A&P

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Which hormone has more target cells in the body than any others

Antidiuretic hormone (ADH)
Corticotropin releasing hormone (CRH)
Growth hormone-releasing hormone (GHRH)
Growth hormone (GH)
Oxytocin (OT)

Growth hormone

Negative feedback inhibition occures when

thyrotropin-releasing hormone (TRH) targets the anterior pituitary.
thyrotropin-releasing hormone (TRH) causes the anterior pituitary to release thyroid-stimulating hormone (TSH).
thyrotropin-releasing hormone (TRH) targets the thyroid gland.
thyroid-stimulating hormone (TSH) targets the thyroid gland.
thyroid hormone (TH) targets the anterior pituitary.

thyroid hormone (TH) targets the anterior pituitary

What organ secrets a hormone as a response to hypocalcemia

thymus
thyroid gland
parathyroid glands
pineal gland
pituitary gland

parathyroid glands

The____ secrete____, which promotes Na+ and water retention
adrenal medulla; epinephrine
pancreas; cortisol
kidneys; corticosterone
adrenal cortex; aldosterone
thyroid; calcitonin

adrenal cortex; aldosterone

Many hours after a meal, alpha (α) cells in the pancreatic islets (islets of Langerhans) secrete
glucagon, which lowers blood glucose.
glucagon, which raises blood glucose.
insulin, which lowers blood glucose.
insulin, which raises blood glucose.
glucocorticoids, which raise blood glucose.

glucagon, which raises blood glucose.

These are all secreted by the pancreas except


glucagon.
pancreatic polypeptide.
gastrin.
somatostatin (growth hormone-inhibiting hormone).
somatotropin (growth hormone).

somatotropin (growth hormone).

This gland has both endocrine and exocrine function.
the adrenal gland
the salivary gland
the ovary
the pineal gland
the thymus

the ovary

_____is synthesized in the rough endoplasmic reticulum

Aldosterone
Cortisol
Testosterone
Calcitriol
Glucagon

Glucagon

Absence of iodine in the diet leads to
hypoparathyroidism.
hypothyroidism.
hypocalcemia.
hypoglycemia.
hypoxemia.

hypothyroidism.

___ enters the target cell's nuclei and acts directly on the genes
Insulin
Antidiuretic hormone (ADH)
Estrogen
Glucagon
Oxytocin (OT)

Estrogen

Even a small quantity of hormone can have a strong effect on its target cell because of

negative feedback inhibition.
an antagonistic effect.
up-regulation.
enzyme amplification.
down-regulation.

enzyme amplification.

Neither follicle stimulating (FSH) hormone nor testosterone alone can stimulate significant sperm production, whereas when they act together, the testes produce some 300,000 sperm per minute. This exemplifies

hormone clearance.
the cascade effect.
the synergistic effect.
the permissive effect.
the antagonistic effect.

the synergistic effect

Cortisol
inhibits fat digestion.
stimulates protein synthesis.
promotes glycogen synthesis.
stimulates glucose intake by most organs.
promotes breakdown of fat and protein.

promotes breakdown of fat and protein.

These statements about diabetes mellitus (DM) are correct except


the body produces autoantibodies that destroy the pancreatic beta cells in type I DM.
target cells are unresponsive to insulin in type II DM.
both type I and type II DM are characterized by lack of, or low levels of, insulin.
diabetic neuropathy is a common long term effect of DM.
type II DM is more common than type I DM.

both type I and type II DM are characterized by lack of, or low levels of, insulin.

Choose the correct statement(s) regarding the composition of plasma.


Water represents 92% by weight.

Albumin is 60% of the total protein portion.

Protein is the second most abundant plasma solute by weight.

The most abundant nitrogenous waste is urea.

Water represents 72% by weight.

Water represents 92% by weight.
Albumin is 60% of the total protein portion.
The most abundant nitrogenous waste is urea

Choose the accurate statement(s) about the two reaction pathways to coagulation

The intrinsic mechanism uses only clotting factors found in the blood itself.

The extrinsic mechanism uses only clotting factors found in the blood itself.

The intrinsic mechanism is initiated by clotting factors released by the damaged blood vessel and perivascular tissues.

In most cases of bleeding, both the extrinsic and intrinsic mechanisms work simultaneously to contribute to hemostasis.

The extrinsic mechanism is initiated by clotting factors released by the damaged blood vessel and perivascular tissues.

The intrinsic mechanism uses only clotting factors found in the blood itself.
In most cases of bleeding, both the extrinsic and intrinsic mechanisms work simultaneously to contribute to hemostasis
The extrinsic mechanism is initiated by clotting factors released by the damaged blood vessel and perivascular tissues.

How is hemophilia characterized

It has sex-linked recessive mechanism of heredity.

Most hemophilia occurs predominantly in males.

It can be inherited from mothers and fathers.

The lack of factor VIII causes classical hemophilia (hemophilia A), which accounts for about 83% of cases.

Lack of factor IX causes hemophilia B, which accounts for 15% of cases.

It has sex-linked recessive mechanism of heredity
Most hemophilia occurs predominantly in males.
The lack of factor VIII causes classical hemophilia (hemophilia A), which accounts for about 83% of cases.
Lack of factor IX causes hemophilia B, which accounts for 15% of cases.

Which of the following characteristics of a red blood cell increases its ability to carry oxygen to the tissues?

Lacking mitochondria, RBCs rely exclusively on anaerobic fermentation to produce ATP.

The cytoplasm of an RBC consists mainly of a 33% solution of hemoglobin.

RBCs lose nearly all organelles during their development.

The cytoplasm also contains an enzyme, carbonic anhydrase.

Lacking a nucleus and DNA, RBCs also are incapable of protein synthesis and mitosis.

Lacking mitochondria, RBCs rely exclusively on anaerobic fermentation to produce ATP.
The cytoplasm of an RBC consists mainly of a 33% solution of hemoglobin.
RBCs lose nearly all organelles during their development.
Lacking a nucleus and DNA, RBCs also are incapable of protein synthesis and mitosis.

Choose the statement(s) associated with hemolytic disease of the newborn.

It occurs when an Rh- woman carries an Rh+ fetus.

The first pregnancy is likely to be uneventful because the placenta normally prevents maternal and fetal blood from mixing.

At the time of birth, or if a miscarriage occurs, placental tearing exposes the mother to Rh+ fetal blood and she begins to produce anti-D antibodies.

If an Rh- woman gives birth to (or mis-carries) an Rh+ child, she cannot be given an Rh immune globulin.

If she becomes pregnant again with an Rh+ fetus, her anti-D antibodies may pass through the placenta and agglutinate the fetal erythrocytes.

It occurs when an Rh- woman carries an Rh+ fetus
The first pregnancy is likely to be uneventful because the placenta normally prevents maternal and fetal blood from mixing
At the time of birth, or if a miscarriage occurs, placental tearing exposes the mother to Rh+ fetal blood and she begins to produce anti-D antibodies.
If she becomes pregnant again with an Rh+ fetus, her anti-D antibodies may pass through the placenta and agglutinate the fetal erythrocytes.

Identify the components of the circulatory system.

heart

blood vessels

blood

The first and second choices are correct.


All of the choices are correct.

All of the choices are correct ( heart, blood vessels, blood)

Viscosity and osmolarity will both increase if the amount of ____________ in the blood increases

RBCs

proteins

water

The first and second choices are correct.

The second and third choices are correct.

The first and second choices are correct. ( RBC and proteins)

Choose the correct statement regarding the function of platelets.

They secrete chemicals that repel neutrophils and monocytes.

They secrete factors that inhibit mitosis in fibroblasts and smooth muscle.

They secrete procoagulants, or clotting factors, which promote blood clotting.

They secrete vasodilators.

They prevent the formation of a clot-dissolving enzyme that dissolves blood clots that have outlasted their usefulness.

They secrete procoagulants, or clotting factors, which promote blood clotting

Which of the following is NOT a function of platelets?

They stick together to form temporary platelet plugs that seal small breaks in injured blood vessels.

They inhibit procoagulants.

They internalize and destroy bacteria.

They secrete growth factors that stimulate mitosis in fibroblasts and smooth muscle and thus help to maintain and repair blood vessels.

They initiate the formation of a clot-dissolving enzyme that dissolves blood clots that have outlasted their usefulness.

They inhibit procoagulants.

Factor XII catalyzes the formation of a plasma enzyme called kallikrein, that in turn converts an inactive protein into _________, a fibrin-dissolving enzyme that breaks up the clot
prothrombin

plasminogen

plasmin

fibrin

thromboplastin

plasmin

_____________ is the enzyme responsible for promoting the formation of more kallikrein, completing the positive feedback loop in dissolving clots.
Plasmin

Prekallikrein

Fibrin

Fibrinogen

Prothrombin

Plasmin

In healthy blood vessels, platelets do not adhere because the smooth, endothelium is coated with


heparin

prostacyclin

antithrombin

plasminogen

fibrin

prostacyclin

The two principal functions of the erythrocytes are:
to pick up nitrogen from the tissues and unload it in the lungs.

to pick up oxygen from the lungs and deliver it to tissues.

to pick up carbon dioxide from the tissues and unload it in the lungs.

The first and second choices are correct.

The second and third choices are correct.

The second and third choices are correct. (to pick up oxygen from the lungs and deliver it to tissues and to pick up carbon dioxide from the tissues and unload it in the lungs.

Identify the INCORRECT statement regarding blood groups other than ABO and Rh.

They include the MN, Duffy, Kell, Kidd, and Lewis groups.

They frequently cause transfusion reactions.

They are useful for such legal purposes as paternity and criminal cases.

They are useful for research in population genetics.

They are useful for research in anthropology.

They frequently cause transfusion reactions.

Identify the correct statement regarding leukocytes.
Leukocytes spend only a few hours in the bloodstream, then migrate through the walls of the capillaries.

Leukocytes are the most abundant formed elements, totaling only 5,000 to 10,000 WBCs/μL.

We can live for a long without them.

Leukocytes differ from erythrocytes in that they do not retain their organelles throughout life.

Not all leukocytes have lysosomes in the cytoplasm.

Leukocytes spend only a few hours in the bloodstream, then migrate through the walls of the capillaries.

Choose the correct statement(s) associated with the metabolism of cardiac muscle.

Its mitochondria fill about 2% of the cell.

Cardiac muscle depends almost exclusively on aerobic respiration to make ATP.

At rest, the heart gets about 35% of its energy from fatty acids, 60% from glucose, and 5% from other fuels such as ketones, lactic acid, and amino acids.

It is very rich in myoglobin (a source of stored oxygen) and glycogen (for stored energy).

Cardiac muscle depends almost exclusively on anaerobic respiration.

Cardiac muscle depends almost exclusively on aerobic respiration to make ATP.
It is very rich in myoglobin (a source of stored oxygen) and glycogen (for stored energy).

Choose the correct statements that accurately explain impulse conduction to the myocardium

Firing of the SA node excites atrial cardiocytes and stimulates the two atria to contract almost simultaneously.

In the AV node, the signal slows down to about 0.05 m/sec because the cardiocytes have fewer gap junctions over which the signal can be transmitted.

The entire ventricular myocardium depolarizes within 200 msec after the SA node fires, causing the ventricles to contract one after another.

Signals travel through the AV bundle and Purkinje fibers at a speed of 4 m/sec, the fastest in the conduction system.

The delay at the AV node is essential because it gives the atria time to fill with blood before they begin to contract.

Firing of the SA node excites atrial cardiocytes and stimulates the two atria to contract almost simultaneously.
The delay at the AV node is essential because it gives the atria time to fill with blood before they begin to contract.
Signals travel through the AV bundle and Purkinje fibers at a speed of 4 m/sec, the fastest in the conduction system.
In the AV node, the signal slows down to about 0.05 m/sec because the cardiocytes have fewer gap junctions over which the signal can be transmitted.

Exercise has the following effects on cardiac output.
Parasympathetic output from the cardiac centers increases cardiac output to meet the expected demand.

The main reason the heart rate increases at the beginning of exercise is that proprioceptors in the muscles and joints transmit signals to the cardiac centers.

As the exercise progresses, muscular activity increases venous return.

A sustained program of exercise causes hypertrophy of the ventricles, which increases their stroke volume.

As the exercise progresses, muscular activity decreases venous return.

The main reason the heart rate increases at the beginning of exercise is that proprioceptors in the muscles and joints transmit signals to the cardiac centers.
As the exercise progresses, muscular activity increases venous return.
A sustained program of exercise causes hypertrophy of the ventricles, which increases their stroke volume.

Heart sound ____________ is thought to result from the transition from expansion of the empty ventricles to their sudden filling with blood.
S1

S2

S3

S4

S3

Given that cardiac output equals ____________, you can see that there are only two ways to change it: change the heart rate or change the stroke volume

HR X SV

HR + SV

HR/SV

None of the choices are correct.

HR X SV

The difference between the maximum and resting cardiac output is called

cardiac reserve.

preload.

stroke volume.

afterload.

contractility.

cardiac reserve.

is the amount of tension in the ventricular myocardium immediately before it contracts.


Contractility

Afterload

Preload

Cardiac reserve

None of the choices are correct.

Preload

has a strong, positive inotropic effect, meaning it increases the strength of each contraction of the heart.

Hypocalcemia

Hypercalcemia

Hyperkalemia

Myocardial hypercapnia

Myocardial hypoxia

Hypercalcemia

If the right ventricle begins to pump an increased amount of blood, this soon arrives at the left ventricle, stretches it more than before, and causes it to increase its stroke volume and match that of the right. This is and example of ________________.


preload

afterload

contractility

cardiac reserve

None of the choices are correct.

preload

As the exercise progresses, muscular activity __________ venous return. This increases the _________ on the right ventricle.
decreases; preload

increases; afterload

increases; preload

decreases; afterload

increases; preload

Oxygen-poor blood passes through

the right AV (tricuspid) valve and pulmonary valve.

the right AV (tricuspid) valve only.

the left AV (bicuspid) valve and aortic valve.

the left AV (bicuspid) valve only.

the pulmonary and aortic valves.

the right AV (tricuspid) valve and pulmonary valve.

Opening and closing of the heart valves is caused by
breathing.

gravity.

valves contracting and relaxing.

osmotic gradients.

pressure gradients.

pressure gradients

Obstruction of the ___________ will cause a more severe myocardial infarction (MI) than the obstruction of any of the others


left marginal vein

left coronary artery (LCA)

posterior interventricular vein

anterior interventricular branch

circumflex branch

left coronary artery (LCA)

Cardiac muscle shares this feature with skeletal muscle.

cardiac muscle fibers have striations

all cardiac muscle fibers depend on nervous stimulation

cardiac muscle fibers communicate by electrical (gap) junctions

cardiac muscle fibers are joined end to end by intercalated discs

some cardiac muscle fibers are autorhythmic

cardiac muscle fibers have striations

Atrial systole begins

immediately before the P wave.

immediately after the P wave.

during the Q wave.

during the S-T segment.

immediately after the T wave.

immediately after the P wave.

The long plateau in the action potential observed in cardiocytes is probably related with _____________ staying longer in their cytosol.
Na+

K+

Ca2+

Cl-

Na+, K+, and Ca2+

Ca2+

The long absolute refractory period of cardiocytes

ensures a short twitch.

prevents tetanus.

makes the heart prone to arrhythmias.

prevents the occurrence of ectopic focuses.

causes the pacemaker potential.

prevents tetanus.

Mitral valve stenosis causes blood to leak back into the ___________ when the ventricles contract.
left atrium

right atrium

aorta

pulmonary trunk

pulmonary arteries

left atrium

Isovolumetric contraction occurs during the _________ of the electrocardiogram.

P wave

P-Q segment

R wave

S-T segment

T wave

R wave

During isovolumetric contraction, the pressure in the ventricles
falls rapidly.

rises rapidly.

remains constant.

rises and then falls.

falls and then rises

rises rapidly.

Mitral valve prolapse (MVP) generates a murmur associated with the _____ heart sound that occurs when the ____.



lubb (S1); atria contract

dupp (S2); atria relax

lubb (S1); ventricles contract

dupp (S2); ventricles relax

lubb (S1); ventricles relax

lubb (S1); ventricles contract

Most of the ventricle filling occurs
during atrial systole.

when the AV valve is closed.

during ventricular systole.

during atrial diastole.

during isovolumetric contraction.

during atrial systole.

_____________ increase(s) stroke volume.
during atrial systole.

when the AV valve is closed.

during ventricular systole.

during atrial diastole.

during isovolumetric contraction.

Increased venous return

Cardioinhibitory centers in the _____________ receive input from __________.



cortex; proprioceptors in the muscles

thalamus; chemoreceptors in the medulla oblongata

hypothalamus; proprioceptors in the joints

medulla oblongata; chemoreceptors in the aortic arch

pons; baroreceptors in the internal carotid

medulla oblongata; chemoreceptors in the aortic arch

The Frank-Starling law of the heart states that stroke volume is proportional to

the end-systolic volume.

the end-diastolic volume.

the afterload.

the heart rate.

contractility.

the end-diastolic volume.

During periods of exercise


the sympathetic nervous system can selectively reduce blood flow to the kidneys and digestive tract.

the sympathetic nervous system can increase perfusion of the skeletal muscles.

metabolite accumulation in a tissue can stimulate local vasodilation.

the parasympathetic nervous system can selectively reduce blood flow to the kidneys and digestive tract.

metabolite accumulation in a tissue can stimulate local vasoconstriction.

the sympathetic nervous system can increase perfusion of the skeletal muscles
metabolite accumulation in a tissue can stimulate local vasodilation.
the parasympathetic nervous system can selectively reduce blood flow to the kidneys and digestive tract.

Choose the accurate statements regarding the effects of edema



Cerebral edema can produce headaches, nausea, and sometimes delirium, seizures, and coma.

As the tissues become congested with fluid, oxygen delivery and waste removal are impaired and the tissues may begin to die.

Pulmonary edema presents a threat of suffocation as fluid replaces air in the lungs.

As the tissues become congested with fluid, oxygen delivery and waste removal are improved.

Even severe edema does not cause blood volume and pressure to drop low enough to cause circulatory shock.

Cerebral edema can produce headaches, nausea, and sometimes delirium, seizures, and coma.
As the tissues become congested with fluid, oxygen delivery and waste removal are impaired and the tissues may begin to die.
Pulmonary edema presents a threat of suffocation as fluid replaces air in the lungs

Muscle perfusion during exercise increases dramatically. Perfusion is increased via

arterioles dilating in response to epinephrine and norepinephrine.

precapillary sphincters dilating in response to muscle metabolites such as lactic acid, CO2, and adenosine.

muscular contraction compressing the blood vessels.

precapillary sphincters constricting in response to muscle metabolites such as lactic acid, CO2, and adenosine.

blood being diverted from other organs such as the digestive tract and kidneys to meet the needs of the working muscles.

-arterioles dilating in response to epinephrine and norepinephrine.
- precapillary sphincters dilating in response to muscle metabolites such as lactic acid, CO2, and adenosine.
-muscular contraction compressing the blood vessels.
-blood being diverted from other organs such as the digestive tract and kidneys to meet the needs of the working muscles.

The advantage(s) of there being a much lower blood pressure in the pulmonary circuit include


hydrostatic pressure overrides oncotic pressure, so pulmonary capillaries are engaged almost entirely in absorption.

blood flows more slowly through the pulmonary capillaries and therefore has more time for gas exchange.

it prevents fluid accumulation in the alveolar walls and lumens, which would compromise gas exchange.

oncotic pressure overrides hydrostatic pressure, so pulmonary capillaries are engaged almost entirely in absorption.

blood flows more quickly through the pulmonary capillaries, and therefore it has more time for gas exchange.

- blood flows more slowly through the pulmonary capillaries and therefore has more time for gas exchange
-it prevents fluid accumulation in the alveolar walls and lumens, which would compromise gas exchange.
-oncotic pressure overrides hydrostatic pressure, so pulmonary capillaries are engaged almost entirely in absorption.

Blood usually passes through one network of capillaries from the time it leaves the heart until the time it returns, but there are exceptions, notably ______________.


vasa vasorum

portal systems

anastomoses

The first and third choices are correct.

The second and third choices are correct.

The second and third choices are correct. (portal systems and anastomoses)

Arterial anastomoses, in which two arteries merge, are found


in the fingers, palms, toes, and ears.

in the coronary circulation.

connecting the hypothalamus and anterior pituitary.

connecting the intestines to the liver.

None of the choices are correct.

in the coronary circulation.

The best estimate of MAP is


an arithmetic mean of systolic and diastolic pressures.

the difference between systolic and diastolic pressure.

the diastolic pressure plus one-third of the pulse pressure.

heart rate X stroke volume.

None of the choices are correct.

the diastolic pressure plus one-third of the pulse pressure.

Identify the physiological purposes of vasomotion.

It can cause a generalized raising or lowering of blood pressure throughout the body.

It can selectively modify the perfusion of a particular organ by rerouting blood from one region of the body to another.

It can cause widespread vasodilation to raise blood pressure throughout the entire body.

The first and third choices are correct.

The first and second choices are correct.

The first and third choices are correct.

Choose the accurate statement(s) about how materials get from the blood to the surrounding tissues.
The most important mechanism of exchange is diffusion.

Filtration and reabsorption is the result of a shifting balance between hydrostatic and osmotic forces.

Transcytosis is a process in which endothelial cells pick up material on one side of the plasma membrane by receptor-mediated endocytosis, transport the vesicles across the cell, and discharge the material on the other side by exocytosis.

The first and third choices are correct.

The first, second, and third choices are correct.

The first, second, and third choices are correct.

Identify the INCORRECT statement regarding the fundamental causes of edema.
A deficiency of albumin (hypoproteinemia) produces edema by reducing the reabsorption of tissue fluid.

Capillary reabsorption does not depend on oncotic pressure.

Obstruction of lymphatic vessels can interfere with fluid drainage and lead to the accumulation of tissue fluid distal to the obstruction.

Kidney failure leads to water retention and hypertension, thus raising capillary blood pressure and filtration rate.

Since albumin is produced by the liver, liver diseases such as cirrhosis tend to lead to hypoproteinemia and edema.

Capillary reabsorption does not depend on oncotic pressure.

Which of the following is NOT a mechanism that assists venous return?

Pressure generated by the heart

Gravity

The skeletal muscle pump

Central venous pressure being greater than pressure in the venules

Cardiac suction

Central venous pressure being greater than pressure in the venules

Venous return is achieved by all of the following mechanisms EXCEPT
venule suction.

the thoracic (respiratory) pump.

the pressure gradient.

the skeletal muscle pump.

venule suction.

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