TYPE A: Choose the ONE that is BEST in each case and darken the
1. Which of the following is TRUE about gas exchange during exercise?
a) The arterial blood oxygen content increases proportionately to the
b) The mixed venous blood oxygen content remains unchanged from
c) The mixed venous content decreases proportionately to the exercise
d) The arterial oxygen content decreases by maximum of 20% from rest
to maximal exercise.
e) The arterio-venous oxygen difference remains unchanged from rest to
2. Tetanus does not occur in heart muscle because of
a) a prolonged refractory period.*
b) the presence of gap junctions.
c) the arrangement of actin and myosin fibers.
d) the isovolumetric relaxation.
e) the sarcoplasmic reticulum. 3. Which of the following statements is CORRECT?
a) Vasopressin in synthesized in the pituitary gland.
b) Vasopressin secretion is stimulated by low plasma osmolarity.
c) If a person sweats a lot without drinking water or other hypotonic
fluid, vasopressin secretion is stimulated.*
d) Increased plasma volume stimulates vasopressin secretion.
e) Vasopressin is a steroid hormone.
4. If a person has congestive heart failure, which of the following is NOT
a) Increased extracellular fluid volume is often observed.
b) Plasma concentration of renin is usually low.*
c) Diuretics are often used to treat a person with congestive heart failure.
d) Total body sodium is usually increased.
e) None of the above statements is true
5. If the plasma concentration of substance X is 5 mEq/L, glomerular
filtration rate is 180 L
per day, and urine output is 2 L per day, filtered load of substance X is: a) 1800 mEq per day.
b) 900 mEq per day.*
c) 450 mEq per day.
d) 360 mEq per day.
e) None of the above.
6. Which of the following is NOT true in a healthy person?
a) Urinary excretion of glucose is smaller than filtered load.
b) Urinary excretion of sodium is smaller than filtered load.
c) When urinary excretion of substance Y is larger than filtered load, net
secretion of substance Y is happening.
d) When substance Z is secreted in the tubules, urinary excretion of
substance Z is always larger than filtered load.*
e) Glomerular filtration rate is much larger than urine output.
7. Regarding each nephron segment, which statement is NOT true?
a) Proximal tubule reabsorbs more than 50% of filtered load of sodium.
b) Proximal tubule reabsorbs more than 50% of filtered load of water.
c) Distal convoluted tubule and cortical collecting duct are the major
sites of potassium secretion. d) At the end of the distal convoluted tubule, nephrons touch their
e) Fine tuning of sodium reabsorption occurs mainly in distal convoluted
tubule and cortical collecting duct.
8. Regarding glomerular filtration, which of the following is TRUE?
a) Calcium ion is freely filtered.
b) Potassium concentration in glomerular filtrate (fluid in the Bowman’s
space) is about 10% of the plasma concentration.
c) Sodium is freely filtered.*
d) Concentration of albumin in glomerular filtrate (fluid in the
Bowman’s space) is similar to the plasma concentration.
e) Lipids (e.g. fatty acids) are usually freely filtered.
9. In response to alkalosis (low plasma concentration of H ),
a) kidneys secrete sufficient H to reabsorb all the filtered HCO . 3
b) urine becomes acidic.
c) less HCO is 3dded to the plasma by the kidneys.*
d) tubular glutamine metabolism and ammonium excretion are increased.
e) the amount of hydrogen irons bound with nonbicarbonate urinary
buffers (such as HPO ) in4reases. 10. Concerning potassium homeostasis, which of the following is NOT true?
a) High plasma concentration of potassium disturbs membrane potential
of excitable cells.
b) Potassium if freely filtered at glomerulus. It is reabsorbed, but not
secreted in the tubule.*
c) High plasma concentration of potassium stimulates aldosterone
d) Potassium distributed in the extracellular fluid is only 2% of the total
body potassium in a normal person.
e) None of the above statements is true.
11. Concerning renin-angiotensin system, which of the following is TRUE?
a) Angiotensinogen is generated by the kidneys.
b) Renin converts angiotensin I to angiotensin II.
c) Renin directly stimulates aldosterone secretion.
d) Increased sympathetic nerve activities stimulates renin secretion from
macula densa cells.
e) None of the above statements is true.*
12. If a person loses a large amount of extacellular fluid (e.g. bleeding),
which of the
following changes will occur? Renal Na reabsorption Renal water reabsorption Plasma aldosterone
a) Decreased Increased Increased
b) Increased Decreased Increased
c) Increased Increased Decreased
d) Increased Increased Increased *
e) Decreased Increased Decreased
13. Which of the following statements is NOT true?
a) Thick ascending limb of Henle’s loop is impermeable to water.
b) Descending limb of Henle’s loop is permeable to water.
c) Osmolarity in the renal medullary interstitium increases toward the
papilla (the part closest to the renal pelvis).
d) Descending limb of Henle’s loop is highly permeable to NaCl.*
e) Sodium reabsorpti+n +n thick ascending limb of Henle’s loop is
dependent on Na /K -ATPase activity.
14. The sympathetic innervation reaches the wall of the gastrointestinal tract
as a) preganglionic fibres, which synapse with inhibitory enteric neurons.
b) preganglionic fibres which release noradrenaline.
c) postganglionic fibres, which synapse directly with cells of the
longitudinal layer of muscle.
d) postganglionic fibres, which release a non-adrenergic-non-
cholinergic (NANC) neurotransmitter.
e) postganglionic fibres which exert an inhibitory effect on both
excitatory and inhibitory enteric neurons.*
15. The intactness of the enteric innervation (ENS) of the gastrointestinal
tract is essential
a) closure of the UES.
b) closure of the LES.
c) relaxation of the LES.*
d) relaxation of the pyloric sphincter.
e) ALL of the above statements are correct.
16. Correct statements regarding Receptive Relaxation include all of the
EXCEPT one (choose the incorrect one). a) It is the major mechanism responsible for the gastric accommodation
of a new meal.
b) It is restricted to the proximal region of the stomach.
c) It is part of the deglutition reflexes.
d) It involves the vagal supply to the stomach.
e) It no longer occurs following the administration of atropine.*
17. The Basic Electrical Rhythm (BER/ECA)
a) has a higher frequency in the esophagus than in the colon.
b) has a higher frequency in the proximal stomach than in the distal
c) has a higher frequency in the distal stomach than in the duodenum.
d) has a higher frequency in the duodenum than in the ileum.*
e) All of the above statements are correct.
18. Correct statements regarding gastric emptying include all of the
one (choose the incorrect one).
a) The relaxation of the pyloric sphincter during antral systole is the
major regulator of gastric emptying.*
b) The administration of atropine slows down the gastric emptying of
solids. c) Liquids empty faster than solids.
d) Hypertonic meals empty more slowly than isotonic meals of equal
e) Fatty meals empty more slowly than carbohydrate meals of equal
19. The Chemoreceptor Trigger Zone (CTZ)
a) is also known as the vomiting centre.
b) is located in the cerebral cortex.
c) is essential for vomiting in response to unpleasant smells.
d) is essential for vomiting in response to circulating toxic agents.*
e) All of the above statements are correct.
20. The Migrating Myoelectric Complex
a) plays an important role in clearing the esophagus, when the bolus
swallowed is particularly large and sticky.
b) plays an important role in the clearing of the stomach of large, non-
c) requires the integrity of the extrinsic nerves in order to be functional
in the small intestine.
d) is propagated more rapidly in the colon than in the distal ileum.
e) is activated by the intake of a new meal. 21. Correct statements regarding salivary secretion include all of the
one (choose the incorrect one):
a) It results in the production of a fluid which is isotonic at all rates of
b) It results in the production of a fluid which contains an enzyme that
breaks down polysaccharides to the level of disaccharides.
c) Its rate of secretion is not under the regulation of gut hormones.
d) Its rate of secretion is increased in response to parasympathetic
e) Its rate of secretion is decreased in the presence of atropine.
a) is a duodenal hormone.
b) is a trypsin inhibitor.
c) is capable of breaking down proteins into smaller peptides.*
d) is responsible for the activation of trypsinogen to trypsin.
e) is activated from its precursor chymotrypsinogen in the presence of a
pH less than 2.
23. Secretin a) is a hormone secreted by the pancreas.
b) is a choleretic agent.*
c) has the same effect on the gall bladder as does cholecystokinin
d) inhibits gastric secretion, but stimulates gastric emptying.
e) stimulates gastric secretion, but inhibits gastric emptying.
24. The cells in the Crypts of Lieberkűhn
a) are derived from the division and migration of cells originally located
at the tips of the villi.
b) secrete into the intestinal lumen the enzymes which complete the
digestion of carbohydrates, proteins, and lipids.
c) are responsible for the absorption of the products of digestion of
carbohydrates, proteins and lipids.
d) are responsible for the absorption of ~80% of the water in the
e) secrete daily into the intestinal lumen ~3L of an isotonic, alkaline
25. Which of the following can be a cause of cretinism?
a) Hyperthyroidism during infancy. b) Hyperparathyroidism during infancy
c) Production of too much parathyroid hormone because of a parathyroid tumor.
d) Excessive iodine in the diet.
e) None of the above statements is correct.*
26. Acromegaly arises from
a) production of too much growth hormone during infancy.
b) production of too much growth hormone during adulthood.*
c) production of too much growth hormone during pregnancy.
d) failure to release growth hormone releasing hormone from the
e) failure to synthesize growth hormone releasing hormone.
a) is a mineralocorticoid.
b) is synthesized in the adrenal cortex.
c) binds to a receptor that functions in the nucleus.
d) increases the reabsorption of sodium from the kidneys.
e) All of the above statements are correct.* 28. ACTH
a) is produced by the hypothalamus.
b) blocks release of glucocorticoids into the circulation.
c) blocks release of mineralocorticoids into the circulation.
d) is a steroid hormone.
e) None of the above statements is correct.*
29. Atrial natriuretic peptides
a) mimic the effects of aldosterone.
b) decrease the concentration of sodium in the urine.
c) were discovered in the heart but are also produced by some other
d) are produced as a response to a decrease in blood pressure.
e) in the kidneys, decrease sodium excretion.
30. Thyroid hormone
a) is composed of two active forms known as T3 and T4.*
b) is derived from threonine amino acids.
c) depresses basal metabolic rate. d) is also known as thyroid stimulating hormone.
e) is so named because its receptors are expressed only in the thyroid
31. A reliable pregnancy test is based on detection of
a) increased production of human growth hormone due to pregnancy.
b) decreased levels of circulating progesterone.
c) presence of human chorionic gonadotropin.*
d) increased production of lutenizing hormone.
e) production of testosterone by the embryo.
a) is produced in females only.
b) is related in structure to human chorion