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كسرة لناس دفعة 2024 ، مراجعة الفسيولوجي ح تكون مساء غداً السبت ( 7:45 مساءً) بإذن الله..

نبدأ بحل ومناقشة اسئلة دكتور محمد نور

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1. A patient loses 2 L of isotonic fluid due to severe diarrhea. Which of the following changes occurs immediately?
A. ↓ Plasma osmolarity, ↓ ECF volume, ↑ ICF volume
B. ↑ Plasma osmolarity, ↓ ECF volume, ↓ ICF volume
C. No change in plasma osmolarity, ↓ ECF volume, no change in ICF volume
D. ↑ Plasma osmolarity, ↑ ICF volume

2. Which fluid compartment contains the greatest proportion of body water?
A. Plasma
B. Interstitial fluid
C. Intracellular fluid
D. Transcellular fluid

3. Edema is LEAST likely to occur with:
A. Increased capillary hydrostatic pressure
B. Increased plasma protein concentration
C. Lymphatic obstruction
D. Increased capillary permeability

4. A patient has:
Na⁺ = 160 mEq/L
Glucose = 90 mg/dL
BUN = 28 mg/dL
Calculated plasma osmolarity is:
A. 295 mOsm/L
B. 310 mOsm/L
C. 325 mOsm/L
D. 335 mOsm/L

5. Blood volume is 5 L, and hematocrit is 40%. Plasma volume is:
A. 2.0 L
B. 2.5 L
C. 3.0 L
D. 3.5 L

6. A healthy volunteer consumes 250 mL O₂/min. Given 1 L O₂ releases 4.82 kcal, calculate daily BMR:
A. 1600 kcal/day
B. 1735 kcal/day
C. 1850 kcal/day
D. 2000 kcal/day

7. A patient receives a drug that blocks ganglionic nicotinic receptors. Which function is least affected?
A. Heart rate
B. Sweat secretion
C. Skeletal muscle contraction
D. Pupillary diameter

8. Which autonomic neurotransmitter is released directly from postganglionic sympathetic fibers supplying sweat glands?
A. Norepinephrine
B. Dopamine
C. Acetylcholine
D. Epinephrine

9. A patient receives aspirin during fever. The fall in body temperature results primarily from:
A. Reduced metabolic rate
B. Decreased hypothalamic prostaglandin synthesis
C. Increased sympathetic discharge
D. Direct inhibition of shivering

10. A red blood cell is placed in a solution containing 300 mOsm/L urea. What is the immediate outcome?
A. No change in cell volume
B. Cell shrinks permanently
C. Cell swells and may eventually lyse
D. Water leaves the cell continuously

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8. Which autonomic neurotransmitter is released directly from postganglionic sympathetic fibers supplying sweat glands?
A. Norepinephrine
B. Dopamine
C. Acetylcholine
D. Epinephrine

9. A patient receives aspirin during fever. The fall in body temperature results primarily from:
A. Reduced metabolic rate
B. Decreased hypothalamic prostaglandin synthesis
C. Increased sympathetic discharge
D. Direct inhibition of shivering

10. A red blood cell is placed in a solution containing 300 mOsm/L urea. What is the immediate outcome?
A. No change in cell volume
B. Cell shrinks permanently
C. Cell swells and may eventually lyse
D. Water leaves the cell continuously

C. AUTONOMIC NERVOUS SYSTEM

31. Which neurotransmitter is released by all autonomic preganglionic neurons?
A. Norepinephrine
B. Acetylcholine
C. Dopamine
D. Epinephrine

32. A patient receives a drug that blocks muscarinic receptors. Which effect is most likely?
A. Increased salivation
B. Increased intestinal motility
C. Tachycardia
D. Bronchoconstriction

33. Stimulation of sympathetic β₂ receptors in bronchial smooth muscle produces:
A. Bronchoconstriction
B. Bronchodilation
C. Increased mucus secretion only
D. Complete inhibition of respiration

34. Which autonomic receptor is primarily responsible for increased heart rate?
A. α₁
B. α₂
C. β₁
D. β₂

35. A patient suddenly stands from a supine position. The resulting decrease in arterial pressure causes:
A. Increased baroreceptor firing
B. Decreased sympathetic activity
C. Increased sympathetic activity
D. Increased vagal activity

36. Which structure contains the highest concentration of autonomic ganglia?
A. Cerebral cortex
B. Brainstem
C. Peripheral autonomic pathways
D. Skeletal muscle

37. A drug blocks ganglionic nicotinic receptors. Which function would remain relatively unaffected?
A. Heart rate regulation
B. Sweating
C. Gastrointestinal motility
D. Voluntary skeletal muscle contraction

38. Which sympathetic response is mediated by α₁ receptors?
A. Bronchodilation
B. Increased heart rate
C. Vasoconstriction
D. Increased cardiac contractility

39. Which organ receives predominantly parasympathetic innervation?
A. Sweat glands
B. Most systemic blood vessels
C. Heart
D. Adrenal medulla

40. The adrenal medulla is best considered a modified:
A. Parasympathetic ganglion
B. Sympathetic ganglion
C. Sensory ganglion
D. Somatic motor nucleus

D. TEMPERATURE & METABOLIC RATE

41. The hypothalamic region most important for promoting heat loss when body temperature rises is the:
A. Anterior hypothalamus
B. Posterior hypothalamus
C. Medulla
D. Cerebellum

42. Which response occurs during exposure to a cold environment?
A. Cutaneous vasodilation
B. Sweating
C. Shivering
D. Decreased metabolic rate

43. A patient develops fever following bacterial infection. Pyrogens ultimately cause:
A. Decreased hypothalamic set point
B. Increased hypothalamic set point
C. Direct inhibition of heat production
D. Complete inhibition of sweating

44. During fever, a patient feels cold and begins shivering despite having an elevated body temperature. This occurs because:
A. His hypothalamic set point has increased
B. His hypothalamic set point has decreased
C. His metabolic rate has stopped
D. His skin temperature has increased above the set point

45. Which mechanism accounts for the greatest proportion of heat loss from the body under ordinary environmental conditions?
A. Conduction
B. Radiation
C. Evaporation
D. Convection

46. A person enters a very hot environment. Which mechanism becomes particularly important for heat loss?
A. Sweating and evaporation
B. Shivering
C. Cutaneous vasoconstriction
D. Increased muscle tone

47. Which hormone has the greatest direct effect on increasing basal metabolic rate?
A. Insulin
B. Thyroid hormone
C. ADH
D. Aldosterone

48. A healthy volunteer consumes 200 mL O₂/min. If 1 L O₂ releases 4.82 kcal, the approximate daily energy expenditure is:
A. 965 kcal/day
B. 1157 kcal/day
C. 1393 kcal/day
D. 1735 kcal/day

49. Which condition would be expected to increase basal metabolic rate?
A. Sleep
B. Starvation
C. Hypothyroidism
D. Hyperthyroidism

50. A patient is exposed to severe cold. Which mechanism increases heat production without producing voluntary movement?
A. Sweating
B. Non-shivering thermogenesis
C. Cutaneous vasodilation
D. Increased evaporation

B. BODY FLUIDS

21. Total body water in a healthy adult male is approximately what percentage of body weight?
A. 20%
B. 40%
C. 60%
D. 80%

22. Approximately what fraction of total body water is located in the extracellular fluid?
A. One-third
B. Two-thirds
C. One-half
D. Three-quarters

23. A patient receives 1 L of isotonic saline intravenously. Where will most of the administered fluid initially remain?
A. Entirely inside cells
B. Entirely in plasma
C. Extracellular fluid compartment
D. Intracellular fluid compartment

24. A patient receives a large amount of pure water. Which change is expected?
A. Increased ECF osmolarity
B. Decreased ECF osmolarity
C. Increased intracellular osmolarity
D. Decreased total body water

25. Which plasma protein contributes most importantly to plasma colloid osmotic pressure?
A. Fibrinogen
B. Albumin
C. Globulin
D. Hemoglobin

26. A patient with severe liver disease develops generalized edema. The most important mechanism is:
A. Increased plasma albumin
B. Increased plasma colloid osmotic pressure
C. Decreased plasma colloid osmotic pressure
D. Decreased capillary permeability

27. Which condition would most directly increase capillary hydrostatic pressure and promote edema?
A. Severe dehydration
B. Heart failure
C. Hypoalbuminemia
D. Increased lymphatic drainage

28. A patient has a plasma sodium concentration of 150 mEq/L, glucose of 90 mg/dL, and BUN of 14 mg/dL. Approximate plasma osmolarity is:
A. 250 mOsm/L
B. 270 mOsm/L
C. 295 mOsm/L
D. 330 mOsm/L

29. A patient has a blood volume of 6 L and a hematocrit of 50%. What is the approximate plasma volume?
A. 1 L
B. 2 L
C. 3 L
D. 4 L

30. Which condition would LEAST favor the development of edema?
A. Increased capillary hydrostatic pressure
B. Decreased plasma protein concentration
C. Increased capillary permeability
D. Increased plasma protein concentration