EoM MOD 2 2022.pdf test your understanding

Department of Physiology
Module two
End of Module exam
3/8/2022

Instructions
1. The exam consists of 100 multiple choice questions, from
cardiovascular, gastrointestinal, nervous system and endocrine
physiology
2. Answer all question on the provided answer sheet
3. Each student must indicate their registration number and course
on the answer sheet
4. At the end of the exam you will pass your sheet to the person on
your right
5. Failure to submit your exam will result in disqualification
6. Any misconduct during the exam will be delt with according to
university regulations

1. In the systemic circulation:
a) Symphathetic stimulation decreases the venous
return.
b) The mean arterial blood pressure is 102 mmHg
c) At the capillary level, the net filtration is equal to
net reabsorption.
d) The pressure in the right atrium is higher than in
the veins
e) The venous return is normal during right heart
failure

2. Regarding ventricular hypertrophy, All of the
following statements are true, EXCEPT:
a) Occurs in chronic hypertension
b) Can lead to heart failure
c) Can result from volume overload
d) Increases diastolic compliance of the heart
e) Decreases diastolic compliance of the heart

3. The following contribute to increased
ventricular afterload; EXCEPT
a) Increased Vascular Resistance
b) Aortic Stenosis
c) Increased Pleural Pressure
d) Increased vascular compliance
e) None of the above

4. Which one of the following statements is false
with regard to cardiac output?
a) typically, 4–6 l/min in a resting adult.
b) increased by a rise in central venous pressure
c) decreased by a rise in arterial blood pressure.
d) increased when circulating catecholamine
concentration falls
e) regulated by both sympathetic and
parasympathetic autonomic nerves.

5. A four years old boy brought to the primary healthcare
centre with swollen and highly irritable. On examination, he
weight 9 Kg, generalized oedema, abdominal distension and
hepatomegaly. What is the mechanism of his generalized
oedema?
a) The oedema is caused by increased intravascular pressure
b) It is due to the decreased interstitial hydrostatic pressure
c) It is the result of decreased capillary osmotic pressure
d) It is the result of increased interstitial osmotic pressure
e) It is the result of increased capillary hydrostatic pressure

6. A 40-year-old executive consults the doctor for a routine
medical check. He has no symptoms. He is overweight, blood
pressure is 130/70, smokes 5 cigarettes per day, and his serum
cholesterol is normal. He has no family history of ischemic
heart diseases.
a) He should reduce weight to achieve a body mass index of 24
b) He should start drinking alcohol in moderation
c) He should reduce smoking
d) He should continue with normal life style
e) He should be advised to reduce fat and increase
carbohydrates food

7. Which of the following is not TRUE
a) Venous blood is dark red
b) The elastic lamina is highly developed in arteries than
veins
c) The deep valves in the veinous system are engorged in
deep vein
thrombosis and are easily observed under the skin as
varicose veins
d) Deep vein thrombosis can lead to pulmonary embolism
e) A&D are not true

8. Regarding the physiology of the heart
a) Isovolumic contraction includes closure of the mitral
valves and opening
of aortic valves
b) Endocardium contains major coronary vessels
c) The SAN and AVN are the only pacemakers of the heart
d) Rapid ventricular filling can cause the third heart sound
e) Interseptal fibrous tissue is less efficient for people with
hypertension

9. The conduction system of the heart
a) The SAN firing is increased during heart failure
b) The noradrenaline activity is the only
neurotransmitter responsible for
increasing heart rate
c) The vagus nerve discharge is high during
hypertension
d) The SAN automaticity is mainly due to calcium
channels opening

10. Microcirculation
a) The venous end pressure is responsible for
extravasation of fluid
b) The sinusoidal capillaries are mainly found in spleen to
allow large molecules diffusion
c) The capillary hydrostatic pressure is high in patients
with liver cancer
d) Interstitial fluid lacks protein molecules
e) Myogenic autoregulation of blood flow maintains a
normal tissue blood flow beyond 200mmHg

11. Mark the TRUE values, EXCEPT
a) Systemic arteries – 120/80 mmHg
b) Pulmonary veins – 13 mmHg
c) Pulmonary arteries – 50 mmHg
d) Systemic veins – 4 mmHg
e) Right atrium – 0 mmHg

12. Atherosclerosis, which is not TRUE
a) Start in young age
b) Is a chronic inflammatory response that lead to
atheroma formation
c) It can result to acute limb infarction in a situation
where the thrombus is
dislodged from the vessel,
d) A, B and C are true
e) Only A and B are true.

13. Lymphatic system, mark the TRUE statement
a) Bacteria and proteins can squeeze and pass through
the contractile capillaries of the lymphatic system
b) The afferent vessels carry lymph away from the lymph
notes
c) The lymph nodes contain mast cells and eosinophils to
prevent infections
d) Lymphatic oedema is a result of bacterial infection
carried in the lymph
e) All of the above are TRUE

14. ECG. One of the following is TRUE
a) Polarized cardiac fibre means positive charges
inside and negative outside the cell
b) Repolarization means a state of the muscle cell
from a polarized state to depolarized state.
c) The P wave is present in patients with atrial
fibrillation
d) QRS complex is ventricular repolarization
e) All of the above are FALSE

15. Afterload, preload and contractility
a) Cytosolic potassium is responsible for cardiac
muscle contractility
b) Exercise increases both preload and afterload but
not contractility
c) Increase venous return increases preload
d) Aortic stenosis decreases afterload
e) B & C are correct

16. The following can lead to hypovolemic shock,
except
a) Dehydration
b) Burns
c) Blood loss of less than 2-5%
d) Excessive oedema
e) A & D are correct

17. Neurogenic shock can be caused by the
following
a) Sympathetic decrease
b) Spinal shock
c) Vasovagal syncope
d) All of the above are correct (A, B &C)
e) Only A &B are correct

18. The following non-pharmacological measures
are useful in the treatment of hypertension,
EXCEPT
a) Moderate dietary sodium restriction
b) Weight reduction in obese
c) Moderate alcohol intake
d) Meditation
e) Regular aerobic exercise

19. Left heart failure can lead to the following
symptom(s),
a) Difficulty in breathing
b) Swollen lower limbs
c) Tender liver
d) Swollen abdomen
e) C and D are correct

20. The cardiac cycle
a) The normal ejection fraction is 55%
b) The second heart sound occurs during
isovolumic contraction
c) The left atria received blood from pulmonary
arteries
d) The coronary vessels form the first branches of
the descending aorta
e) A and C are correct

21. Regarding starling forces
a) Capillary hydrostatic pressure is affected in
patients with liver failure
b) Interstitial hydrostatic pressure in equal to
13mmHg
c) Interstitial oncotic pressure is due to presence of
bacterial materials in the interstitial space
d) Only A &C are correct

22. The following are mechanisms responsible
for non-essential (secondary) hypertension
a) Obesity
b) Genetic or family history
c) Pheochromocytoma
d) Hyperthyroidism
e) Only C &D are correct

23. Regarding aortic baroreceptors are true, EXCEPT
a) Are located at the bifurcation of carotid and aortic
arc
b) Are innervated by sympathetic branch of the ANS
c) Are stimulated during stretching of the arterial
wall
d) Firing rate decreases during hypotension
e) The signals are relayed in the nucleus tractus
solitarius

24. In septic shock
a) It’s a form of distributive shock
b) Mast cells are responsible for hypersensitivity
c) Vascular microthrombi can occur
d) Can only be caused by bacteria
e) A &D are correct

25. The physiology of exercise
a) Improves cardiorespiratory function
b) Lowers the ejection fraction
c) Lowers basal metabolic rate
d) A &B are correct
e) A &C are correct

26) Which region of the hypothalamus, when
lesioned, produces hyperphagia:
a) Arcuate nucleus
b) Lateral
c) Ventromedial
d) Posterior
e) Dorsomedial

27) In normal healthy individuals the amount of
circulating leptin is directly proportional to:
a) Blood sugar
b) Body fat
c) Food intake
d) Rate of digestion
e) Satiety status

28) The physiological actions of CCK include:
a) Increased esophageal motility
b) Closing of sphincter of Oddi
c) Increased bile synthesis
d) Contraction of pancreatic acini
e) Increased enzyme secretion from the exocrine
pancreas

29) Saliva does not contain:
a) Lysozyme
b) Blood group antigens
c) Immunoglobulins
d) Platelets
e) Chloride ions

30) Duodenum and jejunum are the main site for
absorption of the following EXCEPT:
a) Glucose
b) Fat-soluble vitamins
c) Water
d) Bile salts
e) Iron

31) The defecation reflex:
a) Is initiated by stretching anal canal
b) Is integrated in a control center in the lumbar
spinal cord
c) Is integrated in a control center in the sacral
spinal cord
d) Is controlled by the vagus nerve
d) Involves contraction of sigmoid colon

32) A tumor producing large amount of the
intestinal hormone GIP may result in:
a) Hypoglycemia
b) Hyperglycemia
c) Diarrhea
d) Dyspepsia
e) Hyperacidity in the stomach

33) If the stomach is removed (gastrectomy), the
patient is unlikely to suffer from:
a) Malnutrition
b) Iron deficiency anemia
c) Inability to digest proteins
d) Macrocytic anemia
e) Inability to absorb alcohol

34) The pharyngeal phase of swallowing:
a) Is preceded by a deep inspiration
b) The tongue is elevated against hard palate
c) Includes contraction of upper esophageal
sphincter
d) Is partially voluntary
e) Is associated with elevation of epiglottis and
closure of glottis

35) Vomiting is not usually caused by:
a) Motion sickness
b) Pregnancy
c) Irritation of stomach mucosa
d) Microbial toxins in the blood
e) Aerobic exercise

36) The function of Migrating Motor Complex
(MMC) is to:
a) Empty non-digestible materials from the stomach
and small intestine during fasting
b) Initiate mass movement in the large intestine
c) Increase intestinal peristalsis in response to
overfeeding
d) Increase ileal motility in response to entry of
chyme into the stomach
e) Overcome intestinal obstruction

37) Cushing ulcer refers to stress ulceration after:
a) Head trauma
b) Abdominal surgery
c) Severe burns
d) Sepsis
e) Chronic NSAIDS exposure

38) When a part of the intestine invaginates into
the next segment resulting in obstruction, it is
called:
a) Incarcerated hernia
b) Volvulus
c) Intussusception
d) Paralytic ileus
e) Post-operative adhesion

39) The following are the “cardinal” symptoms of
intestinal obstruction EXCEPT:
a) Obstipation
b) Vomiting
c) Abdominal distension
d) Colicky pain
e) Diarrhea

40) In a recently reported myocardial infarction
(heart attack), which of the following liver enzymes
will be elevated?
a) GGT
b) AST
c) ALT
d) ALP
e) None will be elevated during heart attack

41) Which of the following enzyme is a sensitive
marker of excessive alcohol use?
a) Alanine transaminase
b) Aspartate transaminase
c) Gamma-glutamyltransferase
d) Alkaline phosphatase
e) Both AST and ALP

42) Which of the following samples will you take
for liver function tests (LFTs)?
a) Blood sample
b) Urine sample
c) Sputum sample
d) Liver biopsy
e) Stool sample

43) The following is true about small intestine:
a) Stores food for several hours
b) It has the main source of digestive enzymes
c) Has haustra
d) Has segmentation contractions
e) Secretes intrinsic factor

44) Which of the following is likely to fail to
reduce secretion of HCL in the stomach:
a) A H2 receptor blocker
b) A nicotinic cholinergic receptor blocker
c) A proton pump inhibitor
d) A gastrin receptor blocker
e) Somatostatin from D-cells

45) The secretion of exocrine pancreas is
increased by the following EXCEPT:
a) Vagal stimulation
b) Secretin
c) Acetylcholine
d) CCK
e) Atropine

46) What are some of the symptoms of lactose
intolerance?
a) Headache and nausea
b) Skin redness/flushing, wheezing
c) Bloating, cramps, flatulence, abdominal
discomfort
d) Hypotension, dizziness and edema
e) Lactose intolerance does not have noticeable
symptoms

47) Which of the following synthesized by
adipocytes has a tendency to suppress appetite?
a) CCK
b) Peptide YY
c) Amylin
d) Leptin
e) GLP-1

48) Duodenal ulcer (DU) differs from gastric
ulcer (GU) in that the former (i.e. DU) presents
with all of the following EXCEPT:
a) Night pain
b) Anti-acid relieves symptoms
c) Weight gain
d) Hyperacidity
e) Food-pain patterns

49) Auerbach's plexus which controls GI
motility is present in:
a) Submucosa
b) Muscularis mucosae
c) Serosa
d) Mucosa
e) Muscularis externa

50) Chief cells secretes which of the following:
a) Pepsinogen
b) Intrinsic factor
c) Somatostatin
d) Histamine
e) Ghrelin

51) The circadian rhythm controls the sleep cycle in
human. It is regulated by the ----- nucleus of the
Hypothalamus
A. Medial Preoptic nucleus
B. Suprachiasmatic nucleus
C. Lateral nucleus
D. Paraventricular nucleus
E. Supraoptic nucleus

52) Addiction and reward are neuronally
regulated via increase in which neurotransmitter
A. Oxytocin
B. Neuropeptide Y
C. Dopamine
D. Endocabbinoids
E. Nociceptin

53) During REM sleep all are true except
A. The person is easily aroused
B. It only represents 20-25% of total sleep
C. Heart rate increases
D. There is increased blood pressure
E. Increased brain activity

54) Loss of taste sensation is called
a. Taste blindness
b. Ageusia
c. Dysgeusia
d. Hypogeusia
e. Dysarthria

55) What type of gelatinous material are hair
cells of vestibular system in?
a. Tectorial membrane
b. Cupula
c. A and B
d. Otolithic membrane
e. B and D

56) ………… is sensitive to head tilt from sideways
position while ………… is sensitive to head title
from the upright position
a. Saccule, semicircular canals
b. Utricle, saccule
c. Semicircular canals, ampulla
d. Saccule; utricle
e. Ampulla; saccule

57) When the hair cells are bent toward the
kinocilium, the nerve endings
a. Hyperpolarize
b. Depolarize
c. Reach tonic level discharge
d. Reduce the number of action potentials
e. Lead to massive influx of Na

58) During the beginning of a rotation, the endolymph
in the SSC goes in the …………..direction as the
rotation, resulting in ………….of hair cells
a. Same, excitation
b. Opposite, excitation
c. Opposite, inhibition
d. Same, inhibition
e. Neutral, excitation

59) What does the lateral vestibulospinal tract
control (reflex)?
a. Direction of ocular movements
b. Interacts with cerebellum for overall motor
control
c. Fine movements
d. Postural control
e. Vestibulo-ocular reflex

60. If you start dosing off in class and your head bobs
down and then jerks up, what reflex is occurring?
a. Medial longitudinal fasciculus
b. Vestibulo-cerebellar reflex
c. Lateral vestibulospinal tract
d. Nystagmus
e. Medial vestibulospinal tract

61. The organ of Corti is the sensitive element in
the inner ear and can be thought of as the
body’s microphone. Where is it located?
a. Behind the oval window
b. Sits atop the Reisner’s membrane
c. On the basilar membrane
d. At the top of the Eustachian tube
e. At the base of the ampulla

62. Sound waves are collected by the
a. Tympanic membrane
b. External auditory meatus
c. Oval window
d. Pinna
e. Ear ossicles

63. Tonotopy of the ear is arranged such that
high frequency sounds are transduced where
the
a. Basilar membrane is narrower and stiffer
b. Influx of Na is highest
c. Basilar membrane is wider and flexible
d. Greatest concentrations of outer hair cells
e. Frequency is between 200Hz and 440 Hz

64) Which tongue papillae are taste buds NOT
associated with?
a. fungiform
b. folliate
c. circumvallate
d. filiform
e. None of the above

65) A 79-year-old man is experiencing peripheral
nerve damage of his right limb. Which of the
following is characteristic of lower motor neurone
damage?
a. Hyperreflexia
b. Increased tone
c. Hyporeflexia
d. Spastic paralysis’
e. Increased muscle mass

66) The frequency of the sound waves determines
the sound’s
a. Loudness
b. Clarity
c. Pitch
d. Length
e. Variation

67) What is the condition when light rays focus in
front of the retina instead of on? Also, when
looking through glasses of someone with this
condition everything will appear small
a. Presbyopia
b. Myopia
c. Hyperopia
d. Diplopia
e. Astigmatism

68) 52 y/o females comes into your office
complaining that he can't see as well as he used
to when reading a book but his vision is fine for
distance. What is the most likely Dx?
a. Hyperopia
b. Nystagmus
c. Presbyopia
d. Stabismus
e. Myopia

69) Deficiency of vitamin A can result in trouble seeking
at low levels of light illumination. At what levels does
vitamin A act
a. Vitamin A can be oxidized in cis trans-retinal
b. Vitamin A can be oxidized in all-trans retinal
c. Neural retina is the site of Vitamin A oxidation into
components that forms the photopigments
d. Vitamin A can be synthesized in the body by the liver
e. supply of all-trans retinal as a photopigment breakdown
product is insufficient to maintain adequate photopigment
production

70) Which of the following is a binocular cue
for depth perception?
a. Perspective
b. Relative retinal size
c. Retinal disparity
d. Relative apparent movement
e. Loss of detail due to atmospheric haze

71) A disease that attacks the photoreceptors of
the retinal periphery would be expected to
a. Disrupt color vision
b. Diminish our ability to perceive depth
c. Impair night vision
d. Impair vision for fine detail
e. Disrupt eye movements

72) The following is true about smell reception
a. Axons of bipolar olfactory receptors synapse
with dendrites of mitral cells.
b. Groups of mitral cells form globular structures
called the accessory olfactory organ
c. The olfactory tract ends in occipital lobe
d. Olfactory transduction is through mechano-
transduction
e. Olfactory receptors adapt very slowly

73) Which sensory modality is transduced by
free nerve endings?
A. Vision
B. Taste
C. Pain
D. Sound
E. Joint position

74) Imagine you taste a menthol(pipi kifua). You
immediately start to feel a “cold” sensation in
your mouth. This is caused by activation of which
type of receptor?
a. Free nerve endings
b. Mechanoreceptors
c. Ligand gated receptors
d. Merkel discs
e. Voltage gated receptors

75) A 50-year-old man was admitted to the hospital
with a cerebral hemorrhage in the left motor
cortex. This injury will likely result in the inability to
perform the following
a. Pick up a cup with your right hand
b. Stop the arm from moving after it reaches its
target
c. Move the toes of your left foot
d. Sense a cold drink in your left hand
e. Feel pain on your right ear

76) Glucagon is produced by ------ islet cells of the
pancreas
A. Acini
B. Alpha
C. Beta
D. Delta
E. Acini

77) Increased thirst (polydypsia) is a common
symptom of type II Diabetes Mellitus. What is
the underlying physiological explanation for it?
A. Insulin resistance
B. Dehydration
C. Increased hunger
D. Increased ADH secretion
E. Renal Failure

78) Glucagon facilitates the utilization of stored
glycogen in all of the following tissues except
A. Muscles
B. Liver
C. Adipocytes
D. All the above are correct
E. None are correct

79) Components of the metabolic syndrome
include all of the following except
A. Elevated HDL
B. Central obesity
C. Blood pressure of ≥ 130/85 mm Hg
D. Fasting blood glucose ≥ 100mg/dl
E. Elevated LDL

80) Insulin is required for glucose entry via the
following transporter/s
A. Glut1
B. Glut 2
C. Glut 3
D. Glut 4
E. All of the above are correct

81) Diabetes insipidus arises from increased
production of
A. Insulin
B. Renin
C. Angiotensin
D. ADH
E. All of the above are true

82) One of the following completes the following
signaling mechanism
Insulin Protein kinase
a) Activation of cAMP
b) Phosphorylation of a downstream target protein
c) dephosphorylation of a downstream protein
target
d) Activation of phospholipase C

83) Defective aquaporins may cause
a) Nephrogenic Diabetics insipidus
b) Neurogenic Diabetes insipidus
c) Diabetes mellitus
d) Chronic kidney disease
e)None of the above

84) In Graves disease, all the following are
correct except
a) T4 and T3 levels are high in plasma
b) Goiter may be present
c) It is an autoimmune disease due to antibodies
that are produced by the patient’s own body
d) One of the findings is high levels of thyroid
destructing auto antibodies

a) A is a steroid
b) A action at point B utilizes PI3 as
a second messenger
c) A action at point C utilizes cAMP
second messenger system
d) Point B cells are rich in
aquaporins that are regulated by A
e) Impossible to tell
85) Carefully study the diagram/figure and answer the
following questions. A is a hormone that has effects on both
B and C. Choose the correct answer regarding A

a)If O is removed effect P will
completely NOT happen
b) C and D are important for
maintenance of a healthy
pregnancy
c) C and D are made up of
cholesterol and are lipid soluble
d) The phase in O that coincide with
production of both C and D is called
the luteal phase
86) Carefully study the diagram/figure below and answer the
following questions. O and O2 both produce hormone C and D that
together cause effect P. All the following are true except

87) True about Graves disease
a. There is stimulation of TSH receptors
b. Destruction of thyroid cells
c. Low levels of T4 and T3
d. Iodine deficiency

88) Sex determination
a. Completes after puberty
b. Occurs before fertilisation
c. Is complete just after fertilisation
d. Is never complete before puberty

89) Human chorionic gonadotrophin
a. Is the base for pregnancy test
b. Is positive in urine just after fertilization
c. Causes testis to remain in the stomach
d. All the above are correct about hCG
d. None of the above are correct

90) Zona glomerulosa
a. Forms parts of adrenal medulla
b. Has abundancy of ACTH receptors
c. Is strongly stimulated by hypokalemia
d. Is potently stimulated by hyperkalemia
e. Is the inner most layer of the adrenal cortex

91) On hirsutism
a. Is the same as baldness
b. Can be caused by high levels of testosterone
c. Can be caused by high levels of adrenal
androgens
d. Can NOT happen in females

92) On the Luteal phase of the ovarian cycle
a. Corpus albicans
b. Secretory phase of the endometrial cycle
c. FSH is the hallmark
d. LH surge

93) Spermatogenesis occurs in;
a. Sertoli cells
b. Leydig’s cells
c. Testosterone
d. LH

94) Cushing’s syndrome is associated with;
a. Masculinisation
b. Low levels of cortisol
c. High levels of epinephrine
d. Insulin resistance

95) Can result from a pituitary adenoma
a. Primary hypothyroidism
b. Secondary hyperthyroidism
c. Primary hyperthyroidism
d. Non space occupying
e. Total blindness

96) Associated with primary hypothyroidism
a. Low TSH levels
b. High levels of anti thyroid auto antibodies
c. High levels of thyroid stimulating auto
antibodies
d. Graves disease

97) Acromegaly
a. Is the same as gigantism
b. Occurs Post Epiphysial plate fusion
c. GH excess before adolescence
d. Can result in cretinism
e. Is associated with diabetes insipidus

98) True about FSH
a. Only found in females
b. Stimulated by gonadotrophin stimulating
hormone
c. Results in ovulation
d. Associated with Luteinization

99) The Mullerian duct forms;
a. Testis
b. Testosterone
c. Wolffian duct
d. Uterus

100) Associated with growth hormone
a. Increased Lean body mass
b. lipogenesis
c. Increased insulin sensitivity
d. Increased glucose uptake
e. Reduction in bone length

End of Exam
1. Stop writing
2. Please pass your sheet to the person on your right
3. Failure to submit your exam will result in
disqualification
4. Any misconduct during the exam will be delt with
according to university regulations

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