Punjab Institute of Medical Sciences

Department of Physiology
MBBS [1st Prof.]
GIT

M.M:20
Time: 30 min.

Q 1. Secretion of the acinar cells within the exocrine pancreas is not increased by:
a. Secretin
b. CCK
c. Parasympathetic stimulation
d. Bicarbonate ions

Q 2. Iron is actively absorbed in

a. Stomach
b. Duodenum and proximal jejunum
c. Large intestine
d. Ileum

Q 3. A 60-year-old woman undergoes total pancreatectomy because of the presence of a tumor.

Which of the following outcomes would not be expected after she recovers from the operation?
a. Steatorrhea
b. Hyperglycemia
c. Metabolic acidosis
d. Weight gain

Q 4. A 43-year-old man eats a meal consisting of 40% protein, 10% fat, and 50% carbohydrate.
Thirty minutes later, the man feels the urge to defecate. Which reflex results in the urge to
defecate when the duodenum is stretched?
a. Duodenocolic
b. Enterogastric
c. Intestinointestinal
d. Rectosphincteric

Q 5. 50-year-old man comes to see his clinician complaining of severe epigastric pain, frequent
heartburn, and unexplained weight loss of 20 pounds over a 6-month period. He claims to have
obtained no relief from over-the-counter H2 antihistamine drugs. He is referred to a
gastroenterologist, and upper endoscopy reveals erosions and ulcerations in the proximal
duodenum and an increased output of gastric acid in the fasting state. The patient is most likely
to have a tumor secreting which of the following hormones?
a. Secretin
b. Somatostatin
c. Motilin
d. Gastrin
Q 6. In infants defecation often follows a meal. The cause of colonic contraction in this situation
is
a. Gastroileal reflex
b. Enterogastric reflex
c. Increased circulation of CCK
d. Gastrocolic reflex

Q 7. Vast majority of obese individuals have increased levels of

a. Adiponectin
b. Leptin
c. Ghrelin
d. Cortisol

Q 8. Migrating motor complexes (MMC) occur about every 90 min between meals and are
thought to be stimulated by the gastrointestinal hormone, motilin. An absence of MMCs causes
an increase in which of the following?
a. Duodenal motility
b. Gastric emptying
c. Intestinal bacteria
d. Mass movements

Q 9. A 90-year-old man with congestive heart failure explains to his physician that he has dull,
aching chest pains when he consumes a large meal. Which of the following mechanisms can best
explain the cause of ischemic chest pain following a large meal in this patient?
a. Vasoconstriction of skeletal muscle arterioles
b. Vasoconstriction of intestinal arterioles
c. Vasodilation of skeletal muscle arterioles
d. Vasodilation of intestinal arterioles

Q 10. Swallowing a bolus of food involves the following: (1) relaxation of upper esophageal
sphincter, (2) peristaltic contractions of pharynx, (3) upward movement of the soft palate, and (4)
medial placement of palatopharyngeal folds. Which of the following best describes the correct
temporal order of events during the swallowing process?
a. 4, 1, 2, 3
b. 3, 4, 2, 1
c. 2, 1, 4, 3
d. 3, 4, 1, 2

Q 11. A medical student presents to emergency room with a two day history of severe vomiting
and orthostatic hypotension. What kind of metabolic abnormalities would you expect?
a. Hyperkalemia, hyperchloremia and metabolic alkalosis
b. Normal serum electrolytes and metabolic acidosis
c. Normal serum electrolytes and metabolic alkalosis
d. Hypokalemic, hypochloremic and metabolic alkalosis

Q 12. The stomach has the ability to absorb

 a. Ca²⁺
b. Alcohol
c. Glucose
d. Aromatic amine acids

Q 13. A 79-year-old man has a cerebrovascular accident (stroke) in the medulla and pons that
eliminates all vagal output to the gastrointestinal tract. Which function is most likely to be
eliminated in this man?
a. Gastric acid secretion
b. Pancreatic bicarbonate secretion
c. Primary esophageal peristalsis
d. Secondary esophageal peristalsis

Q 14. The symptoms of the dumping syndrome (discomfort after meals in patients with intestinal
short circuits such as anastomosis of the jejunum to the stomach) are caused in part by
a. Increased blood pressure
b. Increased secretion of CCK
c. Hypoglycemia
d. Hyperglycemia.

Q 15. Chymotrypsinogen is a
a. Carboxypeptidase
b. Zymogen
c. Transaminase
d. Elastase

Q 16. A premenopausal woman who is physically active seeks advice from her primary care
clinician regarding measures she can take to ensure adequate availability of dietary calcium to
ensure bone health later in life. Which of the following dietary components should enhance
calcium uptake?
a. Protein
b. Oxalates
c. Iron
d. Vitamin D

Q 17. Which of the following has the highest pH?

a. Gastric juice
b. Colonic luminal contents
c. Pancreatic juice
d. Saliva

Q 18. A 12-year-old girl consumes a glass of milk and two cookies. Her lower esophageal
sphincter (LES) and fundus relax while the food is still in the esophagus. Which substance is
most likely to cause relaxation of the LES and fundus in this girl?
a. Gastrin
b. Histamine
 c. Motilin
d. Nitric oxide

Q 19. Which of the following cell types protects against sepsis secondary to translocation of
intestinal bacteria?
a. Hepatic stellate cell
b. Cholangiocyte
c. Kupffer cell
d. Hepatocyte

Q 20. A 40-year-old woman comes to her primary care clinician complaining of severe, episodic
abdominal pain that is particularly intense after she ingests a fatty meal. An imaging procedure
reveals that her gallbladder is acutely dilated, and a diagnosis of cholelithiasis is made. A
gallstone lodged in which location will also increase her risk of pancreatitis?
a. Left hepatic duct
b. Right hepatic duct
c. Cystic duct
d. Sphincter of Oddi

Q 1. A 20 yr old female presents with fatigue and weakness. Her Hb was reduced. The MCV was
68 fl, MCH 22pg and Red cell distribution 20. The total iron binding capacity was increased. The
most likely diagnosis is:

a) Iron deficiency anemia

b) Thalassemia minor
c) Megaloblastic anemia
d) Anemia of chronic disease

Q 2. In a 30 year old jaundiced patient, investigations show reticulocytosis, absence of urinary

bilirubin with normal liver function tests. The most likely diagnosis is:

a) Hemolytic jaundice
b) Hepatic jaundice
c) Obstructive jaundice
d) Physiological jaundice

Q 3. Foetal RBCs differ from adult RBCs by following except:

a) Foetal RBCs are bigger

b) More 2-3 DPG in foetal RBCs
c) Foetal RBCs have shorter life span
d) Foetal RBCs have less of carbonic anhydrase
Q 4. A person whose hematocrit is equal to 60% with reference to normal will have all of the
following except:

a) Has higher viscosity of blood

b) Has higher platelets count
c) Has higher WBC count
d) Has high blood pH

Q 5. Calcium deficiencies do not produce coagulation disorders because

a) Only traces of calcium are required for coagulation

b) If deficiency is very severe, it may produce bleeding symptoms
c) Calcium acts as a co-factor
d) All other clotting factors are intact

Punjab Institute of Medical Sciences

Department of Physiology
MBBS [1st Prof.]
CVS

M.M:10 Time: 11:00 AM - 11:15

AM

Q 1. Calculate the heart rate in beats per minute?

A. 70
B. 78
C. 84
D. 94
E. 104

Q 2. According to Einthoven’s law, if the QRS voltage in lead III is 0.4 millivolt, what is the
QRS voltage in lead I ? ( Refer above picture)
A. 0.05 millivolt
B. 0.50 millivolt
C. 1.05 millivolt
 D. 1.25 millivolt
E. 2.05 millivolt

Q 3. A 54 year old man is seen in clinic with complaints of palpitations and light-headedness.
Physical examination is remarkable for a heart rate of greater than 200/min and a blood pressure
of 75/40 mmHg. Which of the following adjustments have probably occurred in the cardiac
cycle?
A. Diastolic time has decreased and systolic time has increased
B. Diastolic time has decreased but systolic time has decreased more
C. Systolic time has decreased and diastolic time has increased
D. Systolic time has decreased but diastolic time has decreased more
E. Systolic time has decreased but diastolic time has not changed

Q 4. A 60 year old has blood pressure reading of 160/100 mmHg. His pulse pressure will be
A. 130 mmHg
B. 60 mmHg
C. 260 mmHg
D. 30 mmHg

Q 5. A person having suffered acute blood loss in an accident is brought to the emergency. His
mean arterial pressure is 30 mmHg. Which reflex will be activated to prevent further fall in his
blood pressure
A. Baroreceptor reflex
B. B. CNS ischemic reflex
C. Chemoreceptor reflex
D. Bainbridge reflex

Q 6. Absolute refractory period in heart

A. Lasts till cardiac contraction
B. Longer than refractory period in skeletal muscle
C. A phase of cardiac cycle in which heart cannot be stimulated by any amount of stimulus
D. Corresponds with duration of action potential
E. All of the above

Q 7. A 65 year old man has congestive heart failure. He has a cardiac output of 4L/min, arterial
pressure of 115/85 mmHg and heart rate of 90 beats/min. Further tests by a cardiologist reveal
that the patient has a right atrial pressure of 10 mmHg. An increase in which of the following
would be expected in this patient?
A. Plasma colloid osmotic pressure
B. Interstitial colloid osmotic pressure
C. Arterial pressure
D. Cardiac output
E. Vena cava hydrostatic pressure

Q 8. Bainbridge reflex is initiated in which of the following condition:

 A. Increase venous pressure
B. Right atrial engorgement
C. Injection of saline in left atrium
D. Serotonin

Q 9. A shortened PR interval, slurring (called a delta wave) of the initial QRS deflection, and
prolonged QRS duration are charecteristics of:
A. Wolff-Parkinson-White (WPW) syndrome
B. Atrial tachycardia
C. Left bundle branch block
D. Myocardial ischemia

Q 10. A 60 year old patient known case of Hypertension for past 25 years underwent Renal
Doppler which showed narrowing of right renal artery. If the diameter is decreased by 50%, how
much blood flow will be reduced?
A. 1/4th
B. 1/8th
C. 1/16th
D. 1/32nd

Punjab Institute of Medical Sciences

Department of Physiology

MBBS [1st Prof.] SA-I

M.M: 20

Note: Attempt all questions:

1. A 55-year-old man has been diagnosed with Strokes -Adams syndrome. Two minutes after
the syndrome statrts to cause active blockade of the caridac impulse, which of the following is
the pacemaker of the heart?

a. Sinus node

b. A-V node

c. Purkinje fibers

d. Cardiac septum.
2. The intrapleural pressure is negative both during inspiration and expiration
because__________

a. Intrapulmonary pressure is negative

b. Tharacic cage and lung recoil in opposite direction

c. Transpulmonary pressure determines negativity

d. Surfactant prevents lung collapse

3. The groundbreaking discovery of these channels by David Julius and Ardem Potapoutian have
allowed us to understand how heat, cold and mechanical force can iniate the nerve impulse
that allow us to perecive and adapt to world around us. The channels discovered in 2021 are?

a. TRPV1

b. TRPM8

c. PIEZO

d. Both A and C

4. Calculate the alveolar ventilation if the respiratory rate is 10/min and tidal volume is 600 ml?

a. 1.5 L/min

b. 3.5 L/min

c. 4.5 L/min

d. 5.0 L/min

5. Carotid body chemoreceptors are stimulated by all of the following types of hypoxia
except___________?

a. Anemic

b. Hypoxic

c. Stagnant
 d. Histotoxic

6. Rahul , a 23 year old boy wakes up due to pain, paresthesia, tingling of the arms.He slept
with arm below his head. Which fibers are involved?

a. Type A fibers

b. Type B

c. Type C (pain).

d. Type C (pastganglionic)

7. Thin-walled and delicate vessels like capillaries are less prone to rupture. This can be
explained by _________?

a. Poiseuille’s law

b. Laplace law

c. Frank starling law

d. Ficks law

8. Which of the following statements is false?

a. Meissner's plexus is present in submucosa

b. Myentric plexus is present between inner circular and outer longitudinal muscle
layers

c. Muscularis mucosa is associated with peristalsis

d. Villi are absent in large intestine

9. Which of the following causes some malnourished patients to bleed excessively when
injured?

a. Vitamin K deficiency

b. Platelet sequestration by fatty liver.

c. Serum bilirubin that raise neutralizing thrombin.

d. Low serum protein levels that cause factor XIII problems.

10. A 35-year-old man with shortness of breath is undergoing tests to assess lung function.
Which of the following is used to measure lung diffusion capacity?

a. CO

b. N₂O

c. CO₂

d. O₂ (under normal condition)

11. The factor favouring filtration at the arterial end of the capillary bed is _______?

a. Increase in interstitial hydrostatic pressure

b. Increase in hyrostatic pressure of the capillary

c. Increase in oncotic pressure of the capillary

d. Decrease in oncotic pressure of the interstitium

12. A 62-year-old female arrives for her annual physical. She complains of itching in her hands
along with headache and vertigo. A routine complete blood count (CBC) shows red blood cells
(RBCs) of 8.2 million/µl, white blood cells (WBCs) 37,000/µl, and platelets 640,000/µl. Her
erythropoietin levels are lower than normal. The primary diagnosis would be

a. Thrombocytopenia

b. Relative Polycythemia

c. Secondary Polycythemia

d. Polycythemia vera

13. According to Haldane, oxygenation of Hb produces following effect in the respiratory

dynamics.

a. Shifts the CO₂ dissociation curve to the right and facilitates unloading of
CO₂

b. Shifts the CO₂ dissociation curve to the left and facilitates unloading of CO₂

c. Increases the affinity of CO₂ for Hb

d. Has no effect on the affinity of Hb for CO₂

14. Damage to the sensory fibers of the urinary bladder results in

a. Atonic bladder

b. Periodic but unannounced bladder emptying

c. Neurogenic bladder

d. Overflow incontinence.
15. A young vegetarian woman with heavy bleeding during menstrual cycles has started
complaning of lethargy, tiredness and loss of energy. Her investigations reveal a decrease in
hemoglobin levels and the peripheral smear reveals a typical dimorphic picture with both micro
and macrocytes in red blood cell. Most likely she is suffering from-

a. Iron deficiency anemia

b. Vitamin B12 deficiency anemia

c. Thalassemia

d. Deficiency of both iron and Vitamin B12.

16. An O Rh negative woman met an accident and had to be tranfused with O Rh positive blood
as O Rh negative blood was not available Which of the statements is FALSE:

a. She will not develop severe mismatch blood transfusion reaction this time.

b. She can develop mismatch blood transfusion if later in her life she is agian
transfused with O Rh positive blood.

c. If she gets pregnant with Rh Positive child the child can develop
erthroblastosis fetalis.

d. Outcome of her pregnancy will not be affected by the Rh status of the child.

17. The best tests to assess the function of the platelets is

a. Clotting time

b. Bleeding time

c. Clot retraction time

 d. Both bleeding and clotting time.

18. In a patient with cardiac output 5 liters/minute and body surface area 1.7 m², what will be
the cardiac index?

a. 3 liter/min/m²

b. 4 liter/min/m²

c. 5 liter/min/m²

d. 2.5 liter/min/m².

19. A scientist is studying the Nerve conduction. Four neurons have axons of the same
length,but different states of myelination and axon diameter. What combination of axon
myelination and nerve fiber diameter would produce the fastest nerve conduction speed.

Axon myelination Axon diameter (um)

Nerve 1 Myelinated 15
Nerve 2 Myelinated 10
Nerve 3 Unmyelinated 15
Nerve 4 Unmyelinated 10

a. Nerve 1
b. Nerve 2
c. Nerve 3

d. Nerve 4

20. A 40 year-old lady undergoes thyroidectomy and inadvertently her parathyroid gland is
damaged. Subseuently she develops parathyroid deficiency and would have

a. Low plasma phosphate and Ca²⁺ levels and tetany.

b. Low plasma phoshate and Ca²⁺ levels and tetanus.

 c. A low plasma Ca²⁺ phosphate and Ca⁺ level, increased muscular
excitability, and spam of the muscles the upper extremity.

d. High plasma phosphate and Ca²⁺ levels and bone demineralization.

21. A 3 year old child was suffering from diarrhea for the last 2 days, On examination signs of
dehydration i.e sunken eyes, dry mouth and drowsiness were present, Which of the following is
the reason for rapid and more severe development of dehydration in children as compared to
adults:

a. ECFV/ICFV ratio is smaller

b. ECFV/ICFV ratio is larger

c. Total body water is larger

d. Total ECFV is smaller.

22. A teenager does a strernous exercise for 10 minute. After the exercise, he continues to
breathe hard and to consume large amounts of oxygen for minute. The additional oxygen is
used for the following EXCEPT?

a. Reconvert the lactic acid that has accumulated during excercise back into
glucose.

b. Replenish the ATP and phosphoryl creatine stores.

c. Recovery from exhaustive muscle glycogen depletion

d. Re-establish the normal concentrations of oxygen bound with myoglobin.

23. A research scholar joins a neurophysiology lab to study the excitability of neurons. The
experimental model is the spinal motor neuron. He stimulates the neuron at four different sites
and monitors the production of action potentials at the axon. At which of the following regions
does he need the lowest strength of stimulus to induce an acion potential?

a. Cell body
 b. Myelin sheath

c. Initial segment

d. Axon terminal

24. A female infant is delivered at a gestational age of 32 weeks and weighing 1 kg. Forty eight
hours after birth, she noted to have heart murmur and bounding pulse and is feeding poorly.
Her symptoms resolve with administration of indomethacin. What is the most likely diagnosis?

a. Respiratory distress syndrome

b. Bronchopulmonary dysplasia
c. Apnea
d. Patent ductus arteriosus

Punjab Institute of Medical Sciences

Department of Physiology

MBBS [1st Prof.] Paper - A

M.M: 20

Note: Attempt all questions

Q 1. A 25-year-old factory worker develops a noise-induced hearing loss over a period of 6

months because of repeated, prolonged exposures to loud sounds. The physical loss of which of
the following structures is most likely to contribute to the hearing deficit?

a. Cochlea
b. Hair cells
c. Organ of Corti
d. Scala vestibuli
Q 2. A 10-year-old boy jumps off the porch and lands on the balls of his feet. The increase in
muscle tension causes a sudden, complete relaxation of the affected muscles. Which sensory
receptor is most likely to mediate this relaxation of muscles when tension is increased?

a. Free nerve ending

b. Golgi tendon organ
c. Krause corpuscle
d. Muscle spindle

Q 3. A 60 year old man develops a thrombosis of a cerebral blood vessel following which he
develops slow speech and difficulty in generating verbal or written words and he is limited to
two or three words to express the whole range of meaning and emotion. What is the likely area
of the lesion?

a. Wernicke’s area
b. Broca’s area
c. Angular gyrus
d. Arcuate fasciculus

Q 4. During a meeting the Executive picks up a cup of tea and sips the tea. Match the control of
voluntary movement with the areas:

Area Function

1. Cortical association areas a. Motor commands

2. The cortex, basal ganglia and cerebellum b. Adjust and smoothen movement

3. Corticospinal tracks and corticobulbar tracts c. Commands originate

relay to motor neurons

4. Cerebellum feedback d. Plan movements

a. 1-a, 2-b, 3-c, 4-d

b. 1-c, 2-d, 3-a, 4-b
c. 1-a, 2-c, 3-b, 4-d
d. 1-d, 2-b, 3-c, 4-a
 Q 5. A 43-year-old man wakes up at night and turns on a light. Which of the following
substances is most likely to increase in the rods of the retina when the man is exposed to
photopic conditions?
a. cAMP
b. cGMP
c. Metarhodopsin II
d. Rhodopsin

Q 6. An Electroencephalogram (EEG) recorded in an adult man awake at rest with eyes closed
and mind wandering would show the following rhythm when electrodes are placed on occipital
lobe
a. Alpha (8-13 Hz)
b. Beta (18-30 Hz)
c. Theta ( 4-7 Hz)
d. Delta ( 0.5-4 Hz)

Q 7. A man loses his right hand in a farm accident, four year later, he has episodes of severe
pain in the missing hand (phantom limb pain). A detailed PET scan study of his cerebral cortex
might be expected to show:
a. Expansion of the right hand area in his right somatic sensory area (SI)
b. Expansion of the right hand area in his left somatic sensory area (SI)
c. Projection of fibre from neighboring sensory areas into the right hand area of his right
somatic sensory area (SI)
d. Projection of fibre from neighboring sensory areas into the right hand area of his left
somatic sensory area (SI)

Q 8. If a single spinal nerve is cut, the area of tactile loss is always greater than the area of loss
of painful sensations, because:
a. Tactile information is carried by myelinated fast conducting fibres
b. Tactile receptors adapt quickly
c. Degree of overlap of fibres carrying tactile sensation is much less
d. In the primary sensory cortex tactile sensation is represented on a larger area

Q 9. The membrane potential of a particular cell is at the K+ equilibrium. The intracellular

concentration for K+ is at 150 mmol/L and the extracellular concentration for K+ is at 5.5
mmol/L. What is the resting potential?
a. –70 mV
 b. –90 mV
c. +70 mV
d. +90 Mv

Q 10. A researcher working in the area of body is intrested in measurement of the body fluid
volumes for which different indicators are to be used. Match the volume to be measured to the
indicator to be used:
Volume Indicators
1. Total body water a. Radioactive chromium
2. Extracellular fluid b. Deuterium
3. Plasma volume c. Radioactive sodium
4. Blood volume d. Evans blue
a. 1-b, 2-c, 3-d, 4-a
b. 1-a, 2-c, 3-d, 4-b
c. 1-b, 2-d, 3-c, 4-a
d. 1-a, 2-b, 3-c, 4-d

Q 11. A man slept with head over forearm, next morning he complains of tingling, numbness
over forearm. It is caused by:
a. Sensitivity to hypoxia A > B > C
b. Sensitivity to pressure A > B > C
c. Sensitivity to hypoxia C > B > A
d. Sensitivity to pressure B >A > C

Q 12. A 35-year-old woman sees her physician to report muscle weakness in the extraocular
eye muscles and muscles of the extremities. She states that she feels fine when she gets up in
the morning, but the weakness begins soon after she becomes active. The weakness is
improved by rest. Sensation appears normal. The physician treats her with an
anticholinesterase inhibitor, and she notes immediate return of muscle strength. Her physician
diagnoses her with

a. Lambert–Eaton syndrome.
b. Myasthenia gravis.
c. Parkinson disease.
d. Muscular dystrophy.
Q 13. A man was on a trip to Japan and consumes puffer fish without precautions leading to
muscle paralysis, which channels were blocked by the tetrado toxin of pufferfish:

a. Voltage sensitive Ca²⁺ channels

b. Voltage sensitive Na⁺ channels
c. Ryanodine receptors
d. DHP receptors

Q 14. An event of very fast muscle contraction which lasts for only 3 seconds the energy
supplied is from:

a. Phosphocreatin
b. Glycogen
c. Oxidative phosphorylation
d. Stored ATP

Q 15. Which of the following would you expect to find in a patient whose diet has been low in
calcium for 8 weeks?

a. Increased phosphate levels

b. Raised calcitonin levels
c. Increased parathormone secretion
d. Activation of 24-25 dihydroxycholecalciferol

Q 16. A young man presents with a blood pressure of 175/110 mm Hg. He is found to have a
high circulating aldosterone but a low circulating cortisol. Glucocorticoid treatment lowers his
circulating aldosterone and lowers his blood pressure to 140/85 mm Hg. He probably has an
abnormal

a. 17α-hydroxylase
b. 21β-hydroxylase
c. 3β-hydroxysteroid dehydrogenase
d. Aldosterone synthase
Q 17. A 18 year old individual presents with male characteristics; male genitalia and mental
retardation. On further follow up he is found to be having abnormal seminiferous tubules. His
chromosomal pattern will be

a. XO
b. YO
c. XXX
d. XXY

Q 18. A 25 year old woman is admitted to labour unit with early labour pain. The cramping pain
in early labour is caused mainly by :

a. Compression of blood vessels by cervical stretching

b. Compression of blood vessels by perineal stretching
c. Streching or tearing of structures in vaginal canal
d. Hypoxia of the uterine muscle resulting from compression of the blood vessels in the
uterus

Q 19. A 30-year-old woman is breastfeeding her infant. During suckling, which hormonal
response is expected in the woman?

a. Increased secretion of ADH from the supraoptic nuclei

b. Increased secretion of ADH from the paraventricular nuclei
c. Increased secretion of oxytocin from the paraventricular nuclei
d. Decreased secretion of neurophysin

Q 20. A sustained program of lifting heavy weights will increase bone mass. What is the
mechanism of this effect of weightlifting?

a. Elevated metabolic activity stimulates parathyroid hormone secretion

b. Mechanical stress on the bones increases the activity of osteoblasts
c. Elevated metabolic activity results in an increase in dietary calcium intake
d. Elevated metabolic activity results in stimulation of calcitonin secretion
1. Which of the following can be resposible for Bezold-Jarisch reflex?
a. Serotonin
b. Histamine
c. Prostaglandin
d. Angiotensin

2. In a patient,urine flow rate is 10 mL/min; plasma inulin is 2 mg/mL; and urine inulin is 25 mg/mL. Which of the
following is true assuming GFR to be normal?
a. Inulin clearance = GFR
b. Inulin clearance >GFR
c. Inulin clearance < GFR
d. GFR cannot be calculated

3. In a patient with renal diseases,albumin is the first to appear in the urine. What is the reason behind this?
a. Its high concentration in plasma
b. Its effective molecular diameter
c. Its high albumin: globulin ratio
d. Epithelial cells are sensitive

4. Two particles share the same diameter. The one which will pass through the glomerular membrane has_________
a. Positive charge
b. Negative charge
c. No charge
d. Filtration across GBM does not depend on charge

5. The order of depolarization after stimulation of Purkinje fibers is:

a. Septum →Endocardium →Epicardium
b. Endocardium →Epicardium → Septum
c. Epicardium →Endocardium →Septum
d. Septum →Epicardium →Endocardium.

6 When a person changes position from standing to supine,__________

a. Heart rate increases
b. Venous return to heart rises immediately
c. Cerebral blood flow increases
d. Decrease in blood flow to the lung apices .

7. A patient with cardiac output 5L/min and body surface area 1.7m2. What will be the cardiac index (L/min/m2)?
a. 3
b. 4
c. 5
d. 6 .

8 Venous return to the heart during quiet standing is facilitated by all of the following factors expect__________
a. Calf muscle contraction during standing
b. Valves in perforators
c. Deep fascia
d. Increased arterial pressure due to gravitation.

9. A man inspires 1000ml from a spirometer. The intrapleural pressure was -4cm H2O before inspiration and -12cm H2O
at the end of inspiration. What is the compliance of lungs?(ml/cm H2O)?
a. 50
b. 100
 c. 125
d. 150 .

10. Which of the following tranporter is present in the ascending loop of Henle?
a. Na+ - Cl- co tranporter
b. EnaC channel
c. Na+ - 2Cl- -K+ co transporter
d. Na+ - aminoacid co transporter .

11. Which of the following is the most common trigger for hemolysis in patients with G6PD deficiency?
a. Infection
b. Drugs
c. Fava beans
d. Dehydration.

12. A concerned mother brings her infant to the OPD for advice regarding nutrition. She says, soon after every meal, her
kid defecates. What is the cause of colonic contraction in this situation?
a. Gastroileal reflex
b. Enterogastric reflex
c. Increased circulation of CCK
d. Gastrocolic reflex .

13. Ptyalin is secreted by which of the following glands?

a. Gastric gland
b. Duodenal gland
c. Salivary gland
d. Pancreatic gland .

14. A young couple was spending their afternoon on a picnic. Suddenly, the woman got down on her knee, pulled out a
ring, and proposed . The man was taken aback and began to hyperventilate. The overdrive mechanism observed is due to ___
a. Pneumotaxic center
b. Dorsal group of neurons (DRG) in the medulla
c. Apneustic center
d. Ventral group of neurons (VRG) in the medulla .

15 Which of the following is seen in a patient on parasympathetic stimulation?

a. Sphincter closure of gall bladder
b. Increased peristalsis
c. Decreased GI motility
d. Decreased pancreatic secretion .

16 A 34-year-old woman with sever anaemia was started on parenteral iron. Which of the following would occur first in
this patient as a response to therapy?
a. Increase in reticulocyte count
b. Increase in serum ferritin level
c. Increase in RBC count
d. Immediate increase in serum iron level.

17. A few night before the respiratory physiology exam, a student was suffering from a recurring nightmare. In this
nightmare, a knife-wielding horse was chasing him through the streets and threatening to cut off his brainstem at the mid-pontine
level. Assuming the horse was proficient in its threat, and performed a bilateral vagotomy as well, which of the following
outcomes would occur?
a. Gastroileal reflexCeasationof spontaneous respiration
b. Continuation of regular breathing
c. Irregular but rhythmic respiration
d. Apneusis .
18 In which of the following patiens with megaloblastic anaemia would you not suspect vitamin B12 deficiency as a
cause?
a. A 5-year-old child fish tapeworm infestation
b. A 45-year-old man who underwant gastrectomy
c. A 38-year-old man with Celiac disease
d. A 23-year-old woman on phenytoin therapy .

19. In a patient with microcytic hypochromic anaemia, red cell distribution width was measured. What is this parameter
used to identify?
a. Anisocytosis
b. Poikilocytosis
c. Anisochromia
d. Biconcavity .

20 A 53-year-old woman presents with complaints of light-headedness every time she stands up. She is a know case of
rheumatoid arthritis on methotrexate. On examination,she has pallor and brittle nails. Which of the following statements is ture
regarding her condtion?
a. Serum iron and tissue iron levels are normal
b. Anemia can be normocytic amd normochromic
c. Hepcidin levels are low
d. Total iron-binding capacity is high .