Aldosterone stimulates the reabsorption of water in the nephron via which process?
Synthesis of glucose channels
Increasing the flow of filtrate
Upregulation of epithelial sodium channels
Excretion of water
Which of the following produce antibodies
Erythrocytes
T lymphocytes
B lymphocytes
Thrombocytes
which of the following provides the correct definition of cor pulmonale
abnormal enlargement of the right side of the heart as a result of diesease of the lungs or the pulmonary blood vessels
abnormal enlaregemnt of the left side of the heart as a resukt of disease of the lungs or the pulmonary blood vessels
abnormal enlargement of the right side of the heart as a resukt of an increase in systemic afterload
abnormal enlargement of the left side of the heart as a result of an increase in right sided afterload
During myocyte depolarisation this outside of the cell become:
positive
negative
stays the same
become hyperpolerized
What is the source of energy used to power the sodium-potassium pump?
breakdown of ATP
formation of ATP
transport of ATP by the pump
breakdown of GTP
which of the following is true?
In systolic heart failure the heart’s ejection fraction increases
In systolic heart failure the heart’s ejection fraction stays the same
In systolic heart failure the heart’s ejection fraction decreases
In diastolic heart failure the ejection fraction increases
During myocardial diastole the sodium / potassium pump:
Pumps out 3 sodium ion and pump in 2 potassium ions
Pumps out 6 sodium ions and pumps in 4 potassium ions
Pumps in 3 sodium ions and pumps out 2 potassium ions
Pumps in 6 sodium ions and pumps out 4 potassium ions
Which of the following types of emphysema is most commonly associated with smoking and chronic bronchitis
Paraseptal
Panacinar
Centriacinar
Irregular
Haemoglobin
is composed of four identical subunits
has iron at the centre of haem groups which must be in the ferrous form to bind O2
binding of oxygen is reduced in the presence of high Pco2 because CO2 and O2 compete for the same binding sites on haemoglobin
variants (such as fetal haemoglobin) often differ from normal adult haemoglobin in the precise structure of the haem group.
Which of the following is a neurotransmitter in the sympathetic nervous system?
Acetylcholine
Norepinephrine
Vasopressin
Enoximone
The alveolar pores that enable collateral ventilation are called:
Pores of Oddi
Pores of Kohn
Pores of Dalton
Pores of Boyles
Peripheral chemoreceptors are highly responsive to:
Dysponea
Coughing
Hypoxemia
Breath holding
Aspirin is given in the treatment of myocardial infarction in order to prevent platelet aggregation. Which of the following effects means it is useful in this situation?
Inhibition of actin myosin filaments in platelets
Inhibition of thromboxane A2
Inhibition of collagen
Inhibition of calcium
During myocyte (heart cell) depolarisation, the inside of the cell becomes momentarily:
electrically neutral
unchanged
The Law stating that the more the ventricle is filled with blood during diastole (end-diastolic volume), the greater the volume of ejected blood will be during the resulting systolic contraction (stroke volume) is the:
Frank-Starling’s Law
Cushing’s Law
Virchow’s triad Law
Best-Banting Law
The anaerobic metabolism of carbohydrates results in the production of:
Citric acids
keto acids
lactic acid
hydrochloric acid
Flattened T waves on an ECG can signify:
1st Degree heart block
Hyperkaleamia
Hypokaleamia
Atrial fibrillation
The diuretic Spironolactone interferes with the action of which endogenous hormone?
Renin
Aldosterone
Anti Diuretic Hormone (ADH)
During acidosis the pH scale moves
up
down
moves to one
A disease caused by the demyelination of the oligodendrocytes
Myasthenia gravis
Multiple sclerosis
Amyotrophic Lateral Sclerosis
Parkinson’s disease
Intra-plural pressure is:
the same as atmospheric pressure
higher than atmospheric pressure
Concerning fats, when triglyceride molecules contain only single carbon bonds (c-c-c) these are referred to as:
Poly unsaturated fats
saturated fats
Hyper-carbonated fats
Mono unsaturated
With a nasal cannula in-situ @ 2L O2 what % increase in FiO2 will there be
21 %
50%
100%
31%
Which of the following is a restrictive lung disease:
Asthma
Pneumoconiosis
Emphysema
Chronic bronchitis
Heart failure results in which of the following type of hypoxia
Anaemic hypoxia
Histo-toxic
Hypoxic
Stagnant
Type II pneumocytes in the lung are the major source of
IgG
cytokines
oxygen
surfactant proteins (SP)
A reduction in lung compliance would lead to a
Obstructive lung disease
Type II respiratory failure
Restrictive lung disease
Hypercapnic lung disease
Which lung volume would (usually) be reduced in restrictive lung disease
Inspiratory reserve volume
Function residual capacity
Residual volume reserve
Expiratory reserve volume
If the fraction of an inspired gas was .35 what would its partial pressure be at 1ATM
210mmHg
160mmHg
350mmHg
266mmHg
E = P + pgh + ½ PV2 which, if we remove gravity, reads as E = P + ½ PV2. Or, more simply, the faster the flow, the lower the pressure is which theorem
Venturi’s
Dalton’s
Bernoulli’s
Charles’s
Hypocalcaemia caused by hyperventilation results in which of the following signs
Dahl’s sign
Palmar erythema
Trousseau sign
Schamroth's sign
Replacing inspired air with a gas mixture that contains 60% oxygen
causes a large increase in oxygen content with little increase in oxygen saturation in a healthy person at high altitude
causes a large increase in arterial PaO2 and a small increase in oxygen content in a healthy person at sea level
would greatly enhance the exercise tolerance of a patient COPD
would greatly reduce the oxygen delivery problems of a patient in circulatory shock
Antidiuretic hormone (ADH) is secreted by
Adrenal glands
Kidneys
Pineal gland
Hypothalamus
Macula densa cells help regulate blood pressure by detecting changes to
Sodium
Potassium
calcium
Which of the following anatomical portion of a nephron connects the Bowman’s capsule to the loop of Henle?
Connecting tubule
Proximal convoluted tubule
Collecting duct
Distal convoluted tubule
The gene responsible for causing Duchenne muscular dystrophy is found on
Y chromosome
X chromosome
Autosomal chromosome number 8
Autosomal chromosome number 5
Which of the following is the primary neurotransmitter of the parasympathetic nervous system
Adrenaline
Dopamine
Serotonin
Which of the following heart layers secretes pericardial fluid?
Myocardium
Endocardium
Serous pericardium
Fibbrous pericardium
The Haldane effect states that
for any given Pco2 less CO2 is carried by oxygenated blood
an increase in Pco2 shifts the O2 dissociation curve to the left
an increase in Pco2 reduces the amount of haemoglobin in the red cell.
for any given Pco2 more CO2 is carried by oxygenated blood
Ventilation is NOT increased by
decreased Po2 at the central chemoreceptor
increased Paco2
decreased CSF pH
decreased arterial pH
The amount of a gas dissolved in a solution as a result of partial pressure is which of the following gas laws
dalton
henrys
charles
boyles
How is the ejection fraction worked-out
SV/EDV x 100
EDVEDV/SV x 100
RVEDV x EDV x 100
EDV/100 x 60
The layer of blood close to the walls of lung capillaries is known as the
RBC layer
Tissue barrier layer
Alveolar fluid layer
plasma layer
A pulmonary embolism would result in
Intrapulmonary shunting
decrease in dead space
increase in dead space
increase in lung surface area
The rate of diffusion of a gas across a membrane is inversely proportional to the square root of its molecular weight - is a definition of which of the following gas laws
ficks law
daltons law
grahams law
chales law
Angiotensin I is converted to angiotensin II in the:
lungs
nephron
pancreas
bowman's capsule
Hydrostatic pressure at the venule end of a capillary is usually (approximately)
25mmHg (3.3kPa)
32mmHhg (4.2kPa)
80mmHg (10.6kPa)
12mmhg (1.6Pa)
A symptom seen in the patient with Keto-acidosis
Bradycardia
Keto-alkalosis
kussmaul respiration
Bradyapnoea
During DKA sodium bicarbonate levels are:
raised
lowered
absent
normal
Which of the following will increase the stroke volume:
Decreased venous return
Increased afterload
Decreased preload
Increased venous return
The renal system does not play a direct role in regulating which of the following
Blood pressure
Blood temperature
Blood acid base balance
Blood solute concentrations
Angiotensin II exerts its action by binding to various receptors throughout the body. In response to angiotensin II, the adrenal cortex is stimulated to release
Angiotensin I
Angiotensin ll
Most of the glucose that is filtered through the glomerulus undergoes reabsorption in the
Distal tubule
Descending loop of Henle
Assessing limb loop of Henle
Which is not a function of angiotensin ll
Vasoconstriction
Inhibition of ADH
Reabsorption of sodium
Stimulation of aldosterone secretion
Which is not a sign of renal cell carcinoma
Flank pain
Flank mass
Heamaturia
Cullen's sign
Aldosterone stimulates the reabsorption of water in the nephron via which process
The majority of carbon dioxide produced by the body is transported
As hydrogen and bicarb ions
Bound to haemoglobin
As an alkaline
Bound to intercellular albumin
Von Hippel-Lindau syndrome is
An inherited disorder characterized by the formation of tumours
An autoimmune disease
An infectious disease
A condition only seen within the renal architecture
4)The first stage of the RAAS is the release of angiotensinogen, which is produced (primarily)
Carotid arch
Brain
Lungs
Liver
Insufficiency of ADH is a condition called
Addison's disease
Renal disease
Cushing's disease
Diabetes insipidus
In the adult the majority
Basophils
Eosinophils
Lymphocytes
Neutrophils
Macula densa cells are chemoreceptors found in the
Proximal tubule
Ascending loop of Henle
The amount of air that is moved in and out of the lungs during normal quiet breathing is
Vital capacity
Tidal volume
Residual vohimo
increase in the partial pressure of carbon dioxide favours oxygen dissociation from oxyHb. The effect is known as
The Nernst effect
The Bohr effect
Henderson effect
Dalton effect
The Hering-Breuer reflex
Inhibits expiration
prolongs inspiration time
Shortens inspiration time
Is initiated by expiration
Which definition best suits the term 'inflammation' in relation to asthma
Inflammation is caused by infectious agents in asthma, and is mediated by antiproteases
Inflammation is associated with airway remodelling in asthma. Inflammation is triggered by a stimulus, and causes epithelial injury, among other things
Mast cells can help to reduce inflammation by releasing histamine and preventing further lung damage
Inflammation is caused by airway remodelling in asthma.
Interstitial fluid enters capillaries at the venular end through the action of
Negative pressure
Colloid osmotic pressure
Active transport
Capillary co-transport
What are the classic signs of a cardiac tamponade
Tachycardia, dyspnoea, fever
Bradycardia, arm weakness, diaphoresis
Hypertension, palpitations, chest pain
Hypotension, increased jugular venous distention, muffled heart sounds
The term 'ectopic pacemaker' (or ectopic focus)
An ectopic arrythmia due to hyponatraemia
Any cardiac dysrhythmia
A shift of the pacemaker function of the SA node to another part of the heart
An arrythmia due to hyper
In cor pulmonale the
the mean pulmonary arterial pressure increases
the mean arterial pressure decreases
the mean pulmo
the mean pulmonary arterial pressure is 10mmhg
a person who smoked 20 cigarettes a day for 30 years has a pack years of
20
30
40
25
which of the following types of emphysema is most commonly asscoiated with smoking and chronic bronchitis
paraseptal
panacinar
centaicinar
irregular
a patients blood gas analysis shows that both their Paco2 and bicarbnate concentration are increased above normal by 25% what does this mean ?
They are excercising and so producing more CO2
The arterial Ph is unchanged
They are likely to have renal damage
They are likely to be polycythaemic
Which of the following is not normally associated with chironic bronchitis
CO2 retention
less than 15% increase in FeV1 following treatment with a bronchodilator or steroids
Polycythemia
Increased total lung capacity
Urine is formed in a three step process, which of the follwoing gives the correct order in which these steps take place in the nephron
Tubular secretion, tubular re-absorption, glomerular filtration
Tubular reabsorption, tubular secretion, glomerular filtration
Glomerular filtration, tubular reabsorption, tubular secretion
glomerular filtration, tubular secretion, tubular reabsorption
Which of the following is least likely to be present in the gfiltrate, (the filtrate produced by the nephron before it enters the loop of henle) of a healthy adult nnephron
Amino acids
Glucose
electrolytes
Large molecular weight proteins
Which of the following is not a function of aldosterone
Stimulates the secretion of K+ into the tubular lumen
Stimulates Na+ and water reabsorption
Upregulates epithelial sodium channels
Causes vasodilation
Which of the following produces surfactant
Type 1 pneumocytes
Type 2 pneumocytes
Oligodendrocytes
Schwann cells
Which of the following is NOT a restrictive lung disease
pneumoconiosis
Silcosis
Tuberculosis
The enzyme that assists rapid inter conversion of carbon dioxide and water into carbonic acid is
Amylase
Lipase
Trypsin
Carbonic anhydrase
The (normal) intra-venous partial pressure of carbon dioxide is
40 mmHg
55mmHg
46mmHg
35mmHg
Which of the following is NOT found in the service side of type 1 pneumocytes
nerve endings
macrophages
Collagen
Surfactant
Within the cerebral spinal space and the CSF what regulates ventilation
carbon dioxide
carbonic anhydrase
Hydrogen ions
carbonic acid
Carbon dioxide is how many times more soluble than oxygen
10 times
20 times
100 times
40 times
With a nasal cannula, we assume that the fraction of O2 that is inspired (above the normal atmospheric level) increases by how much for every additional litre of oxygen flow administered
10 percentage points
100 percentage points
4 percentage points
21 percentage points
Which of the following does NOT contribute to maintaining osmotic pressure
Albumin
Calcium
A respiratory acidosis moves the O2 curve and the PH respectfully
Right/down
Left/up
Right/up
left/down
the protein whose production gets affected in Duchenne muscukar dystrophy is
actin
myotropin
dystropin
leucovorin
Duchenne muscular dystrophy can be cured with
allopurinol
creatinine phosphokinase inhibitors
corticosteroids
none of these
The involvement of this muscle affects the breathing in duchenne muscular dystrophy
triceps
biceps
diaphragm
quadriceps
Which of the following represents one of the most recent developments in the treatment of MD
replacing muscles
create customised diets for them to be healthier and stronger
attempting to correct defective genes so it creates the right proteins
SLUDGE syndrome stands for which of the following
Salvation, lacrimation, urination, defacation, gastrointestinal symptoms and emesis
sodium retention, lactic acidosis, urine retention, deafness, gastrointestinal bleeding and episodes of dizzines
Scoliosis, limited movement, urinary failure, decay, gastrointestinal ulceration, and epilepsy
sepsis, lymphedema, ulceration, diabetes, genital warts and Ecoli infection
Which portion of the heart is the base and which sis the apex
Two thirds apex and one third base
one third base, two thirds apex
one half base, one half apex
three quaters base and one quater apex
Which of the following factors increase cardiac output
Increased sympathetic activity
Increased end diastolic volume
increased venous return
all of the above
Where is the stethoscope (best) placed to auscultate the mitral valve
5th intercostal space at sternum
5th intercostal space inferior to left nipple
2nd intercostal space left of sternum
2nd intercostal space right of sternum
On the ECG the short flat segment between the S and T waves represents the refractory state of the
Atrial myocardium
AV node
SA node
Ventricular myocardium
Considering cardiac tamponade - the heart is covered by
pericardium
endocardium
epicardium
supracradium
Which of the following is isotonic
0.9% saline
water
5% dextrose
Lucozade
Fenestrated capillaries are found in the
muscles
adipose tissue
central nervous system
intestines
Which of the following would be the best initial management of an acute cardiac tamponade
Intravenous fluids
Percardiocentesis
Intravenous beta blockers
coronary angioplasty
which of the following is not a structure of the respiratory system
pharynx
larynx
bronchus
hyoid
the roof of the nasal cavity is formed primarily by the
cribriform plate
hard palate
superior concha
sphenoid
in the blood most of the carbon doixide is transported as
carboxyhaemoglobin
dissolved carbon dioxide
as free hydrogen
as bicarbonate
peripheral chemoreceptors are located in
lung tissue
pons and medulla
aortic & carotid bodies
renal arch
Factors determining the extent to which oxygen will combine with haemoglobin include
partial pressure oxygen
blood temperature
blood PH
expectorate in uncomplicated asthma has a high level of
neutrophils
eosinophils
red blood cells
IgD
Which of the following is not a classic clinical characteristic of asthma
dyspnoea
wheeze
cough
Increased FEV1
In the adult the majority of leukocytes are
basophils
lymphocytes