Part A.

1. A 5% dextrose is isoosmotic to plasma. What effect would infusion of 1L of a 5% dextrose solution have on ECF and ICF volumes? How it would affect body fluid osmolality of a 70 kg individual and why?

2. What effect would furosemide, an inhibitor of Na+ reabsorption by the thick ascending limb of Loop of Henle, have on urinary Ca++ excretion?

3. List the most important hormones involved in water-electrolyte balance regulation.

4. Briefly describe the importance of ejection fraction assessment in patients with heart failure.

5. Briefly describe the local and nervous regulation of blood flow. How cardiac output depends on preload?

1. If cardiac muscle is deprived of its normal blood supply, damage would primarily result from:

A. a lack of blood cells to feed into metabolic pathways.
B. a decrease in the number of available mitochondria for energy production.
C. decreased delivery of oxygen.
D. an inadequate supply of lactic acid.

2. In comparing the right and left ventricular systems, the volume of blood pumped by each is

A. similar, but the pressure generated in the adjacent arteries is much higher for the right ventricle
B. similar, and the pressure generated in the adjacent arteries is the same
C. similar, but the pressure generated in the adjacent arteries is much lower for the right ventricle
D. different, with the right ventricle pumping considerably more blood for each stroke

3. Which of the following is not a vasodilator?

A. bradykinin
B. angiotensin II
C. atrial natriuretic factor
D. nitric oxide
E. nitroglycerin

4. Decreasing the radius of a blood vessel twofold will increase the resistance to blood flow

A. three
B. sixteen fold
C. four fold
D. eight fold

5. Which one of the following normally does not carry highly oxygenated blood?

A. pulmonary veins
B. aorta
C. renal artery
D. pulmonary artery

6. One difference between atrial contraction and ventricular contraction is that

A. atrial contraction is delayed and involves conducting-system fibers
B. ventricular contraction is faster than atrial, and involves conducting-system fibers
C. ventricular contraction is delayed and involves conducting-system fibers
D. atrial contraction is initiated by the AV node while ventricular contraction is initiated by the SA node

7. The initial depolarization for initiating a heart beat originates in the

A. AV node
B. Brain
C. CNS
D. SA node

8. A person with a heart rate of 60 beats/ minute and a stroke volume of 85 ml will have a cardiac output of

A. 51.1 L/min
B. 3.06 L/min
C. 510 ml/min
D. 5.1 L/min

9. The amount of blood remaining in the heart after contraction is the

A. end-diastolic volume
B. cardiac output
C. stroke volume
D. end-systolic volume

10. A person with a blood pressure reading of 140/80 has a mean arterial pressure of

A. 90 mm Hg
B. 220 mm Hg
C. 100 mm Hg
D. 110 mm Hg

11. Atrial systole begins

A. immediately before the P wave.
B. during the P wave.
C. during the Q wave.
D. immediately after the T wave.

12. The major force bringing fluid back into the capillaries from the interstitial fluid is

A. osmotic pressure due to salts
B. osmotic pressure due to water
C. hydrostatic pressure
D. osmotic pressure due to protein

13. Baroreceptors involved in the regulation of blood pressure are found in the

A. capillaries only
B. arteries only
C. arteries and veins
D. veins only

14. AV valves open and close because of

A. nervous impulses
B. contractions of muscles attached to the valves
C. changes in blood content in the adjacent chambers
D. changes in blood pressure in the adjacent chambers

15. The major factor for setting long-term blood pressure is

A. venous baroreceptors
B. arterial baroreceptors
C. the brain
D. the medulla
E. blood volume

16. Action potentials are able to spread from myocardial cell to myocardial cell via

A. tight junctions
B. interneurons
C. nerve fibers
D. gap junctions

17. At any given moment, the percent of total blood volume in the veins is

A. 70%
B. 20%
C. 50%
D. 5%

18. Transport of oxygen and nutrients across most capillary walls occurs primarily by

A. active transport
B. vesicle transport
C. co-transport
D. diffusion

19. During exercise, which of the following is not true?

A. there is vasodilation of arterioles in skeletal muscle
B. cardiac output increases more than total peripheral resistance decreases
C. the main increase in cardiac output is due to an increase in heart rate and in stroke volume
D. the main increase in cardiac output is due to a large increase in stroke volume and a small increase in heart rate

20. A typical stroke volume for an adult at rest would be:

A. 20 ml
B. 40 ml
C. 130 ml
D. 70 ml

21. The preload is directly related to:

A. isovolumetric contraction
B. isovolumetric relaxation
C. ventricular ejection
D. ventricular filling

22. Hemorrhage with a large loss of blood causes:

A. a lowering of blood pressure due to change in cardiac output.
B. a rise in blood pressure due to change in cardiac output.
C. no change in blood pressure but a slower heart rate.
D. no change in blood pressure but a change in respiration.

23. The Frank-Starling mechanism is a relationship in which

A. cardiac output is equal to heart rate multiplied by stroke volume
B. left ventricular output is always greater than right ventricular output
C. with continued stretch of cardiac muscle, there is an eventual decline of contractility
D. stroke volume increases as enddiastolic volume increases

24. The amount of blood in ventricles at the end of filling is called:

A. ejection fraction
B. end-systolic volume
C. end-diastolic volume
D. coronary circulation
E. stroke volume

25. SA node action potentials are due to

A. the opening of slow calcium channels.
B. the closing of potassium channels.
C. non-stable RMP.
D. potassium entrance.
E. potassium exit.

Part B.

26. Endothelial cells can secrete substances that cause either vasoconstriction or vasodilation.

27. Even though blood pressure decreases throughout the circulatory system, when it finally gets back to the heart from the systemic circuit, the pressure in the veins is still relatively high.

28. The decrease in arterial compliance due to atherosclerosis will cause the mean arterial pressure to lower in that individual.

29. If the activity of the SA node is depressed or blocked another portion of the conducting system can take over as pacemaker and set the heart rate.

30. Just standing up from a lying, or horizontal position can cause a decrease in the effective circulating blood volume.

Part C.

31. Normal glomerular filtration rates can be in the range of

A. 20 liter/day
B. 2 liter/day
C. 180 liter/hour
D. 180 liter/day
E. 180 ml/day

32. Glomerular filtrate

A. is almost identical to plasma except that it contains more protein
B. is almost identical to plasma except that it contains very little protein
C. is quite different from plasma in the concentration of most substances
D. will normally contain significant amounts of protein and red blood cells
E. has greatly increased concentrations of salts and ions compared to plasma

33. The positive driving force for glomerular filtration originates from

A. osmotic pressure due to ions in the plasma of the capillaries
B. larger than normal arterioles that create as much as 60 mm Hg blood pressure in the glomerular capillaries
C. hydrostatic pressure in Bowman's space
D. osmotic pressure due to proteins in the plasma of the capillaries
E. the bound ions and lipids in the plasma

34. The kidneys regulate hydrogen ion concentration by the

A. secretion of hydrogen ions in the tubules
B. excretion of bicarbonate in the tubules
C. production of bicarbonate in the tubule cells
D. secretion of calcium ions in the tubules E. a, b, and c

35. Aldosterone acts by

A. stimulating glucose metabolism
B. inhibiting protein synthesis in sodium-transporting cells
C. stimulating synthesis of proteins that function as water channels and are involved in direct water absorption
D. stimulating synthesis of proteins that function as sodium channels and are involved in membrane sodium pumps
E. increasing porosity of cell membranes along the renal tubule

36. A high plasma concentration of ADH causes

A. increased water permeability in collecting ducts, and therefore a large final urine volume
B. increased water permeability in collecting ducts, and therefore a small final urine volume
C. decreased water permeability in collecting ducts, and therefore a large final urine volume
D. decreased sodium permeability in collecting ducts, and therefore a small final urine volume
E. increased potassium permeability in collecting ducts, and therefore a large final urine volume

37. As the kidneys work to maintain water balance in the body, it must be remembered that water can also be lost via

A. perspiration
B. the intestinal tract
C. respiration
D. liver
E. a, b, and c

38. Because of the countercurrent multiplier system in the loop of Henle and medullary collecting duct

A. isoosmotic urine is generated by alternating active sodium reabsorption through membranes impermeable to water, and variable diffusion of water through ADH-responsive membranes
B. hyperosmotic urine is generated by alternating active sodium reabsorption through membranes impermeable to water, and variable diffusion of water through ADH-responsive membranes
C. hypoosmotic urine is generated by alternating active sodium reabsorption through membranes impermeable to water, and variable diffusion of water through ADH-responsive membranes
D. hyperosmotic urine is generated by active sodium secretion into the loop of Henle and the medullary collecting duct

39. Renal clearance is the

A. volume of urine produced per day
B. volume of blood from which a substance is removed per unit time
C. volume of plasma from which a substance is removed per unit time
D. amount of inulin in the urine

40. Calcium levels in the body are regulated by

A. kidney reabsorption
B. intestinal absorption
C. bone, which is a major calcium reservoir in the body
D. liver metabolism
E. a, b, and c

Extra

1. Explain the significance of pressures involved in filtration and reabsorption processes. Briefly present the factors causing pulmonary edema.

2. Select the correct statement about cardiac output.

A. A slow heart rate reduces stroke volume and force of contraction.
B. Decreased venous return will result in increased stroke volume.
C. If a semilunar valve were partially obstructed, the stroke volume in the affected ventricle would be decreased.
D. Stroke volume increases if the filling decreases.
E. a and c

3. Which one of the following is not a factor in determining the flow rate of blood in a particular vessel

A. viscosity of the blood in the vessel
B. length of the blood vessel
C. radius of the vessel
D. a and c
E. thickness of the vessel