2013-2014 MEDF1011B Final Exam

MCQs (Q5, 21 and 49 are missing)

1. The polymers in the organism is mostly made up of
A. monomers that are easily affected by gene expression
B. monomers except for lipids
C. DNA which consists of 3 monomers
D. 10-20 types of monomers with 1-2 rare species
E. monomers formed by dehydration

2. C55H110O55 is most probably a

A. protein
B. lipid
C. polysaccharide
D. steroid
E. eicosanoid

3. Which of the following can be found in DNA but not in RNA?

A. adenine
B. guanine
C. deoxyribose
D. thymine
E. C and D

4. The cohesive force in water is mainly due to

A. molecular mass
B. mass
C. size
D. hydrogen bond
E. surface area

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6. The plasma membrane fluidity decreases with:
A. increasing temperature
B. longer hydrocarbon tail
C. more double bonds
D. less cholesterol
E. more anchoring junctions

7. Which of the following molecules can pass through cell membrane

by simple diffusion?
A. hydrogen ion
B. glucose
C. insulin
D. urea
E. water-soluble vitamins

8. The nucleus
A. contains one layer of nuclear membrane
B. contains 46 pairs of chromosomes
C. is a site for lipid synthesis
D. acts as storage for calcium ions
E. contains small pores on the surface

9. Which of the following description about golgi apparatus is

correct?
A. golgi apparatus is the major site of protein synthesis
B. The synthesized protein is released from golgi apparatus to rough
endoplasmic reticulum for sorting
C. phospholipid and cholesterol are primarily synthesized in golgi
apparatus
D. the cis-golgi apparatus network is the side facing the
endoplasmic reticulum and receives the transport vesicles

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from it
E. golgi apparatus is continuous with the outer membrane of ER

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10. Which of the following about enforced exhalation is correct?
A. lung volume increases
B. diaphragm flattens out (i.e. stay at the same lv)
C. intrapleural pressure is smaller than aveoli pressure (Pip is
ve and pa
should >0 for exhalation)
D. transpulmonary pressure increases

(should be decrease)

E. it is an active process which requires muscle contraction ( lungs

are passively forced to move but not by muscle
contraction)

11. Lung compliance can be increased by:

A. Stop breathing for a few second
B. Surfactant produced by type 1a alveolar cell (should be type 2)
C. Patient who has emphysema ()
D. Patient who has deformity of the thorax
E. Patient who has fibrosis on lungs (would diminish C --- scar tissue)

Low compliance indicates a stiff lung and means extra work is required to bring in a
normal volume of air. This occurs as the lungs in this case become fibrotic, lose their
distensibility and become stiffer.
In a highly compliant lung, as in emphysema, the elastic tissue is damaged by
enzymes. These enzymes are secreted by leukocytes (white blood cells) in response to a
variety of inhaled irritants, such as cigarette smoke. Patients with emphysema have a
very high lung compliance due to the poor elastic recoil, they have no problem inflating
the lungs but have extreme difficulty exhaling air. In this condition extra work is required
to get air out of the lungs. Compliance also increases with increasing age.

12. What vessels are the major sites of variable pressure and
contribute to 60- 70% of total pressure?
Ans: Arteriole

13. Which of the following is correct?

A. Cardiac output= heart rate x stroke volume

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14. The integration center of neural control of blood pressure is
located in
A. Cerebellum
B. Medulla Oblongata
C. Pons
D. Cerebrum
E. Hypothalamus

15. What is the driving force for the blood flow in the systemic
circuit?
A. Capillary hydrostatic pressure
B. Central venous pressure
C. Left ventricular pressure
D. Mean atrial pressure
E. Right atrial pressure

16. Which of the following is true?

A. Sound is longitudinal wave in air and water as vibrating
medium.
B. Sound is transverse wave in air and water as vibrating medium.
C. Sound is transvers wave in all medium.
D. Sound is longitudinal wave in vacuum.
E. Sound is transverse wave in vacuum.

17. Which of the following statements are true:

i. low (high???) frequency of the sound is a high-pitched one
ii. High-pitched sound is usually produced with more open
and close of
vocal cord ( )
iii. When producing high-pitched sound, usually less tense (
) vocal
cord is used

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Ans: All of the above (???)

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The faster the vocal folds vibrate, the higher the pitch.
Extremely slow vocal fold vibration is about 60 vibrations per second
and produces a low pitch. Extremely fast vocal fold vibration
approaches 2000 vibrations per second and produces a very high
pitch. Only the highest sopranos can attain those extremely high
pitches. In general, men's vocal folds can vibrate from 90 - 500 Hz, and
they
average about 115 Hz in conversation. Women's vocal folds
can vibrate from 150 -1000 Hz, and they average about 200 Hz in
conversation.
Vocal folds (also called vocal cords) vibrate faster as they're
pulled longer, thinner, and more taut. This is done by contracting the
cricothyroid muscle, which pulls the thyroid cartilage down and forward
on its hinge, away from the arytenoid cartilages, thus lengthening the
vocal folds. When they're lengthened they also get thinner and more
taut (like a rubber band - try it).
Vocal folds vibrate more slowly when they're shorter, thicker,
and floppier. This is done by contracting the thyroarytenoid muscle,
which pulls the arytenoid end of the vocal folds closer to the thyroid
end, thus bunching them up. The thyroarytenoid muscle is contracted,
so it's firmer, but the mucosa overlying the vocal fold becomes floppier,
so it vibrates slower.

Vocal FOLDS or
Vocal CORDS???
You've probably heard the term "vocal cords" used to describe the part of the
body that creates sound for the voice. You've probably also heard the term
"vocal folds" in the same context. So what's the difference between the two?
Well . . .
Vocal folds are the same as vocal cords. The two terms refer to the exact
same part of the body performing the exact same functions. The term "vocal
cords" is less technically correct but more often used among singers and
laypersons.
Why, then, do voice scientists and otolaryngologists refer to them as vocal
folds? Years ago, vocal folds were thought of as being two cords stretched
across the airway, like strings on a piano (hence the term "cords"). Now we
know that vocal folds are multilayered folds of tissue that are continuous with
other tissues in the throat. Therefore, vocal "folds" is a more accurate term,
but it's OK with us if you call them vocal cords. Just don't get confused and
call them vocal "chords!"

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18. Which one of these are correct?
a) Hearing tests are usually conducted over a range of around
250Hz-8000Hz.
b) The Ear canal resonates and is hence partly responsible for
detecting higher frequencies of around 2000-5000Hz.
(T)
The ear canal resonates sound waves and increases the loudness of the tones in the
3000-4000 Hz range.

c) The tectorial membrane resonates at different frequencies with

the near end being responsible for higher frequencies and the far
end being responsible for lower frequencies (T)
d) The ear is a transducer that converts sound waves to electric
messages for the brain.
(T)
Ans: All of the above

19. Which of the following are TURE?

i) A high-pitch screaming sound dramatically changing into a
low-pitch roar can be observed when a motorcycle passes by
a stationary observer. (T)
ii) Doppler effect is greater when the motorcycle is faster.
(T)
iii) Doppler effect is the alteration of observed frequency
produced by the movement of the source or the observer.
(T)
iv) A stationary warning bell changes from a low-pitch sound to a
high-pitch when heard by an observer on a moving train passing it.
(F)

20. Which of the following is not an application of ultrasound?

A. Determine motion.
B. Determine velocity.
C. Observe a fetus inside the womb.
D. Test hearing ability of humans.
E. Destroy cancerous tumors in body.
High-Intensity Focused Ultrasound (HIFU) is a highly precise medical procedure
that applies high-intensity focused ultrasound energy to locally heat and
destroy diseased or damaged tissue through ablation.

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22. Which of the following is incorrect
A. Blood flow is controlled by pressure gradient.
B. Systemic circulation has higher pressure than pulmonary
circulation.
C. Venous circulation contains most of the blood due to its larger
diameter.
D. Lymphatic vessel does
constant blood volume.

not

involve

in

maintaining

23. The heart contains the following except

A. Myocardium (Y)
B. Pacemaker cell (Y)
C. Nerve cell (?)
D. Autonomic nerve terminal
E. Blood vessels (Y)

24. Endothelium of blood vessels release:

A. Oxygen
B. Nitrogen oxide
C. Nitric oxide
D. Hydrogen sulphide
E. None of the above

25. Which of the following is not the common risk factor of CVS?
A. Hypertension
B. Moderate alcohol consumption
C. Overweight
D. High cholesterol diet
E. Tobacco smoking

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26. What is not a measure to prevent the occurrence of
cardiovascular disease?
A. Reduce salt intake
B. Increase physical activity
C. Increase consumption of saturated fatty acids
D. Increase consumption of chocolate
E. Increase consumption of nuts and seeds

27. Which statement about visible light is correct?

A. It requires a medium to travel and cannot travel in vacuum.
B. It is a king of longitudinal wave.
C. It moves faster in glass than in air.
D. It contains electric fields and magnetic fields.
E. It always moves in a straight line without bending.

28. Visible light

wavelengths

is

part

of

electromagnetic

spectrum

A. Longer than ultraviolet

B. Shorter than X-rays
C. Shorter than Gamma rays
D. Longer than Radar
E. 400-700mm (should be nm)

29. Why does an apple appear red in color?

A. It absorbs red wavelengths.
B. It reflects red wavelengths.
C. Red wavelength is able to pass through it.
D. It produces and emits red wavelengths.
E. It has a red filter so allows red wavelengths to pass through.

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30. Which of the following is correct about the structure of human
eye?
A. Ciliary bodies relax when near vision is required.
B. Ciliary body is derived from choroid.
C. Suspensory ligament is elastic...
D. Fovea of retina contains the highest density of rods.
E. There is greater number of cones than rods on the retina.

31. Which statement about ultraviolet is correct?

A. UVC stimulates Vitamin D synthesis by skin
B. UVC has more penetrating ability than UVB and UVA
C. UVB is mostly reflected by the ozone in atmosphere
D. Germicidal lamps in laboratories produce and emit UVB to kill
bacteria
E. UVB exposure is a risk factor for melanoma of the skin

32. Which of the following is true about radioactive decay?

A. Decay occurs as electrons have excess energy.
B. Decay process may be controlled by external force.
C. Decay mostly involves the outermost orbital electrons.
D. Radioactive decay is a random process.
E. Visible light is produced during the decay process.

33. The half-life of a 10mCi source is 10 days:

A. It takes 20 days for the activity to become 2.5mCi
B. After 5 days, the activity becomes 5mCi
C. It integrates at a rate of 1mCi per day
D. after 100 days, the source is not radioactive
E. The source should be used within 10 days

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34. Which of the following is TRUE to describe pair production?
A. It occurs when two x ray photons are in collision
B. It can only occur at photons energies greater than 1.02
MeV
C. It results in the formation of two positrons
D. It is most likely to occur in low atomic number isotopes
E. Two beta particles are created.
pair production occurs in nucleus not collision of photons

35. Which of the followings describing PET is wrong?

A. PET is an imaging procedure that uses tracers which are labeled
with positron emitters.
B. PET scanners are equipped with a detectors ring that is able to
simultaneously acquire the 511keV gamma radiation emitted in 180
degrees angles by the positrons.
C. The most popular PET procedure is imaging of glucose
metabolism using 18F~FDG as radiopharmaceutical
D. PET could provide a detailed anatomical image of the structures.
E. 18F~FDG is mostly used for whole body imaging in the context of
staging and therapy monitoring in oncological patients

36. Radiation does delivery principle does not include which of the
following?
A. Accuracy in treatment volume
B. Uniform in treatment target dose
C. High enough for treatment dose
D. As high as possible for target organs
E. Consider possible side effects

37. In our body, what is carbonic acid formed from?

A. Water and Carbon dioxide
B. Water and carbon monoxide
C. Hydrogen carbonate ion and hydrogen ion

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D. Either A or C
E. Either B or C

38. Order of low to high H+ concentration:

A. Bile ( - PH 5-6), brain fluid (7.28-7.32), saliva (6.2-7.4), gastric
secretion (1.5-3.5)
B. Bile, semen ( - 7.2-7.8), gastric secretion, pancreatic secretion
(7-8)
C. Gastric secretion, semen, pancreatic secretion, blood (7.35-7.45)
D. Gastric secretion, urine (4.6-8), saliva, blood
E. Gastric secretion, saliva, brain fluid, bile

39. What fraction of base is ionized if pH is 7.2 and pKa is 7.5

A. 1/2
B. 1/4
C. 2/3
D. 0.3
E. 1/3

40. If blood pH is 7.0 and PaCO2 is 6.4, what is the condition that
the patient has?
A. Metabolic acidosis
B. Respiratory acidosis

(Arterial carbon dioxide partial pressure: 4.76.0 kPa, 35-45 mmHg)

C. Metabolic alkalosis
D. Respiratory alkalosis
E. None of them are correct

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41. A drug is weak base (acid???) with pKa 6.4. Given that pH of
urine is 5.4, calculate the ratio of drug in blood to urine.
A. 1.1
B. 10
C. 0.3
D. 72
E. 0.67

42. Which of the following would cause a rapid decrease in

movement of K+ out of a neuronal cell?
A. Decrease in extracellular Na+ concentration
B. Hyperpolarization of the membrane
C. Increase in extracellular Cl- concentration
D. Increased membrane permeability to Na+
E. Inhibiting the activity of Na+/K+-ATPase pumps

43. When the extracellular Na+ is decreased by half,

A. Decrease in equilibrium potential of K+
B. Threshold is lowered
C. The peak of action potential is lower
D. Rate of depolarization will increase
E. Hyperpolarization is less negative

44. Which of the following will generate IPSP?

A. Decreased activity of the Na+/K+ ATPase
B. Decreased membrane permeability of ClC. Increased membrane permeability of K+
D. Increased membrane permeability of Na+
E. Increased membrane permeability of Ca2+

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45. Which of the following description can be applied to both graded
potential
and action potential?
A. They are of stereotypical size and shape.
B. They can be conducted without decrement.
C. They can be summated.
D. They can give rise to depolarization.
E. They do not have a refractory period.

46. Which of the following is the best account of the occurrence of

relative refractory period after the action potential period?
A. Activation gate of Na+ ion channels is closed
B. Opening of K+ ion channel begins
C. Driving force for the inflow of Na+ ion decreases
D. Driving force for the outflow of K+ increases
E. Na+ ion channels are partially inactivated

47. A fireman enter a building on fire. What is the major heat

transfer?
A. Conduction
B. Convection
C. Evaporation
D. Radiation
E. All of the above

48. What is the type of heat transfer utilized by a tympanic

thermometer?
A. conduction
B. Convection
C. Radiation
D. Conduction and convection
E. Conduction and radiation

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50. Which of the following would result in increased evaporative
heat loss from the skin surface?
A. Contraction of arrector pili muscle in hair follicles
B. High air humidity
C. Increased air flow on skin surface
D. Low ambient temperature
E. Vasoconstriction of skin blood vessels

51. Which of the following concerning ECF is true?

A. Provide a stable environment for a cell
B. Same as cerebrospinal fluid in composition
C. Equivalent to intersitial fluid
D. Contains more k than ICF

52. Which of the following has the highest body water content?
A. thin man
B. thin woman
C. fat man
D. fat woman
E. infant

53. What is major driving force for the fluid movement from ICF to
ECF?
A. effective osmole
B. Ineffective osmole
C. Oncotic pressure
D. hydrostatic pressure
E. All of the above

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54. What is the direct effect of pyrogens in development of a fever?
A. constriction of skin blood vessel
B. reduce sweat production by sweat gland
C. increase production of prostagladin in hypothalamus
D. increase thyroxine produced by thyroid gland
E. increase heat production by muscle shivering

55. Which of the following chemical will affect fluid movement

between plasma and interstitial fluid?
A. Na
B. Ca
C. K
D. Glucose
E. Albumin (The albumins are a family of globular proteins)

56. 5% Glucose stays in:

A. Equally distributed in ICF and ECF
B. ICF
C. ECF
D. Blood plasma
E. None of the above

Dextrose 5% is a Maintenance Fluid. (Dextrose is d-glucose). It is isosmotic as

administered and does not cause hemolysis. The glucose is rapidly taken up by
cells. The net effect is of administering pure water, so it is distributed
throughout the total body water. Each compartment receives fluid in
proportion to its contribution to the TBW (ie 2/3rd to ICF and 1/3rd to ECF; the ECF
fluid is distributed one quarter to plasma & three quarters to ISF).
The distribution of 1,000 mls of dextrose 5% is:

ICF 670mls

ECF 330mls (with ISF 250mls and plasma 80mls).

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(The figures are rounded slightly)

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Intravascular volume increases from 5000 to 5080 mls. This volume increase of
less then 2% which will not be sensed by the volume receptors (as it is below the
7-10% threshold).
The osmolality of plasma (3,200 mls) will decrease by: [ 287 - (287 x 3.20 / 3.28) ]
which is about 7 mOsmoles/l or a 2.5% decrease. This is enough to be detected by
the osmo-receptors. ADH release will be decreased and renal water excretion will
rise. A delay will occur because the changes have to be detected centrally and
then ADH levels need 3 half-lifes to fall to a new steady state.
Dextrose 5% is essentially treated by the body as pure water and a significant
percent moves intracellularly. It is a useful fluid to replenish intracellular fluid but
does so at the expense of tonicity. It is inappropriate for intravascular volume
replacement. It is excreted because ADH levels decline in response to the drop in
plasma osmolality.
Normal saline is a replacement fluid (meaning ECF replacement) because it adds
only to the ECF volume. Only about a third remains intravascularly. To replace
intravascular volume will require transfusion with about 3 times the volume of
blood lost. It is cheap and readily available. It is excreted because the small drop
in plasma oncotic pressure causes glomerulotubular imbalance. ADH is not
affected.
Plasma protein solutions (eg 5% human albumin) are excellent for replacing
intravascular volume. ISF and ICF will not be replenished. Albumin is slow to be
excreted and the transfused volume is excreted much slower than with
replacement solutions. Plasma protein solutions are expensive and supply is
limited. The fluid is initially excreted because of a fall in ADH level falling
stimulation of the volume receptors.

57. The relationship of the gas pressure and gas volume is described
by which
law:
A. Henry
B. Poisson
C. Boyle
D. Dalton
E. Goldman

58. Which of the component of the ECG represents ventricle

depolarization?
A. U wave
B. T wave

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C. P wave
D. QRS complex
E. ST segment

59. Some neurons in the sympathetic nerve terminate on the

sinoatrial
node
cells.
These
neurons
produce
norepinephrine(noradrenaline), which ultimately
increases
the cardiac output. This is an example of
A. Neuronal control
B. Homeostatic control
C. Paracrine control
D. Autocrine control

60. Which of the following will decrease the resistance of blood flow
in a blood vessel
A. decrease the vessel length by half
B. increase the vessel length by half
C. decrease the vessel diameter by half
D. increase the vessel diameter by half
E. B and D

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SQs
1. Describe the relations
penetration, mAs and KVp.

between

X-ray

wavelength,

X-ray

2. Describe the process of lens accommodation for near vision.

3a. In the table below, show 4 abnormal combinations of pH and

CO2 level in
blood. Show the pH and PaCO2 ranges for these
combinations.
3b. Hypoventilation may cause which of the 4 above abnormal
conditions?
Respiratory acidosis
3c. Vomiting may cause which of the 4 above abnormal conditions?
Vomiting results in the loss of hydrochloric acid
(hydrogen and chloride ions) with the stomach contents.--------metabolic alkalosis
Chronic renal failure------- Metabolic acidosis

4. In a maritime accident, a victim was rescued from the sea. What

would you do to prevent hypothermia? Explain using the 4
processes of heat transfer.
Use of foil reflective blanket

1. Briefly describe the functions of membrane proteins.

2. What is ultrasound and what are its clinical applications?

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3. Briefly describe how venous return can be improved in a resting
adult in good health.

4. Name two groups of muscles in iris and also briefly describe how
these muscles change the pupil size.

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