physio block 3

1.A mother brings her 6-yr-old son to his pediatrician because he has been having recurrent nosebleeds. Physical examination reveals diffuse petechiae and purpura. Laboratory studies show a Hb of 9.0 g/L, platelet count of 20,000/cu.mm, & leukocyte count of 14,500/cu mm. Bone marrow smear is shown below. The large cells are most probably precursors of

HTMLCONTROL Forms.HTML:Hidden.1 a.Eosinophils

HTMLCONTROL Forms.HTML:Hidden.1 b.Basophils

HTMLCONTROL Forms.HTML:Hidden.1 c.Neutrophils

HTMLCONTROL Forms.HTML:Hidden.1 d.Lymphocytes

HTMLCONTROL Forms.HTML:Hidden.1 e.Monocytes

HTMLCONTROL Forms.HTML:Hidden.1 f.RBC

HTMLCONTROL Forms.HTML:Hidden.1 g.Platelets

2.Release of which of the following peptides leads to an increase in the secretion of pancreatic bicarbonates into the small intestine?

HTMLCONTROL Forms.HTML:Hidden.1 a.Cholecystokinin

HTMLCONTROL Forms.HTML:Hidden.1 b.Gastrin

HTMLCONTROL Forms.HTML:Hidden.1 c.Motilin

HTMLCONTROL Forms.HTML:Hidden.1 d.Secretin

HTMLCONTROL Forms.HTML:Hidden.1 e.Somatostatin

3.A 6 -year-old boy playing in a dusty field in windy weather inhales many very small particles that become lodged in his terminal bronchioles. Which of the following are most important in cleaning the particles?

HTMLCONTROL Forms.HTML:Hidden.1 a.Type I pneumocytes

HTMLCONTROL Forms.HTML:Hidden.1 b.Type II pneumocytes

HTMLCONTROL Forms.HTML:Hidden.1 c.Alveolar macrophages

HTMLCONTROL Forms.HTML:Hidden.1 d.Submucosal glands

HTMLCONTROL Forms.HTML:Hidden.1 e.Ciliated cells

4.Which of the following substances use a protein-carrier molecule to traverse the cell membrane?

HTMLCONTROL Forms.HTML:Hidden.1 a.Water

HTMLCONTROL Forms.HTML:Hidden.1 b.Oxygen

HTMLCONTROL Forms.HTML:Hidden.1 c.Glucose

HTMLCONTROL Forms.HTML:Hidden.1 d.Alcohol

HTMLCONTROL Forms.HTML:Hidden.1 e.Glycerol

5.A 78-year-old woman has a mean arterial pressure of 100 mm Hg and a heart rate of 62/min. She has a stroke volume of 80 mL and a right atrial pressure of 0 mm Hg. What is the total peripheral resistance (in mm Hg/mL/min) in this woman?

HTMLCONTROL Forms.HTML:Hidden.1 a.0.2

HTMLCONTROL Forms.HTML:Hidden.1 b.0.1

HTMLCONTROL Forms.HTML:Hidden.1 c.0.5

HTMLCONTROL Forms.HTML:Hidden.1 d.0.3

HTMLCONTROL Forms.HTML:Hidden.1 e.0.4

6.An 8-yr-old boy has had an upper respiratory infection for the past 3 days. Today, he is brought to the pediatrician by his mother, who says that he looks yellow. Physical examination shows pallor and icterus. Laboratory studies reveal a Hb of 9.0 g/L, reticulocytes constituting 10.8%, platelets of 218,000/cu mm, and leukocyte count of 7,500/cu mm. A probable diagnosis of spherocytosis was made. The peripheral smear which is shown below indicates

HTMLCONTROL Forms.HTML:Hidden.1 a.Normal RBC

HTMLCONTROL Forms.HTML:Hidden.1 b.Hypochromic RBC

HTMLCONTROL Forms.HTML:Hidden.1 c.Defect in Spectrin

HTMLCONTROL Forms.HTML:Hidden.1 d.Microcytic RBC

7.A 34-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 hydrochloric acid. The patients condition is most likely associated with which of the following acid-base disturbances?

HTMLCONTROL Forms.HTML:Hidden.1 a.High anion gap metabolic acidosis

HTMLCONTROL Forms.HTML:Hidden.1 b.Normal anion gap metabolic acidosis

HTMLCONTROL Forms.HTML:Hidden.1 c.Respiratory acidosis

HTMLCONTROL Forms.HTML:Hidden.1 d.Respiratory alkalosis

HTMLCONTROL Forms.HTML:Hidden.1 e.Metabolic alkalosis

8.Basophils are increased in which of the following conditions?

HTMLCONTROL Forms.HTML:Hidden.1 a.Acute infection

HTMLCONTROL Forms.HTML:Hidden.1 b.Chronic infection

HTMLCONTROL Forms.HTML:Hidden.1 c.Parasitic infestation

HTMLCONTROL Forms.HTML:Hidden.1 d.Allergic reaction

9.A researcher is studying the effect of various manipulations on kidney blood flow and glomerular filtration. Which of the following is most likely to increase both renal plasma flow and peritubular capillary pressure but decrease the glomerular capillary pressure?

HTMLCONTROL Forms.HTML:Hidden.1 a.Constrict afferent arteriole

HTMLCONTROL Forms.HTML:Hidden.1 b.Dilate afferent arteriole

HTMLCONTROL Forms.HTML:Hidden.1 c.Constrict efferent arteriole

HTMLCONTROL Forms.HTML:Hidden.1 d.Dilate efferent arteriole

10.If the above researcher dilates the afferent arteriole then which of the following changes will be seen in renal plasma flow, peritubular capillary pressure, and glomerular capillary pressure respectively?

HTMLCONTROL Forms.HTML:Hidden.1 a.Increases, increases, and increases

HTMLCONTROL Forms.HTML:Hidden.1 b.Decreases, decreases, and decreases

HTMLCONTROL Forms.HTML:Hidden.1 c.Decreases, decreases, and increases

HTMLCONTROL Forms.HTML:Hidden.1 d.Increases, increases, and decreases

11.The vascular systems of five organs are arranged as shown in the drawing below. The vascular resistance of each organ is the same and the total resistance of the entire circuit is 2.0 mm Hg/mL/min. What is the individual vascular resistance (mm Hg/mL/min) of each organ?

HTMLCONTROL Forms.HTML:Hidden.1 a.10

HTMLCONTROL Forms.HTML:Hidden.1 b.8

HTMLCONTROL Forms.HTML:Hidden.1 c.6

HTMLCONTROL Forms.HTML:Hidden.1 d.4

HTMLCONTROL Forms.HTML:Hidden.1 e.2

HTMLCONTROL Forms.HTML:Hidden.1 f.1

12.In the above picture, which of the following values is the total resistance of the entire circuit if another organ with the same invidual vascular resistance (mm Hg/mL/min) was added to the circuit shown in the picture above?

HTMLCONTROL Forms.HTML:Hidden.1 a.0.6

HTMLCONTROL Forms.HTML:Hidden.1 b.1.0

HTMLCONTROL Forms.HTML:Hidden.1 c.1.6

HTMLCONTROL Forms.HTML:Hidden.1 d.2.0

HTMLCONTROL Forms.HTML:Hidden.1 e.2.6

13.A 65-year-old male was brought to the ER with severe chest pain, sweating and nausea. EKG showed ST elevation in leads II, III and aVF. Medical management of acute myocardial infarction was initiated. After initial treatment the pain decreased in intensity, but a reperfusion complex ventricular arrhythmia emerged. The arrhythmia was asymptomatic and resolved spontaneously. Which of the following drug was most likely responsible for rapid reperfusion in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.Heparin

HTMLCONTROL Forms.HTML:Hidden.1 b.Argatroban

HTMLCONTROL Forms.HTML:Hidden.1 c.Warfarin

HTMLCONTROL Forms.HTML:Hidden.1 d.tPA

HTMLCONTROL Forms.HTML:Hidden.1 e.Aspirin

14.A 54-year-old male is being evaluated for lung disease. Ventilator function testing reveals a decreased forced vital capacity, and a FEV1 /FVC ratio of 60%. The most likely diagnosis in this patient is

HTMLCONTROL Forms.HTML:Hidden.1 a.Pulmonary fibrosis

HTMLCONTROL Forms.HTML:Hidden.1 b.Interstitial lung disease

HTMLCONTROL Forms.HTML:Hidden.1 c.Pleural effusion

HTMLCONTROL Forms.HTML:Hidden.1 d.Pericardial effusion

HTMLCONTROL Forms.HTML:Hidden.1 e.Emphysema

15.Which of the following factors inhibit erythropoietin production?

HTMLCONTROL Forms.HTML:Hidden.1 a.Low blood volume

HTMLCONTROL Forms.HTML:Hidden.1 b.Anemia

HTMLCONTROL Forms.HTML:Hidden.1 c.Low Hb

HTMLCONTROL Forms.HTML:Hidden.1 d.Normal blood flow

HTMLCONTROL Forms.HTML:Hidden.1 e.Pulmonary diseases

16.A patient came with bone pain and abdominal cramps. Examination revealed depressed mood. X-ray revealed a 0.5 mm stone in the left ureter. Based on these findings, which of the following is the likely diagnosis in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.Hyperparathyroidism

HTMLCONTROL Forms.HTML:Hidden.1 b.Hypoarathyroidism

HTMLCONTROL Forms.HTML:Hidden.1 c.Hyperthryoidism

HTMLCONTROL Forms.HTML:Hidden.1 d.Hypopituitarism

HTMLCONTROL Forms.HTML:Hidden.1 e.Hyperpituitarism

17.During a fast, a brief phase of intense sequential contractions begins in the stomach and gradually migrates to the ileum. Release of which of the following intestinal hormones is most likely responsible for this observedeffect?

HTMLCONTROL Forms.HTML:Hidden.1 a.Cholecystokinin

HTMLCONTROL Forms.HTML:Hidden.1 b.Gastrin

HTMLCONTROL Forms.HTML:Hidden.1 c.Gastrin-releasing peptide

HTMLCONTROL Forms.HTML:Hidden.1 d.Motilin

HTMLCONTROL Forms.HTML:Hidden.1 e.Secretin

HTMLCONTROL Forms.HTML:Hidden.1 f.Somatostatin

18.A 55-year-old caucasian female presents to the clinic complaining of weight gain and easy fatiguability. She takes a multi-vitamin and some over-the-counter medications for constipation. Her blood pressure is 140/96 mm Hg and her heart rate is 55/min. Physical examination reveals a delayed relaxation of the knee and ankle reflexes. Skin is very dry and thick. What is the most likely diagnosis in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.Hyperthyroidism

HTMLCONTROL Forms.HTML:Hidden.1 b.Hyperparathyroidism

HTMLCONTROL Forms.HTML:Hidden.1 c.Hypothyroidism

HTMLCONTROL Forms.HTML:Hidden.1 d.Hypoparathyroidism

HTMLCONTROL Forms.HTML:Hidden.1 e.Hyperaldosteronism

19.Which of the following parameters will be seen in the base of the lung in comparision to the apex in a normal healthy individual?

HTMLCONTROL Forms.HTML:Hidden.1 a.Perfusion decreased, V/Q increased

HTMLCONTROL Forms.HTML:Hidden.1 b.Perfusion increased, V/Q decreased

HTMLCONTROL Forms.HTML:Hidden.1 c.Perfusion decreased, V/Q decreased

HTMLCONTROL Forms.HTML:Hidden.1 d.Perfusion increased, V/Q increased

20.Gastric inhibitory peptide is an important gastrointestinal hormone. The cells producing it and the functions of the peptide respectively are

HTMLCONTROL Forms.HTML:Hidden.1 a.K cells and inhibits insulin release

HTMLCONTROL Forms.HTML:Hidden.1 b.M cells and stimulates gastric motility

HTMLCONTROL Forms.HTML:Hidden.1 c.S cells and inhibits gastric acid secretion

HTMLCONTROL Forms.HTML:Hidden.1 d.M cells and stimulates intestinal motility

HTMLCONTROL Forms.HTML:Hidden.1 e.K cells and stimulates insulin release

HTMLCONTROL Forms.HTML:Hidden.1 f.S cells and stimulates pepsin secretion

21.In the ECG given below, what is the most likely diagnosis?

HTMLCONTROL Forms.HTML:Hidden.1 a.RBBB

HTMLCONTROL Forms.HTML:Hidden.1 b.RVH

HTMLCONTROL Forms.HTML:Hidden.1 c.LBBB

HTMLCONTROL Forms.HTML:Hidden.1 d.LVH

22.A person who is suffering with severe claustrophobia (fear of closed spaces) was locked accidentally in a closet for some amount of time. If the blood of this patient was analyzed then which of the following sets of lab findings is most likely to be found in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.1. pH of 7.29; PaCO2 of 50 mmHg; & HCO3- of 18 mEq/L

HTMLCONTROL Forms.HTML:Hidden.1 b.2. pH of 7.61; PaCO2 of 32 mmHg; & HCO3- of 28 mEq/L

HTMLCONTROL Forms.HTML:Hidden.1 c.3. pH of 7.32; PaCO2 of 34 mmHg; & HCO3- of 18 mEq/L

HTMLCONTROL Forms.HTML:Hidden.1 d.4. pH of 7.43; PaCO2 of 50 mmHg; & HCO3- of 40 mEq/L

HTMLCONTROL Forms.HTML:Hidden.1 e.5. pH of 7.26; PaCO2 of 50 mmHg; & HCO3- of 35 mEq/L

HTMLCONTROL Forms.HTML:Hidden.1 f.6. pH of 7.52; PaCO2 of 30 mmHg; & HCO3- of 18 mEq/L

23.In the above sets of lab findings, which set will correspond to a patient suffering with Conns syndrome?







24.Transport of glucose from the intestinal lumen into a small intestinal cell is inhibited when the usual Na+ gradient across the membrane is abolished. This would suggest inhibition of which of the following transport mechanisms?

HTMLCONTROL Forms.HTML:Hidden.1 a.Simple diffusion

HTMLCONTROL Forms.HTML:Hidden.1 b.Facilitated diffusion

HTMLCONTROL Forms.HTML:Hidden.1 c.Primary active transport

HTMLCONTROL Forms.HTML:Hidden.1 d.Cotransport

HTMLCONTROL Forms.HTML:Hidden.1 e.Countertransport

25.On routine physical examination, a 21-year-old Caucasian male is found to have only one testis in his scrotum. Further evaluation reveals an elevated serum FSH level and a normal serum LH level. Production of which of the following substances is likely to be impaired in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.Testosterone

HTMLCONTROL Forms.HTML:Hidden.1 b.Dihydrotestosterone

HTMLCONTROL Forms.HTML:Hidden.1 c.DHEA

HTMLCONTROL Forms.HTML:Hidden.1 d.Inhibin B

HTMLCONTROL Forms.HTML:Hidden.1 e.Cortisol

26.The blood of a patient is tested in the lab for grouping and typing. The blood did not react when A and B antibodies were added but reacted when D antibodies are added. The patient's blood group based on the above reactions is

HTMLCONTROL Forms.HTML:Hidden.1 a.A positive

HTMLCONTROL Forms.HTML:Hidden.1 b.B positive

HTMLCONTROL Forms.HTML:Hidden.1 c.AB positive

HTMLCONTROL Forms.HTML:Hidden.1 d.O positive

HTMLCONTROL Forms.HTML:Hidden.1 e.A negative

HTMLCONTROL Forms.HTML:Hidden.1 f.B negative

HTMLCONTROL Forms.HTML:Hidden.1 g.AB negative

27.A series of photographs taken of a middle-aged man over a period of two decades demonstrates gradual coarsening of facial features and progressive protrusion of the brows. Upon questioning, the patient reports having to wear larger shoes than he did as a young man. MRI scan revealed the presence of hypothalamic tumor. Which of the following changes can be seen in this partiular case?

HTMLCONTROL Forms.HTML:Hidden.1 a.GH increase, GHRH decrease, Somatostatin decrease

HTMLCONTROL Forms.HTML:Hidden.1 b.GH decrease, GHRH increase, Somatostatin decrease

HTMLCONTROL Forms.HTML:Hidden.1 c.GH increase, GHRH increase, Somatostatin increase

HTMLCONTROL Forms.HTML:Hidden.1 d.GH increase, GHRH decrease, Somatostatin increase

HTMLCONTROL Forms.HTML:Hidden.1 e.GH decrease, GHRH decrease, Somatostatin decrease

28.Which of the following characteristics is shared by simple and facilitated diffusion of glucose?

HTMLCONTROL Forms.HTML:Hidden.1 a.Is saturable

HTMLCONTROL Forms.HTML:Hidden.1 b.Requires metabolic energy

HTMLCONTROL Forms.HTML:Hidden.1 c.Is inhibited by the presence of galactose

HTMLCONTROL Forms.HTML:Hidden.1 d.Occurs down an electrochemical gradient

HTMLCONTROL Forms.HTML:Hidden.1 e.Requires a Na+ Gradient

29.Which of the following tests is used for measuring specifically intrinsic pathway?

HTMLCONTROL Forms.HTML:Hidden.1 a.Prothrombin time

HTMLCONTROL Forms.HTML:Hidden.1 b.Bleeding time

HTMLCONTROL Forms.HTML:Hidden.1 c.Clotting time

HTMLCONTROL Forms.HTML:Hidden.1 d.aPTT (partial thromboplastin time)

30.Prior to a major abdominal surgery a patient was found to have low levels of vitamin K. Which of the following clotting factors would be decreased in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.I

HTMLCONTROL Forms.HTML:Hidden.1 b.III

HTMLCONTROL Forms.HTML:Hidden.1 c.V

HTMLCONTROL Forms.HTML:Hidden.1 d.VII

HTMLCONTROL Forms.HTML:Hidden.1 e.XI

31.On performing an arterial blood analysis in a patient the physician noted that the pH and HCO3- levels are decreased but PCO2 level is increased. Which of the following conditions best describes this patients problem?

HTMLCONTROL Forms.HTML:Hidden.1 a.Respiratory acidosis

HTMLCONTROL Forms.HTML:Hidden.1 b.Respiratory alkalosis

HTMLCONTROL Forms.HTML:Hidden.1 c.Metabolic acidosis

HTMLCONTROL Forms.HTML:Hidden.1 d.Metabolic alkalosis

HTMLCONTROL Forms.HTML:Hidden.1 e.Mixed acidosis

HTMLCONTROL Forms.HTML:Hidden.1 f.Mixed alkalosis

32.Which of the following is true about the secretion from the exocrine pancreas?

HTMLCONTROL Forms.HTML:Hidden.1 a.It has a higher Cl- concentration than does plasma

HTMLCONTROL Forms.HTML:Hidden.1 b.It is stimulated by the presence of HCO3- in the duodenum

HTMLCONTROL Forms.HTML:Hidden.1 c.Pancreatic secretion is increased by gastrin

HTMLCONTROL Forms.HTML:Hidden.1 d.Pancreatic enzyme secretion is increased by cholecystokinin (CCK)

HTMLCONTROL Forms.HTML:Hidden.1 e.It is hypotonic

33.Which of the following hormones maintains the corpus luteum of pregnancy?

HTMLCONTROL Forms.HTML:Hidden.1 a.GnRH

HTMLCONTROL Forms.HTML:Hidden.1 b.FSH

HTMLCONTROL Forms.HTML:Hidden.1 c.hCG

HTMLCONTROL Forms.HTML:Hidden.1 d.Progesterone

HTMLCONTROL Forms.HTML:Hidden.1 e.Estrogen

HTMLCONTROL Forms.HTML:Hidden.1 f.Prolactin

34.The hormone responsible for stimulating milk production from a lactating mammary gland is

HTMLCONTROL Forms.HTML:Hidden.1 a.Prolactin

HTMLCONTROL Forms.HTML:Hidden.1 b.Vasopressin

HTMLCONTROL Forms.HTML:Hidden.1 c.Oxytocin

HTMLCONTROL Forms.HTML:Hidden.1 d.FSH

HTMLCONTROL Forms.HTML:Hidden.1 e.LH

35.A 59-yr-old male patient is brought to the ER with complaints of chest pain, breathlessness, palpitations, & sweating. Blood tests, ECG and Angiogram were done in this patient and flow rates were measured. It is a known fact that for a given vessel length, flow depends on radius, pressure gradients, and viscosity. Angiogram revealed an atherosclerotic plaque in the LAD that has reduced the radius of the vessel by a factor of 2. The flow change only due to the plaque is:

HTMLCONTROL Forms.HTML:Hidden.1 a.Increase by a factor of 2

HTMLCONTROL Forms.HTML:Hidden.1 b.Decrease by a factor of 2

HTMLCONTROL Forms.HTML:Hidden.1 c.Increase by a factor of 8

HTMLCONTROL Forms.HTML:Hidden.1 d.Decrease by a factor of 8

HTMLCONTROL Forms.HTML:Hidden.1 e.Increase by a factor of 16

HTMLCONTROL Forms.HTML:Hidden.1 f.Decrease by a factor of 16

36.In the above patient, blood tests revealed that the patient is suffering with severe anemia with low RBC count that reduced the hematocrit to 1/4th of its original value. The flow change only due to the hematocrit variation is:







37.In the above patient, BP monitoring of the patient revealed a raise of systolic pressure from 120 to 160 while the diastolic pressure remained at 80 mm Hg. The flow change only due to the pressure gradient is:







38.In the above patient, what would be the overall change in flow if we take into consideration all the 3 variations mentioned above together?







39.A patient presents with complaints of chest pain, breathlessness on exertion, & syncope. After performing an ECG exam on the patient they physician came to the conclusion that the patient is suffering with second-degree heart block. Which of the following ECGs represents this type of heart block?







40.If the above patient was diagnosed to be suffering with atrial fibrillation then which of the above ECGs will be seen in the patient?







41.In the above patient, if the diagnosis was changed to ventricular fibrillation then the above ECGs will corresponding to this new diagnosis







42.A 65-year-old male with long history of chronic obstructive pulmonary disease (COPD) is brought to the emergency room complaining of shortness of breath, fever, yellow sputum and lower extremity edema. Physical examination reveals cyanosis, finger clubbing and bilateral lung wheezes. Which of the following findings is the most likely in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.Normal arterial blood oxygen content

HTMLCONTROL Forms.HTML:Hidden.1 b.Normal mixed venous blood oxygen content

HTMLCONTROL Forms.HTML:Hidden.1 c.Increased pH of the arterial blood

HTMLCONTROL Forms.HTML:Hidden.1 d.Increased pulmonary arterial resistance

HTMLCONTROL Forms.HTML:Hidden.1 e.Increased cerebral vascular resistance

43.Anemia is usually characterized by an increased:

HTMLCONTROL Forms.HTML:Hidden.1 a.Hematocrit

HTMLCONTROL Forms.HTML:Hidden.1 b.Blood viscosity

HTMLCONTROL Forms.HTML:Hidden.1 c.Total peripheral resistance

HTMLCONTROL Forms.HTML:Hidden.1 d.Exercise performance

HTMLCONTROL Forms.HTML:Hidden.1 e.Work load on the heart

44.A young boy presents with failure to thrive. Biochemical analysis of a duodenal aspirate after a meal reveals a deficiency of enteropeptidase (enterokinase). The levels of which of the following digestive enzymes would be affected?

HTMLCONTROL Forms.HTML:Hidden.1 a.Amylase

HTMLCONTROL Forms.HTML:Hidden.1 b.Colipase

HTMLCONTROL Forms.HTML:Hidden.1 c.Lactase

HTMLCONTROL Forms.HTML:Hidden.1 d.Pepsin

HTMLCONTROL Forms.HTML:Hidden.1 e.Trypsin

45.The partial pressure of oxygen in the tracheal air of a resting, young, healthy patient is known to be 150 mmHg, however, when the alveolar oxygen partial pressure is tested, the pressure reads 80 mmHg. This finding mostly likely indicates which of the following about this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.A normal alveolar ventilation and perfusion

HTMLCONTROL Forms.HTML:Hidden.1 b.Poor alveolar ventilation

HTMLCONTROL Forms.HTML:Hidden.1 c.Poor alveolar perfusion

HTMLCONTROL Forms.HTML:Hidden.1 d.Diffusion limited gas exchange

HTMLCONTROL Forms.HTML:Hidden.1 e.Arteriovenous blood shunting

46.Carbon monoxide is a deadly gas and binds to hemoglobin when inhaled. It creates problems because it binds to the same site as oxygen does, competing for the same binding site. This ultimately causes the erythrocyte to deliver carbon monoxide instead of oxygen to the tissues. Which of the following is the binding site for carbon monoxide?

HTMLCONTROL Forms.HTML:Hidden.1 a.globin

HTMLCONTROL Forms.HTML:Hidden.1 b. amino acid

HTMLCONTROL Forms.HTML:Hidden.1 c.copper

HTMLCONTROL Forms.HTML:Hidden.1 d.iron

HTMLCONTROL Forms.HTML:Hidden.1 e.manganese

47.A patient presents with fatigue and generalized weakness. Examination revealed significant pallor. Peripheral blood smear which is shown below shows small and pale RBC. The patient will benefit with intake of

HTMLCONTROL Forms.HTML:Hidden.1 a.Iodine

HTMLCONTROL Forms.HTML:Hidden.1 b.Iron

HTMLCONTROL Forms.HTML:Hidden.1 c.Vitamin B12

HTMLCONTROL Forms.HTML:Hidden.1 d.Riboflavin

HTMLCONTROL Forms.HTML:Hidden.1 e.Vitamin A

48.Angiography on a 63-year-old male reveals atherosclerotic narrowing of the right renal artery. The left renal artery is intact. You conclude that the flow in the right-sided artery is decreased by a factor of 16 compared to the left. Thus, the degree of stenosis in the right renal artery is

HTMLCONTROL Forms.HTML:Hidden.1 a.25%

HTMLCONTROL Forms.HTML:Hidden.1 b.33%

HTMLCONTROL Forms.HTML:Hidden.1 c.50%

HTMLCONTROL Forms.HTML:Hidden.1 d.75%

HTMLCONTROL Forms.HTML:Hidden.1 e.90%

49.Which of the following mechanisms help in acclimatization to high altitude?

HTMLCONTROL Forms.HTML:Hidden.1 a.Decrease in pulmonary ventilation

HTMLCONTROL Forms.HTML:Hidden.1 b.Decreased numbers of red blood cells

HTMLCONTROL Forms.HTML:Hidden.1 c.Increased diffusing capacity of the lungs

HTMLCONTROL Forms.HTML:Hidden.1 d.Decreased vascularity of the peripheral tissues

HTMLCONTROL Forms.HTML:Hidden.1 e.Decreased ability of the tissue cells to use oxygen despite low Po2

50.A 70-year-old woman undergoes a gastrectomy for Zollinger-Ellison syndrome. Her doctor informs her that she will need to take intramuscular vitamin B12 shots for the rest of her life. Absence of which of the following cell types is responsible for this vitamin replacement requirement?

HTMLCONTROL Forms.HTML:Hidden.1 a.Chief cells

HTMLCONTROL Forms.HTML:Hidden.1 b.G cells

HTMLCONTROL Forms.HTML:Hidden.1 c.Goblet cells

HTMLCONTROL Forms.HTML:Hidden.1 d.Mucous neck cells

HTMLCONTROL Forms.HTML:Hidden.1 e.Parietal cells

51.The pulmonary volume curve for a 34-year-old male is shown on the slide below in comparison with a normal curve (dashed line). Which of the following measures is increased in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.Forced vital capacity (FVC)

HTMLCONTROL Forms.HTML:Hidden.1 b.Forced expiratory volume in one second (FEV1)

HTMLCONTROL Forms.HTML:Hidden.1 c.FEV1/FVC

HTMLCONTROL Forms.HTML:Hidden.1 d.Residual volume

HTMLCONTROL Forms.HTML:Hidden.1 e.Tidal volume

52.A 24-yr-old male person was brought to the ER with severe hypovolemia following severe burns. How does his Osmolality and volume for ECF and Osmolality and volume for ICF change respectively?

HTMLCONTROL Forms.HTML:Hidden.1 a.Decrease, increase, decrease, and increase

HTMLCONTROL Forms.HTML:Hidden.1 b.Decrease, decrease, decrease, and increase

HTMLCONTROL Forms.HTML:Hidden.1 c.No change, increase, no change, and no change

HTMLCONTROL Forms.HTML:Hidden.1 d.No change, decrease, no change, and no change

HTMLCONTROL Forms.HTML:Hidden.1 e.Increase, increase, increase, and decrease

HTMLCONTROL Forms.HTML:Hidden.1 f.Increase, decrease, increase, and decrease

53.Which of the following areas represents the volume of air inhaled or exhaled with each breath?

HTMLCONTROL Forms.HTML:Hidden.1 a.BC

HTMLCONTROL Forms.HTML:Hidden.1 b.CD

HTMLCONTROL Forms.HTML:Hidden.1 c.DE

HTMLCONTROL Forms.HTML:Hidden.1 d.BE

HTMLCONTROL Forms.HTML:Hidden.1 e.CE

HTMLCONTROL Forms.HTML:Hidden.1 f.AB

54.In the above picture, which area represents inspiratory capacity?

HTMLCONTROL Forms.HTML:Hidden.1 a.CE

HTMLCONTROL Forms.HTML:Hidden.1 b.DE

HTMLCONTROL Forms.HTML:Hidden.1 c.BC

HTMLCONTROL Forms.HTML:Hidden.1 d.AC

HTMLCONTROL Forms.HTML:Hidden.1 e.BD

HTMLCONTROL Forms.HTML:Hidden.1 f.BE

55.In the above picture, the area BE represents

HTMLCONTROL Forms.HTML:Hidden.1 a.Tidal volume

HTMLCONTROL Forms.HTML:Hidden.1 b.Forced inspiratory volume

HTMLCONTROL Forms.HTML:Hidden.1 c.Inspiratory capacity

HTMLCONTROL Forms.HTML:Hidden.1 d.Forced expiratory volume

HTMLCONTROL Forms.HTML:Hidden.1 e.Vital capacity

HTMLCONTROL Forms.HTML:Hidden.1 f.Functional residual capacity

56.In the above picture, the area AC represents

HTMLCONTROL Forms.HTML:Hidden.1 a.Tidal volume

HTMLCONTROL Forms.HTML:Hidden.1 b.Forced inspiratory volume

HTMLCONTROL Forms.HTML:Hidden.1 c.Inspiratory capacity

HTMLCONTROL Forms.HTML:Hidden.1 d.Forced expiratory volume

HTMLCONTROL Forms.HTML:Hidden.1 e.Vital capacity

HTMLCONTROL Forms.HTML:Hidden.1 f.Functional residual capacity

57.A patient visits the clinic complainig of confusion and disoreinetation. Investigations revealed cerebral edema. CT chest revealed a lung tumor. Which of the following abnormalities would one find in this patient?

HTMLCONTROL Forms.HTML:Hidden.1 a.Hyponatremia due to excess water

HTMLCONTROL Forms.HTML:Hidden.1 b.Hyponatremia due to excess sodium loss

HTMLCONTROL Forms.HTML:Hidden.1 c.Hypernatremia due to dehydration

HTMLCONTROL Forms.HTML:Hidden.1 d.Hypernatremia due to excess sodium intake

58.A patient presents to the clinic with complaints of breathlessness and cough with sputum production. The breathlessness has increased in recent days. X-ray and CT scan revealed the presence of a collapsed lobe in the right lung. This condition leads to

HTMLCONTROL Forms.HTML:Hidden.1 a.Wasted ventilation (dead space)

HTMLCONTROL Forms.HTML:Hidden.1 b.Venous admixture

HTMLCONTROL Forms.HTML:Hidden.1 c.Wasted perfusion (shunt)

HTMLCONTROL Forms.HTML:Hidden.1 d.Shifting in the hemoglobin diffusion curve

HTMLCONTROL Forms.HTML:Hidden.1 e.Decreased tissue O2 utilization

59.What is the direction of the flow of the fluid in relation to the capillaries and what is the net outward/inward pressure in a given tissue if the pressures are as followsCapillary hydrostatic pressure 55 mm HgCapillary oncotic pressure 34 mmHgInterstitial fluid hydrostatic pressure 28 mm HgTissue oncotic pressure 4 mmHg

HTMLCONTROL Forms.HTML:Hidden.1 a.Inwards and 45 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 b.Outwards and 3 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 c.Inwards and 3 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 d.Outwards and 57 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 e.Inwards and 57 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 f.Outwards and 45 mm Hg

60.In the above question, if the Interstitial fluid hydrostatic pressure was changed to negative 10 mm Hg (-10 mm Hg), then what is the direction of the flow of the fluid in relation to the capillaries and what is the net Outward/Inward pressure?

HTMLCONTROL Forms.HTML:Hidden.1 a.Inwards and 35 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 b.Outwards and 7 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 c.Inwards and 7 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 d.Outwards and 83 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 e.Inwards and 83 mm Hg

HTMLCONTROL Forms.HTML:Hidden.1 f.Outwards and 35 mm Hg

61.A 16-year-old male patient visited the emergency room with complaints of deep, rapid breathing, dry skin and mouth, and flushed face. Laboratory examination revealed very high levels of glucose and ketone bodies. The patients condition is most likely associated with which of the following acid-base disturbances?

a.High anion gap metabolic acidosis

b.Normal anion gap metabolic acidosis

c.Respiratory acidosis

d.Respiratory alkalosis

e.Metabolic alkalosis

62.A 24-yr-old male person was brought to the ER with severe hemorrhage following a motor vehicular accident. How does his Osmolality and volume for ECF and Osmolality and volume for ICF change respectively?

a.Decrease, increase, decrease, and increase

b.Decrease, decrease, decrease, and increase

c.No change, increase, no change, and no change

d.No change, decrease, no change, and no change

e.Increase, increase, increase, and decrease

f.Increase, decrease, increase, and decrease

63.A patient presents with complaints of breathlessness, puffiness of face, swollen legs, & bloated abdomen. Examination revealed pitting edema of legs, pleural effusion, & ascites. Urinalysis revealed a proteinuria of 4.5 g/day. A diagnosis of nephrotic syndrome with chronic renal failure was made. Which of the following characteristics will be seen in this patient?

a.Metabolic alkalosis

b.Hypophosphatemia

c.Hyperkalemia

d.Decreased blood urea levels

e.Megaloblastic anemia

64.The blood of a patient is tested in the lab for grouping and typing. The blood did reacted when A and B antibodies were added but did not react when D antibodies are added. The patient's blood group based on the above reactions is

a.A positive

b.B positive

c.AB positive

d.O positive

e.A negative

f.B negative

g.AB negative

65.A 28-year-old male patient was brought to the hospital after collapsing at a construction site where he worked all day long in the summer heat without taking enough breaks. History given by co-workers confirmed that he was sweating excessively. Which of the following Darrow-Yannet diagrams would be representative of this patient's condition?

a.A

b.B

c.C

d.D

e.E

f.F

http://medicowesome.blogspot.com/2013/08/darrow-yannet-diagrams-simplified.html

66.Which of the Darrow-Yannet diagrams shown above corresponds to kidney disease leading to increased salt excretion?

http://medicowesome.blogspot.com/2013/08/darrow-yannet-diagrams-simplified.html

a.A

b.B

c.C

d.D

e.E

f.F

67.A prematurely born infant is found to exhibit polyuria, polydipsia, muscle weakness, vomiting, & high heart rate. Examination revealed normal blood pressure & sensorineural deafness. Investigation revealed hypokalemia, hypocalcemia, & hypomagnesemia. A diagnosis of Bartter's syndrome was given. The pathophysiology of this disease is similar to the mechanism of action of which of the following drugs?

a.Acetozolamide

b.Hydrochlorthiazide

c.Furosemide

d.Mannitol

e.Amiloride

f.Spironolactone

68.A 22-year-old man participates in a research experiment in which the ICF must be determined. His inulin space is 15.2 L, 125I-albumin space is 2.9 L, 3H2O space is 41.3 L, and his hematocrit is 43%. What is the ICF of this man (in L)?

a.5.3

b.12.3

c.13.2

d.18.1

e.20.3

f.26.1

69. A 42-year-old obese woman experiences episodic abdominal pain. She notes that the pain increases after the ingestion of a fatty meal. The action of which of the following hormones is responsible for the postprandial intensification of her symptoms?

A. Cholecystokinin B. Gastrin

C. Pepsin

D. Secretin

E. Somatostatin

71.A patient undergoes a total gastrectomy because of a proximally located gastric cancer. After the surgery, which of the following digestive enzymes will be produced in inadequate amounts?

A. Amylase

B. Chymotrypsin

C. Lipase

D. Pepsin E. Trypsin

72. A 42-year-old obese woman experiences episodic abdominal pain. She notes that the pain increases after the ingestion of a fatty meal. The action of which of the following hormones is responsible for the postprandial intensification of her symptoms?

A. Cholecystokinin B. Gastrin

C. Pepsin

D. Secretin

E. Somatostatin

73. A pregnant woman in her second trimester complains of heat intolerance and palpitations. Physical examination reveals a slightly enlarged, non-tender thyroid gland, and a normal cardiac exam. The serum thyroxine (T4) level is increased; however, the serum thyroid-stimulating hormone (TSH) is normal. Which of the following best explains the laboratory findings in this patient?

A. Decreased estrogen

B. Increased free thyroxine (T4)

C. Increased progesterone

D. Increased serum triiodothyronine (T3)

E. Increased thyroid-binding globulin (TBG)74. Two normal, healthy subjects volunteer for a study on insulin secretion. In Patient 1, blood glucose is increased to 150 mg/dL by direct intravenous infusion. In Patient 2, blood glucose is increased to 150 mg/dL by ingestion of oral glucose. The peak plasma insulin concentration produced in Patient 1 is 70 U/mL while in Patient 2, it is 95 U/mL. Which of the following best explains the higher insulin concentration in Patient 2?

A. Ingested glucose activates a sympathetic reflex that increases cell release of insulin

B. Ingested glucose increases duodenal secretion of gastric inhibitory peptide (GIP), increasing cell release of insulin C. Intravenous glucose increases islet cell secretion of somatostatin, inhibiting cell release of insulin

D. Intravenous glucose increases islet cell secretion of glucagon, inhibiting cell release of insulin

75. An XX genotypic infant is born with ambiguous genitalia. Laboratory examination reveals hypoglycemia hyperkalemia, and salt wasting. Serum 17-OH progesterone is markedly increased. Which of the following is the most likely diagnosis?

A. 5-alpha-reductase deficiency

B. 11-beta-hydroxylase deficiency

C. 17-alpha-hydroxylase deficiency

D. 21-hydroxylase deficiency E. Complete androgen resistance

76. Most of the testosterone secreted by the testes exists in the plasma in the form of A. dihydrotestosterone bound to gonadal steroid-binding hormone

B. free dihydrotestosterone

C. free testosterone

D. testosterone bound to albumin

E. testosterone bound to sex-steroid-binding globulin77. Which of the following directly inhibits insulin secretion?

A. Alpha2-adrenergic agonist

B. Beta2-adrenergic agonist

C. Cholecystokinin

D. Glucagon

E. Ingestion of a high-sugar meal

F. Muscarinic agonists78. Endometrial biopsy demonstrates a thick endometrium with long, coiled glands lined by a columnar epithelium with prominent cytoplasmic vacuoles adjacent to the gland lumen. Earlier in the menstrual cycle, the glands were much smaller and were lined with cells that did not have vacuoles. Which of the following hormones is primarily responsible for inducing this change in appearance?

A. Aldosterone

B. Cortisol

C. Estrogen

D. Progesterone E. Thyroxine79. A 55-year-old woman stopped menstruating approximately 3 months ago. Worried that she may be pregnant, she decided to have a pregnancy test. The test came back negative. Which of the following series of tests resultswould confirm that the woman is postmenopausal?

A. Decreased LH, decreased FSH, increased estrogen

B. Decreased LH, increased FSH, decreased estrogen

C. Increased LH, decreased FSH, decreased estrogen

D. Increased LH, increased FSH, decreased estrogen E. Increased LH, increased FSH, increased estrogen80. Which of the following hormones is most important in initiating gall bladder contraction?

A. Cholecystokinin (CCK) B. Gastric inhibitory peptide (GIP)

C. Gastrin

D. Secretin

E. Vasoactive intestinal polypeptide (VIP)81. In the transition from a Graafian follicle to a functional corpus luteum, which of the following cellular events occurs?

A. Granulosa cells begin to express aromatase

B. Granulosa cells begin to express FSH receptors

C. Granulosa cells begin to express LH receptors D. Theca cells begin to express LH receptors

E. Theca cells begin to express side-chain cleavage enzyme

82. Which of the following areas of the adrenal gland would you expect to increase in activity in a patient subjected to salt restriction?

A. Adrenal medulla

B. Zona fasciculata of the adrenal cortex

C. Zona glomerulosa of the adrenal cortex D. Zona reticularis of the adrenal cortex

83. A normal, healthy, 24-year-old woman has regular menstrual cycles, each lasting about 28 days. Daily serum samples from the woman reveal decreasing progesterone and 17--estradiol levels. Serum LH and FSH levels are low, and begin rising. Basal body temperature begins falling. Within three days, which of the following events would be expected to occur?

A. Markedly increased inhibin levels

B. Menstruation C. Ovulation

D. Rapidly decreased LH levels

E. Significantly increased basal body temperature

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physio block 3

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