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MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007


Physiology (SEQs)

Model Paper

09 SEQs of 05 marks each
Total Marks 45 Time 2 hours and 15 minutes

Q.1 Define paracrines. What is the mechanism of action of Thyroid
Hormones? (5)

Topic Specification: Endocrines Mechanism of action of hormones.



KEY:

Paracrines are secreted by cells into extracellular fluid and affect
neighbouring cells of a different type. (1)
Examples: Gastrin, Cholecystokinin, Interleukins, Secretin. (1)

Mechanism of action of thyroid hormones. Thyroid hormones act on
target cells by increasing gene transcription in the cell nucleus.
Thyroid hormones enter the target cell and bind directly with receptor
proteins in the nucleus. This initiates the transcription process
formation of messenger RNA RNA translation on the cytoplasmic
ribosomes formation of intracellular proteins.
(1)

(1)

(1)




Reference: Guytons Physiology









Page 2 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper



Q.2 Enumerate physiological actions of Insulin on carbohydrate, fat
and protein metabolism. Write down four features of Diabetes
Mellitus. (5)


Topic Specification: Endocrines - Insulin



KEY:
Physiological actions of insulin on carbohydrate metabolism.
1) Increases uptake of glucose into cells. ()
2) Increases glucose utilization by the cells. ()
3) Storage of glucose as glycogen in the muscles and liver. ()
4) Promotes conversion of excess glucose into fatty acids and inhibits
gluconeogenesis in the liver. ()
Fat Metabolism:
1) Promotes fat synthesis and storage by:
a) Inhibiting the hormone sensitive lipase. ()
b) Promoting glucose entry into fat cells. ()
c) Activating lipoprotein lipase in the capillary walls of the adipose tissue.
()
Protein metabolism:
It promotes protein synthesis and storage by:
a) Increasing transport of amino acids into cells. ()
b) Increasing translation of mRNA. ()
c) Stimulating gene transcription. ()
d) Inhibiting protein catabolism. ()
e) Inhibiting gluconeogenesis. ()
04 features of Diabetes Mellitus:
Polyuria,polyphagia, polydipsia, glycosuria. (, ,,)

Reference: Guytons Physiology

Page 3 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper



Q.3 What are the features in a patient having right sided
Hemisection of the Spinal cord? (5)

Topic Specification: Nervous System


KEY:
Features in right sided hemisection of the spinal cord.
At the level of Hemisection:
Sensory loss.
Complete anesthesia on the right side due to damage to the dorsal roots.
()
No sensory loss on the left side. ()
Motor Loss.
Lower motor neuron type of paralysis on the right side due to damage to
alpha motor neurons. ()
No motor loss on the opposite side. ()
Below the level of Hemisection
Sensory Loss.
Loss of sensations carried by the dorsal column medial lemniscal system
(tactile discrimination, proprioception, vibration) on the right side. ()
Loss of sensation carried by the spinothalamic tracts (crude touch, pain,
temperature) on the left side. ()
Motor Loss upper motor neuron type of paralysis on the right side. ()
No motor loss on the left side. ()
Above the level of Hemisection
Hyperesthesia on the right side. ()
If hemisection is in segments T
1
-L
2
loss of sweating, vasodilatation.
()

Reference: Guytons Physiology




Page 4 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper




Q.4 Which Neurotransmitters are released in the Basal Ganglia?
Enumerate features of the Parkinsons Disease. (5)

Topic Specification: Nervous System Basal Ganglia


KEY:

Neurotransmitters in the Basal Ganglia.
Nigrostriate fibers release dopamine. ()
Corticostriate fibers release acetyl choline. ()
Fibers from caudate and putamen to substantia nigra and globus pallidus
release GABA. ()
Fibers from brain stem to basal ganglia release nor-epinephrine, serotinin
and enkephalin. ()
Features of Parkinsonism:
1) Akinesia inability to initiate movements. ()
2) Lead pipe or cog-wheel rigidity. ()
3) Static tremors, pill rolling movements of fingers and hands. ()
4) Statue like appearance, Back and knee are flexed. ()
5) Mask like face, loss of expression. ()
6) Loss of associated movements e.g. swinging of arms during walking,
short stepped gait. ()



Reference: Guytons Physiology







Page 5 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper

Q.5 Enumerate the effects of Sympathetic Stimulation through Alpha
Adrenergic Receptors and Beta Adrenergic Receptors. (5)

Topic Specification: Nervous System - ANS


KEY:

Effects of sympathetic stimulation through alpha adrenergic receptors.
1) Dilatation of the pupil.
2) Contraction of internal urinary sphincter.
3) Contraction of intestinal sphincters.
4) Vasoconstriction.
5) Pilomotor contraction.

Effects of sympathetic stimulation through beta adrenergic receptors:
1) Cardioacceleration, increased myocardial strength.
2) Bronchodilatation.
3) Glycogenolysis.
4) Lipolysis.
5) Bladder wall relaxation.
6) Vasodilatation.


Reference: Guytons Physiology





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Page 6 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper


Q.6 What is the mechanism of Determination of the Sound
Frequency?
(5)

Topic Specification:



KEY:

Mechanism of determination of sound frequency.
a) Place Principle:
Low frequency sounds cause maximal activation of the basilar membrane
near the apex of the cochlea and high frequency waves activates the basilar
membrane near the base of cochlea.
Intermediate frequency sounds activate at intermediate distance between
the two extremes. Specific brain neurons are activated by specific sound
frequencies. The nervous system can detect sound frequencies by
determining the position along the basilar membrane.
b) Volley or Frequency Principle:
Low frequency sounds (20-2000c/second) can cause volleys of nerve
impulses and these are transmitted to the cochlear nuclei through the
cochlear nerve which can distinguish the different frequencies of the
volleys.

Reference: Guytons Physiology













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Page 7 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper


Q.7 Define Filtration Coefficient and Filtration Fraction. Enumerate
factors which affect the Glomerular Filtration Rate. (5)

Topic Specification: Kidney - GFR


KEY:
Filtration Coefficient. Ratio between GFR and net filtration pressure. (1)


K
f

=
GFR
=
125
=
12.5 ml/min/mmHg ()
Net filtration 10
Pressure
Filtration Fraction: it is the fraction of renal plasma flow filtered through the
glomerular membrane. (1)

Filtration Fraction
=
GFR ()
Renal Plasma Flow

= 125 = 0.2 or 20%
650

Factors affecting GFR
1. Glomerular capillary hydrostatic pressure GFR. ()
2. Capillary permeability GFR. ()
3. Plasma colloid osmotic pressure GFR. ()
4. Bowmans capsule hydrostatic pressure GFR. ()
5. Arterial blood pressure GFR. ()
6. Renal blood flow GFR. ()
7. Angiotensin II GFR. ()
8. Sympathetic stimulation GFR. ()

Reference: Guytons Physiology



Page 8 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper


Q.8 What are the features, causes and compensatory mechanisms of
Metabolic Acidosis? (5)

Topic Specification: Kidney Acid Base Balance Disorders.


KEY:

Metabolic Acidosis

Features:
1. Decreased HCO
3
-
concentration in ECF. ()
2. H
+
concentration pH below 7.4. ()

Causes:
1. Failure of the kidneys to excrete metabolic acids normally formed in the
body e.g. renal diseases renal failure.
2. Formation of excess quantities of metabolic acids in the body e.g.
diabetes mellitus, severe hypoxia.
3. Addition of metabolic acids to the body by ingestion or infusion of acids.
4. Loss of base from the body e.g. diarrhea, vomiting of intestinal contents.
5. Addisons disease, use of carbonic anhydrase inhibitors.

Compensatory Mechanisms:
1. Buffering by chemical buffers in the blood.
2. Respiratory rate of pulmonary ventilation which reduces PCO
2
.
3. Renal:
a) Increased secretion of H
+
.
b) Increased secretion of ammonia.
c) Regeneration of HCO
3
-
and addition to ECF.


Reference: Guytons Physiology





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Page 9 of 9
MBBS FIRST PROFESSIONAL PART- II EXAMINATION 2007
Physiology (SEQs)

Model Paper


Q.9 Enumerate physiological actions of Estrogens. (5)

Topic Specification: Reproduction - Estrogens


KEY:

Physiological actions of Estrogens:

1. At puberty, cause marked growth and enlargement of female sex
organs. ()
2. Change of vaginal epithelium from cuboidal type to stratified type.()
3. Cause proliferation of the uterine endometrium and epithelium of
fallopian tubes. ()
4. Cause development of breast stroma, duct system and deposition of fat
in the breasts. ()
5. Stimulate bone growth and inhibit osteoclastic activity. Early union of
epiphyses with the shafts in long bones. ()
6. Protein deposition in sexual organs, bones, fat deposition on buttocks
and thighs, increase metabolic rate. ()
7. Cause the skin to become soft, smooth, vascular with increased
warmth. ()
8. Cause the cervical mucous to become thin, alkaline, and watery. ()
9. Sodium and water retention by the renal tubules is produced by
estrogens. ()
10. Behavioural changes at puberty, interest in the opposite sex. ()



Reference: Guytons Physiology