Review of Physiology by mikeholy

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									62 Review of Physiology

 36. If blood parameters read pH 7.3, HCO 3 20 mEq
     and PCO2 37 mmHg, then patient is having:
      A. Metabolic acidosis
      B. Respiratory acidosis
                                                                           Kidney Diseases and
      C. Metabolic acidosis with respiratory compensation                  Diuretics
      D. None of the above                              (p. 361)
 37. If blood parameters read pH 7.5, PCO2 38 mmHg and             1. Trigone is situated in:
     HCO3 20 mEq, then patient is having:                             A. Anterior bladder wall
     A. Respiratory alkalosis                                         B. Posterior bladder wall
     B. Respiratory alkalosis with renal compensation                 C. Lateral bladder wall                             (p. 364)
     C. Metabolic alkalosis with respiratory compensation
     D. None of the above                               (p. 361)   2. Urine passes through ureter by:
                                                                      A. Gravity
 38. Normal anion gap is:
     A. 10 mEq/L                       B. 20 mEq/L                    B. Parasympathetic tone
     С 25 mEq/L                        D. 30 mEq/L                    C. Sympathetic tone
                                                                      D. All of the above                                  0. 365)
                            (p. 362)
                                                                   3. Facilitory and inhibitory centers for micturition
                                                                      reflex are mainly located in:
                                                                      A. Medulla                    B. Pons
                                                                      С Midbrain                    D. Thalamus        (p. 366)
                                                                   4. Which of the following is a loop diuretic:
                                                                      A. Furosemide
                                                                      B. Bumetanide
                                                                      C. Ethacrynic acid
                                                                      D. All of the above                                 (p. 368)
                                                                   5. Site of action of loop diuretics is:
                                                                      A. Proximal tubule
                                                                      B. Thin descending loop of Henle
                                                                      C. Thick ascending loop of Henle
                                                                      D. Distal tubule                                    (p. 368)
                                                                   6. Loop diuretics mainly act upon:
                                                                      A. Na+K+ATPase
                                                                      B. Sodium-hydrogen counter transport
                                                                      C. 1 sodium, 2 chloride, - 1 potassium cotransport
                                                                      D. Carbonic anhydrase                           (p. 368)
                                                                   7. What happens to osmolality of medullary intersti-
                                                                      tium with use of loop diuretics:
                                                                       A. Increased
                                                                       B. Decreased
                                                                       С Unchanged                                      (p. 368)


36 С   37 В   38 A                                                 1 В    2В      3В        4D          5С      6С        7В
64 Review of Physiology                                                                 Kidney Diseases and Diuretics 65

  8. Carbonic anhydrase inhibitors act in:                        17. End stage renal failure is nowadays commonly due
     A. Proximal tubule                                               to:
     B. Distal tubule
                                                                      A. Hypertensive nephrosclerosis
     C. Collecting ducts
                                                                      B. Diabetes mellitus
     D. At all of the above sites                      (p. 368)       C. Primary glomerulonephropathies
  9. Potassium sparing diuretics include:                             D. All of the above                          (p. 371)
     A. Amiloride
     B. Triamterine                                               18. Chronic pyelonephritis causes damage to:
     C. Spironolactone                                                A. Glomeruli
     D. All of the above                               (p. 368)       B. Interstitium
                                                                      C. Both of the above
10. Kidneys receive what percentage of cardiac output:                D. None of the above                          (p. 373)
    A. 10%                     B. 15%
     С 25%                     D. 35%               (p. 369)      19. What is isosthenuria:
                                                                      A. Concentrated urine of specific gravity 1018
11. Acute renal failure due to hypotension can be rever
                                                                      B. Dilute urine of specific gravity 1006
    sed unless renal blood flow does not fall below:
                                                                      C. Fixed specific gravity urine of 1010
     A. 5% of normal
                                                                      D. None of the above                         (p. 375)
     B. 10% normal
     C. 15% of normal                                             20. What happens in chronic renal failure:
     D. 20% of normal                                (p. 369)         A. Concentration of urine is impaired
12. Nephrosclerosis involves:                                         B. Dilution of urine is impaired
    A. Main renal arteries                                            C. Concentrating mechanism is more impaired than
    B. Segmental renal arteries                                          diluting mechanism
    C. Arterioles                                                     D. Diluting mechanism is more impaired than
    D. All of the above                                (p. 371)          concentrating mechanism                (p. 375)
13. After age of 40 years, the nephron loss per year is:          21. Which of the following is non-protein nitrogen:
    A. 1%                        B. 2%                                A. Urea
    С 5%                        D. 7%               (p. 372)          B. Uric acid
                                                                      C. Creatinine
14. In acute renal failure which of the following is most
                                                                      D. All of the above                           (p. 376)
    life-threatening:
    A. Water retention                                            22. Death is imminent when pH falls below:
    B. Hyperkalaemia                                                  A. 7.2
    C. Hypernatraemia                                                 B. 7
    D. Acidosis                                       (p. 370)        С 6.8
15. Symptoms of uraemia develop when GFR is reduced                   D. 6.5                                        (p. 376)
    below:
                                                                  23. Anaemia in chronic renal failure is due to:
    A. 100 ml/min             B. 75 ml/min
                                                                      A. Decreased erythropoietin
    С 50 ml/min               D. 25 mj/min     (p. 371)
                                                                      B. Major GI bleed
16. End stage renal failure is said to have set in with               C. Bone marrow aplasia
    GFR below:                                                        D. All of the above                            (p. 376)
    A. 50 ml/min                B. 25 ml/min
    С 10 ml/min                 D. 5 ml/min         (p. 371)

8A    9D    10 С    11 D    12 С      13 A      14 В      15 С
                                                                   17 В   18 В   19 С   20 С   21 D     23 А

                                                                   22 С
66 Review of Physiology

  24.Bones become decalcified in chronic renal failure
      due to:
      A. Decreased calcium intake
      B. Increased urinary calcium loss
      C. Decreased vit D production                                     Haematology
      D. Decreased vit D intake                     (p. 376)
25. Is hypertension a constant accompaniment of
                                                                 1. Average volume of RBC is:
    chronic renal failure:
                                                                    A. 80-85 ц               B. 85-90 ц
     A. Yes
                                                                    C. 90-95 ц               D. 95-100 u            (p. 382)
     B. No                                   (p. 376)
26. Renal phosphaturia leads to:                                 2. Average number of RBC in a male is:
    A. No symptoms                                                  A. 6 mill/cmm
    B. Rickets that promptly responds to vit D                      B. 5.5 mill/cmm
    C. Ricket refractory to vit D                                   С 5-2 mill/cmm
    D. None of the above                       (p. 377)             D. 4.5 mill/cm                                  (p. 382)
27. In renal tubular acidosis, the urine is:                     3. The normal haematocrit is:
     A. Acidic                                                      A. 30-35%                  B. 35-40%
     B. Alkaline                                                    С 40-45%                   D. 45-50%            (p. 382)
     С Neutral                                        (p. 377)
                                                                 4. Bach gram of haemoglobin can carry bow much of О2
28. The dializing fluids contain all solutes in lesser
                                                                    A. 4.5 ml                   B. 4.3 ml
    concentration to uraemic plasma except:.
    A. Sodium                   B. Bicarbonate                     C. 3.1 ml
    С Chloride                  D. Calcium         (p. 378)                                                          (p. 382)
29. Which of the following solute is significantly low in
                                                                 5. In middle trimester of pregnancy, the main organ of
    dialyzing fluid in comparison to uraemic plasma:
                                                                    haematopoiesis is:
    A. Calcium                 B. Magnesium
                                                                    A. Liver                    B. Spleen
    C. Potassium               D. Lactate
                                                                    C. Bone marrow              D. Yolk sac         (p. 382)
                                                     (p. 378)
30. Urea clearance of normal kidney is:                          6. The normal reticulocyte % among red cells is:
    A. 70 ml/min             B. 90 ml/nun                           A. 0.5%                    B. 1%
    С 110 ml/min             D. 130 ml/min                          С 2%                       D. 5%              (p. 383)
                                                      (p. 378)   7. In macrocytic anaemia due to B 12 folic acid
                                                                    deficiency there is failure of:
                                                                    A. Haemoglobin formation
                                                                    B. Haemoglobin incorporation
                                                                    C. Maturation
                                                                    D. All of the above                      (p. 386)
                                                                 8. Haeme synthesis starts with combination of:
                                                                    A. 2 succinyl CoA + 1 glycine
                                                                    B. 2 succinyl CoA + 2 glycine
                                                                    С 2 acetyl CoA + 2 glycine
                                                                    D. 2 malonyl CoA + 2 glycine                     (p. 387)


24 С   25 В   26 С   27 В    28 В     29 С     30 А                                                                 8В
                                                                  1С    2С      3С      5A       6В         7C
                                                                  4 D
68 Review of Physiology                                                                                                     Haematology 69

10.In maturation failure of macrocytosis there is:                                 18. In sickle cell anaemia, the defect lies in:
       A. Excess formation of DNA in comparison to RNA                                 A. Alpha chain              B. Beta chain
       B. Excess formation of RNA in comparison to DNA                                 С Gamma chain               D. Delta chain    (p. 389)
       С Excess formation of both DNA and RNA
       D. Deficient formation of both RNA and DNA                                  19. What is erythroblastosis foetalis:
                                                                       (p. 387)        A. Destruction of RBCs of mother by foetal
                                                                                          antibodies
 10. Each Hb molecule carries how many molecules of                                    B. Haemolysis in foetus due to maternal Rh
     oxygen:
                                                                                          antibodies
     A. 2                      B. 4
                                                                                       С Haemolysis in mother due to foetal ABO
     С 6                       D. 8            (p. 387)                                   antibodies
 11. What is not true of oxygen carriage by Hb:                                        D. All of the above                   (p. 390)
     A. Hb combines looser and reversibly with O 2
                                                                                   20. The viscosity of blood is how many times that of
     B. O2 binds to coordination bond of iron atom
     C. O2 is carried as ionic oxygen                                                  water:
     D. All are true                                                                   A. 2                       B. 3
                                                 (p. 387)
                                                                                       С 4                        D. 5             (p. 390)
12. Iron helps in formation of which of the
following:                                                                         21. In compensated anaemia, the cardiac output is
     A. Cytochrome oxidase                                                             increased because of:
     B. Peroxidase                                                                      A. Decreased peripheral resistance
     С Catalase                                                                         B. Decreased blood viscosity
     D. All of the above                             (p. 387)                           С Increased venous return
                                                                                        D. All of the above                       (p. 390)
13. The total stored iron in body as ferritin is about:
    A. 2 gm                     B. 1000-1500 mg                                    22. What is not true of polycythemia vera:
    С 500-1000 mg               D. 200-500 mg        (p. 387)                          A. All the three cell lines proliferate
                                                                                       B. Rise in blood viscosity
14. The daily loss of iron from body is:
                                                                                       C. Rapid blood flow in capillaries
    A. 1 mg                    B. 2 mg
                                                                                       D. Ruddy complexion with bluish skin          (p. 390)
    С 3 mg                     D. 5 mg               (p. 388)
                                                                                   23. Interleukins responsible for growth of all form of
15 In normal state transferrin saturation is:
                                                                                       stem cells is:
    A. 1/3                       B. 1/2
                                                                                       A. IL-1                      B. IL-2
    С 2/3                       D. Full              (p. 388)                          С IL-3                       D. IL-5           (p. 383)
16. RBC does not contain:
    A. Nucleus
    B. Mitochondria
    C. Endoplasmic reticulum
    D. All of the above                              (p. 389)
17. The function of NADPH in RBC:
    A. Maintains pliability of cell membrane
    B. Maintains membrane transport of ions
    C. Maintains hemoglobin iron in ferrous form
    D. Prevents oxidation of proteins within RBC
    E. All of the above                          (p. 389)
           9В       10 В   11 С   12 D     13 С    14 A         15 A        16 D
                                                                                        18 В   19 В   20 В   21 D   22 С      23 С
          17 E
                                                                                                    Body Resistance 71

                                                               9. Which of the following neutrophil product is
                                                                  bactericidal:
                                                                  A. Myeloperoxidase
                                                                  B. Superoxide
          Body Resistance                                         C. Hydrogen peroxide
                                                                  D. Hydroxyl ions
1. The plasma cells are principally formed in:                    E. All of the above                   (p. 395)
   A. Lymph node               B. Bone marrow                  10. What is histiocyte:
   С Liver                     D. Spleen       (p. 392)            A. Alveolar macrophage
2. The term polymorphonuclear cell includes:                       B. Eosinophil derivative
   A. Neutrophils                                                  С Plasma cell
   B. Basophils                                                    D. Tissue macrophages of skin                     (p. 395)
   C. Eosinophils
                                                               11. Neutrophil invasion of inflamed area is:
   D. All of the above                              (p. 392)
                                                                   A. First line defence
3. The life of granulocytes in peripheral blood is:                B. Second line defence
   A. 1-2 hours                B. 4-5 hours                        C. Third line defence
   С 12-24 hours               D. 2-5 days                         D. Fourth line defence                            (p. 397)
   E. 7-14 days                                    (p. 393)
                                                               12. The granulocyte monocyte production in inflamma
4. The life of granulocytes in tissues is:                         tion is stimulated by:
   A. 10-12 hours              B. 4-5 days                          A. M-CSF
   С 7-14 days                 D. 28 days           (p. 393)        B. G-CSF
6. The lymphocytes have a life span of:                             С GM-CSF
                                                                    D. All of the above                          (p. 398)
   A. Few weeks
   B. Few months                                               13. Which of the following mainly secretes the colony
   С Years                                                         stimulating factors:
   D. All of the above/any of the above             (p. 393)       A. Neutrophils
6. The half life of platelet is:                                   B. Lymphocytes
                                                                   C. Macrophages
   A. 10 days                    B. 24 days
                                                                   D. None of the above                         (p. 398)
   С 6 weeks                     D. 6 months        (p. 393)
                                                               14. The function of eosinophil is:
7. The tissue macrophages are derived from circula
   ting:                                                           A. Phagocytosis of bacteria
   A. Granulocytes                                                 B. Killing of small parasites
   B. Lymphocytes                                                  C. Destruction of allergens
   C. Monocytes                                                    D. All of the above                                (p. 399)
   D. All of the above                          (p. 394)       15. The substances released by basophil and mast cells
8. The chemotaxic agents include:                                  include:
   A. Bacterial toxins                                              A. Heparin
   B. Cell degeneration products                                    B. Histamine
   С Complement complex                                             C. Bradykinin
   D. All of the above                              (p. 394)        D. Serotonin
                                                                    E. All of the above                           (p. 399)
1A   2D     3B     4С      SD        6A        7С      8D|
                                                                9E   10 D   11 В    12 D   13 С     14 D      15 E
72 Review of Physiology                                                                            Body Resistance 73

 16. Common drugs causing agranulocytosis include all         23. The stereochemical characteristic of antigenic mole
     except:                                                      cule is called:
     A. Thiouracil                                                A. Epitome
     B. Barbiturate                                               B. Epitope
     C. Penicillin                                                C. Apotosis
     D. Chloramphenicol                          (p. 399)         D. None of the above                            (p. 403)
 17. The common effects of leukaemias include:                24. All of the following are antigenic except:
     A. Anaemia                                                   A. Polysaccharides          B. Proteins
     B. Infections                                                С Fatty acids               D. Haptens          (p. 403)
     С Bleeding
     D. All of the above                           (p. 443)   25. The T lymphocytes are preprocessed in:
                                                                  A. Liver                  B. Bone marrow
 18. The cause of death in leukaemia in absence of                С Thymus                  D. Lymph node (p. 403)
     infection, anaemia or bleeding is:
     A. Cardiac failure                                       26. Body's recognition of self antigens is made in:
     B. Respiratory failure                                       A. Thymus                   B. Lymph node
     C. Metabolic starvation                                      С Bone marrow               D. Brain            (p. 404)
     D. None of the above                     (p. 400)        27. Interleukin I is produced by:
 19. What is innate immunity:                                     A. T-lymphocytes            B. B-lymphocytes
     A. Nonspecific natural immunity                              C. Macrophages              D. Plasma cells (p. 405)
     B. Specific immunity against certain agents              28. The steps in secretion of antibody is as follows
     C. Immunity induced by vaccines and sera                     except:
     D. None of the above                        (p. 402)         A. Antigen is ingested by macrophage
20. Members of innate immunity system include all                 B. Next it presents to T and В cells
    except:                                                       С T helper cells activate В cells
    A. Macrophage system                                          D. Each В cell transforms to one plasma cell to secrete
    B. Lysozyme                                                       imrnunoglobulins                            (p. 406)
    С NK cells                                                29. Which of the following statement is true about
    D. Activated T lymphocytes                                    composition of immunoglobulins:
    E. Complement system                     (p. 402)             A. All immunoglobulins contain 2 light and 2 heavy
21. В cell immunity refers to:                                       chains
    A. Humoral immunity                                           B. Most Immunoglobulins contain 2 light and 2
    B. Cell mediated immunity                                        heavy chains
    С Innate immunity                                             C. Constant portion contains light chains
    D. None of the above                           (p. 402)       D. Antigens bind to heavy chain             (p. 406)
22. The molecular Wt of a substance to be antigenic           30. The antibodies inactivate the antigen by which of
    must be above:                                                the following mechanisms:
    A. 1000                                                        A. Agglutination
    B. 4000                                                        B. Precipitation
    С 8000                                                         C. Neutralization
    D. 20,000                                   (p. 403)           D. Lysis
                                                                   E. All of the above                          (p. 407)

16 С   17 D   18 С   19 A   20 D   21 A     22 С              23 В   24 С   25 С   26 A   27 С     28 D    29 В    30 E
   74 Review of                                                                                     Body Resistance 75
   Physiology

31. The number of proteins constituting complement                39. Examples of autoimmunity where self tolerance is
    system number:                                                    lost include all except:
    A. 8                     B. 15                                    A. Rheumatic fever
    С 20                     D. 17            (p. 407)                B. Glomerulonephritis
                                                                      C. Diabetes insipidus
32. Antigen antibody reaction activates complement
                                                                      D. Myasthenia gravis
    system by:
                                                                      E. Lupus erythematosus                     (p. 410)
    A. Direct pathway
    B. Alternative pathway                                        40. Drug allergy is caused by:
    C. Both of the above                                              A. Antibodies
    D. None of the above                       (p. 407)               B. Activated T cells
                                                                      C. В cells
33. C5b56789 of complement complex is known as:
    A. Opsonizing complex                                             D. None of the above
    B. Lytic complex                                                                                              (p. 411)
    C. Chemotaxic complex                                         41. Atopic asthma is due to:
    D. Agglutinating complex                  (p. 408)                A. IgE
34. Mast cell and basophil activation with amplification              B. Activated T cells
    of inflammatory response is by: ,                                 С IgG
    A. C3b                                                            D. None of the above
    B. C3a                                                                                                        (p. 412)
    C. Сба                                                        42. Anaphylaxis results from liberation of all except:
    D. All of the above                             (p. 408)          A. Histamine               B. SRSA
35. The most T cell population consists of:                           С Interleukins             D. Leukotrienes (p. 412)
    A. Helper T cell
    B. Memory T cells
    C. Suppressor T cells
    D. NK cells                                      (p.
    409)
36. The l ymphokines s ecr eted by helper T cells are
    all except:
    A. IL2 B. Interferon gamma
    C. IL1 D. GM CSF                           (p. 409)
37. Which of the following interleukins is known as В
    cell growth factor:
    A. IL4
    B. IL5
    С IL6
    D. All of the above                          (p. 409)
38. What is true of perforins:
    A. Secreted by cytotoxic T cells
    B. Secreted by macrophages
    C. Secreted by plasma cells
    D. All are false                                 (p. 410)

31 С   32 A   33 В   34 В   35 A     36 С     37 D         38 A    39 С   40 В   41 A   42 С
                                                                  ________ Blood Groups Transfusion, Transplantation 77

                                                                   8. HLA antigens occur on:
                                                                      A. RBC
                                                                      B. WBC
           Blood Groups Transfusion,                                  C. Both of the above
                                                                      D. None of the above                            (p. 417)
           Transplantation                                         9. Cyclosporine has specific inhibitory effect on:
                                                                      А. В cells                  B. Helper T cells
1. The least frequent blood group is:                                 С Suppressor T cells       D. NK cells          (p. 417)
   A. AB                      В. А
   CO                         D. В                  (p. 413)      10. Which of the following achieves haemostasis:
                                                                      A. Vascular spasm
2. The antigen binding sites on IgM is:                               B. Platelet plug
   A. 2                       B. 4                                    C. Blood clot formation
   С 6                        D. 10                 (p. 414)          D. All of the above                          (p. 419)
3. How many types of Rh antigen are present in blood:             11. The vascular spasm following injury is due to:
   A. 1                      B. 4                                     A. Anoxia                 B. Thromboxane A2
   С 6                       D. 10                (p. 415)            С Endothelin              D. Prostacycline (p. 419)
4. The most prevalent Rh antigen is:                              12. RBC and platelets cannot replicate because they do
   A. С                                                               not have:
   B. D                                                               A. Mitochondria
   C. Е                                                               B. Nuclei
   D. None of the above                             (p. 415)          С Cell wall
5. The risk of erythroblastosis foetalis in Rh negative               D. Endoplasmic reticulum                       (p. 419)
   mother with Rh positive baby is second pregnancy               13. Which of the following is present in platelet
   in:                                                                cytoplasm:
   A. 3%                                                              A. Actin               B. Myosin
   B. 7%                                                              C. Thrombosthenin      D. All of the above
   С 12%                                                                                                        (p. 419)
   D. 25%                                          (p. 415)
                                                                  14. Which cation is important for conversion of pro
6. A baby of erythroblastosis foetalis is given exchange              thrombin to thrombin:
   transfusion with which blood group:                                A. Sodium                 B. Magnesium
   A. Rh positive                                                      С Calcium                D. Cobalt          (p. 421)
   B. Rh negative
   С Any of the above                               (p. 416)      15. Normal prothrombin concentration of plasma is:
                                                                      A. 10 mg/dl              B. 15 ml/dl
7. Match the following:                                               С 25 mg/ dl              D. 35 mg/dl        (p. 421)
   A. Autograft                1. From one identical
                                  twin to another                 16. Platelets are essential for clotting because:
      В., Isograft             2. Transplant from one                 A. Formation of thrombin from prothrombin occurs
                                   part to another in same                once, latter is attached to platelets
                                  subject                             B. Platelets secrete fibrin stabilizing factor
      С Allograft              3. From one human being                C. Help in clot retraction
                                   to another      (p. 417)           D. All of the above                            (p. 420)


                                                                      8 B 9 B 10 D 11 B 12 B 13 D 14 C 15 B 16 D

1 A     2D     3С    4 В      5A        6В       7 A:2, B:1,C:3
                                                                            Blood Groups Transfusion, Transplantation   79
78 Review of Physiology

  17. The difference between plasma and serum is that           24. Protamine neutralizes heparin because it:
       later does not contain:                                      A. Enzymatically splits heparin
       A. Platelets                                                 B. Combines with heparin and facilitates renal
       B. RBC                                                          excretion
       C. Clotting factors                                          C. Neutralizes heparin electrostatically
       D. All of the above                         (p. 421)         D. None of the above                      (p. 427)
18. Which pathway of coagulation is very fast:                  25. Which of the following act as anticoagulants:
    A. Intrinsic                                                    A. Sodium oxalate
    B. Extrinsic                                                    B. Ammonium citrate
    С Both are equally fast                          (p. 423)       C. Sodium acetate
                                                                    D. All of the above                           (p. 428)
19. Healthy vascular endothelium is essential to prevent
    clotting in normal person because:                          26. Normal prothrombin time is:
     A. Its smoothness prevents contact activation of               A. 10 seconds             B. 12 seconds
         intrinsic clotting system                                  С 14 seconds              D. 16 seconds       (p. 429)
     B. Glycocalyx layer repels platelets and clotting
                                                                27. Warfarin blocks hepatic synthesis of:
         factors
                                                                    A. Prothrombin
     C. Thrombomodulin binds to thrombin and this comp
                                                                    B. Factor VII
         lex activates protein kinase-C-(an anticoagulant)
                                                                    С Factor IX and X
     D. All of the above                             (p. 425)
                                                                    D. All of the above                            (p. 428)
20. Which of the following have anticoagulant property:
    A. Antithrombin III                                         28. tPA is required for:
    B. Heparin                                                      A. Clot formation
    С Protein С and S                                               B. Clot removal
    D. All of the above                             (p. 425)         D. Clot organisation
                                                                     D. None of the above                           (p. 425)
21. Lack of vit К causes deficiency of all except:
    A. Prothrombin
    B. Fibrinogen
    С Factor VII
    D. Factors IX and X                            (p. 426)
22. Haemophilia is:
    A. Autosomal dominant
    B. Autosomal recessive
    C. X-linked recessive
    D. X-linked dominant                             (p. 426)
23. Bleeding in thrombocytopenia usually occurs when
    platelet count is reduced below:
    A. 1 lac/cmm
    B. 75,000/cmm
    С 50,000/cmm
    D. 20,000/cmm                                (p. 426)

                                                                 | 24 С   25 D   26 В   27 D   28 В
17 C' 18 В   19 D   20 D   21 В      22 С     23 С
                                                                                                              Ventilation 81

                                                               7. Surfactant is secreted by:
                                                                  A. Type I pneumocytes
                                                                  B. Type II pneumocytes
                                                                  С Both of the above
                         Ventilation                              D. None of the above                               (p. 434)
                                                               8. Match the following pulmonary volume data for
1. All the following muscles help in respiration except:          average young man: A.
   A. Sternocleidomastoid                                         Tidal volume             1. 1200 ml
   B. Intercostals                                                B. Inspiratory reserve   2. 500 ml
   С Deltoid                                                         volume
   D. Serratus anterior                             (p. 432)      C. Residual volume      3. 3000 ml        (p. 437)

2. Expiration is aided by:                                     9. Match the following          data   about   pulmonary
   A. External intercostal                                        capacities in young:
   B. Internal intercostal                                        A. Functional residual        1. 5.8 lit
   С Both of the above                                                capacity
   D. None of the                                                 B. Vital capacity              2. 4.5 lit
   above(p.432)                                                   С Total lung capacity          3. 2.3 lit          (p. 437)
3. The normal pleural pressure at beginning of                 10. When vital capacity is added to residual volume it
inspiration is;                                                    gives to:
                                                                   A. Total lung capacity
A. 5 cm H2O                                                        B. Functional residual capacity
B. 1 cm H2O                                                        C. Inspiratory reserve volume
                                                                   D. All of the above                           (p- 437)
C. -5 cm H2O
D. -10 cm H 2O(p. 433)                                         11. In a normal person the equation between anatomical
4. The change in pleural pressure from -5 cm H2O to                and physiological dead space is:
   -7 cm H 2O during quiet inspiration changes lung                A. Equal
   volume by:                                                      B. Anatomic dead space > physiological dead space
   A. 1/2 litre               B. 1 litre                           С Physiological dead space > anatomical dead space
                                                                                                                   (p. 439)
   С IVi litre                D. 2 litres        (p. 433)
5. Lung compliance is defined as:                              12. The anatomical dead space is normally:
   A. Lung expansion per unit increase in transpul -               A. 150 ml                  B. 500 ml
                                                                   С 700 ml                   D. 950 ml              (p. 439)
      monary pressure
   B. Lung retraction per unit decrease in transpul -          13. Which of the following does not occur as the air
      monary pressure                                              passes through nose:
   C. Rate of rise of intrapulmonary pressure with respi           A. Warming up           B. Humidification
      ration                                                       С Purification          D. Filtration       (p. 441)
   D. None of the above                           (p. 433)
                                                               14. The particles that reach     alveoli are smaller than:
6. Normal lung compliance is:                                      A. 10 p                      В. 6 u
   A. 100 ml/cm H 2O                                               С. 1ц                        D. 0.1 ц              (р- 441)
   B. 200 ml/cm H2O
   С 300 ml/cm H 2O
   D. 350 ml/cm H 2 O                              (p. 434)
                               7В     8 А:2, В:3, С:1 9 А:3, В:2, С:1   10 А   11 А   12 А
1С   2В   ЗС   4A   5A   6В   13 С   14 С
82 Review of Physiology

15. What is true about output of left and right ventricles:
    A. Equal
    B. LV output > RV output
    С RV output > LV output                              (p. 444)
16. The mean pulmonary artery pressure is:
                                                                            Gas Exchange
    A. 50 mmHg                B. 25 mmHg
    С 15 mmHg                 D. 10 mmHg                (p. 444)    1. The oxygen concentration of inspired air is:
17. The mean pressure in pulmonary vein is:                            A. 20%                     B. 21%
                                                                       С 22%                                            (p. 452)
    A. 10 mmHg               B. 5 mmHg                                                            D. 23%
    С 3 mmHg                 D. 2 mmHg                   (p. 444)   2. Partial pressure of O 2 in
18. Pulmonary wedge pressure is normally:                              inspired gas is:
                                                                       A. 100 mmHg                B. 130 mmHg           (p. 452)
    A. 15 mmHg                B. 10 mmHg
    С 5 mmHg                  D. 3 mmHg                  (p. 445)      С 160 mmHg                 D. 190 mmHg

19. The blood volume of lungs is:                                   3. The vapour pressure in air passage is:
                                                                       A. 47 mmHg                  B. 57 mmHg           (p. 453)
    A. 450 ml                B. 350 ml
                                                                       С 67 mmHg                   D. 76 mmHg
    С 250 ml                 D. 150 ml                   (p. 445)
                                                                    4. The diffusion co-efficient is highest for:
20. Blood flow through the apices of lungs occurs
                                                                      A. CO B. CO2
    during:                                                                                                             (p. 454)
                                                                      С O9 D. Nitrogen
    A. Systole
    B. Diastole                                                     5. How much of fresh air is brought in contact with
    С Both systole and diastole                                        alveoli with each inspiration:
    D. Upright posture                       (p. 445)                  A. 750 ml                   B. 500 ml
                                                                       С 350 ml                    D. 250 ml        (p. 454)
21. Which of the following nerves influence pulmonary
    blood flow:                                                     6. Normal O2 absorption at
    A. Sympathetic                                                  rest per minute is:             B. 350 ml
    B. Parasympathetic                                                  A. 250 ml С 500 ml          D. 750 ml
                                                                                                                         (p. 455)
    C. Somatic                                                      7. The normal quantity of respiratory units in
    D. None of the above                          {p. 447)             both
22. The net filtration pressure in pulmonary capillaries               lungs in adult is about:
                                                                       A. 100 million
       A. 1 mmHg B. 5 mmHg                                             B. 200 million
       С 7 mmHg                                         (p. 448)       С 300 million
                 D. 10 mmHg                                            D. 500 million                                    (p- 456)
23. The safety factor for pulmonary oedema in normal                8. The total surface area for gas exchange in both lungs
person is:                                                                        is about:
    A. 15 mmHg                 B. 21 mmHg                              A. 1 m2 B. 5 m2
    С 27 mmHg                  D. 30 mmHg        (p. 449)              С 15 m2 D. 70 m2
                                                                                                                         (p. 456)
24. The beating of cilia in respiratory passage is:
    A. 5-10/sec                  B. 10-20/sec                       9. The average diametre of pulmonary capillary
    С 20-40/sec             .    D. 50-100 sec      (p. 441)            through which RBCs pass during gas exchange is:
                                                                        A. 20 u                  B. 10 ц
                                                                        С 5ц                        D. 2 ц               (p. 456)

15 В    16 С   17 D   18 С    19 А     20 А      21 D      22 А      1 В9      2С    ЗА      4В        5С       6 А       7С        8D
23 В    24 В                                                         С
 84 Review of Physiology
                                                                                                                 Gas Exchange 85
  10.      Diffusing capacity is the volume of gas diffusing:
        A. Each second for pressure difference of 100 mmHg             20. Saturation of haemoglobin in venous blood is:
        B. Each minute for pressure difference of 1 mm of Hg               A. 100 %                  B. 75 %
        C. Each minute for pressure difference of 10 mm of                 С 50 %                    D. 25 %            (p. 466)
           Hg
                                                                       21. 1 gram of haemoglobin can approximately carry how
        D. None of the above                          (p. 459)
                                                                           much of oxygen:
  11.      Diffusing capacity for O 2 at rest is:                          A. 3.3 ml '                B. 2.3 ml
        A. 1 ml/min/mmHg                                                   С 1.3 ml                   D. 0.3 ml           {p. 466)
        B. 11 ml/min/mmHg
        С 21 ml/min/mmHg                                               22. What will happen to arterial O2 saturation if alveolar
        D. 31 ml/min/mmHg                                   (p. 459)       PO2 is raised to 500 mmHg:
                                                                           A. 100 %                     B. 110 %
 12. Maximum diffusing capacity for oxygen is:                             С 150 %                      D. 200 %              {p. 467)
      A. 42 ml/min/mmHg
      B. 5 ml/min/mmHg                                                 23. What is Bohr effect:
      С 84 ml/min/mmHg                                                     A. Rise in O2 saturation of blood with rise in alveolar
      D. 110 ml/min/mmHg                                    (p. 459)          oxygen concentration
 13. VA/Q at base of lung in normal upright posture is:                    B. Fall in O2 saturation of blood with rise in alveolar
      A. 1                       B. 2                                         CO2 concentration
      С 0.6                      D. 0.4               (p. 460)             C. Shift in oxygen-haemoglobin dissociation in
                                                                              response to hydrogen ion concentration ,
14. PO 2 of capillary venous blood in alveoli is:                          D. All of the above                              (p. 468)
     A. 100 mmHg                B. 84 mmHg
     С 40 mmHg                  D. 28 mmHg                 (p. 463)    24. Shifting of O 2 dissociation curve to right means:
                                                                           A. Decreased O 2 delivery to tissues
15. Diffusion pressure of oxygen in alveoli is:
                                                                           B. Increased O 2 delivery to tissues
    A. 64 mmHg                B. 44 mmHg
                                                                           C. None of the above                            (p. 468)
    С 24 mmHg                 D. 4 mmHg                     (p. 463)
                                                                       25. All the following cause O2 dissociation curve to shift
16. The percentage of blood bypassing alveoli and
    hence oxygen transfer in lung constitute what                          to right except:
    percentage of pulmonary blood flow:                                    A. Alkalosis                B. Raised PCO2
    A. 20%                    B. 10%                                       С Fever                     D. Increased DPG (p. 468)
    С 5%                      D. 2%           (p. 464)                 26. O2 dissociation curve shifts to left in presence of all
17. PCO2 of venous blood entering lungs is:                                except:
    A. 49 mmHg                B. 45 mmHg                                   A. Fetal Hb                  B. Exercise
    С 43 mmHg                D. 40 mmHg                    (p. 465)        С Alkalosis                  D. Cold               (p. 468)
18. Diffusion pressure for CO 2 in alveolar blood is:                  27. The amount of oxygen carried to tissues dissolved in
    A. 20 mmHg                  B. 10 mmHg                                 blood is:
    С 5 mmHg                   D. 2 mmHg            (p. 465)               A. 0.29 ml/dl              B. 0.12 ml/dl
19. The per cent of oxygen carried dissolved in plasma                     С 0.17 ml/dl               D. 0.1 ml/dl        (p. 469)
    is:
    A. 10 %                   B. 7 %                                   28. Affinity of Hb for CO is how many times great in
    С 3%                      D. 1 %               (p. 466)                comparison to O2:
                                                                           A. 100 times               B. 150 times
                                                                           C. 250 times               D. 350 times    (p. 469)


                                                                           20 B 21 C 22A 23 C 24 B 25 A 26 B 27 C 28 C
10 В    11 С   12 В    13 С    14 С     15 А        16 D      17 В
18 С    19 С
86 Review of Physiology                                                                                           Gas Exchange 87

 29. CO concentration in air lethal to man is:                            38. Under normal conditions amount of O2 passing from
     A. 10 %                     B. 1 %                                       100 ml of blood in capillaries to tissues in:
     С 0.1%                      D. 0.01 %                                    A. 5 ml                    B. 10 ml
                                                              (p. 470)        С 15 ml                    D. 30 ml            (p. 466)
 30. The amount of CO2 transported in blood from                          39. Diffusion of CO2 in how many times faster than that of
     tissues to lungs is:                                                 O2:
     A. 40 ml/dl                                                          A. 5 times           B. 10 times
     B. 4 ml/dl                                                                                                               (p. 465)
     С 0.4 ml/dl                                                          C. 20 times           D. 40 times
     D. None of the above                      (p. 470)
 31. The most common form in which CO2 is transported
     is as:
     A. CO2
     B. Hb-CO2
       с. нсо
                 '3
       D. None of the above                               (p. 470)
 32. What is chloride shift:
     A. Exchange of chloride for sodium
     B. Exchange of chloride for bicarbonate
     C. Exchange of chloride for potassium
     D. None of the above                                 (p. 471)

 33. What is Haldane affect:
     A. Binding of CO 2 to Hb displaces O 2
     B. Binding of O 2 to Hb displaces CO 2
     C. Binding of CO to Hb displaces O 2                 (p. 471)
 34. Combination of O 2 with Hb makes it:
       A. Neutral                     B. More acidic
       C. More alkaline               D. No change        (p. 471)
 35. The pH of venous blood is:
     A. 7.41                  B. 7.40
     С 7.37                   D. 7.35                         9. 472)
 36. The ratio of CO 2 output to O2 uptake is called:
     A. Respiratory exchange ratio
     B. Metabolic exchange ratio
     C. Gaseous exchange ratio
     D. None of the above                             (p. 472)
 37. Respiratory exchange ratio for fat is:
     A. 1
     B. 2
     С 0.7
     D. 0.5                                               (p. 472)
29 С      30 В        31 С   32 В   33 В    34 В       35 С        36 А
                                                                              38 A   39 С
37 С
                                                                                            Regulation of Respiration 89

                                                                                         7.       What is Hering's nerve:
                                                                   A.   Nerve from aortic bodies to recurrent laryngeal
        Regulation of                                              B.
                                                                   C.
                                                                        Nerve from carotid bodies to glossopharyngeal
                                                                        Nerve from JG apparatus to renal sympathetic
        Respiration                                                D.   None of the above                         (p. 478)
                                                                8. Aortic and carotid chemoreceptors primarily sense:
1. Rate and pattern of breathing is controlled by:               A. Arterial PO2 B. Arterial PCO2
   A. Dorsal respiratory centre                                  С Arterial pH D. All of the above (p. 478)
   B. Ventral respiratory centre                                                  9. The respiratory drive of low PO2 is
   C. Pneumotaxic centre                                           not blocked by
   D. All of the above                             (p. 474)        decrease in PCO2 and hydrogen ions in:
2. Which part of respiratory centre is most vital for              A. Pneumonia                B. Emphysema
   respiratory control:                                            C. Atelectasis              D. All of the above
   A. Ventral                                                  10. Mountain climbing needs acclimatization for 2-3
   B. Dorsal                                                       days because:
   С Pneumotaxic centre                            (p- 474)        A. To sensitize respiratory centre to respond to low
3. Pneumotaxic centre is situated in:                                 PO2
   A. Upper medulla                                                B. To desensitize respiratory centre to the effects of
   B. Lower medulla                                                   PCO2 and pH
   С Pons                                                          C. Both of the above
   D. Midbrain                                     (p. 475)        D. None of the above                           (p. 479)

4. Ramp Signal refers to:                                      11. With strenuous exercise in an athlete which of the
   A. Inspiratory signal                                           following changes:
   B. Expiratory signal                                            A. PO2
   C. Signal to stop inspiration                                   B. PCO2
   D. Signal to stop expiration                                    С pH
                                                    (p. 474)       D. None of the above
                                                                                                                  (p. 479)
5. What is Hering-Breuer reflex:
   A. A chemically mediated reflex for inspiration             12. Pulmonary '}' receptors are responsible for:
   B. A stretch receptor mediated reflex for stopping              A. Inspiration               B. Expiration
      inspiration                                                  C. Breathlessness           D. Apneusis        (p. 481)
   C. A chemically mediated reflex to stop expiration          13. Pulmonary ']' receptors are present in:
   D. None of the above                         (p. 475)           A. Alveoli                  B. Trachea
6. Which of the following has no direct effect on                  С Bronchi                   D. Bronchioles     (p. 481)
   respiratory centre:                                         14. Which of the following depresses respiration:
   A. CO2                                                          A. Brain edema            B. Narcotics
   B. pH                                                           C. Halothane              D. All of the above
   С O2                                                                                                          (p. 482)
   D. All of the above
                                             (p. 477)          15. Cheyne-Stokes respiration occurs in:
                                                                   A. Children                B. Heart failure
                                                                   С Stroke                   D. All of the above
                                                                                                                (p. 482)




                                                               7 B 8 D 9 D 10 B 11 D 12 C 13 A 14 D 15 D



1С    2В     3С        4 A      5В       6С
                                                                                           Respiratory Insufficiency 91


            Respiratory Insufficiency*                        8. Raised PCO2 though is a respiratory stimulant, can
                                                                 cause respiratory depression when the level exceeds:
             НУРО- and Hyperbaric                                A. 40 mmHg
                                                                 С 80 mmHg
                                                                                              B. 60 mmHg
                                                                                              D. 100 mmHg        (p. 491)
                   Conditions                                 9. Cyanosis is common to patients of:
                                                                 A. Anaemia
1. Henderson-Hasselbalch equation refers to estima               B. Polycythemia
   tion of blood:                                                C. Both of the above
   A. PO2                                                        D. None of the above                              (p. 491)
   B. PCO2                                                   10. Which of the following has least role in dyspnoea:
   C. рН                                                         A. Hypoxia
   D. None of the above                          (p. 484)        B. Hypercapnoea
2. FEVj to FVC in a normal person is:                            C. Increased work of breathing
   A. 50%                    B. 70%                              D. State of mind                              (p. 491)
   С 80%                     D. 90%               (p. 486)   11. Barometric pressure on top of Everest is:
3. Physiological effects of emphysema include:                   A. 760 mmHg                B. 353 mmHg
                                                                 С 253 mmHg                 D. 153 mmHg         (p. 496)
   A. Increased airway resistance
   B. Reduced diffusing capacity                             12. Alveolar PO2 top of Everest is:
   С Va/Q mismatch                                               A. 147 mmHg                B. 47 mmHg
   D. All of the above                         (p. 487)          С 40 mmHg                  D. 27 mmHg          (p. 496)
4. Atelectasis occurs due to:                                13. Body acclimatization to low PO2 include:
   A. Surfactant loss                                            A. Increased RBC mass
   B. Obstruction of airways                                     B. Increased diffusing capacity
   C. Both of the above                           (p. 488)       C. Increased vascularity of tissue
                                                                 D. All of the above                               (p. 497)
5. The sequel of bronchial asthma include:
   A. Barrel chest                                           14. In a person living at high altitude of 15000 feet is
   B. Increased functional residual capacity                     likely to have which of the following:
   C. Increased residual volume                                  A. PO^ 40 mmHg
   D. All of the above                            (p.489)        B. Venous PO2 25 mmHg
                                                                 С Hb 18 gm%
6. Cyanide poisoning causes death due to:
                                                                 D. All of the above                             (p. 498)
   A. Respiratory depression
   B. Brainstem depression                                   15. An airforce pilot is exposed to which of the
   C. Blockade of cytochrome oxidase                             following forces:
   D. None of the above                           (p. 489)       A. Linear acceleratory force
                                                                 B. Linear deceleratory force
7. Oxygen therapy is not of much value in all of the             С Centrifugal acceleration force D.
   following except:                                             All of the above
   A. Anaemia
                                                                                                         (p. 500)
   B. Circulatory deficiency
   C. Reduced alveolar diffusion                             16. The seats of astronauts is:
   D. Intrapulmonary shunt                      (p. 490)         A. Vertical                 B. Reclining
                                                                                    C. Horizontal       (p. 501)
1С   2С 3D 4C 5D 6C 7C

                                                               8 C 9 B 10 A 11 c 12 C 13 D 14 D 15 D 16 B
92 Review of Physiology                                                                        Respiratory Insufficiency 93

 17. Spot the wrong statement:                                    25. Hyperbaric oxygen therapy in most useful in:
     A. Positive G causes venous hypertension in legs                 A. Gas gangrene
     B. With positive G hypotension is a danger                       B. Bronchial asthma
     C. Negative G causes intracranial hypertension                   C. CO poisoning
     D. High acceleratory forces can cause vertebra                   D. Osteomyelitis                             (p. 509)
        fracture
                                                                  26. At a depth of 700 feet, body oxygen requirement is
     E. None of the above                        (p. 500)
                                                                                  met by:
 18. The force of impact on the ground while parachute                А.      O2               B. 5% O2
     jumping is equal to that of jumping without                      С. 10% O,               D. 20% O2
                                                                                                                   (p. 508)
     parachute from a height of:
     A. 50 feet                  B. 30 feet
     С 12 feet                   D. 6 feet         (p. 501)
 19. A person working in 66' deep water is exposed to
     pressure of:
     A. 1 atom                 B. 2 atom
     С 3 atom                  D. 4 atom          (p. 504)
 20. In deep sea diving, the danger is from:
     A. Nitrogen                B. Oxygen
     С Carbon dioxide           D. All of the above (p. 504)
 21. Dissolved nitrogen in blood causes:
     A. DIC
     B. Haemolysis
     С Narcosis
     D. All of the above                               (p. 504)
 22. The amount of nitrogen expected to be dissolved in
     body at a depth of 100 feet below water is:
     A. 1 litre                 B. 2 litre
     С 3 litre                  D. 5 litre         (p. 506)
 23. The commonest          symptom     of    decompression
     sickness is:
     A. Joint pain                  B. Paralysis
     С Collapse                     D. Coma            (p. 507)
 24. Helium-oxygen mixture is used for deep sea divings
     because:
     A. Helium has l/5th narcotic effect of nitrogen
     B. Helium dissolves less in body and diffuses out
         quickly
     С Helium keeps airway resistance at minimum
     D. All of the above                            (p. 508)



17 E   18 D   19 В   20 D    21 С      22 С     23 A    24 D      25 A   26 A
                                                                                                          Nervous System 95

                                                                 8. Spot the wrong statement:
                                                                    A. Dopamine is secreted by substantia nigra
                                                                    B. Glycine is secreted in spinal cord
                                                                    C. GABA is secreted in most parts of CNS
           Nervous System                                           D. All are true                             (p. 520)
                                                                 9. Which of the following is an excitatory transmitter:
                                                                    A. GABA                     B. Glycine
 1. Motor functions include:                                        С Dopamine                  D. Glutamate       (p. 520)
    A. Contraction of skeletal muscles
    B. Contraction of smooth muscles                             10. Nitric oxide as a neurotransmitter is localised to:
    C. Secretion of exocrine and endocrine glands                    A. Motor cortex             B. Limbic cortex
    D. All of the above                         (p. 512)             С Cerebellar cortex        D. Basal ganglia (p. 520)

 2. Skeletal muscle's function can be influenced by:             11. Re-uptake is the principal way of disposal for which
    A. Cerebellum               B. Cerebral cortex                   neurotransmitter:
    C. Spinal cord              D. Reticular formation               A. Adrenaline               B. Noradrenaline
    E. All of the above                            (p. 512)          С Acetylcholine             D. GABA              (p. 520)
 3. Most synapses in nervous system are:                         12. What is Nernst potential:
    A. Chemical                                                      A. Potential difference of inside and outside of cell
    B. Electrical                                                       membrane
    C. Mechanical                                                    B. Potential that facilitates movement of ions across
                                                      (p. 517)          cell membrane
                                                                     C. Potential that opposes movement of ions across
4. Opening up of chloride channel causes:
                                                                        cell membrane
   A. Stimulation of postsynaptic neuron
                                                                     D. None of the above                           (p- 521)
   B. Inhibition of postsynaptic neuron
   C. Either of the above                                        13. The resting negative membrane potential is due to
   D. None of the above                             (p. 519)         intracellular:
                                                                      A. Na+
5. The activation component of G protein is:
                                                                      B. K+
   A. Alfa
   B. Beta                                                            c. cr
   C. Gamma                                                           D. None of the above                              (p. 521)
   D. None of the above                                          14. The excitatory postsynaptic potential likely to elicit
                                                     (p. 517)        an action potential is:
6. Which of the following is not a synaptic transmitter:              A. -40 to -20 mV
   A. Dopamine                 B. Nitric oxide                        B. -20 to -0 mV
   С Lysine                    D. Glycine            (p. 519)         С 10 to 20 mV
                                                                      D. 40 to 60 mV                                    (p. 522)
7. Acetylcholine acts as a neurotransmitter in:
   A. Pyramidal cells of motor cortex, basal ganglia             15. What electrical event occurs in neuronal inhibition:
   B. Motor neurons to skeletal muscles                              A. Depolarisation
   C. Preganglionic neurons of autonomic nervous                     B. Hyperpolarisation
      system                                                         C. None of the above                              (p- 522)
   D. Postganglionic neurones of parasympathetic
      nervous system
   E. All of the above                          (p. 520)

1 D   2E     3A       4В        5A
                                                                       8D     9D   10 В    11 В    12 С     13 В    14 С     15 В
                                          6C        7E
  96 Review of Physiology                                                                                 Nervous System 97

   16. The inhibitory postsynaptic potential is in the order        23. Which of the following sensations is carried by 'C
       of:                                                              fibers (unmyelinated):
       A. -5 to -10 mV                                                  A. Warmth
       B. -20 to -30 mV                                                 B. Cold
       С 10 to 20 mV                                                    С Crude touch (pressure)
       D. Any of the above                               (p. 523)       D. Aching pain
  17.Which of the following neurotransmitters causes                    E. All of the above                            (p- 529)
        presynaptic inhibition:
       A. GABA                                                      24. Vibration sensation is sensed by:
       B. Glycine                                                       A. Touch receptors
                                                                        B. Pressure receptors
       С Glutamate
                                                                        C. Thermo receptors
       D. Serotonin                                     (p. 523)                                                         (p. 541)
                                                                        D. Pain receptors
  18. Synaptic transmission is influenced by which of the
       following:                                                   25. Which of the following is a pain receptor:
       A. Acidosis                                                      A. Meissner corpuscle
       B. Alkalosis                                                     B. Free nerve endings
       C. Hypoxia                                                       C. Merkle's disc
       D. All of the above                             (p. 526)         D. Pacinian corpuscle
                                                                        E. All of the above                                 (p- 541)
 19. The minimal synaptic delay is:
     A. 1 ms                   B. 3 ms                              26. Transmission of tactile sensation is via:
      С 5 ms                   D. 7 ms                  (p. 526)        A. A delta fiber
 20. Which of the following is not a class of receptor:                 B. A beta fiber
     A. Chemoreceptor                                                   C. С fiber
     B. Electromagnetic receptor                                        D. All of the above                                 (p- 542)
     С Mechano receptor
                                                                    27. Dorsal column sensation has which of the following
     D. None of the above                           (p. 529)
                                                                        characteristic:
 21. What are Ruffini endings:                                          A. Rapid conduction
     A. Expanded tip endings                                            B. Temporal fidelity
     B. Encapsulated endings                                            C. Spatial orientation
     С Spray endings                                                    D. All of the above                            (p. 543)
     D. Free nerve endings                             (p. 529)
                                                                    28. Which of the following is not transmitted in dorsal
 22. Spot the wrong statement about nerve transmission:
     A. Thicker the nerve fiber, greater is velocity of                 column:
        conduction                                                      A. Vibration
     B. Myelinated nerves conduct faster                                B. Position
     C. The range of conducting velocities is 0.5 to 120                C. Itch sensation
        m/s                                                             D. Two point discrimination                     (p. 543)
     D. None of the above                          (p. 532)          29. Which of the following is not transmitted in antero-
                                                                         lateral column:
                                                                         A. Crude touch              B. Pain
                                                                         С Thermal sensation        D. Sexual sensation
                                                                         E. Pressure                                      (p- 542)


16 A   17 A   18 D   19 С   20 D      21 С      22 D                 23 D   24 A   25 E   26 D    27 D      28 С     29 E
  98 Review of Physiology
                                                                                                           Nervous System 99

    30. In thalamus the dorsal column fibers end in:                 38. Transmission in antero-lateral pathway differs from
         A. Ventropostero-medial nucleus
                                                                         that in dorsal column by:
         B. Ventropostero-lateral nucleus
                                                                         A. Slower velocity of conduction
         С Anteromedial nucleus
                                                                         B. Poor spatial localization
        D. None of the above                               (p.           C. Less accurate gradation of intensities
        543)                                                             D. Rapid repetitive signals are poorly transmitted
    31. Which part is represented most down below on the                 E. All of the above                             (ft. 550)
        medial aspect of brain in somatosensory area I:
        A. Lip                     B. Genitalia                      39. Slow pain is the one perceived after:
                                                                         A. 0.1 seconds of application
        C. Toes                    D. Tongue              (p. 544)
                                                                         B. 1 second after application
   32. The cells in cerebral cortex are organized into how               C. 5 seconds after application
        many layers:
                                                                         D. 10 seconds after application                  (p- 552)
        A. 4                       B. 5
        С 6                        D. 8                  (p. 545)    40. The chemicals stimulating pain include all except:
   33.Incoming sensory signals excite which neuronal                     A. Histamine             B. Potassium ion
       layer:                                                            C. Chloride ion          D. Serotonin
       A. I                       B. Ill                                 E. Bradykinin                                (p. 552)
       С IV                       D. VI                 (p. 545)     41. Substantia gelatinosa of spinal cord corresponds to
 34. Sensation from muscle, tendon and joints is                         which lamina:
      conveyed to which part of sensory cortex:                          A. II                      B. IV
       A. Most anterior                                                  С VI                        D. VIII           (p. 554)
       B. Most posterior
       С Middle                                        (p. 545)      42. Fibers carrying slow chronic pain end in:
 35. Which Brodmann areas function as somatosensory                      A. Reticular nuclei of brainstem
      cortex:                                                            B. Tectal area of mesencephalon
      A. 4 and 6                                                         C. Periaqueductal gray matter
                                                                          D. All of the above                                (p. 554)
      B. 5 and 7
      С 3 and 1                                                       43. Neurotransmitter for slow chronic pain is:
      D. 9 and 11                                     (p. 545)            A. Glutamate
 36. Weber-Fechner principle applies to which of the                      B. Substance P
      following sensations:                                               C. Adrenaline
      A. Visual
                                                                          D. None of the above                               (p- 555)
      B. Auditory
      C. Cutaneous                                                    44. Cerebral cortex is concerned with perception of:
      D. All of the above                            (p. 548)             A. Quality of pain
 37. Pain sensation is relayed in thalamus to which                       B. Location of pain
     nuclei:                                                              C. Intensity of pain
     A. Ventrobasal                                                       D. All of the above                           (p. 555)
     B. Dorsolateral                                                  45. The analgesia system of brain consists of all except:
     С Intralaminar                                                       A. Thalamus
     D. None of the above                           (p. 549)              B. Periaqueductal gray matter
                                                                          C. Raphe magnus nucleus
                                                                          D. Nucleus reticularis paragiauto cellularis (p. 556)
30 В   31 В   32 С   33 С    34 А     35 В    36 D     37 С
                                                                      38 Е   39 В   40 С    41 А    42 D     43 В     44 А      45 А
 100 Review of Physiology

   46. Pain transmission is inhibited by:
         A. Substance P
         B. GABA
         С Encephalin
        D. None of the above                               (p. 557)           Special Senses
   47. Heart pain is felt in which dermatomes:
        А- СГТ,                      В. C3-T5
        С C5-T7                     D. C7-T10             (p. 558)    1. What happens to light rays when confronting a
 48. Thalamic syndrome due to block in postero lateral                   convex lens:
       branch of posterior cerebral artery manifests with:               A. Converge
       A. Ataxia                                                         B. Diverge
                                                                         C. Depends upon focal length
       B. Contralateral analgesia
                                                                         D. Depends upon position of source        (p. 566)
       C. Hyperpathia
       D. All of the above                               (p. 559)     2. What will happen to light rays if two concave cylin
 49. Tic Douloureux is characterised by:                                 drical lenses are held at right angles to each other:
       A. Electric shock like pain                                       A. Convergence
       B. Precipitated by stimulation of triggers areas                  B. Divergence
       С Involves Vth and IXth cranial nerves                            C. No change                                      (p. 567)
       D. All of the above                              (p. 559)      3. When an object is placed beyond the focal point of
 50. Brown-Sequard's syndrome is characterised by all                    a convex lens the image formed is:
      except:                                                            A. Inverted               B. Real
     A. Motor paralysis ipsilateral to lesion                            C. Magnified              D. All of the above
     B. Pain, temperature loss on opposite side                          E. A + В                                      (р. 568)
     C. Loss of kinesthetic sensation on opposite side
     D. Preserved crude touch on paralytic side (p. 560)              4. When an object is placed within focal point of a
                                                                         convex lens the image formed is:
51. Which of the following is insensitive to pain:                       A. Virtual                B. Inverted
     A. Tentorium                                                        C. Enlarged               D. All of the above
     B. Venous sinuses                                                   E. В + С                                     (р. 568)
     C. Brain parenchyma
     D. Meninges at base of brain                      (p. 560)        5. A convex lens with a focal length of 5 cm has a
52. In human body which thermo receptors are more                         power of:
    prevalent:                                                            A. 5 D                  B. 10 D
    A. Cold receptors                                                     С 20 D                  D. 40 D            (p. 569)
    B. Warm receptors
    С Both in equal amount                            (p. 561)         6. Refractive index of crystalline lens is:
                                                                          A. 1                        B. 1.2
                                                                          С 1.4                       D. 1.6                (p. 569)
                                                                       7. The refractive interfaces of eye are all except:
                                                                          A. Air and cornea
                                                                          B. Aqueous humor and lens
                                                                          C. Vitreous and retina
                                                                          D. Vitreous and posterior lens                   (p. 569)
    46 C 47 B 48 D 50 C 51 C 52 A


                                                                       1 A    2В     3E      4D        SС       6C        7В
  102 Review of Physiology
                                                                                                             Special Senses 103

        The total refractive power of eye is about:
        A. 25 D                    B. 37 D                             17. Average normal intraocular pressure is:
        С 59 D                     D. 93 D                                 A. 10 mmHg                 B. 15 mmHg
                                                                           С 20 mmHg                  D. 25 mmHg            (p. 576)
                                                            (p. 569)
    9. Refractive power of lens without accommodation is:              18. The total number of cell layers in human retina is:
        A. 10 D                      B. 20 D                               A. 4                       B. 6
        С 30 D                       D. 40 D               (p. 570)        С 8                         D. 10
  10.                                                                      E. 12                                          (p. 579)
       The refractive power of crystalline lens increases with         19. The outer most cell layer in retina is:
       contraction of which fibres of iris:                                A. Outer limiting membrane
       A. Circular fibres
                                                                           B. Pigment cell layer
       B. Meridonial fibres                                                C. Inner limiting membrane
       С Both of the above
                                                                           D. Layer of rods and cones                       (p. 579)
       D. None of the above                               (p. 570)
  11. The size of pupil in human eye varies from:                      20. In albinos the visual acuity is poor because of:
      A. 3-5 mm                     B. 2-6 mm                              A. Degeneration of fovea
      С 1.5-8 mm                                                           B. Degeneration of rods and cones
                                   D. 1-10 mm            (p. 571)
 12. Can one distinguish 2                                                 C. Lack of melanin with scattering of light entering
      bright spots of light placed 1 mm apart 10 meter away                    the eye
      from the eyes as separate entities:
      A. Yes                                                               D. None of the above                            (p. 579)
      B. No                                                            21. The visual electrical signal is generated by:
      С Possibly yes                                    (p. 574)           A. Lumi rhodopsin
13. Visual acuity is tested with the test chart placed at:                 B. Meta rhodopsin I
     A. 15 feet                   B. 18 feet                               C. Meta rhodopsin II
     С 20 feet                    D. 22 feet           (p. 574)            D. Bath rhodopsin                                 (p. 580)
14. Distance of an object from the eye is perceived from:               22. Colour perception is a function of:
     A. Stereopsis                                                          A. Rods
     B. Moving parallax                                                     B. Cones
    С Size of images of known objects                                       C. Both of the above                             (p. 582)
    D. All of the above                               (p. 574)
15. Acqueous humor is formed by:                                        23. The excitation cascade in rods is linked to:
    A. Transudation from plasma                                             A. Closure of sodium channel
    B. Secretion by corneal epithelium                                      B. Opening up of sodium channel
    C. Secretion from ciliary processes                                     C. Opening of calcium channel
    D. All of the above                                                     D. Closing of potassium channel                   (p. 582)
                                                     (p. 575)
                                                                         24. The colour pigments presents in cones are all except:
16. Canal of Schlemm is present in between:
                                                                             A. Red                     B. Yellow
    A. Cornea and iris
                                                                             С Green                    D. Blue               (p. 582)
    B. Lens and iris
    C. Lens and ciliary processes                                        25. The receptor potential generated by rods by single
    D. None of the above                             (p. 576)                excitation lasts for:
                                                                             A. l/10th second           B. 1 second
                                                                             С 10 seconds               D. 1 minute         (p. 582)

8 C 9 B 10 C 11 C 12 B 13 C 14 C 15 C 16 A                             17 В 18 D 19 19B 20 C 21C 22 B 23 A
                                                                         24 B 25 B
  104 Review of Physiology ________________________                 _____________________________ Special Senses
   26.   Dark adaptation is faster in:                              105
        A. Rods
                                                                    35. Each optic nerve fibre on average is linked to:
        B. Cones                                                        A. 30 rods and one cone
        С Equal in both                                  (p. 583)       B. 60 rods and one cone
   27. Equal stimulation of red, green and blue cones gives             C. 60 rods and 2 cones
       rise to perception of which colour:                              D. 90 rods and 3 cones                       (p. 588)
       A. Pink                      B. White
       С Gray                       D. Orange            (p. 582)   36. Which visual pigment is more sensitive to light:
                                                                        A. Rods
  28. A person with red-green colour blindness cannot                   B. Cones
       distinguish colour in the wavelength of:
       A. 850-675 nm                                                    С Both equally                               (p. 588)
       B. 675-525 nm                                                37. Which type of ganglion cell transmits colour vision:
       С 525-400 nm                                                     A. X cells
       D. All of the above                               (p. 584)       B. Y cells
  29. Colour blindness is:                                              С W cells
      A. Autosomal dominant                                             D. All of the above                            (p. 588)
      B. Autosomal recessive                                        38. The lateral inhibition is mainly responsible for:
      C. X-linked recessive                                             A. Intensity of illumination
      D. X-linked dominant                              (p. 584)        B. Colour of object
 30. The neuronal cell types in retina are:                             С Contrast
      A. 4                         B. 5                                 D. None of the above                          (p. 589)
      С 6                          D. 8                 (p. 586)    39. Visual fibres besides terminating in calcarine cortex
31. The visual pathway of rods is different from that of                are also relayed to:
     cones due to which of the following:                               A. Fretectal nuclei
      A. Amacrine cells                                                 B. Superior colliculous
      B. Bipolar cells                                                  C. Hypothalamus
      С Ganglion cells                                                  D. All of the above                              (p. 589)
      D. All of the above                              (p. 586)
                                                                    40. The nuclear layers in lateral geniculate body is:
32. Transmission of signals in retinal neurons is by:
                                                                        A. 4                         B. 6
     A. Action potential                                                С 8                          D. 10              (p. 591)
     B. Electrotonic conduction
     С None of the above                              (p. 586)      41. Primary visual cortex is Brodmann area:
                                                                        A. 17
33. The characteristic of action potential conduction is:
                                                                        B. 18
     A. Graded                                                          С 19
     B. All or none                                                     D. None of the above                              (p. 593)
     С Both of the above                             (p. 586)
                                                                    42. Signals for visual detail and colour are mainly
34. The output of horizontal cells of retina is:
                                                                        transmitted to:
    A. Inhibitory                                                        A. Posterior occipital pole
    B. Stimulatory                                                       B. Superior posterior occipital lobe
    C. None of the above                             (p. 587)            C. Anteroventral occipital lobe
                                                                         D. None of the above                     (p. 594)
26 B 27 B 28 B         29 С    30 С    31 A     32B      33 B
34 А


                                                                    35 С   36 A   37 A    38 С    39 D    40 В     41 A      42 С
   106 Review of Physiology                                                                                         Special Senses 107

     43. In retinitis pigmentosa, the visual loss first involves:          51. Footplate of stapes covers:
         A. Central vision                                                     A. Oval window
         B. Peripheral vision                                                  B. Round widow
         C. Visual acuity                                                      С Both of the above
         D. All of the above                                    (p. 595)       D. None of the above
                                                                                                                               (p. 602)
    44. In bitemporal hemianopsia the lesion in visual
         pathology lies in:               5?.. Average surface area of             52. Average surfase area of                footplate
         A. Optic nerve                   Optic stapes is:
                                      B. s: isof chiasma
         C. Optic radiation           D. Visual cortex (p. 595)             is:
   45.     The fixation mechanism of eye is in Brodmann area:               A. 3 m m2                 B. 5 m m2                (p. 602)
        A. 17
        B. 18                                                               C. 7 m m2                 D. 10 mm2
        С 19                                                                53. Sound perception is mainly a function of:
        D. None of the above                                   (p. 596)         A. Outer hair cells
   46. The superior colliculi orient the eyes, head and body                    B. Inner hair cells
        with respect to which disturbances:                                     С Both of the above                            (p. 606)
        A. Visual
        B. Auditory                                                         54. Which type of movement of hair in hair cells
        C. Somatic                                                              originates sound signal:
                                                                                A. Clockwise             B. Counter clockwise
        D. All of the above                                   (p. 598)          C. To and fro            D. Rocking       (p. 606)
  47. Tensor tympani muscle is attached to:
       A. Malleus                                                           55. Depolarisation of hair cell membrane is due to:
       B. Incus                                                                 A. Movement of sodium
       C. Stapes                                                                B. Movement of potassium
       D. None of the above                                  (p. 602)           C. Movement of chloride
                                                                                D. None of the above                          (p. 606)
 48. The function of ossicular chain is:
       A. Increases movement distance of stapes                             56. Scala media is filled with:
       B. Reduces force of movement of stapes                                   A. Perilymph
       C. Amplifies pressure on cochlear fluid                                  B. Endolymph
       D. All of the above                                  (p. 602)            C. None of the above                           (p. 607)
 49. What happens to sound with contraction of                              57. The auditory pathway passes via all except:
      stapedius:
                                                                                A. Superior olivary nucleus
      A. Attenuated
                                                                                B. Lateral lemniscus
      B. Amplified                                                              C. Superior colliculus
      С No change                                          (p. 602)             D. Medial geniculate nucleus                   (p. 608)
 50. Function of stapedius is:
      A. Protection of cochlea from loud sound                              58. The two auditory pathways have cross over at which
                                                                                of the following:
      B. Masks low frequency sounds
                                                                                A. Trapezoid body
      C. Decreasing sensitivity to one's own speech
                                                                                B. Commissure of Probst
      D. All of the above                                 (p. 602)
                                                                                C. Inferior culliculi
                                                                                D. All of the above                            (p. 608)
                                                                            59. With movement of basilar membrane towards scala
                                                                                vestibuli, the impulse traffic:
                                                                                A. Increases                 B. Decreases
                                                                                C. Unchanged
43 В   44 В   45 С   46 A    47 A     48 С     49 A     50 D                51 A      52 A   53 В   54 С     55 В    56 В   57 С     58 D
                                                                            59 A
108 Review of Physiology ________________________

 60. In the primary auditory cortex, the high frequency
     sounds are located:
     A. Anteriorly
     B. Posteriorly
     С Centrally                                     (p. 609)
                                                                                    33Taste and Smell
 61. The direction from which sound is coming is known
     by:                                                        1. Which of the             following is not a primary taste
     A. Time lag in entry of sounds into the ears                  sensation:
     B. Difference in intensities of sounds in the two ears        A. Sweet                          B. Sour
     С Both of the above                                           С Pungent                         D. Salty        (p. 613)
     D. From proprioceptive receptor signals        (p. 610)
                                                                2. Match the taste with the substance:
 62. The auditory cortex is essential for:                         A. HC1                      1. Bitter
     A. Recognition of sound                                       B. Morphine                 2. Sour
     B. Discrimination of tonal and sequential sound               С Maltose                   3. Salt
        patterns                                                   D. Sodium fluoride          4. Sweet              (p. 613)
     С Both of the above                       (p. 610)
                                                                3. Sustentacular cells in taste bud are:
 63. If a person can repeat a sound but does not                   A. Taste cells
     understand its meaning the lesion is in:                      B. Supporting cells
     A. Primary auditory cortex                                    C. Nerve cells
     B. Auditory association area                                  D. Lymphoid cells                                 (p. 614)
     С Both of the above
                                                                4. The taste buds are present on which type of papillae:
     D. Frontal cortex                        (p. 610)
                                                                   A. Circumvalate
                                                                   B. Fungiform
                                                                   C. Foliate
                                                                   D. All of the above                              (p. 614)
                                                                5. The taste sensation from anterior 2/3 of tongue
                                                                   passes via all except:
                                                                   A. Trigeminal             B. Chorda tympani
                                                                   C. Glossopharyngeal      D. Facial           (p. 615)
                                                                6. The Bowman's cells in olfactory epithelium are:
                                                                   A. Supporting cells
                                                                   B. Mucous secreting cells
                                                                   C. Lymphoid cells
                                                                   D. None of the above                          (p. 616)
                                                                7. To stimulate the olfactory cells the substance should
                                                                   be:
                                                                   A. Volatile
                                                                   B. Slightly water soluble
                                                                   C. Slightly lipid soluble
                                                                   D. All of the above                               (p. 617)

                                                                1 С   2 A:2, B:1,C:4, D:3       3B       4D     5С      6В
60 В 61 С    62 В    63 В                                       7D
 110 Review of Physiology

     8. Odorants cause depolarisation by acting through:
        A. Protein kinase
        B. G-proteins
        C. Ion channels
        D. None of the above                          (p. 617)
                                                                        Neurophysiology
     9. The odor is sensed by:
        A. Mitral cells                                          1. The Renshaw cells in the spinal cord are:
        B. Tufted cells                                             A. Stimulatory
        C. Glomerulus                                               B. Inhibitory
        D. All of the above                                         С Supporting                                   (p. 623)
                                                      (p. 618)   2. Golgi tendon organ senses:
 10. Prepyriform, pyriform and                                      A. Muscle length
     amygdaltoid nuclei correspond                                  B. Rate of change of muscle length
     to:                                                            C. Muscle tension
     A. Very old olfactory system                                   D. None of the above                           (p. 628)
     B. Less old olfactory system
     C. Most primitive olfactory system                          3. The nuclear chain type of intrafusal fibre is
                                                                    innervated by:
                                                                     A. Primary ending
                                                                     B. Secondary ending
                                                                     С Both of the above                      (p. 624)
                                                                 4. The rate of change of muscle spindle (dynamic
                                                                     response) is sensed by:
                                                                      A. Primary ending
                                                                      B. Secondary ending
                                                                      С Both of the above                     (p. 625)
                                                                  5. The nuclear bag fibres have:
                                                                      A. Primary endings
                                                                      B. Secondary endings
                                                                      С Both of the above                     (p. 624)
                                                                 6. Which muscles have high density of muscle
                                                                    spindles:                  ■
                                                                    A. Antigravity muscles
                                                                    B. Muscle of mastication
                                                                    C. Intestinal smooth muscles
                                                                    D. Short muscles of palm             (p. 626)
                                                                 7. Which of the following reflexes is stretch reflex:
                                                                    A. Ankle jerk
                                                                    B. Knee jerk
                                                                    C. Jaw jerk
                                                                    D. All of the above                             (p. 627)

8В     9С    10 В                                                1 В    2С    3С      4 А      5 А      6 А       7D
112 Review of Physiology

  8. Golgi tendon reflex is meant for:
     A. To limit muscle tension
                                                                35.Motor Function
     B. To facilitate muscle tension
     C. To stimulate muscle contraction                         1. In the motor cortex the toe is represented:
     D. None of the above                            (p. 628)      A. Most medially
 9. Which of the following is an autonomic reflex:                 B. Most laterally
     A. Stumble reflex                                             C. On the top of the hemisphere                   (p. 635)
     B. Galloping reflex
     С Mass reflex                                              2. Characteristics of supplemental motor area is that its
    D. All of the above                             (p. 632)       stimulation causes:
10. Which of the following can occur in mass reflex:               A. Bilateral muscle contraction
    A. Evacuation of bladder and bowel                             B. Trunk and hand rotation
    B. Rise in blood pressure                                      C. Movement of both eyes
    C. Profuse sweating                                            D. All of the above                                (p. 635)
    D. Flexor spasm of body
                                                                3. Ventral corticospinal tract contains:
    E. All of the above                            (p. 632)
                                                                   A. Crossed fibres             B. Uncrossed fibres
   11. Crossed extensor reflex is mediated at the level of:        C. Both of the above                            (p. 636)
   A. Spinal cord
   B. Medulla                                                   4. Uncrossed fibres in ventral corticospinal tract are
   C. Cerebellum                                                   mainly meant for:
   D. Cerebral cortex                              (p. 630         A. Leg muscles
                                                                   B. Hand muscles
                                                                   C. Trunk muscles
                                                                   D. All of the above                              (p- 637)
                                                                5. The Betz cells in brain are found in:
                                                                   A. Thalamus
                                                                   B. Sensory cortex
                                                                   C. Primary motor cortex
                                                                   D. Secondary motor cortex                          (p. 637)
                                                                6. The fastest transmission of signal from brain to
                                                                   spinal cord is by:
                                                                   A. Lateral corticospinal B. Vestibulo spinal
                                                                   C. Tectospinal            D. Reticulospinal (p. 637)
                                                                7. With destruction of corticospinal but intact cortico-
                                                                   rubrospinal tract which movement is impaired:
                                                                    A. Shoulder girdle movement
                                                                    B. Hip girdle movement
                                                                    C. Finger movement
                                                                    D. Wrist movement                                 (p. 639)
                                                                 1 A    2D     3 В 4C 5 C 6 A 7 C
                   8 A 9 C 10 E 11 A
 114 Review of Physiology
                                                                                                             Motor Function 115
    8. Brainstem controls which of the following func
        tions:                                                        17. Semicircular ducts are essential for maintenance of:
         A. Respiration             B. GI function                        A. Static equilibrium
         C. Equilibrium             D. Eye movement                       B. Equilibrium during linear acceleration
        E. All of the above                                (p. 640)       C. Both of the above
    9. Destruction of primary motor cortex alone causes:                  D. None of the above                             (p. 644)
        A. Spasticity               B. Rigidity                       18. Which part of brain controls semicircular duct
        С Hypotonia                 D. Clonus              (p. 640)       function:
  10. Which part of brain is essential for supporting body                A. Cortex
       against gravity:                                                   B. Caudate nucleus
       A. Thalamus                                                        C. Flocculonodular lobe
       B. Dentate nucleus                                                 D. None of the above                       (p. 645)
       G. Vestibular nuclei
                                                                      19. Which of the following stereotyped movements are
       D. None of the above                               (p. 641)
                                                                          controlled in brainstem only:
  11. The maculae that sense equilibrium are present in:                  A. Rotational movements
       A. Crista ampullaris      B. Saccule                               B. Raising movements
       C. Utricle                 D. All of the above                     C. Flexing movements
       E. В + С                                          (р. 641)         D. All of the above
 12,The stataconia are:
      A. Calcium lactate                                              20. Raising movements of head and body are controlled
      B. Calcium carbonate                                                by:
      C. Calcium gluconate                                                A. Interstitial nucleus
      D. Calcium oxalate                                                  B. Prestitial nucleus
                                                        (p. 642)          C. Nucleus precommisuralis
 13. The three semicircular canals are all except:                        D. None of the above
      A. Anterior                 B. Posterior
      С Superior                  D. Lateral            (p. 643)
14. When a person is lying, which detects
orientation:
      A. Saccule
      B. Utricle
      C. Both of the above                             (p. 643)
15. Head rotation is primarily detected by hair cells in:
     A. Utricle and saccule      B. Crysta ampullaris
     C. Ampullae                 D. All of the above
     B. В + С                                          (р. 644)
16. Rate of angular acceleration required to stimulate
     semicircular canals is:
    A. 1° per second, per second
    B. 2° per second, per second
    C. 3° per second, per second
    D. None of the above                              (p. 644)
8 E 9 C 10 C 11 E 12 С        13 С    14 A     15 E 16 A
                                                                      17 D   18 С   19 D    20 В
                                                                                      Extrapyramidal Motor Control 117

                                                               8. The principal afferent input to cerebellum from
                                                                  cortex is via:
           Exfrapyramidal Motor Control                           A. Superior cerebellar peduncle
                                                                  B. Middle cerebellar peduncle
          1. The silent area of brain refers to:                  C. Inferior cerebellar peduncle
     A. Frontal lobe             B. Temporal lobe                 D. All of the above                           (p. 649)
     C. Cerebellum               D. Occipital lobe (p. 647)    9. The most rapid conduction in any pathway in CNS
2. Which of the following is essential for normal motor           is via:
   function:                                                      A. Corticospinal tract
    A. Cerebral cortex                                            B. Spinocerebellar tract
    B. Basal ganglia                                              C. Lateral spinothalamic tract
    C. Cerebellum                                                 D. None of the above                         (p. 649)
    D. All of the above                             (p. 647)
                                                               10. Which of the following belongs to deep cerebellar
3. Role of cerebellum in motor activity includes:                  nuclei:
   A. Fine rapid movement                                          A. Dentate
   B. Control of intensity of muscle contraction                   B. Interposed
   C. Control of direction of movement                             С Fastigial
   D. All of the above                            (p. 647)         D. All of the above                         (p. 649)
4. The oldest lobe of cerebellum is:                           11. The mossy fibres in cerebellum directly connect to:
   A. Anterior lobe                                                A. Granule cells
   B. Posterior lobe                                               B. Purkinje cells
   C. Flocculonodular lobe                                         C. Molecular layer
   D. None of the above                             (p. 647)       D. All of the above                           (p. 650)
5. The control of finger movement in cerebellum lies           12. Which of the following is an inhibitory cell in
   in:                                                             cerebellum:
   A. Vermis                                                       A. Stellate cell
   B. Flocculonodular lobe                                         B. Basket cell
   C. Intermediate zone of hemisphere                              C. Golgi cell
   D. Lateral zone of hemisphere                (p. 648)           D. All of the above                      (p. 651)
6. Topographical representation of body is present in:         13. Which part of cerebellum is concerned with control
   A. Motor area              B. Sensory area                      of equilibrium and posture:
   C. Basal ganglia           D. Vermis                            A. Vermis
   E. All of the above                             (p. 648)        B. Flocculonodular lobe
7. Body's rapid sequential activities are controlled by            C. Anterior cerebellum
   which part of cerebellum:                                       D. All of the above                            (p. 653)
   A. Vermis
   B. Flocculonodular lobe                                     14. Ballistic movements are under control of:
   C. Intermediate hemisphere                                      A. Cerebral cortex
   D. Lateral hemisphere                            (p. 648)       B. Cerebellum
                                                                   C. Basal ganglia
                                                                   D. All of the above                                (p. 654)
1С    2D      3D     4C      5C        6E      7D                8В    9В    10 D   11 A    12 D    13 В       14 В
118 Review of Physiology                                         _______________ Extrapyramidal Motor Control 119

 15. Cerebellar nystagmus occurs with damage to:              22. Match the following pathways with the appropriate
     A. Vermis                                                    neurotransmitter:
     B. Flocculonodular lobe                                      A. Cortex to caudate     1. Acetylcholine
     C. Anterior lobe                                                 nucleus
     D. All of the above                               (p.        B. Caudate nucleus        2. GABA
     655)                                                             to putamen
 16. Which of the following is not a part of basal ganglia:       C. Substantia nigra to    3. Dopamine
     A. Caudate nucleus                                               caudate nucleus                           (p. 659)
     B. Globus pallidus                                       23. Which of the following characterizes Parkinson's
     C. Substantia nigra                                          disease:
     D. Subthalamic nucleus                                       A. Akinesia
     E. None of the above                              (p.        B. Fixed tremor
     656)                                                         C. Rigidity
 17. Dysfunction of basal ganglia leads to:                       D. All of the above                          (p. 659)
     A. Agraphia                                              24. What is the role of dopamine in extrapyramidal
     B. Crude writing                                             system:
     C. Miswritten alphabets                                       A. Stimulatory
     D. All of the above                               (p.         B. Inhibitory
     656)                                                          С Neutral                                  (p. 659)
 18. The putamen circuit bypasses:                            25. Dementia of Huntington's disease is due to loss of
     A. Globus pallidus                                           which neurotransmitter:
     B. Substantia nigra                                          A. Acetylcholine
     C. Caudate nucleus
                                                                  B. Dopamine
     D. Subthalamic nucleus                            (p.
                                                                  С GABA
     657)
                                                                  D. None of the above                          (p. 660)
 19. Disruption of putamen circuit leads to:
                                                              26. Which amino acid repetition occurs in Huntington's
     A. Athetosis
                                                                  disease gene:
     B. Hemiballisms
                                                                  A. Alanine                  B. Valine
     C. Choreoathetosis                                           С Glutamine                 D. Histidine       (p. 660)
     D. All of the above                               (p.
     657)
 20. The caudate circuit is essential for:
     A. Motor coordination of crude movement
     B. Motor coordination of finer movements
     C. Cognitive control of sequence motor pattern
     D. All of the above                         (p.
     657)
 21. The dopamine pathway in basal ganglia is
     predominantly from:
     A. Substantia nigra to caudate nucleus
     B. Caudate nucleus to putamen
     C. Cortex to caudate nucleus
     D. All of the above                    (p.
                                                               22 A:1,B:2, C:3   23 D 24 В   25 A 26 С
     659)




15 В   16 E   17 В    18 С    19 D     20 С     21 A
                                                                     ____________________ Intellectual Functions of Brain 121

                                                                      8. The non-dominant hemisphere is responsible for
                                                                         which of the following:
                Intellectual Functions of                                A. Music
                                                                         B. Reading
            Brain                                                        C. Writing
                                                                         D. Repetition
                                                                         E. None of the above                   (p. 667)
 1. The total cerebral cortex contains:
     A. 10 billion neurons                                            9. Higher intellectual function is linked to:
     B. 100 billion neurons                                              A. Limbic system
     C. 1000 billion neurons                                             B. Prefrontal cortex
     D. 10,000 billion neurons                            (p. 663)       C. Parietal cortex
                                                                         D. Temporal cortex                              (p. 668)
 2. Most of the output signals leave the cortex from cell
     layer:                                                          10. The arcuate fasciculus joins:
     A. I                          B. III                                A. Motor area with sensory area
     С V                           D. II                 (p. 663)        B. Auditory area with visual area
3. Which of the following functions as association area:                 C. Broca's area with Wernicke's area
   A. Prefrontal cortex                                                  D. None of the above                            (p. 671)
   B. Parts of parieto-occipitotemporal cortex
                                                                     11. Anterior commissure is essential for coordination of
   C. Limbic cortex
                                                                         which function between two hemispheres:
   D. All of the above                                   (p. 665)
                                                                         A. Speech
4. Limbic system is concerned with:                                      B. Vision
   A. Emotion                                                            C. Emotion
   B. Behaviour                                                          D. None of the above                          (p. 671)
   C. Motivation
   D. All of the above                                   (p. 666)    12. Which part of brain principally stores memory:
                                                                         A. Amygdala
5. Prosophenosia refers to:
                                                                         B. Hippocampus
   A. Inability to name
                                                                         C. Angular gyrus
   B. Inability to recognise faces
                                                                         D. None of the above                       (p. 672)
   C. Inability to read
   D. None of the above                                  (p. 666)    13. Match the brain area with the hormonal system:
6. The posterior part of left superior temporal lobe is                  A. Locus ceruleus       1. Serotonin
   seat of:                                                              B. Substantia nigra     2. Acetylcholine
   A. Auditory area              B. Broca's area                         C. Raphe nuclei         3. Dopamine
   C. Wernicke's area            D. Visual area   (p. 667)               D. Reticular excitatory 4. Norepinephrine
                                                                            area                                    (p. 679)
7. Dyslexia or world blindness occurs in lesion of:
   A. Angular gyrus                                                  14. Hypothalamus is responsible for:
   B. Superior temporal gyrus                                            A. Temperature regulation
   C. Inferior temporal gyrus                                            B. Exiting behaviour
   D. None of the above                             (p. 667)             C. Control of body weight
                                                                         D. All of the above                             (p. 681)

1 В    2С    3D     4D      5B            6C      7A
                                                                      8A    9B 10 C   11 C 12B      13 A:4, B:3,C:1,D:2 14 D
 122 Review of Physiology                                     .

  15.Besides hypothalamus other parts of brain constitu-
      ting limbic system include:
      A. Epithalamus
      B. Anterior nucleus of rhalamus                                     Brain Waves and
      C. Hippocampus
      D. Amygdala
                                                                          Epilepsy
      E. All of the above                               (p. 681)
  16. Match the part of hypothalamus with its likely               1. Characteristic of REM sleep is all except:
       function:                                                      A. Active dreaming
      A. Paraventricular        1. Satiety                            B. Dreams not remembered
          nucleus                                                     C. Morning awakening is from REM sleep
      B. Lateral hypothalamic 2. Rage                                 D. Brain is highly active with increased metabolism
          area                                                        E. Muscle tone exceedingly depressed         (p. 689)
      C. Perifornical nucleus 3. Oxytocin release                  2. Stimulation of which area of brain produces sleep
      D. Ventromedial nucleus 4. Thirst and hunger
                                                                      akin to natural sleep:
                                                  (p. 683)
                                                                      A. Raphe nuclei in lower pons and medulla
17. Vasopressin is released from which part of                        B. Nucleus of tractus solitarius
    hypothalamus:                                                     C. Rostral hypothalamus
     A. Infundibulum           B. Supraoptic nuclei                   D. All of the above                            (p- 690)
     C. Paraventricular nuclei D. Mammillary body
                                                                   3. The alpha waves are most intense in which portion
18. Hippocampus is a part of:                                         in a resting normal person:
    A. Frontal lobe           B. Parietal lobe                         A. Frontal                 B. Parietal
    C. Temporal lobe          D. Occipital lobe (p. 686)               C. Occipital               D. Temporal        (p. 692)
19. Major output pathway of hippocampus is:                        4. Delta wave in EEG has a frequency below:
    A. Anterior commissure                                            A. 10/sec                 B. 6/sec
    B. Fornix                                                         C. 4/sec                  D. 2/sec              (p. 691)
    C. Corpus callosum
    D. None of the above                                (p.686)    5. The fastest frequency EEG waves called:
                                                                      A. Alpha wave             B. Beta wave
20. Sexual behaviour of a person is dependent upon:                   C. Theta wave             D. Delta wave         (p. 692)
    A. Frontal lobe          B. Thalamus
    C. Hypothalamus          D. Parietal lobe (p. 686)             6. In an alert wakeful patient, the common EEG wave
                                                                      recorded is:
21. Kluvver-Bucy syndrome is characterised by all                      A. Alpha wave                B. Beta wave
    except:                                                            C. Theta wave                D. Delta wave  (p. 692)
    A . Timidity           B. Hypersexuality
    C. Hearing loss       D. Loss of fear (p. 687)                 7. The brain wave dominant in stage 2 and 3 sleep is:
                                                                      A. Alpha wave             B. Beta wave
22. Behavioral response appropriate to a situation is                 C. Theta wave             D. Delta wave      (p. 693)
    mediated by:
    A. Amygdala              B. Thalamus                            8. Connect the stage of sleep with the EEG wave:
    C. Cerebellum            D. Frontal lobe (p. 687)                  A. Stage I                 1. Delta wave
                                                                       B. Stage II                2. Sleep spindles
                                                                       C. Stage IV                3. Theta wave     (p. 693)
15 E 16 A:3, B:4, C:2, D:1      17B    18 C     19 B    20 C 21
C 22 A
                                                                    1 B 2D         3C     4C     5B      6B      7C
                                                                    8 A:2,B:3, C:1
124 Review of Physiology                               .

  9. Which of the following can precipitate grand mal
     attack in a susceptible epileptic:                                       Autonomic Nervous System
     A. Emotional .stimuli
     B. Alkalosis
     C. Fever                                                                 1. The sympathetic         nerves in spinal cord origina
     D. Loud noise/intense light                                         between:
     E. Each of the above                      (p. 693)                  A. C5-L1                                        B. C7-L5
                                                                         C. Tr-L2                      D. T2-L5          (p. 697)
 10. Spike and dome pattern in EEG characterises which
     type of seizure:                                                 2. The origin of sympathetic nerves in spinal cord is
     A. Grand mal               B. Petit mal                             from:
     C. Psychomotor             D. Focal            (p. 694)             A. Anterior horn cells
                                                                         B. Posterior horn cells
 11. Psychomotor seizure originates from:                                C. Intermediolateral horn cells
     A. Frontal cortex                                                   D. All of the above                           (p. 697)
     B. Parietal cortex
     C. Temporal cortex                                               3. The parasympathetic outflow from brain is via the
     D. Occipital cortex                                   (p. 694)      following cranial nerves except:
                                                                         A. III                     B. VII
 12. Characteristics of psychomotor seizure are all except:              C. X                       D. XI               (p. 698)
     A. Amnesia                  B. Anger
     C. Anxiety                  D. Athetosis                         4. The maximum parasympathetic fibres are contained
     E. Abnormal behaviour                              (p. 694)         in:
                                                                         A. Occulomotor
 13. Depression is caused by deficiency of which neuro-                  B. Facial
     transmitters:                                                       C. Vagus
     A. Norepinephrine         B. Serotonin                              D. Glossopharyngeal                           (p. 698)
     C. GABA                   D. A+B
     E. A + C                                      (p. 695)           5. Parasympathetic supply to parotid glands is via:
                                                                         A. Facial                  B. Trigeminal
 14. Schizophrenia is due to excess activity of which                    C. Glossopharyngeal       D. Vagus              (p. 698)
     neurotransmitter:
     A. Glutamate             B. GABA                                 6. The ganglia of parasympathetic system is situated
     C. Serotonin             D. Dopamine        (p. 695)                in:
                                                                         A. Spinal cord
 15. The brain area undergoing atrophy in schizo                         B. Para vertebral region
     phrenics is:                                                        C. In the viscera
     A. Hypothalamus         B. Hippocampus                              D. None of the above                          (p. 699)
     C. Amygdala             D. Frontal cortex (p. 695)
                                                                      7. All the preganglionic fibres in the body secrete:
 16. The defective gene in Alzheimer's disease is that                   A. Adrenaline
     which codes for:                                                    B. Acetylcholine
     A. Acetylcholine         B. Apoprotein E                            C. Acetylcholine and adrenaline
     C. Serotonin             D. Dopamine        (p. 696)                D. None of the above                           (p. 699)

                                                                      1 C   2C     3D      4C     5C       6C       7B


 9 E   10 B   11 C     12 D   13 D     14 D    15 B        16 B
126 Review of Physiology                                   .      ____________________ Autonomic Nervous System 127

  8. Postganglionic sympathetic supply to sweatglands              16. Which of the following is not a stress response:
     and piloerector muscle secrete:                                   A. Rise in blood pressure
     A. Non-adrenaline                                                 B. Hypoglycemia
     B. Acetylcholine                                                  C. Increased blood coagulation
     C. Adrenaline                                                     D. Increased muscle strength                  (p. 706)
     D. All of the above                          (p. 699)         17. Which of the following has anticholinesterase
  9. Monoamine oxidase destroys:                                       activity:
     A. Adrenaline                                                     A. Neostigmine
     B. Noradrenaline                                                  B. Pyridostimine
     C. Acetylcholine                                                  C. Ambenonium
     D. All of the above                               (p. 700)        D. All of the above                      (p. 707)
 10. Adrenergic alpha receptor stimulation causes all of           18. The action of acetylcholine in ganglionic trans
     the following except:                                             mission is blocked by:
     A. Vasoconstriction                                               A. Pentolinium
     B. Intestinal relaxation                                          B. Hexamethonium
     C. Sphincter contraction                                          C. Tetraethyl ammonium
     D. Iris contraction                             (p. 701)          D. All of the above                         (p. 708)
 11. Beta receptor stimulation causes all except:
     A. Vasodilatation
     B. Bronchodilatation
     C. Bladder sphincter relaxation
     D. Cardiac acceleration                           (p. 701)
 12. Parasympathetic stimulation causes:
     A. Increased sweating
     B. Decreased sweating
     C. No change in sweating                          (p. 701)
 13. Cardiac conduction is inhibited by:
     A. Sympathetic stimulation
     B. Parasympathetic stimulation
     C. A + B
     D. None of the above                              (p. 702)
 14. Noradrenaline and adrenaline secretion          from
     adrenal medulla is in the ratio of:
     A. 1:1                      B. 1:2
     C. 1:4                      D. 2:1                (p. 703)
 15. Normal adrenal adrenaline secretion is:
     A. 0.1 ugm/kg/min
     B. 0.2 ugm/kg/min
     C. 0.3 ugm/kg/min
     D. 0.5 ugm/kg/min                                 (p. 704)

 8B   9B    10 D   11 C    12 C   13 B     14 C     15 B           16 B   17 D   18 D
                                                                                                 Brain Metabolism 129

                                                            8. What is the effect of sympathetic reflex on cerebral
                                                               circulation:
                                                               A. Protective
                                                               B. Harmful
                                                               C. Neutral                                      (p. 710)
                  Brain Metabolism                          9. Stroke is most severe when blood supply is cut off
                                                               to:
                                                               A. Forebrain
1. Total cessation of blood flow to brain causes
                                                               B. Midbrain
   unconsciousness within:
                                                               C. Parietal cortex
   A. 1-2 sec              B. 5-10 sec
                                                               D. Occipital cortex                           (p. 711)
   C. 20-40 sec            D. 1-2 min       (p. 709)
                                                            10. The capacity of brain and spinal cord is:
2. What percentage of resting cardiac output is
                                                                A. 2500 ml                 B. 2000 ml
   distributed to brain:
                                                                C. 1600 ml                 D. 1200 ml          (p. 711)
   A. 5%                   B. 10%
   C. 15%                  D. 25%           (p. 709)        11. Normal amount of CSF in brain and spinal cord is:
                                                                A. 500 ml                B. 250 ml
3. The metabolic factors controlling cerebral blood-
   flow are all except:                                         C. 150 ml                D. 100 ml           (p. 711)
   A. pH                                                    12. What is contrecoup injury:
   B. CO9 concentration                                         A. Damage to brain at the site of blow
   C. Calcium ion concentration                                 B. Damage to brain opposite the site of blow
   D. Oxygen concentration                       (p. 709)       C. Damage to brain tangential to site of blow
4. Carbon dioxide is a cerebral:                                D. None of the above                         {p- 711)
   A. Vasoconstrictor                                       13. Maximum CSF is formed in choroid plexuses of:
   B. Vasodilator                                               A. Lateral ventricle
   C. No effect                                  (p. 709)       B. Third ventricle
5. Oxygen consumption of brain tissue is:                       C. Fourth ventricle
   A. 2.5 ml/100 gm/min                                         D. Cisterns                               (p. 712)
   B. 3.5 ml/100 gm/mm                                      14. CSF from fourth ventricle is drained to cisterna
   C. 4.5 ml/100 gm/mm                                          magna via:
   D. 5.5 ml/100 gm/min                          (p. 709)       A. Foramen of Luschka
6. Cerebral tissue PO 2 essential for normal neuronal           B. Foramen of Magendie
   functioning is:                                              C. Aqueduct of Sylvius
   A. 90-100 mmHg              B. 50-60 mmHg                    D. All of the above
   C. 35-40 mmHg               D. 20-25 mmHg (p. 709)           E. A + B                                      (p. 712)
7. Cerebral autoregulation functions within mean BP         15. Which of the following is not a character of CSF:
   limit of:                                                    A. Osmotic pressure equal to plasma
   A. 40-180 mmHg                                               B. Sodium ion concentration equal to plasma
   B. 60-220 mmHg                                               C. Potassium equal to that of plasma
   C. 60-180 mmHg                                               D. Glucose 30-40% less of plasma              (p. 712)
   D. 40-240 mmHg                                (p. 710)

                                                            8A     9B    10 C   11 C 12 B      13 A     14 E    15 C
1 B   2C     3C      4B     5B      6C      7C
130 Review of Physiology

 16. The lymphatic drainage of brain is into:
     A. Internal jugular vein
     B. Thoracic duct                                                       Gastrointestinal Physiology
     C. Cavernous sinus
     D. None of the above                            (p. 712)
                                                                             1. The rhythmic contraction in GI tract is highest
 17. Normal CSF pressure in a lying person is within the               in:
     range of:                                                         A. Stomach                 B. Duodenum
      A. 10-20 mmHg             B. 5-15 mmHg                            C. Ileum                  D. Colon              (p. 719)
      C. 15-30 mmHg             D. 20-50 mmHg (p. 713)            2. In gastrointestinal smooth muscle, the action poten
  18. CSF pressure increases in which of the following:              tial is generated by opening up of:
      A. Brain tumour                                                A. Sodium channel
      B. Brain haemorrhage                                           B. Calcium channel
      C. Brain infection                                             C. Sodium-calcium channel
      D. All of the above                           (p. 713)         D. None of the above                              (p. 720)
  19. The dividing factor for conversion of mm of H2O to          3. Auerbach's plexus in intestine lies:
      mm of Hg is:                                                   A. Beneath the mucosa
      A. 10                       B. 12.5                            B. Within submucosa
                                                                     C. Between longitudinal and circular muscles
      C. 13.6                     D. 14.9            (p. 713)
                                                                     D. Beneath the serosal coat                 (p. 720)
  20. Blood brain barrier is deficient around:                    4. The myenteric plexus receives which type of
      A. Hypothalamus                                                parasympathetic fibres:
      B. Pineal gland                                                A. Preganglionic
      C. Area postrema                                               B. Postganglionic
      D. All of the above                              (p. 714)      C. Both of the above                    (p. 720)
  21. Under resting conditions, metabolism of brain tissue        5. Which of the following is not a gastrointestinal
      is:                                                            neurotransmitten
      A. Similar to rest of body tissues                             A. Cholecystokinin
      B. Twice that of other body tissues                            B. Substance P
      C. 7.5 times that of other body tissue                         C. Bombesin
      D. 15 times that of other body tissues           (p. 714)      D. None of the above                         (p. 721)
   22. In non-communicating hydrocephalus the block is            6. The ratio of afferent to efferent nerve fibres in vagus
       commonly at:                                                  is:
       A. Foramen of Monro                                           A. 1:1                         B. 2:1
       B. Aqueduct of Sylvius                                        C. 4:1                         D. 1:2               (p. 722)
       C. Foramen of Magendie
                                                                  7. The nonwater soluble fat-based nutrients in
       D. None of the above                       (p. 713)
                                                                     intestine are absorbed into:
   23. What is not true of neuronal metabolism:                      A. Portal venous blood
       A. Most neuronal energy is supplied by glucose                B. Intestinal lymphatics
       B. Anaerobic metabolism is lacking in neurons                 C. Both of the above                    (p. 724)
       C. Insulin is required for glucose entry into neurons
       D. Glycogen store of neurons is minimal       (p. 714)     1B     2C      3C      4A     5D       6C       7B

   16 D 17 B   18 D   19 C   20 D    21 C   22 B    23 C
132 Review of Physiology                                               ____________________ Gastrointestinal Physiology 133
  8. Increased Gl blood flow during digestion is mostly                16. Which of the following is function of mucus:
     contributed by:                                                       A. Prevents contact of food particle with mucosa
     A. Adenosine                                                          B. Helps in formation of faecal masses
     B. Bombesin                                                           C. Resistant to enzymatic digestion
     C. Cholecystokinin                                                    D. Buffering action
     D. None of the above                          (p. 725)                E. Each of the above                         (p. 740)
  9. Which of the following peristaltic wave is not                    17. Match the gastrointestinal secretion with the
     normal for esophagus:                                                 quantity:
      A. Primary peristalsis                                               A. Saliva                1. 2000 ml
      B. Secondary peristalsis                                             B. Gastric secretion     2. 1500 ml
      C. Tertiary peristalsis                                              C. Succus entericus      3. 1000 ml       (p. 740)
      D. B + C                                      (p. 730)
  10. The normal pressure of lower isophageal sphincter I              18. Saliva has very high content of:
                                                                           A. Sodium                  B. Potassium
      is:                                                                  C. Chloride                D. Bicarbonate          (p. 741)
      A. 20 mmHg                B. 30 mmHg
      C. 40 mmHg                 D. 50 mmHg        (p. 730)            19. An oxyntic gland contains which of the following
                                                                           secreting cells:
  11. What is 'chyme':                                                      A. Chief cells
       A. Food mixed with salvia                                            B. Parietal cells
       B. Food mixed with gastric secretion
                                                                            C. Mucous cell
       C. Food mixed with pancreatic enzymes                                D. All of the above                         (p. 742)
       D. None of the above                          (p. 731)
   12. The gastric glands secreting digestive juices are                20. The pH of mucous is:
       present in all parts of body of stomach except:                      A. Acidic
       A. Anterior wall                                                     B. Alkaline
       B. Posterior wall                                                    C. Neutral                                         (p. 744)
       C. Lesser curvature                                              21. The parietal cells secrete which of the following:
       D. Greater curvature                            (p. 731)             A. HC1                      B. Gastrin
   13. The pH of duodenal content that inhibits stomach                     C. Intrinsic factor         D. A + B
       emptying via secretion of cholecystokinin is:                        E. A + C                                        (p. 744)
        A. 7-8                    B. 5-8
                                                                        22. The stimulatory effect of gastrin on parietal cells is
        C. 3-4                    D. 1-2             (p. 732)
                                                                            via:
    14. Intestinal motility is enhanced by:                                 A. Local effect because of contiguity
        A. Gastrin                   B. CCK                                 B. Through blood stream
        C. Insulin                   D. Serotonin                           C. Through stimulation of vagus
        E. All of the above                                (p. 733)         D. All of the above                                (p. 744)
    15. Ileolecal valve can resist reverse pressure of:                 23. Hormones inhibiting gastric acid secretion include:
         A. 4-5 mmHg                                                        A. Secretin
         B. 5-10 mmHg                                                       B. GIP
         C. 10-15 mmHg                                                      C. VIP
         D. 15-25 mmHg                                     (p. 734).        D. Somatostatin
                                                                            E. All of the above                             (p. 745)
     8A    9 C 10 B     11 B    12 C    13 C    14 E      15 A
                                                                       16 E 17 A:3, B:2, C:3 18 B     19 D     20 B    21 E    22 B 23
                                                                       E
134 Review of Physiology                                                                 Gastrointestinal Physiology 135

 24. Which carbohydrate is not hydrolysed by pancreatic           32. The amount of bile salt in enterohepatic circulation:
     amylase:                                                         A. 1 gm                     B. 2.5 gm
     A. Starch                                                        C. 3.5 gm                   D. 5 gm              (p. 751)
     B. Glycogen                                                  33. Which of the following is responsible for gallstone
     C. Cellulose                                                     formation:
     D. None of the above                           (p. 746)          A. Gallbladder inflammation
 25. Enterokinase helps in activation of which pro-                   B. Excess of cholesterol in bile
     enzymes:                                                         C. Concentration of bile
     A. Chymotrypsinogen                                              D. All of the above                           (p. 751)
     B. Trypsinogen                                               34. The Brunner's glands of duodenum secrete:
     C. Procarboxypoly peptidase                                      A. Mucous
     D. All of the above                        (p. 746)              B. Secretin
 26. The pancreatic exocrine function is best assessed                C. Cholecystokinin
     mostly from estimation of which of the following in              D. All of the above                              (p. 752)
     pancreatic juice:                                            35. The function of goblet cells in crypts of Lieberkuhn
     A. Trypsin inhibitor                                             is:
     B. Bicarbonate                                                   A. Absorption of nutrients
     C. Trypsinogen                                                   B. Secretion of enzymes
     D. Trypsin                                     (p. 747)          C. Secretion of mucous
 27. Stimulus to pancreatic secretion is from:                        D. All of the above                             (p. 752)
     A. Acetylcholine                                             36. The life cycle of intestinal epithelial cell is:
     B. Secretin                                                      A. 28 days                  B. 10 days
     C. Cholecystokinin                                               C. 5 days                   D. 2 days            (p. 752)
     D. All of the above                              (p. 748)
                                                                  37. In triglyceride the number of fatty acid is:
 28. Secretin stimulation of pancreas causes secretion of             A. 2                       B. 3
     pancreatic juice deficient in:                                   C. 5                       D. 7
     A. Bicarbonate
     B. Enzymes                                                   38. Cholesterol, though does not contain fatty acid is
     C. Chloride                                                      considered as fat because:
     D. None of the above                             (p. 748)        A. Derived from fats
                                                                      B. Metabolised similarly to fats
 29. Daily bile secretion by liver is:                                C. Physical and chemical characteristic of fats
     A. 300-500 ml               B. 500-750 ml                        D. AH of the above
     C. 600-1000 ml              D. 750-1500 ml      (p. 749)
                                                                  39. The total GI secretion per day is:
 30. The maximum solute concentration of bile is due to:              A. 5 litre                 B. 7 litre
     A. Bile salts            B. Bile acids                           C. 9 litre                 D. 10 litre           (p. 758)
     C. Cholesterol           D. Lecithin            (p. 749)
                                                                  40. The total daily water absorption in small intestine
  31. The bile salt concentration of gallbladder is how               is:
      many times that of liver bile:                                  A. 5 litre                 B. 7 litre
      A. 2                       B. 4                                 C. 9 litre                 D. 10 litre        (p. 758)
      C. 6                       D. 8                (p. 750)
                                                                 32 B 33 D 34 A       35 C    36 C     37 B    38 D    39 B
 24 C 25 D 26 B      27 D   28 B     29 C   30 A    31 C         40 B
136 Review of Physiology                                                                 Gastrointestinal Physiology 137

 41. The presence of villi on the intestinal mucosal              49. The medium chain fatty acids are transported from
     surface enhances the absorptive area by:                         intestine via:
     A. 5 fold                  B. 10 fold                            A. Lymphatics
     C. 15 fold                 D. 20 fold      (p. 758)              B. Portal blood
                                                                      C. Both of the above                            (p. 762)
 42. The total absorptive area of small intestine is over:
     A. 100 m2                   B. 200 m2                        50. Brown colour of stool is due to:
               2
     C. 250 m                     D. 350 m2            (p. 758)       A. Mercaptans              B. Skatole
                                                                      C. Stercobilin             D. Indole            (p. 762)
 43. Which of the following contribute to increased
     absorptive area of small intestine:                          51. Which of the following is secreted in colon:
     A. Folds of Kerckring                                            A. Water                   B. Sodium
     B. Villi                                                         C. Chloride                D. Bicarbonate (p. 762)
     C. Microvilli                                                62. Which of the following plays key role in causation
     D. All of the above                        (p. 758)              of acid peptic disease:
 44. The large intestine absorbs all except:                          A. High HC1
     A. Water                                                         B. Poor blood supply
     B. Minerals                                                      C. Poor mucus secretion
     C. Nutrients                                                     D. H. pylori
     D. None of the above                              (p. 759)       E. Not exactly known                          (p. 765)

 45. Sodium absorption from chyme into epithelial cell            63. The motor impulses for act of vomiting are
     is by:                                                           transmitted via:
      A. Diffusion                                                    A. 5th and 7th cranial nerve
      B. Active transport                                             B. 9th, 10th and 12th cranial nerves
      C. Passive transport                                            C. Spinal nerves to diaphragm and upper abdominal
      D. None of the above                         (p. 760)               muscles
                                                                      D. All of the above                        (p. 768)
 46. Glucose absorption in intestine is by:
     A. Passive diffusion                                         54. Vomiting from dilatation of duodenum is caused
                                                                      via:
     B. Active transport
     C. Sodium cotransport                                            A. Chemoreceptor trigger zone
     D. None of the above                              (p. 761)       B. Vomiting centre of medulla
                                                                      C. Both of the above                       (p. 769)
 47. What is 'Solvent drag':
                                                                  55. Gastrointestinal obstruction can occur due to:
     A. Absorption of glucose through enterocyte
                                                                      A. Obstructing/constricting growth
     B. Absorption of glucose directly into para cellular
                                                                      B. Peritoneal adhesion
        space
                                                                      C. Spasm or paralysis of a segment
     C. Glucose transport linked to chloride secretion
                                                                      D. All of the above                            (p. 769)
     D. None of the above                         (p. 759)
                                                                  56. Match the gas with site of origin in GI tract:
 48. In absence of bile acids, fat absorption in small                A. Nitrogen                 1. Colon
     intestine falls to:                                              B. Carbon dioxide          2. Stomach
      A. 5%                     B. 15%                                C. Methane                 3. Small intestine (p. 769)
      C. 45%                    D. 75%             (p. 762)

                                                                  49 B 50 C 51 D       52 E     53 D     54 B      55 D
41 B    42 C   43 D    44 C    45 A   46 C 47 B     48 C          56 A:2, B:3, C:1
138 Re view of Physiology

 57. Gas explosion occurs during which procedure:
     A. Upper GI endoscopy
     B. ERCP
     C. Sigmoidoscopic cauterisation
     D. None of the above                         (p. 769)
                                                                         Metabolism
 58. Which food items cause increase gas production:                     1. In ATP, the number of phosphate molecule is:
     A. Bean                   B. Cabbage                         A. 1                       B. 2
     C. Cauliflower            D. Corn                            C. 3                       D. 4               (p. 772)
     E. All of the above                           (p. 769)
                                                               2. One mole of ATP on conversion to AMP releases:
 59. Amount of gases entering or forming large intestine          A. 1200 cal             B. 2400 cal
     each day averages:                                           C. 3600 cal             D. 600 cal         (p. 771)
     A. 1-2 liters              B. 3-5 litres
      C. 7-10 litres            D. 12-15 litres     (p. 770)   3. In body what percentage of carbohydrate is used for
                                                                  energy production:
                                                                  A. 100%                     B. 90%
                                                                  C. 75%                      D. 50%               (p. 772)
                                                               4. Molecular weight of glucose is:
                                                                  A. 100                    B. 180
                                                                  C. 280                    D. 450                 (p. 773)
                                                               5. Glucose entry into cell is facilitated by which
                                                                  hormone:
                                                                  A. Thyroxine             B. Insulin
                                                                  C. Glucagon              D. Cortisone     (p. 773)
                                                               6. Phosphorylation of glucose is reversible in which
                                                                  cells of body:
                                                                  A. Hepatic cells
                                                                  B. Renal tubular cells
                                                                  C. Intestinal epithelial cells
                                                                  D. All of the above                           (p. 774)
                                                               7. Glycogenolysis is done by which enzyme:
                                                                  A. Hydrolase
                                                                  B. Phosphorylase
                                                                  C. Ketalase
                                                                  D. None of the above                             (p. 774)
                                                               8. Glycogenolysis is facilitated by:
                                                                  A. Glucagon
                                                                  B. Epinephrine
                                                                  C. Cortisone
                                                                  D. A + B
                                                                  E. B + C                                         (p. 774)

                                                               1 C   2B      3B    4B     5B     6D      7B      8D
   57 C 58 E 59 C
                                                                                                   Metabolism 141
140 Review of Physiology
                                                               18. What is gluconeogenesis:
  9. Complete oxidation of 1 gram molecule of glucose              A. Conversion of glucose to fat and protein
     yields:                                                       B. Formation of glucose from glycogen
     A. 4000 cal               B. 40000 cal                        C. Formation of glucose from fat and protein
     C. 686000 cal             D. 880000 cal    (p. 775)           D. None of the above                        (p. 780)
 10. How much ATP is generated when one molecule of            19. Cortisol increases blood sugar by:
     glucose is converted to pyruvic acid:                         A. Glycogenolysis
     A. 1                       B. 2                               B. Stimulates insulin secretion
     C. 4                       D. 8          (p. 775)             C. Gluconeogenesis
 11. For complete oxidation of one molecule of glucose,            D. All of the above                          (p. 780)
     the number of molecule of CO2 formed is:
     A. 4                       B. 8
     C. 16                     D. 32              (p. 775)
 12. In citric acid cycle the number of hydrogen atoms
     formed per molecule of glucose is:
      A. 16                      B. 20
      C. 24                      D. 28              (p. 776)
 13. The total number of ATP formed during complete
     breakdown of one molecule of glucose is:
     A. 28                    B. 38
     C. 48                    D. 58             (p. 778)
 14. The maximum efficiency of energy transfer during
     glycolysis is:
     A. 100%                 B. 86%
     C. 66%                  D. 56%               (p. 778)
 15. In anaerobic glycolysis, the energy produced per
     gram molecule of glucose is:
     A. 12,000 cal              B. 24,000 cal
     C. 240,000 cal             D. 480,000 cal   (p. 778)
 16. What happens to most of the lactic acid produced
     during strenuous exercise:
     A. Converted to pyruvic acid
     B. Converted to pyruvic acid and then all of it enters
         into Kreb's cycle for oxidative phosphorylation
     C. Converted to pyruvic acid and part of it enters
         Kreb's cycle and most part converted to glucose
     D. None is true                                (p. 779)
 17. Glucose metabolism via pentose phosphate pathway
     accounts for what percentage of glucose breakdown
     in liver cells:
     A. 50%                     B. 30%
     C. 10%                     D. 1%              (p. 779)
 9C    10 B   11 A   12 A    13 B    14 C   15 B   16 C        18 C   19 C
17 B
                                                                                              Lipid Metabolism 143

                                                               9. What is beta oxidation:
                                                                  A. Acetyl CoA formation from pyruvate
                                                                  B. Acetyl CoA formation from fatty acid
                                                                  C. Acetyi CoA formation from amino acid
                                                                  D. None of the above                            (p. 784)
        LiPid Metabolism                                      10. Oxidation of once molecule of stearic acid produces
                                                                  how many molecules of ATP:
1. The three common fatty acids in triglyceride are all           A. 38                     B. 68
   except:                                                        C. 89                     D. 148               (p. 784)
    A. Stearic acid           B. Oleic acid
    C. Linolenic acid         D. Palmitic acid (p. 781)       11. Ketone body concentration in plasma is usually
                                                                  below:
2. The principal component of chylomicron is:                     A. 1 mg/dl              B. 3 mg/dl
   A. Triglyceride           B. Phospholipid                      C. 20 mg/dl             D. 30 mg/dl      (p. 784)
   C. Cholesterol            D. Apoprotein B (p. 781)
                                                              12. Ketone body formation occurs principally in:
3. The ionized free fatty acids in plasma circulate in            A. Liver                  B. Kidney
   combination with:                                              C. Intestine             D. Muscles             (p. 785)
   A. Albumin
   B. Cholesterol                                             13. What will happen if one eats excess of protein:
   C. Glycerol                                                    A. Greater muscle mass
   D. None of the above                            (p. 782)       B. Greater size of brain
                                                                  C. Increase in fat deposit
4. Concentration of free fatty acid in plasma is:                 D. None of the above                          (p. 786)
   A. 5 mg/dl                  B. 15 mg/dl
   C. 30 mg/dl                 D. 45 mg/dl        (p. 782)    14. The principal utility of phospholipid is:
                                                                  A. Transport of cholesterol and other lipids in plasma
5. Total lipoprotein concentration in plasma is:                  B. Insulation of nerves
   A. 200 mg/dl                B. 350 mg/dl                       C. Cell membrane formation
   C. 500 mg/dl                D. 700 mg/dl      (p. 782)         D. Donor of phosphate radicals                  (p. 787)
6. In LDL, which of the following is highest:                 15. Cholesterol-3 hydroxy 3 methylglutaryl CoA
   A. Triglyceride                                                reductase function is in:
   B. Phospholipid                                                A. Breakdown of cholesterol
   C. Cholesterol                                                 B. Synthesis of cholesterol
   D. None of the above                            (p. 782)       C. Incorporation of cholesterol into lipoproteins
7. The fat in the fat depot is in which state:                    D. None of the above                          (p. 788)
   A. Solid                                                   16. The maximum use of cholesterol in body is:
   B. Semisolid                                                   A. Formation of corticosteroids
   C. Liquid                                       (p. 782)       B. Formation of vit D
8. Fatty acids are used interchangeably with glucose              C. Formation of cholic acid
   for energy production by all cells in body except:             D. Cell membrane formation                 (p. 788)
   A. Heart muscle             B. Brain cells                 17. Apoprotein B1oo is absent in:
   C. Muscle cells             D. Fibroblasts    (p. 784)         A. LDL                      B. HDL
                                                                  C. IDL                      D. Triglyceride
                                                               9 B 10 D    11 B   12 A    13 C    14 C     15 B   16 C
1 C   2A    3A    4B     5D         6C       7C      8B       17 B
144 Review of Physiology

 18. Predisposing factors for atherosclerosis include all
     except:.
     A. High lipoprotein         B. High HDL
     C. Hypothyroidism            D. Smoking
     E. High serum iron                               (p. 789)             Protein Metabolism
 19. For each mg decrease in plasma LDL, the decrease in
     cardiac mortality from atherosclerotic heart disease                  1. The protein from GI tract is absorbed in the form
     is:                                                          of:
     A. 0.5%                      B. 1%                                 A. Amino acid              B. Polypeptide
     C. 2%                        D. 4%                (p. 790)         C. Dipeptides              D. All of the above (p. 791)

 20. The drug mevinolin used in hypercholesterolemia              2. Fibrinogen is synthesized in:
     acts through:                                                   A. Liver
     A. Decreases absorption of cholesterol                          B. Bone marrow
     B. Decreases hepatic synthesis of cholesterol                   C. Spleen
     C. Sequestrates bile acids                                      D. All of the above                                (p. 793)
     D. Increased utilisation of cholesterol                      3. Which vitamin is essential for synthesis of non -
                                                                     essential amino acids in body:
                                                                     A. Vit B 1                 B. Vit B2
                                                                     C. Vit B6                  D. Vit E          (p. 794)
                                                                  4. Pyruvic acid on transamination forms:
                                                                     A. Alanine                  B. Guamine
                                                                     C. Cytosine                 D. Histidine           (p. 794)
                                                                  5. Urea is formed in the liver from:
                                                                     A. One ammonia molecule and one molecule of CO 2
                                                                     B. Two ammonia molecule and one molecule of CO 2
                                                                     C. Two ammonia molecule and two molecule of CO 2
                                                                     D. One ammonia molecule and two molecule of O 2
                                                                                                               (p. 795)
                                                                  6. Out of 20 amino acids, how many can be converted
                                                                     to glucose:
                                                                     A. All of them            B. 18
                                                                     C. 16                     D. 12             (p. 794)
                                                                  1, How many amino acids out of 20 can be converted to
                                                                     fatty acids:
                                                                     A. All of them          B. 19
                                                                     C. 17                   D. 15             (p. 795)
                                                                  8. Obligatory protein            degradation daily in adult
                                                                     human is:
                                                                     A. 60-70 gm                                   B. 30-40 gm
                                                                     C. 20-30 gm                     D. 10-20 gm       (p. 795)

 18 B 19 C     20 B
                                                                  1A 2A         3C      4A    5B          6B       7B      8C
146 Review of Physiology                                                                        Protein Metabolism 147

  9. All the following hormones favour protein synthesis       19. The skin appears jaundiced when serum bilirubin
     except:                                                       exceeds:
     A. Growth hormone          B. Insulin                         A. 1 mg%                  B. 1.5 mg%
     C. Testosterone            D. Glucocorticoids (p. 795)        C. 2 mg%                  D. 3 mg%           (p. 801)
10. The total lobules within liver number:                     20. 1 gm of fat on oxidation provides:
    A. 1 billion                 B. 1-5 million                    A. 5 calories              B. 7.2 calories
     C. 50,000-100,000           D. 10,000-50,000 (p. 797)         C. 9.3 calories            D. 11.5 calories      (p. 803)
11. The total blood flow to liver is what percentage of        21. Match the food substrate and caloric yield per gram:
    cardiac output:
                                                                   A. Carbohydrate             1. 4.1
     A. 30%                      B. 25%                            B. Fat                      2. 4.3
     C. 20%                      D. 15%             (p. 797)       C. Protein                  3. 7
12. Average portal vein pressure is:                               D. Alcohol                  4. 9.3                (p. 803)
     A. 5 mmHg                  B. 7 mmHg
                                                               22. On gram to gram basis which of the following is
     C. 9 mmHg                  D. 15 mmHg         (p. 797)
                                                                   richest source of calories:
13. The hepatic lymph has a protein concentration of:              A. Peanuts                  B. Walnuts
     A. 3 gm/dl                B. 4 gm/dl                          C. Chocolate                D. Cashew nuts (p. 803)
     C. 6 gm/dl                D. 8 gm/dl          (p. 798)
                                                               23. Which of the following nuts has higher protein
14. Which of the following is function of liver:
    A. Storage of glycogen                                         content:
    B. Gluconeogenesis                                             A. Peanut
    C. Conversion of fructose and galactose to glucose             B. Cashew nut
    D. All of the above                          (p. 798)          C. Walnut                                  (p. 804)
15. The functions of liver in protein metabolism               24. Which of the following is protein breakdown
    include:                                                       product excreted in urine:
     A. Deamination of amino acids                                 A. Urea
     B. Formation of urea                                          B. Uric acid
     C. Formation of plasma proteins                               C. Creatinine
     D. All of the above                     (p. 799)              D. All of the above                        (804)
16. Most plasma proteins are formed in liver except:            25. The average nitrogen content of protein is:
    A. Albumin                 B. Alpha-globulin                    A. 25%                    B. 16%
    C. Gamma-globulin          D. Fibrinogen     (p. 799)           C. 10%                    D. 8%                   (p. 804)-
17. The storage form of iron in liver is called:                26. Daily protein breakdown in adult is:
    A. Apoferritin                                                  A. 55 gm                  B. 45 gm
    B. Ferritin                                                     C. 35 gm                  D. 25 gm                (p. 804)
    C. Transferrin
                                                                27. The respiratory quotient of fat is:
    D. All of the above                            (p. 799)         A. 1                         B. 0.8
18. Vit K is essential for hepatic synthesis of all the             C. 0.7                       D. 0.5               (p. 804)
    following clotting factors except:
                                                                28. The position of satiety centre in hypothalamus is:
    A. Prothrombin              B. Factor XI
                                                                    A. Lateral                   B. Periventricular
    C. Factor X                 D. Factor VII     (p. 799)          C. Ventromedial              D. None of the above
 9 D 10 C 11 A       12 C    13 C    14 D   15 D   16 C                                                               (p. 805)
17 B 18 B
                                                                19 B 20 C 21 A:1,B:4, C:2, D:3 22 B 23 A 24 D 25 B 26 A
                                                                27 C 28 C
148 Review of Physiology                                                                    Protein Metabolism 149

29. In thiamine deficiency, the neurological symptoms          36. In human body composition which of the food
    are due to:                                                    constituent is minimum:
     A. Poor glucose utilisation                                   A. Protein              B. Fat
     B. Poor glycogenolysis                                        C. Carbohydrate         D. Water        (p. 813)
     C. Poor glucose delivery to neurons
                                                               37. Low magnesium concentration leads to:
     D. All of the above                           (p. 810)
                                                                   A. Arrhythmia
30. The syndrome of diarrhoea, dermatitis and                      B. Vasodilatation
    dementia occurs in deficiency of:                              C. Convulsion
    A. Vit B1                                                      D. All of the above                            (p. 812)
    B. Pyridoxine
                                                               38. Daily requirement of which of the following
    C. Nicotinic acid
    D. Hydroxocobalamin                    (p. 810)                minerals is more:
                                                                   A. Sodium              B. Potassium
31. Nicotinic acid is produced from which amino acid:              C. Calcium             D. Phosphorus   (p. 813)
    A. Arginine .
                                                               39. Zinc is a component for functioning of which of the
    B. Glycine
                                                                   following enzymes:
    C. Tyrosine
                                                                   A. Lactic dehydrogenase
    D. Tryptophan                                 (p. 810)
                                                                   B. Peptidase
32. Vit B12 deficiency produces which of the following:            C. Carbonic anhydrase
    A. Megnloblastic anaemia                                       D. All of the above                            (p. 813)
    B. Demyelination
                                                               40. Zinc helps in which body functions:
    C. Glossitis
                                                                   A. Haemopoiesis
    D. All of the above                             (p. 811)
                                                                   B. Wound healing
33. The principal function of pantothenic acid in body             C. Spermatogenesis
    is:                                                            D. All of the above                            (p. 813)
    A. Oxidation of fat                                        41. Antioxidant vitamins include all except:
    B. Metabolism of carbohydrate                                  A. Vit A                   B. Vit B
    C. Both of the above                                           C. Vit C                   D. Vit E            (p. 813)
    D. None of the above                           (p. 811)
                                                               42. Under standard physiological conditions one mole
34. In vit C deficiency wound healing is poor because              of ATP gives:
    of:                                                            A. 7300 calories          B. 9000 calories
    A. Poor angiogenesis                                           C. 12000 calories         D. 16000 calories (p. 815)
    B. Poor collagen formation
    C. Poor macrophage function                                43. The energy from ATP is utilised for:
    D. All of the above                           (p. 812)         A. Muscle contraction
                                                                   B. Active transport across membranes
35. Which of the following is a feature of vit C                   C. Glandular secretion
    deficiency:                                                    D. Nerve conduction
    A. Cessation of bone growth                                    E. All of the above                             (p. 815)
    B. Purpura
    C. Spongy bleeding gums                                    44. The most abundant store of high energy phosphate
    D. All of the above                     (p. 812)               bonds in body is:
                                                                    A. ATP                    B. ADP
                                                                   C. Phosphocreatine         D. AMP             (p. 816)
29 A 30 C    31 D    32 D   33 C     34 B     35 D             36 C 37 D 38 C 39 D 40 D 41 B 42 C 43 E
                                                               44 C
150 Review of Physiology                                                                          Protein Metabolism 151

 45. Under physiological condition high energy bond of             54. When body is exposed to cold it raises temperature
     phosphocreatine yields:                                           by:
     A. 7000 calories          B. 8500 calories                        A. Skin vasoconstriction
     C. 13000 calories         D. 16000 calories (p. 816)              B. Reduced heat conduction by piloerection
 46. What per cent of food energy is converted to heat:                C. Increased heat production
     A. 5%                     B. 15%                                  D. All of the above                         (p. 828)
     C. 35%                    D. 55%              (p. 818)        55. Fever is usually caused by:
 47. The energy equivalent of oxygen is:                               A. Encephalin             B. Interleukin 1
     A. 4.8                    B. 5.1                                  C. Dynorphin              D. Endorphin     (p. 831)
     C. 4.7                    D. 4.6                   (p. 819)
 48. Specific dynamic action is higher for:
     A. Protein                  B. Fat
     C. Carbohydrate             D. Equal for all      (p. 819)
 49. Which of the following works expend maximum
     calories/hour:
     A. Swimming
     B. Walking upstairs
     C. Running (5.3 miles/hour)
     D. Wood sawing                           (p. 820)
 50. Rectal temperature is higher than oral temperature
     by:
     A. 0.5°F                    B. 1°F
     C. 1.5°F                    D. 2°F              (p. 822)
 51. Heat is lost from body by:
     A. Radiation               B. Conduction
     C. Convection              D. All of the above (p. 822)
 52. Constituents of secreted sweat are similar to plasma
     except for:
     A. Chloride
     B. Bicarbonate
     C. Proteins
     D. Potassium                                      (p. 825)
 53. Which part of hypothalamus               functions as
     thermostat:
     A. Preoptic
     B. Paraventricular
     C. Periventricular
     D. Dorsomedial                                     (p. 827)


 45 C 46 C     47 A     48 A   49 B    50 B     51 D    52 C
 53 A                                                               54 D 55 B
                                                                                                    Endocrinology 153

                                                               9. The second messenger system in body is:
                                                                  A. cAMP
                                                                  B. Calmodulin
                                                                  C. Phosphatidyl inositol
                                                                  D. All of the above                            (p. 843)
                                                               10. One billion part of a miligram is:
                        Endocrinology                              A. One microgram
                                                                   B. One picogram
                                                                   C. One nanogram
 1. Which of the following hormones is secreted by                 D. None of the above
     placenta:
     A. hCG                    B. Estrogen                     11. Hormones are cleared from body by which process:
     C. Progesterone           D. Somatomammotropin                A. Metabolic destruction
     E. All of the above                        (p. 838)           B. Excretion in bile
                                                                   C. Excretion by kidneys
2. Steroid hormones are secreted by all except:
    A. Ovary                   B. Testes                           D. All of the above
     C. Adrenal medulla        D. Placenta      (p. 838)       12. The weight of normal pituitary gland is:
3. Which of the following is not a peptide hormone:                A. 1 gm                    B. 5 gm
   A. Insulin                 B. Epinephrine                       C. 10 gm                   D. 25 gm            (p. 846)
    C. Parathermone           D. Oxytocin       (p. 838)       13. Developmentally anterior pituitary is from:
4. Receptors within cell cytoplasm are specific to:                A. Neural crest
   A. Peptide hormones        B. Protein hormones                  B. Neural tube
                                                                   C. Pharyngeal epithelium
   C. Cortisol                 D. Catecholamine (p. 840)
                                                                   D. None of the above                           (p. 846)
5. The receptors for TSH are found in:
   A. Cell membrane                                             14. The maximum number of hormone secreting cells of
   B. Nucleus                                                       anterior pituitary are:
   C. Cytoplasm                                                     A. Somatotropes         B. Thyrotropes
   D. All of the above                              (p. 840)        C. Corticotropes        D. Gonadotropes
                                                                    E. Lactotropes                               (p. 847)
6. Hormone combination with receptor leads to which
   of the following:                                            15. Which of the following is a function of growth
   A. Change in membrane permeability                               hormone:
   B. Activation of intracellular enzyme                             A. Protein synthesis
   C. Activation of genes                                            B. Mobilisation of depot fat
   D. All of the above                          (p. 841)             C. Conservation of carbohydrate
7. Formation of cAMP leads to which of the following:                D. All of the above                       (p. 849)
   A. Grandular secretion                                        16. Which of the following is not an effect of growth
   B. Protein synthesis                                              hormone in glucose metabolism:
   C. Muscle contraction                                             A. Diminished glucose uptake by cell
   D. All of the above                           (p. 842)            B. Decreased glucose utilisation
8. The cation essential for adenyl cyclase activity to               C. Suppression of insulin secretion
   form cAMP is:                                                     D. Decreased sensitivity to insulin        (p. 850)
   A. Sodium                  B. Magnesium
   C. Calcium                 D. Potassium      (p. 842)           9 D 10 B   11 D   12 A   13 C   14 A   15 D   16 C

1 E   2C    3B     4C    5B          6D       7D      8B
154 Review of Physiology                                                                               Endocrinology 155

17. Chondrocytes are converted to osteogenic cells            25. Spot the correct statement about formation of pos
    under influence of:                                           terior pituitary hormones:
    A. Growth hormone                                             A. ADH and oxytocin are formed in paraventricular
    B. Testosterone                                                   nuclei
    C. Corticosteroids                                            B. ADH is formed in supraoptic nuclei and oxytocin
    D. Thyroxine                              (p. 850)                in paraventricular nuclei
18. Somatomedic C is secreted by:                                 C. Oxytocin is formed in supraoptic nuclei and ADH
    A. Hypothalamus                                                   in paraventricular nuclei
    B. Anterior pituitary                                         D. Both oxytocin and ADH are formed in supraoptic
    C. Liver                                                          nuclei                                     (p. 855)
    D. Bone marrow                                 (p. 851)   26. Both oxytocin and vasopressin (ADH) have 9 amino
19. Normal growth hormone level in a child or                     acids with partial functional similarities except for
    adolescent is:                                                amino acid structure involving:
    A. 1 ng/ml                                                    A. Arginine
    B. 2-3 ng/ml                                                  B. Valine
    C. 6 ng/ml                                                    C. Histidine
    D. 10-15 ng/ml                        (p. 851)                D. All of the above                               (p. 855)
20. Growth hormone level increases during:                    27. Iodine requirement of normal adult per week is:
    A. Sleep                                                      A. 1 mg                   B. 0.5 mg
    B. Exercise                                                   C. 0.25 mg                D. 0.1 mg           (p. 858)
    C. Starvation                                             28. When peroxidase system is blocked or congenitally
    D. All of the above                            (p. 851)       absent which step of thyroid hormone synthesis is
21. In protein calori malnutrition, growth hormone                affected:
    level is:                                                     A. Iodine trapping
    A. Increased                                                  B. Iodine oxidation
    B. Decreased                                                  C. Organification of iodine                  (p. 859)
    C. Unchanged                                (p. 851)      29. The normal storage of thyroid hormones in thyroid
22. Somatostatin is secreted by:                                  gland is for:
    A. Liver                   B. Duodenum                        A. 1 week                   B. 1 month
    C. Pancreas                D. Thyroid          (p. 852)       C. 2 months                 D. 6 months        (p. 859)
23. Which of the following is inhibited by somatostatin:      30. The thyroid hormone mainly effective at tissue level
    A. Growth hormone                                             is:
    B. Insulin                                                     A. T4
    C. Glucagon                                                    B. T3
    D. All of the above                            (p. 852)        C. Both equally                                 (p. 860)
24. Growth hormone is an antiaging agent because:             31. What is not true of reversed T3:
    A. Increased protein deposition in the body                   A. Metabolically inactive
    B. Decreased fat deposits                                     B. Formed from T3
    C. Feeling of increased energy and drive                      C. Formed by iodine removal from carboxyl end of T4
    D. All of the above                         (p. 854)          D. All of the above

17 A 18 C   19 C   20 D    21 A   22 C   23 D   24 D
                                                              25 B 26 A 27 A        28 B    29 C     30 B    31 B
156 Review of Physiology                                                                                 Endocrinology 157

 32.Among thyroid hormones which is rapid acting:                    40. The exophthalmos in Graves' disease is due to:
     A. T4                  B. Reversed T3                               A. Increase in size of eyeball
     C. T3                  D. All equal       (p. 860)                  B. Increased blood lymph content of eye
                                                                         C. Oedema of retro-orbital tissue
 33. Deficient IQ is a feature of:                                       D. All of the above                            (p. 866)
      A. Thyroid deficiency
      B. Growth hormone deficiency                                   41. Hypothyroid patients should not eat which of the
      C. Both of the above                                (p. 863)       following vegetables:
                                                                         A. Ladies finger          B. Beans
34. Which of the following is not an action of thyroid                   C. Cabbage                D. Brinjal          (p. 867)
    hormones:
     A. Raised BMR                                                   42. In myxoedema, serum findings are all except:
     B. Increased cardiac output                                         A. Low T3, T4            B. High TSH
     C. Decreased cholesterol                                             C. Low cholesterol      D. Normal sugar (p. 867)
     D. Loss of libido                             (p. 862)          43. A cretin can be differentiated from hypopituitary
35. Thyrotropin releasing hormone is secreted by which                   dwarf by:
    part of hypothalamus:                                                 A. Short stature
     A. Suprachiasmatic nucleus                                           B. Normal soft tissue growth
     B. Dorsomedial nucleus                                               C. Low IQ
     C. Paraventricular nucleus                                           D. All of the above                           (p. 867)
     D. All of the above                            (p. 864)
                                                                     44. The total number of hormones isolated from adrenal
36. The other competitor for iodide trapping in thyroid                  cortex are more than:
    is:
                                                                         A. 10                      B. 20
     A. Perchlorate ion                                                  C. 30                      D. 50                (p. 869)
     B. Thiocyanate ion
     C. Nitrate ion                                                  45. Aldosterone is secreted from:
     D. Each of the above                            (p. 865)            A. Zona glomerulosa
                                                                         B. Zona fasciculata
37. Thiourea compounds suppress thyroid hormone
                                                                         C. Zona reticularis
    secretion by:
                                                                         D. All of the above                                 (p. 869)
    A. Inhibit peroxidase    B. Inhibit coupling C.
    Inhibit organification D. B + C                                  46. Cortisol is secreted from:
    E. A + B                                     (p. 865)                A. Zona glomerulosa        B. Zona fasciculata
38. Iodides in high concentration decrease plasma T3, T4                 C. Zona reticularis         D. B + C           (p. 869)
    by inhibiting:                                                   47. The degraded adrenal hormones are mainly secreted
    A. Iodine trapping           B. Release of T3 T4
                                                                         in:
    C. Coupling                  D. Organification (p 865)
                                                                          A. Urine                  B. Bile
39. In Graves' disease, increased T3 T4 levels are due to:                C. Sweat                  D. Stool             (p. 872)
    A. Raised TSH
    B. Raised TSH receptor antibodies                                 48. Normal morning plasma cortisol is:
    C. Increased TRH                                                      A. 1 ug/dl
    D. All of the above                               (p. 866)            B. 5 pg/dl
                                                                          C. 12 ug/dl
                                                                          D. 30 pg/dl                                        (p. 871)

32 C 33 A   34 D   35 D    36 D    37 E   38 B     39 B
                                                                      40 C 41 C   42 C   43 C   44 C   45 A    46 D   47 A
                                                                      48 C
158 Review of Physiology                                                                          Endocrinology 159

                                                                 57. Which of the following is a feature of Addison's
 49. Normal plasma aldosterone is:
     A. 1 ng/dl               B. 6 ng/dl                             disease:
     C. 12 ng/dl              D . 18 n g/dl           (p.872)        A. Hyperpigmentation
                                                                     B. Hypotension
 50. Excess aldosterone secretion causes all except:                 C. Hyponatremia
     A. Hypertension             B. Hypernatremia                    D. All of the above                       (p. 881)
     C. Hyperkalemia             D. Hypervolemia (p. 873)
                                                                 58. Match the pancreatic cell type with the hormone it
 51. The least important factor in regulation of aldo                secretes:
     sterone secretion is:                                           A. Alpha cells            1. Insulin
     A. Potassium               B. Angiotensin-renin                 B. Beta cells             2. Glucagon
     C. ACTH                    D. Sodium           (p. 874)         C. Delta cells            3. Somatostatin (p. 884)
 52. The raised blood sugar level in hypercortisolism is         59. Beta cells constitute what percentage of pancreatic
     due to:                                                         cell population:
     A. Increased glucose absorption                                 A. 100%                   B. 75%
     B. Decreased glucose utilisation                                C. 60%                    D. 40%            (p. 884)
     C. Gluconeogenesis
     D. All of the above                                         60. Banting and Best, isolated insulin in:
     E. B + C                                        (p. 875)        A. 1890                   B. 1902
                                                                     C. 1922                   D. 1942
 53. Cortisol is antiinflammatory because it:
     A. Stabilises lysosomal membranes                           61. Half life of insulin in plasma is:
     B. Decreases capillary permeability                             A. 1 minute
     C. Inhibits white cell migration                                B. 6 minutes
     D. Suppresses lymphocytes                                       C. 30 minutes
     E. All of the above                              (p. 877)       D. 60 minutes                                 (p. 885)
 54. In hypercortisolism, which of the following is not          62. The insulin receptor complex stimulates protein
     true:                                                           kinase C:
     A. Eosinopenia                                                  A. Directly
   x B. Lymphocytopenia                                              B. ViacAMP
     C. Anaemia                                                      C. Via adenylate cyclase
     D. None of the above                          (p. 878)          D. None of the above                     (p. 885)
 55. ACTH prehormone contains which of the following:            63. Insulin receptor combination enhances glucose
     A. Beta lipotropin                                              permeability of all cell except that of:
     B. Beta endorphin                                               A. Muscle cell
     C. Melanocyte stimulating hormone                               B. Adipose cell
     D. All of the above                          (p. 879)           C. Nerve cell                            (p. 886)
 56. The amount of melanin in skin is more dependent
                                                                 64. Insulin increases hepatic glycogen conten t by:
     upon:
                                                                     A. Inactivates phosphorylase
     A. MSH
                                                                     B. Simulates glucokinase
     B. ACTH
                                                                     C. Stimulates glycogen synthetase
     C. Both of the above
                                                                     D. All of the above                          (p. 887)
     D. None of the above                      (p. 879)

49 B 50 C      51 C     52 E     53 E     54 C      55 D
56 B                                                             57 D 58 A:2, B:1,C:3 59 C    60 C    61 B     62 A     63
                                                                 C
                                                                 64 D
160 Review of Physiology                                                                               Endocrinology 161

 65. Very thin but healthy people take insulin to mainly            73. Persistent hypoglycemia is dangerous because of:
     increase:                                                           A. Shock
     A. Muscle mass                                                      B. Brain damage
     B. Fatty deposit                                                    C. Renal shut down
     C. Bone mass                                                        D. Visual impairment                        (p. 897)
     D. All of the above                             (p. 888)
                                                                    74. Normal daily calcium excretion in urine is:
 66. Insulin secretion is facilitated by:                               A. 50 mg                   B. 100 mg
     A. Amino acids                                                      C. 250 mg                 D. 500 mg              (p. 900)
     B. Growth hormone                                              75. Chole calciferol is:
     C. Cortisol                                                         A. Vit D 1
     D. GIP                                                              B. Vit D 2
     E. All of the above                                (p. 891)         C. Vit D3                                        (p. 904)
 67. For which of the following glucose is the principal            76. Conversion of Vit D3 to 1-25 dihydroxychole-
     fuel:                                                              calciferol occurs in which part of nephron:
      A. Brain                                                           A. Glomerulus
      B. Retina                                                          B. Proximal tubules
      C. Gonads                                                          C. Distal tubules                          (p. 904)
      D. All of the above                           (p. 891)
                                                                    77. Formation of 1-25 dihydroxycholecalciferol in
  68. Renal threshold for glucose is:                                   kidney is under control of:
      A. 120 mg%                 B. 140 mg%                             A. Self feedback
      C. 180 mg%                 D. 220 mg%             (p. 894)        B. Parathermone
  69. Normal level of ketone bodies in plasma is:                       C. Calcitonin
      A. 1 mEq/L                B. 5 mEq/L                              D. Plasma phosphorus                      (p. 905)
      C. 10 mEq/L               D. 20 mEq/L       (p. 895)          78. Tetany occurs usually when serum calcium level
  70. What is asthenia:                                                 falls below:
      A. Tall lanky body                                                A. 8 mg%                 B. 6 mg%
      B. Lack of energy                                                 C. 4 mg%                 D. 2 mg%          (p. 900)
      C. Lack of adipose tissue                                     79. In compact bone, bone salts constitute:
      D. None of the above                               (p. 895)       A. 80%                      B. 70%
  71. In a patient of suspected diabetic coma which of the              C. 60%                      D. 50%                (p. 901)
      following finding is unlikely:                                80. Which of the following conforms to hydroxyapatite:
      A. Blood sugar - 550 mg%                                          A. Ca8 (PO4)6 (OH)2
      B. HCO ~ 3 -25 mEq/L                                              B. Ca10 (PO4)6 (OH)2
      C. C1~ - 96 mEq/L                                                 C. Ca10 (PO4)8 (OH)2
      D. pH 6.9                                        (p. 896)         D. Ca8 (PO4)8 (OH)2                          (p. 902)
  72. The principal villain for complications of diabetes is:       81. The tensile strength of bone is due to:
      A. High blood sugar                                               A. Calcium salts
      B. Raised serum lipids                                            B. Collagen fibres
      C. Raised glucagon                                                C. Proteoglycans
      D. None of the above                               (p. 897)       D. Ground substance                              (p. 902)
                                                                    73 B 74 B    75 C   76 B   77 B     78 B      79 B   80 B 81 B
  65 B   66 E    67 D      68 C   69 A      70 B     71 B     72
  B
162 Review of Physiology                                                                        Endocrinology 163

 82. Membrane receptor protein for parathyroid                 90. Fluorine prevents caries by all except:
     hormone is present on:                                        A. Makes enamel more strong
     A. Osteoblasts         B. Osteoclasts                         B. Makes enamel less soluble in lactic acid
     C. Both of the above   D. None of the above                   C. Promotes calcium deposition
                                                                   D. Lethal to bacteria                         (p. 914)
 83. High doses of vit D causes:
     A. Enhanced bone calcium deposition                       91. The bacterium responsible for caries can be all
     B. Bone absorption                                            except:
     C. No change                                                  A. Streptococci
 84. Calcitonin is secreted from:                                  B. Diphtheroid
     A. Parathyroid                                                C. Staphylococci
     B. Thyroid                                                    D. Lactobacilli                             (p. 914)
     C. Kidney
     D. All of the above                            (p. 909)
 85. Hyperparathyroidism manifests with which of the
     following:
     A. Renal stone
     B. Lytic areas in bone
     C. Hypercalcemia
     D. All of the above                         (p. 911)
 86. In rickets plasma level of which of the following is
     markedly depressed:
     A. Calcium
     B. Phosphorus
     C. Parathermone                                (p. 911)
 87. Which of the following contributes to osteoporosis:
     A. Estrogen lack
     B. Inactivity
     C. Lack of vit C
     D. Each of the above                           (p. 912)
 88. Enamel is formed by:
     A. Ameloblasts
     B. Odontoblasts
     C. Periodontal membrane
     D. All of the above                            (p. 912)
 89. Eruption of deciduous teeth is completed by:
     A. 1 year
     B. 2 years
     C. 3 years
     D. 5 years                                   (p. 913)



 82 A 83 B    84 B 85 D 86 B        87 D   88 A   89 B         90 A 91 C
                                                                                M ale Reproductive Physiology 165

                                                             8. Daily sperm production in adult is around:
                                                                A. 1 million               B. 3 million
       Male Reproductive Physiology                             C. 4 million               D. 6 million         (p. 918)
                                                             9. The sperm passage across tubular system of
                                                                epididymis spans across:
       1. The Cowper's glands are located in which part
                                                                A. 1 meter               B. 3 meters
   of male genital system:
                                                                C. 6 meters              D. 9 meters   (p. 918)
   A. Epididymis           B. Prostate
   C. Root of urethra      D. Glans            (p. 916)     10. The life of sperm in female genital tract is:
                                                                A. 1-2 days
2. The period of spermatogenesis from germinal cell to
                                                                B. 2-3 days
   sperm is:
                                                                C. 3-4 days
   A. 24 days                B. 45 days
                                                                D. 4-5 days                                     (p. 918)
   C. 64 days                D. 81 days          (p. 917)
                                                            11. The function of seminal vesicle is all except:
3. The acrosome of the sperm is mainly formed from:
                                                                A. Storage of sperms
   A. Nucleus                B. Golgi apparatus
                                                                B. Supply of fructose for sperm nutrition
   C. Mitochondria           D. Microtubules (p. 917)
                                                                C. Secretion of prostaglandins
4. For spermatogenesis which of the following                   D. All are true                                (p. 918)
   hormones is essential:
                                                            12. Although average speed of sperm migration is only
   A. FSH
                                                                1-4 mm/min, sperms can reach end of fallopian tube
   B. LH
                                                                in 5 minutes by:
   C. Testosterone
                                                                A. Increasing the motility
   D. Each of the above                  (p. 918)
                                                                B. Short circuiting the distance via lymph
5. Testosterone secretion from Leydig cell is under             C. Reverse peristalsis
   control of:                                                  D. All of the above                            (p. 918)
   A. LH                                                    13. Sperm motility is optimum in:
   B. FSH                                                       A. Acid medium
   C. Estrogens                                                 B. Alkaline medium
   D. Growth hormone                            (p. 918)        C. Neutral medium                               (p. 918)
6. FSH is essential for spermatogenesis because it          14. Sperm ejection is due to contraction of:
   stimulates:                                                  A. Vas deferens
   A. Sertoli cells                                             B. Seminal vesicle
   B. Leydig cells                                              C. Prostate
   C. Germinal epithelium                                       D. All of the above                             (p. 919)
   D. All of the above                        (p. 918)
                                                            15. Which of the following forms of sperm is abnormal:
7. What is function of epididymis:                              A. Double head
   A. Sperm transport                                           B. Double tail
   B. Sperm maturation                                          C. Short tail
   C. Sperm storage                                             D. Coiled tail
   D. All of the above                           (p. 918)
                                                                E. Each of the above                           (p. 919)

1C    2C    3B    4D     5A          6A     7D
                                                            8A     9C    10 A   11 A 12 C      13 B     14 D    15 E
166 Review of Physiology

 16. In crypto-orchidism, the testis lies in abdomen
     because of:
     A. Defect in gubernaculum                                               Female Reproductive Physiology
     B. Defect in inguinal ring
     C. Defect in testis itself
                                                                             1. The theca cells are derived from ovarian:
     D. All of the above                          (p. 920)
                                                                       A.   Germinal epithelium
 17. Parasympathetic stimulation causes vasodilatation                 B.   Interstitium
     in penis by secretion of:                                         C.   Granulosa cells
      A. Acetylcholine          B. Nitric oxide                       'D.   None of the above                          (p. 930)
      C. Epinephrine            D. All of the above                2. Time of ovulation is usually:
                                                     (p. 921)          A. 14 days prior to menses
                                                                       B. 16 days prior to menses
  18. Emission and ejaculation is under control of which
                                                                       C. 12 days prior to menses
      nerves:                                                          D. None of the above                             (p. 932)
      A. Sympathetic
                                                                   3. The colour of corpus luteum is:
      B. Parasympathetic                                               A. White
      C. Spinal                                       (p. 921)         B. Dark red
  19. The maximum estrogen in male is formed in:                       C. Yellow
      A. Testes                    B. Adrenal                          D. Pink                                         (p. 932)
       C. Liver                    D. Peripheral tissues
                                                                   4. The theca cells of corpus luteum principally secrete:
                                                        (p. 923)      A. Estrogen
   20. Melatonin the secretion of pineal gland helps in               B. Progesterone
                                                                      C. Androgens
       regulation of:
                                                                      D. All of the above                              (p. 933)
       A. Bone growth
       B. Muscle growth                                            5. Inhibin is secreted by:
       C. Sleep rhythm                                                A. Sertoli cells            B. Granulosa cells
       D. None of the above                         (p.               C. Luteal cells             D. A + C
       927)                                                           E. B + C                                         (p. 933)
                                                                   6. The principal estrogen secreted by ovary is:
   21. Inhibin is secreted from:
                                                                      A. Estrone
        A. Sertoli cells
                                                                      B. Estriol
        B. Leydig cells
                                                                      C. Beta estradiol
        C. Granulosa cell
                                                                      D. None of the above                             (p 933)
        D. None of the above                             (p.
        926)                                                       7. Which of the following is weakest estrogen:
                                                                      A. Estrone
    22. Testosterone secretion from Leydig cells is                   B. Estriol
        under                                                         C. Beta estradiol
        control of:                                                   D. All of equal potency                     (p 933)
        A. FSH                   B. LH
        C. Inhibin               D. Cortisol     (p.               1 B 2 A         3C    4C     5D      6C       7B
        925)
    23. Testosterone is responsible for:
        A. Acne
        B. Boldness
        C. Union of epiphyses to shaft
        D. All of the above                               (p.
        924)

    16 D 17 B     18 A     19 C   20 C   21 A   22 B   23 D
168 Review of Physiology                                                             Female Reproductive Physiology 169

  8. The prepubertal vaginal epithelium is:                       17. Female factor accounts for sterility in:
     A. Stratified squamous B. Columnar                               A. 20%                       B. 40%
     C. Cuboidal                D. Transitional      (p. 935)          C. 60%                      D. 80%                 (p. 942)
  9. Which of the following breast changes is not a               18. Occurrence of ovulation can be monitored from:
     function of estrogen:                                            A. Temperature charting
     A. Acinar growth        B. Ductular growth                       B. Ultrasound of pelvis
     C. Stromal growth       D. Fat deposits  (p. 935)                C. Pregnanediol in urine
 10. The thickness of endometrium at prolif erative phase             D. All of the above                           (p. 942)
     is:                                                          19. Fertilization commonly occurs at:
     A. 1-2 mm                  B. 2-3 mm                              A. Uterus                 B. Isthmus
     C. 3-4 mm                  D. 5-7 mm             (p. 936)         C. Ampulla                D. Fimbrial end       (p. 944)
 11. GnRH release occurs from which part of hypotha-              20. The ovum enters the uterus at which stage:
     lamus:                                                           A. Just after fertilization
                                                                      B. Blasto cyst
      A. Arcuate nuclei
                                                                      C. Morula
      B. Suprachiasmatic
                                                                      D. None of the above                              (p. 945)
      C. Paraventricular
      D. None of the above                        (p. 937)        21. The stay of fertilized ovum in fallopian tube is for:
                                                                      A. 1-2 days                  B. 2-3 days
  12. For ovulation to occur which hormone is essential:
                                                                      C. 3-4 days                  D. 4-5 days          (p. 945)
      A. FSH                     B. LH
      C. Estrogen                D. Progesterone (p. 938)         22. Placenta provides nutritional support to developing
                                                                      embryo how many weeks after fertilization:
  13. The cause of normal menopause is:
                                                                      A. 1 week                    B. 2 weeks
      A. Endometrial atrophy
                                                                      C. 3 weeks                   D. 4 weeks          (p. 946)
      B. Pituitary exhaustion
      C. Ovarian "burning out"                                    23. The mean pressure gradient for O 2 diffusion in
      D. All of the above                              (p. 940)       placenta is:
                                                                      A. 20 mmHg              B. 30 mmHg
  14. Menopause manifests with which of the following:                C. 40 mmHg              D. 50 mmHg          (p. 947)
      A. Hot flushes
      B. Bone pain                                                24. How the foetal oxygen requirement is met when PO2
      C. Irritability and nervousness                                 of umbilical vein blood is only 30 mmHg:
      D. All of the above                          (p. 940)           A. HbF carries more oxygen for given PO2 in
                                                                          comparison to adult Hb
  15. Granulosa cell tumours of ovary secrete:                        B. Hb concentration in foetus is greater
      A. Estrogen                                                     C. Double Bohr effect
      B. Progesterone                                                 D. All of the above                           (p. 947)
      C. hCG
      D. All of the above                              (p. 940)   25. CO2 gradient in placenta is:
                                                                      A. 2-3 mmHg
  16. The desire for sex in ladies is high:                           B. 4-5 mmHg
        A. Just after menstruation                                    C. 5-10 mmHg
        B. At the time of ovulation                                   D. 10-15 mmHg                                    (p. 947)
        C. Just prior to beginning of menstruation
        D. Equal at all times                        (p. 941)
                                                                  17C 18 D 19 C 20 B 21 C            22 B   23 A   24 D
    8 C 9 A 10 C 11 A 12 B           13 C   14 D   15A~            25 A
   16 B
170 Revew of Physiology                                                              Female Reproductive Physiology 171

 26. In comparison to maternal blood, foetal blood                34. During pregnancy all the pituitary hormone
     glucose level is:                                                secretion is increased except:
     A. Equal to that of mother                                       A. ACTH                     B. FSH and LH
     B. 20-30 mg% lower than mother                                   C. TSH                      D. Prolactin  (p. 949)
     C. 20-30 mg% higher than mother            (p. 947)          35. Relaxin is secreted by:
 27. Which of the following is formed by placenta:                    A. Corpus luteum               B. Placenta
     A. hCG                     B. Estrogens                          C. Adrenal                     D. A + B
     C. Progesteron             D. Somatomammotropin                  E. B + C                                         (p. 950)
     E. All of the above                           (p. 948)
                                                                  36. The weight of non-pregnant uterus is:
 28. The main function of hCG is:                                     A. 50 gm                 B. 100 gm
     A. Secretion of LH and FSH by pituitary                          C. 150 gm                D. 200 gm               (p. 950)
     B. Secretion of estrogen and progesterone by corpus          37. Average weight gain during pregnancy is:
         luteum                                                       A. 5 kg                   B. 7 kg
     C. Secretion of milk                                             C. 9 kg                   D. 11 kg               (p. 950)
     D. None of the above                         (p. 948)
                                                                  38. Greatest growth of foetus occurs during:
  29. Corpus luteum maintains pregnancy up to:                        A. First trimester
      A. 8 weeks                B. 12 weeks                           B. Second trimester
      C. 20 weeks               D. 28 weeks           (p. 948)        C. Third trimester                               (p. 950)
  30. Which estrogen estimation is a measure of placental         39. The total demand of extra iron during pregnancy is:
      function:                                                       A. 1000 mg
      A. Estriol                                                      B. 1500 mg
      B. Estradiol                                                    C. 2000 mg
      C. Estrone                                                      D. 3000 mg                                      (p. 950)
      D. None of the above                            (p. 949)
                                                                  40. During later months of pregnancy there is tendency
  31. What is the role of estrogen during pregnancy:                  for:
      A. Uterine growth                                               A. Respiratory acidosis
      B. Breast enlargement                                           B. Respiratory alkalosis
      C. Enlargement of external genitalia                            C. Metabolic acidosis
      D. All of the above                            (p. 949)         D. Metabolic alkalosis                         (p. 951)
  32. What is the role of progesterone during pregnancy:          41. Uterine contraction at labour is brought about by:
      A. Relaxation of uterus                                         A. Oxytocin
      B. Development of decidua                                       B. Altered estrogen: progesterone ratio
      C. Preparation of breast for lactation                          C. Prostaglandins from foetal membranes
      D. All of the above                            (p. 949)         D. All of the above                             (p. 952)
  33. Chorionic somatomammotropin has:                            42. Spot the wrong statement about lactation:
      A. Estrogenic activity                                          A. Estrogen causes ductular growth
      B. Progesterone-like activity                                   B. Progesterone causes lobular and alveolar growth
      C. General metabolic activity                                   C. Prolactin helps in milk formation
      D. All of the above                              (p. 949)       D. All are true                              (p. 954)


                                                                  34 B 35 D   36 A     37 C   38 C    39 A   40 B   41 D
   26 B 27 E   28 B   29 B   30 A   31 D    32 D    33 C          42 D
172 Review of Physiology

 43. Hypothalamic stimulation increases secretion of all
     except:
     A. FSH                    B. Prolactin
     C. ACTH                   D. TSH               (p. 955)
                                                                       Neonatal Physiology
 44. Milk ejection is aided by:
     A. Estrogen
     B. Prolactin                                              1. The developing foetus weighs 1 pound at:
     C. Oxytocin                                                  A. 3 months              B. 4 1/2 months
     D. All of the above                            (p. 956)      C. 5 1/2 months          D. 7 months            (p. 958)

 45. In comparison to cow's milk human milk has high           2. Red blood cell formation in foetus occurs at:
     content of:                                                  A. Soon after fertilisation
     A. Fat                    B. Lactose                         B. 3rd week
      C. Casein                D. Lactalbumen (p. 956)            C. 6th week
                                                                  D. 10th week                                  (p. 958)
                                                               3. Which of the following organs first forms red blood
                                                                  cells in foetus:
                                                                  A. Liver             ,     B. Bone marrow
                                                                  C. Spleen                  D. Placenta          (p. 958)
                                                               4. Deficiency of which vitamin may cause abortion:
                                                                  A. VitA                   B. VitB12
                                                                  C. Vit C                  D. Vit E           (p. 959)
                                                               5. Hypoxia occurs during delivery due to:
                                                                  A. Compression of umbilical cord
                                                                  B. Premature separation of placenta
                                                                  C. Excessive contraction of uterus
                                                                  D. All of the above                              (p. 959)
                                                               6. Neonates can tolerate complete asphyxia up to:
                                                                  A. 4 minutes              B. 10 minutes
                                                                  C. 15 minutes             D. 30 minutes      (p. 960)
                                                               7. How much negative pressure is required to open up
                                                                  the foetal alveoli for first time:
                                                                  A. 10 mmHg
                                                                  B. 25 mmHg
                                                                  C. 50 mmHg
                                                                  D. 60 mmHg                                    (p. 960)
                                                               8. Surfactant is secreted by which pneumocytes:
                                                                  A. Type I
                                                                  B. Type II
                                                                  C. Both of the above                         (p. 960)


                                                               1 C    2B    3A    4D     5D          6B      7B       8B
  43 B   44 C   45 B
174 Review of Physiology

  9. What percentage of            foetal cardiac output passes
     through placenta:
     A. 30%                                            B. 45%
     C. 55%                          D. 75%            (p. 961)
 10. What is true of LA pressure:                                        Sports Physiology
     A. Equal to RA pressure
     B. 2-3 mm higher than RA pressure                            1. The maximum force achievable by contraction of
     C. 2-3 mm less than RA pressure                                 skeletal muscle is:
     D. 5-10 mm higher than RA pressure                (p. 961)      A. 3-4 kg/cm2          B. 4-5 kg/cm2
                                                                                  2
 11. The cardiac output of neonate is:                               C. 5-6 kg/cm           D. 6-7 kg/cm2 (p. 968)
     A. 200 ml/min             B. 300 ml/min
                                                                  2. In long distance swimming ladies have better
     C. 400 ml/min             D. 500 ml/min          (p. 962)
                                                                     performance because:
 12. The TWBC of neonate is:                                         A. Better buoyancy
     A. 10,000 cmm           B. 20,000 cmm                           B. Extra long-term energy
     C. 30,000 cmm           D. 45.000 cmm            (p. 962)       C. Extra fat (heat insulation)
 13. What is true of liver function in neonate:                      D. All of the above                     (p. 968)
     A. Poor bilirubin conjugation                                3. Endurance is greatly influenced by:
     B. Poor albumin synthesis                                       A. High carbohydrate diet
     C. Poor gluconeogenesis                                         B. High protein diet
     D. Poor synthesis of coagulation factors                        C. High fat diet
     E. All of the above                               (p. 963)      D. Mixed diet                                    (p. 969)
 14. Cow's milk is deficient in:                                  4. Muscle energy requirement is dependent upon:
     A. VitD                     B. VitC                             A. Phosphagen system
     C. Vit A                    D. Vit E              (p. 964)      B. Glycogen lactic acid system
 15. High concentration O2 therapy in premature infant               C. Aerobic system
     leads to:                                                       D. All of the above                          (p. 969)
     A. Rupture of lung                                           5. The amount of ATP present in muscle is enough for
     B. Collapse of lung
                                                                     a dash of:
     C. Retrolental fibroplasia
                                                                     A. 50 meter              B. 100 meter
     D. None of the above                           (p. 968)
                                                                     C. 150 meter             D. 200 meter       (p. 970)
 16. In relation to body mass, the body surface area in
     neonate is:                                                  6. For a 100 meter swim which energy system plays the
     A. More                     B. Less                             key role:
     C. Normal                                      (p. 963)         A. Phosphagene system
                                                                     B. Glycogen-lactic acid system
 17. The tidal volume in neonate is:                                 C. Aerobic system
     A. 10 ml                  B. 16 ml                              D. All of the above                           (p. 970)
     C. 26 ml                  D. 31 ml                (p. 962)
                                                                  7. The quantity of stored oxygen in body is:
 18. In fetal life the portal venous pressure is:                    A. 1 litre                 B. 2 litre
     A. 0                         B. 2 mmHg                          C. 3 litre                 D. 5 litre            (p. 970)
     C. 6 mmHg                    D. 10 mmHg          (p. 962)
 9 C 10 B     11 D 12 D     13 E      14 B    15 C   16 A 17 B
18 A                                                              1 A    2D    3A    4D    5A          6B        7B
176 Review of Physiology
  8. Athletic training leads to which of the following:                      Practice Paper 1
     A. Increased number of myofibrils
     B. Increased stored glycogen and triglycerides
     C. Increased mitochondrial enzymes
     D. All of the above                          (p. 972)       1. Insensible water loss per day is:
                                                                    A. 400 ml                 B. 800 ml
  9. In a marathon runner, the proportion of fast twitch            C. 1200 ml                D. 1500 ml
     to slow twitch muscle fibre is:
     A. 1:4                    B. 1:2                            2. Oxygen-haemoglobin dissociation curve is:
     C. 1:1                    D. 2:1             (p. 973)          A. Hyperbolic          B. Parabolic
                                                                    C. Sigmoid             D. None of the above
 10. Which of the following is not a feature of slow
     twitch fibre:                                               3. Following are features of active thyroid except:
     A. Increased capillary mass                                    A. Follicles are large
     B. More mitochondria                                           B. Scalloped colloid with reabsorption lacunae
     C. Large diameter                                              C. Cell lining of follicle is columnar
     D. None of the above                     (p. 973)              D. Increased vascularity
 11. How much VO 2 max can increase with endurance               4. Respiratory quotient of more than 1 is in:
     training:                                                      A. Fat                   B. Protein
     A. 10%                B. 20%                                   C. Pyruvic acid          D. Glycerol
     C. 45%                D. No change     (p. 974)
                                                                 5. Head ganglion of autonomic system is:
 12. Which of the following is not true about endurance             A. Hypothalamus
     training:                                                      B. Thalamus
     A. Increases number of muscle fibres                           C. Superior cervical ganglion
     B. Increases VO2 max by 50%                                    D. Stellate ganglion
     C. Does not increase O2 diffusion in lungs
     D. All are false                            (p. 976)        6. All are monosynaptic reflexes except:
                                                                    A. Ankle jerk             B. Abdominal reflex
 13. With training cardiac output can increase:                     C. Knee jerk              D. Triceps jerk
     A. 3 times                B. 4 times
     C. 5 times                D. 8 times            (p. 976)    7. Potassium is secreted into gut mainly in:
                                                                    A. Stomach                B. Jejunum
 14. Supplemental fluid drink for athlete should include:           C. Colon                  D. Rectum
     A. NaCl                   B. Sugar
     C. Potassium              D. All of the above               8. Normal myeloid-erythroid ratio is:
                                                   (p. 977)         A. 1:1                  B. 1:2
                                                                    C. 3:1                  D. 3:2
 15. During most strenuous exercise maximum muscle
     blood flow is:                                              9. Bitot's breathing occurs in:
     A. 10 fold              B. 20 fold                             A. Uraemia                 B. Meningitis
     C. 25 fold              D. 30 fold      (p. 974)               C. Ketoacidosis            D. None of the above
 16. In well trained athlete, the oxygen consumption can        10. Normal arm to tongue circulation time is:
     rise:                                                          A. 10 sec               B. 16 sec
     A. 10 fold                  B. 20 fold                         C. 20 sec               D. 26 sec
     C. 30 fold                  D. 35 fold
                                                                1 B 2C      3A    4C    5A     6B     7C    8C
  8D    9 A 10 C     11 A   12 D     13 C     14 C      15 C    9 B 10 B
 16 B
178 Revew of Physiology                                                                      Practice Paper 1 179

 11. Insulin acts at all the sites except:                  20. In addition to renal parenchyma counter current
     A. Liver                      B. Brain                     multiplier system is present in:
     C. Adipose tissue             D. Muscle                     A. Gastric mucosa          B. Muscle
                                                                 C. Lung                    D. Skin
 12. Substances secreted by proximal tubule are all
     except:.                                               21. Endothelial cells synthesize:
     A. Creatinine            B. Uricacid                       A. Fibrinogen               B. Factor VIII
     C. Ammonia               D. Penicillin                     C. Factor X                 D. Factor XII
 13. Cogwheel appearance of nucleus is seen in:             22. Vessels not under sympathetic control are those of:
     A. Sertoli cell         B. Leydig cell                     A. Heart                  B. Brain
     C. Sperms                D. Spermatoid                     C. Kidney                 D. Muscle
 14. Rise in ESR occurs with rise in:                       23. Chemical gradient across cell membrane is main
     A. Leukocytes                                              tained by:
     B. Gammaglobulin                                            A. K^                    B. Na+ _
     C. Complement                                               C. Q                     D. HCO 3
     D. Coagulation factors
                                                            24. Increase in insulin receptors is seen in:
 15. Which of the following is not a function of insulin:       A. Acromegaly                B. NIDDM
     A. Glycogenesis                                            C. Starvation                D. Obesity
     B. Gluconeogenesis
                                                            25. Resting membrane potential is due to isoelectrical
     C. Triglyceride synthesis                                  potential of:
     D. Glucose utilization                                     A. Na+                   B. K+
 16. Transection of pituitary stalk leads to increase in:       C. Q                     D. Mg++
     A. TSH                       B. ACTH                   26. Spinothalamic tract transmits following sensations
     C. Prolactin                 D. FSH                        except:
 17. Systolic time interval is the time between:                A. Pain                    B. Proprioception
     A. P wave to T wave                                        C. Touch                   D. Temperature
     B. Beginning of QRS to aortic valve closure            27. Following are seen in REM sleep except:
     C. Beginning of QRS to end of T wave                       A. Tachycardia           B. Bruxism
     D. None of the above                                       C. Hypotonia             D. Dreams
 18. First change to occur after an axon is severed in:     28. All of the following change with advancing age
     A. Degeneration of myelin sheath                           except:
     B. Degeneration of axolemma                                A. Haematocrit          B. GFR
     C. Sprouting of axons                                      C. GTT                  D. FEV,
     D. Degeneration of Nissl granule
                                                            29. Oxygen dissociation curve shifts to left in all except:
 19. Which of the following hormones does not need a            A. Hypoxia                 B. Low PCO 2
     second messenger:                                          C. Low 2-3 DPG             D. Alkalosis
     A. Estrogen
     B. FSH                                                 30. Normal daily urinary protein is less than:
     C. LH                                                      A. 150 mg                 B. 250 mg
     D. Glucagon                                                C. 500 mg                 D . 1 gm

                                                            20 A 21 B   22 B   23 A   24 C    25 C    26 B    27 C
 11 B 12 B   13 A    14 B   15 B    16 C    17 B   18 A     28 C 29 A   30 A
 19 A
180 Review of Physiology
                                                                                               Practice Paper 1 181
 31. Erythropoietin is increased in:
     A. Blood loss                B. Exercise                 40. Carbonic anhydrase in RBC helps in formation of:
     C. High altitude             D. All of the above             A. Carboxy Hb            B. Bicarbonate
                                                                  C. Carbamino Hb          D. None of the above
 32. The secretion of aldosterone is controlled by:
     A. Angiotensin             B. ACTH                       41. Paradoxical sleep consists of:
     C. Epinephrine             D. Insulin                        A. REM, spike and slow wave
                                                                  B. REM, sharp wave and fast rhythm
 33. Most sensitive hearing range is:                             C. NREM, delta wave
     A. 500 Hz-1000 Hz                                            D. NREM, high spike, theta wave
     B. 1000 Hz-4000 Hz
     C. 6000 Hz-10,000 Hz                                     42. Stimulation of both glucocorticoids and mineral
     D. 10,000 Hz-15,000 Hz                                       corticoids is seen in:
                                                                  A. Anxiety                B. Exercise
 34. Thyroid binding globulin is decreased in:                    C. Low sodium diet        D. Hyperkalemia
     A. Renal failure
     B. Nephrotic syndrome                                    43. Hydrostatic pressure is highest in capillaries of:
     C. Anaemia                                                   A. Brain                    B. Kidney
     D. Heart failure                                             C. Liver                    D. Intestine

 35. Growth hormone is diabetogenic because it:               44. Heparin is secreted by:
     A. Promotes glycogenolysis                                   A. Eosinophils               B. Basophils
     B. Blocks beta cells                                         C. Mast cells                D. Lymphocyte
     C. Increases glucose absorption                          45. Blood brain barrier is maximum permeable to:
     D. Causes gluconeogenesis                                    A. Na+                      B. Ca++
                                                                      +
                                                                  C. K                        D. CO2
 36. In athletes, bradycardia is because of:
     A. Decreased sympathetic tone                            46. Surfactants act by decreasing:
     B. Increased vagal tone                                      A. Pleural fluid secretion
     C. High cardiac output                                       B. Surface tension
     D. None of the above                                         C. Pleural capillary pressure
                                                                  D. None of the above
 37. In hypoglycemia hormone to be decreased is:
     A. Adrenaline            B. GH                           47. When stroke volume is 5.4 litre and systolic BP is 90
     C. Thyroxine             D. Cortisol                         mmHg, peripheral resistance is:
 38. Ventricular repolarisation in ECG is indicated by:           A. 1                        B. 3
     A. P wave                    B. QRS                          C. 4                        D. 6
     C. T wave                    D. ST segment               48. Purkinje cells in cerebellum are:
 39. According to Starling's law, cardiac output is               A. Input cells
     increased by:                                                B. Output cells
     A. Increased end systolic volume                             C. Interneurons
     B. Increased end diastolic volume                            D. Glial component
     C. Increased heart rate                                  49. Vital capacity is minimum in which position:
     D. None of the above                                         A. Lithotomy               B. Supine
                                                                  C. Prone                   D. Trendelenburg

31 C   32 A   33 B   34 B   35 D   36 B   37 C   38 C 3 9 B
                                                              40 B 41 A   42 A   43 B   44 C   45 D   46 B    47 C 48 A 49
                                                              D
182 Review of Physiology                                                                            Practice Paper 1 183

 50. Capacity of tissues to use oxygen is lost in:                 60. Presence of bilirubin glucuronide in urine without
     A. Hypoxic hypoxia                                                urobilinogen indicates:
     B. Anaemic hypoxia                                                A. Haemolytic jaundice B. Obstructive jaundice
     C. Histotoxic hypoxia                                             C. Cirrhosis of liver       D. All of the above
     D. Stagnant hypoxia                                           61. What is true of Hering-Breuer reflex:
 51. Pulmonary vasculature is different from systemic                  A. Initiates rhythmicity of normal breathing
     vasculature by:                                                   B. Influences only depth of normal breathing
     A. Mean pressure difference of arteries is low                    C. Influences depth and rate of normal breathing
     B. Absent sympathetic vasoconstrictor tone                        D. All of the above
     C. Accommodate large amount of blood                          62. Hyponatremia is symptomatic with serum sodium
     D. All of the above                                               below:
 52. The best method for Hb estimation is:                             A. 120 mEq/L             B. 130 mEq/L
     A. Acid haematin          B. Alkali haematin                      C. 135 mEq/L             D. 140 mEq/L
     C. Cyanometh Hb           D. None of the above                63. All are concerned with accommoiation reflex except:
 53. Increased ventilation: perfusion is seen in:                      A. Area 19
     A. Apices of lung                                                 B. Lateral geniculate body
     B. L-R shunt                                                      C. Superior coliculus
     C. Decrease in dead space                                         D. Edinger-Westphal nucleus
     D. All of the above                                           64. Patients with end stage renal failure fail to utilise
 54. 2/3rd of body water is:                                           dietary:
     A. Intravascular              B. Extracellular                    A. VitA                    B. VitB12
     C. Intracellular              D. Interstitial                     C. VitC                    D. VitD

 55. Glycosylated Hb has:                                          65. Hypoxic hypoxia can be caused by all except:
     A. High O2 affinity           B. Low O2 affinity                  A. Alveolar-capillary diffusion block
     C. Nil oxygen affinity        D. Normal O 2 affinity              B. Hyperventilation
                                                                       C. Decreased partial O 2 pressure in inspired air
 56. Cyanosis may not occur in:                                        D. Excessive V:Q ratio
     A. Anaemic hypoxia      B. Hypoxic hypoxia C.
     Histotoxic hypoxia   D. Stagnant hypoxia                      66. The band which disappears on muscle contraction
                                                                       is:
 57. Respiratory acidosis occurs in:
                                                                       A. I                     B. H
     A. Emphysema                 B. Hyperventilation
                                                                       C. Z                     D. A
     C. Diabetes                  D. Vomiting
                                                                   67. Patency of terminal bronchiole is maintained by:
 58. Cheyne-Stokes respiration is characterised by:
     A. Increased sensitivity of respiratory centre                    A. Surfactant
     B. Continuous hyperpnoea                                          B. Negative intrapleural pressure
     C. Fluctuating PO 2 with stable PCO 2                             C. Elastic recoil of lung
     D. Decreased sensitivity of respiratory centre                    D. Smooth muscle in wall of bronchiole

  59. Normal daily fecal fat excretion is less than:               68. Cyanemeth Hb estimation is useful in all except:
      A. 2 gm                     B. 5 gm                              A. Carboxy Hb            B. Sulph Hb
      C. 8 gm                     D. 10 gm                             C. Reduced Hb            D. Foetal Hb

  50 C 51 D   52 C   53 A   54 C   55 B   56 A      57 A 58 D 59   60 B 61 A   62 A   63 A   64 D     65 B    66 B    67 C
  B                                                                68 D
184 Review of Physiology                                                                  Practice Paper 1 185

 69. What is not true of chromaffin cells of adrenals:   78. Bilateral destruction of auditory cortex in man
     A. Derivative of neuroectoderm                          causes:
     B. Secrete catecholamine                                A. Total deafness
     C. Innervated by preganglionic sympathetic              B. Defect for higher frequency sound
     D. Concentrated in adrenal cortex                       C. Defect in interpretation of sounds
                                                             D. Defect in orientation of sounds
 70. The most important renal defence against
     respiratory alkalosis is:                           79. AB blood group belong to which system:
     A. Increased secretion of K+                            A. Duffy                 B. Landsteiner
     B. Decreased production of NH3                          C. Rhesus                D. Lutheran
     C. Increased excretion of NaHCO3                    80. Most potent endogenous vasopressor is:
     D. Increased excretion of H+                            A. Angiotensin II        B. Aldosterone
 71. In photopic vision:                                     C. Renin                 D. Cortisol
     A. Eye is most sensitive to blue light              81. The transmitter released at neuromuscular junction
     B. Rods are not stimulated                              is:
     C. Colour is perceived by cones                         A. Acetylcholine             B. Norepinephrine
     D. Eye is accommodated to dimlight                      C. Dopamine                  D. Epinephrine
 72. Function of thyroid acini is synthesis of:          82. Normal blood pH is:
     A. Mucus                    B. T3                       A. 7.3                      B. 7.4
     C. T4                       D. Thyroglobulin            C. 7.5                      D. 7.2
 73. Beta2 stimulation causes all except:                83. In postmenopausal women which is increased:
     A. Tachycardia                                          A. Estrogen             B. Progesteron
     B. Bronchodilatation                                    C. FSH                  D. Cortisone
     C. Increased AV conduction
     D. Splanchnic vasoconstriction                      84. Pulmonary wedge pressure corresponds to:
                                                             A. LA pressure           B. RA pressure
 74. Total body iodine content is:                           C. SVC pressure    .      D. IVC pressure
     A. 20 mg                   B. 30 mg
     C. 40 mg                   D. 50 mg                 85. Thrombosthenin is:
                                                             A. Coagulation factor
 75. At rest stimulus for ventilation is derived from:       B. Contractile protein
     A. O2                        B. CO2                     C. Thrombosis promoting protein
     C. pH                        D. HCO3                    D. Platelet production regulating protein
 76. Baroreceptors act mainly through:                   86. Thrombosthenin is present in:
     A. Sympathetic system                                   A. Muscle                 B. RBC
     B. Parasympathetic system                               C. Platelet               D. All of the above
     C. Cerebral cortex
     D. Capillary pressure                               87. Transection of medullary pyramids results in:
                                                             A. Hypotonia
 77. First enzyme to act on milk is:
                                                             B. Atrophy of distal muscles
     A. Pepsin
                                                             C. Forced grasping
     B. Rennin
                                                             D. Positive Babinski
     C. Trypsin
     D. Enterokinase
69 D   70 C   71 C   72 D   73 D   74 D   75 B   76 B    78 C 79 B 8U A   81 A   82 B   83 C   84 A   85 B
77 B                                                      86 C 87 D
                                                                                                          Practice Paper 1 187
186 Review of Physiology
                                                                    100. Lifespan of normal platelet is from ________to
 88. Blood group antigens are:
                                                                            ______ days
     A. Carried by sex chromosomes
                                                                    101. The first step in haeme synthesis is the condensation
     B. Attached to plasma proteins
                                                                          of _______
     C. Attached to Hb molecule
                                                                    102. The main function of neutrophil is_________
     D. Found in saliva
                                                                    103. Time taken for maturation from stem cells to mature
 89. Temporal lobe lesions cause:                                         granulocyte is _______ days
     A. Lower quadrantic hemianopia                                 104. The P wave represents ________
     B. Upper quadrantic hemianopia                                 105. The QRS represents ________
     C. Bitemporal hemianopia                                       106. The normal PR interval is below _______
     D. Binasal hemianopia                                          107. Normal R:S ratio in V1 is less than ________
 90. Prostaglandin secretion is maximum in:                         108. In hyperkalemia T wave is ________
                                                                    109. In left axis deviation QRS axis more than _______
     A. Vagina                   B. Semen
     C. Saliva                   D. Urine                           110. A T wave is called tall when its height is more
                                                                          than ________
 91. Metyrapone inhibits:                                           111. __________cells produce neurilemma
     A. 17-alpha hydroxylase                                        112. ________ cells are phagocytic in CNS
     B. 21-alpha hydroxylase                                        113. CSF is formed at ________ .
     C. 11 -beta hydroxylase                                        114. Duration of action potential in nerve cell membrane
     D. Desmolase                                                         is ________
                                                                    115. Duration of action potential in sarcollema
 92. Conduction velocity is maximum in:                                   is ________
     A. Atria                  B. AV node                           116. Acetylcholine is destroyed by ________
     C. Bundle of His          D. Ventricle
 93. In iron deficiency, RBC is:
     A. Microcytic hypochromic
     B. Macrocytic hypochromic
     C. Macrocytic normochromic
     D. Microcytic normochromic
Fill in the blanks:
 94. Oxygen affinity of Hb falls as ________ falls
 95. The relationship of O2 affinity to Hb is known
       as ________
 96. Red cell 2,3 DPG is increased as an adaptation
       to ________
 97. Iron in Hb is in ________ state
 98. _________ can improve spherocytic anaemia in many
        patients
 99. Megaloblastic anaemia of pregnancy is mostly due to
       deficiency of    ___

                                                                    1008,10 101 Glycine, succinyl CoA 102 pH agocytosis 10312 104
                                                                    Atrial contraction 105 Ventricular contraction 106 0.2 sec 107 1 108
 88 D 89 B 90 B 91 C 92 C           93 A     94 PH 95 Bohr effect   Tall 109-30° 110 10 mm 111 Schwann 112 Microglia 113 Choroid
 96 Hypoxia 97 Ferrous 98 Splenectomy 99 Folic acid                 plexus 114 0.5 ms 1155 ms 116 Chotine esterase
                                                             _____________________________ Practice Paper 2 189

                                                               9. What is true about endplate spike potential recorded from
           Practice Paper 2                                       cell body of neuron:
                                                                  A. Lasts only for the duration of presynaptic
                                                                      stimulation
                                                                  B. Always follows the axon spike
1. As compared to extracellular fluid CSF has more                C. Always initiates action potential
   concentration of:                                              D. Can be summated temporally during repetitive
                                                                      presynaptic stimulation
   A. Sodium                 B. Potassium
   C. Chloride               D. Bicarbonate                  10. During excitation of a nerve cell peak potassium
                                                                 efflux occurs:
2. Osmolarity of CSF is:                                          A. After peak of sodium efflux and after the spike
    A. Same as that of plasma                                     B. After the spike but before peak sodium efflux
    B. Lower than that of plasma                                  C. Coincident with peak of sodium efflux
    C. Higher than that of plasma                                 D. None of the above
 3. The blood brain barrier is relatively most
                                                             11. The basic spinal reflex of posture is:
    impermeable to:
                                                                 A. Flexor reflex            B. Extensor reflex
     A. Sodium                   B. Chloride                     C. Stretch reflex           D. None of the above
     C. CO2                      D. Potassium
 4. The blood brain barrier is less effective around:        12. All the following can initiate visceral pain except:
    A. Cerebrum                  B. Midbrain                     A. Cutting                   B. Distention
                                                                 C. Spasm                     D. Ischaemia
     C. Base of brain            D. Choroid plexus
  5. Which part of a motor neuron has the lowest             13. Muscle tone is:
     threshold for a propagated action potential:                A. Reduced by curare like drugs
     A. Axon                     B. Axon hillock                 B. Increased in decerebrate
      C. Soma                     D, Dendrite                    C. Decreased in cerebellar lesion
                                                                 D. All of the above
 6. Renshaw cell inhibition is:
     A. Exerted entirely as presynaptic inhibition           14. Which of the following is not a feature of lower
     B. An example of lateral inhibition                         motor lesion:
     C. Involves an interneuron in its reflex arc                A. Motor paralysis
     D. An example of positive feedback                          B. Loss of stretch reflex
                                                                 C. Exaggerated deep tendon reflexes
  7. All and none phenomenon is usually related to:              D. Hypotonia
     A. Resting potential
     B. Spike potential                                      15. Which of the following is not a feature of upper
     C. Miniature end plate potential                            motor neuron palsy:
     D. None of the above                                        A. Spasticity
                                                                 B. Loss of sensations
  8. At high ambient temperature heat loss from body             C. Clonus
     occurs principally by:                                      D. Extensor plantar
      A. Radiation
      B. Convection                                          16. Athetosis is a manifestation of lesion at:
      C. Evaporation                                             A. Thalamus                B. Basal ganglia
      D. Conduction                                              C. Cerebral cortex         D. Cerebellum

                                                              9D   10 A   11 C   12 A   13 D    14 C    15 B    16 B
  1C    2C      3C     4C     5B      6C      7B        8C
                                                                                                  Practice Paper 2 191
190 Review of Physiology
                                                                 27. Main site of action of opiates is:
 17. Extrapyramidal tracts include all except:                       A. Thalamus                B. Sensory cortex
     A. Reticulospinal             B. Vestibulospinal                C. Limbic system           D. Spinal cord
     C. Corticospinal              D. Rubrospinal
                                                                 28. Spot the wrong statement:
 18. Roof nuclei of cerebellum refers to all except:                 A. Anterior corticospinal tract contains fibres from
     A. Dentate nucleus        B. Emboliform nucleus                    ipsilateral motor cortex
     C. Fastigius nucleus       D. Red nucleus                       B. Lateral corticospinal tract contains 90% of
 19. Which of the following reflexes is likely to                       pyramidal fibres
     disappear in spinal animal:                                     C. Pyramidal tract is so named as its fibres originate
     A. Stretch reflex           B. Withdrawal reflex                   from pyramidal cells
     C. Vomiting reflex          D. Flexor reflex                    D. Pyramidal tract stimulation can cause presynaptic
                                                                        inhibition of cutaneous afferents
 20. Alpha adrenergic blockade leads to:
     A. Bronchospasm           B. Hypotension                    29. Spot the wrong statement:
     C. Constriction of pupil D. Bradycardia E.                      A. The cerebellar input through climbing fibres are
     All of the above                                                   more specific, one fibre relaying in one Purkinje
                                                                        cell
 21. Beta blockade leads to all except:                              B. The climbing fibres of cerebellum are mainly
     A. Bradycardia              B. Hypotension                         constituted by olivocerebellar tract
     C. Bronchodilatation        D. Loss of libido                   C. Cerebellum has ipsilateral connection with spinal
 22. Basal ganglia lesions cause all except:                            cord but contralateral cerebral cortex
     A. Spasticity              B. Resting tremor                    D. All are true
     C. Akinesia                D. Dysmetria                     30. Spot the correct statement:
 23. All the following are features of cerebellar lesion             A. Neostrial influence on cerebral cortex are
     except:                                                            excitatory
     A. Hypotonia               B. Scanning speech                   B. The cerebellar cortex has six layers which are
     C. Resting tremor          D. Gait ataxia                          histologically similar and uniform
     E. Nystagmus                                                    C. Alpha rhythm in EEG is 8-12 cycles/second
                                                                     D. Patients with frontal lobe lesion cannot dis
 24. The major afferent input to basal ganglia is from:                 tinguish between a metal and rubber ball
     A. Motor cortex             B. Association cortex
     C. Cerebellum               D. Thalamus                     31. Which of the following is required for haemopoiesis:
                                                                     A. Iron
 25. The fibres that join both cerebral cortex are known             B. Cobalt
     as:                                                             C. Zinc
     A. Mossy fibre                                                  D. Copper
     B. Climbing fibre                                               E. All of the above
     C. Commissural fibre
     D. Projection fibres                                        32. What is true about RBC:
                                                                     A. Responsible for major part of blood viscosity
 26. Acetyl salicylic acid is a pain killer because it:              B. Carries oxygen
     A. Inhibits GABA                                                C. Non-nucleated
     B. Suppresses release of substance P                            D. Contains carbonic anhydrase
     C. Inhibits prostaglandin synthesis                             E. All of the above
     D. Blocks endogenous opiate receptors

 17 C 18 D   19 C    20 B   27 C     720    23 C     24 B 25 C   27 C 28 C    29 D    30 C    31 E     32 E
 26 C
192 Review of Physiology                                                                  Practice Paper 2 193

 33. Haemopoiesis in adult occurs in:                       41. What is not true of neutrophils:
     A. Sternum                B. Pelvic bones                  A. Motile
     C. Ribs                   D. Vertebra                      B. Confined to vascular compartment
     E. All of the above                                        C. Contain lysosomes
                                                                D. Have chemoluminiscence
 34. Absence of intrinsic factor is characterised by all
     except:                                                42. What is true of eosinophils:
     A. Macrocytic anaemia                                      A. Quantity increased in pyogenic infection
     B. Megaloblastic marrow                                    B. Liberate IgE
     C. Hypertrophic gastric mucosa                             C. Comprise 10-12% of in differential count
     D. Achlorohydria                                           D. None of the above
 35. The process by which WBC's squeeze through pores       43. What is not true of monocyte:
     in capillary wall is:                                      A. Is an agranulocyte
     A. Chemotaxis           B. Diapedesis                      B. Rich in lipase
     C. Pinocytosis          D. None of the above               C. Abundant in tissues
                                                                D. All are true
 36. RBC requires energy through EM pathway for:
     A. To maintain shape and flexibility                   44. What is true of platelets:
     B. To keep Hb in reduced form                              A. Non-nucleated
     C. To preserve internal milieu                             B. Adhere to collagen
     D. All of the above                                        C. Have contractile power
                                                                D. All of the above
 37. Polycythemia can occur due to excess intake of:
     A. Iron                                                45. Intravascular clotting is prevented by:
     B. Copper                                                  A. Circulating heparin
     C. Zinc                                                    B. Circulating fibrinolysin
     D. All of the above                                        C. Circulating antithrombin
                                                                D. Vessel lining with negatively charged protein
 38. Anaemic patients have which of the following:
                                                                E. All of the above
     A. Raised cardiac output
     B. Heart murmur                                        46. Serum does not contain:
     C. Pallor of mucus membrane                                A. Calcium                B. Factor VII
     D. All of the above                                        C. Factor VIII            D. Prothrombin
 39. O2 dissociation curve is shifted to right by:          47. Hepatic formation of which of the following is not
     A. Increased hydrogen ion                                  dependent on vit K:
     B. Increase in PCO2                                        A. Factor VII             B. Factor IX
     C. Increased temperature                                   C. Fibrinogen             D. Prothrombin
     D. Increased DPG
     E. All of the above                                    48. Storage of blood beyond 7 days shows:
                                                                A. Increase in prothrombin time
 40. Neutrophil granulocytes:                                   B. Decrease in glucose and increased lactic acid
     A. Contain histamine                                       C. Rise in potassium
     B. Phagocytic                                              D. Decrease in platelet
     C. Increased in pyogenic infections                        E. All of the above
     D. All of the above

 33 E 34 C 35 B      36 D   37 C    38 D   39 E      40 D   41 B 42 D    43 D   44 D   45 E     46 D   47 C   48 E
194 Review of Physiology                                                                     Practice Paper 2 195

 49. Anticoagulant action of heparin is via:                  57. Highest concentration of carbonic anhydrase is in:
     A. Blocks conversion of fibrinogen to fibrin                 A. RBC
     B. Blocks conversion of prothrombin to thrombin              B. Ciliary epithelium
     C. Chelates calcium ions                                     C. Renal tubular epithelium
     D. All of the above                                          D. Skeletal muscle

 50. Best index of platelet function is:                      58. If blood is exposed to PO2 of 500 mmHg what will
     A. Bleeding time            B. Clotting time                 happen:
     C. Clot retraction time      D. Prothrombin time              A. Five fold increase in O 2 content of blood
                                                                   B. Five fold increase in dissolved O 2
 51. Rapid infusion of citrated blood can cause:                   C. Five fold increase in both Hb-Oxygen and
     A. Tetany
                                                                       dissolved oxygen
     B. Flaccid palsy
                                                                   D. None of the above
     C. Thrombosis
     D. All of the above                                      59. Spot the correct statement:
 52. Characteristics of antibody include all except:
                                                                  A. RBCs utilise Kreb's cycle for glucose metabolism
     A. Are immunoglobulins                                       B. G6PD activity is low in old RBCs
     B. Are formed by plasma cells                                C. Glucose enters RBCs by diffusion and it is insulin
     C. Are excreted in urine                                        dependent
     D. Are protective and destructive                            D. All are correct
 53. What is not true about Rh factor:                        60. Spot the wrong statement:
     A. RhD is common in India                                    A. Acidosis favours O 2 dissociation from Hb
     B. 15% people are Rh negative                                B. In splenomegaly platelets are pooled up in spleen
     C. Rh negative mother with Rh positive baby may              C. Erythrocytes and platelets always remain
        have complications                                           intravascular
     D. All are true                                              D. All are true
 54. What is true of carbon monoxide:                          61. Spot the wrong statement:
     A. Cigarette smoke emits carbon monoxide                      A. Duration of granulopoiesis is 10 days
     B. It has better affinity for Hb than O 2                     B. Myeloperoxidase is essential for phagocytosis
     C. Cherry red colour of skin is seen CO poisoning             C. Breakdown of haeme is the only reaction in body
     D. All are true                                                  releasing carbon monoxide
 55. One molecule of haemoglobin is composed of:                   D. All are true
     A. Two haem plus two globin                               62. Spot the correct statement:
     B. Four haem plus two globin                                  A. Defect in enzymes of haeme synthesis process
     C. Four haem plus one globin                                     leads to porphyria
     D. Two haem plus one globin                                   B. In methaemoglobinemia iron of Hb is oxidised to
 56. Most carbon dioxide in blood is transported as:                  ferric form and does not carry oxygen
     A. Bicarbonate                                                C. Sickling causes increase in blood viscosity and
     B. Carbonic acid                                                 vascular occlusion
     C. Dissolved in blood                                         D. All are correct
     D. None of the above



 49 B   50 C   51 A    52 C   53 D   54 D    55 C      56 A
                                                                57 A   58 B   59 B    60 D     61 D     62 D
196 Review of Physiology                                                                      Practice Paper 2 197

 63. Thiocyanates inhibit thyroid function by affecting:       71. Spot the wrong statement:
     A. Organification                                             A. 80% of hormone secretion from thyroid is T 4
     B. Trapping                                                   B. Most metabolic effects of thyroid hormones is by
     C. Proteolysis of thyroglobulin                                  T3
     D. Synthesis mono and di-idotyrosine                          C. T3 has a slower onset of action
 64. In investigating a hypothyroid patient which of the           D. In primary hypothyroidism TSH is high
     following test is not essential:                          72. What is true about androgens:
     A. TSH                      B. T3, T4                         A. Formed in greater quantity in foetal life than in
     C. RIU                      D. Blood sugar                       childhood
     E. Serum cholesterol                                          B. Have anabolic effect
 65. Use of thyroxine in hypothyroid patient improves              C. Adult females also secrete some androgen
     which of the following:                                       D. All are true
     A. GI motility                                            73. Spot the wrong statement:
     B. BMR                                                        A. FSH is required for spermatogenesis
     C. Memory and fatigue                                         B. Testosterone helps in normal sperm development
     D. Cardiac force of contraction                               C. When in epididymis sperms are infertile
     E. All of the above                                           D. All are true
 66. Which fraction of serum calcium is highest:               74. What is true about semen ejaculation:
     A. Freely Ionised          B. Bound to albumin                A. Rhythmic contraction of pelvic floor muscles and
     C. Bound to phosphates D. Bound to globulin                      sphincters
 67. Effects of insulin on liver is all except:                    B. Aided by sympathetic discharge
     A. Synthesis of glycogen                                      C. Coicides with feeling of orgasm
     B. Increased glucose removal from blood                       D. All of the above
     C. Gluconeogenesis                                        75. What is true of undescended testis:
     D. Reduced glucose release into blood                         A. Does not interfere with fertility
 68. Insulin promotes cellular transport of:                       B. Should be treated by testosterone injection
     A. Magnesium                 B. Phosphate                     C. Prone for malignant change
      C. Potassium                D. All of the above              D. All of the above

 69. All the following hormones are secreted by adrenal        76. Development of secondary sexual characteristics
     cortex except:                                                before 8 years causes:
      A. Cortisol               B. Aldosterone                     A. Short stature
      C. Estriol                D. DHAE                            B. Associated with hypothalamic tumours
                                                                   C. Mostly constitutional
  70. Spot the correct statement:                                  D. All of the above
      A. Corticosteroids in excess cause hyperglycemia
      B. Corticosteroids inhibit insulin and promote           77. In the days following ovulation which of the
         gluconeogenesis                                           following occurs:
      C. Growth hormone level increases with hypogly-              A. Rise in body temperature
         cemia                                                     B. Rise in plasma progesterone
      D. All are correct                                           C. Fall in plasma LH
                                                                   D. Copious but less viscous cervical mucous
                                                                   E. All of the above

 63 B   64 D   65 E   66 A     67 C    68 D    69 C     70 D   71 C 72 D    73 D    74 D   75 C     76 D    77 E
198 Rewew of Physiology                                                                       Practice Paper 2 199

 78. All the following hormones are secreted by placenta       85. The maximum volume of air that can be forcefully
                                                                   breathed out after deep inspiration is:
     except:
                                                                   A. Tidal volume
      A. hCG                    B. HPL                             B. Vital capacity
      C. Progesterone           D. Oxytocin                        C. Functional residual capacity
      E. Estrogen                                                  D. None of the above
 79. Which of the following secretion is maximum
                                                               86. What is true about surfactant:
     during first trimester:                                       A. Increases lung compliance
      A. Estrogen                                                  B. Reduces surface tension of aveolar fluid
      B. Progesterone                                              C. Prevents collapse of alveoli
      C. hCG                                                       D. All of the above
      D. Oxytocin
                                                               87. Spot the false statement about normal lung:
  80. All the following are true of amniotic fluid except:         A. Physiological dead space is always more than
      A. Produced mainly by foetal kidneys                            anatomical dead space
      B. Actively swallowed by foetus                              B. Oxygen transfer in lungs is by passive diffusion
      C. Protein and electrolyte content same as of plasma         C. In upright position V:Q Increases from base to
      D. Is the fluid cushion for foetus                              apex
  81. In a lactating woman which of the following is               D. All are true
       correct:                                                88. Bronchoconstriction can be caused by all except:
       A. Oxytocin causes contraction of myoepithelial cells       A. Beta1 receptor stimulation
       B. Prolactin causes secretion of milk                       B. Beta2 receptor stimulation
       C. Suckling inhibits FSH and LH                             C. Inhalation of cold air
       D. All are correct                                          D. Decrease in PCO2 in bronchial air
   82. Identify the incorrect statement:                       89. Total lung capacity is:
       A. Estrogen controls endometrial proliferation              A. Inspiratory capacity plus residual volume
       B. Prolactin influences secretory phase                     B. Tidal volume plus residual volume
       C. Corpus luteum maintains pregnancy                        C. Vital capacity plus residual volume
       D. Degeneration of corpus luteum causes establish           D. None of the above
          ment of menstruation                                 90. What is true about residual lung volume:
   83. The respiratory quotient is:                                A. Is the air remaining in lung after full expiration
        A. Minute volume to tidal volume                           B. Amounts to 3-4 litre
        B. O2 consumption to CO 2 output per unit time             C. Decreases with age
        C. O2 consumption to minute volume                         D. All are false
        D. Volume of CO2 generation to O2 absorbed per unit     91. The work of breathing is:
           time                                                     A. Decreased in recumbency
    84. Spirometer can measure all the following except:            B. Inversely related to lung compliance
        A. Tidal volume                                             C. Constant during exercise
        B. Vital capacity                                           D. All of the above
        C. Expiratory reserve volume
        D. Functional residual capacity


                                                                85 D   86 D    87 D    88 B     89 C      90 A       91 A
    78 D 79 C    80 C     81 D   82 B    83 D    84 D
200 Review of Physiology                                                               Practice Paper 2 201

 92. What will happen to respiration if both the vagus    99. Gastric emptying is promoted by:
     nerves are severed:                                      A. Hyperosmolarity of duodenal chyme
     A. Increase               B. Decrease                    B. Presence of protein in the duodenum
     C. No change              D. Complete cessation          C. Distention of duodenum
                                                              D. Decreased secretion of cholecystokinin
 93. Which of the following has maximum regulatory
     function on respiration:                            100. What is true of renin:
     A. O2                    B. CO2_                         A. Secreted by JGA
     C. pH                    D. HCO3                         B. Lowers blood pressure
                                                              C. Favours excretion of salt
 94. Hering-Breuer reflex leads to:                           D. All are false
     A. Increased respiratory rate
     B. Increase in tidal volume
     C. Prolonged duration of respiration
     D. All of the above
 95. What happens when blood passes through the
     capillaries:
     A. pH rises
     B. O2 dissociation curve shifts to left
     C. Carbonate ions pass from RBC to plasma
     D. Chloride concentration in RBC falls
     E. All of the above
 96. A shift to right in Hb oxygen dissociation curve
     occurs in the following except:
     A. Fever
     B. Rise in PCO2
     C. Fall in pH
     D. In pulmonary capillaries
 97. What happens to pulmonary function parameters in
     chronic obstructive lung disease:
     A. Rise in residual volume
     B. Reduced PEFR
     C. Unchanged diffusion
     D. All of the above
 98. Restrictive lung disease is differentiated from
     obstructive lung disease by:
     A. Unchanged ratio of VC to FEV1
     B. Vital capacity
     C. Residual volume
     D. None of the above




 92 B 93 B    94 A    95 C   96 0    97 D     98 A       99 D 100 A
                                                                                         Practice Paper 3 203

                                                          8. Which of the following statement is incorrect about
             Practice Paper 3                                ileocaecal sphincter:
                                                             A. Normally closed
                                                             B. Controlled in part by myenteric plexus in caecum
                                                             C. Removal leads to large reflux of stool into
1. A patient after gastrectomy usually develops:                 smallgut
   A. Megaloblastic anaemia                                  D. Frequency of opening increases in response to
   B. Iron deficiency anaemia                                    stomach distension
   C. Dimorphic anaemia
   D. None of the above                                   9. What is true of defaecation reflex:
                                                             A. Facilitated by entry of food into stomach
2. What is not true of gastrin:                              B. Absent when lumbar cord is destroyed
   A. Stimulates HC1 secretion                               C. Diminished when abdominal rectus muscles are
   B. Weakly stimulates gallbladder contraction                 paralysed
   C. Decreases antral motility                              D. All of the above
   D. Increases LES pressure
                                                         10. Spot the wrong statement:
3. Functions of secretin include:                            A. Removal of half of pancreas does not impair
   A. Reduced gastric motility                                  exocrine function
   B. Increased mucus output from Brunner's gland            B. Chylomicron from intestine preferentially enters
   C. Stimulates pancreatic exocrine secretion                  lymphatics
   D. All of the above                                       C. In only terminal ileum B12 is absorbed
4. Function of cholecystokinin-pancreozymin is:              D. Segmental movements of intestine is independent
   A. Enhanced small bowel motility                             of neurons
   B. Enhanced pancreatic enzyme secretion               11. Spot the wrong statement:
   C. Slow gastric emptying                                  A. Liver and brain are the two organs producing urea
   D. All of the above                                       B. All essential fatty acids are polyunsaturated
5. Which of the following is not present in pancreatic       C. Testosterone causes positive nitrogen balance
                                                             D. Copper deficiency can cause anaemia
   juice:
    A. Pepsin                                            12. Spot the correct statement:
    B. Trypsin                                               A. Thirst is produced by fall in blood volume
    C. Chymotrypsin                                          B. Thirst is abolished in hypothalamic lesions
    D. Carboxypeptidase                                      C. Increase in body fat decreases percentage of body
                                                                water
6. Bile salt is absorbed in:
                                                             D. All are true
   A. Duodenum
   B. Jejunum                                            13. Light with longest wave length is:
   C. Terminal ileum                                         A. Violet                 B. Blue
   D. Colon                                                  C. Green                  D. Red
 7. Which of the following statements is incorrect:      14. Light with the greatest frequency is:
    A. Gallbladder capacity in 50 ml                         A. Violet
    B. Concentration of bile occurs in GB                    B. Blue
    C. All the bile from hepatic duct enters GB              C. Yellow
    D. All are true                                          D. Red

 1 C    2C     3D      4D      5A    6C      7C          8C    9A    10 C    11 B    12 D     13 D    14 A
                                                                                           Practice Paper 3 205
204 Review of Physiology
                                                            22. In the fovea centralis:
 15. Most of the refraction that occurs in the eye is at:       A. Only rods are present
     A. Anterior surface of cornea                              B. No amacrine cells
     B. Posterior surface of cornea                             C. 1:1 connection between receptors, bipolar cells and
     C. Anterior surface of lens                                    ganglion cells
     D. Posterior surface of lens                               D. All are false
 16. During accommodation which of the following            23. What is true about colour blindness:
     occurs:                                                    A. Is more common in women than men
     A. Ciliary muscles relax                                   B. Is due to defective cone function
     B. Amount of light entering increases                      C. Is an acquired disorder
     C. Field of vision decreases                               D. Is associated with total blindness
     D. Spherical aberration increases
                                                            24. The hair cells of semicircular canals are stimulated
 17. What is true about rods in retina:                         by:
     A. More dense in the fovea                                 A. Movement of perilymph
     B. Are rendered insensitive by bright light                B. Linear acceleration
     C. More numerous in night shift workers                    C. Changes in gravitational pull
     D. None is true                                            D. Cessation of rotation
 18. What is true about rhodopsin:                          25. Spot the correct statement about endolymph:
     A. A purple pigment                                        A. Lies in bony labyrinth
     B. Most sensitive to violet light                          B. Bathes the organ of corti and cupulae
     C. Absent in people who are blind                          C. Has sodium and potassium concentration resemb
     D. Regenerated when eyes are closed                           ling intracellular fluid
 19. Which of the following statement is correct:               D. None is true
     A. Atropine causes mydriasis                           26. The organ of corti is on the:
     B. Brain ischaemia produces mydriasis                      A. Tectorial membrane
     C. Morphine causes miosis                                  B. Basilar membrane
     D. Miosis occurs in organophosphorus poisoning             C. Reissner's membrane
     E. All of the above                                        D. None of the above
 20. What is true about fovea:                              27. The stria vascularis plays a major role in:
     A. Lies on nasal side of optic disk                        A. Production of perilymph
     B. Relatively thick part of retina                         B. Resorption of perilymph
     C. Highly vascular                                         C. Maintaining the ionic milieu in the endolymph
     D. All are false                                           D. None of the above
 21. The cones in the retina are:                           28. Semicircular canal is stimulated by:
     A. Responsible for colour vision                           A. Linear acceleration
     B. More light sensitive than the rods                      B. Rotational acceleration
     C. In vit A deficiency affected more than rods             C. Oscillation of stapes
     D. All are true                                            D. None of the above




                                                            22 C 23 B     24 D    25 B    26 A     27 C    28 B
15 A   16 C    17 B    18 D    19 E     20 D     21 A
206 Review of Physiology                                                                      Practice Paper 3 207

 29. The utricle in the inner ear:                             36. What is true of saltatory conduction:
     A. Is a gravity receptor                                      A. Occurs only in myelinated nerve fibres
     B. Contains calcified granules                                B. Conduction velocity is proportional to the
     C. Communicates with semicircular canals and                     diameter of nerve fibre
        cochlea                                                    C. Nerve impulse jumps from node to node
     D. All are true                                               D. All of the above
 30. Which of the following sensations has no relay in         37. Non-myelinated fibres differ from myelinated
     thalamus:                                                     fibres in that they:
     A. Touch                                                      A. Have higher conduction velocity
     B. Smell                                                      B. Are more excitable
     C. Taste                                                      C. Lack nodes of Ranvier
     D. Taste and smell                                            D. Are not capable of regeneration
 31. Which of the following generates thirst:                  38. Conduction velocity in a myelinated fibre is directly
     A. Increased tonicity of intracellular fluid                  related to:
     B. Increased tonicity of extracellular fluid                  A. Length of fibre
     C. Increase in cell size                                      B. Diameter of fibre
     D. All of the above                                           C. Length of dendrite
                                                                   D. All of the above
 32. Which receptors sense water deficiency:
     A. Baroreceptors          B. Chemoreceptors               39. What is true of action potential:
     C. Osmoreceptors          D. Stretch receptors                A. Initiated by a reduction in membrane potential to
 33. Spot the wrong statement:                                        a critical value
     A. In auditory hair cells deflection of stereocilia           B. Is due to increased ionic permeability of the
        towards the basal body causes depolarisation                  membrane
     B. Deflection of stereocilia away from basal body             C. Is associated with a reduction in the electrical
        hyperpolarises the cells                                      resistance of the membrane
     C. These are three inner rows of hair cells and one           D. All of the above
        outer layer                                            40. What will happen if axon of a motor neurone is
     D. There is a continuous low level firing in hair cells       stimulated with supermaximal stimulus:
 34. Spot the wrong statement:                                     A. Action potential generation throughout the course
     A. Utricle and saccule detect head position and linear            of motor neuron
        acceleration                                               B. Action potential generation in the axon only
     B. Opsins confer wavelength specificity to the                C. Action potential in axon and cell body
        photopigment                                               D. None of the above
     C. Cones mediate scotopic and rods photopic vision        41. Plasma clearance is maximum for:
     D. The cone density in fovea is highest                       A. Sodium                 B. Calcium
 35. What is true of a skeletal muscle cell:                       C. Magnesium              D. Phosphorus
     A. Obeys all or none phenomenon                           42. Plasma clearance is lowest for:
     B. Sarcoplasm is the store of calcium                         A. Glucose
     C. Has negative resting potential                             B. Urea
     D. All are true                                               C. Insulin
                                                                   D. Uric acid

29 D 30 D 31 A        32 C    33 C    34 C     35 D            36 D 37 C    38 B    39 D    40 B     41 A     42 D
208 Review of Physiology                                                                          Practice Paper 3 209

 43. Which of the following statements is incorrect:           50. Fat synthesis is promoted by:
     A. Glomerular filtrate in Bowman's capsule is                 A. Insulin                 B. Thyroxine
        isotonic with plasma                                       C. Growth hormone          D. Adrenaline
     B. Fluid in tip of loop of Henle is hypotonic with
                                                               51. Best stimulus for cholecystokinin-P ancreozymin
        respect to that in Bowman's capsule
                                                                   secretion is:
     C. ADH causes fluid in the collecting duct to be
                                                                   A. Protein                B. Fat
        hypertonic in comparison to glomerular filtrate
                                                                   C. Carbohydrate           D. Vagal stimulation
     D. Fluid in proximal convoluted tubule is hypertonic
        with respect to plasma                                 52. Swallowing centre is present in:
                                                                   A. Midbrain               B. Pons
 44. As fluid passes down the proximal convoluted
                                                                   C. Spinal cord            D. Medulla
     tubule:
     A. Sodium level rises                                     53. Which of the following is absorbed in proximal
     B. Urea concentration falls                                   intestine:
     C. Flow velocity falls                                        A. Electrolyte           B. Iron
     D. All of the above                                           C. Bile salt             D. Vit B12
 45. What is true of potassium:                                54. Most potent respiratory stimulant is:
     A. Is absorbed in proximal convoluted tubule                  A. O2                       B. CO2
     B. Transport is blocked by aldosterone                        C. pH                       D. Bicarbonate
     C. Actively secreted into tubular fluid                   55. Chymotrypsinogen       is activated into chymotrypsin
     D. None of the above
                                                                   by:
 46. A patient taking carbonic anhydrase inhibitor is              A. Gastric acid                B. Bile salt
     likely to show:                                               C. Trypsin                     D. Fatty acid
     A. Increase in urine volume
     B. Increase KT loss in urine                              56. Daily salvia secretion is:
     C. Fall in plasma bicarbonate                                 A. 1 litre                     B. 1.5 litre
     D. All of the above                                           C. 2 litre                     D. 3 litre

 47. Spot the correct statement:                               57. The "Paneth cells" in large intestine:
     A. Collecting ducts modify composition of urine               A. Produce pepsin
     B. Insulin is neither secreted nor reabsorbed                 B. Multinucleated
     C. ADH increases water permeability in distal                 C. Present in glands of Liberkuhn
        convoluted tubule                                          D. Basophillc cytoplasm
     D. All are correct                                        58. Gastric activity is enhanced by:
 48. Secretin secretion is stimulated by:                          A. Fat                      B. Protein
     A. Acidic chyme in duodenum                                   C. Carbohydrate             D. Minerals
     B. Fatty acid                                             59. Pepsinogen is activated by:
     C. Protein                                                    A. Chymotrypsin             B. Trypsin
     D. Vagal stimulation                                          C. Gastric acidity          D. Bile salts
 49. Effect of secretin on secretion of pancreatic juice is:   60. Normal basal gastric acid output is:
     A. Increased enzyme         B. Increased bicarbonates         A. 2-3 mmol/hr             B. 5-10 mmol/hr
     C. Increased chloride         D. All of the above             C. 15-20 mmol/hr           D. 20-25 mmol/hr

                                                               50 A 51 B    52 D   53 B    54 B      55 C    56 B   57 C 58 B
43 D 44 C     45 B   46 D    47 D     48 A     49 B            59 C 60 B
210 Review of Physiology                                                                              Practice Paper 3 211

61. Gastric acid secretion is inhibited by:                       72. Melatonin is secreted by:
    A. Vagus activity            B. Somatostatin                      A. Pituitary              B. Hypothalamus
    C. Gastrin                   D. High pH                           C. Pineal gland           D. Melanocytes
62. Satiety centre in hypothalamus is regulated by:               73. DNA double helix is bound by:
    A. Gastric dilatation       B. Blood glucose level                A. Covalent bond        B. Disulphide
    C. Blood insulin level     D. All of the above                    C. Hydrogen bond        D. All of the above

63. Pancreatic polypeptide is secreted by:                        74. Antiperistalsis is commonly seen in:
    A. Alpha cells               B. Beta cells                        A. Duodenum                B. Jejunum
    C. Delta cells               D. F cells                           C. Colon                   D. Rectum

64. Daily fluid loss in stool is:                                 75. Macrophages are the mature form of:
    A. 200 ml                    B. 500 ml                            A. Neutrophils            B. Monocytes
    C. 700 ml                    D. 1000 ml                           C. Lymphocytes            D. Plasma cells
                                                                  76. Antegrade amnesia is caused by lesion of:
65. Highest concentration of serotonin is in:
                                                                      A. Hypothalamus           B. Hippocampus
    A. Intestinal               B. Brain
                                                                      C. Cerebellum             D. Midbrain
    C. Platelet                 D. Liver
                                                                  77. The maximum resistance to blood flow is in:
66. Thromboxane A2 is principally produced by:
                                                                      A. Arteries              B. Arteriole
    A. Liver                  B. Endothelium
    C. Platelet               D. RBC                                  C. Venule                D. Capillaries

67. Somatostatin inhibits secretion of all except:                78. The iron transporting protein is:
    A. Insulin                  B. Prolactin                          A. Apoferritin              B. Ferritin
    C. TSH                      D. Growth hormone                     C. Transferrin              D. Haemosiderin

68. Anreppe effect is:                                            79. Defect in haemophilia is in:
    A. Increased ventricular contractility with increased             A. Extrinsic pathway of clotting
       after load                                                     B. Intrinsic pathway of clotting
    B. Increased contractility with increased preload                 C. In the complement cascade
    C. Increased contractility with expanded blood                    D. All of the above
       volume                                                     80. Which of the following about baroreceptor is false:
    D. None of the above                                              A. Present in aortic arch and carotid sinus
69. ']' receptor is present in:                                       B. From these afferent pass to medulla
    A. Brain                      B. Bronchiole                       C. Impulses then generate to inhibit vagal supply to
    C. Carotid body               D. Liver                               heart
                                                                      D. Responds to both sustained pressure and pulse
70. Largest amount of systemic blood is pooled in:                       pressure
    A. Arteries               B. Pulmonary veins
    C. Capillary bed          D. Large veins                      81. Osmoreceptors are present in:
                                                                      A. Hypothalamus
71. Biological membranes contain all except:                          B. Left atrium
    A. Protein receptors    B. Cholesterol                            C. JG cells of kidney
    C. Cytochrome D450      D. Fatty acid esters                      D. Aortic arch


                                                                  72 C 73 B   74 C   75 B   76 B       77 B     78 C   79 B 80
61 B 62 B 63 D      64 A   65 C   66 C   67 B    68 A 69 B 70 C   C 81 A
71 C
212 Review of Physiology                                                                                     Practice Paper 3 213

 82. All the following are superficial reflexes except:
                                                                   9I. Circadian rhythm is controlled by:
     A. Ankle reflex            B. Babinski
                                                                       A. Arcuate nucleus
                                                                       B. Paraventricular nucleus
     C. Corneal                 D. Abdominal
                                                                       C. Suprachiasmatic nucleus
 83. For measuring GFR, the ideal substance should be                  D. Supraoptic nucleus
     all except:                                                   92. O2 saturation of systemic venous blood is:
     A. Should not be reabsorbed or secreted                           A. 90%                     B. 82%
     B. Should not be metabolised                                      C. 72%                     D. 50%
     C. Should be highly protein bound
     D. Easy to measure                                            93. Administration of oxygen will improve hypoxia in
                                                                       all except;
 84. CVP is decreased in all except:
     A. Increased cardiac output
                                                                        A. Right to left shunt B. Pneumonitis C.
     B. Decreased blood volume
                                                                        Bronchoconstriction D. Poliomyelitis
     C. Decreased contractility                                     94. Citrate is anticoagulant because it depletes:
     D. Increased venous compliance                                     A. Vit K                    B. Prothrombin
                                                                        C. Ca++                     D. All of the above
 85. Exchangeable sodium is:
     A. 10%                      B. 40%                             95. Hb combines with O 2 by:
     C. 70%                      D. 90%                                 A. Covalent bond         B. Coordinate bond
 86. The pitch of average male voice during conversation                C. Disulphide bond       D. Hydrogen bond
     is:                                                             96. Hormone activated in lung is:
     A. 120 Hz                  B. 600 Hz                                 A. Angiotensin I          B. Renin
     C. 1200 Hz                 D. 1500 Hz                                C. Vasopressin            D. None of the above
 87. Under basal conditions caloric need of heart is met             97. Cephalic phase of gastric secretion is mediated by:
     by:                                                                  A. Vagus
     A. Fat                     B. Protein                                B. Sympathetic
     C. Carbohydrate            D. Ketones                                C. Gastrin
                                                                          D. Hypothalamic hormones
 88. Function of nuclear bag fibre is:
     A. Maintain muscle length                                        98. In venous blood CO2 is in form of:
     B. Relaxation of antagonistic muscles                                A. Carbonic acid           B. Bicarbonate
     C. Relaxation in response to strong stretch                          C. Free CO 2               D. Carbonate
     D. None of the above                                             99. Chloride shift during CO2 transport is seen in:
                                                                          A. Lungs                   B. Kidneys
 89. Platelet adhesion is dependent upon all except:                       C. RBC                    D. Muscle
     A. Ca++                    B. ADP
     C. Collagen                D. Stasis of blood                   100. The decrease in oxygen affinity of Hb in acidic pH is
                                                                          called:
 90. Cyanosis is seen when methaemoglobin concentra
     tion exceeds:
                                                                          A. Brain bridge reflex
      A. 1 gm%                                                            B. Axon reflex
      B. 1.5 gm%                                                          C. Bohr effect
      C. 2.5 gm%                                                          D. None of the above
      D. 5 gm%
                                                                      91 C 92 C               93 A   94 C 95 B    96 A    97 A    98 A 99
 82 A 83 C 84 C 85 C 86 A 87 A 88 A 89 D                              C 100 C
 90 B

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