ENDOCRINE AND METABOLIC PHYSIOLOGY:

1. Effects of a 24 hour fast:A. Glycogenolysis or gluconeogenesis CORRECTB. Protein catabolism – only prolonged fastingC. Acidosis – only prolonged fastingD. Ketone production from protein

2. After 24 hours without food or water a healthy young adult will:A. Deplete glycogen rapidly – No, it should only last about 24 hours (and the question states ‘after’)B. Develop a metabolic acidosisC. Demonstrate ketone body formation in the liver - CORRECTD. Have decreased protein content of body

3. Which hormone causes increased glycogenolysis, increased gluconeogenesis, increased protein anabolism & increased plasma FFA?A. CortisolB. Parathyroid hormoneC. Growth hormone - CORRECTD. Insulin

4. Which hormone causes increased BSL, increased protein catabolism & increased plasma FFA?A. Cortisol – CorrectB. Parathyroid hormoneC. Growth hormoneD. Insulin

5.The hypothalamus inhibits the release of:A. TSHB. ACTHC. FSHD. GH – Correct (somatostatin)E. Oxytocin

6. Which decreases renin release: mark any 2:A. PG – No, this stimulates renin secretionB. Angiotensin II – Correct, negative feedback by A2 on renin releaseC. Vasopressin – Correct, this inhibits renin secretionD. Baroceptor stimulation – No, this would increase renin secretion

7. Secretion of renin is stimulated by:

A. Increased left atrial pressureB. Increased angiotensin IIC. Decreased right atrial pressure – CORRECT: if this sufficient to activate renal sympathetic nervesD. erythropoietin

8. Regarding hyperglycaemia: Which of the following is untrue? It causes:A. Increased H+B. Increased Na+ (?K+)C. Increased urine outputD. Increased ECF (or blood volume)E. Increased glucagon - ANSWER

9. Mechanism of action of ADH:A. Insertion of water channels (pores) into basolateral membrane – No, apical membraneB. Increase in GFRC. Insertion of water channels into luminal (apical) membrane – CORRECT V2 receptors -> Adenalyl cyclase -> cAMP acting on vesicles containing Aquaporin-2 Channels (removed when cAMP levels fall)C. Increased Na+ uptake in DCTD. Removal of water pores from apical membrane

10. ADH and the cortical collecting ducts which is correct:A. Inserts water channels into the apical membrane – CorrectB. Inserts water channels into the basolateral membrane - IncorrectC. Increases paracellular flowd. removal of water pores froma apical membrane.

11. How many hours after a meal is Basal Metabolic Rate (BMR) measured?A. 1 hourB. 2 hoursC. 6 hoursD. 12 hours – CORRECTE. 18 hour

12. Which ONE of the following is a water soluble vitamin?A. Vitamin AB. Vitamin B – CorrectC. Vitamin DD. Vitamin EE. Vitamin K

13. regarding Insulin receptorA. Receptor site intracellular – No, extracellular (2 alpha subunits), and the 2 beta subunits are

intracellularB. Inactivates tyrosine kinase – Insulin binds to receptor, triggering the tyrosine kinase activity of the betasubunitsC. Activates membrane glucose transport - CORRECTD. Acts via activation of transport protein to increase glucose transport into cells

14. How does insulin act?A. Voltage gated ion channelsB. Tyrosine kinase membrane receptor - CorrectC. Nuclear receptorD. G protein

15. Heat production at rest is mostly due to:A. Skeletal muscle activityB. Na,K ATPase pump CORRECT -accounts for about 30% of basal activity, most is actually for ATP synthesisC. Dynamic action of foodD. activity of heart

16. Decreased heat production under general anaesthesia is due to:A. Decreased skeletal muscle tone – CorrectB. Decreased anterior pituitary functionC. VasodilatationD. StarvationE. Decreased Na+/K+ ATPase activity

17. Heat loss in anaesthesia due toA. Loss Na/K ATPaseB. Loss of skeletal muscle toneC. Vasodilatation – CorrectD. Respiratory tract

18. Angiotensinogen secretion is increased by:A. ACTH -CORRECT - glucocorticoids increase angiotensinogen secretion (Ganong, p439)B. Beta-endorphinC. Growth hormoneD. Antidiuretic hormoneE. Prolactin

19. The energy value of 1g of carbohydrate is:A. 3 kcal

B. 4 kcal – CORRECT - 4.1kcal/g liberated from carbohydrateC. 5 kcalD. 7 kcalE. 9 kcal

20. G protein coupled receptors. All true EXCEPT:A. Seven transmembrane componentsB. Hydrophobic linksc. G protein has intrinsic GTPase activity – CORRECT ., the alpha-subunit has GTPase activityD. The receptor is a heterotrimeric protein – No, the G protein is – the receptor is coupled to it - ANSWER

21. Endothelins:A. Produced by damaged vascular endotheliumB. VasoactiveC. Found in brain & intestineD. all are correct. - ANSWER

22. low respiratory quotient in a septic patient is due to:A. Increased lactic acidB. Fat metabolism – Correct, sepsis -> increased fat metabolism -> decreased RQC. Increased ventilationD. Fever