DIRECTIONS: Each of the questions or incomplete statements below is followed by five
suggested answers or completions. Select the ONE that is BEST in each case.
1. The resistance to flow through a mesenteric artery will be decreased by all of the following
EXCEPT:
(A) A change in the pattern of flow from turbulent to laminar
(B) A decrease in length of the artery due to less tension on the mesentery
(C) A decrease in the hematocrit of the blood flowing through the artery
(D) A decrease in the volume flow through the artery
(E) Relaxation of its smooth muscle
2. If there were no changes in interstitial pressure, an increase in the end pressure in a capillary
would cause a(n)
(A) increase in tension (stress) in the wall of that capillary.
(B) decrease in the filtration coefficient of that capillary.
(C) increase in the reabsorption of fluid by that capillary.
(D) increase in resistance to flow through that capillary.
(E) decrease in the oncotic pressure of the blood flowing through that capillary.
3. During the ventricular rapid ejection phase,
(A) mean circulatory filling pressure is increasing.
(B) the pressure difference across the TPR is constant.
(C) blood flow across the TPR is decreasing.
(D) ventricular end systolic pressure is increasing.
(E) blood flow into the aorta is greater than blood flow across the TPR.
4. Cutting the carotid sinus nerves would lead to a(n)
(A) decrease in mean arterial blood pressure.
(B) increase in firing of cardiac vagal efferent fibers.
(C) decrease in myocardial contractility.
(D) decrease in venoconstriction.
(E) increase in total peripheral resistance.
5. If the length-tension properties of the ventricular myocardium, heart rate and total peripheral
resistance all remained unchanged while ventricular end diastolic pressure increased, then
(A) cardiac output would have decreased.
(B) ventricular contractility would have increased.
(C) preload would have decreased.
(D) stroke volume would have increased.
(E) venous return would have decreased.
6. While a constant force is applied to fluid in a pumping chamber, the resistance to flow via
the output port is doubled. This would result in
(A) no change in the volume flow from the pumping chamber.
(B) no change in the pressure in the pumping chamber.
(C) an increase in the work per unit volume ejected.
(D) a decrease in the energy expended per unit volume ejected.
(E) None of the above.
1
7. A patient is connected to a heart-lung machine that is producing an output of 7 liters per
minute. If TPR is increased while blood volume and venoconstriction remained unchanged,
at the new steady state the
(A) mean circulatory filling pressure would be decreased.
(B) pressure difference across the TPR would be unchanged
(C) central venous pressure would be decreased.
(D) mean arterial pressure would be unchanged.
(E) cardiac function curve would have moved downward and to the left.
8. In a Starling heart-lung preparation, venous return is doubled while heart rate and TPR
remain constant. At the new steady state, ventricular end diastolic volume increased. One
can conclude that
(A) preload remained unchanged.
(B) stroke volume increased.
(C) stroke work remained unchanged.
(D) mean circulatory filling pressure increased.
(E) mean arterial pressure was unchanged.
9. In a normal individual, heart rate and ventricular end systolic pressure remain unchanged
while ventricular end diastolic pressure increased. One can conclude that
(A) mean circulatory filling pressure increased.
(B) venous return increased.
(C) cardiac output remained unchanged.
(D) ventricular contractility increased.
(E) blood volume increased.
10. Atrial low-pressure baroreceptors, also called volume receptors, can initiate
(A) release of vasopressin from the posterior pituitary when central venous pressure is
reduced.
(B) decreased urine production.
(C) increased mean circulatory filling pressure.
(D) increased mean arterial pressure.
(E) All of the Above.
11. A decrease in mean arterial pressure below normal
(A) triggers angiotensin II release from the kidneys.
(B) induces hormonally mediated generalized arteriolar constriction.
(C) induces relaxation of venous smooth muscle.
(D) decreases blood levels of renin.
(E) decreases blood levels of antiduretric home (ADH).
12. A rise in intracranial pressure due to traumatic intracranial hemorrhage
(A) decreases mean arterial pressure to prevent further brain hemorrhage.
(B) produces cerebral ischema which raises mean arterial pressure to extremely high levels.
(C) decreases total peripheral resistance.
(D) does not alter renal blood flow due to pronounced renal pressure-flow autoregulation.
(E) does not affect heart rate.
13. During a single cardiac cycle, blood flow through the left coronary artery is lowest during
(A) ventricular isovolumetric contraction.
(B) rapid ventricular ejection.
(C) rapid ventricular filling.
(D) reduced ventricular filling.
(E) atrial contraction.
2
14. When steady-state blood flow through an organ system remains virtually constant even
though steady-state mean arterial pressure may have increased or decreased, the organ
system is demonstrating
(A) pressure-flow autoregulation.
(B) active hyperemia.
(C) reactive hyperemia.
(D) a reflex induced extrinsic control mechanism.
(E) a constant input resistance.
15. Mean circulatory filling pressure would be increased by which of the following?
(A) Decreased total peripheral resistance.
(B) Widespread constriction of arteriolar smooth muscle.
(C) Stimulation of sympathetic efferent fibers innervating venous smooth muscle.
(D) Decreased blood volume.
(E) Increased total peripheral resistance.
16. Which of the following changes would increase the maximum amount of cardiac output that
an all-powerful heart in this system could produce? Increased
(A) ventricular end diastolic volume.
(B) ventricular contractility.
(C) heart rate.
(D) blood volume.
(E) total peripheral resistance.
---------------------------------------------------------------------------------------------------------A beating heart is observed to produce the following:
Variable
Ventricular End Systolic Pressure (mm Hg)
Ventricular End Systolic Volume (ml)
Ventricular End Diastolic Volume (ml)
Initial State
100
80
160
New State
108
60
160
17. These data indicate that at the new steady state
(A) preload decreased.
(B) stroke volume decreased
(C) aortic systolic pressured was 108 mm Hg.
(D) ventricular contractility increased.
(E) total peripheral resistance decreased.
18. The vasculature is connected to a mechanical pump that has an output of 8 L/min. Mean
circulatory filling pressure is pharmacologically decreased from 9 to 7 mm Hg and
maintained constant. Total peripheral resistance was unchanged from the initial state. When
the new state is compared to the old, one observes
(A) an increased pressure difference across the total peripheral resistance.
(B) that both mean arterial pressure and central venous pressure decreased by 2 mm Hg.
(C) an increase in the maximum output that can be produced by the pump.
(D) a change in slope of the vascular function curve.
(E) none of the above.
3
19. A sensor placed in the lumen of a region of the GI tract records the following pressures during swallowing, pressure decreases and then increases back to a stable pressure a few
mm Hg above atmospheric; during digestion of a meal, pressure remains rather constant at a
few mm Hg above atmospheric; during the interdigestive state, a short (5-10 min) series of
strong contractions occur about every 90-120 min. The sensor is most likely located in the
(A) body of the esophagus.
(B) lower esophageal sphincter.
(C) orad (proximal) stomach.
(D) distal stomach (antrum).
(E) duodenum.
20. The following observations were made while monitoring esophageal contractile activity in a
patient. Between swallows, pressures in the upper esophageal sphincter, all regions of the
body of the esophagus, and the lower esophageal sphincter were normal. During a
voluntarily initiated swallow, the upper esophageal sphincter relaxed and there was a normal
peristaltic contraction in the upper esophagus; however, contraction in the lower esophagus
was abnormal and there was minimal relaxation of the lower esophageal sphincter. These
data indicate
(A) that the vagus nerve had been transected.
(B) an impairment in the esophageal enteric nerves.
(C) an impairment in the smooth muscle of the esophagus and lower esophageal sphincter.
(D) an impairment in the striated muscle of the esophagus.
(E) damage to the dorsal motor nucleus of the vagus.
21. During ingestion and digestion of a meal, peristaltic contractions are the primary type of
contractions occurring in the
A. esophagus
B. orad (proximal) stomach
C. jejunum
D. ileum
E. colon
22. Two of the regions of the gastrointestinal tract that are most dependent on extrinsic nerves
for regulation are the
A. lower esophagus and distal stomach (antrum)
B. lower esophagus and orad (proximal) stomach
C. small intestine and large intestine
D. upper esophagus and distal stomach (antrum)
E. upper esophagus and external anal sphincter
23. Salivary gland blood flow is
(A) increased by vagotomy.
(B) initially decreased and then increased by sympathetic stimulation.
(C) inhibited by bradykinin.
(D) decreased by parasympathetic stimulation.
(E) low in comparison to other exocrine tissue (when expressed as mls perfused/wt of
tissue)
4
24. Histamine release from the enterochromaffin-like (ECL) cell is stimulated (either directly or
indirectly) by all of the following, EXCEPT:
(A) Gastrin
(B) Acetylcholine
(C) Ingestion of a meal
(D) Somatostatin
(E) Administration of omeprazole
25. HCl in the GI lumen will do all of the following, EXCEPT:
(A) Stimulate secretin release
(B) Inhibit gastrin release
(C) Stimulate somatostatin release
(D) Denature pepsin
(E) Stimulate pepsinogen secretion
26. Pancreatic enzyme secretion is
(A) stimulated by trypsin in the intestinal lumen.
(B) stimulated by pancreatic polypeptide (PP).
(C) not essential for life.
(D) stimulated primarily by the presence of fat in the intestinal lumen.
(E) stimulated primarily by an acidic luminal pH.
27. Which of the following GI peptides has been demonstrated to stimulate insulin release?
(A) Gastrin
(B) Secretin
(C) Neuropeptide Y (NPY)
(D) Pancreatic polypeptide (PP)
(E) Glucagon-like peptide-1 (GLP-1)
28. An increase in the concentration of glycodeoxycholate in the portal blood will result in an
increased uptake of the conjugated bile salt into the hepatocyte and
(A) the development of jaundice.
(B) decreased expression of the bile salt export pump (bsep) on the canalicular membrane
of the hepatocyte.
(C) increased expression of the sodium taurocholate co-transporter (ntcp) on the basolateral
membrane of the hepatocyte.
(D) reduced activity of 7α-hydroxylase (CYP 7A) of the hepatocyte.
(E) gallstone formation.
29. Which of the following is actively transported by enterocytes following a starch meal?
(A) Fructose
(B) Galactose
(C) Trehalose
(D) Alpha dextrin
(E) None of the above
30. Which of the following is stored in its tissue of origin as an active enzyme?
(A) Lipase
(B) Trypsin
(C) Elastase
(D) Carboxypepdidase
(E) Pepsin
5
31. Micelles are involved in the intestinal absorption of
(A) triglyceride.
(B) chylomicrons.
(C) butyric acid.
(D) carbonic acid.
(E) vitamin K.
32. Which of the following enzymes functions in contact digestion?
(A) Colipase
(B) Amylase
(C) Lingual lipase
(D) Isomaltase
(E) Elastase
DIRECTIONS: Each group of questions below consists of five lettered headings or a diagram
or table with five lettered components, followed by a list of numbered words, phrases, or
statements. For each numbered question, select the ONE lettered heading or component that is
MOST CLOSELY ASSOCIATED WITH IT. Each lettered component or heading may be
selected once, more than once, or not at all.
(A) large arteries
(B) arterioles
(C) capillaries
(D) venules
(E) large veins
33. Vessels with the lowest velocity of blood flow
34. Vessels with the lowest end pressure in a recumbent patient
35. Vessels exhibiting the lowest resistance to blood flow
6
ANSWERS:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
D
A
E
E
D
B
C
B
B
E
B
B
A
A
C
D
D
B
C
B
A
E
B
D
D
D
E
D
E
A
E
D
C
E
E
7