

d)

M phase

118.

Which type of cell junction allows direct cytoplasmic communication between adjacent cells?

a)

Tight junction

b)

Gap junction

c)

Desmosome

d)

Hemidesmosome

119.

In receptor-mediated endocytosis, the receptor-ligand complexes are internalized by:

a)

Phagocytosis

b)

Pinocytosis

c)

Clathrin-coated pits

d)

Exocytosis

120.

Which of the following molecules pass most freely through the plasma membrane without a transporter?

a)

Glucose

b)

Sodium ions

c)

Oxygen

d)

Amino acids

121.

The resting membrane potential is typically closest to:

a)

+60 mV

b)

-70 mV

c)

0 mV

d)

-120 mV

122.

Which cytoskeletal component provides structural support and resists tension?

a)

Microtubules

b)

Intermediate filaments

c)

Microfilaments

d)

Actin

123.

Protein synthesis occurs primarily at the:

a)

Smooth endoplasmic reticulum

b)

Rough endoplasmic reticulum

c)

Golgi apparatus

d)

Mitochondria

124.

Which phase of mitosis involves chromosome alignment at the cell's equator?

a)

Prophase

b)

Metaphase

c)

Anaphase

d)

Telophase

125.

The primary role of lysosomes is:

a)

ATP production

b)

Protein synthesis

c)

Digestion of cellular waste and foreign material

d)

Lipid synthesis

126.

Which of the following is a second messenger involved in signal transduction?

a)

cAMP

b)

DNA

c)

ATP

d)

NADH

127.

Osmosis is the movement of water across a semipermeable membrane from:

a)

Low solute concentration to high solute concentration

b)

High solute concentration to low solute concentration

c)

Areas of high pressure to low pressure

d)

Areas of low water concentration to high water concentration

128.

Which enzyme is responsible for breaking down ATP to provide energy in cells?

a)

Kinase

b)

ATPase

c)

Ligase

d)

Polymerase

129.

The endoplasmic reticulum is involved in:

a)

Protein and lipid synthesis

b)

DNA replication

c)

Cellular respiration

d)

Intracellular digestion

130.

The primary pacemaker of the heart is located in the:

a)

Atrioventricular node

b)

Sinoatrial node

c)

Purkinje fibers

d)

Bundle of His

131.

The primary function of bile salts in digestion is to:

a)

Neutralize stomach acid

b)

Emulsify dietary fats to increase surface area for lipase action

c)

Absorb vitamins B12 and K

d)

Stimulate pancreatic enzyme secretion

132.

Which segment of the small intestine is the MAIN site of nutrient absorption?

a)

Duodenum

b)

Cecum

c)

Ileum

d)

Jejunum

133.

During the cephalic phase of digestion, which of the following occurs?

a)

Activation of vagus nerve stimulating gastric secretions

   

b)

Gastric emptying slows down

c)

Increased pancreatic bicarbonate secretion via secretin

d)

Release of cholecystokinin to relax the sphincter of Oddi

134.

Which digestive enzyme is responsible for breaking down starch into maltose?

a)

Pepsin

b)

Lactase

c)

Lipase

d)

Amylase

135.

The intrinsic factor secreted by the stomach is essential for:

  

a)

Iron absorption in the duodenum

b)

Calcium absorption in the jejunum

c)

Vitamin B12 absorption in the ileum

d)

Protein digestion in the stomach

136.

Which of the following BEST describes the function of secretin?

a)

Stimulates pancreatic bicarbonate secretion to neutralize gastric acid

b)

Stimulates gastric acid secretion

c)

Stimulates bile release from the gallbladder

d)

Stimulates appetite

137.

Which hormone regulates blood calcium levels by increasing osteoclastic activity?

a)

Calcitonin

b)

Insulin

c)

Aldosterone

d)

Parathyroid hormone (PTH)

138.

During inspiration, the diaphragm:

a)

Relaxes and moves upward

b)

Contracts and moves downward

c)

Relaxes and moves downward

d)

Contracts and moves upward

139.

The primary buffer system in the blood is:

a)

Bicarbonate buffer

b)

Protein buffer

c)

Phosphate buffer

d)

Sulfate buffer

140.

The functional unit of the kidney is the:

a)

Collecting duct

b)

Loop of Henle

c)

Nephron

d)

  Glomerulus

141.

Which blood vessel layer contains smooth muscle?

a)

Tunica intima

b)

Tunica media

c)

Tunica adventitia

d)

Endothelium

142.

In skeletal muscle contraction, which ion initiates the interaction between actin and myosin?

 

a)

Potassium

b)

Calcium

c)

Chloride

d)

Sodium

143.

  The hormone that increases glucose uptake by cells is:

a)

Glucagon

b)

  Insulin

c)

Cortisol

d)

Epinephrine

144.

The portion of the nervous system responsible for “rest and digest” functions is the:

a)

Parasympathetic nervous system

b)

Sympathetic nervous system

c)

Somatic nervous system

d)

Enteric nervous system

145.

Which of the following is the main gas exchanged in the alveoli?

a)

Nitrogen

b)

Carbon dioxide

c)

Hydrogen

d)

Oxygen

146.

The osmotic pressure of plasma is mainly due to:

a)

Plasma proteins (albumin)

b)

Lipids

c)

Electrolytes

d)

Glucose

147.

The primary effect of aldosterone on the kidney is to:

a)

Increase sodium reabsorption

b)

Increase potassium reabsorption

c)

Decrease water reabsorption

d)

Increase glucose reabsorption

148.

The sensory receptor for detecting stretch in muscles is the:

a)

Golgi tendon organ

b)

Pacinian corpuscle

c)

Ruffini ending

d)

Muscle spindle

149.

Which blood component is primarily responsible for oxygen transport?

a)

Plasma

b)

Hemoglobin erythrocytes

c)

Leukocytes

d)

Platelets

150.

The Frank-Starling law of the heart states that:

a)

Increased venous return leads to decreased cardiac output

b)

  Increased stretch of ventricular muscle fibers leads to increased force of contraction

c)

Heart rate decreases with increased preload

d)

Stroke volume is independent of end-diastolic volume