NEET-PG 2023 — Physiology

Q: Which substance has the least renal clearance?

Glucose. ***Glucose (Correct Answer)*** - Under normal physiological conditions, **glucose is almost completely reabsorbed** in the proximal tubule of the nephron, leading to a **renal clearance of nearly zero**. - While glucose is freely filtered by the glomerulus, the extensive reabsorption mechanisms (via SGLT2 and SGLT1 transporters) ensure that virtually no glucose appears in the urine under normal circumstances. - This makes glucose the substance with the **least renal clearance** among the given options. *Inulin (Incorrect)* - **Inulin** is freely filtered by the glomerulus but is neither reabsorbed nor secreted by the renal tubules. - Its renal clearance equals the **glomerular filtration rate (GFR)** (~125 mL/min), making it an ideal marker for GFR measurement. - Inulin has a **much higher clearance than glucose**. *Urea (Incorrect)* - **Urea** is filtered by the glomerulus, and approximately **50% of the filtered urea** is reabsorbed in the renal tubules, primarily in the proximal tubule and medullary collecting duct. - Its clearance (~60-70 mL/min) is lower than GFR but still **significantly higher than glucose clearance**. *Creatinine (Incorrect)* - **Creatinine** is freely filtered by the glomerulus and is also **secreted by the renal tubules** (approximately 10-20% secreted). - This secretion means its renal clearance (~130-140 mL/min) is slightly **higher than the actual GFR**. - Despite this, creatinine is commonly used as an estimate of GFR due to its relatively stable production and ease of measurement. [Practice more Physiology PYQs on OnCourse]

Q: Following occurs in living cells only:

Active transport. ***Active transport*** - **Active transport** requires energy (ATP) to move substances against their concentration gradient, a process only possible in **living cells** that can produce ATP. - This process is crucial for maintaining cellular homeostasis, accumulating nutrients, and removing waste, all of which are vital functions of **living organisms**. *Simple diffusion* - **Simple diffusion** is the passive movement of substances across a membrane from an area of higher concentration to lower concentration, without the need for energy or membrane proteins. - This process can occur in **both living and non-living systems**, as it is driven by random molecular motion and concentration gradients. *Facilitated diffusion* - **Facilitated diffusion** involves the passive movement of molecules across a membrane with the help of **transport proteins** (channels or carriers) but still moves down the concentration gradient without direct energy expenditure. - While it uses proteins, these proteins can sometimes function in **isolated membrane systems** even if the cell is not metabolically active (e.g., in a cell lysate). *Osmosis* - **Osmosis** is the specific type of diffusion involving the net movement of **water molecules** across a selectively permeable membrane, driven by differences in solute concentration. - Similar to simple diffusion, osmosis is a **physical process** based on water potential gradients and can occur in both **living and non-living membranes** given the right conditions. [Practice more Physiology PYQs on OnCourse]

Q: Which of the following is NOT a characteristic of a biphasic action potential of a mixed nerve?

Two or more positive peaks. ***Two or more positive peaks*** - A **biphasic action potential** of a mixed nerve, when recorded extracellularly, typically consists of two phases: an initial **negative deflection** followed by a **positive deflection**. It does not exhibit multiple positive peaks for a single action potential. - The shape is determined by the propagation of the action potential past two recording electrodes, illustrating the **depolarization and repolarization** of the nerve. *All or none phenomenon* - This is a fundamental characteristic of **individual nerve fibers** and thus applies to the action potentials propagating within a mixed nerve. - If a stimulus reaches a threshold, a full-sized action potential is generated; otherwise, none is generated, regardless of stimulus strength. *Refractory period* - The **refractory period** is a crucial characteristic of nerve excitability, ensuring unidirectional propagation and limiting the frequency of action potentials. - This period, comprising absolute and relative phases, applies to the individual fibers within the mixed nerve. *Recorded on surface* - **Compound action potentials (CAPs)** of mixed nerves are typically recorded extracellularly (on the surface) using electrodes, often seen in nerve conduction studies. - This contrasts with intracellular recordings which measure the potential across the cell membrane directly. [Practice more Physiology PYQs on OnCourse]

Q: Absolute refractoriness of a neuron is due to?

Inactivation of Na channels. ***Inactivation of Na channels*** - During the **absolute refractory period**, voltage-gated **Na+ channels** enter an inactivated state, making them unresponsive to further stimulation. - This inactivation prevents another action potential from being generated, regardless of the stimulus intensity, ensuring unidirectional propagation. *Hyperpolarization of Cl channels* - While **Cl- channels** can cause hyperpolarization, this typically leads to **inhibition** rather than absolute refractoriness. - Their activity doesn't directly prevent the generation of a new action potential by blocking Na+ channel function. *Opening of rectifier K+ channels* - The opening of **rectifier K+ channels** is involved in **repolarization** and the **relative refractory period**, by increasing K+ efflux. - While it contributes to making the neuron less excitable, it doesn't cause the absolute inability to fire associated with Na+ channel inactivation. *Closure of activated Na channels* - The **closure of activated Na+ channels** occurs as part of the repolarization process, but the critical mechanism for absolute refractoriness is their transition into an **inactivated state**, not simply closure. - **Inactivation** locks the channels in a non-responsive configuration, whereas simple closure would allow them to reopen quickly with sufficient depolarization. [Practice more Physiology PYQs on OnCourse]

5 Previous Year Questions with Answers & Explanations

Questions

Which substance has the least renal clearance?

Following occurs in living cells only:

Which of the following is NOT a characteristic of a biphasic action potential of a mixed nerve?

A patient presents with symptoms of muscle weakness and fatigue. Serum potassium levels are significantly elevated. How does hyperkalemia affect the resting membrane potential and action potential generation in neurons?

Absolute refractoriness of a neuron is due to?

NEET-PG 2023 - Physiology NEET-PG Practice Questions and MCQs

Question 1: Which substance has the least renal clearance?

A. Glucose (Correct Answer)
B. Inulin
C. Urea
D. Creatinine

Explanation: ***Glucose (Correct Answer)*** - Under normal physiological conditions, **glucose is almost completely reabsorbed** in the proximal tubule of the nephron, leading to a **renal clearance of nearly zero**. - While glucose is freely filtered by the glomerulus, the extensive reabsorption mechanisms (via SGLT2 and SGLT1 transporters) ensure that virtually no glucose appears in the urine under normal circumstances. - This makes glucose the substance with the **least renal clearance** among the given options. *Inulin (Incorrect)* - **Inulin** is freely filtered by the glomerulus but is neither reabsorbed nor secreted by the renal tubules. - Its renal clearance equals the **glomerular filtration rate (GFR)** (~125 mL/min), making it an ideal marker for GFR measurement. - Inulin has a **much higher clearance than glucose**. *Urea (Incorrect)* - **Urea** is filtered by the glomerulus, and approximately **50% of the filtered urea** is reabsorbed in the renal tubules, primarily in the proximal tubule and medullary collecting duct. - Its clearance (~60-70 mL/min) is lower than GFR but still **significantly higher than glucose clearance**. *Creatinine (Incorrect)* - **Creatinine** is freely filtered by the glomerulus and is also **secreted by the renal tubules** (approximately 10-20% secreted). - This secretion means its renal clearance (~130-140 mL/min) is slightly **higher than the actual GFR**. - Despite this, creatinine is commonly used as an estimate of GFR due to its relatively stable production and ease of measurement.

Question 2: Following occurs in living cells only:

A. Simple diffusion
B. Facilitated diffusion
C. Osmosis
D. Active transport (Correct Answer)

Explanation: ***Active transport*** - **Active transport** requires energy (ATP) to move substances against their concentration gradient, a process only possible in **living cells** that can produce ATP. - This process is crucial for maintaining cellular homeostasis, accumulating nutrients, and removing waste, all of which are vital functions of **living organisms**. *Simple diffusion* - **Simple diffusion** is the passive movement of substances across a membrane from an area of higher concentration to lower concentration, without the need for energy or membrane proteins. - This process can occur in **both living and non-living systems**, as it is driven by random molecular motion and concentration gradients. *Facilitated diffusion* - **Facilitated diffusion** involves the passive movement of molecules across a membrane with the help of **transport proteins** (channels or carriers) but still moves down the concentration gradient without direct energy expenditure. - While it uses proteins, these proteins can sometimes function in **isolated membrane systems** even if the cell is not metabolically active (e.g., in a cell lysate). *Osmosis* - **Osmosis** is the specific type of diffusion involving the net movement of **water molecules** across a selectively permeable membrane, driven by differences in solute concentration. - Similar to simple diffusion, osmosis is a **physical process** based on water potential gradients and can occur in both **living and non-living membranes** given the right conditions.

Question 3: Which of the following is NOT a characteristic of a biphasic action potential of a mixed nerve?

A. Refractory period
B. All or none phenomenon
C. Recorded on surface
D. Two or more positive peaks (Correct Answer)

Explanation: ***Two or more positive peaks*** - A **biphasic action potential** of a mixed nerve, when recorded extracellularly, typically consists of two phases: an initial **negative deflection** followed by a **positive deflection**. It does not exhibit multiple positive peaks for a single action potential. - The shape is determined by the propagation of the action potential past two recording electrodes, illustrating the **depolarization and repolarization** of the nerve. *All or none phenomenon* - This is a fundamental characteristic of **individual nerve fibers** and thus applies to the action potentials propagating within a mixed nerve. - If a stimulus reaches a threshold, a full-sized action potential is generated; otherwise, none is generated, regardless of stimulus strength. *Refractory period* - The **refractory period** is a crucial characteristic of nerve excitability, ensuring unidirectional propagation and limiting the frequency of action potentials. - This period, comprising absolute and relative phases, applies to the individual fibers within the mixed nerve. *Recorded on surface* - **Compound action potentials (CAPs)** of mixed nerves are typically recorded extracellularly (on the surface) using electrodes, often seen in nerve conduction studies. - This contrasts with intracellular recordings which measure the potential across the cell membrane directly.

Question 4: A patient presents with symptoms of muscle weakness and fatigue. Serum potassium levels are significantly elevated. How does hyperkalemia affect the resting membrane potential and action potential generation in neurons?

A. Hyperpolarizes the resting membrane potential, making action potentials harder to generate
B. No change in resting membrane potential, no change in action potential generation
C. Hyperpolarizes the resting membrane potential, making action potentials easier to generate
D. Depolarizes the resting membrane potential, making action potentials harder to generate (Correct Answer)

Explanation: ***Depolarizes the resting membrane potential, making action potentials harder to generate*** - Hyperkalemia causes the **extracellular potassium concentration** to rise, which leads to a **less negative resting membrane potential** (depolarization), bringing it closer to the threshold for action potential firing. - However, prolonged depolarization **inactivates voltage-gated sodium channels**, making them unresponsive to further stimulation and **preventing the generation of new action potentials**. - This explains the **paradoxical muscle weakness** seen in hyperkalemia despite initial membrane depolarization. *Hyperpolarizes the resting membrane potential, making action potentials harder to generate* - This statement incorrectly suggests that hyperkalemia causes hyperpolarization (more negative resting potential). Hyperkalemia actually **depolarizes** (makes less negative) the resting membrane potential. - While hyperpolarization would make action potentials harder to generate, this is not the mechanism in hyperkalemia. *Hyperpolarizes the resting membrane potential, making action potentials easier to generate* - This is incorrect because hyperkalemia causes **depolarization**, not hyperpolarization of the resting membrane potential. - Hyperpolarization would move the membrane potential further from threshold, making action potentials harder, not easier to generate. *No change in resting membrane potential, no change in action potential generation* - This is incorrect as serum potassium levels are a primary determinant of the **resting membrane potential** of excitable cells according to the **Nernst equation**. - Significant changes in potassium levels directly alter the **electrochemical gradient** and the membrane potential, thereby affecting excitability.

Question 5: Absolute refractoriness of a neuron is due to?

A. Hyperpolarization of Cl channels
B. Opening of rectifier K+ channels
C. Closure of activated Na channels
D. Inactivation of Na channels (Correct Answer)

Explanation: ***Inactivation of Na channels*** - During the **absolute refractory period**, voltage-gated **Na+ channels** enter an inactivated state, making them unresponsive to further stimulation. - This inactivation prevents another action potential from being generated, regardless of the stimulus intensity, ensuring unidirectional propagation. *Hyperpolarization of Cl channels* - While **Cl- channels** can cause hyperpolarization, this typically leads to **inhibition** rather than absolute refractoriness. - Their activity doesn't directly prevent the generation of a new action potential by blocking Na+ channel function. *Opening of rectifier K+ channels* - The opening of **rectifier K+ channels** is involved in **repolarization** and the **relative refractory period**, by increasing K+ efflux. - While it contributes to making the neuron less excitable, it doesn't cause the absolute inability to fire associated with Na+ channel inactivation. *Closure of activated Na channels* - The **closure of activated Na+ channels** occurs as part of the repolarization process, but the critical mechanism for absolute refractoriness is their transition into an **inactivated state**, not simply closure. - **Inactivation** locks the channels in a non-responsive configuration, whereas simple closure would allow them to reopen quickly with sufficient depolarization.