GMS FINAL A COMPREHENSIVE STUDY
GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ Propranolol.
Answer: non-selective beta AR antagonistbeta 1 antagonism: decrease in
HR, contractility and CObeta 2 antagonism: acute increase in peripheral
vascular resistanceincrease airway resistance (precaution for asthma)
◍ What is the functional unit of the kidney?.
Answer: nephron
◍ cardiac suppression (negative ionotrpic action)pro arrythmia (syncope and
torsade de pointes)-constipation, dry mouth, blurred vision, worsening of
pre-existing glaucoma-metabolized in liver-thrombocytopenia.
Answer: quinidine side effects
◍ What are the 7 phases of the cardiac cycle?.
Answer: (1) Rapid Ventricular Filling(2) Reduced Ventricular Filling
(Diastasis)(3) Atrial Systole(4) Isovolumetric Contraction(5) Rapid
Ejection(6) Reduced Ejection(7) Isovolumetric Relaxation
◍ converts angiotensinogen (blood protein) to angiotensin I.
Answer: renin
◍ Hyperpolarization following an action potential induced by ACh
administration is primarily caused by activation of which receptors?.
Answer: mAChR
◍ buspirone.
Answer: very slow acting, treats GAD, novel structure; benzodiazepine
◍ located in capillary beds and control flowrelaxed=capillaries perfuse with
, bloodcontract=constrict enrey to capillary and blood bypasses capillary.
Answer: precapillary sphincters
◍ GPCR Mechanism.
Answer: - Ligand binds to receptor and activates it. - Receptor interacts with
G protein which leads to a conformational change. - GDP is exchanged for
GTP and alpha dissociates (helped by GEF). - The receptor dissociates from
G protein and subunits go interact with their effectors. -alpha- GTP and
Beta/gamma subunits disassociate. Alpha interacts with E1. - Alpha
catalyzed hydrolysis of GTP to GDP makes subunits re-associate (RGS
helps). - Signaling stops.
◍ transitional epithelium-umbrella cells on the surface protect it from
hypertonic acidic urinerugae: wrinkles in empty bladder.
Answer: mucosa
◍ What are some of the functions of Primary Active Transporters?.
Answer: -pump electrolytes out of one compartment into another-solute
gradients for osmotic stability-ion gradients for bioelectricity-ion gradients
for secondary active transport
◍ smaller forms have better bioavailability and longer half lives -enoxaparin,
deltaparin, fondaparinux.
Answer: low molecular weight heparins
◍ -hypercalcemia-dehydration-pH imbalances-frequent UTI-enlarged prostate
gland (urine retention).
Answer: kidney stone causes
◍ base: broad concave portion resting on diaphragmapex: tip that projects just
above clavicle costal surface: pressed against ribcagemediastinal surface:
faces medially toward heart.
Answer: lung
◍ inability of heart to pump sufficient blood to meet the metabolic demands of
the body-reduced efficiency of heart as a pump.
Answer: heart failure
,◍ What are the two neuron types? What muscle fibers do they affect?.
Answer: (1) Fast Twitch- Type IIA (oxidative), Type IIB (glycotic)(2) Slow
Twitch- Type I (fatigue resistant)
◍ Epinephrine.
Answer: acts directly at receptora1, a2, b1, and b2 - AR agonistb1 = b2 > a1
= a2*good for preserving local blood flow (constricts surrounding vessels,
allows lidocaine to remain at site of injection for longer period)@ low dose:
no change or slight increase in mean BPincrease systolic
(contractility)decrease diastolic, decrease TPR (vasodilation)increase HR,
SV, CO decrease renal and cutanous blood flow (vasoconstriction)@high
dose: acts like norepinephrine
◍ Pseudohypoparathyroidism.
Answer: PTH normally acts at the kidney and bone and exerts effects to
increase blood calcium. With this disease, they cannot do so because Gas
protein that the PTH receptor normally signals through is defective.
Hypocalcemic.
◍ Standard activation of nicotinic receptors causes?.
Answer: A shift in membrane potential (-80mV ——> -15mV)
◍ How do you calculate heart rate through an EKG?.
Answer: (1) Determine the number of boxes and multiply those by 0.04 sec
to determine the amount of time per beat(2) Have 60 sec/min divided by the
time per beat you found to get beats per min
◍ A negative contractility is a result of decreased [Ca++]. This is cause by....
Answer: (1) Ca++ channel blockers(2) Low extracellular [Ca++](3) High
extracellular [Na+]
◍ The nucleus of the solitary tract (NTS) integrates information from
baroreceptors into the....
Answer: Nucleus ambiguus (NA)Caudal Ventrolateral Medulla (CVLM)
◍ Phosphodiesterase (PDE) inhibitor-increases cyclic AMP=INCREASES
, CONTRACTILITY AND STROKE VOLUME-decreases afterload
(vasodilation)-little to no change in heart rateLIMITS: hypotension,
proarrythia, increased mortaility.
Answer: Milrinone
◍ vasodilators ca channel blockers.
Answer: smooth muscle
◍ slow, onset of action and a long half life-less reflex tachycardia.
Answer: amlodipine
◍ normal action potential is interrupted or followed by an abnormal
depolarization EAD (early after depolarizations)DAD (delayed
afterdepolarization).
Answer: triggered activity
◍ vasodilating beta blocker -selective alpha 1 blocker -nonselective beta
blockercarvedilol: heart failureLabetalol: oral or IV (hypertensive
emergencies).
Answer: carvedilol, labetalol
◍ Adverse effects: cardiac suppression (decrease cardiac ouput) and rebound
effect Cautious:asthma, diabetes, heart failure, peripheral vascular disease.
Answer: Beta AR antagonists
◍ Pathway of Circulatory System.
Answer: Deoxygenated Blood - Right Atrium - tricuspid valve - Right
Ventricle - pulmonary artery - Lungs - Oxygenated Blood - pulmonary vein
- Left Atrium - mitral valve - Left Ventricle - Aorta - artery - arteriole -
capillary - venule - vein - vena cava
◍ lowers very high TGs-made of omega-3-fatty acids found naturally in some
plants and in oil.
Answer: lovaza
◍ 3 lobes-shorter than left since liver rises higher here.
Answer: right lung
GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ Propranolol.
Answer: non-selective beta AR antagonistbeta 1 antagonism: decrease in
HR, contractility and CObeta 2 antagonism: acute increase in peripheral
vascular resistanceincrease airway resistance (precaution for asthma)
◍ What is the functional unit of the kidney?.
Answer: nephron
◍ cardiac suppression (negative ionotrpic action)pro arrythmia (syncope and
torsade de pointes)-constipation, dry mouth, blurred vision, worsening of
pre-existing glaucoma-metabolized in liver-thrombocytopenia.
Answer: quinidine side effects
◍ What are the 7 phases of the cardiac cycle?.
Answer: (1) Rapid Ventricular Filling(2) Reduced Ventricular Filling
(Diastasis)(3) Atrial Systole(4) Isovolumetric Contraction(5) Rapid
Ejection(6) Reduced Ejection(7) Isovolumetric Relaxation
◍ converts angiotensinogen (blood protein) to angiotensin I.
Answer: renin
◍ Hyperpolarization following an action potential induced by ACh
administration is primarily caused by activation of which receptors?.
Answer: mAChR
◍ buspirone.
Answer: very slow acting, treats GAD, novel structure; benzodiazepine
◍ located in capillary beds and control flowrelaxed=capillaries perfuse with
, bloodcontract=constrict enrey to capillary and blood bypasses capillary.
Answer: precapillary sphincters
◍ GPCR Mechanism.
Answer: - Ligand binds to receptor and activates it. - Receptor interacts with
G protein which leads to a conformational change. - GDP is exchanged for
GTP and alpha dissociates (helped by GEF). - The receptor dissociates from
G protein and subunits go interact with their effectors. -alpha- GTP and
Beta/gamma subunits disassociate. Alpha interacts with E1. - Alpha
catalyzed hydrolysis of GTP to GDP makes subunits re-associate (RGS
helps). - Signaling stops.
◍ transitional epithelium-umbrella cells on the surface protect it from
hypertonic acidic urinerugae: wrinkles in empty bladder.
Answer: mucosa
◍ What are some of the functions of Primary Active Transporters?.
Answer: -pump electrolytes out of one compartment into another-solute
gradients for osmotic stability-ion gradients for bioelectricity-ion gradients
for secondary active transport
◍ smaller forms have better bioavailability and longer half lives -enoxaparin,
deltaparin, fondaparinux.
Answer: low molecular weight heparins
◍ -hypercalcemia-dehydration-pH imbalances-frequent UTI-enlarged prostate
gland (urine retention).
Answer: kidney stone causes
◍ base: broad concave portion resting on diaphragmapex: tip that projects just
above clavicle costal surface: pressed against ribcagemediastinal surface:
faces medially toward heart.
Answer: lung
◍ inability of heart to pump sufficient blood to meet the metabolic demands of
the body-reduced efficiency of heart as a pump.
Answer: heart failure
,◍ What are the two neuron types? What muscle fibers do they affect?.
Answer: (1) Fast Twitch- Type IIA (oxidative), Type IIB (glycotic)(2) Slow
Twitch- Type I (fatigue resistant)
◍ Epinephrine.
Answer: acts directly at receptora1, a2, b1, and b2 - AR agonistb1 = b2 > a1
= a2*good for preserving local blood flow (constricts surrounding vessels,
allows lidocaine to remain at site of injection for longer period)@ low dose:
no change or slight increase in mean BPincrease systolic
(contractility)decrease diastolic, decrease TPR (vasodilation)increase HR,
SV, CO decrease renal and cutanous blood flow (vasoconstriction)@high
dose: acts like norepinephrine
◍ Pseudohypoparathyroidism.
Answer: PTH normally acts at the kidney and bone and exerts effects to
increase blood calcium. With this disease, they cannot do so because Gas
protein that the PTH receptor normally signals through is defective.
Hypocalcemic.
◍ Standard activation of nicotinic receptors causes?.
Answer: A shift in membrane potential (-80mV ——> -15mV)
◍ How do you calculate heart rate through an EKG?.
Answer: (1) Determine the number of boxes and multiply those by 0.04 sec
to determine the amount of time per beat(2) Have 60 sec/min divided by the
time per beat you found to get beats per min
◍ A negative contractility is a result of decreased [Ca++]. This is cause by....
Answer: (1) Ca++ channel blockers(2) Low extracellular [Ca++](3) High
extracellular [Na+]
◍ The nucleus of the solitary tract (NTS) integrates information from
baroreceptors into the....
Answer: Nucleus ambiguus (NA)Caudal Ventrolateral Medulla (CVLM)
◍ Phosphodiesterase (PDE) inhibitor-increases cyclic AMP=INCREASES
, CONTRACTILITY AND STROKE VOLUME-decreases afterload
(vasodilation)-little to no change in heart rateLIMITS: hypotension,
proarrythia, increased mortaility.
Answer: Milrinone
◍ vasodilators ca channel blockers.
Answer: smooth muscle
◍ slow, onset of action and a long half life-less reflex tachycardia.
Answer: amlodipine
◍ normal action potential is interrupted or followed by an abnormal
depolarization EAD (early after depolarizations)DAD (delayed
afterdepolarization).
Answer: triggered activity
◍ vasodilating beta blocker -selective alpha 1 blocker -nonselective beta
blockercarvedilol: heart failureLabetalol: oral or IV (hypertensive
emergencies).
Answer: carvedilol, labetalol
◍ Adverse effects: cardiac suppression (decrease cardiac ouput) and rebound
effect Cautious:asthma, diabetes, heart failure, peripheral vascular disease.
Answer: Beta AR antagonists
◍ Pathway of Circulatory System.
Answer: Deoxygenated Blood - Right Atrium - tricuspid valve - Right
Ventricle - pulmonary artery - Lungs - Oxygenated Blood - pulmonary vein
- Left Atrium - mitral valve - Left Ventricle - Aorta - artery - arteriole -
capillary - venule - vein - vena cava
◍ lowers very high TGs-made of omega-3-fatty acids found naturally in some
plants and in oil.
Answer: lovaza
◍ 3 lobes-shorter than left since liver rises higher here.
Answer: right lung
