Jake age 3yrs has atopic eczema but is otherwise well.

At a party he ate a cashew and within 5

minutes was noted to be distressed. He developed generalised uricaria (hives) and began coughing.
His left eye swelled. What antibody/antibodies and mediators is/are involved in this immune
response?
a) IgA
b) histamine
c) IgG & IgM
d) IgE
e) adrenaline

Upon mast cell activation and degranulation, which preformed mediator(s) is/are released within
the first few minutes?
a) Prostaglandins
b) Histamine
c) Leukotrienes
d) Tryptase
e) IL 4

William is a 70 year old man undergoing chemotherapy for the treatment of lymphoma. He presents
to hospital with fever, cough, and X-ray changes of pneumonia. His WCC is 3.2 (NR 4-9) with a
neutrophil count of 0.2 (NR 3-7). Which answer best explains why William has developed
pneumonia?
a) The low neutrophil count has rendered the complement system inactive, resulting in an
inability to opsonise bacteria.
b) The low neutrophil count has prevented transport of bacterial antigen to hilar lymph
nodes, resulting in failure to activate T and B lymphocytes
c) The low neutrophil count has blunted the local response to bacterial penetration of the
epithelium, resulting in failure to phagocytose the bacteria.
d) The low neutrophil count has resulted in a failure to produce chemokines and cytokines
that opsonise the bacteria and act as chemoattractants for other leucocytes.

The most important cytokine for IgE production is:

a) TGF ß
b) IL 10
c) IL 4
d) IL 5
e) IL-13

Regarding cytokines, which statement(s) is/are true:

a) have predominantly distant effects
b) may have chemotactic activity
c) active at very small concentrations
d) operate via receptors
e) have overlapping actions

Which of the following effects in airway inflammation are mediated by IL -13?

a) activation of macrophages
b) increased permeability of airway epithelial cells
c) production of inducible nitric oxide synthase
d) Dendritic cells release of chemoattractants
e) Increased airway hyperreactivity
Which one of the following is the predominant stimulus to gastric acid secretion in a healthy
individual?
a) Acetylcholine
b) Gastrin
c) Histamine
d) Somatostatin

Somatostatin is secreted by:

a) D cells
b) Enterochromaffin-like cells
c) Parietal cells
d) Chief cells

The factor most commonly responsible for gastro-oesophageal reflux is:

a) transient relaxations of the lower oesophageal sphincter.
b) reduced resting lower oesophageal sphincter tone
c) the presence of a hiatus hernia
d) impaired oesophageal clearance of acid

The predominant site of gastrointestinal absorption of dietary iron is the:

a) gastric fundus
b) proximal small intestine
c) terminal ileum
d) colon

The presence of which one of the following histological findings in a biopsy of the distal oesophagus
is most important for a diagnosis of Barrett’s oesophagus?
a) Eosinophils in the submucosa
b) Chronic inflammation
c) Specialised intestinal metaplasia
d) Chronic inflammation

The most common cause for asymptomatic, mildly elevated serum transaminases in Western society
is:
a) Hepatitis B
b) Non-alcoholic fatty liver disease
c) Drug-induced reactions
d) Haemochromatosis

In a patient with a distal gastrectomy, which of the following deficiencies is most likely?
a) Vitamin B12
b) Folate
c) Iron
d) Calcium

Which of the following is least likely to cause predominantly zone 3 (centrilobular) liver pathology?
a) Alcohol steatohepatitis
b) Paracetamol toxicity
c) Yellow fever
d) Hypoxia
All of the following structures form the walls of the inguinal canal except?
a) The conjoint tendon
b) The aponeurosis of the external oblique muscle
c) The internal oblique muscle
d) The lacunar ligament

All of the following are derivatives of hind gut, except:

a) Descending colon
b) Last third of anal canal
c) Rectum
d) Last third of transverse colon

Which of the following is true in gut embryology?

a) The gut is a mesodermal derivative
b) The whole of the foregut apart from the stomach undergoes rotation
c) The stomach is a midgut derivative
d) Midgut development involves herniation of bowel into the umbilicus

After a fatty meal, most of the fat would be:

a) Absorbed in the portal circulation and directly transported to the liver
b) Absorbed in the portal vein and transported to the hepatic artery
c) Absorbed as chylomicrons in the lymphatics
d) Absorbed as triglycerides into the portal vein and bypasses the liver

The myenteric plexus of the stomach wall is present:

a) In the serosa
b) Between the middle circular muscle layer and the mucosa
c) Between the outer longitudinal muscle layer and the middle circular layer
d) In the muscularis mucosa

Which of the following is not true regarding peristalsis?

a) Peristalsis is a reflex response
b) It occurs in all parts of the gastrointestinal tract apart from the oesophagus
c) Its occurrence is independent of the extrinsic innervations
d) It is only initiated when the gut wall is stretched by the contents of the lumen

Fructose is absorbed by:

a) Active transport
b) Simple diffusion
c) Osmosis
d) Facilitated diffusion

At low flow rate saliva in the mouth is:

a) Isotonic and low in K⁺
b) Hypotonic and low in K⁺
c) Hypertonic and rich in Na⁺
d) Hypotonic and rich in K⁺

All of the following constituents of saliva contribute to immune protection except:

 a) Ptyalin
b) Lysozyme
c) Lactoferrin
d) IgA

Hepcidin and ferroportin regulate systemic iron absorption by inhibition of:

a) enterocyte brush border iron reduction
b) enterocyte apical iron uptake
c) iron oxidation by hephaestin
d) enterocyte basolateral iron release

Approximately 5 – 10 percent of Caucasians have reduced capacity to metabolise drugs via

cytochrome P450 2D6 (CYP 2D6). This is most likely to be clinically relevant in treatment with
standard doses of which of the following drugs?
a) Cyclosporin (renal toxicity)
b) Codeine (failure of analgesia)
c) Ibuprofen (peptic ulceration)
d) Paracetamol (hepatic toxicity)

A 28-year-old male has the following biochemical findings 24 hours after suffering a thoracic gun
shot wound resulting in hypovolemic shock, requiring massive blood transfusion. His blood tests are:
AST 3800 U/L [5-55 U/L] Alkaline Phosphatase 69 U/L [0-130 U/L] ALT 6400 U/L [5-55 U/L] Gamma
GT 90 U/L [0-60 U/L] Bilirubin 20 micromole/L [0-18 micromole/L] LDH 1800 U/L [<220 U/L] The
most likely explanation for the liver enzyme results is:

a) halothane hepatitis.
b) hepatic vein transection.
c) transfusion reaction.
d) ischaemic hepatitis.

A 3 year old boy with recurrent severe bacterial infections would be more likely to have which of the
following immunological abnormalities?
a) A deficiency of NK cells.
b) A defect in CD8 T cell function.
c) A defect in production of MHC I molecules.
d) Antibody deficiency

A 56 year old woman is being treated with azathioprine for her problem of Crohn’s Disease.
Azathioprine acts against T cells. She presents with a localised skin rash. Which of the following
infections may have caused the skin rash due to the effect of the azathioprine?
a) Staphylococcal cellulitis.
b) Shingles (Varicella-Zoster viral infection)
c) Disseminated meningococcaemia.
d) HIV primary infection.

Which of the following would not be a likely complication of prolonged peptic ulcers?
a) Infection
b) Cancer
c) Diarrhoea
d) Gastric or duodenal perforation
 e) Obstruction

Consider the following statements

i. Gastrin and cholecystokinin increase intestinal peristatlic activity
ii. Glucagon, motilin, and serotonin increase intestinal motility
iii. In the small intestine, D cells secrete cholecystokinin and S cells secrete secretin
iv. Peristaltic rush is a phenomenon caused by intestinal mucosal irritation and is mediated by
the myenteric plexus

Which of the following above is/are TRUE:

a) I only
b) III only
c) II and IV
d) I and IV

Helicobacter pylori gut colonisation is commonly associated with peptic ulcer disease. After
infiltration of the mucous layer, H.pylori uses a number of mechanisms to induce inflammation
leading to gastric cell damage. Which cytotoxic factors are responsible for initiating this response?

a. Ammonium, VacA, CagA, urease

b. VacA, CagA, ammonium, chloride
c. Ammonium, chloride, VacA, urease
d. Ammonium,c hloride, CagA
e. Ammonium, urease, VacA, CagA

During the gastric phase the stomach produces acid to aid food digestion. Due to the action of this
substance, the expectation is the destruction of the gastric mucosa. How does the stomach prevent
self-digestion by HCl?

a. Mucus neck cells secrete mucus creating a thick protective barrier over the epithelia
b. Prostaglandins primarily increase mucosal blood flow to epithelial cells promoting quick cell
recovery
c. Promotes the secretion of hydrogen bicarbonate from gastric epithelial cells
d. All of the above

A common treatment strategy for peptic ulcers, as a result of H.pylori infection is to prescribe two
antibiotics and a proton pump inhibitor such as omeprazole. Antibiotics assist in eradicating the
infection but how does the mechanism of action of the proton pump inhibitor assist in gastric
healing?

a. Prevents H+ secretion by inhibiting P-type H/K ATPase on the luminal surface of parietal cells
b. Prevents H+ secretion by inhibiting F-type H/K ATPase on the luminal surface of parietal cells
c. Prevents H+ secretion by inhibiting P-type H/K ATPase on the basal surface of parietal cells
d. Prevents H+ secretion by inhibiting F-type H/K ATPase on the basal surface of parietal cells
e. Prevents H+ secretion by inhibiting V-type H/K ATPase on the luminal surface of parietal cells
Long term use of ibuprofen can have significant systemic effects. How does it mechanism of action
affect gastric function?

a. Prevents the biosynthesis of prostaglandins thus reducing bicarbonate, mucus secretion and
mucosal blood flow rendering the mucosa susceptible to acid damage.
b. Non-selectively inhibits COX1 and COX2 preventing arachidonic acid conversion to
prostaglandins reducing gastric protection
c. Causes gastric bleeding by allowing resident H.pylori to destroy the gastric epithelia and
expose blood vessel
d. Selectively inhibits COX2 preventing the synthesis of prostaglandins involved in pain, fever
and inflammation.

Upon ingestion of a meal, the secretion of HCL by______ occurs when stimulated by _____. In order
of appearance select the appropriate answers.

I- Chief Cells
II- Parietal cells
III- Histamine
IV- Somatostatin
V- Gastrin
VI- Ach

PBL 2

The pancreas has a variety of roles that can be classified into either exocrine or endocrine origin. The
exocrine functions of the pancreas aid in the processing of food in the intestine. What does the
pancreatic epithelial duct cell contribute to the composition of pancreatic juice?

a. Na, Cl, H20, HCO3, glycoproteins

b. Na, HCO3, H20, Ca
c. Na, HCO3, H20
d. Na, Cl, zymogens, H20
e. Na, Cl, H20, HCO3

How does the small intestine encourage post-prandial absorption of sodium?

I- Transcellular absorption via the basolateral Na-K-ATPase pump

II- Passive sodium absorption via luminal ENaCs
III- Electroneutral exchange with H via apical NHE2 and NH3 and luminal alkalinity
IV- Glucose and amino acid coupled transport in villous epithelial cells
V- Electroneutral NaCl absorption via Na-H and Cl-HCO3 exchangers
VI- Glucose and amino acid coupled transport in crypt epithelial cells.

How does the lack of vitamin B12 and folate as a result of ileum resection lead to megaloblastic
anaemia?

a. Cannot complex with ATP preventing enzymes from working; DNA synthesis is altered
b. Promotes protein degradation; allows an increase in intracellular reactive oxygen species
 c. Promotes protein degradation; prevents the absorption of enzyme cofactors
d. Gene transcription of proteins is reduced; allows an increase in reactive oxygen species
e. DNA synthesis and cell division is altered; promotes alternate mechanisms for methionine
synthesis

What is the first step of enterohepatic recycling of conjugated bile salts?

a. Absorbed throughout the small intestine and colon

b. Absorbed throughout the small intestine
c. Absorbed in the duodenum and jejunum
d. Absorbed in the duodenum and terminal ileum
e. Absorbed in the terminal ileum

What enzymes allow for the digestion of oligosaccharides into monosaccharides?

a. Salivary α-amylase, pancreatic α-amylase

b. Lactase, glucoamylase
c. Lactase, glucoamylase, sucrose-isomaltase
d. Sucrase-isomaltase
e. Pancreatic α-amylase, lactase, sucrose-isomaltase

PBL 3

What process occurs for an orthochromatic erythroblast to become a reticulocyte?

a. Extrusion of nucleus from the cell occurs

b. There is a large accumulation of haemoglobin within the cell
c. This is the cell where haemoglobin first appears
d. There is an increased synthesis of ribosomes
e. Other remaining organelles disappear from the cell

Your patient, Freda, complains of tiredness and breathing more than usual. You conduct a physical
exam and everything seems normal though she is quite pale. You perform a blood test; it shows a
decrease in RBC, decrease in iron. How can you explain the cause of the anaemia?

a. Rectal bleeding
b. Colon cancer
c. Intestinal malabsorption of folate
d. Intestinal bleeding
e. Intestinal malabsorption of iron

Haemoglobin reversibly binds to CO2 and O2, depending on the requirements of the body. What
requirements are desirable to promote O2 binding to heme?

a. Low pH, Co2 and temperature

b. Low ph, low CO2, high temperature
c. High pH, low CO2, low temperature
d. High pH, low CO2. High temperature
The iron in haemoglobin is the mobile carry site for O2 in RBCs. Why does the lack of iron result in
tiredness?

a. Increases CO to increase O2
b. Low oxygen carrying capacity of haemoglobin
c. Low RBC count
d. Stimulates the production of reticulocytes by bone
e. Reduced energy production by aerobic respiration

How does mobilferrin contribute to maintaining iron levels?

a. Transports iron out of the cell across the basolateral surface

b. Converts ferric (Fe3+) iron to ferrous (Fe2+) iron
c. Carries iron throughout the cell
d. Extracts the iron from heme

PBL 4

For a child whose clinical presentation is consistent with breastmilk jaundice, where breastfeeding is
well established, what is the appropriate management?

a. Continue breastfeeding and introduce formula feeding

b. Introduce formula feeding
c. Continue breastfeeding
d. Stop breastfeeding and replace with formula

A 10 day old baby presents with jaundice, the mother is only breastfeeding. The baby isn’t gaining
weight and the mother doesn’t need to change many diapers. How do you explain his jaundice?

a. Increased RBC destruction↑unconjugated serum bilirubin

b. Not enough breastmilk decreased urine/stool output ↑unconjugated serum bilirubin
c. Young child↓UDGT activity ↑ unconjugated serum bilirubin
d. He has a mutation in UDGT ↑unconjugated serum bilirubin
e. Components in the breast milk interfering with bilirubin metabolism ↑unconjugated
serum bilirubin

Results of Liver function test of a patient are below; what is the most likely cause of the patient’s
jaundice?

a. Bile duct obstruction

b. Conjugation enzyme deficiency
c. Liver cirrhosis
d. Acute liver damage
e. Increased haemolysis

Physiological jaundice typically presents in neonates after the second or third day of life. How can
you explain why unconjugated bilirubin levels rise so early in life?
 a. The life span of foetal haemoglobin is shorter
b. Decreased activity of UDGT
c. Increased enteroheptatic circulation due to decreased gut motility
d. Reduced liver function
e. All of the above

Bilirubin metabolism involves numerous organs responsible for its conjugation and excretion. Which
metabolite is the common link between the enteric system and the hepatic and urinary systems?

a. Bilirubin-glucuronide
b. Urobilin
c. Stercobilin
d. Bile
e. Urobilinogen

PBL 5

How does alcohol metabolism induce direct liver damage?

I- Free radicals
II- Fat accumulation
III- Reduced oxygen availability
IV- Reduced glutathione
V- Release of cytokines
VI- Fibrosis
VII- Nodule formation
VIII- Acetaldehyde

Portal hypertension can result from cirrhosis amongst many other causes arising from pre-hepatic,
intrahepatic or post-hepatic origin. Which mechanism best describes a pre-hepatic cause?

a. Accumulation of scar tissue in space of disse increases resistance restricted blood flow
through liver re-directed blood flow through portosystemic anastomoses
b. Obstruction in the IVC increase blood flow into the liver re-directed blood flow through
portosystemic anastomoses
c. Portal vein blockage increased resistance redirected blood flow through portosystemic
anastomoses
d. Occlusion of the hepatic vein increased blood flow into the live redirected blood flow
through portosystemic anastomoses
e. Accumulation of fat increased resistance restricted blood flow through liver blood
flow directed through portosystemic anastomoses

What is the most common cause of cirrhosis worldwide?

a. Viral infection
b. NAFLD
c. Alcohol
d. All of the above
How does alcohol metabolism alter other metabolic pathways in the liver?

a. Increases fatty acid oxidation

b. Decreases pool of NAD+
c. Promotes gluconeogenesis
d. Increases production of acetate
e. Increases fatty acid oxidation

Which cells are primarily activated during cirrhosis that result in the deposition of collagen and
fibronectin in the space of disse?

a. Kupffer cells
b. Hepatocytes
c. Endothelial cells
d. Stellate cells

PBL 7

Two determinants of cardiac output are heart rate and stroke volume. How does the body alter
these determinants during exercise?

a. Decrease, increase
b. Decrease, decrease
c. Increase, decrease
d. Increase, increase

Two determinants of cardiac output are heart rate and stroke volume. How does the body alter
these determinants during blood loss?

a. Decrease, increase
b. Decrease, decrease
c. Increase, decrease
d. Increase, increase

Valvular lesions can result from any disease causing damage to any of the four heart valves. How
does rheumatic fever initiate the sequence of events that leads to mitral stenosis?

a. Valvular narrowing
b. Calcification and fibrosis
c. Fusion of commissure
d. Macrophage and T-lymphocyte inflammation
e. All of the above

During the cardiac cycle, pressures within the heart change during diastole and systole. In order how
does the pressure change during systole within the: aorta/pulmonary artery, atria and ventricles?

a. Increases, remains constant, increases

b. Increases, decreases, increases
c. Decreases, increases, increases
 d. Decreases, remains constant, increases

The mechanism for Frank-Starlings law describes the ability of the heart to change its force of
contraction in response to changes in venous return. How does the heart initially respond to
increased ventricular filling?

a. Increased sarcomere length

b. Myocyte stretching
c. Increased stroke volume
d. Decreased afterload
e. A+B

What mechanism describes the abnormal circulatory dynamics due to uncomplicated aortic
stenosis?

a. Backflow of blood into LV increased workload LV hypertrophy and increased chamber
size
b. Increased flow out of the LV during systole LA pressure Lung congestion
c. Decreased blood into LV LA pressure Lung congestion
d. Decreased emptying of LV Increased workload LV hypertrophy

Airway patency is affected by both neural mechanisms and anatomical characteristics. Which
structures commonly result in the anatomical narrowing of the upper airway which put an individual
at higher risk of obstructive sleep apnoea

I. Neck fat deposition

II. Large tongue
III. Large oesophagus
IV. Enlarged soft palate
V. Large lateral pharyngeal walls
VI. Pharyngeal dilator muscle

a. I,II,III,IV,V
b. I, II, III,IV,VI
c. I, II,IV,V
d. All of the above

To treat mild to severe obstructive sleep apnea. CPAP is the first line treatment strategy. How does
CPAP prevent apnoeic episodes?

When sleeping, keeps the airways open during:

a. Apnoeic episodes
b. Inspiration
c. Expiration
d. Inspiration and Expiration
In addition to neural control of respiration, there is also chemical control of respiration. Which
chemical changes can elicit a response in the chemosensitive area in the medulla to the dorsal
respiratory centre to increase respiration.

a. Increase H+, Decrease PCO2, Decrease PO2

b. Increase H+, Increase PCO2, Decrease PO2
c. Increase pH, increase PCO2, increase PO2
d. Decrease pH, decrease PCO2
e. Increase H+, Increase PCO2

What phases of a cardiac action potential are absent in pacemaker cells?

a. 0
b. 1
c. 2
d. 3
e. 4

What changes occur during phase 2 of a ventricular action potential?

a. Influx of Ca2+ ions, outflux of K+ ions

b. Influx of Na+ ions, outflux of K+
c. Influx of Ca2+
d. Outflux of K+
e. Influx of K+

At the end of the systole, how is blood prevented from leaving the heart?

a. Pulmonary and Aortic valves close

b. Mitral and bicuspid valves close
c. Pulmonary and aortic valves are open
d. Mitral and bicuspid valves are open

How do catecholamines affect the SA node?

a. Increases pacemaker current (if)

b. Increases Ca2+ current
c. Decreases pacemaker current (if)
d. Decreases Ca2+ current
e. A+B
f. C+ D

In an ECG what represents AV node conduction?

a. P wave
b. PR interval
c. QRST complex
d. ST segment
e. T wave
Following autonomic stimulation by sympathetic drive, how would the ECG waveform change?

a. Increase in duration
b. Increase in amplitude
c. Decrease in duration
d. Decrease in amplitude

Which of the following statements is true?

a. Ventricular blood volume is low during the first heart sound

b. The S1 heart sound is heart just before the R wave
c. The S1 heart sound corresponds to closing of the tricuspid and mitral valves
d. The S1heart sound corresponds to isovolumetric relaxation

What does the P wave correspond to?

a. Repolarisation of Ventricles
b. Depolarisation of the Atria
c. Depolarisation of the ventricles

During Ventricular systole which heart valves would be open?

a. Tricuspid and aortic

b. Aortic and pulmonary
c. Bicuspid and tricuspid
d. Bicuspid and pulmonary

The Vagus Nerve provides sympathetic innervation to the heart?

a. True
b. False

During atrial systole the remaining 20% of the blood is ejected from the atria to the ventricles when:

a. The atria contract and pressure in the ventricles exceeds that of the atria
b. The atria contract and the pressure in the atria exceeds that of the ventricles
c. The ventricles contract and the pressure in the ventricles exceeds that of the atria
d. The ventricles contract and the pressure in the atria exceeds that of the ventricles

What is the correct order of the electrical events resulting in depolarisation of the heart?

a. SA node AV bundle AV node Purkinje fibres

b. AV bundle AV node Purkinje fibres Ventricular wall
c. SA node AV node AV bundle Purkinje Fibres
d. AV node Purkinje fibres AV bundle Ventricular wall

Heart Murmurs result from poor or defective:

a. Ventricular contraction
b. Arterioles
c. Blood supply to the myocardium
d. Valves
START HERE Which of the following is true in relation to the cardiac cycle?

a. The P wave corresponds to low atrial blood volume and high ventricular pressure
b. Upon closing of the AV valves pressure in the ventricles is at its highest
c. Pressure in the atria is high at the start of ventricular systole
d. During ventricular systole pressure is low in the atria and high in the ventricles.

The absence of a P wave and an irregular heart beat would suggest a diagnosis of:

a. Pericarditis
b. Atrial fibrillation
c. Ventricular Hypertrophy
d. Ventricular ectopic beats

Mean arterial pressure can be determined by:

a. Cardiac Output x Ventricular systole

b. Stroke volume x heart rate
c. Cardiac output x total peripheral resistance
d. Stroke volume x cardiac output

Blood flow to the fingers is derived predominantly from the radial artery

a. True
b. False

If a patient has a systolic blood pressure of 140mmHg and a diastolic pressure of 80mmHg. Then the
pulse pressure would be:

a. 220mmHg
b. 1.75mmHg
c. 60mmHg
d. 110mmHg
e. None of the above. Pulse pressure cant be calculated with these values

Mammals have the innate ability to redirect blood flow. In freezing conditions what would happen
to the peripheral blood vessels supplying the fingers?

a. Increased pulse amplitude, vasoconstriction, decrease blood flow and increase resistance
b. Decrease pulse amplitude, vasoconstriction, decreased blood flow and decreased resistance
c. Increased pulse amplitude, vasodilation, increase blood flow and decreased resistance
d. Decreased pulse amplitude, vasoconstriction, decrease blood flow and increased resistance

During the cardiac cycle, if the ejection fraction was increased then there would be a decrease in:

a. Pulse pressure
b. End-diastolic volume
c. End-systolic volume
 d. Heart rate
e. Cardiac output

The Frank-starling law of the heart:

a. Does not function when exercising

b. Explains the decrease in cardiac output when sympathetic nerves supplying the heart are
stimulated
c. Explains the increase in heart rate during exercise
d. Explains the increase in cardiac output when venous return is increased

Which of the following statements is true:

a. Isovolumetric relaxation corresponds to low pressure and high blood volume in the
pulmonary trunk
b. Isovolumetric relaxation corresponds to the S-T interval on an ECG
c. Isovolumetric relaxation corresponds to high pressure and high blood volume in the
pulmonary trunk
d. Isovolumetric relaxation corresponds to the QRS interval on an ECG

Most arterioles are innervated by adrenergic nerve fibres. These fibres are:

a. Sympathetic, release epinephrine and vasoconstrict

b. Parasympathetic, release epinephrine and vasoidilate
c. Sympathetic, release norepinephrine and vasodilate
d. Parasympathetic, release norepinephrine and vasodilate

When air gains access to and accumulates in the pleural cavity this is known as pneumothorax. How
does the presence of air in the pleura promote lung collapse? Select all that apply.

a. Surface tension between visceral and parietal pleura is disturbed

b. Intrapleural pressure becomes more positive
c. Intrapleural pressure becomes more negative
d. Enhances lung recoil

When breathing, various muscles are used to assist with inspiration and expiration. From the list
below which muscles are involved in forced expiration?

I. Scalenes
II. Parasternal internal intercostals
III. Diaphragm
IV. Abdominal
V. Upper respiratory tract
VI. Caudal internal intercostals
VII. Rostral/Dorsal External Intercostals
VIII. Ventral/caudal external intercostals
IX. Neck and back
X. Sternocleidomastoids
Mechanical ventilation primarily involves the diaphragm during inspiration. By increasing the volume
of the chest wall, what changes in intrapleural, transpulmonary and alveolar pressure promote air
flow into the lungs? Select answer based on order of appearance.

a. More negative, decrease, increases

b. More negative, increases, decreases
c. More positive, decreases, increases
d. More positive, increases, decreases

During whole body exercise:

a. End-diastolic volume would increase and end-systolic volume would decrease

b. End-diastolic volume would decrease and end-systolic volume would increase
c. End-diastolic volume would decrease and end-systolic volume would decrease
d. End-diastolic volume would increase and end-systolic volume would increase

During exercise the release of norepinephrine has a positive inotropic effect on cardiac muscle cells:

a. True
b. False

During whole body exercise:

a. Arteries to the large intestine undergo sympathetic vasoconstriction and resistance

decreases
b. Arteries to the large intestine undergo sympathetic vasoconstriction and resistance
increases
c. Arteries to the large intestine undergo parasympathetic vasoconstriction and resistance
increases
d. Arteries to the large intestine undergo parasympathetic vasoconstriction and resistance
increases

What happens to the stroke volume id EDV increases

a. Increases
b. Decreases
c. No change

During exercise which interval would decrease the most:

a. R-T interval
b. P-T interval
c. P-R interval
d. R-R interval

Parasympathetic stimulation from the vagus nerve has a negative inotropic effect on the heart:

a. True
b. False

The amount of air which moves in and out of the lungs during resting breathing is termed the:

a. Vital capacity
 b. Residual volume
c. Tidal volume
d. Ventilation rate

Vital capacity can be calculated by adding together which of the following lung volumes and
capacities:

a. IRV+ERV
b. IRV+ERV=TV
c. IRV=ERV=TV=RV
d. VC cant be calculated

Asthma causes inflammation and narrowing of the airways in the bronchi

a. True
b. False

What is forced vital capacity?

a. It is the maximum volume of gas that the patient can exhale during the first second
b. It is the maximum volume of gas that the patient can exhale as forcefully and as quickly as
possible
c. It is the maximum volume of gas that the patient can inhale from the point of maximal
expiration

The inspiratory reserve volume is the:

a. Total amount of air in the lungs at maximal inspiration

b. Sum of vital capacity and residual volume
c. Amount of air that can be inhaled past the tidal volume
d. Amount of air that can be exhaled past the tidal volume

Henry’s gas law states that:

a. The amount of gas dissolved in a liquid is directly proportional to the partial pressure of that
gas at a constant temperature
b. The pressure of a given mass of an ideal gas is inversely proportional to its volume
c. The volume of an ideal gas at constant pressure is directly proportional to the absolute
temperature

What is obstructive sleep apnoa:

a. The medical term for constant snoring

b. Waking during the night for no apparent reason
c. The temporary interruption of breathing during sleep
d. Sleeping longer ‘that periods of 10hours’

During an anxiety attack, hyperventilation would lead to:

a. Hypercapnia and respiratory acidosis

b. Hypercapnia and respiratory alkalosis
 c. Hypocapnia and respiratory acidosis
d. Hypocapnia and respiratory alkalosis

Which of the following muscles is most active during maximal inspiration:

a. Innermost intercostals
b. Internal intercostals
c. External intercostals
d. Transverus thoracis