MULTIPLE CHOICE (2 points each). Questions 1-35 must be answered on the computer form to receive credit. Choose the one best answer.

1. Plasma contains all of the following EXCEPT
A) glucose.
B) oxygen.
C) hemoglobin.
D) electrolytes.
E) clotting factors.

2. A hematocrit reading of 45% indicates that
A) 45% of the blood is made up of white blood cells.
B) 45% of the blood is made up of red blood cells.
C) 45% of the blood is made up of cells, BOTH red and white blood cells.
D) 45% of the blood is made up of plasma.

3. The class of plasma proteins that produces antibodies is
A) albumins.
B) alpha globulins.
C) beta globulins.
D) gamma globulins.
E) fibrinogen.

4. Erythropoietin
A) stimulates red blood cell synthesis.
B) stimulates white blood cell synthesis.
C) is released in response to a decrease in blood flow to the bone marrow.
D) A and C
E) B and C

5. In which of the following types of white blood cells do the cytoplasmic granules stain
preferentially with red-staining dyes?
A) Neutrophils
B) Basophils
C) Eosinophils
D) Lymphocytes
E) Monocytes

6. What type of white blood cell differentiates into macrophages in the tissue?
A) Neutrophils
B) Basophils
C) Eosinophils
D) Lymphocytes
E) Monocytes

7. Which of the following is activated by both the intrinsic and extrinsic clotting
pathways?
A) Thrombin
B) Factor XIII
C) Both
D) Neither

8. What converts fibrinogen to fibrin?
A) Thrombin
B) Thromboxane A2
C) Factor XIII
D) Tissue thromboplastin
E) ADP

9. Which of the following statements about pulmonary pressures is true?
A) Alveolar pressure is always subatmospheric.
B) Intrapleural pressure is always greater than alveolar pressure.
C) Alveolar pressure is always greater than intrapleural pressure.
D) Intrapleural pressure equals atmospheric pressure.

10. The elastic recoil of the lungs and chest wall are both at equilibrium with the
intrapleural pressure when the volume of air in the lungs equals the
A) Tidal Volume
B) Functional Residual Capacity
C) Residual Volume
D) Vital Capacity
E) Forced Vital Capacity

11. Which of the following statements about inspiration is FALSE?
A) Contraction of the diaphragm increases the volume of the thoracic cavity.
B) Movement of air into the lungs increases the volume of the thoracic cavity.
C) Pressure in the lungs decreases due to an increase in volume.
D) Movement of air into the lungs increases alveolar pressure.
E) Alveolar pressure equals atmospheric pressure at both the beginning and end of
inspiration.

12. Which of the following statements about expiration is FALSE?
A) During quiet breathing, expiration is a passive process.
B) Contraction of expiratory muscles can increase the volume of air expired.
C) Expiration occurs when alveolar pressure exceeds atmospheric pressure.
D) The volume of air in the lungs at the end of a forced expiration is the
functional residual capacity.
E) Following a maximum inspiration, a healthy person can exhale 80% of the forced
vital capacity in 1 second.

13. Aldosterone is
A) released in response to low serum [K+].
B) released in response to high serum [Na+].
C) a peptide hormone.
D) a mineralocorticoid.
E) produced in the hypothalamus.

14. Pulmonary surfactant
A) decreases the surface tension of alveoli.
B) is secreted by Type I alveolar cells.
C) is secreted by Type II alveolar cells.
D) A and B
E) A and C

15. A person who has a tidal volume of 450 ml/breath, a respiration rate of 10
breaths/min, and an anatomic dead space volume of 150 ml will have an alveolar
ventilation rate of
A) 3000 ml/min
B) 4000 ml/min
C) 4500 ml/min
D) 5000 ml/min
E) 6000 ml/min

16. The same person from question 15 will have a minute ventilation rate of
A) 3000 ml/min
B) 4000 ml/min
C) 4500 ml/min
D) 5000 ml/min
E) 6000 ml/min

17. If air is composed of 10% gas X (molecular weight = 1) and 90% gas Y (molecular
weight = 2), then the partial pressure of X at sea level, where atmospheric pressure
is 760 mmHg, would be
A) 7.6 mmHg
B) 10 mmHg
C) 38 mmHg
D) 76 mmHg
E) 152 mmHg

18. Acid-Base balance is important for
A) normal enzyme functions.
B) normal metabolite solubility.
C) normal membrane potentials.
D) A and C
E) All of the above

19. If ventilation of an alveolus decreases,
A) an increase in pCO₂ causes the airways to dilate.
B) blood flow to the alveolus increases.
C) pulmonary arterioles to the alveolus constrict.
D) A and B
E) A and C.

20. The amount of oxygen unloaded from hemoglobin at the tissue level increases when
A) pCO₂ in the tissue increases.
B) The concentration of DPG in the erythrocytes increases.
C) Temperature increases.
D) A and C
E) All of the above

21. What is the primary method by which O₂ is transported in the blood?
A) Physically dissolved
B) As bicarbonate
C) As carbonic anhydrase
D) Bound to hemoglobin
E) Bound to erythropoietin

22. What is the primary method by which CO₂ is transported in the blood?
A) Physically dissolved
B) As bicarbonate
C) As carbonic anhydrase
D) Bound to hemoglobin
E) Bound to erythropoietin

23. A comatose patient is brought into a hospital emergency room and analysis of a blood
sample provides the following data: [CO₂] = 1.3 mM (normal range: 1.1 – 1.4 mM)
and [HCO₃^-] = 13 mM (normal range: 22-28 mM). This patient is suffering from a
severe case of
A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic acidosis.
D) metabolic alkalosis.
E) sleep deprivation.

24. Metabolic acidosis has what effect on ventilation?
A) Increases ventilation by stimulating peripheral chemoreceptors.
B) Increases ventilation by stimulating central chemoreceptors.
C) Decreases ventilation by stimulating peripheral chemoreceptors.
D) Decreases ventilation by inhibiting central chemoreceptors.

25. Which of the following statements concerning the peripheral chemoreceptors is
FALSE?
A) Peripheral chemoreceptors are stimulated whenever the arterial pO₂ falls
below normal.
B) Peripheral chemoreceptors are stimulated when blood pH decreases, regardless of
whether pCO₂ changes.
C) Peripheral chemoreceptors are located at the bifurcation of the carotid arteries and
at the aortic arch.
D) When stimulated, peripheral chemoreceptors reflexly increase ventilation.

26. Which of the following statements about Atrial Natriuretic Peptide (ANP) is FALSE?
A) ANP is a peptide hormone
B) ANP increases GFR by relaxing the contractile cells surrounding the filtration
slits.
C) ANP is secreted when myocardial cells in the atria stretch more than normal.
D) ANP increases reabsorption of sodium and water in the collecting duct.

27. Given that GFR = 125 ml/min, plasma concentration of substance X = 1 mg/ml, and
urine excretion rate of X = 10 mg/min, then
A) There is a net reabsorption of X in the kidneys.
B) There is a net secretion of X in the kidneys.
C) There is no net reabsorption or secretion of X.
D) There is not enough information provided to determine the fate of X in the kidney.

28. You go back-packing in the Andes moountains, which have a very high altitude.
Which of the following will occur during the first few days of your trip (prior to any
long term adaptations)?
A) pO₂ of alveoli decreases
B) pO₂ of blood decreases
C) pCO₂ of blood decreases
D) pH increases
E) All of the above

29. Which of the following is NOT a normal constituent of the glomerular filtrate?
A) Glucose
B) Sodium
C) Potassium
D) Protein
E) Water

30. Urine is carried to the urinary bladder by
A) blood vessels.
B) lymphatics.
C) ureters.
D) urethra.

31. The Na⁺/K⁺-ATPase transport system that is critical for much of the tubular
reabsorption is located in the
A) luminal membrane of the tubular cells.
B) basolateral membrane of tubular cells.
C) basement membrane.
D) glomerular capillary membrane.

32. Which of the following statements about the renal counter-current mechanism is
true?
A) The descending limb of the Loop of Henle is permeable to water.
B) The ascending limb of the Loop of Henle is impermeable to water.
C) Sodium and Chloride are actively transported out of the lumen of the ascending
limb of the Loop of Henle to the interstitial Fluid.
D) A and C
E) All of the above

33. The glomerular filtration rate (GFR) is regulated by
A) the myogenic response of the afferent arteriole.
B) sympathetic neural control.
C) angiotensin II
D) A and C
E) All of the above

34. All of the following conditions tend to induce acidosis EXCEPT
A) vomiting.
B) diabetes mellitus.
C) diarrhea.
D) obstructive pulmonary disease.
E) exercise.

35. Assuming normal average renal blood flow of 625 ml/min, what volume of fluid is
reabsorbed from the ascending Loop of Henle?
A) 625 ml/min
B) 125 ml/min
C) 100 ml/min
D) 0 ml/min
E) depends upon osmolarity of plasma

Short answer and fill-in the blanks. PRINT answers directly on the exam as indicated. Points for each question are as indicated.

36. (2 points) Fill in the blanks.

     What nerve innervates the diaphragm? ________________________________

     Will this nerve fire during inspiration or expiration? ________________________________

37. (2 points) Fill in the blanks.

______________________________ refers to a ventilation rate that exceeds the metabolic needs of the body, whereas _______________________________ refers to an increased ventilation rate that matches the metabolic needs of the body.

38. (3 points) The medulla contains two areas that control respiration, a dorsal respiratory group and a ventral respiratory group. For each area, state whether it contains inspiratory neurons, expiratory neurons, both or neither. Which group is active during normal quiet breathing?

     Dorsal respiratory group ________________________________________

     Ventral respiratory group ________________________________________

     Quiet breathing? ________________________________________

39. (5 points) Answer the following questions about acid-base balance.

     Normal blood pH = _______________________________

     To maintain normal blood pH, the ratio of bicarbonate to carbon dioxide must be ____________.

     The control of bicarbonate levels occurs in what organ? ____________________

     The control of carbon dioxide levels occurs in what organ? ____________________

     The enzyme that converts CO₂ and H₂O to carbonic acid is _______________________.

40. (4 points) Name two processes by which substances can enter the renal tubules.

     _________________________________________________________________

     _________________________________________________________________

      Name two processes by which substances can leave the renal tubules.

     _________________________________________________________________

     _________________________________________________________________

41. (4 points) Circle the correct word from the pairs in ().

If a person ingests 3 liters of water in an hour, the body fluids become (hypertonic or hypotonic). In response, ADH secretion is (stimulated or inhibited). As a result, a (small or large) volume of (hypertonic or hypotonic) urine is excreted.

 

 

42. (3 points) Fill in the blanks or circle the correct word from the pairs in ().

The juxtaglomerular cells secrete ______________________, which converts

angiotensinogen to angiotensin I. Angiotensin I is converted to angiotensin II by

___________________________________. Angiotensin II will directly (increase or

decrease) blood pressure.

44. (5 points) Answer the questions as indicated.

An infection with group A streptococcus can cause kidney damage, including increasing the leakiness of the glomerulus to proteins so that proteins are filtered. Predict whether the following will increase, decrease, or not change.

     Concentration of proteins in Bowman’s capsule _______________________

     Colloid osmotic pressure in Bowman’s capsule _______________________

     GFR ________________________

      Plasma volume ________________________

      ADH secretion _________________________

Inulin is freely filtered and neither secreted nor reabsorbed. What will happen to the
clearance of inulin when proteins can cross the glomerulus? Will it increase, decrease, or
not change?