Which of the following is considered the most important intracellular buffer in human physiology?
Penile erection is mediated by which system?
Inhibition of heart by vagus is mediated by which receptors?
What is the average size of platelets in micrometers?
What is the respiratory quotient?
What is Proaccelerin?
Regarding Caisson's disease which statement among the following is CORRECT?
The major role of 2,3-bisphosphoglycerate in RBCs is -
Which of the following cell types is considered insulin-dependent?
Chemotaxis is mediated by-
NEET-PG 2015 - Physiology NEET-PG Practice Questions and MCQs
Question 81: Which of the following is considered the most important intracellular buffer in human physiology?
- A. Albumin protein
- B. Ammonia buffer
- C. Bicarbonate buffer
- D. Phosphate buffer (Correct Answer)
Explanation: ***Phosphate buffer*** - The **phosphate buffer system (H₂PO₄⁻/HPO₄²⁻)** is the most important intracellular buffer due to relatively high concentrations of inorganic phosphates within cells - The pKa₂ of approximately **6.8 is close to intracellular pH** (~7.0-7.2), providing optimal buffering capacity - Plays a crucial role in buffering acids and bases generated by metabolic processes within cells and is also important in renal tubular buffering *Albumin protein* - **Proteins**, including albumin, are important **extracellular buffers** in plasma due to their abundant ionizable amino acid residues - While proteins do contribute to intracellular buffering (especially hemoglobin in RBCs), the **phosphate system is more significant** for general intracellular pH regulation *Ammonia buffer* - The **ammonia buffer system (NH₃/NH₄⁺)** is primarily a **renal buffer system** that plays a crucial role in acid excretion via urine - It is not considered the primary intracellular buffer for metabolic acid-base balance within cells *Bicarbonate buffer* - The **bicarbonate buffer system (HCO₃⁻/H₂CO₃)** is the **most important extracellular buffer system**, critical for maintaining blood pH - Although present intracellularly, its buffering capacity is less prominent than phosphate within cells due to lower intracellular bicarbonate concentration and its pKa of 6.1 being further from intracellular pH
Question 82: Penile erection is mediated by which system?
- A. Parasympathetic system via muscarinic receptors (Correct Answer)
- B. Parasympathetic system via nicotinic receptors
- C. Sympathetic system via α-receptors
- D. Sympathetic system via β-receptors
Explanation: ***Parasympathetic system via muscarinic receptors*** - Penile erection is primarily a **parasympathetic response** mediated by the **pelvic splanchnic nerves (S2-S4)**. - The key mechanism involves **nitric oxide (NO)** release from non-adrenergic, non-cholinergic (NANC) neurons, which activates guanylate cyclase → increases cGMP → smooth muscle relaxation in the **corpora cavernosa**. - **Acetylcholine acting on muscarinic receptors** plays a **supportive role** by enhancing NO release and contributing to vasodilation. - For exam purposes, the parasympathetic system (with its cholinergic muscarinic component) is the recognized answer. *Parasympathetic system via nicotinic receptors* - **Nicotinic receptors** are located at **autonomic ganglia** and **neuromuscular junctions**, not at the effector sites in penile vasculature. - While nicotinic transmission occurs at the parasympathetic ganglia, the post-ganglionic fibers act on **muscarinic receptors** and release **NO** at the target tissue. - This option confuses the ganglionic transmission with the effector mechanism. *Sympathetic system via α-receptors* - The **sympathetic nervous system** via **α1-adrenergic receptors** causes **vasoconstriction** and maintains penile **flaccidity** (detumescence). - Sympathetic activation is responsible for **ejaculation** and the resolution phase after orgasm. - Activation of α-receptors opposes erection by causing smooth muscle contraction. *Sympathetic system via β-receptors* - **β-adrenergic receptors** are involved in functions like **cardiac stimulation** and **bronchodilation**, but play no significant role in penile erection. - The sympathetic system's role in sexual function is primarily through **α-receptors** (detumescence and ejaculation), not β-receptors.
Question 83: Inhibition of heart by vagus is mediated by which receptors?
- A. M1
- B. M2 (Correct Answer)
- C. NN
- D. NM
Explanation: ***M2*** - The **vagus nerve** primarily mediates its inhibitory effects on the heart through **muscarinic M2 receptors**. - Activation of M2 receptors by **acetylcholine** (released from the vagus nerve) decreases heart rate and contractility. *M1* - **M1 receptors** are primarily found in neuronal tissue and glands, playing a role in **gastric acid secretion** and cognitive functions. - They are not the primary muscarinic subclass responsible for vagal inhibition of the heart. *NN* - **NN receptors** are **nicotinic receptors** found on postganglionic neurons in autonomic ganglia. - They are involved in **ganglionic transmission** and are not directly responsible for efferent vagal effects on the heart. *NM* - **NM receptors** are **nicotinic receptors** found at the **neuromuscular junction** of skeletal muscles. - Their activation leads to **skeletal muscle contraction**, and they have no role in regulating heart function.
Question 84: What is the average size of platelets in micrometers?
- A. 4-5 µm
- B. 3-4 µm
- C. 2-3 µm (Correct Answer)
- D. 1-2 µm
Explanation: ***2-3 µm*** - Platelets, also known as **thrombocytes**, are small, anucleated cell fragments crucial for **hemostasis**, and their average diameter generally falls within the range of 2-3 micrometers. - This **small size** allows them to easily navigate through capillaries and aggregate rapidly at sites of vascular injury. *3-4 µm* - While platelets can vary slightly in size, an average of 3-4 µm is generally considered a bit on the larger side and not the typical average diameter. - Larger platelets might be seen in certain conditions like **idiopathic thrombocytopenic purpura (ITP)**, but this is not the average normal size. *4-5 µm* - This range is significantly larger than the typical size of normal circulating platelets. - Platelets this large would be considered **macroplatelets** and could indicate specific pathological conditions or inherited platelet disorders. *1-2 µm* - This size range is generally considered smaller than the average normal platelet size. - Very small platelets might be seen in some specific conditions, but it's not the usual average for healthy individuals.
Question 85: What is the respiratory quotient?
- A. CO2 released to O2 consumed (Correct Answer)
- B. CO2 consumed to O2 released
- C. O2 released to CO2 consumed
- D. O2 consumed to CO2 released
Explanation: **CO2 released to O2 consumed** - The **respiratory quotient (RQ)** is a ratio used in metabolism to describe the proportion of **carbon dioxide (CO2) produced** by the body relative to the **oxygen (O2) consumed**. - It is calculated as the **volume of CO2 released** divided by the **volume of O2 consumed** over a specific period. - RQ = VCO2/VO2, where VCO2 is CO2 production and VO2 is O2 consumption. *CO2 consumed to O2 released* - This option is incorrect as it reverses the correct order and refers to **CO2 consumption and O2 release**, which are not the standard components of the RQ calculation. - The body primarily **releases CO2** and **consumes O2** during cellular respiration. *O2 released to CO2 consumed* - This option is also incorrect because it inverts both the gases and the direction of their metabolic flow (release vs. consumption). - Metabolic processes involve **O2 consumption** and **CO2 release**, not the other way around. *O2 consumed to CO2 released* - This option incorrectly reverses the numerator and denominator in the RQ formula. - The standard definition places **CO2 production** in the numerator and **O2 consumption** in the denominator.
Question 86: What is Proaccelerin?
- A. Factor VII
- B. Factor II
- C. Factor V (Correct Answer)
- D. Factor X
Explanation: ***Factor V*** - **Factor V**, also known as **proaccelerin** or **labile factor**, is a **plasma protein** that plays a crucial role in the coagulation cascade. - It is activated by thrombin to **Factor Va**, which then combines with Factor Xa, calcium, and phospholipid to form the **prothrombinase complex**, significantly enhancing thrombin generation. *Factor II* - **Factor II** is **prothrombin**, a precursor to **thrombin**, which is central to coagulation. - It is not referred to as preaccelerin. *Factor VII* - **Factor VII** is primarily involved in the **extrinsic pathway** of coagulation, becoming activated to Factor VIIa upon contact with tissue factor. - It works to activate Factor IX and Factor X, but it is not preaccelerin. *Factor X* - **Factor X**, also known as **Stuart-Prower factor**, is a key enzyme in the **common pathway** of coagulation, converting prothrombin to thrombin. - It is distinct from Factor V, which acts as a cofactor.
Question 87: Regarding Caisson's disease which statement among the following is CORRECT?
- A. Lung damage is caused by air embolism
- B. Pain in the joints is due to nitrogen bubbles (Correct Answer)
- C. Tremors are seen due to nitrogen narcosis
- D. High pressure Nervous syndrome can be prevented by using mixtures of Oxygen & Helium
Explanation: ***Pain in the joints is due to nitrogen bubbles*** - Caisson's disease, or **decompression sickness**, is characterized by the formation of nitrogen gas bubbles in tissues and blood due to rapid depressurization. - These gas bubbles can accumulate in joints, causing **severe pain** often referred to as "the bends." *Lung damage is caused by air embolism* - While air embolism can occur due to **pulmonary barotrauma** during ascent (rapid depressurization), the primary lung damage associated with decompression sickness is not typically directly caused by an air embolism reaching the lungs from within the body. - Air embolism from pulmonary barotrauma is a distinct complication, where air from ruptured alveoli enters the arterial circulation, potentially leading to cerebral or cardiac ischemia. *Tremors are seen due to nitrogen narcosis* - **Nitrogen narcosis** is a condition that occurs at high ambient pressures when breathing compressed air, causing a reversible alteration in consciousness similar to alcohol intoxication, but it does not primarily cause tremors. - Tremors are more characteristic of other neurological conditions or high-pressure nervous syndrome, not nitrogen narcosis itself. *High pressure Nervous syndrome can be prevented by using mixtures of Oxygen & Helium* - **High-pressure nervous syndrome (HPNS)** is indeed associated with deep dives using helium-oxygen mixtures. Its symptoms include tremors. - HPNS is actually **prevented or mitigated** by adding small amounts of narcotic gases like nitrogen to the helium-oxygen mixture (e.g., trimix) to counteract the excitatory effects of helium, rather than solely using oxygen and helium.
Question 88: The major role of 2,3-bisphosphoglycerate in RBCs is -
- A. Acid-base balance
- B. Reversal of glycolysis
- C. Release of oxygen (Correct Answer)
- D. Binding of oxygen
Explanation: ***Release of oxygen*** - **2,3-bisphosphoglycerate (2,3-BPG)** binds allosterically to **deoxyhemoglobin**, stabilizing its T (tense) state. - This binding reduces hemoglobin's affinity for oxygen, promoting the **release of oxygen** to tissues. *Acid-base balance* - While red blood cells play a role in **acid-base balance** through the bicarbonate buffer system, 2,3-BPG's primary role is not buffering. - The **chloride shift** and **carbonic anhydrase** are more directly involved in RBC acid-base regulation. *Reversal of glycolysis* - 2,3-BPG is an intermediate of the **Rapoport-Luebering shunt**, a side pathway of glycolysis. - It does not reverse glycolysis but rather is produced during glycolysis to serve a specific function in oxygen transport. *Binding of oxygen* - 2,3-BPG **decreases** hemoglobin's affinity for oxygen, thus promoting its *release* from hemoglobin, not its binding. - Oxygen binding to hemoglobin occurs primarily at the **heme iron** without 2,3-BPG.
Question 89: Which of the following cell types is considered insulin-dependent?
- A. Myocytes (Correct Answer)
- B. Pituitocytes
- C. Adipocytes
- D. RBCs
Explanation: ***Myocytes*** - **Myocytes** (skeletal muscle cells) are **insulin-dependent** and represent the **largest site of insulin-mediated glucose disposal** in the body - Insulin promotes translocation of **GLUT4 transporters** to the cell membrane, enabling glucose uptake - Skeletal muscle accounts for approximately **70-80% of postprandial glucose disposal**, making it the most quantitatively significant insulin-dependent tissue *Adipocytes* - **Adipocytes** (fat cells) are also **insulin-dependent** and utilize **GLUT4 transporters** for glucose uptake - Insulin stimulates glucose uptake and conversion to triglycerides for storage - However, adipose tissue accounts for only **10-15% of glucose disposal**, making it less quantitatively significant than skeletal muscle - Both myocytes and adipocytes are considered the two major insulin-dependent tissues in the body *Pituitocytes* - **Pituitocytes** are supporting cells in the pituitary gland - They use **insulin-independent glucose transporters** (GLUT1/GLUT3) - The pituitary gland requires constant glucose supply independent of insulin status *RBCs* - **Red blood cells** lack mitochondria and depend entirely on **anaerobic glycolysis** - Glucose uptake occurs via **insulin-independent GLUT1 transporters** - RBCs must maintain glucose uptake at all times, regardless of insulin levels
Question 90: Chemotaxis is mediated by-
- A. Histamine
- B. Leukotriene C4 and C3a
- C. Bradykinin
- D. Leukotriene B4 and C5a (Correct Answer)
Explanation: ***Leukotriene B4 and C5a*** - Both **Leukotriene B4** [2] and **C5a** [1] are potent **chemoattractants** that guide the migration of neutrophils and other immune cells to sites of inflammation. - They are crucial in amplifying the **immune response**, particularly during acute inflammatory reactions. *Histamine* - Primarily involved in **vasodilation** and increased **vascular permeability**, rather than mediating chemotaxis. - Does not specifically attract immune cells to sites of injury or infection like leukotrienes do. *Bradykinin* - Mainly functions in **pain sensation** and promoting **vascular permeability**, not as a direct chemotactic agent. - It influences inflammation but does not effectively recruit immune cells to tissues. *Leukotriene C4 and C3a* - **Leukotriene C4** is involved in bronchoconstriction, while **C3a** [1] has roles in the complement system but is less potent than C5a in chemotaxis. - These mediators have different primary roles in inflammation, lacking the specificity of B4 and C5a for leukocyte attraction. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 99-100. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 95-96.