1. Helper T cells act by

A. activating only cytotoxic T cells

B. stimulating antibodies release directly

C. activating B cells and cytotoxic T cells

D. presenting antigen to macrophages

E. producing class II MHC proteins

2. The cells in the body that are target cells for HIV are

A. B cells

B. helper T cells

C. microglial cells

D. macrophages

E. b and c

3. Cytotoxic T cells act by

A. secreting antibodies which attack invaders

B. attaching to antigens on invaders and secreting antibodies

C. attaching to antigens on invaders and secreting chemicals toxic to the invaders

D. secreting cytokines toxic to invaders into the blood to seek out and kill invaders

E. producing interferons that stop invading viruses from entering cells

4. In order for a helper T cell to interact with a macrophage or B cell and become activated

A. the antigen must be complexed with MHC I protein and presented to the cell surface

B. the antigen must be complexed with MHC II protein and presented to the cell surface

C. IL-1 must be produced by the helper T cell

D. the antigen must be complexed with MHC I protein and presented to lymphocytes

5. Transfusion of an incorrect blood type into a person will cause a form of tissue rejection mediated by

A. antigens

B. antibodies

C. cytotoxic T cells

D. NK cells

E. macrophages

6. When AIDS develops

A. B cells cannot perform adequately

B. cytotoxic T cells cannot perform adequately

C. T cells cannot perform adequately

D. macrophages cannot perform adequately

E. a, b, and c

7. One distinction between B cells and T cells is that

A. B cells directly attack an invader while T cells secrete antibodies that attack the invader

B. T cells produce antibodies

C T cells directly attack an invader while B cells become plasma cells that secrete antibodies that attack the invader

D. both cell types attack invaders directly but some B cells differentiate into plasma cells that also simultaneously secrete antibodies

8. All blood cells derive from a single population of cells called

A. hematopoietic cells

B. lymphocytes

C. interleukins

D.  monopotent stem cells

9. Which sequence is correct for the following events?  1. Fibrinogen

—-> fibrin 2.  clot retraction  3.  activation of prothrombin 4. prothrombin —-> thrombin

a. 3, 1, 4, 2

b. 3, 4, 1, 2

c. 1, 2, 3, 4

d. 4, 3, 1, 2

10. Warfarin (as a coumarin) acts by:

  a. inhibiting platelets production

b. stimulating platelets production

c. inhibiting Vitamin K epoxide reductase

  b. stimulating Vitamin K epoxide reductase

11. The flow rate of blood through the pulmonary capillaries is slow enough and the

exchange of gases fast enough, under resting conditions, that partial pressures of oxygen and carbon dioxide in pulmonary capillaries is nearly equal to those of alveolar air.  When more strenuous exercise necessitates larger exchanges of gases

A. diffusion rates of gases are increased by increased blood flow

B. pulmonary capillary beds, which normally are closed during quiet breathing, are opened up by the increase in blood pressure associated with increased activity, and in turn increases the gas transport surface area of the lungs

C. greater partial pressure of oxygen is created in the alveoli

D. pulmonary capillary beds, which normally are open during quiet breathing, are closed with increase in blood pressure, resulting in a more rapid exchange of gases between the alveoli and capillaries

12. If the atmospheric pressure is 752 mm Hg, and the partial pressure of nitrogen is 593 mm Hg, the partial pressure of oxygen would be:

A. 160 mm Hg

B. 257 mm Hg

C. 159 mm Hg

D. 79 mm Hg

13. In nonstrenuous circumstances, after “unloading” oxygen at tissue capillaries, hemoglobin normally remains approximately

A. 25% saturated with oxygen

B. 50% saturated with oxygen

C. 75% saturated with oxygen

D. nearly 100% saturated with oxygen

14. The subatmospheric intrapleural pressure that keeps the lungs ‘open’ is created by the

A. elastic recoil of the lungs and chest wall

B. diaphragm

C. transpulmonary pressure

D. presence of thin but rigid cartilage

15. The alveolar cells in the lungs are lined with a layer of water molecules.  This layer

A. often causes lung collapse due to surface tension

B. helps keep the lungs expanded and resists collapse

C. must contain surfactant to increase surface tension

D. must contain surfactant to reduce surface tension

16. The reason air does not flow in or out of the lungs at rest is that the

A. alveolar pressure is 4 mm Hg

B. intrapleural pressure is 4 mm Hg above atmospheric pressure

C. transpulmonary pressure is 0 mm Hg

D. intrapleural pressure and transpulmonary pressure are of equal but opposite value to each other which results in a alveolar pressure of 0 mm Hg

17. Inspiration occurs as a result of

A. an upward movement of the diaphragm

B. a moving downward of the ribs due to contraction of the inspiratory intercostal muscles

C. a downward movement of the diaphragm and an upward and outward expansion of the thoracic cavity

D. compression upward of the bowel and diaphragm by the abdominal muscles

18. For a premature infant without pulmonary surfactant which of the following will occur?

A. surface tension of alveoli is less than normal

B. large alveoli collapse more easily than small alveoli

C. a greater than normal pressure difference between the inside and outside of the lungs is required for lung inflation

D. the lungs can be inflated with normal muscle effort

19. A patient with a normal vital capacity expires only 40% of his forced expiratory volume/forced vital capacity in 1 second (FEV1/FVC). Which problem does this suggest?

A. abnormal low lung compliance

B. obstructive disease

C. restrictive disease

D. weak respiratory muscles

20. Which of the following neurotransmitters plays a role in brainstem centers for alternating states of consciousness?

A. serotonin

B. dopamine

C. acetylcholine

D. all of the above

21. The primary motor cortex and premotor areas

A. are the prime initiators of movement

B. contain only interneurons for the various reflex arcs

C. are located deep within the brain

D. are important relay and integrative stations but not prime initiators of movement

22. Effective therapy for behavioral disorders such as schizophrenia, depression, and manic behavior often involve treatment that

A. alters neurotransmitter function in the brain

B. modifies the basic structure of the brain

C. alters the nature of action potentials in neurons

D. alters the blood supply to the brain

23. The region of the brain that compares information about what muscles should be doing versus what they actually are doing is the

A. cerebrum

B. cerebellum

C. brain stem

D. sensorimotor cortex

24. The initial defect in Parkinson’s disease is due to degeneration of neurons in the

A. basal ganglia

B. dopamine receptors

C. substantia nigra

D. sensorimotor cortex

25. The region or system in the brain associated with emotions and learning is the

A. brainstem

B. cerebellum

C. peripheral system

D. limbic system

26. Second order neurons of both the specific and nonspecific ascending pathways terminate in the:

A. spinal cord.

B. medulla.

C. thalamus.

D. somatosensory cortex.

27. The region of the brain that deals primarily with control of posture, balance and coordination is the

A. cerebellum

B. cerebrum

C. hypothalamus

D. medulla oblongata

28. Which of the following characterizes lower motorneuron diseases?

A. exaggerated reflexes

B. enhanced recurrent activation of Schwann cells

B. atrophy of cerebrum

C. atrophy of the affected muscles

D. overactivity of medulla oblongata

29. An obese 39-year old man complains of falling asleep frequently during the day. Data from sleep laboratory shows frequent airway blockage during the night. What is your diagnosis?

A. Narcolepsy

B. Hypersomnia

C. Sleep apnea

D. Parkinson’s Disease

E. Alzheimer’s Disease

30. A 46-year-old man is diagnosed with a heart attack partly due to pain in his left upper arm. Why does he experience pain in his arm?

A. The heart attack limits his blood flow to the arm.

B. Afferent fibers from the heart and arm converge onto the same spinal neuron

C. Sensory input from the heart projects to relays in the thalamus

D. Sympathetic efferent fibers innervate both the heart and blood vessels in the arm

Part IIB.  (20 pts). Choose two.

1. Explain why patients with chronic respiratory diseases (COPD) are developing respiratory acidosis.

2. Explain why young person with anxiety attack can develop respiratory alkalosis.

3. A 22-year old man was in a motorcycle accident with resultant neck injuries that led to partial paralysis of the upper and lower limbs. Almost immediately his chest felt heavy and he became dyspneic. His pulmonary values:

Vital capacity (supine) = 650 ml

Minute ventilation (supine) = 6 L/min

Respiratory rate (supine) = 30 b/min

PaO2   = 61 mmHg

PaCO2 = 47 mmHg

What nerves and muscles are involved in this case? What is causing significantly reduced alveolar ventilation? ______________________________________

4. What would happen to cerebrospinal fluid pressure if the outflow of cerebrospinal fluid to the venous system by the way of arachnoid granulations would be blocked? If CSF accumulated, what would this do to the volume of brain tissue and blood contained within the skull? Does it need an emergency intervention or not?

1. Which of the following values characterizes uncompensated respiratory alkalosis?

	pH	PCO2 mmHg	HCO3 mmol/L
A	7.40	60	37
B	7.25	66	28
C	7.51	29	22
D	7.60	42	37
E	7.25	35	15

2. Memory is located in or throughout

A. just one part of the brain, the cerebrum

B. several parts of the brain depending upon the type of memory, including cerebral cortex

C. the hypothalamus

D. virtually all parts of the brain

3.Compare physiological, pathophysiological and clinical changes in patients with Parkinson’s and Alzheimer’s Disease.