NEET-PG 2013 - Physiology Practice Questions

Q: Which of the following is the most accurate measure of Glomerular Filtration Rate (GFR)?

Iothalamate Clearance. ***Iothalamate Clearance*** - **Iothalamate clearance** is considered the **gold standard** for directly measuring GFR in clinical practice because it is a substance that is freely filtered by the glomerulus and is neither reabsorbed nor secreted by the renal tubules. - This method provides the most accurate and precise assessment of kidney function by quantifying the actual GFR, often used in research settings or for precise diagnosis. - **Note:** Inulin clearance is the traditional reference standard, but iothalamate is more practical and widely used clinically as it can be measured using radioactive or non-radioactive methods. *Serum creatinine* - **Serum creatinine** is a commonly used biomarker but is an **imperfect measure** of GFR because it can be influenced by factors like muscle mass, diet, and certain medications. - Its levels can remain within the normal range even when GFR has significantly decreased, especially in the early stages of kidney disease. *Cystatin C* - **Cystatin C** is a protein produced by most nucleated cells and is also freely filtered by the glomerulus, with less influence from muscle mass and diet compared to creatinine. - While considered a better marker than serum creatinine, it is still an **estimated measure** and is more expensive and less widely available than creatinine, and can be affected by inflammation or thyroid dysfunction. *Creatinine Clearance* - **Creatinine clearance** (often estimated using urine and serum creatinine levels over a timed collection) attempts to approximate GFR but can be **inaccurate** due to incomplete urine collection and tubular secretion of creatinine. - The **creatinine secretion** by the renal tubules leads to an overestimation of the true GFR, making it less accurate than direct measurement methods.

Q: What is the normal range of renal blood flow in humans?

1 to 1.2 L/min. ***1 to 1.2 L/min*** - The **kidneys** receive a substantial portion of the **cardiac output**, typically around 20-25%, to perform their filtration and regulatory functions. - This translates to an absolute renal blood flow of approximately **1000 to 1200 mL/min**, or **1 to 1.2 liters per minute**. - This represents the normal physiological range for healthy adults at rest. *1.5 to 2 L/min* - This range is **higher than the normal physiological** renal blood flow. - While renal blood flow can be influenced by various factors, sustained flow in this range would typically be considered **above the average baseline** for healthy individuals. *2 to 2.5 L/min* - This range significantly **exceeds the typical** renal blood flow observed in healthy humans. - Such high flow rates would be **unusual** and are not representative of normal renal perfusion. *2.5 to 3 L/min* - This range represents an **extremely high** renal blood flow, far beyond what is considered normal. - Sustained perfusion at this level would be **pathological** or indicative of an experimental setting rather than a physiological state.

Q: What is the primary solute responsible for the hyperosmolarity of the renal medulla?

Na. ***Na*** - **Sodium (Na+), along with chloride**, is the primary solute responsible for establishing the **corticomedullary osmotic gradient** in the renal medulla. - Actively reabsorbed in the **thick ascending limb of the loop of Henle** via the Na-K-2Cl cotransporter, creating hyperosmolarity in the outer medulla. - NaCl accounts for the majority of osmolality in the **outer medulla** and provides the foundation for the countercurrent multiplication system. - While **urea contributes significantly to inner medullary hyperosmolarity** (especially during antidiuresis), **sodium chloride** is considered the **primary driving force** for the overall medullary concentration gradient. *K* - **Potassium (K+)** is primarily involved in maintaining intracellular fluid balance and cellular membrane potentials. - While K+ is reabsorbed in the loop of Henle (via Na-K-2Cl cotransporter), it does not accumulate in the medullary interstitium to contribute significantly to hyperosmolarity. *urea* - **Urea** contributes substantially to hyperosmolarity, particularly in the **inner medulla** (accounting for ~40-50% of inner medullary osmolality). - Through **urea recycling** (collecting duct → medullary interstitium → thin limbs), it enhances urinary concentration, especially during water deprivation. - However, the **initial establishment** of the osmotic gradient depends on **NaCl reabsorption** in the ascending limb, making sodium the primary solute. *Cl* - **Chloride (Cl-)** is reabsorbed together with sodium via the Na-K-2Cl cotransporter in the thick ascending limb. - Functionally, **NaCl works as a unit** to create medullary hyperosmolarity, so chloride and sodium are inseparable in this process. - Among the listed options, **sodium** represents this NaCl contribution as the cation driving active transport.

Q: What is the air remaining in the lung after normal expiration?

Functional Residual Capacity (FRC). ***Functional Residual Capacity (FRC)*** - **FRC** represents the volume of air remaining in the lungs after a **normal expiration**. - It is the sum of the **expiratory reserve volume (ERV)** and the **residual volume (RV)**. *Tidal Volume (TV)* - **TV** is the volume of air inspired or expired with a **normal breath**. - It does not represent the total air remaining in the lungs after expiration. *Residual Volume (RV)* - **RV** is the volume of air remaining in the lungs after a **maximal expiration**. - It is a component of FRC but does not fully describe the air remaining after a *normal* expiration. *Vital Capacity (VC)* - **VC** is the maximum volume of air that can be exhaled after a **maximal inspiration**. - It represents the maximum amount of air that can be exchanged with a single breath, not the air remaining after normal expiration.

Q: What is the most important extracellular buffer?

Bicarbonates. ***Bicarbonates*** - The **bicarbonate buffer system** is the most important extracellular buffer because its components (carbonic acid and bicarbonate) are present in high concentrations and their levels can be regulated by both the lungs (CO2 excretion) and the kidneys (bicarbonate reabsorption/secretion). - Its pKa (6.1) makes it an effective buffer against metabolically produced acids, which frequently challenge blood pH. *Phosphate buffer* - The **phosphate buffer system** is more important as an intracellular buffer and in renal tubular fluid due to its higher concentration in these compartments. - Its concentration in the extracellular fluid is relatively low compared to bicarbonate, limiting its capacity as the primary extracellular buffer. *Plasma protein buffer* - **Plasma proteins**, particularly albumin, have numerous ionizable groups and contribute to buffering in the extracellular fluid. - However, their overall buffering capacity is less significant than that of the bicarbonate system due to lower concentration compared to bicarbonate and less dynamic regulation. *Ammonium buffer* - The **ammonium buffer system** (ammonia/ammonium) is primarily important for acid-base regulation by the kidneys, where it plays a critical role in excreting excess acid, particularly in chronic acidosis. - It is not a major extracellular fluid buffer in the systemic circulation under normal physiological conditions.

Q: Which of the following is the primary site of gastrin production?

Gastric G cells. ***Gastric G cells*** - **G cells**, primarily located in the **antrum of the stomach**, are the main site for **gastrin production** - Gastrin is a hormone that stimulates the secretion of **gastric acid** by the parietal cells in the oxyntic glands of the stomach - G cells are specialized endocrine cells that release gastrin in response to gastric distension, amino acids, and vagal stimulation *Pancreas* - The pancreas produces hormones such as **insulin** and **glucagon**, and digestive enzymes like **amylase** and **lipase** - While the pancreas does contain some hormone-producing cells, it is not the primary site for gastrin synthesis *Pituitary gland* - The **pituitary gland** is the master endocrine gland, regulating various **hormonal axes** like thyroid, adrenal, and reproductive functions - It does not produce gastrin; its hormones include **growth hormone**, **prolactin**, **TSH**, **ACTH**, **FSH**, and **LH** *Gastric chief cells* - Chief cells (also called zymogenic cells) are located in the **gastric glands of the fundus and body** of the stomach - They produce **pepsinogen**, the inactive precursor of the proteolytic enzyme pepsin, not gastrin

Q: During starvation, which hormone level increases?

Ghrelin. ***Ghrelin*** - **Ghrelin** is often referred to as the "hunger hormone" because its levels typically rise during fasting or periods of starvation. - It stimulates **appetite** and signals the brain to increase food intake, playing a crucial role in energy balance. *Leptin* - **Leptin** is a hormone produced by **adipose tissue** that signals satiety and helps regulate long-term energy balance. - During starvation, **leptin levels typically decrease** as fat stores are depleted, which further increases appetite and reduces energy expenditure. *MSH* - **Melanocyte-stimulating hormone (MSH)** is involved in skin pigmentation and appetite regulation, but its levels do not primarily increase in response to starvation. - While MSH can influence appetite, it is often seen to decrease appetite when present in higher concentrations, which is counterintuitive during starvation. *Insulin* - **Insulin** is a hormone produced by the **pancreas** that helps regulate blood glucose levels by promoting glucose uptake into cells. - During starvation, blood glucose levels decrease, leading to a **reduction in insulin secretion** to preserve glucose for vital organs like the brain.

Q: Which of the following hormones is not stored in cells?

Cortisol. ***Cortisol*** - Cortisol is a **steroid hormone** that is synthesized from **cholesterol** on demand and is **not stored** in secretory vesicles or elsewhere within cells. - Being **lipophilic**, it diffuses freely across cell membranes immediately after synthesis. - Its release is regulated by the **hypothalamic-pituitary-adrenal (HPA) axis**, with synthesis and immediate secretion occurring upon stimulation. *Insulin* - Insulin is a **peptide hormone** synthesized as **proinsulin** and then cleaved into active insulin. - It is **stored in secretory granules** within pancreatic beta cells, allowing for rapid release in response to elevated blood glucose. *Thyroxine* - Thyroxine (T4) is a **thyroid hormone** that is synthesized from tyrosine and iodine. - It is **stored extracellularly** within the thyroid gland's follicles as part of a large protein called **thyroglobulin**. - Unlike cortisol (which is never stored), thyroxine has a **substantial storage pool** that can last weeks, though the storage is extracellular rather than intracellular. *Renin* - Renin is an **enzyme** produced by the **juxtaglomerular cells** of the kidney. - It is **stored in secretory granules** within these cells and released in response to decreased renal perfusion pressure or sympathetic stimulation.

Q: Which hormone is secreted by the "Delta cells" of the stomach?

Somatostatin. ***Somatostatin*** - **Delta cells (D cells)** in the stomach and pancreas secrete **somatostatin**, a potent inhibitory hormone. - Somatostatin **inhibits the release of gastrin**, histamine, secretin, cholecystokinin, and gastric acid secretion, acting as a "universal off switch." *Cholecystokinin* - **Cholecystokinin (CCK)** is primarily secreted by **I cells** in the duodenum and jejunum. - Its main functions include stimulating gallbladder contraction and pancreatic enzyme secretion. *Gastrin-releasing peptide* - **Gastrin-releasing peptide (GRP)**, also known as **bombesin**, is a neuropeptide released from **enteric neurons**. - It stimulates the release of **gastrin** from G cells. *Secretin* - **Secretin** is secreted by **S cells** in the duodenum in response to acidic chyme entering the small intestine. - Its primary role is to stimulate the pancreas to release **bicarbonate-rich fluid** to neutralize gastric acid.

Question 1

Which of the following is the most accurate measure of Glomerular Filtration Rate (GFR)?

Accepted Answer

Iothalamate Clearance

Answer

Cystatin C

Answer

Serum creatinine

Answer

Creatinine Clearance

Question 2

What is the normal range of renal blood flow in humans?

Accepted Answer

1 to 1.2 L/min

Answer

1.5 to 2 L/min

Answer

2 to 2.5 L/min

Answer

2.5 to 3 L/min

Question 3

What is the primary solute responsible for the hyperosmolarity of the renal medulla?

Accepted Answer

Na

Answer

urea

Answer

K

Answer

Cl

Question 4

What is the air remaining in the lung after normal expiration?

Accepted Answer

Functional Residual Capacity (FRC)

Answer

Tidal Volume (TV)

Answer

Residual Volume (RV)

Answer

Vital Capacity (VC)

Question 5

What is the primary function of the 'patch-clamp' technique in electrophysiology?

Accepted Answer

To record ionic currents through single or multiple ion channels

Answer

To record facilitated diffusion

Answer

To record osmotic pressure around semipermeable membrane

Answer

To record RMP

Question 6

What is the most important extracellular buffer?

Accepted Answer

Bicarbonates

Answer

Phosphate buffer

Answer

Plasma protein buffer

Answer

Ammonium buffer

Question 7

Which of the following is the primary site of gastrin production?

Accepted Answer

Gastric G cells

Answer

Gastric chief cells

Answer

Pancreas

Answer

Pituitary gland

Question 8

During starvation, which hormone level increases?

Accepted Answer

Ghrelin

Answer

Leptin

Answer

MSH

Answer

Insulin

Question 9

Which of the following hormones is not stored in cells?

Accepted Answer

Cortisol

Answer

Thyroxin

Answer

Renin

Answer

Insulin

Question 10

Which hormone is secreted by the "Delta cells" of the stomach?

Accepted Answer

Somatostatin

Answer

Cholecystokinin

Answer

Gastrin-releasing peptide

Answer

Secretin

NEET-PG 2013 — Physiology