NEET-PG 2015 - Physiology Practice Questions

Q: Cerebral blood flow is regulated by all, EXCEPT:

Potassium ions. ***Potassium ions*** - While potassium ions play a crucial role in neuronal excitability and membrane potential, they are **not a primary direct regulator** of cerebral blood flow (CBF) in the same way as other factors listed. - Changes in extracellular potassium can affect vascular smooth muscle, but their direct impact on CBF auto-regulation is less pronounced compared to metabolic or pressure-related factors. *Intracranial pressure* - **Increased intracranial pressure (ICP)** can significantly decrease cerebral blood flow due to the **Monro-Kellie doctrine**, which states that an increase in ICP reduces the cerebral perfusion pressure (CPP). - A sustained and significant elevation in ICP can lead to **cerebral ischemia** as it opposes the arterial pressure driving blood into the brain. *Arterial PCO2* - **Arterial PCO2** is a potent regulator of cerebral blood flow, with **hypercapnia (high PCO2)** causing **vasodilation** and increased CBF. - Conversely, **hypocapnia (low PCO2)** leads to **vasoconstriction** and decreased CBF, which is a key mechanism in the management of cerebral edema. *Cerebral metabolic rate* - **Cerebral metabolic rate (CMR)** is directly coupled to cerebral blood flow, meaning that regions of the brain with higher metabolic activity receive increased blood flow. - This **neurovascular coupling** ensures adequate supply of oxygen and nutrients to meet the brain's metabolic demands.

Q: Which of the following statements is true regarding the Bezold-Jarisch reflex?

Hypotension. ***Hypotension*** - The Bezold-Jarisch reflex is a **cardioinhibitory reflex** that is typically activated by strong ventricular contraction or noxious stimuli, leading to a triad of **bradycardia**, **peripheral vasodilation**, and subsequent **hypotension**. - This reflex is thought to be a protective mechanism to prevent excessive cardiac work or to trigger a "fainting" response to remove the body from danger. *Hypertension* - The Bezold-Jarisch reflex primarily causes a **decrease in blood pressure**, making hypertension an incorrect outcome. - Its activation directly opposes the mechanisms that would lead to increased blood pressure. *Tachycardia* - A key component of the Bezold-Jarisch reflex is **bradycardia** (slowing of the heart rate), not tachycardia. - This reflex is mediated by the vagus nerve, which primarily exerts inhibitory control over heart rate. *Hyperpnea* - The Bezold-Jarisch reflex primarily impacts **cardiovascular function** and does not directly cause hyperpnea (increased rate and depth of breathing). - While other reflexes can affect respiration, this particular reflex is not known for its respiratory effects.

Q: During the sympathetic fight-or-flight response, what is the primary cardiovascular effect of epinephrine and norepinephrine on skeletal muscle vasculature?

Increased blood flow to muscles. ***Increased blood flow to muscles*** - **Epinephrine** and **norepinephrine** cause **vasodilation** in skeletal muscle arterioles, shunting blood toward tissues critical for immediate physical action. - This response ensures that muscles have adequate **oxygen** and **nutrients** to support intense activity, enabling a quick escape or confrontation. *Increased blood flow to the skin* - During fight-or-flight, the body prioritizes essential organs, causing **vasoconstriction** in the skin to redirect blood flow away from non-essential areas. - This redirection helps to conserve blood and reduce potential blood loss from surface injuries. *Bronchoconstriction* - **Epinephrine** and **norepinephrine** actually cause **bronchodilation**, leading to the relaxation of airway smooth muscles. - This effect increases the diameter of the airways, allowing more air to enter and exit the lungs, thereby enhancing **oxygen intake** and carbon dioxide expulsion. *Decreased heart rate* - The primary effect of **epinephrine** and **norepinephrine** is to **increase heart rate** and myocardial contractility. - This cardiac acceleration enhances **cardiac output**, ensuring rapid and efficient delivery of oxygenated blood throughout the body to meet the demands of stress.

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

Decreased in emphysema. ***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.

Q: Lysosome with undigested particle inside is known as?

Residual body. ***Residual body*** - A **residual body** is a lysosome that contains **undigested material** after the digestive process is complete. - These bodies can accumulate in cells over time and are sometimes associated with **cellular aging**. *Phagosome* - A **phagosome** is a vesicle formed around a particle engulfed by a cell through **phagocytosis**. - It has not yet fused with a lysosome, so digestion has not begun. *Phagolysosome* - A **phagolysosome** is formed when a **phagosome fuses with a lysosome**, initiating the process of digestion of the engulfed material. - At this stage, the contents are actively being broken down by lysosomal enzymes. *Autophagosome* - An **autophagosome** is a double-membraned vesicle that sequesters cellular components, such as damaged organelles or misfolded proteins, for degradation via **autophagy**. - It eventually fuses with a lysosome to form an autophagolysosome, but it is not itself a lysosome with undigested particles.

Q: Small intestinal peristalsis is controlled by :

Myenteric plexus. ***Myenteric plexus*** - The **myenteric (Auerbach's) plexus** is located between the longitudinal and circular muscle layers of the muscularis propria and is primarily responsible for **controlling gastrointestinal motility**, including peristalsis. - Its neurons coordinate the contractions and relaxations of these muscle layers to propel contents through the alimentary canal. *Meissners plexus* - The **Meissner's (submucosal) plexus** is located in the submucosa and mainly controls **glandular secretion**, local blood flow, and absorption, rather than muscle motility. - While it subtly influences motility through local reflexes, it is not the primary controller of peristalsis. *Vagus nerve* - The **vagus nerve (cranial nerve X)** provides parasympathetic innervation to the small intestine, modulating activity but not directly initiating or solely controlling peristalsis. - It influences the activity of the enteric nervous system (including the myenteric plexus) but does not itself generate the complex, coordinated patterns of muscle contraction. *Parasympathetic system* - The **parasympathetic nervous system**, through nerves like the vagus, generally **stimulates gastrointestinal motility**, but it acts by modulating the intrinsic enteric nervous system. - The local control and generation of specific peristaltic movements are primarily mediated by the enteric nervous system, especially the myenteric plexus.

Q: Inotropic effect of thyroid hormone is by ?

Enhancement of Catecholamines. ***Enhancement of Catecholamines*** - Thyroid hormones **potentiate the effects of catecholamines** (like adrenaline and noradrenaline) on the heart, leading to increased heart rate and contractility, which is an **inotropic effect**. - This occurs by increasing the number and sensitivity of **beta-adrenergic receptors** on cardiac muscle cells. *Membrane receptors* - While thyroid hormones do have some rapid, non-genomic effects that may involve **membrane receptors**, their primary and well-established inotropic effect is mediated indirectly through catecholamine sensitivity. - The classic action of thyroid hormones is via intracellular receptors that modulate gene expression, not direct membrane receptor signaling for inotropic effects. *cAMP* - **cAMP** is a common second messenger for many hormones, particularly those acting via G protein-coupled receptors. - While catecholamines themselves act through cAMP to exert their cardiac effects, thyroid hormones *enhance the action* of catecholamines rather than directly using cAMP as their primary inotropic mechanism. *cGMP* - **cGMP** is a second messenger often associated with nitric oxide signaling and vasodilation, contributing to cGMP-dependent protein kinases. - It is not the primary mediator for the *positive inotropic effect* of thyroid hormones on the heart.

Q: All are true about GFR except:

Best estimated by creatinine clearance. ***Best estimated by creatinine clearance*** - While **creatinine clearance** can be used as a measure of GFR, it is not the *best* estimate; it tends to slightly **overestimate** GFR due to tubular secretion of creatinine. [1] - The gold standard for measuring GFR involves methods like **inulin clearance**, but in clinical practice, GFR is often *estimated* using equations based on **serum creatinine** (e.g., CKD-EPI, MDRD). [2] *30-40% decrease after 70 years of age* - **Aging** is associated with a physiological decline in GFR, with a general decrease often cited as 30-40% after the age of 70 years. - This decline is part of the normal **age-related changes in renal function**. *GFR is dependent on height in children* - In children, GFR is often adjusted for **body surface area (BSA)**, which is calculated based on both **height and weight**, making height an important factor. [1] - This adjustment is crucial for accurate assessment of renal function in a growing pediatric population. *Chronic Kidney Disease (CKD) is defined as GFR < 60 ml/min/1.73 m² for 3 months or more.* - This statement accurately reflects the widely accepted definition of **Chronic Kidney Disease (CKD)** according to clinical guidelines. [3] - A GFR below this threshold sustained for more than three months indicates persistent kidney damage or dysfunction.

Q: What is the most common mechanism responsible for causing arrhythmias in the heart?

Re-entry. ***Re-entry*** - **Re-entry** is the most common mechanism for arrhythmias and involves a re-excitation of cardiac tissue due to a circulating electrical impulse. - This requires at least two pathways with differing conduction velocities and refractory periods, creating a path for the impulse to re-excite an area after its normal refractory period has ended. *Early after depolarization* - **Early afterdepolarizations (EADs)** occur during phase 2 or 3 of the action potential when repolarization is incomplete, often due to prolonged action potential duration. - They are typically associated with conditions like **long QT syndrome** and can trigger polymorphic ventricular tachycardia, but are less common than re-entry. *Late after depolarization* - **Late afterdepolarizations (DADs)** occur during phase 4 of the action potential, after repolarization is complete, due to excessive intracellular calcium. - They are often seen in conditions like **digoxin toxicity** or **catecholaminergic polymorphic ventricular tachycardia**, but are not the most prevalent mechanism. *Automaticity* - **Abnormal automaticity** refers to pacemaker activity arising in non-pacemaker cells or an acceleration of normal pacemaker activity. - While it can cause arrhythmias such as accelerated idioventricular rhythm, re-entry is far more frequently implicated in the etiology of clinical arrhythmias.

Q: What is the average survival time of a person without food and water under normal conditions?

3 to 5 days. ***3 to 5 days*** - When deprived of **both food and water**, the human body can typically survive for **3 to 5 days** under normal conditions. - **Water is the critical limiting factor** - while the body can tolerate food deprivation for weeks, lack of water becomes life-threatening within days. - Water is essential for cellular metabolism, temperature regulation, waste elimination, and cardiovascular function. *1 to 3 days* - This represents the **absolute minimum survival time** without water, particularly under harsh environmental conditions (heat, physical exertion, humidity). - However, under normal/average conditions, most individuals can survive slightly longer than this range. *10 to 12 days* - This duration is **not possible** without water, even with optimal conditions. - This timeframe is more consistent with survival **without food but WITH water**, which can extend to 3-4 weeks or more. *5 to 10 days* - While exceptional cases might approach 5-7 days without water in cool, resting conditions with low metabolic demands, **10 days is physiologically implausible**. - Severe dehydration typically causes death by day 5-7 maximum, with most succumbing earlier.

Question 1

Cerebral blood flow is regulated by all, EXCEPT:

Accepted Answer

Potassium ions

Answer

Intracranial pressure

Answer

Cerebral metabolic rate

Answer

Arterial PCO2

Question 2

Which of the following statements is true regarding the Bezold-Jarisch reflex?

Accepted Answer

Hypotension

Answer

Hypertension

Answer

Tachycardia

Answer

Hyperpnea

Question 3

During the sympathetic fight-or-flight response, what is the primary cardiovascular effect of epinephrine and norepinephrine on skeletal muscle vasculature?

Accepted Answer

Increased blood flow to muscles

Answer

Increased blood flow to the skin

Answer

Bronchoconstriction

Answer

Decreased heart rate

Question 4

Which of the following statements about lung compliance is false?

Accepted Answer

Decreased in emphysema

Answer

Total compliance is 0.2 L/cm H2O

Answer

A measure of lung distensibility

Answer

Change in volume per unit change in pressure

Question 5

Lysosome with undigested particle inside is known as?

Accepted Answer

Residual body

Answer

Phagosome

Answer

Phagolysosome

Answer

Autophagosome

Question 6

Small intestinal peristalsis is controlled by :

Accepted Answer

Myenteric plexus

Answer

Meissner's plexus

Answer

Vagus nerve

Answer

Parasympathetic system

Question 7

Inotropic effect of thyroid hormone is by ?

Accepted Answer

Enhancement of Catecholamines

Answer

Membrane receptors

Answer

cAMP

Answer

cGMP

Question 8

All are true about GFR except:

Accepted Answer

Best estimated by creatinine clearance

Answer

30-40% decrease after 70 years of age

Answer

GFR is dependent on height in children

Answer

Chronic Kidney Disease (CKD) is defined as GFR < 60 ml/min/1.73 m² for 3 months or more.

Question 9

What is the most common mechanism responsible for causing arrhythmias in the heart?

Accepted Answer

Re-entry

Answer

Early after depolarization

Answer

Late after depolarization

Answer

Automaticity

Question 10

What is the average survival time of a person without food and water under normal conditions?

Accepted Answer

3 to 5 days

Answer

10 to 12 days

Answer

1 to 3 days

Answer

5 to 10 days

NEET-PG 2015 — Physiology