Skriftlig eksamen August 2018

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1 Skriftlig eksamen August 2018 Titel på kursus: Almen patologi Uddannelse: Semester: 4 th Semester Medicin/Medis bachelor Eksamensdato: August 2018 Tid: Bedømmelsesform: Eksamensansvarlig: 3 timer bestået/ikke bestået Meg Duroux Vigtige oplysninger: Husk at medbringe studiekort til eksamen Hele eller dele af opgaven kan være formuleret på engelsk (NB! der vil ikke blive stillet ordbøger til rådighed) Opgaven er sammensat af multiple choice opgaver og essayopgaver af forskellig længde. Den enkelte opgaves point er angivet efter hvert spørgsmål. Ved åbne spørgsmål (også kaldet essayspørgsmål), hvor man til et stillet spørgsmål selv skal skrive en besvarelse, skal besvarelsen skrives inden for den med streger angivne ramme: Rammens størrelse angiver den ønskede maksimale længde på besvarelsen. Der må således ikke skrives mere til det enkelte spørgsmål, end det kan rummes inden for den relevante ramme. Det er tilladt at skrive besvarelsen på et dansk, svensk, norsk eller engelsk Intet af det udleverede papir (eksamenssæt og kladdepapir) må tages med ud af eksamenslokalet Ingen former for kommunikation med andre eksaminander er tilladt Hjælpemidler er ikke tilladt The exam is a mixture of MCQ short and long essay type questions. Total number of questions: 23 Total number of points: 100

2 ANSWER SCHEME FOR MULTIPLE CHOICE QUESTIONS EXAM 4.3. HUSK AT SKRIVE STUDIENUMMER ØVERST PÅ HVER SIDE. SKRIV IKKE NAVN ELLER CPR-NUMMER. Opgave Svar (i) (ii) (iii) (iv) (v) (i) (ii) (iii) (iv) (v) (vi) MCQ TOTAL = 15 questions Marks =26

3 1 Hvad er IKKE korrekt om nekrose? A. Processen inducerer inflammation B. Forekommer altid under patologiske forhold C. Cellen svulmer og lyserer under processen D. Er en for cellen aktiv proces. E. Processen er altid eksternt induceret Max point :1 Opnåede point 2 The most frequent histological form of invasive cervical cancer is: A B C D E Basal cell carcinoma Intraepithelial neoplasia Adenocarcinoma Squamous cell carcinoma Dysplasia Max point :1 Opnåede point 3 Hvad er ubiquitins funktion? A. Medvirker i nedbrydningen af proteiner i cellen. B. Nedsætter produktionen af strukturelle celleproteiner. C. Medvirker til at folde proteiner korrekt. D. Øger cellemembranens smeltepunkt.

4 E. Styrer ekspressionen af cellens stressgener. Max point :1 Opnåede point 4 Horace Stafford has developed an abdominal aortic aneurysm. Which one of the following is an unlikely consequence of this problem? A. Femoral artery embolism B. Local thrombosis. C. Pulmonary embolism. D. Rupture. E. Vessel wall calcification Max point: 1 Opnåede points 5 Dysplasi i et væv betyder, at A. Vævet er skrumpet B. Antallet af celler er formindsket C. Der forekommer ekspansion af umodne celler D. De enkelte cellers volumen er formindsket E. Mængden af ekstracellulær matrix er formindsket Max point :1 Opnåede point 6 Which one of the following statements is false? A. Telomeres shorten with each round of replication. B. Telomerase activity is decreased in 90% of tumors. C. Telomeres play a role in the replicative potential of a cell.

5 D. Telomeres are composed of thousands of TTAGGG repeats. E. Telomerase activity is increased in 90% of tumors. Max point: 1 Opnåede points 7 The cyclin D-cdk4 complex phosphorylates C-terminal residues of prb upon growth factor stimulation. Which one of the following events does this lead to? A. The cyclin A gene is expressed upon release of HATs from prb. B. The cyclin E gene is expressed upon release of HDAC from prb. C. The cyclin E gene is down regulated upon release of HDAC from prb. D. The cyclin D gene is expressed upon release of HDAC from prb. E. The cyclin A gene is regulated upon release of HATs from prb. Max point: 1 Opnåede points 8 Which finding is associated with a decreased risk for atherosclerosis? A. Elevated plasma HDL. B. Elevated plasma LDL. C. Elevated plasma IDL. D. Elevated plasma VLDL. E. Elevated plasma chylomicrons. Max point: 1 Opnåede points 9 Which of the statements below is TRUE regarding Radiotherapy? A. It is the medical use of ionizing radiation as part of cancer treatment to control malignant cells

6 B. The use of radiotherapy in non-malignant conditions is limited partly by worries about the risk of radiation-induced cancers C. Radiation therapy is commonly applied to the cancerous tumour D. Radiation therapy works by damaging the DNA of cells E. All of the above Max point : 1 Achieved point 10 Which of the following is NOT a sign of arteriosclerosis? A. Xanthelasmas B. Arcus senilis C. Atrial septal defect D. Extra rapid heart sounds E. All of the above Max point : 1 Achieved point 11 Thrombosis refers to the vascular obstruction with a blood clot. There are some distinctions in characteristics of arterial and venous thrombosis. Identify which of the following 3 statements are correct: A. Venous thrombus is rich in fibrin, whereas arterial thrombus is rich in platelets B. Arterial thrombosis is promoted by blood stasis, whereas venous thrombosis is caused by turbulent blood flow C. Pulmonary thromboembolism is a typical consequence of arterial, but not venous thrombosis

7 D. Ruptured atherosclerotic plaque may often lead to arterial thrombosis E. White (anemic) infarction typically results from venous thrombosis, whereas red (hemorrhagic) infarction is always caused by arterial thrombosis F. The risk for venous thrombosis is increased by prolonged bed rest and immobilization G. Deep leg vein thrombosis is leading to the gangrene of the distal part of the limb Max point: 3 Opnåede points 12 Using the definitions (A-J), select the correct option that best fits the following questions. A B C D E F G H I J Metaplasia Dysplasia Neoplasia Hamartoma Carcinoma Sarcoma Teratoma Lymphoma Hypertrophy Atrophy Questions: select the option from the list above that best fits the description below (i) (ii) A type of germ cell tumor that may contain several different types of tissue A change of cells to a form that does not normally occur in the tissue: e.g.

8 squamous cells from the oesophagus changing to resemble those in the stomach (iii) (iv) (v) A decrease in size of an organ caused by disease or disuse Benign growth made up of an abnormal mixture of cells and tissues normally found in the area of the body where the growth occurs Loss of uniformity of cells and loss of architectural organisation Max point: 5 Opnåede points 13 Which of the following is the most superficial layer of the skin? A. Stratum basale. B. Papillary region of the dermis. C. Hypodermis. D. Stratum granulosum. E. Stratum corneum. Max point: 1 Opnåede points 14 A woman's risk of developing cervical cancer increases if: A. She is infected with human papillomavirus (HPV). B. She smokes. C. Her mother or sisters have had cervical cancer. D. She has recurrent cervical infections, such as Chlamydia infection. E. All of the above. Max point: 1 Opnåede points

9 15 Match the different rates of cell division found for different cell types A B C D E F G H I J 12 hours Never 5 days 3 weeks hours 12 months 6 months 3 days 20 hours 4 hours Questions: select the option from the list above that best fits the description below (i) (ii) (iii) (iv) (v) (vi) Intestinal epithelium cells Bone marrow Nerve cells Normal skin regeneration Liver cells Cancer cells Max point: 6 Opnåede points END MCQ

10 ESSAY AND SHORT ANSWER QUESTIONS. 1 What are the 6 hallmarks of cancer cells? Provide an example of a gene(s) involved in each these processes? (6 marks) 6 marks

11 2 1. What is a tumor suppressor gene? (2 marks) 2. Provide 2 examples of tumor suppressor genes and 2 examples of oncogenes. Describe how they function. (4 marks) 6 marks

12 3 Cancer pathology: 1. With the aid of a diagram, how would you grade and stage a suspected Malignant Melanoma. (6 marks)

13 6 marks

14 4 Molecular biology of cancer: 1. Explain how the cell cycle is regulated with respect to the action of the different cyclin dependent kinases (CDK)? Why are check point controls important? (6 marks) 2. How does p53 trigger cell growth arrest? (4 marks)

15 Marks 10

16 5 Describe the key steps in metastasis and how tumour cells recolonise and grow new tumours. (10 marks)

17 Marks 10

18 6 Explain the terminology chronic versus acute, myeloid versus lymphoid, in relation to leukaemias. (8 marks)

19 10 marks

20 7 Cancer Treatment. 1. Name 4 different types of chemotherapy treatment and provide examples (8) 8 marks

21 8 Cancer Treatment: 1. What drug is commonly used to treat chronic myeloid leukemia (CML)? (1 marks) 2. Explain the mechanism of action of this drug? (4 marks) 3. Describe with the aid of a diagram how CML can evolve resistance to therapy / treatment. (5 marks)

22 10 marks