whole mpp class

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Match the methods and approximate quantities regarding how carbon dioxide transported from the tissues to the lungs to be exhaled?

Dissolved in the blood plasma ~3% Bound to Hemoglobin ~30% Converted to bicarb ~60%

A healthy person living on the coast at sea level attempts to climb to a mountain peak at 14,000 feet, which of the following changes are expected?

Increased respiratory rate A lower pulse oximeter reading because of a reduction in the arterial PO2. Increased firing of the chemoreceptors

In the distal tubule, when absorption of sodium _________, potassium secretion is promoted by ___________.

Increases via ENaC, creation of an electronegative luminal environment

Patient 1 (Blue-solid line), Patient 2 (Green-dashed line), and Patient 3 (Red-dotted line) all underwent a glucose tolerance test. If all three patients have the same urine threshold of 250, according to the graph below, what time will glucose begin to be present in the urine for each patient? (hint: you may want to use a ruler to help you be precise).

Patient 1: at time 40 Patient 2: never Patient 3: At time 75

Urinary buffers with a major role in excretion of net acid by the kidneys include

Phosphate and ammonia

Three male patients, pink, green and blue, came into a medical clinic with symptoms of lethargy (feeling tired) and chest congestion. A blood sample was taken for each patient to measure the hematocrit levels and to determine the hemoglobin saturation curves for each patient. The results are shown below with the saturation curve on the left and the hematocrit on the right. What should the oximeter readings be for Patients Pink, Green and Blue if arterial PO2 was 80 mm Hg? Which patient(s) has a significant reduction in total oxygen carrying capacity?

Pink: 97% Green: 97% Blue: 85% Patients Green and Blue

Maintaining normal levels of plasma calcium is focused on regulating

Plasma free, ionized calcium (Ca2+)

Where on the pressure-volume loop is end-diastole

Point B

which of the following are true concerning thyroxine (T4)

elevated levels inhibit pituitary responsiveness to TRH regulates cellular metabolism and neural development synthesis requires iodine and thyroglobulin

the endocrine portion of the pancreas is made up of alpha cells and beta cells. what hormone is produced and released by the beta cells of the pancreas?

insulin

3 molecules in skeletal muscle that directly require ATP binding and hydrolysis are the Sodium -Potassium ATPase pump, Myosin heads, and SERCA pumps, the calcium pumps located in the sarcoplasmic reticulum which pump calcium back in the SR after it was released to the cytoplasm during contraction.

true

Extrinsic factors that influence the stroke volume of the heart arise from changes that occur in the vasculature and intrinsic factors that influence stroke volume of the heart arise from changes that occur within the heart itself.

true

The PO2 of the blood is the primary determinant of the level of O2 saturation of hemoglobin.

true

The left ventricle must generate more pressure than the right ventricle because the left ventricle is required to drive blood throughout the body and the right ventricle just drives blood to the lungs (which are very near the heart).

true

A patient has a tumor in their pancreas which causes continuous hormone secretion from their pancreatic alpha cells. Using your knowledge of negative feedback loops and blood glucose regulation, select all the likely effects of the tumor from the given options when the patient is in the fed state.

insulin levels in the blood will be high Glycogen levels in the liver will be low glucagon levels in the blood will be high C-peptide levels in the blood will be high Glucose levels in the blood will be high

which of the following statements is true

insulin stimulates glycogen synthase in the liver insulin stimulates glucose uptake in the liver via GLUT2

where are SGLTS co transporters found?

kidney tubule

Ion channels can be open or closed by different types of gating signals. A channel that is open or closed by a molecule binding the channel is called a gated channel. A channel that is opened or closed by a specific change in voltage is called a gated channel.

ligand and voltage

Glucose uptake into resting skeletal muscle cells:

results in the breakdown of glycogen is enhanced in people with type I diabetes mellitus OCCURS VIA GLUT4 TRANSPORTERS IS INSULIN-DEPENDENT primarily requires the sodium glucose linked transporter (SGLT2)

The 3 ways that neurotransmitters can be removed from the synapse are 1) diffusion out of the synaptic space 2) by a transporter located on the (pre or post) synaptic nerve or 3) an enzyme on the post synaptic cell body.

reuptake and presynaptic

match the following hormones with their function

secretin- stimulates bicarbonate secret cholecystokinin (CCK)- stimulates bile acid secretion insulin- leads to a decrease in blood glucose Glp-1- stimulates insulin release

which of the following statements is true concerning the digestion and absorption of fat

the digestion of fat requires bile acids and lipase absorption is via the lymphatics triglycerides are digested into fatty acids and a monoglyceride

in diabetes mellitus

A therapy which acts on the pancreatic beta cells to stimulate the release of insulin would be helpful in type 2 diabetes

What is the name of the enzyme that breaks down acetylcholine at the neuromuscular junction.

Acetylcholinesterase AchE

in diabetes mellitus

a medication which stimulated pancreatic beta cells would be beneficial to treat Type II diabetes

In a resting cell, the membrane permeability to sodium is: low or high and the membrane permeability to potassium is: higher than or lower than sodium higher than

low and higher than

which of the following statement is true concerning the intracellular storage of glucose as glycogen

maintains a glucose concentration gradient, decreases the osmotic effect of glucose

Sequence the events of bicarbonate 'reabsorption' in the kidney

(HALF RIGHT) 1) NHE secretes H+ into the tubular lumen 2) CO2 diffuses across the apical membrane 3) carbonic anhydrase generates CO2 and H2O in the tubular lumen 4) bicarbonate is moved into interstitial fluid via Na+ -bicarbonate symporter

Put the following events in the correct sequence of activation for the somatic motor neuron pathway:

(in order) An action potential is propagated down the upper motor neuron Calcium levels increase in the nerve terminal causing vesicles containing glutamate to fuse with the membrane An action potential is propagated down the lower motor neuron Acetylcholine binds its receptor and causes depolarization Calcium levels increase in the cytoplasm of the muscle cell Contraction

1) What type of potential is occurring at the membrane at time B? graded 2) Are voltage gated sodium channels open at time B? No 3) What is the status of the activation gate at time D? open 4) What is the status of the inactivation gate at time D? closed 5) At what time point(s) are voltage gated potassium channels open? C, D and E 6) Can another action potential be fired at time E? yes

1) graded 2) no 3) open 4) closed 5) c,d,e 6) yes

order the following events in the digestion of carbohydrates

1) salivary amylase begins carbohydrate 2) brush border enzymes complete carbohydrate metabolism 3) glucose is absorbed into enterocytes via SGLT 4)glucose is transported out of enterocytes by GLUT2

1) Molecule that binds calcium and positions tropomyosin 2)An ATPase pump found on the SR 3)Binds actin to generate force 4)Clears the synapse of acetylcholine

1) troponin 2) SERCA 3) Myosin 4) acetylcholineesterase

Answer the following questions regarding the plot of the action potential: 1) The voltage-gated sodium channels are open at B 2) At time D, the activation gate of the voltage-gated sodium channels is open 3) At time D, the voltage-gated potassium channels are open 4) At time F, the inactivation gate on the voltage-gated sodium channel is open

1. False 2. True 3. True 4. False

what are products of the citric acid cycle

2 ATPS, NADH and 2 CO2

When hemoglobin is fully bound with oxygen it is said to be saturated. How many sites on Hemoglobin are filled with oxygen when it is saturated?

4

At a mountainous elevation of 18,000 feet, the total barometric pressure is 380 mmHg. If you maintained the same alveolar ventilation there as at sea level, what would your alveolar PO2 be closest to?

60mmHg (remember that water vapor is added to the air in the respiratory tract and anatomical dead space always exists and results in lowering of alveolar PO2 below the PO2 of the atmosphere.)

select all the options below that would result in elevated blood glucose level.

A GLUCAGON-SECRETING TUMOR IN THE PANCREATIC ALPHA CELLS inhibiting the breakdown of liver glycogen INSENSITIVITY OF THE INSULIN RECEPTORS an insulin-secreting tumor in the pancreatic beta cells inhibition of the SGLT2 transporter in the kidney tubule

Hypoxic vasoconstriction is

A mechanism to match vascular perfusion through pulmonary capillaries with alveolar ventilation and oxygenation

Below are 4 separate graphs showing a representative of the membrane potential observed from 4 excitable cells during an action potential. Each cell had an unusual change to an ion channel. Based on what you know from a normal cell's action potential, match the change in ion channel to the representative graph of the membrane potential.

A- Decreased Potassium leak channels open at rest B- The voltage-gated potassium channels open later C- Increased Potassium leak channels open at rest D- There are more positive charges on the voltage-sensor region of the voltage-gated sodium channels

Please match the following buffer systems with the appropriate description

ALL WRONG hemoglobin- rapid acting plasma buffer Phosphate- synthesized in the kidney to buffer secreted H+ ammonia- primary filtered buffer system in the kidney bicarbonate- intracellular buffer system

which of the following statement s are true concerning the aerobic metabolism of glucose

ATP synthase requires a high concentration of hydrogen in the inter membrane space the initial steps of glycolysis require ATP the citric acid cycle occurs in the mitochondria glycolysis and the citric acid cycle each produce 2 ATP

is the neurotransmitter that is released from lower motor neurons and binds and opens ligand gated sodium channels on the skeletal muscle membrane. is the enzyme that breaks down and inactivates the neurotransmitter at the neuromuscular junction.

Ach (acetylchline) and AchE (acetylcholinesterase)

Select all the incorrect statements regarding voltage gated sodium channels.

Action potential size will be relative to the signal size. Voltage gated sodium channels open when the membrane potential increases above -70 mV When a voltage gated sodium channel opens, so much sodium rushes into the cell that the sodium concentration inside the cell gets close to the sodium concentration outside the cell.

Select the statement that is FALSE regarding the ventricular pressure volume relationship.

Afterload is set by the end-diastolic volume and determines the point when the atrial-ventricular valve opens.

Which of the following is FALSE regarding exhalation in a healthy quietly-breathing person?

Alveolar pressure goes below atmospheric pressure

while a healthy person is in the fed state

C-peptide will be in the blood

Which statement about the factors that affect the affinity of hemoglobin for oxygen are FALSE?

CO2 increases the affinity of oxygen for hemoglobin so that hemoglobin binds oxygen more strongly.

Select the pair that is an appropriate match.

Epinephrine and norepinephrine: increased heart rate and strength of contraction

Match the following with their function

HALF RIGHT Type I alveolar cells- gas exchange type II alveolar cells- H+ secretion intercalated cells in collecting duct- surfactant production principal cells in collecting duct- sodium reabsorption

In the following curve, the solid blue line represents normal. Select all of the following statement that are TRUE about the red and green curves

HALF RIGHT red line=decreased affinity; green line=increased affinity the shift to the red line may be caused by decreased pH the shift to the green line may be due to high altitude

Most CO2 is transported through the blood

In the form of bicarbonate (HCO3-)

What acid-base disturbance would result from a decreased ability of the kidney to reabsorb bicarbonate and what might be the body's compensatory response?

Metabolic acidosis, respiratory rate increases

What 2 molecules do the SGLTs transport?

Na and glucose

the ____ transporter in the nephron tubule allows for the reabsorption of glucose back to the blood.

Na+ glucose linked transporter, SGLT2 sodium glucose linked transporter 2

Order the sequence of sodium reabsorption in the kidney

ONE IS RIGHT 1) Na+K+2Cl 2) SGLT 3)ENaC

At an oxygen saturation of 50%, what is the oxygen partial pressure in the blood for the 4 patients' hemoglobin saturation curves below?

Patient 1: 100 Patient 2: 25 Patient 3: 35 Patient 4: 75

According to the hemoglobin saturation curve below, how much oxygen do Patients X, Y, and Z deliver if the amount of oxygen in blood LEAVING the lungs is 85 mm Hg and the amount of oxygen in the blood RETURNING TO the lungs is 45 mm Hg?

Patient X: 40 Patient Y: 45 Patient Z: 42

Where is the partial pressure of oxygen highest in a normal, resting person?

Pulmonary vein

what can you infer from the following graphs

SGLT2 is saturated at blood glucose of 6

which answer is false regarding the transport of glucose across cell membranes?

THE TRANSPORT OF GLUCOSE FROM THE NEPHRON TUBULE BACK TO THE BLOOD CAUSE WATER TO BE EXCRETED VIA OSMOSIS the SGLT2 utilizes secondary active transport glucose moves into cells through the GLUT4 transporter down its concentration gradient the SGLT2 is an example of cotransport

In comparison to the partial pressure of oxygen (PO2) in atmospheric air:

The PO2 in the alveoli is lower because some air stays in the lungs at the end of expiration.

During an action potential:

The opening of voltage-gated sodium channels allows a region of a neuronal membrane to rapidly depolarize.

If the heart becomes less compliant due to chronic fibrosis, how does this change affect the ventricular pressure volume relationship?

The slope of a-b is increased

Select all the correct answers regrading making an ECG recording:

The strongest reading and largest peaks are measured from the electrodes aligned parallel from how the ventricles are aligned in the chest. If cardiac myocytes become damaged they will no longer normally conduct the action potential often causing an altered ECG signal Gap junctions allow the spread of action potentials from nodes to cardiac myocytes and the general spread of electrical activity is seen as the ECG waveforms The QRS waveform is due to the spread of ventricular depolarization

Which of the following intrinsic or extrinsic changes would result in an increase in stroke volume?

Venous constriction

In tissues with high cellular respiration, the high levels of CO2 being produced

WRONG ANSWER (Increase affinity of hemoglobin for O2)

Graded or action [_______] potentials are large changes in localized membrane potential that are either all or none and once initiated, will travel the distance of the axon.

action

match the digestive enzymes with their site of action and target

amylase- intestine, carbohydrates trypsin- intestine, proteins lipase- intestine, lipids pepsin- stomach, proteins

The arterial side of the vascular system is known as a pressure reservoir whereas, the venous side of the vascular system is known as the volume reservoir.

arterial and venous (veins)

which organ does not utilize fatty acids?

brain

what is the name of the peptide that is released from the pancreatic beta cells when insulin is released?

c-peptide

If a positively charged ion, a , moves into a cell, the membrane potential will become less or more negative. If a negatively charged ion , an anion moves into the cell, the membrane potential will become more negative.

cation and less

which of the following hormones regulate the secretion of cortisol

cortisol, ACTH, CRH

which is the correct sequence of events in the digestion of proteins

denaturation of proteins; enzymatic digestion of peptides; secondary active transport of amino acids into intestinal epithelial cells; facilitated diffusion into the circulation

When a neuronal cell becomes it makes the cell more excited. When a neuronal cell becomes it inhibits the cell.

depolarized (less negative) and hyperpolarized (more negative)

which of the following statements is true regarding bile salts

emulsify triglycerides in the intestines released in response to CCK

Select all that directly modulate force of cardiac contraction:

epinephrine binding to beta1 receptors sympathetic stimulation

An ECG measures the membrane potential within a cardiac myocyte undergoing an action potential.

false

GLUT4 transports glucose from the blood into liver cells?

false

the drug SU causes pancreatic beta cells to secrete more insulin into the blood than normal as a way to combat insulin receptor insensitivity in type II diabetics. Do you expect a patients blood C-peptide levels to be higher or lower than normal if they are taking SU?

higher

Which of the following is TRUE concerning respiratory alkalosis

hyperventilation may be the cause

Which electrolyte imbalance could be due to an excess of exogenous administration of insulin.

hypokalemia

which of the following is a therapeutic target for type II diabetes

increasing insulin receptor semitivity inhibiting SGLT2 transporters in the kidney increasing insulin release from beta cells in the pancreas

Where will GLUT4 transporters be located of resting skeletal muscle in the fasted state?

intracellular, in vesicles, inside

which of the following statements about the Na+/K+ pump is true

it transports K+ into the cell and Na+ out of the cell it is an antiporter its activity requires ATP

during a glucose challenge, would a patient with type I diabetes secrete more or less insulin compared to normal?

less

glucose uptake into muscle and fat cells

occurs by facilitated diffusion through GLUT4s

Select all of the following statements that are TRUE

peripheral chemoreceptors sense pO2 and pCO2 central chemoreceptors sense pCO2 a low pO2 (less than 70) can stimulate increased respiration

Where on the pressure-volume loop is end-systole?

point D

A person is wearing compression stockings that increase the return of blood from the systemic veins to the right atrium, right ventricle, lungs and then to the left atrium and therefore the left ventricle. This increases end diastolic volume. How would compression stockings alter the pressure-volume loop?

preload increases

Select all that are TRUE of the CO2-bicarbonate buffer system requires carbonic anhydrase is limited by end-product accumulation is regulated only the by lung is an important extracellular buffer system (I think it is this one) the reaction is reversible and driven by mass balance

requires carbonic anhydrase the reaction is reversible and driven by mass balance !!!THERE IS ONE MORE CORRECT ANSWER!!!

Select all that are TRUE of parathyroid hormone (PTH)

secreted in response to low plasma Ca++ increases calcium release from the bone effects are antagonized by calcitonin

Primary active transport uses the energy obtained from cleaving ATP to pump Na ions out of the cell and K ions into the cell.

sodium and potassium

For blood to flow there must be 2 things, a pressure gradient and a pathway. The pressure gradient is caused by contraction of the heart. The term for this is The term for when the heart is not contracting is

systole diastole

Since Hemoglobin is found in red blood cells, the number of red blood cells will affect the oxygen carrying capacity of a patient's blood.

true

True or False. Action potentials can rapidly send a signal along the entire length of a neuronal axon.

true

diabetes mellitus, type I is characterized by the inability of the pancreatic beta cells to secrete insulin. diabetes mellitus, type II is characterized by having less sensitive or resistance insulin receptors.

type I, type II

According to the picture below, select all the patients that would be helped from a blood transfusion?

why, zee

if a type I diabetic gave them self an insulin injection just after a meal, what will their blood levels of C-peptide be?

zero

Arteriole constriction will cause:

An increase in afterload and a decrease in stroke volume

Venous constriction will cause:

An increase in preload and an increase in stroke volume

Expansion of the thoracic cavity increases its volume. This

Decreases the pressure in the cavity

Sequence the following steps of the cardiac cycle in order of what comes first starting at the left side of the heart

(in order) As blood returns from the lungs it flows into the left atria, through the AV valve, into the ventricle The atria cells depolarize and contract to squeeze the last bit of blood out to the ventricle The ventricular cells depolarize and begin to contract As pressure begins to rise in the ventricle, pressure goes above atrial pressure, which closes the AV valve The ventricle continues to contract generating pressure but the valves are closed Ventricular pressure goes above the pressure in the aorta causing the aortic valve to open The ventricle continues to contract and blood is ejected out of the ventricle into the aorta Blood moves from the aorta to the rest of the vascular system bringing oxygen and nutrients to the tissues

Sequence the order of electrical activation of the heart from 1-6:

(in order) SA node atrial cells AV node bundle of his purkinje fibers ventricles

Order the following steps in sequence for normal synaptic signaling.

(in order) Voltage gated sodium channels send an action potential towards the nerve terminal Voltage gated calcium channels open Calcium comes into the nerve terminal Vesicles fuse with the membrane and release neurotransmitter into the synaptic space Neurotransmitter binds its specific receptor and causes a graded potential Neurotransmitter is removed from the synaptic cleft

Listed below are steps from the sequence of excitation-contraction coupling in skeletal muscle cells. Select all the steps that have errors.

Calcium binds to tropomyosin Voltage-gated calcium channels open to allow calcium into the SR Voltage-gated calcium channels open allowing calcium to enter the skeletal muscle cell from the extracellular fluid

Select the INCORRECT statement regarding gases:

Carbon monoxide in the air results in a significant reduction in the PO2 of the arterial blood.

Select the statement that is not true of both cardiac muscle and skeletal muscle.

Cardiac and skeletal muscle cells require innervation by a nerve to contract.

Starting at the ventricular filling phase, put the following steps of the cardiac cycle in order from first to last.

(in order) AV valve closes Isovolumetric contraction Aortic valve opens Ejection Aortic valve closes Isovolumetric relaxation

put the following steps involved in blood glucose regulation in order starting with having a glucose containing meal

(in order) glucose is absorbed from the intestine to the blood blood glucose increase pancreatic beta cells sense increased blood glucose insulin is released into the blood insulin binds to insulin receptors on target cells GLUT4 glucose transporters will take up glucose into skeletal muscle and fat cells blood glucose levels decrease

Sequence the order of blood flow through the heart starting where it returns to the heart from the body. Hint: remember the blood in the right side of the heart is lower in oxygen and the blood in the left side of the heart is higher in oxygen.

(in order) right atrium right ventricle pulmonary artery lungs left atrium left ventricle aorta body

match the following metabolic reactions with their function

1) Cori cycle- the conversion of lactic acid to pyruvate in the liver 2) urea cycle- allows excretion of amino groups 3) B-oxidation- the production of acetyl CoA from fatty acids 4) Glycolysis- the conversion of glucose to 2 pyruvates 5) Lipogenesis- the generation of triglycerides

A patient is given a drug that increases atrial pressure. Which corner(s) on the traditional pressure volume curve (a, b, c, d) would change? And for the corner(s) that changed would the pressure be higher or lower than normal?

a, higher

1) An 11 year-old is to have his gall bladder removed. He is known to have one copy of an abnormal hemoglobin gene. This abnormal hemoglobin gene has extra high affinity for oxygen. If the normal hemoglobin curve is the middle line, which curve is for the high affinity hemoglobin found in this patient? 2) According to this curve, how much oxygen would be delivered to this patient's tissues if their arterial PO2 is 100 mmHg and their venous PO2 is 40 mmHg ~20% ? 3) During surgery, anesthesia depresses cellular function so venous PO2 often increases to ~50 mmHg. According to the patient's curve, how much oxygen will be delivered to the patient's tissues if the venous PO2 is ~50 mmHg during surgery? 4) Will breathing via ventilator (air will contain 95% oxygen) help this patient?

1) dotted blue line 2) ~20% 3) <5% 4) no (Since this patient harbors a mutant hemoglobin molecule that has increased affinity for oxygen, less oxygen will be delivered to the patient's tissues. Although the patient may be okay under normal conditions (delivery is only reduced from ~30% to 20%, this patient would have very compromised oxygen delivery to their tissues under anesthesia when all their cell's functions are depressed and the venous PO2 levels don't fall enough to get to the steeper part of the affinity curve to unbind oxygen. Loading oxygen is not the issue so breathing air containing 95% will not help. Instead, this patient suffers from compromised oxygen unloading/delivery. This patient will need a blood transfusion that contains normal hemoglobin molecules so that they can undergo anesthesia during the surgical procedure.)

Order the following steps in sequence for the somatic motor neuron pathway.

Action potential in the lower motor neuron Calcium enters the nerve terminal Vesicles fuse with the membrane Acetylcholine binds the acetylcholine receptors (ligand gated sodium channels) Activation of voltage gated sodium channels on the muscle membrane Calcium released from internal skeletal muscle stores called the sarcoplasmic reticulum Contraction is initiated

Select all the incorrect statements regarding kidney regulation of blood pressure.

Aldosterone is released from the anterior pituitary Sodium reabsorption in the proximal tubule is modulated to regulate blood pressure If more water is excreted, blood volume should increase

Select all the true statements regarding respiration and the exchange of gases between the environment and the tissues.

Due to the very thin membranes, diffusion of gases between the alveoli and pulmonary capillaries is very fast and efficient For inspiration, the volume of the lungs increases causing the pressure in the lungs to go below atmospheric air pressure For oxygen delivery to the tissues, the affinity between oxygen and hemoglobin must decrease when the partial pressure of oxygen falls Rapid diffusion allows for equilibration of the PO2 between the alveoli and the pulmonary capillaries and the arterial blood. Oxygen poorly dissolves in blood plasma

True or False. As soon as there is a large concentration gradient of an ion, the ion immediately flows back down its concentration gradient.

False

The calcium that triggers vesicles to fuse with the membrane of the lower motor neuron comes from the same source as the calcium that causes skeletal muscle contraction.

False The calcium that triggers vesicles to fuse comes from the extracellular fluid around the lower motor neuron. The calcium that causes skeletal muscles to contract comes from the sarcoplasmic reticulum, a specialized endoplasmic reticulum, found within the skeletal muscle cells.

Select all that are true:

Filling occurs when the ventricle is relaxed In isovolumetric contraction the ventricle is contracting but all valves are closed When all valves are closed blood cannot flow Valves in the heart open only one-way When the ventricular muscle cells depolarize this leads to contraction Since the ventricular myocytes are connected by gap junctions, they contract as a unit and this generates pressure on the blood.

Select the false statement about GLUT4 transporters.

GLUT4s are important to take up excess glucose from the blood to fat and muscle cells GLUT4s are the glucose transports in fat cells Insulin binding to insulin receptors allows GLUTS to transport glucose into muscle cells in the absence of insulin, GLUT4s are found inside resting muscle cells THEY ARE FOUND AT THE MEMBRANE OF SKELETAL MUSCLE ALL THE TIME

The name of the protein that binds oxygen with high affinity is:

Hemoglobin

Select all the true statements regarding normal hemoglobin:

Hemoglobin is found inside red blood cells Hemoglobin has a relatively lower affinity for oxygen when the PO2 is below 60 mm Hg. Hemoglobin has a safety zone for oxygen binding so that even when the PO2 of oxygen slightly falls hemoglobin remains highly saturated. Hemoglobin has a higher affinity for oxygen when the PO2 is high.

Select the statement that is INCORRECT.

Hemoglobin's affinity for CO2 is greater than O2.

During contraction of a skeletal muscle fiber, myosin binds to actin which can result in filament sliding. Select all the regions of the skeletal muscle fiber, as seen by microscopy, that will shorten in length during contraction?

I band (The I band is the light region which is composed of the thin filament and no thick filament. When muscle cells shorten, there is more overlap between the thick and thin filament so the length of the I band is reduced) H band, (the H band is the area in the middle of the thick filament where there is no thin filament overlap. The length of the H band would be reduced as the muscle cell shortens and thin filaments move towards the center of the sarcomere.)

What type of ligand gated sodium channels are located at the skeletal muscle membrane in the neuromuscular junction?

NAchR Acetylcholine receptors Nicotinic Acetylcholine Receptors The type of acetylcholine receptors are nicotinic.

According to the table below showing hematocrit and pulse oximeter values, select the patients that may be helped by both supplemental oxygen and getting a blood transfusion?

Nu

Select all the answers that are true for chemoreceptors located in the carotid bodies and aortic arch:

Once activated, respond quickly to regulate respiratory rate (The central chemoreceptors provide the major control of respiratory rate but act slowly. The peripheral chemoreceptors act quickly but not until PO2 levels drop to ~60 mmHg.) Sense arterial blood levels of PO2 and PCO2 Sense PCO2 of the arterial blood. Sense PO2 when it drops <60mmHg.

Select the answers which correctly matched the names of the waves seen on an ECG recording with the region of the heart which is undergoing a change in electrical activity.

P: Atrial depolarization QRS: Ventricular depolarization T: Ventricular repolarization

During surgery, the anesthesia given causes breathing slow to slow. This lowers PO2 in the alveoli but also lowers the O2 consumption of the tissues which raises pO2 in the venous blood. On room air, measurement of pulse oximeter oxygen saturation provides a good estimate of adequate breathing (and adequate CO2 removal) if the patient has normal hemoglobin. Two patients harboring mutations in hemoglobin are to undergo surgery. Their mutant hemoglobin oxygen binding curves are shown below. What is the oxygen saturation level in each patient under anesthesia when they have a decrease in breathing and a decrease in alveolar PO2 to 80 mm Hg? Patient 1: 100% Patient 2: 83% If both patients PO2 in the venous blood is 60 mm Hg, how much oxygen did each patient deliver to the tissues while under anesthesia? Patient 1: 100 % Patient 2: 60%

Patient 1: 99% Patient 2: 91% Patient 1: 0% Patient 2: 10%

Examine the pressure volume loops below. To be able to compare the PV loops from patient to patient, the diagonal purple line for all the plots is the ESPVR line for the reference patient. The actual ESPVR line for each individual lettered patient may or may not be different from the reference patient. Match the Patient's pressure volume loop with the intrinsic or extrinsic alteration.

Patient 1: Contractility Patient 2: Afterload, no change in contractility Patient 3: Compliance Patient 4: Preload, no change in compliance

A patient who is excited would have an increase in sympathetic activity and this will increase contractility. For these questions, make the simplifying assumption that the heart rate does NOT change. Select all the statements that describe the changes that occur to the ventricular pressure-volume loop.

Stroke volume increases Ejection fraction increase Steeper ESPVR line A higher ventricular pressure can occur at a lower volume

As you are walking home from studying at the library late one evening, you get startled by a strange sound behind you. This activates your sympathetic nervous system. What affect does this change have on stroke volume?

Stroke volume will increase due to an increase in contractility

Select the statement that is false regarding pulmonary surfactant.

Surfactant is produced by type I alveolar cells Surfactant is produced by type II alveolar cells. Type I alveolar cells make up the wall of the alveolar sacs.

select all the correct statements regarding the transport of glucose across cell membranes

THE SGLT2 IS AN EXAMPLE OF SECONDARY-ACTIVE TRANSPORT the transport of glucose from the nephron tubule back to the blood causes water to be excreted via osmosis GLUCOSE ABSORPTION OCCURS THROUGH GLUCOSE TRANSPORTERS IN THE SMALL INTESTINE glucose moves into the liver cells through the GLUT4 transporter down its concentration gradient GLUT4 transporters are typically insulin-independent

Select the answer that is false regarding the effects of Carbon monoxide:

The central chemoreceptors will detect the reduction in oxygen delivered to the cells and will increase their firing rate.

During inspiration:

The diaphragm contracts and moves downward to decrease the pulmonary pressure.

Select the incorrect statement regarding external respiration.

The partial pressure of CO2 in the arterial blood is the same as the venous blood.

a patient was brought to the emergency department not feeling well and showing signs of confusion and extreme lethargy. Their blood work showed low blood glucose levels, high blood insulin levels, high C-peptide levels, and high glucagon levels. Which of the following might best explain the cause of their symptoms?

The patient has an insulin-secreting pancreatic tumor

A patient underwent assessment of their cardiovascular health. One of the procedures done was ventricular pressure-volume measurements. The clinical patient's pressure-volume loop is on the right. A reference pressure-volume loop of a "normal" patient is on the left. Select the answer that best fits with the clinical patient's current health status during the assessment.

The patient has elevated blood pressure

Select the FALSE statement regarding valves in the heart.

The valves have to contract to open or relax to close.

Select all the answers that correctly complete the statement: At the neuromuscular junction,

To terminate contraction, acetylcholine is broken down by acetylcholinesterase at the muscle cell membrane. Opening of nicotinic acetylcholine receptors increases the sodium permeability of the skeletal muscle membrane.

Select all the statements that are true during the Ejection phase of the cardiac cycle.

Ventricles are contracting Aortic Valve is open Ventricular pressure is greater than aortic pressure Ventricular Systole

Select all the statements that are true during the ejection phase of the cardiac cycle.

Ventricular Systole Ventricular pressure is greater than aortic pressure Ventricles are contracting Atrial pressure is less than ventricular pressure Aortic Valve is open The AV valves are closed

Listed below are steps from the sequence of excitation-contraction coupling in skeletal muscle cells. Select all the steps that have errors.

Voltage gated calcium channels open and calcium moves out of the nerve cell terminal. (calcium moves into the nerve terminal) Acetylcholine binds muscarinic acetylcholine receptors on the skeletal muscle cell membrane (nicotinic acetylcholine receptors) Sodium moves into the muscle cell hyperpolarizing the membrane triggering voltage gated sodium channels to open. (depolarizing) Voltage gated calcium channels open allowing calcium to move from the extracellular fluid to the cytoplasm of the muscle cell. (sarcoplasmic reticulum) Calcium binds to tropomyosin to allow myosin to bind actin and generate force. (calcium binds to troponin)

Movement of air into the lungs is the result of

WRONG ANSWER (Positive pressure within the intrapleural space)

Most filtered potassium is reabsorbed in

WRONG ANSWER (The proximal tubule via Na+K+2Cl transporter)

Acidosis _________________ plasma K+ levels due to __________________.

WRONG ANSWER (decreases, potassium exchange for hydrogen)

Select the INCORRECT statement regarding gases:

When you go to higher elevation, the O2 composition is reduced below 21% of the atmospheric air.

Select the INCORRECT statement regarding gases:

When you go to higher elevation, the O2 composition is reduced below 21% of the atmospheric air. This is not true, The total atmospheric pressure is reduced at higher elevations but the oxygen still makes up 21%. Since total atmospheric pressure is lower, 21% of that lower total pressure reduces oxygen partial pressure.

A patient underwent a glucose tolerance test in the clinic. According to the results which are shown in the two plots below, what is the blood glucose concentration that saturates the patients SGLT2 transporters? (hint: A ruler or straight edge will again help you be precise).

[Glucose] = 150

A decrease in the affinity of binding between oxygen and hemoglobin indicates a patient must have decreased O2 delivery to their cells.

false A decrease in affinity most likely indicates less binding of oxygen to hemoglobin in the arterial blood, however, unloading of oxygen in the tissue capillaries may be enhanced.

Once initiated in a presynaptic neuron, an action potential will be directly transmitted to the post-synaptic neuron.

false Electrical signals can only be transmitted along the membrane of one neuron and can't pass directly through the synaptic space between the neurons. Instead the electrical signal that reaches the nerve terminal of the pre-synaptic neuron must be converted to a chemical signal to pass through the synaptic space and bind to a ligand gated channel on the cell body/dendrites of the post-synaptic nerve.

Voltage-gated sodium channels open any time the membrane depolarizes.

false The depolarization must reach threshold.

Provided below are the pressures in the left atrium, left ventricle, and aorta at a given point during the cardiac cycle of two different NORMAL patients. Based on the three pressures, what phase of the cardiac cycle is patient 1 in? Based on the three pressures, what phase of the cardiac cycle is patient 2 in? Patient 1 Atrial pressure: 15mmHg Ventricular pressure: 10 mmHg Aortic pressure: 90 mmHg Patient 2 Atrial pressure: 10 mmHg Ventricular pressure: 90 mmHg Aortic pressure: 118 mmHg

filling and isovolumetric relaxation

junctions allow the electrical activity in one cell to pass directly to the neighboring cell.

gap

a pharmaceutical company has developed a drug that can bind and activate insulin receptors all the time. which of the following is a likely consequence of this drug?

glucagon secretion from pancreatic alpha cells should increase

which answer is false regarding the role of glucagon

glucagon signals skeletal muscle cells to release glucose to the blood

in the fasting state

glucagon will stimulate the breakdown of glycogen

what is the name of the glucose transporters found on skeletal muscle and fat cells?

glucose transporter 4 or GLUT4

what is the name of the polymer which is the stored form of glucose

glycogen

in the fasted state

glycogen will be converted to glucose

which of the flowing is the correct sequence of the events in the aerobic respiration of glucose

glycolysis, citric acid cycle, electron transport/ oxidative phosphorylation

A [____________] graded or action potential is a small change in localized membrane potential that varies in magnitude relative to the triggering event.

graded

A leftward shift in the O2-hemoglobin saturation curve indicates an increase or a decrease in the affinity of binding between oxygen and hemoglobin. A rightward shift in the O2-hemoglobin saturation curve indicates an increase or a decrease in the affinity of binding between oxygen and hemoglobin.

increase and decrease

Based on mass balance of the reaction CO2+H2O-><-H2CO3-><-H+ +HCO3

increased CO2 - decreased pH decreased CO2 - decreased bicarbonate increased bicarbonate- increased CO2

When blood glucose levels increase, more glucose get filtered to the kidney.

more

is GLUT4 expressed in liver cells?

no

In the somatic motor neuron pathway, how many neurons run from the spinal cord to the target skeletal muscle cell (the peripheral nervous system)? What is the name of this/these neuron(s)?

one and lower (lower motor neuron)

when will glucose show up in the urine?

only when blood glucose levels get very high and saturate the SGLTs

The negative resting membrane potential of neuronal cells is a result of some ions flowing down their concentration gradient at rest and these ions are flowing into or out of the cell.

potassium and out of

anaerobic metabolism of glucose

produces less ATP per glucose than aerobic pathways can occur in skeletal muscles

A decrease in PO2 in a pulmonary capillary bed will result in vasoconstriction of the arterioles that control blood flow to those pulmonary capillaries.

true. When an alveolar sac has reduced ventilation, the PO2 levels will fall. If the capillaries that bring blood flow to that alveolar sac remain open, this will result in a reduction in the PO2 of the blood leaving the lungs and lead to a reduction in arterial PO2. That would not be good. A very important regulatory control mechanism exists to try to maintain high arterial PO2 levels. Thus, when the arterioles sense low PO2 levels in pulmonary capillaries, this causes the arterioles controlling the blood flow to those capillaries to constrict. This way less blood flows to areas where the alveolar are poorly ventilated. Instead, blood flow can be redirected to just the alveolar sacs that are well ventilated and receiving lots of fresh air with higher PO2 levels. If this feels a little counter-intuitive to what you learned for the regulation at the tissues it is. When PO2 levels decrease at the tissues, the arterioles dilate to try to send oxygen carrying blood to the cells that need it. To keep these two different areas/effects straight remember the main purpose of the two separate capillary beds. The pulmonary beds are to get oxygen into the blood. The tissue beds are to bring oxygen to the cells that need it the most.

Activation or opening of ________ gated sodium channels located along a neuronal cell can send a signal all the way from a sensory receptor neuron all the way to the central nervous system or the brain.

voltage

water will move into a cell if

water channels are present and intracellular osmolarity is higher than extracellular

which of the following is not a potential adverse effect of type I diabetes

weight gain

According to the plot below, what is the glucose concentration that saturates the SGLT2? Same plot, how much glucose will be in the urine at a blood glucose concentration of 12?

where the line plateaus, 5 I dont know how I got this answer but, 7

Select all patients who would be helped from breathing supplemental oxygen, (100% oxygen).

zee, ex


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