Question: Autosomal varient of nephrogenic diabetes insipidus is due to defect in

Another cause of diabetes insipidus is inability of the kidneys to respond to vasopressin (nephrogenic diabetes insipidus). Two forms of this disease have been described. In one form, the gene for the V2 receptor is mutated, making the receptor unresponsive. The V2 receptor gene is on the X chromosome, thus this condition is X-linked and inheritance is sex-linked recessive. In the other form of the condition, mutations occur in the autosomal gene for aquaporin-2 and produce nonfunctional versions of this water channel, many of which do not reach the apical membrane of the collecting duct but are trapped in intracellular locations. Ref: Ganong&;s review of medical physiology,23rd edition, page: 668


Question: Appetite is increased by

Ans. (d) Ghrelin(Ref: Ganong, 25th ed/p.485)Ghrelin#Ghrelin is a 28-amino acid peptide secreted primarily by oxyntic gland area of the stomach#Major Functions of ghrelin are,It increases the appetite (orexinergic)Increases gastric motilityIncreases secretion of gastric acid,Increases adipogenesisIncreases insulin secretionIncreases growth hormone#Ghrelin levels peak just before food intake begins (fasting state)#Plasma levels of ghrelin are low in obese persons#Ghrelin levels are high in anorexia nervosa


Question: Arterial O2 content is reduced in one of the following

Arterial PO2/ Dissolved oxygen is normal in anemic hypoxia, but the arterial oxygen content is low. Whereas, in Hypoxic hypoxia, both are low. In case of stagnant hypoxia/ischemic hypoxia and histotoxic hypoxia, both are normal.


Question: Initiating event of Endotoxic shock

The receptor for the endotoxin in humans is the TLR-4 located on the surface of antigen presenting cells. b. Binding to the receptor activates a cascade of enzymatic reactions which finally leads to the activation of the genes for the proinflammatory cytokines. Ref ganong's review of medical physiology 25e p465


Question: Type I Glomus cells of peripheral chemoreceptors have

O2 sensitive K+ channel is present in Type I Glomus cell.


Question: The only excitatory neuron in the cerebellar coex is

Granular cells are the only excitatory cells of cerebral coex, use glutamate as neurotransmitter, their axons from parallel fibres Ref: Ganong 25th ed/page 248


Question: Melatonin is secreted by

Retinohypothalamic fibers synapse in the suprachiasmatic nuclei (SCN), and there are connections from the SCN to sympathetic preganglionic neurons in the spinal cord that project to the superior cervical ganglion. Postganglionic neurons project from this ganglion to the pineal gland that secretes melatonin. The cyclic activity of SCN sets up a circadian rhythm for melatonin release. This rhythm is entrained to light/dark cycles by neurons in the retina.(Ref: Ganong's Review of Medical Physiology Twenty-Third Edition)


Question: Extrafiisal fibre innervated by

Extrafusal fibers are innervate by A-alfa motor neurons They are myelinated and fast conducting Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:769,770,771


Question: The per cent of fluid present in arterial system is

(A) 85% > An average value is 3500 mL (5% of the body weight of a 70 kg man, assuming unit density)approx.70%-80%.


Question: Severe HTN cut off is

Ans. D >170 mm HgRef: Harrison's, 19th ed. pg. 1616Guidelines for threshold values between normal and high blood pressure Clinic measurement (mm Hg)Home measurement (mm Hg)Optimal control<140/85<130/80Mild hypertension140-150/90-100135-145/85-95Moderate hypertension150-170/100-110145-165/95-105Severe hypertension>170/110>165/105The question mentioned was severe hypertension, however if the grading of hypertension is asked, then answer must be according to this table:BP classificationSystolic mm HgDiastolic, mm HgNormal<120and <80Pre-hypertension120-129<80Stage 1 HTN130-13980-89Stage II HTN>140>90Isolated systolic HTN>140and <90


Question: Major poion of coronary blood flow occurs during

The pressure inside the left ventricle is slightly higher than in the aoa during systole. Flow occurs in the aeries supplying the subendocardial poion of the left ventricle only during diastole, although the force is sufficiently dissipated in the more superficial poions of the left ventricular myocardium to permit some flow in this region throughout the cardiac cycle.Ref: Ganong&;s Review of medical physiology 25th edition. Page: 611


Question: Gastric employing is rabid with

Isotonic raline causes most rapid gastric emptying among food substances > proteins > fats.


Question: Most of the neurons in the Autonomic Nervous System are

Ans: a (cholinergic) Ref: Ganong 22nd ed/ p.226Most of the neurons in ANS are cholinergic.Autonomic Nervous System:Parasympathetic preganglionic fibres have a long course.Parasympathetic postganglionic fibres have a short course. This is because the parasympathetic ganglions are located near the tissues it supplies.Each preganglionic axon diverges to an average of 8 or 9 postganglionic neurons.Preganglionic: Postganglionic = 1:8 or 9.Conduction speed in different fibres:* Autonomic preganglionic axons are B type* Autonomic postganglionic axons are C type* Conduction speed A>B>CPreganglionic fibres are myelinated, whereas, postganglionic fibres are unmyelinated.Cholinergic neuronso All preganglionic neuronso Parasympathetic postganglionic neuronso Sympathetic postganglionic neurons which innervate sweat glands and vessels in skeletal muscles.Remaining sympathetic postganglionic neurons are adrenergic or noradrenergic.Types of nerve fibresFibre typeFunctionsA alphaProprioception; somatic motorA betaTouch, pressureA gammaMotor to muscle spindlesA deltaPain, coId, touchBPreganglionic autonomicC- Dorsal rootPain, temperature, some mechano- reception, reflex responsesC - SympatheticPostganglionic sympathetic Relative susceptibility of nerve fibres Most susceptibleIntermediateLeast susceptibleHypoxiaBACPressureABCLocal anaestheticsCBA


Question: Calcium initiates a skeletal muscle contraction by

During excitation-contraction coupling in a skeletal muscle fiber, calcium is released from the sarcoplasmic reticulum (not the sarcolemma) and binds to troponin (not tropomyosin or myosin). The binding of calcium to the troponin causes the troponin to shift the position of the tropomyosin to which it is attached, thus uncovering the actin binding sites for binding with myosin.

Being released primarily from the sarcolemma during an action potential


Question: Lobe of civilization


Question: In caissons disease pain in joint is because of

In Caisson’s disease, the gas embolism is caused by nitrogen that expands in the tissues and passes to the circulation.


Question: Plateau of cardiac action potential is due to

Ans. c (Opening of voltage-activated slow calcium channels) (Ref. Ganong Physiology 22nd/pg. Chapter 29).In contrast to skeletal muscle:1. Cardiac muscle action potential has a plateau, which is due to Ca2+ influx2. Cardiac nodal cells spontaneously depolarize, resulting in automaticity3. Cardiac myocytes are electrically coupled to each other by gap junctions# Slow influx of calcium is responsible for the plateau phase of the action potential.Myocardial action potentialPhase 0Rapid depolarizationRapid sodium influx; these channels automatically deactivate after a few msPhase 1Early repolarizationEfflux of potassiumPhase 2PlateauSlow influx of calciumPhase 3Final repolarizationEfflux of potassiumPhase 4Restoration of ionic concentrationsResting potential is restored by Na+/K+ ATPase; there is slow entry of Na+ into the cell decreasing the potential difference until the threshold potential is reached, triggering a new action potential.

Opening of voltage-activated fast sodium channels

Opening of voltage-activated potassium channels

Opening of voltage- activated calcium -sodium channels.


Question: Surfacant is made up of

Dipalmitoylphoshatidylcholine is a phospholipid which along with proteins acts as surfactant.


Question: In an adult man weighing 70kgs, the extracellular fluid volume will be about

Body water varies from 45-75% of body weight. The intracellular component of body water accounts for about 40% of body weight and the extracellular component constitute 20% of body weight. Hence 20% of 70 equals to 14L approximately. (REF TEXTBOOK OF MEDICAL P G N 2 EDITION, PAGE NO 61)


Question: Diuresis produced by alcohol is due to

Diuresis- increased formation and secretion of urine. Diuresis occurs in conditions such as diabetes mellitus, diabetes insipidus, and acute renal failure.Vasopressin is a peptide hormone that increases water permeability of the kidney&;s collecting duct and distal convoluted tubule by inducing translocation of aquaporin-CD water channels in the plasma membrane of collecting duct cells. It also increases peripheral vascular resistance, which in turn increases aerial blood pressure. It plays a key role in homeostasis, by the regulation of water, glucose, and salts in the blood.Ref: Ganong&;s review of medical physiology; 24th edition; page no:- 311


Question: The best indicator of cystic fibrosis is

A positive sweat test (i.e., a sweat chloride level greater than 60 mEq/L) is diagnostic of cystic fibrosis.

A positive family history of cystic fibrosis

A sweat test with a chloride concentration of 70mEq/L


Question: Main site of peripheral vascular resistance is

Arterioles are the chief site of vascular resistance.


Question: D20 (Deuterium oxide) is used to measure volume of


Question: Juxtaglomerular apparatus lies in relation to;

The proximal pa of the distal tubule comes in contact with the afferent aeriole. This complex of cells is called Juxtaglomerular apparatus. It lies in relation to glomerulus, and is made up of: Juxtaglomerular cells in afferent aeriole, Macula densa of the DCT, Agranular Polkissen or 'Lacis' cells situated in the angle created by the entrance and exit of afferent and efferent aerioles. Note: If the question asked is: "JG cells lie in close relation with....." and the options include ascending pa of DCT or descending pa of DCT, the answer would be ascending pa of DCT.

Excretory System (Kidney, Bladder) Acid-Base Balance


Question: Characteristic feature of cells of collecting duct are

Features of collecting duct cells :

No brush border
No carbonic anhydrase in lumimal membrane
Has 'tight' tight junction
Para cellular transport not possible

Pressure of carbonic anhydrase in lumimal membrane


Question: Transcellular fluids are present in

Transcellular fluid is part of ECF present in body cavities
Eg:Pleural fluid, pericardial fluid.


Question: Nerve Fibres innervating sweat glands release the following at their endings

(B) Acetylcholine > Sympathetic cholinergic system serves two important function.> Sweat gland: Secretion of sweat> Vasodilation in skeletal Muscles: A part of the neurons to blood vessels in skeletal muscles are anatomically sympathetic secrete acetylcholine. Simulation of this system of neurons produces vasodilatation in skeletal muscles.


Question: Glucose is reabsorbed in

Ans. a (PCT). (Ref. Ganong, Physiology, 21st/pg.713; Table 38-6.)PROXIMAL CONVOLUTED TUBULE (PCT) - "Workhorse of the nephron".# Reabsorbs all of the glucose, inorganic phosphate, Cl, lactate and amino acids and most of the bicarbonate, sodium, and water.# Secretes ammonia, which acts as a buffer for secreted H\Transport Proteins Involved in the Movement of Na+ and Cl Across the Apical Membranes of Renal Tubular Cells.SiteApical TransporterFunctionProximal tubuleNa+/ glucose CTNa+ uptake, glucose uptake Na+/ Pi CTNa+ uptake, Pi uptake Na+ amino acid CTNa+ uptake, amino acid uptake Na+/lactate CTNa+ uptake, lactate uptake Na+/H+ exchangerNa+ uptake, H extrusion Cl-/base exchangerCl- uptakeThick ascending limbNa+-K4-2CINa+ uptake, Cl uptake, K+ uptake Na+/H+ exchangerNa+ uptake, H+ extrusion K+ channelsK+ extrusion (recycling)Distal convoluted tubuleNaCI CTNa+ uptake, Cl uptakeCollecting ductNa+ channel (ENaC)Na+ uptake


Question: The major prostanoid synthesized in kidney is

PGE2 is the major prostanoid synthesized in the kidney. It is secreted by: RMICs (Renal Medullary Interstitial cells) Macula densa Cells in the collecting ducts. Prostacyclin (PGI2) and other prostaglandins are secreted by the aerioles and glomeruli. Renal Medullary interstitial cells (RMICs) and are specialized fibroblast-like cells which are major site of cyclooxygenase 2 (COX-2) and prostaglandin synthase (PGES) expression. Ref: Ganong&;s Review of Medical Physiology 26th editon Pgno: 662


Question: Transcription refers to

the process where an mRNA is used as a template for protein production.

the process where a DNA sequence is copied into RNA for the purpose of gene expression.

the process where DNA wraps around histones to form a nucleosome.

the process of replication of DNA prior to cell division.


Question: Cerebral blood supply

The average cerebral blood flow in young adults is 54 mL/100 g/minRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 575


Question: Blood pressure in the right ventricle

Right atrium- 2mmHg
Right ventricle- 25mmHg
Pulmonary artery- 25/8 mmHg
Left atrium- 5mmHg
Left ventricle- 120 mmHg
Aorta- 120/80 mmHg


Question: Satiety center is located at

Ans. (a) Ventromedial nucleus of hypothalamus(Ref: Ganong, 25th ed/p.308)Feeding center - lateral nucleus of hypothalamusSatiety center - ventromedial nucleus of hypothalamus


Question: The per cent of Free or Ionized Calcium in the body is

(C) 50% # IONIZED CALCIUM:> Total calcium consists of free or ionized calcium (50%), calcium bound to protein (40-45%), principally albumin and calcium complexed to anions (5-10%), E.g. citrate, lactate, bicarbonate. Total calcium level does not give an indication of what is available at the cellular level.> Ionized calcium (iCa) is the form of calcium that is readily available to cells, and measurement of iCa is a more accurate reflection of the physiological calcium state.> Measurement of ionized calcium requires instrumentation with ion-specific electrodes. Unlike total calcium, ionized calcium is unaffected by albumin concentration, but it is affected by acid-base balance.> Acidosis (decreased pH) increases iCa, where as Alkalosis (increased pH) decreases iCa.> The pH of blood, serum or plasma changes rapidly with storage (usually decreases with refrigeration and increases with freezing), therefore iCa is unstable in stored blood samples.


Question: In clinical practice, Glomerular Filtration Rate (GFR) is estimated using the plasma clearance value of


Question: Used for measuring GFR

GLOMERULAR FILTRATION
Glomerular Membrane (GBM)
The barriers through which filtration has to take place

Glomerular endothelial cell layer: (Fenestrated capillary with a gap of 70-90 nm in between endothelium cells)
Basement membrane: A gel-like acellular meshwork of glycoproteins and proteoglycans.
Visceral epithelial layer of Bowman’s capsule:

i) The visceral epithelial cell is called a podocyte.
ii) Each podocyte has many foor processes, which interdigitate to form filtration slits.
iii) The slits are approximately 25 nm wide and each is closed by an extremely thin processes called slit diaphragms which bridge the slits between the pedicels.
iv) Slit diaphragms are widened versions of the tight junctions and adhering junctions.
v) Slit diaphragm is composed of several proteins, including nephrin (NPHS1), NEPH-1, podocin (NPHS2), a-actinin 4 (ACT), and CD2-Ap.
Glomerular Membrane Permeability Depends on

Size of particle: Neutral substances which are < 4 nm are freely filtered; > 8 nm are not filtered. Between 4 nm and 8 nm, the permeability is inversely proportional to the diameter.
Charge of the particle: Since the filtration membrane are negatively charged, filtration of positively charged particles is facilitated whereas negatively charged particles are repelled.
Electron microscopy demonstrates presence of an-ionic sites (negative charge) in all three layers of GBM

Measuring GFR (mGFR): to detect early damage

Clearance of exogenous substances: Inulin, iohexol, 51 CR-EDTA, 125I-iothalamate, 99m Tc-diethylenetriaminepenta-acetic acid (DTPA)

- Evaluation: Precise and accurate, but costly, time-consuming.

Clearance of endogenous blood substances

 - Serum creatinine: Insufficiently sensitive for detection of chronic renal disease (CRD)
- Creatinine clearance: No longer recommended due to errors in urine collection
Exception: Patients with highly abnormal muscle mass or vegetarian diet
- Serum cystatin C: More sensitive than serum creatinine for detection of GFR reduction in the range 70-40; better than creatinine in children.


Question: Trapezoid body is associated with

Ans: a (Auditory pathway) Ref: IB Singh 6th ed/p. 107Trapezoid body is concerned with auditory pathway.Auditory Pathway:First order neurons start from the spiral ganglion and end in the dorsal and ventral cochlear nuclei.From there, the second order neurons end in superior olivary nucleus of both sides. Some fibres do not relay in superior olivary nucleus, instead go through the Trapezoid body.From both the trapezoid body and superior olivary nuclei, the fibres pass through the lateral lemniscus, to reach the inferior colliculus.From there, it goes to the medial geniculate body and is projected to superior temporal gyrus. Note:-Fibres arising from the ventral cochlear nucleus pass through the trapezoid body.Some fibres arising from the dorsal cochlear nucleus does not pass through the trapezoid body and project directly into the superior colliculus.Superior olivary nucleus receives fibres from both cochlea (bilateral).Fibres from both dorsal and ventral cochlear nucleireach superior olivary nucleus.


Question: Sympathetic stimulation on the bronchus causes

Increased secretion of glands into bronchi


Question: Resting membrane potential of nerve is equal to equilibrium potential of


Question: pH of urine is

Thats the normal ph of urine. Ref: guyton and hall textbook of medical physiology 12 edition page number: 503,504,505


Question: The vanity of mesencephalic brain vesicle is

The cerebral aqueduct, (aqueductus mesencephali, mesencephalic duct, syln aqueduct, or aqueduct of Sylvius), is within the midbrain. It contains cerebrospinal fluid (CSF), and connects the third ventricle to the fouh ventricle, located dorsal to the pons and ventral to the cerebellum Ref: guyton and hall textbook of medical physiology 12 edition page number: 841,842,843


Question: Auditory processing of spoken language is done by

Ans. (b) Temporal lobe(Ref: Ganong, 25th ed/p.291)Part of the temporal lobe concerned with auditory processing of spoken language is called Planum temporale. It is larger in left hemisphere


Question: Lower esophageal sphincter

Lower esophageal sphincter (LES) The resting pressure is about 20 mm Hg. Basal tone regulated by both intrinsic and extrinsic nerves, and hormones. A significant fraction of this basal tone is mediated by vagal cholinergic fibers (contraction of LES). Hence, options A & B are not correct. Stimulation of sympathetic nerves to the sphincter causes the LES to contract. Relaxation LES occurs in response to primary peristalsis in the esophagus is mediated by VIP and NO. Contraction of the diaphragm or increased intra-abdominal pressure will increase the pressure in LES. Option C is not correct.

Has a tone which is provided by the sympathetic system

Relaxes on increasing abdominal pressure


Question: Starling's law of the heart

Explains the increase in cardiac output that occurs when venous return is increased

Explains the increase in cardiac output when the sympathetic nerves supplying the heart stimulated


Question: The duration of atrial systole is

The duration of each of the hea sounds is slightly more than 0.10 second, with the first sound about 0.14 second and the second about 0.11 second. Ref: Guyton and Hall textbook of medical physiology 13th edition. Page: 119


Question: Prothrombin time is useful for

For evaluation in a patient taking anticoagulant drugs


Question: Ventilation perfusion ratio is maximum at

Ventilation perfusion ratio is maximum at the apex of the lung Ref: guyton and hall textbook of medical physiology 12 edition page number: 332,333,334


Question: Area number for Motor area include

4 & 6 {Description: Bradman's areas of Cerebral cortex)


Question: The anterior pituitary is mainly composed of the following secretory cells

Hormone - secreting cells of the human anterior pituitary gland. Cell Type hormones Secreted percentage of Total secretory Cells Somatotrope Growth hormone 50 Lactotrope Prolactin 10-30 Coicotrope ACTH 10 Thyrotrope TSH 5 Gonadotrope FSH, LH 20 ACTH, adrenocoicotropic hormone; FSH, follicle-stimulating hormone; LH, luteinizing hormone; TSH, thyroid-stimulating hormone.


Question: Pain and temperature in the thalamus is controlled by the nucleus

Ventroposterior medial nuclei receive trigeminothalamic afferents and relay to postcentral gyrus.
Ventroposterior lateral nuclei receive spinothalamic (Pain and temperature) and medial lemniscus afferents and relays to the cerebral cortex.


Question: Mitral and periglomerular cells are seen in

Ans. (b) Olfactory bulb(Ref: Ganong, 25th ed/p.217)Olfactory bulb has got special synaptic units called olfactory glomeruli where four types of cells are seen namely,#Mitral cells#Tufted cells#Granule cells#Periglomerular cells


Question: Thrombosthenin is a

Thrombasthenin, platelet contractile proteins contract and help in clot retraction 48 hours after injury. The contractile protein of platelets is, responsible for clot retraction, platelet aggregation, and release of ADP and other biologic amines essential to platelet function.

A protein regulating platelet production


Question: Inner hair cells depolarise due to

K+ channals on stereocilia are linked by elastic filaments Displacement of cilia opens or closes potassium channals K+entry causes depolarization and causes voltage gated calcium channels to open Clacium triggers release of neurotransmitters Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:722,723,724


Question: Thyroid hormone acts through receptors present on

Thyroid hormoneEither of two hormones, thyroxine (T4) or triiodothyronine (T3, secreted by the follicles of the thyroid gland. They act on receptors in tissues throughout the body to increase the production of cellular proteins, the metabolic rate, and the activities of the sympathetic nervous system.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 341


Question: GFR increases ifa) Efferent arteriole constrictsb) Efferent arteriole dilatesc) Afferent arteriole constrictsd) Afferent arteriole dilates

Increase in glomerular hydrostatic pressure increases the filtration, whereas decrease in glomerular osmotic pressure or increase in bowman’s capsule hydrostatic pressure decreases the filtration.

Similarly, when afferent arterioles constrict, there is less flow to the glomerulus and less glomerular hydrostatic pressure, consequently less filtration. Whereas, when efferent arterioles constrict, there is increased hydrostatic pressure in the glomerulus resulting in increased filtration.


Question: 2nd Most Common Hb in adult is

a 2 ss 2 is the most abundant Hb in adult About 2.5% of the hemoglobin is hemoglobin A2, in which b chains are replaced by d chains (a2d2) which is second most abundant Hb in adult humanRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 522


Question: In circulatory system, the highest velocity of blood flow is in the

In circulatory system, the highest velocity of blood flow is in the aoa. The velocity of blood flow is inversely propoional to vascular cross-sectional area. v=Velocity F= Blood flow through the area A= Vascular cross sectional area Aoa has the least cross sectional area (4.5 cm2) and capillaries have the maximum cross sectional area (4500 cm2). Thus, under resting conditions, the velocity is highest in aoa and least in capillaries. Ref: Guyton and Hall 13th edition Pgno: 169-170


Question: First change observed in distal part, of a cut nerve is

Ans. (a) Axonal degeneration(Ref: Ganong, 25th ed/p.89)Axonal degeneration is the earliest to occur followed by degeneration of myelin sheathMacrophages and Schwann cell clear the debris following degenerationThe neurolemma of the nerve fiber doesn't degenerate and remains as a hollow tube


Question: Oxygen affinity decreases in

Factors that shift O2- Hb dissociation curve to right - ie. Decrease O2 affinity with Hb: |ed in H+ cone. (|pH, Bohr effect) |ed CO2 (|O2, Hypoxic condition) |ed in temperature. |ed DPG. Factors that shi O2-Hb dissocia on curve to the left side ie. increase the O2 affinity with Hb Just reverse of the right shift |in temperature (Hypothermia) |in pH (7.6) | HbF (fetal Hb) CO poisoning


Question: Maximum voluntary ventilation is

The maximal voluntary ventilation (MVV) is the largest volume of gas that can be moved into and out of the lungs in 1 min by voluntary effo. The normal MVV is 125 to 170 L/min.Ref: Ganong review of medical physiology 23rd edition Page no: 593


Question: In cases of hypercapnia there is


Question: Appreciation of shape and size of an object placed in hand is lost in the lesion of

Stereognosis is the perception of the form and nature of an object without looking at it. Normal persons can readily identify objects such as keys and coins of various denominations. This ability depends on relatively intact touch and pressure sensation and is compromised when the dorsal columns are damaged.Within the dorsal columns, fibers arising from different levels of the cord are somatotopically organized. Specifically, fibers from the sacral cord are positioned most medially and those from the cervical cord are positioned most laterally. This arrangement continues in the medulla with lower body (eg, foot) representation in the gracilus nucleus and upper body (eg, finger) representation in cuneate nucleus.


Question: In echocardiography pulses of of ultrasonic waves are admitted at a frequency of

In echocardiography pulses of ultrasonic waves at a frequency of 2.25 megahez are admitted from a transducer that also functions as a receiver as a receiver to detect waves reflected back from various pas of the hea. Ref:page no 347 Textbook of physiology Volume 1 AK Jain 7th edition


Question: Surfactant production is accelerated by

Ans. (b) Glucocorticoids(Ref: Ganong, 25th ed/p.631)Surfactant Production is Accelerated by:GlucocorticoidsThyroid hormonesThyrotropin releasing hormone (TRH)ProlactinEpidermal growth factor (EGF)Cyclic adenosine monophosphate (cAMP)


Question: 'Swinging flashlight' test can be helpful to elicit

The relative afferent pupillary defect(RAPD) - Marcus Gunn pupil- can be elicited with the swinging flashlight test.


Question: Myelin is stained by

Bielschowsky staining is done for the detection of myelin. The Bielschowsky technique is a silver staining method used in histochemistry for the visualization of nerve fibers, including multipolar interneurons in the cerebellum. Ref ganong's review of medical physiology 25e


Question: Testosterone production is mainly contributed by

Testosterone- the principal male sex hormone (androgen) that is produced by Leydig&;s cells of the testes in response to luteinizing hormone secreted by the pituitary gland. It is also produced by the adrenal coex in both males and females. Its chief function is to stimulate the development of the male reproductive organs, including the prostate, and the secondary sex characters, such as the beard. It encourages growth of bone and muscle and helps maintain muscle strength.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-423


Question: SA node acts as a pacemaker of the heart because of the fact that it

SA node acts as the pacemaker of heart because the impulses generated here is having the fastest rate.

Is capable of generating impulses spontaneously


Question: Visceral pain

In addition to being poorly localized, unpleasant, and associated with nausea and autonomic symptoms, visceral pain often radiates or is referred to other areas.

is mediated by B fibers in the dorsal roots of the spinal nerves.

resembles "fast pain" produced by noxious stimulation of theskin.


Question: In a DNA molecule adenine always forms a linkage with


Question: If one of your nerves is compressed and this leads to paraesthesia for some time, the type of nerve fiber affected is probable

The velocity of conduction through a nerve fiber is directly proportional to the thickness of the axon.
Thickest and fastest is A fibers. Among A fibers, the thickest is Aα. Hence the maximum affected by pressure will be Aα.


Question: Massage and the application of liniments to painful areas in the body relieves pain due to

Massage and liniments application causes a tactile stimulus which is transmitted by Aβ fibers which are large myelinated fibers. This causes stimulation of enkephalinergic inhibitory interneurons through the collaterals, thus inhibiting the pain sensation through the spinothalamic tract.

Stimulation of endogenous analgesic system

Release of endorphins by the first order neurons in the brain stem

Release of glutamate and substance P in the spinal cord

Inhibition by large myelinated afferent fibres


Question: Sympathetic postganglionic neurotransmitter in sweat gland

sympathetic postganglionic neurotransmitter in sweat glands is Ach Ref: Ganong's review of medical physiology, 23rd edition Page no:134


Question: The important feature of 2,3 disphosphoglycerate includes

Associated with foetal blood to promote oxygenation


Question: Associative learning

In associative learning, the organism learns about the relation of one stimulus to another.Ref: Ganong&;s review of medical physiology; 23rd edition; pg:290.


Question: From the left ventricular pressure volume loop calculate Ejection fraction

Ejection fraction = Stroke volume / End diastolic volume = (130-60) /13 =0.538 =53.8%


Question: The longest transit time in GIT is seen in

The longest transit time is seen in the colon. Average Transmit Time Segment Transit time Esophagus 2-3 seconds Stomach 2-5 hours Small intestine 3-6 hours Caecum 4 hours First third of colon 6 hours Second third of colon 9 hours Sigmoid colon 12 hours Ref: Ganong&;s Review of medical physiology 26th edition pgno: 493-494


Question: In low blood pressure, the kidney secretes

(Renin): Ref: 245-SL, 245-G (670- Ganong 23rd)RENIN: - is a glycoprotein hormone secreted by the granular cells (Juxtaglomerular cells) of juxtaglomerular apparatusSecretion of renin is stimulated by four factors1. Fall in arterial blood pressure2. Reduction in the volume of extracellular fluid3. Increased sympathetic activity4. Decreased load of sodium and chloride in macula densaVasopressin (ADH) secreted by mainly by (supraoptic nucleus of hypothalamusVasoprossin secretion increasedVesopressin secretion decreased* Increased effective osmotic pressure of plasma* Decreased extracellular fluid volume* Pain, emotion, stress exercise* Nausea and vomiting* Standing* Clofibrale, carbamazepine* Angiotensin II* Decreased effective osmotic pressure of plasma* Increased extracellular fluid volume* Alcohol


Question: Transducin is a protein found in

Transducin (Gt) is a protein naturally expressed in veebrate retina rods and cones and it is very impoant in veebrate phototransduction. It is a type of heterotrimeric G-protein with different a subunits in rod and cone photoreceptors. Light leads to conformational changes in rhodopsin, which in turn leads to the activation of transducin. Transducin activates phosphodiesterase, which results in the breakdown of cGMP. The intensity of the flash response is directly propoional to the number of transducin activated. Ref: guyton and hall textbook of medical physiology 12 edition page number: 742,743,744


Question: Role of growth hormone in spermatogenesis

Growth hormone (as well as most of the other body hormones) is necessary for controlling background metabolic functions of the testes. Growth hormone specifically promotes early division of the spermatogonia themselves; in its absence, as in pituitary dwarfs, spermatogenesis is severely deficient or absent, thus causing infeility.


Question: Antegrade peristalsis is due to

* Peristalsis can be defined as a motor pattern of the gut organ musculature that can propel content into the anal (antegrade peristalsis) or oral (retrograde peristalsis) direction * Impulses travelling orad activate ascending contraction * Neurotransmitters here are acetylcholine, substance P, and neurokinin A. * Impulses travelling caudad activate descending relaxation * Neurotransmitters here are VIP, NO, and PACAP (pituitary adenylyl cyclase activating polypeptide). Ref:- Physiology of the Gastrointestinal Tract Sixth Edition; pg num:- 368


Question: Brain perfusion means

MAP is the average blood pressure during one cardiac cycle and can be directly measured through invasive hemodynamic monitoring or can be calculated as the systolic blood pressure, plus two times the diastolic blood pressure, divided by three. The normal range of MAP is 70 to 100 mm Hg. Ref: guyton and hall textbook of medical physiology 12 edition page number:813,814,815

Mean aerial pressure - Intracranial pressure

Mean aerial pressure + Intracranial pressure


Question: Within the endocrine system, specificity of communication is determined by

Hormones produce their effects on target cells by interacting with specific receptors. Hormone binding to its receptor generally initiates a cascade of events that lead to biological effects in the target cells.

The distance between the endocrine cell and its target cell(s)

The presence of specific receptors on target cells

Anatomical connections between the endocrine and target cells


Question: Growth is not modified by


Question: Lifespan of platelets and neutrophils is respectively

Erythrocytes 120 days
Platelets 8-9 days
Neutrophils 5 days


Question: Episodic hypeension is a feature of

Classic triad: Headache + Diaphoresis+ Palpitation


Question: Number of neurons in enteric nervous system

The ENS consists of some 100 million neurons, one-thousandth of the number of neurons in the brain, and about one-tenth the number of neurons in the spinal cord. The enteric nervous system is embedded in the lining of the gastrointestinal system. Ref: guyton and hall textbook of medical physiology 12 edition page number:442,443,444


Question: Decreased basal metabolic rate is seen in

The remaining options utilise energy. Basal metabolic rate and obesity The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals. It is influenced by several factors. BMR typically declines by 1-2% per decade after age 20, mostly due to loss of fat-free mass, although the variability between individuals is high. Ref guyton and hall textbook of medical physiology 12/e pg843


Question: Ist urge of micturition comes at

When 100-150 millilitres (3.5-5 ounces) of urine accumulate, the first sensations of a need to void are felt. The feeling increases in intensity as more urine accumulates, and it becomes uncomfoable at a bladder volume of 350-400 millilitres. Impulses from the pelvic nerves mediate the sensations of bladder filling, painful distension, and the conscious need to urinate. Ref: guyton and hall textbook of medical physiology 12 edition page number:519,520,521


Question: Lowest recurrence rate in duodenal ulcer treatment is seen with

For the management of PUD,vagotomy is sometimes combined with antrectomy (removal of the distal half of the stomach) to reduce the rate of recurrence. Reconstruction is performed with gastroduodenostomy (Billroth I) or gastrojejunostomy (Billroth II). Ref surgery Srb p1178


Question: Thrombopoietin is produced by


Question: Elasticity of the corneal layer of skin is due to the presence of

B i.e. Keratin The elasticity, stability and integrity of stratum corneum of skin is due to disulfide cross linkages between the keratin moleculesQIn the stratum corneum layer, keratohyaline granules are present. These granules form protein profilaggrin, which is degraded into filaggrin (filament aggregating protein), as granular cells transform to keratinized corneum cells. Filaggrin is a hyaline rich protein which functions as interfilamentous glue to aggregate and align the keratin filaments in keratinized cells. Keratohyaline also contain cysteine rich proteins, whose disulfide bonds contribute to the chemical ineness and strengh of the keratinized layer.


Question: Most accurate measurement of extracellular fluid volume (ECF) can be done by using

Ans. (c) Inulin(Ref: Guyton, 13th ed/p.309)Inulin - Gold standard substance for ECF measurementOther indicators used in ECF measurement are,#Sucrose#Mannitol#Sodium Thiosulphate


Question: Receptors for thyroid hormone are located in

Ans. b (Nucleus). (Ref. Ganong Physiology 22nd/pg. Chapter 1 and Figure 1-35)Thyroid hormones enter cells, and T3 binds to thyroid receptors (TR) in the nuclei. T4 can also bind, but not as avidly. The hormone-receptor complex then binds to DNA via zinc fingers and increases or in some cases decreases the expression of a variety of different genes that code for enzymes which regulate cell function. Thus, the nuclear receptors for thyroid hormones are members of the superfamily of hormone-sensitive nuclear transcription factors.There are two human TR genes: an a receptor gene on chromosome 17 and a b receptor gene on chromosome 3. By alternative splicing, each forms at least two different mRNAs and therefore two different receptor proteins. TRb2 is found only in the brain, but TRal, TRa2, and TRbl are widely distributed. TRs bind to DNA as monomers, homodimers, and heterodimers with other nuclear receptors, particularly the retinoid X receptor (RXR).MECHANISM OF ACTION OF STEROID AND THYROID HORMONESTypeCharacteristic HormonesDisease states due to impairment of receptor functionIntracellular ReceptorsTranscription regulatory proteinsGlucocorticoids, mineralocorticoids, estradiol, androgens, progesterone, triiodothyronine, 1,25-dihydroxy vitamin D, retinoic acidTesticular feminization and other androgen resistance syndromes; cortisol resistance; vitamin D-dependent rickets type II; thyroid hormone resistance; estrogen resistanceMembrane receptorsSeven transmembrane domain receptorsLH, TSH, parathyroid hormone, epinephrine, somatostatin, vasopressin,glucagon, angiotensin II, FSH, prostaglandins, serotoninPseudohypoparathyroidism, nephrogenic diabetes insipidus, malepseudohermaphroditism due to mutations of the LH receptor, Jansen's metaphyseal chondrodysplasiaProtein tyrosine kinasesInsulin, insulin-like growth factor- 1, platelet derived growth factor, epidermal growth factor, fibroblast growth factorDiabetes mellitus with profound insulin resistanceGuanylate cyclaseGrowth hormone, prolactin, cytokines, nerve growth factorLaron dwarfismGrowth hormone prolactin familyAtrial natriuretic peptide Also Know:The differentiation of adipocytes requires the action of a nuclear receptor protein--in the same family as the receptors for thyroid hormone, vitamin A, and vitamin D--known as PPAR# Nuclei:# Microtubules:# Active zones:# Clear vesicles:# Granulated vesicles:Contain steroid receptorsAssociated with kinesinContain syntaxinContain acetylcholineContain catecholamines


Question: Myelin sheath in CNS is produced by

Oligodendrocytes and Schwann cells are involved in myelin formation around axons in the CNS and peripheral nervous system respectively. Ref: Ganong&;s review of medical physiology; 23rd edition; pg: 80.


Question: The usual voltage of alpha rhythm is

Alpha waves are neural oscillations in the frequency range of 8-12 Hz arising from the synchronous and coherent (in phase or constructive) electrical activity of thalamic pacemaker cells in humans. Ref: guyton and hall textbook of medical physiology 12 edition page number: 818,819,820


Question: Biological clock of brain is located in

Ans. is 'c' i.e., Suprachiasmatic nucleus


Question: The frequency of beta waves (per sec) in EEG is


Question: ‘A’ wave in Electro Retinogram corresponds to the activity

The electroretinogram (ERG) is a diagnostic test that measures the electrical activity generated by neural and non-neuronal cells in the retina in response to a light stimulus. The electrical response is a result of a retinal potential generated by light-induced changes in the flux of trans retinal ions, primarily sodium and potassium.
A-wave: initial corneal-negative deflection, derived from the cones and rods of the outer photoreceptor layers.
This wave reflects the hyperpolarization of the photoreceptors due to the closure of sodium ion channels in the outer segment membrane. Absorption of light triggers the rhodopsin to activate transducin, a G-protein. This leads to the activation of cyclic guanosine monophosphate phosphodiesterase (cGMP PDE) eventually leading to a reduction in the level of cGMP within the photoreceptor. This leads to closure of the sodium ion channels resulting in a decrease of inwardly directed sodium ions, or a hyperpolarization of the cell. The a-wave amplitude is measured from the baseline to the trough of the A-wave.


Question: Testosterone is produced in Leydig cells in fetus due to

Testosterone is the principal male sex hormone (androgen) that is produced by Leydig&;s cells of the testes in response to luteinizing hormone secreted by the pituitary gland. It is also produced by the adrenal coex in both males and females. Its chief function is to stimulate the development of the male reproductive organs, including the prostate, and the secondary sexcharacters, such as the beard. It encourages growth of bone and muscle and helps maintain muscle strength.Ref: Ganong&;s review of medical physiology;24th edition; page no:-423


Question: The volume in lungs at the time of full relaxation of lungs is

Functional residual capacity: Amount of air remaining in the lungs after a normal tidal expiration (RV + ERV). Around 2400 mlRef: Ganong review of medical physiology 23rd edition Page no: 593


Question: Sleep waves in the hippocampal area are

Sleep waves and brain areas
-        Alpha rhythm- Parietal and occipital lobe
-        Beta rhythm- Frontal lobe
-        Theta rhythm- Hippocampus (Mammals other than human), Cortex (Human)


Question: ECF volume assessment can be done most accurately by

Indicators used for fluid volumes
1.       Total body water (TBW)- Deuterium Oxide D2O, Tritium oxide, Aminopyrine, Antipyrine
2.       ECF- Inulin, Sucrose, Mannitol, Sodium thiosulphate, Na22
3.       Plasma volume- Evan’s blue, radioactive iodine labelled serum albumin (I125)

4.       Blood cell volume- Cr51 labelled RBC
The most accurate indicator for ECF volume assessment is Inulin.


Question: Weight of 1 cc of air at normal pressure and temperature

Ans: a (0.001297g)Weight of 1 cc of air at normal temperature and pressure is 0.001297g


Question: Resting membrane potential of a neuron is

In neurons, the resting membrane potential is usually about - 70mV, which is close to the equilibrium potential for K+. Because there are more open K+channels than Na+ channels at rest Ref: Ganong&;s Review of medical physiology;25th edition; pg: 90


Question: Nucleus of basal ganglia

Ans. (c) Caudate(Ref: Ganong, 25th ed/p.243)Basal ganglia nuclei are,#Caudate and Putamen#Globus pallidus#Substantia nigra#Subthalamic nucleus


Question: Oxyhemoglobin dissociation curve is shifted to left in

When blood becomes slightly acidic wit PH decreasing from normal value of 7.4 to 7.2, the O2 - Hb curve shifts on an average about 15% to right. A shift in O2-Hb curve to right occurs in response to increased blood CO2 and hydrogen ions. Decreased blood temperature shifts the curve to left In normal BPG in blood shifts curve slightly to right all the time. In hypoxic condition, the level of BPG increases and shifts curve to right even faher.Ref: Textbook of medical physiology by Guyton and Hall,2nd South Asia Edition, page no.373,374


Question: Carbon monoxide effect on O2 dissociation curve is

Carbon monoxide (CO) combines with hemoglobin at the same point on the hemoglobin molecule as does O2; it can, therefore, displace O2 from the hemoglobin, thereby decreasing the O2-carrying capacity of blood. Fuher, it binds with about 250 times as much tenacity as O2.The presence of HbF and carbon monoxide (CO) shift the curve to the left, increasing the oxygen affinity of hemoglobin.Ref: Guyton; 13th edition; Chapter 41; Transpo of Oxygen and Carbon Dioxide in Blood and Tissue Fluids


Question: Initiation of impulse starts in

(B) Axon hillock + initial segment # Neuron:- Neuron generally have four important zones:> There is a Receptor, or Dendritic zone, where multiple local potential changes generated by synaptic connections are integrated (i.e. Non conducted local potentials are integrated in the receptor zone)> A site where propagated action potential are generated (initial segment in spinal motor neurons, the initial node of Ranvier in cutaneous sensory neurons)> An axonal process that transmits propagated impulses to the nerve endings and (iv) The nerve endings, where action potential cause the release of synaptic transmitters# Nissl bodies (granules): -- are small basophilic granules, membranous organelles containing ribosomes; present through out the cell body (soma, or perikaryon) except in axon hillock (from where axon arises); flow into the dendrites but not into axon; they are stained with basic dyes (E.g.. Methylene blue, thioneine or cresyl violet)> During fatigue or injury of neuron, these bodies fragment and disappear by a process called chromatolysis; within 48 hours of section of the nerve the Nissl substance begins to disintegrate into a fine duct - chromatolysis).


Question: Relaxation of mesangial cells is responsible for

Mesangial cells are specialized cells around blood vessels in the kidneys, at the mesangium. They are specialized smooth muscle cells that function to regulate blood flow through the capillaries,Ref: Ganong&;s review of medical physiology; 24th edition; page no: 673


Question: Vital capacity is sum of

Ans. a (Inspiratory reserve volume, Tidal volume and expiratory reserve volume) (Ref Ganong 23rd/593)Ganong 23rd/Fig. 35-7:# VC = 4700 ml = ERV + TV + IRVRespiratory volumes and capacities for an average young male.MeasurementTypicalDefinitionRespiratory volumes1Tidal volume (TV)500 mlAmount of air inhaled or exhaled in one breath during relaxed quiet breathing2Inspiratory reserve volume (IRV)3000 mlAmount of air in excess of tidal inspiration that can be inhaled with maximum effort3Expiratory reserve volume (ERV)1200 mlAmount of air in excess of tidal expiration that can be exhaled with maximum effort4Residual volume (RV)1200 mlAmount of air remaining in the lungs after maximum expiration; keeps alveoli inflated between breaths and mixes with fresh air on next inspirationRespiratory Capacities5Vital capacity (VC)4700 mlAmount of air that can be exhaled with maximum effort after maximum inspiration (ERV + TV + IRV); used to assess strength of thracic muscles as well as pulmonary function6Inspiratory capacity (1C)3500 mlMaximum amount of air that can be inhaled after a normal tidal expiration (TV + IRV)7Functional residual capacity (FRC) 2400 mlAmount of air remaining in the lungs after a normal tidal expiration (RV + ERV)8Total lung capacity (TLC)5900 mlMaximum amount of air the lungs can contain (RV + VC)Additional Educational points# In a healthy normal adult male, FVC is approximately 5.0 L, FEV, is approximately 4.0 L, and thus, the calculated FEV1/ FVC is 80%.# Obstructive disorders result in a marked decrease in both FVC and FEV1/FVC, whereas restrictive disorders result in a loss of FVC without loss in FEV1/FVC.# FEV1/FVC for obstructive (42%) versus restrictive (90%) patients defines the hallmark measurements in evaluating these two diseases.

Inspiratory reserve volume, Tidal volume and Expiratory reserve volume

Tidal volume, Inspiratory reserve volume and Residual volume

Expiratory reserve volume, Inspiratory reserve volume and Residual volume.

Residual volume, Inspiratory volume, and Expiratory reserve volume.


Question: Respiratory minute volume of lung is

Respiratory minute volume of the lung is 6 litres Ref: guyton and hall textbook of medical physiology 12 edition page number:324,325,326


Question: A marker of Golgi apparatus is

Golgi apparatus is a collection of membrane-enclosed sacs. They are directed at proper glycosylation of proteins and lipids. (REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY 24 EDITION, PAGE NO - 46)


Question: Sour taste is mediated by

Salt ⇒ mediated by Na+ selective channel (ENaC)
Sour ⇒ mediated by H+ ions permeable to ENaCs
Bitter, sweet, umami ⇒ mediated by G-protein coupled receptors


Question: Inhibition of myenteric plexus results in

Two major networks of nerve fibers are intrinsic to the gastrointestinal tract: the myenteric plexus (Auerbach's plexus), between the outer longitudinal and middle circular muscle layers, and the submucous plexus (Meissner's plexus), between the middle circular layer and the mucosa. Collectively, these neurons constitute the enteric nervous system. The myenteric plexus innervates the longitudinal and circular smooth muscle layers and is concerned primarily with motor control, whereas the submucous plexus innervates the glandular epithelium, intestinal endocrine cells, and submucosal blood vessels and is primarily involved in the control of intestinal secretion.REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, KIM BARRETT, SCOTT BOITANO, HEDDWEN BROOKS, SUSAN BARMANTWENTY THIRD EDITIONPAGE NO:448


Question: Following change is noted during exercise

During strenuous exercise, the body&;s heat production may exceed 1000 W. Some of the heat produced is stored, raising body core temperature by a few degrees. Rises in body temperature are sensed by central and skin thermoreceptors and this sensory information are processed by the hypothalamus to trigger appropriate effector responses. Other sensory inputs from baroreceptors and osmoreceptors can modify these responses.

Blood flow to brain increases with increase in mean systolic blood pressure

Blood flow to muscles increase after half a minute


Question: Best denotes airway resistance

The maximal expiratory flow at 50 % of the forced vital capacity (MEF50) is the flow where half of forced vital capacity (FVC) remains to be exhaled . It corresponds to the forced expiratory flow at 50 % (FEF50) and correlates highly with the maximum mid-expiratory flow (FEF25-75 %) Ref: guyton and hall textbook of medical physiology 12 edition page number:326,327,328


Question: Pulmonary vasoconstriction is caused by

Prostacyclin, alpha 2 stimulation, and Histamine are potent vasodilators.Ref: Ganong review of medical physiology 23rd edition Page no: 563


Question: Flocculo nodular lobe has direct connection with

Flocculonodular lobe is also called as vestibulocerebellum. Fibers doesn’t have to project to deep nuclei from here. The efferents from this lobe are sent directly to the vestibular nuclei in the brain stem.


Question: Cushing phenomenon is

Cushing reflex (also referred to as the vasopressor response, the Cushing effect, the Cushing reaction, the Cushing phenomenon, the Cushing response, or Cushing's Law) is a physiological nervous system response to increased intracranial pressure (ICP) that results in Cushing's triad of increased blood pressure Ref: guyton and hall textbook of medical physiology 12 edition


Question: Reason for hyperosmolarity is

Hyperosmolarity in the interstitium of kidney is due to activity of na+k+2cl- pump at the ascending limb of loop of henle Ref:Guyton and Hall textbook of medical physiology 12th edition,page:480,481,482

Increased activity of Na+ K+ 2cl- ATPase in loop

Decreased activity of Na+ K+ ATPase in loop


Question:
The regeneration of nerve fibres is possible in the
peripheral nervous system than the central nervous system because

Presence of neurilemmal sheath in peripheral nerve

Presence of neurilemmal sheath in central nervous system

The absence of myelin sheath in the central nervous system


Question: Beta HCG is secreted by

In molecular biology, human chorionic gonadotropin (hCG) is a hormone produced by the syncytiotrophoblast, a component of the feilized egg, after conception. Following implantation, the syncytiotrophoblast gives rise to the placenta.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-414


Question: Food in stomach


Question: Neocerebellum is concerned with

. Neocerebellum comprises of remaining pas of the posterior cerebellum viz., the declive, tuber and the lateral ansiform and paramedian lobules. The neocerebellum receives information from the cerebral coex and pons. It occupies the more lateral regions of the cerebellar coex. It is concerned with skilled voluntary movements. Ref: guyton and hall textbook of medical physiology 12 edition page number: 780,781,782


Question: Source of calcium for smooth muscle contraction

Ca2+ plays a prominent role in the initiation of contraction of smooth muscle. Depending on the activating stimulus, Ca2+increase can be due to influx through voltage- or ligand-gated plasma membrane channels, efflux from intracellular stores through the RyR, efflux from intracellular stores through the inositol trisphosphate receptor (IP3R) Ca2+channel, or a combination of these channels.

Influx into intracellular store through IP3 receptor Ca2+ channel

Efflux through voltage - gated Ca2+ channel

Efflux through ligand - gated Ca2+ channel

Combination of influx of Ca2+ through voltage - gated, ligand gated Ca2+channel


Question: Glucose transpo occur with the help of following ion in absorption in gut region

Glucose is absorbed into the epithelial cells lining the mucous membrane of the small intestine from their brush border surface by an active transpo mechanism Sodium co-transpo mechanism. Binding of glucose & Na+ to carrier protein: The carrier protein in cell membrane has 2 binding sites, one for sodium & another for glucose.It is called sodium-dependent glucose transpoer-I. The conformational change in the carrier protein occurs only when the binding sites are occupied by the sodium & glucose present in the gut lumen forming the sodium- glucose - carrier complex. Ref: Medical Physiology, Indu Khurana


Question: Epicritic perception of pain occurs at the level of


Question: Refractory period is minimum for


Question: The primary respiratory regulatory centre is located at

The respiratory centers are located in the medulla oblongata and pons, which are pas of the brainstem. The respiratory centers are divided into four major groups, two groups in the medulla and two in the pons. The two groups in the medulla are the dorsal respiratory group and the ventral respiratory group. The two groups in the pons are the pneumotaxic center also known as the pontine respiratory group, and the apneustic center. The Inspiratory center (Dorsal respiratory group) -Location: Dorsal poion of medulla -Nucleus: Nucleus tractus solitarius. Ref: guyton and hall textbook of medical physiology 12 edition page number:370,371,372


Question: Endolymph in ear equivalent to

The inner ear (labyrinth) is made up of two pas, one within the other. The bony labyrinth is a series of channels in the Petros poion of the temporal bone. Inside these channels, surrounded by a fluid called perilymph, is the membranous labyrinth. This membranous structure more or less duplicates the shape of the bony channels. It is filled with a K+rich fluid called endolymph, and there is no communication between the spaces filled with endolymph and those filled with perilymph.Reference: Ganong review of medical physiology 23rd edition Page no; 205


Question: Decompression sickness is seen ina) Diverb)  Pilotc)  Mountaineerd)  Long distance drivers

Sudden decrease in atmospheric pressure results in gas embolism. This is seen in sudden ascent in aircraft, sudden ascent from deep sea etc. This is known as Caisson’s disease or decompression sickness.


Question: Drinking can be induced by

(B) Osmotic stimulation of supraoptic nucleus

Electrical stimulation of the posterior hypothalamus


Question: Estrogen is secreted during pregnancy, mostly by

Estrogens, in females, are produced primarily by the ovaries, and during pregnancy, the placenta. Follicle-stimulating hormone (FSH) stimulates the ovarian production of estrogens by the granulosa cells of the ovarian follicles and corpora lutea. Some estrogens are also produced in smaller amounts by other tissues such as the liver, adrenal glands, and the breasts. These secondary sources of estrogens are especially impoant in postmenopausal women. Ref: Ganong&;s review of medical physiology; 24th edition; page no:-365


Question: Serious complication of prolonged sitting posture

There is mounting evidence that prolonged cramped sitting in connection with long lasting air travel increases risk to DVT of the leg which prolongs to pulmonary embolism Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:236,237


Question: If the plasma concentration of a freely filterable substance is 2 mg/mL, GFR is 100 mL/min, urine concentration of the substance is 10 mg/mL, and urine flow rate is 5 mL/min, we can conclude that the kidney tubules

Reabsorbed 150 mg/minThe filtered load of the substance is P x GFR = 2 mg/mL x 100 mL/min = 200 mg/min. The rate of excretion is UxV=10 mg/mL x5 mL/min = 50 mg/min. Hence, more substance X was filtered than was excreted, and the difference, 200 mg/min - 50 mg/min = 150 mg/min, gives the rate of tubular reabsorption of substance X.(Note : amount or quantity = volume x concentration)Ref: Ganong - Review of Medical Physiology 23rd Ed Page 888


Question: A man cannot digest carbohydrate. The enzyme deficient is

Amylase: The Impoance of Carbohydrates Carbohydrates are one of the three major food groups needed for proper nutrition. Amylase is the digestive enzyme needed to digest carbohydrates.50-60% of carbohydrates are digested by amylases. Ref: guyton and hall textbook of medical physiology 12 edition page number:426,427,428


Question: Destruction of zona glomerulosa will deplete

The zona glomerulosa makes up 15% of the mass of the adrenal gland; the zona fasciculata, 50%; .and the zona reticularis, 7%. All three coical zones secrete coicosterone, but the active enzymatic mechanism for aldosterone biosynthesis is limited to the zona glomerulosa, whereas the enzymatic mechanisms for forming coisol and sex hormones are found in the two inner zones. Fuhermore, subspecialization occurs within the inner two zones, the zona fasciculata, secreting mostly glucocoicoids and the zona reticularis, secreting mainly sex hormones. Ref: Ganong&;s review of medical physiology,23rd edition, page: 338


Question: Sympathetic stimulation causes

Sympathetic stimulation causes vasoconstriction in all blood vessels except those in skeletal muscles. And causes pupillary dilatation, bronchial smooth muscle dilation, relaxation of detrussor muscle of bladder Ref: Ganong&;s review of medical physiology; 23rd edition; pg:556

Vasoconstriction of skin and mucus membranes


Question: Massive splenomegaly is least likely to occur in

Thrombocytosis is defined as a platelet count greater than 400 x 109/L. ... The presence of chronic thrombocytosis, thrombohemorrhagic complications, microvascular symptoms, or splenomegaly ors the diagnosis of primary thrombocytosis. Spleenomegaly is least likely to occur. Ref ganong's review of medical physiology 25e


Question: Conversion of Prothrombin to thrombin requires

In the presence of tissue phospholipids (PL) and calcium ions, activated Factor X (Xa) combines with Factor Va to form prothrombin activator which initiates the conversion of prothrombin to thrombin.Factor V, X, and XII are activated and involved in other steps of intrinsic pathway.Ref: Ganong&;s review of medical physiology, 23rd edition, page: 533


Question: The percentage of body water is greater in

In a 70 kilogram adult man, the total body water is about 60 percent of the body weight, or about 42 liters. This percentage depends on age, gender, and degree of obesity. As a person grows older, the percentage of total body weight that is fluid gradually decreases. This decrease is due in part to the fact that aging is usually associated with an increased percentage of the body weight being fat, which decreases the percentage of water in the body.
Because women normally have a greater percentage of body fat compared with men, their total body water averages about 50 percent of the body weight. In premature and newborn babies, the total body water ranges from 70 to 75 percent of body weight. Therefore, when discussing “average” body fluid compartments, we should realize that variations exist, depending on age, gender, and percentage of body fat.
Reference: GUYTON AND HALL TEXTBOOK OF MEDICAL PHYSIOLOGY, THIRTEENTH EDITION(INTERNATIONAL EDITION ) page no 306


Question: During voiding (iv) pressure in bladder is

Voiding is the process of expelling fluids from the body in the urine.Ref: Ganong&;s review of medical physiology; 24th edition; page no; 694


Question: Most potent stimulus for bile secretion is

Bile is secreted in two stages by the liver: (1) The initial portion is secreted by the principal functional cells of the liver, the hepatocytes; this initial secretion contains large amounts of bile acids, cholesterol, and other organic con-stituents.  It is secreted into minute bile  canaliculi that originate between the hepatic cells. (2)  Next,  the  bile  flows in the canaliculi toward the interlobular  septa,  where  the  canaliculi  empty into terminal bile ducts and then into progressively larger ducts, finally reaching the hepatic duct and common bile duct.


Question: Exocytosis is by

Ans: d (Expulsion) Ref: Ganong 22nd ed/p. 28-30Exocvtosis:-Vesicles containing the material for export are targeted to the cell mem-brane, where they bond via the vsnare/ t-snare arrangement.The area of fusion then breaks down, leaving the contents of the vesicle outside and the cell membrane intact.This is a Ca2+ dependant process.Thus, there is a net increase in the surface area of the cell as the cytoplas-mic sides of two membranes fuse.Endocvtosis:-The process by which cells take up large molecules. In endocytosis, two non cytoplasmic sides of membranes fuse. Endocytotic vesicles are generated when segments of the plasma membrane invaginate, enclosing a minute volume of extracellular fluid and is contents. The vesicle then pinches off as the fusion of plasma membranes seal the neck of the vesicle at the original site of invagination.There are two general types of endocytosis:-a) Phagocytosisb) PinocytosisPhagocvtosis:-Involves ingestion of large particles such as viruses, bacteria, cells or debris.Occurs only in specialized cells such as macrophages and granulocytes.Pinocvtosis:-Property of all cellsIt is a cellular uptake of fluid and fluid contents.It is of two types:-Fluid phase pinocytosis is a non selective process in which the uptake of a solute is simply proportionate to its concentration in the surrounding extracellular fluid.Absoipti ve pinocytosis is a receptor mediated selective process primarily responsible for the uptake of mac- romolecules. The vesicles formed dur-ing absorptive pinocytosis are derived from invagination (pits) that are coated on the cytoplasmic side with a Filamentous material.In many systems, Clathrin is the filamentous material. For e.g., LDL is internalised by means of coated pits containing the LDL receptors.


Question: Histiocytic necrotizing lymphadenitis is

Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a benign and self-limited disease that mainly affects young women. Patients present with localized lymphadenopathy, fever, and leukopenia in up to half of the cases.


Question: Mass movements of the colon would be abolished by

Auerbach's plexus which is located between the inner circular and outer longitudinal muscle layer is the one which controls local GI motility Ref: Ganong 25th ed/page 497


Question: 'Heliotrope rash' over face is seen in

Dermatomyositis a. Heliotrope erythema and oedema of the periorbital skin are seen in dermatomyositis, b. Dermatomyositis is a well established cutaneous marker of interval malignancy. c. About 10% of all patients of dermatomyositis have an underlying malignancy. d. The most common malignancies associated with dermatomyositis are Lung, Ovary, breast, GIT and lymphoprol iterative disorders.


Question: Appreciation of shape and size of an object placed in the hand is lost in the lesion of

Ans. (b) Tractus cuneatus(Ref: Ganong, 25th ed/p.168)Appreciation of shape and size of an object placed in the hand is a function of Tractus cuneatus


Question: Gastric secretion of H+ ions

Gastric parietal cells are highly specialized for their unusual task of secreting concentrated acid. The cells are packed with mitochondria that supply energy to drive the apical H, K-ATPase, or proton pump, that moves H+ ions out of the parietal cell against a concentration gradient of more than is terminated after the meal moves from the stomach into the small intestine. Gastric parietal cells are highly specialized for their unusual task of secreting concentrated acid. The cells are packed with mitochondria that supply energy to drive the apical H, K-ATPase, or proton pump, that moves H+ ions out of the parietal cell against a concentration gradient of more than a million-fold. At rest, the proton pumps are sequestered within the parietal cell in a series of membrane compaments known as tubulovesicles. When the parietal cell begins to secrete, on the other hand, these vesicles fuse with invaginations of the apical membrane known as canaliculi, thereby substantially amplifying the apical membrane area and positioning the proton pumps to begin acid secretion. The apical membrane also contains potassium channels, which supply the K+ ions to be exchanged for H+, and Cl- channels that supply the counterion for HCl secretion. The secretion of protons is also accompanied by the release of equivalent numbers of bicarbonate ions into the bloodstream, are later used to neutralize gastric acidity once its function is complete.Reference: Ganong review of medical physiology 23rd edition Page no: 434

Is enhanced by carbonic anhydrase inhibitors


Question: White fibres are present in

Muscles that react rapidly are composed mainly of "fast" (Type 2, white Muscle) fibres with only small numbers of the slow variety.Conversely, muscles that respond slowly but with prolonged contraction are composed mainly of "slow" fibres (Type 1, Red Muscle).Fast fibres have fewer mitochondria than do slow fibres, also because oxidative metabolism is secondary. A deficit of red myoglobin in fast muscle gives it the name white muscle.Guyton 13e pg:83


Question: Pressure on carotid sinus cause

Ans. (b) Reflex bradycardiaRef: Ganong, 25th ed/p.590The definition of Baroreflex is - "Whenever blood pressure increases, baroreceptors increase their discharge and send their impulse to medulla which ultimately decreases the blood pressure and decreases heart rate (reflex bradycardia)"


Question: Sympathetic stimulation has following effect on insulin release

Sympathetic stimulation decreases the release of insulin Ref: guyton and hall textbook of medical physiology 12 edition page number:610,611,612


Question: Respiratory burst in neutrophils occurs due to

When the cell membrane-bound enzyme NADPH oxidase is activated, with the production of toxic oxygen metabolites. The combination of the toxic oxygen metabolites and the proteolytic enzymes from the granules makes the neutrophil a very effective killing machine. Activation of NADPH oxidase is associated with a sharp increase in O2 uptake and metabolism in the neutrophil (the respiratory burst) and generation of O2- by the following reaction: NADPH + H+ + 2O2+ - NADP+ + 2H++ 2O2- O2- is a free radical formed by the addition of one electron to O2.Ref: Ganong's Review of Medical Physiology Twenty-Third Edition Page no: 64


Question: Autoregulation means


Question: Apparent mineralocoicoid excess is d/t

D i.e. 11 13 hydroxysteroid dehydrogenase Apparent mineralocoicoid excess is d/t inhibition or absence of /V hydroxysteroid dehydrogenase type 2Q AME syndrome & 11 HSD type 2 Invitro (in lab), the mineralocoicoid receptor has much higher affinity for glucocoicoids than the glucocoicoid receptor does, & glucocoicoids are present in large amount in body (vivo). But binding of glucocoicoids to mineralocoicoid receptor (& so production of mineralcoicoid effects by glucocoicoids) is prevented by presence of 11 3 hydroxyl steroid dehydrogenase tye 2 enzyme in mineralocoicoid sensitive tissues. This enzyme leaves aldosterone untouched, but conves coisol to coisone & coicosterone to its 11 oxy derivatives. These 11 oxy derivatives do not bind to receptor. If 11 hydroxysteroid dehydrogenase type 2 is congenitally absent or inhibited by prolonged ingestion of licorice (containing glycyrrhetinic), coisol has marked mineralocoicoid effects resulting in apparent mineralocoicoid excess (AME syndrome. Patient with AME have clinical picture of hyper aldosteronism because coisol is acting on their mineralo coicoid receptors, & their plasma aldosterone levels and plasma rennin activity is low.


Question: Blood in the splanchnic area during exercise is decreased due to

During exercise, there is vasodilation in the skeletal muscles and myocardium, whereas in the splanchnic area, the sympathetic activity causes vasoconstriction. This results in diversion of more blood to the skeletal muscles and myocardium.

Venoconstriction with decreased blood flow


Question: Reflex responsible for tachycardia during right atrial distension is

Reflex resposible for tachycardia during right atrial distension is Bainbridge reflex. Atrial Reflex Control of hea rate: The Bainbridge Reflex The stretch recceptors of the atria that elicit the Bainbridge reflex transmit their afferent signals through the vagus nerve nerves to the medulla of the brain. Then efferent signals are transmitted back through vagal and sympathetic nerves to increase hea rate and strength of hea conntraction. Bezold-Jarisch Reflex: Activation of chemosensitive vagal C fibers in the cardiopulmonary region (eg,, Juxta capillary ragion of alveoli, ventricles, atria, great veins, and pulmonary aery) causes profound bradycardia, hypotension and a brief period of apnea followed by rapid shallow breathing. Cushing Reflex: When ICP is increased, the blood supply to RVLM neurons is compromised. The local hypoxia and hypercapnia causes an increase in discharge from the neurons, producing hypeension, bradycardia and irregular respiration. The resultant rise in systemic aerial pressure tends to restore the blood flow to the medulla. REF: Guyton and Hall 13th edition PGno: 223


Question: Relaxation of skeletal muscle occurs by

Once the calcium ions have been released from the sarcoplasmic tubules and have diffused among the myofibrils, muscle contraction continues as long as the calcium ion concentration remains high. However, a continually active calcium pump located in the walls of the sarcoplasmic reticulum pumps calcium ions away from the myofibrils back into the sarcoplasmic tubules. This pump can concentrate the calcium ions about 10,000-fold inside the tubules. In addition, inside the reticulum is a protein called calsequestrin that can bind up to 40 times more calcium. Ref: Guyton 13th ed, p 94

Removal of Acetylcholine from synaptic cleft

Closure of nicotinic cholinergic receptor


Question: Post prandial motility is maximum in

Post prandial motility is maximum in sigmoid colon followed by transverse colon.


Question: ETHER DAY is celebrated on

Ether Day," Friday 16 October 1846 marks the first successful demonstration of the inhalation of ether vapour as a means of overcoming pain of surgery by the dentist William Thomas Green Moon Ref ganong's review of medical physiology 25e 561


Question: SAN acts as a pacemaker of the heart because of the fact that it

Is capable of generating impulses spontaneously


Question: Chyme is formed by

Stomach the semifluid, homogeneous, creamy or gruel- like material produced by action of the gastric juice on ingested food in the stomach Ref: guyton and hall textbook of medical physiology 12th edition page number:395,396,397


Question: The overdrive mechanism observed during hyperventilation is due to

The ventral respiratory group contributes to the extra respiratory drive (overdrive mechanism) During quiet breathing: Expiration is a passive process and the neurons from the ventral respiratory group remain almost totally inactive during quiet respiration. Unlike the dorsal respiratory group (DRG; dorsal group of neurons), VRG (the ventral group of neurons) doesnot appear to paicipate in the basic rhythmic oscillations that control respiration. Extra-respiratory drive(overdrive mechanism) : When the reapiratory drive for increased pulmonary ventilation becomes greater than normal, for example, during exercise, respiratory signals spill over to VRG from DRG. So, VRG contributes to the extra respiratory drive (overdrive mechanism). The neurons of VRG contribute to both inspiration and expiration; especially, they are impoant in providing powerful expiratory signals to the abdominal muscles during very heavy expiration. Dorsal Respiratory group Ventral Respiratory group Location Nucleus Tractus Solitarius in medulla Nucleus Retro Ambigualis in medulla Function Inspiratory ramp signals- stimulates inspiration Inactive during quiet breathing; Active during forced expiration. Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 645-657


Question: Urgent reversal of warfarin therapy can be done by administration of

Fresh frozen plasma Oral anticoagulants should be stopped 7 days prior to elective surgery. But during emergency rapid reversal can be done with vitamin K a day before surgery or with fresh frozen plasma on the day of surgery.


Question: Ability to perceive shape and size is lost due to the lesion of

Though both tractus cuneatus & tractus gracilis are correct, since it is a single answer question, the best answer would be tractus cuneatus, as we commonly use hands to recognize size and shape of objects, more than the foot.
Somatosensory cortex lesion- proprioception and tactile sensations are lost while pain and temperature sensations are preserved.
Tractus cuneatus- formed by fasciculus cuneatus (spinal cord) and nucleus cuneatus (medulla). Pass through the lateral portion of the dorsal column.
Carries sensations of the dorsal column- proprioception and tactile sensations from the upper part of the body.
Tractus gracilis- formed by fasciculus gracilis (spinal cord) and nucleus gracilis (medulla). Pass through a medial portion of the dorsal column.
Carries sensations of the dorsal column- proprioception and tactile sensations from the lower part of the body.


Question: Increase in threshold level on applying subthreshold, slowly rising stimulus is k/a

Neural accommodation. Neural accommodation or neuronal accommodation occurs when a neuron or muscle cell is depolarised by slowly rising current (ramp depolarisation) in vitro Ref: guyton and hall textbook of medical physiology 12 edition page number: 543,544,545


Question: While getting blood pressure tested patient repos abnormal feeling in fingeips followed by involuntary spasm of fingers likely patient has

Trousseaus sign can be seen in hypocalcemic tetany. There is spasm of muscles of upper extremity that causes flexion of wrist and thumb with extension of the fingers. It can be produced by occluding the circulation for a few minutes with a blood pressure cuff.Ref: Ganong&;s Review of medical physiology, 24th edition.Pg no.382

Pressure spasm of muscles due to reuropaxia


Question: The following facilitates synaptic transmission of neurotransmitter

Hypocalcemia facilitates synaptic transmission.
Hypercalcemia, hypoxia, Botulinum toxin, tetanus toxin acidosis inhibits synaptic transmission.


Question: Depolarization of the ventricular muscles starts at

A. i.e. (Left side of the interventricular septum) (549- Ganong 22nd) (492- Ganong 23rd)* In humans - depolarization of the ventricular muscle starts at the left side of the interventricular septum** and moves first to the right across the midportion of the septum. The wave of depolarization then spreads down the septum to the apex of the heart* Depolarization initiated in the SA node spreads radially through the atria then converges on the AV node.


Question: A Patient with increased BP and decreased hea rate is likely to have

Cushing's reflex , is a physiological nervous system response to increased intra cranial pressure.Results in cushings triad - increased BP, irregular breathing and bradycardia. Usually seen in terminal stages of head injury . It can also be seen after iv administration of epinephrine. In head injury- CPP=MAP-ICP. CPP- cerebral perfusion pressure. MAP- Mean aerial pressure. ICP- intra cranial pressure Head injury causes increased ICP thus lowering CPP causing ischemia. When ICP approaches the level of mean systemic pressure , cerebral perfusion falls . Bodys response to fall in cerebral perfusion is raise systemic blood pressure and dialate cerebral vessels which increases cerebral blood volume and increases ICP followed by lowering CPP.And causes a vicious cycle. When aerial pressure lowers , a reflex called CNS ischaemic response is initiated by the hypothalamus . Hypothalamus activates sympathetic nervous system causing peripheral vasoconstriction and increased cardiac output. This increases aerial pressure and cerebral blood flow is restored. This response stimulates the baroreceptors in the carotid bodies thus slowing the hea rate drastically- bradycardia(baroreceptor reflex -refer image) 2) Marey's law- Explained by barereceptor reflex States that' hea rate is inversely propoional to blood pressue '(but not the vice versa) . Bainbridge reflex- infusion of saline or blood --- increased venous filling of atria--- stimulation of tachycardia producing atrial receptor(TPAR)---tachycardia


Question: Transection of medullary pyramids results in

(B) Positive Babinski sign > Transection of brainstem at supoerior border of pons result in marked spasticity & decerebrate rigidity> Forced grasping is a primitive reflex indicating frontal lobe lesion.> The corticospinal and corticobulbar system is primary pathway for initiation of skilled voluntary movements.> Lesions of ventral corticospinal tracts produce axial muscle deficits, causing of difficulty with balance, walking and climbing.> Damage to lateral corticospinal tract in humans produces the 'Babinski sign' dorsi flexion of great toe and fanning of the other toes when the lateral aspect of sole of foot is scratched.> Except in infancy, the normal response to this stimulation is plantar flexion in all toes.> Babinski sign is believed to be a flexor withdrawal reflex, that is normally held in check by lateral corticospinal system


Question: Hyperophy is

Hyperophy is an increase in size of parenchymal cells resulting in enlargement of the organ or tissue, without any change in the number of cells.REF. Textbook of Pathology HARSH MOHAN 6th Edition page no.55


Question: Vanilloid receptors are activated by

Vanilloid receptors are VR 1 and VRL 1 for painful temperature.


Question: Na+ uptake at basolateral surface of apical cells is by


Question: Myentric plexus is present in

Between the circular and longitudinal muscle layer lies the Auerbach plexus/ Myenteric plexus.


Question: Hypehyroid state is characterized by

People with hypothyroidism often have no or only mild symptoms. Numerous symptoms and signs are associated with hypothyroidism, and can be related to the underlying cause, or a direct effect of having not enough thyroid hormones. Hashimoto's thyroiditis may present with the mass effect of a goiter (enlarged thyroid gland). Symptoms and signs of hypothyroidism Symptoms Signs Fatigue Dry, coarse skin Feeling cold Cool extremities Poor memory and concentration Myxedema (mucopolysaccharide deposits in the skin) Constipation, dyspepsia Hair loss Weight gain with poor appetite Slow pulse rate Shoness of breath Swelling of the limbs Hoarse voice Delayed relaxation of tendon reflexes In females, heavy menstrual periods (and later light periods) Carpal tunnel syndrome Abnormal sensation Pleural effusion, ascites, pericardial effusion Poor hearing Delayed relaxation after testing the ankle jerk reflex is a characteristic sign of hypothyroidism and is associated with the severity of the hormone deficit Ref: guyton and hall textbook of medical physiology 12 edition page number:567,568,569


Question: Blood pressure in right ventricle

Peak pressures in theright ventricles is about 25 mm HgRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:508


Question: Transcytosis occurs in

In transcytosis, vesicles undergo Endocytosis on one side of a cell and then undergo exocytosis on the opposite side of the cell. Transcytosis is mostly seen in capillaries but also seen in M cells of intestine, osteoclasts,neurons (Ref: Ganong's Review of medical physiology)


Question: Neurophysiological defects present in right lobe involvement are A/E

C i.e. Dyscalculia - Categorical (dominant) hemisphere (ie left lobe in most cases) is responsible for sequential - analytic processes such as language (understanding language, verbal memory, motor speech, written & spoken language) and mathematical ability. Therefore lesions of left (dominant) side produce aphasias (receptive & expressive), dyslexia and dyscalculia. - Representational (non dominant mostly right) hemisphere is responsible for visuo-spatial orientation & musical (a) awareness. Its lesion causes anosognosia and dysgraphia. Cerebral Dominance or Complementary Specialization of Hemisphere


Question: Clay Shovel's fracture involves

Clay shoveller's fracture' is an avulsion of the spinous process of C6, C7 or T1 caused either by rotation of the upper trunk when the cervical spine is relatively fixed or, less commonly, as the result of a direct blow.


Question: Stimulation of medial portion of vasomotor centre results in

Ans. d). Decreased cardiac output. (Ref. Ganong Physiology 23rd/Chapter 33)Inflation of the lungs causes vasodilation and a decrease in blood pressure. This response is mediated via vagal afferents from the lungs that inhibit vasomotor discharge. Pain usually causes a rise in blood pressure via afferent impulses in the reticular formation converging in the RVLM.VASOMOTOR CONTROL# Spinal reflex activity affects blood pressure, but the main control of blood pressure is exerted by groups of neurons in the medulla oblongata that are sometimes called the vasomotor area / center.# Neurons that mediate increased sympathetic discharge to blood vessels and the heart project directly to sympathetic preganglionic neurons in the intermediolateral gray column (IML) of the spinal cord.# On each side, the cell bodies of these neurons are located near the pial surface of the medulla in the rostral ventrolateral medulla (RVLM). They contain PNMT, but it appears that the excitatory transmitter they secrete is glutamate rather than epinephrine.# When vasoconstrictor discharge increases, arteriolar constriction also increases and blood pressure rises.# Venoconstriction and a decrease in the stores of blood in the venous reservoirs usually accompany these changes, although changes in the capacitance vessels do not always parallel changes in the resistance vessels. Heart rate and stroke volume are increased because of activity in the sympathetic nerves to the heart, and cardiac output is increased.# Control of heart activity bx vasomotor center:# Lateral portions of vasomotor center transmit excitatory impulses through sympathetic fibers and increases heart rate and contractility.# Medial portion of vasomotor center- Lies in apposition to dorsal motor nuclei of vagus nerves- Transmits parasympathetic impulses through the vagus nerves to the heart to decrease heart rate. Vasomotor center can also decrease heart rate.Factors Affecting the Activity of the Vasomotor Area in the MedullaDirect stimulationCO2 and hypoxiaExcitatory inputsFrom cortex via hypothalamus.From pain pathways and muscles.From carotid and aortic chemoreceptorsInhibitory inputsFrom cortex via hypothalamus.From lungs.From carotid, aortic, and cardiopulmonary baroreceptors.


Question: Hormone acting on nuclear receptors

Thyroid Hormones Increase Gene Transcription in the Cell Nucleus The thyroid hormones thyroxine and triiodothyronine cause increased transcription by specific genes in the nucleus. To accomplish this, these hormones first bind directly with receptor proteins in the nucleus; these recep- tors are activated transcription factors located within the chromosomal complex, and they control the function of the gene promoters, as explained in Chapter 3. Two impoant features of thyroid hormone function in the nucleus are the following: 1. They activate the genetic mechanisms for the forma- tion of many types of intracellular proteins--probably 100 or more. Many of these are enzymes that promote enhanced intracellular metabolic activity in viually all cells of the body. 2. Once bound to the intranuclear receptors, the thyroid hormones can continue to express their control functions for days or even weeks. Hormones That Act Mainly on the Genetic Machinery of the Cell Steroid Hormones Increase Protein Synthesis Another means by which hormones act--specifically, the steroid hormones secreted by the adrenal coex, ovaries, and testes--is to cause synthesis of proteins in the target cells. These proteins then function as enzymes, transpo proteins, or structural proteins, which in turn provide other functions of the cells. The sequence of events in steroid function is essen- tially the following: 1. The steroid hormone diffuses across the cell membrane and enters the cytoplasm of the cell, where it binds with a specific receptor protein. 2. The combined receptor protein-hormone then diffuses into or is transpoed into the nucleus. 3. The combination binds at specific points on the DNA strands in the chromosomes, which activates the tran- scription process of specific genes to form mRNA. 4. The mRNA diffuses into the cytoplasm, where it pro- motes the translation process at the ribosomes to form new proteins. To give an example, aldosterone, one of the hormones secreted by the adrenal coex, enters the cytoplasm of renal tubular cells, which contain a specific receptor protein often called the mineralocoicoid receptor. Therefore, in these cells, the sequence of events cited earlier ensues. After about 45 minutes, proteins begin to appear in the renal tubular cells and promote sodium reabsorption from the tubules and potassium secretion into the tubules. Thus, the full action of the steroid hormone is characteristically delayed for at least 45 minutes--up to several hours or even days. This is in marked contrast to the almost instantaneous action of some of the peptide and amino acid-derived hormones, such as vasopressin and norepinephrine. Ref guyton and hall textbook of medical physiology edtion 12 pg 891


Question: Vomiting center is located at

(A) Area postrema # Chemoreceptor cells in the medulla initiate vomiting when they are stimulated by certain circulating chemical agents.> Chemoreceptor trigger zone cells are located in Area postrema, a V-shaped band of tissue on the lateral walls of the fourth ventricle near the apex.> Swallowing, coughing, sneezing, gagging, and vomiting are also reflex responses integrated in the medulla oblongata.> Vomiting is another example of the way visceral reflexes integrated in the medulla include coordinated and carefully timed somatic as well as visceral components.> Vomiting centre in the reticular formation of the medulla really consists of various scattered groups of neurons in this region that control the different components of the vomiting act.


Question: Stimulant for gastric emptying is

Distention of the stomach is the major and the only natural stimulus known to increase gastric emptying. The basic pattern of gastric emptying is propoional to the square root function of a volume of a meal. Ref: Ganong 25th ed/page 353


Question: Auditory receptors are found in

(Organ of corti) (175- Ganong 22th) (911 - K- Sembulingum 4th) (211-12- Ganong 23rd)AUDITORY PATHWAY* Receptors - The hair cells in the organ of corti are the receptors of the auditory sensations* First order neurons - are the bipolar cells. The bipolar cells form the spiral ganglion situated in the modiolus of cochlea* Second order neurons - are the dorsal and ventral cochlear nuclei present in the medulla- oblongata* Third order neurons - are in the superior olivary nucleus of the lateral lemniscus* Cortical auditory centers are in the temporal lobe of cerebral cortex*** Cortical auditory centres are concerned with perception of auditory impulses, analysis of pitch and intensity of sound and determination of source of sound.Visual receptors - Rods and cones , which are present in the retina of eye form the visual receptors.


Question: Resting membrane potential of neurons is about

A membrane potential results from separation of positive and negative charges across the cell membrane. In neurons, the resting membrane potential is usually about –70 mV, which is close to the equilibrium potential for K+


Question: The oxygen buffer function of hemoglobin is related to

Acid and base shifts in the blood are largely controlled by three main buffers in blood: (1) proteins, (2) hemoglobin, and (3) the carbonic acid-bicarbonate system. Plasma proteins are effective buffers because both their free carboxyl and their free amino groups dissociate. The second buffer system is provided by the dissociation of the imidazole groups of the histidine residues in hemoglobin. In the pH 7.0-7.7 range, the free carboxyl and amino groups of hemoglobin contribute relatively little to its buffering capacity. However, the hemoglobin molecule contains 38 histidine residues, and on this basis--plus the fact that hemoglobin is present in large amounts--the hemoglobin in blood has six times the buffering capacity of the plasma proteins. In addition, the action of hemoglobin is unique because the imidazole groups of deoxyhemoglobin (Hb) dissociate less than those of oxyhemoglobin (HbO2), making Hb a weaker acid and therefore a better buffer than HBO.Ref: Ganong's Review of Medical Physiology Twenty-Third Edition Page no: 614


Question: Pseudodementia is commonly seen in

Pseudodementia is forgetfulness that is one of the symptoms of depression and pt has insight in pseudodementia. Pseudodementia (otherwise known as "depression-related cognitive dysfunction") is a condition where mental cognition can be temporarily decreased. Ref ganong's review of medical physiology 25e


Question: Ther term "Milieu interior" was given by

The internal environment in which the body cells survive is called milieu interieur coined by the French physiologist Claude Bernard. (Ref: Textbook of physiology N Geetha 2nd edition page no.62)


Question: Salivary amylase is activated by

Both salivary and pancreatic α -amylases are activated by Cl–


Question: Growth hormone secretion is decreased by

Growth hormone (GH) any of several related polypeptide hormones secreted by the anterior lobe of the pituitary gland that directly influences protein, carbohydrate, and lipid metabolism and controls the rate of skeletal and visceral growth; their secretion is in pa controlled by the hypothalamus. It is used pharmaceutically as somatrem and somatropin. Called also somatotrophin, somatotropin, and somatotrophic or somatotropic hormone.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-327


Question: Erythropoiesis in gestation age takes place in

In the first 2 months of gestation yolk, sac is the main site of Erythropoiesis(mesoblastic stage) Ref: Medical Physiology Indu Khurana 2015 page No:104 In early weeks of embryonic life, primitive nucleated red cells are producedin yolk sac. During middle trimester of gestation-liver (also spleen,lymph nodes in reasonable numbers) During last month of gestation and after bih- exclusively in the bone marrow


Question: Resting membrane potential of muscle fibre is

The resting membrane potential of skeletal muscle is about –90 mV. The action potential lasts 2 to 4 ms and is conducted along the muscle fiber at about 5 m/s.
Ganong 23 rd ed, pg 96


Question: Surfactant is made up of

Ans. (c) Phospholipids(Ref: Ganong, 25th ed/p.630)Composition of surfactantSurfactant lipidsSurfactant proteins* Account for approximately 90% of surfactant (phospholipids)Major surfactant lipids are,* Dipalmotoyl phosphatidylcholine (DPPC) - Lecithin- most abundant component of surfactant* Phospthatidylglycerol* Account for approximately 10% of surfactantMajor surfactant proteins are,* Surfactant protein-A (SP-A)* Surfactant protein-B (SP-B)* Surfactant protein-C (SP-C)* Surfactant protein-D (SP-D)


Question: ABC transpoer

P-glycoprotein 1 (permeability glycoprotein, abbreted as P- gp or Pgp) also known as multidrug resistance protein 1 (MDR1) or ATP-binding cassette sub-family B member 1 (ABCB1) or cluster of differentiation 243 (CD243) is an impoant protein of the cell membrane that pumps many foreign substances out of cells. More formally, it is an ATP-dependent efflux pump with broad substrate specificity. It exists in animals, fungi, and bacteria and likely evolved as a defense mechanism against harmful substances. (Ref: <a href="


Question: While doing sigmoidoscopy, if the rectum is inflated with gas, increased peristalsis is seen in

Defecation reflex - When the rectum is distended, a reflex propulsive movement from descending colon to rectum occurs. Along with that, the internal anal sphincter relaxes. The same happens when the rectum is distended by gas.


Question: The normal daily excretion of uric acid ranges from

Uric acid the end product of purine metabolism or oxidation in the body. It is present in blood in a concentration of about 5 mg/100 ml and is excreted in the urine in amounts of a little less than 1 g per day.Ref: Ganong&;s review of medical physiology; 24th edition; page no; 13


Question: Osmoreceptors are located in

Osmoreceptors are sensory receptors present in supraoptic nucleus. Hypothalamus regulates the water balance of the body through osmoreceptors by controlling water loss. The increased plasma osmolality stimulates the osmoreceptors in supraoptic nucleus. The stimulated neurons of supraoptic nucleus send impulses to the posterior pituitary gland to secrete ADH. ADH reaches tge kidney tubules through blood and causes increased absorption of water from collecting ducts of the kidneys. Thus water loss is decreased. Ref: guyton and hall textbook of medical physiology 12 edition page number:559,560,561


Question: Pacemaker potential occurs due to

Pacemaker potential occurs due to

Opening of slow type funny Na+ channel
Opening of transient, rapid T-type Ca2+ channel
Early closure of K+ channel


Question: The Windkissel effect is seen in

The Windkissel effect is seen in large elastic vessels. The aoa, the pulmonary aery, and their major branches have a large amount of elastin in their walls. Hence, they have a high elastic recoil effect. This propey of elastic recoil is called windkessel effect (windkessel is a German for the elastic reservoir) This recoil of the vessels that have been stretched during systole helps to propel the blood forward during diastole thus maintaining a continuous flow throughout the cardiac cycle. Types Features Windkessel Aoa and large aeries Abundant elastic tissues in the inner and external elastic lamina Shows elastic recoil (Windkessel effect) when stretched Resistance Vessels Aerioles Have a less elastic tissue and lot of smooth muscle (maximum wall thickness to lumen ratio) Major site of resistanceto blood flow Exchange Vessels Capillaries Donot have smooth muscles, consist of single layer of endothelial cells surrounded by a basement membrane. Site exchange of nutrients,, water and gases. Types Continuous -brain, retina (have tight junctions) Fenestrated-glomeruli, choroid plexus Sinusoidal-liver,spleen Blood flow regulation is by contraction and relaxation of the aerioles and precapillary sphincter. Capacitance Vessels Venules and veins Thin-walled , easily distensible (maximum percentage of blood volume) Shunt Vessels AV anastomoses Have thick muscular walls with rich innervation Found in- finger tips, ear lobes Ref: Berne and Levy Physiology 7th edition Pgno: 351


Question: A/E one results in increased secretion of Renin


Question: Feilization most commonly takes place at


Question: Muscle spindle detects

Muscle spindles are sensory receptors within the belly of a muscle that primarily detect changes in the length of this muscle. They convey length information to the central nervous system sensory neurons. Ref guyton and hall textbook of medical physiology 12/e pg 71


Question: Gastric emptying sequence into the duodenum

Food rich in carbohydrate leaves the stomach in a few hours. Protein-rich foods leave more slowly and emptying is slowest after a meal containing fat.
Hyperosmotic contents in duodenum decrease gastric emptying.
CCK is also an inhibitor of gastric emptying


Question: Venterolateral cordotomy for relief of pain in right lower limb due to cutting

Sensations carried by the posterior column
-        Proprioception, Vibration, kinesthesia, fine touch.
Sensations carried by the anterolateral column
-        Temperature, pain (lateral) and crude touch (anterior)
Crossing over of fibers occurs in case of the anterolateral system.


Question: Glucose mediated insulin release is mediated through

Ans. (a) ATP dependent K+ Channels(Ref: Ganong, 25th ed/p.43l)Glucose mediated insulin release is mediated through ATP dependent K+ ChannelsATP sensitive potassium channel contains the binding site for sulfonylurea group of oral hypoglycemic drugs


Question: Paial pressure of O2 at atmospheric pressure of 760 mm of Hg

Paial pressure of oxygen at atmospheric pressure is 160 mm HG Ref: guyton and hall textbook of medical physiology 12 edition page number:311,312,313