ANATOMY

1. The Merkel cells which are interspersed among c) Integument and axillary fascia
the cells of the stratum basale of the epidermis d) Subscapularis
a) Undergo keratinization 11. The point of convergence of the ilium, ischium
b) Serve as mechanoreceptors and pubis is the
c) Produce melanin pigments a) Sacroiliac joint
d) Are actively phagocytic b) Symphysis pubis
2. The most numerous cells of the papillary layer c) Acetabulum
of the dermis is the d) Iliopectineal line
a) Adipocytes 12. Footdrop results from paralysis of what
b) Fibroblasts muscle?
c) Macrophages a) Flexor digitorum longus
d) Lymphocytes b) Tibialis anterior
3. Which of the following amino acid is needed by c) Peroneus longus
the epidermal melanocytes to produce melanin? d) Extensor digitorum brevia
a) Valine
b) Tyrosine diri nag stop
c) Phenylalanine 13. Extracellular edema can be brought about by the
d) Tryptophan following; except
4. In sucking which of these pair of muscles exerts a) Increased capillary pressure
its utmost function b) Decreased plasma colloid osmotic pressure
a) Orbicularis oris and platysma c) Decrease in interstitial fluid pressure
b) Orbicularis oris and buccinator d) Lymphatic obstruction
c) Levator anguli oris and risorius 14. Because aortic pulse pressure can go as high
d) Risorius and zygomaticus major 120 mmHg and right pulmonary artery
5. Which part of the sternoclavicular ligament pressure averages at 25 mmHg during
guards against excessive depression or systole, the quantity of blood flowing
downward glide of the clavicle? through the lungs is
a) Anterior clavicular a) Less than in the systemic circulation
b) Interclavicular b) More than in the systemic circulation
c) Posterior sternoclavicular c) Equal to that in the systemic circulation
d) Costoclavicular d) More than twice the wedge pressure ar
6. Which of the following bones is not part of the recumbent position
knee joint? 15. Diffusion and filtration system include the
a) Femur following blood vessels
b) Patella a) Arteries
c) Fibula b) Arterioles
d) Tibia c) Capillaries
7. Venous access done at about 1 cm anterior to d) Veins
the medial malleolus is thru the 16. Streamline or laminar flow is characterized by
a) Dorsal venous arch the following
b) Superficial malleolar a) Each layer of fluid slides smoothly over an
c) Superficial plantar adjacent layer
d) Great saphenous b) Flow velocity increases toward the
8. The lymphatic system controls the periphery of the tube
a) Concentration of proteins in the interstitial c) Velocity is inversely proportional to tube
fluid radius
b) Volume of the interstitial fluid d) Resistance to flow is greatest at the center
c) Interstitial fluid pressure of the tube
d) All of the above 17. Low pressure in the pulmonary circulation
9. The cricoid cartilage is at the level of which indicates the following
cervical vertebra a) Dilatable vessels
a) 4th b) High resistance vessels
b) 5th c) Lesser vessel diameter
c) 6th d) Less viscous blood
d) 7th 18. According to Poiseuille’s law, an increase in
10. The structure that forms the ventral wall of the the following factor tend to retard fluid
axilla flow
a) Pectoralis minor a) Radius of the tube
b) Teres major muscle b) Viscosity of the fluid
 c) Pressure head
d) Velocity of flow
19. According to the Vasodilator theory of local
blood flow regulation, increase in local blood
flow can be brought about by
a) Increased metabolic rate
b) Diminished oxygen supply
c) Increased in formation of vasodilator
substances
d) All of the above
20. Ted’s blood pressure is normally 120/80
mmHg. This morning it rose to 15-/100 mmHg.
Supposing his kidneys are normal, his renal-
body fluid mechanism is expected to respond
by
a) Kidneys will further retain water until a
diuretic is given
b) Blood volume will remain elevated until a
vasodilator is given
c) The rise in blood pressure will cause
pressure natriuresis
d) Increase thirst and increase in water intake
21. T’was a crisply cold December morning when
Joshua and his mom and dad were walking
calmly towards the village chapel to attend the
early dawn mass. Breathing in the fresh cool
morning air, they were filled with some kind of
peace and serenity. As the air is conducted in
the upper respiratory passages, it undergoes the
following; except
a) Filtration
b) Humidification
c) Cooling
d) Warming
22. The ultimate goal of pulmonary ventilation is to
a) Expand the lungs
b) Conduct fresh air into the alveoli
c) Oxidize nutrients for energy production
d) Aerate the blood
23. Systemic blood supply to the lungs is the
bronchial artery which has the following
function(s)
a) To provide nutrition to the airways, larger
pulmonary vessels and pleura
b) To add water vapor to inspired air
c) To transport oxygenated blood from the
alveoli to the right auricle
d) A and B only
24. Fresh inspired air fills up the anatomic dead
space which
a) Extends from the nose and oral cavity until
the tertiary bronchi
b) Is decreased by tracheostomy
c) Is normally greater than the physiologic
dead space
d) Is always pathological and impairs
pulmonary function
25. Lung efficiency depends on how closely the
following two factors match
a) Diffusion and transport
b) Depth of inspiration and expiration
c) Alveolar ventilation and perfusion
d) External and internal respiration
26. If respiratory rate is 15/min, tidal volume =
500 ml and physiologic dead air space = 150
ml, how much is the alveolar ventilation
a) 4200 ml
b) 5000 ml
c) 5250 ml
d) 6500 ml
27. The importance of residual volume is the
following
a) Keeps the lungs inflated at the end of the
normal expiration
b) Makes the lungs fully expanded during
inspiration
c) Provides air in the alveoli to aerate the
blood even between breaths
d) Allows warming of air in alveoli before
diffusion into the pulmonary blood
28. Normal quiet expiration is entirely a passive
process, because
a) No nerve impulses are sent to the effector
muscles
b) Only inertial work of breathing is
performed
c) No thoracic pressure and volume changes
occur
d) All of the above
29. This refers to the maximum amount of air a
person can expel from the lungs after first
filling the lungs to their maximum extent and
then expiring to the maximum extent
a) Tidal volume
b) Inspiratory capacity
c) Vital capacity
d) Expiratory reserve volume
30. The potent effect of CO2 on the neurons in the
respiratory center, is due to the following
characteristic
a) High utilization coefficient
b) Ability to react with carbonic anhydrase
c) Low molecular weight
d) High kinetic energy
31. Mrs. P. del Rosario was admitted to the hospital
for a transfusion of whole blood due to a
chronic anemia. Her blood type was B, Rh (+)
but inadvertently she was given Type A, Rh (+)
blood. This transfusion was futile and fatal
because
a) Donor’s RBC with A agglutinogens were
destroyed by the patient’s anti-B
agglutinins
b) Patient’s anti-B agglutinins were destroyed
by the donor’s A agglutinogens
c) Patient’s RBC with A agglutinogens were
destroyed by the donor’s anti-B agglutinins
d) Donor’s RBC with A aglutinogens were
destroyed bu the donor’s B agglutinogens
While walking down a dark alley one starless night,
Paulo’s right foot accidentally stepped on a piece of
broken glass which pierced through his rubber sandals.
He immediately raised his right foot as his arms
swayed sidewards as he balanced himself.
32. The following cord reflex(es) exhibited include
the following
a) Flexor reflex, right foot
b) Cross extensor reflex, right foot
c) Stretch reflex, right foot
d) Golgi tendon reflex, arms
33. A powerful feedback mechanism that begins
with tissue inflammation and ends finally with
the removal of the cause of inflammation is
provided by the following:
a) Tumor necrosis factor
b) Interleukin-1
c) Colony stimulating factors
d) AOTA
34. One of the most important of all products of the
complement cascade which has a direct effect
of rupturing the cell membranes of bacteria and
other invading organism is:
a) C5a
b) C3b
c) C5b,6,7,8,9
d) C5b,6,7
35. The following is/are correct of the intrinsic
pathway for initiating clotting:
a) Involves activation of factor XII and release
of platelet phospholipids
b) Initiated by tissue factor such as a
traumatized vascular wall
c) More explosive than the extrinsic pathway
d) With severe trauma, clotting can occur in as
little as 15 seconds
36. The following is/are correct of agglutinins:
a) Present when the corresponding
agglutinogen is absent
b) Immediately after birth, quantity of
agglutinins in the plasma is almost zero
c) May have a maximum of 10 binding sites
thereby causing more RBCs to clumo
together on a single agglutinin
d) AOTA
37. The most essential regulator of RBC production
is:
a) Tissue oxygenation
b) Erythropoeitin
c) Folic acid and cyanocobalamin
d) CFU-erythrocyte
Case 1: Anna is almost at the doorstep of her dream of
becoming an international flight stewardess. She can
almost picture herself elegantly dressed, flashing her
winning grin to all passengers. She has everything
calculated well except for her medical exams,
particularly the ECG taken a day before. This could be
crucial since she has been experiencing occasional
chest pains lately. Can her cardiac status stand the
rigorous schedule of international flights?
38. In this case, Anna’s ECG tracing can give a
clue to the following conditions except
a) Calculate her cardiac output
b) Detect myocardial ischemia
c) Show conduction abnormalities
d) Demonstrate electrolyte alterations
39. Her could have erroneous results if
a) All the 12 conventional leads were recorded
b) The standardization is not indicated at the
start of the tracing
c) In lead III, the (+) electrode was placed on
the left leg and the (-) electrode was placed
on the left arm
d) In V4, the electrode was placed on the 5th
ICS- Left MCL
40. In her ECG, the P wave should tell us about the
following:
a) Her atrial depolarization
b) Her atrial repolarization
c) The start of her ventricular depolarization
d) Her P wave is quite insignificant and can be
disregarded
41. Her P wave was negative in aVR. What could
this mean?
a) There might be chamber enlargement if her
atria
b) There could be a conduction abnormality
from the SA node to the AV node
c) It is a normal finding
d) An echocardiogram is indicated to assess
the valves and chambers
42. A scrutiny of her QRS complex showed that it
was normal in voltage and was positive in leads
V5 and V6 and was bi-phasic in leads V3 and
V4. This would show:
a) Probable ventricular hypertrophy pattern
b) Electrolyte imbalance
c) Ischemic process
d) It is a normal finding
43. Her T wave would show us the following
information:
a) If tall and peaked it could indicate
hyperkalemia
b) If inverted in particular leads, it could
demonstrate ischemia
c) Its configuration could be distorted by
ventricular hypertrophy
d) AOTA
44. There was no U wave seen in her tracing. If it
was seen its significance could be:
a) Further repolarization of her ventricles
b) Electrolyte abnormalities particularly
hypokalemia
c) Ventricular hypertrophy
d) AOTA
45. The upright deflection of her QRS in V4-V6
shows that:
a) The depolarization dipole is moving
towards the electrode
b) This is normal QRS progression
c) The direction of the movement of the dipole
is towards the left
d) AOTA
Case 2: six hours PTA, Joseph, 46 y.o., complained of
constricting substernal chest pain while playing
basketball with friends. In contrast to his other
episodes of chest pains in the past, this chest pain
lasted more than 10 minutes and wasn’t relieved by
rest. He at once took his usual sublingual nitroglycerin
tablets, but there was no relief/ he was rushed to CDH
ER and his attending physician’s admitting diagnosis
was myocardial infarct.
46. If you were Joseph’s cardiologist, which of the
following cardiac enzymes would you request?
a) CK Mb
b) AST
c) LDH
d) AOTA
47. The enzyme levels were not very conclusive.
Another cardiac enzyme test was repeated after
2 days/ it was most probably:
a) AST
b) Troponin T/I
c) LDH
d) Any of the above
48. The utility and advantage of Tropinin T/I over
the other studies could be because:
a) It is more specific when there is a
concomitant skeletal muscle injury that is
below the results
b) It could also be more specific when here is
a small myocardial infarction that is below
the detection limit of CK Mb
c) It could detect infarct has happened for
some days since tropinin T could remain
elevated for 14 days
d) AOTA
49. On the 4th day post admission, Joseph
developed arrythmia. Its causation could be
explained by the following mechanisms:
a) A probable block in the different points of
impulse transmission in the heart
b) There might be spontaneous generation of
abdominal impulses in almost any part of
the conducting system
c) Abnormal rhythmicity of the pacemaker
50. The side by side relationship between myosin
and action filaments is achieved by the
following
a) Large numbers of filament molecules of a
protein called titin
b) Strong insertion of action filaments into the
2 discs by alpha actinin
c) Interaction of myosin and actin filaments
through the cross-bridges
d) Absence of the cross-bridges at the very
most center in myosin
51. A pure actin filament without the presence of
the troponin-tropomyosin complex binds
instantly and strongly with the heads of the
myosin molecules in the presence of the
following
a) Ca ions
b) Mg ions
c) ATP
d) B and C
52. Every muscle of the body is composed of a
mixture of so-called fast and slow muscle
fibers. The differences between these 2 types of
fibers include the following
a) Fast muscle fibers are rich in red myoglobin
b) Fast fibers have less extensive blood supply
c) Slow fibers have fewer mitochondria than
fast fibers
d) Slow fibers have large amounts of glycotic
enzymes
53. Which of the following substances is most
important for skeletal muscle contraction but
not for smooth muscle contraction?
a) Myosin-ATPase
b) Actin
c) Troponin
d) Ca-ATPase
54. Which statement below correctly describes the
channels located on the end-plate
membranes of skeletal muscles?
a) The channels are activated by acetylcholine
b) The channels are primarily permeable to Na
c) When all post synaptic channels are open,
the membrane potential becomes positive
d) The number of open channels increases
when the membrane depolarizes
55. On which of the following sensory systems is
the transducer and spike generator located on
the same cell?
a) Hearing
b) Olfaction
c) Vision
d) Taste
56. The following statements are true of the taste
sensation except
a) Most taste buds are located around the
circumvallate papillae
b) Each taste bud can be exited by more than
one of the primary taste stimuli, when the
taste substance is in low concentration
c) The extreme degree of adaptation that
occurs in taste sensation occurs in the CNS
itself
d) Phenylthiocarbamide is used frequently to
detect taste blindness
57. Which type of receptor is activated by
acetylcholine and blocked by atropine?
a) Nicotinic
b) Muscarinic
c) Beta adrenergic
d) Alpha adrenergic
58. The association area of the central cortex that
provides a high level of interpretative meaning
for signals from all surrounding sensory areas
is the
a) Prefrontal association area
b) Limbic association area
c) Parieto-occipitotemporal association area
d) Secondary somatic sensory area
59. In transmission of a neuronal signal from a
presynaptic neuron to a postsynaptic neuron, a
 certain amount of time is consumed in the the liver
following process(es): a) CCK
a) Discharge of the transmitter substance by b) Histamine
the presynaptic terminal c) Secretin
b) Action of the transmitter on the membrane d) Gastrin
receptor 69. The absorption of glucose by the small
c) Action of the receptor to increase the intestine is via
membrane permeability a) Sodium cotransport
d) AOTA b) Diffusion
60. Which of the following is a feature of both the c) Solvent drag
stretch and the withdrawal reflexes? d) Active transport
a) After discharge 70. These provide the greatest surface are for the
b) Reciprocal innervation absorption in the small intestine
c) Simultaneous stimulation of alpha and a) Valvulae conniventes
gamma motor neurons b) Villi
d) Reduction of Ia fiber activity during c) Microvilli
contraction d) Taenia coli
61. The following events occur when the stapes hit 71. In athletes on training, the changes that occur
the oval window: inside their hypertrophied muscles include the
a) Increase in pressure in the scala vestibule following except:
b) Movement of the basilar fibers a) Increase in the number of myofibrils
c) Excitation of hair cells b) Increase in mitochondrial enzymes
d) AOTA c) Decrease in stored triglyceride
62. Factors that control GI functions are the d) Increase in ATP and phosphocreatine
following except: 72. The final common denominator of
a) Enteric nervous system cardiovascular function in exercise is to
b) Autonomic nervous system a) Deliver oxygen and other nutrients to the
c) Hormones muscles
d) No exception b) To remove CO2 and other waste products of
63. The following conditions that make the GI cell metabolism from muscles
membrane more excitable except: c) To increase CO in response to increase
a) Stretching if the muscle venous return
b) Stimulation by acetylcholine d) To strengthen the cardiac muscles to reduce
c) Parasympathetic stimulation cardiovascular disease
d) Sympathetic stimulation 73. What metabolic systems in exercise is utilized
64. What factor would likely delay gastric by the muscle from power surges of a few
emptying seconds
a) Increase food volume in the stomach a) Glycogen-lactic system
b) Stretching of the stomach wall b) Aerobic system
c) Gastrin secretion c) Phosphagen system
d) Distention of the duodenum d) AOTA
65. Mass movement in the colon 74. Most substances in the plasma are freely
a) Propel the feces from the cecum to the filtered from the glomerulus except
sigmoid a) Glucose
b) Occur 12-24x per day b) Proteins
c) A modified type of peristalsis c) Sodium
d) AOTA d) Bicarbonate
66. This contributes the greatest amount in the total 75. This characteristic feature is not associated with
volume of intestinal juices the glomerulus
a) Saliva a) Composed of anastomosing network of
b) Gastric secretion capillaries
c) Small intestine secretions b) Has a low hydrostatoc pressure
d) Large intestine secretions c) Capillaries are covered by the epithelial
67. The following statements are true about bile cells
salts except d) Fluid filtered flows into the Bowman’s
a) Important in the emulsification of fats capsule
b) Aid in the absorption of fat soluble vitamins 76. The forces that oppose filtration across the
c) They are not reabsorbed into the blood from glomerular capillaries are the following except
the small intestine a) Bowman’s capsule hydrostatic pressure
d) No exception b) Glomerular hydrostatic pressure
68. This hormone stimulates secretion of bile by c) Glomerular capillary colloid osmotic
 pressure c) Vasopressin
d) Net filtration pressure d) Epinephrine
77. Which of these hormones increase the 86. Which of the following substances are not
glomerular filtration rate? reabsorbed by the proximal tubule?
a) Epinephrine a) Protein
b) Norepinephrine b) Amino acids
c) Prostaglandin c) Urea
d) Angiotensin d) Glucose
78. Which of the following is not a major function 87. The kidneys conserve water by excreting a
of autoregulation in the kidneys? concentrated urine with the basic requirement
a) Maintain a relatively constant GFR such as:
b) Allow precise control of renal excretion of a) High level of ADH
water b) High osmolality of the renal medullary
c) Allow control of renal excretion of solutes interstitial fluid
d) Maintain a constant blood pressure c) High level of urea excretion
79. About 65% of the filtered load of sodium and d) A and B
water are reabsorbed by 88. Which of the following feature is a synaptic
a) Proximal tube function of neurons?
b) Descending loop of Henle a) An impulse may be locked in its
c) Ascending loop of Henle transmission
d) Collecting duct b) Each impulse may be changed from a single
80. The part of the loop of Henle that is virtually impulse into repetitive impulse
impermeable to water c) Each impulse may be integrated with
a) Descending thin segment impulses from other neurons
b) Ascending thin segment d) AOTA
c) Thick ascending segment 89. What chemical substance is believed to be the
d) Tip of Henle major transmitter substance associated with the
81. What type of brain waves are found in the EEG production of sleep?
of a normal adult person who is awake, quiet a) Serotonin
and in a resting state of cerebration? b) Acetylcholine
a) Alpha waves c) Dopamine
b) Beta waves d) Norepinephrine
c) Theta waves 90. The most important receptors for determining
d) Delta waves joint angulation in midranges of motion are
82. Which of the following is not a metabolic effect a) Pacinian corpuscles
of growth hormone? b) Muscle spindles
a) Increase rate of protein synthesis c) Golgi tendon apparatus
b) Decrease mobilization of fatty acids d) Krause corpuscles
c) Decrease rate of glucose utilization 91. Research work has suggested that this chemical
d) Enhance conversion of fatty acids to acetyl- agent might be the single agent most
CoA responsible for causing tissue damage type of
83. Which of the following features is related to pain
testosterone? a) Serotonin
a) Serves to inhibit the descent of testes during b) Histamine
the last third month of pregnancy c) Substance P
b) Secretion after puberty causes secondary d) Bradykinin
sexual characteristics to develop 92. The following are physiologic effects of
c) Decrease the total quantity of bone matrix glucocorticoids except
d) Cause calcium retention a) Increase glucose levels in the plasma
84. The most important temperature receptors for b) Decrease protein synthesis and decrease
long term control of body temperature are cellular protein catabolism
neurons located in c) Increase proteins in plasma and liver
a) Preoptic area of the hypothalamus d) Increase levels of blood amino acids
b) Supraoptic nuclei 93. Given the following plasma electrolyte levels,
c) Postoptic area what could possible be the adrenal disorder:
d) Paraventricular nuclei Na: 145 mg/dl; K: 2.4 mg/dl; Cl: 96 mg/dl;
85. The permeability of the late distal tubule and HCO3: 41 mg/dl
cortical collecting duct to water is controlled by a) Normal
the concentration of what hormone? b) Adrenal insufficiency
a) Angiotensin c) Primary aldosteronism
b) Aldosterone d) SIADH
94. The following inhibits the production of insulin d) Her bones were unable to provide calcium
by the pancreas
a) Glucose
b) Somatostatin
c) Glucagon
d) Amino acids
95. Mr. Johns, a 65 y.o male, recently underwent
disarticulation of his right big toe for a non
healing ulcer. His physician told him that he
had adult-onset diabetes. What are the effects of
insulin deficiency on the tissues that brought
about Mr. Johns condition?
a) Inadequate blood supply to the tissues
secondary to structural changes of the blood
vessel
b) Peripheral neuropathy
c) Increased utilization and decreased storage
of proteins
d) AOTA
96. The rate of iodide trapping by the thyroid cells
is influenced by several factors, the most
important being the following
a) Leve; of T3 in the plasma
b) Concentration of TSH
c) Rate of storage of thyroglobulin
d) Rate of transport of thyroxine and
triiodothyronine to the tissues
97. Parathyroid hormone maintains normal ionized
serum calcium concentration by the following
mechanisms of action on the bone
a) Inhibits osteoclastic function
b) Decrease formation of new osteoclasts
c) Increases osteoblast-initiated recruitment of
osteocytes and osteoclasts
d) AOTA
98. The following factors stimulate calcitonin
synthesis and secretion except
a) Cholecystokinin
b) Glucagons
c) Beta-adrenergic agonists
d) Beta-adrenergic antagonists
99. Which of the follwing is not true of a typical
menstrual cycle?
a) Menstruation is induced by an increased in
estrogen and progesterone
b) The increase in FSH on day 28 is induced
by loss of steroid negative feedback
c) Non dominant follicles undergo atresia due
to decrease in FSH
d) The ratio of LH to FSH increases before
ovulation
100. A 28 y.o female underwent thyroidectomy.
Four days post-operatively, she had CP arrest.
Her calcium blood level was 6.2 mg/dl. What
could most likely cause her calcium blood level
reach this value?
a) She had burst of secretion of her calcitonin
prior to the removal of her thyroid gland
b) She has damaged kidneys
c) Her parathyroid gland was probably
accidentally removed