physio block 3 final.doc

8/10/2019 PHYSIO BLOCK 3 final.doc

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1.

A mother brings her 6-yr-old son to his pediatrician because he has been having recurrentnosebleeds. Physical examination reveals diffuse petechiae and purpura. Laboratory studies show aHb of .! g"L# platelet count of $!#!!!"cu.mm# % leu&ocyte count of 1'#(!!"cu mm. )one marrowsmear is shown below. *he large cells are most probably precursors of

a. +osinophils

b. )asophils

c. ,eutrophils

d. Lymphocytes

e. onocytes

f. )/

g. Platelets

$.

elease of which of the following peptides leads to an increase in the secretion of pancreaticbicarbonates into the small intestine0

a. /holecysto&inin

b. astrin

c. otilin

d. 2ecretin

e. 2omatostatin

3.

A 6 -year-old boy playing in a dusty field in windy weather inhales many very small particles thatbecome lodged in his terminal bronchioles. 4hich of the following are most important in cleaning the


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particles0

a. *ype 5 pneumocytes

b. *ype 55 pneumocytes

c. Alveolar macrophages

d. 2ubmucosal glands

e. /iliated cells

'.

4hich of the following substances use a protein-carrier molecule to traverse the cell membrane0

a. 4ater

b. xygen

c. lucose

d. Alcohol

e. lycerol

(.

A 78-year-old woman has a mean arterial pressure of 1!! mm Hg and a heart rate of 6$"min. 2hehas a stro&e volume of 8! mL and a right atrial pressure of ! mm Hg. 4hat is the total peripheralresistance 9in mm Hg"mL"min: in this woman0

a. !.$

b. !.1

c. !.(

d. !.3

e. !.'

6.

An 8-yr-old boy has had an upper respiratory infection for the past 3 days. *oday# he is brought tothe pediatrician by his mother# who says that ;he loo&s yellow


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a. ,ormal )/

b. Hypochromic )/

c. >efect in 2pectrin

d. icrocytic )/

7.

A 3'-year-old male patient visited the emergency room with complaints of severe vomiting.Laborotaory examination of the vomitus is found to contain gastric contents including hydrochloricacid. *he patient?s condition is most li&ely associated with which of the following acid-basedisturbances0

a. High anion gap metabolic acidosis

b. ,ormal anion gap metabolic acidosis

c. espiratory acidosis

d. espiratory al&alosis

e. etabolic al&alosis

8.

)asophils are increased in which of the following conditions0

a. Acute infection

b. /hronic infection

c. Parasitic infestation

d. Allergic reaction


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.

A researcher is studying the effect of various manipulations on &idney blood flow and glomerularfiltration. 4hich of the following is most li&ely to increase both renal plasma flow and peritubular

capillary pressure but decrease the glomerular capillary pressure0

a. /onstrict afferent arteriole

b. >ilate afferent arteriole

c. /onstrict efferent arteriole

d. >ilate efferent arteriole

1!

.

5f the above researcher dilates the afferent arteriole then which of the following changes will be seenin renal plasma flow# peritubular capillary pressure# and glomerular capillary pressure respectively0

a. 5ncreases# increases# and increases

b. >ecreases# decreases# and decreases

c. >ecreases# decreases# and increases

d. 5ncreases# increases# and decreases

11.

*he vascular systems of five organs are arranged as shown in the drawing below. *he vascularresistance of each organ is the same and the total resistance of the entire circuit is $.! mmHg"mL"min. 4hat is the individual vascular resistance 9mm Hg"mL"min: of each organ0

a. 1!


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b. 8

c. 6

d. '

e. $

f. 1

1$.

5n the above picture# which of the following values is the total resistance of the entire circuit ifanother organ with the same invidual vascular resistance 9mm Hg"mL"min: was added to the circuitshown in the picture above0

a. !.6

b. 1.!

c. 1.6

d. $.!

e. $.6

13.

A 6(-year-old male was brought to the + with severe chest pain# sweating and nausea. +@ showed2* elevation in leads 55# 555 and aB. edical management of acute myocardial infarction wasinitiated. After initial treatment the pain decreased in intensity# but a reperfusion complex ventriculararrhythmia emerged. *he arrhythmia was asymptomatic and resolved spontaneously. 4hich of thefollowing drug was most li&ely responsible for rapid reperfusion in this patient0

a. Heparin

b. Argatroban

c. 4arfarin

d. tPA

e. Aspirin

1'.

A ('-year-old male is being evaluated for lung disease. entilator function testing reveals adecreased forced vital capacity# and a B+1 "B/ ratio of 6!=. *he most li&ely diagnosis in this


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patient is

a. Pulmonary fibrosis

b. 5nterstitial lung disease

c. Pleural effusion

d. Pericardial effusion

e. +mphysema

1(.

4hich of the following factors inhibit erythropoietin production0

a. Low blood volume

b. Anemia

c. Low Hb

d. ,ormal blood flow

e. Pulmonary diseases

16.

A patient came with bone pain and abdominal cramps. +xamination revealed depressed mood. C-rayrevealed a !.( mm stone in the left ureter. )ased on these findings# which of the following is theli&ely diagnosis in this patient0

a. Hyperparathyroidism

b. Hypoarathyroidism

c. Hyperthryoidism

d. Hypopituitarism

e. Hyperpituitarism

17.

>uring a fast# a brief phase of intense seDuential contractions begins in the stomach and graduallymigrates tothe ileum. elease of which of the following intestinal hormones is most li&ely responsible for thisobserved


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effect0

a. /holecysto&inin

b. astrin

c. astrin-releasing peptide

d. otilin

e. 2ecretin

f. 2omatostatin

1

8.

A ((-year-old caucasian female presents to the clinic complaining of weight gain and easy

fatiguability. 2he ta&es a multi-vitamin and some over-the-counter medications for constipation. Herblood pressure is 1'!"6 mm Hg and her heart rate is (("min. Physical examination reveals adelayed relaxation of the &nee and an&le reflexes. 2&in is very dry and thic&. 4hat is the most li&elydiagnosis in this patient0

a. Hyperthyroidism

b. Hyperparathyroidism

c. Hypothyroidism

d. Hypoparathyroidism

e. Hyperaldosteronism

1.

4hich of the following parameters will be seen in the base of the lung in comparision to the apex in anormal healthy individual0

a. Perfusion decreased# "E increased

b. Perfusion increased# "E decreased

c. Perfusion decreased# "E decreased

d. Perfusion increased# "E increased

$!

astric inhibitory peptide is an important gastrointestinal hormone. *he cells producing it and the


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. functions of the peptide respectively are

a. @ cells and inhibits insulin release

b. cells and stimulates gastric motility

c. 2 cells and inhibits gastric acid secretion

d. cells and stimulates intestinal motility

e. @ cells and stimulates insulin release

f. 2 cells and stimulates pepsin secretion

$

1.

5n the +/ given below# what is the most li&ely diagnosis0

a. )))

b. H

c. L)))

d. LH

$$.

A person who is suffering with severe claustrophobia 9fear of closed spaces: was loc&ed accidentallyin a closet for some amount of time. 5f the blood of this patient was analyFed then which of thefollowing sets of lab findings is most li&ely to be found in this patient0


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a. 1. pH of 7.$G Pa/$ of (! mmHgG % H/3- of 18 m+D"L

b. $. pH of 7.61G Pa/$ of 3$ mmHgG % H/3- of $8 m+D"L

c. 3. pH of 7.3$G Pa/$ of 3' mmHgG % H/3- of 18 m+D"L

d. '. pH of 7.'3G Pa/$ of (! mmHgG % H/3- of '! m+D"L

e. (. pH of 7.$6G Pa/$ of (! mmHgG % H/3- of 3( m+D"L

f. 6. pH of 7.($G Pa/$ of 3! mmHgG % H/3- of 18 m+D"L

$3.

5n the above sets of lab findings# which set will correspond to a patient suffering with /onn?ssyndrome0

a. 1

b. $

c. 3

d. '

e. (

f. 6

$'.

*ransport of glucose from the intestinal lumen into a small intestinal cell is inhibited when the usual,a gradient across the membrane is abolished. *his would suggest inhibition of which of thefollowing transport mechanisms0

a. 2imple diffusion

b. Bacilitated diffusion

c. Primary active transport

d. /otransport

e. /ountertransport

$ n routine physical examination# a $1-year-old /aucasian male is found to have only one testis in his


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(.

scrotum. Burther evaluation reveals an elevated serum B2H level and a normal serum LH level.Production of which of the following substances is li&ely to be impaired in this patient0

a. *estosterone

b. >ihydrotestosterone

c. >H+A

d. 5nhibin )

e. /ortisol

$6

.

*he blood of a patient is tested in the lab for grouping and typing. *he blood did not react when Aand ) antibodies were added but reacted when > antibodies are added. *he patientIs blood group

based on the above reactions is

a. A positive

b. ) positive

c. A) positive

d. positive

e. A negative

f. ) negative

g. A) negative

$7.

A series of photographs ta&en of a middle-aged man over a period of two decades demonstratesgradual coarsening of facial features and progressive protrusion of the brows. Jpon Duestioning# thepatient reports having to wear larger shoes than he did as a young man. 5 scan revealed thepresence of hypothalamic tumor. 4hich of the following changes can be seen in this partiular case0

a. H increase# HH decrease# 2omatostatin decrease

b. H decrease# HH increase# 2omatostatin decrease

c. H increase# HH increase# 2omatostatin increase

d. H increase# HH decrease# 2omatostatin increase


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e. H decrease# HH decrease# 2omatostatin decrease

$8

.

4hich of the following characteristics is shared by simple and facilitated diffusion of glucose0

a. 5s saturable

b. eDuires metabolic energy

c. 5s inhibited by the presence of galactose

d. ccurs down an electrochemical gradient

e. eDuires a ,a radient

$

.

4hich of the following tests is used for measuring specifically intrinsic pathway0

a. Prothrombin time

b. )leeding time

c. /lotting time

d. aP** 9partial thromboplastin time:

3!.

Prior to a maKor abdominal surgery a patient was found to have low levels of vitamin @. 4hich of thefollowing clotting factors would be decreased in this patient0

a. 5

b. 555

c.

d. 55

e. C5

31

n performing an arterial blood analysis in a patient the physician noted that the pH and H/3-levels are decreased but P/$ level is increased. 4hich of the following conditions best describes this


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. patient?s problem0

a. espiratory acidosis

b. espiratory al&alosis

c. etabolic acidosis

d. etabolic al&alosis

e. ixed acidosis

f. ixed al&alosis

3

$.

4hich of the following is true about the secretion from the exocrine pancreas0

a. 5t has a higher /l- concentration than does plasma

b. 5t is stimulated by the presence of H/3- in the duodenum

c. Pancreatic secretion is increased by gastrin

d. Pancreatic enFyme secretion is increased by cholecysto&inin 9//@:

e. 5t is hypotonic

33.

4hich of the following hormones maintains the corpus luteum of pregnancy0

a. nH

b. B2H

c. h/

d. Progesterone

e. +strogen

f. Prolactin


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3'.

*he hormone responsible for stimulating mil& production from a lactating mammary gland is

a. Prolactin

b. asopressin

c. xytocin

d. B2H

e. LH

3(.

A (-yr-old male patient is brought to the + with complaints of chest pain# breathlessness#palpitations# % sweating. )lood tests# +/ and Angiogram were done in this patient and flow rateswere measured. 5t is a &nown fact that for a given vessel length# flow depends on radius# pressuregradients# and viscosity. Angiogram revealed an atherosclerotic plaDue in the LA> that has reducedthe radius of the vessel by a factor of $. *he flow change only due to the plaDue is

a. 5ncrease by a factor of $

b. >ecrease by a factor of $

c. 5ncrease by a factor of 8

d. >ecrease by a factor of 8

e. 5ncrease by a factor of 16

f. >ecrease by a factor of 16

36.

5n the above patient# blood tests revealed that the patient is suffering with severe anemia with low)/ count that reduced the hematocrit to 1"'th of its original value. *he flow change only due to thehematocrit variation is






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e. 5ncrease by a factor of '

f. >ecrease by a factor of '

37.

5n the above patient# )P monitoring of the patient revealed a raise of systolic pressure from 1$! to16! while the diastolic pressure remained at 8! mm Hg. *he flow change only due to the pressuregradient is







38.

5n the above patient# what would be the overall change in flow if we ta&e into consideration all the 3variations mentioned above together0







3.

A patient presents with complaints of chest pain# breathlessness on exertion# % syncope. Afterperforming an +/ exam on the patient they physician came to the conclusion that the patient issuffering with second-degree heart bloc&. 4hich of the following +/s represents this type of heartbloc&0

a. 1


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b. $

c. 3

d. '

e. (


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f. 6

'

!.

5f the above patient was diagnosed to be suffering with atrial fibrillation then which of the above

+/s will be seen in the patient0

a. 1

b. $

c. 3

d. '

e. (

f. 6

'1.

5n the above patient# if the diagnosis was changed to ventricular fibrillation then the above +/s willcorresponding to this new diagnosis

a. 1


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b. $

c. 3

d. '

e. (

f. 6

'$.

A 6(-year-old male with long history of chronic obstructive pulmonary disease 9/P>: is brought tothe emergency room complaining of shortness of breath# fever# yellow sputum and lower extremityedema. Physical examination reveals cyanosis# finger clubbing and bilateral lung wheeFes. 4hich ofthe following findings is the most li&ely in this patient0

a. ,ormal arterial blood oxygen content

b. ,ormal mixed venous blood oxygen content

c. 5ncreased pH of the arterial blood

d. 5ncreased pulmonary arterial resistance

e. 5ncreased cerebral vascular resistance

'3.

Anemia is usually characteriFed by an increased

a. Hematocrit

b. )lood viscosity

c. *otal peripheral resistance

d. +xercise performance

e. 4or& load on the heart

''.

A young boy presents with failure to thrive. )iochemical analysis of a duodenal aspirate after a mealreveals adeficiency of enteropeptidase 9entero&inase:. *he levels of which of the following digestive enFymeswould be


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affected0

a. Amylase

b. /olipase

c. Lactase

d. Pepsin

e. *rypsin

'(.

*he partial pressure of oxygen in the tracheal air of a resting# young# healthy patient is &nown to be1(! mmHg# however# when the alveolar oxygen partial pressure is tested# the pressure reads 8!mmHg. *his finding mostly li&ely indicates which of the following about this patient0

a. A normal alveolar ventilation and perfusion

b. Poor alveolar ventilation

c. Poor alveolar perfusion

d. >iffusion limited gas exchange

e. Arteriovenous blood shunting

'6.

/arbon monoxide is a deadly gas and binds to hemoglobin when inhaled. 5t creates problemsbecause it binds to the same site as oxygen does# competing for the same binding site. *hisultimately causes the erythrocyte to deliver carbon monoxide instead of oxygen to the tissues. 4hichof the following is the binding site for carbon monoxide0

a. globin

b. amino acid

c. copper

d. iron

e. manganese

'7

A patient presents with fatigue and generaliFed wea&ness. +xamination revealed significant pallor.Peripheral blood smear which is shown below shows small and pale )/. *he patient will benefit with


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. inta&e of

a. 5odine

b. 5ron

c. itamin )1$

d. iboflavin

e. itamin A

'8.

Angiography on a 63-year-old male reveals atherosclerotic narrowing of the right renal artery. *heleft renal artery is intact. Mou conclude that the flow in the right-sided artery is decreased by a factorof 16 compared to the left. *hus# the degree of stenosis in the right renal artery is

a. $(=

b. 33=

c. (!=

d. 7(=

e. !=

'.

4hich of the following mechanisms help in acclimatiFation to high altitude0

a. >ecrease in pulmonary ventilation

b. >ecreased numbers of red blood cells

c. 5ncreased diffusing capacity of the lungs


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d. >ecreased vascularity of the peripheral tissues

e. >ecreased ability of the tissue cells to use oxygen despite low Po$

(!.

A 7!-year-old woman undergoes a gastrectomy for Nollinger-+llison syndrome. Her doctor informsher that shewill need to ta&e intramuscular vitamin )1$ shots for the rest of her life. Absence of which of thefollowing celltypes is responsible for this vitamin replacement reDuirement0

a. /hief cells

b. cells

c. oblet cells

d. ucous nec& cells

e. Parietal cells

(1.

*he pulmonary volume curve for a 3'-year-old male is shown on the slide below in comparison witha normal curve 9dashed line:. 4hich of the following measures is increased in this patient0

a. Borced vital capacity 9B/:

b. Borced expiratory volume in one second 9B+1:

c. B+1"B/

d. esidual volume

e. *idal volume


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($

.

A $'-yr-old male person was brought to the + with severe hypovolemia following severe burns. Howdoes his smolality and volume for +/B and smolality and volume for 5/B change respectively0

a. >ecrease# increase# decrease# and increase

b. >ecrease# decrease# decrease# and increase

c. ,o change# increase# no change# and no change

d. ,o change# decrease# no change# and no change

e. 5ncrease# increase# increase# and decrease

f. 5ncrease# decrease# increase# and decrease

(

3.

4hich of the following areas represents the volume of air inhaled or exhaled with each breath0

a. )/

b. />

c. >+

d. )+

e. /+


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f. A)

('

.

5n the above picture# which area represents inspiratory capacity0

a. /+

b. >+

c. )/

d. A/

e. )>

f. )+

((.

5n the above picture# the area )+ represents

a. *idal volume

b. Borced inspiratory volume

c. 5nspiratory capacity

d. Borced expiratory volume

e. ital capacity

f. Bunctional residual capacity

(6

.

5n the above picture# the area A/ represents

a. *idal volume

b. Borced inspiratory volume

c. 5nspiratory capacity


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d. Borced expiratory volume

e. ital capacity

f. Bunctional residual capacity

(7.

A patient visits the clinic complainig of confusion and disoreinetation. 5nvestigations revealed cerebraledema. /* chest revealed a lung tumor. 4hich of the following abnormalities would one find in thispatient0

a. Hyponatremia due to excess water

b. Hyponatremia due to excess sodium loss

c. Hypernatremia due to dehydration

d. Hypernatremia due to excess sodium inta&e

(8.

A patient presents to the clinic with complaints of breathlessness and cough with sputum production.*he breathlessness has increased in recent days. C-ray and /* scan revealed the presence of acollapsed lobe in the right lung. *his condition leads to

a. 4asted ventilation 9dead space:

b. enous admixture

c. 4asted perfusion 9shunt:

d. 2hifting in the hemoglobin diffusion curve

e. >ecreased tissue $ utiliFation

(.

4hat is the direction of the flow of the fluid in relation to the capillaries and what is the netoutward"inward pressure in a given tissue if the pressures are as follows/apillary hydrostatic pressure (( mm Hg/apillary oncotic pressure 3' mmHg5nterstitial fluid hydrostatic pressure $8 mm Hg*issue oncotic pressure ' mmHg

a. 5nwards and '( mm Hg

b. utwards and 3 mm Hg


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c. 5nwards and 3 mm Hg

d. utwards and (7 mm Hg

e. 5nwards and (7 mm Hg

f. utwards and '( mm Hg

6!.

5n the above Duestion# if the 5nterstitial fluid hydrostatic pressure was changed to negative 1! mmHg 9-1! mm Hg:# then what is the direction of the flow of the fluid in relation to the capillaries andwhat is the net utward"5nward pressure0

a. 5nwards and 3( mm Hg

b. utwards and 7 mm Hg

c. 5nwards and 7 mm Hg

d. utwards and 83 mm Hg

e. 5nwards and 83 mm Hg

f. utwards and 3( mm Hg

physio block 3 final.doc

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