Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

CHAPTER 1 General Principles & Energy Production in Medical D) metabolism of 1 mol of amino acid
Physiology E) metabolism of 1 mol of long-chain fatty acid
1. The membrane potential of a particular cell is at the K+
equilibrium. The intracellular concentration for K+ is at 150 mmol/L 8. When LDL enters cells by receptor-mediated endocytosis, which
and the extracellular concentration for K+ is at 5.5 mmol/L. of the following does not occur?
What is the resting potential? A) Decrease in the formation of cholesterol from mevalonic
A) –70 mv acid.
B) –90 mv B) Increase in the intracellular concentration of cholesteryl
C) +70 mv esters.
D) +90 mv C) Increase in the transfer of cholesterol from the cell to HDL.
D) Decrease in the rate of synthesis of LDL receptors.
2. The difference in concentration of H+ in a solution of pH 2.0 E) Decrease in the cholesterol in endosomes.
compared with one of pH 7.0 is
A) 5-fold. CHAPTER 2 Overview of Cellular Physiology in Medical Physiology
B) 1/5 as much. 1. The electrogenic Na, K ATPase plays a critical role in cellular
5
C) 10 fold. physiology by
–5
D) 10 as much. A) using the energy in ATP to extrude 3 Na+ out of the cell in
exchange for taking two K+ into the cell.
3. Transcription refers to B) using the energy in ATP to extrude 3 K+ out of the cell in
A) the process where an mRNA is used as a template for protein exchange for taking two Na+ into the cell.
production. C) using the energy in moving Na+ into the cell or K+ outside
B) the process where a DNA sequence is copied into RNA for the cell to make ATP.
the purpose of gene expression. D) using the energy in moving Na+ outside of the cell or K+
C) the process where DNA wraps around histones to form a inside the cell to make ATP.
nucleosome.
D) the process of replication of DNA prior to cell division. 2. Cell membranes
A) contain relatively few protein molecules.
4. The primary structure of a protein refers to B) contain many carbohydrate molecules.
A) the twist, folds, or twist and folds of the amino acid sequence C) are freely permeable to electrolytes but not to proteins.
into stabilized structures within the protein (ie, α-helices D) have variable protein and lipid contents depending on their
and β-sheets). location in the cell.
B) the arrangement of subunits to form a functional structure. E) have a stable composition throughout the life of the cell.
C) the amino acid sequence of the protein.
D) the arrangement of twisted chains and folds within a protein 3. Second messengers
into a stable structure. A) are substances that interact with first messengers outside
cells.
5. Fill in the blanks: Glycogen is a storage form of glucose. _______ B) are substances that bind to first messengers in the cell
refers to the process of making glycogen and _______ refers to the membrane.
process of breakdown of glycogen. C) are hormones secreted by cells in response to stimulation
A) Glycogenolysis, glycogenesis by another hormone.
B) Glycolysis, glycogenolysis D) mediate the intracellular responses to many different
C) Glycogenesis, glycogenolysis hormones and neurotransmitters.
D) Glycogenolysis, glycolysis E) are not formed in the brain.

6. The major lipoprotein source of the cholesterol used in cells is 4. The Golgi complex
A) chylomicrons. A) is an organelle that participates in the breakdown of proteins
B) intermediate-density lipoproteins (IDLs). and lipids.
C) albumin-bound free fatty acids. B) is an organelle that participates in posttranslational
D) LDL. processing of proteins.
E) HDL. C) is an organelle that participates in energy production.
D) is an organelle that participates in transcription and
7. Which of the following produces the most high-energy translation.
phosphate compounds? E) is a subcellular compartment that stores proteins for
A) aerobic metabolism of 1 mol of glucose trafficking to the nucleus.
B) anaerobic metabolism of 1 mol of glucose
C) metabolism of 1 mol of galactose

1 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

5. Endocytosis 4. Cells responsible for innate immunity are activated most

A) includes phagocytosis and pinocytosis, but not clathrinmediated commonly by
or caveolae-dependent uptake of extracellular A) glucocorticoids.
contents. B) pollen.
B) refers to the merging of an intracellular vesicle with the C) carbohydrate sequences in bacterial cell walls.
plasma membrane to deliver intracellular contents to the D) eosinophils.
extracellular milieu. E) cytoplasmic proteins of bacteria.
C) refers to the invagination of the plasma membrane to uptake
extracellular contents into the cell. CHAPTER 4 Excitable Tissue: Nerve
D) refers to vesicular trafficking between Golgi stacks. 1. The distance from between one stimulating electrode to
recording electrode is 4.5 cm. When the axon is stimulated, the
6. G protein-coupled receptors latent period is 1.5 ms. What is the conduction velocity of the
A) are intracellular membrane proteins that help to regulate axon?***
movement within the cell. A) 15 m/s
B) are plasma membrane proteins that couple the extracellular B) 30 m/s
binding of primary signaling molecules to activation of C) 40 m/s
small G proteins. D) 67.5 m/s
C) are plasma membrane proteins that couple the extracellular E) This cannot be determined from the information given.
binding of primary signaling molecules to the activation of
heterotrimeric G proteins. 2. Which of the following has the slowest conduction velocity?
D) are intracellular proteins that couple the binding of primary A) Aα fibers
messenger molecules with transcription. B) Aβ fibers
C) Aγ fibers
7. Gap junctions are intercellular connections that D) B fibers
A) primarily serve to keep cells separated and allow for transport E) C fibers
across a tissue barrier.
B) serve as a regulated cytoplasmic bridge for sharing of small 3. A man falls into a deep sleep with one arm under his head. This
molecules between cells. arm is paralyzed when he awakens, but it tingles, and pain
C) serve as a barrier to prevent protein movement within the sensation in it is still intact. The reason for the loss of motor
cellular membrane. function without loss of pain sensation is that in the nerves to his
D) are cellular components for constitutive exocytosis that arm,
occurs between adjacent cells. A) A fibers are more susceptible to hypoxia than B fibers.
B) A fibers are more sensitive to pressure than C fibers.
CHAPTER 3 Immunity, Infection, & Inflammation C) C fibers are more sensitive to pressure than A fibers.
1. In normal human blood D) motor nerves are more affected by sleep than sensory nerves.
A) the eosinophil is the most common type of white blood cell. E) sensory nerves are nearer the bone than motor nerves and
B) there are more lymphocytes than neutrophils. hence are less affected by pressure.
C) the iron is mostly in hemoglobin.
D) there are more white cells than red cells. 4. Which part of a neuron has the highest concentration of Na+
E) there are more platelets than red cells. channels per square millimeter of cell membrane?
A) dendrites
2. Lymphocytes B) cell body near dendrites
A) all originate from the bone marrow after birth. C) initial segment
B) are unaffected by hormones. D) axonal membrane under myelin
C) convert to monocytes in response to antigens. E) none of the above
D) interact with eosinophils to produce platelets.
E) are part of the body’s defense against cancer. 5. Which of the following statements about nerve growth factor is
not true?
3. The ability of the blood to phagocytose pathogens and mount a A) It is made up of three polypeptide subunits.
respiratory burst is increased by B) It facilitates the process of apoptosis.
A) interleukin-2 (IL-2). C) It is necessary for the growth and development of the
B) granulocyte colony-stimulating factor (G-CSF). sympathetic nervous system.
C) erythropoietin. D) It is picked up by nerves from the organs they innervate.
D) interleukin-4 (IL-4). E) It is present in the brain.
E) interleukin-5 (IL-5).

2 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

CHAPTER 5 Excitable Tissue: Muscle 2. Fast excitatory postsynaptic potentials (EPSPs)

1. The action potential of skeletal muscle A) are a consequence of decreased Cl– conductance.
A) has a prolonged plateau phase. B) occur in skeletal muscle.
B) spreads inward to all parts of the muscle via the T tubules. C) can be produced by an increase in Na+ conductance.
C) causes the immediate uptake of Ca2+ into the lateral sacs of D) can be produced by a decrease in Ca2+ conductance.
the sarcoplasmic reticulum. E) all of the above
D) is longer than the action potential of cardiac muscle.
E) is not essential for contraction. 3. Initiation of an action potential in skeletal muscle by stimulating
its motor nerve
2. The functions of tropomyosin in skeletal muscle include A) requires spatial facilitation.
A) sliding on actin to produce shortening. B) requires temporal facilitation.
B) releasing Ca2+ after initiation of contraction. C) is inhibited by a high concentration of Ca2+ at the neuromuscular
C) binding to myosin during contraction. junction.
D) acting as a “relaxing protein” at rest by covering up the sites D) requires the release of norepinephrine.
where myosin binds to actin. E) requires the release of acetylcholine.
E) generating ATP, which it passes to the contractile
mechanism. 4. A 35-year-old woman sees her physician to report muscle
weakness in the extraocular eye muscles and muscles of the
3. The cross-bridges of the sarcomere in skeletal muscle are made extremities. She states that she feels fine when she gets up in the
up of morning, but the weakness begins soon after she becomes active.
A) actin. The weakness is improved by rest. Sensation appears normal. The
B) myosin. physician treats her with an anticholinesterase inhibitor, and she
C) troponin. notes immediate return of muscle strength. Her physician
D) tropomyosin. diagnoses her with
E) myelin. A) Lambert–Eaton syndrome.
B) myasthenia gravis.
4. The contractile response in skeletal muscle C) multiple sclerosis.
A) starts after the action potential is over. D) Parkinson disease.
B) does not last as long as the action potential. E) muscular dystrophy.
C) produces more tension when the muscle contracts isometrically
than when the muscle contracts isotonically. CHAPTER 7 Neurotransmitters & Neuromodulators
D) produces more work when the muscle contracts isometrically 1. Which of the following is a ligand-gated ion channel?
than when the muscle contracts isotonically. A) VIP receptor
E) decreases in magnitude with repeated stimulation. B) norepinephrine receptor
C) GABAA receptor
5. Gap junctions*** D) GABAB receptor
A) are absent in cardiac muscle. E) metabotropic glutamate receptor
B) are present but of little functional importance in cardiac
muscle. 2. Which of the following synaptic transmitters is not a peptide,
C) are present and provide the pathway for rapid spread of polypeptide, or protein?
excitation from one cardiac muscle fiber to another. A) substance P
D) are absent in smooth muscle. B) met-enkephalin
E) connect the sarcotubular system to individual skeletal muscle C) β-endorphin
cells. D) serotonin
E) dynorphin
CHAPTER 6 Synaptic & Junctional Transmission
1. Fast inhibitory postsynaptic potentials (IPSPs) 3. Activation of which of the following receptors would be
A) are a consequence of decreased Cl– conductance. expected to decrease anxiety?
B) occur in skeletal muscle. A) nicotinic cholinergic receptors
C) can be produced by an increase in Na+ conductance. B) glutamate receptors
D) can be produced by an increase in Ca2+ conductance. C) GABAA receptors
E) interact with other fast and slow potentials to move the D) glucocorticoid receptors
membrane potential of the postsynaptic neuron toward or E) α1-adrenergic receptors
away from the firing level.

3 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

4. Which of the following receptors is coupled to a heterotrimeric C) hair cells : olfactory epithelium
G protein? D) receptors sensitive to stretch : carotid sinus
A) glycine receptor E) glomus cells : carotid body
B) GABAB receptor
C) nicotinic acetylcholine receptor at myoneural junction 6. Which best describes the law of specific nerve energies?
D) 5-HT3 receptor A) No matter where a particular sensory pathway is stimulated
E) ANP receptor along its course to the cortex, the conscious sensation produced is
referred to the location of the receptor.
5. Which of the following would not be expected to enhance B) A nerve can only be stimulated by electrical energy.
noradrenergic transmission? C) Receptors can respond to forms of energy other than their
A) A drug that increases the entry of arginine into neurons. adequate stimuli, but the threshold for these nonspecific
B) A drug that enhances tyrosine hydroxylase activity. responses is much higher.
C) A drug that enhances dopamine β-hydroxylase activity. D) For any given sensory modality, the specific relationship
D) A drug that inhibits monoamine oxidase. between sensation and stimulus intensity is determined by
E) A drug that inhibits norepinephrine reuptake. the properties of the peripheral receptors.
E) The sensation evoked by impulses generated in a receptor
CHAPTER 8 Properties of Sensory Receptors depends in part on the specific part of the brain they ultimately
1. Pacinian corpuscles are activate.
A) a type of thermoreceptor.
B) usually innervated by Aδ nerve fibers. 7. Which of the following does not contain cation channels that are
C) rapidly adapting touch receptors. activated by mechanical distortion, producing depolarization?
D) slowly adapting touch receptors. A) olfactory receptors
E) nociceptors. B) Pacinian corpuscles
C) hair cells in cochlea
2. Adaptation to a sensory stimulus produces D) hair cells in semicircular canals
A) a diminished sensation when other types of sensory stimuli E) hair cells in utricle
are withdrawn.
B) a more intense sensation when a given stimulus is applied CHAPTER 9 Reflexes
repeatedly. 1. The inverse stretch reflex
C) a sensation localized to the hand when the nerves of the brachial A) has a lower threshold than the stretch reflex.
plexus are stimulated. B) is a monosynaptic reflex.
D) a diminished sensation when a given stimulus is applied C) is a disynaptic reflex with a single interneuron inserted
repeatedly over time. between the afferent and efferent limbs.
E) a decreased firing rate in the sensory nerve from the receptor D) is a polysynaptic reflex with many interneurons inserted
when one’s attention is directed to another matter. between the afferent and efferent limbs.
E) requires the discharge of central neurons that release
3. Sensory systems code for the following attributes of a acetylcholine.
stimulus:***
A) modality, location, intensity, and duration 2. When γ-motor neuron discharge increases at the same time as
B) threshold, receptive field, adaptation, and discrimination α-motor neuron discharge to muscle,
C) touch, taste, hearing, and smell A) prompt inhibition of discharge in spindle Ia afferents takes
D) threshold, laterality, sensation, and duration place.
E) sensitization, discrimination, energy, and projection B) the contraction of the muscle is prolonged.
C) the muscle will not contract.
4. In which of the following is the frequency of stimulation not D) the number of impulses in spindle Ia afferents is smaller
linearly related to the strength of the sensation felt? than when α discharge alone is increased.
A) sensory area of the cerebral cortex E) the number of impulses in spindle Ia afferents is greater than
B) specific projection nuclei of the thalamus when α discharge alone is increased.
C) lateral spinothalamic tract
D) dorsal horn 3. Which of the following is not characteristic of a reflex?
E) cutaneous receptors A) Modification by impulses from various parts of the CNS
B) May involve simultaneous contraction of some muscles and
5. Which of the following receptors and sense organs are relaxation of others
incorrectly C) Chronically suppressed after spinal cord transection
paired? D) Always involves transmission across at least one synapse
A) rods and cones : eye E) Frequently occurs without conscious perception
B) receptors sensitive to sodium : taste buds
4 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

4. Withdrawal reflexes are not 3. A 40-year-old man loses his right hand in a farm accident. Four
A) initiated by nociceptive stimuli. years later, he has episodes of severe pain in the missing hand
B) prepotent. (phantom limb pain). A detailed PET scan study of his cerebral
C) prolonged if the stimulus is strong. cortex might be expected to show
D) an example of a flexor reflex. A) expansion of the right hand area in his right somatic sensory
E) accompanied by the same response on both sides of the area I (SI).
body. B) expansion of the right-hand area in his left SI.
C) a metabolically inactive spot where his hand area in his left
CHAPTER 10 Pain & Temperature SI would normally be.
1. The distance by which two touch stimuli must be separated to D) projection of fibers from neighboring sensory areas into the
be perceived as two separate stimuli is greatest on the right-hand area of his right SI.
A) lips. E) projection of fibers from neighboring sensory areas into the
B) palm of the hand. right-hand area of his left SI.
C) back of the scapula.
D) dorsum of the hand. 4. A 50-year-old woman undergoes a neurological exam that
E) tips of the fingers. indicates loss of pain and temperature sensitivity, vibratory sense,
and proprioception in both legs. These symptoms could be
2. Visceral pain explained by
A) shows relatively rapid adaptation. A) a tumor on the medial lemniscal pathway in the sacral spinal
B) is mediated by B fibers in the dorsal roots of the spinal cord.
nerves. B) a peripheral neuropathy.
C) is poorly localized. C) a large tumor in the sacral dorsal horn.
D) resembles "fast pain" produced by noxious stimulation of the D) a large tumor affecting the posterior paracentral gyri.
skin. E) a large tumor in the ventral posterolateral and posteromedial
E) causes relaxation of nearby skeletal muscles. thalamic nuclei.

3. Nociceptors CHAPTER 12 Vision

A) are activated by strong pressure, severe cold, severe heat, and 1. A visual exam in an 80-year-old man shows he has a reduced
chemicals. ability to see objects in the upper and lower quadrants of the left
B) are absent in visceral organs. visual fields of both eyes but some vision remains in the central
C) are specialized structures located in the skin and joints. regions of the visual field. The diagnosis is
D) are innervated by group II afferents. A) central scotoma.
E) all of the above B) heteronymous hemianopia with macular sparing.
C) lesion of the optic chiasm.
4. Thermoreceptors D) homonymous hemianopia with macular sparing.
A) are activated only by severe cold or severe heat. E) retinopathy.
B) are located on superficial layers of the skin.
C) are a subtype of nociceptors. 2. Visual accommodation involves
D) are on dendritic endings of Aδ fibers and C fibers. A) increased tension on the lens ligaments.
E) all of the above B) a decrease in the curvature of the lens.
C) relaxation of the sphincter muscle of the iris.
CHAPTER 11 Somatosensory Pathways D) contraction of the ciliary muscle.
1. A ventrolateral cordotomy is performed that produces relief of E) increased intraocular pressure.
pain in the right leg. It is effective because it interrupts the
A) left dorsal column. 3. The fovea of the eye
B) left ventral spinothalamic tract. A) has the lowest light threshold.
C) right lateral spinothalamic tract. B) is the region of highest visual acuity.
D) left lateral spinothalamic tract. C) contains only red and green cones.
E) right corticospinal tract. D) contains only rods.
E) is situated over the head of the optic nerve.
2. Which of the following does not exert an analgesic effect?
A) morphine
B) cholinergic antagonists
C) adrenergic antagonists
D) substance P antagonists
E) anandamide

5 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

4. Which of the following parts of the eye has the greatest lasted longer than bone conduction. The diagnosis was:
concentration of rods? A) sensorial deafness in both ears
A) ciliary body B) conduction deafness in the right ear
B) iris C) sensorial deafness in the right ear
C) optic disk D) conduction deafness in the left ear
D) fovea E) sensorineural deafness in the left ear
E) parafoveal region
2. What would the diagnosis be if a patient had the following test
5. The correct sequence of events involved in phototransduction in results? Weber test showed that sound from a vibrating tuning
rods and cones in response to light is: fork was louder than normal; Schwabach test showed that bone
A) activation of transducin, decreased release of glutamate, conduction was better than normal; and Rinne test showed that
structural changes in rhodopsin, closure of Na+ channels, air conduction did not outlast bone conduction.
and decrease in intracellular cGMP. A sensorial deafness in both ears
B) decreased release of glutamate, activation of transducin, closure B) conduction deafness in both ears
of Na+ channels, decrease in intracellular cGMP, and C) normal hearing
structural changes in rhodopsin. D) both sensorial and conduction deafness
C) structural changes in rhodopsin, decrease in intracellular E) a possible tumor on the eighth cranial nerve
cGMP, decreased release of glutamate, closure of Na+ channels, and
activation of transducin. 3. Postrotatory nystagmus is caused by continued movement of
D) structural changes in rhodopsin, activation of transducin, A) aqueous humor over the ciliary body in the eye.
decrease in intracellular cGMP, closure of Na+ channels, and B) cerebrospinal fluid over the parts of the brain stem that contain
decreased release of glutamate. the vestibular nuclei.
E) activation of transducin, structural changes in rhodopsin, C) endolymph in the semicircular canals, with consequent
closure of Na+ channels, decrease in intracellular cGMP, and bending of the cupula and stimulation of hair cells.
decreased release of glutamate. D) endolymph toward the helicotrema.
E) perilymph over hair cells that have their processes embedded in
6. Vitamin A is a precursor for the synthesis of the tectorial membrane.
A) somatostatin.
B) retinene1. 4. Some diseases damage the hair cells in the ear. When the
C) the pigment of the iris. damage to the outer hair cells is greater than the damage to the
D) scotopsin. inner hair cells,
E) aqueous humor. A) perception of vertical acceleration is disrupted.
B) K+ concentration in endolymph is decreased.
7. Abnormal color vision is 20 times more common in men than C) K+ concentration in perilymph is decreased.
women because most cases are caused by an abnormal D) there is severe hearing loss.
A) dominant gene on the Y chromosome. E) affected hair cells fail to shorten when exposed to sound.
B) recessive gene on the Y chromosome.
C) dominant gene on the X chromosome. 5. Which of the following are incorrectly paired?
D) recessive gene on the X chromosome. A) tympanic membrane : manubrium of malleus
E) recessive gene on chromosome 22. B) helicotrema : apex of cochlea
C) footplate of stapes : oval window
8. Which of the following is not involved in color vision? D) otoliths : semicircular canals
A) activation of a pathway that signals differences between S E) basilar membrane : organ of Corti
cone responses and the sum of L and M cone responses
B) geniculate layers 3–6 6. The direction of nystagmus is vertical when a subject is rotated
C) P pathway A) after warm water is put in one ear.
D) area V3A of visual cortex B) with the head tipped backward.
E) area V8 of visual cortex C) after cold water is put in both ears.
D) with the head tipped sideways.
CHAPTER 13 Hearing & Equilibrium E) after section of one vestibular nerve.
1. A 40-year-old male, employed as a road construction worker for
nearly 20 years, went to his physician to report that he recently
began to notice difficulty hearing during normal conversations.
A Weber test showed that sound from a vibrating tuning fork
was localized to the right ear. A Schwabach test showed that
bone conduction was below normal. A Rinne test showed that
both air and bone conduction were abnormal, but air conduction
6 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

7. In the utricle, tip links in hair cells are involved in 5. Which of the following are incorrectly paired?
A) formation of perilymph. A) ENaC : sour
B) depolarization of the stria vascularis. B) α-gustducin : bitter taste
C) movements of the basement membrane. C) nucleus tractus solitarius : blood pressure
D) perception of sound. D) Heschel sulcus : smell
E) regulation of distortion-activated ion channels. E) Ebner glands : taste acuity

8. A patient enters the hospital for evaluation of deafness. He is 6. Which of the following is true about olfactory transmission?
found to also have an elevated plasma renin, although his blood A) An olfactory sensory neuron expresses a wide range of odorant
pressure is 118/75 mm Hg. Mutation of what single gene may receptors.
explain these findings? B) Lateral inhibition within the olfactory glomeruli reduces the
A) the gene for barttin ability to distinguish between different types of odorant
B) the gene for Na+ channel receptors.
C) the gene for renin C) Conscious discrimination of odors is dependent on the
D) the gene for cystic fibrosis transmembrane conductance regulator pathway to the orbitofrontal cortex.
E) the gene for tyrosine hydroxylase D) Olfaction is closely related to gustation because odorant and
gustatory receptors use the same central pathways.
CHAPTER 14 Smell & Taste E) all of the above
1. Odorant receptors are***
A) located in the olfactory bulb. 7. Which of the following is not true about gustatory sensation?
B) located on dendrites of mitral and tufted cells. A) The sensory nerve fibers from the taste buds on the anterior
C) located on neurons that project directly to the olfactory cortex. two-thirds of the tongue travel in the chorda tympani
D) located on neurons in the olfactory epithelium that project branch of the facial nerve.
to mitral cells and from there directly to the olfactory cortex. B) The sensory nerve fibers from the taste buds on the posterior
E) located on sustentacular cells that project to the olfactory third of the tongue travel in the petrosal branch of the
bulb. glossopharyngeal nerve.
C) The pathway from taste buds on the left side of the tongue is
2. Taste receptors transmitted ipsilaterally to the cerebral cortex.
A) for sweet, sour, bitter, salt, and umami are spatially separated D) Sustentacular cells in the taste buds serve as stem cells to
on the surface of the tongue. permit growth of new taste buds.
B) are synonymous with taste buds. E) The pathway from taste receptors includes synapses in the
C) are a type of chemoreceptor. nucleus of the tractus solitarius in the brain stem and ventral
D) are innervated by afferents in the facial, trigeminal, and posterior medial nucleus in the thalamus.
glossopharyngeal nerves.
E) all of the above 8. A 20-year-old woman was diagnosed with Bell palsy (damage to
facial nerve). Which of the following symptoms is she likely to
3. Which of the following does not increase the ability to exhibit?
discriminate many different odors? A) loss of sense of taste
A) many different receptors B) facial twitching
B) pattern of olfactory receptors activated by a given odorant C) droopy eyelid
C) projection of different mitral cell axons to different parts of D) ipsilateral facial paralysis
the brain E) all of the above
D) high β-arrestin content in olfactory neurons
E) sniffing CHAPTER 15 Electrical Activity of the Brain, Sleep–Wake States, &
Circadian Rhythms
4. As a result of an automobile accident, a 10-year-old boy suffered 1. In a healthy, alert adult sitting with the eyes closed, the
damage to the brain including the periamygdaloid, piriform, and dominant EEG rhythm observed with electrodes over the occipital
entorhinal cortices. Which of the following sensory deficits is he lobes is
most likely to experience? A) delta (0.5–4 Hz).
A) visual disturbance B) theta (4–7 Hz).
B) hyperosmia C) alpha (8–13 Hz).
C) auditory problems D) beta (18–30 Hz).
D) taste and odor abnormalities E) fast, irregular low-voltage activity.
E) no major sensory deficits

7 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

2. Which of the following pattern of changes in central C) planning voluntary movement.

neurotransmitters/neuromodulators are associated with the D) neuroendocrine control.
transition from NREM to wakefulness? E) slow-wave sleep.
A) decrease in norepinephrine, increase in epinephrine,
increase in acetylcholine, decrease in histamine, and 2. The therapeutic effect of L-dopa in patients with Parkinson
decrease in GABA disease eventually wears off because
B) decrease in norepinephrine, increase in epinephrine, A) antibodies to dopamine receptors develop.
increase in acetylcholine, decrease in histamine, and B) inhibitory pathways grow into the basal ganglia from the
increase in GABA frontal lobe.
C) decrease in norepinephrine, decrease in epinephrine, C) there is an increase in circulating α-synuclein.
increase in acetylcholine, increase in histamine, and increase D) the normal action of nerve growth factor (NGF) is disrupted.
in GABA E) the dopaminergic neurons in the substantia nigra continue
D) increase in norepinephrine, increase in epinephrine, to degenerate.
decrease in acetylcholine, increase in histamine, and
decrease in GABA 3. Increased neural activity before a skilled voluntary movement is
E) increase in norepinephrine, decrease in epinephrine, first seen in the
decrease in acetylcholine, increase in histamine, and A) spinal motor neurons.
decrease in GABA B) precentral motor cortex.
C) midbrain.
3. A gamma rhythm (30–80 Hz) D) cerebellum.
A) is characteristic of seizure activity. E) cortical association areas.
B) is seen in an individual who is awake but not focused.
C) may be a mechanism to bind together sensory information 4. After falling down a flight of stairs, a young woman is found to
into a single percept and action. have partial loss of voluntary movement on the right side of
D) is independent of thalamocortical loops. her body and loss of pain and temperature sensation on the left
E) is generated in the hippocampus. side below the midthoracic region. It is probable that she has a
lesion
4. Melatonin secretion would probably not be increased by A) transecting the left half of the spinal cord in the lumbar
A) stimulation of the superior cervical ganglia. region.
B) intravenous infusion of tryptophan. B) transecting the left half of the spinal cord in the upper thoracic
C) intravenous infusion of epinephrine. region.
D) stimulation of the optic nerve. C) transecting sensory and motor pathways on the right side of
E) induction of pineal hydroxyindole-O-methyltransferase. the pons.
D) transecting the right half of the spinal cord in the upper thoracic
5. Absence seizures region.
A) are a form of nonconvulsive generalized seizures accompanied by E) transecting the dorsal half of the spinal cord in the upper
momentary loss of consciousness. thoracic region.
B) are a form of complex partial seizures accompanied by
momentary loss of consciousness. 5. Patients with transected spinal cords frequently have a negative
C) are a form of nonconvulsive generalized seizures without a nitrogen balance because
loss of consciousness. A) they develop hypercalcemia, and this causes dissolution of
D) are a form of simple partial seizures without a loss of the protein in bone.
consciousness. B) they are paralyzed below the level of the transection.
E) are a form of convulsive generalized seizures accompanied C) they lack the afferent input that normally maintains growth
by momentary loss of consciousness. hormone secretion.
D) they have difficulty voiding, and this causes nitrogen to
6. Narcolepsy is triggered by abnormalities in the accumulate in the urine in the bladder.
A) skeletal muscles. E) their corticotropin response to stress is reduced.
B) medulla oblongata.
C) hypothalamus. 6. Which of the following diseases is not known to be caused by
D) olfactory bulb. overexpression of a trinucleotide repeat?
E) neocortex. A) Alzheimer disease
B) Fragile X syndrome
CHAPTER 16 Control of Posture & Movement C) Spinocerebellar ataxia, type 3
1. A primary function of the basal ganglia is D) Huntington disease
A) sensory integration. E) Friedreich ataxia
B) short-term memory.
8 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

CHAPTER 17 The Autonomic Nervous System In questions 3–8, select A if the item is associated with (a) below, B
1. Which of the following drugs would not be expected to increase if the item is associated with (b) below, C if the item is associated
sympathetic discharge or mimic the effects of increased with both (a) and (b), and D if the item is associated with neither
sympathetic discharge? (a) nor (b).
A) Prazosin (a) V1A vasopressin receptors
B) Neostigmine (b) V2 vasopressin receptors
C) Amphetamine B 3. Activation of Gs
D) Isoproterenol A 4. Vasoconstriction
E) Methoxamine A 5. Increase in intracellular inositol triphosphate
B 6. Movement of aquaporin
2. Sympathetic nerve activity D 7. Proteinuria
A) is essential for survival. D 8. Milk ejection
B) causes contraction of some smooth muscles and relaxation
of others. CHAPTER 19 Learning, Memory, Language, & Speech
C) causes relaxation of the radial muscle of the eye to dilate the 1. The representational hemisphere
pupil. A) is the right cerebral hemisphere in most right-handed
D) relaxes smooth muscle of the gastrointestinal wall and individuals.
gastrointestinal sphincter. B) is the left cerebral hemisphere in most left-handed
E) all of the above individuals.
C) includes the part of the brain concerned with language
3. Parasympathetic nerve activity functions.
A) is essential for survival. D) is the site of lesions in most patients with aphasia.
B) affects only smooth muscles and glands. E) is morphologically identical to the opposite nonrepresentational
C) causes contraction of the radial muscle of the eye to allow hemisphere.
accommodation for near vision.
D) contracts smooth muscle of the gastrointestinal wall and 2. The optic chiasm and corpus callosum are sectioned in a dog,
relaxes the gastrointestinal sphincter. and with the right eye covered, the animal is trained to bark
E) all of the above when it sees a red square. The right eye is then uncovered and
the left eye covered. The animal will now***
4. Which of the following is correctly paired? A) fail to respond to the red square because the square does not
A) sinoatrial node : nicotinic cholinergic receptors produce impulses that reach the right occipital cortex.
B) autonomic ganglia : muscarinic cholinergic receptors B) fail to respond to the red square because the animal has
C) pilomotor smooth muscle : β2-adrenergic receptors bitemporal hemianopia.
D) vasculature of some skeletal muscles : muscarinic cholinergic C) fail to respond to the red square if the posterior commissure
receptors is also sectioned.
E) sweat glands : α2-adrenergic receptors D) respond to the red square only after retraining.
E) respond promptly to the red square in spite of the lack of
CHAPTER 18 Hypothalamic Regulation of Hormonal Functions input to the left occipital cortex.
1. Thirst is stimulated by
A) increases in plasma osmolality and volume. 3. The effects of bilateral loss of hippocampal function include***
B) an increase in plasma osmolality and a decrease in plasma A) disappearance of remote memories.
volume. B) loss of working memory.
C) a decrease in plasma osmolality and an increase in plasma C) loss of the ability to encode events of the recent past in longterm
volume. memory.
D) decreases in plasma osmolality and volume. D) loss of the ability to recall faces and forms but not the ability
E) injection of vasopressin into the hypothalamus. to recall printed or spoken words.
E) production of inappropriate emotional responses when
2. When an individual is naked in a room in which the air recalling events of the recent past.
temperature is 21 °C (69.8 °F) and the humidity 80%, the greatest
amount of heat is lost from the body by
A) elevated metabolism.
B) respiration.
C) urination.
D) vaporization of sweat.
E) radiation and conduction.

9 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

4. Which of the following are incorrectly paired? E) hyperthyroidism due to a primary abnormality in the
A) lesion of the parietal lobe of the representational hemisphere : hypothalamus.
unilateral inattention and neglect
B) loss of cholinergic neurons in the nucleus basalis of Meynert 3. The enzyme primarily responsible for the conversion of T4 to T3
and related areas of the forebrain : loss of recent memory in the periphery is
C) lesions of mamillary bodies : loss of recent memory A) D1 thyroid deiodinase.
D) lesion of the angular gyrus in the categorical hemisphere : B) D2 thyroid deiodinase.
nonfluent aphasia C) D3 thyroid deiodinase.
E) lesion of Broca’s area in the categorical hemisphere : slow D) thyroid peroxidase.
speech E) none of the above

5. The representational hemisphere is better than the categorical 4. The metabolic rate is least affected by an increase in the plasma
hemisphere at level of
A) language functions. A) TSH.
B) recognition of objects by their form. B) TRH.
C) understanding printed words. C) TBG.
D) understanding spoken words. D) free T4.
E) mathematical calculations. E) free T3.

6. A lesion of Wernicke’s area (the posterior end of the superior 5. Which of the following is not essential for normal biosynthesis of
temporal gyrus) in the categorical hemisphere causes patients to thyroid hormones?
A) lose short-term memory. A) iodine
B) speak in a slow, halting voice. B) ferritin
C) experience déjà vu. C) thyroglobulin
D) talk rapidly but make little sense. D) protein synthesis
E) lose the ability to recognize faces. E) TSH

7. Which of the following is most likely not to be involved in 6. Which of the following would be least affected by injections
production of LTP? of TSH?
A) NO A) thyroidal uptake of iodine
B) Ca2+ B) synthesis of thyroglobulin
C) NMDA receptors C) cyclic adenosine monophosphate (AMP) in thyroid cells
D) membrane hyperpolarization D) cyclic guanosine monophosphate (GMP) in thyroid cells
E) membrane depolarization E) size of the thyroid

CHAPTER 20 The Thyroid Gland 7. Hypothyroidism due to disease of the thyroid gland is associated
1. In which of the following conditions is it most likely that the with increased plasma levels of
TSH response to TRH will be reduced? A) cholesterol.
A) hypothyroidism due to tissue resistance to thyroid hormone B) albumin.
B) hypothyroidism due to disease destroying the thyroid gland C) RT3.
C) hyperthyroidism due to circulating antithyroid antibodies D) iodide.
with TSH activity E) TBG.
D) hyperthyroidism due to diffuse hyperplasia of thyrotropes of
the anterior pituitary 8. Thyroid hormone receptors bind to DNA in which of the
E) iodine deficiency following forms?
A) a heterodimer with the prolactin receptor
2. A young woman has puffy skin and a hoarse voice. Her plasma B) a heterodimer with the growth hormone receptor
TSH concentration is low but increases markedly when she is C) a heterodimer with the retinoid X receptor
given TRH. She probably has D) a heterodimer with the insulin receptor
A) hyperthyroidism due to a thyroid tumor. E) a heterodimer with the progesterone receptor
B) hypothyroidism due to a primary abnormality in the thyroid
gland.
C) hypothyroidism due to a primary abnormality in the pituitary
gland.
D) hypothyroidism due to a primary abnormality in the
hypothalamus.

10 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

9. Increasing intracellular I– due to the action of NIS is an D) the membranes of liver cells contain receptors different from
example of those in adrenocortical cells.
A) endocytosis. E) liver cells contain a protein that inhibits the action of ACTH.
B) passive diffusion.
C) Na+ and K+ cotransport. 7. A meal rich in proteins containing the amino acids that stimulate
D) primary active transport. insulin secretion but low in carbohydrates does not cause
E) secondary active transport. hypoglycemia because
A) the meal causes a compensatory increase in T4 secretion.
CHAPTER 21 Endocrine Functions of the Pancreas & Regulation of B) cortisol in the circulation prevents glucose from entering
Carbohydrate Metabolism muscle.
1. Which of the following are incorrectly paired? C) glucagon secretion is also stimulated by the meal.
A) B cells : insulin D) the amino acids in the meal are promptly converted to glucose.
B) D cells : somatostatin E) insulin does not bind to insulin receptors if the plasma
C) A cells : glucagon concentration of amino acids is elevated.
D) pancreatic exocrine cells : chymotrypsinogen
E) F cells : gastrin CHAPTER 22 The Adrenal Medulla & Adrenal Cortex
1. Which of the following is produced only by large amounts of
2. Which of the following are incorrectly paired? glucocorticoids?
A) epinephrine : increased glycogenolysis in skeletal muscle A) normal responsiveness of fat depots to norepinephrine
B) insulin : increased protein synthesis B) maintenance of normal vascular reactivity
C) glucagon : increased gluconeogenesis C) increased excretion of a water load
D) progesterone : increased plasma glucose level D) inhibition of the inflammatory response
E) growth hormone : increased plasma glucose level E) inhibition of ACTH secretion

3. Which of the following would be least likely to be seen 14 days 2. Which of the following are incorrectly paired?
after a rat is injected with a drug that kills all of its pancreatic B A) gluconeogenesis : cortisol
cells? B) free fatty acid mobilization : dehydroepiandrosterone
A) a rise in the plasma H+ concentration C) muscle glycogenolysis : epinephrine
B) a rise in the plasma glucagon concentration D) kaliuresis : aldosterone
C) a fall in the plasma HCO3+ concentration E) hepatic glycogenesis : insulin
D) a fall in the plasma amino acid concentration
E) a rise in plasma osmolality 3. Which of the following hormones has the shortest plasma
halflife?
4. When the plasma glucose concentration falls to low levels, a A) corticosterone
number of different hormones help combat the hypoglycemia. B) renin
After intravenous administration of a large dose of insulin, the C) dehydroepiandrosterone
return of a low blood sugar level to normal is delayed in D) aldosterone
A) adrenal medullary insufficiency. E) norepinephrine
B) glucagon deficiency.
C) combined adrenal medullary insufficiency and glucagon 4. Mole for mole, which of the following has the greatest effect on
deficiency. Na+ excretion?
D) thyrotoxicosis. A) progesterone
E) acromegaly. B) cortisol
C) vasopressin
5. Insulin increases the entry of glucose into D) aldosterone
A) all tissues. E) dehydroepiandrosterone
B) renal tubular cells.
C) the mucosa of the small intestine. 5. Mole for mole, which of the following has the greatest effect on
D) most neurons in the cerebral cortex. plasma osmolality?
E) skeletal muscle. A) progesterone
B) cortisol
6. Glucagon increases glycogenolysis in liver cells but ACTH does C) vasopressin
not because D) aldosterone
A) cortisol increases the plasma glucose level. E) dehydroepiandrosterone
B) liver cells have an adenylyl cyclase different from that in
adrenocortical cells.
C) ACTH cannot enter the nucleus of liver cells.
11 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

6. The secretion of which of the following would be least affected D) decreased blood coagulability.
by a decrease in extracellular fluid volume? E) increased formation of 24,25-dihydroxycholecalciferol.
A) CRH
B) arginine vasopressin 3. Which of the following is not involved in regulating plasma Ca2+
C) dehydroepiandrosterone levels?
D) estrogens A) kidneys
E) aldosterone B) skin
C) liver
7. A young man presents with a blood pressure of 175/110 mm Hg. D) lungs
He is found to have a high circulating aldosterone but a low E) intestine
circulating cortisol. Glucocorticoid treatment lowers his circulating
aldosterone and lowers his blood pressure to 140/85 mm Hg. He 4. 1,25-dihydroxycholecalciferol affects intestinal Ca2+ absorption
probably has an abnormal through a mechanism that
A) 17α-hydroxylase. A) includes alterations in the activity of genes.
B) 21β-hydroxylase. B) activates adenylyl cyclase.
C) 3β-hydroxysteroid dehydrogenase. C) decreases cell turnover.
D) aldosterone synthase. D) changes gastric acid secretion.
E) cholesterol desmolase. E) is comparable to the action of polypeptide hormones.

8. A 32-year-old woman presents with a blood pressure of 155/96 5. Which of the following would you expect to find in a patient
mm Hg. In response to questioning, she admits that she loves whose diet has been low in calcium for 2 mo?
licorice and eats some at least three times a week. She probably A) increased formation of 24,25-dihydroxycholecalciferol
has a low level of B) decreased amounts of calcium-binding protein in intestinal
A) type 2 11β-hydroxysteroid dehydrogenase activity. epithelial cells
B) ACTH. C) increased parathyroid hormone secretion
C) 11β-hydroxylase activity. D) a high plasma calcitonin concentration
D) glucuronyl transferase. E) increased plasma phosphates
E) norepinephrine.
6. In osteopetrosis, which of the following is defective?
9. In its action in cells, aldosterone A) phosphate deposition in trabecular bone
A) increases transport of ENaCs from the cytoplasm to the cell B) structure of parathyroid hormone related protein (PTHrP)
membrane. C) osteoblasts
B) does not act on the cell membrane. D) osteoclasts
C) binds to a receptor in the nucleus. E) bone collagen
D) may activate a heat shock protein.
E) also binds to glucocorticoid receptors. 7. At epiphysial closure
A) cortical bone and trabecular bone merge.
CHAPTER 23 Hormonal Control of Calcium & Phosphate B) osteoclasts and osteoblasts undergo differentiation.
Metabolism & the Physiology of Bone C) there is an extended amount of proliferating cartilage that
1. A patient with parathyroid deficiency 10 days after inadvertent contributes to bone elongation.
damage to the parathyroid glands during thyroid surgery would D) lacunae meet the trabecular bone.
probably have E) ephyses unite with the shaft to end normal linear bone
A) low plasma phosphate and Ca2+ levels and tetany. growth.
B) low plasma phosphate and Ca2+ levels and tetanus.
C) a low plasma Ca2+ level, increased muscular excitability, and CHAPTER 24 The Pituitary Gland
a characteristic spasm of the muscles of the upper extremity 1. Which of the following hormones exerts the least effect on
(Trousseau sign). growth?
D) high plasma phosphate and Ca2+ levels and bone A) growth hormone
demineralization. B) testosterone
E) increased muscular excitability, a high plasma Ca2+ level, C) T4
and bone demineralization. D) insulin
E) vasopressin
2. A high plasma Ca2+ level causes
A) bone demineralization.
B) increased formation of 1,25-dihydroxycholecalciferol.
C) decreased secretion of calcitonin.

12 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

2. Which of the following pituitary hormones is an opioid peptide? 3. In humans, fertilization usually occurs in the
A) a-melanocyte-stimulating hormone (a-MSH) A) vagina.
B) b-MSH B) cervix.
C) ACTH C) uterine cavity.
D) growth hormone D) uterine tubes.
E) b-endorphin E) abdominal cavity.

3. Which of the following is not characteristic of hypopituitarism? 4. In human males, testosterone is produced mainly by the
A) cachexia A) Leydig cells.
B) infertility B) Sertoli cells.
C) pallor C) seminiferous tubules.
D) low basal metabolic rate D) epididymis.
E) intolerance to stress E) vas deferens.

4. A scientist finds that infusion of growth hormone into the 5. Home-use kits for determining a woman’s fertile period depend
median eminence of the hypothalamus in experimental animals on the detection of one hormone in the urine. This hormone is
inhibits the secretion of growth hormone and concludes that this A) FSH.
proves that growth hormone feeds back to inhibit GHRH secretion. B) progesterone.
Do you accept this conclusion? C) estradiol.
A) No, because growth hormone does not cross the blood– D) hCG.
brain barrier. E) LH.
B) No, because the infused growth hormone could be stimulating
dopamine secretion. 6. Which of the following is not a steroid?***
C) No, because substances placed in the median eminence A) 17α-hydroxyprogesterone
could be transported to the anterior pituitary. B) estrone
D) Yes, because systemically administered growth hormone C) relaxin
inhibits growth hormone secretion. D) pregnenolone
E) Yes, because growth hormone binds GHRH, inactivating it. E) etiocholanolone

5. The growth hormone receptor 7. Which of the following probably triggers the onset of labor?
A) activates Gs. A) ACTH in the fetus
B) requires dimerization to exert its effects. B) ACTH in the mother
C) must be internalized to exert its effects. C) prostaglandins
D) resembles the IGF-I receptor. D) oxytocin
E) resembles the ACTH receptor. E) placental renin

CHAPTER 25 The Gonads: Development & Function of the CHAPTER 26 Overview of Gastrointestinal Function & Regulation
Reproductive System 1. Water is absorbed in the jejunum, ileum, and colon and excreted
1. If a young woman has high plasma levels of T3, cortisol, and in the feces. Arrange these in order of the amount of water
renin activity but her blood pressure is only slightly elevated and absorbed or excreted from greatest to smallest.
she has no symptoms or signs of thyrotoxicosis or Cushing A) colon, jejunum, ileum, feces
syndrome, the most likely explanation is that*** B) feces, colon, ileum, jejunum
A) she has been treated with TSH and ACTH. C) jejunum, ileum, colon, feces
B) she has been treated with T3 and cortisol. D) colon, ileum, jejunum, feces
C) she is in the third trimester of pregnancy. E) feces, jejunum, ileum, colon
D) she has an adrenocortical tumor.
E) she has been subjected to chronic stress. 2. Drugs and toxins that increase the cAMP content of the
intestinal mucosa cause diarrhea because they
2. Full development and function of the seminiferous tubules A) increase Na+–K+ cotransport in the small intestine.
require B) increase K+ secretion into the colon.
A) somatostatin. C) inhibit K+ absorption in the crypts of Lieberkühn.
B) LH. D) increase Na+ absorption in the small intestine.
C) oxytocin. E) increase Cl– secretion into the intestinal lumen.
D) FSH.
E) androgens and FSH.

13 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

3. A patient with a tumor secreting abnormal amounts of gastrin 5. A newborn baby is brought to the pediatrician suffering from
(gastrinoma) would be most likely to exhibit which of the severe diarrhea that worsens with meals. The symptoms diminish
following? when nutrients are delivered intravenously. The child most likely
A) decreased chief cell exocytosis has a mutation in which of the following intestinal transporters?
B) duodenal ulceration A) Na+,K+ ATPase
C) increased gastric pH in the period between meals B) NHE3
D) a reduced incidence of gastroesophageal reflux disease C) SGLT1
E) protein malabsorption D) H+,K+ ATPase
E) NKCC1
4. Which of the following has the highest pH?
A) gastric juice CHAPTER 28 Gastrointestinal Motility
B) hepatic bile 1. In infants, defecation often follows a meal. The cause of colonic
C) pancreatic juice contractions in this situation is
D) saliva A) histamine.
E) secretions of the intestinal glands B) increased circulating levels of CCK.
C) the gastrocolic reflex.
5. Which of the following would not be produced by total D) increased circulating levels of somatostatin.
pancreatectomy? E) the enterogastric reflex.
A) vitamin E deficiency
B) hyperglycemia 2. The symptoms of the dumping syndrome (discomfort after
C) metabolic acidosis meals in patients with intestinal short circuits such as anastomosis
D) weight gain of the jejunum to the stomach) are caused in part by
E) decreased absorption of amino acids A) increased blood pressure.
B) increased secretion of glucagon.
CHAPTER 27 Digestion, Absorption, & Nutritional Principles C) increased secretion of CCK.
1. Maximum absorption of short-chain fatty acids produced by D) hypoglycemia.
bacteria occurs in the E) hyperglycemia.
A) stomach.
B) duodenum. 3. Gastric pressures seldom rise above the levels that breach the
C) jejunum. lower esophageal sphincter, even when the stomach is filled with
D) ileum. a meal, due to which of the following processes?
E) colon. A) peristalsis
B) gastroileal reflex
2. Calcium absorption is increased by C) segmentation
A) hypercalcemia. D) stimulation of the vomiting center
B) oxalates in the diet. E) receptive relaxation
C) iron overload.
D) 1,25-dihydroxycholecalciferol. 4. The migrating motor complex is triggered by which of the
E) increased Na+ absorption. following?
A) motilin
3. A decrease in which of the following would be expected in a B) NO
child exhibiting a congenital absence of enterokinase? C) CCK
A) incidence of pancreatitis D) somatostatin
B) glucose absorption E) secretin
C) bile acid reabsorption
D) gastric pH 5. A patient with achalasia would be expected to exhibit a decrease
E) protein assimilation in which of the following?
A) esophageal peristalsis
4. In Hartnup disease (a defect in the transport of neutral amino B) expression of neuronal NO synthase at the esophageal/
acids), patients do not become deficient in these amino acids gastric junction
due to the activity of C) acetylcholine receptors
A) PepT1. D) substance P release
B) brush border peptidases. E) contraction of the crural diaphragm
C) Na+,K+ ATPase.
D) cystic fibrosis transmembrane conductance regulator
(CFTR).
E) trypsin.
14 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

CHAPTER 29 Transport & Metabolic Functions of the Liver 4. Currents caused by opening of which of the following channels
1. Removal of the entire colon would be expected to cause contribute to the repolarization phase of the action potential of
A) death. ventricular muscle fibers?
B) megaloblastic anemia. A) Na+ channels
C) severe malnutrition. B) Cl– channels
D) a decrease in the blood level of ammonia in patients with C) Ca2+ channels
cirrhosis of the liver. D) K+ channels
E) decreased urinary urobilinogen. E) HCO3– channels

2. After complete hepatectomy, a rise would be expected in the 5. In complete heart block
blood level of A) fainting may occur because the atria are unable to pump
A) glucose. blood into the ventricles.
B) fibrinogen. B) ventricular fibrillation is common.
C) 25-hydroxycholecalciferol. C) the atrial rate is lower than the ventricular rate.
D) conjugated bilirubin. D) fainting may occur because of prolonged periods during
E) estrogens. which the ventricles fail to contract.

3. Which of the following cell types protects against sepsis CHAPTER 31 The Heart as a Pump
secondary to translocation of intestinal bacteria? 1. The second heart sound is caused by
A) hepatic stellate cell A) closure of the aortic and pulmonary valves.
B) cholangiocyte B) vibrations in the ventricular wall during systole.
C) Kupffer cell C) ventricular filling.
D) hepatocyte D) closure of the mitral and tricuspid valves.
E) gallbladder epithelial cell E) retrograde flow in the vena cava.

4. P450s (CYPs) are found in many parts of the body. In which of 2. The fourth heart sound is caused by
the following do they not play an important role? A) closure of the aortic and pulmonary valves.
A) bile acid formation B) vibrations in the ventricular wall during systole.
B) carcinogenesis C) ventricular filling.
C) steroid hormone formation D) closure of the mitral and tricuspid valves.
D) detoxification of drugs E) retrograde flow in the vena cava.
E) glycogen synthesis
3. The dicrotic notch on the aortic pressure curve is caused by***
CHAPTER 30 Origin of the Heartbeat & the Electrical Activity of the A) closure of the mitral valve.
Heart B) closure of the tricuspid valve.
1. Which part of the ECG (eg, Figure 30–5) corresponds to C) closure of the aortic valve.
ventricular repolarization?*** D) closure of the pulmonary valve.
A) the P wave E) rapid filling of the left ventricle.
B) the QRS duration
C) the T wave 4. During exercise, a man consumes 1.8 L of oxygen per minute.
D) the U wave His arterial O2 content is 190 mL/L, and the O2 content of his
E) the PR interval mixed venous blood is 134 mL/L. His cardiac output is
approximately
2. Which of the following normally has a slowly depolarizing A) 3.2 L/min.
“prepotential”? B) 16 L/min.
A) sinoatrial node C) 32 L/min.
B) atrial muscle cells D) 54 L/min.
C) bundle of His E) 160 mL/min.
D) Purkinje fibers
E) ventricular muscle cells

3. In second-degree heart block

A) the ventricular rate is lower than the atrial rate.
B) the ventricular ECG complexes are distorted.
C) there is a high incidence of ventricular tachycardia.
D) stroke volume is decreased.
E) cardiac output is increased.
15 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

5. The work performed by the left ventricle is substantially greater 5. When the radius of the resistance vessels is increased, which of
than that performed by the right ventricle, because in the left the following is increased?
ventricle A) systolic blood pressure
A) the contraction is slower. B) diastolic blood pressure
B) the wall is thicker. C) viscosity of the blood
C) the stroke volume is greater. D) hematocrit
D) the preload is greater. E) capillary blood flow
E) the afterload is greater.
6. When the viscosity of the blood is increased, which of the
6. Starling’s law of the heart following is increased?
A) does not operate in the failing heart. A) mean blood pressure
B) does not operate during exercise. B) radius of the resistance vessels
C) explains the increase in heart rate produced by exercise. C) radius of the capacitance vessels
D) explains the increase in cardiac output that occurs when D) central venous pressure
venous return is increased. E) capillary blood flow
E) explains the increase in cardiac output when the sympathetic
nerves supplying the heart are stimulated. 7. A pharmacologist discovers a drug that stimulates the
production of VEGF receptors. He is excited because his drug might
CHAPTER 32 Blood as a Circulatory Fluid & the Dynamics of Blood & be of value in the treatment of
Lymph Flow A) coronary artery disease.
1. Which of the following has the highest total cross-sectional area B) cancer.
in the body?*** C) emphysema.
A) arteries D) diabetes insipidus.
B) arterioles E) dysmenorrhea.
C) capillaries
D) venules 8. Why is the dilator response to injected acetylcholine changed to
E) veins a constrictor response when the endothelium is damaged?
A) More Na+ is generated.
2. Lymph flow from the foot is B) More bradykinin is generated.
A) increased when an individual rises from the supine to the C) The damage lowers the pH of the remaining layers of the artery.
standing position. D) The damage augments the production of endothelin by the
B) increased by massaging the foot. endothelium.
C) increased when capillary permeability is decreased. E) The damage interferes with the production of NO by the
D) decreased when the valves of the leg veins are incompetent. endothelium.
E) decreased by exercise.
CHAPTER 33 Cardiovascular Regulatory Mechanisms
3. The pressure in a capillary in skeletal muscle is 35 mm Hg at the 1. When a pheochromocytoma (tumor of the adrenal medulla)
arteriolar end and 14 mm Hg at the venular end. The interstitial suddenly discharges a large amount of epinephrine into the
pressure is 0 mm Hg. The colloid osmotic pressure is 25 mm Hg circulation, the patient’s heart rate would be expected to
in the capillary and 1 mm Hg in the interstitium. The net force A) increase, because the increase in blood pressure stimulates
producing fluid movement across the capillary wall at its arteriolar the carotid and aortic baroreceptors.
end is B) increase, because epinephrine has a direct chronotropic
A) 3 mm Hg out of the capillary. effect on the heart.
B) 3 mm Hg into the capillary. C) increase, because of increased tonic parasympathetic
C) 10 mm Hg out of the capillary. discharge to the heart.
D) 11 mm Hg out of the capillary. D) decrease, because the increase in blood pressure stimulates
E) 11 mm Hg into the capillary. the carotid and aortic chemoreceptors.
E) decrease, because of increased tonic parasympathetic
4. The velocity of blood flow*** discharge to the heart.
A) is higher in the capillaries than the arterioles.
B) is higher in the veins than in the venules. 2. Activation of the baroreceptor reflex
C) is higher in the veins than the arteries. A) is primarily involved in short-term regulation of systemic
D) falls to zero in the descending aorta during diastole. blood pressure.
E) is reduced in a constricted area of a blood vessel. B) leads to an increase in heart rate because of inhibition of the
vagal cardiac motor neurons.
C) inhibits neurons in the CVLM.

16 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

D) excites neurons in the RVLM. 6. A baby boy is brought to the hospital because of convulsions. In
E) all of the above the course of a workup, his body temperature and plasma glucose
are found to be normal, but his cerebrospinal fluid glucose
3. Sympathetic nerve activity would be expected to increase is 12 mg/dL (normal, 65 mg/dL). A possible explanation of his
A) if glutamate receptors were blocked in the NTS. condition is
B) if GABA receptors were blocked in the RVLM. A) constitutive activation of GLUT 3 in neurons.
C) if there was a compression of the RVLM. B) SGLT 1 deficiency in astrocytes.
D) during hypoxia. C) GLUT 5 deficiency in cerebral capillaries.
E) for all of the above. D) GLUT 1 55K deficiency in cerebral capillaries.
E) GLUT 1 45K deficiency in microglia.

CHAPTER 34 Circulation Through Special Regions CHAPTER 35 Pulmonary Function

1. Blood in which of the following vessels normally has the lowest 1. On the summit of Mt. Everest, where the barometric pressure is
PO2? about 250 mm Hg, the partial pressure of O2 is about
A) maternal artery A) 0.1 mm Hg.
B) maternal uterine vein B) 0.5 mm Hg.
C) maternal femoral vein C) 5 mm Hg.
D) umbilical artery D) 50 mm Hg.
E) umbilical vein E) 100 mm Hg.

2. The pressure differential between the heart and the aorta is 2. The forced vital capacity is***
least A) the amount of air that normally moves into (or out of) the
in the lung with each respiration.
A) left ventricle during systole. B) the amount of air that enters the lung but does not participate in
B) left ventricle during diastole. gas exchange.
C) right ventricle during systole. C) the largest amount of air expired after maximal expiratory
D) right ventricle during diastole. effort.
E) left atrium during systole. D) the largest amount of gas that can be moved into and out of
the lungs in 1 min.
3. Injection of tissue plasminogen activator (t-PA) would probably
be most beneficial 3. The tidal volume is
A) after at least 1 y of uncomplicated recovery following occlusion of A) the amount of air that normally moves into (or out of) the
a coronary artery. lung with each respiration.
B) after at least 2 mo of rest and recuperation following occlusion of B) the amount of air that enters the lung but does not participate in
a coronary artery. gas exchange.
C) during the second week after occlusion of a coronary artery. C) the largest amount of air expired after maximal expiratory
D) during the second day after occlusion of a coronary artery. effort.
E) during the second hour after occlusion of a coronary artery. D) the largest amount of gas that can be moved into and out of
the lungs in 1 min.
4. Which of the following organs has the greatest blood flow per
100 g of tissue? 4. Which of the following is responsible for the movement of O2
A) brain from the alveoli into the blood in the pulmonary capillaries?
B) heart muscle A) active transport
C) skin B) filtration
D) liver C) secondary active transport
E) kidneys D) facilitated diffusion
E) passive diffusion
5. Which of the following does not dilate arterioles in the skin?
A) increased body temperature 5. Which of the following causes relaxation of bronchial smooth
B) epinephrine muscle?***
C) bradykinin A) leukotrienes
D) substance P B) vasoactive intestinal polypeptide
E) vasopressin C) acetylcholine
D) cool air
E) sulfur dioxide

17 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

6. Airway resistance 5. O2 delivery to the tissues would be reduced to the greatest

A) is increased if the lungs are removed and inflated with extent in
saline. A) a normal subject breathing 100% O2 on top of Mt. Everest.
B) does not affect the work of breathing. B) a normal subject running a marathon at sea level.
C) is increased in paraplegic patients. C) a patient with carbon monoxide poisoning.
D) is increased in asthma. D) a patient who has ingested cyanide.
E) makes up 80% of the work of breathing. E) a patient with moderately severe metabolic acidosis.

7. Surfactant lining the alveoli CHAPTER 37 Regulation of Respiration

A) helps prevent alveolar collapse. 1. The main respiratory control neurons
B) is produced in alveolar type I cells and secreted into the A) send out regular bursts of impulses to expiratory muscles
alveolus. during quiet respiration.
C) is increased in the lungs of heavy smokers. B) are unaffected by stimulation of pain receptors.
D) is a glycolipid complex. C) are located in the pons.
D) send out regular bursts of impulses to inspiratory muscles
CHAPTER 36 Gas Transport & pH in the Lung during quiet respiration.
1. Most of the CO2 transported in the blood is E) are unaffected by impulses from the cerebral cortex.
A) dissolved in plasma.
B) in carbamino compounds formed from plasma proteins. 2. Intravenous lactic acid increases ventilation. The receptors
C) in carbamino compounds formed from hemoglobin. responsible for this effect are located in the
–
D) bound to Cl . A) medulla oblongata.
–
E) in HCO3 . B) carotid bodies.
C) lung parenchyma.
2. Which of the following has the greatest effect on the ability of D) aortic baroreceptors.
blood to transport oxygen? E) trachea and large bronchi.
A) capacity of the blood to dissolve oxygen
B) amount of hemoglobin in the blood 3. Spontaneous respiration ceases after
C) pH of plasma A) transection of the brain stem above the pons.
D) CO2 content of red blood cells B) transection of the brain stem at the caudal end of the
E) temperature of the blood medulla.
C) bilateral vagotomy.
3. Which of the following is not true of the system? D) bilateral vagotomy combined with transection of the brain
CO2 + H2O ← →1 H2CO3 ← →2 H+ + HCO3– stem at the superior border of the pons.
A) Reaction 1 is catalyzed by carbonic anhydrase. E) transection of the spinal cord at the level of the first thoracic
B) Because of reaction 2, the pH of blood declines during segment.
breath holding.
C) Reaction 1 occurs in the kidneys. 4. The following physiologic events that occur in vivo are listed in
D) Reaction 1 occurs primarily in plasma. random order: (1) decreased CSF pH; (2) increased arterial
E) The reactions move to the left when there is excess H+ in the PCO2; (3) increased CSF PCO2; (4) stimulation of medullary
tissues. chemoreceptors; (5) increased alveolar PCO2.
What is the usual sequence in which they occur when they
4. Uncompensated respiratory acidosis differs from affect respiration?
uncompensated metabolic acidosis in that A) 1, 2, 3, 4, 5
A) plasma pH change is always greater in uncompensated B) 4, 1, 3, 2, 5
respiratory acidosis compared to uncompensated metabolic C) 3, 4, 5, 1, 2
acidosis. D) 5, 2, 3, 1, 4
B) there are no compensation mechanisms for respiratory E) 5, 3, 2, 4, 1
acidosis, whereas there is respiratory compensation for
metabolic acidosis.
C) uncompensated respiratory acidosis involves changes in
plasma [HCO3–], whereas plasma [HCO3–] is unchanged in
uncompensated metabolic acidosis.
D) uncompensated respiratory acidosis is associated with a
change in PCO2, whereas uncompensated metabolic acidosis
occurs along the isobar line for PCO2.

18 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

5. The following events that occur in the carotid bodies when they 3. If the clearance of a substance which is freely filtered is less than
are exposed to hypoxia are listed in random order: (1) that of inulin,
depolarization of type I glomus cells; (2) excitation of afferent A) there is net reabsorption of the substance in the tubules.
nerve endings; (3) reduced conductance of hypoxia-sensitive K+ B) there is net secretion of the substance in the tubules.
channels in type I glomus cells; (4) Ca2+ entry into type I glomus C) the substance is neither secreted nor reabsorbed in the
cells; (5) decreased K+ efflux. What is the usual sequence in which tubules.
they occur on exposure to hypoxia? D) the substance becomes bound to protein in the tubules.
A) 1, 3, 4, 5, 2 E) the substance is secreted in the proximal tubule to a greater
B) 1, 4, 2, 5, 3 degree than in the distal tubule.
C) 3, 4, 5, 1, 2
D) 3, 1, 4, 5, 2 4. Glucose reabsorption occurs in the
E) 3, 5, 1, 4, 2 A) proximal tubule.
B) loop of Henle.
6. Stimulation of the central (proximal) end of a cut vagus nerve C) distal tubule.
would be expected to D) cortical collecting duct.
A) increase heart rate. E) medullary collecting duct.
B) stimulate inspiration.
C) inhibit coughing. 5. On which of the following does aldosterone exert its greatest
D) raise blood pressure. effect?
E) cause apnea. A) glomerulus
B) proximal tubule
7. Injection of a drug that stimulates the carotid bodies would be C) thin portion of the loop of Henle
expected to cause*** D) thick portion of the loop of Henle
A) a decrease in the pH of arterial blood. E) cortical collecting duct
B) a decrease in the PCO2 of arterial blood.
C) an increase in the HCO3– concentration of arterial blood. 6. What is the clearance of a substance when its concentration in
D) an increase in urinary Na+ excretion. the plasma is 10 mg/dL, its concentration in the urine is 100 mg/
E) an increase in plasma Cl–. dL, and urine flow is 2 mL/min?***
A) 2 mL/min
8. Variations in which of the following components of blood or B) 10 mL/min
CSF do not affect respiration?*** C) 20 mL/min
A) arterial HCO3– concentration D) 200 mL/min
B) arterial H+ concentration E) Clearance cannot be determined from the information
C) arterial Na+ concentration given.
D) CSF CO2 concentration
E) CSF H+ concentration 7. As urine flow increases during osmotic dieresis***
A) the osmolality of urine falls below that of plasma.
CHAPTER 38 Renal Function & Micturition B) the osmolality of urine increases because of the increased
1. In the presence of vasopressin, the greatest fraction of filtered amounts of nonreabsorbable solute in the urine.
water is absorbed in the C) the osmolality of urine approaches that of plasma because
A) proximal tubule. plasma leaks into the tubules.
B) loop of Henle. D) the osmolality of urine approaches that of plasma because an
C) distal tubule. increasingly large fraction of the excreted urine is isotonic
D) cortical collecting duct. proximal tubular fluid.
E) medullary collecting duct. E) the action of vasopressin on the renal tubules is inhibited.

2. In the absence of vasopressin, the greatest fraction of filtered CHAPTER 39 Regulation of Extracellular Fluid Composition &
water is absorbed in the Volume
A) proximal tubule. 1. Dehydration increases the plasma concentration of all the
B) loop of Henle. following hormones except
C) distal tubule. A) vasopressin.
D) cortical collecting duct. B) angiotensin II.
E) medullary collecting duct. C) aldosterone.
D) norepinephrine.
E) atrial natriuretic peptide.

19 of 20
 Ganong’s 23rd Review of Medical Physiology End-of-Chapter Questions #PakGanong

2. In a patient who has become dehydrated, body water should be CHAPTER 40 Acidification of the Urine & Bicarbonate Excretion
replaced by intravenous infusion of 1. Which of the following is the principal buffer in interstitial fluid?
A) distilled water. A) hemoglobin
B) 0.9% sodium chloride solution. B) other proteins
C) 5% glucose solution. C) carbonic acid
D) hyperoncotic albumin. D) H2PO4
E) 10% glucose solution. E) compounds containing histidine

3. Renin is secreted by 2. Increasing alveolar ventilation increases the blood pH because

A) cells in the macula densa. A) it activates neural mechanisms that remove acid from the
B) cells in the proximal tubules. blood.
C) cells in the distal tubules. B) it makes hemoglobin a stronger acid.
D) juxtaglomerular cells. C) it increases the PO2 of the blood.
E) cells in the peritubular capillary bed. D) it decreases the PCO2 in the alveoli.
E) the increased muscle work of increased breathing generates
4. Erythropoietin is secreted by more CO2.
A) cells in the macula densa.
B) cells in the proximal tubules. 3. In uncompensated metabolic alkalosis
C) cells in the distal tubules. A) the plasma pH, the plasma HCO3– concentration, and the
D) juxtaglomerular cells. arterial PCO2 are all low.
E) cells in the peritubular capillary bed. B) the plasma pH is high and the plasma HCO3– concentration
and arterial PCO2 are low.
5. When a woman who has been on a low-sodium diet for 8 d is C) the plasma pH and the plasma HCO3– concentration are low
given an intravenous injection of captopril, a drug that inhibits and the arterial PCO2 is normal.
angiotensin-converting enzyme, one would expect D) the plasma pH and the plasma HCO3– concentration are
A) her blood pressure to rise because her cardiac output would high and the arterial PCO2 is normal.
fall. E) the plasma pH is low, the plasma HCO3– concentration is
B) her blood pressure to rise because her peripheral resistance high, and the arterial PCO2 is normal.
would fall.
C) her blood pressure to fall because her cardiac output would 4. In a patient with a plasma pH of 7.10, the [HCO3–]/[H2CO3]
fall. ratio in plasma is
D) her blood pressure to fall because her peripheral resistance A) 20.
would fall. B) 10.
E) her plasma renin activity to fall because her circulating C) 2.
angiotensin I level would rise. D) 1.
E) 0.1.
6. Which of the following would not be expected to increase renin
secretion?
A) administration of a drug that blocks angiotensin-converting
enzyme
B) administration of a drug that blocks AT1 receptors
C) administration of a drug that blocks β-adrenergic receptors
D) constriction of the aorta between the celiac artery and the
renal arteries
E) administration of a drug that reduces ECF volume

7. Which of the following is least likely to contribute to the

beneficial effects of angiotensin-converting enzyme inhibitors in
the treatment of congestive heart failure?
A) vasodilation
B) decreased cardiac growth
C) decreased cardiac afterload
D) increased plasma renin activity
E) decreased plasma aldosterone

20 of 20