NEET-PG 2015 - Physiology Practice Questions

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

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

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

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

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

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

Q: What does the transient response observed during the insertion of an electrode in electromyography (EMG) indicate?

Cell membrane disruption. **Cell membrane disruption** - The **transient response** observed during electrode insertion in **EMG** is caused by the mechanical trauma of the needle disrupting the **muscle fiber cell membranes**. - This disruption leads to a brief depolarization and subsequent repolarization of the affected fibers, generating characteristic electrical activity. *Spontaneous muscle activity* - **Spontaneous muscle activity**, such as **fibrillation potentials** or **positive sharp waves**, occurs independently of electrode insertion. - While observed during EMG, these are indicative of **denervation** or **myopathy** and are not directly caused by the act of insertion itself. *Voluntary muscle contraction* - **Voluntary muscle contraction** is recorded when the patient actively contracts the muscle and results in **motor unit action potentials (MUAPs)**. - This is a distinct process from the transient activity produced by electrode insertion. *Induced muscle contraction* - **Induced muscle contraction** typically refers to activity caused by **nerve stimulation** (e.g., in nerve conduction studies) or direct electrical stimulation of the muscle. - This is not the mechanism for the transient response during simple electrode insertion.

Q: What is the primary process involved in Wallerian degeneration?

Nerve degeneration. ***Nerve degeneration*** - **Wallerian degeneration** specifically refers to the process of **axon degeneration** that occurs distal to the site of injury when a nerve fiber is severed [2]. - This process involves the breakdown of the **axon** and its myelin sheath, leading to loss of function [1]. *Muscle degeneration* - While prolonged nerve degeneration can lead to muscle **atrophy** due to denervation, **muscle degeneration itself** is not the primary process of Wallerian degeneration. - Wallerian degeneration focuses on the **nerve itself**, not the target tissue. *Nerve regeneration* - **Nerve regeneration** is the process where damaged nerves attempt to regrow and re-establish connections [2]. - This is a subsequent, and not always successful, event that can occur *after* Wallerian degeneration has cleared the debris [1]. *Muscle regeneration* - **Muscle regeneration** refers to the repair and regrowth of damaged muscle tissue, typically involving satellite cells. - It is unrelated to Wallerian degeneration, which is a process affecting the **nerve**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 697-698. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 109-110.

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

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

Q: Which of the following statements is true regarding smooth muscle contraction?

Phosphorylation of myosin is essential for contraction.. **Phosphorylation of myosin is essential for contraction.** - In **smooth muscle**, the **myosin light chain (MLC)** must be phosphorylated by **myosin light chain kinase (MLCK)** to enable interaction with actin and initiate contraction. - This phosphorylation causes a conformational change in the **myosin head**, increasing its ATPase activity and allowing cross-bridge cycling. *Calmodulin plays no role in smooth muscle contraction.* - **Calmodulin (CaM)** is crucial for smooth muscle contraction, as it binds **calcium ions (Ca²⁺)** forming a Ca²⁺-CaM complex. - This complex then activates **myosin light chain kinase (MLCK)**, which phosphorylates myosin, triggering contraction. *None of the options.* - This statement is incorrect because one of the provided options, "Phosphorylation of myosin is essential for contraction," is indeed true. *Troponin plays a significant role in smooth muscle contraction.* - Unlike **striated muscle (skeletal and cardiac)**, **smooth muscle** does not contain **troponin**. - Regulation of smooth muscle contraction is primarily **calcium-calmodulin-dependent**, with roles for **MLCK** and **MLCP**, rather than troponin.

Q: What is another name for the withdrawal reflex?

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

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

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

Q: What is the composition of epithelial sodium channels?

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

Question 1

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

Accepted Answer

Ionized Ca2+

Answer

Mg2+

Answer

K+

Answer

Na+

Question 2

Which protein primarily contributes to oncotic pressure in the blood?

Accepted Answer

Albumin

Answer

Globulins

Answer

Fibrinogen

Answer

Transferrin

Question 3

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

Accepted Answer

Typically around 7.0, slightly less than ECF

Answer

Typically around 7.4, slightly more than ICF

Answer

Approximately equal to ECF

Answer

Significantly higher than ECF

Question 4

What does the transient response observed during the insertion of an electrode in electromyography (EMG) indicate?

Accepted Answer

Cell membrane disruption

Answer

Spontaneous muscle activity

Answer

Voluntary muscle contraction

Answer

Induced muscle contraction

Question 5

What is the primary process involved in Wallerian degeneration?

Accepted Answer

Nerve degeneration

Answer

Muscle degeneration

Answer

Nerve regeneration

Answer

Muscle regeneration

Question 6

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

Accepted Answer

Hering-Breuer reflex

Answer

J-reflex

Answer

Head's paradoxical reflex

Answer

Proprioceptors

Question 7

Which of the following statements is true regarding smooth muscle contraction?

Accepted Answer

Phosphorylation of myosin is essential for contraction.

Answer

None of the options.

Answer

Calmodulin plays no role in smooth muscle contraction.

Answer

Troponin plays a significant role in smooth muscle contraction.

Question 8

What is another name for the withdrawal reflex?

Accepted Answer

Flexor reflex

Answer

Golgi tendon reflex

Answer

Extension reflex

Answer

Stretch reflex

Question 9

Which of the following statements about ENaC is incorrect?

Accepted Answer

Composed of 2 homologous subunits

Answer

Present in kidney and GIT

Answer

Epithelial channel

Answer

Inhibited by amiloride

Question 10

What is the composition of epithelial sodium channels?

Accepted Answer

1α, 1β, 1γ

Answer

2α, 1β, 1γ

Answer

2α, 1β

Answer

2α, 1β, 2γ

NEET-PG 2015 — Physiology