2012PES ISP 2011 PRACTICE MID SEM EXAM QUESTIONS

WEEKS 1-6 CVS / RESP / REN / CARDIO RENAL

Note: these questions are for practice and are indicative only of those on the
mid-sem paper. They may not be representative of the content proportion or
marks allocation on the actual exam (see exam information for confirmation).
No specific answers will be released.
MULTIPLE CHOICE QUESTIONS (21 QUESTIONS @ 1 MARK EACH)

1. The aortic valve

a. prevents the backflow of blood into the aorta during ventricular diastole.
b. prevents the backflow of blood into the left ventricle during ventricular diastole.
c. prevents the backflow of blood into the right ventricle during ventricular diastole.
d. closes when the first heart sound is heard.
e. None of these answers.

2. Put these phases of the cardiac cycle in the correct order.

1) opening of the semilunar valves
2) isovolumetric contraction
3) atrial systole begins
4) closure of the AV valves
5) ventricular filling is complete
6) ventricular systole begins
7) ventricular relaxation
8) ventricular ejection

a. 4-5-1-2-7-8-3-6
b. 3-2-6-1-4-5-8-7
c. 3-5-6-4-2-1-8-7
d. 3-5-6-1-8-6-2-7
e. 3-2-6-4-5-8-7-1

3. Which of the following are possible treatments for hypertension?

a. calcium channel blockers

b. ACE inhibitors
c. ANP blockers
d. chloride leak channel blockers
e. A and B

4. Within the central nervous system, the generation of automatic breathing is believed to arise
in respiratory control networks located in

(a) The frontal lobe

(b) The occipital lobe
(c) The cerebellum
(d) The brainstem (pons and medulla)
(e) The spinal cord
5. At rest and assuming a normal arterial pH a patient with COPD breathing 40% O2 and an arterial PO2 of
72 mmHg would have an arterial oxygen saturation or around

(a) 100%
(b) 90%
(c) 80%
(d) 70%
(e) 60%

6. The alveolar-capillary gas exchange unit does NOT contain

(a) Ciliated epithelial cells

(b) Endothelial cells
(c) Type I pneumoctyes
(d) Type II pneumocyctes
(e) Erythrocytes

7. Emphysema results from:

(a) Destruction of elastic tissue in alveolar walls

(b) Excessive mucus secretion in brochial tress
(c) Loss of ciliary function
(d) Both a and b
(e) All of a b and c

8. Blood pressure and flow to the brain are monitored by receptors located in the wall of the _________.

a. carotid artery
b. aorta
c. venae cavae
d. cerebral arteries
e. cephalic arteries

9. Measurements in a nephron reveal a glomerular hydraulic pressure of 69 mm Hg, and a fluid pressure in
the Bowman's capsule of 15 mm Hg. Assuming that the plasma osmotic pressure is 30 mm Hg, and that
essentially no plasma proteins are filtered by the glomerulus, what is the net glomerular filtration pressure
in this case?

a. -6 mm Hg
b. 24 mm Hg
c. 54 mm Hg
d. 84 mm Hg
e. 114 mm Hg
10. If plasma levels of potassium get too high, __________.

a. excitable cells depolarize readily

b. cells are unable to repolarize fully
c. muscle weakness occurs
d. action potentials become smaller or nonexistent
e. all of these events occur

11. ACE inhibitors __________.

a. block the conversion of angiotensin I to II

b. lower blood pressure
c. reduce Na+ reabsorption and decrease extracellular fluid volume
d. A and B
e. A, B and C

12. When plasma water is lost but electrolytes are retained, __________.

a. the osmolarity of the ECF falls

b. osmosis moves water from the ICF to the ECF
c. both the ECF and the ICF become more dilute
d. there is an increase in the volume of the ICF
e. all of the above

13. Measurements in a nephron reveal a glomerular hydraulic pressure of 69 mm Hg, and a fluid pressure in
the Bowman's capsule of 15 mm Hg. Assuming that the plasma osmotic pressure is 30 mm Hg, and that
essentially no plasma proteins are filtered by the glomerulus, what is the net glomerular filtration pressure
in this case?

a. -6 mm Hg
b. 24 mm Hg
c. 54 mm Hg
d. 84 mm Hg
e. 114 mm Hg

14. When the concentration of sodium ion in the ECF increases, __________.

a. osmoreceptors are stimulated

b. there is a decreased thirst
c. ADH secretion decreases
d. aldosterone secretion increases
e. there is an increase in the volume of urine produced

15. Secretion of potassium into the urine __________.

a. is decreased by aldosterone
b. is associated with the reabsorption of sodium from the distal tubules and collecting ducts
c. is minimal because humans ingest very little potassium
d. is increased with elevated levels of ADH
e. is increased in the presence of atrial natriuretic peptide
16. When large amounts of pure water are consumed, __________.

a. the ECF becomes hypertonic to the ICF

b. a fluid shift occurs and the volume of the ICF decreases
c. osmolarities of both ECF and ICF will be slightly lower
d. the volume of the ECF will decrease
e. the volume of the ICF will decrease

17. Glomerular filtration is favored by the __________.

a. increased hydraulic pressure of the blood in the glomerular capillaries

b. increased osmotic pressure inside the glomerular capillaries
c. elevated fluid pressure produced in the lumen of the distal tubules
d. A and B
e. A, B and C

18. The portion of the nephron which creates dilute urine is the __________.

a. collecting duct
b. proximal convoluted tubule
c. loop of Henle
d. distal convoluted tubule
e. Bowman's capsule

19. Desert Dan has been lost in the desert for 2 days with very little water. As a result, you would expect to
observe __________.

a. elevated ADH levels

b. decreased blood osmolarity
c. normal urine production
d. increased blood volume
e. cells enlarged with fluid

20. Dangers of hypokalemia include __________.

a. arrhythmias
b. weakness and failure of the muscles of respiration
c. skeletal muscle weakness
d. A and B
e. A, B and C

21. Select the INCORRECT major deflection of the QRS complex in a normal 12 LEAD ECG tracing.

a. LEAD III = POSITIVE

b. V5 = POSTITIVE
c. aVR = NEGATIVE
d. V2 = POSITIVE
e. aVF = POSITIVE
 SHORT ANSWER (MARKS AS ALLOCATED, ALLOW 1 MINUTE / MARK AND USE SPACE
ALLOCATED TO COMPLETE ANSWER)

1. Miguel is a 25-year-old jogger with a target heart rate of 125 bpm. His resting pulse is 70 bpm. His blood
volume is approximately 6.8 liters. At rest, his cardiac output is 6.3 liters/min.

a. What must his stroke volume be? (1 MARK)

b. What might his EDV and ESV be? (1 MARK)

c. During his workout, his heart rate increases to 125 bpm and his cardiac output to 12500
mL/min. Do his SV, EDV and ESV change with exercise? (2 MARKS)

2. If the stroke volume of the left ventricle is 65 mL/beat and the stroke volume of the right ventricle is 68
mL/beat, what will happen to the relative distribution of blood in the systemic and pulmonary circulation
after 15 beats? (2 MARKS)

3. A package insert for a medication states that "this medicine is a beta receptor stimulant used to treat
symptoms of asthma, emphysema and other breathing conditions. Possible side effects include fast heart
rate, nervousness, tremors or nausea." Why would these be common and expected? (2 MARKS)
4. Siegfried experiences a hemorrhage in an artery, and now blood is leaking out of the resulting hole. His
blood pressure decreases. Draw a flow chart illustrating the cardiovascular reflex responses that follow,
to compensate for the drop in blood pressure. (5 MARKS)

5. Nicotine stimulates cholinergic receptors of the autonomic nervous system. Based on this information,
how would cigarette smoking affect the cardiovascular system? (3 MARKS)
6. Brian, 53, finally visited his doctor, after 6 months of being winded after climbing two flights of stairs. He
kept blaming himself for being "out of shape," and thought he would be okay after his spring yard work
started, but he wasn't. The doctor wasn't surprised when Brian's blood pressure was 160/110 mm Hg. The
doctor prescribed some beta blockers and more tests, including an ECG and blood tests. Why did the
doctor want this additional information? What are some items he would check in the blood tests, and
why? (5-6 MARKS)

7. Sherry is not able to produce surfactant. In order to inhale a normal tidal volume, will her intrapleural
pressure be more or less subatmospheric than normal? Explain. (2 MARKS)
8. Millie's grandfather suffers from congestive heart failure (CHF). Whenever she visits him, she notices that
his ankles and feet appear to be quite swollen. She knows that you are an avid student of physiology, and
she asks you why this occurs. What would you tell her? (4-5 MARKS)

9. List and explain factors that regulate the radius of the alveoli. (3-4 MARKS)
10. During the winter, Brad sleeps in a dorm room that lacks a humidifier for the heated air. In the mornings
he notices that his nose is "stuffy," similar to when he has a cold, but after showering and drinking some
water, the stuffiness disappears until the next morning. What might be the cause of Brad's nasal
condition? (3-4 MARKS)

11. The graph below shows an oxygen dissociation curve, with the normal curve on the left. What is the name
of the phenomenon that shifts the curve to the right? What causes this change in oxygen dissociation? Is
the shift beneficial or detrimental? Explain. (4-5 MARKS)
12. Complete the following spaces. (5 MARKS)

During exercise the increase in heart rate results from a withdrawal of _______________________ tone and an

increase in __________________ tone to the heart. Increases in stoke volume occurs as a result of increases in

end ______________ volume and myocardial ____________________. The increased breathing during

exercise results from increased activity of the diaphragm muscle which is innervated by the _______________

nerve which in turn relays increased neural activity within the __________________________ region of the

brain. These responses cannot be explained by conventional feedback reflexes from either arterial baroreceptors

located in the __________________________________ or peripheral chemoreceptors also known as

______________________________. Cardiorespiratory control during exercise is thus best explained by a

___________________ mechanism involving brain centres such as the _____________________________.

13. Write a simple equation showing how anatomical dead space alveolar dead space and physiological dead
space are related (1 MARK). Give a typical value (in L) for anatomical dead space of a healthy young
adult male weighing 70 kg (1 MARK). Define what the term COPD stand for (1 MARK) and in no
more than 2 sentence explain why a patient with COPD would have a greater physiological dead space
than a similar individual (i.e. same age, size and gender) who was healthy (1 MARK).
14.
Volume above FRC (L)

Pleural Pressure (cm H2O)

Using the graph above draw the work of breathing curve for a normal subject, include both the inspiration and
expiration curves. (2 MARKS). Provide a realistic scale for each axis (1 MARK)

Explain in one or two sentences what forces are overcome to yield the curves above. (2 MARKS)

Draw in a different colour the curves for either OBSTRUCTIVE or RESTRICTIVE lung disorders
(2 MARKS)

Why are they different? (1 MARK)

15. In a healthy person at rest give normal values (including units) for the following:

Pulmonary artery (PA) pressure: systolic =________; diastolic = __________; (1 MARK)

Pulmonary artery blood gas levels: P02 = __________; PCO2 = _________; (1 MARK)

16. Mr. Gregory comes to the doctor with high blood pressure. Tests show that he also has elevated levels of
renin in his blood and atherosclerotic plaques that have nearly blocked blood flow through his renal
arteries. Mr. Gregory is puzzled. Explain to him how decreased blood flow in his renal arteries could
cause renin secretion to increase. Map the pathways through which elevated renin causes high blood
pressure for Mr. Gregory. (7-8 MARKS)
17. Sylvia is suffering from severe edema in her arms and legs. Her physician prescribes a diuretic (a
substance that will increase the volume of urine produced). Why might this help to alleviate Sylvia's
problem? (3-4 MARKS)

18. You eat an entire bag of salty popcorn while watching a two-hour movie. You have nothing to drink.
Diagram the homeostatic reflexes that occur while you are eating and watching the movie. Assume that
any fluid shift between the ICF and ECF is not sufficient to cause a significant volume change in the ECF.
(5-6 MARKS)
19. Explain with the aid of a diagram, the pressures that influence primary filtration in the glomerulus, supply
the overall equation and an indication of net filtration pressure. (4 MARKS)

20. Explain why about 0.4 litre of water is lost as urine each day, even when a person is suffering from thirst
due to water deprivation. (2 MARKS)

21. Outline the sequence of steps that link changes in renin secretion to the control of sodium reabsorption
by the kidney. (3 MARKS)
 22. Match the listed disease or condition with the laboratory findings in the Table. To answer the question,
write the disease or condition in the row that best fits the correspond data. (5 MARKS)

• Diabetes insipidus
• Nephrosis
• Fasting
• Dehydration
• Diabetes mellitus

Disease/condition 24 hour urine Ketones Glucose Protein

volume
(Litres)
1.4 + 0 0
6.2 2+ 4+ 0
1.6 0 0 4+
6.4 0 0 0
0.4 0 0 0

23. Define one of the following drug classes: diuretic, inotrope (+ or -), bronchodilators,
antiarrhthymic, antianginal, lipid lowering, antihypertensive. Describe briefly how each might work
and give a specific example OR examples of their side effects. (4 MARKS)
24. A patient is suffering from primary hyperaldosteronism (xs aldosterone) due to an adrenal cortical
tumor. Is plasma renin higher, lower, or unchanged compared to normal? Explain. (2 MARKS)

END OF PRACTICE QUESTIONS