BIOL 215
Human Anatomy & Physiology II
Proctored Midterm Exam
2026
(Questions & Answers)
Multiple Choice (12 Questions)
1. Case: A patient with mitral valve stenosis develops pulmonary edema.
Q: Which mechanism explains this?
• A. Increased right ventricular preload
• B. Backflow into left atrium increases pulmonary venous pressure
• C. Decreased systemic vascular resistance
• D. Increased coronary perfusion
Answer: B
Rationale: Mitral stenosis causes left atrial pressure rise → pulmonary congestion.
2. Case: A patient with chronic kidney disease shows anemia.
Q: Which hormone deficiency explains this?
• A. Aldosterone
• B. Erythropoietin
• C. Renin
• D. Cortisol
Answer: B
Rationale: Kidneys produce erythropoietin to stimulate RBC production.
3. Case: A patient with emphysema has difficulty exhaling.
Q: Which physiological change occurs?
• A. Increased elastic recoil
• B. Loss of alveolar elasticity
• C. Increased tidal volume
• D. Decreased residual volume
Answer: B
Rationale: Emphysema destroys elastic tissue, impairing recoil.
4. Case: A patient with hyperthyroidism shows tachycardia.
Q: Which mechanism explains this?
• A. Increased sympathetic tone
• B. Increased metabolic rate and β-adrenergic sensitivity
• C. Decreased parasympathetic tone
• D. Increased vagal stimulation
Answer: B
Rationale: Thyroid hormones upregulate β-adrenergic receptors.
5. Case: A patient with cirrhosis develops ascites.
Q: Which factor contributes most?
• A. Increased plasma albumin
,• B. Portal hypertension and hypoalbuminemia
• C. Increased lymphatic drainage
• D. Hypernatremia
Answer: B
Rationale: Cirrhosis causes portal hypertension and reduced oncotic pressure.
6. Case: A patient with diabetes insipidus shows polyuria.
Q: Which hormone is deficient?
• A. Aldosterone
• B. ADH
• C. Cortisol
• D. Insulin
Answer: B
Rationale: ADH deficiency prevents water reabsorption.
7. Case: A patient with myocardial infarction shows ST elevation.
Q: Which event explains this?
• A. Ischemia causes abnormal depolarization
• B. Increased vagal tone
• C. Hyperkalemia only
• D. Increased preload
Answer: A
Rationale: Ischemic tissue alters conduction → ST elevation.
8. Case: A patient with hypocalcemia develops tetany.
Q: Which physiological mechanism explains this?
• A. Decreased excitability of neurons
• B. Increased excitability of neurons
• C. Decreased acetylcholine release
• D. Increased GABA activity
Answer: B
Rationale: Low calcium lowers threshold, increasing excitability.
9. Case: A patient with COPD develops respiratory acidosis.
Q: Which compensation occurs?
• A. Renal bicarbonate retention
• B. Increased CO₂ exhalation
• C. Decreased hemoglobin buffering
• D. Increased ventilation
Answer: A
Rationale: Kidneys retain bicarbonate to buffer acidosis.
10. Case: A patient with hypovolemic shock shows tachycardia.
Q: Which mechanism explains this?
• A. Increased vagal tone
• B. Sympathetic activation to maintain cardiac output
• C. Decreased baroreceptor activity
• D. Increased parasympathetic tone
Answer: B
Rationale: Sympathetic system compensates for low volume.
11. Case: A patient with gallstones develops jaundice.
, Q: Which bilirubin type increases?
• A. Unconjugated
• B. Conjugated
• C. Both equally
• D. None
Answer: B
Rationale: Obstruction prevents excretion of conjugated bilirubin.
12. Case: A patient with hyperaldosteronism shows hypertension.
Q: Which mechanism explains this?
• A. Sodium retention increases plasma volume
• B. Potassium retention increases vascular tone
• C. Decreased renin secretion
• D. Increased cortisol secretion
Answer: A
Rationale: Aldosterone promotes sodium/water retention → hypertension.
True/False (8 Questions)
13. Case: The pulmonary arteries carry oxygenated blood.
Answer: False
Rationale: They carry deoxygenated blood to lungs.
14. Case: The liver produces clotting factors such as fibrinogen and prothrombin.
Answer: True
Rationale: Hepatic synthesis is essential for coagulation.
15. Case: The pancreas secretes bicarbonate into the duodenum.
Answer: True
Rationale: Neutralizes gastric acid.
16. Case: The loop of Henle is primarily responsible for glucose reabsorption.
Answer: False
Rationale: Glucose reabsorbed in proximal tubule.
17. Case: The sinoatrial node initiates cardiac rhythm.
Answer: True
Rationale: SA node is pacemaker.
18. Case: The thyroid gland secretes calcitonin to lower blood calcium.
Answer: True
Rationale: Calcitonin inhibits bone resorption.
19. Case: The stomach absorbs most nutrients.
Answer: False
Rationale: Small intestine is primary site.
20. Case: The adrenal medulla secretes catecholamines.
Answer: True
Rationale: Epinephrine/norepinephrine secreted.
Human Anatomy & Physiology II
Proctored Midterm Exam
2026
(Questions & Answers)
Multiple Choice (12 Questions)
1. Case: A patient with mitral valve stenosis develops pulmonary edema.
Q: Which mechanism explains this?
• A. Increased right ventricular preload
• B. Backflow into left atrium increases pulmonary venous pressure
• C. Decreased systemic vascular resistance
• D. Increased coronary perfusion
Answer: B
Rationale: Mitral stenosis causes left atrial pressure rise → pulmonary congestion.
2. Case: A patient with chronic kidney disease shows anemia.
Q: Which hormone deficiency explains this?
• A. Aldosterone
• B. Erythropoietin
• C. Renin
• D. Cortisol
Answer: B
Rationale: Kidneys produce erythropoietin to stimulate RBC production.
3. Case: A patient with emphysema has difficulty exhaling.
Q: Which physiological change occurs?
• A. Increased elastic recoil
• B. Loss of alveolar elasticity
• C. Increased tidal volume
• D. Decreased residual volume
Answer: B
Rationale: Emphysema destroys elastic tissue, impairing recoil.
4. Case: A patient with hyperthyroidism shows tachycardia.
Q: Which mechanism explains this?
• A. Increased sympathetic tone
• B. Increased metabolic rate and β-adrenergic sensitivity
• C. Decreased parasympathetic tone
• D. Increased vagal stimulation
Answer: B
Rationale: Thyroid hormones upregulate β-adrenergic receptors.
5. Case: A patient with cirrhosis develops ascites.
Q: Which factor contributes most?
• A. Increased plasma albumin
,• B. Portal hypertension and hypoalbuminemia
• C. Increased lymphatic drainage
• D. Hypernatremia
Answer: B
Rationale: Cirrhosis causes portal hypertension and reduced oncotic pressure.
6. Case: A patient with diabetes insipidus shows polyuria.
Q: Which hormone is deficient?
• A. Aldosterone
• B. ADH
• C. Cortisol
• D. Insulin
Answer: B
Rationale: ADH deficiency prevents water reabsorption.
7. Case: A patient with myocardial infarction shows ST elevation.
Q: Which event explains this?
• A. Ischemia causes abnormal depolarization
• B. Increased vagal tone
• C. Hyperkalemia only
• D. Increased preload
Answer: A
Rationale: Ischemic tissue alters conduction → ST elevation.
8. Case: A patient with hypocalcemia develops tetany.
Q: Which physiological mechanism explains this?
• A. Decreased excitability of neurons
• B. Increased excitability of neurons
• C. Decreased acetylcholine release
• D. Increased GABA activity
Answer: B
Rationale: Low calcium lowers threshold, increasing excitability.
9. Case: A patient with COPD develops respiratory acidosis.
Q: Which compensation occurs?
• A. Renal bicarbonate retention
• B. Increased CO₂ exhalation
• C. Decreased hemoglobin buffering
• D. Increased ventilation
Answer: A
Rationale: Kidneys retain bicarbonate to buffer acidosis.
10. Case: A patient with hypovolemic shock shows tachycardia.
Q: Which mechanism explains this?
• A. Increased vagal tone
• B. Sympathetic activation to maintain cardiac output
• C. Decreased baroreceptor activity
• D. Increased parasympathetic tone
Answer: B
Rationale: Sympathetic system compensates for low volume.
11. Case: A patient with gallstones develops jaundice.
, Q: Which bilirubin type increases?
• A. Unconjugated
• B. Conjugated
• C. Both equally
• D. None
Answer: B
Rationale: Obstruction prevents excretion of conjugated bilirubin.
12. Case: A patient with hyperaldosteronism shows hypertension.
Q: Which mechanism explains this?
• A. Sodium retention increases plasma volume
• B. Potassium retention increases vascular tone
• C. Decreased renin secretion
• D. Increased cortisol secretion
Answer: A
Rationale: Aldosterone promotes sodium/water retention → hypertension.
True/False (8 Questions)
13. Case: The pulmonary arteries carry oxygenated blood.
Answer: False
Rationale: They carry deoxygenated blood to lungs.
14. Case: The liver produces clotting factors such as fibrinogen and prothrombin.
Answer: True
Rationale: Hepatic synthesis is essential for coagulation.
15. Case: The pancreas secretes bicarbonate into the duodenum.
Answer: True
Rationale: Neutralizes gastric acid.
16. Case: The loop of Henle is primarily responsible for glucose reabsorption.
Answer: False
Rationale: Glucose reabsorbed in proximal tubule.
17. Case: The sinoatrial node initiates cardiac rhythm.
Answer: True
Rationale: SA node is pacemaker.
18. Case: The thyroid gland secretes calcitonin to lower blood calcium.
Answer: True
Rationale: Calcitonin inhibits bone resorption.
19. Case: The stomach absorbs most nutrients.
Answer: False
Rationale: Small intestine is primary site.
20. Case: The adrenal medulla secretes catecholamines.
Answer: True
Rationale: Epinephrine/norepinephrine secreted.
