Gabi N. Waite
Maria Sheakley
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,Medical Physiology Q&A
Gabi N. Waite, PhD
Professor
Department of Basic Sciences
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
Maria Sheakley, PhD
Associate Professor
Department of Biomedical Sciences
Western Michigan University Homer Stryker M.D. School of Medicine
Kalamazoo, Michigan
183 illustrations
Thieme
New York • Stuttgart • Delhi • Rio de Janeiro
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Managing Editor: Kenneth Schubach undergoing continual development. Research and clini-
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In-House Production Editor: Naamah Schwartz drug therapy. Insofar as this book mentions any dosage
International Production Director: Andreas Schabert or application, readers may rest assured that the authors,
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the manufacturers differ from the statements made in the
Library of Congress Cataloging-in-Publication Data present book. Such examination is particularly important
Names: Waite, Gabi Nindl, author. | Sheakley, Maria, with drugs that are either rarely used or have been newly
author. released on the market. Every dosage schedule or every
Title: Medical physiology Q&A/ Gabi N. Waite, form of application used is entirely at the user’s own risk
Maria Sheakley. and responsibility. The authors and publishers request ev-
Description: New York : Thieme, [2018] | Includes index. ery user to report to the publishers any discrepancies or
Identifiers: LCCN 2017024887| ISBN 9781626233843 inaccuracies noticed. If errors in this work are found after
(pbk.) | ISBN 9781626233850 (eISBN) publication, errata will be posted at www.thieme.com on
Subjects: | MESH: Physiological Phenomena | Examina- the product description page.
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Classification: LCC QP40 | NLM QT 18.2 | DDC 612.0076- signs referred to in this book are in fact registered trade-
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the appearance of a name without designation as propri-
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publisher that it is in the public domain.
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,To my mentor and close friend, Dr. Walter Balcavage.
Gabi N. Waite
To the mentors in my life: Dr. Barbara Francois, Dr. Charles “Chuck” Seidel, and Dr. Hashim
Shams.
Maria Sheakley
,
Contents
Preface................................................................................................................................................ viii
Acknowledgments.......................................................................................................................... viii
How to Use This Series......................................................................................................................ix
1 Cellular Physiology.............................................................................................................................1
2 The Nervous System........................................................................................................................ 25
3 Musculoskeletal and Integumentary Systems......................................................................... 39
4 Blood and Immune Systems.......................................................................................................... 61
5 Cardiovascular and Lymphatic Systems..................................................................................... 75
6 Respiratory System........................................................................................................................ 133
7 Renal and Urinary Systems.......................................................................................................... 153
8 Gastrointestinal System................................................................................................................ 209
9 Endocrine System........................................................................................................................... 241
10 Reproductive System..................................................................................................................... 265
11 Multisystem Processes.................................................................................................................. 283
Index.......................................................................................................................................................... 305
vii
,
Preface
A successful student of the medical profession easy and moderate questions. Students who
is able to synthesize concepts and principles need to integrate physiological principles
that govern a human body and apply those with their new understanding of pathology,
concepts and principles to healthy and diseased pharmacology, or other medical topics can
patients. This requires the ability to integrate select moderate and difficult questions.
basic and clinical science information, such Nursing and allied health students, who need
as understanding how the Frank Starling to perform at a higher level in their area of
principle applies to cardiac resuscitation and expertise, will study moderate and difficult
how gastrointestinal physiology can aid in questions to prepare for their discipline-
choosing the best diet for a patient. specific certifying exams. Even residents and
With this book, it is our goal to provide professionals will benefit from a refresher in
examples of how to synthesize, integrate, the mechanistic understanding of medicine.
and apply physiological concepts to clinical With the ever-expanding pool of medical
situations, in a format similar to that used in the knowledge, we see this book as an ongoing
United States Medical Licensing Examination project that will continually be revised and
(USMLE). Accordingly, we took examples of updated based on scientific discovery and
high-yield concepts that we provide in the audience feedback. In this aspect, this book
classroom and turned them into challenging contributes to the new era of electronic
multiple-choice questions. publishing, where continuous improvement
This book is a valuable resource for becomes a necessary reality. We welcome
medical students to prepare for the USMLE feedback, and look forward to hearing about
Step 1 exam. Additionally, it is a book that the ways in which this book is used by aspiring
provides students of any health profession and established medical professionals.
the opportunity to self-assess their level of
understanding. Students who need a resource Gabi N. Waite, PhD
for a condensed review, after completing Maria Sheakley, PhD
a medical physiology course, can focus on
Acknowledgments
We gratefully acknowledge a multitude remarkable editorial and production work. A
of colleagues who reviewed materials and special thanks to Delia DeTurris (acquisitions),
answered questions, including David B. Kenny Chumbley (production), and Kenneth
Averill, PhD (Geisinger Commonwealth), Roy Schubach (management) for their continued
W. Geib, PhD (Indiana University), David R. help and encouragement throughout the
Riddle, PhD (Western Michigan University process.
School of Medicine), Dr. Hashim Shams, MD, Last, but not least, we are thankful to
PhD (Ross University), and Brian Wilcox, MD, our wonderful husbands, parents, friends,
PhD (Geisinger Commonwealth). colleagues, and pets who deserved more
We are grateful for guidance and support attention but accepted our determination to
from the entire Thieme staff and for their meet the next deadline. Thank you!
viii
,
How to Use This Series
Question Difficulty Key
Green Box = Easy question
Yellow Box = Medium question
Chapter
Red Box = Hard question
Head
Section
Header
Question
Stem
Answer
Options
Difficulty Level Icon
In general, an easy question requires only a diagnosis
based upon the question stem.
A medium question requires not just the diagnosis of the
condition based upon the question stem, but knowledge
about that diagnosis so as to answer a question about it.
Hard questions are a combination of medium questions
with less commonly known material about the diagnosis.
ix
,
Question Difficulty Key
Chapter
Green Box = Easy question
Head Yellow Box = Medium question
Red Box = Hard question
Indicates
Question
Difficulty
Correct
Answer
Correct
Answer
Explanation
Incorrect
Answer
Explanation
x
, Chapter 1
Cellular Physiology
LEARNING OBJECTIVES
▶ Explain the general physiology of the cellular
membrane, including diffusion, membrane transport,
intracellular signaling, and feedback.
▶ Discuss the physiology of osmosis, tonicity, body fluid
compartment, Starling forces, and edema formation.
▶ Discuss the ion channels of the cell membrane and
their role in membrane potentials and excitation.
Describe the neuronal action potential.
