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. An otherwise normal female with a sudden loss of FSH, but not LH, secretion by the
pituitary early in the follicular phase of the menstrual cycle would exhibit
(A) normal production of progesterone by the ovaries during the luteal phase of the
menstrual cycle.
(B) a slowing of the GnRH pulse generator following ovulation.
(C) a normal estrogen surge prior to ovulation.
(D) a lower than normal aromatase activity in granulosa cells.
(E) normal maturation of Graafian follicles.
2. The hormone GnRH
(A) is synthesized from cholesterol.
(B) is released from nerve endings in the pituitary gland.
(C) acts on the ovaries to promote the synthesis of estrogens.
(D) is synthesized by cells in the medulla oblongata.
(E) often is absent in women lacking a sense of smell.
3. The continuous infusion of GnRH to a normal woman would result in
(A) a decrease in LH and FSH secretion by the pituitary.
(B) continuation of normal 28 day menstrual cycles.
(C) increased levels of plasma estrogens.
(D) ovulation within 36 hrs of beginning the continuous infusion.
(E) abnormally high ovarian testosterone production.
4. In the absence of GnRH secretion for at least 28 days in an adult female,
(A) plasma levels of LH and FSH would be higher than normal.
(B) administration of estrogen sufficient to achieve markedly elevated plasma levels for
36 hrs would fail to induce ovulation.
(C) ovarian production of androgens would be normal.
(D) ovarian production of progesterone would be normal.
(E) Graafian follicles would develop normally.
5. In an otherwise normal woman who several months previously had both ovaries removed,
continuous administration of a substance induced a lowering of plasma levels of LH and
FSH. Injection of a large dose of a long-acting estrogen during the continuous
administration of the substance resulted in a surge of LH secretion. The substance most
likely was
(A) estradiol.
(B) a drug that blocked the action of GnRH at the pituitary.
(C) progesterone.
(D) inhibin.
(E) testosterone.
6. During the menopause, serum hormone levels/patterns of secretion, relative to
levels/patterns of secretion occurring during the normal menstrual cycle are:
(A) low FSH and LH, high estrogen, normal GnRH pulse frequency
(B) high FSH and LH, low estrogen, normal GnRH pulse frequency
(C) high FSH and LH, low estrogen, low GnRH pulse frequency
(D) low FSH and LH, low estrogen, low GnRH pulse frequency
(E) high FSH and LH, high estrogen, high GnRH pulse frequency
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7. All of the following are true about testosterone EXCEPT:
(A) Its action depends upon binding to plasma membrane receptors
(B) It inhibits LH secretion.
(C) It promotes development of male secondary sexual features.
(D) It is present in seminal fluid.
(E) It is necessary for spermatogenesis
8. Inhibin
(A) is produced by Leydig cells.
(B) is responsible for inhibiting secretion of FSH.
(C) is produced in response to LH stimulation.
(D) brings about feedback inhibition of LH secretion.
(E) inhibits action of testosterone on Sertoli cells.
9. LH
(A) is secreted by the posterior pituitary gland
(B) fitimulates testosterone production
(C) acts on the Sertoli cells of the testes
(D) enters its target cell by diffusion through the lipid bilayer
(E) is a sterol molecule
10. An agent that blocks ATP sensitive K+ channels would most likely
(A) increase plasma glucose levels.
(B) reduce skeletal muscle contractility.
(C) stimulate β-cell insulin secretion.
(D) hyperpolarize pancreatic cells.
(E) stimulate gluconeogenesis.
11. Glucagon increases the plasma glucose concentration by causing an increase in each of the
following EXCEPT:
(A) β-oxidation
(B) Phosphorylase
(C) Gluconeogenesis.
(D) Hepatic amino acid utilization
(E) Fatty acid synthesis
12. In diabetic ketoacidosis the lack of insulin results in all of the following EXCEPT:
(A) Increased hepatic glucose production
(B) Increased glucokinase activity
(C) Accelerated β-oxidation of fatty acids
(D) Increased lipolysis
(E) Inhibition of glucose utilization
13. During starvation when there is an increase in the rate of production of ketone bodies
(starvation ketosis) all of the following are true EXCE'P'T':
(A) Ketone bodies are preferentially oxidized by some tissues reducing demand for glucose
(B) PFA mobilization is increased due to reduced lipoprotein lipase activity
(C) Triglyceride formation is limited by availability of glucose
(D) Muscle protein catabolism leads to an increase in the circulating levels of ketogenic
amino acids
(E) Muscle glucose utilization is reduced due to inhibition of glycolysis
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14. Intravenous injection of 5µM tetra-iodothyronine (T4) will
(A) reduce AMR.
(B) induce hypercholestero1emin.
(C) decrease hepatic glucose release.
(D) inhibit TRH-regulated TSH secretion.
(E) elevate serum albumin levels.
15. A patient undergoes evaluation in order to determine the origin of his thyroid disorder.
Thyroid stimulating hormone (TSH) levels were found to be abnormally low but, were
markedly elevated following injection of synthetic thyrotropin releasing hormone (TRH).
Based on this information the physician determines that the lesion is localized to the
(A) thyroid gland.
(B) anterior pituitary.
(C) hypothalamus.
(D) adrenal cortex.
(E) posterior pituitary.
16. Fever onset occurs before one can detect elevated endogenous pyrogen levels in the serum.
Vagotomy ablates the fast onset component of fever. Which of the following best explains
these facts?
(A) Pyrogenic substances preferentially accumulate in the brain at levels higher than in
the serum.
(B) Fever onset is driven by liver Kupfer cell stimulated vagal afferents.
(C) Reduced vagal input within the anterior hypothalamic/pre-optic area sensitizes the
brain to pyrogens.
(D) Circulating T-lymphocytes stimulate vagal afferents.
(E) Vasopressin release by brain vagal inputs elevates the temperature set-point.
17. An individual without adequate clothing, exposed to an environmental temperature of
7°C (45° F) exhibits all of the following EXCEPT:
(A) Closure of sub-cutaneous arteriovenous shunts
(B) Shivering
(C) Piloerection
(D) A decrease in adrenergic nerve activity
(E) An increase in whole-body oxygen consumption
18. All of the following are important physiological regulators of pituitary growth hormone
secretion EXCEPT:
(A) GHRH
(B) T4
(C) GHrelin
(D) dopamine
(E) somatostatin
19. All of the following may result in short stature EXCEPT:
(A) anorexia
(B) inactivating mutations in the Pit l transcription factor
(C) testosterone excess
(D) inactivating mutations in IGF-I
(E) inactivating mutations in the estrogen receptor
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20. Growth Hormone elicits all of the following effects EXCEPT:
(A) stimulation of IGF-H production
(B) stimulation of free fatty acid release in fat cells
(C) stimulation of glucose release from glycogen in liver cells
(D) inhibition of GHRH secretion
(E) increased amino acid uptake in liver
21. The biologically active form of Vitamin D is produced in the
(A) skin.
(B) liver.
(C) kidney.
(D) intestine.
(E) bone.
22. Elevation of plasma Ca to 12 mg would cause
(A) inhibition of calcitonin secretion.
(B) inhibition of PTH secretion.
(C) an increase in plasma 1,25(OH)2D3.
(D) increased neuromuscular excitability.
(E) an increase in osteoclast activity
23. All of the following statements are true EXCEPT:
(A) Activating mutations of the Ca sensing receptor lead to hypoparathyroidsm
(B) The final metabolic step leading to the active form of Vitamin D involves
hydroxylation at the 1 position
(C) An increase in serum calcium leads to stimulation of calcitonin secretion
(D) 1,25(OH)2D3 acts directly on the kidney to increase the reabsorption of phosphate
(E) 1,25(OH)2D3 acts directly on intestinal epithelial cells to increase absorption of
calcium
24. Binding of oxygen to hemoglobin is increased by all of the following EXCEPT:
(A) metabolic acidosis
(B) decreased plasma PCO2
(C) decreased body temperature
(D) decreased 2.3-diphosphoglycerate
(E) increased plasma PO2
DIRECTIONS: Each group of questions below consists of lettered headings or a diagram or
table with 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) Insulin
(B) Glucagon
(C) Both
(D) Neither
25. Secretion stimulated by glucose
26. Secretion stimulated by parasympathetic activity
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--------------------------------------------------------------------------------Extracellular Right
Cardiac
Fluid
Ventricular EndContractility
Compartment Diastolic
Pressure
A.
↑
↓
↑
B.
↓
↓
↓
C.
↑
↑
↓
D.
↓
↓
↑
E.
↑
↑
↓
Total Peripheral
Resistance
↑
↓
↑
↑
↓
27. Congestive Heart Failure
28. Diabetic ketoacidosis
29. Hemorrhagic shock
---------------------------------------------------------------------------------
A.
B.
C.
D.
E.
GFR
Filtration
Fraction
Plasma
Renin
Plasma ADH
↑
↑
↓
↑
↑
↑
↓
↑
↓
↓
↓
↓
↑
↑
↓
↑
↓
↑
↓
↓
Ability to
Concentrate
Final Urine
Maximal
Maximal
Reduced
Maximal
Reduced
30. Hemorrhagic shock
31. Intravenous infusion of saline to a normal individual
32. Diabetic ketoacidosis
---------------------------------------------------------------------------------------------------------------
A.
B.
C.
D.
E.
Plasma pH
↑
↓
↑
↑
↓
Urine pH
↑
↓
↑
↓
↓
PaCO2
↓
↓
↑
↑
↑
Minute volume
↑
↑
↓
↓
↓
33. Diabetic ketoacidosis
34. Hemorrhagic shock
----------------------------------------------------------------------------------------------------------
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Plasma HC03↑
↓
↑
↑
↑
Mean
Arterial
Pressure
Total
Peripheral
Resistance
Right
Atrial
Pressure
↓
B ↓
C ↓
D ↓
↓
↓
↓
↓
↑
↓
A
E
↑
↑
↑
↑
↑
Extracellular
Fluid Volume
Pulse
Rate
→
↓
↓
↑
↑
↑
↑
↑
↑
↓
35. Diabetic ketoacidosis
36. Chronic administration of aldosterone
37. Hemorrhagic shock
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PHYSIOLOGY 2003
EXAM IV
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
D
E
A
B
A
B
A
B
B
C
E
B
D
D
C
B
D
D
E
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
A
C
B
D
A
A
C
C
D
D
A
E
E
B
B
B
E
B
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