NEET-PG 2015 - Physiology Practice Questions

Q: What is the composition of epithelial sodium channels?

1α, 1β, 1γ. ***1α, 1β, 1γ*** - Epithelial sodium channels (**ENaCs**) are heterotrimeric complexes composed of one **alpha (α)**, one **beta (β)**, and one **gamma (γ) subunit**. - This specific subunit composition is essential for the channel's proper function in **sodium reabsorption** across epithelial tissues. *2α, 1β* - This composition is incomplete as it lacks the **gamma (γ) subunit**, which is a crucial component of the functional ENaC. - While alpha and beta subunits are present, the absence of the gamma subunit would impair the channel's ability to efficiently transport sodium. *2α, 1β, 2γ* - This composition is incorrect because a functional ENaC typically includes only **one gamma (γ) subunit**, not two. - An imbalance in subunit stoichiometry can lead to misfolding or improper assembly, affecting channel function. *2α, 1β, 1γ* - This combination correctly includes all three types of subunits (alpha, beta, gamma) but incorrectly states there are **two alpha (α) subunits**. - A functional ENaC has a single alpha subunit, making this option incorrect.

Q: Which of the following statements about ENaC is incorrect?

Composed of 2 homologous subunits. ***Composed of 2 homologous subunits*** - ENaC (Epithelial Sodium Channel) is a **heterotrimeric complex** composed of **three distinct subunits**: α, β, and γ. - The functional channel typically has a stoichiometry of 2α:1β:1γ, forming a heterotrimer. - These subunits share sequence homology but are **non-identical proteins**, not just two homologous subunits. - A fourth related subunit (δ) exists and can substitute for α in some tissues, but the classical ENaC is a three-subunit channel. *Epithelial channel* - ENaC is indeed an **epithelial channel** responsible for critical **sodium reabsorption** in various epithelia. - It plays a vital role in regulating **fluid and electrolyte balance** across tight epithelial layers. *Present in kidney and GIT* - ENaC is abundantly expressed in the **distal nephron of the kidney**, specifically in the collecting duct, where it mediates fine-tuning of sodium reabsorption. - It is also present in the **lower gastrointestinal tract (colon)**, contributing to sodium absorption, and in the airways and salivary glands. *Inhibited by amiloride* - **Amiloride** is a well-known **potassium-sparing diuretic** that specifically acts by blocking ENaC. - This inhibition reduces sodium reabsorption and, consequently, water reabsorption, leading to increased diuresis.

Q: What is the typical pH range of intracellular fluid (ICF) compared to extracellular fluid (ECF)?

Typically around 7.0, slightly less than ECF. ***Typically around 7.0, slightly less than ECF*** - The **intracellular fluid (ICF)** tends to be slightly more acidic due to metabolic processes within cells that produce **acidic byproducts**. - This makes its pH typically around **7.0–7.2**, which is subtly lower than the extracellular fluid. *Typically around 7.4, slightly more than ICF* - A pH of approximately **7.4** is characteristic of **extracellular fluid (ECF)**, which includes plasma and interstitial fluid. - The ECF is maintained within a **narrow, slightly alkaline** range to support cellular function and enzyme activity throughout the body. *Approximately equal to ECF* - While both fluid compartments are maintained within a **narrow physiological range**, their pH values are not exactly equal. - This slight difference is essential for various biological processes, including maintaining **membrane potential** and **enzyme efficiency**. *Significantly higher than ECF* - The ICF pH is **not significantly higher** than ECF; in fact, it is slightly lower. - Maintaining too high a pH intracellularly would disrupt **cellular metabolism** and **protein structure**.

Q: Increase in plasma viscosity is maximally caused by which plasma protein?

Fibrinogen. ***Globulin*** - Increased levels of **globulin** proteins, particularly in inflammatory or proliferative conditions, have a significant impact on plasma viscosity due to their **high molecular weight** [1]. - **Globulins** contribute to **hyperviscosity syndrome**, which can lead to clinical symptoms like fatigue and visual disturbances [1]. *Albumin* - While **albumin** is the most abundant plasma protein, its primary role is in maintaining **oncotic pressure**, not significantly affecting plasma viscosity. - An increase in albumin does not correlate with plasma viscosity increases to the extent seen with globulins. *All have equal effect* - Different plasma proteins do not have **equal effects** on viscosity; **globulins** and **fibrinogen** particularly influence it more than **albumin**. - The impact on viscosity varies significantly with protein concentration and type, making this statement inaccurate. *Fibrinogen* - **Fibrinogen** does contribute to plasma viscosity but is typically less than that caused by globulins, especially when globulin levels are markedly elevated. - Its effect is more pronounced during **coagulation**, rather than in the general increase of plasma viscosity associated with inflammatory states. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 141-142.

Q: Which protein primarily contributes to oncotic pressure in the blood?

Albumin. ***Albumin*** - **Albumin** is the most abundant plasma protein and its small size and high concentration make it the primary determinant of **oncotic pressure** in the blood. - Its presence in the capillaries draws water from the **interstitial space** back into the blood vessels, maintaining **fluid balance** and blood volume. *Fibrinogen* - **Fibrinogen** is a crucial protein involved in **blood clotting**, where it is converted into **fibrin** to form a clot. - While a plasma protein, its contribution to **oncotic pressure** is minor compared to albumin, as it's less abundant and larger in size. *Globulins* - **Globulins** are a diverse group of proteins involved in immune function (**immunoglobulins**), transport (e.g., **alpha** and **beta globulins**), and clotting. - While they contribute to total plasma protein concentration, their collective impact on **oncotic pressure** is secondary to that of albumin due to lower concentrations and varied molecular weights. *Transferrin* - **Transferrin** is a specific **beta-globulin** that plays a vital role in **iron transport** in the blood. - Its primary function is not related to **oncotic pressure**, and its concentration is significantly lower than albumin.

Q: Which transport process is mediated by carriers and occurs against the concentration gradient?

Active transport. ***Active transport*** - **Active transport** systems use carrier proteins to move molecules across a membrane **against their concentration gradient**, requiring **metabolic energy** (e.g., from ATP hydrolysis). - This process is crucial for maintaining cellular homeostasis, accumulating specific substances, and establishing ion gradients. *Facilitated diffusion* - **Facilitated diffusion** also uses **carrier proteins**, but it moves substances **down their concentration gradient**, thus **not requiring metabolic energy**. - It increases the rate of diffusion for molecules that cannot easily cross the lipid bilayer, like glucose. *Osmosis* - **Osmosis** is the movement of **water molecules** across a selectively permeable membrane **down their water potential gradient**, driven by solute concentration differences, and does **not involve carrier proteins**. - This process equalizes solute concentrations on both sides of the membrane. *Endocytosis* - **Endocytosis** is a bulk transport mechanism where cells **engulf substances** from outside by forming vesicles from the plasma membrane; it's a form of active transport but **does not typically involve specific carrier proteins** embedded in the membrane for individual molecules. - This process is used for taking in larger molecules, particles, or even other cells.

Q: What physiological mechanism is responsible for the increase in the duration of expiration?

Hering-Breuer reflex. ***Hering-Breuer reflex*** - The **Hering-Breuer reflex** is initiated by **stretch receptors in the bronchi and bronchioles** which are activated during lung inflation. - This reflex **inhibits inspiration** and **prolongs expiration**, preventing overinflation of the lungs. *J-reflex* - The **J-reflex** is stimulated by **juxtacapillary (J) receptors** in the alveolar walls, usually in response to pulmonary edema or congestion. - It typically causes **rapid, shallow breathing** and **bronchoconstriction**, not prolonged expiration. *Head's paradoxical reflex* - **Head's paradoxical reflex** (also known as the **inflation reflex** in newborns) involves an inspiratory effort triggered by lung inflation, often overcoming the Hering-Breuer reflex in specific conditions. - It tends to **increase respiratory rate** and depth, not prolong expiration. *Proprioceptors* - **Proprioceptors** are sensory receptors in muscles, tendons, and joints that provide information about body position and movement. - While they can influence respiration during exercise, they are not primarily responsible for directly **increasing the duration of expiration** as a reflex mechanism against overinflation.

Q: What is another name for the withdrawal reflex?

Flexor reflex. ***Flexor reflex*** - The withdrawal reflex is also known as the **flexor reflex** because it causes the rapid flexion (bending) of a limb to withdraw it from a noxious stimulus. - This reflex is a **polysynaptic reflex** involving interneurons in the spinal cord. *Golgi tendon reflex* - The **Golgi tendon reflex** is a protective reflex that causes muscle relaxation in response to excessive muscle tension. - It involves activation of **Golgi tendon organs**, which are proprioceptors located in the tendons. *Extension reflex* - The **extension reflex** is typically observed in withdrawal reflexes of the opposing limb, known as the **crossed extensor reflex**, to maintain balance. - It involves the extension of the contralateral limb while the ipsilateral limb flexes. *Stretch reflex* - The **stretch reflex** (or myotatic reflex) causes muscle contraction in response to stretching of the muscle. - It is a **monosynaptic reflex** involving muscle spindles and maintaining muscle tone.

Q: Tetany in muscle occurs in spite of normal serum Ca2+ level. Which ion is responsible?

Ionized Ca2+. ***Ionized Ca2+*** - While total serum calcium might be normal, **tetany** is specifically caused by a decrease in the concentration of **ionized (free) calcium** in the extracellular fluid. - Ionized calcium is the physiologically active form of calcium responsible for neuromuscular excitability. *Mg2+* - **Hypomagnesemia** can exacerbate hypocalcemia and contribute to tetany, but it is not the primary ion directly responsible for tetany when **total serum calcium is normal**. - A deficiency in Mg2+ can impair the release of **parathyroid hormone** and reduce target organ responsiveness to PTH. *K+* - Abnormalities in **potassium levels** (hypokalemia or hyperkalemia) primarily affect cardiac and muscular excitability, leading to arrhythmias or muscle weakness/paralysis. - While electrolyte imbalances are interconnected, changes in potassium are not the direct cause of tetany due to calcium's role. *Na+* - **Sodium ions** are crucial for nerve impulse transmission and muscle contraction by establishing the resting membrane potential and initiating action potentials. - However, direct changes in sodium concentration do not typically cause tetany; rather, they can lead to neurological symptoms like seizures (hyponatremia) or altered mental status (hypernatremia).

Q: Vibrations are detected by which types of receptors?

Rapidly adapting. ***Rapidly adapting*** - **Rapidly adapting mechanoreceptors**, such as **Pacinian corpuscles** and **Meissner's corpuscles**, are highly sensitive to changes in pressure and movement. - They fire at the **onset and offset of a stimulus**, making them ideal for detecting vibrations, which are rhythmic changes in pressure. *Slowly adapting* - **Slowly adapting mechanoreceptors**, such as **Merkel cells** and **Ruffini endings**, are responsible for sustained pressure and touch. - They continue to fire as long as the stimulus is present, making them less suited for detecting transient vibratory stimuli. *Non-adapting* - The human body does not typically have **truly non-adapting** sensory receptors; most receptors show some form of adaptation to continuous stimuli. - This term is not standard in the classification of mechanoreceptors based on their adaptation rates. *None of the above* - This option is incorrect because rapidly adapting receptors are indeed responsible for detecting vibrations.

Question 1

What is the composition of epithelial sodium channels?

Accepted Answer

1α, 1β, 1γ

Answer

2α, 1β, 1γ

Answer

2α, 1β

Answer

2α, 1β, 2γ

Question 2

Which of the following statements about ENaC is incorrect?

Accepted Answer

Composed of 2 homologous subunits

Answer

Present in kidney and GIT

Answer

Epithelial channel

Answer

Inhibited by amiloride

Question 3

What is the typical pH range of intracellular fluid (ICF) compared to extracellular fluid (ECF)?

Accepted Answer

Typically around 7.0, slightly less than ECF

Answer

Typically around 7.4, slightly more than ICF

Answer

Approximately equal to ECF

Answer

Significantly higher than ECF

Question 4

Increase in plasma viscosity is maximally caused by which plasma protein?

Accepted Answer

Fibrinogen

Answer

Albumin

Answer

All have equal effect

Answer

Globulin

Question 5

Which protein primarily contributes to oncotic pressure in the blood?

Accepted Answer

Albumin

Answer

Globulins

Answer

Fibrinogen

Answer

Transferrin

Question 6

Which transport process is mediated by carriers and occurs against the concentration gradient?

Accepted Answer

Active transport

Answer

Facilitated diffusion

Answer

Osmosis

Answer

Endocytosis

Question 7

What physiological mechanism is responsible for the increase in the duration of expiration?

Accepted Answer

Hering-Breuer reflex

Answer

J-reflex

Answer

Head's paradoxical reflex

Answer

Proprioceptors

Question 8

What is another name for the withdrawal reflex?

Accepted Answer

Flexor reflex

Answer

Golgi tendon reflex

Answer

Extension reflex

Answer

Stretch reflex

Question 9

Tetany in muscle occurs in spite of normal serum Ca2+ level. Which ion is responsible?

Accepted Answer

Ionized Ca2+

Answer

Mg2+

Answer

K+

Answer

Na+

Question 10

Vibrations are detected by which types of receptors?

Accepted Answer

Rapidly adapting

Answer

Slowly adapting

Answer

Non-adapting

Answer

None of the above

NEET-PG 2015 — Physiology