Free practice final
Anatomy and Physiology 2 practice final (free, with answers)
A typical second-semester anatomy and physiology final covers the endocrine system and blood, the cardiovascular, lymphatic and immune, respiratory, digestive, urinary, and reproductive systems, and fluid and acid-base balance. These 15 questions mix structure and function with a few short calculations. Try each one on your own before opening the answer, then use the explanation to connect the fact to the physiology behind it.
For exam practice only, not clinical advice.
Topics
- Endocrine System
- Blood
- Cardiovascular System
- Lymphatic and Immune Systems
- Respiratory System
- Digestive System
- Urinary System
- Fluid and Acid-Base Balance
- Reproductive System
15 questions
Try each one before you open its answer.
1. A patient has a high blood cortisol level and an abnormally low ACTH level. Which problem best explains this combination?
- A A pituitary tumor that secretes ACTH
- B A tumor of the adrenal cortex that secretes cortisol
- C Excess CRH secretion by the hypothalamus
- D A tumor of the adrenal medulla that secretes epinephrine
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Answer: B. A tumor of the adrenal cortex that secretes cortisol
Cortisol inhibits CRH and ACTH release by negative feedback, so cortisol made independently by an adrenal tumor drives ACTH down. Excess CRH or an ACTH-secreting pituitary tumor would raise both ACTH and cortisol, and the adrenal medulla makes catecholamines, not cortisol.
2. In dietary iodine deficiency the thyroid cannot make enough T₃ and T₄. Will the blood level of TSH be higher or lower than normal?
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Answer: Higher than normal
Low T₃ and T₄ remove negative feedback on the hypothalamus and anterior pituitary, so TRH and TSH secretion rise. Constant TSH stimulation makes the thyroid enlarge, forming a goiter.
3. A patient with type A, Rh-negative blood needs a transfusion of packed red blood cells. Red cells from which donor are compatible?
- A AB, Rh-negative
- B B, Rh-negative
- C O, Rh-negative
- D AB, Rh-positive
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Answer: C. O, Rh-negative
Type A plasma contains anti-B antibodies, so donor red cells must lack the B antigen, and an Rh-negative patient should receive Rh-negative cells to avoid forming anti-Rh antibodies. Type O, Rh-negative cells carry none of the A, B or Rh(D) antigens, while every other choice carries the B antigen that the patient's anti-B would attack.
4. After several weeks living at high altitude, a person's hematocrit rises. Which hormone, from which main source, drives this change?
- A Erythropoietin, mainly from the kidneys
- B Erythropoietin, mainly from the red bone marrow
- C Thrombopoietin, mainly from the liver
- D Renin, mainly from the kidneys
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Answer: A. Erythropoietin, mainly from the kidneys
When oxygen delivery to the kidneys falls, kidney cells release more erythropoietin, which stimulates the red bone marrow to make more red blood cells. The marrow is the target rather than the source, thrombopoietin regulates platelet production, and renin starts the renin-angiotensin-aldosterone system.
5. A resting heart has an end-diastolic volume of 120 mL, an end-systolic volume of 50 mL and a heart rate of 72 beats per minute. What is the cardiac output?
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Answer: 5.04 L/min (5040 mL/min)
Stroke volume = EDV − ESV = 120 − 50 = 70 mL per beat, and cardiac output = heart rate × stroke volume = 72 × 70 = 5040 mL/min. That is about 5 L/min, a typical resting value.
6. During isovolumetric contraction of the ventricles, what is the state of the heart valves?
- A AV valves open, semilunar valves closed
- B AV valves closed, semilunar valves open
- C All four valves open
- D All four valves closed
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Answer: D. All four valves closed
As the ventricles start to contract, their pressure rises above atrial pressure and the AV valves close, but it is still below the pressure in the aorta and pulmonary trunk, so the semilunar valves stay shut. With every valve closed, the volume of blood in the ventricles cannot change, which is what isovolumetric means.
7. Which cells recognize viral peptides presented on MHC class I molecules of an infected body cell and kill that cell directly?
- A Helper T cells (CD4⁺)
- B Cytotoxic T cells (CD8⁺)
- C Plasma cells
- D Neutrophils
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Answer: B. Cytotoxic T cells (CD8⁺)
Nearly all nucleated cells use MHC class I to display peptides from proteins made inside them, and CD8 binds MHC class I, so cytotoxic T cells can find and kill virus-infected cells with perforin and granzymes. Helper T cells recognize antigen on MHC class II and coordinate the response, and plasma cells secrete antibodies.
8. A person breathes 12 times per minute with a tidal volume of 500 mL, and the anatomical dead space is 150 mL. What is the alveolar ventilation rate?
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Answer: 4200 mL/min (4.2 L/min)
Only the part of each breath beyond the dead space reaches the alveoli: 500 − 150 = 350 mL. Alveolar ventilation = 350 mL × 12 breaths/min = 4200 mL/min, less than the minute ventilation of 500 × 12 = 6000 mL/min.
9. Which change shifts the oxygen-hemoglobin dissociation curve to the right, helping hemoglobin unload more O₂ in an exercising muscle?
- A A decrease in temperature
- B An increase in blood pH
- C An increase in PCO₂
- D A decrease in 2,3-BPG
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Answer: C. An increase in PCO₂
A higher PCO₂, along with the H⁺ it generates, lowers hemoglobin's affinity for O₂ (the Bohr effect), so more O₂ is released at a given PO₂. Rising temperature and rising 2,3-BPG also shift the curve right, so the opposite changes listed in the other choices shift it left.
10. When acidic chyme enters the duodenum, which hormone mainly stimulates the pancreas to release bicarbonate-rich fluid?
- A Secretin
- B Gastrin
- C Cholecystokinin (CCK)
- D Ghrelin
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Answer: A. Secretin
Cells in the duodenal lining release secretin in response to acid, and pancreatic duct cells answer with bicarbonate that neutralizes the chyme. CCK mainly triggers enzyme secretion and gallbladder contraction, gastrin stimulates the stomach, and ghrelin signals hunger.
11. Inulin is filtered at the glomerulus but is neither reabsorbed nor secreted. A patient's plasma inulin is 1.0 mg/mL, urine inulin is 60 mg/mL and urine flow is 2.0 mL/min. What is the glomerular filtration rate (GFR)?
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Answer: 120 mL/min
For a substance that is only filtered, the amount filtered per minute equals the amount excreted, so GFR = (U × V)/P = (60 mg/mL × 2.0 mL/min)/(1.0 mg/mL) = 120 mL/min. That is why inulin clearance is a standard measure of GFR.
12. In which part of the nephron is the largest share, about two-thirds, of filtered sodium and water reabsorbed?
- A Collecting duct
- B Distal convoluted tubule
- C Ascending limb of the nephron loop (loop of Henle)
- D Proximal convoluted tubule
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Answer: D. Proximal convoluted tubule
The proximal convoluted tubule, with its brush border and many mitochondria, reabsorbs about 65% of filtered Na⁺ and water, along with nearly all filtered glucose and amino acids. Later segments handle smaller amounts, but they are where hormones such as aldosterone and ADH fine-tune the final urine.
13. A patient who took an opioid overdose is breathing slowly and shallowly. Arterial blood shows pH 7.28, PaCO₂ 55 mmHg and HCO₃⁻ 25 mEq/L (normal: pH 7.35–7.45, PaCO₂ 35–45 mmHg, HCO₃⁻ 22–26 mEq/L). Which disturbance is present?
- A Metabolic acidosis
- B Respiratory acidosis
- C Metabolic alkalosis
- D Respiratory alkalosis
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Answer: B. Respiratory acidosis
The pH is low, so this is acidosis, and the high PaCO₂ explains it: hypoventilation retains CO₂, which forms carbonic acid. Bicarbonate is still in the normal range, so the kidneys have not yet compensated, which fits a sudden problem.
14. Repeated vomiting of stomach contents causes which acid-base disturbance?
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Answer: Metabolic alkalosis
Vomiting removes HCl from the stomach, and for each H⁺ the parietal cells secrete to replace it, a HCO₃⁻ enters the blood, so blood bicarbonate rises. The accompanying loss of fluid and Cl⁻ also leads the kidneys to hold on to bicarbonate, which keeps the alkalosis going.
15. Midway through the ovarian cycle, a surge of LH from the anterior pituitary triggers ovulation. What causes this LH surge?
- A A fall in progesterone from the corpus luteum
- B A rise in inhibin from the dominant follicle
- C High, sustained estrogen from the dominant follicle
- D hCG from the implanting embryo
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Answer: C. High, sustained estrogen from the dominant follicle
For most of the cycle estrogen inhibits GnRH and LH release, but once estrogen from the mature follicle stays high for long enough, its feedback on the hypothalamus and anterior pituitary switches to positive. Falling progesterone at the end of the cycle leads to menstruation instead, and hCG appears only after an embryo implants.