FUNDAMENTALS OF HUMAN PHYSIOLOGY UNIVERSITY OF
IOWA– EXAM 3 PRACTICE COMPREHENSIVE 100 QUESTION
STUDY GUIDE WITH ANSWERS AND EXPLANATIONS
1. A 68-year-old man with chronic heart failure is started on a new medication that increases
cardiac contractility. Which of the following changes in his cardiovascular parameters is most
expected?
A. Increased stroke volume and decreased end-systolic volume
B. Decreased stroke volume and increased end-systolic volume
C. Increased heart rate and decreased cardiac output
D. Increased end-diastolic volume and decreased stroke volume
Answer: A. Increased stroke volume and decreased end-systolic volume
2. A medical student is reviewing the pressure-volume loop of the left ventricle. Which point on
the loop corresponds to the opening of the aortic valve?
A. The point where ventricular pressure exceeds aortic pressure during systole
B. The point where ventricular pressure falls below atrial pressure during diastole
C. The point where ventricular volume is at its maximum
D. The point where the atrioventricular valves close
Answer: A. The point where ventricular pressure exceeds aortic pressure during systole
3. A 45-year-old woman is diagnosed with mitral stenosis. Which of the following hemodynamic
changes is most characteristic of this condition under resting conditions?
A. Increased left atrial pressure and reduced left ventricular filling
B. Increased left ventricular end-diastolic volume and pressure
C. Decreased pulmonary capillary wedge pressure
D. Increased cardiac output due to compensatory tachycardia
Answer: A. Increased left atrial pressure and reduced left ventricular filling
4. A 72-year-old man with COPD has an arterial blood gas showing pH 7.32, PaCO2 55 mm Hg,
HCO3- 30 mEq/L. Which of the following BEST describes his acid-base status?
A. Chronic respiratory acidosis with metabolic compensation
B. Acute respiratory acidosis with no compensation
C. Metabolic alkalosis with respiratory compensation
D. Mixed respiratory and metabolic acidosis
Answer: A. Chronic respiratory acidosis with metabolic compensation
5. A 60-year-old woman with chronic kidney disease has an arterial blood gas showing pH 7.28,
PaCO2 30 mm Hg, HCO3- 15 mEq/L. What is the primary acid-base disorder and the
compensatory response?
A. Metabolic acidosis with respiratory compensation (hyperventilation)
B. Respiratory alkalosis with renal compensation (bicarbonate excretion)
C. Metabolic alkalosis with respiratory compensation (hypoventilation)
D. Respiratory acidosis with metabolic compensation (bicarbonate retention)
Answer: A. Metabolic acidosis with respiratory compensation (hyperventilation)
,6. A 50-year-old patient on a ventilator has an arterial blood gas showing pH 7.48, PaCO2 28
mm Hg, HCO3- 24 mEq/L. What is the acid-base disorder?
A. Acute respiratory alkalosis
B. Chronic respiratory alkalosis with renal compensation
C. Metabolic alkalosis with respiratory compensation
D. Mixed respiratory alkalosis and metabolic acidosis
Answer: A. Acute respiratory alkalosis
7. A 55-year-old man with diabetic ketoacidosis presents with deep rapid breathing and an
arterial blood gas showing pH 7.20, PaCO2 20 mm Hg, HCO3- 8 mEq/L. Which of the following
BEST describes the compensation status?
A. Fully compensated metabolic acidosis
B. Partially compensated metabolic acidosis
C. Uncompensated respiratory acidosis
D. Combined metabolic and respiratory acidosis
Answer: B. Partially compensated metabolic acidosis
8. A 70-year-old woman with chronic obstructive pulmonary disease has an arterial blood gas
showing pH 7.36, PaCO2 68 mm Hg, HCO3- 38 mEq/L. What is the most likely acid-base status?
A. Fully compensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Metabolic alkalosis with respiratory compensation
D. Combined respiratory and metabolic acidosis
Answer: A. Fully compensated respiratory acidosis
9. A 40-year-old patient with severe vomiting has an arterial blood gas showing pH 7.52, PaCO2
49 mm Hg, HCO3- 40 mEq/L. Which of the following is the primary disorder and compensation?
A. Metabolic alkalosis with respiratory compensation (hypoventilation)
B. Respiratory acidosis with metabolic compensation (bicarbonate retention)
C. Metabolic acidosis with respiratory compensation (hyperventilation)
D. Respiratory alkalosis with renal compensation (bicarbonate excretion)
Answer: A. Metabolic alkalosis with respiratory compensation (hypoventilation)
10. A 65-year-old man with heart failure is given a diuretic, which leads to a decrease in blood
pressure. Which of the following baroreceptor-mediated responses would be expected?
A. Decreased sympathetic outflow to the heart and blood vessels
B. Increased parasympathetic outflow to the heart and decreased heart rate
C. Increased sympathetic outflow to the heart and blood vessels, and decreased parasympathetic outflow
D. Increased renin release from the kidneys and decreased vasopressin secretion
Answer: C. Increased sympathetic outflow to the heart and blood vessels, and decreased
parasympathetic outflow
11. A 45-year-old woman with renal artery stenosis has chronic activation of the
renin-angiotensin-aldosterone system. Which of the following hormonal changes would most
likely be present?
A. Increased aldosterone and decreased antidiuretic hormone (ADH)
B. Decreased aldosterone and increased ADH
, C. Increased aldosterone and increased ADH
D. Decreased aldosterone and decreased ADH
Answer: C. Increased aldosterone and increased ADH
12. A 30-year-old woman with a pituitary adenoma secretes excess adrenocorticotropic
hormone (ACTH), leading to increased cortisol production. Which of the following feedback
mechanisms would be impaired?
A. Positive feedback of cortisol on the hypothalamus and anterior pituitary
B. Negative feedback of cortisol on the hypothalamus and anterior pituitary
C. Positive feedback of ACTH on the adrenal cortex
D. Negative feedback of CRH on the hypothalamus
Answer: B. Negative feedback of cortisol on the hypothalamus and anterior pituitary
13. A 25-year-old man with type 1 diabetes mellitus accidentally administers too much insulin
and develops hypoglycemia. Which of the following hormonal responses would be most likely
to occur?
A. Decreased glucagon and increased insulin
B. Increased glucagon and decreased insulin
C. Increased cortisol and decreased epinephrine
D. Decreased growth hormone and increased somatostatin
Answer: B. Increased glucagon and decreased insulin
14. A person is exposed to a sudden loud noise. Which of the following autonomic responses
would be most expected?
A. Pupillary constriction
B. Increased heart rate and bronchodilation
C. Decreased heart rate and bronchoconstriction
D. Increased salivation and gastrointestinal motility
Answer: B. Increased heart rate and bronchodilation
15. A patient is given a drug that blocks muscarinic acetylcholine receptors. Which of the
following effects would be most expected?
A. Decreased heart rate and increased salivation
B. Increased heart rate and decreased salivation
C. Bronchoconstriction and pupillary constriction
D. Increased gastrointestinal motility and bladder contraction
Answer: B. Increased heart rate and decreased salivation
16. A 70-year-old woman has a blood pressure of 90/60 mm Hg and is feeling dizzy. Which of
the following mechanisms would most directly attempt to restore blood pressure?
A. Decreased sympathetic activity to the heart and blood vessels
B. Increased parasympathetic activity to the heart
C. Increased secretion of atrial natriuretic peptide from the heart
D. Increased renal release of renin and increased vasopressin secretion
Answer: D. Increased renal release of renin and increased vasopressin secretion
17. A 60-year-old man with dehydration has an increased plasma osmolality. Which of the
IOWA– EXAM 3 PRACTICE COMPREHENSIVE 100 QUESTION
STUDY GUIDE WITH ANSWERS AND EXPLANATIONS
1. A 68-year-old man with chronic heart failure is started on a new medication that increases
cardiac contractility. Which of the following changes in his cardiovascular parameters is most
expected?
A. Increased stroke volume and decreased end-systolic volume
B. Decreased stroke volume and increased end-systolic volume
C. Increased heart rate and decreased cardiac output
D. Increased end-diastolic volume and decreased stroke volume
Answer: A. Increased stroke volume and decreased end-systolic volume
2. A medical student is reviewing the pressure-volume loop of the left ventricle. Which point on
the loop corresponds to the opening of the aortic valve?
A. The point where ventricular pressure exceeds aortic pressure during systole
B. The point where ventricular pressure falls below atrial pressure during diastole
C. The point where ventricular volume is at its maximum
D. The point where the atrioventricular valves close
Answer: A. The point where ventricular pressure exceeds aortic pressure during systole
3. A 45-year-old woman is diagnosed with mitral stenosis. Which of the following hemodynamic
changes is most characteristic of this condition under resting conditions?
A. Increased left atrial pressure and reduced left ventricular filling
B. Increased left ventricular end-diastolic volume and pressure
C. Decreased pulmonary capillary wedge pressure
D. Increased cardiac output due to compensatory tachycardia
Answer: A. Increased left atrial pressure and reduced left ventricular filling
4. A 72-year-old man with COPD has an arterial blood gas showing pH 7.32, PaCO2 55 mm Hg,
HCO3- 30 mEq/L. Which of the following BEST describes his acid-base status?
A. Chronic respiratory acidosis with metabolic compensation
B. Acute respiratory acidosis with no compensation
C. Metabolic alkalosis with respiratory compensation
D. Mixed respiratory and metabolic acidosis
Answer: A. Chronic respiratory acidosis with metabolic compensation
5. A 60-year-old woman with chronic kidney disease has an arterial blood gas showing pH 7.28,
PaCO2 30 mm Hg, HCO3- 15 mEq/L. What is the primary acid-base disorder and the
compensatory response?
A. Metabolic acidosis with respiratory compensation (hyperventilation)
B. Respiratory alkalosis with renal compensation (bicarbonate excretion)
C. Metabolic alkalosis with respiratory compensation (hypoventilation)
D. Respiratory acidosis with metabolic compensation (bicarbonate retention)
Answer: A. Metabolic acidosis with respiratory compensation (hyperventilation)
,6. A 50-year-old patient on a ventilator has an arterial blood gas showing pH 7.48, PaCO2 28
mm Hg, HCO3- 24 mEq/L. What is the acid-base disorder?
A. Acute respiratory alkalosis
B. Chronic respiratory alkalosis with renal compensation
C. Metabolic alkalosis with respiratory compensation
D. Mixed respiratory alkalosis and metabolic acidosis
Answer: A. Acute respiratory alkalosis
7. A 55-year-old man with diabetic ketoacidosis presents with deep rapid breathing and an
arterial blood gas showing pH 7.20, PaCO2 20 mm Hg, HCO3- 8 mEq/L. Which of the following
BEST describes the compensation status?
A. Fully compensated metabolic acidosis
B. Partially compensated metabolic acidosis
C. Uncompensated respiratory acidosis
D. Combined metabolic and respiratory acidosis
Answer: B. Partially compensated metabolic acidosis
8. A 70-year-old woman with chronic obstructive pulmonary disease has an arterial blood gas
showing pH 7.36, PaCO2 68 mm Hg, HCO3- 38 mEq/L. What is the most likely acid-base status?
A. Fully compensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Metabolic alkalosis with respiratory compensation
D. Combined respiratory and metabolic acidosis
Answer: A. Fully compensated respiratory acidosis
9. A 40-year-old patient with severe vomiting has an arterial blood gas showing pH 7.52, PaCO2
49 mm Hg, HCO3- 40 mEq/L. Which of the following is the primary disorder and compensation?
A. Metabolic alkalosis with respiratory compensation (hypoventilation)
B. Respiratory acidosis with metabolic compensation (bicarbonate retention)
C. Metabolic acidosis with respiratory compensation (hyperventilation)
D. Respiratory alkalosis with renal compensation (bicarbonate excretion)
Answer: A. Metabolic alkalosis with respiratory compensation (hypoventilation)
10. A 65-year-old man with heart failure is given a diuretic, which leads to a decrease in blood
pressure. Which of the following baroreceptor-mediated responses would be expected?
A. Decreased sympathetic outflow to the heart and blood vessels
B. Increased parasympathetic outflow to the heart and decreased heart rate
C. Increased sympathetic outflow to the heart and blood vessels, and decreased parasympathetic outflow
D. Increased renin release from the kidneys and decreased vasopressin secretion
Answer: C. Increased sympathetic outflow to the heart and blood vessels, and decreased
parasympathetic outflow
11. A 45-year-old woman with renal artery stenosis has chronic activation of the
renin-angiotensin-aldosterone system. Which of the following hormonal changes would most
likely be present?
A. Increased aldosterone and decreased antidiuretic hormone (ADH)
B. Decreased aldosterone and increased ADH
, C. Increased aldosterone and increased ADH
D. Decreased aldosterone and decreased ADH
Answer: C. Increased aldosterone and increased ADH
12. A 30-year-old woman with a pituitary adenoma secretes excess adrenocorticotropic
hormone (ACTH), leading to increased cortisol production. Which of the following feedback
mechanisms would be impaired?
A. Positive feedback of cortisol on the hypothalamus and anterior pituitary
B. Negative feedback of cortisol on the hypothalamus and anterior pituitary
C. Positive feedback of ACTH on the adrenal cortex
D. Negative feedback of CRH on the hypothalamus
Answer: B. Negative feedback of cortisol on the hypothalamus and anterior pituitary
13. A 25-year-old man with type 1 diabetes mellitus accidentally administers too much insulin
and develops hypoglycemia. Which of the following hormonal responses would be most likely
to occur?
A. Decreased glucagon and increased insulin
B. Increased glucagon and decreased insulin
C. Increased cortisol and decreased epinephrine
D. Decreased growth hormone and increased somatostatin
Answer: B. Increased glucagon and decreased insulin
14. A person is exposed to a sudden loud noise. Which of the following autonomic responses
would be most expected?
A. Pupillary constriction
B. Increased heart rate and bronchodilation
C. Decreased heart rate and bronchoconstriction
D. Increased salivation and gastrointestinal motility
Answer: B. Increased heart rate and bronchodilation
15. A patient is given a drug that blocks muscarinic acetylcholine receptors. Which of the
following effects would be most expected?
A. Decreased heart rate and increased salivation
B. Increased heart rate and decreased salivation
C. Bronchoconstriction and pupillary constriction
D. Increased gastrointestinal motility and bladder contraction
Answer: B. Increased heart rate and decreased salivation
16. A 70-year-old woman has a blood pressure of 90/60 mm Hg and is feeling dizzy. Which of
the following mechanisms would most directly attempt to restore blood pressure?
A. Decreased sympathetic activity to the heart and blood vessels
B. Increased parasympathetic activity to the heart
C. Increased secretion of atrial natriuretic peptide from the heart
D. Increased renal release of renin and increased vasopressin secretion
Answer: D. Increased renal release of renin and increased vasopressin secretion
17. A 60-year-old man with dehydration has an increased plasma osmolality. Which of the
