PHYSIOLOGY

CVS

1. In a cardiac cycle
a) Systole is longer than diastole
b) In exercise diastolic time is affected than systolic time
c) In isovolumetric contraction phase the ventricles contract against closed AV and
semilunar valves
d) Blood flows to the aorta when the LV pressure > 80 mmHg
e) 3rd heart sound is commonly pathological

2. In cardiac cycle
a) Systole is longer than diastole
b) In exercise, duration of diastole decreases
c) In isometric ventricular contraction atrio-ventricular valves and semilunar valves
arc closed
d) Valves open once the left ventricle pressure exceeds > 80 mmHg in normal
individuals

3. Cardiac output is increased in

a) Standing up
b) Increased venous tone
c) Anaemia
d) Atrial fibrillation
e) Increased intrathoracic pressure

4. Cardiac output is increased in

a) Hyperthyroidism
b) Anaemia
c) Increased sympathetic tone
d) Going to high altitude
e) Tension pneumothorax

5. Normal ECG
a) Q wave in aVR is a normal finding
b) Negative reflection is normal in aVR
c) PR interval is from the beginning of p to midpoint of QRS
d) In atrial flutter, normal QRS complexes are seen
e) Normally p waves are seen in ventricular fibrillation
f) Sinus tachycardia is a recognize feature in sick sinus syndrome
 6. Regarding blood supply of left ventricle
a) Subendocardial blood flow is considered to be totally absent during diastole
b) During systole the blood supply is similar to that of the right ventricle
c) Sympathetic vasodilatory system activation causes increase in blood supply
d) During exercise blood flow increases

7. Left lenticular blood supply

a) Increased in isometric contraction
b) Increased during exercise
c) Increased with adenosine
d) Sub endocardial portion of left ventricle receives directly from ventricular cavity
e) Markedly reduced in strenuous exercises

8. Ventricular myocardial blood supply is increased by

a) Adenosine
b) Isotonic exercise
c) Increased heart rate
d) Hypoxic damage to myocardium
e) Systole

9. In early LV dysfunction following are reduced

a) End diastolic volume
b) Stroke volume/ CO
c) Ejection fraction
d) Contractility
e) Pulmonary capillary wedge pressure

RS

10. T/F regarding respiratory physiology

a) Anatomical dead space and physiological dead space mismatch in pulmonary
embolism
b) V/Q ratio is high in lung apices
c) Respiratory alkalosis occurs in high altitudes
d) Hypoxic hypoxia occurs in pulmonary atelectasis
e) Oxygen is the treatment for all forms of hypoxia

11. Regarding respiratory physiology

a) Airway resistance accounts for more than half of the work of breathing
b) Oxygen can diffuse readily than CO2 through alveolar capillary membrane
c) Alveolar oxygen diffusion is inversely proportionate to the thickness of the
alveolar capillary membrane
 d) Anatomical dead space is equal to physiological dead space in a healthy
individual
e) Alveolar ventilation is more in rapid shallow breathing than in slow and deep
breathing

12. T/F regarding respiratory functions.

a) Tidal volume is 500 ml
b) Respiratory centre is stimulated by H+ in CSF
c) During inspiration, negative intrathoracic pressure is seen
d) Lung ventilation is 6L /min
e) Basal areas get more blood supply than apical

13. Surfactant
a) Is a protein
b) Reduce surface tension
c) Effect is related to alveolar surface area
d) Helps to reduce pulmonary oedema

14. Right shift of Oxygen dissociation curve occurs in

a) Reduced temperature
b) Increased CO, in blood
c) Fetal haemoglobin
d) Increased 2,3 DPG in blood
e) Increased H+ in blood

15. Causes for left shift of Oxygen dissociation curve include,

a) Chronic anemia
b) Increased temperature
c) Hyperventilation
d) Increased 2,3-DPG
e) Lactic acidosis

16. Followings can be directly measured by spirometry

a) Residual volume
b) Tidal volume
c) Vital capacity
d) Expiratory reserve volume
e) Inspiratory capacity

17. Airway resistance caused by

a) Glucocorticoids
b) Alpha agonists
c) Dopamine
 d) Cholinergic drugs
e) Betablockers

18. Central cyanosis is seen in

a) COPD
b) Severe anaemia
c) ASD
d) Carboxyhaemoglobin
e) Cyanide poisoning

Renal

19. GFR
a) GFR is 125 mL/min
b) Urea is used to measure the GFR
c) GFR is reduced with afferent arteriolar constriction
d) ADH does not influence GFR
e) Reduced in severe burns

20. T/F regarding glomerular filtration rate

a) Normal value is 125 ml/min
b) Reduced by afferent arteriolar constriction
c) Unaffected by secretion of ADH
d) Is reduced in severe burns
e) Measured by urea clearance

21. Regarding GFR

a) Rate is 125 ml/min
b) Afferent arteriolar constriction increases
c) ADH levels affects the GFR
d) Reduced due to burns
e) Is measured by urea clearance

22. Causes for increased GFR,

a) Efferent arteriolar constriction
b) Chronic hypoproteinemia
c) Ureteric obstruction
d) Increase of glomerular capillary hydrostatic pressure
e) Increase of hydrostatic pressure in fluid inside the Bowman's capsule
23. Renin secretion stimulated by
a) Renal artery stenosis
b) Heart failure
c) Prostaglandin
d) ANP
e) Angiotensin II

24. ADH
a) Secreted by anterior pituitary
b) A neurosecretory hormone
c) Elevate in early post-operative period
d) Increased by reduced plasma osmolality
e) Acts on collecting ducts by increasing permeability

25. Regarding sodium reabsorption

a) Occurs in PCT via Na/H exchanger
b) Descending loop via aquaporin 1 channels
c) Ascending limb via epithelial Na channels
d) DCT via Na/CI transporter
e) Collecting duct via Na/H/CI transporters

26. Kidneys
a) Renal cortical blood flow is increased by prostaglandins
b) Both loops of Henle are impermeable to water
c) DCT contains hypertonic fluid
d) Daily Filtration volume is 8 times TBW
e) GFR measured by substance freely filtered, secreted and reabsorbed.

27. T/F
a) Pre-renin is secreted by smooth muscle of Juxta Glomerular apparatus.
b) Juxta Glomerular apparatus is stimulated by constriction of afferent arteriole.
c) Proximal convoluted tubule disease cause reduction in erythropoietin.
d) 25-Hydroxylase conversion occurs in DCT.
Endocrine

28. PTH hormone

a) Reduces plasma PO43-
b) Secretion regulated by hypothalamus
c) Increased in response to increased plasma ionic Ca' level
d) Stores in thyroid follicles
e) Increases serum calcium level

29. Parathyroid hormone

a) Is a polypeptide hormone
b) Transported in blood bound to albumin
c) Decreases gut absorption of calcium
d) Increases urinary calcium excretion
e) Reduced phosphate reabsorption

30. Primary hyperparathyroidism

a) Hypercalcaemia
b) Hyperphosphataemia
c) Increased calcium excretion from urine
d) Presents with pancreatitis
e) Loss of lamina dura

31. Primary hyperparathyroidism

a) Common in children
b) Reduced urinary calcium
c) Associated with MEN II

32. True or false regarding calcium metabolism

a) Born mass is normal in osteomalacia
b) Looser zones are seen in osteoporosis
c) Hypocalcaemia causes neuromuscular irritability
d) Hyperparathyroidism is associated with nephrocalcinosis
e) Conversion of vitamin D to 25-hydroxy calciferol is affected by chronic renal
failure

33. Hypercalcaemia is seen in

a) Primary hyperparathyroidism
b) Thiazide diuretics
c) Acute pancreatitis
d) Paget's disease of bone
e) Milk alkali syndrome
34. Growth hormone
a) Level is increased by glucose infusion
b) Causes growth of cartilage
c) Causes enlargement of facial bones in adults
d) Somatomedin gives a synergistic action
e) Low levels are found in Laron dwarfism

35. Growth hormone secretion stimulated by

a) Exercise
b) Sleep
c) Starvation
d) Free fatty adds
e) Hyperglycaemia

36. Characteristic features of hyperprolactinaemia in females

a) Headaches
b) Galactorrhoea
c) Amenorrhoea
d) Dyspareunia
e) Reduced cervical mucus

37. Drugs causes hyperprolactinaemia

a) Bromocriptine
b) Chlorpromazine
c) Cabergoline
d) Metoclopramide
e) Digoxin

38. Pregnancy and lactation

a) Oestrogen causes breast enlargement
b) Oestrogen inhibits lactation
c) Delivery of placenta increases prolactin secretion
d) Suction increases prolactin secretion
e) Prolactin causes increase number of duct lobular units

39. Hypopituitarism can get in

a) Chromophobe adenoma
b) In congenital toxoplasmosis
c) Hypothalamic cyst
d) Craniopharyngioma
e) Head injury
40. Follicle stimulation hormone
a) Is an anterior pituitary hormone
b) Secreted by acidophilic cells
c) High levels are seen in patients treated with GNRH analogues for endometriosis
d) High levels are seen in patients with primary amenorrhea due to Kallmann
syndrome
e) Stimulate secretion of oestrogen by Graafian follicle

41. Pancreas
a) Glucagon secreted by alpha cells of the islets of Langerhans
b) Alpha amylase is secreted by pancreas
c) Trypsin is secreted in active form
d) Pancreatic juice contains plenty of HCO3-
e) Secretin releases enzyme rich secretion from pancreas

42. Insulin secretion is increased by

a) Glucagon
b) Beta blockers
c) Thiazide diuretics
d) Theophylline

43. Insulin stimulates,

a) Increase ketogenesis in liver
b) Increase gluconeogenesis in liver
c) Increase protein synthesis in muscles
d) Increase glycogen synthesis in muscles
e) Entry of potassium ions into adipose tissue

44. T/F regarding glucagon

a) Secreted by pancreatic islets beta cells
b) Is a peptide hormone
c) Causes positive inotropic effect
d) Causes hepatic glycogenolysis
e) Causes hepatic gluconeogenesis

45. Menstrual cycle

a) Progesterone is the main hormone in luteal phase
b) Granulosa cells contain iron
c) Diagnosis of peri menopause is through oestrogen/ progesterone levels
d) Corpus luteum continues to degrade in early pregnancy
e) Luteal phase depends on duration of corpus luteum
 46. Puberty in a girl,
a) Initiated by FSH
b) First cycles are anovulatory
c) Thelarche followed by adrenarche
d) Pubic hair growth due to progesterone effect
e) Tanner staging use for assess puberty

47. Hypoadrenalism
a) Cardiomegaly
b) Hypocalcaemia
c) Postural hypotension
d) Hypoglycaemia
e) Reduced Cortisol level at 9 am.

48. Regarding normal and abnormal sexual development

a) Adrenarche is followed by thelarche
b) There is elevated level of LH during puberty
c) Female genital tract is formed by the fusion of the Wolffian ducts
d) Mullerian agenesis results in normal development of ovaries
e) Hypogonadotropic hypogonadism is seen in Turner’s syndrome

CNS

49. Cholinergic stimulation results in

a) Ciliary muscle contraction
b) Detrusor muscle contraction
c) Ejaculation
d) Gall bladder contraction
e) Reduction of inhibition of systemic arterial contractility

50. Brain and its higher function

a) Emotion — hippocampus
b) Planning — frontal lobe
c) Memory — temporal lobe
d) Sensory - parietal
e) Muscle tone — Basal ganglia

51. PNS
a) Cholinergic neurons stimulate release from adrenal medulla
b) Cholinergic and noradrenergic release inhibit erection and ejaculation
 52. Nerve conduction
a) K+ efflux is responsible for maintenance of resting membrane potential
b) Opening of ligand gated Na+ channels cause spike of action potential
c) Opening of long-acting Ca2+ channels cause depolarization
d) Increased extracellular K+, increase the threshold for generation of an action
potential

Haematology

53. Anaemia
a) Causes hypoxic hypoxia
b) Stimulated peripheral chemoreceptors
c) Reduces O2 carrying capacity of Hb
d) In malabsorption mixed peripheral blood picture is seen
e) Haemolysis increases the methemoglobin level

54. Increased viscosity of blood seen in

a) High altitude
b) Chronic infections
c) Anaemia
d) Venous blood is less viscous than arterial blood
e) Proteins contributes to the viscosity

55. Clotting pathway

a) Thrombin thrombomodulin complex stabilizes the clot
b) Deficiency in factor VII prolongs the PT
c) Extrinsic pathway initiated by tissue thromboplastin
d) VWF bind and activates Antithrombin III
e) Activated protein C is necessary to activate factor V

56. Events involved in haemostasis following a cut injury with bleeding,

a) Antithrombin III binds with Serine protease
b) Platelets secrete serotonin
c) Conversion of Plasminogen into plasmin
d) Increase Bradykinin synthesis
e) Release of tissue Plasminogen
Foundation

57. Which of following act on cell membrane receptors?

a) Vasopressin
b) Adrenalin
c) Thyroxin
d) Glucagon
e) Aldosterone

58. lmmunoglobulins
a) IgG is the only immunoglobulin to cross the placenta
b) IgA accounts for 75% of Ig s in serum
c) IgA is secreted by B cells of lamina propria of GIT
d) IgD is mainly found on surface of lymphocytes
e) IgG is produced by transformed T cells

59. HLA antigen

a) Is used by the MHC
b) Found only in leucocytes
c) Appears two in each leucocyte
d) Associated with transplant reactions
e) Is a glycoprotein

60. Adrenaline differs from noradrenaline from, adrenaline having

a) VMA excrete as metabolite in the urine
b) Levels rarely exceed to cause cardio vascular problems
c) Predominantly acts on beta receptors
d) Does not act on the alfa receptors
e) Causes vasodilatation in the skeletal muscle

61. Regarding arterioles

a) Have more smooth muscles than arteries
b) Creates more cross-sectional area than the capillary network
c) Recoils during systole
d) Peripheral vasodilatation is caused by adrenergic stimulation
e) Responsible for total peripheral vascular resistance

62. T/F
a) The level of serum ALP reflects the osteoclastic activity
b) Osteoclasts are formed by osteoblasts
c) Osteoid is unmineralized bone matrix
d) Collagen is a peptide
e) Osteoblasts secrete acid phosphatases