COVER -- HALF-TITLE -- TITLE -- COPYRIGHT -- CONTENTS -- LIST OF ABBREVIATIONS -- DEDICATION -- PREFACE -- A CHANGE IN POSTURE -- 1. What happens to the stroke volume when standing up after a period of lying supine? Explain why this change occurs -- 2. What happens to the arterial pressure during this period? -- 3. What is the physiologic relationship between the cardiac output (CO) and the arterial pressure normally? -- 4. What physiologic mechanisms ensure that the arterial pressure is maintained after standing? -- 5. Give some common causes for postural hypotension. -- ACID-BASE -- 1. Define the pH. -- 2. What is the pH of the blood? -- 3. Where does the H+ in the body come from? -- 4. What are the main buffer systems in the intravascular, interstitial and intracellular compartments? -- 5. What does the Henderson-Hasselbalch equation describe, and how is it derived? -- 6. Which organ systems are involved in regulating acid-base balance? -- 7. How does the kidney absorb bicarbonate? -- 8. Define the base deficit. -- ACTION POTENTIALS -- 1. What is meant by the 'equilibrium potential' for an ion? -- 2. What is meant by the 'resting membrane potential' for a cell? -- 3. What is the typical value of the resting membrane potential for a neurone? -- 4. What is the importance of the Na+ /K+ pump for the equilibrium potential? -- 5. What is an action potential? Draw and label the axes of a typical action potential for a neurone. -- 6. Briefly describe the ionic basis for the action potential. -- 7. What is meant by the 'refractory period'? -- 8. What is the effect of myelination on a nerve fibre? -- 9. What types of nerve fibres are there? -- 10. Briefly list some drugs that may alter the conduction along a neurone. -- ADRENAL CORTEX I -- 1. What are the anatomic layers of the adrenal cortex, and which hormones do they produce?.

2. What is the basic composition of these hormones? -- 3. From which molecule are these hormones all derived? -- 4. What are the main mineralocorticoids, glucocorticoids, androgens and oestrogens produced? -- 5. What are the physiological effects of aldosterone? -- 6. Describe the principle mechanisms controlling aldosterone release -- 7. Where is renin produced? -- 8. Summarise the main effects of glucocorticoids. -- 9. What are the principle metabolic effects? -- 10. What is the basic mechanism of action of the adrenal cortical hormones? -- ADRENAL CORTEX II - CLINICAL DISORDERS -- 1. What types of hyperaldosteronism are there, and what basic features characterise each? -- 2. What causes Conn's syndrome? -- 3. What is the dominant clinical feature? -- 4. What biochemical abnormalities might you detect? -- 5. What will the urine show? -- 6. Apart from the important features mentioned above, what other clinical feature commonly occurs with Conn's syndrome? -- 7. Which aldosterone antagonist has been used in the medical management of this disorder? -- 8. What are the most common causes of Cushing's syndrome of cortisol excess? -- 9. What clinical features might you find on examination of a patient with Cushing's syndrome? -- 10. What are the principle causes of adrenal insufficiency? -- 11. What is the most common cause of congenital adrenal hyperplasia? -- ADRENAL MEDULLA -- 1. How does the embryonic origin of the adrenal cortex differ from that of the medulla? -- 2. What are the two major hormones produced by the adrenal medulla? What is the ratio of production for each? -- 3. What is the precursor for these hormones? -- 4. Briefly describe the path of production, including the names of the enzymes at each step. -- 5. How is the adrenal medulla innervated? -- 6. What are the metabolic effects of sympathetic stimulation by the catecholamines?.

7. How are these hormones metabolised? -- 8. What are the physiological effects of phaeochromocytoma? -- 9. What biochemical tests may be performed to make the diagnosis? -- 10. Which drug is used in the management of this condition? -- 11. How are the multiple endocrine neoplasia (MEN) syndromes classified? -- ARTERIAL PRESSURE -- 1. Draw the arterial pressure waveform, and label the axes. -- 2. How is the mean arterial pressure (MAP) calculated from this waveform? -- 3. How may the MAP be calculated simply? -- 4. Why is the mean pressure not a simple average of the systolic and diastolic pressures? -- 5. What is blood pressure? -- 6. How does the arterial pressure waveform differ at the aortic root compared to further distally in the arterial tree? Why does this occur? -- 7. What are the two basic mechanisms involved in the control of the arterial pressure? -- AUTONOMIC NERVOUS SYSTEM (ANS) -- 1. What are the components of the ANS? -- 2. Where are the locations of the cell bodies of the neurones that make up the SNS? -- 3. Other than their location, how else do pre and postganglionic cells of the SNS differ? -- 4. What is special about the mode of sympathetic supply to the adrenal medulla? -- 5. How does the origin of the PNS differ from the SNS? -- 6. Which cranial nerves have a parasympathetic outflow? -- 7. Taking all of this into account, summarise briefly the neurotransmitters of the ANS, and which types of receptor they act on. -- 8. Generally speaking, how does the distribution of parasympathetic innervation in the body differ from sympathetic distribution? -- 9. Which second messengers are important for the function of the different types of receptors in the ANS? -- 10. Give some examples of the results of stimulation of the various adrenoceptors by noradrenaline. -- CARBON DIOXIDE TRANSPORT.

1. In which forms is CO2 transported in the blood? -- 2. How does the mode of CO2 transport differ between arterial and venous blood? -- 3. How does the amount of CO2 physically dissolved in the plasma compare to the amount of dissolved oxygen? -- 4. You mentioned that CO2 combines with plasma proteins to form carbamino compounds. What is the most significant of these plasma proteins? -- 5. How does CO2 come to be carried as the bicarbonate ion? -- 6. What happens to all of the H generated by this process? -- 7. What effect does all of this haemoglobin-binding of H have on the transport of oxygen by this molecule? -- 8. What is the fate of all the bicarbonate generated in the red blood cell when it carries CO2? -- 9. How does the transport of CO2 affect the osmotic balance of the red cell? -- 10. How does the shape of the oxygen dissociation curve differ from the CO2 dissociation curve? Show this by drawing graphs. -- 11. Why cannot the amount of CO2 in the blood be expressed as a percent-saturation, unlike the case for oxygen? -- 12. What is the difference between the Bohr effect and the Haldane effect? -- CARDIAC CYCLE -- 1. What is the duration of the cardiac cycle at rest? -- 2. Below is a diagram of the pressure changes in the left side of the heart during the cardiac cycle. What do the points A, B, C, and D represent? -- 3. What name is given to the portion of the cycle between A and B? What is its significance? -- 4. Define the stroke volume. Give a typical value for this and the ejection fraction. -- 5. What is the name given to the point in the cycle between B and C? How does it relate to the aortic root pressure? -- 6. What causes the dicrotic notch in the aortic root pressure at the end of rapid ventricular ejection? -- 7. Why is there a small rise in the atrial pressure just before the onset of ventricular systole?.

8. Draw the diagram of the electrocardiogram (ECG) waveform and the timing of the heart sounds. -- 9. What causes the heart sounds? -- 10. Briefly describe the effect of exercise on the phase duration of the cardiac cycle. -- CARDIAC OUTPUT (CO) -- 1. What is the definition of the CO? -- 2. Give a normal resting value for the CO. -- 3. How do the outputs of the two ventricles compare to one another? -- 4. Which factors influence the stroke volume? -- 5. What determines the preload? -- 6. Define the afterload. What is this analogous to, in simple terms? -- 7. What happens to the Frank-Starling curve of the heart when the myocardial contractility is increased? -- 8. What causes a rise in the myocardial contractility? -- 9. Aside from increasing the myocardial contractility, by what other mechanisms does sympathetic stimulation increase the CO? -- CELL SIGNALLING -- 1. Which parts of a cell express receptors? -- 2. Can you name the four main types of receptor involved in cellular signalling? Give some examples. -- 3. What basically happens when a ligand binds to a G-protein coupled receptor? -- 4. What are the components of the G-protein? -- 5. What is the functional significance of the Alpha subunit? -- 6. What is the result of activation or inhibition of adenylyl cyclase by the activated G-protein? -- 7. Can you give some more examples of other second messengers generated through G-protein receptor stimulation? What effects do these have within the cell? -- 8. Do G-protein coupled receptors always produce their effects through second messenger pathways? -- 9. What is the single most important effect of stimulation of any kind of tyrosine kinase linked receptor? -- 10. What is the basic structure of the tyrosine kinase linked receptor? -- 11. What is so distinctive about the way that it signals?.

12. Generally speaking, what kinds of hormones signal directly through intracellular receptors? Give examples.