1017MSC Intensive Practice Exam: Anatomy & Physiology Systems II

Studocu is not sponsored or endorsed by any college or university 1017MSC Intensive Practice EOS Exam 2017 Anatomy&Physiology Systems Ii (Griffith University) Studocu is not sponsored or endorsed by any college or university 1017MSC Intensive Practice EOS Exam 2017 Anatomy&Physiology Systems Ii (Griffith University) Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

Student Name: Student ID: (Family Name), (Given Name) Griffith University School of Medical Science 1017MSC (Intensive) - Anatomy and Physiology Systems II Summer Semester 2017 – Practice End of Semester Exam WORKING TIME: 3 Hrs 00 Mins PERUSAL TIME: 05 Mins EXAMINATION TYPE: Closed Book PERUSAL INSTRUCTIONS: Students may not write during perusal EXAMINATION INSTRUCTIONS TO STUDENTS: N/A STUDENTS ARE PERMITTED TO BRING THE FOLLOWING MATERIALS INTO THE EXAMINATION VENUE: CALCULATOR: Non-programmable calculator DICTIONARY: Dictionary not permitted OTHER MATERIALS ALLOWED: THE FOLLOWING MATERIALS ARE SUPPLIED BY GRIFFITH UNIVERSITY: MARK SENSE CARD: 1 THIS EXAMINATION PAPER MUST NOT BE REMOVED FROM THE EXAMINATION VENUE. Paper Number: XX Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 1 of 29 Multiple Choice Questions – use MarkSense Cards provided, and a soft pencil. Ensure you also write your name on MarkSense Card, in addition to your student number. 50 marks for 50 Multiple Choice Questions THE RESPIRATORY SYSTEM 1. The function of alveolar type I cells is: a. to secrete pulmonary surfactant b. to trap dust and other debris c. to provide structural support d. to facilitate diffusion of O 2 and CO 2 2. The chloride shift at the tissues occurs when a. hydrogen ions leave the red blood cells. b. bicarbonate ions enter the red blood cells. c. bicarbonate ions leave the red blood cells. d. carbonic acid is formed. 3. The statement, "when a gas is in contact with a liquid, the gas will dissolve in the liquid in proportion to its partial pressure" is known as: a. Henry's law b. Boyle's law c. Dalton's law d. Poiseuille’s law 4 . Airway resistance is greatest in the…… a. terminal bronchioles b. respiratory bronchioles c. medium-sized bronchi d. alveolar ducts Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 2 of 29 5. The Hering- Breuer reflex…… a. alters pulmonary ventilation when the P O 2 changes b. alters pulmonary ventilation when the P CO 2 changes c. prevents overexpansion of the lungs d. is an important aspect of normal, quiet breathing 6. The respiratory membrane is composed of ________. a. the alveolar sacs and pulmonary arteries b. the alveolar membrane, the capillary endothelium, and their fused basement membranes c. the fusion of the type I and type II alveolar cells d. pseudostratified columnar epithelial cells 7. Which of these statements concerning respiration is NOT true? a. higher brain centres can modify the activity of the respiratory centre b. a decrease in pH of the blood increases respiration rate c. the Bohr effect allows carbon dioxide to bind more easily to haemoglobin that has released its oxygen d. an increase in carbon dioxide in the blood causes pH to decrease 8. A typical value for intrapleural pressure in the resting lung is ________ mm Hg. a. +3 b. 0 c. -4 d. -6 Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 3 of 29 9. The partial pressure of carbon dioxide leaving the cells of peripheral tissues is approximately ________ mm Hg. a. 40 b. 45 c. 50 d. 70 10. Approximately 98.5% of the oxygen transported in the blood is transported a. attached to the heme in haemoglobin of red blood cells b. attached to the globin in haemoglobin of red blood cell c. dissolved in the plasma d. dissolved in red blood cell cytosol 11. For inspiration during forced breathing, which of these muscles is NOT contracted? a. diaphragm b. internal intercostal muscles c. scalene muscles d. sternocleidomastoid muscles 12. A lung volume measurement used to calculate the following lung capacity cannot be measured directly by simple spirometry a. inspiratory reserve volume b. residual volume c. expiratory capacity d. expiratory reserve volume Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 4 of 29 13. Which of the following is not correct? a. gas flow equals pressure gradient divided by resistance b. resistance equals pressure gradient divided by gas flow c. intrapleural pressure is always negative during quiet breathing d. pressure gradient equals gas flow divided by resistance 14. With intense exercise, one's core body temperature may rise to as much as 40°C. This higher temperature benefits an exercising muscle with its increased O 2 usage rate because higher temperatures increase a. the amount of O 2 that can be picked up by hemoglobin at the lungs b. CO 2 production, and hence increase the amount of O 2 bound by haemoglobin c. CO 2 dissociation to HCO 3 - and H + , thus increasing O 2 binding to haemoglobin d. the ease of O 2 dissociation from haemoglobin in the tissues 15. Although children believe that "holding my breath until I die" is possible, parents know this to not be true because a. as a child holds his or her breath, oxygen levels build, stimulating breathing by the brain stem b. as a child holds his or her breath, carbon dioxide levels decrease, stimulating breathing by the brain stem c. as a child holds his or her breath, carbon dioxide levels increase, stimulating breathing by the brain stem d. as a child holds his or her breath, the pH of blood will increase, stimulating breathing by the brain stem THE RENAL SYSTEM 16. The forces acting to oppose movement of fluid from blood int o Bowman’s capsule are 1. the colloidal osmotic (oncotic) pressure of blood 2. the hydrostatic pressure of blood 3. the hydrostatic pressure of fluid in Bowman’s capsule 4. the osmotic pressure of the fluid in Bowman’s capsule Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 5 of 29 a. 1 and 2 b. 2 and 4 c. 1 and 3 d. 1, 2 and 3 17. When blood volume and/or blood pressure rise, this hormone is released to help correct the homeostatic imbalance a. atrial natriuretic peptide b. aldosterone c. angiotensin II d. antidiuretic hormone 18. Which of the following is NOT involved in autoregulation of the GFR? a. a myogenic mechanism in which the afferent arteriole automatically constricts when it is stretched b. a tubulo-glomerular feedback mechanism in which chemicals released from the juxtaglomerular apparatus bring about change in the afferent arteriole radius c. sympathetically induced vasoconstriction of the afferent arterioles d. change in the radius of the afferent arteriole to alter glomerular capillary hydrostatic pressure 19. Desert Dan has been lost in the desert for 2 days with very little water. As a result, you would expect to find __________. a. elevated ADH levels b. decreased blood osmolarity c. increased blood volume d. increased glomerular filtration rate Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 6 of 29 20. In a normal kidney, which of the following conditions would cause an increase in the glomerular filtration rate (GFR)? a. constriction of the afferent arteriole b. a decrease in the glomerular blood hydrostatic pressure c. an increase in the concentration of plasma proteins in the blood d. constriction of the efferent arteriole 21. Which of the following is NOT true about angiotensin II (Ag II)? a. Ag II is produced in response to a rise in mean arterial pressure b. Ag II is a potent vasoconstrictor c. Ag II elevates blood pressure d. Ag II stimulates thirst 22. During the micturition (voiding) reflex, _________. a. voluntary motor activity contracts the detrusor muscle b. there is increased activity of the parasympathetic motor neurons which contract the detrusor muscle of the bladder wall c. the external sphincter relaxes as the result of a parasympathetic reflex d. sympathetic nerve activity relaxes the internal sphincter 23. Which of the following statements concerning the countercurrent system is NOT correct? a. the loops of Henle of the cortical nephrons are responsible for establishing a vertical osmotic gradient in the interstitial fluid of the renal medulla by countercurrent multiplication b. the ascending and descending limbs of the loop of Henle have different permeabilities to sodium and water c. by means of countercurrent exchange, the vasa recta preserve the vertical osmotic gradient while supplying blood to the medullary tissue Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 7 of 29 d. the collecting tubules of all nephrons use the driving force of the vertical osmotic gradient to accomplish variable H 2 O reabsorption under the control of ADH, which alters their permeability. 24. All of the following are true EXCEPT: a. facultative reabsorption of water occurs in the collecting duct b. obligatory reabsorption of water is dependent on plasma ADH c. osmoreceptors in the hypothalamus measure the osmolarity of the plasma d. the portion of the distal convoluted tubule which measures the sodium content of the filtrate is known as the macula densa 25. The tubuloglomerular feedback mechanism helps to reduce GFR when it is increased. Increased GFR will increase NaCl in the loop of Henle, which is sensed by the macula densa, and finally leads to: a. decreased afferent arteriolar resistance b. increased afferent arteriolar resistance c. decreased efferent arteriolar resistance d. increased efferent arteriolar resistance 26. The glomerular capillary blood pressure in the nephron is 65 mm Hg. The Bowman's capsular hydrostatic pressure is 13 mm Hg. The plasma oncotic pressure is 20 mm Hg, and the osmotic pressure of the fluid in Bowman’s capsule is 2 mm Hg. The net filtration pressure is __________ mm Hg. a. 18 b. 26 c. 34 d. 42 Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 8 of 29 27. Which of the following statements regarding tubular reabsorption is incorrect? Tubular reabsorption ____________________________. a. refers to the movement of a substance from the tubular fluid to the peritubular capillary blood b. is important for the conservation of substances important to the body, such as Na + , Cl - , glucose, and amino acids c. involves the process of transcellular transport d. takes place only in the proximal tubule 28. What are the approximate osmolarities (in milliosmols) of the urine which leaves the proximal convoluted tubule, and the urine which leaves the ascending limb of the nephron loop? a. 100, 300 b. 200, 100 c. 300, 100 d. 1200, 300 29. During tubular reabsorption in the proximal tubule of the nephron, glucose is moved across the apical membrane by _________, and across the basal membrane by ____________. a. cotransport, cotransport b. cotransport, facilitated diffusion c. facilitated diffusion, cotransport d. primary active transport, cotransport 30. Which of these conditions decreases the amount of urine produced? a. decreased ADH secretion b. decreased atrial natriuretic hormone secretion c. increased hydrostatic pressure in the glomerular capillaries d. parasympathetic stimulation of the afferent arterioles Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 9 of 29 THE GASTROINTESTINAL TRACT 31. Bile. Which one of the following is clearly incorrect ? a. initiates emulsification of lipids b. contains bicarbonate c. is produced in the liver and pancreas d . despite acting as a detergent, it’s primary component is water 32. Gastric epithelium: what do parietal cells, chief cells, gastric cells (also known as enteroendocrine cells) and goblet cells produce, in order? a. acid (HCl), pepsinogen, gastrin, mucous b. pepsinogen, acid (HCl), mucous, hormones c. acid (HCl), mucous, gastrin, pepsinogen d. gastrin, acid (HCl), mucous, pepsinogen 33. The hormone cholecystokinin (CCK) is secreted by epithelial cells of the duodenum primarily in response to ________________, stimulating the _________________. a. fatty chyme; liver to increase bicarbonate production b. fatty chyme; gall bladder to contract, releasing concentrated bile c. acid chyme; gall bladder to release bicarbonate d. options a) and c) are both correct 34. By far the greatest amount of enzymatic digestion of macronutrients like proteins and fats, occurs in the ____________. a. stomach b. duodenum c. Ileum d. large intestine Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 10 of 29 35. This secreted fluid contains mucus, bicarbonate, lysosomes, antibodies and small amounts of amylase – which is it? a. gastric juice b. duodenal intestinal juice c. saliva d. all of the above contain most, if not all, of these components 36. Where would you find a periodontal ligament? a. about the socket of a tooth b. linking the tongue to the floor of the mouth c. linking the parietal and visceral surfaces of the peritoneal cavity d. in the pylorus e. at the junction of the small and large intestine 37. Intestinal villi & microvilli…………… a. villi are lined by columnar epithelial cells, termed microvilli b. villi are lined by epithelial cells that possess microvilli c. each epithelial columnar cell possess a single microvilli d. microvilli help anchor the epithelial cells to each other e. microvilli help to move fluid along the GI tract, but serve no other purpose 38. During swallowing, which process is specifically invoked to prevent passage of food into the trachea? a. upward movement of tongue b. closure via the vocal cords c. closure via the uvula d. closure via the epiglottis e. both a) and d) are involved Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 11 of 29 39. In which part of the GI tract are haustra found? a. colon b. small intestine c. duodenum d. stomach e. oesophagus 40. Which cells in the gastric mucosa secrete intrinsic factor? a. the parietal cells b. the chief cells c. the serous cells d. the G-cells 41. Which membrane bound enzyme activates trypsinogen in the small intestine? a. carboxypeptidase b. amylase c. procarboxypeptidase d. enteropeptidase 42. These structures are aggregates of digested fats, coated in proteins for transport away from the gut wall – what are they? a. emulsified fat droplets b. chylomicra (chylomicrons) c. micelles d. all of the above Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 12 of 29 43. Where is the pylorus sphincter situated? a. between the oesophagus and the stomach b. between the stomach and the duodenum c. between the duodenum and the jejunum d. between the ileum and the caecum 44. With regard to carbohydrate digestion and absorption, ____________ are taken up from the gut lumen into gut epithelial cells in the small intestine. a. monosaccharaides only b. monosaccharaides, disaccharides and trisaccharrides c. all those products listed in option b) plus amino acids d. glycogen 45. The primary role of the gall bladder is to: a. Make bile salts b. Increase the alkalinity of the bile c. Store and concentrate bile d. Improve fat digestion 46. Attraction of neutrophils toward an inflamed tissue is an example of … a. chemotaxis b. margination c. diapedesis d. vasodilation 47. Insertion of MAC into bacterial cell walls will…. a. directly stimulate phagocytosis by macrophages b. activate the complement system c. cause osmotic lysis of the bacteria d. cause cells to agglutinate Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 13 of 29 48. The two intrinsic defense systems have many components. Which of the following cell types is not a contributor to specific immunity? a. natural killer cells b. plasma cells c. t cells d. b cells 49. If a patient contracts hepatitis C, which of the following drug therapies might be effective? a. aspirin b. interferon c. penicillin d. ibuprofen 50. The process of attaching complement proteins to the bacterial cell wall to enhance phagocytosis is called __________. a. MAC attachment b. complement activation c. opsonisation d. leukocytosis Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 14 of 29 Written answer questions and diagrams. Answer ALL questions in this section. The total marks for this section is 40 marks. RESPIRATORY SYSTEM Knowledge/comprehension questions Q1. Fill in the blanks ( 3 marks ) (i) As the thoracic cavity enlarges, intrapleural pressures become more ______________ , and intrapulmonary pressure __________________. (ii) A stiff lung will have _____________ compliance. (iii) Respiratory bronchioles are part of the _______________ zone. (iv) The ____________ chemoreceptors are responsible for mediating 70% of the chemoreceptor response in the control of breathing. (v) A low PO 2 in alveoli causes __________ of the pulmonary arterioles. Q2. How is oxygen transported around the body? Include in your answer, the percentage of oxygen transported via each method. ( 2 marks ) Q3 . A person at rest is breathing with a tidal volume of 500 mls and the average duration of each complete breath cycle is 4 seconds. Relative to atmospheric pressure, where atm = 0, give vlues for the following. ( hint: pressures lower than atmospheric need to be shown as negative ) (3 marks ) a) Intrapleural pressure at the end of expiration _____________ b) Intrapleural pressure at the end of inspiration _____________ c) Intrapulmonary pressure at mid expiration _____________ d) Intrapulmonary pressure at mid inspiration _____________ e) Transpulmonary pressure at the end of inspiration _____________ f) Transpulmonary pressure at the end of expiration _____________ Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 15 of 29 THE RENAL SYSTEM Knowledge/comprehension question Q4. For centuries before the arrival of modern medical technology, diabetes was diagnosed by the doctor dipping his finger into a urine sample and tasting it to detect abnormal sugar levels. Why would the urine of a diabetic taste sweet, and why do uncontrolled diabetics pass large volumes of urine? ( 3 marks ) Q5. Explain the storage reflex , which prevents emptying of the full bladder in an adult. ( 6 marks ) Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 16 of 29 Q6. Margaret Taylor’s GP diagnoses primary hypertension. She prescribes an angiotensin converting enzyme (ACE) inhibitor . Using your knowledge of the physiology involved, explain how this class of drugs acts to reduce systemic blood pressure . ( 5 marks ) Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 17 of 29 THE GASTROINTESTINAL TRACT Knowledge/comprehension questions Q7. Secretin and cholecystokinin are two GI tract hormones that influence liver and pancreatic secretions. (4 marks) a) From where are these hormones secreted? b) What stimulates the release of each of these hormones from their secretory cells? c) How do each of these hormones affect liver secretion and gall bladder activity? d) How do they affect pancreatic secretion? Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 18 of 29 Q8. The digestive system is responsible for extracting nutrients/macromolecules from our food for use by our body. Briefly describe the processes of digestion and absorption for proteins OR carbohydrates OR fats. In your answer include: the locations where digestion takes place, the mechanisms of digestion involved and the mechanisms of absorption for the macromolecule chosen. At the start of your answer clearly indicate which macromolecule’s digestive and absorptive processes you have chosen to describe. (6 marks) Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 19 of 29 Critical thinking/application question Q9. Gary Jones goes to his doctor and complains of a gnawing pain in his stomach. The pain is most severe about 2 hours after eating and is reduced upon consumption of a glass of alkaline milk. After a thorough investigation the doctor prescribes Gary an extended course of antibiotics. a) What is the most likely diagnosis? (1 mark) b) What is the purpose of the medication? (1 mark) c) Why did his symptoms arise? (1 mark) (3 marks). Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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1017MSC Intensive Practice END OF SEMESTER EXAMINATION Summer Semester 2017 Page 20 of 29 IMMUNOLOGY Q10. Explain the contribution of the antigen-antibody complex to our adaptive defense system, by describing its possible mechanisms of action . (5 marks) END OF EXAMINATION WRITE YOUR NAME ON THIS LAST PAGE: Downloaded by Balanced goods (goodsbalanced@gmail.com) lOMoARcPSD|7489231

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