1 A deficiency of choline in the diet may cause abnormalities in metabolism of

1. lipids.
2. proteins.
3. minerals.
4. carbohydrates.
5. nucleoproteins.

The correct answer is choice 1. Choline is a structural component of phosphatidylcholine or
lecithin, a phosphoglyceride. Phosphoglycerides are maor components of cell membranes. The
raw material for the synthesis of phosphatidylcholine is dietary choline. !n the absence of
choline, phosphatidylcholine cannot be produced and a maor phospholipid component of wall
membranes will be una"ailable. #o the correct answer to $uestion is choice 1. Choline is not
directly in"ol"ed in the metabolism of the other choices% proteins, minerals, carbohydrates or
nucleoproteins.
2. A deficiency of rhodopsin is most likely caused by decreased dietary intake of
1. glucose.
2. adenine.
3. "itamin &.
4. tryptophan.
5. ribofla"in.
The correct choice to $uestion is '3, "itamin &. (hodopsin is a photosensiti"e molecule in rods.
!t is made up of opsin and 1)cis)retinal. The precursor of 11)cis)retinal is !!)trans)retinol, or
"itamin &. *itamin & is an essential "itamin+ that is, it cannot be synthesi,ed in mammals. The
all)trans)retinol is con"erted to 11)cis)retinal by retinol dehydrogenase, followed by an
isomeri,ation between the 11th and 12th carbon double bonds, from trans to cis configuration
by retinal isomerase. !f "itamin & is deficient in the human it will lead to night blindness and
e"entual degeneration of the rods. #o the correct choice is '3, "itamin &.
3 A deficiency of vitamin A in a developing tooth most likely affects the
1. pulp.
2. enamel.
3. dentin.
4. cementum
&ns 2 ...-nly *it & &nd C are in"ol"ed in tooth enal n dentin de"elopment.... now *it C is
in"ol"ed with collagen synthesis n dentin has more collagen compared to enamel so *it C help in
dentin de"elopment n *it & with .namel de"elopment
The correct answer is '2. To answer this $uestion it is important to thin/ bac/ to the
de"elopment of the tooth. !n loo/ing at our choices, pulp enamel, dentine and cementum, we
see that dentine, cementum and pulp are classified as connecti"e tissues, while enamel may be
classified as a product of epithelial cells. The tooth, therefore, is from mesenchymal and
ectodermal origin. The mesenchyme is deri"ed from neural crest, and the epithelium, as !
mentioned before, is deri"ed from ectoderm. *itamin & plays a /ey role in protein synthesis of
epithelial cells. The e0act role has not been elucidated. 1owe"er, you can see here that you can
answer this $uestion by ust loo/ing at your choices. #o again, the correct choice is '2.
4 A derivative of vitamin K is the coenzyme for which of the following?
&. Production of menadiol
2. .steilfication of retinol
C. 1ydrolysis of peptide bonds
3. Cross)lin/ing of fibrinogen
.. Carbo0ylation of glutamate side chains
The correct answer is Choice .. *itamin 4 is essential for the normal synthesis of prothrombrin
and se"eral other clotting factors in the li"er. !t acts as a coen,yme for the carbo0ylation of
glutamate side chains 5Choice .6 into 7 ) carbo0yglutamate. 8ithout this "itamin 4)independent
carbo0ylation reaction, the prothrombin formed does not bind ca29 and may result in
hemorrhage and death. Choice & through 3 are incorrect as "itamin 4 is not the coen,yme for
any of the reactions listed.

A disease that results in the destruction of a large number of cells and their
nuclei would be e!pected to cause an increased blood level of which of the
following?
&. &mmonia
2. 3:&
C. 4etones
3. ;itochondria
.. <ric acid
The correct answer is .. 8hen a cell is bro/en down, the maority of the cells constituents, such
as proteins and sugars, are cataboli,ed into non)to0ic waste products. 1owe"er, when 3:& and
(:& are cataboli,ed only the sugars and pyrimidines are able to be used for energy production.
The purines 5adenine and guanine6 cannot be cataboli,ed+ instead they are deaminated and
e0creted as uric acid. <ric acid is a relati"ely non)to0ic nitrogenous waste product that is non)
soluble in blood. 8hen large amounts of uric acid are produced, this waste product will begin to
accumulate due to an inability of the /idneys to e0crete this substance. 1yperuricemia is a
clinical condition where the uric acid le"els in the blood are greater than =.5 mg>d?. This
condition often de"elop into clinical state called gout. #ince ammonia 5choice &6 is not found in
the interior of a cell, blood le"els of ammonia would not be e0pected to increase. 3:& 5choice 26
blood le"els would not increase in a disease that results in the destruction of a large number of
cells and their nuclei because this compound is cataboli,ed into waste products and uric acid.
4etones 5choice C6 are produced when lipids and amino acids are cataboli,ed. &lthough
mitochondria 5choice 36 pre found in the inside of a cell, they would also be cataboli,ed when
the cell is destroyed.
" A lack of e!ercise has which of the following physiological effects on bone?
&. 2ones are able to store more calcium
2. 2ones become thin and brittle
C. 2ones increase in length
3. .0ercise or lac/ thereof has no effect on bone
.. The thic/ness)of the bone increases
#he correct answer is $.
#ince bones are adaptable, their shapes often reflect the forces applied to them on a regular
basis. @or e0ample, the "arious bumps and ridges on the surface of bone often indicate the sites
where tendons attach to the bone. &s the muscle becomes stronger and the force applied to the
bone becomes larger, these bumps and ridges will become larger to withstand the increased
force applied to them. Con"ersely, during periods of inacti"ity the si,e of the bone will decrease
and the bone will subse$uently become thin and brittle. !n general, bones are able to store
more calcium 5choice &6, increase in length 5choice C6, and the thic/ness of the bone will
increase in periods of acti"ity 5choice .6. 2ased on this information, it is easy to conclude that
e0ercise or lac/ thereof does ha"e an effect on bone 5choice 36.
=.
A man is being chased by a vicious dog. %econdary to stimulation of the
sympathetic nervous system& which of the following would most likely occur?
&. 3ecreased heart rate
2. 3ilation of the peripheral blood "essels
C. 3ilation of the pupils
3. !ncreased peristalsis in the small intestine
.. lncreased secretions of the sali"ary glands
#he correct answer is '.
The sympathetic ner"ous system promotes the Afight or flightA reaction. 3uring periods of
stress, the sympathetic ner"ous system will help the body handle the stressor by promoting a
series of physiologic changes. @or e0ample, one would e0pect to see dilation of the pupils,
secretion of the sweat glands, increased heart rate, constriction of the blood "essels to
nonessential organs, bronchodilation, and decreased peristalsis. &ll the other answer choice
decreased heart rate 5choice &6, dilation of the peripheral blood "essels 5choice 26, increased
peristalsis in the small intestine 5choice 36, and increased secretions of the sali"ary glands
5choice .6 would be e0pected to occur with the stimulation of the parasympathetic ner"ous
system.
B A muscle devoid of tonus is
1. atonic.
2. spastic.
3. hypotonic.
4. hypertonic.
The correct choice is '1, atonic. This is a simple definition)type problem.
&n atonic muscle will be flaccid. The muscle will be freely mo"able, and lies without
tone. This occurs with lower motor neuron lesions+ that is, the destruction of the alpha
motor neurons.
#pasticity is a hypertonus state of the affected muscles. This is due to a release of the
tonic inhibition of the brainstem, facilitory information which leads to gamma motor
neuron e0citation.
Thus, hyperacti"ity of the gamma fibers causes e0aggerated response to stretch of
muscle spindles. 1ypotonia is simply a decrease in alpha motor neuron stimulation+
howe"er, not a complete destruction. #o therefore we ha"e partial tone loss. #o again,
the correct choice to $uestion is '1, atonic.
1C
A patient diagnosed with cystinuria will have difficulties reabsorbing all of the
following in the renal tubules ()'(*#
&. arginine
2. cysteine
C. lysine
3. methionine
.. ornithine
The correct answer is 3.
The transport systems for amino acids in the intestinal and luminal cells are similar to those for
glucose, where transport across the luminal membrane is sodium dependent and transport
across the contraluminal membrane is sodium independent. Denetic deficiencies in a "ariety of
these carrier systems ha"e been identified. @or e0ample, cystinuria is a clinical condition arising
from faulty transport mechanisms. !t is an autosomal)recessi"e disease caused by a defect in
the transport of cysteine, ornithine, arginine, and lysine, resulting in these amino acids being
e0creted in the urine. & mnemonic% cystinuria results from an inability to reabsorb C-&?
5cysteine, ornithine, arginine, and lysine6 in the renal tubules.
11.
A patient presents with dry skin& cold intolerance& constipation& muscle
weakness& recent weight gain& chronic lethargy& easy fatigue& loss of ambition&
and periorbital puffiness. #his patient+s condition is most likely caused by which
of the following?
&. &ldosterone hypersecretion
2. &ndrogen hypersecretion
C. 1ypercortisolism
3. 1ypocorticoidism
.. 1ypothyroidism
The correct answer is ..
1ypothyroidism, or my0edema, is caused by a lac/ of thyroid function. Patients with this
condition often present with dry s/in, cold intolerance, constipation, muscle wea/ness, recent
weight gain, chronic lethargy, easy fatigue, loss of ambition, and periorbital puffiness.
&ldosteronism is caused by a hypersecretion of aldosterone 5choice &6, leading to hypo/alemia,
which can e"entually lead to periods of muscle paralysis. &drenogenital syndrome is the result
of e0cessi"e production of androgens 5choice 26, leading to premature masculini,ing effects in
young males. Cushing syndrome, which is caused by a hypersecretion of cortisol 5choice C6 by
the adrenal corte0, is characteri,ed by an increased fat deposition in the thoracic region and an
edematous appearance of the face+ it may also cause acne and hirsutism. &ddison disease
results from the failure of the adrenal corte0 to produce adrenocortical hormones, resulting in
glucocorticoid 5choice 36 and mineralocorticoid deficiency. ?oss of cortisol 5a glucocorticoid6
secretion results in the depression of many metabolic functions and decreases oneEs ability to
tolerate "arious stressors.
A person who is severely deficient in folic acid would most likely e!perience
which of the following?
&. &cidosis
2. &nemia
C. 1emorrhage
3. #ei,ure
.. Thrombocytopenia
The correct answer is 2. &nemia is a condition mar/ed by a reduction in the hemoglobin and>or
hematocrit content of the blood+ this condition can be caused by a number of factors, one of
which includes folic acid deficiency. @olic acid is the generic term for pteroylmonoglutamic acid,
which ser"es as an important mediator of many reactions in"ol"ing one)carbon transfers. This
substance is found in many fruits and "egetables, especially citrus fruits and green leafy
"egetables. The most common cause of folate deficiency is inade$uate dietary inta/e and
indi"iduals most commonly seen with folate deficiency are alcoholics, the elderly and anore0ic
patients. The most common signs and symptoms of folic acid deficiency are megaloblastic
anemia, with changes in the mucosa. The diagnosis is made upon finding macrocytic anemia
with macroo"alocytes and hypersegmented neutrophils on peripheral blood smear. &cidosis
5choice &6 is a condition where the blood p1 is less than =.4 and is not related to folic acid
content in the body. 1emorrhage 5choice C6 can be caused by a number of factors, including
"itamin 4 deficiency. &de$uate amounts of "itamin 4 must be present for the li"er to be able to
synthesi,e four clotting factors, which include prothrombin. 8ithout "itamin 4, the entire
clotting system will be inacti"ated. Therefore, if an indi"idual were "itamin 4 deficient, they
would most li/ely e0perience some degree of hemorrhage because the body would be unable to
stop bleeding in a traumatic e"ent. & sei,ure 5choice 36 can be defined as a condition
characteri,ed by a sudden onset of con"ulsions or other epileptic symptoms+ its incidence is not
increased in folic acid deficiency. Thrombocytopenia 5choice .6 is characteri,ed by an abnormally
low platelet count+ its incidence is also not increased in folic acid deficiency.
*hysiology
A protein in solution is at its isoelectric point when the
&. p1 is the same as that of the blood.
2. logarithm of the concentration is ,ero.
C. p1 allows for ma0imum solubility.
3. p1 is such that no migration occurs during electrophoresis.
.. p1 is produced by a 1%1 mi0ture of the protein solution with isotonic saline.
The correct answer is Choice 3. The isoelectric point is the p1 reached when there is no net
electric charge on a protein. !n other words, no migration of a protein in an electric field occurs
during electrophoresis 5Choice 36 Choices &, 2, C, and . do not describe isoelectric point.
A reduction in the population of which of the following lymphocytes would impair
all aspects of an immune response?
&. 2 cells
2. Cytoto0ic T cells
C. 1elper T cells
3. ;emory T cells
.. #uppressor T cells
#he correct answer is '.
#pecific immunity is pro"ided by the coordinated acti"ities of both the T cells and 2 cells when
antigens in"ade the human body. T cells play a crucial role in the initiation, maintenance and
control of the immune response. 1elper T cells stimulate the responses of both the T cells and 2
cells. They are absolutely essential to the immune response since 2 cells and other T cells must
be acti"ated by the helper T cells. 8ithout helper T cells, an immune response to a gi"en
pathogen will not be elicited. The immunodeficiency caused by the &!3# "irus occurs secondary
to a reduction of helper T cells. 2 cells 5choice &6 are responsible for launching a chemical attac/
on antigens through the production of antibodies+ without 2 cells an immu.ne response can still
be elicited by T cells. Cytoto0ic T cells 5choice C6 are responsible for cell mediated immiinity+
these cells pro"ide a direct physical and chemical attac/ on antigens. ;emory T cells 5choice 36
remain long after an antigen enters the body. These cells ensure that an immediate immune
response is elicited when the AsameA antigen enters the body again. The suppressor T cells
5choice .6 inhibit both T cell and 2 cell acti"ities+ they moderate the immune response.
Acidosis is most likely to occur in patients severely deficient in which of the
following hormones?
&. &ntidiuretic hormone
2. Calcitonin
C. !nsulin
3. Prolactin
.. Thyro0ine
The correct answer is C. 4etoacidosis, a specific form of acidosis, is most commonly seen in
diabetic patients deficient in insulin. 8hen an indi"idual is insulin deficient, the cells of the body
are unable to properly utili,e the glucose in the blood. Therefore, the body brea/s down fatty
acids in an effort to maintain normal physiological functions. 8hen these fatty acids are bro/en
down, large numbers of /etone bodies are formed and the blood p1 decreases, leading to
systemic acidosis. &ntidiuretic hormone 5choice &6 pre"ents e0cessi"e water loss. !n the
absence of the hormone dehydration can occur. Calcitonin 5choice 26 is primarily responsible for
the regulation of calcium ion concentrations in the blood. 8hen blood le"els calcium ions
become ele"ated, calcitonin is secreted to reduce calcium ion le"els to normal limit. 3eficiencies
of calcitonin would result in the de"elopment of hypercalcemia. Prolactin 5choice 36 is
responsible for the production of mil/ in the mammary glands of women after pregnancy. !f the
hormone were deficient in a AnewA mother, mil/ production would be substantially decreased.
The thyroid hormones, such as thyro0ine 5choice .6, are responsible for the ele"ation of o0ygen
consumption and the rate of energy consumption+ increased heart rate+ stimulation of acti"ity of
other endocrine tissue+ maintenance of sensiti"ity of respiratory centers as well as "arious other
functions. !ndi"iduals deficient in thyroid hormones are typically lethargic, unable to adust to
cold temperatures, ha"e dry s/in and some degree of hair loss, muscle wea/ness and slowed
refle0es.
A,- receptors in the nephron are located on the tubular membrane of which of
the following?
&. 3istal tubule
2. Pro0imal tubule
C. &scending loop of 1enle
3. 3escending loop of 1enle
The correct answer is Choice &. The nephron is the functional unit of the /idney. !t is organi,ed
into different components each with speciali,ed functions. &31 receptors are located on the
distal tubule 5Choice &6 portion of the nephron. The distal tubule is responsible for the
reabsorption if ions such as sodium, potassium, and chloride. <nder the influence of &31, the
distal tubule can also dilute or concentrate the urine by regulating the amount of water entering
into its lumen. Choice 2, pro0imal tubule, functions mainly in the reabsorption of glucose. :o
&31 receptors are present in this segment of the nephron. Choice C, ascending loop of 1enle, is
"irtually impermeable to water and itEs also responsible for reabsorption of ions. Choice 3 the
descending loop of 1enle is highly permeable to water and functions mainly to allow simple
diffusion of substances through its walls. ?i/e the absorption part of the loop, it does not posess
&31 receptors.
Albinism is a genetic disease that results in incomplete metabolism of
1. alanine.
2. tyrosine.
3. cysteine.
4. histidine.
5. tryptophan.
The correct answer is choice 2, tyrosine. &lbinism is a condition in which melanin is not
produced and pigment is absent from s/in, hair and the iris of the eyes. !t is due to the absence
of the en,yme tyrosinase. Tyrosinase is a copper)containing en,yme which acts on tyrosine to
form dopa$uinone which cycli,es and e"entually forms melanin. ;elanin granules are generally
both dar/ and insoluble and are composed of high molecular weight polymers. &nyway, we need
tyrosine for tyrosinase
to act on to form melanin and the correct answer to $uestion is choice 2.
Aldosterone is normally associated with partial regulation of which of the
following processes?
1. #odium balance
2. Dluconeogenesis
3. ?ipid digestion
4. Protein degradation
5. Carbohydrate metabolism
The correct choice is '1, sodium balance. &ldosterone is a mineralocorticoid which is
synthesi,ed by the ,ona glomerulosa of the adrenal corte0. &ldosterone increases the resorption
of sodium from gastric secretions, sweat, urine and sali"a. &ldosterone acts on the epithelium of
the distal tubule and collecting duct in the /idney. !t does three important things% 516 it
increases the resorption of sodium 526 promotes secretion of potassium and 536 promotes the
secretion of hydrogen. #odium retention occurs with e0cessi"e secretion of aldosterone. &long
with increased sodium retention goes e0pansion of e0tracellular fluid "olume, depletion of
potassium and conse$uently metabolism al/alosis. 3eficiency of aldosterone results in loss of
sodium, hyper/alemia and acidosis. The renin angiotensin system regulates aldosterone.
&ngiotensin !! stimulates secretion of aldosterone. &ldosterone secretion also increases with
increasing plasma potassium concentrations and decreases with decreasing plasma potassium
concentrations. &gain, the correct choice is '1.
*hysiology
All of the following are associated with the action of postganglionic sympathetic
fibers ()'(*#
&. Constriction of pupils
2. !ncreased heart rate
C. !ncreased sweat secretion
3. (eduction of blood flow to the s/in
.. (elease of stored lipids from subcutaneous adipose tissue
The correct answer is &. The maor actions of the postganglionic sympathetic fibers are as
follows% dilation of the pupils 5:-T constriction of the pupils6 and focusing on distant obects+
acceleration of the heart rate 5choice 26 and increased force of contraction+ increased sweat
secretion from the sweat glands 5choice C6+ constriction of cutaneous blood "essels leading to a
reduction of blood flow to the s/in 5choice 36+ and release of stored lipids from subcutaneous
adipose tissue 5choice .6.
All of the following are derivatives of the amino acid tyrosine ()'(*#
&. 3opamine
2. .pinephrine
C. ;elatonin
3. :orepinephrine
.. Thyro0ine
The correct answer is C. #ome hormones are small molecules that are structurally related to
amino acids. @or e0ample, the following are deri"ati"es of the amino acid tyrosine% dopamine
5choice &6, epinephrine 5choice 26, norepinephrine 5choice 36 and the thyroid hormones,
thyro0ine 5choice .6 and triiodothyronine. 8ith respect to the synthesis of norepinephrine, the
following steps apply. The synthesis of norepinephrine begins in the a0oplasm of the terminal
ner"e endings of adrenergic fibers and is completed inside the "esicles of these fibers. The basic
steps in the synthesis of norepinephrine are as follows% Tyrosine is con"erted to 3-P& through
the process of hydro0ylation and then 3-P& undergoes decarbo0ylation to become dopamine.
3opamine is then transported into the "esicles of the adrenergic fibers where it undergoes
hydro0ylation to become norepinephrine. !n the adrenal medulla, norepinepherine is
transformed into epinephrine through the process of methylation. Choline is combined with
&cetyl)Co& to become acetylcholine. ;elatonin 5choice C6 is a deri"ati"e of the amino acid
tryptophan
All of the following are essential amino acids in adults ()'(*#
&. arginine
2. isoleucine
C. leucine
3. methionine
.. tryptophan
The correct answer is &.
&n essential amino acid is one that cannot be synthesi,ed in ade$uate amounts to meet the
needs of the cell and therefore must be supplied by dietary protein. There are 1C essential
amino acids% arginine, histidine, isoleucine, leucine, lysine, methionine, phenylalanine,
threonine, tryptophan, and "aline. Two of these 5arginine and histidine6 are considered
AessentialA only in infants and children. & mnemonic to help remember these amino acids is as
follows% A&ny help in learning these little molecules pro"es "aluable
*hysiology
All of the following are the result of parasympathetic stimulation ()'(*#
&. Contraction of the urinary bladder during urination
2. Constriction of the pupils
C. !ncreased heart rate
3. !ncreased sali"ary gland secretion
.. !ncreased smooth muscle acti"ity of the intestinal tract
The correct answer is C. The parasympathetic and sympathetic ner"ous systems, for the most
part, oppose each other. The maor actions of the parasympathetic ner"ous system are as
follows% 3ecreased heart rate 5:-T increased heart rate6+ Contraction of the urinary bladder
during urination 5choice &6, constriction of the pupils 5choice 26 increased sali"ary gland
secretion 5choice 36 and increased smooth muscle acti"ity of the intestinal tract 5choice .6.
-ther parasympathetic actions include secretion of hormones that promote the absorption and
utili,ation of nutrients by peripheral cells, stimulation and coordination of defecation,
constriction of the respiratory pathways and se0ual arousal and stimulation of se0ual glands in
both se0es.
All of the following changes in the skeleton are considered age.related ()'(*#
&. &ppearance of maor "ertebral cur"es
2. &ppearance of secondary dentition
C. 3ecrease in mineral content of the bones
3. @usion of epiphyseal plates
.. (emodeling of the bone
/ood 0ork
The correct answer is .. & re"iew of the human s/eleton can re"eal important information about
an indi"idualEs age and>or se0. 1owe"er, there are certain characteristics of the human s/eleton
that are independent of an indi"iduals age or se0. @or e0ample, bone remodeling is a process
that occurs throughout a persons life at a relati"ely constant rate. !n the AremodelingA process,
the matri0 of the bone is replaced while lea"ing the bone as whole unchanged. 8ith respect to
indi"idual "ariations in the s/eletal system, the following principles apply% The appearance of
maor "ertebral cur"es occur between the age of 2 fetal months and adulthood 5choice &6+ The
fetal spine is AbowA shaped and the adult spine is more A#A shaped. The appearance of
secondary dentition 5choice 26 , occurs when the primary teeth are lost and the permanent
teeth ta/e their place. The mineral content of bone 5choice C6 typically decreases after the age
of 75. The fusion of epiphyseal plates 5choice 36 typically occurs near the beginning of
adulthood.
*hysiology
All of the following hormones involved in the regulation of bone growth stimulate
osteoblast activity and the synthesis of bone matri! ()'(*#
&. .strogen
2. Drowth hormone
C. Parathyroid hormone
3. Testosterone
.. Thyro0ine
The correct answer is C. :ormal bone growth and maintenance depend on a combination of
hormonal and nutritional factors. 8ith respect to the hormonal factors, the only hormone
in"ol"ed in the regulation of bone growth, listed as an answer choice, that does not stimulate
osteoblast acti"ity and the synthesis of bone matri0 is parathyroid hormone. Parathyroid
hormone is responsible for stimulation of osteoclast acti"ity and ele"ation of calcium ion
concentrations in body fluids. .strogen 5choice &6 secreted in the o"aries, Drowth hormone
5choice 26 secreted from the pituitary gland, Testosterone 5choice 36 secreted from the testes,
and Thyro0ine 5choice .6 secreted from the follicle cells of the thyroid gland, are all responsible
for stimulating osteoblast acti"ity and synthesis of bone matri0 to either a small or large degree
All of the following hormones promote protein synthesis ()'(*#
&. Cortisone
2. .strogen
C. !nsulin
3. Drowth hormone
.. Testosterone
The correct answer is &. & summary of protein synthesis is as follows% &n m(:& strand contains
codons that are complementary to the 3:& strand. The molecules of t(:& contain the
anticodons that are complementary to the m(:& codons. 3ifferent amino acids are then
deli"ered by the t(:&Es. The se$uence of amino acids in the completed peptide will reflect the
se$uence of the t(:& arri"als. The human body then uses these amino acids to build proteins.
Cortisone is a glucocorticoid hormone that has the following effects on the peripheral tissues% !t
decreases the use of glucose and releases amino acids from s/eletal muscles and lipids from
adipose tissue. Cortisone also has anti)inflammatory effects. .strogens 5choice 26 and
androgens, such as testosterone, 5choice .6 are Ase0 hormonesA that increase the rate of amino
acid usage in protein synthesis. !nsulin 5choice C6 is primarily responsible for increasing glucose
upta/e and utili,ation in the li"er, adipose tissue and s/eletal muscle. !nsulin also promotes
increased amino acid upta/e and protein synthesis. This is also one of the primary functions of
growth hormone 5choice 36.
All of the following statements are true with respect to blood pressure and
resistance to blood flow ()'(*#
&. blood pressure increases with a decrease in arterial elasticity
2. resistance to blood flow is directly related to the blood "iscosity
C. resistance to blood flow is directly related to "essel diameter
3. stro/e "olume is directly related to blood pressure
.. "ascular resistance is directly proportional to the length of the blood "essel
The correct answer is C.
8ith respect to the "ascular system, resistance represents the opposition to the flow of blood. &
number of factors can affect blood flow, such as "essel diameter, arterial elasticity, blood
"iscosity, and "essel length. &s the "essel diameter increases, resistance to blood flow will
decrease. !n other words, resistance to blood flow is in"ersely, not directly, related to "essel
diameter.
*hysiology
All of the following statements are true with respect to deglutition ()'(*#
&. appro0imately one)twelfth of all AswallowsA that occur daily occur during sleep
2. food is mo"ed to the esophagus under the direction of cranial ner"e F!!
C. in"oluntary contraction of the pharyn0 ad"ances the bolus into the esophagus
3. the nucleus of the solitary tract coordinates the swallowing mechanism
.. swallowing is triggered by cranial ner"es *!!! and !F
The correct answer is ..
#wallowing is a refle0 action with its afferent impulses carried primarily by the glossopharyngeal
5C: !F6 and "agus 5C: F6 ner"es. The act of swallowing is triggered by cranial ner"es !F and F,
not *!!! and !F. &ll the other statements about deglutition are true. &ppro0imately one twelfth
of all daily AswallowsA occur during sleep 5choice &6, and one)third occur during eating. @ood is
mo"ed to the esophagus under the direction of cranial ner"e F!! 5choice 26. !n"oluntary
contraction of the pharyn0 ad"ances the bolus into theesophagus 5choice C6. The nucleus of the
solitary tract coordinates the swallowing mechanism 5choice 36 "ia the nucleus ambigus and
hypoglossal nucleus.
All of the following statements are true with respect to proteins ()'(*#1
&. Proteins are the structural components of androgens
2. Proteins are the structural components of antibodies
C. Proteins consist of small organic molecules called amino acids
3. Proteins help to create the threedimensional framewor/ of the body
.. Protein structures transport materials around the body
The correct answer is &. Proteins perform a "ariety of essential functions in the body+ these
functions include the following% The proteins of the immune system are /nown as antibodies. !n
other words, proteins are the structural components of antibodies 5choice 26. Proteins consist of
small organic molecules called amino acids 5choice C6. The human body contains significant
$uantities of about 2C different amino acids. !n fact, these proteins help to create the three)
dimensional framewor/ of the body 5choice 36. !nsoluble lipids, respiratory gasses, special
minerals, such as iron and se"eral hormones are carried throughout the body attached to
special transport proteins 5choice .6. Cholesterol is the structural component of androgens
5choice &6.
All of the following would lead to an increase in the glomerular filtration rate
()'(*#
&. Constricting the efferent arterioles
2. 3ecreasing plasma protein concentrations
C. 3ecreasing renin le"els
3. 3ilation of the afferent arteriole
.. !nhibition of sympathetic stimulation of the /idney
The correct answer is C. The glomerular filtration rate is defined as the amount of filtrate
produced in the /idneys each minute, which a"erages around 125 m? of filtrate per minute.
There are many different factors that can alter 5increase or decrease6 the glomerular filtration
rate. @or e0ample, when renin le"els are decreased 5choice C6, there is a decreased con"ersion
of angiotensin ! to angiotensin !!. #ince angiotensin !! is a potent constrictor of the efferent
arteriole, decreasing renin will decrease the D@(. Constricting the efferent arterioles choice &6
and dilation of the afferent arteriole 5choice 36 will directly increase the glomerular filtration
rate. Con"ersely, constriction of the afferent arteriole often occurs when there is a fall in blood
pressure, which will lead to a decrease in the glomerular filtration rate. The constriction of the
afferent arteriole occurs when there is sympathetic stimulation of the /idney+ therefore,
inhibition of sympathetic stimulation of the /idney 5choice .6 will cause glomerular filtration rate
to increase. 8hen plasma protein concentrations are decreased 5choice 26, the /idneys will
increase the glomerular filtration rate to increase the production of urine.
*hysiology
An alcoholic man is diagnosed with 0ernicke triad and Korsakoff syndrome.
0hich of the following would be the most appropriate treatment for this patient?
&. 2iotin
2. :iacin
C. Pyrido0ine
3. (ibofla"in
.. Thiamine
The correct answer is ..
The diagnosis of classic 8ernic/e triad 5ophthalmoplegia, ata0ia, and global confusion6 and
4orsa/off psychosis is considered to be a medical emergency that necessitates the immediate
administration of thiamine, or "itamin 21. 2iotin 5choice &6 acts as a carrier of Aacti"ated
carbo0ylA groups for three /ey en,ymes that cataly,e carbo0ylation reactions. #ymptoms of
biotin deficiency are alopecia, s/in and bowel inflammation, and muscle pain. :iacin 5choice 26,
or "itamin 23, is con"erted to nicotinamide, which is then incorporated into the coen,ymes
:&39 and :&3P9. Pellagra is a condition associated with a deficiency of niacin, which can result
in the de"elopment of diarrhea, dermatitis, and dementia. Pyrido0ine 5choice C6, or "itamin 27,
is associated with the coen,yme pyrido0al phosphate. & deficiency in pyrido0ine can lead to the
de"elopment of peripheral neuropathy and dermatitis. (ibofla"in 5choice 36, or "itamin 2P, is
responsible for maintaining proper le"els of both fla"in mononucleotide 5@;:6 and fla"in adenine
dinucleotide 5@&36. !ndi"iduals deficient in ribofla"in are li/ely to present with lesions of the lips,
mouth, s/in, and genitalia.
An electrocardiogram showing e!tra * waves before each 23% comple! indicates
1. fibrillation.
2. atrial bradycardia.
3. partial heart bloc/.
4. "entricular tachycardia.
5. left bundle branch bloc/.
The correct choice is '3, partial heart bloc/. !n order to understand this $uestion you must be
familiar with the normal .CD tracings. The P)wa"e is the first wa"e of the .CD tracing, and it
represents the spread of depolari,ation through the atria. The P)( inter"al is measured from the
beginning of the P)wa"e to the beginning of the G(# comple0. !t reflects the time it ta/es for
the depolari,ation impulse to tra"el from the #)& node to the "entricular myocardium. The P)(
segment is measured between the end of the P)wa"e and the beginning of the G(# comple0. !t
reflects the spread of depolari,ation through the &)* node, the bundle of 1is and the Pur/ine
fibers. The G(# comple0 is the second and most important deflection on the .CD tracing. !t
represents the spread of depolari,ation through the "entricular muscle. The #T segment is
measured from the end of the G(# to the beginning of the T wa"e. !t represents the portion of
the cardiac cycle in which all the "entricular myocardial fibers are depolari,ed and no further
current flows. The T)wa"e is the third deflection of the G(# and represents the reco"ery period
or repolari,ation of the "entricles. The G)T inter"al is measured from the beginning of the G(#
to the end of the T)wa"e and gi"es the total duration of "entricular systole. Partial heart bloc/
represents a delay in the transmission of the action potential from the atrial pacema/er to the
"entricles. This delay may be due to abnormalities in the atria or the &)* node or the bundle of
1is, and is reflected by prolongation of the P)( inter"al on the .CD. !t is also characteri,ed by
e0tra P)wa"es before each G(# comple0. #o again, the correct choice to $uestion is '3, partial
heart bloc/.
An impulse can travel from one nerve to another in only one direction because
the
1. synapse limits the direction of tra"el.
2. myelin sheath limits the direction of tra"el.
3. myoneural unction limits the direction of tra"el.
4. ner"e fiber permits conduction in only one direction.
5. cell body must be stimulated before the ner"e fiber will conduct.
The correct choice is '1, synapse limits the direction of tra"el. &ction potentials are propagated
along the a0on. The electrical conduction between neurons occurs by gap unctions. Chemical
transmission occurs at the synapse. The neurotransmitter, upon arri"al of the impulse, is
released by the presynaptic neuron and reacts with receptors on the postsynaptic neuron. The
conductance for ions is then increased, and an electrochemical current is propagated. #ince the
presynaptic neuron releases the neurotransmitter upon arri"al of the impulse the impulse is
unidirectional. Due to the synapse the myelin sheath limits the direction of lateral conduction to
adacent ner"es. Conduction along the ner"e fiber itself can be bidirectional, and the ner"e
conducts an impulse due to the am"al of the action potential. #o again, the correct choice is '1,
synapse limits the direction of tra"el.
An individual deficient in which of the following is most likely to develop
pernicious anemia?
&. Cholecysto/in
2. Dastrin
C. 1ydrochloric acid
3. !ntrinsic factor
.. #ecretin
The correct answer is 3. !ntrinsic factor is the secretion of parietal cells that facilitates the
absorption of "itamin 212 across the intestinal lining. *itamin 212 is a member of the cobalamin
family and ser"es as a cofactor for two important reactions in humans. &s methylcobalamin, it
ser"es as a cofactor for methionine synthetase in the Con"ersion of homocysteine to
methionine, and as idenosylcobalamin, it ser"es as a cofactor for the sn"ersion of methyl)
malonyl)Co& to succinyl)Co& after being ingested, it becomes bound to intrinsic factor, which is
a protein secreted by gastric parietal cells. -nce absorbed, it is stored in the li"er. The most
common disorder seen with *itamin 212 deficiency is pernicious anemia, which is associated
with the de"elopment of a megaloblastic anemia. This megaloblastic state often leads to "arious
mucosal changes, intestinal disturbances, such as anore0ia and diarrhea, and a neurological
syndrome where the peripheral ner"es are often affected first, causing paresthesias and
difficulty i n balance. Cholecysto/inin 5choice &6 is produced and stored in the ! cells of the
duodenal and eunal mucosa. The parietal cell secretes two substances% intrinsic factor and
hydrochloric acid. The hormone gastrin 5choice 26, which is produced in the D cells of the
duodenum, primarily functions to stimulate hydrochloric acid, histamine, and pepsinogen
secretion as well as increase gastric blood flow. 1ydrochloric acid 5choice C6 functions primarily
to denature proteins and acti"ate digesti"e en,ymes. #ecretin 5choice .6 is synthesi,ed and
stored in the # cells of the upper intestine. !t stimulates the secretion of bicarbonate containing
substances from the pancreas and inhibits gastric emptying and gastric acid production.
An individual that has anti.A agglutinins and 3h agglutinogens would have which
of the following classifications of blood?
&. Type & negati"e
2. Type & positi"e
C. Type 2 negati"e
3. Type 2 positi"e
.. Type &2 positi"e
The correct answer is 3. There are two antigens 5type & and type .6 that appear on the surfaces
of red blood cells. @urthermore, strong antibodies that react specifically with either the type & or
type 2 antigens, occur in indi"iduals who do not ha"e these particular antigens on their cells.
1ence, type & and type 2 antigens are called agglutinogens and the antibodies that cause
agglutination are called anti &>2 agglutinins. &long the same lines, indi"iduals who ha"e the (h
agglutinogen will be (h9, and those without the (h agglutinogen will produce the anti)(h
agglutinin. (emember that agglutinogens are antigens, and agglutinins are antibodies. &n
indi"idual that has anti)& agglutinins and (h agglutinogens would ha"e a Type 2 596 blood
classification. -ne would e0pect to see anti2 agglutinin and no (h agglutinogen in a person with
type & 5)6 blood 5choice &6, con"ersely anti)2 agglutinin and (h agglutinogen 5choice 26 is seen
in persons with & 596 blood. &nti)& agglutinin and no (h agglutinogen 5choice C6 is seen in 2 5)6
blood types. 8hen there are no anti)& or anti)2 agglutinins 5the person has both agglutinogens6
and there is (h agglutinogen, the person has blood type of &2 positi"e 5choice .6.
An individual who is chronically lethargic& unable to ad4ust to cold temperatures
and has chronic dry skin is most likely deficient in of which of the following
hormones?
&. Calcitonin
2. Drowth hormone
C. Parathyroid hormone
3. Testosterone
.. Thyroid hormone
The correct answer is .. &dults with hypothyroidism are chronically lethargic, unable to adust to
cold temperatures and often ha"e chronically dry s/in as well as ha"e some degree of hair loss,
muscle wea/ness and slowed refle0es. !n other words, the patient in this $uestion is most li/ely
deficient in their thyroid hormones, since the effects of thyroid hormones are as follows%
.le"ation of o0ygen consumption and the rate of energy consumption+ increased heart rate+
stimulation of acti"ity of other endocrine tissues+ maintenance of sensiti"ity of respiratory
centers as well as "arious other functions. Calcitonin 5choice &6 is the hormone primarily
responsible for the regulation of calcium ion concentrations in the blood. 8hen blood le"els of
calcium ions become ele"ated, calcitonin is secreted to reduce calcium ion le"els to normal
limits+ Therefore, deficiencies of calcitonin would result in the de"elopment of hypercalcemia.
Drowth hormone 5choice 26 stimulates cell growth and replication by accelerating the rate of
protein synthesis. !ndi"iduals deficient in growth hormone are often described as Apituitary
dwarfsA. Parathyroid hormone 5choice C6 is responsible for increasing calcium ion concentrations
in the body fluids+ therefore indi"iduals deficient in this hormone would most li/ely be
hypocalcemic. Testosterone 5choice 36 promotes the production of functional sperm, maintains
the secretory glands of the male reproducti"e tract and stimulates growth. 3eficiencies of
testosterone are associated with a decreased de"elopment of male secondary se0
characteristics.
An inflammatory response is triggered when which of the following occur?
&. 2lood flow to an area increases
2. Clot formation occurs
C. @ibroblasts secrete beta)interferon
3. ;ast cells release histamine
.. :eutrophils phagocyti,e bacteria
The correct answer is 3. !nflammation is a locali,ed tissue response to inury that produces
"arious local sensations, such as swelling, heat, redness and pain. There are many different
factors that can cause inflammation, including abrasion, impact, irritation, and infection. ;ast
cells play an important role in the inflammation process. These cells release histamine,
prostaglandins, heparin and other chemicals into the immediate area. 8hen histamine is
released, capillary permeability is increased and blood flow to the area increases. &lthough
blood flow to the area 5choice &6 is the most common cause of inflammation, the inflammatory
response is triggered when mast cells release histamine. Clot formation 5choice 26 is one of the
final states of tissue repair+ it does not promote inflammation. 8hen fibroblasts secrete beta)
interferon, this substance slows the inflammation process in damaged tissue. 8hen neutrophils
phagocyti,e bacteria 5choice .6, inflammation is not promoted
An inflammatory response is triggered when which of the following occur?
&. 2lood flow to an area increases
2. Clot formation occurs
C. @ibroblasts secrete beta)interferon
3. ;ast cells release histamine
.. :eutrophils phagocyti,e bacteria
The correct answer is 3. !nflammation is a locali,ed tissue response to inury that produces
"arious local sensations, such as swelling, heat, redness and pain. There are many different
factors that can cause inflammation, including abrasion, impact, irritation, and infection. ;ast
cells play an important role in the inflammation process. These cells release histamine,
prostaglandins, heparin and other chemicals into the immediate area. 8hen histamine is
released, capillary permeability is increased and blood flow to the area increases. &lthough
blood flow to the area 5choice &6 is the most common cause of inflammation, the inflammatory
response is triggered when mast cells release histamine. Clot formation 5choice 26 is one of the
final states of tissue repair+ it does not promote inflammation. 8hen fibroblasts secrete beta)
interferon, this substance slows the inflammation process in damaged tissue. 8hen neutrophils
phagocyti,e bacteria 5choice .6, inflammation is not promoted.
Antidiuretic hormone acts to
1. decrease renal filtration fraction.
2. increase storage capacity of the bladder.
3. decrease permeability of distocon"oluted tubules and>or collecting ducts to water.
4. increase permeability of distocon"oluted tubules and>or collecting ducts to water.
The correct choice is '4, increase permeability of distal con"oluted tubules and>or collecting
ducts to water. 8hen plasma osmotic pressure changes the brainEs osmoreceptors respond by
stimulating or inhibiting antidiuretic hormone, abbre"iated &31. &0ons of neurons in the
supraoptic and para"entricular nuclei of the anterior hypothalamus e0tend down the pituitary
stal/ to the posterior lobe of the pituitary, where the a0on terminals release secretory products
into the blood. *asopressin, or &31, is one of the two hormones released. The other is o0ytocin.
&31 binds to specific cell receptors of the distal con"oluted tubule and the collecting duct,
acti"ating adenylate cyclase+ C&;P is produced, followed by acti"ation of protein /inase. 8ater
then flows across the cell, due to the phosphorylation of lumenal membrane components. <rine
flow will decrease, and the osmolarity of bloodwill drop. !n the presence of &31 the /idney will
produce a small amount of "ery concentrated urine. &gain, the correct choice is '4, increase
permeability of the distal con"oluted tubules and>or collecting ducts to water.
Avidin influences which of the following vitamins?
1. :iacin
2. 2iotin
3. Thiamine
4. Tocopherol
5. Phyllo$uinone
The correct answer is choice 2. &"idin, which is a glycoprotein found in egg white, can produce
biotin deficiency as it binds biotin tightly, pre"enting its absorption from the intestine. !t has no
effect on any of the other choices. Choice 1, niacin, is in"ol"ed in producing :&3 and :&3P and
niacin deficiency leads to pellagra. Choice 3, thiamin, or "itamin 21 deficiency, causes beriberi.
Thiamin acts as a co)en,yme in reactions in"ol"ing aldehyde groups. Tocopherol, or "itamin .
deficiency, is related to infertility, and "itamin . has antio0idant properties. Choice 5,
phyllo$uinone, is a member of the $uinone family. Guinones are in"ol"ed in electron transport in
the respiratory chain. #o the correct answer to $uestion is choice 2.
$acteria in the intestinal tract are responsible for synthesis of all the following
()'(*#
&. ammonia
2. ascorbic acid
C. folic acid
3. small organic acids
.. "itamin 4
The correct answer is 2.
!n normal feces, 3CH of the solid waste may be composed of bacteria. !n the intestinal tract,
bacteria split urea to form ammonia 5choice &6 and synthesi,e folic acid 5choice C6, small
organic acids 5choice 36 from unabsorbed fat and carbohydrates, and "itamin 4. The brown
color of feces is mainly due to the action of bacteria on bile pigments. The odor of feces is due
to sulfides and indolic compounds. &scorbic acid 5choice 26, or "itamin C, is :-T produced by
the bacteria in the intestinal tract.
*hysiology
$oth control and regulation of sympathetic function primarily occur in centers in
the
&. cerebellum
2. cerebrum
C. mesencephalon
3. posterior and lateral hypothalamus
.. spinal cord and adrenal medulla
/ood 0ork
The correct answer is .. The autonomic ner"ous system consists of two subdi"isions, the
sympathetic and parasympathet ner"ous systems. !n summary, an increase sympathetic acti"ity
leads to stimulation of tissue metabolism, increased alertness and preparation of the body for an
emergency. The sympathetic di"ision consists of preganglionic neurons located between spinal
segments T! and ?2. @urthermore, the ganglionic neurons are also located in ganglia near the
"ertebral column. The center of each adrenal gland 5adrenal medulla6 is a modified sympathetic
ganglion. !n other words, both control and regulation of sympathetic function primarily occurs in
centers in the spinal cord and adrenal medulla. The cerebellum 5choice &6 adusts "oluntary and
in"oluntary motion acti"ities as well as compares incoming sensory information with anticipated
sensations. Consciousness, thought processes, sensations, intellectual function, memory storage
and retrie"al and comple0 motion actions originate in the cerebrum 5choice 26. The
mesencephalon 5choice C6 is the center responsible for processing "isual and auditory
information. The posterior and lateral portion of the hypothalamus choice 36 contain "arious
centers in"ol"ed with emotions, autonomic function and hormone production. @urthermore, the
hypothalamus is the primary lin/ between ner"ous and endocrine system.
*hysiology
$reathing a gas mi!ture with percent '52& ultimately leads to which of the
following?
&. 1ypo"entilation
2. & decrease in heart rate
C. & stimulation of central chemoreceptors
3. &n inhibition of peripheral chemoreceptors
.. & decrease in cerebrospinal fluid hydrogen)ion concentration
The correct answer is Choice C. CC2 has a direct effect on the respiratory center of the brain in
controlling respiration. 2reathing a gas mi0ture with e0cess CC2 will stimulate control
chemoreceptors 5Choice C6 to cause increased strength of pulmonary "entilation, thus reducing
CC2 concentration by e0piring greater amounts of CC2 out of the body.
Choice & is incorrect as an e0cess amount of CC2 will ultimately lead to hyper"entilation as the
lungs labor to rid the body of C-2.
Choice 2 is also incorrect as CC2 concentration in the blood can stimulate peripheral
chemoreceptors especially at the onset of e0ercise. !t will not, howe"er, inhibit peripheral
chemoreceptors as stated in this choice. Choice . is incorrect as e0cess CC2 can pass through
the blood)cerebrospinal fluid barrier, react with water present to form hydrogen ions thus
increasing the hydrogen ion concentration in the cerebrospinal fluid.
*hysiology
'alcium ions initiate contraction in skeletal muscle when they
&. bind to T tubules.
2. bind to troponin.
C. interact with actin.
3. interact with myosin.
.. bind to sarcoplasmic reticulum
The correct answer is Choice 2. Calcium ions bind strongly to troponin 5Choice 26 changing the
condition between troponintropomyosin comple0 and actin in the rela0ed muscle state to
produce a new relationship that leads to muscle contraction.
T)tubule 5Choice &6 facilitates transmission of action potentials to all s/eletal muscle fibers. !t
does not bind with calcium ions.
Calcium ions also do not bind with actin 5choice C6 or myosin 5Choice 36. &ctin must attach to
the heads of the myosin filaments to cause contraction.
#arcoplasmic reticulum 5Choice .6 releases calcium ion in the "icinity of all myofibrils to bring
about contraction.

'alcium ions trigger contraction of muscles by binding to
1. actin.
2. myosin.
3. troponin.
4. tropomyosin.
The correct answer is choice 3, troponin. 3uring muscular contractions, the hea"y meromyosin
subunit of myosin e0tends to reach and bind with the actin filament. This binding acti"ates the
&TPase acti"ity of the myosin head and in the presence of &TP, a confirmational change may
occur in the end causing a spring li/e shortening. This results in pulling the actin filament past
the myosin filament. Tropomyosin on the actin molecule co"ers the binding site for myosin cross
bridges in the absence of calcium ion.8hen calclum ion is present, it binds to troponin and
e0poses the binding site on the actin molecule for myosin to interact and allows the contraction
cycle to occur. Choice 1 is incorrect. &ctin is a maor protein found in the thin filament of the
myofibril. Choice 2 is incorrect. ;yosin is large protein consisting of two sets of light chains and
one set of hea"y chain composing the thic/ filament. Choice 4 is incorrect. Tropomyosin is found
in the thin filament. These rod shaped molecules are associated with actins to form the basic
structural component of the thin filament. #o the correct answer to $uestion is
choice 3.
'arbohydrate is stored in the body principally as
1. glucose.
2. maltose.
3. sucrose.
4. glycogen.
5. glycosaminoglycans.
The correct choice is '4, glycogen. Dlycogen is stored in the li"er. &t times, when glucose is in
demand glycogen will be con"erted into glucose "ia glycogenolysis, which is the lysis of
glycogen, or stored carbohydrate. .pinephrine, or glucagon, stimulates the con"ersion of &TP to
cyclic &;P "ia adenylate cyclase. Cyclic &;P then con"erts protein /inase inacti"e to protein
/inase acti"e. Protein /inase aids in the phosphorylation of phosphorylase /inase inacti"e to
phosphorylase /inase acti"e "ia &TP. The phosphorylase /inase acti"e then con"erts to
phosphorylase)2 inacti"e to phosphorylase)& acti"e. This then releases successi"e glucose)1)
phosphate residues from the branch chains of glycogen. Thus, we ha"e the production of
glucose from our stored carbohydrate. #o again, the correct choice is 4, glycogen.

'arbon mono!ide decreases the amount of
1. bicarbonate in the blood plasma.
2. carbonic anhydrase a"ailable in the lungs.
3. o0ygen that can be transported by hemoglobin.
4. al"eolar surface a"ailable for gaseous e0change.
5. carbon dio0ide that can be transported by the blood.
The correct answer is '3, o0ygen that can be transported by hemoglobin. Carbon mono0ide
combines with ferromyoglobin and ferrohemoglobin, interfering with o0ygen transport. 1eme
has a high affinity for carbon mono0ide. ;yoglobin and hemoglobin ha"e less affinity than the
isolated heme. 1owe"er, they still bind. These proteins decrease the affinity of carbon mono0ide
to the heme)protein comple0 by sterically hindering the binding of carbon mono0ide. ;ore
specifically, the myoglobin and hemoglobin change the geometry of the binding of carbon
mono0ide from that of the protein)o0ygen binding and in doing so wea/ens the interaction of
carbon mono0ide with the heme, optimi,ing -2 binding. :e"ertheless, carbon mono0ide has a
greater affinity for binding than o0ygen, and this fact decreases the amount of o0ygen that can
be transported by hemoglobin. #o again, the correct choice is '3, o0ygen that can be
transported by hemoglobin.
'ardiac muscle differs from the other types of muscle tissue in that cardiac
muscle
&. Contains "isible striations
2. @orms muscle fibers
C. 1as both actin and myosin filaments
3. 1as only one nucleus per cell
.. !s able to contract without neural stimulation
0ork
The correct answer is .. There are three types of muscle tissue in the human body% cardiac,
s/eletal and smooth muscle. &ll of these types of muscle tissue are speciali,ed for contraction.
.ach of these types of muscle is designed to perform specific functions in the body. @or
e0ample, cardiac muscle is found only in the heart and functions to circulate blood and maintain
blood pressure. This type of muscle differs from s/eletal and smooth muscle in that it is able to
contract without neural stimulation. 8ithin the cardiac muscle are speciali,ed muscle cells called
pacema/er cells, which establish a regular rate of contraction. &lthough the ner"ous system
may alter the rate of pacema/er acti"ity, it does not pro"ide AcontrolA o"er the cardiac muscle
cells. *isible striations 5choice &6 are found in both s/eletal and cardiac muscle. 2oth cardiac
and s/eletal muscle form muscle fibers 5choice 26. &ctin and myosin filaments 5choice C6 are
found in all three types of muscle. &lthough cardiac and smooth muscle contain one nucleus
5choice 36, s/eletal muscle cells may contain hundreds of nuclei per cell
*hysiology
'ell bodies of sympathetic preganglionic neurons are located in
1. dorsal root ganglia.
2. sympathetic chain ganglia.
3. the brain stem and the spinal cord.
4. thoracic and lumbar segments of the spinal cord.
5. none of the abo"e.
The correct answer is choice 4. ?etEs re"iew the location of the cell bodies of pre) and post)
ganglionic neurons of the sympathetic and parasympathetic ner"ous systems. !n the
sympathetic ner"ous system, pre)ganglionic cell bodies are located in thoracic spinal segments
T1 through T12 and lumbar segments ?1 through ?3 or 4. ;ost of these neurons synapse in
sympathetic ganglia in the sympathetic ganglion chain. 1ere, the post)ganglionic ner"es
originate and the post)ganglionic cell bodies are located in thc sympalhctic chain. These post)
synaptic neurons tra"el a much longer distance than the pre)synaptic neurons, ending near the
effector muscle or gland. !n the parasympathetic system, the pre)ganglionic cell bodies are
located in the mid)brain or medulla or the sacral regions of the spinal cord, sections #1 through
#5. They synapse in ganglia far from the spinal cord, but near the effector musclc or gland. #o
choice 1 is incorrect. 3orsal root ganglia contain cell bodies of afferent neurons. Choice 2 is
incorrect and is the location of cell bodies of the sympathetic post)synaptic neurons. Choice 3 is
incorrect and is the location of pre)ganglionic parasympathetic cell bodies. #o the correct
answer to $uestion is choice 4.
'holesterol is primarily used by mammalian cells as
1. an energy storage material.
2. a precursor of /etone bodies.
3. a component of cell membranes.
4. a precursor of polyunsaturated fatty acids.
The correct answer is choice 3, a component of cell membrane. Cholesterol, which can be
deri"ed from the diet or manufactured de no"o in "irtually all of the cells of the human body,
plays a number of important roles. The first role of cholesterol is ! that it is the maor sterol in
humans and a component of "irtually all cell membranes and intracellular membranes. The
second role of cholesterol is as the immediate precursor of the bile acid. The third physiological
role of cholesterol is as the precursor of the "arious steroid hormones. #o the correct answer to
$uestion is choice 3
*hysiology
'hondroitin sulfate occurs primarily in
1. bile.
2. blood.
3. li"er.
4. urine.
5. cartilage.
/ood 0ork
The correct answer is choice 5. Chondroitin sulfate is in the chemical family of acid
mucopolysaccharides which includes hyaluronic acid. &s chondroitin 4)sulfate or chondroitin)&,
and chondroitin 7)sulfate or chondroitin)C, chondroitin sulfates ma/e up a large percentage of
cartilage, bone and cornea structure. -f the other answer choices, it should be noted that a
related acid mucopolysaccharide is heparin which pre"ents coagulation of blood and is found in
arterial walls and in the lungs. #o the correct answer to $uestion is choice 5
. 'linical adult onset diabetes mellitus 6#ype 778 results from
1. deficient secretion of insulin.
2. e0cess secretion of epinephrine.
3. failure of the /idneys to retain sugar.
4. secretion of o0ytocin from the posterior pituitary.
5. loss of the insulin receptor function in the target tissues.
The correct answer is choice 5, loss of the insulin receptor function in the target tissues. :on)
insulin)dependent diabetes mellitus, which accounts for BC)ICH of the diagnosed cases of
diabetes, is also called adult onset diabetes to differentiate it from insulin)dependent u"enile
diabetes. !t usually occurs in middle aged, obese people. !nsulin is present at near normal to
ele"ated le"els in this form of the disease. The defect in these patients lies in the loss of the
insulin receptor function. (eceptors are normally located on the plasma membranes of normally
insulin) responsi"e cells, that is, hepatocytes, adipocytes and muscle cells. !nsulin)dependent
diabetes mellitus is also called u"enile onset diabetes or diabetes mellitus !, because it usually
appears in childhood or the teens, but it is not limited to these patients. !nsulin is either absent
or nearly absent in this disease because of defecti"e or absent beta cells in the pancreas. Choice
1 is incorrect. 3eficient secretion of insulin would be associated with diabetes mellitus !. Choice
2 is incorrect as e0cess secretion of epinephrine does not lead to either form of diabetes. Choice
3 is incorrect. #ugar in the urine is due to e0cretion of the large $uantity of plasma glucose
present in diabetes. This is a normal function of the /idney. Choice 4 is incorrect. -0ytocin
release is connected with uterine contraction and is not connected with either form of diabetes.
#o the correct answer to $uestion is choice 5. 9$,( *art 7 released :uestions .
$iochemistry.*hysiology
'orti+s organ is responsible for perception of
1. light.
2. sound.
3. taste.
4. temperature.
5. proprioception.
The correct answer is choice 2. The organ of Corti is a spiral)shaped organ within the cochlea of
the ear. !t contains hair cells which are the auditory receptor cells. #ensation from the hair cells
tra"els along the auditory or cochlear di"ision of the "estibulocochlear acoustic ner"e which
terminates in the cochlear nuclei of the medulla. #o the correct answer to $uestion is choice 2.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
,ecreased arterial pressure upon standing is compensated by
&. decreased heart rate.
2. dilation of mesenteric "essels.
C. constriction of systemic arterioles.
3. dilation of "enules
The correct answer is Choice C. !mmediately upon standing from a prone or supine position, a
personEs arterial blood pressure in the head and upper part of the body tends to fall. The
baroreceptors located in the walls of large systemic arteries compensate by eliciting strong
sympathetic discharge throughout the body resulting in constriction of systemic arterioles
5Choice C6 and thus raising blood pressure. 3ecreased heart rate 5Choice &6, dilation of
mesenteric "essels 5Choice 26, and dilation of "enules 5Choice C6 will all decrease blood
pressure further which is undesirable in this case.
,ecreased response of sense organs when e!posed to a constant stimulus is
called
&. occlusion.
2. summation.
C. adaptation.
3. facilitation.
.. sensory depri"ation.
The correct answer is Choice C. & common characteristic that applies to all sensory organs is
that their response to a constani stimulus decreases after a period of time. This special trait is
/nown as adaptation 5Choice C6. &daptation occurs in all sensory receptors but to different
e0tents and by different mechanisms.
Choice & occlusion as a general term refers to the act of closing or the state of being closed. !t
does not describe sensory organ response to stimuli.
Choice 2 summation often refers to the additi"e effect of fre$uent repetiti"e stimuli applied to
ner"e terminals to achie"e e0citation. &gain, it does not in"ol"e sensory organs or their
response.
Choice 3 facilitation is the enhancement or reinforcement of a ner"ous acti"ity by the arri"al of
signals from other neurons.
Choice . sensory depri"ation occurs when some or all usual e0ternal stimuli are absent. !t will
often result in psychological stress and abnormal beha"ior. !t also does not apply to sensory
receptors response to stimuli
,ental pla:ue arises primarily as a result of enzymatic reactions using which of
the following?
1. #ucrose and lipid
2. #ucrose and sali"a
3. Dlucose and sali"a
4. Dlucose and protein
The correct answer is choice 2. -ne of the few dental $uestions on this e0am, you should
recogni,e that the maor carbohydrate substrate and energy source of pla$ue is sucrose, not
glucose. !n addition, the sali"ary proteins are often in"ol"ed in aiding the pla$ue to adhere to
tooth structure. !n general, lipids are not highly in"ol"ed in pla$ue formation, so choice 1 is
incorrect. Choices 3 and 4 are incorrect because they include glucose and not sucrose. #o the
correct answer to $uestion is choice 2.
,estruction of the cerebellum causes loss of
1. memory.
2. "ision.
3. hearing.
4. muscular coordination.
5. both 526 and 536 abo"e
The correct answer is choice 4. The cerebellum acts to coordinate "oluntary muscular acti"ity.
Choice 1 is incorrect. ;emory function is located within the cerebral corte0, especially in the
temporal lobes. Choice 2 is incorrect. *isual function within the brain is located within the "isual
corte0 of the cerebrum in the occipital lobes. Choice 3 is incorrect. 1earing function is located
within the cerebral corte0 in the area of the auditory corte0 of the temporal lobes. #o the
correct answer to $uestion is choice 4.
,evelopment of ovarian follicles to the point of ovulation is stimulated primarily
by
1. estrone.
2. progesterone.
3. luteini,ing hormone.
4. follicle)stimulating hormone.
5. chorionic gonadotropic hormone. ,evelopment of ovarian follicles to the point of
ovulation is stimulated primarily by
1. estrone.
2. progesterone.
3. luteini,ing hormone.
4. follicle)stimulating hormone.
5. chorionic gonadotropic hormone.
,uring an automobile accident& a child+s posterior pituitary is severely damaged.
0hich of the following would most likely be seen?
&. &ddison disease
2. 3ecreased s/in pigmentation
C. 3ecreased thyroid function
3. 3iabetes insipidus
.. 3warfism
This is a 3)step $uestion. @irst, you need to /now which hormones are produced in the posterior
pituitary+ then /now the function of each hormone+ and finally /now which pathologic condition
will follow when this AparticularA hormone is absent. The posterior pituitary produces antidiuretic
hormone 5&31, or "asopressin6 and o0ytocin. &31 is responsible for maintaining plasma
osmolarity and pre"enting e0cessi"e water loss. 8hen &31 is absent, diabetes insipidus can
result. This condition is caused by a decrease in the renal reabsorption of water, an increase in
serum osmolarity, and the generation of a dilute 5hypotonic6 urine. &ll the other conditions can
result from a decrease in the secretions of the anterior pituitary. &ddison disease 5choice &6 is
caused by decreased production of corticosteroids, such as cortisol. The production is decreased
secondary to a decrease in the secretion of &CT1. 3ecreased s/in pigmentation 5choice 26 can
occur when melanocyte)stimulating hormone is not secreted. 8hen thyroid)stimulating hormone
5T#16 is not secreted, you can e0pect to see a decreased thyroid function 5choice C6. 3warfism
5choice .6 is a condition that can occur in young children when growth hormone production is
decreased.
,uring e!tended periods of fasting& all of the following are able to utilize ketones
and;or fatty acids as a fuel source ()'(*#
&. the brain
2. cardiac muscle
C. the li"er
3. s/eletal muscle
.. red blood cellsThe correct answer is ..
Patterns of fuel utili,ation depend on the metabolic state 5well)fed "ersus fasting6 and on the
indi"idual tissue. ;ost cells in the body are able to utili,e different fuels during the fasting state,
e0cept red blood cells. (ed blood cells are only able to utili,e glucose as a fuel source. &lthough
glucose is the primary fuel for the brain 5choice &6, during periods of fasting, this organ can
utili,e /etone as an energy source. The primary source of fuel for cardiac muscle 5choice 26 is
glucose and fatty acids. 1owe"er, cardiac muscle can utili,e /etones during periods of fasting.
The li"er 5choice C6 prefers to utili,e glucose and amino acids+ howe"er, it can utili,e glycogen,
lactate, glycerol, fatty acids, and amino acids. #/eletal muscle 5choice 36 can utili,e glucose, as
well as fatty acids and /etones.
,uring periods of fasting or starvation& an increased production of ketone bodies
leads to
&. 3ecreased blood p1
2. 3iabetes
C. !ncreased blood p1
3. !ncreased protein brea/down
.. #/eletal muscle brea/down
The correct answer is &. & /etone body is also referred to as a /eto acid since it dissociates in
solution releasing a hydrogen ion. &s a result, the appearance of /etone bodies in circulation will
decrease the blood p1, ma/ing it more acidic. This acidification process is referred to as
/etoacidosis. 4etone bodies are produced as a result of lipid and amino acid brea/down during
periods of fasting or star"ation 8hen e0cessi"e amounts of /etone bodies are formed, the
pathological state /nown as /etoacidosis can occur. 4etoacidosis occurs most commonly in
patients with diabetes 5choice 26. :ote% 3iabetes can lead to /etoacidosis, not "ise "ersa.
4etoacidosis would not increase protein brea/down 5choice 36 or s/eletal muscle production.
,uring periods of moderate e!ercise& one would e!pect to see all of the following
()'(*#
&. decreased carbon dio0ide production
2. increased o0ygen consumption
C. increased pulmonary blood flow
3. increased "entilation rate
.. no change in arterial p1
The correct answer is &.
3uring periods of e0ercise, a number of physiologic changes occur that account for the
increased o0ygen demand in the body. 3uring periods of moderate e0ercise, one would e0pect
to find an increased, not decreased, production of carbon dio0ide. There is an increased o0ygen
consumption 5choice 26, increased pulmonary blood flow 5choice C6, and increased "entilation
rate 5choice 36. !n addition, there is no change in arterial p1 5choice .6+ howe"er, one may see
a decrease in arterial p1 during periods of strenuous acti"ity.
,uring red blood cell recycling each heme unit is stripped of its iron and
immediately converted to1
&. bilirubin
2. bili"erdin
C. ferritin
3. transferrin
.. urobilin
The correct answer is 2. &n erythrocyte is e0posed to se"ere mechanical stresses o"er the
course of its life. & single round)trip of the circulatory system for an erythrocyte often ta/es less
than 3C seconds. 3uring this time period it is bounced off "essel walls and s$uee,ed through
tiny capillaries. 8ith all this wear and tear and no repair mechanisms, the red blood cell has a
relati"ely short life span. &s the AoldA red blood cells are bro/en down and recycled, each
component of the hemoglobin has a different fate. @or e0ample, during this red bloodcel
recycling each heme unit is stripped of its iron and immediately con"erted to bili"erdin.
2ili"erdin is a porphyrin deri"ati"e with a green color. The bili"erdin is then con"erted into
bilirubin 5choice &6 which is found in the general circulation. ?i"er cells absorb the bilirubin and
use it to synthesi,e a comple0 molecule, conugated bilirubin, which is e0creted in the bile.
Transferrin 5choice 36 is a plasma protein to which e0cessi"e iron is bound. (ed blood cells
de"eloping in the bone marrow absorb amino acids and transferrins from circulation and use
them to synthesi,e new hemoglobin molecules. .0cessi"e transferrins are remo"ed by the li"er
and bone marrow and the iron is then stored in two special protein)iron comple0es, ferritin
5choice C6 and hemosiderin. !nside the large intestine, bacteria will con"ert the conugated
urobilin to urobilogen. 8hen e0posed to o0ygen, the urobilinogen is con"erted to urobilin
5choice .6 which is the substance that gi"es urine its yellow color.
,uring which of the following phases of the cardiac cycle are all cardiac valves
open?
1. (apid filling
2. .arly eection
3. lso"olumic rela0ation
4. lso"olumic contraction
5. :one of theseThe correct answer is choice 5, none of the abo"e. 3uring atrial systole, a
small amount of blood is pumped into the "entricles. The semilunar "al"es are closed and the
&* "al"es are then opened to pro"ide a funnel for the transfer of blood from atrium to "entricle.
This continues until the "entricular pressure e0ceeds the atrial pressure and causes the &*
"al"es to close during "entricular systole. *entricular systole causes the semilunar "al"es to
open when "entricular pressure e0ceeds pulmonary and aortic diastolic pressure, thus beginning
the period of isotonic contraction during which blood is eected into the outflowing trun/. 8hen
pulmonary and ! aortic pressures e0ceed end systolic "entricular pressure, it causes the
semilunar "al"es to close. #o in summary there is no point at which all "al"es are open at the
same time. Choice 1 is incorrect. 3uring rapid filling. &* "al"es are open, semilunar "al"es are
closed. Choice 2 is incorrect. 3uring early eection, semilunar "al"es are open but &* "al"es are
closed. Choice 3, iso"olumetric rela0ation, semilunar "al"es are closed. Choice 4, iso"olumetric
contraction, &* "al"es are closed. #o the correct answer to $uestion again, is choice 5.
(levated levels of calcium ions in the blood stimulates the secretion of which of
the following?
&. Calcitonin
2. Drowth hormone
C. Parathyroid hormone
3. Testosterone
.. Thyroid hormone
The correct answer is &. Calcitonin is the hormone primarily responsible for the regulation of
calcium ion concentrations in the blood. 8hen blood le"els of calcium ions become ele"ated,
calcitonin is secreted to reduce calcium ion le"els to normal limits. Drowth hormone 5choice 26
stimulates cell growth and replication by accelerating the rate of protein synthesis. Parathyroid
hormone 5choice C6 is responsible for increasing calcium ion concentrations in the body fluids+
therefore, this hormone would not be secreted in an indi"idual with hypercalcemia. Testosterone
5choice 36 promotes the production of functional sperm, maintains the secretory glands of the
male reproducti"e tract and stimulates growth. The effects of thyroid hormones 5choice .6 are
as follows% .le"ation of o0ygen consumption and the rate of energy consumption+ increased
heart rate+ stimulation of acti"ity of other endocrine glands+ maintenance of sensiti"ity of
respiratory centers as well as "arious other functions.
(motional feelings are <5%# closely related to which area of the brain?
&. Thalamus
2. 2rain stem
C. Cerebellum
3. 1ypothalamus
.. ?imbic system
The correct answer is Choice .. .motional dri"es, moti"ation, and beha"ior are most closely
associated with the limbic system of the brain 5Choice .6. !t is located in the midbasal region of
the brain.
Choice & thalamus, located in the lower region of the brain, contributes to the subconscious
acti"ities of the body such as control of blood pressure and respiration.
Choice 2 the brain stem consists of the medulla, pons, and mesencephalon. !t is concerned with
the motor and sensory functions for the face and head regions.
Choice C the cerebellum lies abo"e the pons and medulla and is chiefly responsible for motor
coordination and body e$uilibrium.
Choice 3 the hypothalamus is important in the control of autonomic body functions to maintain
homeostasis.
(nergy for A#* synthesis is derived from the electron transport system by which
of the following processes?
1. Transamination
2. &ldoli,ation
3. (educti"e synthesis
4. -0idati"e deamination
5. -0idati"e phosphorylation
The correct choice is '5, o0idati"e phosphorylation. -0idati"e phosphorylation is necessary for
all cells that deri"e energy "ia aerobic o0idation. ;itochondria, the powerhouses of the cell, are
the locations of the o0idati"e phosphorylation and electron transport en,ymes. The mitochondria
ha"e two membranes, the inner membrane and the outer membrane. The inner membrane
contains cytochromes b, c, c1, a and a3, and the @&TP)ase associated with the mechanism of
o0idati"e phosphorylation. Proof has been established that electron transport from :&31 to
o0ygen is the main source of energy used for the completed phosphorylation of &3P, so the
correct answer is '5, o0idati"e phosphorylation.
(stablishing a tracheostomy results in
1. increased airway resistance.
2. increased anatomic dead space.
3. increased physiologic dead space.
4. decreased respiratory wor/.
5. decreased effecti"e al"eolar "entilation.
The correct answer is choice 4, decreased respiratory wor/. &natomic dead space is that part of
the conducting airway in which almost no gas e0change occurs. This includes the trachea, the
main stem bronchi, and their subdi"isions. This anatomic dead space is decreased by
tracheostomy because of remo"al or bypass of some of the conducting airway. !n doing so, the
wor/ of breathing which is defined as P *, pressure 0 the change in "olume, is decreased
because "olume is decreased. Choice 1 is incorrect. ;ost of the turbulence to air flow is in the
trachea and therefore bypassing the trachea results in decreased airway resistance. Choice 2 is
incorrect. The trachea is part of the anatomic dead space. Tracheostomy actually decreases and
not increases the anatomic dead space. Choice 3 is incorrect. Physiologic dead space J the
anatomic dead space plus the "olume of air that reaches the al"eoli but does not come into
contact with pulmonary capillary blood and therefore does not participate in gas e0change.
Choice 5 is incorrect. .ffecti"e al"eolar "entilation is "entilation that occurs at the gas e0change
surfaces of the al"eoli. & tracheostomy does not affect the effecti"e al"eolar "entilation. #o the
correct answer to $uestion is choice 4.
(!cluding the effect of drugs& apnea occurring after hyperventilation of an
anesthetized patient results from
1. decreased demand for o0ygen.
2. increased cerebral blood flow.
3. decreased carbon dio0ide tension.
4. increased hydrogen ion concentration
5. decreased o0ygenation of carotid bodies.
The correct answer is choice 3. The term AapneaA refers to respiratory arrest, a time period
during which breathing ceases. (espiratory acti"ity is stimulated by the CC2 le"el of the blood
as sensed by chemoreceptors in the medulla. !t is also triggered by C2 le"els as sensed by the
aortic and carotid bodies. 8hen a patient is hyper"entilated, sufficient o0ygen can be ta/en in,
but e0cess CC2 may be released from the blood. ?ow CC2 le"el will then fail to stimulate the
medullary chemoreceptors. Choice 1 is incorrect. 1yper"entilation will not cause decreased
o0ygen demand. Choice 2 is also incorrect as hyper"entilation does not increase cerebral blood
flow. Choice 4 is incorrect. 1yper"entilation will cause loss of CC2 which causes acid loss or
increased p1 or respiratory al/alosis. Choice 5 is incorrect as well. 3ecreased o0ygenation would
not occur during hyper"entilation and decreased o0ygenation of thc carotid bodies should
increase respiration, not cause apnea. #o the correct answer to $uestion is choice 3.
=ollowing an antineoplastic treatment regimen& a patient+s uric acid level
increases dramatically. #herefore& this individual would derive the most benefit
from an agent that inhibits the action of which of the following enzymes?
&. &lpha)glucosidase
2. &ngiotensin)con"erting en,yme
C. 2eta)lactamase
3. Cycloo0ygenase
.. Fanthine o0idase
The correct answer is ..
&fter selected antineoplastic therapies, patients can ha"e a high le"el of urate secondary to the
brea/down of nucleic acids. Therefore, they are often administered allopurinol to decrease
plasma urate le"els. &llopurinol pre"ents the formation of uric)acid by inhibiting the
en,ym/0anthine o0idase. 3ecreasing uric acid le"els will help pre"ent the formation of /idney
stones, as well as bloc/ the appearance of other deleterious effects of hyperuricemia. &carbose
is an agent used in the treatment of type 2 diabetes. This agent inhibits the acti"ity of alpha)
glucosidase 5choice &6 in the intestinal tract, thereby helping to pre"ent postprandial surges of
hyperglycemia. !nhibition of angiotensin)con"erting en,ymes 5choice 26 will result in a lowering
of blood pressure and aid in the pre"ention of the "entricular remodelingn that occurs secondary
to congesti"e heart failure. 2eta)lactamase 5choice C6 inhibitors are combined with peniciliin
antibiotics to help impro"e their acti"ity against bacteria that produce the en,yme beta)
lactamase. :onsteroidal antiinflammatory drugs 5:#&!3s6 inhibit the acti"ity of the en,yme
cycloo0ygenase 5choice 36, thereby decreasing the production of prostaglandins.
=ollowing e!ercise& ventilation is in e!cess of the metabolic re:uirement. ,uring
this period& the level of lactic acid in blood
1. increases.
2. decreases.
3. remains unchanged
The correct choice is '2, decreases. #e"ere e0ercise will increase the demands on the muscle to
a point where it must rely on glycolysis for the energy. ?actic acid, as a result, will be produced.
This produces an acidotic state. &cidosis will increase "entilation, along with increasing the
number of open capillaries, to increase surface area. &n increase in the cardiac output causes an
increase in the capillary blood flow. &ll of these factors tend to decrease the concentration of the
lactic acid in the blood and return it a to its normal pre)e0ercise conditions. #o again, the
correct choice is 2.
=ollowing the birth of an infant& which of the following hormones is responsible
for increasing milk production in the mother?
&. .strogen
2. ?eutini,ing hormone
C. -0ytocin
3. Progesterone
.. Prolactin
The correct answer is .. Prolactin is the hormone responsible for increasing the production of
mil/ in the mammary glands of women after the birth of a child. :ote% The role of prolactin in
males is poorly understood although it is belie"ed to ha"e a role in the regulation of androgen
production. ;il/ is continuously secreted into the al"eoli of the breasts+ howe"er, it does not
flow easily from the al"eoli into the ductal system. The mil/ is inhibited from entering the ductal
system to prn," ent the continuous lea/ing of mil/ from the breasts when the mother is not
feeding. Therefore, the mil/ must be Alet downA from al"eoli to the ductal system before the
baby can obtain it. -0ytocin 5choice C6 stimulates the myoepithelial cells in the mammary
glands to e0press mil/ from the breast when a baby suc/les. &side from their other actions,
both estrogen 5choice &6 and progesterone 5choice 36 aid in the de"elopment of breast tissue+
howe"er, these hormones inhibit the production of mil/ in the mammary glands. ?uteini,ing
1ormone 5choice 26 plays an important role in causing o"ulation and secretion of female se0
hormones from the o"aries.
=or which of the following are the loops of -enle responsible?
1. The acidification of urine
2. The reabsorption of amino acids
3. The reabsorption of most of the glomerular filtrate
4. The formation of most of the ammonium ion e0creted in the urine
5. The establishment of an osmotic gradient within the medulla of the /idney
The correct answer is choice 5. The maor function of the loop of 1enle is to reabsorb sodium
ions into the cells surrounding the tubule. This absorption sets up a high concentration of solute
which is then used to help in the passi"e reabsorption of water through the collecting tubules.
Choice 1 is incorrect. &cidification of the urine occurs by hydrogen ion secretion. This occurs
throughout all tubules of the /idney. Choices 2 and 3 are both incorrect. ;ost reabsorption, for
e0ample, of glucose and amino acids occurs in the pro0imal con"oluted tubule. @or e0ample,
more than IIH of all filtered glucose is reabsorbed in the pro0imal con"oluted tubule. Choice 4
is incorrect. *ery little ammonia is e0creted by the /idney as most is changed by the li"er to
urea. &ny ammonia in urine is the result of deamination. &s a re"iew point, remember that the
reabsorption of water is through the collecting tubules and that reabsorpuon is under the control
of &31 or antidiuretic hormone from the posterior pituitary. !ts action is to ma/e the collecting
tubule more permeable to water therefore more reabsorption occurs and we get a more
concentrated urine. #o the correct answer to $uestion is choice 5.
/lomerular filtration rate may be determined by clearance of
1. urea.
2. water.
3. inulin.
4. glucose.
5. para)aminohippuric acid 5P&16.
The correct answer is choice 3, inulin. Dlomerular filtration rate or D@( is a measure of the
"olume per time of filtrate that lea"es the glomerulus and enters the 2owmanEs capsule. !t is
measured by a material that is freely filtered into the 2owmanEs capsule and not reabsorbed nor
secreted by any tubules. !nulin, a fructose polymer, is usually used for this purpose. Choices 2
and 4 are incorrect because they are reabsorbed from the blood in the /idney tubules. Choice 5,
P&1 or para)aminohippurate acid, is often used to measure renal plasma flow and is a substance
freely filtered by the glomerulus but acti"ely secreted by tubular cells. Choice 1, urea, although
readily filtered into the 2owmanEs capsule, is more than 5CH reabsorbed and readily flows into
and out of certain areas of the /idney. #o our correct answer to $uestion is choice 3.
/lycolysis begins when glucose reacts with which of the following enzymes?
&. &ldolase
2. 1e0o/inase
C. Phosphofructo/inase
3. Phosphoglucose isomerase
.. Pyru"ate /inase #he correct answer is $.
Dlycolysis is defined as the se$uence of reactions that con"erts glucose into pyru"ate with the
concomitant production of &TP. The process of glycolysis begins when glucose reacts with
he0o/inase to form glucose)7)phosphate. 8hen this compound interacts with the en,yme
phosphoglucose isomerase 5choice 36, the compound fructose)7)phosphate is formed. @ollowing
the formation of this compound, it is interacted with the en,yme phosphofructo/inase 5choice C6
to form the compound fructose 1,7)biphosphate. 8hen interacted with aldolase 5choice &6
glyceraldehyde 3)phosphate is formed. &fter a number of en,ymatic reactions, the compound
phosphoenolpyru"ate is formed. 8hen acted upon by pyru"ate /inase 5choice .6, pyru"ate is
formed and the glycolytic pathway is completed.
/lycosaminoglycans function as important structural components of
1. glycogen.
2. nucleic acids.
3. hyaluronidase.
4. connecti"e tissue
The correct answer is choice 4, connecti"e tissue. Dlycoprotein contains carbohydrate and
protein, usually more protein than carbohydrate. There is another class of glycoprotein which
contains I5H or more carbohydrate. To distinguish these compounds from other glycoproteins,
they are referred to as proteoglycans and their carbohydrate chains as glycosaminoglycans or
D&D. There are si0 classes of D&D molecules now recogni,ed. They are made up largely of
disaccharide repeating units. 2oth their electrical charge and 1 molecular structure aid in their
biological role. Choice 1, glycogen, is incorrect. Dlycogen consists of alpha 1,4 or alpha 1.7)
lin/ed glucose molecules. Choice 2 is incorrect. :ucleic acids form chromatin, the material which
ma/es up chromosomes. Choice 3, hyaluronidase, is incorrect. 1yaluronidase functions as a
lubricant and support element in connecti"e tissue. #o the correct answer to $uestion is choice
4.
-uman parotid saliva is believed to be hyposmolar because
1. water is reabsorbed by e0cretory ducts of the gland.
2. acinar cells transport water more readily than sodium ions.
3. striated duct cells produce e0cess water and retain potassium.
4. reabsorption of water by striated duct cells is less than reabsorption of sodium.
The correct choice is '4, resorption of water by striated duct cells is less than resorption of
sodium. To answer this $uestion you must ha"e an understanding of the epithelial components
of the sali"ary gland and the o"erall morphology. The epithelial components of a sali"ary gland,
histologically, include the acini, intercalated and striated ducts and the e0cretory duct cells. The
acinus resembles a spherical arrangement of protein)producing cells with well)de"eloped rough
endoplasmic reticulum. The product is secreted "ia secretory "esicles and tra"els through the
ductile lumen, passing by the cuboidal intercalated duct cells and striated cells. The striated
cells are responsible for the alteration of the fluid product. #odium ions, chloride ions and water
are remo"ed and transported bac/ into the blood, and potassium ions are added to the product
from the blood. Thus, we ha"e an acti"e process and the formation of the hypo)osmolar sali"a is
dependent on &TP and the functioning sodium)potassium pump. !n formation of sali"a the
resorption of water "ia the striated duct cells is less than the resorption of sodium. @rom the
striated duct the sali"ary product passes into the e0cretory duct, which carries sali"a into the
oral ca"ity. &gain, the correct choice is '4, resorption of water by striated duct cells is less than
the resorption of sodium.
-ypoactivity of the posterior pituitary gland leads to
&. dwarfism.
2. cretinism.
C. acromegaly.
3. diabetes insipidus.
The correct answer is Choice 3. The posterior pituitary gland secretes two important hormones,
o0ytocin and antidiuretic hormone. &ntidiuretic hormones control and regulate the concentration
of water in the body fluids. & hypoacti"ity of the posterior pituitary gland resulting in a
deficiency of antidiuretic hormone will lead to diabetes insipidus 5Choice 36. !n this condition.
the /idneys e0crete larger amounts of dilute urine causing dehydration and increased
concentration of sodium chloride in the e0tracellular fluid.
3warfism 5Choice &6 is caused by deficiency of anterior pituitary secretion of D1 5growth
hormone6 and not posterior pituitary secretion.
Cretinism 5Choice 26 is caused by e0treme hypothyroidism during fetal life, infancy, and
childhood.
&cromegaly 5Choice C6 is caused by an e0cessi"ely acti"e anterior pituitary gland, and e0cess
D1 in adulthood.
-ypothyroidism in an adult results in
1. my0edema.
2. thyroto0icosis.
3. osteitis fibrosa cystica.
4. increased basal metabolic rate.
The correct answer is choice 1. 1ypothyroidism refers to an underacti"e thyroid which produces
insufficient thyro0in. <nder this condition, basal metabolism rate is low, hair is sparse, s/in is
yellowish and dry, and cold is not well tolerated. !n adults, hypothyroidism is often termed
my0edema. !t is the opposite of choice 4, hyperthyroidism, which causes increased metabolic
rate. Choice 2. thyroto0icosis, is another term for hyperthyroidism. Choice 3, osteitis fibrosa
cystica, refers to a bone disease caused by hyperparathyroidism. !n this disease, multiple bone
cysts occur. #o the correct answer to $uestion is choice 1.
7f a patient becomes e!cited and nervous before a tooth e!traction and e!hales
large amounts of carbon dio!ide& the most likely effect on the body would be
&. ?actic acidosis
2. ;etabolic acidosis
C. ;etabolic al/alosis
3. (espiratory acidosis
.. (espiratory al/alosis
The correct answer is .. &n important buffer system in the human body in"ol"es carbon dio0ide
and bicarbonate ions as seen below.
CC2 9 12C K)L 12C-3 K)L 19 9 1CC3
&lterations in the carbon dio0ide and>or bicarbonate le"els will result in alterations in the blood
p1. (espiratory al/alosis de"elops when increased respiratory acti"ity, as seen with
hyper"entilation, lowers plasma PC-2 le"els below normal le"els. The resultant effect on blood
p1 will be a net increase. Con"ersely, respiratory acidosis 5choice 36 de"elops when decreased
respiratory acti"ity, as seen with hypo"entilation, increases plasma PCC2 le"els abo"e normal
le"els. The resultant effect on blood p1 will be a net decrease. ?actic acidosis 5choice &6 may
de"elop following se"ere e0ercise or prolonged tissue hypo0ia. The most common causes of
metabolic acidosis are lactic acidosis and /etoacidosis. ;etabolic acidosis 5choice 26 occurs when
the hydrogen ions liberated by these acids o"erwhelm the bicarbonate buffer system leading to
a net decrease in blood p1. ;etabolic al/alosis 5choice C6 occurs when bicarbonate
concentrations become ele"ated, leading to a net increase of blood p1.
7f a patient becomes hypotensive after the administration of a sedative before a
dental procedure& which of the following refle!es should help to correct the
patients low blood pressure?
&. &c$uired refle0
2. 2aroreceptor refle0
C. Chemoreceptor refle0
3. 1ering)2reuer refle0
.. Protecti"e refle0
The correct answer is 2. & refle0 is defined as a rapid automatic response to a stimulus. The
baroreceptor refle0es affect systemic blood pressure and stimulate the respiratory rate when
blood pressure declines. @or e0ample, aortic baroreceptors monitor blood pressure within the
ascending aorta. The aortic refle0, which is a baroreceptor refle0, adusts blood pressure in
response to changes at this particular location. The goal of this refle0 is to maintain ade$uate
blood flow throughout the circulatory system. &n ac$uired refle0 5choice &6 is a refle0 that is
considered to be "ery comple0 and is a learned motor pattern. &n e0ample of an ac$uired refle0
would be when an e0perienced dri"er steps on the bra/es of the car when an animal runs in
front of the "ehicle. The chemoreceptor refle0es 5choice C6 are stimulated by changes in p1,
PCC2 and PC2. The 1ering)2reuer refle0 5choice 36 is composed of two different refle0es+ the
inflation refle0 and the deflation refle0. The inflation refle0 pre"ents o"er e0pansion of the lungs
during forceful breathing and the deflation refle0 inhibits the e0piratory center and stimulates
the inspiratory center when the lungs are in danger of collapsing. Coughing and snee,ing are
protecti"e refle0es 5choice .6 that operate on the e0posure to chemical irritants, to0ic "apors or
mechanical stimulation of the respiratory system. Coughing is triggered by irritation of the
laryn0 and snee,ing is triggered by irritation of the wall of the nasal ca"ity.
7f a person has a stroke that results in a depression of the activity in the
pneumota!ic center of the pons& one would e!pect to see
&. 3ecreased apneustic center acti"ity
2. 3ecreased tidal "olume
C. !ncreased pulmonary "entilation
3. !ncreased respiratory rate
.. ?onger inspiratory cycle The correct answer is .. The apneustic center of the lower pons
and the pneumota0ic center of the upper pons adust the respiratory rate and depth of
respiration in response to stimuli. !n summary, the apneustic center promotes inhalation and the
pneumota0ic center, which inhibits apneustic center acti"ity, promotes e0halation. Therefore, if
the acti"ity of the pneumota0ic center is inhibited, there would be a much longer inspiratory
cycle since the acti"ity of the apneustic center cannot be inhibited. !n other words, apneustic
center acti"ity would increase 5choice &6. #ince only inspiration is promoted, the tidal "olume in
this person would be e0pected to increase 5choice 26. #ince the respiratory rate 5choice 36 will
decrease due to a lac/ of cyclic inhalations and e0halations, pulmonary "entilation would also be
e0pected to decrease 5choice C6.
7f a person suffered a stoke that left them partially paralyzed on one side of the
body& one would e!pect to see an increased number of which of the following cell
types in the area of the brain affected by the stroke?
&. &strocyte
2. .pendymal cells
C. ;icroglia
3. -ligodendrocyte
.. #atellite cells
The correct answer is C. !n a stro/e, the blood flow to a specific area of the brain is interrupted
by some /ind of bloc/age or "ascular rupture. !f the circulation to a gi"en region is interrupted
for more than a few seconds the neurons will be permanently damaged. The degree of
functional impairment that an indi"idual will suffer after a stro/e is determined by the duration
of circulatory interruption as well as the si,e of the region depri"ed of blood. &fter a stro/e, the
ner"e cells will become damaged. Therefore, one would e0pect to see an increased number of
microglia cells in the affected area. ;icroglia cells are responsible for remo"ing cellular debris,
wastes and pathogens by the process of phagocytosis. &strocytes 5choice &6 are glial cells that
maintain the integrity of the blood brain barrier, pro"ide structural support and regulate ion,
nutrient and dissol"ed gas concentrations. .pendymal cells 5choice 26 assist in the production,
circulation and monitoring of cerebrospinal fluid. -ligodendrocytes 5choice 36 myelinate C:#
a0ons and pro"ide the structural framewor/ for the a0ons in the C:#. #atellite cells 5choice .6
are the glial cells found in the peripheral ner"ous system and surround the neuron cell bodies in
the ganglia.
7f a person& who has lived at sea level all their life& takes a vacation to a
mountain resort& which of the following physiological changes will most likely be
seen in this individual after a few days?
&. 3ecreased blood pressure
2. .le"ated hematocrit
C. 3ecreased P-2 in the al"eoli
3. 3ecreased "entilation rate
.. !ncreased hemoglobin saturation
The correct answer is 2. 2oth atmospheric pressure and the partial pressures of the component
gasses, including o0ygen, decline with increasing altitude. !ndi"iduals li"ing at sea le"el
normally function with an al"eolar pressure around BC)IC mm1g. 1owe"er, at higher ele"ations,
the al"eolar P-2 can fall to as low as 7C mm1g. &lthough the al"eolar P-2 decreases, the body
will ma/e important physiological adustments to compensate, such as increasing heart rate
5leading to an increased blood pressure 5choice &6, ele"ated hematocrit 5choice 26 to account
for the decreased hemoglobin saturation 5choice .6 as well as increasing the "entilation rate
5choice 36 to increase the flow of o0ygen through the lungs.
7f an agonist produces fle!ion& the primary action of the antagonist would be
&. &bduction
2. &dduction
C. .0tension
3. -pposition
.. Protraction
The correct answer is C. @le0ion is described as a mo"ement in the anterior>posterior plane that
decreases the angle between the articulating e0tremities. @or e0ample, fle0ion occurs at the
biceps. !f an agonist produces fle0ion, the primary action of the antagonist would be e0tension,
which re"erses the action of fle0ion. .0tension occurs in the same plane but increases the angle
between the articulating e0tremities. The triceps cause e0tension. &bduction 5choice &6 is the
mo"ement away from the longitudinal a0is of the body. @or e0ample, swinging the right arm to
the side. Con"ersely, adduction 5choice 26 is mo"ement toward the longitudinal a0is of the body.
-pposition 5choice 36 is the mo"ement of the thumb that allows it to grasp and hold "arious
obects. Protraction 5choice .6 is described as the mo"ement of a gi"en part of the body
anteriorly in a hori,ontal plane% the grasping of ones upper lip with their lower teeth is a
protracting mo"ement.
7f an individual becomes hyponatremic& which of the following physiological
responses would one e!pect to see?
&. !ncreased aldosterone le"els
2. !ncreased antidiuretic hormone release
C. !ncreased thirst
3. !ncreased water retention
.. #timulation of the osmoreceptors
#he correct answer is A.
1yponatremia is a condition where sodium ion le"els in the blood are lower than normal. There
are many different mechanisms through which sodium le"els can be regulated. -ne of the
primary ways in which hyponatremia occurs is through the dilutional effect of increased blood
"olume secondary to increased fluid inta/e. 8hen sodium le"els are low, one would e0pect to
see an increased blood le"el of aldosterone. &ldosterone causes sodium to be reabsorbed from
the filtrate in e0change for potassium. Therefore, aldosterone increases sodium ion
concentrations. &ll of the other answer choices 5situations6 would be e0pected to be seen in an
indi"idual with hypernatremia. !n hypernatremia, osmoreceptors are stimulated 5choice .6 which
then causes antidiuretic hormone 5&316 to be released 5choice 26 and an increased thirst for
fluid 5choice C6. 8hen &31 is released there is an increased water retention 5choice 36, leading
to an increased blood "olume and a subse$uent lowering of sodium ion le"els.
7f an individual contracted a disease that destroyed a portion of the cells in the
anterior gray horn of the lumbar region of the spinal cord& one would e!pect to
e!perience which of the following?
&. 3ecreased ability to breathe
2. 3ecreased sensation in the hands
C. 3ecreased sensation in the legs
3. Problems with raising the arms
.. Problems with wal/ing
The correct answer is .. The cell bodies of the neurons in the gray matter of the spinal cord
contain two types of nuclei% sensory nuclei and motor nuclei. The posterior portion of the gray
horn contains somatic and "isceral sensory nuclei. The anterior gray horn contains somatic
motor nuclei. Therefore, if an indi"idual damages the cells in the anterior gray horn of the spinal
cord, one would be e0pected to ha"e a decreased ability to perform associated motor functions.
#ince the lumbar ple0us of the spinal cord is responsible for coordinating ones ability to wal/,
the indi"idual in this $uestion would most li/ely ha"e problems wal/ing. 1owe"er, since the
white matter was not damaged, the sensation in the legs would not be affected 5choice C6.
-neEs ability to breathe would be affected by the neurons of the cer"ical ple0us 5choice &6. The
sensations of the hands 5choice 26 and ability to mo"e the arm 5choice 36 are regulated by the
ner"es in the brachial ple0us.
7f an individual contracted travelers diarrhea and was unable to ingest
carbohydrates& one would e!pect to see which of the following?
&. 3ecreased gluconeogenesis in the li"er
2. 3ecreased le"els of urea in the blood
C. !ncreased blood p1
3. !ncreased protein metabolism
.. 4etosis
The correct answer is .. !f carbohydrates cannot be ingested for an e0tended period of time, the
body will begin to con"ert both fat and protein stores into carbohydrates. 4etosis is a condition
that occurs when the body increases the production of /etone bodies from the catabolism of the
glucogenic and /etogenic amino acids. &s mentioned before, when carbohydrate reser"es ha"e
been e0hausted, the body will cataboli,e amino acids 5choice 36 during the process of
gluconeogenesis 5choice &6. -nce the amino acids ha"e been bro/en down, ammonia will be
generated through this catabolic process. The ammonia created will be con"erted to urea
5choice 26. 8ith the increased production of /eto acids, one would e0pect to see a decreased
blood p1 5choice C6.
7f an individual damaged their fifth cranial nerve& they would be e!pected to have
an inability to perform which of the following cranial refle!es?
&. &uditory refle0
2. Corneal refle0
C. 3irect light refle0
3. Tympanic refle0
.. *estibuloocular refle0
The correct answer is 2. The cranial refle0 arc in"ol"es both sensory and motor fibers of the
cranial ner"es. The afferent di"ision of cranial ner"e * 5trigeminal ner"e6 is responsible for
pro"iding the corneal refle0. The cranial refle0 is a somatic refle0 that results in the blin/ing of
the eye when there is contact with the corneal surface. The "estibuloocular ner"e 5cranial ner"e
*!!!6 coordinates three somatic refle0es% &uditory refle0, tympanic refle0 and "estibuloocular
refle0. The auditory refle0 5choice &6 is stimulated by a loud noise+ the eyes and>or head will
mo"e in the direction of the sound. The tympanic refle0 5choice 36 is also stimulated by a loud
noise. This refle0 causes a reduced mo"ement of the auditory ossicles. The "estibuloocular
refle0 5choice .6 is stimulated by the rotation of the head. 8ith this refle0, there is an opposite
mo"ement of the eyes in the direction of the mo"ing head to stabili,e the filed of "ision. The
direct light refle0 5choice C6 results in the constriction of the ipsilateral pupil when light is
stri/ing the photoreceptors in the eye.
7f an individual decides to go on a hunger strike and ingest only water on a daily
basis& one would e!pect to see which of the following after appro!imately one
week?
&. 3ecreased urine output
2. !ncreased androgen le"els
C. !ncreased glucocorticoid le"els
3. !ncreased insulin le"els
.. !ncreased lipogenesis
The correct answer is C. 8hen indi"iduals do not ingest nutrients for a period of time, the body
goes into a metabolic state where it must rely on internal energy reser"es to continue meeting
its own energy demands. &ppro0imately 12 hours each day is spent in this metabolic state. The
primary focus of this state is to mobili,e energy reser"es and maintain normal blood glucose
le"els. 8ith respect to the indi"idual on the Ahunger stri/eA in this $uestion, carbohydrate
reser"es will become depleted se"eral hours after the last meal. -nce these reser"es are
depleted, the body will then focus on con"erting lipids and proteins into carbohydrates in an
effort to maintain AnormalA blood glucose le"els. !ncreased glucocorticoid le"els will ha"e the
following metabolic effects% stimulation of amino acid and lipid brea/down by the li"er+ protein
brea/down in s/eletal muscles+ and gluconeogenesis and glycogenolysis in the li"er. !n other
words, if an indi"idual decides to go on a hunger stri/e and ingest only water on a daily basis,
one would e0pect to see increased glucocorticoid le"els se"eral hours after the ingestion of the
last meal. &s long as the indi"idual on the hunger stri/e maintains normal water inta/e, urine
output should remain constant 5choice &6. !n Astar"ation,A androgen le"els would be e0pected to
decrease 5choice 26 because these hormones increase amino acid usage in protein synthesis.
#ince insulin 5choice 36 is responsible for decreasing blood glucose le"els, one would e0pect to
see decreased insulin le"els in this indi"idual. ?ipids are being bro/en down in this indi"idual,
not being stored 5lipogenesis6 5choice .6.
7f an individual had hepatitis& one would e!pect to see
&. 3ecreased clotting time
2. 1yperglycemia
C. 1ypernatremia
3. 1ypoalbuminemia
.. 1ypoglycemia
The correct answer is 3. The li"er is responsible for both metabolic and hematological regulation
as well as o"er 2CC different functions. The li"er is also responsible for plasma protein synthesis.
The hepatocytes synthesi,e and release the maority of plasma proteins in the blood, including
albumin. &lbumin is responsible for contributing to the osmotic concentration of the blood as
well as acting as a transport protein. Therefore, in indi"iduals with hepatitis, one would e0pect
to see hypoalbuminemia. #ince the li"er is responsible for the production of "arious clotting
factors and the storage of "itamin 4, one would e0pect to see increased clotting times 5choice
&6. The pancreas is responsible for the production of glucagon and insulin, which ha"e
hyperglycemic 5choice 26 and hypoglycemic 5choice .6 effects, respecti"ely. 1ypernatremia
5choice C6 is a condition characteri,ed by high sodium ion concentrations+ this condition often
occurs in indi"iduals with renal failure.
7f an individual ingested a large amount of medication that inhibited the liver
from utilizing vitamin K& this individual would most likely e!perience which of the
following?
&. &cidosis
2. &nemia
C. 1emorrhage
3. #ei,ure
.. Thrombocytopenia
The correct answer is C. 2oth "itamin 4 and calcium ions affect almost e"ery aspect of the
clotting process+ the intrinsic, e0trinsic and common clotting pathways. &de$uate amounts of
"itamin 4 must be present for the li"er to be able to synthesi,e four clotting factors, which
include prothrombin. 8ithout "itamin 4, the entire clotting system will be inacti"ated. Therefore,
if an indi"idual ingested a large amount of medication that inhibited the li"er from utili,ing
"itamin 4, this indi"idual would most li/ely e0perience some degree of hemorrhage.
1emorrhage would most li/ely occur because the body would be unable to stop bleeding in a
traumatic e"ent. 8arfarin sodium is a medication that inhibits the action of "itamin 4. &cidosis
5choice &6 is a condition where the blood p1 is less than =.4. &nemia 5choice 26 is a condition
mar/ed by a reduction in the hemoglobin and>or hematocrit content of the blood. & sei,ure
5choice 36 can be defined as a condition characteri,ed by a sudden onset of con"ulsions or other
epileptic symptoms. Thrombocytopenia 5choice .6 is characteri,ed by an abnormally low platelet
count.
7f an individual is dehydrated& one would e!pect to see increased production of
the hormone necessary for preserving water. #his hormone is produced in
&. &nterior pituitary
2. 1ypothalamus
C. Pancreas
3. Parathyroid
.. Posterior pituitary
The correct answer is 2. The hypothalamus produces antidiuretic hormone that leads to
increased water reabsorption in the /idney. Therefore, if an indi"idual is dehydrated, one would
e0pect to see increased production of this hormone in an effort to pre"ent water loss. The
hypothalamus also produces o0ytocin, which is responsible for stimulating uterine contractions.
&lthough both these hormones are produced in the hypothalamus, they are stored in the
posterior pituitary 5choice .6. The anterior pituitary 5choice &6 produces "arious hormones, such
as growth hormone, prolactin, adrenocorticotropin hormone, thyroid stimulating hormone,
luteni,ing hormone and follicle stimulating hormone, all of which do not affect blood calcium
le"els. The pancreas, 5choice C6, produces the hormones insulin and glucagon that are in"ol"ed
with the regulation of blood glucose le"els. The parathyroid, 5choice 36, produces parathyroid
hormone, which increases calcium blood le"els in body fluids through the simulation of
osteoclasts. These are large, motile multinucleated cells found on bone surfaces. 8hen
stimulated by parathyroid hormones, these cells increase blood calcium le"els by the resorption
of bone tissue.
7f an otherwise healthy 2 year old female had her ovaries removed& one would
e!pect to see all of the following ()'(*#
&. &menorrhea
2. !ncreased blood le"els of estrogen
C. !ncreased blood le"els of follicle stimulating hormone
3. !ncreased blood le"els of luteini,ing hormone
.. !ncreased blood le"els of gonadotropin releasing hormone
The correct answer is 2. The o"aries are small organs located near the lateral walls of the pel"ic
ca"ity of females. These organs are responsible for the production of o"a, secretion of estrogen
and progestins, and the inhibition of other reproducti"e hormones. !f the o"aries were remo"ed,
estrogen le"els would decrease immediately. .strogen is responsible for maintaining secondary
se0 characteristics, stimulation of the repair of the endometrium and inhibition of gonadotropin
releasing hormone 5Dn(16 5choice .6. 8ithout estrogen, amenorrhea 5choice &6 will occur+ this
condition is characteri,ed by a cessation of menstruation. #ince estrogen inhibits the secretion
of Dn(1, and Dn(1 stimulates the secretion of both follicle stimulating hormone 5@#16 5choice
C6 and luteini,ing hormone 5?16 5choice 36 , one would e0pect to find increased blood le"els of
all three hormones in the absence of estrogen. 2oth follicle stimulating hormone and luteini,ing
hormone stimulate follicular de"elopment.
7f it is dangerous for an infant to ingest a product containing aspartame& he most
likely has which of the following genetic disorders?
&. 1yperornithemia
2. 1yperuricemia
C. 1yper"alinemia
3. Phenyl/etonuria
.. 8ilson disease
The correct answer is 3.
The administration of any product that contains phenylalanine, such as aspartame, to an
indi"idual with any of the hyperphenylaninemias could be detrimental to his or her general
health. The hyperphenylaninemias result from an impaired con"ersion of phenylalanine to
tyrosine. The most common and clinicaliy important is phenyl/etonuria, which is characteri,ed
by an increased concentration of phenylalanine in blood, increased concentration of
phenylalanine and its by)products 5such as phenylpyru"ate, phenylacetate, and phenyllactate6
in urine, and mental retardation. Phenyl/etonuria is a condition caused by a deficiency of
phenylalanine hydrolase. &lthough this is a rare condition, the <.#. @ood and 3rug
&dministration re$uires that the following warning be placed on all food products that contain
aspartame% Caution phenyl/etonurics ) Contains phenylalanine. 1yperornithemia 5choice &6 is
an inherited disorder of amino acid metabolism that results from a defect of the en,yme
ornithine decarbo0ylase. This condition is associated with mental retardation, neuropsychiatric
dysfunction, and protein intolerance. 1yperyricemia 5choice 26 is a condition associated with
higher than normal blood le"els of uric acid. This condition is commonly /nown as gout.
1yper"alinemia 5choice C6 is an inherited disorder of amino acid metabolism that results from a
defect of the en,yme "aline aminotransderase. This condition is associated with mental
retardation, neuropsychiatric dysfunction, and protein intolerance. 8ilson disease 5choice .6 is
an autosomal)recessi"e disorder associated with an abnormality of the hepatic e0cretion of
copper resulting in to0ic accumulations of the metal in the brain, li"er, and other organs.
7f one individual is diagnosed with a parasitic infection and another individual is
diagnosed as having an allergic reaction& one would e!pect to see increased
blood levels of which of the following in both patients?
&. 2asophils
2. .osinophils
C. .rythrocytes
3. ;ega/aryocytes
.. ;onocytes
The correct answer is 2. .osinophils attac/ foreign obects in the body that ha"e already been
coated with antibodies. They are phagocytic cells that will engulf antibody)mar/ed bacteria,
cellular debris and parasites. #ince they are sensiti"e to circulating allergens 5substances that
trigger allergies6, their numbers increase during allergic reactions. 2asophils 5choice &6 migrate
to the site of inury and cross the capillary endothelium to accumulate within the damaged
tissues, where they discharge their granules. These granules include histamine and heparin.
.rythrocytes 5choice C6, or mature red blood cells, are responsible for transporting o0ygen
throughout the body. ;ega/aryocytes 5choice 36 form platelets, which are responsible for
helping blood to AclotA when inury occurs. ;onocytes 5choice .6 are aggressi"e phagocytes that
engulf foreign bodies and release chemicals that attract and stimulate neutrophils and other
phagocytic cells.
7f the conversion of #4 to #3 was inhibited& what physiological changes would
one e!pect to see?
&. 3ecreased T#1 le"els
2. !ncreased body temperature
C. !ncreased heart rate
3. !ncreased thyro0ine le"els
.. :ormal metabolic rate
The correct answer is 3. The thyroid gland produces large $uantities of T4 5thyro0ine6+ howe"er,
T3 5triiodothyronine6 is the hormone responsible for producing the obser"ed effects of the
thyroid hormones. T4 is typically con"erted to T3 by en,ymes in the peripheral tissues.
&ppro0imately ICH of the T3 that reaches its target cells is produced from the con"ersion of T4.
Therefore, if the con"ersion of T4 to T3 were bloc/ed, one would e0pect to see increased T4
5thyro0ine6 le"els. 8ith a decrease in the T3 le"els in the blood. the body will compensate by
increasing the secretion of thyroid stimulating hormone 5choice &6 in an effort to increase both
T4 and T3 le"els. #ince T3 is primarily responsible for the physiological effects of thyroid
hormones, one would e0pect to see decreased body temperature 5choice 26, decreased heart
rate 5choice C6 and decreased metabolic rate 5choice .6.
7f the digestion of a carbohydrate results in large amounts of the
monosaccharides glucose and galactose& the parent compound was most likely
&. Cellulose
2. Dlycogen
C. ?actose
3. ;altose
.. #ucrose
The correct answer is C. Prior to absorption, disaccharides and polysaccharides must be bro/en
down into simple sugars by a "ariety of en,ymes. @or e0ample, the en,yme lactase causes the
release of a molecule of glucose and galactose from the hydrolysis of the disaccharide lactose.
Cellulose 5choice &6 is a structural component found in many plants+ the body cannot digest this
compound at all. Dlycogen 5choice 26 is a branched polysaccharide composed of interconnected
glucose molecules+ when this compound is bro/en down, many glucose molecules are formed.
The en,yme maltase splits the bonds in a molecule of the disaccharide maltose 5choice 36 to
yield two glucose molecules. Dlucose and fryctose are formed when sucrose 5choice .6 is
hydroly,ed by the en,yme sucrase.
7f the thymus decreased the production of thymosins& one would e!pect to see a
decrease in which of the following?
&. 2)lymphocytes
2. Complement
C. Cytoto0ic T cells
3. :4 cells
.. :eutrophils
The correct answer is C. ?ymphopoiesis 5or lymphocyte production6 in"ol"es the bone marrow,
thymus and peripheral lymphatic tissues. The bone marrow produces hemocytoblasts which
e"entually generate lymphocytic stem cells responsible for Me production of lymphocytes. The
lymphocytic stem cells that migrate to the thymus to differentiate into T cells do so under the
influence of AthymosinsA Therefore, if the thymus decreased production of thymosins, there
would be a decrease in the number of T cells in the body, including cytoto0ic T cells. !f the
lymphocytic stem cells remain in the bone marrow, they will differentiate into immature 2 cells
5choice &6 and :4 5natural /iller6cells 5choice 36. -nce matured, the 2 cells will mo"e to the
lymph nodes and the :4 cells will roam throughout the body in search of abnormal cells.
Complement 5choice 26 is a system of circulating proteins that assists antibodies in the
destruction of pathogens through the brea/down of their cell walls. Complement is not affected
by thymosin secretion. :eutrophils 5choice .6 or P;:Es attac/ cells or pathogens that ha"e been
Amar/edA with antibodies or complement proteins. The production of these cells is stimulated by
colony stimulating factors, such as D#@.
7f the.action of >?.alpha.hydro!ylase is inhibited& the formation of which of the
following is most likely to be decreased?
&. &ldosterone
2. Cholesterol
C. Cortisol
3. Progesterone
.. Testosterone
The correct answer is ..
8hen cholesterol 5choice 26 comes in contact with the en,yme cholesterol desmolase, the
substance pregnenolone is formed. This compound is generally in"ol"ed in two en,ymatic
processes. 8hen pregnenolone is reacted with 1=)alpha hydrolase, it will be con"erted to the
compound 1=)hydro0ypregnenolone. &fter a series of en,ymatic reactions, it will e"entually be
con"erted to testosterone. Therefore, if the action of 1=)alpha)hydro0ylase is inhibited, the
formation of testosterone is most li/ely to be decreased. !f pregnenolone is reacted with 3)beta)
hydro0ysteroid dehydrogenase, it will be con"erted to progesterone 5choice 36. 8hen
progesterone undergoes a series of en,ymatic reactions, it can be con"erted to either
aldosterone 5choice)&6 or cortisol 5choice C6.
7f& through a traumatic event& the blood flow to the kidneys decreases& one would
e!pect to see which of the following?
&. 3ecreased aldosterone secretion
2. 3ecreased water reabsorption
C. 3ilation of the efferent arteriole
3. !ncreased renin secretion
.. !ncreased systemic "asodilation
The correct answer is 3. The glomerular filtration rate depends on the filtration pressure mo"ing
across the glomerular capillaries. 8hen there is a decline in the renal blood pressure, the /idney
will ta/e se"eral actions to increase this low blood pressure. (enin release increases when the
glomerular pressure decreases or the osmolarity of f glucose the tubular fluid reaching the distal
tubule decreases. (enin is a hormone released by the u0taglomerular apparatus in the /idneys.
This hormone con"erts the inacti"e protein angiotensinogen to angiotensin !. -nce this occurs, a
con"erting en,yme will con"ert angiotensin ! to angiotensin !!, which has the following
physiological effects% Peripheral "asoconstriction, constriction of the efferent arteriole 5choice C6,
stimulation of the reabsorption of sodium ions and water in the pro0imal tubule and triggering
the release of two hormones 5antidiuretic hormone and aldosterone 5choice &6. &ll of these
factors ser"e to increase blood pressure. 3ecreasing water reabsorption 5choice 26 will further
lower blood "olume and blood pressure. #ystemic "asodilation 5choice .6 will draw blood from
the internal organs, including the /idneys, to the peripheral tissues.
7n a comparison of the sympathetic and parasympathetic divisions of the
autonomic nervous system& all of the following are true ()'(*#
&. &cetylcholine is secreted by the postganglionic fibers of both the sympathetic and
parasympathetic ner"ous systems.
2. .pinephrine is secreted by some of the ganglionic neurons in the sympathetic ner"ous
system.
C. The parasympathetic ner"ous system promotes energy storage and the sympathetic
ner"ous system promotes usage of energy reser"es.
3. The preganglionic neurons of the sympathetic ner"ous system are relati"ely short and
the preganglionic neurons of the parasympathetic ner"ous system are relati"ely long.
.. The sympathetic di"ision is primarily located between spinal segments T1 and ?2 and the
parasympathetic di"ision is primarily located between spinal segments #2 and #4
The correct answer is &. The sympathetic and parasympathetic di"isions of the autonomic
ner"ous system ha"e distincti"e characteristics. @or e0ample, acetylcholine is secreted by the
postganglionic fibers of parasympathetic ner"ous system, whereas, norepinephrine is primarily
secreted by the post ganglionic fibers of the sympathetic ner"ous system. .pinephrine is
secreted by the ganglionic neurons in the sympathetic ner"ous system, that release this
hormone directly into the circulatory system 5choice 26 The parasympathetic ner"ous system
promotes energy storage 5rest6 and the sympathetic ner"ous system promotes usage of energy
reser"es. 5fight or flight6 5choice C6. The preganglionic neurons of the sympathetic ner"ous
system are relati"ely short and the preganglionic neurons of the parasympathetic ner"ous
system are relati"ely long 5choice 36. 8ith respect to general anatomy the sympathetic di"ision
is primarily located between spinal segments T1 and ?2, and the parasympathetic di"ision is
primarily located between spinal segments #2 and #4 5choice .6.
7n addition to causing beriberi& thiamine deficiency can lead to the development
of which of the following?
&. Carotenemia
2. 4orsa/off syndrome
C. Pellagra
3. Pernicious anemia
.. #cur"y
The correct answer is 2.
2eriberi is a condition caused by a deficiency of thiamine. !t typically occurs in alcoholics
because of impaired absorption. Cardio"ascular complications secondary to beriberi include a
high)output state, bi"entricular myocardial failure, and retention of sodium. &nother
complication of thiamine deficiency is 4orsa/off syndrome. This condition is mostly associated
with neurologic complications. Carotenemia 5choice &6 results from e0cessi"e inta/e of "itamin &
and leads to a yellowing of the s/in, especially on the palms and soles. & deficiency of niacin can
lead to pellagra 5choice C6, which is a disease typically associated with dermatitis, dementia,
and diarrhea. Pernicious anemia 5choice 36 is a condition caused by a deficiency of "itamin 212,
or cyanocobalamin. #cur"y 5choice .6 is caused by a deficiency of "itamin Cand can lead to
perifollicular hemorrhage.
*hysiology
7n anaerobic glycolysis& glucose is broken down into pyruvic acid& which is then
primarily converted to
&. &cetyl)Co&
2. Citric acid
C. Dlycogen
3. ?actic &cid
.. Creatinine phosphate
The correct answer is 3. The anaerobic process of glycolysis enables the cell to create &TP when
the mitochondria are unable to meet the AcurrentA energy demands in the absence of o0ygen.
8hen the local area is o0ygen deficient, glucose is still con"erted into pyru"ic acid, which is
subse$uently con"erted to lactic acid. ?actic acid is an organic acid that in the body dissociates
into a lactate ion and a hydrogen ion. This process is a temporary solution to maintain the
energy demands of the body+ howe"er, when the muscle is continually subected to this
anaerobic state, it will cease to contract secondary to the low p1. !n the presence of o0ygen
5aerobic glycolysis6 glucose is bro/en down into pyru"ic acid, which is then primarily con"erted
to &cetyl)Co& 5choice &6, which then enters the TC& cycle. The formation of citric acid 5choice 26
is the first step in the TC& cycle. Dlycogen 5choice C6 is the storage form of glucose. !n s/eletal
muscle, some of the &TP generated is transferred and stored in another high)energy compound,
creatinine phosphate 5choice .6. The energy stored in this compound is used to ArechargeA &3P
to &TP during muscle contractions
*hysiology
7n males& growth and development of secondary se! organs are under direct
control of
1. @#1 and ?1.
2. aldosterone.
3. progesterone.
4. testosterone
/ood 0ork
The correct choice is '4, testosterone. Testosterone is the primary se0 steroid produced by the
?eydig cells of the testes. !ts effects are as follows% stimulates se0 dri"e, maintains secondary
se0ual characteristics, stimulates growth and secretory acti"ities of the accessory se0 glands,
maintains spermatogenesis. !t is also responsible for embryogenesis of male ducts, systems and
e0ternal genitalia and subse$uent maturation at the time of puberty. 3escent of the testes into
the scrotum from the abdominal ca"ity at birth is under control of testosterone. !t also promotes
the growth of many bodily tissues through anabolic effects. The action of testosterone on
androgen)sensiti"e tissues appears to be mediated by con"ersion of testosterone to
dihydrotestosterone by the target cell. 3ihydrotestosterone is the acti"e hormone in the
prostate, epididymis and on the tissues to promote growth. The action is mediated by induction
of (:& and protein synthesis "ia androgen receptors, similar to the effects of other steroids on
other steroid receptors. Testosterone can also be con"ened to estradiol in the testes and
peripherally. &gain, the correct choice is '4, testosterone.
*hysiology
7n o!idative phosphorylation& the energy for the synthesis of A#* is provided by
the
&. brea/ing of co"alent bonds in glucose molecules
2. creation of carbon dio0ide and a metabolic waste product
C. formation of DTP from DP3
3. mo"ement of hydrogen ions through channels in the respiratory en,ymes
.. splitting of water molecules into hydrogen and o0ygen atoms
The correct answer is 3. -0idati"e phosphorylation is the process that produces greater than
ICH of the &TP used by the cells in our body. The maor steps in"ol"ed in this process occur
within the Aelectron transport system 5.T#6A or Arespiratory chainA of the mitochondria. The
steps at the end of the electron transport system where &TP is generated are as follows% &long
the .T#, the respirafory en,ymes continually pump hydrogen ions from the matri0 of the
mitochondria to the intermembrane space, which creates a large concentration gradient. &t the
end of the .T#, hydrogen ions pass through channels in the respiratory en,ymes along the
concentration gradient. &s the hydrogen ions pass through these en,ymes, the energy created
is used to con"ert &3P to &TP. The brea/ing of co"alent bonds in glucose molecules 5choice &6,
creation of carbon dio0ide and a metabolic waste product in the TC& cycle 5choice 26 and
splitting of water molecules into hydrogen and o0ygen atoms 5choice .6 all re$uire energy or do
not create energy. The formation of DTP from DP3 5choice C6 is a process that creates &TP in
the TC& cycle 54rebEs cycle6.
*hysiology
7n response to e!cess water in the body& one would e!pect to see which of the
following physiological changes?
&. 3ecreased glomerular filtration rate
2. 3ecreased permeability of the distal con"oluted tubules and collecting duct
C. !ncreased antidiuretic hormone le"els
3. !ncreased permeability of the ascending loop of 1enle
.. !ncreased urine osmolality
The correct answer is 2. 8hen the blood "olume increases due to an accumulation of water in
the body, the /idneys are responsible for remo"ing the e0cess fluid. &lthough both the distal
con"oluted tubule and collecting tubules are primarily in"ol"ed in the reabsorption of sodium
ions, they can impact the osmolality of urine by increasing or decreasing the reabsorption of
water. 8hen there is e0cess fluid in the body, these two portions of the nephron will decrease
their permeability to water+ hence, the elimination of fluid in the urine will increase. 3eareasing
the glomerular filtration rate 5choice &6 will decrease the amount of water e0creted by the
/idneys. &ntidiuretic hormone 5choice C6 primarily functions to decrease the elimination of
water, through greater reabsorption through the more permeable walls of the collecting tubules.
#ince the ascending loop of 1enle is primarily in"ol"ed with the reabsorption of ions, increasing
its permeability will not increase the elimination of water 5choice 36. &s a general rule, as the
urine osmolality increases 5urine is more salty6, the amount of water in the urine decreases.
Therefore, an increased urine osmolality is associated with a decreased e0cretion of fluid.
*hysiology
7n response to respiratory alkalosis& which of the following physiological effects
will most likely occur?
&. The body will retain carbon dio0ide
2. The /idneys will conser"e bicarbonate
C. The /idneys will increase the secretion of hydrogen ions
3. The respiratory rate will increase
.. The tidal "olume will increase
The correct answer is &. (espiratory al/alosis typically de"elops when the plasma PCC2 le"els
drop below normal le"els. Therefore, when this condition occurs, the body will wor/ to retain
carbon dio0ide to increase the PCC2 le"els and correct the al/alosis. !f the /idneys were to
conser"e bicarbonate 5choice 26 or increase the secretion of hydrogen ions 5choice C6, the
se"erity of the respiratory al/alosis would increase. #ince the primary cause of respiratory
al/alosis is hyper"entilation and loss of CC2, increasing the respiratory rate 5choice 36 would
only worsen the situation. !ncreasing the tidal "olume 5choice .6 would not affect an indi"iduals
respiratory al/alosis.
*hysiology
7n the absence of compensatory changes& a drop in blood pressure results from
1. "asoconstriction.
2. increased hematocrit.
3. increased stro/e "olume.
4. increased cardiac output.
5. decreased "enous return.
The correct choice is '5, decreased "enous return% The autonomic ner"ous system plays a
maor role in controlling the circulation, regulating the cardiac output, "ascular resistance and
"enous capacitance. :er"ous control mechanisms respond $uic/ly and powerfully, allowing for
rapid adustments in different parts of the circulation. The ner"ous control of circulation in"ol"es
central control, sympathetic control and parasympathetic control, baroreceptor control and
chemoreceptor regulation. The baroreceptors are situated in the carotid sinus and aortic arch,
the heart and lungs. <pon stretching of the atria the ner"e endings are acti"ated, secondary to
an increase in blood pressure. The greater the stretch the greater the fre$uency of firing. & fall
in blood pressure produces a decrease in fre$uency which leads to sympathetically mediated
"asoconstriction and an increase in the heart rate. !ncrease in blood pressure will stretch atrial
walls, leading to an increase in the baroreceptor firing, resulting in a decrease in sympathetic
tone and a "agally mediated decrease in blood pressure. !n the absence of compensatory
changes a drop in blood pressure results from a decreased "enous return, or the correct choice
of '5.
*hysiology
7n the catabolism of an amino acid& all of the following are true statements
()'(*#
&. &mino acid catabolism re$uires the coen,yme deri"ati"e of "itamin 27 5pyrido0ine6.
2. 3eamination results in the generation of ammonia.
C. The first step in the catabolism of an amino acid is the remo"al of the central carbon.
3. The li"er is the primary site of deamination
.. Transamination attaches the amino group of an amino acid to a /eto acid.
The correct answer is C. The first step in the catabolism of an amino acid is the remo"al of the
amino group, not the central carbon. This process of amino acid catabolism re$uires the
coen,yme deri"ati"e of "itamin 27 5pyrido0ine6 5choice &6. The amino group can be remo"ed
either by deamination or transamination. 3eamination results in the generation of ammonia
5choice 26, which is then $uic/ly deto0ified into urea, which is subse$uently e0creted in the
urine. The li"er is the primary site of deamination reactions 5choice 36. Transamination is a
process that attaches the amino group of an amino acid to a /eto acid 5choice .6.
7n the coagulation phase& which of the following is involved in the common
pathway?
&. Christmas factor
2. @ibrinogen
C. 1ageman factor
3. Proaccelerin
.. Tissue factor
The correct answer is 2.
The process of homeostasis aids in the pre"ention of blood loss through the wall of damaged
"essels and establishes a framewor/ for tissue repairs. The common pathway begins when the
thromboplastin from both the intrinsic and e0trinsic pathways appears in the plasma. &fter a
series of reactions, prompted by these compounds, thrombin completes the coagulation process
by con"erting fibrinogen to fibrin. Christmas factor 5choice &6, or factor !F, is in"ol"ed in the
intrinsic pathway. 1ageman factor 5choice C6, or factor F!!, is in"ol"ed in the intrinsic pathway
and inacti"ates plasmin. Proaccelerin 5choice 36, or factor *, and tissue factor 5choice .6, or
factor !ll, are in"ol"ed with both the e0trinsic and intrinsic pathways.
*hysiology
7n the glycolytic pathway& the substance formed after the enzyme
phosphoglucose isomerase e!erts its action is
&. @ructose)7)phosphate
2. @ructose)1,7)biphosphate
C. Dlucose)7)phosphate
3. Dlyceraldehyde)3)phosphate
.. Pyru"ate
The correct answer is &. Dlycolysis, in summary, is a series of reactions that con"erts glucose
into pyru"ate with the concomitant production of &TP. Dlycolysis begins when glucose reacts
with he0o/inase to form the compound glucose) 7)phosphate 5choice C6. 8hen this compound
interacts with the en,yme phosphoglucose isomerase, the fructose)7)phosphate 5choice &6 is
formed. @ollowing the formation of this compound, the en,yme phosphofructo/inase will interact
with the fructose)7) phosphate to form fructose ! ,biphosphate 5choice 26. 8hen fructose)l,7)
biphosphate interacts with aldolase, glyceraldehyde 3)phosphate 5choice 36 is formed. &fter a
number of en,ymatic reactions, the compound phosphoenolpyru"ate is formed. 8hen it
interacts with pyru"ate /inase, pyru"ate 5choice .6 is formed. !n the presence of o0ygen the
pyru"ate is con"erted to acetyl)Co&.
*hysiology
7n the process known as cotransport all of the following are true ()'(*#
&. & carrier protein is re$uired
2. &TP is :-T re$uired
C. ;olecules can be mo"ed against a concentration gradient
3. -nly one molecule or ion can be mo"ed through the cell membrane at one time
.. The saturation phenomenon may be obser"ed
The correct answer is 3. !n secondary acti"e transport or cotransport, the carrier protein 5choice
&6 does not re$uire energy or &TP 5choice 26. !n this process, a secondary acti"e transport
protein is able to mo"e one or more ions along a concentration gradient. &s one material enters
a cell, another is remo"ed, hence the term Aco)transportA 5thus Choice 3 is not true and is our
answer6. 1owe"er, unli/e facilitated diffusion, the carrier proteins in this process are able to
mo"e molecules against a concentration gradient 5choice C6. #ince there are a limited number of
carrier proteins, when large $uantities of the ions or molecules present to the carrier proteins,
these proteins may become saturated 5choice .6.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
7n which of the following conditions might the systolic blood pressure be
abnormally high?
&. Cardiac shoc/
2. 1eart failure
C. &naphylactic shoc/
3. 3ecreased arterial compliance
.. *entricular fibrillation
The correct answer is Choice 3. #ystole is the period of contraction following diastole, a period
of rela0ation. #ystolic and diastolic pressures are often measured by the ausculatory method. !n
a young adult, the systolic pressure is about 12C mm 1g and about BC mm 1g for diastolic
pressure. #ystolic blood pressure may be abnormally high when the arteries become hardened
with arteriosclerosis and ha"e decreased compliance 5Choice 36. Conditions in Choices &, 2, C
and . will not cause an abnormally high systolic pressure. !n these circumstances, the systolic
pressure may be lower than normal because the contractility of the heart is compromised
*hysiology
7n which of the following parts of the circulatory system is blood pressure the
lowest?
1. &orta
2. *eins
3. &rterioles
4. Capillaries
5. ?arge arteries
Answer
The correct choice is '2 "eins. Pressure in the circulation is the force applied by the blood
against the unit of area of the wall of a blood "essel. !t is by con"ention measured in millimeters
of mercury. 2lood pressure of 12C mm1g, for e0ample, means that blood e0erts the force
sufficient to support a "ertical column of mercury 12C mm in height. The systolic pressure is the
pea/ of the entire cardiac cycle, occurring early in "entricular systole. The diastolic pressure is
the lowest pressure of the entire cardiac cycle, occurring in "entricular diastole. The pulse
pressure is the difference between the systolic and diastolic pressure. The "enous portion of the
circulation returns blood to the heart. They ser"e as capacitance "essels and at rest store up to
=5H of systemic blood "olume. Compared to the arterial part of the circulation the "enous
portion is characteri,ed by much lower pressures and much higher compliances. The normal
pressure ranges are as follows%
The right atrium has a pressure between 2)5 mm1g.
The right "entricle has a pressure between 15)2C mm1g.
Pulmonary artery 15)25 mm1g.
?eft atrium 5) 12 mm1g.
?eft "entricle 1CC) 14C mm1g.
&orta 1CC)14C mm1g.
#o again, the correct choice to $uestion is '2, "eins.

7n which of the following situations is an osmotic diuresis observed?
1. 3uring diabetes mellitus
2. 3uring water depri"ation
3. @ollowing ingestion of starch
4. @ollowing inection of Pitressin
The correct choice is '1, during diabetes mellitus. 2efore we answer this $uestion it is
important you understand the mechanism of insulin action. !nsulin increases the ma0imum
"elocity of carrier)mediated glucose transport increased energy)dependent transport of amino
acid, increased mo"ement of potassium, leads to hyperpolari,ation of cells. !n adipose tissue it
increases the affinity of carriers for glucose. !n the li"er it may increase amino acid transport,
but it is important that you understand that it has no effect on glucose transport in the li"er.
!nsulin causes a decrease in the cyclic &;P le"els, which affects en,ymes that cataly,e reactions
in"ol"ing gluconeogenesis and glycogen brea/down. !nsulin increases ribosomal (:& acti"ity,
therefore increasing protein synthesis. Dlucose is the most important signal promoting insulin
secretion by the beta cells of the pancreas. &rginine also stimulates the secretion of insulin.
3iabetes mellitus type !, or absent insulinopenia, is a state of inade$uate glucose utili,ation.
!nade$uate le"els of insulin lead to an inability to remo"e e0cess glucose from the blood. There
is a se"ere lac/ of ability to store foodstuffs as glycogen, fat and protein. The response is li/e
star"ation, so that there is an increase in gluconeogenesis and, therefore, an increase in the
concentration of glucose. ?oss of glucose in the urine osmotically brings with it the loss of water.
8ith it comes dehydration. #o the correct choice is 'l.
Ketone bodies are produced as a result of
&. Dluconeogenesis
2. Dlycogen brea/down
C. ?ipid and amino acid brea/down
3. Protein brea/down
.. Triglyceride brea/down
The correct answer is C. 4etone bodies are produced as a result of lipid and amino acid
brea/down. 8hen these substances brea/ down, acetyl)Co& is generated. &s acetyl)Co& le"els
increase, /etone bodies begin to form. 8hen e0cessi"e amounts of /etone bodies are formed,
the pathological state /nown as /etosis can occur. Dluconeogenesis 5choice &6 and
glycogenolysis 5glycogen brea/down6 occur when glucose is needed for the production of &TP
for "arious cells in the body. Dlycogen brea/down 5choice 26 results in the production of
glucose+ lactic acid is also produced in this process. 8hen protein is bro/en down 5choice 36,
amino acids are formed. Triglyceride brea/down 5choice .6 results in the production of lipids
@ipids are most characteristic of which of the following cellular components?
1. Cytoplasm
2. Ribosomes
3. Membranes
4. Chromosomes
The correct choice is '3, the membranes. The cell membrane is selecti"ely permeable and has
many transmembrane proteins whose functions are still being in"estigated. #ome
transmembrane proteins may function as channels for transport of materials into and out of the
phospho)lipid bilayer. &ll of the other choices listed here are subcellular structures and not
composed primarily of lipid. The cytoplasm contains these subcellular structures and is confined
by the membrane. #o again, the correct choice is '3.
@ow ,ensity @ipoprotein 6@,@8 particles get into cells by
&. simple diffusion.
2. cell)cell fusion.
C. acti"e transport.
3. facilitated diffusion.
.. receptor)mediated endocytosis.
The correct answer is Choice .. ?ow density lipoproteins 5?3?6 are large spherical particles made
up of a core of esterified cholesterol surrounded by a lipid bilayer containing protein. !t is the
primary source of cholesterol for cells outside of the li"er and intestine. ?3? are transported into
cells by receptor)mediated endocytosis 5Choice .6. 8hen cholesterol is needed, a cell
synthesi,es receptor proteins for ?3? and inserts them into its plasma membrane. ?3? binds to
these receptors and is ta/en up by the cell during endocytosis. 8hen too much free cholesterol
is accumulated, the cell shuts off ?3? receptor synthesis and thus stops the flow of cholesterol
into the cell.
Choices & through 3 do not describe the pathway in which ?3? is transported into a cell.
*hysiology
<5%# fluid reabsorption by the kidney occurs in which of the following?
&. 3istal tubule
2. Pro0imal tubule
C. Collecting duct
3. &scending loop of 1enle
.. 3escending loop of 1enle
The correct answer is choice 2. The nephron is the functional unit of the /idney. !t consists of
two main parts. The glomerulus portion through which large amounts of fluid are filtered from
the blood, and the tubule portion in which the filtered fluid from the glomerulus is con"erted into
urine. @luid absorption by the /idney occurs in the tubule portion of the nephron. This section is
further di"ided into segments each with a special function. The pro0imal tubule 5Choice 26 has
the highest capacity for fluid reabsorption. !n fact, most of the fluid reabsorbed by the /idney
occurs here.
The distal tubule 5Choice &6 is mainly responsible for reabsorption of ions. !t is "irtually
impermeable to water and urea.
The collecting duct 5Choice C6 is the terminal segment of the nephron tubule system. !t
reabsorbs less than 1CH of filtered water.
The ascending loop of 1enle 5Choice 36 is also "irtually impermeable to water. !t is chiefly
concerned with reabsorption of solute.
The descending loop of 1enle 5Choice .6 is highly permeable to water and moderately
permeable to most solutes. !t, howe"er, only reabsorbs about 2CH of the filtered water, far less
than the pro0imal tubules.
*hysiology
<ost heat is lost from the body by which of the following processes?
&. Conduction
2. Con"ection
C. ."aporation
3. !nsensible perspiration
.. (adiation
/ood 0ork
The correct answer is .. 1eat e0change with the en"ironment in"ol"es four basic processes%
(adiation, conduction, con"ection, and e"aporation. 8arm obects, such as the sun or our
bodies, will lose heat energy as infrared radiation. -ur bodies lose heat energy in the same
manner as the sun, e0cept in much smaller amounts. Dreater than half the heat lost from our
body can be attributed to the process of radiation. Conduction 5choice &6 is the process where
energy is directly transferred through physical contact with another substance. Con"ection
5choice 26 is the result of Aconducti"eA heat loss to the air that o"erlies the body. &s the body
conducts heat to the air ne0t to the s/in, the air warms and rises and is replaced by cool air.
&ppro0imately 1C)15H of the bodyEs heat is lost through this process. ."aporation 5choice C6 is
a process that changes li$uid to a "apor. !nsensible perspiration 5choice 36 is a form of
e"aporation where heat is lost at a constant rate throughout the day. This form of perspiration
accounts for appro0imately 2CH of the bodyEs heat loss.
*hysiology
<ost muscles in the body can be classified as
&. Circular muscles
2. Con"ergent muscles
C. Parallel muscles
3. Pennate muscles
.. #mooth muscles
The correct answer is C. #/eletal muscle is the most common type of muscle found within the
human body. ;uscle fibers within a s/eletal muscle form bundles called fascicles. The muscle
fibers within a fascicle organi,ation can be classified as being parallel muscles, circular muscles,
con"ergent muscles and pennate muscles. #ince most s/eletal muscles are composed of parallel
muscles, the maority of the muscles in the body can be classified as being parallel muscles. !n
a parallel muscle the fascicles are parallel to the long a0is of the muscle. !n a circular muscle
5choice &6 or sphincter, the muscle fibers are concentrically arranged around an opening or
recess. Circular muscles guard the entrances and e0its of internal passageways, such as the
digesti"e and urinary tracts. !n a con"ergent muscle 5choice 26, the muscle fibers are based
o"er a broad area+ howe"er, all the fibers come together at a common attachment site. @or
e0ample, they may pull on a tendon, a tendinous sheet or a slender band of collagen fibers. !n a
pennate muscle 5choice 36, the fascicles form a common angle with the tendon. #mooth
muscles 5choice .6 are not considered to be s/eletal muscles+ these muscles, for e0ample, line
the digesti"e tract.
9eutral fats contain mi!tures of one or more fatty acids esterified with
1. sterol.
2. glycerol.
3. lecithin.
4. sphingosine.
5. alcohols of high molecular weight.
The correct answer is choice 2. :eutral fats are formed when a molecule of glycerol combines
with three fatty acids through a dehydration synthesis. Choice 1, sterols, including cholesterol
and lanosterol, are steroids and are not chemically closely related to neutral fats. Choice 3,
lecithin, is another name for phosphatidylcholine, a phosphoglyceride found in cell membranes.
Choice 4, sphingosine, is a molecule which, together with a fatty acid and a polar head group,
ma/es up a sphingolipid which is another lipidtype molecule. Choice 5 is incorrect. The glycerol,
which combines with fatty acids, is an alcohol with three -1 groups, but it is a low molecular
weight substance. #o the correct answer to $uestion is choice 2.
*hysiology
9eutralization of acids by saliva results mainly from which of the following
salivary contents?
1. ;ucin
2. &mmonia
3. Carbonate
4. 2icarbonate
5. &mino &cids
The correct choice is '4, bicarbonate. #ali"a is secreted from three pairs of sali"ary glands% the
parotid, subma0illary and sublingual. The a"erage adult secretes 1)2 liters of sali"a a day. #ali"a
is al/aline, which means it has a p1 of L=, due to its high concentration of 1CC3. This helps
pre"ent dental caries by neutrali,ing any acid produced by bacteria in the oral ca"ity. #ali"a also
has ele"ated concentrations of potassium, amylase, lyso,yme, !g& and lactoferrin. The
stimulation of parasympathetics and the release of acetylcholine increases the "olume of sali"a
and the concentration of the bicarbonate ion. #timuli for sali"ation includes conditioned refle0es,
the taste of acid and other tastes, smell, nausea and mechanical stimulation of the oral ca"ity.
#o again, the correct choice is '4, bicarbonate.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
5ne would e!pect to see edema in all of the following situations ()'(*#
&. The blood hydrostatic pressure in the capillaries increases
2. The heart becomes an insufficient pump
C. The /idneys are unable to produce urine
3. The lymphatic "essels become bloc/ed
.. The plasma protein concentration in the blood increases
0ork
The correct answer is .. .dema is defined as an abnormal accumulation of interstitial fluid. The
underlying problem associated with all types of edema is the disturbance of the normal balance
between hydrostatic and osmotic forces at the capillary le"el. Plasma proteins affect osmotic
forces at the capillary le"el in the following manner% 8hen plasma protein le"els increase, fluid
is drawn from the interstitial tissue into the capillaries. Con"ersely, when plasma protein le"els
decrease, fluid will flow from the capillaries into the interstitial tissue. &s the blood hydrostatic
pressure in the capillaries increases 5choice &6 fluids will be forced out of the capillaries. :ote%
all of the other answer choices either directly or indirectly cause the hydrostatic pressure in the
capillaries 5or lymphatic "essels6 to increase. 8hen the heart becomes an insufficient pump
5choice 26, as commonly seen in congesti"e heart failure, blood will begin to ApoolA in the
capillary system leading to an increased hydrostatic pressure. !f the /idneys are unable to
produce urine 5choice C6 the blood "olume will increase, leading to an increased hydrostatic
pressure. 8hen the lymphatic "essels become bloc/ed 5choice 36, fluid will mo"e out of the
lymph "essels into the interstitial tissue.
5ver a period of time& a man uses 4 liters of o!ygen and produces 3 liters of '52.
0hat is his 32 for that period?
1. C.=5
2. 1.CC
3. 1.33
4. =.CC
The correct choice is '1,C.=5. The (.G. or respiratory $uotient is defined as the "olume of
carbon dio0ide produced>"olume of o0ygen consumed. This is a fairly straightforward problem,
since it is not e"en necessary to con"ert the units of "olume into the same units, since both
o0ygen and carbon dio0ide are in liters. #o in this case we ha"e a man producing 3 liters of
carbon dio0ide and consuming 4 liters of o0ygen. -ur (.G. is e$ual to CC2 produced>C2
consumed, or 3 liters>4 liters. ?iters canceling out, we are left with 314 or C.=5 for the correct
choice of '1.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
5vulation is triggered by a marked increase in which of the following?
&. .strogen
2. .stradiol
C. Progesterone
3. ?uteini,ing hormone
.. @ollicle)stimulating hormone
The correct answer is Choice 3. -"ulation is the first step in the female reproducti"e cycle when
a single o"um is released from an o"arian follicle. !t is triggered by a mar/ed increase of
luteini,ing hormone 5Choice 36 secreted by the anterior pituitary gland. The luteini,ing hormone
in turn causes a cascade of effects until the follicle ruptures with the discharge of the o"um.
.strogen, choice &, is incorrect as it has a strong feedbac/ effect in the anterior pituitary gland
to maintain low secretory rates of both @#1 and ?1. .strogen is in fact used in oral
contracepti"es to suppress o"ulation.
.stradiol, Choice 2, is one of the three estrogens presents in the human female. !t is also an
incorrect choice as e0plained abo"e.
Progesterone, Choice C, is also incorrect as it promotes secretory changes of the uterine
endometrium in preparation for implantation during the latter part of the reproducti"e cycle.
@ollicle stimulating hormone, Choice ., causes growth of the follicles before o"ulation, but will
not trigger o"ulation
*hysiology
5!ygen tension is /3(A#(%# in which of the following blood vessels?
&. &orta
2. Pulmonary "ein
C. Pulmonary artery
3. Coronary artery
.. Coronary "ein
The correct answer is Choice 2. -0ygen tension is highest in the pulmonary "ein 5Choice 26.
Pulmonary "eins contains blood that is richly o0ygenated by the lungs on its way to the left
atrium of the heart. The "ein is unusual as "eins are normally o0ygen poor.
The aorta 5Choice &6 recei"es o0ygenated blood from the left "entricle and distributes it to
"arious parts of the body. Though the o0ygen tension in the aorta is high, it is not as o0ygen
rich as the pulmonary "ein.
Pulmonary artery 5Choice C6 recei"es o0ygen poor blood from the right "entricle on its way to
the lungs.
Coronary artery and "ein 5Choices 3 and .6 pro"ide local circulation to the heart muscle itself.
They also do not ha"e the greatest o0ygen concentrations in the body.
*hysiology
*antothenic acid is an integral part of
1. :&3.
2. cobalamin.
3. folic acid.
4. coen,yme &.
5. pyrido0ine phosphate.
The correct answer is choice 4. Co)en,yme &, in"ol"ed in fatty acid o0idations, fatty acid
syntheses, pyru"ate o0idation and other reactions, contains a pantothenic acid group as well as
an adenine, a ribose phosphate, and a beta)mercaptoethylamine. Choice 1 , :&3, is in"ol"ed as
a co)en,yme in many o0idation reduction reactions, and is /nown as nicotinamide)adenine
dinucleotide. !t contains nicotinamide, adenines, phosphate groups and pyridine. Choice 2,
cobalamin, is incorrect. Cobalamin, combined with a cyanide group, forms *itamin 2 12.
Cobalamin contains a corrin ring system, a cobalt atom, and a ribonucleotide. Choice 3, folic
acid, is incorrect. !t contains pteridine, para)aminoben,oic acid and glutamic acid. @olic acid is
in"ol"ed in purine and pyrimidine synthesis and transfers one)carbon groups. Choice 3 is
incorrect. Pyrido0ine phosphate is a pyrido0ine co)en,yme closely related to "itamin 27
especially in"ol"ed in transamination. !t contains a pyrido0ine ring and phosphate group. #o
only choice 4, co)en,yme &, contains a pantothenic acid group, and the correct answer to
$uestion is choice 4.
the following?
9$,( *art 7 released :uestions . $iochemistry.*hysiology
*henylalanine is the precursor essential amino acid of which of the following?
&. &sparagine
2. Cysteine
C. Dlutamine
3. Proline
.. Tyrosine
/ood 0ork
The correct answer is .. The human body is able to synthesi,e roughly half of the amino acids
necessary to build protein. The amino acids that must be supplied in the diet are termed
essential, whereas the amino acids that the body is able to synthesi,e are termed non)essential.
The essential amino acids are as follows% 1istidine, !soleucine, ?eucine, ?ysine, ;ethionine,
Phenylalanine, Threonine, Tryptophan, and *aline. The non)essential amino acids are &lanine,
&rginine, &sparagine, &spartate, Cysteine, Dlutamate, Dlutamine, Dlycine, Proline, #erine, and
Tyrosine. &s noted before, phenylalanine is an essential amino acid in mammals. This amino
acid undergoes hydro0ylation to one of the non)essential amino acids, tyrosine. This reaction is
cataly,ed by the en,yme phenylalanine hydro0ylase. !t is noteworthy that tyrosine is an
essential amino acid in indi"iduals lac/ing this en,yme. &sparagine 5choice &6 is a member of
the Ao0aloacetate familyA+ its immediate precursor is aspartate. The immediate precursor of
cysteine 5choice 26 is serine. #erine is also the precursor of the non)essential amino acid
glycine. Dlutamine 5choice C6 proline 5choice 36 and arginine are produced from glutamate. The
synthesis of glutamate occurs by the reducti"e amination of alpha)/etoglutarate.
*latelets play an important role in hemostasis. 0hich of the following describes
this role?
1. They con"ert fibrinogen to fibrin.
2. They agglutinate and plug small, ruptured "essels.
3. They supply fibrin stabili,ing factor.
4. They supply procon"ertin for thromboplastin acti"ation.
The correct answer is choice 2, they agglutinate and plug small ruptured "essels. 8ithin seconds
after "ascular inury platelets, small anuclear circulating blood cell fragments adhere to the site
of damage and pile up on one another to pro"ide a mechanical plug that effecti"ely stops
bleeding from minor inuries. Clot formation. howe"er, in"ol"es a networ/ of fibers of the blood
/nown as fibrin. Choice 1 is incorrect. Prothrombin con"erts fibrinogen to fibrin. Choice 3 is
incorrect. Plasmin released by damaged cells acti"ates fibrinolysis. Choice 4 is incorrect. @ibrin
stabili,ing factor is part of the fibrinolytic system. Choice 5 is incorrect. Procon"ertin @actor *!!
is a factor in the e0trinsic pathway. #o the correct answer to $uestion is choice 2.
*reganglionic autonomic nerve fibers are e!clusively
1. somatic.
2. adrenergic.
3. sympatetic.
4. cholinergic.
5. parasympathetic.
The correct answer is choice 4, cholinergic. &cetylcholine is the transmitter for a6 all autonomic
preganglionic neurons either sympathetic or parasympathetic b6 parasympathetic postganglionic
neurons and c6 motor neurons of the spinal cord at the neuromuscular unction. Postganglionic
sympathetic neurons use norepinephrine as the neurotransmitter. Choice 1, somatic, is
incorrect. #omatic refers to the body or peripheral. 1owe"er, preganglionic autonomic ner"e
fibers arise in the central ner"ous system. Choice 2, adrenergic, is incorrect. -nly postganglionic
sympathetic fibers are adrenergic. Choice 3, sympathetic, is incorrect, as there are both
sympathetic and parasympathetic preganglionic fibers. Choice 5, parasympathetic, is incorrect
for the same reason as choice 3. There are both sympathetic and parasympathetic preganglionic
fibers. so the correct answer to $uestion is choice 4.
*rostaglandins are made within cells
1. on an (:& template.
2. on rough endoplasmic reticulum.
3. from methionine.
4. from progesterone.
5. from polyunsaturated fatty acids
/ood 0ork
The correct choice is '5, from polyunsaturated fatty acids. Prostaglandin synthesis occurs in cell
membranes, utili,ing polyunsaturated fatty acids. & prostaglandin is a 2C)carbon fatty acid
which has contained in its structure a 5)carbon ring. The prostaglandins are hormone fine
tuners. They are, therefore, not hormones. #ome prostaglandins are PD.!, which functions in
brea/down of fat+ PD.2, which induces deli"ery, playing a /ey role in parturition. PD@2)alpha is
another prostaglandin. This functions by decreasing the secretion of progesterone. Prostaglandin
synthetase is a /ey en,yme in prostaglandin synthesis. &nother name for this en,yme is
cycloo0ygenase, since it is in"ol"ed in the formation of the fi"e)membered ring of this 2C)carbon
compound. The reason ! mention cycloo0ygenase is that it is important to /now that aspirin
inhibits the formation of prostaglandins by inhibiting the cycloo0ygenase. Prostaglandins
e0acerbate the inflammation reaction. #o again, the correct choice is '5, from polyunsaturated
fatty acids.
*hysiology
*rotein kinase regulate the activities of key enzymes through which of the
following?
&. -0idation
2. 1ydrolysis
C. &cetylation
3. Phosphorylation
.. 3ephosphorylation
The correct answer is Choice 3. Protein /inase when acti"ated by cyclic &;P modulates /ey
en,ymes in different cells by phosphorylation 5Choice 36. !n this way, cyclic &;P can influence
many cellular processes. @or e0ample, protein /inase phosphorylate glycogen synthetase
rendering it inacti"e and phosphorylate phosphorylase /inase rendering it acti"e. #o cyclic &;P
is a indirectly responsible for stimulation of glycogen brea/down and inhibition of glycogen
synthesis. Choices &, 2, C and . do not describe the process in which protein /inase e0erts its
influence.
*urine bases taken in the human diet in the form of ,9A or 39A are mostly
1. e0creted as urea.
2. e0creted in the form of uric acid.
3. reused and con"erted to &TP needed as a source of energy.
4. bro/en down to gi"e :13, and either malonic acid or methylmalonic acid.
The correct answer is choice 2. The purine bases are adenine and guanine. 8hen digested, their
final brea/down product is uric acid. :ucleic acids are acted on by "arious nucleases which will
split the nucleic acid into either guanine nucleotides or adenine nucleotides. @urther degradation
leads to guanosine or adenosine, and then e"entually 0anthine and finally to uric acid. #o the
correct answer to $uestion is choice 2.
*hysiology
3iboflavin is a vitamin that is a constituent of which of the following?
&. coen,yme for amino acid metabolism
2. coen,yme @&3
C. coen,yme :&3
3. decarbo0ylation reactions
.. prothrombin
The correct answer is 2. (ibofla"in is a "itamin that is a constituent of the coen,ymes @&3 and
@;:+ deficiencies of this "itamin result in epithelial and mucosal deterioration. Pyrido0ine acts
as a coen,yme in amino acid and nucleic acid metabolism 5choice &6. 3eficiencies of pyrido0ine
result in retarded growth, anemia, and "arious D! disorders. :iacin 5nicotinic acid6 is a "itamin
constituent of the coen,yme :&3 5choice C6. 3eficiencies of niacin result in the de"elopment of
C:#, D!, epithelial and mucosal deterioration+ this condition is /nown as pellagra. Thiamine is a
"itamin that acts as a coen,yme in decarbo0ylation reactions 5choice 36. Thiamine deficiency
can lead to muscle wea/ness as well as C:# and cardio"ascular problems. *itamin 4 or
phytonadione is essential for the synthesis of prothrombin 5choice .6 and other clotting factors
in the li"er. #pecifically the "itamin 4 dependent clotting factors are @actor !!, *!!, !F and F. &
deficiency of "itamin 4 results in a "ariety of bleeding disorders.
%ecretin functions in digestion of proteins by increasing
1. flow of bile.
2. secretion of pepsin.
3. flow of pancreatic uice.
4. secretion of carbo0ypeptidase.
The correct answer is choice 3. #ecretin is secreted by the duodenum as food from the stomach
enters the duodenum. 8hen secretin reaches the pancreas, it causes the pancreas to secrete
pancreatic uice into the duodenum. Pancreatic uice contains en,ymes and also raises the p1 of
the acidic contents lea"ing the stomach. Choice 1, flow of bile, would be controlled by
cholecysto/inin, also from the intestine. Choice 2, secretion of pepsin, is controlled by gastrin
from the stomach. #ecretion of carbo0ypeptidase is accomplished by the walls of the small
intestine. Carbo0ypeptidase, choice 4, is a protease and its secretion is not controlled by
secretin. #o the correct answer to $uestion is choice 3.
*hysiology
%evere thiamin deficiency will result in the development of
&. beriberi
2. pellagra
C. pernicious anemia
3. retarded growth
.. scur"y
The correct answer is &. 2eriberi is a condition that occurs with thiamin deficiency+ this
condition is associated with the de"elopment of muscle wea/ness, and C:# and cardio"ascular
problems, including heart disease. :iacin is a water soluble "itamin. 8hen se"ere niacin
deficiency occurs, there is a good chance that patients will de"elop C:#, D!, epithelial and
mucosal deterioration, otherwise /nown as pellagra 5choice 26. Pernicious anemia 5choice C6 is a
type of anemia that occurs with cyanocobalamin deficiency. (etarded growth can occur with
deficiencies of pantothenic acid, pyrido0ine, and folic acid. #cur"y 5choice .6 is associated with
the de"elopment of epithelial and mucosal deterioration+ this condition is seen in patients that
are "itamin C deficient.
%ounds heard during systole in the antecubital space are produced by
1. closure of &* "al"es.
2. closure of the aortic "al"e.
3. turbulent blood flow through the artery.
4. laminar blood flow through the occluded artery
The correct answer is choice 3. ?etEs re"iew the heart sounds briefly. The first sound or lub
occurs when the mitral and tricuspid "al"es, the &)* "al"es, close ust before systole or
"entricular pumping. This rules out choice 1 because &)* closure occurs before systole. Closing
of the aortic and pulmonic arterial "al"es constitute the second sound or dub. This occurs ust
after systole and so it is also incorrect. #ometimes a low third sound can be heard after diastole
during "entricular filling. Choice 3 is correct. 3uring systole, blood flows out of the "entricles
into the aorta and pulmonary artery. !f this flow is turbulent, a sound can be heard. !f it is
laminar or smooth flow, it is $uiet and therefore choice 4 is incorrect. #o the correct answer to
$uestion is choice 3.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
%trong stimulation of spindles in the masseter muscle causes
1. rela0ation of the masseter muscle.
2. contraction of the masseter muscle.
3. contraction of the digastric muscle.
4. no change in mandibular position.
The correct answer is choice 2. #pindles are muscle stretch receptors. They set up a refle0 arc
which tends to /eep muscles at a physiologic length. !f the spindle fibers of the masseter are
stimulated by stretching, a refle0 contraction will be set up to return the masseter to normal
length. Choice 1 is incorrect and opposite. ?i/ewise, choice 4 is incorrect as we do e0pect a
refle0 contraction. Choice 3 is incorrect. The masseter is primarily a closing muscle while the
digastric is primarily an opening muscle. The refle0 contraction caused in the masseter, which is
a closing muscle, might induce rela0ation or stretching of the opposing digastric, but would not
cause the digastric to contract. #o the correct answer to $uestion is choice 2.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
%ympathetic stimulation of the intestinal tract results in all of the following
()'(*#
&. !ncreased intestinal secretions
2. 1ypomotility
C. 3ecreased gastric en,yme production
3. !nhibition of smooth muscle contractions
.. *asoconstriction of blood "essels
The correct answer is &. The sympathetic ner"ous system, when stimulated, leads to the
following% 1ypomotility, decreased gastric en,yme production, inhibition of smooth muscle
contractions, "asoconstriction of blood "essels, and decreased intestinal secretions, not
increased intestinal secretions. (emember the sympathetic ner"ous system prepares the body
for A@ight or @lightA by increasing the acti"ity of the organs essential for the response+ the
intestinal tract is not needed in the A@ight or @lightA response. Con"ersely, parasympathetic
stimulation results in increased motility, blood supply to the gut through "asodilatation of blood
"essels and increased gut secretions.
*hysiology
#ension on the vocal cords is regulated by which of the following?
&. .0trinsic laryngeal muscles
2. .0trinsic ligaments
C. !ntrinsic laryngeal muscles
3. !ntrinsic ligaments
.. *ocal folds
The correct answer is C. The laryn0 is composed of two sets of muscles, the intrinsic laryngeal
muscles and the e0trinsic laryngeal muscles. The intrinsic laryngeal muscles ha"e two primary
functions% regulation of the tension in the "ocal folds and opening and closing the glottis. The
e0trinsic laryngeal muscles 5choice &6 are responsible for positioning and stabili,ing the laryn0.
3uring swallowing, both sets of e0trinsic and intrinsic laryngeal muscles cooperate to pre"ent
food from entering the glottis. The e0trinsic ligaments 5choice 26 attach the thyroid cartilage to
the hyoid bone and the cricoid cartilage to the trachea. The intrinsic ligaments 5choice 36 bind
all nine laryngeal cartilages together. The "ocal folds 5choice .6 protect the entrance to the
glottis.
e!piration is the
9$,( *art 7 released :uestions . $iochemistry.*hysiology
#he air remaining in alveoli at the end of a forced ma!imal e!piration is the
1. tidal "olume.
2. "ital capacity.
3. residual "olume.
4. e0piratory reser"e "olume.
5. inspiratory reser"e "olume.
The correct choice is '3, residual "olume. ?etEs briefly re"iew the different lung "olumes. The
tidal "olume is the amount of air inspired and e0pired with e"ery normal breath, which is
appro0imately 5CC ml. The inspiratory reser"e "olume is the e0tra "olume of air that would be
inspired o"er and abo"e the normal tidal "olume. The e0piratory reser"e "olume is the e0tra
"olume of air that could still be e0pired beyond the normal tidal "olume. The residual "olume is
the "olume of air remaining in the lungs after ma0imal e0piration. ?etEs discuss lung capacities.
The total lung capacity is the ma0imum "olume to which the lungs can be e0panded with the
greatest possible inspiratory effect. The "ital capacity is the ma0imal e0piration following a
ma0imal inspiration, which is the tidal "olume plus inspiratory reser"e "olume plus e0piratory
reser"e "olume. The functional residual capacity is the amount of air remaining in the lungs
after normal e0piration, and the inspiratory capacity is the total amount of air that can be
inhaled after a normal e0piration. #o again, the correct choice to $uestion is '3, residual
"olume.
#he cerebral nuclei of the e!trapyramidal system are specifically responsible for
&. Control of s/eletal muscle tone
2. Coordination of limb mo"ements
C. !ntegration of sensory feedbac/
3. Processing of e$uilibrium information
.. Processing of "isual information
7ncorrect Answer
The correct answer is 2. The a0ons of the pyramidal cells of the motor corte0 descend to
synapse on lower motor neurons in the brain stem and the spinal cord. #ince there are no
inter"ening synapses, the pyramidal system is able to pro"ide rapid commands to the s/eletal
muscles and "arious other organs. There are se"eral other centers that can issue somatic motor
commands as a result of processing performed at the unconscious, in"oluntary le"el. These
centers and their associated tracts comprise the e0trapyramidal system. The cerebral nuclei
primarily control coordination and preparation of limb mo"ements. The red nucleus, located in
the mesencephalon, is the component of the e0trapyramidal system primarily responsible for
controlling s/eletal muscle tone 5choice &6. The cerebellar nuclei, located in the cerebellum,
primarily control the AgeneralA coordination of body mo"ements as well as integrating sensory
feedbac/ 5choice C6. The "estibular nuclei, located in the pons and medulla oblongata, process
e$uilibrium sensations 5choice 36. The superior colliculi, located in the mesencephalon, process
"isual information 5choice .6.
*hysiology
#he destruction of a clot is a normal physiological process that begins with the
&. &cti"ation of calcium to produce tissue plasmin
2. &cti"ation of prothrombin, which initiates the production of thrombin
C. &cti"ation of the proen,yme fibrinogen, which initiates the production of fibrin
3. &cti"ation of the proen,yme plasminogen, which initiates the production of plasmin
.. Production of tissue thromboplastin
7ncorrect Answer
The correct answer is 3. @ollowing a traumatic inury, a blood AclotA will form to pre"ent
e0cessi"e blood loss and promote healing. &s this repair process proceeds, the clot will gradually
dissol"e. The dissolution of a clot, /nown as fibrinolysis, begins with the acti"ation of the
proen,yme plasminogen, which initiates the production of plasmin. Plasmin is a substance that
will begin to AdigestA the fibrin strands and erode the foundation of the clot. &cti"ation of
plasminogen can occur with tissue plasminogen acti"ator. 8hen introduced into systemic
circulation, at therapeutic concentrations, this agent will bind to fibrin in a thrombus and con"ert
the entrapped plasminogen to plasmin, which initiates local fibrinolysis, through the degradation
of fibrin matri0 of the thrombus. &cti"ation of calcium to produce tissue plasmin 5choice &6
occurs after the proen,yme plasminogen is acti"ated. 2oth choices 2 and C are in"ol"ed in the
common clotting pathway+ the acti"ation of prothrombin initiates the production of thrombin.
Thrombin acti"ates the proen,yme fibrinogen, which in turn initiates the production of fibrin.
The production of tissue thromboplastin 5choice .6 or @actor !!! is in"ol"ed in the e0trinsic
clotting pathway.
*hysiology
#he distribution of carbonate within dental enamel follows the same surface to
dentinoenamel 4unction patterns as which of the following?
1. ?ead
2. Calcium
3. @luoride
4. #trontium
5. :one of the abo"e
/ood 0ork
The correct choice is '5, none of the abo"e. To understand this $uestion you must understand
about the de"elopment of the enamel prisms. The enamel prism is laid down "ia the
ameloblasts, specifically "ia the TomesE processes on the ameloblasts. 8hen the enamel matri0
is formed hydro0yapatite crystallites are deposited in the enamel matri0 along the long a0is
oriented perpendicular to the TomesE process. ;aturation of the enamel matri0 in"ol"es
calcification of the enamel matri0, so distribution of calcium, not carbonate, follows the pattern
of the enamel matri0 which was laid down "ia the ameloblasts. The enamel prisms are cur"ed
nearest to the dento)enamel unction, and therefore calcification will follow this pattern. #o
again, the correct choice is '5, none of the abo"e.
*hysiology
#he dominant factor controlling absorption of iron from the gastrointestinal tract
is
1. e0cretion of iron in the urine.
2. e0cretion of iron in the stools.
3. saturation of mucosal cells with iron.
4. concentration of the ferrous iron in bone marrow, spleen and li"er.
7ncorrect Answer
The correct choice is '3, saturation of the mucosal cells with iron. ;ost iron absorption occurs
at the pro0imal small intestine. !ron first binds to a receptor on the brush border membrane and
then gets transported into the cell. The iron may then be transported to the blood, comple0ing
with transferrin, while some binds to apoferritin in the cell to form ferritin. 8ith time some of
the iron in ferritin is con"erted to free iron and transported to the blood. 1owe"er, much is lost
upon sloughing of the cells. -ther maor electrolytes absorbed from the small intestine are
sodium, potassium and chloride. #odium is absorbed "ia passi"e diffusion, cotransport, or
secondary acti"e transport and cotransport with chloride ion. &gain, the correct choice is '3, the
mucosal cells must be saturated with iron.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
#he fluid.mosaic model for membrane structure proposes that
&. the outer and inner faces of the membrane are identical.
2. peripheral proteins are situated only on the outer face of the plasma membrane.
C. integral proteins are associated with the hydrophobic phase of the bilayer.
3. both polar and nonpolar ends of membrane phospholipids are within the hydrophobic
phase of the bilayer.
The correct answer is Choice C. The fluid)mosaic model for embryological membranes was
proposed in 1I=2. This model suggests that membranes are made up of a bilayer of
phospholipid molecules with their hydrophobic tails pointing toward the center of the structure
where they interact with the hydrophobic tails of the opposing phospholipid layer. !ntegral
proteins are found scattered in the hydrophobic phase of the bilayer 5Choice C6. These proteins
may e0tend through the entire thic/ness of the membrane and they may also mo"e freely
within the plane of the phospholipid bilayer.
Choice & is incorrect as the outer and inner faces of the membrane are not identical. The inner
face as made up of the hydrophobic portion of the phospholipid molecules while the outer face is
made up of the hydrophilic portion.
Choice 2 is incorrect since membrane proteins may e0tend through to the outer face of the
membrane but are not situated only on the outer surface.
Choice 3 is also incorrect since the model contends that only the non)polar end of the
phospholipid molecule stays within the hydrophobic phase of the bilayer.
by the hormone
9$,( *art 7 released :uestions . $iochemistry.*hysiology
#he gallbladder is caused to contract by the hormone
1. gastrin.
2. secretin.
3. pancreo,ymin.
4. enterogastrone.
5. cholecysto/inin.
/ood 0ork
The correct choice is '5, cholecysto/inin. The primary role of the gallbladder is bile storage for
release during meals when the gallbladder is rela0ed. The sphincter of -ddi has low resistance.
&ppro0imately 5CH of bile is stored, while the remainder enters the duodenum. Contraction
begins appro0imately a half an hour after meals. Contraction is stimulated by acetylcholine
5thatEs the "agocephalic phase of digestion6. 1ormones which stimulate contraction include
cholecysto/inin, or CC4, secretin and gastrin. Contraction, howe"er, is seldom complete, being
from 51 H to IIH emptying. The gallbladder wall absorbs water and also it absorbs
electrolytes. !t concentrates cholesterol and absorbs sodium by the electrogenic pump. !t also
allows for the passi"e mo"ement of chloride and the passi"e mo"ement of water. The secretory
product, bile, contains water, phospholipid, cholesterol, bile acids and bilirubi
*hysiology
#he hormone responsible for decreasing gluconeogenesis in the liver is
synthesized in which of the following?
&. &drenal corte0
2. &drenal medulla
C. &lpha cells in the pancreas
3. &nterior lobe of the pituitary
.. 2eta cells in the pancreas
/ood 0ork
The correct answer is ..
!n humans, insulin is the hormone that promotes fuel storage by decreasing gluconeogenesis in
the li"er, promoting glycogen deposition in the li"er, and decreasing blood glucose le"els. !nsulin
is synthesi,ed in the beta cells in the islets of ?angerhans in the pancreas. The release of insulin
from the beta cells is stimulated by an increase in the concentration of glucose in the blood. The
action of insulin is antagoni,ed by the hormones produced by the other answer choices. The
adrenal corte0 5choice &6 is responsible for the production of cortisol. 2oth epinephrine and
norepinephrine are produced in the adrenal medulla 5choice 26. Dlucagon is synthesi,ed in the
alpha cells in the pancreas 5choice C6. The anterior lobe of the pituitary 5choice 36 is responsible
for the production of growth hormone
#he lack of which of the following substances during tooth formation most likely
induces enamel hypoplasia?
1. *itamins & and 3
2. *itamins C and 3
3. *itamins C and 4
4. Phosphorus and iron
5. Calcium and fluoride
7ncorrect Answer
The correct answer is choice 1, "itamins & and 3. *itamin & is /nown to be re$uired for the
production and maintenance af healthy epithelial tissue and enamel is an epithelial tissue.
*itamin 3 is produced in the s/in by ultra"iolet irradiation of = dehydrocholesterol. *itamin 3
induces synthesis of a protein re$uired for calcium transport and since calcium transport is
in"ol"ed in enamel formation, *itamin 3 would be re$uired. !n the formation of enamel, many
organic and inorganic substances, for e0ample calcium and phosphate, are re$uired. 1owe"er,
e"en if there are abundant substrate materials, if there is not an ade$uate amount of "itamin &
and 3, the formation of enamel will not be ade$uate. #o the correct answer to $uestion is choice
1.
#he largest amount of body water can be found in which of the following?
&. <rine
2. 2lood plasma
C. lntracellular fluid
3. !nterstitial fluid
.. #tomach and intestines
The correct answer is Choice C. The human body is made up of 5C to 7CH of water by total
body weight. ;ost of this water is found in intracellular fluid 5Choice C6 which constitutes
appro0imately 33H of total body weight.
The amount of water in urine 5Choice &6 is "ariable. !t depends on a number of factors,
including the amount of fluid inta/e, and the amount that is reabsorbed. !t does not account,
howe"er, for the largest amount of body water.
Choice 2 body plasma contains only 4.5H of water by total body weight.
Choice 3 interstitial fluid accounts for appro0imately 2=H of water by weight. !t is the source of
the second largest $uantity of water found in the body.
Choice . stomach and intestines also contain a substantial amount of fluid but do not ha"e the
largest $uantity.
*hysiology
#he main control over body temperature& located in a portion of the central
nervous system& is the
1. pons.
2. cerebellum.
3. hypothalamus.
4. medulla oblongata.
The correct choice is '3, hypothalamus. The hypothalamus has a multitude of functions. !t
centrally maintains the homeostasis of the body by integrating autonomic, somatic and
endocrine systems. Temperature regulation in"ol"es both posterior hypothalamus and anterior
hypothalamus. The posterior hypothalamus responds to cold by producing shi"ering,
"asoconstriction of s/in "essels, piloerection and discharge of catecholamines. The anterior
hypothalamus responds to e0cessi"e heat through sweating, panting and "asodilatation of s/in
"essels. The receptors monitoring body temperature seem to be located primarily in the anterior
or preoptic area of the hypothalamus. -ther functions of the hypothalamus include the release
of corticotropin, thyrotropin, gonadotropin, somatastatin, prolactin and growth hormone
releasing factors. These releasing factors in turn regulate the release of the abo"e hormones
from the anterior lobe of the pituitary. #o again, the correct choice is '3, hypothalamus.
*hysiology
#he ma4or center in the brain for autonomic nervous system regulation is the
1. hypothalamus.
2. pituitary.
3. cerebral corte0.
4. "estibular nuclei.
5. floor of the fourth "entricle
The correct choice is '1, hypothalamus. The autonomic ner"ous system is defined as the
efferent or motor neurons to the "iscera, cardiac and smooth muscle and glands. !t functions to
adust the amplitude of "isceral acti"ity and coordinate acti"ities of different "iscera. The central
ner"ous system centers are the hypothalamus and brainstem, especially the reticular formation.
They contain the controlling neurons, cell bodies which are the sites of autonomic regulation
*hysiology
#he ma4or driving force for formation of a lipid micelle is
1. protein)lipid interaction.
2. hydrophobic interaction between hydrocarbon tails.
3. hydrogen bonding between water molecules of the micellar core.
4. electrostatic interaction between the micellar core and polar heads.
The correct answer is choice 2. ;icelles are formed by bile salts or bile acids that are in"ol"ed in
lipid absorption. 2ile salts ha"e polar heads and non)polar tails. Polar heads remain outside in
contact with the polar water molecules, while the non)polar tails remain on the interior and
attach to fatty acid and phospholipid molecules. Thus, the entire micelle is made miscible with
water. The dri"ing forces for the formation of micelles are actually two. The first is the
interaction of the nonpolar bile salt tail with hydrophobic fatty acids and phospholipids and
remo"al of these hydrophobic groups from the water. The second is the interaction of the polar
heads with water. Choice 2 refers to one of these dri"ing forces. Choice 1 is incorrect as proteins
are not in"ol"ed in micelle formation. Choice 3 is incorrect because the micelle core is lipid and
hydrophobic, not water. Choice 4 is incorrect as the micelle core is hydrophobic and does not
interact with polar heads. #o the correct answer to $uestion is choice 2.
*hysiology
#he ma4or function of serum @,@ is to transport which of the following?
&. 2ile salts from the intestine
2. Triglycerides from the intestine
C. @ree fatty acids from adipose tissue
3. cholesterol and phospholipids from peripheral tissues
.. Cholesterol, cholesterol esters, and phospholipids from the li"er
/ood 0ork
The correct answer is Choice .. ?ipoproteins are compounds containing both lipids and proteins.
#erum ?3? or low density lipoproteins are intermediate)density lipoproteins with a high
concentration of cholesterol, moderately high concentration of phospholipids, and minimal
amount of triglycerides. Their primary function is to transport their lipid components,
cholesterol, cholesterol esters, and phospholipids from the li"er to the peripheral tissues 5Choice
.6. Choice & through 3 are all incorrect since serum ?3? does not perform functions described in
those choices
9$,( *art 7 released :uestions . $iochemistry.*hysiology
#he ma4ority of the hydro!yapatite produced in bone occurs when calcium
phosphate interacts with
&. calcium carbonate
2. calcium hydro0ide
C. fluoride
3. magnesium
.. sodium
The correct answer is 2. Calcium phosphate, Ca35PC462. which accounts for appro0imately two)
thirds of the weight of bone. interacts with the calcium hydro0ide, Ca5-162, to form crystals of
hydro0yapatite, Ca1C5PC4675-162. &s these crystals form, they will incorporate other calcium
salts, such as calcium carbonate 5choice &6, fluoride 5choice 26, magnesium 5choice 36 and
sodium 5choice .
*hysiology
#he ma!imal number of impulses that a nerve fiber can carry is determined by
which of the following?
1. The intensity of the stimulus
2. The diameter of the ner"e fiber
3. The duration of the absolute refractory period
4. The duration of the relati"e refractory period
The correct answer is choice 3, the duration of the absolute refractory period. The absolute
refractory period is a period during which a second stimulus no matter how strong cannot
initiate another impulse and it therefore determines the ma0imum number of impulses that a
ner"e fiber can cany. Choice 1, the intensity of the stimulus is incorrect. #timulus is a current
such that the membrane is depolari,ed to the firing le"el. &ny stimulus at or abo"e the
threshold intensity would result in the same action potential with constant amplitude. This is
/nown as the all or none response. Choice 2 is incorrect, the diameter of the ner"e fiber. The
greater the diameter of a gi"en ner"e fiber, the greater its speed of conduction. Choice 4, the
duration of the relati"e refractory period is incorrect. The relati"e refractory period which
immediately follows the absolute refractory period is the phase at which sodium inacti"ation is
ending. &t this point, a stronger than normal stimulus can initiate another action potential. #o
the correct answer to $uestion is choice 3.
#he nitrogenous product that is e!creted in high amounts after prolonged
acidosis is
1. urea.
2. ammonia.
3. glutamine.
4. creatinine.
5. aspartic acid
The correct answer is choice 2. !n prolonged acidosis, higher than usual amounts of ammonia
are e0creted. &s ammonia is e0creted, hydrogen ions are e0creted as well in the combined
:149 form. This helps to reduce the le"el of hydrogen ions in the body. Choice 1 is incorrect.
<rea is normally the primary nitrogenous waste, but after prolonged acidosis, ammonia
e0cretion is greater than urea e0cretion. Choice 3 is incorrect. Dlutamine is changed to
glutamate in tubular cells, forming :149 or ammonium ions. 1owe"er, glutamine itself is not
e0creted. Creatinine is e0creted to a small degree in normal urine and to a greater degree in
children and in pregnant women, but is ne"er the chief nitrogenous waste product. #o choice 4
is incorrect. Choice 5 is incorrect. &spartic acid and amino acid is not a maor nitrogenous
waste. #o the correct answer to $uestion is choice 2.
*hysiology
#he normal delay in se!ual development until puberty is attributed to
1. lac/ of effect of se0 hormones on somatic tissue.
2. failure of the gonads to respond to gonadotrophins.
3. inability of the hypophysis to synthesi,e gonadotrophins.
4. lac/ of hypothalamic stimulation of gonadotrophin release.
5. inability of the hypophysis to respond to hypothalamic releasing hormones.
The correct choice is '4, lac/ of hypothalamic stimulation of gonadotropin release. !n e0plaining
this $uestion letEs use the female as an e0ample. The hypothalamic pituitary cycle initiates the
menstrual cycle of the female. ?uteini,ing hormone and follicular stimulating hormone initiate
de"elopment of the o"ary. Donadotropic releasing hormone regulates the release of ?1 and @#1.
8ithout hypothalamic stimulation of the gonadotropin release the female will remain
prepubescent. !n males the production of androgenic steroid hormones by ?eydig cells and
spermatogenesis is regulated by the anterior pituitary secretions, luteini,ing hormone and
follicle stimulating hormone. The anterior pituitary also is regulated by the hypothalamic
secretion of gonadotropic releasing hormone. !n prepubertal boys gonadotropin occurs at low
le"els. 2y age 1C there are surges in gonadotropin in the sleep and this initiates puberty. &gain,
the correct choice is '4.
#he o!ygen atoms in a molecule of o!ygen are held together by
&. a single co"alent bond
2. a double co"alent bond
C. a triple co"alent bond
3. a polar co"alent bond
.. an ionic bond
The correct answer is 2. -0ygen, with an atomic number of B, has two electrons in its first
energy le"el and si0 in its second energy shell. Two o0ygen atoms in a molecule of o0ygen are
stable and held together by a double co"alent bond+ with the configuration CJC or C2. & single
co"alent bond 5choice &6 can be found between two hydrogen atoms+ with the configuration 1)1
or 12. & triple co"alent bond 5choice C6 is rarely found+ it would be represented with the
configuration 1C.:. & polar co"alent bond 5choice 36 e0ists when two elements share electrons
and one of the elements has a much stronger affinity for the electrons than the other. @or
e0ample, in molecules of water, an o0ygen atom forms co"alent bonds with hydrogen atoms.
The o0ygen has a much stronger attraction for the shared electrons than the hydrogen atoms.
&n ionic bond 5choice .6 is formed by the electrical attraction between atoms that ha"e gained
or lost electrons and thus carry an electrical charge. #alts are formed by ionic bonds.
*hysiology
#he partial pressure of o!ygen in arterial blood is lower than that in alveoli. #he
condition suggested is
1. hyper"entilation.
2. slow blood flow.
3. high blood pressure.
4. inade$uate "entilation.
5. thic/ening of the al"eolar membrane
/ood 0ork
The correct choice is '5, thic/ening of the al"eolar membrane. The assumption that al"eolar
partial pressure, or P&C2 e$uals end capillary partial pressure is not strictly true. That is,
e$uilibrium in the al"eoli is not complete. The result is an al"eolar atrial o0ygen gradient. !f
there is a diffusion disturbance such as thic/ened al"eolar capillary barriers or when we ha"e
pulmonary blood flow which is faster, or a low o0ygen mi0ture is inspired, the al"eolar arterial
o0ygen gradient is e0aggerated. .$uilibrium is approached less and less, and pC2 falls. #o
again, the correct choice is '5, thic/ening of the al"eolar membrane.
*hysiology
#he postganglionic neurons of the sympathetic nervous system release which of
the following neurotransmitters?
&. &cetylcholine
2. 3opamine
C. .pinephrine
3. :orepinephrine
.. #erotonin
The correct answer is 3. The sympathetic and parasympathetic ner"e fibers all secrete one of
two synaptic neurotransmitters% acetylcholine and>or norepinephrine. The ner"e fibers that
secrete acetylcholine are termed cholinergic and those that secrete norepinephrine are
adrenergic ner"e fibers. &ll the preganglionic neurons in both the parasympathetic and
sympathetic ner"ous systems are cholinergic and release the neurotransmitter acetylcholine.
The postganglionic neurons of the sympathetic ner"ous system release norepinephrine. The
postganglionic neurons of the parasympathetic ner"ous system are also cholinergic+ hence,
release acetylcholine 5choice &6. 2oth dopamine 5choice 26 and serotonin 5choice .6 are
neurotransmitters primarily located in the brain. .pinephrine 5choice C6 is a catecholamine that
is a potent sympathomimetic stimulator of the alpha and beta receptors throughout the body
#he *3 interval in an electrocardiogram is an inde! of the
1. length of auricular filling.
2. period of isometric rela0ation.
3. length of auricular contraction.
4. conduction time between atria and "entricles.
5. period of ma0imal eection of "entricular systole.
The correct answer is choice 4. ?etEs re"iew the P, G, (, #, T aspects of the electrocardiogram.
The upward P wa"e is produced by atrial depolari,ation, the G(# comple0 by "entricular
depolari,ation, and the #T segment and T wa"e by "entricular repolari,ation. #o in this case the
P( inter"al is the time from the beginning of depolari,ation of the atria to the beginning of
depolari,ation of the "entricles. Therefore, it represents the time for the depolari,ation wa"e to
mo"e from the atria to the "entricles. #o choice 4 is our correct answer to $uestion.
#he preganglionic neurons of both the parasympathetic and sympathetic nervous
systems release which of the following?
&. &cetylcholine
2. 3opamine
C. .pinephrine
3. :orepinephrine
.. #erotonin
The correct answer is &.
The sympathetic and parasympathetic ner"e fibers all secrete one of two synaptic
neurotransmitters% acetylcholine and>or norepinephrine. The ner"e fibers that secrete
acetylcholine are termed cholinergic+ those that secrete norepinephrine are adrenergic ner"e
fibers. &ll the preganglionic neurons in both the parasympathetic and sympathetic ner"ous
systems are cholinergic. The postganglionic neurons of the parasympathetic ner"ous system are
also cholinergic+ hence, they release acetylcholine. The postganglionic neurons of the
sympathetic ner"ous system mostly release norepinephrine 5choice 36. 2oth dopamine 5choice
26 and serotonin 5choice .6 are neurotransmitters primarily located in the brain. .pinephrine
5choice C6 is a catecholamine+ it is a potent sympathomimetic stimulator of the alpha and beta
receptors throughout the body.
#he presence of glucose in the urine proves that the patient has
1. diabetes mellitus.
2. negati"e nitrogen balance.
3. e0ceeded his renal threshold for glucose.
4. e0cessi"e damage to a glomerulus of the /idney.
The correct choice is '3, e0ceeded his renal threshold for glucose. ;ost solutes appearing in the
glomerular filtrate are reabsorbed. The ma0imum rate of reabsorption for a gi"en solute is
defined as its ma0imum tubular resorpti"e capacity, or Tm Dlucose has a gi"en "alue for Tm.
:ormally, all filtered glucose is resorbed. Thus, normally it does not show up in the urine. The
filtration load of glucose is directly proportional to the plasma glucose concentration. 8hen T, or
ma0imum tubular resorpti"e capacity is e0ceeded glucose is e0creted. &t this point the tubules
are absorbing to their ma0imum, and any e0tra glucose spills into the urine. The presence of
glucose in the urine does not pro"e the patient has diabetes mellitus, since other states may
induce glucose in the urine. :egati"e nitrogen balance indicates star"ation and may show
/etonuria, and the appearance of glucose in the urine does not damage the glomerulus, so
again, the correct choice is '3, e0ceeded his renal threshold for glucose.
#he primary determinant of the resting membrane potential in a neuron is
&. intracellular negati"ely charged chloride ions
2. e0tracellular negati"ely charged chloride ions
C. membrane permeability to calcium
3. membrane permeability to potassium
.. membrane permeability to sodium
The correct answer is 3. 8ith respect to the resting membrane in a neuron, the primary
determinant of this "alue is related to the electrochemical gradient of the neuron. This gradient
is described as the sum of the chemical and electrical forces across the cell membrane. This
resting membrane potential for a gi"en neuron is primarily a reflection of the membrane
permeability to the potassium ions. !n.other words, the primary determinant of the resting
membrane potential in a neuron is membrane permeability to potassium. &lthough the
electrochemical gradient for sodium ions is "ery large, sodium permeability is small+ therefore,
sodium ions ha"e a small effect on the normal resting membrane potential 5choice .6. #odium
ions are primarily attracted by e0cess negati"e charges inside of the cell, such as intracellular
negati"ely charged chlorine ions 5choice &6 and intracellular negati"ely charged chloride ions
5choice 26. 1ence, these two factors will ha"e a minimal effect on the resting membrane
potential. Calcium 5choice C6 has no effect on the resting membrane potential.
#he primary link between the nervous and endocrine system is the
&. Cerebellum
2. Cerebrum
C. 1ypothalamus
3. ;esencephalon
.. Pons
The correct answer is C. The walls of the diencephalon are composed of the left and right
thalamus. & narrow stal/, the infundibulum, connects the floor of the diencephalon, or
hypothalamus, to the pituitary gland, which is a component of the endocrine system. The
hypothalamus contains "arious centers in"ol"ed with emotions, autonomic function and
hormone production. The hypothalamus is the primary lin/ between the ner"ous and endocrine
system. The cerebellum 5choice &6 adusts "oluntary and in"oluntary motor acti"ities as well as
comparing incoming sensory information with anticipated sensations. Conscious thought
processes, sensations, intellectual functions, memory storage and retrie"al and comple0 motor
actions originate in the cerebrum 5choice 26. The mesencephalon 5choice 36 is the center
responsible for processing "isual and auditory information. The pons 5choice .6 connects the
cerebellum to the brain stem. !t also contains nuclei in"ol"ed with somatic and "isceral motor
control.
#he process of chewing food is associated with which of the following
movements?
&. &bduction
2. .le"ation
C. @le0ion
3. -pposition
.. Protraction
#he correct answer is $.
2y definition, ele"ation occurs when a structure mo"es in a superior direction. Con"ersely,
depression occurs when a structure mo"es in a inferior direction. @or e0ample, one depresses
the mandible when the mouth opens and ele"ates the mandible upon closing the mouth. !n
other words, the process of chewing is a repetiti"e cycle of depressing and ele"ating the
mandible. &bduction 5choice &6 is the mo"ement away from the longitudinal a0is of the body.
@or e0ample, swinging the right arm to the side. @le0ion 5choice C6 is described as a mo"ement
in the anteriorlposterior plane that decreases the angle between the articulating e0tremities. @or
e0ample, fle0ion of the biceps. -pposition 5choice 36 is the placement of the thumb opposite to
the fingers that allows the hand to grasp and hold "arious obects. Protraction 5choice .6 is
described as the mo"ement of a gi"en part of the body anteriorly in a hori,ontal plane+ the
grasping of ones upper lip with their lower teeth is a protracting mo"ement.
#he process of deamination produces which of the following?
&. &cetyl)Co&
2. &mmonia
C. 4eto acids
3. <rea
.. <ric acid
The correct answer is 2. &mino acids can be cataboli,ed in one of two processes% 3eamination
or transamination. 3eamination is a process that is performed in the preparation of an amino
acid for brea/down in the TC& cycle. !n deamination, an amino group is remo"ed and ammonia
is generated. #ince the ammonia produced is a to0ic substance, the li"er immediately
metaboli,es the ammonia molecule to urea 5choice 36, which is a relati"ely non)to0ic, water)
soluble compound that is e0creted in the urine. &cetyl)Co& 5choice 26 is produced by the
brea/down of pyru"ic acid+ an acetyl)group is added to these by)products to produce acetyl)
Co&. !n the process of transamination, the amino group of a gi"en amino acid is transformed to
a /eto acid 5choice C6. & /eto acid resembles an amino acid e0cept that the second carbon is
bound to an o0ygen rather than an amino group. <ric acid 5choice .6 is another non)to0ic waste
product that is produced when either 3:& or (:& is cataboli,ed during the Abrea/downA of a
cell.
#he second heart sound is related to
1. e0citation of atria.
2. opening of &* "al"es.
3. closure of &* "al"es.
4. opening of aortic "al"es.
5. closure of aortic "al"es.
The correct choice is '5, closure of the aortic "al"es. ?etEs discuss the heart sounds. #1, or the
first heart sound, is synchronous with mitral and tricuspid "al"e closure. !ts intensity is a
clinically useful sign. #1 intensity "aries in"ersely with the P( inter"al on the .CD. The shorter
the P)( inter"al the louder #1. !n mitral stenosis the absence of a loud #1 is an important sign
suggesting a rigid, hea"ily)calcified and immobile mitral "al"e. The second heart sound is called
#2. !t is synchronous with aortic and pulmonary "al"e closure. !ts intensity also is a clinically
useful sign. The third heart sound, #3, or "entricular gallop, occurs in early diastole. !t
represents "ibrations of the left "entricular structures and blood mass as the rapid inflow of
blood is limited to the left "entricular diastolic e0pansion. #3 is a normal sound in children and
young adults. !n adults, howe"er, o"er the age of 3C or 35 years, it represents significant global
"entricular dysfunction and is fre$uently associated with "entricular dilatation. !t can also be
present in se"ere anemia, thyroto0icosis and mitral regurgitation. The fourth heart sound is #4.
This is atrial gallop. !t occurs after atrial contraction and before #1. &gain, the correct choice is
'5, closure of the aortic "al"es.
#he second step in glycolysis involves the formation of
&. 3ihdyro0yacetone phosphate
2. @ructose)l,7)bisphosphate
C. Dlucose)7)phsophate
3. Phosphoenolpyru"ic acid
.. Pyru"ic acid
The correct answer is 2. !n summary, glycolysis brea/s down a si0 carbon glucose molecule into
two three carbon molecules of Pyru"ic acid. This process in"ol"es a series of en,ymatic steps.
The second step in glycolysis in"ol"es the formation of @ructose)l,7)bisphosphate. The entire
glycolysis pathway is as follows% Dlucose Dlucose)7)phsophate )L @ructose)1.7)bisphosphate )L
3ihdyro0yacetone phosphate )L Dlyceraldehyde 3) phosphate )L 1,3 2iphosphoglyceric acid )L
3) Phosphoglyceric acid )L Phosphoenolpyru"ic acid )L Pyru"ic acid.
#he sensory organs concerned with maintenance of skeletal muscle tonus are
1. muscle spindles.
2. gamma efferents.
3. pacinian corpuscles.
4. golgi tendon organs.
The correct choice is ' 1 , muscle spindles. 8ithin muscles there are speciali,ed receptors, the
muscle spindles and Dolgi tendon organs. The muscle spindles function when the muscles are
stretched. & good e0ample of this is tapping on the patellar tendon. This stretching causes a
"olley of impulses in the primary endings which synapse directly on the alpha motor neurons,
inner"ating the e0trafusal fibers of the muscle in which the spindle is imbedded. Thus, we elicit
a contraction of the $uadriceps muscles when we tap on the patellar tendon, and obtain the
familiar /nee er/ refle0. #o again, the correct choice to $uestion is '1, muscle spindles.
#he smooth endoplasmic reticulum is primarily responsible for which of the
following?
&. Control of metabolism
2. 3istribution of materials by diffusion
C. ?ipid and carbohydrate synthesis
3. :eutrali,ation of to0ic compounds
.. #ecretory protein synthesis
The correct answer is C. 8ith respect to basic cell physiology, the synthesis of both lipids and
carbohydrates occurs in the smooth endoplasmic reticulum. Control of metabolism 5choice &6 is
the responsibility of the nucleus of the cell. !n addition, the nucleus is also responsible for
storage and processing genetic information and controlling protein synthesis. The cytosol of the
cell is responsible for the distribution of materials by diffusion 5choice 26. Pero0isomes are
intracellular compounds that contain degradati"e en,ymes and are primarily responsible for the
neutrali,ation of to0ic compounds. The synthesis of secretory proteins 5choice .6 occurs in the
rough endoplasmic reticulum. :ote, protein synthesis, in general, is the responsibility of the
ribosomes.
#he spinal cord is the only structure in the central nervous system necessary for
which of the following body functions?
1. (espiration
2. #imple refle0
3. Temperature regulation
4. Coordinated muscle ma"ement
The correct answer is choice 2. #imple refle0 arcs in"ol"e a receptor and afferent neurons which
ta/e impulses to the spinal cord, possibly an inter"ening connecting neuron within the spinal
cord, and an efferent neuron to the effector muscle or gland. Thus, in a refle0, the only C:# or
central ner"ous system section in"ol"ed is the spinal cord. !n other words, the brain is not
in"ol"ed in the refle0 arc. The brain is in"ol"ed in choice 1, respiration, as the respiratory control
center is located in the medulla. The brain is also in"ol"ed in choice 3, as the hypothalamus
primarily controls the temperature regulation. Coordinated muscle mo"ement, choice 4, is
controlled by the cerebellum of the brain. #o the correct answer to $uestion is choice 2.
#he tone of the masseter muscle is maintained by the
1. fle0or refle0.
2. stretch refle0.
3. crossed)e0tensor refle0.
4. continuous production of metabolic products.
The correct choice is '2, stretch refle0. The stretch refle0, or myotactic or tendon er/ refle0, is
a fast refle0. !t in"ol"es the stretch of the annulospiral endings to initiate the muscle
contraction. The best e0ample of this is the /nee er/ refle0. !n the masseter, howe"er, this
refle0 in"ol"es muscle tone, which in"ol"es a continuous stretch refle0. This tone helps prepare
the muscle for mo"ement. 8ithout the stretch refle0 the muscle would not be optimally
effecti"e. !t would be flaccid and inoperable. The annulospiral endings are muscle spindle,
primary endings, and 1& fibers come from them. They ha"e a diameter of 12)2C microns and a
conduction "elocity of =5)125 m>sec. #o again, the correct choice to $uestion is '2, stretch
refle0.
#he two most important skeletal elements generally used to determine se! and
age are
&. 2one thic/ness and "ertebrae cur"ature
2. 2one weight and bone mar/ings
C. Condition of teeth and muscular mass
3. Presence and percentage of muscular and fatty tissue
.. Teeth and healed fractures
The correct answer is 2. & study of a human s/eleton can re"eal important information about an
indi"idual. @or e0ample, the two most important s/eletal elements generally used to determine
se0 and age are bone weight and bone mar/ings. 8ith respect to the se0 of an indi"idual, one
can e0amine the s/ull. The s/ull of a male, as compared to a female, will ha"e the following
characteristics% The general appearance will be rougher and hea"ier, the forehead tends to
slope, the sinuses are larger, the cranium is around 1CH larger, the mandible is larger and
robust and the teeth are typically larger. The actual weight of all male bones is often larger to
support a bigger mass. @uhthermore, bone mar/ings are more prominent on all male bones. &s
years pass, there is a reduction in the si,e and roughness of bone mar/ings. @urthermore, the
weight of a gi"en bone will also decrease. Therefore, one can see that the two most important
s/eletal elements generally used to determine se0 and age are bone weight and bone mar/ings.
(egarding choice &, thethic/ness of AsimilarA bones in males and females can be closely related
and "ertebrae cur"ature increases with age only. The condition of teeth and muscular mass
5choice C6 are good indicators of a persons general health and e0ercise habits. The presence
and percentage of muscular and fatty tissue 5choice C6 will depend on an indi"iduals e0ercise
habits, not primarily their se0 or age. ?oo/ing at a personEs teeth and healed fractures 5choice
.6 will show information about an indi"iduals medical history.
#he type of articulation found between the temporal bone and the mandible can
best be described as a 6an8
&. .llipsoidal diarthrosis
2. Dliding diarthrosis
C. 1inge diarthrosis
3. Pi"ot diarthrosis
.. #ynarthrosis 5gomphosis6
The correct answer is C. The type of articulation found between the temporal bone and the
mandible, otherwise /nown as the temporomandibular oint, can best be described as a hinge
diarthrosis since it allows for ele"ation and depression of the aw. &n ellipsoidal diarthrosis
5choice &6 is a type of articulation that has an o"al articular face that rests within a depression
on the opposing surface, which allows angular mo"ement in two planes, along or across the
length of the o"al. &n e0ample of an ellipsoidal diarthrosis would be the articulation found
between the occipital bone and the atlas. & gliding diarthrosis 5choice 26 is a type of articulation
that has flattened or slightly cur"ed faces that slide across one another. .0amples of this type of
diarthrosis would be the articulations between the thoracic "ertebrae and ribs. &n e0ample of a
pi"ot diarthrosis 5choice 36 would be the articulation between the a0is and the atlas, since a
pi"ot diarthrosis allows for rotation. &n e0ample of a synarthrosis 5gomphosis6 5choice .6 would
be the articulation found between the ma0illa and the upper teeth as well as the mandible and
the lower teeth. ;o"ement does not occur with this type of articulation.
#hyroid secretion is stimulated by
1. hypo0ia.
2. propylthiouracil.
3. e0ogenous thyroid hormone.
4. high serum iodide concentration.
5. prolonged e0posure to a cold en"ironment.
7. prolonged e0posure to a warm en"ironment.
The correct choice is '5, prolonged e0posure to a cold en"ironment. There are two forms of
thyroid hormone, T3, triiodothyronine and T4, thyro0in. The thyroid hormones tra"el in the
blood, largely bound to plasma proteins in e$uilibrium with free hormones. ;ost of the T3 and
T4 is bound to thyro0ine binding globulin. T3 is more acti"e, but present at much lower plasma
le"els than T4. <nder thyroid stimulating hormone stimulation the apical membrane of the
thyroid follicles undergo mar/ed de"elopment of the micro"illi proecting into the colloid. The
epithelial cell micro"illi engulf peripheral colloid from the periphery of the follicles. Phagocytic
"acuoles containing colloids fuse with lysosomes, and lysosomal proteases brea/ down the
thyroglobulin into small peptides, which include T3 and T4. Thyroid hormones are essential to
sur"i"al in the cold. :ormal animals $uic/ly adapt to increase their o0ygen consumption,
catecholamines and increase muscular acti"ity. These are the direct agents of the adaptation,
and T3 and T4 are permissi"e to the actions of catecholamines. #o again, the correct choice to
$uestion is 5, prolonged e0posure to a cold en"ironment.
#ropic hormone releasing factors produced in the hypothalamus are transported
into the anterior pituitary through
1. ner"e impulses.
2. the ultrashort feedbac/ mechanism.
3. the peripheral circulatory system.
4. the microcirculatory portal system.
5. long ner"e fibers or duas that also transport neurophysins. The correct answer is choice
4. Tropic hormone releasing factors are chemicals made in the hypothalamus which act on the
anterior pituitary to cause release of tropic hormones. @or e0ample, thyroid stimulating hormone
releasing factor will be secreted by the hypothalamus, tra"el in a portal circulation, enter the
anterior pituitary and cause that gland to secrete thyroid)stimulating hormone or T#1 which will
then stimulate the thyroid to release thyro0in. #o our correct answer is choice 4. !n a portal
circulation, one bed of capillaries is connected to another bed of capillaries by a "ein. The other
main portal system in the body is the hepatic portal systenl in which a capillary bed in the
intestine is connected to another capillary bed in the li"er by the hepatic portal "ein. !n the
other choices, we should note that neurophysins in choice 5 are sections of precursor molecules
of o0ytocin and "asopressin which are posterior pituitary hormones produced in the
hypothalamus. They are not related to releasing factors. The neurophysins are remo"ed and the
acti"e hormone remains. #o the correct answer to $uestion is choice 4.
#widdling your thumbs during a dental physiology lecture demonstrates the
action that occurs at
&. 2all)and)soc/et oints
2. .llipsoidal oints
C. Dliding oints
3. 1inge oints
.. #addle oints
The correct answer is .. #addle oints ha"e articular faces that resemble AsaddlesA. .ach face is
conca"e at one a0is and con"e0 on the other a0is. This arrangement permits angular motion,
including circumduction+ howe"er, rotation is pre"ented. The carpometacarpal oint at the base
of the thumb is a prime e0ample of a saddle oint+ twiddling your thumbs during a dental
physiology lecture demonstrates the action that can occur at this oint. 2all)and)soc/et oints
5choice &6 ha"e a round head at one end that rests within a cup)shaped depression in another.
&ll combinations of mo"ements can be performed at this oint. Prime e0amples of ball)and)
soc/et oints would be at the hip and shoulder. .llipsoidal oints 5choice 26 ha"e an o"al articular
face that rests within a depression on the opposing surface, which allows angular mo"ement in
two planes, along or across the length of the o"al. These oints connect the fingers and toes
with the metacarpals and metatarsals, respecti"ely. Dliding oints 5choice C6 ha"e flattened or
slightly cur"ed faces that slide across one another. &lthough rotation is theoretically possible,
ligaments usually pre"ent or restrict such mo"ements. These oints are at the ends of the
cla"icles, for e0ample. 1inge oints 5choice 36 permit angular mo"ement in a single plane, much
in the same way as opening and closing a door on a hinge. Prime e0amples of hinge oints
include the elbow and /nee.
#wo atoms are considered isotopic if
1. their nuclei contain the same number of neutrons.
2. their atomic numbers are the same, but their mass numbers differ.
3. their mass numbers are the same, but their atomic numbers differ.
4. one is a beta emitter, and the other an alpha emitter.
The correct answer is '2, their atomic numbers are the same but their mass numbers are
different. This is a simple definition type $uestion from general chemistry. The atomic number,
as you may recall, is the number of protons in the nucleus of an atom. !sotopes ha"e the same
number of protons bur a different number of neutrons. The number of protons plus neutrons of
an atom is referred to as the mass number of the atom. !f two atoms are isotopes they
therefore ha"e different mass numbers. since mass number e$uals number of protons plus the
number of neutrons. !f the number of protons is the same and the number of neutrons is
different the number of protons plus the number of neutrons will be different, or the mass
number will be different. #o the correct choice is '2, their atomic numbers are the same but
their mass numbers are different.
Aascular resistance is directly related to all of the following ()'(*#
&. The amount of friction in the blood "essels
2. The diameter of the blood "essel
C. The length of the blood "essel
3. The "iscosity of the blood
.. The "olume of blood in the body
The correct answer is .. (esistance is defined as any force that opposes mo"ement. The most
important component in "ascular resistance is the friction caused between the blood and the
"essel walls, which is related to the "iscosity of the blood as well as the length and diameter of
the blood "essel itself. &lthough the "olume of blood in the blood may impact "ascular
resistance, it does not directly oppose blood flow. &s a general rule, "ascular resistance and
friction 5choice &6 will increase when the following occur+ the diameter of the "essel decreases
5choice 26 and>or the length of the "essel increases 5choice C6. @urthermore, as the "iscosity of
the blood increases 5choice 36, the resistance will increase as well+ remember, syrup flows
slower than water.
Aascular smooth muscle rela!es in response to
&. hypero0ia.
2. adenosine.
C. "asopressin.
3. angiotensin.
3. norepinephrine.
The correct answer is Choice 2. -f the following substances, only adenosine 5Choice 26 has a
"asodilator effect on blood "essel smooth muscles. !t is released from the tissue in response to
o0ygen deficiency causing increased blood flow and o0ygen concentration.
Choice & hypero0ia, or an increased o0ygen content in body tissues, will cause a local
"asoconstriction in the blood "essels and not "asodilation.
Choice C "asopressin, or antidiuretic hormone, is mainly responsible for the retention of water in
the body. !n large concentrations, it will cause constriction of the blood "essels and ele"ate
blood pressure.
Choice 3 angiotensin is a powerful "asoconstrictor. !ts primary role is to increase the total
peripheral resistance in regulation of arterial pressure.
Choice . norepinephrine is released by the sympathetic ner"e endings during stress or e0ercise.
:orepinephrine stimulates the "eins and arterioles by constriction of these "essels.
*hysiology
Aisual purple& rhodopsin& is usually formed in the
1. lens.
2. li"er.
3. retina.
4. adrenals.
5. "itreous humor
The correct choice is '3, the retina. (hodopsin is a light)sensiti"e pigment found in the retina.
(hodopsin is formed by the combination of opsin, a protein, with "itamin & aldehyde. *itamin &
aldehyde is also referred to as retinal. (etinal is formed by the o0idation of "itamin &, or retinol.
(etinol is preformed "itamin & found in li"er, whole mil/, eggs and fish oils. 1umans inta/e pro)
"itamin & from plants and preformed "itamin & from animals. 2eta carotene is the principal
dietary source of pro)"itamin &. !t is found in yellow and orange "egetables. -ne molecule of
beta carotene is clea"ed in the intestinal mucosa into two molecules of retinol, or "itamin &.
&gain, the correct choice is '3, retina.
Aitamin A functions to
1. pre"ent pellagra.
2. promote absorption of calcium.
3. promote differentiation of epithelial cells.
4. maintain the integrity of connecti"e tissues.
The correct answer is choice 3. *itamin & is a constituent of "isual pigments and maintains
epithelial tissues by promoting differentiation. 3eficiency of "itamin & is signalled by night
blindness and dry s/in. Choice 1 is incorrect. Pellagra is caused by niacin deficiency. Choice 2 is
incorrect. *itamin 3 increases intestinal absorption of calcium and phosphorous. Choice 4 is
incorrect. *itamin C is associated with maintaining normal intercellular materials such as
collagen in bone, cartilage and dentin. #o our correct answer to $uestion is choice 3.
Aoluntary control of the muscles involved in the process of mastication is
provided by which of the following?
&. &fferent ner"ous system
2. &utonomic ner"ous system
C. Parasympathetic ner"ous system
3. #omatic ner"ous system
.. #ympathetic ner"ous system
The correct answer is 3. The somatic ner"ous system pro"ides "oluntary control o"er all s/eletal
muscle contractions. Therefore, "oluntary control of the muscles in"ol"ed in the process of
mastication would be pro"ided by the somatic ner"ous system. The afferent ner"ous system
5choice &6 is primarily in"ol"ed with bringing sensory information to the C:# from peripheral
organs and tissues. The autonomic ner"ous system 5choice 26 is responsible for pro"iding
autonomic, in"oluntary regulation of cardiac muscle, smooth muscle and glandular acti"ity. The
autonomic ner"ous system contains both the parasympathetic 5choice C6 and the sympathetic
5choice .6 ner"ous systems. 2oth of these di"isions of the autonomic ner"ous are antagonistic
to one another.
*hysiology
0hat type of muscle contraction occurs when both ends of the muscle are fi!ed
and no change in length occurs during the contraction& but the tension increases?
&. Concentric contraction
2. 3ynamic contraction
C. .ccentric contraction
3. !sometric contraction
.. !sotonic contraction
The correct answer is 3. &n isometric contraction occurs when both ends of the muscle are fi0ed
and no change in length occurs during the contraction, but the tension increases. & concentric
contraction 5choice &6 is a type of dynamic contraction where the muscle fibers shorten and the
tension on the muscle increases. & dynamic contraction 5choice 26 includes both concentric and
eccentric types of contractions. !n general, a dynamic contraction results in the change in length
of the muscle with a corresponding change in tension on that muscle. &n eccentric contraction
5choice C6 is a type of dynamic contraction where the muscle fiber lengthens and the tension on
the muscle increases. &n isotonic contraction 5choice .6 occurs when a muscle shortens against
a fi0ed load while the tension on that muscle remains constant.
0hen a muscle is producing peak tension during rapid cycles of contraction and
rela!ation& it is said to be in
&. Complete tetanus
2. !ncomplete tetanus
C. Treppe
3. 8a"e summation
#he correct answer is $. #ince there is no mechanism to regulate the amount of tension
produced in a gi"en muscle contraction, the muscle fiber is either producing tension or is
rela0ed. This feature is /nown as the all) or)none principle. Therefore, the amount of tension
produced by a s/eletal muscle as a whole is determined by both the fre$uency of stimulation
and the number of muscle fibers stimulated. 8ith these principles in mind, the following
definitions can be applied% 8hen a muscle is producing pea/ tension during rapid cycles of
contraction and rela0ation, it is said to be in incomplete tetanus. Complete tetanus 5choice &6
occurs when a muscle is stimulated so fre$uently that the rela0ation phase is completely
eliminated. (ecruitment 5choice C6 occurs when there is a smooth but steady increase in the
muscle tension that is produced by increasing the number of acti"e motor units. Treppe, 5choice
36 is a situation where a muscle is stimulated repeatedly for se"eral seconds with a constant
stimulus+ the amount of tension produced then gradually increases to a ma0imum. 8a"e
summation 5choice .6 occurs when a second stimulus arri"es before the rela0ation phase has
ended and a second, more powerful, contraction occurs.
*hysiology
0hen an individual is administered large amounts of glucocorticoids& such as
prednisone& a condition similar to one of the following may result. #he patients
clinical appearance would be most similar to
&. &ddisonEs disease
2. &drenogenital syndrome
C. CushingEs syndrome
3. ;y0edema
.. Primary &ldosteronism
The correct answer is C. The CushingEs syndrome is caused by a hypersecretion of cortisol by
the adrenal corte0. Cortisol is glucocorticoid similar to prednisone. Therefore, if one were
administered large amounts of prednisone for an e0tended period of time, a CushingEs)li/e
syndrome could result. CushingEs syndrome is characteri,ed by an increased fat deposition in
the thoracic region, an edematous appearance of the face, as well as the de"elopment of acne
and hirsutism. &ddisonEs disease 5choice &6 results from the failure of the adrenal corte0 to
produce adrenocortical hormones, resulting in glucocorticoid and mineralocorticoid deficiency.
?oss of cortisol 5a glucocorticoid6 secretion results in the depression of many metabolic functions
and decreases oneEs ability to tolerate "arious stressors. &drenogenital syndrome 5choice 26 is
the result of e0cessi"e production of androgens, leading to premature masculini,ing effects in
young males. ;y0edema 5choice 36 is caused by a lac/ of thyroid function. Patients typically
present with swelling under the eyes as well as swelling of the face. Primary &ldosteronism,
5choice .6, is caused by a hypersecretion of aldosterone leading to hypo/alemia, which can
e"entually lead to periods of muscle paralysis.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
0hen an individual :uickly rises from a prone position& one would e!pect to see
&. 1eart rate decrease
2. The cardiostimulatory center in the medulla become less e0cited
C. The carotid baroreceptors become inhibited
3. *asoconstriction of the peripheral blood "essels
.. *enous return increase
The correct answer is 3. 8hen a person rises from a prone position, there will typically be a
ApoolingA of blood in the "enous system. !n an effort to maintain uniform blood pressures, the
carotid baroreceptors, when stimulated by a decrease in blood pressure, will initiate the
following% There will be widespread "asoconstriction of the peripheral blood "essels. The net
effect will be a shunting of blood to the internal organs and a decreased "enous return 5choice
.6. &lso, when the carotid baroreceptors are stimulated 5choice 26, the heart rate will increase
5choice &6 due to stimulation of the cardiostimulatory center in the adrenal medulla 5choice C6.
0hen are nerve fibers hypoe!citable?
1. 3uring resting potential
2. &t the firing le"el
3. 3uring local depolari,ation
4. 3uring negati"e after)potential
5. 3uring positi"e after)potential
/ood 0ork
The correct answer is choice 5. &t certain times or under certain conditions, ner"e cells may
become hypoe0citable+ that is, the ner"e cell becomes more difficult to stimulate in order to
initiate an action potential. ?etEs loo/ at our choices one at a time. Choice 1, during resting
potential, the neuron is at its normal state of e0citability, being neither hyper nor hypoe0citable.
Choice 2, when ner"e fibers are at the firing le"el or at the point of initiating an action potential,
any further stimulation will cause the action potential to occur, so they would not be
hypoe0citable at this point. Choice 3 is incorrect. 8hen a neuron e0periences a local
depolari,ation response, a depolari,ation occurs which is strong enough to cause changes in the
membrane, but not strong enough to cause an action potential. 1owe"er, further depolari,ation
may cause the action potential to occur. !n this way, the neuron can be "iewed as perhaps
hypere0citable, but certainly not hypoe0citable. Choice 4 is incorrect. @ollowing an action
potential, a refractory period occurs during which the neuron cannot be stimulated again.
@ollowing this period, a brief negati"e after)potential will occur, during which the neuron is
hypere0citable. @ollowing this period, a positi"e after)potential will occur, during which the
neuron is slightly hypoe0citable. ?ater, the neuron will return to its normal le"el of e0citability.
#o the correct answer to $uestion is choice 5.
*hysiology
0hen the blood supply to the dermis decreases and the sweat glands become
less active& as seen in the elderly& which of the following factors would be
affected the most?
&. The ability to fight infection
2. The ability to produce "itamin 3
C. The ability to repair itself
3. The ability to thermoregulate
.. The s/in will begin to wrin/le
The correct answer is 3. The s/in is a highly comple0 organ that has many different
physiological functions. &s indi"iduals age, the s/in begins to lose its ability to perform each of
these speciali,ed functions. !n the elderly, the blood flow to the dermis begins to decrease.
@urthermore, glandular acti"ity decreases. 8hen the blood supply to the dermis decreases and
the sweat glands become less acti"e, the indi"idual is less able to lose body heat. Therefore,
increased physical e0ertion can lead to e0tremely high body temperatures. The decreased ability
of the s/in to fight infection in the elderly 5choice &6 is related to the decreased number of
?angerhans cells and the thinning of the germinati"e cell layer. & decreased ability to produce
"itamin 3 5choice 26 is a normal part of the aging process. This decreased production
contributes to a reduction of calcium le"els e"entually leading to muscle wea/ness and
decreased bone density. The thinning of the epidermis and the loss of elasticity of epidermis
contribute to the decreased ability of the s/in to repair itself 5choice C6 as in increased
Awrin/lingA 5choice .6 of the s/in.
*hysiology
0hen the p- of the e!tracellular fluid decreases& the kidney will compensate by
&. .0creting more bicarbonate ions
2. .0creting more sodium ions
C. !ncreasing the urine p1
3. (eabsorbing less water
.. (etaining more potassium ions
/ood 0ork
The correct answer is .. &lthough the buffer system in the body is able to regulate the blood p1
during normal circumstances, the /idneys may need to aid in the regulation of the blood p1
when this system becomes o"erwhelmed. 8hen the p1 of the e0tracellular fluid declines, the
following will occur with respect to potassium% 1ydrogen ions will mo"e into the intracellular
fluid in e0change for potassium. @urthermore, the /idneys will decrease the elimination of
potassium because hydrogen ions are being eliminated in the urine instead of potassium. !t is
important to note that both of the pre"iously mentioned factors can lead to se"ere
hyper/alemia. !n addition to the remo"al of hydrogen ions, the /idneys will decrease the
elimination of bicarbonate ions 5choice &6, sodium ions 5choice 26 and water 5choice 36. !n a
situation where the e0tracellular fluid p1 is acidic, the /idneys will compensate by acidifying the
urine by e0creting more hydrogen ions 5choice C6.
0hen the ventricle of the heart contracts& the stimulus for the contraction comes
directly from which of the following?
&. &trial muscle
2. &* node
C. 1is)bundles
3. Pur/ine fibers
.. #& node
The correct answer is 3.
8ith respect to normal cardiac conduction, the electrical impulse that depolari,es the heart
normally originates in the sinoatrial 5#&6 node 5choice .6. The depolari,ing impulse tra"els from
the #& node concentrically through the atrial myocardium 5choice &6, e"entually reaching the
atrio"entricular 5&*6 node 5choice 26. @rom the &* node, the depolari,ing impulse enters the
1is)bundles 5choice C6, where conduction becomes rapid again. The 1is)bundle penetrates the
interarterial septum, where it di"ides into the right bundle branch 5(226 and left bundle branch
5?226. The (22 and ?22 arbori,e into a fine networ/ of Pur/ine fibers 5choice 36. The Pur/ine
fibers penetrate the "entricular myocardium and function to depolari,e the "entricular muscle
mass, leading to "entricular contraction.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
0here in the autonomic nervous system is norepinephrine stored?
&. Preganglionic sympathetic ner"e endings
2. Postganglionic sympathetic ner"e endings
C. Preganglionic parasympathetic ner"e endings
3. Postganglionic parasympathetic ner"e endings
The correct answer is Choice 2. :orepinephrine is synthesi,ed and stored in "esicles located in
the postganglionic sympathetic ner"e endings 5Choice 26.
Preganglionic sympathetic ner"e endings 5Choice &6, preganglionic parasympathetic ner"e
endings 5Choice C6, and postganglionic parasympathetic ner"e endings 5Choice 36 are all
cholinergic because the neurosecretory transmitter for these neurons to acetylcholine.
Choices & through 3 do not describe the pathway in which ?3? is transported into a cell.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
0here is norepinephrine stored?
1. &t preganglionic sympathetic ner"e endings
2. &t postganglionic sympathetic ner"e endings
3. &t preganglionic parasympathetic ner"e endings
4. &t postganglionic parasympathetic ner"e endings
The correct answer is '2, at the postsynaptic ganglionic sympathetic ner"e endings.
:orepinephrine is the transmitter in C postganglionic neurons of the autonomic ner"ous system.
!n the central ner"ous system norepinephrine)containing neurons are prominent in the locus
ceruleus, which proects diffusely to the corte0, cerebellum and spinal cord and is in"ol"ed in
alerting mechanisms. #ympathetic postganglionic fibers usually store norepinephrine as their
neurotransmitter. 1owe"er, there are always e0ceptions to a rule. #ympathetic postganglionic
neurons to sweat glands and to some of those causing dilatation of blood "essels in s/eletal
muscles are often cholinergic neurons. &gain, the correct answer is '2, at postganglionic
sympathetic ner"e endings.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
0hich of following vitamins prevents the destruction of fatty acids and vitamin
A?
&. *itamin 27
2. *itamin C
C. *itamin 3
3. *itamin .
.. *itamin 4
The correct answer is 3. *itamins are typically classified as being fat)soluble or water)soluble.
The fat soluble "itamins are "itamins &, 3, . and 4. &ll of the A2A "itamins and "itamin C are
classified as being water)soluble "itamins. *itamin . is responsible for pre"enting the
brea/down of "itamin & and fatty acids. *itamin . is typically found in meats, mil/ and
"egetables. 8hen *itamin . is deficient, anemia can de"elop. *itamin 27 5choice &6 acts as a
coen,yme in amino acid and lipid metabolism. *itamin C 5choice 26 acts as a coen,yme+ it
deli"ers hydrogen ions and acts as an antio0idant. !t is essential for connecti"e tissue formation.
*itamin 3 5choice C6 is re$uired for normal bone growth as well as facilitating both calcium and
phosphorus absorption from the intestinal tract. *itamin 4 5choice .6 is essential for li"er
synthesis of prothrombin and other clotting factors.
0hich of the following age.related skeletal changes will occur first in an
individual+s life?
&. &ppearance of maor "ertebral cur"es
2. &ppearance of secondary dentition
C. 3ecrease in the bones mineral content
3. @usion of epiphyseal plates
.. (emodeling of the bone
The correct answer is &. & re"iew of the human s/eleton can re"eal important information about
an indi"idualEs age and>or se0. !n se$uential order of oneEs life)span the following age) related
e"ents will occur% The appearance of maor "ertebral cur"es occur begin at the age of two fetal
months. The fetal spine is AbowA shaped and the adult spine is more A#A shaped. The
appearance of secondary dentition 5choice 26 occurs when the primary teeth are lost and the
permanent teeth ta/e their place. The fusion of epiphyseal plates 5choice 36 typically occur near
the beginning of adulthood. The mineral content of bone 5choice C6 typically decreases after the
age of 75. The bone remodeling process 5choice .6 is one that occurs throughout a persons life
at a relati"ely constant rate and is not related to age. !n the bone remodeling process, the
matri0 of the bone is replaced while lea"ing the bone as a whole unchanged.
0hich of the following amino acids can most easily be converted to tyrosine in
the human body?
1. Dlycine
2. &rginine
3. ;ethionine
4. Tryptophan
5. Phenylalanine
The correct answer is choice 5, phenylalanine. !n the category of aromatic amino acids are
phenylalanine, tyrosine and tryptophan. !n phenylalanine, the ( group contains a ben,ene ring
and in tyrosine, it contains a phenol group. Therefore, forming tyrosine from phenylalanine only
re$uires hydro0ylation of the ben,ene ring at carbon 3. #o the correct answer to $uestion is
choice 5.
0hich of the following causes activation of the pyloric pump& rela!ation of the
pylorus& and contraction of the lower esophageal sphincter?
&. Dastrin
2. #ecretin
C. Pepsinogen
3. &cetylcholine
.. Cholecysto/inin
The correct answer is Choice &. Dastrin 5Choice &6 causes acti"ation of the pyloric pump along
with rela0ation of the pylorus, and contraction of esophageal sphincter. !t is a hormone released
by the antral mucosa of the stomach.
#ecretin 5Choice 26 is also a hormone of the digesti"e tract. !t is formed by the epithelial cells of
the duodendum and its primary function is to stimulate pancreatic secretion of sodium
bicarbonate.
Pepsinogen 5Choice C6 is an inacti"e proen,yme formed and secreted by the chief cells of the
gastric mucosa. 8hen it comes into contact with hydrochloric acid, it becomes acti"e en,yme
pepsin.
&cetylcholine 5Choice 36 is a neurotransmitter synthesi,ed in the cytoplasm of synaptic
terminals.
Cholecysto/inin 5Choice .6 secreted by the duodenal and upper eunal mucosa is chiefly
responsible for the stimulation of gallbladder contraction.
0hich of the following causes some degree of temporary alkalosis?
1. 1yper"entilation
2. 1igh fluid inta/e
3. .0cessi"e smo/ing
4. #e"ere muscular effort
5. !ngestion of ammonium chloride
The correct choice is '1, hyper"entilation. &l"eolar "entilation is ade$uate for o0ygenation when
it matches the o0ygen with its supply. 1ypo"entilation leads to a buildup of pCC2 and a decrease
in pC2. The buildup of pCC2 leads to an acidotic state in the blood, and since it is caused by a
respiratory abnormality+ that is, hypo"entilation, it is referred to as respiratory acidosis.
?i/ewise, hyper"entilation leads to a decrease in pCC2 and an increase in pC2 for an al/aline
blood p1. This is called respiratory al/alosis. 3rugs which depress the respiratory center in the
medulla, such as barbiturates, will cause an acidosis. &lso, some drugs may induce a
hyper"entilatory state, thus may induce a respiratory al/alosis. #o again, the correct choice to
$uestion '72 is '1, hyper"entilation.
0hich of the following cells are responsible for producing antibodies against the
bacteria found in a abscessed tooth?
&. @ibroblasts
2. ;ast cells
C. ;acrophages
3. ;esenchymal cells
.. Plasma cells
The correct answer is .. Plasma cells are deri"ed from lymphocytes. These cells are responsible
for producing antibodies, including the antibodies produced against the bacteria found in a
abscessed tooth. 8hen an antibody binds to an antigen, an antibody)antigen comple0 is formed.
The specificity of the binding depends on the type of antibody employed to the site of the
infection. There are fi"e maor classes of antibodies% !gD, !g;, !g., !g& and !g3. @ibroblasts
5choice &6 are the most common cells in the connecti"e tissue proper. These cells are
responsible for the production and maintenance of connecti"e tissue fibers. ;ast cells 5choice 26
are mobile connecti"e tissue cells commonly found near blood "essels. The cytoplasm of these
cells contain histamine which stimulates local inflammation when an infection or inury to the
area is present. ;acrophages 5choice C6 are large cells that primarily function to engulf
damaged cells or pathogens in the body. ;esenchymal cells 5choice 36 are the stem cells
present in many connecti"e tissues. These cells respond to a local infection or inury by di"iding
and producing AdaughterA cells that e"entually differentiate into macrophages, fibroblasts or
other connecti"e tissue cells

0hich of the following characterize the links between monomeric units of nucleic
acids?
1. !onic bonds
2. Dlycosidic bonds
3. Phosphodiester bonds
4. Phosphotriester bonds
The correct answer is choice 3. ;onomeric units of 3:& consist of a phosphate group,
deo0yribose, sugar, and nitrogen base of adenine, guanine, cytosine or thymine. These
monomeric units are lin/ed together to form the 3:& strand by phosphodiester bonds. !n these
bonds, the 3)prime carbon of one deo0yribose lin/s with one o0ygen of the phosphate group,
while a 5)prime carbon of another deo0yribose lin/s with another o0ygen of the phosphate
group. This is /nown as a phosphodiester bond, indicating two bonds to a phosphate group. #o
the correct answer to $uestion is choice 3.
0hich of the following enzymes converts trypsinogen to trypsin?
&. .ntero/inase
2. Peptidase
C. #ecretin
3. Pepsin
The correct answer is Choice &. Trypsin is a powerful proteolytic en,yme present in pancreatic
secretions. !t aids in the digestion of proteins. 8hen synthesi,ed in the pancreatic cells, the
proteolytic en,yme is in its inacti"e form trypsinogen. !t is important for the en,yme to remain
inacti"e as it will digest the pancreas itself. Trypsinogen is acti"ated to trypsin only after it is
released into the intestinal tract by entero/inase 5Choice &6. .ntero/inase is secreted by the
intestinal mucosa when chyme comes into contact with the mucosa.
Peptidase 5Choice 26 is an en,yme present in the micro"illi of the small intestine capable of
splitting large polypeptides into their components.
#ecretin 5Choice C6 is a hormone secreted by duodenal and eunal mucosa in response to high
acid content in the small intestine. This hormone in turn stimulates pancreatic secretion of
sodium bicarbonate.
Pepsin 5Choice 36 is the maor digesti"e en,yme of the gastric uices. !t is acti"e in an acidic
en"ironment to digest proteins and collagen.
0hich of the following enzymes is involved in the synthesis of fatty acids?
&. &cetyl Co& carbo0ylase
2. Dlucose 7)phosphate dehydogenase
C. Dlycogen synthase
3. Phosphorylase
.. Thiolase
The correct answer is &. The synthesis of lipids is /nown as lipogenesis. Pathways of lipid
synthesis begin with acetyl)Co&+ these molecules can be stmng together in the cytosol yielding
fatty acids. &cetyl Co& carbo0ylase is the /ey en,yme in"ol"ed in fatty acid synthesis. Dlucose
7) phosphate dehydogenase 5choice 26 is in"ol"ed in the pentose phosphate pathway. The two
en,ymes in"ol"ed in the synthesis and degradation of glycogen are phosphorylase and glycogen
synthase. @urthermore, glycogen synthesis and degradation are coordinated by a hormone)
triggered cascade, which ensures that when one en,yme is acti"e, the other en,yme is inacti"e.
The en,yme in"ol"ed in glycogen degradation is phosphorylase 5choice 36 and the en,yme
in"ol"ed in glycogen synthesis is glycogen synthase 5choice C6, as the name implies. Thiolase
5choice .6 is responsible for con"erting acetoacetyl Co& into acetyl Co&
0hich of the following enzymes is responsible for catalyzing the first step in fatty
acid synthesis?
&. &cetyl)Co& carbo0ylase
2. Carnitine)acyl transferase
C. Carnitine translocase
3. @atty acid synthase
.. ?ecithin cholesterol acyl transferase
The correct answer is &.
The en,yme responsible for cataly,ing the first step in fatty acid synthesis is acetyl)Co&
carbo0ylase. This en,yme re$uires the presence of both biotin and bicarbonate for con"erting
acetyl)Co& to malonyl)Co&. @atty acid synthase 5choice 36 is a multien,yme comple0 that
cataly,es the remaining reactions for fatty acid synthesis. Carnitine)acyl transferase ! 5choice 26
transfers the fatty acid from fatty acid acyl)Co& to carnitine to form acyl carnitine. Carnitine
translocase 5choice C6 transports fatty acyl carnitine into the mitochondria and transports free
carnitine bac/ outside the mitochondria. ?ecithin cholesterol acyl transferase 5choice 36 is a
plasma en,yme that esterifies 13? cnolesterol.
0hich of the following functions as part of the e!tracellular matri!?
&. ;ucin
2. 1eparin
C. Collagenase
3. Chondroitin sulfate
.. 3olichol phosphate
The correct answer is Choice 3. -f the following, only chondroitin sulfate 5Choice 36 functions as
part of the e0tracellular matri0. !t is a proteoglycan that acts as a filler between collagen fibers
and cells. Chondroitin sulfate is also a principal component in the organic matri0 of bone and
cartilage.
;ucin 5Choice &6 is a mucus secretion produced by sali"ary glands that acts as a lubricant for
surface protection.
1eparin 5Choice 26 is a powerful anticoagulant produced mainly by the basophilic mast cells
located in the pericapillary connecti"e tissues.
Collagenase 5Choice C6 is an en,yme that cataly,es the hydrolysis of collagen. !t is not a
functional part of normal e0tracellular matri0.
3olichol phosphate 5Choice .6 is a "ery long chain lipid that acts as a carrier for oligosaccharide.
0hich of the following hormones conserves body protein& carbohydrate& and fat
stores?
&. Cortisol
2. Dlucagon
C. !nsulin
3. #omatotropin
The correct answer is Choice C. -f the hormones listed, only insulin 5Choice C6 conser"es body
protein, carbohydrates, and fat stores. !t inhibits the brea/down of proteins in cells, causes
carbohydrates to be stored as glycogen in li"er muscles, and it stimulates fat storage in adipose
tissue.
Cortisol, Choice &, is a potent glucocorticoid that stimulates gluconeogenesis by the li"er. !t also
reduces cellular protein and promotes mobili,ation of fatty acids from adipose tissue. Dlucagon
is secreted by the alpha cells of the islets of ?angerhans. !ts primary function is to increase
blood glucose concentration by stimulating brea/down of li"er glycogen, and acti"ation of
adipose cell lipase ma/ing increased $uantites of free fatty acids. These functions are opposite
of insulin.
#omatotropin, Choice 3, is also /nown as growth hormone. !t promotes growth of almost all
tissues of the body by conser"ing carbohydrates, enhancing body proteins, and increasing
utili,ation of fat stores for energy.
0hich of the following hormones plays a crucial role in the maintenance of
normal body temperature?
&. Calcitonin
2. !nsulin
C. -0ytocin
3. Parathyroid hormone
.. Thyro0ine
/ood 0ork
#he correct answer is (.
Thyroid hormones, such as a thyro0ine and triiodothyronine, affect almost e"ery cell in the body
because they readily cross cell membranes. The effects of thyroid hormones on peripheral
tissues include% ele"ation of o0ygen consumption and the rate of energy consumption, which
leads to an ele"ation of body temperature+ increased heart rate+ stimulation of acti"ity of other
endocrine tissues+ maintenance of sensiti"ity of respiratory centers as well as "arious other
functions. Calcitonin 5choice &6 is primarily responsible for decreasing of calcium ions in body
tissues. !nsulin 5choice 26 facilitates the upta/e of glucose by cells and stimulates lipid and
glycogen formation and storage. -0ytocin 5choice C6 is a hormone that promotes uterine
contractions and mil/ eection. The parathyroid hormone 5choice 36 is responsible for increasing
calcium ion concentrations in the body fluids.
*hysiology
0hich of the following immunoglobulins is the first antibody secreted after the
arrival of an antigen& and plays a role in the determination of ones blood type?
&. !g&
2. !g3
C. !g.
3. !gD
.. !g;
The correct answer is .. !n the human body, there are fi"e classes of antibodies or
immunoglobulins% !g&. !g3, !g., !gD, and !g;. .ach immunoglobulin is classified based on
"ariations in the structure of the hea"y chain constant segment. !g; is the first antibody
secreted after the arri"al of an antigen. 8hen the concentration of !gD increases in the affected
area, !g; le"els decrease. !g; antibodies, also /nown as agglutinins, are responsible for the
agglutination of cross)matched blood and are so used to determine an indi"iduals blood type.
!g& 5choice &6 is primarily found in glandular secretions and functions primarily to attac/
pathogens before they gain access to internal tissues. !g3 5choice 26 is found on the surface of
2 cells. These immunoglobulins help to bind antigen molecules. !g. 5choice C6 attaches to the
e0posed surfaces of basophils and mast cells. 8hen an antigen binds to the !g. molecule, the
cell is stimulated to release histamine, which is the primary cause of allergic reactions. !gD
5choice 36 is the largest antibody found in the body. !t is responsible for pro"iding AresistanceA
against many different bacteria, "iruses, and bacterial to0ins.
*hysiology
0hich of the following important nutrients is present in milk in low
concentration?
1. !ron
2. Protein
3. Calcium
4. Phosphorus
5. Carbohydrate
The correct answer is choice 1, iron. ;il/ is high in protein, in particular, complete protein,
calcium, phosphorus and carbohydrate, particularly lactose. 1owe"er, it is deficient in iron and
also deficient in niacin. #o the correct answer to $uestion is choice 1.
0hich of the following is a classical decomposition reaction?
&. & 9 2 )L &2
2. &2 )L & 9 2
C. & 9 2 K)L &2
3. &2 K)L & 9 2
.. &2 9 C3 K)L &3 9 C2
The correct answer is 2. & decomposition reaction brea/s a molecule into smaller fragments.
The classical synthesis reaction is characteri,ed by the symbols & 9 2 )L &2. This shows two
raw materials oining to form one molecule. Con"ersely, a decomposition reaction &2 )L & 9 2
5choice 26 is the opposite of a synthetic reaction. 1ere, one molecule brea/s down into two
smaller components. Choices C 5& 9 2 K)L &26 and 3 5&2 K)L & 9 26 are essentially the same
type of reaction+ an e$uilibrium reaction. !n an e$uilibrium reaction there is a decomposition
reaction followed by a synthesis reaction or "ise "ersa. These reactions occur on a continual
basis and are re"ersible. The reaction &2 9 C3 K)L &3 9 C2 is termed an e0change reaction
because the two initial compounds 5&2 and C36 decompose and form two different compounds
5&3 and C26 usually by e0changing ions.
0hich of the following is a principal action of insulin?
1. To mobili,e lipid deposits
2. To enhance cell permeability to glucose
3. To decrease cell permeability to glucose
4. To conser"e glucose by brea/ing down amino acids
The correct answer is choice 2. !nsulin acts primarily to reduce blood glucose le"els. !t is made
by beta cells in the pancreas. !ts actions include increasing cell permeability to glucose in fat
tissue and muscle+ therefore, glucose is ta/en out of the blood by these tissues. !t also
increases fatty acid synthesis by fat tissue and glycogen synthesis by the li"er. !t also decreases
the release of gluconeogenic amino acids by the li"er and decreases protein brea/down. #o
choices 1, 3 and 4 are incorrect and opposite. !nsulin will tend to cause formation, not
degradation, of lipids+ increase, not decrease, cell membrane permeability to glucose+ and cause
decreased, not increased, brea/down of amino acids. #o the correct answer to $uestion is
choice 2.
0hich of the following groups includes only amino acids essential for humans?
&. *aline, serine, leucine
2. ?eucine, lysine, glycine
C. Tyrosine, threonine, tryptophan
3. Phenylalanine, methionine, proline
.. Tryptophan, methionine, isoleucine
The correct answer is Choice .. &mino acids are the basic building bloc/s of proteins. They are
classified into two separate groups, the essential and the nonessential amino acids. The
nonessential group includes amino acids that the body can synthesi,e. The essential amino acid
group include ones that the body either cannot synthesi,e or are synthesi,ed in amounts too
small to meet the needs of the body. These amino acids must be supplied in the diet. The
following is a list of essential amino acids%
1. Threonine
2. ?ysine
3. ;ethionine
4. &rginine
5. *aline
7. Phenylalanine
=. ?eucine
B. Tryptophan
I. !soleucine
1C. 1istidine
-f the choices listed, Choice . 5tryptophan, methionine, isoleucine6 contains only essential
amino acids.
0hich of the following hormones are produced by the neurohypophysis and
affect contraction of smooth muscle?
1. *asopressin 5&316 and o0ytocin
2. Thyrotropin and intermedin
3. &drenotropin and somatotropin
4. &ldosterone and luteini,ing hormone
correct answer is choice 1. The neurohypophysis is another term for the posterior pituitary. The
two maor hormones produced by the posterior pituitary are &31, also /nown as "asopressin,
and o0ytocin. &31 raises blood pressure and helps retain fluid by increasing permeability of
collecting tubules in the /idney. -0ytocin causes uterine contraction and mil/ secretion. !n
choice 2, thyrotropin or T#1 comes from the anterior pituitary and stimulates the thyroid gland+
while intermedin or melanotropin is an anterior pituitary hormone that stimulates melanin
production. &nd choice 3, adrenotropin or &CT1 is another anterior pituitary hormone that
stimulates the adrenal corte0, while somatotropin or growth hormone is another anterior
pituitary hormone that stimulates o"erall body growth. &nd choice 4, aldosterone is an adrenal
cortical hormone primarily responsible for sodium retention, while luteini,ing hormone is an
anterior pituitary hormone in"ol"ed in triggering o"ulation and formation of the corpus luteum.
#o the correct answer to $uestion is choice 1.
0hich of the following is a refle! mediated by the vagus?
1. 2ile flow from the li"er
2. ;ucus secretion from the 2runnerEs glands
3. Cephalic phase of gastric secretion
4. Pancreatic secretion of bicarbonate
The correct answer is choice 3. The "agus ner"e functions primarily to promote digestion. !t
increases acid production in the stomach. #electi"e "agotomy is sometimes utili,ed as a
treatment for chronic gastric ulcers. Choice 1, bile flow from the li"er, is incorrect. The "agus
ner"e causes contraction of the gallbladder, not the li"er, to increase bile flow. Choice 2, mucus
secretion from the 2runnerEs glands, is incorrect. ;ucus secretion in the duodenum is stimulated
by the presence of gastrin, secretin and cholecysto/inin. Choice 4, pancreatic secretion of
bicarbonate, is incorrect. Pancreatic secretion of bicarbonate is under the control of secretin. #o
the correct answer to $uestion is choice 3.
0hich of the following is <5%# likely to cause respiratory acidosis?
&. ;o"ing from high altitude to sea le"el
2. <ntreated diabetes mellitus
C. 1ypo"entilation
3. 4idney failure
.. *omiting
The correct answer is Choice C. (espiratory acidosis is a condition caused by retention of CC2
due to abnormal or inade$uate pulmonary "entilation. This may be a result of pathologic
conditions that damage the respiratory centers in the brain or that decrease the lungEs ability to
eliminate CC2 such as obstruction or pneumonia.
-f the following choices, hypo"entilation 5Choice C6 is the most li/ely cause of respiratory
acidosis as discussed abo"e. !nade$uate pulmonary "entilation increases 12C-3 and hydrogen
ion concentration in the blood resulting in acidosis.
;o"ing from high altitude to sea le"el 5Choice &6 will not cause respiratory acidosis. (espiratory
al/alosis, howe"er, may occur when a person ascends from sea le"el to high altitude.
<ntreated diabetes mellitus 5Choice 26 may result in acidosis but it is caused by pathologic
le"els of insulin and not by an abnormality in respiration.
4idney failure 5Choice 36 can lead to acidosis resulting from failure of the /idney to eliminate
acidic products from the body. !t is also not a cause of respiratory acidosis
0hich of the following is 95# a monosaccharide?
1. &mylose
2. Dlucose
3. @ructose
4. Dlyceraldehyde
5. Dlucuronic acid
The correct choice to $uestion is '1, amylose. &mylose is an unbranched polyglycan of starch.
!t is not a monosaccharide. Nou should /now that both glucose, C7112-7 is a monosaccharide,
and fructose is also a monosaccharide. (emember, a monosaccharide is a carbohydrate that
cannot form any simpler sugar by simple hydrolysis. The pentoses and he0oses are
monosaccharides. 2oth glyceraldehyde and glucuronic acid are also monosaccharides. #o again,
the correct choice to $uestion is '1, amylose.
0hich of the following is present in plasma but absent in serum?
1. &lbumin
2. Dlobulin
3. ?ecithin
4. @ibrinogen
5. Prothrombin
The correct answer is choice 4. &nd we will shortly bring up a problem with answer choice 4, but
letEs re"iew the choices anyway. Plasma is the fluid noncellular portion of the blood containing
water, "arious ions, inorganic compounds, proteins and other organic compounds. !f whole blood
is allowed to clot and the clot is remo"ed, the remaining li$uid is /nown as serum. #erum has
essentially the same composition as plasma, e0cept that fibrinogen and "arious clotting factors
)) in particular !!, * and *!!! )) ha"e been remo"ed. Plasma and serum do ha"e similar
composition in terms of albumin, globulin and lecithin. !n what appears to be an o"ersight,
prothrombin, also /nown as clotting @actor !!, is remo"ed from plasma when clotting occurs and
should apparently be "iewed as another correct answer to $uestion. #o anyway, the official
answer is choice 4, but choice 5 is also physiologically correct .
0hich of the following is responsible for protecting tooth enamel and binding
to!ic tannins?
&. 1igh)proline protein
2. immunoglobulin &
C. 4alli/rein
3. ?yso,yme
.. ;ucins
The correct answer is &.
1igh)proline proteins are responsible for protecting tooth enamel nd binding to0ic tannins.
lmmunoglobulin & 5choice 26 helps defend against bacteria on mucosal surfaces. 4alli/rein
5choice C6 is a proteolytic en,yme that clea"es /ininogens to form brady/inin. ?yso,ymes
5choice 36 brea/ down the cell walls of bacteria. ;ucins 5choice .6 are glycoproteins that
lubricate the food and protect buccal and esophageal mucosa from scratching.
0hich of the following is responsible for secreting substances that have a basic
p-?
&. Cholecysto/inin
2. Dastrin
C. 1ydrochloric acid
3. !ntrinsic factor
.. #ecretin
The correct answer is ..
#ecretin is synthesi,ed and stored in the # cells of the upper intestine. !t stimulates the
secretion of bicarbonate)containing substances from the pancreas and inhibits gastric emptying
and gastric acid production. 2icarbonate containing sutistances are AbasicA by chemical nature.
Cholecysto/inin 5choice &6 is produced and stored in the cells of the duodenal and eunal
mucosa. The parietal cell secretes two substances% intrinsic factor and hydrochloric acid. The
hormone gastrin 5choice 26, which is produced in the D cells of the duodenum, primarily
functions to stimulate hydrochloric acid, histamine, and pepsinogen secretion, as well as
increase gastric blood flow. 1ydrochloric acid 5choice C6 functions primarily to denature proteins
and acti"ate digesti"e en,ymes. !ntrinsic factor 5choice 36 is the secretion of parietal cells that
facilitates the absorption of "itamin 212 across the intestinal lining. *itamin 212 is a member of
the cobalamin family and ser"es as a cofactor for two reactions in humans% the methylation of
homocysteine to methionine and con"ersion of methylmalonyl)Co& to succinyl)Co&. The most
common disorder seen with "itamin 212 deficiency is pernicious anemia, which is associated
with the de"elopment of a megaloblastic anemia.
0hich of the following is the ma4or building block& comprising greater than BC&
of all biologic membranes?
&. Cholesterol
2. Dlycolipids
C. !ntegral membrane proteins
3. Peripheral membrane proteins
.. Phospholipids
The correct answer is ..
?ipids are the primary constituents of all biologic membranes. Phospholipids are the maor
building bloc/ of all biologic membranes, comprising between 5CH and 7CH of the total
membrane lipid. &lthough cholesterol 5choice &6 is a maor component of plasma membranes, it
comprises between 15H and 25H of the total membrane. Dlycolipids 5choice 26 generally ma/e
up the remainder of the lipid portion of the cell membrane. !ntegral membrane proteins 5choice
C6 are embedded in the lipid bilayer and cannot be remo"ed without disrupting the membrane.
Peripheral membrane proteins 5choice 36 are also found in the lipid)based membrane+ howe"er,
these proteins can be remo"ed.
0hich of the following is the ma4or contributor to colloid osmotic pressure?
1. &lbumin
2. &lpha globulin
3. 2eta globulin
4. Damma globulin
The correct choice is '1, albumin. Plasma osmotic pressure is a direct result of plasma proteins
in the bloodstream. Plasma proteins such as albumin ha"e osmotic acti"ity because of their
inability to permeate the membrane. They are the most abundant protein relati"e to globulins
and fibrinogen% therefore, due to their abundance they are the maor contributors to osmotic
colloidal pressure. The effecti"e colloidal osmotic pressure is 25 mm1g. This may decrease or
increase in plasma as the concentrations of plasma proteins "ary. &lpha globulin, beta globulin
and gamma globulin are not in abundance relati"e to albumin, and therefore are not maor
contributors to the colloid osmotic pressure. &gain, the correct choice is '1, albumin.
0hich of the following is the region;nucleus of the hypothalamus responsible for
controlling the feeding refle!es& such as swallowing and licking?
&. ;amillary bodies
2. Para"entricular nucleus
C. Preoptic area
3. #upraoptic nucleus
.. Tuberal area
The correct answer is &. The hypothalamus contains a "ariety of important control and
integrati"e centers as well as those associated with the limbic system. The mamillary bodies are
the region of the hypothalamus responsible for controlling the feeding refle0es, such as
swallowing and lic/ing. The para"entricular nucleus 5choice 26 is responsible for secreting
o0ytocin. The preoptic area 5choice C6 is responsible for regulating body temperature. The
supraoptic nucleus 5choice 36 secretes &ntidiuretic hormone, which restricts water loss in the
/idneys. The tuberal area 5choice .6 is the portion of the hypothalamus that releases hormones
that control the endocrine cells of the anterior pituitary.
0hich of the following minerals is responsible for the proper functioning of the
enzyme carbonic anhydrase?
&. Copper
2. ;agnesium
C. ;anganese
3. Phosphorus
.. Oinc
The correct answer is .. ;inerals 5and "itamins6 are essential components of the diet because
the body is unable to synthesi,e the maority of these compounds. ;inerals are inorganic ions
typically released through the dissociation of electrolytes. Oinc is a mineral responsible for the
proper functioning of the en,yme carbonic anhydrase and acts as a cofactor of "arious other
en,yme systems. 8hen indi"iduals are ,inc deficient, the immune system may become
compromised. Copper 5choice &6 acts as a cofactor for hemoglobin synthesis. ;agnesium
5choice 26 is a cofactor of en,yme systems and is responsible for normal membrane functioning.
!t is also a constituent of bones and teeth. ;anganese 5choice C6 is also a cofactor for "arious
en,yme systems+ howe"er, it is not in"ol"ed with the en,yme carbonic anhydrase. Phosphorus
5choice 36 is a constituent of bones, teeth, and &TP phosphorylated metabolic intermediates.
*hysiology
0hich of the following must be digested before being in a form that can be
absorbed by enterocytes?
&. ;onoglycerides
2. @atty acids
C. @ructose
3. Dlycine
.. ;altose
The correct answer is Choice .. @oods from which the human body obtains nutrition can be
classified into carbohydrates, fat, and proteins. These substances generally cannot be absorbed
by the intestinal mucosa without the process of digestion. Carbohydrates, for e0ample, are
mainly large disaccharides and polysaccharides that must be hydroly,ed before they can be
utilli,ed by the enterocytes of the small intestine. ;altose 5Choice .6, a disaccharide found in
starch that must be split into its constituent monosaccharide before it can be absorbed by the
enterocytes.
;onoglycerides 5Choice &6 and fatty acids 5Choice 26 are the digesti"e end products of fat. They
are both readily 5glucose6 absorbable by enterocytes.
@ructose 5Choice C6 is one of the monosaccharides formed from digestion of cane sugar. !t is
already in a form that can be absorbed by enterocytes "ia facilitated diffusion. Dlycine 5Choice
36, an amino acid, can also be absorbed directly by enterocytes without further digestion
0hich of the following occurs in a normal menstrual cycle?
1. -"ulation generally occurs 1C days from the beginning of the cycle.
2. The o"um generally disintegrates or becomes non"iable if it is not fertili,ed within four
days.
3. The blood concentration of estradiol increases as the corpus luteum de"elops.
4. The blood le"el of follicle)stimulating hormone increases and the le"el of luteini,ing
hormone decreases at the time of o"ulation.
The correct answer is choice 2. :onfertili,ed o"a will generally degenerate within about four
days. Choice 1 is incorrect. -"ulation occurs appro0imately on the 14th day of the cycle,
although the e0act time will "ary. Choice 3 is incorrect. .stradiol, or estrogen, secreted by the
o"ary will decrease as the corpus luteum de"elops. The corpus luteum formed after o"ulation
secretes large amounts of progesterone and much smaller amounts of estrogen than at the
pea/ of the follicular stage. Choice 4 is incorrect and opposite. #lightly before o"ulation, @#1
le"els decline and then slowly rise, while ?1 le"els rise dramatically in a spi/e)li/e fashion. The
great increase in ?1, or luteini,ing hormone, is largely responsible for o"ulation. #o the correct
answer to $uestion is choice 2.
0hich of the following occurs last in the generation of an action potential?
&. #odium ions enter the cell
2. The transmembrane potential goes from ) =C m* to 9 3C m*
C. *oltage)regulated potassium channels open
3. *oltage)regulated sodium channels close
.. *oltage)regulated sodium channels open
The correct answer is C. &ction potentials are propagated changes in the transmembrane
potential that spread across an entire e0citable membrane . !n a gi"en neuron, an action
potential usually begins at the initial segment of the a0on and is conducted along the length of
the a0on. The steps in the generation of an action potential are as follows% & graded
depolari,ation brings an area of e0citable membrane to a threshold. The "oltage regulated
sodium channels open 5choice .6 which permits sodium ions to enter the cell 5choice &6. -nce
this occurs, the transmembrane potential goes from ) =C m* to 9 3C m* 5choice 26. The
"oltage)regulated sodium channels then close 5choice 36 and the "oltage regulated potassium
channels open 5choice C6. !n other words, the opening of the potassium channels is the last step
that occurs based on the gi"en answer choices. -nce the potassium channels open, potassium
ions mo"e out of the cell and repolari,ation begins.
0hich of the following portions of the cardiovascular system contains the
greatest volume of blood?
&. &rterioles
2. Capillaries
C. #ystemic "eins
3. Chambers of the heart
.. Pulmonary "asculature
The correct answer is Choice C. The greatest "olume of blood by far is contained in the systemic
"eins 5Choice C6. !t comprises 74H of blood in the systemic circulation. The "eins ser"e as a
maor reser"oir of blood for the body along with their important function as conduits for
transport of blood from tissues bac/ to the heart.
The arterioles 5Choice &6 and capillaries 5Choice 26 carry appro0imately =H of the blood.
The chambers of the heart 5Choice 36 also contain =H of the blood.
The pulmonary "asculature 5Choice .6 holds IH of blood "olume.
*hysiology
0hich of the following portions of the nephron has a primary function of only
reabsorbing water from filtrate?
&. &scending loop of 1enle
2. Collecting tubules
C. 3escending loop of 1enle
3. 3istal con"oluted tubule
.. Pro0imal con"oluted tubule
The correct answer is 2. The primary function of the nephron is to clear the plasma of unwanted
substances as it passes through the /idney. #ince plasma contains both wanted and unwanted
substances, the nephron will selecti"ely reabsorb these AwantedA substances, at selected
portions of the nephron, bac/ into the plasma and the remaining components are subse$uently
e0creted into the urine. The descending loop of 1enle 5Choice C6 and the ascending loop of
1enle 5choice &6 are primarily responsible for the reabsorption of ions and assisting in the
creation of the medullary concentration gradient. The collecting tubules 5choice 26 are primarily
responsible for the resorption of water, under the control of the hormone &31. The distal
con"oluted tubule 5choice 36 is the primary site for secretion of substances into the filtrate as
well as some reabsorption of water and sodium ions. The primary site of nutrient reabsorption in
the nephron is the pro0imal con"oluted tubule 5choice .6.
*hysiology
0hich of the following refle!es complements the withdrawal refle! by making
compensatory ad4ustments on the opposite side of the body receiving the
stimulus?
&. Crossed e0tensor refle0
2. @le0or refle0
C. Patellar refle0
3. #tretch refle0
.. Tendon refle0
The correct answer is &. (efle0es are classified according to the site where the information is
being processed, the nature of the resulting motor response or the comple0ity of the neural
circuit in"ol"ed. The crossed e0tensor refle0 is classified as a contralateral refle0 because of the
motor response that occurs on the opposite side of the body from that recei"ing the stimulus.
@or e0ample, if one were to step on a nail, the fle0or refle0 5a type of withdrawal refle06 would
pull the foot away from the nail and the crossed e0tensor refle0 would AstiffenA the other leg to
support the body. &s pre"iously mentioned, the fle0or refle0 5choice 26 will Afle0A the muscles in
the affected limb to pull away from the painful stimulus. The patellar refle0 5choice C6 is a type
of stretch refle0 5choice 36 that results in a refle0i"e /ic/ when properly stimulated. The stretch
refle0 pro"ides automatic regulation of muscle length. The tendon refle0 5choice .6 pre"ents a
muscle from e0erting too much tension.
0hich of the following represent6s8 the matri! proteins of enamel?
&. Carbo0ylglutamic acid containing proteins
2. Type ! collagen
C. &melogenins
3. Proteoglycans
3. .lastin
The correct answer is Choice C. &s discussed, the human tooth enamel is made up of
appro0imately I5)IBH of inorganic matter by weight. The remaining structure is composed of
an organic matri0 and water. Protein such as amelogenin 5Choice C6 is formed in the matri0.
Choice &, carbo0ylglutamic acid containing protein, is not found in enamel.
Choice 2, type 1 collagen, is found in s/in, tendon, bone and cornea but does not represent
matri0 protein of enamel.
Choice 3 proteoglycans along with e0tracellular fluid ma/e up the ground substances in bone.
Choice . elastin is also a connecti"e tissue protein. !t is the maor component of elastic fibers
that can stretch to se"eral times their length. ?arge amounts of elastin are found in the walls of
blood "essels and ligaments. !t is not present in enamel.
0hich of the following represents a soluble polysaccharide found in dental pla:ue
and is formed from the fructose moiety of sucrose?
1. ?e"an
2. 3e0tran
3. &mylopectin
4. 1yaluronic acid
The correct answer is choice 1, le"an. ?e"an is a polyfructose synthesi,ed by pla$ue bacteria.
?e"an is a stimulator of 2 cells and indi"iduals with periodontal disease e0hibit greater response
to this polysaccharide than do normal control indi"iduals. Choice 2, de0trans is incorrect.
3e0trans are water soluble, high molecular weight glucose polymers. Choice 3, amylopectins, is
incorrect. &mylopectins are branched chain polyglucose molecules or glucans. Choice 4.
hyaluronic acid, is incorrect. This is a component of the ground substance that ma/es up the
intercellular matri0 of the gingi"al connecti"e tissue. #o the correct answer to $uestion is choice
1
0hich of the following represents the amount of dietary calcium normally
absorbed from the gut of an adult man?
1. &n amount less than 5CH
2. &n amount between 7C)=CH
3. &n amount between BC)1CCH
4. &n amount dependent upon the mucosal ferritin le"el
The correct answer is choice 1, an amount less than 5CH. ?ess than 5CH of the dietary calcium
is absorbed through the small intestine "ia acti"e transport. This acti"e transport is mediated by
a carrier synthesi,ed from "itamin 3. Choices 2 and 3 are therefore incorrect. Choice 4 is
incorrect. @erritin is responsible for the transport of iron in the bloodstream and is not connected
to the transport of calcium. #o the correct answer to $uestion is choice 1.
*hysiology
0hich of the following represents the chemical substance that is the immediate
source of energy for muscle contraction?
&. Dlycogen
2. &cetylCo&
C. ?actic acid
3. Creatine phosphate
.. &denosine triphosphate
The correct answer is Choice .. 8hen a muscle contracts, wor/ is performed and energy is
re$uired for this process. The immediate source of energy is pro"ided by the clea"age of
adenosine triphophate 5&TP6 5Choice .6 to form adenosine diphosphate 5&3P6. The
concentration of &TP present in muscle fibers is limited and only sufficient to maintain full
contraction for 1 to 2 seconds. &s muscle contraction continues, creatine phosphate 5Choice 36
is used to rephosphorylate &3P to form new &TP. The amount of creatine phosphate, howe"er, is
also limited. !t will carry the muscle contraction for another 3)5 seconds. Dlycogen 5Choice &6 is
then used to reconstitute both &TP and creatine phosphate.
#o though both glycogen 5Choice &6 and creatine phosphate 5Choice 36 are important energy
sources during muscle contraction, they are not the initial or immediate source of energy.
&cetyl Co& 5Choice 26 reacts in the citric acid cycle to release large amounts of energy to
con"ert &3P to &TP in the mitochondria. !t is not, howe"er, used by the muscle during its
contraction. ?actic acid 5Choice C6 is an end product in the brea/down of glycogen. !t is also not
a primary energy source.
*hysiology
0hich of the following spinal tracts controls the involuntary regulation of eyes&
head& neck and upper limb position in response to either a visuai or auditory
stimulus?
&. Corticobulbar tract
2. (eticulospinal tract
C. (ubrospinal tract
3. Tectospinal tract
.. *estibulospinal tract
The correct answer is 3. !n the e0trapyramidal spinal tract are the following% The tectospinal
tract controls the in"oluntary regulation of eye, head, nec/ and upper limb position in response
to either a "isual or auditory stimulus. The reticulospinal tract 5choice 26 controls the
in"oluntary regulation of refle0 acti"ity and autonomic function. The rubrospinal tract 5choice C6
controls the in"oluntary regulation of posture and muscle tone. The "estibulospinal tract 5choice
.6 controls the in"oluntary regulation of balance and muscle tone. The pyramidal portion of the
spinal tracts contain the corticobulbar 5choice &6, lateral corticospinal and anterior corticospinal
tracts. &ll three tracts are in"ol"ed in the "oluntary motor control of the s/eletal muscles.
*hysiology
0hich of the following substances represents an unsaturated fatty acid?
&. Cholesterol
2. Palmitate
C. #tearate
3. Choline
.. -leate
/ood 0ork
The correct answer is Choice .. @atty acids are long)chain hydrocarbon organic acids. &n
unsaturated fatty acid is one in which its carbon chain contains one or more double or triple
bonds capable of absorbing additional hydrogen atoms. -leate 5Choice .6 is an 1B carbon chain
unsaturated fatty acid with one double bond in the middle of the chain.
Cholesterol 5Choice &6 is one of the most abundant lipids in the body. !t does not contain fatty
acids.
Palmitate 5Choice 26 is a 17)carbon chain fatty acid that is fully saturated.
#tearate 5Choice C6 is an lMcarbon fatty acid fully saturated with hydrogen atoms.
Choline 5Choice 36 is a relati"ely small hydrophilic compound essential in the formation of some
phospholipids such as a lecithin. !t is not a fatty acid.
0hich of the following tissues is primarily responsible for formation of urea?
1. ?i"er
2. 2rain
3. 4idney
4. ;uscle
The correct choice is '1, the li"er. :itrogen is e0creted predominantly in the form of urea in
urine. <rea is formed in the li"er, brain and also the /idney, but mainly in the li"er "ia the urea
cycle. ?et us re"iew this "ery important cycle. CC2 and :13 9 12C 9 2&TP "ia
carbamoylphosphate synthetase form the unstable carbamoylphosphate. Carbamoylphosphate
combines with ornithine, "ia ornithine carbamoyltransferase to form citrulline. Citrulline and
aspartate and &TP form arginosuccinate, then fumarate and arginine, "ia arginosuccinate lyase.
&rginine is then hydroly,ed "ia arginase to form the urea, :12)C-):12 and 12. The net
reaction of the urea cycle is CC2 9 2:13 9 3&TP 9 312C )L urea 9 2&3P 9 &;P 9 4inorganic
phosphates. #o again, the correct choice is '1, the li"er.
*hysiology
0hich of the following vitamins can be supplied to humans by the normal action
of intestinal flora?
1. &
2. 3
3. .
4. 4
5. :one of the abo"e
The correct choice is '4, "itamin 4. *itamin 4 can be supplied to humans by the normal action
of intestinal flora. *itamin 4 is a /ey factor in the synthesis of prothrombin. !n the absence of
"itamin 4 or in the presence of dicumarol or warfarin prothrombin is not produced. Prothrombin
binds to calcium, and in the presence of these antagonists of "itamin 4 it does not bind to
calcium. Prothrombin, "ia acti"ated factor F is con"erted into thrombin. This is modified by
factor *. 8hen calcium binds to prothrombin it increases its affinity to the phospholipid
membranes from platelets of inury. This binding then brings the prothrombin into pro0imity of
factors Fa and *, which are also in"ol"ed in the clotting cascade. Thrombin, in turn, con"erts
fibrinogen to fibrin for the final step in the clotting cascade. #o again, the correct choice to
$uestion is 4, "itamin 4.
9$,( *art 7 released :uestions . $iochemistry.*hysiology
0hich of the following vitamins is the @(A%# likely to be involved in tooth
development and substance that is the immediate source of calcification?
1. &
2. 21
3. C
4. 3
The correct answer is Choice 2. Tooth de"elopment and calcification are similar to that of bone.
They are affected by "arious factors of metabolism such as the a"ailability of calcium and
phosphate in the diet, and rate of secretion of thyroid, growth, and parathyroid hormones.
*itamins are also essential in the formation of teeth. *itamin & 5Choice &6 is necessary for
normal growth and proliferation of epithelial cells, "itamin C 5Choice C6 acti"ates prolyl
hydro0ylase which promotes normal formation of collagen, and "itamin 3 5Choice 36 increases
calcium absorption and helps control calcium deposition in hard tissues. Choice 2, *itamin 21,is
least li/ely to be in"ol"ed in tooth de"elopment since it functions as a cocarbo0ylase specifically
needed in the final metabolism of carbohydrate and amino acids.
*hysiology
0hich type of muscle contraction occurs when there is a change in length of the
muscle with a corresponding change in tension on that muscle?
&. Concentric
2. 3ynamic
C. .ccentric
3. !sometric
.. !sotonic
The correct answer is 2.
& dynamic contraction includes both concentric and eccentric types of contractions. !n general, a
dynamic contraction results in a change in length of the muscle, with a corresponding change in
tension on that muscle. & concentric contraction 5choice &6 is a type of dynamic contraction in
which the muscle fibers shorten and the tension on the muscle increases. &n eccentric
contraction 5choice C6 is a type of dynamic contraction in which the muscle fiber lengthens and
the tension on the muscle increases. &n isometric contraction 5choice 36 occurs when both ends
of the muscle are fi0ed and nochange in length occurs during the contraction, but the tension
increases. &n isotonic contraction 5choice .6 occurs when a muscle shortens against a fi0ed load
while the tension on that muscle remains constant.
0ith respect to a normal kidney& which of the following situations would cause
the glomerular filtration rate to increase?
&. Constricting the afferht arteriole
2. 3ecreasing blood flow to the /idneys
C. 3ecreasing plasma protein concentrations
3. 3ecreasing renin le"els
.. #ympathetic stimulation of the /idney
The correct answer is C. The glomerular filtration rate is the amount of filtrate produced in the
/idneys each minute. The a"erage glomerular filtration rate is around 125 m? of filtrate per
minute. There are many different factors that can affect the glomerular filtration rate. @or
e0ample, when the blood "olume is increased, due to increased water inta/e, the normal
concentration of plasma proteins in the blood will be decreased. This relati"e decrease can be
attributed to the dilutional effect of increased fluid "olume. Therefore, when plasma protein
concentrations are decreased, the /idneys will increase the glomerular filtration rate 5D@(6 to
increase the production of urine. Constricting the afferent arteriole 5choice &6 will directly
decrease the D@( as less blood enters the nephron. Constriction of the afferent arteriole often
occurs when there is a fall in blood pressure or when there is sympathetic stimulation of the
/idney 5choice .6. 8hen blood flow to the /idneys decreases 5choice 26, the D@( will naturally
decrease because there is not as much fluid being presented to the /idneys per unit of time.
3ecreased renin le"els 5choice 36, leads to a decrease in the con"ersion of angiotensin ! to
angiotensin !!. #ince angiotensin !! is a potent constrictor of the efferent arteriole, decreasing
renin le"els will decrease the D@(.
*hysiology
0ith respect to catabolism of amino acids& deamination results in the production
of
&. /eto acid
2. acetyl)Co&
C. ammonia
3. carbon dio0ide
.. urea
The correct answer is C. The first step in the catabolism of an amino acid is the remo"al of the
amino group. The process re$uires a coen,yme deri"ati"e 5"itamin 276. The amino group can be
remo"ed by deamination or transamination. 3eamination is performed in the preparation of an
amino acid for brea/down in the TC& cycle. !n deamination, an amino group is remo"ed and
ammonia is generated. !n the process of transamination, the amino group of a gi"en amino acid
is transformed to a /eto acid 5choice &6. & /eto acid resembles an amino acid e0cept that the
second carbon is bound to an o0ygen rather than an amino group. &cetyl)Co& 5choice 26 is
produced by the brea/down of pyru"ic acid and the addition of an acetyl)group to these
byproducts. :ote% &cetyl)Co& is produced only in aerobic glycolysis. !n the absence of o0ygen,
the pyru"ic acid is con"erted to lactic acid. Carbon dio0ide 5choice 36 is produced in the TC&
cycle. The ammonia produced during deamination is to0ic+ therefore, the li"er metaboli,es the
ammonia molecule to urea 5choice .6, which is a relati"ely non)to0ic, water)soluble compound
that is e0creted in the urine.
0ith respect to the coagulation phase of homeostasis& the intrinsic pathway
involves
&. Clotting factors *!!, !F, F! and F!!
2. Prostacyclin
C. Thrombin and fibrin
3. Thrombo0ane &2 and platelet factors
.. Tissue factor and tissue thromboplastin
The correct answer is &. The coagulation phase of homeostasis has three primary pathways for
stimulation of blood clotting% The intrinsic pathway, the e0trinsic pathway, and the common
pathway. The intrinsic pathway begins with the acti"ation of proen,ymes e0posed to collagen
fiber located at the site of the inury and in"ol"es the clotting factors *!!, !F, F! and F!! 5choice
&6. This pathway, after a series of lin/ed reactions, forms a comple0 called platelet
thromboplastin. The common pathway begins when the thromboplastin from both the intrinsic
and e0trinsic pathways appears in the plasma. &fter a series of reactions, prompted by these
compounds, thrombin completes the coagulation process by con"erting fibrinogen to fibrin
5choice C6. The platelet phase, begins within seconds after the inury, and causes platelet
adhesion to the e0posed surfaces of the site of inury. -nce platelets arri"e at the site of inury,
they begin releasing thrombo0ane &2 and platelet factors 5choice 36 which stimulate platelet
aggregation and "ascular spasms. The platelet phase is regulated by prostacyclin 5choice 26,
which inhibits platelet aggregation. The e0trinsic pathway is part of the coagulation phase of
homeostasis and begins about 3C seconds after the traumatic e"ent. The e0trinsic pathway
begins with the release of tissue factor, which combines with calcium and another procoagulant,
to form tissue thromboplastin 5choice .6.
*hysiology
0ith respect to the physiological movement of a body part& abduction is best
described as
&. the mo"ement away from the longitudinal a0is of the body
2. the mo"ement of a structure in a superior direction
C. the mo"ement in the anterior>posterior plane that decreases the angle between the
articulating e0tremities.
3. the mo"ement of the thumb which allows it to grasp and hold "arious obects
.. the mo"ement of a gi"en part of the body anteriorly in a hori,ontal plane
The correct answer is &. &bduction is the physiological mo"ement away from the longitudinal
a0is of the body. @or e0ample, swinging the right arm to the side. .le"ation occurs when a
structure mo"es in a superior direction 5choice 26. Con"ersely, depression occurs when a
structure mo"es in a inferior direction+ the process of chewing is a repetiti"e cycle of depressing
and ele"ating the mandible. @le0ion 5choice C6 is described as a mo"ement in the
anteriorlposterior plane that decreases the angle between the articulating e0tremities% for
e0ample, fle0ion of the biceps. -pposition 5choice 36 is the mo"ement of the thumb that allows
it to grasp and hold "arious obects. Protraction 5choice .6 is described as the mo"ement of a
gi"en part of the body anteriorly in a hori,ontal plane+ the grasping of ones upper lip with their
lower teeth is a protracting mo"ement.
*hysiology
0ith respect to types of muscle contractions& treppe is a situation where
&. & muscle is producing pea/ tension during rapid cycles of contraction and rela0ation
2. & muscle is stimulated so fre$uently that the rela0ation phase is completely eliminated.
C. & muscle is stimulated repeatedly for se"eral seconds with a constant stimulus+ the
amount of tension produced then gradually increases to a ma0imum.
3. & second stimulus arri"es before the rela0ation phase has ended and a second and a
more powerful contraction occurs.
.. & smooth but steady increase in the muscle tension is produced by increasing the
number of acti"e motor units.
The correct answer is C. 3uring a muscle contraction, there is no mechanism to regulate the
amount of tension produced in a gi"en muscle protraction+ therefore the muscle fiber is either
producing tension or is in a rela0ed state. This characteristic is /nown as the all)or)none
principle. Therefore, the amount of tension produced by a s/eletal muscle as a whole is
determined by both the fre$uency of stimulation and the number of muscles stimulated. 8ith
these principles in mind, the following principles can be considered% Treppe is situation where a
muscle is stimulated repeatedly for se"eral seconds with a constant stimulus+ the amount of
tension produced then gradually increases to a ma0imum 5choice C6. 8hen a muscle is
producing pea/ tension during rapid cycles of contraction and rela0ation rela,ation, it is /nown
as tetanus. Complete tetanus occurs when a muscle is stimulated so fre$uently that the
rela0ation phase is completely eliminated 5choice 26. 8a"e summation occurs when a second
stimulus arri"es before the rela0ation phase has ended and a second, more powerful,
contraction occurs 5choice 36. (ecruitment occurs when there is a smooth but steady increase in
the muscle tension that is produced by increasing the number of acti"e motor units 5choice .6.
The muscle is producing pea/ tension during rapid cycles of contraction and rela0ation.
0ithin physiologic limits& activity of the respiratory center is decreased directly
by
1. decreased p1.
2. increased p1.
3. increased hemoglobin concentration.
4. increased plasma carbon dio0ide partial pressure
The correct answer is choice 2. The respiratory center is located in the medulla. !ncreased CC2
concentration in blood causes e0cess 12C-3 or carbonic acid formation which lowers p1 near
the respiratory center and increases "entilation. The opposite is true for decreased "entilation.
?ow CC2 causes less acidity and higher p1, decreasing the acti"ity of the respiratory center.
Choice 3 is incorrect. The hemoglobin content of blood is fairly stable and does not change fast
enough to be the controlling influence on the respiratory center. Choice 4 is incorrect. &s
mentioned pre"iously, increased PCC2 or partial pressure of carbon dio0ide, will cause lower p1
and will increase, not decrease, "entilation. #o the correct answer to $uestion is choice 2.