Download DIRECTIONS: Each of the questions or incomplete statements

DIRECTIONS: Each of the questions or incomplete statements below is followed by five
suggested answers or completions. Select the ONE that is BEST in each case.
1. Bill and Joe, both healthy adults, are noted to have the same cardiac outputs, the same heart
rates, and the same total peripheral resistances, but Bill is noted to have a larger aortic pulse
pressure. It is likely that
(A) mean arterial pressure is greater in Bill
(B) stroke volume is greater in Bill
(C) diastolic pressure is greater in Bill
(D) Bill is older than Joe
(E) stroke work is greater in Joe
2. Heart rate and ventricular end diastolic pressure remain constant while ventricular end
systolic volume decreases.
(A) Ventricular preload must have increased.
(B) Venous return must have increased.
(C) Stroke volume must have decreased.
(D) Venous unstressed volume must have decreased.
(E) Mean arterial pressure must have remained unchanged.
3. The peak of the R wave of the electrocardiogram coincides in time with the
(A) closure of the aortic value.
(B) start of ventricular isovolumetric relaxation phase.
(C) opening of the aortic value.
(D) peak aortic systolic pressure.
(E) closure of the mitral value.
4. If ventricular end systolic pressure equals 100 mm Hg, the aortic value opens at 80 mm Hg
and aortic pulse pressure equals 50 mm Hg, the aortic pressure at the end of the ventricular
rapid ejection phase is
(A) 50 mm Hg
(B) 150 mm Hg
(C) 20 mm Hg
(D) 130 mm Hg
(E) 110 mm Hg
5. In a Starling Heart-Lung preparation, Heart rate total peripheral resistance and ventricular
contractility remain constant. A decrease in venous return will result in a new steady state
where
(A) mean circulatory filling pressure increases.
(B) ventricular end diastolic volume increases.
(C) stroke volume remains unchanged.
(D) ventricular end systolic volume increases.
(E) mean arterial pressure decreases.
6. If the mean circulatory filling pressure of a patient connected to a heart-lung machine
increased while total peripheral resistance and pump output (5 L/min) remained constant, one
can conclude that
(A) he pressure difference across the total peripheral resistance remained unchanged.
(B) the cardiac function curve moved up and to the left.
(C) mean central venous pressure remained unchanged.
(D) blood volume decreased.
(E) venocontriction increased.
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7. For mean arterial pressure to remain constant when splanchnic blood flow increases by 1.5
liters/min and all other regional blood flows remain unchanged,
(A) total peripheral resistance must increase.
(B) cardiac output must increase.
(C) venous pressure must decrease.
(D) heart rate must increase.
(E) myocardial contractility must increase.
8. An increase in mean arterial blood pressure from 90 to 110 mm Hg will cause
(A) decreased firing of afferent fibers in the carotid sinus nerve.
(B) decreased firing of the cardiac sympathetic efferent fibers.
(C) increased myocardial contractility.
(D) increased venoconstriction.
(E) increased total peripheral resistance.
9. Decreased atrial rec ecauses
(A) increased blood levels of vasopressin.
(B) increased blood levels of angiotensin 1.
(C) decreased venoconstriction.
(D) decreased total peripheral resistance.
(E) None of the above.
10. Intravenous infusion of a beta adrenergic receptor antagonist
(A) increases myocardial contractility.
(B) shifts the cardiac function curve down and to the right.
(C) blocks sympathetic activation of venous smooth muscle
(D) blocks sympathetic induced arteriolar constriction.
(E) blocks the effect of acetylcholine on heart rate.
11. Blood flow in the left coronary artery is
(A) greatest during the ventricular ejection phase.
(B) lowest during ventricular isovolumetric contraction.
(C) not controlled by active hyperemia.
(D) primarily regulated by neural control of myocardial arterioles.
(E) not controlled by pressure-volume autoregulation.
12. Cerebral blood flow is
(A) generally unaffected by changes in mean arterial blood pressure between 80 and
100 mm Hg.
(B) increased by hemorrhage into the cranium.
(C) very insensitive to small changes in arterial levels of CO2.
(D) very sensitive to small changes in arterial levels of hydrogen ions.
(E) does not demonstrate pressure-volume flow regulation.
13. If the efferent nerves to the upper esophageal sphincter (UES) and the lower esophageal
sphincter (LE) are destroyed,
(A) UES muscle will be contracting between swallows.
(B) LES muscle will be relaxed between swallows.
(C) UES muscle will not be relaxed at any time during a swallow.
(D) the LES will not relax during a swallow.
(E) gastric contents will reflux into the esophagus.
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14. In a region of the small intestine that exhibits slow waves at a frequency of 12/min,
(A) the enteric nerves must be intact.
(B) slow waves will be recorded only during the fed state.
(C) all the contractions during the fed state will have the same amplitude.
(D) the majority of contractions during the digestive state will be peristaltic.
(E) the maximum frequency of contractions will be 12/min .
15. Compared to the gastric emptying of a non-nutrient meal, the gastric emptying of a nutrient
meal is associated with
(A) a decrease in force of antral contractions.
(B) an increase in tonic contraction of the orad stomach.
(C) a decrease in contractions of the pylorus.
(D) a decrease in segmenting contractions of the proximal duodenum.
(E) less stimulation of receptors in the duodenal mucosa.
16. All of the following are true about the migrating motility (motor) complex EXCEPT:
(A) It occurs during the interdigestive (fasting) state.
(B) It involves both the stomach and the small intestine.
(C) Its absence is associated with bacterial overgrowth of the intestine.
(D) It cycles at a frequency of about once every 90 - 120 minutes.
(E) It can be initiated by the injection of cholecystokinin (CCK).
17. Distention of the rectum by colonic contents
(A) occurs through the action of haustral (segmenting) contractions of the descending
colon.
(B) elicits an immediate, sustained contraction of the external anal sphincter.
(C) elicits an immediate, transient relaxation of the internal anal sphincter.
(D) affects motility of other regions of the colon via release of gastrin.
(E) is not consciously sensed unless the distention produces pain.
18. All of the following are true about receptive relaxation of the orad stomach EXCEPT:
(A) It is enhanced in patients who have undergone vagotomy.
(B) It occurs in response to swallowing.
(C) It prevents large increases in intragastric pressure during eating.
(D) It is enhanced in the presence of circulating cholecystokinin (CCK).
(E) It likely is mediated by nitric oxide (NO) and/or VIP.
19. All of the following statements about mucus are true EXCEPT:
(A) Mucus contains polymeric neutral and acidic glycoproteins.
(B) Mucus contains lipids to provide it with hydrophobic properties.
(C) Mucus is only synthesized and secreted by gastric (not intestinal) mucous cells.
(D) Mucus entraps bicarbonate ions to buffer HCI, diffusing from the gastric lumen.
(E) Mucus lubricates both the mucosa and food bolus.
20. Pancreatic amylase secretion is
(A) increased by the addition of trypsin to the diet.
(B) decreased by diversion of pancreatic juice to outside the GI lumen.
(C) increased during the cephalic phase of a meal.
(D) increased by elevations in the concentration of pancreatic polypeptide in the
circulation.
(E) decreased by the infusion of acid into the proximal duodenum.
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21. Pancreatic bicarbonate secretion during a meal
(A) will be greater in meals containing a high carbohydrate content than in meals
containing a high content of fat.
(B) will increase if the subject consumes a proton pump inhibitor (omeprazole) one
hour prior to the ingestion of a meal.
(C) will be increased if the subject is administered a CCK receptor antagonist prior to
ingestion of the meal.
(D) is higher during the cephalic than the intestinal phase of a meal.
(E) plays a physiological role in alkalinizing the intestinal fluid of the duodenum and
jejunum.
22. All of the following statements about bile salts are true EXCEPT:
(A) Bile salts are predominantly secreted from the hepatocyte conjugated to either
glycine or taurine.
(B) The majority of the conjugated bile salts are reabsorbed across the jejunal mucosa.
(C) Bile salts are deconjugated and dehydroxylated by intestinal bacteria.
(D) The uptake of conjugated bile salts from the portal blood into the hepatocyte is
dependent on a sodium coupled co-transport pump.
(E) Bile salts circulate via the enterohepatic circulatory system several times during a
single meal.
23. All of the following statements about bilirubin are true EXCEPT:
(A) Is a metabolic product of the liver
(B) Accumulates in the blood during periods of liver failure or cholestasis
(C) Is transported into the hepatocyte from the blood by a specific transport pump
(D) Is secreted into bile conjugated to glucuronic acid
(E) Is converted to urobilinogen by intestinal bacteria
24. All of the following statements about secretin are true EXCEPT:
(A) Secretin release into the blood is stimulated by the presence of acid in the lumen of
the proximal intestine.
(B) Secretin stimulates pancreatic bicarbonate secretion.
(C) Secretin is chemically related to CCK. .
(D) Secretin stimulates cAMP levels in pancreatic ductule cells.
(E) Secretin stimulates a component of bile flow that is NOT dependent on bile acid
output.
25. All of the following statements about gastrin are true EXCEPT:
(A) Gastrin release is stimulated during the cephalic phase of a meal.
(B) Gastrin release is stimulated when the pH of gastric juice is pH 3 or lower.
(C) Gastrin is a physiological regulator of gastric HC1 secretion.
(D) Gastrin release is inhibited by somatostatin.
(E) Gastrin has a well defined active site that binds to membrane receptors on both
parietal and ECL cells.
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26. All of the following statements about gastric HCl secretion are true EXCEPT:
(A) HCl secretion is reduced by vagotomy.
(B) HCl secretion is stimulated in response to histamine binding to H-1 receptors on
parietal cells.
(C) HC1 secretion is dependent on tubulovesicles fusing with the canalicular membrane
of parietal cells.
(D) HC1 secretion is regulated by the rate-limiting enzyme, H+/K' ATPase.
(E) HCl secretion is inhibited by the secretion of intestinal hormones when lipidcontaining food enters the small intestine.
27. Pepsinogen
(A) is stored in gastric parietal cells.
(B) is converted to pepsin at acidic luminal pH.
(C) release is inhibited by vagal stimulation.
(D) is present as a single iso-enzyme.
(E) is activated by trypsin in the lumen of the small intestine.
DIRECTIONS: Each group of questions below consists of five lettered headings or a diagram
or table with five lettered components, followed by a list of numbered words, phrases, or
statements. For each numbered question, select the ONE lettered heading or component that is
MOST CLOSELY ASSOCIATED WITH IT. Each lettered component or heading may be
selected once, more than once, or not at all.
(A) Fructose
(B) Alanine
(C) Butyric acid
(D) Sodium
(E) Palmitic acid
Match items A-E with absorptive mechanism
28. Co-transported across brush border with organic substrates
29. Absorbed by carrier-mediated process not requiring ATP
--------------------------------------------------------------------------------------------------(A) Fructose
(B) Alanine
(C) Butyric acid
(D) Sodium
(E) Palmitic acid
Match items A-E with narrative
30. Bile salts promote absorption
31. Chylomicrons involved in absorption from lumen into blood
32. Exit from enterocyte involves common carrier with galactose
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-------------------------------------------------------------------------------------------------(A) Fructose
(B) Alanine
(C) Butyric acid
(D) Sodium
(E) Palmitic acid
Match items A-E with digestive process involved in assimilating this compound from the
diet:
33. Carboxypepdidase involved in digestion that leads to this product
34. Co-lipase required for digestion yielding this water soluble product
35. Product of membrane digestion that is transported by facilitated diffusion
------------------------------------------------------------------------------------------------------(A) Aorta
(B) Arterioles
(C) Capillaries
(D) Venules
(E) Vena Cava
36. Vessel(s) in which the velocity of flow is the lowest
37. Vessel(s) in which mean end pressure is the highest
38. Vessel(s) that offer the greatest combined resistance to flow
39. Vessel(s) in which pulse pressure is the greatest
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PHYSIOLOGY 2003
EXAM II
1. D
2. B
3. E
4. D
5. E
6. A
7. B
8. B
9. A
10. B
11. B
12. A
13. D
14. E
15. A
16. E
17. C
18. A
19. C
20. C
21. E
22. B
23. A
24. C
25. B
26. B
27. B
28. D
29. A
30. E
31. E
32. A
33. B
34. C
35. A
36. C
37. A
38. B
39. A
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