GEETANJALI MEDICAL COLLEGE & HOSPITAL

DEPARTMENT OF PHYSIOLOGY
2 BLOCK END EXAM (January 15, 2024)
nd

Roll no. _________________________ Name ________________________________________

Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks : 80 + 20 = 100

Q1: History: A 25 year old lady comes to OPD with chief complaints of weakness and easy
fatiguability. She is energetic in the morning but as the day passes by she feels tired with
the routine household activities. The condition improves by some rest or sleep. She also
reports of double vision and difficulty in swallowing.

Physical examination-Vitals – Normal

Presence of Ptosis, Diplopia, Proximal muscle weakness,
Normal deep tendon reflexes with no sensory
impairment
Lab investigations-
 Positive Tensilon test (Anticholinestrase test)
 Presence of Anti-Acetylcholine receptor antibodies
(AChRA)
 Electrodiagnostic tests show rapid reduction in amplitude on the repetitive nerve
stimulation (Decremental response)

Based on the above clinical scenario, answer the following questions:

1. What it the probable diagnosis? Explain the pathophysiology of the disease (1+1.5)
2. Explain the mechanism of transmission of impulse across the Neuromuscular junction with the help
of a flow chart and diagram, (2.5)
3. Why does the patient feel tired after repeated activity? (2.5)
4. What is the physiological basis of management in this patient?
(2.5)
Q2: Write short notes on
a) Describe the degenerative changes taking place in the distal stump of the nerve, which
is cut during an injury? (5)
b) Draw a well labelled, self explanatory diagram of action potential of the following
i. Skeletal muscle (2.5)
ii. Cardiac muscle (2.5)
c) Define V/Q ratio. Discuss in brief factors affecting V/Q ratio. What will happen to V/Q
ratio in a patient of pulmonary embolism? (1+2+2=5)
d) Define surfactant and describe its function. What will happen to the respiration of a
premature new born baby? (1+3+2=5)

1
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
2 BLOCK END EXAM (January 15, 2024)
nd

Q3: Write short notes on

a) Differentiate between sympathetic & parasympathetic nervous system based on-
i. Origin ii. Pre and postganglionic fibers iii. Receptors present in tissues iv. Functions on pupil,
heart, respiratory system, sweat gland and on urinary system (1+1+1+2=5)
b) Describe the property of length tension relationship in a skeletal muscle 5)

Q4: Write short notes on

a) Differentiate between isotonic and isometric contraction (2.5)
b) Describe the various energy sources for the muscle contraction (2.5)
c) Describe the pressure volume changes occurring during mechanical ventilation (2.5)
d) Write any two peculiarities of pulmonary circulation. (2.5)

Q5: Write short notes on

a) Describe the molecular basis of muscle contraction in a skeletal muscle (5)
b) Draw a neat, labeled, self explanatory diagram of Spirogram. (5)
c) i). Why Nerve fiber cannot be stimulated during ARF? (2.5)
ii) What will happen if conc. of K+ increases in extra cellular fluids? (2.5)
d) Write the Classification of nerve fibers: Erlanger Gasser, Numerical and Physioclinical
Classification (5)
Q6: Describe in brief:
a) Describe the strength- duration curve with the help of a well- labelled diagram. (5)
b) A Tourist while his trip to the jungles of South Africa was accidently hit by an arrow following
which he could not move his limbs and was unable to get up? What is the pathophysiology of
his clinical condition? How does it differ from the clinical condition that could arise on
consumption of inappropriately cooked Puffer Fish? (2.5+2.5)

Multiple Choice Questions

 Time duration : 20 Minutes
 Each question has ONE SINGLE BEST RESPONSE.
 Each question carries ONE mark.
 Maximum Marks : 20
 There is no negative marking.
 Fill your responses correctly in the OMR sheet given to you. It has to be submitted in 20 minutes

1. The main site of airway resistance is 3. During standing the mean pulmonary
a) Respiratory bronchioles pressure at the apex of the lungs is
b) Terminal bronchioles a) 30 mm of Hg
c) Alveolar ducts b) 11 mm of Hg
d) Trachea and the major bronchus c) 26mm of Hg
d) 4 mm of Hg
2. All are features of Duchene Muscular
dystrophy EXCEPT
a) Pseudohypertrophy of the muscles 4. Troponin I serves the function of:
b) Waddling gait a) Initiating the process of Excitation –
c) Mutation of gene that encodes for contraction coupling
dystrophin b) Prevents the interaction between
d) Elevated levels of AChR antibodies Myosin head and Actin
c) Causes relaxation of the muscle fiber
d) Acts as an anchoring Protein

2
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
2 BLOCK END EXAM (January 15, 2024)
nd

5. Optimum Length is defined as 9. Label the following diagram in the

a) Length of the muscle at which it will sequence of A, B, C, & D respectively
develop maximum active tension
C
b) Length of the muscle during relaxed B
state A D
c) Length of the muscle before it starts
contracting
d) Length of a relaxed muscle when
detached from its bony attachment
a) Myosin, titin, Actin, z-line
6. Lambert Eaton syndrome is caused due b) Actin, myosin, titin, z-line
to c) Actin, myosin, z-line, titin
a) Formation of Antibodies against the d) Myosin, Actin, z-line, titin
voltage gated sodium channels
b) Formation of Antibodies against the 10. Kartagener syndrome is characterized
acetylcholine gated sodium channels by
c) Formation of Antibodies against the a) Extra copy of X- chromosome
voltage gated calcium channels b) Congenital absence of Axonemal
d) Formation of Antibodies against the Dyein and ATPase resulting in
Ligand gated calcium channels absence of ciliary motility
c) Mutation of gene encoding for Actin
7. If the electrodes are placed on a mixed d) None of the Above
nerve in such a way that both the
electrodes are placed on its surface. 11. In Hysteresis loop air in the lungs
Which out of the following statements is during inspiration is than
TRUE? during expiration for the same
a) The nerve will show compound action intrapulmonary pressure
potential a) More b) Same
b) The resting membrane potential is c) less d) No relation
zero
c) All the motor units will be stimulated 12. The main function of Pulmonary
with threshold stimulus. Alveolar macrophages is
d) The sensory fibers of mixed nerve a) They help in processing of the
respond faster as compared to motor inhaled antigens from
fibers immunological attack
b) Storage of hormones and biologically
8 A person has slept on his arm and on active substances
waking, he feels numbness due to c) Absorption of inhaled toxic gases
compression of nerve fibres:- d) Act as a filter to remove debris from
a) Aα and Aβ the blood
b) C
c) B 13. Two adjacent alveoli communicate with
d) Aδ each other through
a) Gap Junctions
b) Pores of Kohn
c) Intercalated discs

3
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
2 BLOCK END EXAM (January 15, 2024)
nd

d) None of the above 18. Which of the following statement is not

14. A 10 year child was brought to the true for transport of carbon dioxide?
emergency department with complaints a) Combination of Carbon dioxide with
of excessive lacrimation, excessive Hb is irreversible
salivation, excessive urination and pin- b) 23 % of carbon dioxide is
point pupils. What is the transported as carbamino-
pathophysiology of the given clinical compound
condition? c) Exchange of HCO-3 with chloride in
a) Overactivity of muscarinic receptors the blood in the lungs is K/a reverse
b) Blockage of muscarinic receptors chloride shift
c) Overactivity of nicotinic receptors d) 70% of the carbon dioxide is
b) Blockage of nicotinic receptors transported as bicarbonate

15. Pulmonary arterial hypertension can 19. Stiffening of the muscles due to
develop in which of the following depletion of ATP after death is known
condition? as
a) When the pulmonary capillary a) Calcium rigor
hydrostatic pressure is more than b) Heat rigor
11mm of Hg c) Rigor mortis
b) When a person lives at high altitude d) None of the above
c) When patient has a right sided heart
failure 20. Botulinism is characterized by all of
d) When the pulmonary arterial the following features EXCEPT
pressure is more than the a) Damage to the snare proteins that
pulmonary alveolar pressure prevents docking of the Secretory
16 Uneven Alveolar ventilation is seen in: vesicles
a) Bronchial Asthma b) Develops due to consumption of
b) Pulmonary Embolism unrefrigerated or poorly refrigerated
c) Fallot’s Tetralogy food
d) None of the above c) Patient complaints of extreme
17. Normal value of respiratory quotient is tiredness, Ptosis, blurred vision
a) 0.5 b) 0.7 d) Development of Antibodies against
c) O.8 d) >1 the nicotinic receptors present on
the post- synaptic membrane

4
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
3rd BLOCK END EXAM (CARDIOVASCULARPHYSIOLOGY)
March 11, 2024
Roll no. _________________________ Name ____________________________________
Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks: 100

Q1.Describe Cardiac cycle under following headings: (1+4+5=10)

a) Definition
b) The various events taking place in a cardiac cycle
c) Volume and pressure changes in the left ventricle, left atrium and aorta with the help of
Wigger’s diagram
Q2. Case based/ Integrated questions: - (5x4=20)

a) History: A 16-years-old adolescent male complained of palpitations and syncope after

running on the treadmill for 20 minutes. There is a similar history of palpitations in the
past few months. The physical examination shows no significant abnormal findings,
however there is tachycardia. ECG shows supraventricular tachycardia, with shortened
PR intervals along with broad QRS complexes and the presence of delta waves (slurring of
upstroke of QRS complex).
Based on the above clinical scenario answer the following question: (1+3+1=5)
1. What is the probable diagnosis?
2. Explain the pathophysiology of this disease.
3. What is the cause of appearance of delta wave on ECG?

b) History: A 55 year old male presents to OPD with complain of shortness of breath even while
performing routine activities. During sleep he often gets attacks of severe shortness of breath
and coughing which awakes him from sleep. This episode of coughing persists even in sitting
position.
General physical examination- The patient is calm, conscious, well oriented to time, place
and person. Pulse- 90/min with a characteristic pulsus alternans,
B.P = 130/ 90 mm Hg, Pitting edema is seen on the ankles (++),
JVP is 7 cm.
Systemic Examination of:
 Abdomen shows hepatomegaly
 Respiratory system: bilateral dull percussion note on costophrenic
angles.
 Auscultation reveals basal crepitations in both the lungs.
 Cardiovascular system:
o X Ray chest: Cardiomegaly
o ECG shows signs of right and left ventricular hypertrophy.
2D Echocardiography shows dilation of all the cardiac chambers with
poor contractility of cardiac walls and reduced ejection fraction
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
3rd BLOCK END EXAM (CARDIOVASCULARPHYSIOLOGY)
March 11, 2024
Based on the above clinical scenario answer the following question (1+2+2=5)
i. What is your Probable diagnosis?
ii. What is the cause of raised JVP and liver enlargement in this patient?
iii. What is the cause of shortness of breath in this patient?

c) Describe the Mechanism of Bradycardia in a patient with raised Intra-cranial pressure?

Name the reflex which describes this phenomenon. (5)
d) Describe the factors affecting venous return (5)

Q3.Write short notes on: (5x4=20)

a) Describe the physiological basis and significance of all the heart sounds.
b) Draw a well labelled diagram of Normal Electrocardiogram (ECG). What is the clinical
significance of ST segment?
c) What is the role of kidney to regulate blood pressure?
d) Describe the physiological basis of generation and conduction of cardiac impulse.

SECTION B

Q4. Answer the following questions: (5x4=20)

a) Describe the mechanism of Bradycardia in a patient with raised intracranial pressure.

Name the reflex which describes this phenomenon? (4+1=5)
b) Define Heart block. Enumerate the types of Heart block. Describe the Wenckebach
Phenomenon? (1+1++3=5)
c) Describe the Baroreceptor reflex in a patient who stands up from lying position (5)
d) Describe functional anatomy of the coronary circulation. Describe the peculiarities and
regulation of coronary blood flow (5)

Q5.Write short notes on: (2x5=10)

a) Describe the physiological basis and significance of all the heart sounds
b) Describe the innervation of heart and significance of vagal tone.

Q6. Answer the following questions: (4x5=20)

a) Draw a well labelled diagram of pace maker potential of cardiac muscle showing its
phases and physiological basis
b) Define cardiac output. Describe the Heterometric regulation of cardiac output
c) Explain why cardiac muscle cannot be tetanized?
d) Define Shock, Enumerate the types of shock. Describe the pathophysiology of the shock
that would develop in a patient who suffers from severe blood loss and is admitted to the
casualty with a weak thready pulse and BP =90/70 mm of Hg?

_____________________End of Paper _____________________

 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
4nd BLOCK END EXAM (April 08, 2024)

Roll no. _________________________ Name ___________________________________

Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks : 80 + 20 = 100

Section - A

Q. 1. Write short notes on- (20)

a) Enumerate various ECG leads in the 12 lead ECG. Describe Einthoven Law.
(2 + 3= 5)
b) Describe the ionic basis of the Platue potential in cardiac muscle. (5)
c) Draw the diagram showing aortic & left ventricle pressure changes during cardiac
cycle. (2.5 + 2.5 = 5)
d) Regulation of coronary circulation (5)
Q. 2. Clinical Case-
Patient History: Mr. Ram, a 65-year-old male, presents to the emergency department
with complaints of increasing shortness of breath and bilateral lower extremity swelling
for the past week. He reports a history of hypertension and type 2 diabetes, which have
been poorly controlled. He denies any recent fever, chest pain, or palpitations. Upon
further inquiry, he admits to non-compliance with his medications due to financial
constraints.

Physical Examination: Vital Signs: BP 160/100 mmHg, Heart rate 98 bpm, Respiratory
rate 24/min, Temp 98.6°F; Cardiovascular: Jugular venous distension, bilateral basal
crepitations on lung auscultation, displaced apex beat; Extremities: Bilateral pitting
edema up to mid-shin.

Diagnostic Tests: ECG: Sinus rhythm, left ventricular hypertrophy; Chest X-ray:
Cardiomegaly, pulmonary congestion; Echocardiography: Left ventricular ejection
fraction (LVEF) 30%, dilated left ventricle, mitral regurgitation

On the basis of above case scenario answer the following questions- (10)
a) What is the probable diagnosis? (2)
b) What is the cause of bilateral lower extremity swelling? (2)
c) What is the cause of bilateral basal crepitations on lung auscultation? (2)
d) What would be physiological basis of management of this patient? (4)

Q. 3.Explain the following- (10)

a) What will happen to the heart rate if all cardiac innervations are cut? (2.5)
b) Generally, all the ECG observations in Lead aVR are negative (downward deflection).
Why? (2.5)
c) Systolic BP is more than Diastolic BP. Still, mean arterial BP is more dependent on
diastolic BP. Why? (2.5)
d) Capillaries are less prone to rupture. Why? (2.5)
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
4nd BLOCK END EXAM (April 08, 2024)

Section - B

Q 4. Describe the formation of Urine under following headings: (10)

a) Describe the regulation and factors affecting GFR (2.5+2.5=5)
b) Describe counter current system for concentration of urine (5)

Q5. Case based/ Integrated questions: (20)

a) A 44-year-old male comes to the urologist with pain in the suprapubic region and
dribbling micturation. He had met with a Road Traffic Accident (RTA)1 year back
with complete transection of the spinal cord at the level of L4-L5 and is now in the
recovery phase. On leading question, the patient confirms that he has to void urine
at regular intervals. Patient is normotensive, non-diabetic, non-smoker and a social
drinker.
On Examination
Patient is conscious, co-operative well-oriented to time, place and person.
Vitals: Normal
General physical examination (GPE): Normal
CNS examination: Findings are consistent as in the recovery phase after a spinal
injury.
Investigations
Urine routine examination: Pus cells—40-50/Hpf
Albumin—trace
Sugar and ketones—absent
Based on the above case, answer the following questions: (2+1+2=5)
1. What is the physiological basis of the symptoms present in the above case?
2. Enumerate the various bladder dysfunctions.
3. Describe the innervations of the urinary bladder.
b) 1. Describe the Juxtaglomerular apparatus with well labelled diagram. (2.5)
2. Why patients of chronic renal failure (CRF) are more prone to fractures? (2.5)
c) What will happen to the renal blood flow if the dietary intake of protein is high? (5)
d) Define and classify diuretics. Describe the mechanism of loop diuretics (2.5+2.5=5)

Q. 6. Write short notes on (any 2) (10)

a) Describe the role of Kidney in pH regulation (5)
b) Role of PCT in formation of urine (5)
c) 1. Describe the role of ADH in water homeostasis (2.5)
2. Describe transport maximum (TmG) for glucose. (2.5)
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
4nd BLOCK END EXAM (April 08, 2024)

Section - C
Multiple Choice Questions
 Time duration : 20 Minutes
 Each question has ONE SINGLE BEST RESPONSE.
 Each question carries ONE mark.
 Maximum Marks : 20
 There is no negative marking.
 Fill your responses correctly in the OMR sheet given to you. It has to be submitted in 20
minutes

1. If concentration PAH in urine (U PAH ) filtered out through the glomurulus in

=5.85 mg/ml; Urine flow rate= 1 unit time
ml/minute; Extraction ratio= 0.9;
Hematocrit- 50%. The value of Renal 5. Tm limited absorption implies that-
Plasma flow & Renal Blood flow should a) Reabsorption is passive
be, respectively- b) Amount of absorption depends
a) 585 ml/min; 1170ml/min.
critically on the length of time the
b) 650 ml/min; 1300 ml/min
substance is present in the tubules
c) 125 ml/min; 250 ml/min.
c) Below a threshold tubular load, the
d) 1300ml/min; 2600 ml/min. substance is completely reabsorbed
d) Renal clearance of substance
2. Effect of long standing hypertension on reabsorption decreases as its plasma
the kidneys causes concentration increases until its Tm is
a) Damage to the vascular endothelium reached
and replacement of the normal tissue by
fibrous tissue causing 6. Elevated levels of parathyroid hormone
Glomerulosclerosis in CRF is due to
b) Activation of RAAS resulting in a) Hyperphosphatemia
aggravation of hypertension
b) Hyperkalemia
c) Tubular cell injury c) Hypocalcaemia
d) All of the above
d) Hypomagnesaemia

3. ACE inhitors when used in patients of 7. Water dieresis differs from osmotic
renal disease will lead to
dieresis in that-
a) Increased sodium and water retention a) It is produced due to presence of large
b) Increased potassium excretion quantity of unabsorbed solutes in renal
c) Decreased sodium and water tubules
retention b) Characterized by production of large
d) Increase in the blood volume and BP
volume of urine
c) Produced due to decreased
4. Which of the given statement about the reabsorption of water in PCT and loop of
plasma clearance, is wrong- Henle
a) In a healthy person, Plasma d) Characterized by diuresis of dilute
Clearance for albumin is zero urine
b) In a healthy person, for a freely
filtered substance, plasma clearance 8. Frothy urine is indicative of-
may be less than GFR a) Glycosuria
c) In a healthy person, PAH Plasma b) Haematuria
clearance more than 125 ml/minute c) Proteinuria
d) Plasma clearance for a substance
d) Phosphate in urine
represents the amount of substance
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
4nd BLOCK END EXAM (April 08, 2024)

9. In nephrotic syndrome on blood c) Anastomosis is seen between the

examination- branches of coronary arteries and
a) Serum albumin decreases, serum branches of deep systemic veins
globulin decreases, serum cholesterol d) Anastomosis is seen between
Increases coronaries and vessels lying outside the
b) Serum albumin Increases Serum heart
globulin Increases, Serum cholesterol
15. Pre-Load may be represented in terms
Increases
of-
c) Serum albumin decreases serum
a) Peripheral resistance
globulin Increases serum cholesterol
b) End Systolic Volume
Increases
c) End Diastolic Volume
d) Serum albumin Increases serum
d) Left ventricle pressure
globulin decreases, serum cholesterol
Increases 16. Which is CORRECT equation for Blood
Pressure -
10. Which of the following changes tends to a) BP= Stroke Volume X Peripheral
increase peritubular capillary fluid Resistance
reabsorption? b) BP= Stroke Volume X Heart Rate X
a) Increased blood pressure Peripheral Resistance
b) Decreased filtration fraction c) BP= Cardiac Output X Heart Rate X
c) Increased efferent arteriolar Peripheral Resistance
resistance d) None of the above
d) Decreased angiotensin II
17. During day to day life events, which
11. Calculate the Cardiac Output of a given mechanism acts as B.P Buffer system-
subject, it the oxygen consumption of a) Renin angiotensin system
the body is 200 ml/min. and the b) Baroreceptor reflex
arteriovenous difference of oxygen c) Chemoreceptor reflex
concentration is 40 ml- d) Renin angiotensin aldosterone system
a) 4 L/minute
b) 8 L/minute 18. Which statement is WRONG about left
c) 5 L/minute heart failure-
d) Given data is not sufficient to a) It may result in right heart failure
calculate Cardiac output b) Pulmonary oedema might be the
clinical presentation
12. Prolonged PR interval indicates c) Decrease in ejection fraction of left
increased- ventricle
d) There must be increase in pulse
a) Sympathetic tone to SA node
pressure
b) Parasympathetic tone to SA node
c) Parasympathetic tone to AV node
19. Which of the following is not considered
d) Sympathetic tone to AV node
for assessing the effect of Laplace in
13. Peripheral resistance depends upon- vascular system ?
a) Arteries a) Distending intralmural pressure
b) Arterioles b) Wall thickness and tension
c) Capillary c) Radius of vessel
d) All of the above d) Composition of blood

14. Coronary arteries are end arteries 20. In the ECG recording, Q wave is due to-
because- a) Atrial depolarization
b) Depolarization of interventricular
a) A given area of the myocardium is
septum
supplied by a single artery
c) Depolarization of major portion of
b) There occurs overlapping of arteries
major portion of both the ventricles
supplying an area of the myocardium
d) Depolarization of base of ventricle
 DEPARTMENT OF PHYSIOLOGY
FIRST BLOCK END/PCT-1 EXAMINATION
February 02, 2023

Roll no. _________________________ Name ____________________________________

Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours Maximum marks: 100

Q1. Describe Immunity under following headings: (1+4+5=10)

a) Definition
b) Mechanism of cell mediated Immunity
c) Immunoglobulin- structure, types & functions

Q2. Write short notes on:

a) A 20-year-old male complains of pain in loin and passage of dark urine after taking the
treatment for malaria. Examination of the patient revealed nothing significant.
Lab investigations of this patient were obtained as under:
Hemoglobin: 10 g% , RBC count: 3 million/cu.mm.
(Note: Plasma hemoglobin and methemoglobin levels are raised)
PBF: RBC are normocytic and normochromic with polychromasia, basophilic stipplings
and marked poikilocytosis. Bite cells were also seen in the smear.

Based on the above clinical scenario answer the following questions: (1+2+2=5)

1. What do you think, this patient is suffering from?

2. What is mechanism of the deficient enzyme in this condition?
3. Define anaemia. Classify anaemia on the basis of etiology?
b) A young boy of 8 years complained of a swollen knee after he fell from the bicycle. He
also complained of some bluish discoloration of the skin of right arm. His past history is
suggestive of prolonged bleeding even after minor injury. On examination he was found
to have a hematoma of the knee. His lab investigations show prolonged CT, APTT with
normal BT and PT. His hemoglobin is 9.0 g%.
Based on the above clinical scenario answer the following questions: (1+3+1=5)
1. What is the probable diagnosis?
2. Explain the reason for the normal bleeding time in this patient?
3. Give the reason for prolonged CT and APTT in this patient

c) Define homeostasis. Describe the negative feedback mechanism (1+4)

d) Describe the capillary fluid dynamics based on starling forces. How are these forces
affected in hypoproteinemia? (2.5+2.5=5)

Q3. Write short notes on (any 4) (4x5=20)

a) Enumerate the plasma proteins. Describe their functions (1+4)

b) With the help of flowchart, describe the intrinsic and extrinsic pathway of clotting.
(2.5+2.5=5)

1
 DEPARTMENT OF PHYSIOLOGY
FIRST BLOCK END/PCT-1 EXAMINATION
February 02, 2023
c) Define Landsteiner’s law. Describe the physiological & clinical importance of blood
groups (2+3=5)

d) Describe the factors regulating erythropoiesis (5)

e) Describe the fate of haemoglobin. (5)

Q4. Describe the transport across cell membrane under following headings:

a) Enumerate various transport mechanisms. (1)

b) Define and describe the factors affecting diffusion. (4)
c) Describe the physiological significance of Na+ K+ ATPase pump (5)

Q5. Give the physiological basis of (any 4) (5x4=20)

a) Increased RBC count in new borns.

b) Role of plasmin in basal anti clotting mechanism
c) Increase MCV in patients undergoing bariatric surgery for weight loss (stomach is
partially removed)
d) Giving the booster doses in vaccination schedule.
e) Anti D injection to the Rh negative mother, who has delivered Rh positive baby few
hours ago.

Q6. Answer in brief/ Fill in the blanks (not more than 1 line): (Any 20) (1 x 20=20)

i. Name the Globin chains in HbF.

ii. Koilonychia is a sign of ____________
iii. Macrocytic normochromic anaemia is seen in ______________________
iv. Why the RBC doesn’t have nucleus?
v. Clinical significance of plasmapheresis _____________________
vi. Name a natural anti coagulant._____________________________
vii. Name the prothrombin activator ___________________
viii. Name site where tight junctions are present_______________
ix. Enumerate the G-protein linked pathways._________________
x. Heridetary spherocytosis is seen in deficiency of __________________
xi. Increased uptake of O2 by neutrophil after phagocytosis is called as________________
xii. What will happen of terminal ileum is removed____________
xiii. Define apoptosis.
xiv. Enumerate the buffer systems in the blood.
xv. Give one important advantage of biconcave shape of RBC .
xvi. What is the normal value of glycated Hb (Hb A C) in a non diabetic person?
xvii. What will happen to the size of RBC if we place it in a solution containing 0.45% NaCl ?
xviii. Which type of bilirubin will increase in a patient of massive hemolysis?
xix. What is major cross matching?
xx. Name two opsonins.
xxi. Name the storage form of iron.
xxii. Name the indicator substances used to measure the plasma volume.

2
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
2nd BLOCK END EXAM (March 23, 2023)

Roll no. _________________________ Name ____________________________________

Multiple Choice Questions
 Time duration: 30 minutes
 Each question has ONE SINGLE BEST RESPONSE.
 Each question carries ONE mark.
 Maximum Marks: 20
 There is no negative marking.
 Fill your responses correctly in the OMR sheet given to you. It has to be submitted in 30 minutes

1. A person has slept on his arm and on a) Rheobase b) Chronaxie

waking, he feels numbness due to compression c) Utilisation time d) Double the Rheobase
of nerve fibres:-

a) Aα and Aβ b) C c) B d) Aδ
6. Which property of motor unit is elicited if
you pick up a weight of 5 Kg and then 15 Kg?
2. On a business trip to Japan, Mr. Anil went
to ordered a delicacy in which the puffer fish is a) Adaptability b) Recruitment
used. The chef in this restaurant was new and c) Interference d) Asynchrony
couldn’t clear the fish from tetrodotoxin
present in it. Which of the following channel
are most likely to blocked by it?
7. If the electrodes are placed on a mixed nerve
a) Calcium channels in such a way that both the electrodes are
b) Voltage gated Na+ channels placed on its surface. Which out of the
c) ACh gated Na+ channels following statements is TRUE?
d) Ryanodine receptors
a) The nerve will show compound action
potential
3. Identify the proteins A&B required for
docking of synaptic vesicles b) The resting membrane potential is zero
c) All the motor units will be stimulated with
threshold stimulus.
d) The sensory fibers of mixed nerve respond
faster as compared to motor fibers

8. The increase in rate of respiration after

running for some time is due to:

a) A: syntaxin B: synaptobrevin a) Muscle fatigue b) Oxygen debt

b) A:synaptobrevin B: syntaxin c) Respiratory burst d) Increased blood
c) A: SNAP B: syntaxin supply
d) A: synaptobrevin B: SNAP

9. A person is travelling in a bus and feels an

4. Latent period of muscle twitch is 10 m.sec, urge to micturate. After a few minutes, his
contraction period is 50 m.sec. What is the urge dies down due to decreased intravesical
tetanising frequency of the muscle? pressure. Which of the following properties of
smooth muscle best describes this
a) 10 Hz b) 20 Hz phenomenon?
c) 25 Hz d) 30 Hz
a) Capillary fluid shift b) Tetanus
c) Stretch reflex d) Plasticity of smooth
5. The threshold stimulus for a nerve is best muscles
described by
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
2nd BLOCK END EXAM (March 23, 2023)
think, should be the pathophysiology of the
10. Label the following diagram in the given condition?
sequence of A, B,C, & D respectively a) Absence of the inhibitory neurotransmitters
from myenteric plexus
b) Absence of the excitatory neurotransmitters
from myenteric plexus
c) Absence of ganglionic cells from the distal
bowel
d) Absence of interstitial cells of Cajal in the
distal bowel

a) actin, myosin, titin, z-line 16. Functions of liver included production of

b) myosin, titin, actin, z-line
c) myosin, actin, z-line, titin a) Digestive enzymes b) Secondary bile acid
d) actin, myosin, z-line, titin c) Stercobilinogen d) Taurocholic acid

11. A tumour producing large amount of 17. Which of the following statement is NOT
intestinal hormone GIP may result in: TRUE for the GUT-BRAIN AXIS:

a) Hyperglycemia b) Hypoglycemia a) It is a bi-directional communication between

c) Diarrhoea d) Intestinal colic the GUT- microbiota and CNS
b) The GUT-microbiota breaks down the
Dietary fibers into Small chain fatty acids
12. A plain X-Ray film of the abdomen of a c) One of the neurotransmitters involved in the
normal healthy man is expected to show some GUT- BRAIN axis is Serotonin
gas in all following EXCEPT: d) GUT-Brain Axis primarily regulates GI
motility
a) Stomach b) Common bile duct
c) Small intestine d) Transverse colon
18. Atrophy of gastric mucosal glands likely to
result in:-
13. Rat-tail appearance or Bird’s beak
appearance is an X-ray finding in which of the a) Diminished digestion of starch
following clinical condition b) Failure of digestion & absorption of proteins
c) Normochromic Normocytic anaemic
a) Dumping Syndrome b) Adynamic ileus d) High gastric level in blood
c) Achalasia cardia d) GERD

19. The stomach has an ability to absorb:

14. The part of GIT that is not affected by
disorders of the Myenteric plexus a) Ca2+ b) Alcohol
c) Aromatic amino acids d) Fe2+
a) Rectum b) Caecum
c) Esophagus d) Pharynx
20. Secretion of the Acinar cells within the
15. A 2 month old male child was brought to exocrine Pancreas is NOT increased by
the paediatrician with complaints of abdominal
distension, constipation and excessive crying a) Secretin b) CCK
since 2 days. Physical examination of abdomen c) Vagal stimulation d) HCO3 ions
and rectum showed distended abdomen, empty
rectum with hard fecal mass. Barium meal
study shows small rectum with dilated colon
above the narrowed segment. What do you
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
2nd BLOCK END EXAM (March 23, 2023)

Instructions for students:

1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 2.5 hours; Maximum marks: 80
SECTION A

Q1.Describe Excitation contraction coupling mechanism under following headings: (10)

a) Transmission of impulse from nerve to muscle (4)
b) Role of calcium in muscle contraction (2)
c) Molecular mechanism of contraction (4)

Q2. Write short notes on :- (5x3=15)

a) History: A 25 year old lady comes to OPD with chief complain of weakness and fatigability.
Generally, during morning she does not feel any significant weakness but, as day passes and she
gets involve in routine household works, weakness gradually starts to increase. The condition
improves by some rest or sleep. She also reports double vision and difficulty in swallowing.

Physical examination- Ptosis, Diplopia, Proximal

muscle weakness, Normal deep tendon reflex, No
sensory impairment

Lab investigations-

- Positive Anticholinestrase test

- Electrodiagnostic testing shows rapid reduction in
amplitude of the repetitive nerve stimulation (Decremental response)

Based on the above clinical scenario, answer the following questions:

1.What do you think, this patient is suffering from, justify your diagnosis? (2.5)
2. What is the physiological basis of management in this patient? (2.5)

b) Draw a well labelled, self explanatory diagram of action potential of the following
i. Skeletal muscle (1.5)
ii. Cardiac muscle (1.5)
iii. Pacemaker tissue (2)
c) Describe the degenerative changes taking place in distal stump of the nerve, which is cut
during an injury (5)
OR
Explain why the patient, who has been given local anaesthesia, doesn’t feel the pain but can
still feel the touch sensation (5)

Q3.Write short notes on: (5x3=15)

a) Differentiate between the skeletal muscle and cardiac muscle based on various structures,
electrical and functional aspects (5)
b) Describe the property of length tension mechanism in muscle (5)
c) Describe the various energy sources for the muscle contraction (5)
OR
Differentiate between isotonic and isometric contraction (5)
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
2nd BLOCK END EXAM (March 23, 2023)
SECTION B

Q4. Describe the gastric secretion under the following headings (10)
a) Mechanism of secretion (4)
b) Regulation of gastric secretion (4)
c) Why the gastric mucosa is not digested, despite of very low pH (2.5) in stomach (2)
Q5.Write short notes on: - (5x3=15)
a) A 43-year-old female complains of Yellowish discoloration of eyes and pain in right
hypochondrium which is radiating to right shoulder since 7 days. She also has fever since 2
days.
On Examination
1. Yellowish discoloration of sclera & mucus membrane.
2. Radiating pain to the right shoulder on palpating the right hypochondrium (Murphy’s sign).
Lab. Investigations
a. Serum bilirubin – 6 mg/dL (6 times the upper normal limit)
b. S. conjugated bilirubin-5 mg/dL
c. S. unconjugated bilirubin-1 mg/dL
d. SGOT-113 IU (3–4 times the upper normal limit)
e. SGPT-110 IU (3–4 times the upper normal limit)
f. Serum alkaline Phosphatase-300 IU (3 times upper normal limit)
USG
Gall bladder is distended with distal acoustic shadowing and sludge. Common bile duct
appears to be dilated.
Based on the above clinical scenario, answer the following questions:
1. What do you think, this patient is suffering from, justify your diagnosis? (2.5)
2. Describe the mechanism of secretion of bile? (2.5)

b) Describe the functions organisation of enteric nervous system. Describe the effect of
parasympathetic nervous system on ENS (4+1=5)
c) Describe the gastric motility in detail. Describe the physiological significance of migratory
motor complexes. (2.5+2.5=5)
OR
Describe the enterohepatic circulation and its physiological significance (2.5+2.5=5)

Q6. Write short notes on: - (5x3=15)

a) Describe the neuro hormonal control of the digestive secretions pouring into duodenum
(5)
b) Describe the composition and functions of saliva. Why the saliva becomes salty during its
excessive secretion? (3+2=5)
c) Describe the defecation reflex (5)
OR
Describe the deglutition reflex (5)
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
3rd BLOCK END EXAM (CARDIOVASCULARPHYSIOLOGY)
May 8, 2023
Roll no. _________________________ Name ____________________________________
Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks: 80+20=100

Q1.Describe Cardiac cycle under following headings: (1+4+5=10)

a) Definition
b) The various events taking place in a cardiac cycle
c) Volume and pressure changes in the left ventricle, left atrium and aorta with the help of
Wigger’s diagram
Q2. Case based/ Integrated questions: - (5x4=20)

a) History: A 35 year old male is brought to the emergency department after a road traffic
accident. On examination, it is seen that he has got fracture of both bones of right leg
along with fracture of femur on the left side. His pulse rate is 112 beats/ minute & weak
and blood pressure is 70/50 mmHg. The ultrasonography reveals massive intra
abdominal bleeding.
Based on the above clinical scenario answer the following question: (1+1+3=5)
1. Why is the pulse rapid and thready in this patient?
2. What is the cause of hypotension in this patient?
3. How does our body try to restore the decreased blood pressure?

b) History: A 55 year old male presents to OPD with complain of shortness of breath. This
breathlessness is associated with normal activity which, few years back, he could do without
any problem. During sleep he often gets attack with complaints of severe shortness of breath
and coughing which awakes him from sleep. This episode of coughing persists even in sitting
position.
General physical examination- The patient is calm, conscious, well oriented to time, place
and person. Pulse- 90/min with a characteristic pulsus alternans,
B.P = 130/ 90 mm Hg, Pitting edema is seen on the ankles (++),
JVP is 7 cm.
Systemic Examination of :
 Abdomen shows hepatomegaly
 Respiratory system: bilateral dull percussion note on costophrenic
angles.
 Auscultation reveals basal crepitations in both the lungs.
 Cardiovascular system:
o X Ray chest: Cardiomegaly
o ECG shows signs of right and left ventricular hypertrophy.
2D Echocardiography shows dilation of all the cardiac chambers with
poor contractility of cardiac walls and reduced ejection fraction
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
3rd BLOCK END EXAM (CARDIOVASCULARPHYSIOLOGY)
May 8, 2023
Based on the above clinical scenario answer the following question (2+1+2=5)
i. What is the cause of raised JVP and liver enlargement in this patient?
ii. What is the cause of basal crepitations in chest?
iii. What is the cause of shortness of breath in this patient?

c) Describe the physiological basis of cardiorespiratory changes during isometric and isotonic
exercises? (5)
d) What will happen and why to the cardiac output if the heart rate is more than 200
beats/min (5)

Q3.Write short notes on: (5x4=20)

a) Describe the Heterometric regulation of Cardiac output?
b) Draw a well labelled diagram of Normal Electrocardiogram (ECG). What is the clinical
significance of ST segment?
c) What is the role of kidney to regulate blood pressure?
d) What will happen to the capillary fluid dynamics if the patients’ blood pressure is
150mmHg?

Q4. Answer the following questions (5x4=20)

a) Describe the mechanism of Bradycardia in a patient with raised intracranial pressure.

Name the reflex which describes this phenomenon? (4+1=5)
b) Describe the Pacemaker potential with the help of diagram. What will happen to the
potential during sympathetic and parasympathetic stimulation? (3+2=5)
c) Describe the conduction pathway of impulse generated at SA node and describe the
clinical significance of PR interval. (2.5+2.5=5)
d) Describe the peculiarities of coronary circulation.

Q5.Write short notes on: (2x5=10)

a) Describe the physiological basis and significance of all the heart sounds
b) Describe the innervation of heart and significance of vagal tone.

Q6. Answer in 15-20 words (2x10=20)

a) Define Bainbridge reflex?

b) What is the seat of resistance and why?
c) Enumerate the methods to measure cardiac output.
d) Period between first and second heart sound denotes which phase of cardiac cycle?
e) Calculate the ejection fraction if the ventricle is pumping 70ml of blood with each stroke
with an End diastolic volume (EDV) of 130ml?
f) What is the significance of windkessel effect?
g) What is the Frank starling law of heart?
h) What is the physiological significance of A-V nodal delay?
i) Describe the ECG findings in Mobitz type –I heart block.
j) What is the composition and function of Lymph?

_____________________End of Paper _____________________

 DEPARTMENT OF PHYSIOLOGY
FOURTH BLOCK END/PCT-4 EXAMINATION
July 10, 2023

Roll no. _________________________ Name ____________________________________

Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours Maximum marks: 80
SECTION-A
Q1 Describe the regulation of respiration under following headings: (2.5+5+2.5=10)
a) Enumerate respiratory centers in brain and give their functions (2.5)
b) Describe peripheral chemoreceptors on the basis of definition, location, innervation and
mechanism. (5)
c) Describe physiological significance of Herring Breuer inflation reflex (2.5)

Q2. Write short notes on: (5x4=20)

a) History: A 60 yr old male patient came to the OPD with complaint of breathlessness for last 5
yrs and cough with sputum production for last 5 yr. He was a chronic smoker for last 30 years. He
was symptomatic for most of the months but symptoms used to increase during winter. Initially he
was breathless when doing heavy work only but now he feels breathlessness even during routine
work. His sputum was white colored, mucoid in consistency, about 100 ml/day.
General physical examination: He was having tachypnoea & tachycardia. His B.P was normal but
JVP was raised and liver was palpable about 1 cm below the right costal margin.
Examination of Respiratory system: Revealed bilateral hyper-inflated chest with widened
intercostal spaces and hyper resonating note on percussion. Chest auscultation revealed bilateral
wheezes scattered all over the lung fields.
Chest X ray : shows bilateral low placed diaphragm with tubular heart and hyperinflated lungs.
Routine blood investigations: were in normal range.
Spirometry: Showed mild obstructive pattern (FEV 1/ FVC ratio < 0.61) with no significant
reversibility in FEV1.

Based on the above clinical scenario answer the following questions: (1.5+1.5+2=5)

a. What is the cause of breathlessness in this patient? (1.5)

b. What is the cause of expiratory wheeze in this patient? (1.5)
c. What is the significance of FEV1 /FVC in differentiating obstructive and restrictive lung
disease? (2)
1
 DEPARTMENT OF PHYSIOLOGY
FOURTH BLOCK END/PCT-4 EXAMINATION
July 10, 2023
b) History: After a 30 minute expedition on the sea bed, the diver was rapidly pulled up by
his friends. On resurfacing, he experienced difficulty in breathing, body ache and convulsions.
Clinical examination: Pulse rate-90/ minutes. Respiratory rate- 16 breaths/ minute.
Based on the above clinical scenario answer the following questions: (1+3+1=5)
1. What will happen and why if a diver ascends rapidly to the surface after deep sea
diving?
2. What is the physiological basis behind the clinical presentation of this disease?
3. What is the depth of sea when person develops nitrogen narcosis?

c) What is the physiological basis of pulmonary and cerebral edema at high altitude?

(2.5+2.5=5)

d) Describe Hb O2 dissociation curve and factors affecting it. (5)

Q3. Write short notes on (any 2) (5x2=10)

a) Define V/Q ratio. Discuss in brief factors affecting V/Q ratio. What will happen to V/Q ratio
in a patient of pulmonary embolism? (1+2+2=5)
b) Define surfactant and describe its function. What will happen to the respiration of a
premature new born baby? (1+2+2=5)
c) Draw a neat, labeled, self explanatory diagram of Spirogram. (5)

SECTION -B
Q4. Write short notes on / Physiological basis (Attempt any 2) (5x2=10)
a) What will happen to the compliance of lungs in a patient of lung fibrosis as compared to a
normal patient? (5)
b) Define and classify hypoxia. Describe hypoxic hypoxia (2+3=5)

c) Describe the pressure volume changes occurring during ventilation (5)

Q5. Give the physiological basis / Write short notes on (5x4=20)

a) Enumerate the various abnormal breathing patterns. Define periodic breathing and
describe its subtypes. (1+1+3=5)
b) Describe the transport of carbon dioxide. (5)
c) Enumerate the layers of Respiratory membrane and describe the factors affecting gaseous
exchange (1.5+3.5=5)
d) What is the physiological basis of the changes taking place in the body due to long term
exposure of hypoxia?
Q6. Answer in brief (15-20 words) (2x 5=10)
i. What is the physiological significance of J receptor?
ii. Write any two peculiarities of pulmonary circulation.
iii. Enumerate the non- respiratory functions of lungs.
iv. What is the physiological basis of breaking point?
v. Enumerate the indications of Artificial respiration.

…………………………………………………..END………………………………………………………………

2
 DEPARTMENT OF PHYSIOLOGY
FOURTH BLOCK END/PCT-4 EXAMINATION
July 10, 2023

1. Fill in the blanks: Cell ____________, A

______________, B _________________ 5. All can lead to cyanosis except
a. Polycythemia
b. Heart failure
c. Cyanide poisoning
d. Defective V/Q ratio

6. A 37-year-old woman with right lower

extremity edema is evaluated because of the
sudden onset of shortness of breath and
pleuritic chest pain. A diagnosis of
pulmonary embolism is made. Which of the
following signs, if present on physical
examination, would be the most specific
indicator of pulmonary arterial
hypertension in this patient?
a. P2 louder than A2
b. Peripheral edema
c. Presence of an S3
a. Glomus cells, Opening of Potassium d. Raised JVP
Channels, Closure of Calcium
channels 7. A swimmer breathing through a pipe
b. Glomus cells, Closure of Potassium has a respiratory rate of 10/min, a tidal
and Calcium channels volume of 550 mL and an effective
c. Glomus cells, Opening of Potassium anatomical dead space of 250 mL. What is
and Calcium channels his pulmonary ventilation?
d. Glomus cells, Closure of Potassium a. 3000ml/min
Channels, Opening of Calcium b. 5500ml/min
channels c. 5000ml/min
d. 4000ml/min
2. Choose an incorrect statement about
Ondine's curse 8. A and B lines respectively indicates in
a. There is loss of autonomic control of the diagram
respiration
b. It is based on a mythological story
in which the prince was cursed by a
water nymph
c. Seen in Bulbar poliomyelitis
d. Person forgets to breathe

3. Anaemic hypoxia is produced by

a. Methemoglobenemia a. Obstructive and restrictive
b. Circulatory failure b. Restrictive and Obstructive
c. Cyanide poisoning c. Decrease FEV1 but normal VC
d. High altitude d. Normal graph

4. What concentration of CO2 in inspired 9. Bucket handle movement found in

air causes depression in CNS a. 5-7 ribs
a. 4% b. 2-7 ribs
b. 2% c. 7-10 ribs
c. 7% d. 2-5 ribs
d. 10%
3
 DEPARTMENT OF PHYSIOLOGY
FOURTH BLOCK END/PCT-4 EXAMINATION
July 10, 2023
10. Dyspnoea occur when c. Smaller particle size
a. Dyspnoeic index / pulmonary d. Larger surface area of respiratory
reserves >80% membrane available for CO2
b. Dyspnoeic index / pulmonary 15. All are true about functional residual
reserves <60% capacity EXCEPT
c. Dyspnoeic index / pulmonary a. Allows continuous exchange of
reserves <70%
gases
d. Dyspnoeic index / pulmonary
b. Dilutes the toxic inhaled gases
reserves <65%
c. Breath holding is possible
11. Use the following diagram and choose d. Air remains in the lungs after
the correct option forceful expiration
16. A person with rapid shallow breathing
has his alveolar ventilation-
a. Normal
b. Decreased
c. Increased
d. Equal to pulmonary ventilation
17. All are true about bronchial asthma
EXCEPT-
a. Diameter of small airways decreases
b. Airway resistance is high during
inspiration
c. Normal expansion of bronchioles
does take place during inspiration
d. Regarded as disease of expiratory
a. Patient is showing obstructive lung obstruction
disease 18. Maximum Mid Expiratory Flow Rate
b. Patient is showing restrictive lung (MMEFR) indicates flow obstruction in-
disease a. Large airways
c. Subject is showing no lung disease, b. Small airways
normal c. Trachea
d. None of the above d. Trachea and bronchi
19. Which of the following is true regarding
12. Intrapleural pressure become gaseous composition of venous blood? (in
maximally positive in which condition
mmHg)
a. Deep inspiration
a. PO2 = 95 ; PCO2 = 40
b. Valsalva manoeuvre
c. Emphysema b. PO2 = 40 ; PCO2 = 40
d. Pneumothorax c. PO2 = 40 ; PCO2 = 46
13. Major percentage of airway resistance is d. PO2 = 46 ; PCO2 = 40
offered by the-
a. Trachea and bigger bronchi 20. Timed vital capacity differ from vital
b. Terminal bronchiole capacity-
c. Respiratory bronchioles a. Higher volume of air breathed out
d. Alveolar ducts b. Special stress on rapid, forcibly and
complete exhalation
14. Diffusion capacity of CO2 is 20 c. Cannot be measured by simple
times as compared to O2 because of- spirometer
a. Higher solubility coefficient d. Provides useful information about
b. Low solubility coefficient strength of respiratory muscles

4
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
5th BLOCK END EXAM (NEUROPHYSIOLOGY)
September 11, 2023
Roll no. _________________________ Name ____________________________________
Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks: 80+20=100

Q1.Describe Spinal cord under following headings: (5+3+2=10)

a) Describe the pathway carrying sensations of fine touch, proprioception , vibration from
the left side of the body
b) What will happen if there is damage to the left Internal Capsule?
c) Draw a well –labelled diagram of transverse section of spinal cord.

Q2. Case based/ Integrated questions: - (20)

a) History: Harish, A-60-year-old male, reported difficulty in initiating motor activity like
walking, brushing his teeth, etc. He also mentioned that, with advancing age his motor
activities had become slower. Doctor also noted that while he was sitting, there were tremors
in his hand. On further questioning, Harish mentioned that these tremors stop while doing
any activity. Doctor also noted that, along with the change in emotions, there was no change
in facial expressions.
On Examination: His vitals were normal with temperature 98.6°F, pulse 75/min,
BP = 130/80 mm Hg. He was conscious, calm and well oriented to time, place and person.
The general facial expressions of the patient were lost resulting in a mask-like face.
Examination of CNS Revealed
Motor functions:
Tone: Hypertonia with cogwheel type rigidity in limbs.
Power of muscles is Grade +4/+5.
Reflexes: Deep tendon reflexes are normal and plantar response is flexor.
Pill rolling resting tremors of the hands.
Shuffling gait with narrow base and a tendency to fall forward and backwards. He
walks with slight flexion at hip and knee joints.
Cerebellar function tests: Normal.
Sensory function: Normal.
Cortical sensations: Normal.
Higher functions: Normal.

Based on the above clinical scenario answer the following question:

i. What is your probable diagnosis?
ii. What is the pathophysiology of the disease?
iii. What is the physiological basis of Hypokinetic symptoms in this patient (akinesia,
Bradykinesia)?

b) History: An 8 yr old brought to the Ophthalmologist with difficulty in reading the

black board letters at school. He has no difficulty in reading from the text book
On examination:
Visual Acuity for Distant vision: RE: VA 6/12 and LE: 6/9
Visual Acuity fro near vision: N6
Based on the above clinical scenario answer the following question:
(1+2+2=5)
i. What is your probable diagnosis?
ii. Enumerate the causes and Pathophysiology of the diagnosed condition
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
5th BLOCK END EXAM (NEUROPHYSIOLOGY)
September 11, 2023
iii. What treatment will you advise and why?
c) Describe the postural reflexes integrated below the level of inferior colliculus.
What will be the clinical presentation of a patient presenting with injury at the mid-
collicular level. (3+2=5)
d) Define synapse. Describe any four properties of synapse. (1+4=5)

Q3.Write short notes on: (Any 4): (5x4=20)

a) Describe the physiological basis of intention tremors in cerebellar dysfunction. Write any
two functions of cerebellum. (3+2=5)
b) Describe the mechanism of sound transduction with the help of a diagram/ flow chart.
c) Differentiate between REM and Non-REM sleep.
d) Differentiate between Explicit memory and Implicit memory
e) Describe the EEG waves /Berger waves.
SECTION B
Q4. Answer the following questions (10)

a) Draw a well –labelled diagram of Visual Pathway. (4)

b) What will happen to the Vision if there is injury at (3)
(i) Optic chiasma
(ii)Left Optic nerve
(iii) Compression of the lateral side of Optic chiasma due to bulky Cavernous Sinus
c) What will happen to vision if a person enters a dark room from bright light? (3)

Q5.Write short notes on (Any 4) : - (5x4=20)

a) Define and describe Generation of receptor potential. (1+4=5)

b) A 32-year-old male was brought to the emergency following penetrating knife injury
in the posterior part of the left thorax. The patient complained of left lower extremity
numbness and weakness, and right lower extremity burning sensation.
On Examination: left lower extremity paresis as well as diminished proprioception
touch, and pinprick sensation. The right lower extremity demonstrated intact motor
function, and intact proprioception, touch, and pinprick sensation.

Based on the above clinical scenario answer the following question: (1+4=5)
i. What is your probable diagnosis?
ii. Explain the sensory and motor loss at the site of the lesion and below the site of
the lesion with the help of a diagram.

c) A 55-year-old right-handed man experienced a heavy blow on the right posterior

temporal region on account of a traffic accident at the age of 16. He was unconscious
for a week and recovered completely a month later without any sequaelae. . He
worked as a public servant for a few decades without any trouble. However, he began
to make mistakes and had problems at work from last 6 months in terms of
judgement , thinking and execution of motor tasks involving voluntary movements
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
5th BLOCK END EXAM (NEUROPHYSIOLOGY)
September 11, 2023

On Examination
Neuropsychological examinations showed: Decline in his abilities to judge, to
execute, to comprehend and to solve problems, and disturbance of memorization

Cranial MRI showed that the frontal and temporal lobes seemed to be predominantly
atrophic. There was great enlargement of the lateral and third ventricles, and a post-
contusion lesion in the left frontal lobe

Based on the above clinical scenario answer the following question: (2+3=5)
i. What is your probable diagnosis?
ii. Enumerate the functions of frontal lobe and temporal lobe
c) Describe the physiological changes in the eye of people above 40yrs of age that can affect
near vision. (5)
d) Draw a well labelled diagram of muscle spindle and enumerate its functions (2+3=5)
e) Define Aphasia. Differentiate between Sensory and Motor Aphasia (1 +4=5)

Q6.Answer in 15-20 words (2x10=20)

a) What will be the clinical presentation in a patient with damage to temporal lobe?
b) Draw a well –labelled diagram of stretch reflex.
c) Write two functions of thalamus.
d) Enumerate the two cardinal features seen in the neurons of patients with Alzheimer’s
disease.
e) Name the part of the CNS concerned with wakefulness.
h) What is consolidation of memory? Name the site for storage of long term memory?
i Why is REM sleep also called Paradoxical sleep?
j) Name the hyperkinetic disorders of Basal ganglia.
k) Name the primary motor and pre-motor areas.
l) Where is the reward and punishment centre located?

_____________________End of Paper _____________________

 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
SECOND BLOCK END EXAM (NERVE MUSCLE PHYSIOLOGY)
May 20, 2022
Roll no. _________________________ Name ____________________________________
Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks: 100

Q1.Describe the excitation contraction coupling under following headings: (10)

a) Transmission of impulse across neuromuscular junction (4)
b) Release of calcium from Sarcoplasmic reticulum (1)
c) Mechanism of muscular contraction by walk along theory (5)

Q2. Case based/ Integrated questions:- (20)

a) History: A 25-year-old lady comes to OPD with chief complain of weakness and fatigability.
Generally, during morning she does not feel any significant weakness but, as the day
passes and she gets involved in routine household works, weakness gradually starts to
increase. The condition improves by some rest or sleep. She also reports double vision
and difficulty in swallowing.
Physical Examination: Ptosis, diplopia, proximal muscle weakness, normal deep tendon
reflex, no sensory impairment.
Laboratory Investigations
 Positive Anticholinestrase test.
 Electrodiagnostic testing shows rapid reduction in amplitude of the repetitive
nerve stimulation (Decremental response).
Based on above clinical history, answer the following questions:
(i) As the day passes by, why does patient gradually starts getting more and more
fatigue? (2)
(ii) Why the patient complains of diplopia and ptosis? (1)
(iii) Why does the rest, improves the symptoms of weakness? (2)

b) A 28 years old wildlife photographer was taking pictures in Congo valley, when he felt some
pricking sensation near the nape of his neck. To his surprise, he discovered that he was
hit by an arrow shot by the tribals. He felt that he was no longer able to move his limbs
and felt paralysed.

Based on above case history, answer the following questions:

(i) What do you think, has happened to the photographer? (1)
(ii) Why was the photographer, not able to move his limbs? (2)
(iii) What is the physiological basis of treatment in this patient? (2)
c) Describe the action potential in skeletal muscle with the help of a diagram, showing various
phases, ionic movement and physiological basis. (1+1+3)

d) What is muscle tone? Describe the role of muscle spindle in maintaining muscle tone? (1+4)

Q3.Describe the physiological basis/Give reason, why? (2x10=20)

(Answer in 2-3 lines)
a) The patient of Organophosphorus poisoning experiences excessive salivation.
b) The isometric contraction results in early fatigue as compared to isotonic contraction
c) The muscles become stiff after death.
d) Write 4 main differences between isotonic & isometric contraction
P. T. O.

1
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
SECOND BLOCK END EXAM (NERVE MUSCLE PHYSIOLOGY)
May 20, 2022

e) Why the myelinated nerve fibres have a faster conduction than unmyelinated nerve fibres?
f) Name the cells responsible for myelination of neurons in central and peripheral nervous
system.
g) Define Chronaxie and Rheobase.
h) The cardiac muscle cannot be tetanised?
i) Which channels are affected in Lambert Eaton Syndrome?
j) What is the reason for Duchenne’s muscular dystrophy?

Q4. Answer the following questions:

a) Describe the Erlanger Gasser’s classification of nerve fibre. (2)

b) Person feels touch but not pain after the local anaesthesia. (2)
c) What is compound action potential? (2)
d) Describe the Wallerian degeneration of nerve fibre (4)

Q5.Write short notes on:- (5x4=20)

a) Describe various energy sources required for muscle contraction.

b) Describe the Length tension relationship in the skeletal muscle.
c) Describe the action potential of cardiac muscle showing its phases, ionic basis and
physiological basis.

Q6.Answer in 15-20 words (2x10=20)

a) Why nerve fibre cannot be stimulated in absolute refractory period?

b) Define a motor unit.
c) Define Frank Starling law.
d) Write 4 main differences in red & white muscle fibres.
e) Which level of CNS regulates Stretch reflex?
f) Define oxygen debt.
g) Why relaxation period is longer than contraction period in a simple muscle twitch?
h) Define sarcomere.
i) What is the function of T-tubules?
j) What are the different grades of muscle contraction?

_____________________End of Paper _____________________

2
 DEPARTMENT OF PHYSIOLOGY
BLOCK END EXAMINATION FOR HAEMATOLOGY BLOCK
Date : June 17th, 2022 Roll No. ________ Name: _________________
Time allotted: 3 hours MM:100
Read the instructions carefully:
1. All questions are compulsory
2. Attempt all the subparts of each question together
3. Draw adequate diagrams to support your answer
1Q. Describe Erythropoiesis under following subheadings:
a. Definition (1)
b. Site of Erythropoiesis (2)
c. Stages of Erythropoiesis (4)
d. Factors affecting Erythropoiesis (3)

2Q. Answer the questions based on Clinical Scenarios given below/ Physiological basis of:
a. A 35-year-old female complains of breathlessness, loss of appetite, apathy and easy fatigability.
Examination of the patient revealed pallor, koilonychia, increased heart rate and systolic murmur.
Laboratory investigations of this patient were obtained as under:
Hemoglobin: 6.0 gm% PCV: 30%
RBC count: 3.0 million/c.c. S. Ferritin: 9 nanogram/mL
MCV: 70 fL TIBC: 500 microgram/mL
MCHC: 28% PBF: RBC are microcytic and Hypochromic
i. What is your probable diagnosis for this patient? (1)
ii. How is the deficient nutrient absorbed in our body? (3)
iii. What is the cause of raised total iron binding capacity in this patient? (1)

b. Chinku, a 7 year old male child has been brought to orthopedic OPD, with complaint of swollen
right knee after he fell from the bicycle. On further probing, the parents gave a positive history of
easy bruisability. On investigation his platelet count was 1.2 Lakh/ cu.mm, BT: 3 minutes and CT:
7 minutes. His APTT was also prolonged.
i. What is your probable diagnosis for this patient? (1)
ii. What is the pathophysiology related to this disorder? (3)
iii. What is the cause of prolonged APTT in this patient? (1)

c. What is the physiological importance of Plasma proteins in our body? (5)

d. What are changes seen in stored blood after blood donation? (2.5+2.5)
What are the hazards of blood transfusion?

3Q. Write short notes on:

a. Describe the mechanism of occurrence of edema in hypoproteinemia. (3.5+1.5)
b. What is the pathophysiology of β- thalassemia? Why do you find (2.5 + 2.5)
higher levels of HbF in these patients?
c. Describe the structure and properties of Immunoglobulins. (1.5 + 3.5)
d. Define Erythroblastosis fetalis? Why does it occur? What is the (1+3 + 1)
physiological basis of giving Inj. Anti D to mother at the time of delivery?

4Q. Describe Hemostasis under the following headings:

a. Definition (1)
b. Formation of temporary plug (4)
c. Definitive hemostasis (5)

1
 DEPARTMENT OF PHYSIOLOGY
BLOCK END EXAMINATION FOR HAEMATOLOGY BLOCK

5Q. Write short notes on:

a. Describe the role of Neutrophils in providing defense against (5)
microbes in our blood stream.
b. Describe the mechanism of plasminolysis. (5)
c. Describe the mechanism of cell mediated immunity (5)
d. Classify anaemia on the basis of etiology. What will happen to blood picture, if (2.2+2.5)
the person has got terminal ileal resection (removal of terminal ileum)?

6Q. Write very short answers in few words to 2-3 lines:

a. Write the functions of T helper cells. (2)
b. Why the foetus is not affected by ABO incompatibility? (2)
c. Why ingestion of Fava beans leads to hemolysis in some individuals? (2)
d. How do the pluripotent stem cells differentiate into different blood cell lines? (2)
e. Why do we require booster doses in the vaccination schedule? (2)
f. Which type of antibody will be normally being found in a new born baby? (2)
g. Define consumption coagulopathy. (2)
h. What are the causes of purpura? (2)
i. What are the functions of platelet rich plasma (PRP)? (2)
j. How blood is kept fluid in our circulation? (2)

================================End of Paper====================================

2
 DEPARTMENT OF PHYSIOLOGY
BLOCK END EXAMINATION FOR RESPIRATORY SYSTEM
Date: 26th July, 2022 Roll No. ________ Name: ____________________________________
Time allotted: 3 hours MM: (80+20= 100)
Read the instructions carefully:
1. All questions are compulsory
2. Attempt all the subparts of each question together
3. Draw adequate diagrams to support your answer

Q1. Describe the mechanism of ventilation and the pressure volume changes occurring during
ventilation (5+5=10)

Q2. Case based / integrated / Reasoning based (4x5=20)

a) History: A 60 yr. old male patient came to the OPD with complaint of breathlessness for last 5
yrs and cough with sputum production for last 5 yr. He was a chronic smoker for last 30 years.
He was symptomatic for most of the months but symptoms used to increase during winter.
Initially he was breathless when doing heavy work only but now he feels breathlessness even
during routine work. His sputum was white colored, mucoid in consistency, about 100
ml/day.
General physical examination: He was having tachypnoea & tachycardia. His B.P was normal
but JVP was raised and liver was palpable about 1 cm below the right costal margin.
Examination of Respiratory system: Revealed bilateral hyper-inflated chest with widened
intercostal spaces and hyper resonating note on percussion. Chest auscultation revealed bilateral
wheezes scattered all our lung field.
Chest x ray : showing bilateral low placed diaphragm with tubular heart and hyperinflated lungs
Routine blood investigations: were in normal range.
Spirometry: Showed mild obstructive pattern (FEV1/ FVC ratio < 0.61) with no significant
reversibility in FEV1.

Based on above clinical condition, answer the following questions:

i.What is the probable diagnosis in this patient? (1)

ii.What is the cause of breathlessness in this patient? (1)
iii.What is the cause of expiratory wheeze in this patient? (1)
iv.What is the significance of FEV1 /FVC in differentiating obstructive and restrictive lung disease?
(2)

b) Define V/Q ratio. Discuss in brief factors affecting V/Q ratio. What will happen to V/Q ratio in
a patient of pulmonary embolism? (1+2+2)
c) Explain the effect of hyperventilation on the pH of body (5)
d) What is the physiological basis of pulmonary and cerebral edema at high altitude?
(2.5+2.5)

Q3. Describe the regulation of respiration under following headings

a) Enumerate respiratory centers and give their functions (2.5)

1
 DEPARTMENT OF PHYSIOLOGY
BLOCK END EXAMINATION FOR RESPIRATORY SYSTEM
b) Describe chemoreceptors on the basis of location, innervation and chemoreceptors reflex
mechanism. (5)
c) Describe physiological significance of herring Breuer inflation reflex (2.5)

Q4. Answer the following questions (Attempt any 2) (2x5=10)

a) Describe Hb dissociation curve and factors affecting it
b) Describe transport of carbon dioxide
c) Describe the non respiratory functions of lungs
d) Define surfactant and describe its function. What will happen to the respiration of a
premature new born baby? (1+2+2)

Q5. Write short notes on / Physiological bases (Attempt any 2) (2x5=10)

a) What will happen to the compliance of lungs in a patient of lung fibrosis as compared to a
normal patient?
b) Explain the physiological basis of breaking point on breath holding
c) Define hypoxia. Describe hypoxic hypoxia (1+4)
d) Draw a neat, labeled, self explanatory diagram of spirogram.

Q6. Answer in 15-20 words (10x2=20)

a) Define Bohr’s effect
b) Enumerate layers of respiratory membrane
c) Define respiratory unit
d) What is physiological shunt?
e) Define cyanosis
f) Define compliance
g) Enumerate the perfusion zones of the lungs with their physiological significance.
h) What is the physiological significance of J receptor?
i) What will happen to the respiration in a patient if there is damage between the pneumotaxic
centre and apneustic center with bilateral vagotomy
j) Name the centre in which the respiratory pacemaker cells are located.

MCQ
MM: 20

1) Which of the following is true 3) Major percentage of airway

regarding gaseous composition of resistance is offered by the-
venous blood? (in mmHg) a) Trachea and bigger bronchi
a) PO2 = 95 ; PCO2 = 40 b) Terminal bronchiole
b) PO2 = 40 ; PCO2 = 40 c) Respiratory bronchioles
c) PO2 = 40 ; PCO2 = 46 d) Alveolar ducts
d) PO2 = 46 ; PCO2 = 40
4) Diffusion capacity of CO2 is 20 times
2) Timed vital capacity differ from vital as compared to O2 because of-
capacity- a) Higher solubility coefficient
a) Higher volume of air breathed b) Low solubility coefficient
out c) Smaller particle size
b) Special stress on rapid, forcibly d) Larger surface area of respiratory
and complete exhalation membrane available for CO2
c) Cannot be measured by simple
spirometer 5) Maximum Mid Expiratory Flow Rate
d) Provides useful information (MMEFR) indicates flow obstruction
about strength of respiratory in-
muscles a) Large airways
b) Small airways

2
 DEPARTMENT OF PHYSIOLOGY
BLOCK END EXAMINATION FOR RESPIRATORY SYSTEM
c) Trachea d) Decrease in O2 affinity of
d) Trachea and bronchi haemoglobin when pH of blood
falls
6) All are true about bronchial asthma
EXCEPT- 11) Shifting of O2- Haemoglobin
a) Diameter of small airways dissociation curve right means-
decreases a) Decreased O2 delivery to tissue
b) Airway resistance is high during b) Increase O2 delivery to tissue
inspiration c) Loading of CO2 to blood
c) Normal expansion of bronchioles d) Loading of O2 to blood
does take place during inspiration
d) Regarded as disease of expiratory 12) The most important factor in
obstruction transport of CO2 as bicarbonate is-
a) Affinity to haemoglobin
7) A person with rapid shallow b) Basic nature of bicarbonate ion
breathing has his alveolar c) Increased solubility of CO2
ventilation- d) Carbonic anhydrase in RBC
a) Normal
b) Decreased 13) Oxygen Haemoglobin dissociation
c) Increased curve is sigmoid because of-
d) Equal to pulmonary ventilation a) Shifting affinity of Hb for oxygen
b) Shifting affinity of Hb for CO2
8) A shift of O2 haemoglobin c) Blood pH
dissociation curve of blood to the d) Oxygen combines with Hb in
right is a feature not found- linearity
a) With rise in temperature
b) When fetal blood is replace by 14) Role of 2,3 DPG in Haemoglobin-
adult blood a) Unloading oxygen to tissue
c) In pulmonary capillaries b) Increased affinity for oxygen
d) In hypercapnia c) Buffering capacity
d) Osmotic fragility
9) Physiological significance of flat part
of O2 dissociation curve is- 15) In hyperventilation-
a) Causes more release of O2 when a) P50 and Hb affinity for O2
PO2 falls increases
b) Shifting of curve to right makes b) P50 and Hb affinity for O2
this portion steeper decreases
c) Amount of O2 carried by blood c) P50 increases and Hb affinity for
does not change with fall in PO2 O2 decreases
d) Uptake of 02 by the body d) P50 decreases and Hb affinity for
decreases at high altitude O2 increases

10) What is Haldane effect? 16) There is no stimulation of ventilation

a) Loading of CO2 to blood causes by hypoxia until the alveolar PO2 falls
unloading of O2 below-
b) Loading of O2 to blood causes a) 60 mm Hg
unloading of CO2 b) 58 mm Hg
c) Binding of CO to haemoglobin c) 50 mm Hg
displaces O2 d) 45 mm Hg

3
 DEPARTMENT OF PHYSIOLOGY
BLOCK END EXAMINATION FOR RESPIRATORY SYSTEM
17) Raised alveolar pCO2 through a
respiratory stimulation, can cause
respiratory depression when the
level exceeds-
a) 10 mmHg
b) 20 mm Hg
c) 40 mmHg
d) 60 mmHg

18) Tachypnoea means-

a) Normal breathing at rest
b) Stoppage of breathing
c) Difficulty in breathing
d) Rapid, shallow breathing

19) Transaction of mid-pons with vagus

intact leads to-
a) Rapid, shallow breathing
b) Apneusis
c) Hyperventilation
d) Deep breathing

20) In which type of hypoxia, cyanosis

might not seen-
a) Histotoxic
b) Anaemic
c) Stagnant
d) Hypoxic

4
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
FIFTH BLOCK END EXAM (CARDIOVASCULAR PHYSIOLOGY)
August 25, 2022
Roll no. _________________________ Name ____________________________________
Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks: 80+20=100

Q1.Describe the cardiac cycle under following headings: (10)

a) Definition (1)
b) Enumerate the phases and events occurring during the cardiac cycle (4)
c) Draw a well labelled self explanatory diagram showing changes in volume and pressure
(intra-atrial, intra-ventricular and aortic changes during cardiac cycle (5)
Q2. Case based/ Integrated questions:- (20)

a) History
A 55-year-old male presents to OPD with complaints of shortness of breath. The
breathlessness appears on exertion. During sleep he often gets attacks of severe shortness
of breath and coughing which awakes him from sleep. This episode of coughing persists
even in sitting position.
General Physical Examination: The patient is calm, conscious, well oriented to time,
place and person. Pulse: 90/min with a characteristic pulsus alternans, BP = 130/ 90 mm
Hg, pitting edema is seen on the ankles (++), JVP is 7 cm.
Systemic Examination:
• Abdomen shows hepatomegaly.
• Respiratory system: Bilateral dull note on percussion at the costophrenic angles.
Auscultation reveals the basal crepitations in both the lungs.
• Cardiovascular system:
– X-ray chest: Cardiomegaly.
– ECG shows signs of right and left ventricular hypertrophy.
– 2D Echocardiography shows dilation of all the cardiac chambers with poor contractility
of cardiac walls and reduced ejection fraction.

Based on above clinical condition, answer the following questions:

(i) What is the cause of raised JVP and liver enlargement in this patient? (2)
(ii) What is the cause of shortness of breath in this patient? (2)
(iii) What is your probable diagnosis based on physical and laboratory findings? (1)

b) What is the mechanism of generation and conduction of cardiac impulse? (5)

c) Explain why cardiac muscle cannot be tetanised, while skeletal muscle can be tetanised.
What is the physiological significance of this property of cardiac muscle? (5)
d) Draw a well labelled diagram of normal ECG? What is the physiological significance of PR
interval (3+2=5)

1
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
FIFTH BLOCK END EXAM (CARDIOVASCULAR PHYSIOLOGY)
August 25, 2022

Q3.Describe the physiological basis/Give reason, why? (2.5x4=10)

a) Explain the mechanism of increase in Diastolic blood pressure (DBP) during increased
sympathetic stimulation?
b) Define Cardiac output. Write about the Heterometric regulation of cardiac output?
c) Why do we observe Bradycardia in a patient of intracranial haemorrhage?
d) Describe the peculiarities of coronary circulation.

Q4. Answer the following questions (any two) (5x2=10)

a) What is the mechanism of short term regulation of blood pressure?

b) What is the role of Starling’s forces to maintain blood flow
c) What is the role of kidney in regulation of blood pressure?
d) Draw a well labelled self explanatory diagram of
i) Cardiac action potential
ii) Pace maker potential

Q5.Write short notes on: - (2.5x4=10)

a) Describe the physiological basis & importance of Bain Bridge reflex.

b) Enumerate the methods of determining cardiac output. Describe in detail about Fick’s
principle?
c) Describe the physiological basis of all the heart sounds. What is the significance of heart
sounds? Differentiate between first and second Heart sounds.
d) Define and classify Shock. What is the pathophysiology of hypovolemic shock?

Q6.Answer in 15-20 words (2x10=20)

a) What is Bezold-Jarisch reflex?

b) Define Ejection Fraction.
c) Define Frank Starling law.
d) Write 4 main factors on which peripheral resistance depends.
e) Enumerate the pumps regulating venous return?
f) What will be the heart rate, if all the nerve supply to the heart is cut?
g) Why arterioles are the main site of peripheral resistance?
h) Enumerate the mechanisms that regulate the local blood flow to tissue.
i) What is the function of EDRF?
j) Differentiate between reactive and active hyperemia?

_____________________End of Paper _____________________

2
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
FIFTH BLOCK END EXAM (CARDIOVASCULAR PHYSIOLOGY)
August 25, 2022
MCQ MM: 20

Q1. Increase in K+ concentration in ECF Q8. Which of the following is not an event of
leads to death due to: Ventricular diastole?
a) Kidney failure a. Protodiastole
b) Peripheral circulatory failure b. Isovolumic relaxation period
c) Decreased contractility of c. Rapid passive filling phase
myocardium d. Rapid ejection phase
d) Vasomotor centre failure
Q9. The c wave in the intra-atrial pressure
Q2 Vagus inhibits pacemaker potential by curve occurs due to
all EXCEPT
a) Hyperpolarisation of membrane a) Contraction of the papillary muscles
b) Decrease slope of prepotential and subsequent pull on the AV ring
c) Stabilising resting membrane causing right atrial enlargement
potential b) Bulging of the AV valves in the atria
d) Increased K+ permeability due to sharp rise of the intra-
ventricular pressure in the
Q3. All are examples of pacemaker tissue of Isovolumic contraction of the
heart EXCEPT? ventricles
a) S-A Node c) Due to a sharp rise in the intra-atrial
b) A-V Node pressure during atrial-systole
c) Ramification of Bundle of His d) None of the above
d) Intermodal atrial pathway
Q4. The resistance of blood vessels is 16 Q10. First degree heart block is
PRU. Doubling the vessel diameter would characterized by
change the resistance to: a. Prolonged P-R interval with normal
a) 1 PRU QRS complex
b) 2 PRU b. PR interval gets longer and then
c) 8 PRU there is a QRS drop
d) 12 PRU c. Complete AV dissociation, with
Q5. Total cross sectional area of capillary independent atrial and ventricular
bed when fully patent is: rates
a) 1000 times that of aorta d. Prolonged Q-T interval
b) 2000 times that of aorta
c) 3000 times that of aorta Q11. Which of the following statement is
d) 4000 times that of aorta FALSE about shock?
a. Hypovolemic shock is associated
Q6. Axon reflex, which neurotransmitter is with low cardiac output
responsible to produce long lasting b. Septic shock is associated with cold
cuteneous arteriolar dilatation: clammy skin
a) Serotonin c. Cardiogenic shock is associated with
b) Substance - P Tension Pneumothorax, constrictive
c) Acetyl choline pericarditis , pulmonary embolism
d) K+ released from the damaged cells d. Vasogenic shock is associated with
Vasodilatation
Q7. Cushing’s reflex helps in maintaining:
a) Coronary blood flow
b) Cerebral blood flow
c) Hepatic blood flow
d) Skin blood flow

3
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
FIFTH BLOCK END EXAM (CARDIOVASCULAR PHYSIOLOGY)
August 25, 2022
Q12. In patient of MI the following ECG Q15 . Which of the following statement is
changes are seen
TRUE regarding Windkessel Effect?
a. ST segment elevation with elevation a. Seen in large elastic arteries like
of J-point Aorta
b. ST –segment depression b. Allows easy exchange of gases across
c. T- wave inversion
the vessels
d. None of the above
c. Seen in muscular arteries
d. Allows only unidirectional flow of
Q13. Which of the following statement is
blood
FALSE regarding the Innervation of the
Q16. Laminar flow of the blood depends on
heart?
a. Viscosity of blood
a. Sympathetic fibres supply the SA b. Critical velocity
node , Av node and muscles of atria c. Critical Closing pressure
and ventricles d. None of the above
b. Parasympathetic fibres supply the
Q17. . Factors that promote Angiogenesis
SA node , AV node , atria and
are all EXCEPT
ventricles
a. Vascular endothelial growth factor
c. Parasympathetic fibres supply the
b. Platelet – derived endothelial growth
SA node , AV node , atria
factor
d. Stimulation of the sympathetic fibres
c. Fibroblast -growth factor
has a positive ionotropic ,
d. Platelet factor 4
chronotropic ,, bathmotropic and
dromotropic effect Q18. Which of the following is not a
resistance vessel?
a. Arterioles
Q14. Circulating vasodilators include all b. Meta-arterioles
EXCEPT c. Pre-capillary sphincters
d. Veins
a. Adenosine
b. Lactic acid Q19. Blood pressure is inversely
c. Bradykinin proportional to heart rate is k/a Marey’s
d. Endothelin Law. This law is not applicable in
………………………………………………

Q20. Critical closing pressure for blood

vessels is .......................................for
whole blood

4
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
SIXTH BLOCK END EXAM (EXCRETORY SYSTEM)
September 30, 2022

Roll no. _________________________ Name ____________________________________

Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 2 hours; Maximum marks: 50

Q1. Describe the formation of Urine under following headings: (10)

a) Definition and factors affecting GFR (5)

b) Role of PCT in formation of urine (5)

Q2. Write short notes on (any three) (15)

a) A 44-year-old male comes to the urologist with pain in the suprapubic region and
dribbling micturition. He had met with a Road Traffic Accident (RTA)1 year back with
complete transection of the spinal cord at the level of L4-L5 and is now in the recovery
phase. On leading question, the patient confirms that he has to void urine at regular
intervals. Patient is normotensive, non-diabetic, non-smoker and a social drinker.
On Examination
Patient is conscious, co-operative well-oriented to time, place and person.
Vitals: Normal
General physical examination (GPE): Normal
CNS examination: Findings are consistent as in the recovery phase after a spinal
injury.
Investigations
Urine routine examination: Pus cells—40-50/Hpf
Albumin—trace
Sugar and ketones—absent
Based on the above case, answer the following questions:
1. What is your provisional diagnosis?
2. Enumerate the various bladder dysfunctions.
3. Describe the innervation of the urinary bladder. (5)

b) Describe the Juxtaglomerular apparatus with well labelled diagram. Describe

tubuloglomerular feedback mechanism. (3+2)
c) How can you measure renal blood flow using plasma clearance method ? (5)
d) What will happen to urine output volume in patient of diabetes mellitus
(FBS>180mg/dl) ? Describe transport maximum (TmG) for glucose. (1+4)

Q3 Write short notes on (any three) (15)

a) Describe counter current system for concentration of urine (5)

b) Describe the role of Kidney in pH regulation (5)
c) Describe the role of ADH in water homeostasis (5)

1
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
SIXTH BLOCK END EXAM (EXCRETORY SYSTEM)
September 30, 2022

d) Describe the non excretory functions of kidney. (5)

Q4. Very short answers (any five) (2x5=10)

a) Why patients of chronic renal failure (CRF) are more prone to fractures ?
b) Describe the cystometrogram for the study of bladder functions.
c) What will happen to the renal blood flow if the dietary intake of protein is high ?
d) Why colloid osmotic pressure of Bowman’s capsule is zero ?
e) Define obligatory urine volume. What is its clinical significance ?
f) What will happen to the osmolatity of urine, if blood flow in vasa recta is increased?

2
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
7th BLOCK END EXAM (NEUROPHYSIOLOGY)
November 24, 2022
Roll no. _________________________ Name ____________________________________
Instructions for students:
1. Attempt all parts of one question at one place/ together.
2. Write the serial no. of the questions clearly and draw a line between 2 answers.
3. Draw adequate diagrams in support of your answer
4. Time allotted: 3 hours; Maximum marks: 80+20=100

Q1.Describe Synapse under following headings: (1+7+2=10)

a) Definition
b) Properties of synapse
c) Name two excitatory and inhibitory neurotransmitter

Q2. Case based/ Integrated questions: - (20)

a) History: Harish, a-60-year-old male, reported difficulty in initiating any motor activity like
walking, brushing his teeth, etc. He also mentioned that, with aging, his motor activities had
become slower. Doctor also noted that while he was sitting, there were tremors in his hand.
On further questioning, Harish mentioned that these tremors stop while doing any activity.
Doctor also noted that, along with the change in emotions, there was no change in facial
expressions.
On Examination: His vitals were normal with temperature 98.6°F, pulse 75/min, BP =
130/80 mm Hg. He was conscious, calm and well oriented to time, place and person.
The general facial expressions of the patient were lost resulting in a mask-like face.
Examination of CNS Revealed
Motor functions:
Tone: Hypertonia with cogwheel type rigidity in limbs.
Power of muscles is Grade +4/+5.
Reflexes:
Deep tendon reflexes are normal.
Plantar response is flexor.
Pill rolling resting tremor of the hands.
Shuffling gait with narrow base and a tendency to fall forward and backwards. He
walks with slight flexion at hip and knee joints.
Cerebellar function tests : Normal.
Sensory function: Normal.
Cortical sensations: Normal.
Higher functions: Normal.

Based on the above clinical scenario answer the following question:

1. What is your probable diagnosis?
2. What is the pathophysiology of the disease?
3. What is the physiological basis of hypokinetic (akinesia, bradykinesia)?

b) History: After falling from the stairs, a 62-year-old man complained of loss of
touch sensation in the left lower limb and stiffness in the right lower limb.
On examination:
His vitals were normal with temperature 98.6°F, pulse 76/min, BP = 136/76 mm Hg.
He was conscious, calm and well oriented to time, place and person.
Examination of CNS Revealed
Loss of all sensations in the right side of the body 1 cm above umbilicus and
flaccid paralysis.
 GEETANJALI MEDICAL COLLEGE & HOSPITAL
DEPARTMENT OF PHYSIOLOGY
7th BLOCK END EXAM (NEUROPHYSIOLOGY)
November 24, 2022
Loss of fine touch, proprioception, two point discrimination and vibration in right
side of body below the area of complete anesthesia along with spastic paralysis,
exaggerated deep reflexes and lost superficial reflexes in right side of body.
Loss of touch, temperature, pain and pressure sensation in the left side of body, 2
cm below the area of complete anesthesia, with no motor abnormality.
Based on the above clinical scenario answer the following question:
i. What is your probable diagnosis?
ii. What is the pathophysiology of the disease?
iii. Which tracts are involved in carrying the sensations and how are they
involved in this injury?

c) Describe the generation of Receptor potential. What are post-synaptic potentials? (3+2=5)
d) Draw a well labelled diagram of Pain pathway & analgesia system (2.5+2.5=5)

Q3.Write short notes on: (Any 4): (5x4=20)

a) Describe the physiological basis of EEG waves in different stages of sleep.
b) Why does patient complaint of Pain in amputated limb?
c) Describe the speech disorder in patient with lesion in the left angular gyrus.
d) Describe the physiological basis of damping action of the cerebellum.
e) Describe the composition and functions of CSF.

Q4. Answer the following questions (5x2=10)

a) Describe the pathway of corticospinal tract.

b) Differentiate between extra-pyramidal and pyramidal tracts.

Q5.Write short notes on ( Any 4): - (5x4=20)

a) Describe the role of midbrain in regulating the posture.

b) Describe the functions of Hypothalamus.
c) Differentiate between Upper and Lower motor neuron lesions.
d) Describe all the spinal reflexes.
e) Draw a well labelled diagram of muscle spindle with its innervation

Q6.Answer in 15-20 words (2x10=20)

a) What will be the clinical presentation in a patient with lesion of Internal Capsule?
b) Write two important differences between Explicit and Implicit memory.
c) Write the features of thalamic syndrome.
d) What are Phasic receptors?
e) Which system in the body is responsible for alertness and wakefulness?
f) Draw a well labelled diagram of the Papez circuit.
h) Name the biggest relay station in the CNS?
i) Why is REM sleep also called Paradoxical sleep?
j) Define decerebrate rigidity.
k) What is the physiological significance of Somatosensory association area of Parietal lobe?

_____________________End of Paper _____________________