Question: The left shift in the arneth index indicates

Arneth count depends on the number of lobes in the nucleus of neutrophils. If the number is less it comes under young series of cells. Shift to left ie more younger cells means neutrophilia, seen in pyogenic infections. Ref: Textbook of medical physiology by N Geetha, 3rd edition, page no. 102


Question: Calcitonin is secreted by

Calcitonin is a polypeptide hormone secreted by the parafollicular or C cells of the thyroid gland; it is involved in plasma calcium homeostasis and acts to decrease the rate of bone resorption. Preparations of calcitonin are called either calcitonin-human or calcitonin-salmon; the former is a synthetic polypeptide with the same sequence as that occurring naturally in humans, and the latter is either derived from salmon or is a synthetic polypeptide of the same sequence as that found in salmon. They are used in the treatment of severe hypercalcemia, Paget&;s disease of bone, and postmenopausal osteoporosis. Ref: Ganong&;s review of medical physiology; 24th edition; page no:-377


Question: Gamma glutamate carboxypeptidase is linked with absorption of

Function in the brain GCPII directly cleaves NAAG into NAA and glutamate. NAAG has been shown, in high concentration, to indirectly inhibit the release of neutrotransmitters, such as GABA and glutamate. It does this through interaction with and activation of presynaptic group II mGluRs Ref: guyton and hall textbook of medical physiology 12 edition


Question: Satiety centre is located at

Satiety centre is situated in ventromedial, arcuate, and paraventricular nuclei; lateral hypothalamus. Ref: Ganong&;s Review of medical physiology;25th edition; pg: 309; table 17-1.


Question: PO2 over 8kPa is (Hp saturation)

PO2 over 8kPa is 90%Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 642


Question: Circadian rhythms are maintained by

Hypothalamic control of circadian rhythm: A large number of physiologic rhythms ( body temperature, sleep-wakefulness, coisol secretion among a host of others ) in the body run to a cyclic pattern that is approximately 25 hours long. These rhythms are entrained to 24 hours due to environmental signals such as light and darkness. These signals are called zeitgebers. The suprachiasmatic nucleus of the hypothalamus is believed to be responsible for the rhythmicity of these circadian cyclesRef: Guyton & Hall Textbook of medical physiology- a south Indian edition 2014 pg no: 812


Question: Major dopaminergic pathway is

(A) Nigrostriate pathviay> The long dopamine systems are the nigrostriatal system, which projects from the substantia nigra to the striatum and is involved in Motor control.


Question: Somatosensory cortex lesion will affect

Somatosensory cortex lesion- proprioception and tactile sensations are lost while pain and temperature sensations are preserved.


Question: Maximum absorption of the water occurs at

(Proximal convoluted tubule) (802 - Ganong 22th) (294- K.S 4th) (652- Ganong 23rd)* In the presence / abscence of vasopressin, the greatest fraction of filtered water is absorbed in the proximal convoluted tubules* SITE OF REABSORPTIONS1. Substance Reabsorbed from PCT-Glucose, Aminoacid, Na+ ,K+ ,Ca++ ,HCO3 ,Cl- ,PO4, uric acid and water2. Substance Reabsorbed from DCT - Naf ,HCO3 and water3. Substance Reabsorbed from Loop of Henle - Na+ and Cl~**- 80-90% of bicarbonate reabsorption occurs in PCT1. Absorption of water in PCT (obligatory reabsption) i.e. independent of ADH2. Absorption of water in DCT & collecting duct (facultative - reabsorption) i.e. dependent on ADH levels


Question: Discharge from Baroreceptors causes inhibition of


Question: The electrogenic Na+ K+ ATPase plays a critical role in cellular physiology by

Na, K ATPase catalyzes the hydrolysis of ATP to adenosine diphosphate (ADP) and uses the energy to extrude three Na+ from the cell and take two K+ into the cell for each molecule of ATP hydrolyzed.

Extruding 3 Na+ out of the cell in exchange for taking two K+ into the cell.

Extruding 3 K+ out of the cell in exchange for taking two Na+ into the cell.

Using the energy in moving Na+ into the cell or K+ outside the cell to make ATP.

Using the energy in moving Na+ outside of the cell or K+ inside the cell to make ATP.


Question: Urinary metabolite of progesterone

Pregnanediol is most abundant plasma as well as urinary metabolite of progesterone. In plasma 80 % is bound to albumin and 18 % to coicosteroid binding globulin. Progesterone has sho half-life and in liver it is conveed to Pregnanediol and conjugated to glucoronic acid and excreted in urine. Ref: Ganong review of Medical physiology 22nd edition Pgno: 443


Question: Oxygen therapy is least useful in

Administration of oxygen-rich gas mixtures is of very limited value in hypoperfusion, anemic, and histotoxic Hypoxia because all that can be accomplished in this way is an increase in the amount of dissolved O2 in the aerial blood. This is also true in hypoxic hypoxia when it is due to shunting of unoxygenated venous blood past the lungs. In other forms of hypoxic hypoxia, O2 is of great benefit. Treatment regimens that deliver less than 100% O2 are of value both acutely and chronically, and administration of O2 24 h/d for 2 y in this fashion has been shown to significantly decrease the moality of chronic obstructive pulmonary disease.Ref: Ganong review of medical physiology 23rd edition page no: 621


Question: Maximum reabsorption of filtered glucose is from

Reabsorption is the act or process of absorbing again, as the absorption by the kidneys of substances that were already secreted into the tubules, such as glucose, proteins, or sodium. Glucose molecule is maximum absorbed through PCTRef: Ganong&;s review of medical physiology; 24th edition; page no; 682


Question: D2O is used to measure volume of


Question: Commonly used radioisotope for measuring red cell volume

Red cell volume is commonly measured by tagging RBC with Chromium 51.


Question: Distribution of blood flow is mainly regulated by the

Arterioles regulate the distribution of blood flow by altering their diameter to increase or decrease the peripheral resistance as required.


Question: Initial rapid repolarization in cardiac muscle is mediated through

The main factor is opening of K+ channel. Although Ganong has maintained both closure of Na+ channels and opening of one type of K+ channel and closure of Na channel only the recent concept is K+ channel opening is the main reason of phase 1.


Question: Phagocytosis in the CNS is done by

Microglia in CNS has phagocytic activity.


Question: Mifepristone is most useful for Rx of

For treatment of molar pregnancy (hydatidform mole), mifipristone is the drug of choice. Ref mudaliar textbook, obstetrics 6e p156


Question: Primary sites of lymphocyte production are

Lymph nodes and mucosa associated lymphoid tissue

Spleen and mucosa associated lymphoid tissue


Question: Iron is predominantly absorbed in

Almost all iron absorption occurs in the duodenum. Transpo of Fe2+ into the enterocytes occurs divalent metal transpoer 1 (DMT1). Some are stored in ferritin, and the remainder is transpoed out of the enterocytes by a basolateral transpoer named ferropoin 1. A protein called hephaestin (Hp) is associated with ferropoin 1. It is not a transpoer itself, but it facilitates basolateral transpo. In the plasma, Fe2+ is conveed to Fe3+ and bound to the iron transpo protein transferrin. This protein has two iron-binding sites. Normally, transferrin is about 35% saturated with iron, and the normal plasma iron level is about 130 mg/dL (23 mmol/L) in men and 110 mg/dL (19 mmol/L) in women.Ref: Ganong&;s review of medical physiology 23rd edition Page no: 452


Question: Sensory function of the Pacinian corpuscle is

Detection of Vibration:All tactile receptors are involved in detection of vibration, although different receptors detect different frequencies of vibration.Pacinian corpuscles can detect signal vibrations from 30 to 800 cycles/sec because they respond extremely rapidly to the minute and rapid deformations of the tissues. They also transmit their signals over type Ab nerve fibers, which can transmit as many as 1000 impulses per second. Low-frequency vibrations from 2 up to 80 cycles per second, in contrast, stimulate other tactile receptors, especially Meissner's corpuscles, which adapt less rapidly than do Pacinian corpuscles.Ref: Guyton; 13th edition; Chapter 48 Somatic Sensations: I. General Organization, the Tactile and Position Senses


Question: Difference between plasma and interstitial fluid is that interstitial fluid contains

Plasma has more proteins compared to interstitial fluid due to presence of albumin, globumin, clotting factors, transporter proteins and many more.


Question: AV nodal delay is


Question: Vitamin K carboxylates

The vitamin K-dependent (VKD)3carboxylase is a bifunctional enzyme that catalyzes the oxygenation of vitamin Khydroquinone, resulting in formation of vitamin K epoxide, in parallel with the carboxylation of multipleglutamate (Glu) residues in vitamin K-dependent proteins Ref ganong's review of medical physiology 25e


Question: Hyperosmolarity of renal medulla is due to

The renal medulla is the innermost pa of the kidney. The renal medulla contains the structures of the nephrons responsible for maintaining the salt and water balance of the blood. These structures include the vasa rectae, the venulae rectae, the medullary capillary plexus, the loop of Henle, and the collecting tubule. The renal medulla is hypeonic to the filtrate in the nephron and aids in the reabsorption of water.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 671


Question: The connective tissue layer around each muscle fascicle

During embryogenesis, skeletal muscle develops through the fusion of mononucleated precursor cells (myoblasts) into multinucleated myotubes. These subsequently mature into myofibers (muscle fibers) of varying length that contain thousands of nuclei. In adult tissues, these myofibers are arranged in fascicles, each associated with a small pool of tissue stem cells referred to as satellite cells, which can contribute to muscle regeneration following injury. Perimysium is the sheath of connective tissue surrounding a bundle of muscle fibers .Ref: Guyton; 13th edition


Question: Starlings law implies

This intrinsic ability of the hea to adapt to increasing volumes of inflowing blood is called the frank starling mechanism. Basically, the Frank-Starling mechanism means that the greater the hea muscle is stretched during filling, the greater is the force of contraction and the greater the quantity of blood pumped into the aoa.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page: 119


Question: Efferent neuron for skeletal muscle is

Efferent neurone for skeletal muscle is alpha motor neurone Ref: guyton and hall textbook of medical physiology 12 edition page number:761,762,763


Question: Factor increasing gastric emptying

Factors affecting increasing Gastric emptying (predominantly neural pathway is involved) Increased food volume in the stomach- gastric distension - stretch receptor activation -promotes increased emptying from the stomach. Type of food: order of gastric emptying is carbohydrate > protein > fat Gastrin has mild to moderate effect on gastrin emptying. Gastric distension and product of protein digestion stimulates gastrin release while acid in stomach inhibits gastrin release.


Question: A person with intractable pain over the right leg is benefited by

(B) Left Spinothalamic tract cordotomy > Spinothalamic tract Touch sensation is transmitted by ventral spinothalamic tract Pain and temperature pain are transmitted by lateral spinothalamic tract> Fibers of spinothalamic tract cross in the anterior commissure of the cord to the opposite> Hence intractable pain over the right leg is benefited by left spinothalamic tract cordotomy.> In anterolateral cordotomy, the spinothalamic tracts are carefully cut to relieve severe pain.


Question: On insulin administration, change expected in ECF is

Insulin is a polypeptide hormone secreted by the islets of Langerhans and functioning in the regulation of the metabolism of carbohydrates and fats, especially the conversion of glucose to glycogen, which lowers the blood glucose level.Ref: Ganong&;s review of medical physiology;24th edition; page no-433


Question: Volume of interstitial fluid in a normal adult

In a 70 kg man ,60%of body weight is due to water ,about 42 L .of this 10 L is present ias Interstitial fluid Ref.Textbook of physiology AK Jain 5th edition page no.24 table 1.3.2


Question: Stagnant hypoxia is seen in

Stagnant hypoxia, as its name implies, refers to situations in which blood flow is abnormally low as occurs in shock, syncope or other "low-flow" states. In terms of oxygen transpo, decreased blood flow (hypoperfusion) is the primary limitation, and thus, the problem resides with the cardiovascular system Ref: guyton and hall textbook of medical physiology 12 edition page number: 353,354,355


Question: Warmth sensation is sensed by

(C) Ruffini end organ # Ruffini's corpuscles are encapsulated sensory nerve endings located in the dermis and subcutaneous tissue and they mediate the sense of warmth.> Lamellar corpuscles or Pacinian corpuscles are one of the four major types of mechanoreceptor. They are nerve endings in the skin, responsible for sensitivity to vibration and pressure.> Vibrational role may be used to detect surface, e.g., rough vs. smooth.Meissner's corpuscles (or tactile corpuscles) are a type of mechanoreceptor.> They are a type of nerve ending in the skin that is responsible for sensitivity to light touch. In particular, they have highest sensitivity (lowest threshold) when sensing vibrations lower than 50 Hertz.> They are rapidly adaptive receptors. The bulboid corpuscles (end-bulbs of Krause) are cutaneous receptors that have the ability to detect low-frequency vibration.


Question: Cardiac muscle contracts due to


Question: Cardiac output in L/min divided by heart rate equals

Ans. (b) Mean stroke volumeRef: Ganong, 25th ed/p.544Cardiac output is the product of heart rate (HR) and stroke volume (SV)So, Cardiac output/heart rate = stroke volume


Question: During cardiac imaging, the phase of minimum motion of heart is


Question: Semicircular canals are stimulated by

Rotation causes maximal stimulation of semicircular canals most nearly in the plane of rotation.Ref: Ganong&;s review of medical physiology; 23rd edition; pg:215.


Question: The raphe nuclei located in lower pons and medulla secrete the following neurotransmitter

Serotonin is also found within the brain stem in the midline raphe nuclei which project to poions of hypothalamus, limbic system, neocoex, cerebellum and spinal cord. Ref: Ganong&;s review of medical physiology; 23rd edition; pg: 136


Question: Severe anxiety causes

Increase in the alveolar ventilation due to hyperventilation and anxiety ,hysteria causes respiratory alkalosis. Ref:page no 569 Textbook of physiology Volume 1 7th edition AK Jain


Question: Coical representation of body in the cerebrum is

The various pas of the body are represented in the precentral gyrus, with the feet at the top of the gyrus and the face at the bottom. The facial area is represented bilaterally, but the rest of the representation is generally unilateral, with the coical motor area controlling the musculature on the opposite side of the body. The coical representation of each body pa is propoionate in size to the skill with which the pa is used in fine, voluntary movement. The areas involved in speech and hand movements are especially large in the coex; use of the pharynx, lips, and tongue to form words and of the fingers and apposable thumbs to manipulate the environment are activities in which humans are especially skilled.Ref: Ganong's Review of Medical Physiology, Twenty-Third Edition


Question: Motor aphasia refers to defect in

In nonfluent aphasia, the lesion is in Broca area. Speech is slow, and words are hard to come by. Patients with severe damage to this area are limited to two or three words with which to express the whole range of meaning and emotion. Sometimes the words retained are those that were being spoken at the time of the injury or vascular accident that caused the aphasia.


Question: The Principal site of absorption of sodium is

Other than at thin descending limb of the loop of Henle, all other sites of tubule Na+ are reabsorbed by various mechanisms.
-        Proximal tubule- 60-70%

Na+- H+ exchange
Na+- Glucose co-transport
Na+- amino acid co-transport
Na+ unitransport

-        The thick ascending limb of the loop of Henle - 30%

Na+- 2Cl-- K+ co-transport

-        Early distal tubule- 7%

Na+- Cl- co-transport

-        Late distal tubule and collecting duct - 3%

ENaC channels


Question: Muscle spindle

Muscle spindles are receptors of stretch reflex or monosynaptic reflex.(Ref. Textbook of physiology N Geetha 2nd edition page no.514)

Excited by strech and contraction of muscle


Question: Not a stimulus for normal/resting ventilation

Juxtacapillary receptors, J-receptors, or pulmonary C-fiber receptors are sensory nerve endings located within the alveolar walls in juxtaposition to the pulmonary capillaries of the lung, and are innervated by fibers of the vagus nerve Ref: guyton and hall textbook of medical physiology 12 edition page number: 365,366,367


Question: Astereognosis is seen in lesions of

(C) Parietal lobe # Lesions in the representational hemisphere produce astereognos is- inability to identify objects by feeling them-and other agnosias.> Agnosia is the general term used for the inability to recognize objects by a particular sensory modality even though the sensory modality itself is intact.> Lesions producing these defects are generally in the parietal lobe.> Especially when they are in the representational hemisphere, lesions of the inferior parietal lobule, a region in the posterior part of the parietal lobe that is close to the occipital lobe, cause unilateral inattention and neglect.


Question: Fine voluntary movements are transmitted by

(A) Lateral corticospinal tract > The nerve fibers that pass from the motor cortex to the cranial nerve nuclei form the corticobulbar tract. The nerve fibers that cross the midline in the medullary pyramids and form the lateral corticospinal tract make up about 80% of the fibers in the corticospinal pathway.> The remaining 20% make up the anterior or ventral corticospinal tract, which does not cross the midline until it reaches the level of the muscles it controls. At this point, its fibers end on interneurons that make contact with motor nerves on both sides of the body.> The lateral corticospinal tract is concerned with skilled movements, and in humans its fibers end directly on the motor neurons.


Question: Myelin in CNS

Oligodendrocytes - myelin formation in cnsSchwann cells - myelin formation in pns Ref: Ganong&;s review of medical physiology; 23rd edition; pg:80


Question: Golgi tendon organ helps in detection

(Reflex muscle tension): (232-33 Ganong24 edition, 910-A.KJain 5 ; 661-Guyton 12 )Golgi Tendon Organ Helps Control Muscle TensionGTO is an encapsulated sensory receptor through which muscle tendon fibers pass. About 10 to 15 muscle fibers are usually connected to each GTO, and the organ is stimulated when this small bundle of muscle fibers is "tensed" by contracting or stretching the muscle. Thus the major difference in excitation of the Golgi tendon organ versus the muscle spindle is that the spindle detects muscle length and changes in muscle length, whereas the tndon organ detects muscle tension as reflected by the tension in itself* GTO has both dynamic response and static response* GTO provide the nervous system with instantaneous information on the degree of tension in each small segment of each muscle* It acts as a protective reflexGolgi tendon organPathway responsible for the stretch reflex and inverse stretch reflex


Question: The efferent fiber bundle of the substantia nigra transmits dopamine to one of the following areas

Connections in Basal ganglia

Substantia nigra pars compacta (SNPC) to Striatum (Caudate nucleus & Putamen)- Dopaminergic
Striatum to Substantia nigra pars reticulata (SNPR)- GABA
Striatum to Globus pallidus inner segment & external segment- GABA
Globus pallidus external segment to subthalamic nucleus and internal segment- GABA
Subthalamic nucleus to Globus pallidus external segment and internal segment.- Glutamate
Within the striatum- Cholinergic interneurons.


Question: 'Lucid Interval' may be seen in

Lucid interval- This is a period occurring in insanity during which all the symptoms of insanity disappear completely. Lucid interval refers to a brief period during which an insane person regains sanity that is sufficient to regain the legal capacity to contract and to act on his/her own behalf. Ref ganong's review of medical physiology 25e


Question: One of the ways that cells communicate with each other is by secretion of various molecules. The secreted molecule is known as

A signaling molecule is the way by which cells communicate with each other. Three general types of intercellular communication are mediated by messengers in the ECF: neural -in which neurotransmitters are released at synaptic junctions endocrine - in which hormones and growth factors reach cells the circulating blood or the lymph paracrine -in which the products of cells diffuse in the ECF to affect neighboring cells that may be some distance away.


Question: Homeostasis is Body's mechanisms

Homeostasis : refers to maintainence of constant internal environment Hemostasis: refers to stopage of bleeding Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:146,147

For maintemance of nearly constant conditions in the internal environment


Question: Compliance of lungs is

The change in lung volume per unit change in airway pressure (DV/DP) is the compliance (stretchability) of the lungs and chest wall. It is normally measured in the pressure range where the relaxation pressure curve is steepest, and the normal value is approximately 0.2 L/cm H2O.Ref: Ganong review of medical physiology 23rd edition Page no: 595


Question: Increased velocity of conduction in a nerve is favoured by


Question: Cardiac index is defined as

Cardiac index- Cardiac output per minute per square meter of body surface area. Normal- 3.2L/min/ m2.

Cardiac output per minute per unit body surface area


Question: EEG rhythm recorded from the surface of the scalp during REM sleepa) Alphab) Betac) Deltad) Theta

Stages of sleep and rhythm
-        Beta rhythm- Alert, awake, maximum concentration.
-        Alpha rhythm- Eyes closed, mind wandering, less attentiveness
-        Theta rhythm- Stage 1 NREM
-        Sleep spindles, K complex- Stage 2 NREM
-        Delta rhythm- Deep sleep (Stage 3 & 4 NREM)

-        Beta Rhythm and occasional reappearance of alpha rhythm- REM


Question: On changing position from lying down to standing position there is a drop in 10 mm of Hg. Immediately he recovered by 8 mm Hg leaving behind 2 mm Hg. The gain for baroreceptor system for the control of BP is

Ans. (b) 4(Ref: Guyton, 13th ed/p.7)The formula for calculating gain is,Gain=ErrorCorrection So here, Gain =8/2=4The degree of effectiveness with which a control system maintains constant conditions is determined by the GAIN of the negative feedbackAny system which leaves error is not 100 percent effective in preventing changeImagine what would happen if the denominator becomes zero???.The ratio becomes infinity.Such a principle is called INFINITE FEEDBACK GAIN PRINCIPLE. It is the KIDNEY which displays infinite feedback gain principle in regulation of BP which means it won't leave any error during correction of BP.It exactly brings BP back to the previous value


Question: Striped fibrosis of kidney is seen in

Cyclosporin toxicity is classically alternate fibrosis that is striped fibrosis


Question: The satiety centre is located in the

(B) Ventromedian nucleus of hypothalamus


Question: Nociception from abdomen is transmitted by

Pain is carried by type c fibre. Table 4-1 Ref: Ganong&;s review of medical physiology; 23rd edition; pg:89


Question: Gas with greatest affinity for haemoglobin


Question: Clathrins used in

In receptor-mediated Endocytosis, clathrin is the receptors for the ligand. The cell membrane fuses around the receptor-ligand complex forming a vesicle. (Ref: Textbook of medical physiology-Geetha N)


Question: Proprioceptions are carried by

Proprioceptions are carried by A alpha fibresRef: Ganong&;s review of medical physiology 23rd edition Page no: 158


Question: Conduction velocity (m/s) of nerve fibers carrying fast pain is about

(C) # Fast pain, like pricking yourself with a needle or touching a burning object, is mainly related to painful stimuli of the skin, mouth and anus. It is transmitted by relatively thick nerve fibers, although this is relative, because they are still microscopically thin, with a diameter of 2 to 5 thousandth of a millimeter. These nerves are called A-delta fibers. Because of their relatively thick size, these nerve fibers allow the pain stimulus to be transferred very fast (at a speed of five to 30 meter/second), hence the name. This is all to make the body withdraw immediately from the painful and harmful stimulus, in order to avoid further damage.# Slow pain, which starts immediately after the fast pain, is transmitted by very thin nerve fibers, called C-nerve fibers (their diameter is between 0.2 to 1 thousandth of a millimeter). Because of their small size, the pain impulse can only be transmitted slowly to the brain, at a speed of less than 2 meters per second. The response of the body is to hold the affected body part immobile (guarding, spasm or rigidity), so that healing can take place.


Question: Transport of carbon monoxide (CO) is diffusion limited because

Since CO binds to Hb very rapidly, there is always a pressure gradient for its diffusion.
There is no free CO in blood. CO diffusion can be increased only if the thickness of the capillary decreases or if the area of the capillary increases.
So transport of CO is diffusion limited.

Alveolar membrane is less permeable to CO

On exposure to air there is sudden increase in partial pressure


Question: Pulmonary aery pressure is

The pressure gradient in the pulmonary system is about 7 mmHg, compared with a gradient of about 90 mmHg in the systemic circulation. Pulmonary capillary pressure is about 10 mmHg, whereas the oncotic pressure is 25 mmHg so that an inwardly directed pressure gradient of about 15 mmHg keeps the alveoli free of all but a thin film of fluid. When the pulmonary capillary pressure is more than 25 mm Hg--as it may be, for example, in "backward failure" of the left ventricle--pulmonary congestion and edema result.Ref: Ganong review of medical physiology 23rd edition Page no: 602


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

Ans. (b) Anemic hypoxia(Ref: Ganong, 25th ed/p.646)Characterized by reduction in hemoglobin concentration and decline in the O2 -carrying capacity of the blood (reduced arterial O2 content)Anemic hypoxia is seen in Carbon monoxide poisoning and methemoglobinemia


Question: Initiation of impulse stas in

Several inhibitory synapses are located directly on the axon hillock and initial axon segment. This location provides especially powerful inhibition because it has the direct effect of increasing the threshold for excitation at the very point where the action potential is normally generated.Ref: Guyton; 13th edition; Chapter 46; Organization of the Nervous System, Basic Functions of Synapses, and Neurotransmitters


Question: Phospholipid associated with mechanism of hormone action is

Phosphatidylinositol Is a Precursor of Second Messengers The inositol is present in phosphatidylinositol as the stereoisomer, myoinositol. Phosphatidylinositol 4,5 bisphosphate is an impoant constituent of cell membrane phospholipids? upon stimulation by a suitable hormone agonist, it is cleaved into diacylglycerol and inositol trisphosphate, both of which act as internal signals or second messengers.


Question: With respect to oxygen and carbon dioxide transpo

The equilibrium curves are not similar; that for CO2 is steeper and more linear. The blood carries more CO2 than O2. The presence of CO2 will increase the P50. Although red cells carry most of the O2, the plasma carries the majority of the CO2 (mainly as bicarbonate).

The slopes of the oxygen and carbon dioxide content curves are similar

Equal amounts of oxygen and carbon dioxide can be carried in 100 mL of blood

The presence of carbon dioxide decreases the P50 for O2

The presence of oxygen lowers carbon dioxide content in the blood


Question: Dorsal column of spinal cord does not carry fibres of

(B) Pain # Dorsal column transmits Touch (Fine) Pressure Vibration Proprioception# Lateral spinothalamic tract Pain Temperature> Anterior spinothalamic tract Crude touch Pressures.


Question: In the nephrons, the vasopressin mainly acts at the level of

Ans. d (Collecting tubules); (Ref. Guyton, Physiology, 10th ed., 773)HORMONES ACTING ON KIDNEY HormonesStimulus for secretionActions on kidneys1Vasopressin (ADH)||Plasma osmolalityBlood volume||H2O permeability of principal cells incollecting ducts.Urea absorption in collecting duct.Na+/K+2CI-transporter in thick ascending limb.2Aldosterone||Blood volume (via All)plasma (K+)|Na+ re-absorption,K+secretion, H+ secretion in distal tubule.3Angiotensin II Blood volume (Via renin) Contraction of efferent arteriole | GFR,Na+ HCO3 re-absorption in PCT.4Atrial natriureticpeptide (ANP)|Atrial pressure||Na+ reabsorptionGFR5PTH-Plasma (Ca2+)|Ca2+ reabsorption, | PO43-reabsorption, 1,25(OH)2 vitamin D production


Question: Osmotic pressure can be calculated by using

Osmotic pressure is calculated by van hoofs rule. (REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, PAGE NO - 7)


Question: The primary function of basal ganglia is

(A) Preprogramming of voluntary activity > Basal ganglia are involved in the planning and programming of movement or, more broadly, in the process by which an abstract thought is converted into voluntary action. Basal ganglia also play major role in some cognitive processes.


Question: Normal intrapleural pressure is

The normal external pressure is equal to the normal intrapleural pressure (the pressure in the chest  cavity), which is −4 mm Hg. Note in the figure that a rise in intrapleural pressure, to −2 mm Hg, shifts the entire cardiac output curve to the right by the same amount.  This  shift  occurs  because  to  fill  the  cardiac chambers  with blood requires an extra 2 mm Hg right atrial pressure to overcome the increased pressure on the outside of the heart. Likewise, an increase in intrapleural pressure to +2 mm Hg requires a 6 mm Hg increase in right atrial pressure from the normal −4 mm Hg, which shifts the entire cardiac output curve 6 mm Hg to the right.


Question: Maximum water reabsorption in the Gastrointestinal tract occurs in

REABSORPTION OF WATER IN THE GIT Jejunum - 5500 ml Ileum - 2000 ml Colon - 1300 ml Total reabsorption - 8800 ml Ref: guyton and hall textbook of medical physiology 12th edition page number:394,395,396


Question: Impairment of moral and social sense, lack of initiation and difficulty in planning with flight of ideas is a feature of lesion in the

(Frontal lobe) (804 -K.Sth)FRONTAL LOBE SYNDROME(Injury or ablation of prefrontal cortex)TEMPORAL LOBE SYNDROME or Kluver Bucy Syndrome1. Emotional instability: There is lack of restraint leading to hostility, aggressiveness and restlessness2. Lack of concentration and lack of fixing attention occur3. There is lack of initiation and difficulty in planning4. Impairment of recent memory occurs.1. Aphasia: Disturbance in speech2. Auditory disturbances - frequent attacks of tinnitus, auditory hallucinations with sounds like buzzing, ringing or humming3. Disturbance in smell and taste sensation4. Dreamy states - feeling of unreality5. Visual hallucination associated with hemianopiaHowever, the memory of remote events is not lost5. Loss of moral and social sense is common and there is loss of love for family and friends6. There is failure to realize the seriousness of the condition the subject has the sense of well - being and also has flight of ideas7. Functional abnormalities(i) Hyperphagia(ii) Loss of control over sphincter of the- urinary bladder or rectum(iii) Disturbances in orientation(iv) Slight tremorPARIETAL LOBE FUNCTIONS1. Somesthetic area 1 is responsible for perception and integration of cutaneous and kinesthetic sensation2. Movements of head and eyeballs3. Discriminative functions(i) Spatial recognition: Tactile localization, two point discrimination and recognition of position and passive movements of limbs(ii) Recognition of intensity of different stimuli(iii) Recognition of similarities and differences between the stimuliOCCIPITAL LOBE FUNCTONS (Visual cortex)1. Primary visual area - 17 is concerned with perception of visual impulses2. Visual association area - 18 - concerned with interpretation of visual impulses3. Occipital eye field - 19 concerned with movement of eyes


Question: Insulin secretion is inhibited by

Epinephrine (also known as adrenaline or adrenaline) is a hormone and a neurotransmitter. Epinephrine has many functions in the body, regulating hea rate, blood vessel and air passage diameters, and metabolic shifts; epinephrine release is a crucial component of the fight-or-flight response of the sympathetic nervous system.Ref: Ganong&;s review of medical physiology; 24th edition


Question: Osteoclasts are inhibited by

Osteoclasts are Bone cells that break down and remove bone tissue.Calcitonin- a polypeptide hormone secreted by the parafollicular or C cells of the thyroid gland; it is involved in plasma calcium homeostasis and acts to decrease the rate of bone resorption.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-387


Question: Equilibrium potential for an ion is calculated using

Equilibrium potential for an ion is calculated by Nernst equation. the Nernst potential corre- sponding to this ratio is -94 millivolts because the loga- rithm of 35 is 1.54, and this multiplied by -61 millivolts is -94 millivolts. Therefore, if potassium ions were the only factor causing the resting potential, the resting potential inside the fiber would be equal to -94 millivolts, as shown in the figure. (REF: TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, 28)


Question: Question is Here

Ans: a (Clearance) Ref: Ganong,22nd ed, p. 705Clearance of a substance is equal to the concentration of that substance in urine multiplied by urine flow rate divided by arterial plasma level, i.e.Clearance=UxV----PxUx - cone of substance in urineV -urine flow ratePx - cone of substance in plasmaNote:Inulin is used to measure GFR because it is freely filtered and neither reabsorbed nor secreted in the tubules. But in practice we use creatinine clearance to measure GFR because it is easier to measure.PAHA is used to measure renal plasma flow i.e.Clearance of para-aminohippuric acid is equal to effective renal plasma flow.From the renal plasma flow, the renal blood flow can be calculated by dividing by 1 minus the haematocritRenal blood flow = RPF x1------------(1-Haematocrit)Renal blood flow = 1273ml/min which account for about 25% of cardiac output.


Question: The primary action on Nitric oxide (NO) in the gastrointestinal tract is

Peristalsis is a reflex response that is initiated when the gut wall is stretched by the contents of the lumen, and it occurs in all pas of the gastrointestinal tract from the esophagus to the rectum. The stretch initiates a circular contraction behind the stimulus and an area of relaxation in front of it. The wave of contraction then moves in an oral-to-caudal direction, propelling the contents of the lumen forward at rates that vary from 2 to 25 cm/s. Peristaltic activity can be increased or decreased by the autonomic input to the gut, but its occurrence is independent of the extrinsic innervation. Indeed, progression of the contents is not blocked by removal and resuture ofa segment of intestine in its original position and is blocked only if the segment is reversed before it is sewn back into place. Peristalsis is an excellent example of the integrated activity of the enteric nervous system. It appears that local stretch releases serotonin, which activates sensory neurons that activate the myenteric plexus. Cholinergic neurons passing in a retrograde direction in this plexus activate neurons that release substance P and acetylcholine, causing smooth muscle contraction. At the same time, cholinergic neurons passing in an anterograde direction activate neurons that secrete NO, vasoactive intestinal polypeptide (VIP), and adenosine triphosphate (ATP), producing the relaxation ahead of the stimulus.</P>REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, KIM BARRETT, HEDDWEN BROOKS, SCOTT BOITANO, SUSAN BARMANTWENTY THIRD EDITIONPAGE NO:469,470

Gastrointestinal smooth muscle relaxation

Gastrointestinal slow smooth muscle contraction


Question: The major ejection force in vomiting is provided by

The major ejection force in vomiting is provided by Abdominal muscles.


Question: The processing of short term memory to long term memory is done in

(B) Hippocampus # Role of Hippocampus in Memory# HIPPOCAMPUS is currently credited with being the area of the brain in which short term memories are converted into long term memories.> 3 major neuronal pathways have been described in the hippocampus that are responsible for conversion of short term memory into long term memory.> Long term potentiation (LTP) has been used as the cellular model re sponsible for long term memory in the Hippocampus - Journal of Neuroscience> Hippocampus is the site in brain where short term memory are converted into long term memory> Hippocampus is not the site where long term memory is stored.> Memory is a complex function of the brain that uses several storage buffers of differing capacity and duration. It can be divided into three major types: working, episodic, and long-term, or remote, memory.> Memory function includes registration (encoding or acquisition), retention (storage or consolidation), stabilization (consolidation), and retrieval (decoding or recall). Registration and retrieval are conscious processes. The process of encoding is dependent upon the frontal lobes and hippocampal complex, while the process of retrieval requires the frontal lobes.


Question: Membrane integrity of RBC is due to

C i.e. SpectrinWhen the membrane of RBC are analyzed by SDS- PAGE, the protein with slowest migration & hence highest molecular weight being designated band 1 or spectrin. Spectrin is the major protein of RBC cytoskeleton responsible for integrity of RBC membraneQ. It has 1a and 2(3 chains forming triple stranded a -helix. At least 4 binding sites can be defined in spectrin (for) 1) Selfassociation 2) Ankyrin (band 2.1) 3) Actin (band 5), and 4) Protein 4.1SpectrinQ, ankyrin (Pyramidal shaped) and other peripheral membrane protein eg. actin, protein 4.1, adducin, tropomyosin & 4.9 help determine the shape, & flexibility of RBC.


Question: On increasing, vagal tone following occurs in pacemaker

Na+ influx causes the pacemaker potential (prepotential). Due to vagal stimulation, the Na+ influx decreases, this leads to a decrease in the slop of prepotential.


Question: Smooth muscle cell membrane is

Protein kinase C, commonly abbreted to PKC (EC 2.7.11.13), is a family of protein kinase enzymes that are involved in controlling the function of other proteins through the phosphorylation of hydroxyl groups of serine and threonine amino acid residues on these proteins, or a member of this family.


Question: Type 1 glomus cell secrete neurotransmitter because of oxygen sensitive

Type I glomus cells have O2 sensitive K+ channels, whose conductance is reduced in propoion to the degree of hypoxia to which they are exposed. This reduces the K+ efflux, depolarizing the cell and causing Ca2+ influx, primarily L-type Ca2+ channels. The Ca2+ influx triggers action potentials and transmitter release, with consequent excitation. of the afferent nerve endings. The smooth muscle of pulmonary aeries contains similar O2-sensitive K+ channels, which mediate the vasoconstriction caused by hypoxia. This is in contrast to systemic aeries, which contain adenosine triphosphate (ATP) dependent K+ channels that permit more K+ efflux with hypoxia and consequently cause vasodilation instead of vasoconstriction. Ref: Ganong's Review of Medical Physiology, 23rd edition, page no: 628, 629 Ref image:


Question: The pump responsible for gastric acid secretion is

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. 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.


Question: The parvocellular pathway, from the lateral geniculate nucleus to the visual cortex, carnes signals for the detection of

(B) Color vision, shape and fine details. > In the optic nerves and visual pathways there are several different types of nerve fibres, of which the magnocellular and the parvocellular pathway are the most important.> The largest path (approximately 80% of the nerve fibres) is the parvocellular pathway that transfers all colour information and high contrast black and white information.> Its nerve fibres are thin and transfer information relatively slowly. In the optic nerve 80% of the nerve fibres are parvocellular fibres and 10% of the fibres are magnocellular fibres.


Question: Renshaw cell inhibition is

Renshaw cells are inhibitory cells that transmit inhibitory signals.to the surrounding motor neurons.(Ref: Textbook of Medical physiology GUYTON and HALL page no.763)


Question: Amount of water lost in stools

Normal" Output: 1400-2300 mL/d Urine: 800-1500 mL Stool: 200 mL-250mL Insensible loss: 600-900 mL (lungs and skin). (With fever, each degree above 98.6degF adds 2.5 mL/kg/d to insensible losses; insensible losses are decreased if a patient is undergoing mechanical ventilation; free water gain can occur from humidified ventilation.)Ref: <a href="


Question: The thick filament is made up of Heavy chain of myosin Light chain of myosin Dystrophin Titin

The thick filament or the myosin is made up of the heavy chain of myosin and light chain of myosin The myosin molecule is composed of six polypeptide chains- Two heavy chains, each with a molecular weight of about 200,000 and four light chains with molecular weights of about 20,000 each. The two heavy chains wrap spirally around each other to form helix, which is called the tail of the myosin molecule. One each end of these chains is folded into a globular polypeptide structure called myosin head. These heads contain an actin-binding site and a catalytic site that hydrolyses ATP. Thus, there are two free heads at one end of the double-helix myosin molecule. The four light chains are also pa of the myosin head, two to each head. These light chains help control the function of the head during muscle contraction. Ref: Guyton and Hall Textbook of Medical Physiology 13th edition Pgno: 78-79


Question: Intrinsic factor is produced by

The gastric mucosa contains many deep glands. In the cardia and the pyloric region, the glands secrete mucus. In the body of the stomach, including the fundus, the glands also contain parietal (oxyntic) cells, which secrete hydrochloric acid and intrinsic factor, and chief (zymogen, peptic) cells, which secrete pepsinogens. These secretions mix with mucus secreted by the cells in the necks of the glands. Several of the glands open on a common chamber (gastric pit) that opens in turn on the surface of the mucosa. Mucus is also secreted along with HCO3 by mucus cells on the surface of the epithelium between glands.REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, KIM BARRETT, HEDDWEN BROOKS, SCOTT BOITANO, SUSAN BARMANTWENTY THIRD EDITIONPAGE NO:431,432


Question: TSH acting through

Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone that stimulates the thyroid gland to produce thyroxine (T4), and then triiodothyronine (T3) which stimulates the metabolism of almost every tissue in the body. It is a glycoprotein hormone synthesized and secreted by thyrotrope cells in the anterior pituitary gland, which regulates the endocrine function of the thyroid gland. The TSH receptor is a member of the G protein-coupled receptor superfamily of integral membrane proteins and is coupled to the Gs proteins.Ref: Ganong&;s review of medical physiology; 24th edition; page no-302


Question: Activation of the baroreceptor reflex

The baroreceptors are stretch receptors in the walls of the heart and blood vessels. The carotid sinus and aortic arch receptors monitor the arterial circulation. The baroreceptors are stimulated by distention of the structures in which they are located, and so they discharge at an increased rate when the pressure in these structures rises.

Is primarily involved in short-term regulation of systemic blood pressure.

Leads to an increase in heart rate because of inhibition of the vagal cardiac motor neurons.


Question: Pulmonary artery pressure is

Pressures in various portions of CVS

Right ventricle       → 25/0 mm Hg (systolic/diastolic)
Left ventricle         → 120/0 mm Hg
Right atrium          → 2 mm Hg
Left atrium            → 5mmHg
Aorta                    → 120/80 mm Hg
Pulmonary artery → 25/8 mm Hg


Question: Insulin increases the activity of


Question: First response to decreased blood volume

Baroreceptor reflex is an immediate compensatory mechanism in shock. There is stimulation of aerial baroreceptors and so sympathetic output is increased leading to vasoconstriction and reflex tachycardia. Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 184


Question: Total lung capacity depends upon

TLC = (IRV + TV + ERV + RV) When a person inspires maximally, the lungs are at TLC. This total volume of inspired air (3000 + 500) would depend on the distensibility of the lungs. Greater the compliance, more is the distensibility and greater the amount that can be inspired. Conversely, if the compliance is reduced (as in fibrosis), the lungs cannot be distended to a great extent and TLC will be less. TLC is greater in emphysema,Due to incomplete expiration and air trapping beyond compressed airways, residual volume is increased. It may contribute to increase in TLC. However, TLC does not depend on residual volume


Question: Active form of Vitamin D

(C) Calcitriol # Vitamin D Is Metabolized to the Active Metabolite, Calcitriol, in Liver & Kidney.> Cholecalciferol, either synthesized in the skin or from food, undergoes two hydroxylations to yield the active metabolite, 1,25-dihydroxyvitamin D or calcitriol.> Ergocalciferol from fortified foods undergoes similar hydroxylation to yield calcitriol.> In the liver, cholecalciferol is hydroxylated to form the 25-hydroxy-derivative, calcidiol.> This is released into the circula-tion bound to a vitamin D binding globulin, which is the main storage form of the vitamin.> In the kidney, calcidiol undergoes either 1 -hydroxylation to yield the active metabolite 1,25-dihydroxyvitamin D (calcitriol), or 24-hydroxylation to yield a probably inactive metabolite, 24,25-dihydroxyvitamin D (24-hydroxycaicidiol).> Some tissues, other than those that are involved in calcium homeostasis, take up calcidiol from the circulation and synthesize calcitriol that acts within the cell in which it was synthesized.


Question: Intrinsic factor of Castle is secreted by

Characteristics of the Gastric Secretions a. In addition to mucus-secreting cells that line the entire surface of the stomach, the stomach mucosa has two impoant types of tubular glands: oxyntic glands (also called gastric glands) and pyloric glands. b. The oxyntic or Parietal (acid-forming) glands secrete hydrochloric acid, pepsinogen, intrinsic factor. Ref: guyton and hall textbook of medical physiology 12 edition page number: 406,407,408


Question: Most permissible capillaries are seen in

Capillaries are classified in toContinuous or non fenestrated capillaries - Endothelial cells are arranged without any gap in between them. Eg. Skin, BBB. Allows only very small molecules to pass through. Fenestrated capillaries - Gaps in between endothelial cells ranging from 70-100nm in diameter which are lined by basement membrane. Eg. Capillaries of intestinal villi, renal glomeruli, choroid plexus of the ventricles of the brain, ciliary process of eyes and endocrine glandsDiscontinuous type- Very wide cleft are present in between endothelial cells. The basement membrane is incomplete or absent. Almost all substance in plasma can cross this gap. Seen in liver sinusoids, sinusoids of spleen, anterior pituitary and parathyroid gland Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 194


Question: Absent P waves with wide QRS complex indicates serum potassium of

Hyperkalemia Couesy of Dr. Michael McCrea a. Tall hyperacute T wave (earliest ECG finding) b. Prolonged PR interval c. Flattened or absent P wave d. Wide QRS complex that eventually blends with the T wave to assume a "sine wave" appearance e. Hea blocks f. QT interval normal or shoened Ref: guyton and hall textbook of medical physiology 12 edition page number:184,185,186


Question: Major neurotransmitter released at end organ effectors of the sympathetic division of the autonomic nervous system

In the parasympathetic division, neurons are cholinergic (that is, acetylcholine is the primary neurotransmitter). In sympathetic division, neurons are mostly adrenergic (that is, epinephrine and norepinephrine function as the primary neurotransmitters). Ref guyton and hall textbook of medical physiology 12/e pg 83


Question: Receptor for the inverse stretch reflex

The receptor for the inverse stretch reflex is in the Golgi tendon organ . This organ consists of a netlike collection of knobby nerve endings among the fascicles of a tendon.


Question: The most useful diuretic agent in the treatment of recurrent calcium stones is

The thiazides are useful in the prevention of calcium stones because these drugs inhibit the renal excretion of calcium. In contrast, the loop agents facilitate calcium excretion.


Question: The primary function of surfactant is

Surfactant is a mixture of dipalmitoylphosphatidylcholine, other lipids, and proteins. The phospholipids line up in the alveoli with their hydrophobic fatty acid tails facing the alveolar lumen. Surface tension is inversely propoional to their concentration per unit area. If the surface tension is not kept low when the alveoli become smaller during expiration, they collapse I accordance with Laplace law. Surfactant molecules move apa as alveoli enlarge during inspiration and surface tension increases, whereas it decreases when they move closer together during expiration.Ref: Ganong's Review of Medical Physiology Kim E Barrett, Susan M Barman, Scott Boitano, Heddwen L Brooks 23rd edition, page no -597

Decrease the surface tension of the fluid lining the alveoli


Question: Phantom limb sensations are best described by

Weber Fechner law - "Magnitude of sensation felt is proportionate to the log of the intensity of the stimulus"
Bell Magentic law - In the spinal cord - dorsal roots are sensory and ventral roots are motor
Law of projection - Describe phantom  limb sensation


Question: Carbon monoxide poisoning causes

Oxygen dissociation curve shifts to left


Question: GFR is opposed by

(B] (Osmotic pressure in glomerular): (680-Ganong 24th edition, 538- Jain 5th, 317-18; Guyton 10th)Glomerular Filtration RateIn normal resting man the glomerular filtration rate (GFR) averages 125cc/min. The ultrafiltrate is derived from an average total renal plasma flow (RPF) of 600 cc/min. The ratio of glomerular ultrafiltrate to renal plasma flow is referred to as the filtration fraction (FF):FF=GFR/RPFWhere, the FF represents the fraction of plasma which is filtered across the glomerular capillary bed. Alterations in the FF can have an important effect on proximal tubular reabsorption of fluid. The glomerular filtration rate is several fold that of fluid movement in capillary beds of other tissues, principally because the surface area available for diffusion plus the permeability of the glomerular capillary membrane (Kf) is approximately 100 fold that of other capillary beds.Physical Determinants of Glomerular FiltrationThe net filtration across a capillary bed (including the glomerular capillary membrane wall is governed by the algebraic sum of hydrostatic and oncotic pressure across the capillary wall.Schematic depiction of the physical determinants responsible for the formation of an ultra filtrate of plasma in Bowman's space. The principal driving force for the formation of the glomerular ultrafiltrate is the hydraulic pressure within the glomerular capillary (Pgc)- In contrast, the principle forces opposing filtration include the oncotic pressure ( 1/4 GC) within the glomerular capillary and hydrostatic pressure in Bowmans space (PBS). Net ultrafiltration is further modulated by the hydraulic permeability and surface area of the glomerular capillary (Kf).The glomerular filtration rate can be derived using the following mathematical relationshipGFR = Kf x (PGC-PBS)-(pGC-7pBs)= Kf x (AP-Att)= Kf x Pufwhere; Kf is the membrane porosity * surface area;PGC is the hydrostatic pressure in the glomerular capillary network;PBS is the Bowman's space pressure;pGC is the glomerular capillary oncotic pressure;tcBS is the Bowman's space oncotic pressure;AP is the transcapillary hydrostatic pressure (PGC - PBS);Arc is the transcapillary oncotic pressure (rcGC - rcBS) andPUF is the net ultrafiltration pressureSince the glomerular ultrafiltrate is typically protein free, pi BS is equal to zero, and, thus, the oncotic pressure inBowman's space is usually excluded from the above analysis. Therefore, the major direct determinants of GFR include.* PGC* PBS* Kf* rcGCIn addition to the above direct determinants of GFR, RPF also indirectly modulates GFR.PGC - In general, increases in glomerular capillary hydrostatic pressure will increase GFR while decreases result in the opposite effect.p- In general, increases in Kf will tend to increase GFR while decreases will tend to decrease GFR.PBS- Normally Bowman's space pressure remains constant because of unimpeded flow of glomerular filtrate.An obstruction to urinary out flow distal to Bowman's space will result in a fall in delta P (and hence GFR) incident to a rise in Bowman's space pressure.pGC- The glomerular capillary oncotic pressure is the principle factor opposing glomerular filtrationThe pressure in the glomerular capillaries is higher than that in other capillary beds because the afferent arterioles are short, straight branches of the interlobular arteries. Further more the vessels "downstream" from the glomeruli, the efferent arterioles have a relatively high resistance. The capillary hydrostatic pressure is opposed hydrostatic pressure in Bowman's capsule. It is also opposed by the oncotic pressure gradient across the glomerular capillary (pGC - pT) is normally negligible and the gradient is essentially equal to the oncotic pressure of the plasma proteins.Hormones or autocoidsEffect on GFR(i) Norepinephrine, Epinephrine Endothelin,| (ii) Angiotension II -(prevent |)(iii) Endothelial derived nitric oxide prostaglandins (PGE2), Dopamine(iv) High protein intake| (v) Increased blood glucose| Uncontrolled DM|


Question: Volume of ECF in body is

Total body weight = 0.6 × body weight
ICF = 0.4 × body weight
ECF = 0.2 × body weight
Plasma = 0.05 × body weight
Interstitial fluid = 0.15 × body weight


Question: Slow pain in nerves is carried by

(D) C > Sense organs for pain are free nerve ending found in almost every tissue of the body> PAIN PATHWAY> VPN thalamus Ad(myelinated)... fast pain> DRG> C (unmyelinated)... slow pain dorsal root> Substance P is mediator of pain


Question: Cardiac output decreases during

Ans. (d) Standing from lying down positionRef: Ganong, 25th ed/p.544Cardiac output changesNo change:SleepIncreases during:Anxiety and excitement (50-100%)Eating (30%)Exercise (up to 700%)High environmental temperaturePregnancyEpinephrineDecreases during:Standing from lyingHeart diseases

Moderate increase in environmental temperature


Question: Largest lung volume is defined by

Ans: a (Vital capacity) Please go through diagram given below & make the facts clear. LUNG VOLUMES INSPIRATORY CAPACITY (IC)FUNCTIONAL RESIDUAL CAPACITYVITAL CAPACITYTOTAL LUNG CAPACITY= TV + IRV= ERV + RV= ERV + TV + IRV= ERV+ TV + IRV + RV. Male (L)Female (L)Residual volumeExpiratory reserve volume1.211.10.7Tidal volume0.50.5Inspiratory reserve volumeTotal lung capacity3.361.94.2 Respiratory minute volume= 6 LI minAlveolar ventilation= 4.2L/ minMaximum voluntary ventilation= 125-170 L/minMax work done in breathing=10 kg-m/breathNormal work done in breathing= 0.5 kg-m/ minTimed vital capacity / secFEV1=83% FEV3= 97%REMEMBERTotal lung capacity is measured by1) helium dilution method2) body plethismographyResidual volume is measured by1) N2 washout method.


Question: Caisson’s disease is

Sudden decompression of the diver after excess exposure to high pressure: Decompression sickness (synonyms: Bends, Compressed Air Sickness, Caisson Disease, Diver’s Paralysis, Dysbarism):

Nitrogen bubbles can develop in the body fluids and can cause minor or serious damage in almost any area of the body (because nitrogen is not metabolized by the body).
Gas bubbles blocking many blood vessels in different tissues cause the symptoms of decompression sickness.
Most common symptoms (85-90%): Pain in the joints and muscles of the legs and arms. The joint pain accounts for the term "bends".
Nervous system symptoms (5-10%): Dizziness, paralysis or collapse and unconsciousness.
The chokes (2%): Massive numbers of microbubbles plugging the capillaries of the lungs leading to shortness of breath, often followed by severe pulmonary edema and, occasionally death.


Question: An anterolateral cordotomy relieving pain in right leg is effective because it interrupts the

Surgical procedure undeaken to relieve severe pain include cutting the nerve from the site of injury or ventrolateral cordotomy, in which the opposite side spinothalamic tracts are fully cut. Ref: Ganong&;s review of medical physiology;23rd edition; pg:177


Question: Windkessel effect is seen in

Windkessel effects are large vessels that contain large amount of elastic fibres and few amount of smooth muscle fibres. These vessels can distend due to elasticity during systole and can recoil back during diastole. Examples are aoa and its large branches. Since these vessels are elastic, during systole, they are stretched to accommodate the extra blood. The forward flow becomes continuous due to the elastic recoil of vessels during diastole. This recoil effect is called windkessel effect.Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no: 174


Question: According to myogenic hypothesis of renal  autoregulation,  the  afferent  arterioles contract in response to stretch induced by

Stretch on smooth muscle (afferent  arterioles) opens Ca+ channel, which causes contraction of afferent arterioles.the medullary interstitium.
REGULATION OF GFR
Regulation is done by:

Blood pressure: Autoregulation
Resistance of afferent and efferent anterioles

- Autoregulation: Constant maintenance of renal blood flow or, GFR over the span of renal perfusion pressure (pressure in renal artery minus pressure in renal vein ) from 80 to about 170mm Hg
- Mechanism of autoregulation:
i) Myogenic mechanism- contraction or relaxation of anteriolar smooth muscle in response to changes in vascular pressures; mediated by Ca++
ii) Tubule glomerular feedback (TGF) mechanism-mediated by macula densa cells (described later)


Question: Mitochondria have

human mitochondrial DNA is a double-stranded circular molecule containing approximately 16,500 base pairs.(REF: GANONG'S REVIEW OF MEDICAL PHYSIOLOGY 23rd EDITION page no.34.)


Question: Hormone involved in regulation of BP

Ans. (b) Angiotensin - IIRef: Ganong, 25th ed/p.575Angiotensin - II is a vasoconstrictor. By itself, it is involved in short term regulation of BPThe same angiotensin - II is also involved in long term regulation of BP as a part of Renin Angiotensin aldosterone system (RAAS)


Question: The magnitude of an electrical difference that exists across the membrane can be determined by

In electrochemistry, the Nernst equation is an equation that relates the reduction potential of an electrochemical reaction (half-cell or full cell reaction) to the standard electrode potential, temperature, and activities (often approximated by concentrations) of the chemical species undergoing reduction and oxidation Ref: guyton and hall textbook of medical physiology 12 edition page number:58,59,60


Question: Resting membrane potential is mainly due to

Resting membrane potential depends on the concentration of potassium ion. (REF: TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, 23)


Question: The hyperkinetic features of the Huntington's disease are due to the loss of

It is a genetic disease of nervous system inherited as an autosomal dominant disorder usually occurring between 30 and 50 years of age. Site of lesion : There occurs damage to GABAergic and cholinergic neurons of striatum (caudate and putamen ) that project to pallidum The loss of GABAergic pathway to the external pallidum releases inhibition, permitting the hyperkinetic features of the disease to develop. It affects 5 out of 100,000 people worldwide Ref: Ganong's Review of Medical Physiology 26th edition pg no.566

Intrastriatal GABA-ergic and cholinergic system


Question: Selenocysteine residues are present in

Selenocysteine is defined as substance with Cysteine containing selenium in place of one sulfur atom.Deiodinase is an enzyme that deiodinates two of the iodinated amino acids (iodothyronines) within the thyroid gland. Selenium-dependent deiodinase conves thyroxine (T4) to triiodothyronine (T3), the more active thyroid hormone.Pyruvate carboxylase an enzyme that catalyzes the irreversible carboxylation of pyruvate, a reaction necessary for gluconeogenesis from lactate or amino acids forming pyruvate and also providing four-carbon compounds for the citric acid cycle. The enzyme is a mitochondrial protein occurring in liver but not in muscle. Deficiency of the enzyme, an autosomal-recessive trait, causes severe psychomotor retardation and lactic acidosis in infants.Xanthine oxidase flavoprotein containing molybdenum; an oxidoreductase catalyzing the reaction of xanthine, O2, and H2O to produce urate and superoxide. Also oxidizes hypoxanthine, some other purines and pterins, and aldehydes. A lower rate of oxidation is observed in patients with molybdenum cofactor deficiency.Lysyl oxidase is an enzyme, which requires Cu2+ and O2, that oxidizes ceain lysyl residues in collagen to allysyl residues andhydroxylysyl residues to hydroxyalkyl residues; this is a required step for the crosslinking ( aldol condensations and through Amadori rearrangements) of collagen strands; a lower activity of this enzyme is associated with occipital horn syndrome.


Question: Postganglionic sympathetic fibres are

The axons of postganglionic neurons are mostly unmyelinated C fibres and terminate on visceral effectors. Ref: Ganong&;s review of medical physiology; 23rd edition; pg:263.


Question: In a seriously ill patient, addition of amino acids in diet results in a positive nitrogen balance. The mechanism for this is

Nutrition experiments with various levels of calorie and protein intake were carried out on five healthy young men. Three series of experiments with two persons each were undeaken for periods up to 14 days. The first pa of each experiment, with 1100 to 1500 kcal/day, was immediately followed by the second pa, with 3500 to 2300 kcal/day. The concentrations of insulin, free fatty acids, glucose and amino acids were determined in the morning, fasted blood. The nitrogen balance was also determined. When insufficient carbohydrate intake is coupled with normal and high protein content of the food, there is interindividually an initial drop in the insulin concentration. Regardless of the absolute insulin concentration, this drop causes an increase in the free fatty acids and the branched-chain amino acids, together with a decrease in the concentrations of alanine and glycine (threonine) in the blood and a negative nitrogen balance. The high concentrations of branched-chain amino acids and the low threonine concentrations might be involved as feedback regulators in the fuher regulation of the gluconeogenic metabolism. When carbohydrate calories are added to the diet, a simultaneous decrease in the free fatty acids and branched-chain amino acids and increase in the blood concentrations of insulin, alanine, glycine and threonine within 24 to 48 h are only observed with 3500 kcal/day and 0.8 to 1.4 g protein per kg body weight. A positive nitrogen balance, however, is only observed with 1.4 g protein per kg body weight, regardless of the relative changes in the insulin level, while the increase in alanine and decrease in branched-chain amino acids (valine) are greatest at 0.8 g protein per kg body weight and day. In spite of the high glucose level, the falling insulin level provokes counter-regulatory processes in which the low concentrations of branched-chain amino acids and the high threonine (alanine) concentrations may play a role. Ref: guyton and hall textbook of medical physiology 12 edition page number:610,611,612

Increased absorption of amino acids from diet


Question: Body temperature regulation centre is located at

Anterior hypothalamus, responds to heat;Posterior hypothalamus, responds to cold. Ref: Ganongs Review of medical physiology;25 th edition ; pg :309; table 17-1.


Question: Vagal stimulation of heart causes


Question: Counter irritants applied to decrease pain by action on

(B) Inhibition of pain pathways in the dorsal horn gate # Central Inhibition & Counterirritants> Stimulation with an electric vibrator at the site of pain also gives some relief. The relief is due primarily to inhibition of pain path- ways in the dorsal horn gate by stimulation of large-diameter touch-pressure afferents.> The same mechanism is probably responsible for the efficacy of counterirritants.> Stimulation of the skin over an area of visceral inflammation produces some relief of the pain due to the visceral disease.> The old-fashioned mustard plaster works on this principle.


Question: Left lobe of the brain is responsible for

Categorial hemisphere (left)- Spoken language, written language, mathematical calculation.
Representational hemisphere (right)- Visuospatial orientation, musical awareness.


Question: Barometric pressure at 10,000 feet deep in the sea is

The approximate barometric at sea level, the barometric pressure is 760 mm Hg; at 10,000 feet, it is only 523 mm Hg; and at 50,000 feet, it is 87 mm Hg. This decrease in barometric pressure is the basic cause of all the hypoxia problems in high-altitude physiology because, as the barometric pressure decreases, the atmospheric oxygen paial pressure (PO2) decreases propoionately, remaining at all times slightly less than 21 percent of the total barometric pressure; At sea level, PO2 is about 159 mm Hg, but at 50,000 feet, PO2 is only 18 mm Hg.Ref: Guyton; 13th edition; Chapter 44; Ation, High Altitude, and Space Physiology


Question: Substance freely filtered by kidney

Ans: b (Inulin) Ref: Ganong 22nd ed/ p.706, 21st ed/ 709The substance which is freely filtered and neither absorbed nor secreted in the tubules is inulin.Creatinine is practically used to measure GFR, because it is easy to measure.Creatinine is secreted by the tubules and some maybe reabsorbed.Clearance of a substance is equal to the concentration of that substance in urine multiplied by urine flow rate divided by arterial plasma level, i.e.Clearance = UxV/PxUx = concentration of substance in urineV - urine flow ratePx = concentration of the substance in plasmaNote:PAHA is used to measure renal plasma flow i.e.Clearance of PAHA is equal to effective renal plasma flow.From the renal plasma flow, the renal blood flow can be calculated by:Renal blood flow = RPF x 1/ (1-Hematocrit)Renal blood flow = 1273ml/min which account for about 25% of cardiac output.


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

(Na+) (27 -K.S 4th) (318-Ganong 23rd)Sodium co-transport of glucose - Sodium co - transport of glucose occurs during absorption of glucose from the intestine and reabsorption of glucose from renal tubule


Question: Volume determining preload is

Ans. (a) End diastolic volume of ventriclesRef: Ganong, 25th ed/p.544Preload is End diastolic volume of ventriclesAfterload is the aortic pressure


Question: In a neuron, graded electrogenesis occurs at

Graded potentials are associated with depolarization of neuron up to threshold level,increased number of graded potential produce action potential Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:675,676,677


Question: Concentration of sodium in ECF is

Sodium levels are usually between 136to 145 mmol/L . Blood sodium level less than 136mmol/L mean you have less sodium Ref:Guyton and Hall textbook of medical physiology 12th edition,page number: 50


Question: Role of 2,3 DPG in haemoglobin is


Question: The normal adult CSF pressure is


Question: The enzyme associated with the conversion of androgen to oestrogen in the growing ovarian follicle is


Question: Normal respiratory minute volume is


Question: Erythropoiesis in first two months of gestation age takes place in

In the first 2 month of gestation. the yolk sac is the main site of blood formation (MESOBLASTIC PHASE) Ref: Medical Physiology Indu Khurana 2015 edition pAge No:104


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

the anemic type, in which the amount of functional hemoglobin is too small, and hence the capacity of the blood to carry oxygen is too low Ref: guyton and hall textbook of medical physiology 12 edition page number: 353,354,355


Question: Polar bodies are formed during

Polar bodies are one of two small cells formed by the first and second meiotic division of oocytes; the first is usually released just before ovulation, the second not until discharge of the oocyte from the ovary; in mammals, the second polar body may fail to form unless the oocyte has been penetrated by a sperm.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 401


Question: Brodman's area number for motor area

Ans. (a) 4 and 6(Ref: Ganong, 25th ed/p.237)Primary motor cortex Is located in the precentral gyrus of the frontal lobe (Brodmann's area 4)Premotor cortex and supplementary motor cortex - Brodmann's area 6


Question: The rate of lymph flow is

(120 ml/hr) (116-K.S) (172-Gyton 10th) (593-GN) (535- Ganong 23rd)RATE OF LYMPH FLOW - About 120 ml of lymph flows into blood per hour. Out of this, about 100 ml/hour flows through thoracic duct and 20 ml/hour flows through the right lymphatic duct* The normal 24-hour lymph flow is 2-4 L* The rate of lymph flow is determined by the product of interstitial fluid pressure times the activity of the lymphatic pump* Role of the lymphatic system in controlling interstitial fluid protein concentration, interstitial fluid volume, and interstitial fluid pressure.* Its protein content is generally lower than that of plasma, which contains about 7 g/dLFactors influencing the flow of LymphThe flow of lymph is promoted by the increases in1. Interstitial fluid pressure2. Blood capillary pressure3. Surface area of lymph capillaries by means of dilatation4. Permeability of lymph capillaries5. Functional activities of tissues


Question: Postural reflex with integrating center in spine

The crossed extensor reflex or crossed extensor response or crossed extension reflex is a reflex in which the contralateral limb compensates for loss of suppo when the ipsilateral limb withdraws from painful stimulus in a withdrawal reflex Ref: guyton and hall textbook of medical physiology 12 edition page number: 775,776,777


Question: Maximum reabsorption of sodium takes place in

(A) Proximal convoluted tubule Transport Proteins Involved in the Movement.of Na+ and CI-Across the Apical Membranes of Renal Tubular Cells.3SiteApical 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 CI/base exchangerCI- uptakeThick ascending limbNa-K-2CI CTNa+ uptake, CI- uptake, K+ uptake Na/H exchangerNa+ uptake, H+ extrusion K+ channelsK+ extrusion (recycling)Distal convoluted tubuleNaCI CTNa+ uptake, CI- uptakeCollecting ductNa+ channel (ENaC)Na+ uptake# In the proximal tubules, the thick portion of the ascending limb of the loop of Henle, the distal tubules, and the collecting ducts, Na+ moves by cotransport or exchange from the tubular lumen into the tubular epithelial cells down its concentration and electrical gradients and is actively pumped from these cells into the interstitial space. Thus, Na+ is actively transported out of all parts of the renal tubule except the thin portions of the loop of Henle. Na+ is pumped into the interstitium by Na+-K+ ATPase. It extrudes three Na+ in exchange for two K+ that are pumped into the cell.


Question: The cones in the eye are

(C) Associated with higher visual acuity than the rods > The rods and cones, which are next to the choroid, synapse with bipolar cells, and the bipolar cells synapse with ganglion cells. The axons of the ganglion cells converge and leave the eye as the optic nerve.> Horizontal cells connect receptor cells to the other receptor cells in the outer plexiform layer.> Amacrine cells connect ganglion cells to one another in the inner plexiform layer.> They have no axons, and their processes make both pre- and postsynaptic connections with neighboring neural elements.

Dependent on Vitamin-A for their function


Question: Immune rejection in fetus is prevented by

Chorionic gonadotropin (human chorionic gonadotropin (HCG) (hCG) is a glycopeptide hormone that is produced by cells of the fetal placenta and maintains the function of the corpus luteum during the first few weeks of pregnancy. It is thought to promote steroidogenesis in the fetoplacental unit and tostimulate fetal testicular secretion of testosterone. It can be detected by immunoassay in the maternal urine within days after feilization; this provides the basis for the most commonly used pregnancy test. Due to its highly negative charge, hCG may repel the immune cells of the mother, protecting the fetus during the first trimester. It has also been hypothesized that hCG may be a placental link for the development of local maternal immunotoleranceRef: Ganong&;s review of medical physiology;24th edition; page no:-414


Question: Adrenaline acts through

Adrenaline, noradrenaline and dopamine acts via seven pass receptor or Serpentine receptor.


Question: Normal CSF protein measured at basal cistern is

(B) 20-50 mg/dL CEREBROSPINAL FLUIDConstituentReference RangeSI UnitsConventional UnitsOsmolarity292-297 mmol/kg water292-297 mOsm/LElectrolytes * Sodium137-145 mmol/L137-145 meq/L* Potassium2.7-3.9 mmol/L2.7-3.9 meq/L* Calcium1.0-1.5 mmol/L2.1-3.0 meq/L* Magnesium1.0-1.2 mmol/L2.0-2.5 meq/L* Chloride116-122 mmol/L116-122 meq/L* CO2 content20-24 mmol/L20-24 meq/LPCO26-7 kPa45-49 mmHgpH7.31-7.34 Glucose2.22-3.89 mmol/L40-70 mg/dLLactate1-2 mmol/L10-20 mg/dLTotal protein: * Lumbar0.15-0.5 g/L15-50 mg/dL* Cisternal0.15-0.25 g/L15-25 mg/dL* Ventricular0.06-0.15 g/L6-15 mg/dL* Albumin0.066-0.442 g/L6.6-44.2 mg/dL* IgG0.009-0.057 g/L0.9-5.7 mg/dLCEREBROSPINAL FLUID* IgG index0.29-0.59 * Oligoclonal bands (OGB)<2 bands not present in matched serum sample Ammonia15-47 mmol/L25-80 ng/dLCreatinine44-168 pmol/L0.5-1.9 mg/dLMyelin basic protein<4 ng/L CSF pressure 50-180 mmH2OCSF volume (adult)-150 mL Red blood cells00Leukocytes Total0-5 mononuclear cells per pL Differential * Lymphocytes60-70% * Monocytes30-50% * NeutrophilsNone


Question: By spirometry, one can measure

Most lung volumes are measured by Spirometer. Residual volume, total lung capacity, and functional residual capacity cannot be measured with a spirometer.Ref: Ganong review of medical physiology 23rd edition Page no: 593


Question: Pulse pressure in a paicular vessel is determined chiefly by

In advancing age due to loss in elasticity of blood vessels, stretching decreases which results in increased pressure during systole with normal diastolic blood pressure (systolic hypeension). The blood vessels behave like a rigid tube. It is characterized by high pulse pressure. Pulse pressure is determined by elasticity of vessel wall that varies inversely with total peripheral resistance.


Question: Inulin clearance is equal to

Inulin clearance is equal to about 125ml/min, which is the GFR.


Question: During inspiration diaphragm

(A) (Contract) (683, Sembulingam 6th)Diaphragm principal muscle of inspiration* On contraction, the diaphragm descends increasing the vertical diameter of the thorax* During inspiration, due to the contraction, muscle fibers are shortened, but the central tendinous portion is drawn downwards so the diaphragm is flattened. Flattening of diaphragm increases the vertical diameter of the thoracic cageDIAPHRAGM* Motor nerve supply-phrenic nerves ** are the sole motor supply to the diaphragm* Sensory nerve supply- central part- phrenic nerve -peripheral part- Lower six thoracic nerve* Bochdalek hernia occurs through -posterolateral part of diaphragm , more common in left side- Visceral contents herniate and fill the chest cavity stomach and transverse colon are the commonest content of Bochdalek hernia- The abdominal cavity is small and undeveloped and remains scaphoid ** after birth- The herniated viscera as a space occupying lesion and prevent normal lung development- BH can be accurately diagnosed prenately as early as 15th weeks of gestation by USG* Morgagnian Hernia- It is retrosternal hernia ** (occurs through the space between the xiphoid and costal origins of the diaphragm* Level of the diaphragm is highest in the supine position lowest while sitting, and intermediate while standing* The sole motor nerve supply of the diaphragm is phrenic nerve (C4)* Hiccough or hiccup is the result of spasmodic contraction of the diaphragm* Bilateral phrenic nerve paralysis results in adequate ventilation to maintain life* Diaphragmatic ruptures is more common on the LEFT side 9 time more common than right the right diaphragm is protected by two mechanism the liver on the right and the heart in the centre have buffering effect that diffuses the sudden increases in intra-abdominal pressureBochdalek-hernia- Most Bochdalek hernia are on the left side (-80%) and may rarely be bilateral- Compression of the lung results in pulmonary hypoplasia, involving both the lungs( ipsilateral >contralateral- Pulmonary vasculature is also abnormal leading to pulmonary hypertension.- Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertension.- The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemia.- The anteroposterior diameter of the chest may be large along with a scaphoid abdomen.- The diagnosis of CDH can be made prenatally by ultrasound.- The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gas bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the hernia.- Historically. The surgical repair of a CDH was considered to be a surgical emergency because it was bell the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognit role of pulmonary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair; pulmonary function has caused a policy of delayed repair. Thus most pediatric surgeons wait for a variable (24 to 72 hrs) to allow for stabilization of the infant before doing surgical repair.* About contents of the cong. Diaphragmatic hernia.- Most books of surgery write that any abdomen viscera can herniate.- CSDT writes that ''Bowel, spleen & liver sometimes herniate into the chest".* Bag and Mask ventilation is contraindicated in diaphragmatic hernia* Most common prognosis factor in CDH pulmonary hyper tension* Most common site of Morgagni hernia is RIGHT ANTERIOR.* Morgagni hernia is a rare form of cong, diaphragmatic hernia occurring through foramen of Morgagni or space of Larrey i.e, space between the sternal and costal origins of the diaphragm)- It is more common on right side.- Usually it is asymptomatic- Most common viscera to herniate through space of Morgagni is transverse colon (Bailey &Love 24/e,p873)Also know:- Superior epigastric vessels pass through foramen of Morgagni


Question: Otto Loewi is famous for discovery of

Otto Loewi is famous for discovery of acetylcholine for which he received a Nobel price. so the option 2.(Reference: www.nobelprize.org)


Question: Repetitive stimulation increases pain sensation, the probable cause is

Repetitive stimulation causes release of chemical mediators such as histamine, bradykinin, prostaglandins etc, which increase the sensitivity of nociceptors.


Question: cAMP acts by

Cyclic AMP is formed from ATP by the action of the enzyme adenylyl cyclase and conveed to physiologically inactive 5&;AMP by the action of the enzyme phosphodiesterase. Some of the phosphodiesterase isoforms that break down cAMP are inhibited by methylxanthines such as caffeine and theophylline. Consequently, these compounds can augment hormonal and transmitter effects mediated cAMP. Cyclic AMP activates one of the cyclic nucleotide-dependent protein kinases (protein kinase A, PKA) that, like protein kinase C, catalyzes the phosphorylation of proteins, changing their conformation and altering their activity. In addition, the active catalytic subunit of PKA moves to the nucleus and phosphorylates the cAMP-responsive element-binding protein (CREB). This transcription factor then binds to DNA and alters transcription of a number of genes.Ref: Ganong&;s review of medical physiology, 23rd edition, Page no: 56


Question: Iron is absorbed predominantly in the

Iron absorption occurs predominantly in the duodenum and upper jejunum ( Muir and Hopfer, 1985) (Figure 1). The mechanism of iron transpo from the gut into the bloodstream remains a mystery despite intensive investigation and a few tantalizing hits. Ref: guyton and hall textbook of medical physiology 12 edition


Question: Best prognosis in nerve injury

Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery.Ref: Ganong&;s review of medical physiology 23rd edition


Question: Aphasia is most likely associated with a lesion in

Broca's area is a region in the frontal lobe of the dominant hemisphere (usually the left) of the hominid brain with functions linked to speech production.


Question: Pyramids are formed by

The pyramidal tracts include both the coicospinal and coicobulbar tracts. These are aggregations of upper motor neuron nerve fibres that travel from the cerebral coex and terminate either in the brainstem (coicobulbar) or spinal cord (coicospinal) and are involved in control of motor functions of the body.The coicospinal tract conducts impulses from the brain to the spinal cord. It is made up of a lateral and anterior tract. The coicospinal tract is involved in voluntary movement. The majority of fibres of the coicospinal tract cross over in the medulla, resulting in muscles being controlled by the opposite side of the brain. The coicospinal tract also contains Betz cells (the largest pyramidal cells), which are not found in any other region of the body.The nerves within the coicospinal tract are involved in movement of muscles of the body. Because of the crossing-over of fibres, muscles are supplied by the side of the brain opposite to that of the muscle. Ref: guyton and hall textbook of medical physiology 12 edition page number:765,766,767


Question: Oxygen as an emergency drug is contraindicated in


Question: The final sugars in intestinal chyme are


Question: Maximum blood flow per 100 gram of organ is seen in

Organ
Blood flow / 100gm of organ

Kidney
			Liver
			Brain
			Skeletal muscle

400ml / 100gm / min
			100ml / 100gm / min
			50ml / 100gm / min
			2-4ml / 100gm / min


Question: Function of Kupffer cells in liver is

Kupffer cells (KC) constitute 80-90% of the tissue macrophages present in the body. They reside within the lumen of the liver sinusoids and are therefore constantly exposed to gut-derived bacteria, microbial debris, and bacterial endotoxins, known to activate macrophages & has got phagocytic action. Ref: Medical Physiology, Indu Khurana


Question: Amount of blood in hea

Out of 5000 mL blood in our body 12% is in the hea cavitiesWhich is nearly 600Therefore generally 500-600 mL BLOOD IN HEARef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:543


Question: Neurotransmitter of inner hair cells

Hair cells: - Hair cells are surrounded by endolymph Endolymph is high in K+ concentration. Basilar fibre vibration | Shearing force created in Reticular lamina & tectorial membrane | Bending of the stereocilia | Opening of K+ channels | K+ enter hair cells | Depolarization Of hair cells. | Depolarization then open voltage gated Ca++ channels. | Ca++ enter hair cells | Glutamate (NT) is released at the synapse | Glutamate causes excitation of the VIIIth nerve


Question: Cause of vasodilation in spider nevi

B i.e. EstrogenIn chronic liver disease (especially cirrhosis) and pregnancy, impaired estrogen metabolism and consequent hyper estroenemiaQ leads to spider angiomata/nevi (superficial, toous aerioles, that unlike simple telangiectases, typically fill from the center outwards and occur invariably on upper half of body) and palmar erythema (mottled redness of thenar & hypothenar eminences).


Question: Einthoven's law

Einthoven's Law states that if the electrical potentials of any two of the three bipolar limb electrocardiographic leads are known at any given instant, the third one can be determined mathematically by simply summing the first two (but note that the positive and negative signs of the different leads must be observed when making this summation). Thus the sum of the voltages in leads I and III equals the voltage in lead II.


Question: Swimming pool granuloma is caused by

Mycobacterium marinum can cause cellulitis or granulomas on skin surfaces exposed to the water in aquariums or injured in swimming pools.


Question: Bile acid has a detergent action due to

Bile contains bile acids, which are critical for digestion and absorption of fats and fat-soluble vitamins in the small intestine. Many waste products, including bilirubin, are eliminated from the body by secretion into bile and elimination in feces. Ref: guyton and hall textbook of medical physiology 12 edition page number:437,438,439


Question: Hypoxiema independent of

Hb [Ref: Ganong 23/e p617; http://en.wikipedia.org/wiki/Hypoxemiaj Hypoxemia is decreased paial pressure of oxygen in blood. It is the oxygen that is dissolved in the blood not attached with hemoglobin; thus it does not depend on Hemoglobin. Hypoxemia is one of the types of Hypoxia kla Hypoxic Hypoxia. The Hypoxia dependent on hemoglobin is anemic Hypoxia. Hypoxia is defined as 0, deficiency at the tissue level. Hypoxia has been divided into four types. (1) Hypoxic hypoxia, in which the P02 of the aerial blood is reduced; (2) Anemic hypoxia, in which the aerial P02 is normal but the amount of hemoglobin available to carry 02 is reduced; (3) Stagnant or Ischemic hypoxia, in which the blood .flow to a tissue is so low that adequate 02 is not delivered to it despite a normal P02 and hemoglobin concentration; and (4) Histotoxic hypoxia, in which the amount of 02 delivered to a tissue is adequate but, because of the action of a toxic agent, the tissue cells cannot make use of the 02 supplied to them. Hypoxic Hypoxia (Hypoxemia) Hypoxic Hypoxia is the most common form of hypoxia seen clinically. Causes: 1.Low inspired paial pressure of oxygen (low Pi02) 2. Alveolar hypoventilation 3.Impairment of diffusion across blood-gas membrane 4.Ventilation-perfusion inequality 5. Shunt In contrast, primary hemoglobin deficiency, e.g. anemia is not a cause, since it doesn't decrease the paial pressure of oxygen in blood. Low inspired oxygen paial pressure (low PiO2) If the paial pressure of oxygen in the inspired gas is low, then a reduced amount of oxygen is delivered to the alveoli of the lung. The reduced oxygen paial pressure can be a result of reduced fractional oxygen content (low Fi02) or simply a result of low barometric pressure, as can occur at high altitudes. This reduced Pi02 can result in hypoxemia even if the lungs are normal. Alveolar hypoventilation If the alverolar ventilation is low, there may be insufficient oxygen delivered to the alveoli each minute. (e.g., airway obstruction, depression of the brain's respiratory center, or muscular weakness). Impaired diffusion Impaired diffusion across the blood-gas membrane in the lung can cause hypoxemia, e.g. pneumonia, pulmonary fibrosis Shunt Shunting of blood from the right side to the left side of the circulation (right-to-left shunt) is a powerful cause of hypoxemia. The shunt may be intracardiac (tong. cyanotic hea disease) or may be intrapulmonary.(Note that Left-toright shunting does not cause hypoxemia.) Ventilation-perfusion inequality Ventilation-perfusion inequality (or ventilation-perfusion mismatch) is a common cause of hypoxemia in people with lung disease. It is the areas of the lung with ventilation/perfusion ratios that are less than one (but not zero) that cause hypoxemia by this mechanism. A ventilation/perfusion ratio of zero is considered a shunt. (Not sure how PCO\\ is linked with hypoxemia or PaO2 ; possibl! hypoxemia causes lryperventilation which leads todecreased alveolar and aeial PCO2)


Question: Antiperistalsis is more commonly seen in

Excessive distention or irritation of the duodenum provides an especially strong stimulus for vomiting. In the early stages of excessive gastrointestinal irritation or overdistention, antiperistalsis begins to occur, often many minutes before vomiting appears.


Question: Preload to the hea depends upon

When the muscle is stretched, the developed tension increases to a maximum and then declines as stretch becomes more extreme. Starling pointed this out when he stated that the "energy of contraction is propoional to the initial length of the cardiac muscle fiber" (Starling's law of the hea or the Frank-Starling law). For the hea, the length of the muscle fibers (ie, the extent of the preload) is propoional to the end-diastolic volume.Ref: Ganong&;s Review of medical physiology 25th edition. Page: 546


Question: Mycophenolate mofetil is used in

Mycophenolate mofetil is an immunosuppressant used to prevent rejection of allogeneic cardiac, hepatic, and renal transplants. It is administered orally or intravenously. indications It is used to prevent rejection of organ transplants and for prophylaxis of organ rejection in allogeneic cardiac transplants. Contraindications Known hypersensitivity to this drug or to mycophenolic acid prohibits its use.Ref: Ganong&;s review of medical physiology, 23rd edition Page no:75

Prevention of organ transplantation rejection


Question: During standing, in apex of lung

In respiratory physiology, the ventilation/perfusion ratio (V/Q ratio or V/Q ratio) is a ratio used to assess the efficiency and adequacy of the matching of two variables: V or V - ventilation - the air that reaches the alveoli. Q or Q - perfusion - the blood that reaches the alveoli the capillaries Ref: guyton and hall textbook of medical physiology 12 edition page number:331,332,333


Question: QRS complex is due to

P wave is primarily produced by atrial depolarization, the QRS complex is dominated by ventricular depolarization, and the T wave by ventricular repolarization. The U wave is an inconstant finding that may be due to ventricular myocytes with long action potentials. Ref: Ganong&;s Review of medical physiology 25th edition. Page: 522


Question: The systolic pressure in the right ventricle is

The systolic pressure in the right ventricle is about 25 mmHg. Normal Value for Hemodynamic parameters Parameter Pressure (mmHg) Aerial BP Systolic Diastolic Mean Aerial pressure(MAP) 90-140 60-90 70-105 Right Ventricle Systolic Diastolic 15-25 0-8 Pulmonary aery Systolic Diastole Mean 15-25 8-15 10-20 Pulmonary capillary wedge pressure Mean 6-12 Left atrium Mean 6-12 Right atrium ( central venous pressure) Mean 2-6 Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 529


Question: Basal electrical rhythm of GIT is  produced by

Smooth muscle of GIT shows spontaneous fluctuation in membrane potential (between - 65mV and - 45mv) this is called  basal electrical rhythm. It is produced by interstitial cells of cajal.


Question: PGs in semen is secreted by

The seminal vesicles secrete a significant propoion of the fluid that ultimately becomes semen. Lipofuscin granules from dead epithelial cells give the secretion its yellowish color. About 50-70% of the seminal fluid in humans originates from the seminal vesicles, but is not expelled in the first ejaculate fractions which are dominated by spermatozoa and zinc-rich prostatic fluid.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-419


Question: Fever associated with infection

Fever right shifts the oxygen dissociation curve, which allows for a greater release of oxygen to the tissue, making oxygen easily available to neutrophils and monocytes for use in the oxygen-dependent myeloperoxidase system of bactericidal killing. Having more oxygen available to tissue also enhances wound healing. In addition, fever interferes with bacterial and viral replication by providing a hostile environment for incubation. Fever is produced by the release of interleukin-I from macrophages. Interleukin-I, in turn, stimulates the hypothalamus to synthesize prostaglandins, which interact with the thermoregulatory center to produce fever.

Accelerates bacterial and viral replication

Left shifts the oxygen dissociation curve

Is due to interleukin-1 released from CD4 T-helper cells


Question: Not a Glycoprotein hormone

Vasopressin a hormone secreted by cells of the hypothalamic nuclei and stored in the posterior pituitary for release as necessary; it stimulates contraction of the muscular tissues of the capillaries and aerioles, raising the blood pressure, and increases peristalsis, exes some influence on the uterus, and influences resorption of water by the kidney tubules, resulting in concentration of urine.Ref: Ganong&;s review of medical physiology; 24th edition; Page no: 303


Question: Most predominant cells in pars nervosa are


Question: Heat loss at an ambient temperature of 21 degree takes place through

Radiation is a process of heat transfer to or from the surroundings mediam . It doesn't require any conducter Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:863,864


Question: Zona glomerulosa secretes

Zona glomerulosa is the outer layer of the coex of the suprarenal gland just beneath the capsule; secretes aldosterone.Aldosterone is a mineralocoicoid hormone produced by the zona glomerulosa of the adrenal coex; its major action is to facilitate potassium exchange for sodium in the distal renal tubule, causing sodium reabsorption and potassium and hydrogen loss. Coisol is the principal glucocoicoid produced by the zona fasciculata of the adrenal coex. It promotes gluconeogenesis and lipolysis, suppresses protein synthesis, inhibits inflammatory and immune responses, and has mild mineralocoicoid (for example, hypernatremic, kaliuretic, antidiuretic) effects.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 the growth of bone and muscle and helps maintain muscle strength.Catecholamines are any of a group of monoamines, including epinephrine, norepinephrine, and dopamine, that act as neurotransmitters and hormones.Ref: Ganong&;s review of medical physiology;24th edition; page no-354


Question: Koakoffs sounds are due to

Korotkoffs sounds are due to aerial turbulence on occlusion of the vessel. The streamline flow in the unconstricted aery is silent. But when the aery is narrowed, the velocity of flow through the constriction exceeds the critical velocity and turbulent flow results. Turbulent flow in the paly occluded brachial aery sets up the vibration (oscillations) of the vessel wall which are heard through the stethescope and are known as koratkoffs sounds. Phase Description K-1 Tapping sound Corresponds to systolic BP K-2 Murmur (soft swishing sound) K-3 Loud and clear tapping sound K-4 Muffled sound K-5 Disappearance of sounds Corresponds to Diastolic BP Note K-4 (muffles sound) corresponds to DBP in Adults after excercise Children Hypehyroidism Aoic regurgutation Patients with aeriovenous fistulas for hemodialysis Ref: Ganong&; s Review of Medical Physiology 26th edition Pgno: 567

Increased laminar flow on application of pressure

Aerial turbulence on occlusion of vessel

Normal sound existing, even without application of cuff


Question: Compound action potential is

When a nerve bundle is stimulated, more than one axon may be excited. The electrical recording of combination of action potential is called compound Action Potential.

Repetitive stimulation of single nerve fibre

Two nerve fibres stimulated simultaneously

Repetitive stimulation of mixed nerve fibre