CEBU INSTITUTE OF MEDICINE

PHYSIOLOGY 12. Which of the following statements best describes adequate

MEAN MPL FOR THE EXAM = 63.59 stimulus?
a. It is the only form of stimulus, which can activate a
sensory receptor.
1. In nerve cell membranes, a change in transmembrane b. It is the minimum stimulus intensity that activates a
voltage triggers opening of sodium channels, which in turn, sensory receptor.
causes greater change in transmembrane voltage. This c. It is the form of energy to which a particular
system operates in a/an: receptor has lowest threshold.
a. open loop mechanism d. It is the specific form of stimulus that can generate
b. positive feedback mechanism an action potential in the sensory nerve.
c. servo mechanism
d. negative feedback mechanism 13. The sympathetic & parasympathetic nervous systems are
considered physiologic antagonists at the:
2. One way of enhancing neuromuscular transmission is by: a. sweat glands c. lacrimal glands
a. decreasing the release of acetylcholine. b. adrenal medulla d. intestinal smooth muscles
b. increasing the destruction of acetylcholine.
c. increasing the concentration of calcium ions. 14. One of the following conditions is due to a serious
d. decreasing the concentration of sodium ions. derangement of temperature regulator mechanism:
a. heat stroke c. heat cramps
3. During the absolute refractory period of the nerve action b. hyperpyrexia d. heat exhaustion
potential, the axon:
a. shows zero excitability. 15. A subject focuses his eyes on an object. The image of the
b. shows decreased threshold on stimulation. object will fall on the:
c. shows increased permeability to chloride ions. a. lens c. optic disc
d. can be stimulated with supramaximal stimulus. b. ora serrata d. fovea centralis

4. In multiple sclerosis, there is progressive degeneration of the 16. The error of refraction characterized by irregular curvature of
myelin sheath of CNS neurons. The neurologic the cornea:
manifestations of this disease include: a. myopia c. cataract
a. sensory but no motor deficit b. presbyopia d. astigmatism
b. motor but no sensory deficit
c. both sensory & motor deficits 17. A 35-year old female patient was tested for visual acuity
d. neither sensory nor motor deficit using the Snellen's chart. The result was 20/100. This
means that the subject has:
5. The initial segment of the axon is functionally important a. farsightedness
because this is the zone where: b. needs bifocal lenses
a. saltatory conduction takes place. c. retinal disorder
b. integration of nerve signals occur. d. poorer than normal vision
c. action potentials are normally generated.
d. laying down myelin sheath normally begins. 18. In a normal subject, infusion of warm water into the left ear
results in:
6. Which of the following is TRUE regarding deactivation of a. deviation of eyeballs to the left.
acetylcholine? b. deviation of eyeballs to the right.
a. The by-products of enzymatic breakdown of c. upward deviation of eyeballs.
acetylcholine are choline & acetate. d. bitemporal deviation of eyeballs.
b. Acetylcholine that has combined with post-
synaptic receptors cannot be degraded. 19. A 50-year old patient diagnosed with unilateral nerve
c. Acetylcholinesterase inhibitors act primarily by deafness, as tested by Weber method, would present with
decreasing acetylcholine release from the the following:
presynaptic cell. a. sound louder in the normal ear
d. Uptake of acetylcholine into the presynaptic cell is b. bone conduction better than normal
the most important mechanism in terminating c. bone conduction worse than normal
acetylcholine signal. d. air conduction noted after bone conduction is over

7. The type of inhibition that results from decreased transmitter 20. A 35-year old patient suffers from complete memory loss for
release by the presynaptic cell in response to an action events that occurred after a blow to the head. This condition
potential: is termed:
a. direct inhibition a. global amnesia c. sporadic amnesia
b. presynaptic inhibition b. retrograde amnesia d. anterograde amnesia
c. feedback inhibition
d. feedforward inhibition 21. A subject who talks quite fluently was asked to identify a
triangle drawn on a cardboard but was unable to identify it
8. Which of the following local potentials are hyperpolarizing? even if he follows the card with his eyes wherever it is
a. end plate potentials moved. The patient most likely has a lesion in the:
b. inhibitory post synaptic potentials a. retina
c. miniature end plate potentials b. primary visual cortex
d. excitatory post synaptic potentials c. optic chiasma
d. visual association cortex
9. Myasthenia gravis is a clinical condition characterized by
destruction of neuromuscular receptors. The muscle 22. Which of the following phenomena occurs during NREM
weakness in myasthenia gravis may improve by giving a sleep?
drug that prevents the: a. increased muscle tone
a. release of acetylcholine b. conjugate eye movement
b. synthesis of acetylcholine c. increased blood pressure
c. diffusion of acetylcholine d. increased growth hormone
d. hydrolysis of acetylcholine
23. A person wears a perfume but after sometime, he fails to
10. There is an inverse relationship between the velocity of perceive the smell of the perfume. This sensory
muscle contraction & the: phenomenon is:
a. intensity of the stimulus. a. fatigue c. contrast
b. length of the sarcomere. b. adaptation d. afterdischarge
c. load on the muscle during contraction.
d. number of cross bridges formed during 24. The anemia due to maturation failure of the RBC:
contraction. a. hemolytic anemia c. microcytic anemia
b. pernicious anemia d. normocytic anemia
11. According to the law of adequate stimulus, sensory
receptors: 25. Which of the following is a result of acclimatization to high
a. respond to only one type of stimulus. altitude?
b. are nerve endings of sensory neurons. a. increased hematocrit
c. are located close to the site of stimulation.
d. have low threshold to only one form of stimulation. b. increased prothrombin time
c. increased platelet count
 d. increased reticulocyte count 39. A patient is seen with symptoms of anterior wall myocardial
26. A 6-year old child was brought to the clinic for crampy infarction. Arterial blood pressure is 70/40 mm Hg and
abdominal pain. Stool exam showed 1 -2 Ascaris ova/high cardiac output is only 1/3 of normal. Which of the following
power field. Which of the following blood cells would be would be expected of the central venous pressure?
significantly elevated on complete blood count? a. Increased
a. basophils c. monocytes b. Not changed
b. eosinophils d. lymphocytes c. Decreased because of decreased heart rate
d. Decreased because of decreased venous return
27. In the isovolumetric phase of systole:
a. AV valves are open. 40. The volume of blood left in the ventricle after a maximal
b. The 2nd heart sound is produced. ventricular contraction:
c. Ventricular volume rapidly increases. a. Residual volume
d. Ventricular pressure rapidly increases. b. End-systolic volume
c. End-diastolic volume
28. Increased sympathetic discharge during exercise will LEAST d. Systolic reserve volume
likely result in:
a. negative inotropic effect 41. The velocity of blood flow is increased with an increase in:
b. positive chronotropic effect a. Resistance
c. faster impulse conduction b. Vessel length
d. enhanced myocardial contractility c. Blood velocity
d. Pressure gradient between vessel ends
29. Which of the following parameters is the best estimate of
ventricular preload? 42. Which of the following best describes the auscultatory gap?
a. arterial blood pressure a. Disappearance of Korotkoff sounds at the level of
b. ventricular end-diastolic pressure the diastolic pressure
c. myocardial contractility b. Disappearance of Korotkoff sounds below the level
d. ventricular end-systolic pressure of the diastolic pressure
c. Disappearance of Korotkoff sounds at the level
30. The resting membrane potential of the ventricular muscle is above the systolic pressure
predominantly determined by the selective permeability of d. Disappearance of Korotkoff sounds at the level
the membrane to: above the diastolic pressure
a. sodium c. calcium
b. potassium d. chloride 43. Within physiologic limits, an increase in right atrial pressure
will:
31. One of the following statements regarding the cardiac cycle a. Decrease intrathoracic pressure
is CORRECT:
a. It spans the whole of ventricular systole. b. Decrease systemic arterial pressure
b. The electrical events are preceded by the c. Decrease heart rate
mechanical events. d. Increase cardiac output
c. One third of the stroke volume is ejected during
rapid ejection phase. 44. Edema may result from a decrease in:
d. Ventricular repolarization occurs slightly prior to a. Plasma proteins
the end of ventricular contraction.
b. Interstitial fluid colloid osmotic pressure
32. Which of the following cardiac pacemakers conduct faster c. Capillary permeability
than any other tissue in the heart? d. Capillary hydrostatic pressure
a. Sinoatrial node
b. Atrioventricular noded. 45. The following contribute to the anatomic dead space:
c. Bundle of His a. Bronchi
d. His-Purkinje system
b. Respiratory bronchioles
33. The physiologic significance of the AV nodal delay is to allow c. Alveolar ducts
sufficient time for: d. Terminal bronchioles
a. Atrial relaxation
b. Venous return to the atria 46. True of the pulmonary surfactant:
c. Filling of the ventricles a. Reduces lung compliance
d. Contraction of the ventricles b. DPPC synthesized solely from fatty acids in blood
c. Reduces surface tension more if surface area is
34. The 1st heart sound is caused primarily by the: smaller
a. Opening of the mitral valve d. Osmophilic lamellated bodies extruded by Type I
b. Opening of the semilunar valves alveolar cells
c. Closure of the AV valves and related vibrations
d. Surging of blood toward the AV valves to initiate 47. The volume of gas in the lung after a normal expiration:
closure a. Tidal volume

35. The stroke volume increases during exercise due to an b. Residual volume
increase in: c. Vital capacity
a. Heart rate d. Functional residual capacity
b. Peripheral resistance
c. Venous return 48. The diffusing capacity of the lungs is directly proportional to
d. Circulating blood volume the:
a. Flow of blood
36. When a person assumes an upright position from supine,
which of the following compensatory changes occur? b. Thickness of the blood – gas barrier
a. Decreased heart rate c. Amount of gas transferred
b. Decreased cardiac output d. Difference in partial pressure
c. Increased cardiac contractility
d. Decreased total peripheral resistance 49. When arterial pCO2 rises, the main stimulus to increased
ventilation comes from the:
37. Turbulent blood flow is least likely to occur in: a. aortic bodies
a. Anemia
b. Increased blood viscosity b. central chemoreceptors
c. Increased vessel radius c. carotid bodies
d. Increased velocity of blood flow d. pulmonary stretch receptors

38. Which of the following is true of the Riva Rocci method of 50. In a person with chronic obstructive pulmonary disease with
blood pressure determination? chronic retention of CO2, the main stimulus to ventilation
a. It makes use of the Korotkoff sounds. comes from the:
b. It is a direct means of BP measurement. a. J receptors
c. Only the diastolic pressure is determined.
d. It avoids errors caused by the auscultatory gap. b. central chemoreceptors
c. carotid & aortic bodies
d. pulmonary stretch receptors
 65. The sole known physiologic activator of the fibrinolytic
51. The recoil pressures of the lungs and thoracic wall are equal system is:
at: a. Plasmin c. Urokinase
a. end – inspiration b. Streptokinase d. Prothrombinase
b. mid – inspiration
c. residual volume 66. The Rh blood group system differs from the ABO system in
d. functional residual capacity that in the Rh system:
a. The antibodies occur naturally.
b. The agglutinins are of the IgM type.
52. A decrease in ventilation results from stimulation of: c. Hemolytic disease of the newborn is less severe.
a. irritant receptors d. Presence of agglutinins almost always indicates
b. thermal receptors for warmth prior sensitization.
c. proprioceptors of muscles & joints
d. aortic & carotid sinus baroreceptors 67. TRUE of the Rh hemolytic disease of the newborn:
a. First pregnancy is the most severely affected.
53. Victims trapped in burning buildings suffer from hypoxia b. Mother is Rh positive, while fetus is Rh negative.
because of the formation of: c. Preformed maternal antibodies cross the placenta
a. methemoglobin to react with fetal Rh+cells.
b. carboxyhemoglobin d. After an erythroblastic child has been born, future
c. carbon dioxide children are certainly erythroblastotic.
d. glycosylated hemoglobin
68. The 1st born infant of a 28-year old Rh-negative woman, who
54. Which of the following is TRUE of Caisson’s disease? had 2 previous 2nd trimester abortions, has severe hemolysis
a. The gas that is primarily involved is carbon & circulatory failure. Hemolytic disease of the newborn
dioxide. could have been prevented with:
b. The disorder is due to air embolism in the a. Anti-D IgM upon termination of her 1st pregnancy
cardiovascular system. b. Anti-D IgG during the mother’s most recent
c. The condition occurs as a result of sudden rise in pregnancy
atmospheric pressure. c. Anti-D IgM during the mother’s most recent
d. The major cause of death is obstruction of the pregnancy
small respiratory passages. d. Anti-D IgG upon termination of each of the 1st 2
pregnancies
55. The intrapleural pressure is less than intrapulmonary
pressure during: 69. Blood typing was done on Mr. X. His serum agglutinated
a. quiet inspiration both known A & B cells. The blood type of Mr. X is:
b. quiet expiration a. A c. AB
c. both of these b. B d. O
d. neither of these
70. What is the mechanism of autoimmunity in rheumatic fever?
56. A subject was instructed to exhale maximally. The amount of a. The structure of a normal self-antigen is altered.
air present in the lungs after the procedure is known as: b. Foreign antigenic substances attach to the cells.
a. residual volume c. Immune complexes attach to the surfaces of cells.
b. expiratory reserve volume d. A foreign antigen cross-reacts with a normal self-
c. vital capacity antigen.
d. functional residual capacity
71. Which hormone binds with receptors found in the cell
57. A person breathes in & out into a paper bag. After a few membrane of target cells?
cycles, the alveolar air has: a. estrogen c. cortisol
a. increased pO2 & increased pCO2 b. testosterone d. somatotropin
b. decreased pO2 & increased pCO2
c. increased pO2 & decreased pCO2 72. The most biologically potent of the thyroid hormones:
d. decreased pO2 & decreased pCO2 a. thyroxine c. triiodothyronine
b. thyroglobulin d. monoiodotyrosine
58. Which segment of the lung receives the highest perfusion in
an upright position? 73. Thyroid hormone increase the metabolic rate of all body cells
a. upper third c. medial third EXCEPT:
b. middle third d. lower third a. liver cells c. red blood cells
b. myocardial cells d. skeletal muscle cells
59. The pivotal reaction in the activation of the complement
system involves the activation of complement factor: 74. The main regulator of normal blood calcium level is:
a. C1 c. C3 a. calcitonin c. parathormone
b. C2 d. C4 b. cholecalciferol d. anterior pituitary

60. Which immunoglobulin class predominates in various bodily 75. Glucagon increases blood glucose level by:
secretions? a. promoting glycogenesis.
a. IgA c. IgG b. inhibition of gluconeogenesis.
b. IgE d. IgM c. promoting glycogenolysis.
d. promoting fatty acid synthesis.
61. Active vaccination often entails more than one dose in order
to: 76. The phase of the ovarian cycle when LH reaches a peak
a. produce memory cells. level:
b. produce longer lasting immunity. a. luteal phase c. ovulatory phase
c. deplete the number of effector cells. b. follicular phase d. secretory phase
d. increase antigen dose to challenge the immune
system. 77. The normal menstrual fluid:
a. is composed purely of fresh blood.
62. Which of the following factors/ conditions will shift the b. usually flows continuously for 2 weeks.
oxyhemoglobin dissociation curve to the left? c. may have some necrotic endometrial materials.
a. increased pH c. increased pCO2 d. may clot normally unless flow is in profuse
b. increased 2, 3 DPG d. increased temperature amounts.

63. Which of the following clotting factors is NOT common to 78. Growth hormone secretion is stimulated by:
both extrinsic & intrinsic pathways of coagulation? a. exercise c. dopamine
a. Factor I c. Factor III b. hyperglycemia d. somatostatin
b. Factor II d. Factor IV
79. One of the following stimulates the production or release of
64. Heparin prevents clotting because it: thyroid hormone:
a. chelates calcium a. thiocyanates c. iodine in high doses
b. dissolves fibrinogen b. propylthiouracil d. iodine in physiologic doses
c. blocks the action of thrombin
d. blocks conversion of prothrombin to thrombin 80. After a full meal, the main stimulus for insulin secretion is:
a. lysine c. glucose
b. arginine d. somatostatin
 d. The patient would be more likely to have nausea &
81. The most potent androgen is: vomiting.
a. testosterone c. androstenedione
b. dihydrotestosterone d. dehydroepiandrosterone 94. The following substances decrease the glomerular filtration
rate, EXCEPT:
82. One of the following is NOT a physiologic effect of a. endothelin
testosterone: b. epinephrine
a. increased RBC production c. norepinephrine
b. skeletal and muscle growth d. endothelial derived nitric oxide
c. decreased calcium deposition in the bones
d. maturation of internal and external genitalia 95. The reabsorption of amino acids along the proximal tubules
is by:
83. The secretory changes in the 2nd half of the female sexual a. solvent drag c. sodium co-transport
cycle is a function priarily of this hormone: b. facilitated diffusion d. primary active transport
a. Estradiol
b. Luteinizing hormone 96. The reabsorption of water is greatest at this segment of the
c. Progesterone renal tubule:
d. Gonadotropin releasing hormone a. proximal tubule c. ascending loop of Henle
b. distal tubule d. descending loop of Henle
84. The sexual response of the female differs from that of the
male in that: 97. The absence of albumin in the glomerular filtrate is due to:
a. The plateau phase in women is prolonged. a. glomerulo-tubular balance
b. The orgasmic phase in women is usually absent. b. the small diameter of the slit pores
c. The excitement phase in women is generally c. markedly increased peritubular oncotic pressure
shorter & faster. d. presence of proteoglycan coating the basement
d. There is usually no refractory period in women membrane
during the resolution phase.
98. Profuse vomiting of gastric contentsmay result in this primary
85. Secondary peristaltic waves of the esophagus are acid-base disorder:
essentially the same as the primary peristaltic waves. a. metabolic alkalosis c. respiratory alkalosis
EXCEPT that the former: b. metabolic acidosis d. respiratory acidosis
a. are faster
b. are initiated by swallowing 99. Decreased blood flow to the kidneys will result in:
c. are not dependent on neural control a. vasodilatation
d. originate in the esophagus rather than in the b. aldosterone secretion
pharynx c. salt & water secretion
d. vasopressin secretion
86. Which of the following is TRUE of deglutition?
a. The trachea is closed during the buccal stage. 100. Where does aldosterone exert its greatest effect?
b. The pharyngeal stage is under voluntary control. a. Glomerulus c. Loop of Henle
c. During the esophageal stage, respiration is b. Proximal tubule d. Cortical collecting duct
concurrently inhibited.
d. It is a complicated mechanism requiring
coordination of many muscle groups.

87. Which of the following is LEAST likely to inhibit HCl

secretion?
a. gastrin c. dietary fat
b. secretin d. prostaglandins

88. Which of the following is TRUE regarding peristalsis in the

small intestine?
a. It is increased after prolonged fasting.
b. It moves chyme towards the pyloric area.
c. It dies out after traveling a short distance.
d. The velocity is faster in the ileum than in the
duodenum.

89. TRUE of the enterogastric reflex:

a. Paralytic ileus that follows distention of the
intestines
b. Increased motor activity of the terminal ileum
following a meal
c. Inhibition of gastric motility by acidic solutions in
the duodenum
d. Mass movement of the colon that follows
distension of the stomach

90. Cholera toxin stimulates the formation of adenyl cyclase,

which promotes:
a. opening of sodium channels
b. opening of potassium channels
c. opening of the chloride channels
d. inactivation of sodium glucose co-transport system

91. Which of the following inhibits intestinal motility?

a. Insulin c. Gastrin
b. Glucagon d. Cholecystokinin

92. One of the following does NOT predispose to gallstone

formation:
a. Too much water absorption from the bile
b. Too much lecithin absorption from the bile
c. Too much bile salt absorption from the bile
d. Too much cholesterol absorption from the bile

93. If a gallstone were impacted in the distal common bile duct

as opposed to the cystic duct, which statement is
C0RRECT?
a. The patient would be more likely to have pain.
b. The patient would be more likely to have fever.
c. The patient would be more likely to have jaundice.