Download Physiology exam, M i d t e r m - I I , 4.28.11 Name : F. number

Physiology exam, M i d t e r m - I I , 4.28.11
Name :
F. number:
Signature
1-Which is wrong ?
a-there is a continuous diffusion between blood plasma and intersititial fluid
b-excess heat, acid, ions are distributed by blood throughout the body, maintaining homeostasis
c-owing to blood circulation, the body is considered as a single environment (milieu interieur)
d-the formed elements constitute approximately half of whole blood
e-hematocrit (htc) or packed cell volume (PCV) is determined mostly by erythrocyte count
f-erythrocytes are more alkaline than the blood plasma due to anaerobic respiration
1-Correct: f
2-Which is wrong ?
a-albumin is the smallest and the most abundant plasma protein
b-albumin can be filtered to a limited extent through the glomerular capillaries and throughly reabsorbed
c-albumins carry hydrophobic molecules, e.g., more than 99 % of plasma fatty acids, in the blood plasma
d-alpha and beta globulins are produced by the liver, and are specific carriers in the blood.
e-fibrinogen is not hydrosoluble
f-fibrinogen is a huge plasma protein and functions in blood coagulation
g-plasma contains, but serum does not contain, fibrinogen
2-Correct:e
3-Which is wrong ?
erythrocytes
leukocytes
thrombocytes
eosinophils
neutrophils
basophils
normal (per mm3)
: a) 5,000,000
: b) 7,000
: c) 300,000
:
:
:
if rises
d) poikilocytosis
e) leukocytosis
f) thrombocytosis
j) eosinophili
l) neutrophili
n) basophili
if falls
g) anemia
h) leukopenia
i) thrombocytopenia
k) eosinopenia
m) neutropenia
o) basopenia
3-Correct : d
4-Which is wrong ?
a-erythrocytes, which constitute one quarter all the body cells, are renewed in every 120 days.
b-fastest growing tissues are characterized by continuous cell loss, such as in blood, skin, intestinal mucosa
c-cancer drugs mostly harm the fastest growing tissues including cancer tissue.
d-mean diameter of an erythrocyte is 7-8 micrometer
e-red blood cells are spherical and anucleate.
f-mean erythrocyte volume, MCV, is about 90  10 femtoliter (cubic micrometer)
g-total blood volume x Htc / (5, 000, 000 x 1000 x 1000 x 5) =MCV
h-if hemoglobin is 5 g/dl, then mean corpuscular hemoglobin (MCH) is 10 picogram
i-microcytic erythrocytes are mostly hypochromic as well
4-Correct : -5-Which is wrong ?
a-erythrocytes should be elastic and flexible, so that, they can easily change their shape.
b-erythrocytes can easily change their shape in order to slip through capillaries narrower than their diameters
c-erythrocytes can be deformed reversibly into almost any shape thanks to their having great excess of membrane
d-erythrocytes become more rigid with age, hence, fragile.
e-senescent erythrocytes are easily ruptured during passages in the liver and bone marrow, and especially in the spleen
f-spleen can be considered as the major “recycle bin” for erythrocytes.
g-since erythrocytes lack mitochondria, they depend mostly (80 %) on anaerobic respiration for energy
h-blast cells (precursors) are small enough to pass into the blood circulation
i-detection of blast cells in the blood indicates leukemia or severe anemia
5-Correct : h
6-Which is wrong ?
a-hematopoiesis occurs only in flat bones (vertebrae, sternum, ribs, ilia, and skull) during the first five years of life
b-nonproductive bone marrow is yellow due to their large fat content
c-a reticulocyte still has endoplasmic reticulum, ribosom, RNA, and some nucleus remnants
d-a reticulocyte is basophilic and seems bluish
e-a reticulocyte can pass into the blood stream by diapedesis
f-if bone marrow activity is increased, as in anemia, this rate of reticulocytes is expected to increase
g-reticulocyte count is can be considered as a reflection of recent bone marrow activity
h-when anemia is severe, inactive (fatty, yellow) marrow transforms into active hematopoietic (red) marrow
i-when anemia is severe, liver and the spleen can begin hematopoiesis again, causing hepatosplenomegali
6-Correct : a
7-Which is wrong ?
a-B12 and folic acid is essential for the synthesis of DNA.
b-lack of these vitamins causes failure of nuclear maturation and division
c-this first affects the erythrocytes because of their great production rate (nuclear metabolism).
d-as a result, immature erythrocytes which is larger (macrocytes) appear in the blood (megaloblastic anemia)
e-people with GI absorption abnormalities, such as sprue, have serious difficulty in absorbing both B 12 and folic acid.
f-gastric parietal cells secrete intrinsic factor which combines with B12, protecting it from intestinal digestive enzymes
g-in autoimmun atrophic gastritis, some autoantibodies attack on the gastric mucosa causing mucosal atrophy
h-in atrophic gastritis, lack of intrinsic factor causes B 12 deficiency (pernicious anemia).
i-iron deficiency causes macrocytic anemia as well
7-Correct : i
8-Which is wrong ?
a-an erythrocyte is filled with hemoglobin one third of its volume.
b-thalassemia is related with globin chains
c-protoporphyrin + Fe++  heme
d-heme + protein (globin)  hemoglobin chain (α or β)
e-2 α chains + 2 β (hemoglobin chains)  hemoglobin A
f-there are four iron atoms, four heme groups, and four globin molecules in each Hb molecule.
g-each of Fe atom can bind with 1 molecule of oxygen, O 2
h-there are 8 oxygen atom in a hemoglobin molecule.
i-protoporphyrin is converted into bilirubin in the blood
j-in sickle cell anemia there is a mutation in the aminoacid chain
8-Correct : i
9-Which is wrong ?
a-iron does not combine oxygen with its two positive bonds
b-oxygen makes a very loose, hence, reversible bond with hb
c-NADPH keeps iron of the hemoglobin in the ferric form (+3), rather than in ferrous form (+2).
d-in methemoglobinemia hemoglobin becomes oxidized to its ferric state ( +3)
e-when serum bilirubin exceeds 2 mg/dl, hyperbilirubinemia (jaundice, icterus) is termed.
f-bilirubin in the plasma binds with albumin, hence, is not filtrated into the urine
g-bilirubin is taken up by liver cells and congugated in there.
h-conjugated bilirubin is hydrosoluble, and excreted into the small intestine
i-bilirubin in the small intestine is turned into stercobilinogen which gives its color to the feces
9-Correct : c
10-Which is wrong ?
a-the first heart sound is caused mainly by A-V valve closure.
b-the second heart sound is caused mainly by semilunar valve closure.
c-semilunar valves are much heavier than the A-V valves
d-during deep inspiration physiological splitting of the second heart soundis heard.
e-if end-diastolic volume is 125 ml, and end-sistolic volume is 50 then ejection fraction will be 40 %
f-the murmur of the pulmonary stenosis is heard in systole.
g-the murmur of the tricuspid regurgitation is heard in systole.
10-Correct : e
11-Which is wrong ?
a-fluid administration (isotonic solutions) is harmful in cardiogenic shock
b-fluid replacement is essential in hypovolemic shock.
c-if shock deteriorates the circulatory system, irreversible stage will begin
d-brain, heart and sweat glands do not undergo vasoconstriction in a sympathetic state
e-if there is no p wave in an ECG, the heart rhythm is likely to be between 40-60 /minute
f-angiogenesis do not occur rapidly in the neonate
11-Correct : f
12-Which is wrong ?
a-right ventricular output is less than 5 lt / min
b-sympathomimetic drugs are contraindicated in coronary failure (angina pectoris)
c-delay in the A-V node gives time to the atria
d-angiogenesis is a long term regulation of circulation
e-the difference between the systolic and diastolic pressure is pulse pressure
f-duration of cardiac contraction is much longer than skeletal contraction
g-atrium and ventricle contract at different times
h-atrial syncytium and ventricular syncitium is separated by a fibrous plate
12-Correct : a
13-Which is wrong ?
a-fibrous ring is considered as the skeleton of the heart
b-valves attach to the fibrous ring
c-fibrous ring is not excitable, hence is an insulator between atria and ventricles
d-stroke volume X heart rhythm = cardiac output (minute volume)
e-P wave is caused by atrial depolarization.
f-atrial repolarization wave is in the QRS complex
g-adenosine is converted into uric acid which is excreted from the body
h-sympathetic nerves’ distribution is rich in kidney, gut, spleen and skin
13-Correct : g
14-Which is not a defense mechanism against shock?
a- aldosteron b-angiotensin c-vasopressin d-thirst e-antidiuretic hormone
f-baroreceptor reflexes g-renal antidiuretic mechanisms h-parasympathetic tonus
i- appetite for salt
14-Correct : h
15- Which is wrong ?
a-circulatory shock denotes lack of oxygen throughout the body due to the inadequacy of blood flow
b-if heart rate increases, diastolic filling increases too.
c-adenosin phosphat compounds, CO2, lactic acit, and hydrogen ion are all vasodilators
d-during contraction, ventricular pressure rises up to 120 mm Hg
e-75 % of the capacity of the ventricle is filled before the atria contract
f-both S-A node and A-V node is on the right atrium
15-Correct : b
16-Which chambers enlarge in 1) pulmonary regurgitation (failure) and 2) mitral stenosis?
a- right ventr.- left ventr b- left ventr. – right ventr c- right ventr. – left atrium
d- left atrium – right ventr. e- right atrium – left atrium f-left atrium – right atrium
g- left ventr. – right atrium h- right atrium – left ventr.-
16-Correct : c
17-Which is wrong ?
a-cardiac muscle is striated (banded)
b-cardiac muscle has myofibrils containing actin and myosin filaments.
c-slow Ca++ channels in heart cause the contraction to prolong up to 15 times as long as in skeletal muscle.
d-heart musle contraction begins a few miliseconds after an action potential begins in the muscle
e-AV bundle passes through a small hole in the fibrous tissue
f-the first mechanism to recover from shock is baroreceptor reflex
g-all muscular vessels have adrenergic α receptors which cause vasoconstriction
h-when the pressure in left ventricle exceeds the pressure in aorta, the aortic valve is opened.
17-Correct : g
18-Which is wrong ?
a-a balloon of 4.5 lt can be fully blown in a single breath
b-interpleural fluid lubricates the surfaces of the two pleura to minimalize the friction
c-elevation of the ribs increase the anteroposterior diameter of the chest cavity.
d-downward movement of diaphragm lengthens the chest cavity, causing expiration
e-lungs float in the thorasic cavity without attaching to the chest, except at hilum
f-interpleural pressure is - 5 cm at rest which is balanced by recoil pressure of the lungs
g-when glottis is open alveolar pressure is always equal to atmospheric pressure which is 760 mm Hg
18-Correct : d
19-Which is wrong ?
a-there remains still a volume of air in the lungs that can never be blown out even after maximal expiration
b-at rest, normal expiration needs no muscle
c-we can use the oxygen in the residual volume
d-when the two lungs are maximally expanded, they take 5,8 lt of space
e-in forceful expiration, abdominal content is pushed upward
f-ribs move upward in inspiration
g-anatomical dead space is the residual volume.
19-Correct : g
20-Which is wrong ?
a-the incoming air into the lung is conditioned
b-2.5 cm pleural pressure change causes 500 ml volume change in the lungs
c-collapsing pressure of the lungs (recoil pressure) is 5 cm water pressure at rest
d-pneumothorax and hemothorax can increase the negativity of pleural pressure lower than -5 cm.
e-CO2 and H+ in the blood mostly affects the center in the medulla directly
f-oxygen in the alveoli is lower than that in the dead space
20-Correct : d
21-Which is wrong ?
a-lungs lie deep within the thorasic cavity where they are protected from drying out.
b-mucociliary clearance constitutes the first line of defence of the lungs.
c-surfactant synthesis in utero becomes adequate at 7th week.
d-premature infants may develop acut respiratory distress syndrome due to surfactant deficiency.
e-about 75 % of the oxygen a person takes in, is exhaled without using.
f-one person uses about 1 lt oxygen in 4 minutes at rest (if oxygen is 15 % in the exhaled air)
g-when glottis is open, alveolar pressure is always equal to atmospheric pressure which is 760 mm Hg
21-Correct : c
22-Which is wrong ?
a-70 ml oxygen is taken in with each normal breath, but 17.5 ml of it is used
b-in pneumothorax recoil pressure of lung cannot be balanced by pleural negative pressure
c-in order to expand the lungs, we are to expand the thoracal cavity
d-lowering the diaphragm causes inspiration
e-gaining extra thoracal volume causes inspiration
f-we can use the oxygen in the anatomical dead space
g-there are projections in the nasal cavity called as concha, causing a turbulent flow
h-nasal cavities are differentiated for the air intake
22-Correct : f
23-Which is wrong ?
a-compliance = V/P = 200 ml/cm.Hg
b-1 cm Hg difference in pleural pressure causes 300 ml volume change in the lungs
c-fibrosis decreases the compliance of the lung
d-in fibrosis, 2.5 cm pressure is not enough for 500 ml volume change
e-conducting airways have no alveoli
f-conducting airways constitute dead space
g-infection of the trachea is called as tracheitis
23-Correct : b
24-Which is wrong ?
a-mucociliary clearance is provided by the movement of the carpet of mucus in the respiratory tracts
b-mucociliary clearance makes respiratory secretions stay where they are secreted
c- respiratory secretion is ideal medium for microorganisms, hence, feed them
d-in this regard, expectoration (spit out sputum) is an important defense mechanism of the body.
e-some microorganisms alter mucus, and mucus becomes thickened, more cohesive, more resistant to breakup.
f-consequently, a mucolytic expectorant should be used in order to thin the mucus (mucolysis)
g-in this way phlegm can be removed via coughing from the respiratory tracts.
h-the use of antiexpectorants in this case is contraindicated
i-antiexpectorants block essential task of phlegm.
24-Correct : b