Physiology

1. Which of the following can bring about lysis of antibody coated cells when activated? A. immunogen C. immunoglobulin B. hapten D. complement system 2. Which of the following, when present, would indicate that the T cell is an intermediate thymocyte? A. CD 2 B. CD 1 C. CD 38 D. CD 7 3. Which of the following, when present, would indicate that the B cell is mature? A. CD 19 B. CD 25 C. Surface Ig D D. Surface Ig M 4. Which of the following steps in the immune response immediately precedes clonal proliferation of T helper cells? A. Secretion of interleukin 2 by T helper cell B. Secretion of interleukin 1 by macrophage C. Release of interleukin 2 and other cytokines by T helper cell D. Macrophage presents processed antigen to a T helper cell 5. Which of the following is the end point of a cell-mediated immune response? A. activation of NK cells C. death of target cells B. production of antibodies D. production of memory T cells 6. Which of the following best explains why an individual does not develop an immune response in spite of prior exposure to a foreign antigen? A. prozone phenomenon C. regulation by antigen B. postzone phenomenon D. development of tolerance 7. Which of the following best explains why an individual usually does not develop an immune response to foreign antigens present in the food that he eats and in the air that he breathes? Activity of: A. Ig M B. Ig A C. Ig G D. Ig D 8. Chemically, the RBC agglutinogens of the ABO system are: A. glycolipids B. lipoproteins C. glycoproteins D. lipopolysaccharides 9. Which of the following is directly responsible for development of ABO agglutinogens in the body fluids? A. Se gene B. H gene C. Z gene D. O gene 10. The most common Rh phenotype among Filipinos is: A. cDe B. cDE C. CDe D. CDE 11. Which of the following blood groups can be detected in the protein phase of cross-matching? A. Anti-K B. Anti-Jka C. Anti-U D. Anti-Lea 12. Which of the following best explains why parents who are rR 1 and r’R0 respectively, cannot have a child who is CcdEe? The child: A. has a factor present in only one of the parents B. has a factor absent in both parents C. lacks both factors present in one parent D. lacks a factor present in one parent

13. Which of the following best explains why HDN due to ABO incompatibility is less severe among Filipinos? A. Majority of Filipinos are type O B. Antibodies are not yet fully developed C. ABH agglutinins are present in the body fluids D. Many Filipinos practice birth spacing 14. In patients diagnosed with hemophilia B, activation of which clotting factor is directly impaired? A. VIII B. IX C. X D. XI 15. Which blood component is primarily involved in primary hemostasis? A. RBCs B. WBCs C. clotting factors D. platelets 16. Which of the following is true about plasminogen? A. Synthesized, stored and transported in eosinophils B. Activated by a substance found in the endothelium C. Activates the extrinsic pathway of the coagulation system D. Directly cleaves fibrinogen and fibrin to form degradation products 17. Which of these is most necessary in order for platelet adhesion to occur? A. Release of serotonin C. Platelet activation B. Collagen exposure D. vWf binding to GPIb/IX/V 18. Deficiency of which vitamin K-dependent clotting factor will manifest with abnormal prothrombin time? A. II B. VII C. IX D. X 19. In a physiology laboratory exercise, Paul was asked to perform the tourniquet test on Samuel whose blood pressure at that time was 140/70mmHg. She then inflated the blood pressure cuff to ___mmHg and maintained this pressure for 5 minutes. A. 95 B. 100 C. 105 D. 110 20. Which of these statements best supports the idea that secondary hemostasis is a connected diagram? A. Factor X activation occurs either by the intrinsic or extrinsic pathway. B. Coagulation depends largely on the extrinsic pathway. C. Thrombin is capable of activating factor XII. D. Factor IXa can activate factor VII. 21. Which of the following is normally equal to atmospheric pressure at rest? A. intrathoracic pressure C. transthoracic pressure B. intrapulmonic pressure D. transpulmonary pressure 22. Which of the following is directly responsible for entrance of air into the alveoli during inspiration? A. intrathoracic pressure C. transthoracic pressure B. intrapulmonic pressure D. transpulmonary pressure 23. Which of the following muscles involved in forced respiration stabilizes the lower attachments of the diaphragm? A. rectus abdominis C. external oblique B. transverses abdominis D. quadratus lumborum

24. The maximum amount of air that can be exhaled after the deepest inhalation is called: A. tidal volume C. vital capacity B. inspiratory reserve volume D. inspiratory capacity 25. Which of the following represents the amount of fresh air that enter the alveoli during normal quiet inspiration of a healthy adult male weighing 70 kg?? A. 150-175 ml C. 500-600 ml B. 350-450 ml D. 600-800 ml 26. Which of the following can measure minimal air? A. Closed circuit method C. body plethysmography B. Open circuit method D. buoyancy test 27. Which of the following serves as the most sensitive indicator of diffuse obstructive bronchopulmonary disease? A. maximal voluntary ventilation C. forced expiratory volume B. maximal breathing capacity D. timed vital capacity 28. Which of the following gas laws is implicated in gas diffusion in general? A. Boyle’s law C. Dalton’s law B. Charles’ law D. Henry’s law 29. Which of the following gas laws allows continuous diffusion of oxygen from the pulmonary alveolus to the pulmonary capillary? A. Boyle’s law C. Dalton’s law B. Charles’ law D. Henry’s law 30. Which of the following shifts the oxyhemoglobin dissociation curve to the right because it strengthens the salt bridges of the hemoglobin molecule? A. hydrogen ions C. 2,3 diphosphoglycerate B. carbon dioxide D. carbon monoxide 31. Central chemoreceptors are most sensitive to which of the following? A. a decrease in P O2 C. a lowering of pH B. an increase in P CO2 D. drugs in the circulation 32. Which of the following shifts the oxyhemoglobin dissociation curve to the right by stabilizing the deoxy configuration of hemoglobin? A. blood pH C. 2,3 diphosphoglycerate B. blood temperature D. carbon dioxide 33. Maximal brief inspiratory efforts with long periods of exhalation, associated with brain stem lesions is called: A. Cheyne-Stokes respiration C. Kussmaul respiration B. Biot’s respiration D. gasping 34. Stimulation of motor neurons that supply the upper airways is a function of which of the following? A. dorsal respiratory group C. intermediate ventral respiratory group B. rostral ventral respiratory group D. caudal ventral respiratory group 35. Which of the following is associated with the sigh response? A. Hering-Breuer inflation reflex C. carotico-aortic sinus reflex B. Hering-Breuer deflation reflex D. carotico-aortic body reflex

36. During systole the A-V valves are prevented from eversion by the contraction of the: A. Ventricular muscles C. chordae tendinae B. Papillary muscles D. papillary muscles & chordae tendinae 37. Which of the following associations between the phases of the fast response action potential (FRAP) and their primary causes is correct? A. phase 0 – rapid and large Ca++ inward current via fast channels B. phase 1 – closure of Ca++ gates and hence decreased Ca++ entry C. phase 2 – slow and sustained Ca++ current via Ca++ L channels D. phase 3 – rapid outward Ca++ current via fast Ca++ channels 38. This is true of SRAP. A. depolarization is primarily due to inward Ca++ current via L channels B. repolarization is primarily due to Ca++ efflux C. phases 1, 2 and 3 are well demarcated D. exhibited by atrial and ventricular cells 39. The rate of impulse conduction is fastest in the: A. atrial muscles C. Bundle of His B. AV node D. Terminal Purkinje network 40. According to Boron the pacemaker potential is due to these ionic currents: A. Inward “funny” current, inward Ca++ current & outward K+ current B. Inward “funny” current, inward Ca++ current, & inward K+ current C. Inward “funny” current, inward K+ current, & outward Ca++ current D. Inward “funny” current, outward Ca++ current, & outward K+ current 41. According to Guyton automaticity of nodal cells is primarily due to: A. opening of the calcium T channels B. inherent leakiness of P cells to Na+ ions C. opening of the calcium-sodium channels D. time-dependent decline in K+ efflux 42. In the presence of complete right bundle branch block which of the following would occur? A. impulse is not conducted to the right ventricle B. delayed closure of the aortic valve C. splitting of the first and second heart sounds D. first heart sound is due only to closure of the mitral valve 43. Ms Hart is suspected of having diseased papillary muscles of the left ventricle. If this is true, which of the following would result? A. systolic murmur C. systolic and diastolic murmur B. aortic regurgitation D. increased stroke volume of left ventricle 44. Which of these events occur during cardiac diastole? A. Closure of semilunar valves C. occurrence of S1 B. Increasing ventricular pressure D. atrial contraction 45. The patient of Dr Riza is suffering from right ventricular hypertrophy (RVH) secondary to pulmonary stenosis. Because of the RVH the mean QRS vector will most likely be directed: A. Anteriorly, inferiorly, & rightward C. anteriorly, superiorly & rightward B. Posteriotly, inferiorly & rightward D. posteriorly, superiorly & rightward

46. Which of these characteristics is true of both the isovolumetric contraction phase and the isovolumetric relaxation phase of the cardiac cycle? A. Aortic & pulmonary valves are open B. Both ventricles are full of blood C. Left & right atrial pressures are greater than respective ventricular pressures D. Aortic & pulmonary pressures are greater than respective ventricular pressures 47. If there are 2.5 small squares from the onset of the Q wave to the termination of the S wave, then the QRS interval is _____ second. A. 0.05 B. 0.5 C. 0.1 D. 1.0 48. Pedro wanted to estimate the mean electrical axis (MEA) of a patient. He counted the following: In lead I: the R wave occupied 7 small boxes; q wave 1 box and s wave 2 boxes. In lead aVF: the R wave occupied 5 small boxes; no q nor s waves. Based on these data, Pedro concluded that the MEA of the patient is: A. (+) 30 degrees C. (+) 45 degrees B. (-) 30 degrees D. (-) 45 degrees 49-50. Given the following QRS vectors: Initial – at (-) 10 degrees; Mean – at (+) 70 degrees; and terminal – at (+) 100 degrees. 49. In which of these leads will you find only an R wave; no Q nor S waves? A. Lead I B. Lead II C. aVL D. aVR 50. In which of these leads will an R wave be absent? A. Lead I B. Lead II C. aVL D. aVR 51. The following are the laboratory results of Dr Jobelle’s patient who was suspected of having diabetic acidosis. Which of these results will show that her acidosis is not compensated? A. pH = 7.32 C. PCO2 = 42 mmHg B. HCO3- = 16.1 D. BE = (-) 8.1 52. As a result of pure buffer response to a primary loss of CO2, which of the following parameters will be increased at the new equilibrium? A. HCO3 B. Buf C. HBuf D . BB 53. Body responses to the acid-base disturbance secondary to excessive injestion of NAHCO3 tablets include: A. acidification of urine B. renal secretion of acid C. increased respiratory rate D. buffering by the non-bicarbonate buffer system only 54. Buffering of secreted H+ in the renal tubules by these buffers results in formation of new HCO3-. A. HPO4= and NH3+ C. HPO4= and HCO3B. + NH3 and HCO3 D. NH3+, HPO4=, and HCO3-

55. After doing a history and physical examination on Juan, Dr Cess suspected him of also suffering from an acid-base disturbance. She ordered the following laboratory tests and these are the results: pH = 7.26; PCO2 = 78.1mmHg; HCO3 = 34meq/liter; BE = (+)7.2meq/liter. Based on these results, Dr Cess concluded that the most likely acid-base disturbance of Juan is: A. Uncompensated metabolic acidosis B. Uncompensated respiratory acidosis C. Partially compensated metabolic acidosis D. Partially compensated respiratory acidosis 56. Which of the following blood vessels is capable of converting pulsatile inflow into a smooth outflow? A. aorta B. arteriole C. capillary D. vein 57. Which of the following blood vessels would require deformation of red cells before flow can occur? A. artery B. arteriole C. capillary D. venule 58. This pressure is the most important factor to consider in keeping a blood vessel open: A. osmotic pressure C. driving pressure B. transmural pressure D. hydrostatic pressure 59. The mass movement of a given volume of fluid per unit time in a given blood vessel is directly proportional to which of the following? A. square of the radius C. length of the blood vessel B. viscosity of the fluid D. driving pressure 60. Which of the following best explains why venous hematocrit value is greater than capillary hematocrit value? A. Shear thinning C. Fahreus-Lindqvist phenomenon B. Plasma skimming D. Bernouilli principle 61. The pulmonary circulation follows which of the following? A. Law of Laplace C. Fahreus-Lindqvist phenomenon B. Bernouilli principle D. Continuity principle 62. An individual with a blood pressure of 110/80 will have a mean pressure of: A. 30 mm Hg B. 40 mm Hg C. 50 mm Hg D. 60 mm Hg 63. Which of the following indirect methods of blood pressure determination measures mean pressure? A. direct method C. auscultatory method B. palpatory method D. flush method 64. In a given blood vessel, as velocity flow increases, lateral pressure decreases. This is in accordance with which of the following? A. Bernouilli principle C. Starling-Landis concept B. Continuity principle D. Law of Laplace 65. In a given blood vessel, as radius increases, wall tension increases. This is in accordance with which of the following? A. Bernouilli principle C. Frank-Starling relation B. Continuity principle D. Law of Laplace

66. Central venous pressure is mainly influenced by which of the following? A. pressure in the right atrium C. venomotor tone B. cardiac contraction D. venous valves 67. Which of the following is most likely to be influenced by venomotor tone? A. vis a tergo C. vis a latere B. vis a fronte D. mean circulatory pressure 68. Which of the following is the most important factor influencing venous return? A. mean circulatory pressure C. skeletal muscle pump B. venomotor tone D. respiratory pump 69. After standing at attention for quite some time, an air force cadet suddenly fainted. Which of the following might have prevented her from fainting? A. decreasing her heart rate C. having her hold her breath B. dilating systemic arterioles D. taking one step forward 70. Which of the following conditions would be characterized by an increase in arterial pressure associated with a decrease in peripheral resistance? A. increased hematocrit C. vasoconstriction B. increased cardiac output D. turbulence in blood flow 71. Which of the following is the most likely mechanism involved in the transport of very large macromolecules across capillaries? A. diffusion through the lipid membrane C. transcytosis B. diffusion through the pores D. convection 72. Decrease in stretch of the renal afferent arteriole will directly lead to which of the following? A. decrease in renal vascular resistance C. release of ADH B. increase in glomerular filtration rate D. release of renin 73. Which of the following is most likely responsible for increased flow to a tissue following removal of an occluding force A. active hyperemia C. vasodilator theory B. reactive hyperemia D. nutrient lack theory 74. Which of the following is most likely to be responsible for local slowing of blood flow? A. decreased blood pressure C. release of vasodilator metabolites B. decreased perfusion pressure D. increased tissue pressure 75. Which of the following can increase total systemic peripheral resistance? hypertension C. change from supine to standing position A. strenuous exercise D. increase in P CO2 B. 76. Which of the following can result in long-term blood pressure control? A. Passive stretch of vascular smooth muscle B. Release of biogenic amines C. Prolonged increase in tissue metabolism D. Increase in hydrogen ion concentration 77. Which of the following will serve to stimulate the epi-myocardial receptors? A. rise in venous pressure C. rise in left ventricle pressure B. drugs in the coronary circulation D. fall in BP following hemorrhage

78. A 70 kg mhealthy male lost 1 liter of whole blood over a period of 5 minutes, following an accident. Which of the following will most likely be present two minutes after the hemorrhage? A. Decrease in total systemic peripheral resistance B. A marked reduction in mean arterial pressure C. An increase in venomotor tone D. Release of renin by the macula densa 79. Which of the following serves as the stimulus to the McDowall reflex? A. rise in P CO2 C. rise in venous pressure B. inspiration D. fall in blood pressure 80. Which of the following is the expected result of activity of skeletal muscles? A. vasodilation in active areas C. hypotension and bradycardia B. tachycardia and rise in BP D. tachycardia and hypotension 81. Which of the following are the main neural modulators of the systemic circulation? A. Parasympathetic vasodilator fibers B. Histaminergic vasodilator fibers C. Sympathetic vasoconstrictor fibers D. Antidromic vasoconstrictor fibers 82. Which of the following paracrine vasoactive compounds is most likely to produce vasodilation? A. Epinephrine acting on alpha 1 receptors B. Serotonin acting on serotoninergic receptors C. Aldosterone acting on collecting duct D. Histamine acting on histamine 2 receptors 83. Which of the following can bring about contraction of vascular smooth muscles? A. calcium B. potassium C. magnesium D. hydrogen 84. Which of the following is most likely to occur upon stimulation of the rostral hypothalamus? A. vasodilation in skeletal muscles C. cutaneous vasodilation B. bradycardia and hypotension D. splanchnic vasoconstriction 85. Which of the following can bring about vasoconstriction? Stimulation of: A. Nucleus tractus solitarius projections B. Neurons in C 1 of the vasomotor area C. Neurons at the nucleus ambiguous D. The dorsal motor nucleus of the vagus 86. Which of these correctly describes the fetal circulation? A. Greater proportion of CCO leaves the placenta than the amount received by it. B. Blood through the umbilical artery is more oxygenated than that in umbilical vein. C. Greater proportion of CCO leaves the right ventricle than that in the left ventricle. D. Blood that exits the right ventricle is more oxygenated than that in the left ventricle. 87. Which of these occurs in the circulation at or immediately at birth? A. increased total peripheral resistance

B. increased pulmonary vascular resistance C. pressure in the right atrium is greater than that in the left atrium D. O2 saturation in the right atrium is greater than that in the left atrium 88. Which of these allows right-to-left shunting in the fetal circulation? A. conus arteriosus C. placenta B. ductus venosus D. foramen ovale 89. Which of these local metabolic factors, when decreased, will cause vasodilation? A. adenosine B. PCO2 C. PO2 D. hydrogen ions 90. Which of these is the major regulator of blood flow to the coronary circulation? A. Myogenic B. Metabolic C. Neural D. Endothelial influence 91. Which of these occurs in the coronary circulation during systole? Decreased: A. blood flow to left coronary artery C. aortic pressure B. blood flow to right coronary artery D. pulmonary artery pressure 92. Which of these factors, when decreased, increases the mean arterial pressure? A. cardiac output c. total peripheral resistance B. blood viscosity D. stroke volume 93. At rest, which circulation receives the greatest amount of oxygenated cardiac output? A. cerebral B. coronary C. renal D. pulmonary 94. The cerebral circulation is unique because: A. it is intolerant of ischemia B. blood flow is fairly constant at MAP of 60-120mmHg C. autoregulation is predominantly via neural mechanisms D. it is set in an enclosed compartment with limited volume capacity 95. Flushing is a manifestation of _______ blood flow through a ________vessel. A. rapid, dilated B. rapid, narrow C. slow, dilated D. slow, narrow 96. Abdominal cramping usually occurs when an individual immediately undergoes intense physical activity immediately after eating. Why is this so? During exercise, there is: A. decreased blood flow to the splanchnic circulation B. increased peristalsis of intestinal smooth muscles C. decreased constriction of resistance vessels D. increased parasympathetic activity 97. Which of these special circulations will least likely be regulated through metabolic mechanisms? A. Renal B. Coronary C. Splanchnic D. Cerebral For the next 3 items, match the special circulation on the right with the key phrases on the left. Options may be chosen once, more than once or not at all. 98. Hypoxic vasoconstriction 99. Arteriovenous anastomoses 100. Cushing reflex

A. Cerebral B. Coronary C. Cutaneous D. Pulmonary