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1 Multiple-Choice Questions in Medical Physiology For Postgraduate Medical Entrance Examinations Revised 2014 E.S.Prakash, MBBS, MD Written and published by E.S.Prakash. Copyright © 2014, all rights reserved by E.S.Prakash. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means or stored in a database or retrieval system without prior written permission from the author. Disclaimer: Science and medicine constantly change and while I have tried to check information presented here with sources known to be reliable, I cannot guarantee that this book is error free. I encourage you to crosscheck information contained herein with other sources. This book is not written to be used to directly guide the care of patients. Therefore, I cannot accept any responsibility for any consequences that may arise from the use of information contained here in the care of patients. – E.S.Prakash 2 Table of Contents Chapter Pages Frequently used abbreviations 2 2 minutes please 3 General Physiology 4 Nerve, Muscle, Synaptic Physiology and Neurotransmission 22 Central Nervous System 37 Endocrinology and Reproduction 54 Gastrointestinal Physiology 72 Blood and Cardiovascular Physiology 81 Pulmonary Physiology 107 Renal and Acid-Base Physiology 123 Frequently used abbreviations aka – also known as BP – blood pressure CSF – cerebrospinal fluid ECF – extracellular fluid Hb – hemoglobin Hct – hematocrit ICF – intracellular fluid ISF – interstitial fluid MAP – mean systemic arterial pressure MCQ – multiple-choice question PCV – packed cell volume RBC – red blood cell SVR – systemic vascular resistance T/F – True or false TPR – total peripheral resistance (aka. Systemic vascular resistance) WBC – white blood cell WNL – within normal limits 3 2 minutes please Think of this book as a tool to help you assess how well you have learnt medical physiology. It has been written primarily for use in revision courses for doctors who are preparing for competitive postgraduate medical entrance examinations in India, but undergraduate medical students and postgraduate physiology students, may also find this helpful. The intent here is to use multiple-choice questions (MCQ) as a means to help the reader revise key facts, test understanding of concepts and the ability to apply them. Many questions that I have seen appear on entrance examinations test conceptual understanding and meaningful learning. However, depending on the exam, some test knowledge of facts that are not of significance to a practicing primary care physician, and an undesirable backwash effect of this is it tends to encourage rote learning over indepth learning of important concepts. In writing this book, I have focused on the immediate ‘learning needs’ of the target audience, which is to be successful on these exams. I’ve frequently included questions solely for learning and systematic revision of certain topics. Thus, not all questions are written to be equivalent in standard to questions commonly appearing in entrance examinations. That being said, the difficulty level of questions varies from one exam to another with some predominantly testing recall of facts whereas others test knowledge and understanding and the ability to apply concepts and solve problems. Just to be clear, no attempt is made here to be comprehensive. Summaries of certain topics can be found at the start of each section. I’d suggest giving the summaries a quick read before doing questions and explanations (for questions) that may be found in summaries upfront are not repeated. As MCQs with multiple correct answers enable more material to be revised with fewer questions, I have also frequently used such questions; this helps us get into and sustain the important habit of carefully reading all options in a question. Furthermore, some entrance exams use the multiple true-false type of MCQ, so some practice with this type of question is needed. For the purpose of preparing and revising for PG entrance examinations, I recommend: Ganong’s Review of Medical Physiology by Barrett et al, published by Mc Graw Hill, 2012. I continue to revise and publish Multiple-Choice Questions in Medical Physiology on a regular basis, and I welcome suggestions from readers for improving it. If you spot an error, please let me know. If any corrections are needed, I’ll post them on my website at http://esprakash.wordpress.com/mcqmedphy/ as soon as they are identified. This book is dedicated to the memory of Dr. William F. Ganong. E.S.Prakash, MBBS, MD Associate Professor of Physiology Mercer University School of Medicine, Macon, Georgia, USA E-mail: