Physiology ALL

Physio exam 3! (multiple questions comparing obstructive diseases to restrictive diseases (know what increases/decreases for IRV, TV, FEV, FRC, etc for both), lymph flow (pif)) Pulmonary perfusion is aided by... Low velocity of blood Low pressure High flow All of the above Which of the following adds fluid to the capillaries? Plasma colloid osmotic pressure Interstitial fluid osmotic pressure Interstitial fluid hydrostatic pressure Capillary hydrostatic pressure For a given O2 consumption rate, faster ventilation results inL Higher PACO2 Higher PAO2 Lower PAO2 Equal PAO2 Lower PACO2 Under normal breathing condition, CO2 partial pressure gradient across the alveolar-capillary interface is maintained in part by: Bronchial perfusion Greater diffusion rate of CO2 than O2 Capillary Exposure Time "safety factor" Alveolar air ventilation Fast equilibrium rate in pulmonary capillary When fully reclined in the dental chair, the patient reports difficulty in breathing. This is MOST likely the direct result of which of the following? Bronchoconstriction Thalassemia CHF Angina pectoris Hypoxia What is the primary cause of respiratory dysfunction in pulmonary fibrosis? Immunological response leads to alveolar destruction and the formation of large bullae Bacterial infection lead to excessive sputum production and atelectasis Immunological response leads to smooth muscles proliferation, fibrin and collagen deposition Pulmonary hypertension leads to vascular proliferation and diminished gas exchange How does obstructive lung disease compare to restrictive lung disease Higher inspiratory reserve and residual volume What is a risk factor for asthma in children? Maternal smoking Paternal COPD history Autoimmune disorder Alpha 1 anti-trypsin What region of lung has V/Q > 0.8 Lower Adjacent to pulm arteries Upper Adjacent to large bronchus What cells secrete surfactant? Type II pneumocytes What is the critical PaO2 for ventilation to occur? PaO2 < 60 mmHg or was it less than or equal? I'm not sure what answer is tho but choices are correct PaO2 ≥ 70 mmHg < 90 >80 Which ribs move in anterior-superior direction? Ribs 2-6 Ribs 7-10 What is the cause of abnormal remodeling of the chest wall in someone who has emphysema? Increase residual volume Atrophy or skeletal muscles Decrease in pH leads to Increase in O2 saturation of Hb Decrease in O2 saturation of Hb No change in O2 saturation of Hb Pitting edema is 1) mobile. 2) leaves a temporary depression when applied pressure. Both true Bronchial veins empty into Pulmonary veins Vena Cava Subclavian veins Region of Lung with highest V/Q ratio Upper Lower Two other answers Lung volume that indiv cannot exhale? Tidal volume Residual volume - Inspiratory reserve volume Expiratory reserve volume Principal factor that triggers inspiration under normal conditions ? Pa02 Paco2 Bicarbonate Central generator What statement is true abt dead space ? Diff btwn tidal volume and alveolar volume Diff btwn intrapulmonary pressure and pao2 Air in alveoli Blood in capillary... What cause air trapping dysfunction w asthma ? Smooth muscle Macrocytes Edema and cellular infiltration Pulmonary thrombus What is the primary cause of respiratory dysfunction in pulmonary fibrosis? Immunological response leads to alveolar destruction and the formation of large bullae Immunological response leads to smooth muscle proliferation, fibrin, and collagen deposition Bacterial infections lead to excessive sputum production and atelectasis Pulmonary hypertension leads to vascular proliferation and diminished gas exchange. How does the ventral respiratory group (VRG) increase minute ventilation? VRG facilitates the DRG and motor cortex that increases tidal volume and respiratory rate VRG inhibits the DRG and the pneumotaxic center which leads to increase in tidal volume and respiratory rate VRG inhibits the dorsal respiratory group (DRG) and apneustic center that increase rate and inspiratory time VRG facilitates the sensitivity of chemoreceptors to changes in PaO2 that increases respiratory rate What statement is true when an individual exercises? PaCO2 remains consistent even at maximal exercise capacity Desaturation occurs once an individual reaches 80% of maximal capacity There is a linear reduction of a-vO2 difference to workload pH and ventilation are linear to workload until individual reaches about 80% of maximal capacity PO2 95 mmHg, 70% saturation (past IC) CO poisoning Pulmonary embolism CO2 unloading is what Haldane effect Something with CF (cystic fibrosis) Copious secretion leading to disruption of mucociliary blanket What is true? CO2 crosses BBB and releases H+ ion to the brain stem to increase ventilation Tissue factor binds to what Factor VII 70 year old has leg pain and thrombosis in leg, needs immediate meds-- what do you give him? (past IC question) Warfarin Heparin What is false about lymph flow? Lymph flow increases linearly (and indefinitely) with... Negative pif is good for nutrition and mobility 78% of blood is received by brain, kidney, liver muscle Factors that influence Alveolar air composition Alveoli ventilation Capillary perfusion Diffusion capacity O2 consumption levels All the above What is false? Things larger than albumin can pass through with diffusion Which is not a factor that influences extracellular edema? Increased cardiac output Listed all the other correct options Interalveolar septum is lined with Endothelium Epithelium Type 1 pneumocytes Adenosine is a ____. Endothelin is a ____. Vasoconstrictor, vasodilator Vasodilator, vasodilator Vasoconstrictor, vasoconstrictor Vasodilator, vasoconstrictor Pulm arteries have a _____ diameter compared to systemic vessels. Pulm vessels have _____ smooth muscle compared to systemic Smaller, less Larger, less Larger, more Smaller, more When breathing (similar to sleeping) what muscles do you use Contract diaphragm and scalenes for inspiration, passive exhalation Contract diaphragm for inspiration, passive exhalation Why do the respiratory zones have low resistance? (know diff between conducting/resp zones) Resp zones have greater surface area than conducting Acinus is found where: Segmental bronchi Alveolar duct, resp bronchi, alveolar sac RULES - read the rules then scroll down to add your questions To state the obvious: Do not not open this document inside school. Do not talk about it in school. Do not ask about it in school. Do not slyly bring it up in convo. Do not leave this page open on your computer. This is a COMBINED EFFORT, so participation is key to making this work. It's better to have all of our 130 brilliant minds make 1 perfect recall than 20 subpar ones. Read the recall questions that have been posted, and see if you can improve on the questions and answer choices. A good way to have a solid recall is to remember the FIRST FIVE or so questions of the exam verbatim and memory dump them here. It's randomized so everyone will get a different starting set of questions. Please try to improve the formatting as some people may get lazy. If you have the image, try to insert it to make the recalls stronger. Make sure the correct answer choice is indicated by RED font. If you are unsure leave it as is. If you feel inclined, please put the reasons for the correct answer in ORANGE font. A new document link will be released the night before every exam. Only share it with your trustworthy friends. If you give it to someone that hasn't taken the exam, you're just hurting your own grade because ECC can't save you. Also, be wary about sharing it with people not in this group! Feel free to download the file about 24 hours after the exam, by then most people should have given their input. The stronger we make this, the better a community we are creating for the next class. While it may not seem as big of a deal, the more effort we put in to help them should have trickle down effect - creating a stronger community! As always, if you have any questions/comments/concerns or you know someone else who wants to join just reach out to me! Which zone will have the greatest change in alveolar diameter in response to cyclic respiration? Zone 1 Zone 2 Zone 3 Pulmonary vessels have ___ diameter and ___ smooth muscle than systemic vessels Larger, less Smaller, less Equal, less Equal, more A patient lost 15% of blood. What will be most affected? Amount of O2 Hb binding Arterial PO2 Lung diffusion capacity What is the second largest carrier of co2 a. carboxyhemoglobin b. carbaminohemoglobin 5. When u exhale during normal tidal volume and then fully inhale what are u measuring a. Inspiratory capacity (all the air we can breathe in) 6. What is the capillary pulmonary system critical for a. Diffusion b. Ventillation c. Perfusion d. Transport 7. Boy comes in for dental treatment, you recline his chair and apply lidocaine to his gums. He soon becomes cyanotic--what is the likely cause? a. Methemoglobinemia 8. Which part of the conducting system has the most elastic fibers? a. Bronchioles and bronchi b. Nares c. Something else 9. What changes create a response in the ventilation a. CO2 processed into bicarbonate triggers central chemoreceptor's acidotic response b. CO2 processed into H+ triggers central chemoreceptor's acidotic response c. O2 processed into H+ triggers central chemoreceptor's acidotic response 10. Patient has pO2 = 95 mmHg but oxygen saturation is 70%, what could be the cause? a. Pulmonary edema b. Cystic fibrosis c. CO poisoning 11. You have 3x the normal cardiac output and blood sample taken shows pO2 is 95 mmHg, where would this blood sample have been taken from? a. Pulmonary artery b. Pulmonary vein c. Bronchial artery 12. Which one moves fluid into the capillaries from this equation (NFP = Pc - Pif - πp + πif) a. Capillary hydrostatic pressure b. Interstitial fluid pressure c. Plasma colloid osmotic pressure d. Interstitial fluid colloid osmotic pressure 13. All of these statements increase pleural edema EXCEPT a. Decreasing interstitial fluid osmotic pressure b. Decreasing lymph flow c. Increasing capillary pressure d. Increasing capillary permeability 14. What activities increase lymph flow? a. Exercise, yoga, and arterial pulsing (something like this) b. Laying in bed as it distributes lymph across the body 15. There will be more net filtration than reabsorption across the capillary-alveolar interface because of the change in what factor? a. Interstitial fluid pressure b. Plasma colloid osmotic pressure c. Interstitial fluid colloid osmotic pressure d. Capillary hydrostatic pressure 16. What is false about NO? a. Very short half life so it acts locally b. Synthesized from arginine and oxygen in endothelial cells c. Acts on smooth muscle to activate guanylate cyclases d. Aids in thrombus formation and inflammation 17. Adenosine is a vasodilator. Nitric oxide is a vasoconstrictor. a. True, false 18. Vasospasm is facilitated by: a. Parasympathetic innervation of muscle to spasm b. Sympathetic innervation of muscle to spasm c. Local myogenic contraction 19. What is a symptom of acute pulmonary edema? a. Sudden shortness of breath and hemoptysis b. Chest pain and rales 20. Where does the left thoracic duct collect lymph from? a. Right side of the head, neck, diaphragm b. Left side of the head, neck, abdomen, and torso and below 21. How is functional respiration measured? a. Minute ventilation b. PO2 22. What is COPD characterized by? a. Inspiration:Expiration ratio is increased b. Increased residual volume with decreased excursion 23. What does not contribute to an abnormal alveoli-aorta difference? a. COPD b. Emphysema c. Pulmonary embolism d. Aging e. Vigorous exercise doubling cardiac output 24. Man comes in with a deep vein thrombosis in the leg, what medication would you recommend for immediate resolution of the clot? a. Heparin b. Warfarin 25. Which of these facts is true regarding clotting factors? a. Vitamin E is necessary for conversion of clotting factors to functional form b. Clotting factors are synthesized continually in the liver 26. What is associated with tissue factor a. Factor VII b. Associated with the intrinsic pathway 27. What is false? a. vWF binds fibrin to platelets 28. Which of these increases would shift the Hb-Oxygen dissociation curve to the left? a. Increased CO2 b. Increased H+ c. Increased temperature d. Increased O2 affinity of hemoglobin 29. What contributes to normally functioning lymph flow? a. Negative Pif b. Low tissue compliance c. Most of the fluid is in gel form d. Brush piles trapping interstitial fluid e. All of the above 30. How do the cells of the acini at the end of the respiratory bronchioles self-clean? a. They eat the invaders (phagocytosis) b. They kill the invaders c. They expel the invaders through breathing 31. Peanut obstruction causes a full obstruction of a bronchiole (<5% of total lung), what would be the pO2 and pCO2 at the alveoli of the affected area? a. 40 mmHg pO2 and 45 mmHg pCO2 b. 104 mmHg pO2 and 40 mmHg pCO2 32. The type of cell that lines the interalveolar septum is: a. Type I pneumocyte b. Type II pneumocyte c. Clara cell 33. What type of cell secretes surfactant? a. Type I pneumocyte b. Type II pneumocyte c. Clara cell 34. Respiratory mucosa is made up of: a. Lamina propria, submucosa, adventitia 35. Which of these has the largest volume? a. Tidal volume b. Vital capacity c. Inspiratory capacity 36. Pulmonary edema can be caused by? a. Left ventricular failure b. Congestive heart failure c. All of the above 37. Carbonic anhydrase function is? a. Exchange of H+ for Cl- on RBCs b. Exchange of bicarbonate for Cl- on RBCs c. Exchange of H+ for Cl- on body tissue d. Breakdown of carbonic acid 38. The Hering-Breuer reflex works: a. As a protective reflex if lungs are overfilled b. If tidal volume exceeds 1.5 L c. Communicates to the DRG to stop inspiration d. All of the above 39. Resting inspiration and expiration take place through the actions of: a. Inspiration through the diaphragm, expiration through passive recoil b. Inspiration through the diaphragm and scalenes, expiration through abdominal muscles c. Inspiration through the abdominal muscles, expiration through passive recoil 40. Which value will stay the same even when a person is exercising at max ventilation/respiration(forgot the exact wordage)? a. pH b. Arterial pO2 c. Arterial pCO2 d. Ventilation 41. Pulmonary arteries have low pressure and high flow. Bronchial arteries have high pressure and low flow. a. True, false b. False, false c. True, true d. False, true 42. What stimulates CO2 unloading? a. Haldane effect b. High temperature 43. Nosocomial pneumonia? a. Patient with ventilator 44. How does VRG increase ventilation a. Something about increase rhythm and actives accessory muscles 45. Transpulmonary pressure is a. Alveolar pressure and intrapleural pressure Physio 3 Class of 2022 In addition to high mortality rate shock is bad because Patients that survive have PTSD, anxiety, and depression There is a lack of open ICU beds Patients that survive need organ transplantation Consequence of progressive shock? Massive vasoconstriction and ischemia to non-essential organs Increased capillary permeability leading to hypovolemia and peripheral edema Increased cross sectional area in capillaries allows for? Continuous blood flow to allow for nutrient exchange The difference in hydrostatic and oncotic pressure for reabsorption What does not govern resistance? Ejection fraction Vessel radius Vessel length Viscosity What best describes unstable angina? Patient with past history of MI Patient with family history of hemophilia Patient with atypical angina, shortness of breath, and diagnosis of aortic stenosis Patient with unknown CAD experiencing angina with community walking Which one is associated with orthostatic hypotension antidepressants , diuretics, and DM Pregnancy, high sodium, diuretics Exercise, Pregnancy and something else What enzymes is used to measure CAD Troponin CPK What is an issue with the compensatory response to HF Kidneys retain salt and water to increase blood volume Renal to hypertension Decreased ADH and vasodilation to renal arteries Pre-shock is characteristic of? Your body's physiological reserve should compensate for metabolic needs changed by impairment What is an EKG of mature MI? Elevated ST segment, and pathological Q wave Depressed ST segment Elevated ST segment What is not characteristic of shock Hyperlactemia Uremia Arterial hypotension Hypoperfusion Picture of wierd EKG Ventricular tissue Which activates chemoreceptors? Hypoxemia, hypercapnia, acidosis Hyperxemia, hypocapnia, bicarbonate X-ray of ischemic heart failure? Increased cardio-thoracic ratio Decreased cardio-thoracic ratio Baroreceptors are the quickest response, CNS ischemic response is the most potent True, true Larger, albumin recall Adenosine recall NOxide recall All of the above recalls Which is characteristic of Atrial fibrillation? Irregular irregular Picture of EKG what type is it? regular irregular Ohm's law says that flow is directly proportional to resistance and indirectly proportional to pressure? False Rate pressure product is Predictor of Myocardial oxygen perfusion What is the vasovagal response? Decreased blood pressure can lead to loss of consciousness Pulse pressure is Related to compliance Left heart failure causes? Pulmonary edema and left atrial dilation Bainbridge reflex? Increases heart rate in response to atrial stretch via direct stretch of the SA node Common characteristic of premature atrial fibriliiation? P wave is abnormal Primary determinant of blood flow? Tissue metabolic needs and getting rid of waste Fight or flight causes Increase in SNS nervous system to increase mean systemic filling pressure What decreases preload Dehydration, venous pooling, venous obstruction How does the SNS primarily control the blood flow via? Small arteries and arterioles Atria Ventricles Capillaries Beta blockers in a patients with heart failure is used because? Decrease heart rate to increase myocardial perfusion time Why shouldn't you take BP at the carotid? Can activate baroreceptors leading to decrease of BP Can activate baroreceptors leading to increase of BP What doesnt affect flow Radius Length Viscosity Ejection fraction Ideal mean arterial pressure for myocardial perfusion 60-90mmHg Lymph flow does not decrease recall What causes increased lymph flow Massage and shit Be Careful with diabetic patients patients Decreased sense of angina What brings blood back into capillary Plasma oncotic pressure Which one determines filtration and reabsorption Plasma capillary pressure What is the risk factor for CAD Smoking, HTN, and DM Right side heart failure causes? JVD Peripheral edema Weight gain Abdominal discomfort All of the above Importance of capillary surface area being greater than arterioles Permits continuous flow of blood to support nutrient exchange What is the conclusion to the NIH study? If people have BP of 120/80, lower risk of myocardial infarction If people have BP of 140/90, lower risk of myocardial infarction BP does not determine cardiovascular diseases Exercise- hypertension is the best indicator for myocardial infarction Class of 2021 → Physiology Exam III A lot of this exam was recall from Class of 2020 (somewhere around 45% recall from that third exam ice cream) and the rest were basic application questions that you could easily find the answer to if you listened to Wells' lectures (she tests a lot on what she says). Your best bet is to study the topics from questions of this recall and go over Wells' mediasite lectures/take notes on what she says. Which of the following is a characteristic of orthostatic hypotension a. Immobility b. CNS ischemia c. Something and hypertension d. Increased exercise 2. Adenosine: a. Vasodilator of coronary arteries b. Responds to myocardial hypoxia c. All of the above 3. Which of the following is the most common type of heart failure a. Ischemic dilated cardiomyopathy from Coronary Artery Disease 4. Which of following will is true? a. Mechanical ventilation will decrease preload 5. Increase in atrial pressure will cause which of the following? a. Suppression of activity in posterior pituitary b. A decrease in ANP production 6. What is the reason for the cross sectional surface area being larger than that of arterioles a. For continuous flow and increased nutrient uptake 7. Why is it important to monitor your patients carefully who have diabetes 20% increase in heart rate a. Decreased sensation of angina 8. Which vessel controls preload? a. Arterioles b. Arteries c. Vena Cava d. Venules 9. Blood Flow distribution is determined by a. Metabolic needs of tissues 10. What is the main theory for cause of heart disease a. Chronic inflammation b. Chronic hypertension 11. What happens with age a. Blood pressure stays the same, ... b. Blood pressure stays the same, ... c. Blood pressure decreases, cardiac index increases d. Blood pressure increases, cardiac index decreases 12. Someone has lower hematocrit after surgery a. Blood flow increases because viscosity decreases 13. What would happen if the pressure gradient from arterial end to venous end got smaller a. Blood flow would stop b. Pressure would not control blood flow c. Blood flow would increase d. Blood flow will slow down 14. Chemoreceptor in carotid sinus would be triggered by a. Increased pressure on carotid artery b. Something about potassium levels changing c. Decrease in pH below 7.35 15. The two cranial nerves that help in regulating blood pressure a. Vagus & Glossopharyngeal 16. What is the most potent response to a clinically significant drop in blood pressure a. Baroreceptor Reflex b. Chemoreceptor c. CNS ischemic response 17. What happens during flight-or-flight response? a. Increase in PNS causes vasodilation b. Increase in SNS causes and increase in mean arterial pressure c. Increase in vascular resistance causes decrease in peripheral perfusion 18. What causes an increase in blood pressure while running from a tiger a. Increase in total vascular resistance causes increase in mean systemic pressure b. Decrease in stroke volume 19. Pulse pressure a. When stroke volume increases, pulse pressure increases b. When stroke volume increases, pulse pressure decreases c. Something about pulse pressure & compliance that was wrong because it was saying both increase or both decrease together d. Pulse pressure has direct and linear relationship with stroke volume until 80% something?? 20. What would happen in response to low ejection fraction a. Chambers decrease in size b. More myocardial units recruited c. Increase in SNS activity 21. Which is the most clinically relevant way to determine contraction efficiency a. Stroke volume b. Heart rate c. Myocardial oxygen consumption d. Cardiac Index 22. What would happen in response to increased right atrial pressure? a. Decreased afterload b. Increased pulmonary something c. I think right answer was something about how renal system would decrease blood volume OR was it something about increased heart rate (describing Bainbridge reflex) <= correct 23. Ohm's law a. Blood flow is inversely proportional to pressure b. Blood flow is inversely proportional to resistance 24. Something about PNS a. Increases heart rate via vasodilation? b. Decreases heart rate via efferent signaling from vagus nerve c. Increases contractility via vasodilation? d. Decreases contractility via vagal nerve stimulation 25. Orthostatic hypotension causes a. ANS dysfunction related to diabetes & direutics 26. Something about vaso-vagal a. Drop in blood pressure than can lead to unconsciousness 27. Blood flow is determined by a. Cross sectional area and velocity b. Pressure and something wrong 28. What is key result of elevated SNS activity while under stress? a. Increased conductance time to increase heart rate b. Increase in calcium levels to elevate contraction c. Increase in preload? ... something about decrease in oxygen consumption d. Increased inflammatory markers leading to coronary heart disease 29. Myocardial consumption measured by a. Wall tension and product of heart right and systolic blood pressure 30. Thoracic duct empties lymph from a. Left arm, left side of head/neck/thorax, and below diaphragm b. R arm, R side of head and thorax c. Left arm, left side of head and thorax 31. What is false about lymph flow a. Rate is 2-4 liters per day b. Lymph flows at high pressure and speed c. Increased by massage, movement of body/skeletal muscle 32. Amount of filtration at arterial end is slightly __ than amount of reabsorption at venous end. Plasma colloid osmotic pressure is determined by ___ a. Larger, albumin 33. What is true of negative Pif a. Interstitium in gel form b. Something about most fluid being in brush pile c. Low compliance in tissues d. Nutritional needs of tissues are fully met e. All of the above 34. Which is False? a. Hyponatremia can result in brain cell edema, brain swelling, etc. b. Hypernatremia promotes intense thirst and stimulates secretion of antidiuretic hormone c. Something blatantly false about ANP (Anti-naturetic peptide thing) 35. Which of the following can cause extracellular edema a. Increased capillary fluid pressure b. Increased capillary permeability c. Decreased plasma oncotic pressure d. Decreased lymph flow rate e. All of the above 36. Which forces fluid into the capillary A. Capillary hydrostatic pressure B. Interstitial fluid hydrostatic pressure C. Plasma colloid osmotic pressure D. Interstitial fluid colloid osmotic pressure 37. What is true of nitric oxide a. Continually synthesized from arginine and oxygen and released from endothelial cells b. Diffuses into vascular smooth muscle cells where it forms cGMP c. Gets destroyed when it reacts with oxy-hemoglobin in erythrocytes d. Prevent thrombosis and inflammation e. All of the above 38. Example of unstable angina a. Person with unknown coronary artery disease experiences angina from community walk b. Person came into hospital with known symptoms of dyspnea (something like this, the fact that it's KNOWN makes it less likely to be unstable) c. Continuous regular fatigue from carrying laundry up the stairs (she said this one was STABLE angina in lecture when describing a patient's experience with this) 39. Peripheral edema from? a. Tricuspid stenosis 40. Symptoms of left systolic heart failure => should this be ECC-ed like last year?...because in class she said left DIASTOLIC and right SYSTOLIC are caused by pulmonary issues (orthopnea, rales, cyanosis, the tachy-something response).... Even though "no one-sided heart failure is isolated", it seems wrong to list the blatant pulmonary symptoms of LDF/RSF and then say it's correct for LSF as well. LSF is mostly from activity intolerance which doesn't match the pulmonary symptoms listed. None of the other symptom groups matched either all were mispaired. The only correctly paired one (orthopnea and rales) didn't make sense for a non-pulmonary heart failure explanation a. PND & H... b. Orthopnea & pulmonary rales c. S3 abnormal heart sound & ... d. JVD & inability to do activity 41. What will happen if there is tricuspid regurgitation a. Peripheral edema b. Pulmonary edema c. Left atrium enlargement (?) 42. Something like..."What is a key element of stress' affect on SNS? " a. Answer choice with "Increase in Ca+" 43. Which one is responsible for the change in arterial end and venous and + the filtration-absorption along the capillary? a. Capillary hydrostatic pressure b.Interstitial fluid hydrostatic pressure c. Plasma colloid osmotic pressure d. Interstitial fluid colloid osmotic pressure 44. Which will respond for a bout of hypotension? a. Baroreceptor reflex b. Chemoreceptor c. CNS ischemic response 45. How would you clinically measure myocardial oxygen consumption? a. ___ and HR x SBP 46. What happens to coronary arteries in a "Fight or Flight" scenario? a. Overall venodilation of the coronary arteries to provide better perfusion to myocardium b. Overall Vasoconstriction to increase BP c. ...Something else with vasoconstriction d. Venodilation of the major coronary arteries and venoconstriction of the small smaller arteries (not sure why she said "small smaller") 47. Something about what happens to the heart as we age a. Decreased compliance and higher pressure (something like this) 48. What does a prescribed diuretic do for a patient? a. Decrease pressure while decreasing preload 49. Question about mean arterial pressure (what happens if it increases etc.) Exam 3: 2016 Probably about 30 recall, remaining 20 were a little tricky. Repeats mainly at the beginning. A & B or A &C options didn't have the letters listed so had to choose it, if 2 were correct. Lots of reading. Don't send to any @umaryland.edu emails. Which is true of atherosclerosis? a. can be caused by smokeless tobacco b. often but not always clinically evident c. can cause thrombosis and reduce blood flow d. all of the above 1. Which is least permeable? a. glucose b. water c. NaCl d. urea e. albumin 1. What are the effects of left heart failure? a. Orthopnea (shortness of breath) and pulmonary rales (an abnormal rattling sound heard when examining unhealthy lungs with a stethoscope) 1. Which structure provides for proper distribution of blood? a. Arterioles b. Venules c. Veins d. Large arteries 1. What is true of pulse pressure? a. pulse pressure can indicate compliance b. pulse pressure narrows with age c. Pulse pressure indicates myocardial oxygen consumption d. Pulse pressure and SBP both decrease with age, due to increased compliance 1. Why should you not take BP at carotid artery? a. Could stimulate carotid sinus and cause decrease in BP and HR b. Could stimulate carotid sinus and parasympathetics to increase BP c. Could cause CNS ischemia and syncope 1. Pregnant woman feels lightheaded. BP is normal but hear a murmur, what might cause this? a. Murmurs are not uncommon in pregnancy, as predicted by Reynold's number. b. A lot of blow flow is turbulent c. LaPlace's law predicts valvular changes, which are normal d. she has increased hematocrit, which causes blood to stick more tightly to vessels 1. According to Darcy's Law, if you increase resistance by 8 fold, and perfusion pressures stays constant, what happens to flow? a. 8 fold decrease, if perfusion pressure stays the same b. 8 fold increase c. Stays the same 1. What is the main renal regulation of blood volume? a. Fluid and sodium output and intake b. Vasoconstriction of renal arterials c. Renal afterload 1. What is a direct cause of increased interstitial fluid? a. Increase BP b. Decreased BP c. Increased hydrostatic pressure d. Decreased hydrostatic pressure 1. What is a strong response to a decrease in blood pressure? a. Chemoreceptors b. Baroreceptor reflex c. Atrial receptor reflex 1. What happens in a normal response to prevent orthostatic hypotension a. Baroreceptor reflex is activated 1. What is the main result of renin-angiotensin aldosterone system? a. Increase sodium and water retention b. Vasoconstriction and vasodilation 1. If you have a high increase in pulmonary arterial pressure, what would be an immediate effect? a. Increase in PCWP b. Decrease in right ventricle afterload c. Increase in CVP 1. Problem with increased HR in person with heart failure is what? a. Decreased filling time 1. What would most likely get help to match the O2 demand of coronary arteries when it is increased? a. local factors that cause dilation-- answer said something about adenosine release to cause dilation b. sympathetic nervous system 1. Which of the following is true regarding flow and resistance? a. 4 fold decrease in flow b. 16 fold decrease in flow due to r^4 effect c. 16 fold increase in flow due to r^4 effect d. 8 fold decrease in flow rate e. above 4000, flow is no longer linear 1. What is true about mean blood pressure? a. MAP = ⅓ (pulse pressure) + DBP 1. Why is atrial contraction important? a. Delivers more blood to the ventricle to allow for stretch for greater contraction 1. What is true of SNS activation in fight or flight response? a. Vasoconstriction of vessels to active skeletal muscles b. Vasodilation of vessels to active skeletal muscles 1. What is an effect of chronic hypertension? a. Myocardial hypertrophy 1. Mechanism of orthostatic hypotension most closely related with which pressure? a. MAP b. CVP i.(b/c due to change in posture get reduce blood flow to the heart) 1. What is the problem with renin system renal response in heart failure? a. Increase Fluid and after load b. vasoconstriction increases preload 1. What is Frank Starling law? a. Increased stretch leads to increased force and velocity of contraction due to increased calcium uptake 1. Which would directly increase venous return? a. decreased venous resistance and RAP b. Decreased Psf and RAP 1. Why is it important to screen patients for hypertension? a. HTN can lead to LV dysfunction 1. what contributes most to capillary osmotic pressure? a. Albumin b. fibrinogen c. globulin d. plasminogen 1. Which is not true of neural control a. indirect of noradrenaline with beta-adrenergic is vasoconstriction b. indirect of Ach causes decrease HR and contractility c. direct of Ach causes vasodilation d. direct of noradrenaline with alpha receptors causes vasoconstriction 1. Which one doesn't usually lead to death during acute MI a. thickening of descending left ventricular coronary artery (LAD) b. blood pooling in pulmonary (congestive failure) c. electrical mechanical (referring to fib) d. cardiac rupture ( cardiac tamponade) 1. What effect venous system has on blood pressure regulation a. Venoconstriction to increase CO in response to hypotension b. Venodilation to increase preload in response to hypotension c. Venodilation to decrease afterload in response to hypertension 1. What happens to cardiac index as you age a. decreases b. increases c. stays the same 1. What stimulates chemoreceptors a. Hypoxia b. none of these c. hypercapnia d. acidosis e. all of the above 1. Renal control of bp done by a. intake and output fluid balance 1. What normally happens when total blood volume increases a. increase in extracapillary volume b. increase in heart rate 1. Which of the following increases preload a. hypothyroidism b. venous pooling c. dehydration d. hemorrhage e. exercise 1. What is volume of blood ejected per unit time a. Cardiac output b. stroke volume c. EF d. HR 1. What is %EF? a. amount of blood delivered to the ventricles that is ejected per contraction b. amount of ejection per contraction c. amount of blood ejected per minute 1. CNS ischemic response, which is true a. takes 1-2 hours to occur b. the stimulus that initiates this reflux is in the blood c. takes away from nonessential organs 1. Which is false a. flow is pushed forward in the capillaries due to drop in venous to arterial colloid osmotic pressure b. degree of opening and closing of the precapillary sphincters is regulated by reduced oxygen availability c. transcytosis with caveolae to move plasma proteins between the endothelial cells d. capillary filtration coefficient factors in area and permeability of the capillary to water 1. Flow questions including velocity? a. velocity is reduced as it goes through the capillaries b. increase in cross sectional area of the capillaries c. all of the above 1. Which is true about negative Pif a. low compliance of tissues b. better tissue nutrition c. most of interstitial fluid in in gel form d. all of the above 1. Which of the following mechanisms would you see in nephrotic syndrome? a. Decrease in plasma oncotic pressure b. Increase in plasma hydrostatic pressure c. decrease in lymph flow rate 1. Which increases capillary flow efficiency a. metabolic hyperemia will .... b. low arteriovenous extraction allows increases myocardial efficiency in exercise c. something else d. a and c e. not sure what answer was, think it was the one about hyperemia 1. What is true of O2 demand and heart failure? a. non-significant of arteriosclerosis at rest... something like that b. increased ability of O2 to meet demand when have coronary arteriosclerosis is c. tachycardia does not have a significant effect in those with heart failure d. due to decreased resistance in coronary arteries... not sure exactly how this was worded 1. Which of the following factors is the chemoreceptor reflex sensitive to? a. Acidosis b. Hypercapnia c. Hypoxemia d. All of the above 1. Something..about tachycardia? a. less ventricle filling time **37 questions total Which is true of atherosclerosis? a. can be caused by smokeless tobacco b. often but not always clinically evident c. can cause thrombosis and reduce blood flow d. all of the above 2. What is the problem with renin system renal response in heart failure? a. Increase Fluid and after load b. Wrong: vasoconstriction increases preload 3. What is NOT true? . Anesthesia diffusion not lipid soluble a. Liver is very permeable even to plasma proteins b. Blood brain barrier is not permeable 4. Which is lipid soluble and can diffuse with a pore? . O2 a. glucose b. water 5. Which is least permeable? . glucose a. water b. NaCl c. urea d. albumin 6. Which can help determine anginal threshold in patient with heart failure? . Rate pulse pressure = hr x pressure 7. What are the effects of left heart failure? . Orthopnia and rales 8. Which structure provides for proper distribution of blood? . Arterioles a. Venules b. Veins c. Large arteries 9. Pregnant woman feels lightheaded. BP is normal but hear a murmur, what might cause this? . Pregnancy often leads to anemia which could lead to a murmur a. Blood in laminar flow hitting the sides of the vessels b. Murmur is normal sound heard when listening to BP 10. Why is it important to screen patients for hypertension? . HTN can lead to LV dysfunction 11. What is true of pulse pressure? . pulse pressure can indicate compliance 12. According to Darcy's Law, if you increase resistance by 6 fold, and perfusion pressures stays constant, what happens to flow? . 6 fold decrease a. 6 fold increase b. Stays the same 13. What does not directly affect capillary flow? . Capillary pressure a. Interstitial osmotic pressure b. Capillary osmotic pressure c. Lymphatic drainage 14. Mechanism of orthostatic hypotension most closely related with which pressure? . MAP a. CVP 15. What is a result of dilated ventricle in heart failure? . Increased O2 demand 16. What is a direct cause of increased interstitial fluid? . Increase BP a. Decreased BP b. Increased hydrostatic pressure c. Decreased hydrostatic pressure 17. According to Poiseuielle's Law what would result from a 50% increase in radius? . 16 fold increase in flow rate based on r^4 principle 18. What would most likely get help to match the O2 demand of coronary arteries when it is increased? . local factors that cause dilation a. sympathetic nervous system 19. What is true of O2 demand and heart failure? . decreased ability of O2 to meet demand when have coronary arteriosclerosis is due to increased resistance in coronary arteries 20. Problem with increased HR in person with heart failure is what? . Decreased filling time 21. What is a strong response to a decrease in blood pressure? . Chemoreceptors a. Baroreceptors b. CNS ischemic response 22. What is the main result of renin-angiotensin aldosterone system? . Increase sodium and water retention a. Vasoconstriction and venodilation 23. If have a high increase in pulmonary arterial pressure, what would be an immediate effect? . Increase in PCWP a. Decrease in right ventricle afterload b. Increase in CVP 24. What is Frank Starling law? . Increased stretch leads to increased force and velocity of contraction 25. Which would directly increase venous return? . Increased resistance and RAP a. Decreased Psf and RAP 26. Why is atrial contraction important? . Delivers more blood to the ventricle to allow for stretch for greater contraction 27. What is true of SNS activation in fight or flight response? . Vasoconstriction of vessels to active skeletal muscles a. Vasodilation of vessels to active skeletal muscles 28. What is an effect of chronic hypertension? . Myocardial hypertrophy 29. What's the body's response to hypertension? . not sure but might have been something about fluid shift to increase intersistial fluid 30. What best describes the relationship between flow and resistance? . Decreased viscosity increases flow a. MAP = ⅓ (pulse pressure) + DBP 31. What is the main renal regulation of blood volume? . Fluid and sodium output and intake a. Vasoconstriction of renal arterials b. Renal afterload 32. Why should you not take BP at carotid artery? . Could stimulate carotid sinus and cause decrease in BP and HR a. Could stimulate carotid sinus and increase BP b. Could cause CNS ischemia and syncope · Which of the following correctly states the relationship of Ohm's or Darcy's law for systemic circulation? · Q= (Pa - Pv) x R · R = Q / (Pa - Pv) · Q = (Pai - Pv) / R · R = (Pa - Pv) x Q · Which of the following is a lipid soluble substances that does not require pores in the capillary endothelium for capillary exchange to occur? · glucose · protein · oxygen · water · sodium · Which pressure listed below normally contributes to the reabsorption of fluid into normal systemic capillaries? · plasma colloid oncotic pressure · interstitial oncotic pressure · interstitial pressure · capillary fluid pressure · A systolic heart murmur · always indicates aortic valve stenosis · is pathognomonic mitral valve insufficiency · is pathognomonic for aortic lesions · always indicates a valve lesion · is common in pregnancy and young adults · which system is least affects fluid exchange in capillary system · lymphatic drainage · capillary pressure · interstitial pressure · interstitial oncotic pressure A 75 years old dentist is brought to the emergency room with chest pain. He was running this morning when he felt tightness in his chest that improved at rest. Which of the following statements about the impact of exercise on blood flow and oxygen consumption is true? · vascular beds are equal in terms of given priority when the cardiovascular system is stressed · The heart does not have the largest arterial-venous (a-v) oxygen difference · vascular bed are mostly equal in terms of adequacy of blood flow at rest · the heart has the poorest blood flow relative to its metabolic demand Which major vascular bed gets the lowest fraction of cardiac output at rest? · kidneys · skeletal muscles · heart muscle · splanchnic bed · brain Which of the following statements is true regarding systemic hypertension? · systemic hypertension does not cause edema because the capillaries are protected from high BP by the arterioles · systemic hypertension does cause edema because hypertension involves vasoconstriction of the arterioles · systemic hypertension does cause edema because hypertension causes a significant increase in capillary pressure · systemic hypertension does not cause edema because hypertension involves vasodilation of the arterioles

Answer: T, F (It is not about how FAST the system makes corrections, but how effective it is)

Local anesthetics stop bleeding because they are a(n)...

alpha receptor agonist

Physiology exam 2 Answers in RED What clinical reference is used to assess the volume of blood returning to the cardiac system? a. Stroke Volume b. Afterload c. PAP d. CVP e. MAP What clinical reference is used to determine the afterload of the right ventricle Closing of semilunar valves Stroke volume Pulmonary capillary wedge pressure Pulmonary arterial pressure Central venous pressure What is the primary factor that controls cardiac output? - ECC-able? Aldosterone Myocardial oxygen consumption End systolic volume Tissues metabolic needs Stroke volume - SV is one of the four factors that controls CO AND it is in the equation: CO = HR x SV (it was also mentioned on numerous presentations) What rhythm is defined as having no p wave, widened but regular QRS complex with a ventricular rate of 150 bpm? - ECC-able? In the review she said to think of this as above the ventricle so that would technically make junctional tachycardia "more correct" Accelerated idioventricular rhythm Junctional tachycardia - I put this, explanation said "it would be a tachycardia" Accelerated junctional rhythm Ventricular tachycardia What is a compensatory response to chronic elevation in SNS activity? Elevation of sodium retention Myocardial ischemia Myocardial hypertrophy Increase in urine production What type of pacemaker would the Bundle Branches be if it initiates the action potential and depolarization? Principal pacemaker Ectopic pacemaker Secondary pacemaker Latent pacemaker Regarding the rapid control of blood pressure, which statement/s is/are TRUE? I. Vasoconstriction will increase peripheral resistance and thus blood pressure II. Venous constriction will increase preload which will increase stroke volume and thus blood pressure III. The cerebral cortex will increase heart rate and thus blood pressure IV. Venous constriction will increase the activity of the SA node and thus blood pressure When reticulocytes are released in the bloodstream, they are: - ECC-able? Is answer B not correct because it says "few" versus "remnants??" Reticulocytes have Golgi, mitochondria, and other organelles, no nucleus, AND are saturated in hemoglobin (Blood Histology II, Slide 3) so I thought both A and B would be correct A. No nucleus, saturated in hemoglobin B. Nucleated and with few organelles C. Released into the bone marrow and fully saturated in hemoglobin D. No nucleus, half saturated in hemoglobin E. No nucleus, no organelles Which is true: Bohr effect refers to the influence of metabolic activity of tissues in O2 saturation (???) LV fails to eject sufficient blood into circulation. What are the symptoms? A. None of the above B. Elevated ejection fraction and pulmonary edema C. Left atria enlargement and peripheral edema D. Something E. Something else Which compensatory mechanism occurs during chronic elevated SNS activity? Muscle hypertrophy Two main therapeutic drug carriers in plasma albumin and alpha 1 acid glycoprotein When all of atrial contraction fails, what becomes the primary pacemaker? A. Bundle branch B. AV node C. Purkinje fibers D. Bundle of His E. Heart fails completely 14. What occurs during fight or flight response ? A There is a decrease in afterload that leads to SV increase 15. Atrial rate of ekg ? 300 16. Pre-shock Recall Question It is when the body still has enough reserved to compensate (non progressive) Rest were classic progressive phases 17. What is the control center for maintaining vascular tone? Hypothalamus PNS vasodilator area SNS vasodilator area SNS vasoconstrictor area SNS vasodilator area 18. What is true The media has endothelial cells Veins have 70% of blood volume Valves help with viscosity 19. If all of the Atrial fails, what paces the heart next? Bundle of His AV Purkinje 20. Pancreas, intestines and kidneys have ___ capillaries. Muscle, connective tissue and nervous tissue have ___ capillaries. Liver, bone marrow and spleen have ___ capillaries. Fenestrated, continuous, sinusoidal 21. Which statement is true about fibrinogen - I Don't remember the answer to this one?? 1. Because of its elongated shape, it provides viscosity to the blood 2. It is a glycoprotein synthesized in bone marrow 3. It has a high molecular weight, but it does not aggregate due to electrostatic repulsions 4. It is upregulated in cirrhosis 22. Which of these factors increase venous return? (ECC??? Or plz explain??) Venodilation (<- chose this and was incorrect) Hypervolemia Cardiac tamponade Tricuspid stenosis Right Heart Failure 23. What is the leading theory in development and progression of coronary artery disease Chronic inflammation Chronic hypertrophy 24. What is the key component of the pre-shock stage of shock? (ECC???) Body increases the PNS to slow down metabolic needs to compensate for the distress of medical conditions causing shock. (<- chose this and was incorrect) 25. Which rhythm is classified as a supraventricular tachycardia? Atrial fibrillation w rapid ventricular rate Third degree heart block Paroxysmal atrial tachycardia (chose this and got it wrong) Junctional tachycardia None of these 26. What directly occurs if the LV cannot eject sufficient blood into systemic circulation? a. Enlargement of the left atria and interstitial pulmonary edema 27. What occurs during during the fight or flight response a. There is an increase in SNS that leads to an increase in mean systemic filling pressure 28. What neurological structure is responsible for maintaining normal vascular tone? a. SNS vasoconstrictor area 29. Which of following statements is FALSE a. Fetal hemoglobin has a lower affinity for 02 than adult hemoglobin at all partial pressures b. Fetal curve is sigmoidal, hemoglobin is hyperbolic c. All false 30.. Which of the following EKGs can diagnose myocardial ischemia? Telemetry 12 lead (gold standard) Holter Polar monitor 31. What is the role of the PNS on the regulation of cardiovascular function? Via the vagus nerve the PNS, reduces HR Via the vagus nerve the PNS causes vasodilation Glossopharungeal nerves the PNS causes vasodilation Via the glossopharyngeal nerve the PNS reduces HR The PNS does not play any role in the regulation of the cardiovascular function 32. Which factors directly affect afterload? Chamber size and wall thickness. HR and contractility 33. The endothelium is located in ______. Cardiac muscle cells are found in _____. Endocardium, myocardium 34. What does Pousielle's Law state regarding radius? Radius has the greatest influence on blood oxygenation Radius has the greatest influence on blood flow. 35. ___ is a major copper carrying protein, and ___ stores iron Ceruloplasmin, ferritin 36. Hyperalbuminemia is seen in what? Nephrotic syndrome Dehydration and chronic inflammation 37. The stimulus for EPO synthesis and release: Renal and liver tissue hypoxia 38. What occurs during S1 and S2? S1-AV closing, S2-semilunar valves closing 39. What is the formula for CO? CO=(MAP-RAP)/SVR 40. Something about R^4 effect: Flow is increased to fourth power of vessel diameter 41. What is true about fibrinogen? Upregulated in cirrhosis big molecular weight Elongated form contributes to max viscosity in blood RULES - read the rules then scroll down to add your questions To state the obvious: Do not not open this document inside school. Do not talk about it in school. Do not ask about it in school. Do not slyly bring it up in convo. Do not leave this page open on your computer. This is a COMBINED EFFORT, so participation is key to making this work. It's better to have all of our 130 brilliant minds make 1 perfect recall than 20 subpar ones. Read the recall questions that have been posted, and see if you can improve on the questions and answer choices. A good way to have a solid recall is to remember the FIRST FIVE or so questions of the exam verbatim and memory dump them here. It's randomized so everyone will get a different starting set of questions. Please try to improve the formatting as some people may get lazy. If you have the image, try to insert it to make the recalls stronger. Make sure the correct answer choice is indicated by RED font. If you are unsure leave it as is. If you feel inclined, please put the reasons for the correct answer in ORANGE font. A new document link will be released the night before every exam. Only share it with your trustworthy friends. If you give it to someone that hasn't taken the exam, you're just hurting your own grade because ECC can't save you. Also, be wary about sharing it with people not in this group! Feel free to download the file about 24 hours after the exam, by then most people should have given their input. The stronger we make this, the better a community we are creating for the next class. While it may not seem as big of a deal, the more effort we put in to help them should have trickle down effect - creating a stronger community! As always, if you have any questions/comments/concerns or you know someone else who wants to join just reach out to me! Notes -there was a not a ton of ice cream on this repeated, but there was questions that had been seen one time before on this, so pay attention to previous years even if there is one question -collectively, we thought this was better than the first one What are symptoms of left systolic heart failure (ECC?) · JVD and exercise intolerance · Orthopnea and rales 2. What is the effect of a heart rate over 180 bpm? · Decreased cardiac output due to less filling time 3. What is the main cause of distributive shock? · Bacterial infection · Myocardial infarction · Severe diarrhea and vomiting 4. Increased central venous pressure leads to? · Increased cardiac output as a result of stroke volume and heart rate (Bainbridge reflex) 5. What molecules transfer iron in tissues? Store* wasnt it? · Ferritin and transferrin · Ferritin and hemosiderin · Ferritin and albumin 6. What molecules carry therapeutic drugs in the bloodstream? · Albumin and a1 glycoprotein (orosomucoid) · Albumin and fibrinogen · Albumin and ceruloplasmin 7. Person has irregularly irregular EKG with heart rate 136-144 bpm and low blood pressure, what is the diagnosis? · Stable atrial fibrillation · Unstable atrial fibrillation 8. A1AT inhibits neutrophil _____, deficiency in A1AT leads to _____. · Elastase, cirrhosis and emphysema · Elastase, cystic fibrosis and something else 9. What activates the chemoreceptors? · Hypoxemia, hypercapnia, acidosis · Hyperoxemia, hypocapnia, bicarbonate 10. When ejection fraction is low, the body compensates by: · Increase the SNS 11. Picture of wide QRS complexes and arrows pointing to them—what myocardial tissue is acting in this? · Bundle of His · Atrial tissue · Ventricular tissue · AV node 12. What is true about coronary artery disease? · Women are more likely to have a fatal first heart attack than men · The carbon monoxide in cigarettes is what causes coronary artery disease in 70% of men 13. The baroreceptor reflex is the first activated, but the CNS ischemic response is the most potent. · True, true 14. What is true about the shock stage of shock? · Irreversible organ damage · Compensatory mechanism is fixing the problem · PNS is activated to help preserve tissue function in response to this trauma · Compensatory mechanism has failed, so hypoxia and tissue necrosis occur 15. What is false about reticulocytes and erythrocytes? · They have no nucleus · They are present in equal amounts in the blood (50-50%) · Same amount of blood hemoglobin (34%) 16. Why are diuretics and beta blockers indicated with heart failure? · Because they decrease venous return and oxygen demand · Because they increase venous return and oxygen demand 17. What would increase the Bohr reflex? · Increased lactic acid · Increased CO2 · Increased temperature · All of the above 18. What is the purpose of the haptoglobin-hemoglobin (Hp-Hb) complex? · Protects the kidneys by preventing absorption into the tubules 19. What causes a drop in Psf? · External compression · IV drip · Hypovolemia 20. What is a true statement? · Albumin transports free fatty acids, steroids, calcium, bilirubin, copper · Fibrinogen is low molecular weight 21. Which of these statements is FALSE about CAH? · CAH release into blood helps transport the 10% of dissolved carbon dioxide · CAH makes HCO3- into the blood to act as a buffer · CAH adds H+ onto the hemeglobin of the erythrocyte 22. Vasovagal response is defined as: · Gradual decrease in blood pressure · Rapid decrease in blood pressure 23. What is the mean vector of the heart? · The average direction of the depolarization 24. What are the parameters of stroke volume? · EDF and ESF 25. What is the function Haptoglobin? -to protect the kidney 26. What two molecules are used for iron storage? a. Transferrin & hemosiderin b. Transferrin & ferritin 27. What is the point of haptoglobin & hemoglobin complex? (not the exact wording) . Prevents from going into the glomerular filter, protects kidney function (not the exact answer but the general concept of the question was to know the protective functions of this complex) 28. What decreases the Psf to decrease preload? . Hypovolemic shock a. Renal failure 29. What is the most common cause of distributive shock? . Bacterial infection 30. Know what ECMO is and how it has to deal with shock . (it is a treatment therapy for people that experienced shock, extracorporeal membrane oxygenator to revert the systemic response of shock) 31. Nephrotic Syndrome question . Increase in albumin loss 32. What is a sign of shock? . hypotension 33. Complications of Diabetes question 34. What would best describe unstable angina? . Patient with unknown coronary artery disease describes discomfort when walking short distances 35. What is true regarding pulse pressure? . compliance a. Reflects myocardial oxygen consumption b. Described as systolic BP minus the MAP 36. What causes blood flow to be turbulent? . atherosclerosis Physio 2 2022 What seals the fate of glycolysis? a. Hexokinase 2. Glucogenic amino acids leads to _______ and ketogenic amino acids leads to _______. a. Pyruvate, Acetyl CoA 3. Children and teenagers have what bones predominantly responsible for erythropoiesis? . Tibia and Vertebra ← ECC a. Tibia and Femur 4. What is indicated by the dashed lines? a. Portal Triads 5. What is used to measure the afterload in the right ventricle? a. Pulmonary arterial pressure b. Systemic c. CVP d. PCWP 6. What is the function of transferring? a. Supplies iron for erythropoiesis 7. What is hemoglobin made of? a. 4 polypeptide chains and 4 hemes 8. What is true of O-type blood? a. Contains both A and B antibodies b. A-antibodies c. B-antibodies d. Neither A or B-antibodies 9. What part of the EKG is entirely ventricular electrical activity? a. Q-T interval 10. Statins do what? a. Increase HDL b. Decrease LDL c. Inhibit HMGCoA Reductase d. All of the above 11. Where does nitrogen come from in urea synthesis? a. Aspartate and Ammonia 12. Cytosolic enzymes are used for what? a. Glycolysis b. Fatty acid degradation c. Pyruvate → Acetyl CoA d. All of the Above 13. When in a starved state, what is true about ketone bodies? . All of the above [Can't remember other answer choices :(] 14. What is a cardiac index used for? a. Used to compare cardiac function across individuals 15. What happens when you get older? a. Blood pressure increases, cardiac index decreases 16. What is true? a. Albumin carries calcium, copper, bilirubin, and some drugs, etc. b. Nephrotic and cirrhosis is associated with hyperalbuminemia 17. What is the function of alpha-2 macroglobulin? . Inhibits proteases a. Increases nephrotic syndrome b. Carries cytokines c. All of the above 18. What does CCK do? . Relax the sphincter of Oddi and contracts the gallbladder? 19. During gluconeogenesis, TCA slows down due to decrease in what? a. Oxaloacetate b. Malate c. Fumarate d. Succinate 20. What's exclusive to the extrinsic pathway a. Factor VII in the subendothelium b. Factor VII in the endothelium 21. ______ promotes the transport of unesterified fatty acids to the bloodstream, in combination with _____ to peripheral tissues . Glucagon, Albumin 22. What does GII3b bind to? . Fibrinogen 23. What is indicative of the S1 "lub" sound? . AV valves are closing and it marks the beginning of ventricular systole 24. What modification to phospholipid bilayer allows the membrane to stay liquid in cold temperature? a. Increase in unsaturation and decrease in length 25. Fats get digested and is carried as _____ to the _______ where it is synthesized and distributed to the tissues as ______. . Chylomicrons, Liver, LDL 26. When the SA node fails, what is the next "pacing system" in the conduction system? . Atrial tissue 27. Acute phase proteins are DECREASED during inflammation and [something else]? . True a. False 28. What one is false? . 80% cholesterol is used to make bilirubin a. Bile contains digestive enzymes b. Bile salts emulsify fats for absorption 29. Which one of the following is incorrect? . Lactate is produced because it makes NADH which is needed for glycolysis to continue a. NADH/NAD is 100 present in cytosol making it a good electron acceptor ⇐ ECC 30. Which one is responsible for vasoconstriction? . Thromboxin A2 and endothelin 31. What is true about ketone bodies? . Serves as a source of energy under extreme starvation a. Synthesized [something] in the TCA b. All of the above 32. Transferrin: . Binds to 6 iron molecules a. Provides iron to allow erythropoiesis in bone marrow 33. Normal cardiac output on EKG has the following characteristics: . P and P equal distance apart, R and R equal distance apart 34. What happens during fight or flight in the heart? . Heart rate increases to a maximum, then decreases 35. What happens during depolarization phase of the action potential? . Rapid influx of Na+, prolonged influx of Ca 36. Heparin: . Binds to angiotensin III increasing its function 37. Tunica _______ is mainly composed of smooth muscle and tunica ______ has endothelial cells in its layer. . Media, intima 38. Which enzyme is involved in amino acid degradation? . Amino transferase 39. On an EKG, the P presents . Atrial depolarization 40. This portion uses the most oxygen . ST segment 41. During SNS, _______ is released and stimulates ________. . Epinephrine, glycogen phosphatase 42. What is the expected Ejection Fraction of a healthy individual? . 10% a. 30% b. 50-70% c. 100% 43. What is true about AVA? . Important for thermoregulation 44. Question about what is true about A1AT? . Smoking can cause it a. Aggregates in liver for cirrhosis b. Liver cancer c. All of the above 45. Preload question . Increases SV and CO 46. Platelet activation . Change in shape a. Degradation b. Adhesion of GII3b to fibrinogen c. All of the Above Sour Skittles Guidelines: To state the obvious do not open this document inside the dental school. Do not talk about it in school. Do not ask about it in school. Do not slyly bring it up in convo. Do not leave this page open on your computer. This is a combined effort, so participation is key to make this work. It's better to have all of our brilliant minds make 1 perfect recall than 20 subpar ones. Read the recall questions that have been posted, and see if you can improve on the wording and answer choices. Remember the last 5 questions of the exam verbatim and memory dump them here. Its randomized so everyone will get a different starting set of questions. Obviously remember more if you can! Mark the correct answer choice by using RED font and if you feel inclined, please put reasons under questions in ORANGE font. Please try to improve the formatting as some people may get lazy; if you have the image, try to insert it to make the recalls stronger. A new document link will be released the night before every exam, hopefully. Only share it with your trusty friends. If you give it to someone that hasn't taken the exam, then you're just hurting your own grade because ECC can't save you. Feel free to download the file about 24 hours after the exam, by then most people would have given their input. Class of 2021 → Physiology Exam II Where does erythropoiesis occur in adults? Bone marrow of vertebra, sternum, and rib Liver Bone marrow of femur and tibia Bone marrow of tibia and vertebra 2. What is true of erythropoietin? a. It is produced in the kidney (90%) and the liver (10%) b. Released of EPO signaled by hyperoxia 3. Hemoglobin is a a. Tetrameric protein composed of four polypeptide chains and four heme groups b. Tetrameric protein composed of four polypeptide chains and one heme group c. Monomeric protein composed of ... d. Monomeric... e. All of the above 4. Thromboxane A2 and serotonin are released by _________ and cause ________ a. Platelets, vasoconstriction b. Injured epithelium, vasoconstriction 5. Platelet aggregation is facilitated by GpIIb/3a which serves as a bridge between platelets and: a. Fibrinogen b. Prothrombin activator 6. After T cells gain immunocompetency, they travel to the a. Medulla in Thymus b. Medulla in lymphoid organ c. Thymic cortex 7. What EKG region represents the highest oxygen requirement? a. QRS b. ST segment c. PR interval d. T wave 8. A person with O blood has: a. Both A and B antibodies b. Just A c. Just B d. neither 9. Which gland is mostly serous? a. Sublingual b. Submandibular c. Parotid 10. What is the importance of atrial contraction? a. Efficient filling and contraction of ventricles b. Opening of AV valves 11. Which of the following poses most immediate life threatening risk to the patient? a. Ventricular fibrillation b. Atrial fibrillation c. Atrial flutter 12. Which of the following is catalyzed by renin? a. Angiotensinogen → Angiotensin I b. Angiotensin I → Angiotensin II c. None of these 13. Which of the following antibodies is a B surface cell receptor? a. IgD b. IgM c. IgG d. IgA 14. What is true about tissue factor? a. Something about VII b. Is involved in the intrinsic pathway 15. What is the percent of resting saliva made by parotid, submandibular and sublingual? a. 30%, 60%, 5% 16. Which of the following is true about tissue factor a. Activates factor VIII 17. If there is atrial failure in the conduction system which will become the pacemaker? a. Bundle of His (ECC, keyed wrong) b. Purkinje fibers c. SA node 18. Superior cervical ganglion will have what impact on salivary glands a. Decreased fluid secretion and decreased protein secretion b. Increased fluid secretion and decreased protein secretion c. Decreased fluid secretion and myoepithelial contraction d. Increased protein secretion and myoepithelial contraction 19. Photo of irregular heartbeat with QRS complexes were separated by all different # of boxes a. Irregular irregular b. Regular 20. You have a patient with heart failure, how would using a beta blocker help the patient? a. Slows down heart rate and allows for more ventricular filling 21. Which is false? a. Aspirin prevents synthesis of Thromboxane A2 b. Heparin binds alpha-2-antiplasmin and removed thrombin and activated clotting factors c. Warfarin decreases amount of available vitamin K d. Thrombomodulin and Protein C prevent clotting? 22. Which of the following is false a. Hormones cause both the pancreas and salivary glands to secrete proteins b. Both secrete bicarbonate to buffer acid c. Both secrete amylase to digest carbohydrates 23. What is not the role of the pericardium: a. Helps the heart in ventricular filling b. Helps the heart in contraction of ventricles c. Fibrous layer allows for prevention of cardiac infections d. Anchors the heart in the mediastinum 24. What is characteristic of atrial flutter a. Saw-tooth shaped baseline on EKG graph b. Very strong irregular irregular heartbeat 25. Which is true of vasospasm? a. Myogenic spasm causes contraction of smooth muscle layer of vessels b. Sympathetic nervous system causes contraction of smooth muscle layer of vessels c. Parasympathetic nervous system causes contraction of smooth muscle layer of vessels 26. Tunica adventitia is composed mainly of longitudinally arranged fibers, small vaso vasorum, elastic fibers, collagen fibers, and connective tissue. a. True b. false 27. If atrial components fail...REPEAT a. Bundle of His will take over as primary pacemaker - correct answer but miskeyed b. Bundle branches will take over as primary pacemaker c. Purkinje fibers will take over as primary pacemaker d. Heart will fail 28. If tricuspid valve has infection and is therefore leaky... a. Blood will leak back into right atrium causing rise in central venous pressure b. Something... causing increase in pulmonary capillary wedge pressure 29. Layer with smooth muscle cells is tunica_____, layer with endothelial cells is____ a. Media, intima 30. Hemoglobin is important in transport of O2 and CO2. Hemoglobin is important acid buffer in blood. a. True, False b. False, False c. True, True d. False, True 31. What controls ventricular depolarization in this EKG? a. Bundle of His b. Purkinje fibers c. AV node d. SA node ^Googled image of bundle block EKG Pic on exam was similar in consistency of pattern QRS complex looked wider with bigger dip of R (see drawing) P & T waves were not super distinct/straighter baseline (see drawing) 32. What is true about AVA a. If it is closed, it allows blood to bypass the capillary beds b. Important for thermoregulation 33. What is a common characteristic of junctional arrhythmia ?a. Inverted P wave 34. IgA is most likely secreted by?a. Alveolar cellsb. Striated cellsc. Sublingual glandd. Parotid gland 35. What represents entire atrial electrical activity? a. PR interval b. PR segment 36. ____ promotes clot formation, ___ promotes clot dissolution, ___promotes fibrous reorganization a. Platelet phospholipids, t-PA, PDGF 37. Deficiency characteristic of megaloblastic anemia a. Deficiency of intrinsic factor interferes with GI absorption of B12 b. Deficiency of intrinsic factor interferes with metabolism of B12 38. Homing receptors located in a. Spleen b. Liver c. Bronchial associated lymphoid tissues 39. Less extensive rough endoplasmic reticulum and well developed golgi characteristic of a. Serous cells b. Mucous cells 40. Located at the basolateral membrane of _________ are sodium-potassium pumps a. Striated ducts 41. Rapid repolarization occurs because of a. Rapid influx of sodium and prolonged influx of calcium 42. What occurs in plateau phase that promotes myocardial contraction a. Rapid influx of sodium and prolonged influx of calcium b. Rapid influx of calcium and chloride ions c. Slow influx of calcium d. Rapid influx of potassium 43. Difference in myocardial muscle versus skeletal muscle a. Intercalated disc for electrical resistance and selective influx of ions b. T-tubules and sarcoplasmic reticulum release calcium to promote myocardial contraction c. Many more contractile units to promote more contraction 44. What makes second heart sound a. Opening of atrioventricular valves b. Closing of atrioventricular valves c. Opening of semilunar valves d. Closing of semilunar valves 45. Stroke volume depends on a. End diastolic volume and end systolic volume 46. Which is true a. Continuous capillaries in pancreas b. Sinusoid capillaries only found in brain c. Fenestrated capillaries in muscle tissue d. Sinusoid capillaries in spleen and liver 47. Which is false about saliva flow? a. Increased by sucrose and other sugars b. Increased by acids, especially citric acid c. At its highest in the late afternoon d. Almost none during sleep 48. Which is false? a. Anticholinergic drugs will make Tom more like Ed b. If Tom has Sjogren's syndrome, will be more like Jen c. Tom is more likely to get caries than Ed d. Chewing a piece of wax will make Tom more like Ed 49. Which is true? a. Resting saliva has lower chloride ion concentration than plasma because reabsorption b. Resting saliva has higher ion concentration than stimulated saliva c. Stimulated saliva has less bicarbonate than resting saliva because bicarbonate is not sufficiently secreted into saliva d. Resting saliva has less potassium than stimulated saliva because of reabsorption 50. Why shouldn't babies drink milk bottle at night? . Saliva production decreased at night so acids not neutralized a. Acids from bacteria cause demineralization b. Acids stay on teeth longer because less swallowing c. All are true Physio Exam 2 Class of 2019 75% old questions. Read multiple multiple choice questions carefully. Fairly straight-forward in respect to what was emphasized during lecture. B-cells become immunocompetent in: a. bone marrow b. lymph node c. thymus d. spleen 2. Which factors in the tissue promote vasoconstriction? a. Endothelin, Thomboxane A2, and serotonin 2. Atrial flutter has which characteristic sign: a. sawtooth cut baseline 2. ______ converts fibrinogen to fibrin and during degranulation, _____ increases platelet aggregation a. thrombin and ADP b. thrombin and prostacyclin c. prothrombin activating factor and .. 2. Junctional arrhythmia a. inverted P wave 2. symptoms of hyponatermia a. brain edema, seizures, and coma b. intense thirst c. intense body heat 2. What EKG region represents to highest O2 requirement? a. S-T wave b. QRS c. T Wave d. P wave PR 2. The larger thoracic duct drains into a. the junction between the left internal jugular vein and the subclavian b. the junction between the right internal jugular vein and the subclavian 2. 32 year old walks in with leg thrombosis. what quick acting anticoagulant should you give him? a. Heparin b. aspirin c. Warfarin d. Coumadin 2. Which cells have elongated mitochondria for ion transport? a. striated duct cells b. myoepithtelial cells 2. image of EKG with weird rhythm: (it had weird pattern for 5 cycles, but it repeated so regular) a. regularly irregular 2. ****this question is 2015 and was reworded for 2016 but same concepts- Picture of parotid gland: what is true? a. Sjogren's causes acini destruction and decreased salivation b. superior cervical ganglion causes decrease in salivary secretion c. beta adrenergic control--> increase in protein secretion d. salivary secretion is controlled by hormones 2. Lymphocytes get to bronchus system via: a. afferent capillaries b. homing mechanism 2. what % of blood is plasma protein a. 0.9% b. 9% 2. why do you give someone with heart failure beta blockers? a. decrease heart rate and allow proper filling 2. A 32-year-old chef cuts his finger with a kitchen knife. The bleeding can be stopped with application of pressure. Which of the following substances enzymatically causes the polymerization of plasma fibrinogen causing blood to clot? a. Thrombin 2. stroke volume involves a. end systolic, and end diastolic volume 2. Role of pericardium a. Proper ventricular filling 2. hematocrit % in typical male a. 47% 2. what takes over when SA node isnt working a. atrial tissue b. bundle branches c. bundle of His 2. which cells contain myosin a. Myoepithelial cells 2. vasopermeability caused by a. Histamine 2. which cells have lines of mitochondria typical of ionic something (something like that) a. striated duct cells 2. 90% of EPO is made where? a. kidney b. liver c. thymus 2. why should a kid not sleep with milk bottle (multiple answers) a. slower saliva production when sleep so acid is there longer b. increased parasympathetic during sleep causes decreased protein secretion c. acid produced by milk causes remineralization d. less swallowing so acid is there longer 2. tunica intima has most of this: a. endothelial cells b. collagen fibers c. elastic fibers 2. EKG picture pointing to weird waves with a widened QRS and no P wave a. controlled by ventricular fibers b. Bundle of his c. AV node d. Atrial fibers 2. person with O blood has: a. both A and B antibodies 2. Put in order (they were numbered) a. renin → angiotensinogen → angiotensin I → angiotensin II → SM contraction 2. self intolerant T cell elimination a. thymic cortex b. thymic medulla 2. What gland is mostly serous? a. Parotid 2. What secretes IFN-gamma to activate macrophages? a. Th1 2. Rapid depolarization involves: a. rapid Na channels opening with slow Ca channels b. rapid Ca channels opening with slow Na c. slow Na opening 2. True of erythrocytes: a. Can reversibly change shape throughout the circulation 2. Deficiency in von Willebrand factor prevents adhesion of what? a. Platelets 2. Picture of Parotid Gland, what is true (multiple multiple choice) a. duct opening in oral mucosa next to maxillary teeth b. mastication causes increase in saliva high in mucin c. osmolarity decreases with stimulated saliva d. if stimulated the salivatory nucleus would activate muscarinic receptor 2. Had 3 names next to each line, and multiple multiple choice: a. If blue line takes anticholinergic drug it'll be more like white line b. If blue line had Sjoren's, it would look like white line c. one more option d. red line has lower risk for dental caries 2. Which immunoglobulin crosses the placenta? a. IgG b. IgA c. IgD d. IgM 2. Which of the following is true? a. Nervous tissue from sinusoidal b. Bone marrow from continuous c. bone marrow from fenstrated d. Spleen from sinusoidal 2. Where does the 2nd heart sound come from? a. Closing of the semilunar valves b. Opening of the semilunar valves c. Closing of the atrial vavles d. Opening of the atrial vavles 2. ______ blocks platelet aggregation. ______ promotes clot dissolution. ____ promotes clot reorganization a. Heparin, t-pa, PDGF b. Aspirin, t-pa, and PDGF 2. Importance of atrial contraction a. opening of AV valves b. closing of AV valves c. efficient filling and contraction of ventricles 2. Differences between pancreas and salivary glands, which are true (multiple multiple choice) a. stimulation by parasympathetic causes increase in flow b. bicarbonate secretions of both buffer acids c. mucin secretions in both protect mucosa lining d. hormonal control increases both (no hormonal in saliva) 2. Which cell type has big golgi complex for carb digestion a. serous b. mucus c. both d. myoepithelial 2. Segment that includes entire atrial electrical activity? a. PR segment b. PR interval c. ST segment d. QRS 2. Which type of edema is not motile? a. Non-pitting edema b. pitting edema 2. What cause extracellular edema: a. decreased plasma proteins b. blockage of lymph return c. increased interstitial pressure d. increased capillary permeability e. all of the above 2. Which is false about .. a. Most coagulation factors are made continuously in the thymus b. Platelet derived Ca2+ and phospholipids are important in conversion of prothrombin to thrombin c. formation of factor X is common to both extrinsic and intrinsic pathways 2. Factor unique to extrinsic pathway? a. VII b. VIII c. IX d. X 2. Which is false about lymphatic system a. Flow Increases 10 to 50 fold b. lymph system normally returns fluid and protein to the venous system c. Lymphatic system normally returns into circulatory system 2-4L of lymph per minute Physiology EXAM 2 Class of 2018 37 questions 1. Atrial flutter a. saw like pattern 2. heart attack, chorda tendinae ruptures, causing: a. PCWP increases b. preload increases c. EDV decreases d. Atrial ejection decreases 3. Parotid gland secretes: a. serous 4. Myosin is in a. myoepithelial cells b. serous cells c. mucous cells 5. Elongated mitochondria and ion transporting cells a. striated duct 6. What secretes IgA? a. parotid gland, serous 7. Label Na, HCO3, Cl, K in order 8. a. if blue chews wax, it will go to white b. anticholinegenic drug for blue, makes it go to red c. blue has more caries than white 9. Tunica intima has mostly a. endothelial cells 10. Order of BP regulation a. Renin, angiotensinogen, angiotensin I, angiotensin II, smooth muscle contraction 11. Von WIlliebrand disease has impaired adhesion of _________ a. platelets 12. Pericardium's major function a. allows heart to not overfill (fill into right volume) 13. Average Hematocrit for males a. 47% 14. Plasma has _____ % of plasma proteins a. 9 15. Type O blood has ______ anti-A and anti-B a. both 16. 90% of erythropoetin is produced in a. kidney 17. B lymphocytes are matrued in a. Bone marrow 18. most of the oxygen consumption a. ST segment 19. ______ cells release IFN gamma and assist macrophages in killing bacteria a. TH1 20. a person, who went to Asia, has a thrombus on leg. what does he need for treatment? a. Heparin 21. A 35 year old dentist cuts his finger during oral surgery. After damage to a vessel wall, vasospasm is facilitated by which biologically active substance produced from arachidonic acid to promote vasoconstriction? a prothrombin b thromboxane A2 c thrompotin d plasmin e prostaglandin 22. Elimination of self intolerant T lymphocytes and MHC recognition occurs in a. thymus cortex 23. Lymphocytes in GALT use ________ a. homic receptors 24. Prothrombin activator is involved in which pathway? a. final common pathway b. intrinsic pathway c. extrinsic pathway 25. Stroke volume can be calculated using a. EDV and ESV 26. What is the importance of atrial contraction? a. efficient ventricle filling and contraction 27. Junctional arrythmia. whats a common feature? a. inverted P wave 28. ventricular depolarization a. Rapid Na influx and prolonged Ca influx 29. what increases vascular permeability a. histamine 30. a. regularly irregular b. irregularly irregular - wasn't this the answer? ECC! c. Regular but interrupted 31. what is responsible for the ventricular contraction when the SA node is not working? a. atrial tissue 32. Diagram of EKG - Purkinje fiber is responsible for it 33. what is true options about the parotid gland? 1. superior cervical ganglion reduces salivary secretion 2. sjogren syndrome destroys acinar cells and decreases secretion 3. protein release is affected by hormone 4. adrenergic receptor increase parasympathetic a. 1,2,3,4 b.2 only c. d. 34. Beta blocker a. decreases heart rate to increase ventricular filling 35. why should baby not go to sleep w Milk a. acid in milk causes caries b. sleeping decrease salivary secretion c. less swallowing extends time of acid in mouth d. can't remember but it wasnt correct answer (a, b and c)

d. CVP

The sublingual, submandibular, and lacteal glands are innervated by parasympathetic nerves _____ , while the parotid gland is innervated by ____ nerve. Answer: VII, IX Secretin decreases ______ secretion in the stomach and increases _______ alkaline secretions HCl, pancreatic HCl, duodenal Pepsinongen, pancreatic Bicarbonate duodenal Pepsinogen, colon

Answer: VII, IX Secretin decreases ______ secretion in the stomach and increases _______ alkaline secretions HCl, pancreatic HCl, duodenal Pepsinongen, pancreatic Bicarbonate duodenal Pepsinogen, colon