Molecular Basis of Excitability — MCQs

10 questions

Assertion: RMP depends on proteins and phosphate ions. Reason: Diffusion potential can be calculated using nernst equation. Choose the best statement regarding the assertion and reason.

Sequence the events in neuromuscular action potential conduction: 1. Sodium channels open in the end plate 2. Calcium enters at the nerve terminal 3. Release of acetylcholine

Which of the following statements about the Na-K pump is false?

1 ml of 7.5% sodium bicarbonate provides:-

Absolute refractoriness of a neuron is due to?

Which of these is true about the highlighted transporter?

In multiple sclerosis, slow conduction of motor and sensory pathways is due to?

Which part of the action potential in cardiac pacemaker cells is primarily affected by calcium channel blockers?

Hyperpolarization is caused by which ions?

Q10

A research team is developing a gene therapy approach using CRISPR-Cas9 to correct a point mutation causing sickle cell disease. They must decide between two strategies: (A) correcting the mutation in hematopoietic stem cells ex vivo, or (B) in vivo correction in bone marrow. Considering molecular physiology principles, what is the most significant advantage of strategy A over strategy B?

Molecular Basis of Excitability Indian Medical PG Practice Questions and MCQs

Question 1: Assertion: RMP depends on proteins and phosphate ions. Reason: Diffusion potential can be calculated using nernst equation. Choose the best statement regarding the assertion and reason.

A. Assertion false, Reason true
B. Both true, Reason is the explanation of assertion
C. Assertion true, Reason false
D. Both true, Reason is not the explanation of assertion (Correct Answer)

Explanation: ***Both true, Reason is not the explanation of assertion*** - The **Assertion is TRUE**: The resting membrane potential (RMP) does depend on intracellular **proteins and phosphate ions**, which are large, non-diffusible anions that remain trapped inside the cell. These molecules contribute significantly to the **net negative charge** of the intracellular compartment and create the **Gibbs-Donnan effect**. At physiological pH, most intracellular proteins are negatively charged, and phosphate ions (HPO₄²⁻, H₂PO₄⁻) are major intracellular anions. While the primary determinants of RMP are the concentration gradients and membrane permeabilities of K⁺, Na⁺, and Cl⁻ ions, the presence of non-diffusible anions (proteins and phosphates) is essential for establishing the baseline negative intracellular environment. - The **Reason is TRUE**: The **Nernst equation** (E = RT/zF × ln[ion]out/[ion]in) is indeed used to calculate the **equilibrium potential** (also called diffusion potential) for a single permeable ion. This equation determines the membrane potential at which the electrical gradient exactly balances the concentration gradient for that specific ion, resulting in no net ion movement. - **However, the Reason does NOT explain the Assertion**: The Nernst equation calculates equilibrium potentials for diffusible ions like K⁺, Na⁺, and Cl⁻. It does NOT explain the contribution of **non-diffusible** anions (proteins and phosphates) to the RMP. The actual RMP, which involves multiple ions with different permeabilities, is calculated using the **Goldman-Hodgkin-Katz (GHK) equation**, not the Nernst equation. The two statements are independently true but address different aspects of membrane potential physiology. *Assertion false, Reason true* - This is **incorrect** because the assertion is actually TRUE. Intracellular proteins and phosphate ions do contribute to the RMP by providing fixed negative charges that influence the distribution of diffusible ions and create the electrochemical environment necessary for RMP establishment. *Both true, Reason is the explanation of assertion* - This is **incorrect** because while both statements are true, the Nernst equation (Reason) does not explain how proteins and phosphate ions contribute to RMP (Assertion). The Nernst equation applies only to permeable ions, whereas proteins and phosphates are impermeant molecules whose role is explained by the Gibbs-Donnan equilibrium and their contribution to fixed negative charges. *Assertion true, Reason false* - This is **incorrect** because the reason is TRUE. The Nernst equation is a fundamental and valid equation in membrane physiology that accurately calculates the equilibrium potential for any permeable ion based on its concentration gradient.

Question 2: Sequence the events in neuromuscular action potential conduction: 1. Sodium channels open in the end plate 2. Calcium enters at the nerve terminal 3. Release of acetylcholine

A. $1 \rightarrow 2 \rightarrow 3$
B. $1 \rightarrow 3 \rightarrow 2$
C. $3 \rightarrow 2 \rightarrow 1$
D. $2 \rightarrow 3 \rightarrow 1$ (Correct Answer)

Explanation: ***Correct: $2 \rightarrow 3 \rightarrow 1$*** - **Calcium entry at the nerve terminal** is the initial trigger - when an action potential reaches the presynaptic nerve terminal, voltage-gated calcium channels open, allowing Ca²⁺ influx - **Acetylcholine release** follows - the increased intracellular calcium causes synaptic vesicles containing acetylcholine to fuse with the presynaptic membrane and release the neurotransmitter into the synaptic cleft - **Sodium channels open in the end plate** last - acetylcholine binds to nicotinic receptors on the motor end plate, opening ligand-gated sodium channels, which depolarizes the muscle membrane and triggers muscle contraction *Incorrect: $1 \rightarrow 2 \rightarrow 3$* - Places sodium channel opening first, which is physiologically impossible - Sodium channels at the motor end plate only open in response to acetylcholine binding - Cannot occur before acetylcholine is released from the nerve terminal *Incorrect: $1 \rightarrow 3 \rightarrow 2$* - Incorrectly sequences sodium channel opening before calcium entry - Violates the fundamental principle that calcium influx is required for neurotransmitter release - Acetylcholine cannot be released without prior calcium entry *Incorrect: $3 \rightarrow 2 \rightarrow 1$* - Places acetylcholine release before calcium entry, which is impossible - Calcium-triggered exocytosis is an absolute requirement for neurotransmitter release - Without calcium influx, vesicles cannot fuse with the presynaptic membrane

Question 3: Which of the following statements about the Na-K pump is false?

A. It is not directly involved in the generation of action potentials.
B. It is electrogenic
C. It needs ATP for its functioning
D. It is located on the apical membrane of cell (Correct Answer)

Explanation: ***It is located on the apical membrane of cell*** - The **Na-K pump**, or **Na+/K+-ATPase**, is primarily located on the **basolateral membrane** of epithelial cells, not **apical membrane**. - Its strategic placement on the basolateral membrane is crucial for maintaining cellular polarity and driving transepithelial transport processes, such as reabsorption in the kidneys. *It is electrogenic* - The Na-K pump is indeed **electrogenic** because it transports three **Na+ ions** out of the cell for every two **K+ ions** pumped in. - This unequal charge distribution creates a net movement of one positive charge out of the cell, contributing to the **resting membrane potential**. *It is not directly involved in the generation of action potentials.* - While the Na-K pump is essential for **maintaining the ion gradients** necessary for **action potentials**, it is not directly involved in their rapid depolarization or repolarization phases. - Action potentials are primarily generated by the rapid opening and closing of **voltage-gated ion channels** (e.g., Na+ and K+ channels). *It needs ATP for its functioning* - The Na-K pump is an **active transport mechanism** that moves ions against their concentration gradients, requiring **energy in the form of ATP hydrolysis**. - This **ATP-dependent process** ensures the continuous maintenance of the Na+ and K+ gradients, crucial for various cellular functions, including nerve impulse transmission and muscle contraction.

Question 4: 1 ml of 7.5% sodium bicarbonate provides:-

A. 0.5 meq bicarbonate
B. 0.9 meq bicarbonate (Correct Answer)
C. 1.5 meq bicarbonate
D. 1.1 meq bicarbonate

Explanation: ***0.9 meq bicarbonate*** - A 7.5% solution means 7.5 grams of sodium bicarbonate in 100 ml of solution. Thus, 1 ml contains **0.075 grams** (75 mg). - The molecular weight of sodium bicarbonate (NaHCO₃) is approximately **84 g/mol**. Since it is a monovalent ion, 1 mmol equals 1 mEq. Therefore, 75 mg is approximately **0.892 mEq**, which rounds to 0.9 mEq. *0.5 meq bicarbonate* - This value is significantly **lower** than the actual amount of bicarbonate contained in 1 ml of a 7.5% solution. - An error in calculation, such as an incorrect molecular weight or percentage conversion, would lead to this underestimation. *1.5 meq bicarbonate* - This value is **higher** than the actual amount of bicarbonate and would be closer to the concentration of a 12.5% solution or a significantly larger volume. - This suggests a **miscalculation** of the concentration or the amount present in 1 ml. *1.1 meq bicarbonate* - While closer than other incorrect options, this value is still an **overestimation**. - A slight error in the molecular weight used for calculation or in the initial mass conversion could lead to this result.

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.

Question 6: Which of these is true about the highlighted transporter?

A. Both molecules go in
B. One molecule goes in, other molecule goes out (Correct Answer)
C. Both molecules go out
D. One molecule goes in and two exit

Explanation: ***One molecule goes in, other molecule goes out*** - The highlighted transporter is the **Na+/K+ ATPase**, which actively pumps 3 **Na+ ions out** of the cell and 2 **K+ ions into** the cell, maintaining an electrochemical gradient. - This counter-transport (one molecule type going in and another going out) is characteristic of an **antiporter** pump. *Both molecules go in* - This option would describe a **symporter** mechanism where two different molecules move in the **same direction** across the membrane. - The Na+/K+ ATPase explicitly shows Na+ moving out and K+ moving in, which contradicts simultaneous inward movement. *Both molecules go out* - This would mean two molecules are expelled from the cell. The Na+/K+ ATPase, however, has K+ entering the cell. - While Na+ is pumped out by this transporter, K+ is actively transported inward. *One molecule goes in and two exit* - The Na+/K+ ATPase transports three Na+ ions out of the cell and two K+ ions into the cell, which is a 3:2 ratio and not one in and two out. - This option incorrectly describes the stoichiometry and directionality of ions for the Na+/K+ ATPase.

Question 7: In multiple sclerosis, slow conduction of motor and sensory pathways is due to?

A. Loss of myelin sheath (Correct Answer)
B. Dysfunction of sodium channels
C. Dysfunction of calcium channels
D. Defect in the nodes of Ranvier

Explanation: ***Loss of myelin sheath*** - Multiple sclerosis (MS) is characterized by **demyelination**, which is the destruction of the **myelin sheath** surrounding nerve fibers in the central nervous system. - Myelin acts as an electrical insulator, facilitating rapid, **saltatory conduction** of nerve impulses; its loss directly leads to **slowed or blocked signal transmission**. *Dysfunction of sodium channels* - While sodium channel dysfunction can occur secondary to demyelination, it is not the primary cause of slow conduction in MS but rather a downstream effect or an adaptive change. - The initial and fundamental problem leading to slowed conduction in MS is the **loss of the myelin sheath**, which renders the exposed axon less efficient at propagating action potentials. *Dysfunction of calcium channels* - Dysfunction of calcium channels is not the primary pathological mechanism responsible for the slowed conduction in MS. - While calcium dysregulation can play a role in **axonal damage** and neurodegeneration in MS, it is not the direct cause of the characteristic **slowed nerve impulse propagation**. *Defect in the nodes of Ranvier* - The **nodes of Ranvier** are uncovered gaps in the myelin sheath that are crucial for **saltatory conduction**. While their integrity is important, a primary "defect" in the nodes themselves is not the initial cause of slowed conduction in MS. - Slowed conduction occurs because the **myelin surrounding the axons** is lost, leading to longer distances for the action potential to travel and exposing segments of the axon unprepared for continuous conduction.

Question 8: Which part of the action potential in cardiac pacemaker cells is primarily affected by calcium channel blockers?

A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 0 (Correct Answer)

Explanation: ***Phase 0*** - In cardiac pacemaker cells (SA and AV nodes), **Phase 0 (rapid depolarization)** is mediated by **L-type calcium channels**, NOT the fast sodium channels seen in ventricular myocytes. - Calcium channel blockers primarily inhibit these **L-type calcium channels**, leading to a **slower rate of depolarization** and **reduced conduction velocity** through the AV node. - This is the **primary mechanism** by which these drugs slow heart rate and cause AV nodal blockade. *Phase 1* - Phase 1 (initial rapid repolarization) is **absent in pacemaker cells** because they lack the fast sodium channels and transient outward potassium currents characteristic of ventricular myocytes. - This phase is not relevant to pacemaker cell action potentials. *Phase 2* - Phase 2 (plateau phase) is also **absent or minimal in pacemaker cells**. - Pacemaker action potentials lack the prolonged plateau seen in ventricular myocytes. - This phase is not the primary target of calcium channel blockers in pacemaker tissue. *Phase 3* - Phase 3 (repolarization) occurs in pacemaker cells and is mediated by **potassium efflux**. - Calcium channel blockers do **not directly affect** this phase, as it is driven by potassium channels, not calcium channels. - Their effect on Phase 3 is minimal compared to their direct action on Phase 0.

Question 9: Hyperpolarization is caused by which ions?

A. K+ (Correct Answer)
B. Na+
C. HCO3-
D. Ca2+

Explanation: ***K+*** - **Efflux of K+ ions** out of the cell makes the inside of the cell more negative, leading to **hyperpolarization**. - This efflux is typically mediated by **voltage-gated potassium channels** opening, or by activation of **GABA-A** or **glycine receptors** that increase K+ conductance. *Na+* - **Influx of Na+ ions** into the cell makes the inside of the cell more positive, causing **depolarization**, not hyperpolarization. - This influx is responsible for the **rising phase of an action potential**. *Ca2+* - **Influx of Ca2+ ions** into the cell also contributes to **depolarization** and can trigger various intracellular processes. - Ca2+ influx is crucial for **neurotransmitter release** and muscle contraction, but not for hyperpolarization. *HCO3-* - Bicarbonate ions (**HCO3-**) play a significant role in **maintaining pH balance** in the body and are involved in various physiological processes. - While ion channels can conduct HCO3-, their movement is not typically the primary cause of cell membrane hyperpolarization.

Question 10: A research team is developing a gene therapy approach using CRISPR-Cas9 to correct a point mutation causing sickle cell disease. They must decide between two strategies: (A) correcting the mutation in hematopoietic stem cells ex vivo, or (B) in vivo correction in bone marrow. Considering molecular physiology principles, what is the most significant advantage of strategy A over strategy B?

A. Strategy A allows for screening and selection of successfully edited cells before transplantation, minimizing off-target effects (Correct Answer)
B. Strategy A requires lower doses of viral vectors
C. Strategy A produces faster clinical improvement
D. Strategy A is less expensive to implement

Explanation: ***Strategy A allows for screening and selection of successfully edited cells before transplantation, minimizing off-target effects*** - **Ex vivo** correction allows scientists to perform **quality control** by screening the patient's cells for the desired **on-target** modification and ensuring no harmful **off-target** mutations exist. - This selection process ensures that only **genetically verified** hematopoietic stem cells are re-infused, providing a significant safety and efficacy profile compared to blind **in vivo** delivery. *Strategy A requires lower doses of viral vectors* - While the total volume might be smaller, the primary advantage is the **precision** and **safety** of editing, not merely the quantity of the vector used. - **In vivo** methods actually face greater challenges with **vector distribution** and immune clearance, but this is less critical than the ability to screen cells. *Strategy A produces faster clinical improvement* - The **ex vivo** process is time-consuming, involving **cell harvesting**, laboratory editing, and **myeloablative conditioning** before re-infusion. - Clinical improvement depends on the **engraftment** of edited cells and the turnover of red blood cells, which is not necessarily faster than **in vivo** methods. *Strategy A is less expensive to implement* - **Ex vivo** gene therapy is highly expensive due to the need for **specialized laboratory facilities**, intensive cell culture protocols, and prolonged patient **hospitalization**. - **In vivo** strategies are conceptually cheaper and easier to scale, but currently lack the **safety oversight** provided by laboratory screening.

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