Cardiac output in pregnancy shows significant increase from which week of gestation
Oxygen consumption increases in pregnancy by
What is the primary change in fetal circulation that occurs at birth?
Gamma waves of REM sleep are associated with?
Which type of pain is characterized by unknown etiology?
Which of the following is not true about sleep -
Most recently identified taste sensation is?
Vibration sense is detected by ?
Stress induced hyperglycemia is mediated through which hormone:
NEET-PG 2015 - Physiology NEET-PG Practice Questions and MCQs
Question 111: Cardiac output in pregnancy shows significant increase from which week of gestation
- A. 25 weeks
- B. 35 weeks
- C. 5 weeks
- D. 15 weeks (Correct Answer)
Explanation: ***15 weeks*** - Cardiac output shows a **significant and clinically measurable increase around 10-15 weeks of gestation**, which continues to rise, peaking between **20-28 weeks**. - This rise is primarily due to an increase in both **stroke volume** (increased by 25-30%) and **heart rate** (increased by 10-15 bpm) to meet the metabolic demands of the growing fetus and placenta. - By 15 weeks, cardiac output has typically increased by approximately **20-30% above pre-pregnancy levels**. *5 weeks* - While cardiac output does begin to rise very early in pregnancy (as early as 5-8 weeks), the increase at this stage is **subtle and not yet significant**. - At 5 weeks, the **placental circulation is still in early development**, and the hemodynamic changes are just beginning. - The question asks about **significant increase**, which is not yet established at 5 weeks. *25 weeks* - By 25 weeks, cardiac output has already completed its major rise and is at or near its **peak levels** (40-50% above baseline). - The **significant increase had already occurred** much earlier, around 10-15 weeks. - This timing represents the plateau phase rather than the initial significant increase. *35 weeks* - At 35 weeks, cardiac output remains elevated at near-peak levels but the **major increase happened much earlier** in pregnancy. - By this gestational age, the cardiovascular system has been adapted for months. - There may be minor positional variations (e.g., aortocaval compression in supine position) but no new significant increase occurs.
Question 112: Oxygen consumption increases in pregnancy by
- A. 10%
- B. 20% (Correct Answer)
- C. 30%
- D. 40%
Explanation: ***20%*** - During **pregnancy**, the maternal **metabolic rate increases** to support fetal growth and the physiological changes occurring in the mother's body. - This increased metabolic demand leads to a **rise in oxygen consumption** by approximately 20% compared to the non-pregnant state. *10%* - A 10% increase is an **underestimation** of the physiological change in oxygen consumption during pregnancy. - The demands of supporting a growing fetus and increased maternal tissue mass require a more substantial metabolic adjustment. *30%* - While oxygen consumption does increase significantly, a 30% rise is generally considered an **overestimation** of the average increase. - The typical physiological adaptation usually falls within the 15-25% range. *40%* - A 40% increase in oxygen consumption would represent an **extreme physiological demand** that is not typically observed during an uncomplicated pregnancy. - Such a drastic increase might indicate underlying pathology rather than normal adaptation.
Question 113: What is the primary change in fetal circulation that occurs at birth?
- A. Closure of the ductus venosus
- B. Increased activity of the right ventricle
- C. Closure of the foramen ovale (Correct Answer)
- D. Closure of the patent ductus arteriosus
Explanation: ***Closure of the foramen ovale*** - The **foramen ovale** undergoes functional closure within minutes of birth, making it the **primary immediate circulatory change** - At birth, the first breath causes **dramatic decrease in pulmonary vascular resistance** and **increased pulmonary blood flow**, which raises **left atrial pressure** - Simultaneously, umbilical cord clamping **increases systemic vascular resistance** and **decreases right atrial pressure** (loss of placental return) - This **pressure gradient reversal** (left atrial pressure > right atrial pressure) causes the **septum primum** to be pushed against the **septum secundum**, achieving functional closure - This immediately separates the systemic and pulmonary circulations, which is the **most critical primary change** in transitioning from fetal to neonatal circulation *Closure of the patent ductus arteriosus* - The **ductus arteriosus** undergoes **functional closure over 10-15 hours** after birth, followed by **anatomical closure over 2-3 weeks** - Closure occurs due to increased arterial oxygen tension and decreased prostaglandin E2 levels, causing smooth muscle constriction - While important, this is a **secondary change** that occurs more gradually compared to the immediate foramen ovale closure *Closure of the ductus venosus* - The **ductus venosus** closes functionally within 3-7 days as umbilical venous flow ceases - This redirects portal blood through the liver but does not directly impact the critical pulmonary-systemic circulation separation *Increased activity of the right ventricle* - After birth, the **left ventricle** becomes dominant as it pumps against higher systemic vascular resistance - The right ventricle actually experiences **decreased afterload** due to falling pulmonary vascular resistance - This is a consequence of, not the primary change in, the circulatory transition
Question 114: Gamma waves of REM sleep are associated with?
- A. Dream consciousness and memory consolidation
- B. Deep subconscious processing
- C. Non-REM sleep
- D. Subconscious processing (Correct Answer)
Explanation: ***Subconscious processing*** - **Gamma waves (30-100 Hz)** during **REM sleep** represent high-frequency neural oscillations associated with **complex cognitive processing** occurring below the level of conscious awareness. - These waves reflect **integration of neural activity** across different brain regions, facilitating information processing and neural plasticity during sleep. - The term encompasses the underlying **neural mechanisms** that support dream generation and memory consolidation processes. *Dream consciousness and memory consolidation* - While **gamma waves** do correlate with dreaming and memory processes during **REM sleep**, these represent the **experiential and functional outcomes** rather than the primary neurophysiological association. - Dream consciousness is a **manifestation** of the underlying subconscious processing, not the direct association with gamma wave activity itself. *Deep subconscious processing* - The term "deep subconscious" is **non-specific** and lacks precise neurophysiological definition in the context of gamma wave activity. - While directionally correct, this option uses imprecise terminology compared to the more accurate "subconscious processing." *Non-REM sleep* - **Gamma waves** are characteristic of **waking states** and **REM sleep**, not non-REM sleep stages. - **Non-REM sleep** (stages N1, N2, N3) is dominated by **slower wave activity** including theta waves (stage N1), sleep spindles and K-complexes (stage N2), and delta waves (stage N3/deep sleep).
Question 115: Which type of pain is characterized by unknown etiology?
- A. Nociceptive pain
- B. Neuropathic pain
- C. Idiopathic pain (Correct Answer)
- D. Inflammatory pain
Explanation: ***Idiopathic pain*** - This term refers to pain where the **underlying cause** or pathology cannot be identified, despite thorough investigation. - It signifies that the **etiology is unknown**, fitting the description in the question directly. *Nociceptive pain* - This type of pain arises from the activation of **nociceptors** due to actual or threatened tissue damage. - Its etiology is typically clear, involving an injury, inflammation, or mechanical stress. *Neuropathic pain* - This pain results from damage or disease affecting the **somatosensory nervous system**. - The etiology is known to be nerve damage or dysfunction, not an unknown origin. *Inflammatory pain* - This pain is driven by the inflammatory process, involving the release of **pro-inflammatory mediators** at the site of tissue injury or infection. - The cause is directly linked to inflammation, making its etiology known.
Question 116: Which of the following is not true about sleep -
- A. Dreams come in REM sleep
- B. REM sleep comes earlier than NREM sleep (Correct Answer)
- C. REM sleep is also called paradoxical sleep
- D. Sleep walking comes in NREM sleep
Explanation: ***REM sleep comes earlier than NREM sleep*** - This statement is **incorrect** because the sleep cycle typically begins with **NREM (non-rapid eye movement) sleep**, specifically NREM stage 1, before progressing to NREM stages 2 and 3, and then finally entering REM sleep. - NREM sleep accounts for about **75% of total sleep time** and occurs prior to REM sleep in a typical nocturnal sleep episode. *Dreams come in REM sleep* - This statement is **true** as **vivid, memorable dreams** are most commonly associated with **REM sleep**. - During REM sleep, brain activity significantly increases, mimicking the awake state, which facilitates complex dream formation. *REM sleep is also called paradoxical sleep* - This statement is **true** because **REM sleep** is characterized by **high brain activity** (similar to wakefulness) and rapid eye movements, yet the body experiences **muscle atonia**, leading to a state of profound relaxation. - This paradoxical combination of an active brain and a paralyzed body gives it the name **paradoxical sleep**. *Sleep walking comes in NREM sleep* - This statement is **true** as **sleepwalking (somnambulism)** typically occurs during **slow-wave sleep**, which is **NREM stage 3 (deep sleep)**. - During this stage, arousal thresholds are very high, and complex motor behaviors can occur while the individual remains in a sleep state.
Question 117: Most recently identified taste sensation is?
- A. Sour
- B. Bitter
- C. Umami (Correct Answer)
- D. Sweet
Explanation: ***Umami*** - **Umami** is the most recently identified **fifth basic taste**, often described as a savory or meaty taste. - Its discovery and recognition as a distinct taste sensation occurred in the **early 20th century** by Kikunae Ikeda, who isolated glutamate from kombu. *Sour* - The sensation of **sourness** is one of the traditionally recognized basic tastes, identified much earlier than umami. - It is typically associated with **acids**, such as those found in lemons or vinegar. *Bitter* - **Bitterness** is another long-standing basic taste that serves an important protective function, often signaling potential toxins. - It is one of the earliest tastes understood and recognized, with receptors for a wide range of bitter compounds. *Sweet* - **Sweetness** is a fundamental and ancient taste, universally recognized as pleasurable and indicating energy-rich foods. - The perception of sweet taste, primarily from sugars, has been understood for centuries.
Question 118: Vibration sense is detected by ?
- A. Superficial receptors
- B. Free nerve endings
- C. Nociceptors
- D. Deep receptors (Correct Answer)
Explanation: ***Deep receptors*** - **Vibration sense** is primarily mediated by **Pacinian corpuscles** and **Meissner's corpuscles**, which are considered deep receptors. - **Pacinian corpuscles** are located in the **deep dermis** and **subcutaneous tissue** and are highly sensitive to **high-frequency vibration** (200-300 Hz). - **Meissner's corpuscles** in dermal papillae detect **lower frequency vibration** and are rapidly adapting mechanoreceptors. *Superficial receptors* - **Superficial receptors** like **Merkel cells** primarily detect **sustained touch** and **pressure**, providing information about texture. - While they contribute to tactile sensation, they are **slowly adapting** and not specialized for rapidly oscillating stimuli like vibration. *Free nerve endings* - **Free nerve endings** are unmyelinated or lightly myelinated nerve terminals that detect **pain**, **temperature**, and **crude touch**. - They are not specialized mechanoreceptors and lack the structural organization needed to transduce vibratory stimuli. *Nociceptors* - **Nociceptors** are specialized sensory receptors that detect **noxious (harmful) stimuli** and mediate the sensation of **pain**. - They respond to extreme temperatures, intense mechanical stress, or chemical irritants, not to non-painful vibration.
Question 119: Stress induced hyperglycemia is mediated through which hormone:
- A. Cortisol (Correct Answer)
- B. Epinephrine
- C. Insulin
- D. Growth hormone
Explanation: ***Cortisol*** - **Cortisol** is the **primary mediator** of stress-induced hyperglycemia among the counter-regulatory hormones - It promotes **gluconeogenesis** (formation of new glucose from amino acids and glycerol) in the liver - Stimulates **protein catabolism** in muscles, providing substrates for gluconeogenesis - Induces **insulin resistance** in peripheral tissues, reducing glucose uptake - Released as part of the **HPA axis response** to stress, with sustained elevation during prolonged stress - This is the **correct answer** for stress-induced hyperglycemia mediation *Epinephrine* - **Epinephrine** (adrenaline) is a potent hyperglycemic hormone but acts as an **acute, immediate response** to stress - Rapidly increases blood glucose through **glycogenolysis** (breakdown of glycogen) in liver and muscles - Stimulates **gluconeogenesis** and inhibits insulin secretion - Effects are **rapid but short-lived**, making it more of an emergency response rather than the sustained mediator - Works synergistically with cortisol but is not the primary sustained mediator *Growth hormone* - **Growth hormone** does contribute to hyperglycemia through **anti-insulin effects** and promoting lipolysis - Its hyperglycemic effects are **slower and less pronounced** compared to cortisol and epinephrine - Plays a role in **chronic stress** but is not the primary acute mediator - More important for **long-term metabolic adaptation** rather than immediate stress response *Insulin* - **Insulin** is a **glucose-lowering hormone** that facilitates glucose uptake into cells - During stress, insulin secretion is **suppressed** and tissues become **insulin-resistant** due to counter-regulatory hormones - It does **not mediate** stress-induced hyperglycemia; rather, its action is **opposed** by stress hormones - Decreased insulin action contributes to hyperglycemia but insulin itself is not the mediator