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• PAO2 = 570 - pCO2/R (GT-87 Q-26)

FRM Slow to Rapid MPH(miles per hour):

• Slowly adapting tactile receptors :

Free nerve endingsMPH(miles per hour): • Slowly adapting tactile receptors : Ruffini's receptors Merkels disc [So FRM (From)

Ruffini's receptors• Slowly adapting tactile receptors : Free nerve endings Merkels disc [So FRM (From) Slow to]

Merkels disc [So FRM (From) Slow to] [So FRM (From) Slow to]

• Rapidly adapting tactile receptors

Meissner's corpuscles[So FRM (From) Slow to] • Rapidly adapting tactile receptors Paccinians corpuscles Hair end organs. (So

Paccinians corpuscles[So FRM (From) Slow to] • Rapidly adapting tactile receptors Meissner's corpuscles Hair end organs. (So

Hair end organs. (So Rapid Mph) (So Rapid Mph)

Hippocampus- storage of immediate and recent memories. It is inappropriately activated dring a deja vu experience.

• Repetative stimulation of a skeletal muscle fiber cause an increase in contractile streangth because

repeatative stimulation causes an increase in the *duration of cross bridge cycling. Reapeatative firing increases the amount of SEC(Series Elastic Component) stretch by maintaining cross-bridge cycling for a longer period of time.

• Ammonia is produced from aa in the cells of the renal tubules (mainly proximal tubules), and it's rate of

production increases during acidosis. This is important in acidosis because it increases the total amount of H+ ion that can be excreted in a given volume of urine. The ammonia freely diffuses into the tubular lumen, and because of the high pKa(9.2) of the reaction, essentially all of it combines with H+ to form NH4+ ion. This maintains the driving force for more ammonia to passively diffuse into the lumen. The NH4+ that is formed gets trapped in the tubules and excreted because the tubules are impermeable to this cation.

• Funny channel- Called funny because unlike most Na channels which open when cell is depolarised this

channel is activated when cell is polarised. It therefore opens at the end of the previous AP, allowing Na* to flow through the cell membrane and produce Phase-4 depolarisation.

In addition to light, circadian rhythm is also affected by 'zeitgebers' (timing of meals etc

)

though to a lesser

extent.

Q. The actin rich cell cortex is involved in which of the following cell functions-

1. Cytokinesis----------------------------------ans

2. Bidirectional transport of vescicles

3. Fast axoplasmic transport

4. Chromosomal movements

Explnation- GT 87 Q-284 The cells cortex is an area of the cell immediately underneath the plasma membrane and is rich in actin, which is required for cytokinesis. Although movement of vescicles along filaments is regulated by minimyosins (myosin 1),

movement of vescicles and organelles is predoinently a function of microtubules (answers b and c) under the influence of unidirectional motors kinesin and dynein. The movements of chromosomes (answer d) as well as cilia and flagella (answer e) are driven by dynein, and chromosomal movement occur thrugh microtubular kinetics.

Titin is a large protein that located between the Z-line at the end of the sarcomere to the M-line in the middle of the sarcomere. The tinin in cardiac muscle is much than in the skeletal muscle, so it is moe difficult to stretch cardiac muscle than skeletal.

Somatostatin(GH i.e. smatotrophin release inhibitory factor)- produced by D-cells in pancreatic islets.

Inhibits secretion of insulin, glucagon, and pancreatic polypeptide. It leads to dyspepsia d/t slow gastric emptying and and decreased gastric acid secretion, and gallstone formation which are precipitated by decreased gallbladder contraction(d/t inhibition of CCK secretion).

PCT has maximum mitochondia per cell.

Albinos

congenital inability to synthesize melanin

Piebaldism

characterized by patches of skin that lack melanin as a result of congenital defects in the migration of pigment cell precursors from the neural crest during embryonic development. Not only the condition but also the precise pattern of the loss is passed from one generation to the next.

Vitiligo

involves a similar patchy loss of melanin as above, but the loss develops progressively after birth secondary to an autoimmune process that targets melanocytes.

Temperature control(cerebral regions: Mnem-->AC Heavy Hai)-

 

Anterior

Cooling

Heating

Posterior [Hypothalamus]

(Anterior hypothalamus cools the body in response to heat, while Posterior heats the body in response to cold

)

v Super ORS has aa--> increases carrier transport

Glucagon stimulates* insulin secretion

Insulin inhibits glucagons secretion

v Altitude insomnia- Sleep disturbance that is a common consequence of exposure to high altitude. Periodic

breathing of Chynes-Stokes type occurs during NREM sleep about half the time at high altitude, with restoration of a regular breathing pattern during REM sleep. Both hypoxia and hypercapnia are thought to be involved in the development of periodic breathing. Frequent awakenings and poor quality sleep characterise altitude insomnia. Rx-

Acetazolamide

v An action potential is normally an all-or-none response; that is it’s magnitude is independent of the stimulus

strength. The magnitude of the action potential is reduced during the relative refractory period or when the membrane

is depolarised by an abnormally high extracellular potassium concentration.

Q. Muscle of expiration during tidal respiration-

1. Rect. Abdominis

2. Internal intercostal

3. Airway resistance

4. Surface tension elasticity---------ans(expiration is passive)

Discussion- In emphysema compliance increases-->decrease in inspiratory energy consumption-->but expiratory work done is also increases(which was free d/t elastic recoil earlier)

3.

Work done of breathing is mostly due to-

1.

Tissue elasticiy

2.

Viscous resistance

3.

Airway resistance

4.

Surface tension elasticity------------ans

4.

In exersice work done of breathing is increased mainly due to-

1.

Increase in airway resistance

2.

Increase in elastic work

3.

Increase in viscous work done-------------ans

4.

None

Q.

Jaundice in which of the following congenital conditions characteristically increases with fasting-

1.

Crigler Najar syndrome

2.

Gilberts syndrome-------------------ans

3.

Rotor syndrome

4.

Dubin Johnson syndrome

5.

In rapid, shallow breathing-

2.

Pulmonary ventilation less than alveolar ventilation

3. Both equal

4. Data insufficient

Discussion- PV>AV(always) Best indicator for ventilation-->AV Asthemics-->Tell them to take slow and deep breathing

7. Which of the folowing statements is true-

1. PEFR & MEFR are both effort dependent

2. PEFR & MEFR are both independent

3. Only PEFR is effort independent

4. Only MEFR is effort independent-----------ans

Discusison-

Mid expiratory flow rate-->most sensitive indicator for asthma

8. The given flow volume curve shows-

indicator for asthma 8. The given flow volume curve shows- 1. Restrictive lung disease 2.

1. Restrictive lung disease

2. COPD------------------------------ans

3. Extrathoracic obstruction

4. Fixed airway obstruction

disease 2. COPD------------------------------ans 3. Extrathoracic obstruction 4. Fixed airway obstruction Discussion -

Discussion-

12.''Inflation of lungs induces further inflation”is explained by 1. Hering-Breuer inflation reflex 2. Hering

12.''Inflation of lungs induces further inflation”is explained by

1. Hering-Breuer inflation reflex

2. Hering – Breuer deflation reflex

3. Heads paradoxial reflex------------------ans

4. J-reflex

Discussion- Afferents by vagus-->Newborn at birth takes first breadth-->stimulation till all alveoli open

15. Cutting the vagi with section above pons leads to-

1. Hyper ventilation----------ans

2. Hypo ventilation

3. Apneusis

4. None

Discussion- Supplement AA-303

3. Apneusis 4. None Discussion - Supplement AA-303 • P ons--> P neumotaxic

Pons-->Pneumotaxic centre-->inhibits-->apneustic(inspiratory) centre

Medulla- Pacemaker for respiration- Prebottzinger Center

• Medulla-->(important for expiration)

Dorsal inhibitory neuronCenter • Medulla-->(important for expiration) VRG 18. The blood pressure measured sphygmomanometer by is-

VRGfor expiration) Dorsal inhibitory neuron 18. The blood pressure measured sphygmomanometer by is- 1.

18. The blood pressure measured sphygmomanometer by is-

1. Lower than intraarterial pressure

2. Higher than intraarterial pressure-----------ans

3. Same as the intraarterial pressure

4. The same with different cuff size

Discussion- Cannulation measurement is best-->next best is continuous monitoring

Cuff (not instrument) should be at the heart level

20.

After amputation of one limb the total resistance is-

1.

Increased ------------ans

2.

Decreased

4.

Cannot be determined

Discussion- In body all resistances are in parallel. So if you remove a parallel resistence overall resistance increases.

24. Occlusion of common carotid artery on both sides leads to-

1. Increases in HR & BP----------------ans

2. Increases BP & decrease in HR

3. Decrease in HR & BP

4. NO effect on BP & HR

Discussion- Baro-receptor don't get blood-->no inhibition

25. Fick's principle is used for measuring-

1. Blood pressure

2. Pulse pressure

3. Lung volumes

4. Cardiac output----------ans

Discusison: Fick's principle- The amount of substance taken up by an organ(or by the whole body) per unit of time is equal to the arterial level of the substance minus the venous level(A-V difference) times the blood flow.

26.

QSART is used for assessing-

1.

Nodal tissue of heart

2.

autonomic functions---------ans(Quantitative pseudomotor response testing)

3.

nerve conditions

4.

pulmonary functions

27.

In aVR all waves are opposite because-

1.

polarity of electrodes is reversed

2.

the electrodes are placed perpendicular to each other

3.

the lead axis is -150*----------ans

4.

none

3. the lead axis is -150*----------ans 4. none Discussion - 29. What happens when there is

Discussion-

29. What happens when there is efferent arteriolar constriction-

1. inc.RPF,inc.GFR

2. dec.RPF,dec.GFR

3. inc.RPF,dec.GFR

4. dec.RPF,inc.GFR---------------ans

Discussion- Blood flow decreases whether you constrict afferent of efferent

• With afferent constriction--> decreased RBF, decreased GFR

With efferent constriction--> decreased RBF, increased GFR

30.

In the presence of vasopressin the greatest fraction of filtrated water is re-absorbed in which part of the

nephron-

1.

Proximal tubule-------ans

2.

Distal tubule

3.

Loop of Henle

4.

Collecting duct

33.

Transport maximum(Tm) is-

1.

Renal threshold x GFR------------ans

2.

UV/GFR

3.

Renal threshold/GFR

4.

UV xGFR

34.

Calculate clearance if U=5mg/ml,V=1ml/min & P=1mg%-

1.

5ml/min

2.

50ml/min

3.

500ml/min-------------ans

4.

data insufficient

Discussion- Cl=UV/P

35. The renal plasma flow (RPF) of a patient was to be estimated through the measurement of Para Amino

Hippuric acid (PAH) clearance. The technician observed the procedures correctly but due to an error in the weighing inadvertently used thrice the recommended dose of PAH. RPF estimated is likely to be-

1. False-high

2. False -low -----------------------ans

3. False-high or false -low depending on the GFR

4. Correct and is unaffected by the PAH overdose

Discussion- PAH is also secreted in addition to GFR

36. Inducible buffer system in kidney is-

1. Bicarbonate buffer

2. Phosphate buffer

3. Ammonia buffer-----------ans

4. None

Discussion- At 4.5 pH(limiting pH) kidneys can not secrete acid further

46.

Action potential generates in axon hillock due to-

1.

It has least threshold

2.

Neurotransmitters produced

3.

Unmyelinated

4.

Has more Ion channels----------ans

47.

RMP is mainly due to which ion-

1.

Na+

2.

K+ ------------------ans(ROAMS P=70)

3.

Ca2+

4.

Cl-

48.

Neuron is least excitable during-

1.

Depolarization--------------------ans

2.

After Depolarisation

3.

Latent period

50.

Synaptic conduction is mostly orthodromic because-

1.

Dentrities cannot be depolarised

2.

Once repolarised, an area cannot be depolarised

3.

The strength of antidromic impulse is less

4.

Chemical mediator is located only in the presynaptic terminal----------ans

51.

Which of the following is not a Sarcolemmal protein-

1.

Perlecan-------------ans

2.

Dystrophin

3.

Dystroglycan

4.

Sarcoglycan

Discussion-

Actinin--> connects Actin to Z-line

Tinin--> connects Myosin to Z-line(tinin dtermines the normal stiffness of ventricular muscle)

Desmin--> connects Z-line to Sarcolemma

53.

Regarding Golgi tendon organ true is-

1.

Senses dynamic length of muscle

2.

Involved in reciprocal innervation

3.

Alpha-motor neuron stimulation

4.

Senses muscle tension--------------------ans

Discussion- Clasp knife rigidity(actually spasticity)--> occurs d/t golgi tendon organ

54. Which is true about presynaptic inhibition-

1. Occurs due to hyperpolarization of presynaptic membrane----------------ans

2. Occurs due to inhibition of release of neurotransmitter from presynaptic terminal

3. Produces action potential

4. Produces EPSP

Discussion- Presynaptic inhibition occurs by axo-axonic transmission leading to inhibition of a stimulatory neuron before it synapses, by inhibiting Ca2+ entry and blocking downstream processes, preventing neurotransmitter release, and therefore preventing the neuron from generating EPSP post-synaptically. Picrotoxin acts by blocking it. Local anesthesia and Strychnine do not affect presynaptic inhibition.

55. vSnare protein is-

1. Snaptobrevin------------ans

2. Syntaxin

3. SNAP 25

4. None

Discussion-

vSnare--> Synaptobrevin--> blocked by tetanus tSnare--> Syntaxin/SNAP 25--> Botulinim-->used in reduction of wrinkles/Achalasia cardia

58. Damage to categorical hemisphere in temporal region is usually leads to-

1. Normal speech

2. Increased speech

3. Decreased speech

4. Senseless,fluent speech--------------------ans

Discussion- Wernicke's area--> Superior temporal gyrus

59. Papez circuit in limbic system involves-

1. Anterior thalamic nuclei--------ans

2. Pulvinar nuclei

3. Anterior hypothalamic nuclei

4. Interlaminar nuclei

Discussion-

Papez circuit-

Amygdala: Emotion/fear

Pre-frontal cortex: Sham-rage(fearless)

61.

Which of the following is involved in REM sleep-

1.

amygdala

2.

Locus ceruleus-----------ans

3.

Tectal nucleus

4.

Fornix

64.

b wave of ERG is due to which cells-

1.

Rods

2.

Muller cells---------------ans

3.

Ganglionic cells

4.

Bipolar cells

3. Ganglionic cells 4. Bipolar cells Discussion : a-wave (negative) is produced by the

Discussion: a-wave (negative) is produced by the photoreceptors

65. Amacrine cells are seen in-

1. Retina---------------------ans

2. Skin in the axilla

3. Inner ear

4. Blood

Discussion- Amacrine cells are interneurons in the retina.Amacrine cells are responsible for 70% of input to retinal ganglion cells. Bipolar cells, which are responsible forthe other 30% of input to retinal ganglia, are regulated by amacrine cells. Amacrine

cells don't have axon and cause lateral inhibition.

67. Destruction of sensory area 1 of brain leads to loss of which sensations-

1. Pain

2. Touch

3. Stereognosis gone but 2 point discrimination retained

4. Stereognosis & 2 point discrimination----------------------------------------------ans

Discussion- Remember perception is possible even with destruction of cortex

Sensory cortex injury (loss in following sequence):

1. Fine touch

2. Pressure vibration

3. Pain

Recovery(in following sequence):

1.

Pain

2.

Pressure vibration

3.

Fine touch

68.

Mirror neurons are predominately found in-

1.

Frontal lobe

2.

Parietal lobe-----------------------ans

3.

Temporal lobe

70.

Principle neurons found in nucleus accumbens are-

1.

Medium spiney neurons--------ans

2.

Pyramidal neurons

3.

Golgi neurons

2. Pyramidal neurons 3. Golgi neurons 4. Basket cells 71. Leptin acts by increasing the

4.

Basket cells

71.

Leptin acts by increasing the activity of-

1.

AgRP

2.

Neuropeptide Y

3.

alpha-MSH--------------ans

4.

Ghrelin

Discussion- Adipose tissue-->Leptin hormone-->Satiety centre(VMN)-->Depressed

Increased Appetite(GONA-M)

Decreased Appetite(COLA-G)

Ghrelin

CCK-PZ

Orexin

Oxyntomodulin

NpY

Leptin

AgRP

Alpha-MSH

Melanin Concentrating Hormone

GCR-1

72. Lesion of which of the following structure leads to Kluver-Bucy syndrome-

1. Parahippocampus

2. Hippocampus

3. Hypothalamus

4. Temporal lobes--------------ans

Discussion-

Kluver-bucy syndrome features(Man becomes animal like)-

Fearless

Hyperphagia

Visual agonia

Rage

Loss of emotion

73.

Phineas Gage was a worker who had personality disorder following a iron rod injury to his brain .Which

part of his brain was involved-

1. temporal lobe

2. frontal lobe----------------------ans

3. parietal lobe

4. limbic cortex

Discussion-

Functions of frontal lobe-

• Personality

• Social behaviour

• Motor idea (willinness to do something)

• Emotional control

• Higher functions

• Memory

Micturition centre (other in spinal cord)

74.

Fast axonal transport is by all except-

1.

Dynenin

2.

Kinesin

3.

Microtubule---------------ans

4.

Neurofilament

Discussion-

Slow

Microtubule(0.2-4 mm/d)--> anterograde

Fast

Antero-->Kinesin

Retro-->Dynenin

Neurofilaments

75. MMCs are related to-

1. Motilin---------ans

2. CCK-PZ

3. secretin

4. GIP

Discussion- Motilin is released during the interdigestive period and is believed to be involved in the initiation of the

migrating motor complex. MMC occurs at every 90 min during inter-digestive period

Basal Electrical Rhythm:

Stomach--> 4/min

(Interstitial cells of Cajal-->pacemaker in GIT)

Duodenum--> 12/min

Ileum--> 9/min

Sigmoid colon--> *16/min

78.

TRUE about secretin includes all of the following except-

1.

It increases the acidity of biliary and pancreatic secretions----------ans

2.

It decreases gastric acid secretion

3.

It decreases gastric secretion and gastric emptying

4.

Increases flow and velocity of bile

81.

Secondary Peristalsis of oesophagus is d/t-

1.

vagus

2.

pacemaker of peristalsis

3.

local distension---------ans

4.

LES relaxation

Discussion:

• Primary --> Option 2

• Secondary esophageal peristalsis- Esphageal peristalsis and lower esophageal relaxation a/w distension or

irritation of the smooth muscle portion of esophageal body. The event is limited to the smooth muscle component of the esophagus and is the result of activation of enteric nerves. Initiation of secondary peristalsis does not involve extrinsic neural reflexes and thus is not accompanied by the oral-pharyngeal phase of swallowing.

82.

GRP (Gastrin Releasing Peptide) secretion is brought about by-

1.

Acidic chime

2.

Vagus-----------ans

3.

Gastrin

4.

Local distension

83.

Receptive relaxation is seen in-

1.

Oeophagus

2. Duodenum

3. Ileum

4. Stomach--------------ans(also colon)

Discussion-

Important points-

1.

Proximal stomach- Accomodation*

2.

Distal stomach- Peristalsis(grinding), Retropulsion(mixing)

3.

SI- Segmentation

84.

As the rate of salivary secretion increses-

1.

decrease K+

2.

increase Na+

3.

hypotonic saliva-----------ans

4.

all

85.

In GTT glucose is given orally not i.v. because-

1.

Increased insulin release in oral administration--------ans(incretin effect)

2.

slower absorption orally

3.

rapid metabolism in case of i.v.glucose

4.

all

90.

Most of the testosterone secreted by the testes exists in plasma in the form of-

1.

testosterone bound to sex-steroid binding globulin-----ans (92% ; dihydrotestesterone formes at target organ)

2.

free dihydrotestoterone

3.

free testosterone

4.

testosterone bound to albumin

94.

Osteoclasts are characterized by-

1.

TRAP and cathepsin K----------ans

2.

TRAP and cathepsin S

3.

Only TRAP

4.

cathepsin K and cathepsin S

Discussion-

Osteoclasts-

1. TRAP

2.

Cathepsin(A-L)

99.

NE increases all except-

1.

HR------------------ans

2.

SBP

3. DBP

4. PP

Discussion-

NorEpinephrine*

Epinephrine

Vasoconstriction in all organs

Vasodilatation in musle and liver

Increased DBP (Causes relex bradycardia similar to cushing's reflex)

Decreased DBP

100. Glucocorticoids decrease all except-

1. basophils

2. eosinophils

4.

monocytes------------ans(LEB low)

12. C-Wave in JVP indicates-

1. Atrial contraction

2. Bulging of tricuspid valve--------------ans

3. Ventricle systole

4. Rapid ventricular filling

Discussion-

In JVP (Normal JVP--> 8 cm of blood):

"a" wave corresponds to A trial c ontraction Atrial contraction

"v" wave corresponds to V entricular c ontraction Ventricular contraction

X dsescent for A trial rel aX ation Atrial relaXation

Ydescent for V entricular rel aX ation Ventricular relaXation

Abdominojugular reflux– rise in JVP during 10 sec of mid abdominal compression followed by a rapid drop in pressure of 4 cm of blood in release of the compression*. It indicates incipient right-sided heart failure

14. Which of the following is true about S4 heart sound-

1. Heard during ventricular filling--------------------------ans

2. Heardby unaided ear

3. Heard during ventricular ejection phase

4. More than 20 Hz

DISCUSSIONS- S4--> Also known as presystolic or atrial gallop. It is produced by emptying of the atrium into non complant ventricle. It is associated with effective atrial contraction and hence absent in patients with atrial fibrillation*.

63. In cerebellum only excitatory neuron is-

1. purkinje

2. golgi

3. basket

4. granule-----------ans

Discussion- purkinje cells- only output from erebellar cortex and they exert inhibitory influence.

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