2000 midterm II practice

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THIS IS THE NEW COVER SHEET FOR THE FINAL EXAM. PLEASE LOOK AT IT CAREFULLY. I HAVE ALSO POSTED A TEMPLATE OF THE BUBBLE SHEET SO THAT YOU CAN DOWNLOAD IT OR USE IT TO PRACTICE WITH THIS PRACTICE EXAM. STUDENT NAME: ____________________ UWO USER ID: _____________________ (first part of your email) DEPARTMENT OF PHYSIOLOGY AND PHARMACOLOGY Phys/Pharm 2000 Midterm 2 Hour Exam AN HB PENCIL MUST BE USED TO FILL IN THE OVALS ON THE SCANTRON. OVALS MUST BY COMPLETELY FILLED IN. TO MAKE ANY CHANGES. ERASE COMPLETELY AND CAREFULLY. A PEN OR PENCIL CAN BE USED TO WRITE YOUR RESPONSES TO THE SHORT ANSWERS . BE SUCCINT IN YOUR ANSWERS AND PRINT NEATLY WITHIN THE SPACE PROVIDED. FOR SCANNING PURPOSES DO NOT TAMPER WITH THE BARCODE OR WRITE IN THE TOP OF THIS PAGE, USE A PEN OR HEAVY PENCIL WHEN ANSWERING SHORT ANSWER QUESTIONS DIRECTIONS FOR FILLING THE TOP HALF OF THE BUBBLE SHEET: This exam is VERSION A. Under Version, fill in the bubble ‘A’ as per below DIRECTIONS: Each of the questions or incomplete statements Multiple Choice Questions is followed by four suggested answers or completions. Select the ONE that is BEST in each case and blacken the appropriate space on the Scantron sheet. Cell Phone and Device Policy I understand that cell phones, watches and other devices are absolutely prohibited during this exam. By signing below, I acknowledge that I will receive a zero on this exam if I am found tohave a cell phone, watch or other prohibited device. Students Signature _________________________________ Please make sure that this examination booklet contains XX multiple choice questions and X short answer questions and X pages (including this one). Do not sit near anyone you’ve studied with! It is your responsibility that no one can see your answers! Cover them up! User ID (first part of your uwo email) Leave Blank Dec 17, 2023 PHYSPHARM 2000 Print first and last name here

1. If the hypothalamic-hypophyseal tract were damaged, which of the following symptoms would you expect? A) Polyuria - Hypothalamic-hypophyseal tract refers to posterior pituitary , which may affect release of ADH and oxytocin. ADH activity is crucial for osmolar control of the body, thus damaged hypothalamic-hypophyseal tract may produce polyuria. B) Goiter C) Muscle degradation D) Hyperglycemia 2. Which of the following hormones can be regulated through positive feedback loops? A) LH - LH and FSH are regulated via a positive feedback loop in order to enhance estrogen (LH stimulates androstenedione secretion, hence estrogen) production in females. B) ADH C) Oxytocin - 왜 아닐까 .. D) A and C 3. A new hormone is discovered and seems to be required for regulating hair growth. When it is over expressed, hair loss is accelerated. A hydrophilic drug has been developed to act as an antagonist to the hormone receptor. What properties does the hormone likely have? A) It is a protein hormone - Since it being a hydrophilic drug, the drug cannot be steroid/cholesterol since these two are lipophilic drugs; therefore, choices B and C are eliminated since these explain properties of lipophilic drugs. Moreover, the mechanism of action for these hormones are to cause not to cause genetic (transcriptional) changes in the target cell, thus eliminating choice D. B) It is lipophilic C) It requires a carrier protein when circulating through blood D) Its mechanism of action is to cause transcriptional changes in the target cell. 4. A 45-year-old woman is looking to switch birth control. She is on the mini-pill but will be starting a new job that involves shift work and she is concerned that she will forget to take her pill on time. She is a heavy smoker, with a history of blood clots, and has recently been diagnosed with early signs of osteoporosis (bone loss). Considering possible side effects, which of the following birth control options is most suitable? A) The combination pill B) An IUD - Combination pill may not be used since she is concerned of missing a pill and injection would not be the best choice due to a history of blood clots. C) Injections of contraceptive (Drug name is Depo-Provera) D) All of the above are suitable 5. A virus has attacked and damaged a person’s Sertoli cells, which of the following symptoms might they present with? A) Loss of fertility due to the loss of the blood testes barrier.

B) Loss of muscle mass due to a loss of testosterone production. - Testosterone production is controlled by Leydig cells. C) Loss of FSH due to a loss of inhibin production. - Combination Loss of inhibin production will stimulate GnRH to produce more FSH. D) High levels of GnRH due to a loss of testosterone. - Loss of testosterone will stimulate GnRH production in the hypothalamus. 6. If theca cells did not develop properly, what would you expect? A) Ovulation would not occur. B) Fertilization of the ovum would not be possible. C) The Graafian follicle will not develop properly. D) All of the above. - Improper development of theca cells will affect androstenedione, which further impacts the estrogen release, thus all of the above consequences are possible to occur. 7. A doctor is investigating why a person is unable to get pregnant. They measure hormone levels from one blood sample and see that FSH and LH levels are low, but within the normal physiological range, and progesterone is high but within the normal physiological range. At the same time, they do an ultrasound of the ovaries. Based on the hormone profile, what structure should they be looking for to see if normal follicular development has occurred during this cycle? A) A dominant (Graafian) follicle B) A corpus luteum - High progesterone level, in particular, signifies the luteal phase of the status of follicle, where a corpus luteum actively produces progesterone. This contributes to maturation and maintenance of the uterine lining. C) Primordial follicles D) A and C 8. If a person has higher levels of cortisol (still within normal physiological range), which of the following statement is most like TRUE? A) The person has hyperthyroidism B) The person has Cushing’s - High levels of cortisol is the major cause of Cushing’s syndrome. C) The person most likely has lower ACTH levels but still within physiological range D) The person most like has higher CRH levels but still within physiological range 9. What kind of hormone is ACTH? A) A neuropeptide hormone B) A slow acting hormone C) A hormone that travels through the blood bound to a protein D) A hormone that binds to a cell membrane receptor - ACTH is a peptide hormone that produces cortisol, which is signalled to be released by a neuropeptide hormone called CRH. Since peptide hormones are hydrophilic, it is unable to move across the lipid membrane, but rather binds to the membrane receptor.

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10. Which of the following is correctly matched? A) Cortisone is given to patients who have had an organ transplant - Cortisone increases cortisol levels in order to suppress the immune system, which allows to suppress organ transplant rejection in the recipient’s body. B) Thyroxine is given to patients who have asthma - Thyroxine is rather involved in activities of T3 and T4 hormones, where it decreases the T3 and T4 production. C) Cortisone is given to patients with Cushing’s D) Thyroxine is given for joint pain relief 11. A person has had a blood test and is shown to have abnormally low Ca ++ levels. Which of the following hormones would you expect to have concentration levels outside of the normal physiological range? A) Calcitonin B) Parathyroid Hormone C) Progesterone D) A and B - Calcitonin is stimulated by high calcium levels while parathyroid hormone is stimulated by low calcium levels in the blood. A concentration level of calcium outside of the normal physiological range indicates a direct problem to calcitonin and parathyroid hormone. 12. A person has higher than physiologically normal levels of TSH as a symptom of another underlying condition. Which of the following other symptoms would you expect them to have? Select the option with only correct answers. A) Slow reflexes, depression, easily fatigued B) Agitated, rapid heart rate, diarrhea - Increased production of T3 and T4 leads to more rapid heart rate and agitation. C) Easily bruised, round face, prone to infection D) Sensitivity to warm temperatures, rapid heart rate, low blood pressure 13. Which of the following are symptoms of Type 1 Diabetes Mellitus A) Polyuria, thirst, and weight loss B) Complete loss of insulin secretion C) High levels of glucose in the urine D) All of the above - All of the above explains the major symptoms of Type 1 diabetes ( Do not misunderstand weight loss as not being one of the major symptoms of Type 1 diabetes ). 14. Which of the following is true regarding digestion in the oral cavity? A. there is no mechanical digestion that occurs in the mouth B. mastication/chewing is a type of chemical digestion C. lipids are chemically digested within the oral cavity D. amylase is an enzyme secreted in saliva that digests amylose

15. What is FALSE about the comparison between the tissue layers of the stomach compared to the small intestine? A. both organs have four tissue layers B. compared to the small intestine, the stomach muscularis externae layer has more smooth muscle layers C. both organs have acid secreting cells in the mucosa layer D. compared to the stomach, the small intestine has villi in the mucosal layer 16. What is FALSE about peristalsis? A. it is a type of motility pattern the occurs in the esophagus B. its main purpose is to increase the mixing of lumen contents C. it is not under voluntary controlled D. it pushes chyme through the different segments of the small intestine 17. All the following are common mechanisms to reduce the acid in the stomach EXCEPT : A. ingesting a compound that contains bicarbonate B. increase mucus secretion by the stomach mucosa cells C. inhibit the H + /K + ATPase of parietal cells D. reduce the secretion of somatostatin into the blood 18. What is true about absorption in the gastrointestinal tract? A. absorption of amino acids can occur in the mouth B. lactose can be absorbed in the small intestine C. dipeptides or tripeptides can be absorbed in the small intestine - Mono-/di-/tripeptides can be absorbed in the small intestine. Nothing is absorbed in the oral cavity. Lactose is not absorbed as its own form; however, must be broken down into glucose and galactose. Stomach does a minimal absorption of amino acids, for which then small intestine carries on. D. amino acids can be absorbed in the stomach

19. Which of the following is NOT necessary for the efficient digestion and absorption of lipids? A. pancreatic lipase B. intrinsic factor C. colipase D. bile 20. Which of the following is NOT a pancreatic exocrine secretion? A. procarboxypeptidase B. insulin C. chymotrypsinogen D. bicarbonate 21. All the following is true regarding hepatocyte function EXCEPT : A. bilirubin is made insoluble by hepatocytes so that it can be secreted in bile - Bilirubin, a waste product, is made insoluble so that it can be secreted in bile. B. hepatocytes can store glucose as glycogen C. waste products like bilirubin are imported into hepatocytes to be metabolized D. fructose is imported into hepatocytes and converted into glucose 22. The gastric phase of acid secretion is initiated by which of the following? A. the sight, thought or smell of food B. the entry of the bolus into the stomach C. the entry of chyme into the small intestine D. the release of secretin by the small intestine 23. All the following are brush border enzymes that are correctly matched to the biomolecules that they produce through the act of chemical digestion EXCEPT : A. lactase  glucose + galactose B. aminopeptidase  amino acid + peptide C. dipeptidase  amino acid + amino acid D. maltase  glucose + fructose 24. What is true about the intestinal phase of digestion and motility? A. it is initiated by the entry of the bolus into the stomach B. it decreases secretion of acid from the stomach C. it causes the gallbladder to contract - The intestinal phase inhibits the gastric phase, which decreases secretion of acid from the stomach. The intestinal phase further causes the gallbladder to contract. D. it increases gastric emptying

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25. Which of the following will exit out of the stomach the fastest? A. a calorically dense meal will exit faster than a meal that is less calorically dense B. a meal that contains solid carbohydrates will exit faster than a meal that contains liquid carbohydrates C. a meal that contains protein will exit faster than a meal that contains lipids - Calorically dense, carbohydrate-rich, and solid carbohydrate meals trigger slower exit out of the stomach. Protein-rich meals exit faster from the stomach than lipid-rich or carbohydrate-rich meals. D. a meal that contains carbohydrates will exit faster than a meal that contains proteins 26. What is true regarding lipid transport? A. triglycerides are absorbed across the apical membrane of absorptive intestinal cells with a protein carrier - Absorption of triglyceride does not require a protein carrier, as it being lipophilic. B. micelles are exocytosed across the basolateral membrane of absorptive intestinal cells - Micelles enter the lumen cell, while re-packaged triglycerides exit the basolateral membrane via exocytosis. C. the liver exports dietary triglycerides in chylomicrons to adipose tissue - Lumen re-packages the triglyceride (that has been reformed in the ER) in chylomicrons to exit via basolateral membrane. D. cholesterol is sent to the liver via high density lipoproteins - Cholesterol is sent to the liver via high density lipoproteins, which is then broken down with the help of bile solution , that is produced by the hepatocytes. 27. What chemical characteristics does insulin need to have to be short acting? A) Be a part of a complex hexamer or aggregate B) Be able to bind to albumin C) Be able to peak within 2-30 minutes D) Be able to last for 12 hours or more Short answer questions on next page

Short Answer: 1) You have run a blood test on a patient and discover that the patient has abnormally low iodine levels in their body. Explain how iodine is relevant to hormone production (1 mark), and how low iodine levels affect hormone secretion from the hypothalamus and pituitary (2 marks). List one symptom low iodine levels can cause (1 mark)? (4 mark + 1 for clarity) 2) Describe how the adrenal cortex is organized (1 mark) and specify which tissue produces which class of hormones in the adrenal cortex (3 marks)? (4 marks + 1 mark for clarity) 3) List the 3 signals that cause secretion of acid from parietal cells. Indicate the signaling molecule and what receptor it activates on the parietal cell. What is the consequence if one of these signaling pathways does not activate the parietal cell and why? (4 marks + 1 for clarity = 5 marks total) 1. Low iodine levels decrease production of T3 and T4 . 2. Via negative feedback loop , this stimulates more production of TRH from the hypothalamus, which then, via hypophyseal-hypothalamic portal system, stimulates TSH release from the anterior pituitary. 3. The accumulation of TSH may cause a growth of thyroid; for example, causing a goiter . Adrenal cortex is organized in the following layers: zona glumerulosa, zona fasciculata, zona reticularis, and adrenal medulla is at the deepest of the layers. Zona glumerulosa secretes mineral corticoids which regulates water reabsorption and physical osmolarity. Zona fasciculata produces glucocorticoid that regulates glucose metabolism. Moreover, zona reticularis produces androgens , that further produces testosterone, estrogen and progesterone . Lastly, adrenal medulla secretes norepinephrine and epinephrine , which act to stimulate the sympathetic nervous system. - Ach binding to M3 - Histamine binding to H2 - Gastrin binding to CCKB - If the pathway of CCKB is deactivated by – perazoles , it inhibits the ECL cell , which inhibits the production of histamine . Therefore, the binding of histamine and H2 will not be established, thus the acid secretion will only be executed via Ach binding to M3, resulting in the minimal acid secretion.

4) Provide two examples of how hepatocytes can import a substance from the blood and metabolize. Provide one example of what will be secreted back into the blood, and a different example of what will be secreted into bile solution. (4 marks + 1 for clarity = 5 marks total) - Via the portal vein , liver obtains large nutrients to metabolized, and smaller nutrients, such as glucose , is secreted back into the blood to be transported to the heart. - The hepatocytes collect bilirubin from the blood vessels to metabolize to increase solubility so that bilirubin can be excreted out of the body more easily. The metabolized bilirubin with GA is then transported into bile vessels .

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2000 midterm II practice

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