NEET-PG 2015

1414 Questions — Page 29 of 142

Pathology

1 questions

Q281

Post-streptococcal glomerulonephritis (PSGN) is an example of which type of hypersensitivity?

Physiology

9 questions

Q281

Aortic valve closure corresponds to the beginning of which phase of the cardiac cycle?

Q282

How many phases are there in the action potential of cardiac muscles?

Q283

What is the normal O2 extraction ratio of tissues?

Q284

In zero gravity, the V/Q ratio is?

Q285

Which of the following parameters indicates the elimination of CO2 from the lungs?

Q286

In the relaxation pressure curve, at zero relaxation pressure in chronic smokers:

Q287

What is the normal value of respiratory compliance in ml/cm H2O?

Q288

Which of the following statements about lung compliance is false?

Q289

In patients with emphysematous bullae, total lung volume is best determined by?

NEET-PG 2015 - Physiology NEET-PG Practice Questions and MCQs

Question 281: Aortic valve closure corresponds to the beginning of which phase of the cardiac cycle?

A. Systole
B. Parasystole
C. Isovolumetric contraction
D. Isovolumetric relaxation (Correct Answer)

Explanation: ***Isovolumetric relaxation*** - **Aortic valve closure** marks the end of **ventricular ejection** and the beginning of **isovolumetric relaxation** as both the aortic and mitral valves are closed, and ventricular pressure drops without a change in volume. - This phase is vital for the heart to relax and prepare for filling, corresponding to the **second heart sound (S2)**. *Systole* - **Systole** refers to the **contraction phase** of the heart, encompassing both isovolumetric contraction and ventricular ejection. - Aortic valve closure signifies the end of the **ejection phase** of systole, not its beginning. *Parasystole* - **Parasystole** is an **arrhythmia** where an ectopic pacemaker competes with the normal sinus rhythm, leading to independent atrial or ventricular contractions. - It is a **pathological condition** and not a normal phase of the cardiac cycle. *Isovolumetric contraction* - **Isovolumetric contraction** occurs after the **mitral valve closes** and before the aortic valve opens, causing pressure to build in the ventricle. - This phase precedes **ventricular ejection** and is initiated by mitral valve closure, not aortic valve closure.

Question 282: How many phases are there in the action potential of cardiac muscles?

A. 2 phases
B. 3 phases
C. 4 phases
D. 5 phases (Correct Answer)

Explanation: ***5 phases*** - The cardiac myocyte action potential is classically described in **five phases** (phases 0, 1, 2, 3, and 4), which encompass depolarization, repolarization, and the resting state. - Each phase is characterized by specific ion channel activities leading to distinct electrical changes essential for proper cardiac function. *2 phases* - Action potentials in nerve cells typically follow a simpler two-phase model: **depolarization** and **repolarization**. - This model does not account for the additional plateau and resting phases characteristic of cardiac muscle cells. *3 phases* - Some simplified models might describe three phases (depolarization, repolarization, and a resting phase), but this still **omits specific nuances** of cardiac repolarization and the sustained plateau phase. - This simplification leaves out the early repolarization and the critical plateau phase (phase 2), which is vital for the prolonged contraction of the heart. *4 phases* - While some sources might refer to four phases, they typically combine certain repolarization steps or omit the distinct early repolarization phase. - This description would likely miss the **early, rapid repolarization phase (phase 1)**, understating the complex ion movements.

Question 283: What is the normal O2 extraction ratio of tissues?

A. 5 percent
B. 15 percent
C. 25 percent (Correct Answer)
D. 40 percent

Explanation: ***25 percent*** - The normal **O2 extraction ratio** (or **oxygen utilization coefficient**) is approximately 25%, meaning tissues extract about one-fourth of the oxygen delivered by arterial blood. - This ratio is crucial for understanding **tissue oxygenation** and can increase significantly during times of high metabolic demand, such as exercise. *5 percent* - An O2 extraction ratio of 5% is **too low** for normal physiological function, indicating that tissues are receiving much more oxygen than they are utilizing. - Such a low ratio would be seen only in situations of **excessive oxygen delivery** or **severely reduced metabolic demand**. *15 percent* - While 15% represents some oxygen extraction, it is **below the normal physiological range** for resting tissues. - An extraction ratio of 15% would mean the tissues are not extracting sufficient oxygen to meet their typical metabolic needs efficiently. *40 percent* - An O2 extraction ratio of 40% is **higher than the normal resting value** and suggests increased oxygen demand by the tissues. - This level of extraction is typically seen during **strenuous exercise** or in conditions of **reduced oxygen delivery** where tissues compensate by extracting more oxygen from available blood.

Question 284: In zero gravity, the V/Q ratio is?

A. 0.8
B. 1 (Correct Answer)
C. 2
D. 3

Explanation: ***Correct: 1*** - In **zero gravity**, the normal physiological effects of gravity on both ventilation and perfusion are eliminated, leading to a more uniform distribution. - Without gravity, blood flow and gas distribution become more even throughout the lungs, resulting in a V/Q ratio that approaches **unity (1)** across all lung regions. - This represents the ideal physiological state where ventilation perfectly matches perfusion. *Incorrect: 0.8* - A V/Q ratio of **0.8** represents the **average normal V/Q ratio** in an upright individual on Earth, where gravity creates disparities in ventilation and perfusion. - This value is an average, with regional variations (apex ~3.3, base ~0.6) in the lungs; it does not reflect the uniform conditions of zero gravity. *Incorrect: 2* - A V/Q ratio of **2** would indicate a significant **ventilation-perfusion mismatch** where ventilation greatly exceeds perfusion. - This scenario suggests substantial **dead space ventilation**, which is not the expected outcome in a zero-gravity environment where distribution is balanced. *Incorrect: 3* - A V/Q ratio of **3** represents an even more extreme case of **ventilation exceeding perfusion**, indicating severe physiologic dead space. - Such a high V/Q ratio would signify a major functional impairment, which is contrary to the more ideal and uniform distribution expected in zero gravity.

Question 285: Which of the following parameters indicates the elimination of CO2 from the lungs?

A. pH
B. PaCO2 (Correct Answer)
C. PaO2
D. HCO3 level

Explanation: ***PaCO2*** - **Partial pressure of carbon dioxide in arterial blood (PaCO2)** directly reflects the efficiency of **alveolar ventilation**, which is the process of eliminating CO2 from the lungs. - When CO2 elimination is adequate, PaCO2 remains within the normal range (35-45 mmHg); higher or lower values indicate ventilatory impairment or hyperventilation, respectively. *PaO2* - **PaO2** measures the partial pressure of **oxygen in arterial blood** and indicates oxygenation, not the efficiency of carbon dioxide elimination. - While CO2 elimination and oxygenation are interdependent, **PaO2** primarily reflects how well oxygen is being transported from the lungs to the blood. *pH* - **pH** indicates the **acidity or alkalinity of the blood**, which is influenced by both respiratory (CO2) and metabolic (bicarbonate) components. - Although CO2 elimination affects pH through the carbonic acid-bicarbonate buffer system, pH itself is an overall measure of acid-base balance, not a direct indicator of CO2 elimination. *HCO3 level* - **Bicarbonate (HCO3-)** is a **metabolic component** of the acid-base balance, primarily regulated by the kidneys. - While it helps buffer CO2-induced acid changes, HCO3 level alone does not directly reflect the efficiency of CO2 elimination from the lungs.

Question 286: In the relaxation pressure curve, at zero relaxation pressure in chronic smokers:

A. Lung volume decreases significantly
B. Lung volume remains elevated (Correct Answer)
C. No significant change in lung volume
D. Lung compliance decreases

Explanation: ***Lung volume remains elevated*** - In chronic smokers, conditions like **emphysema** lead to loss of elastic recoil and **air trapping**. - At zero relaxation pressure (the point where the respiratory system is at its resting equilibrium), the **functional residual capacity (FRC)** is higher due to less elastic recoil, which maintains the lungs at a more inflated state. - The balance between inward lung recoil and outward chest wall recoil shifts, resulting in a new equilibrium at a higher lung volume. *Lung volume decreases significantly* - This would imply increased elastic recoil or significant **airway obstruction** preventing air from entering, which is contrary to the typical pathophysiological changes in chronic smokers (e.g., emphysema). - In emphysema, the **loss of elastic recoil** actually prevents the lungs from deflating efficiently, leading to increased rather than decreased lung volume at rest. *No significant change in lung volume* - Chronic smoking often results in **structural changes** to the lungs, particularly **emphysema**, which significantly alters lung mechanics. - These changes directly impact the **resting lung volume (FRC)** as the balance between elastic recoil and chest wall compliance is disturbed, leading to a noticeable increase. *Lung compliance decreases* - This is incorrect; in emphysema, lung **compliance actually increases** due to destruction of alveolar walls and loss of elastic tissue. - Increased compliance means the lungs are more easily distensible but have reduced elastic recoil, contributing to air trapping and elevated FRC.

Question 287: What is the normal value of respiratory compliance in ml/cm H2O?

A. 200 ml/cm H2O (Correct Answer)
B. 100 ml/cm H2O
C. 150 ml/cm H2O
D. 50 ml/cm H2O

Explanation: ***200 ml/cm H2O*** - Normal respiratory system compliance is approximately **200 ml/cm H2O**, indicating a relatively compliant lung and chest wall system. - This value reflects the **change in lung volume per unit change in pressure**, with higher values indicating greater elasticity and ease of inflation (distensibility). *50 ml/cm H2O* - A compliance of **50 ml/cm H2O** is significantly lower than normal, suggesting a **stiff respiratory system**. - This could be indicative of conditions like **pulmonary fibrosis**, **acute respiratory distress syndrome (ARDS)**, or severe asthma, where the lungs are harder to inflate. *100 ml/cm H2O* - A compliance of **100 ml/cm H2O** is typically considered **reduced compliance**, although not as severely as 50 ml/cm H2O. - This value might be seen in moderate lung diseases or conditions causing **reduced chest wall expansion**. *150 ml/cm H2O* - While closer to the normal range, **150 ml/cm H2O** is generally still considered to be on the **lower side of normal or mildly reduced compliance**. - This could indicate early or mild conditions affecting **lung or chest wall mechanics**.

Question 288: Which of the following statements about lung compliance is false?

A. Decreased in emphysema (Correct Answer)
B. Total compliance is 0.2 L/cm H2O
C. A measure of lung distensibility
D. Change in volume per unit change in pressure

Explanation: ***Decreased in emphysema*** - This statement is **false** because **emphysema** is characterized by the destruction of elastic fibers in the lung parenchyma, which paradoxically leads to an **increase** in lung compliance. - The loss of elastic recoil makes the lungs more distensible and easier to inflate, but also impairs their ability to passively exhale. *Total compliance is 0.2 L/cm H2O* - This value represents the **normal total lung compliance** in a healthy adult (0.17 to 0.25 L/cm H2O), including both lung and chest wall compliance. - Lung compliance alone is typically around 0.2 L/cm H2O for healthy lungs. *A measure of lung distensibility* - **Compliance** is intrinsically defined as a measure of how easily the lungs or chest wall can be stretched or distended. - High compliance means the lungs are easy to inflate, while low compliance means they are stiff and difficult to inflate. *Change in volume per unit change in pressure* - This is the explicit **formula and definition of compliance** (C = ΔV/ΔP). - It quantifies the change in lung volume in response to a given change in transpulmonary pressure.

Question 289: In patients with emphysematous bullae, total lung volume is best determined by?

A. Spirometry
B. Any of the above
C. Helium dilution method
D. Plethysmography (Correct Answer)

Explanation: ***Plethysmography*** - This method accurately measures **total lung capacity (TLC)**, functional residual capacity (FRC), and residual volume (RV) by determining the **volume of gas in the thorax**. - It is particularly useful in conditions like **emphysema** with air trapping and bullae, as it accounts for **non-communicating air spaces** that other methods miss. *Spirometry* - Spirometry measures volumes of air that can be **exhaled or inhaled forcibly**, such as FVC and FEV1. - It cannot measure residual volume (RV) or total lung capacity (TLC) directly, especially in cases of **air trapping** where trapped air cannot be exhaled. *Helium dilution method* - The helium dilution method measures **communicating lung volumes**, like functional residual capacity (FRC), by assessing the dilution of a known concentration of helium after rebreathing. - In conditions with **emphysematous bullae** and air trapping, it **underestimates total lung volume** because it cannot measure air in non-communicating or poorly communicating spaces. *Any of the above* - Only plethysmography can accurately measure total lung volume in the presence of **emphysematous bullae** due to its ability to measure both communicating and non-communicating air spaces. - Spirometry and helium dilution methods would provide **inaccurate or incomplete measurements** in this clinical scenario.