Medsci 203 TT 2012 - notes PDF

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VERSION: 20312188 MEDSCI 203THE UNIVERSITY OF AUCKLANDFIRST SEMESTER, 2012 Campus: CityMEDSCI 203Mechanisms of DiseaseMID SEMESTER TEST(Time Allowed: 50 MINUTES)MULTIPLE CHOICE QUESTIONSNOTE: Write your NAME, ID NUMBER and THIS TEST VERSION NUMBER on the Scantron sheet provided. Use a 2B pencil for ...

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VERSION: 20312188 MEDSCI 203

THE UNIVERSITY OF AUCKLAND FIRST SEMESTER, 2012 Campus: City

MEDSCI 203 Mechanisms of Disease MID SEMESTER TEST (Time Allowed: 50 MINUTES)

MULTIPLE CHOICE QUESTIONS

NOTE: Write your NAME, ID NUMBER and THIS TEST VERSION NUMBER on the Scantron sheet provided. Use a 2B pencil for all marking on the answer sheet. Each question contains five suggested answers. Indicate your choice on the Scantron Sheet by shading in the box for the correct answer. Responses are either correct = 1 mark, or incorrect = 0 marks

CONTINUED VERSION: 20312188 MEDSCI 203 -21. A T helper population that is concerned with immunity against helminths (worms) but that can also drive allergic conditions is known as: (a) TH1 (b) TH2 (c) TH17 (d) Treg (e) Tbet 2. Regurgitated stomach contents are able to induce Barrett’s oesophagus and oesophageal cancer because they contain: (a) high levels of acid (b) bile salts (c) proteolytic enzymes such as trypsin (d) enzymes that generate N-nitroso compounds (e) all of the above components

3. H pylori-induced stomach disease progresses through several steps. The step associated with the loss of cell differentiation that precedes cancer development is called: (a) atrophic gastritis (b) chronic superficial gastritis (c) dysplasia (d) metaplasia (e) peptic ulceration

4. Chronic inflammation is seen in all of the following situations EXCEPT:

(a) long-term exposure to irritants (b) infections with resistant micro-organisms (c) inflammatory bowel diseases (d) autoimmunity (e) systemic inflammatory response syndrome (SIRS)

CONTINUED VERSION: 20312188 MEDSCI 203 -35. Crohn’s disease may be best thought of as: (a) arising from a largely genetic aetiology (b) arising from infection with a known but rare pathogenic bacterium (c) a condition that has become more frequent because of excessive use of anti-inflammatory drugs (d) reflecting changes in unknown environmental factors, together with a genetic predisposition (e) an allergic TH2-mediated disease 6. A major protein associated with fibrosis is: (a) fibrin (b) fibrinogen (c) collagen type 1 (d) laminin (e) plasmin

7. Granulation tissue is: (a) a long-term inflammatory lesion found in tuberculosis (b) composed of aggregations of neutrophils (c) formed by long-term interactions between macrophages and lymphocytes, orchestrated by TH1 cells (d) tissue rich in blood vessels that forms during wound repair (e) the location of caseous necrosis

8. Myofibroblasts that cause liver fibrosis are believed to develop mainly from: (a) Kupffer cells (b) stellate cells (c) cholangiocytes (d) oval cells (e) circulating monocytes

9. DNA ligase is an enzyme that can: (a) unwind the double stranded DNA molecule (b) seal single stranded nicks in double stranded DNA (c) synthesise new DNA strands (d) cut double stranded DNA at defined sites (e) add phosphate groups to the 5’termini of DNA molecules

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10. Which of these methods is used to locate specific genes on chromosomes? (a) PCR (b) Southern blotting (c) ELISA (d) FISH (e) Northern blotting

11. A substitution of a pyrimidine with a pyrimidine is called a: (a) deletion (b) truncation (c) transition (d) frameshift (e) transversion

12. Huntington disease normally shows which of the following patterns of inheritance? (a) Autosomal recessive (b) X-linked recessive (c) X-linked dominant (d) Y-linked

(e) Autosomal dominant

13. Which of these statements about X-linked inheritance is FALSE? (a) Males and females are equally affected (b) The gene tends to be transmitted through carrier females (c) The gene tends not to be transmitted from father to son (d) Carrier females are generally unaffected (e) All daughters of an affected male will be carriers

14. Which of these tests is undertaken at the earliest stage? (a) Post-natal testing (b) Chorionic villus sampling (c) Pre-implantation genetic diagnosis (d) Pre-symptomatic testing (e) Amniocentesis

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15. Which of these statements best describes allelic heterogeneity? (a) The frequency at which a genotype will have a given clinical outcome (b) The same disease resulting from different mutations, but all within the same gene (c) Variation in the clinical severity as a result of a particular genetic defect (d) The same disease resulting from mutations at different loci (e) Heterozygotes having a reproductive advantage over homozygotes

16. Which of these methods can be used to confirm a known genetic mutation within another family member? (a) DNA sequencing (b) Western blotting (c) Microarrays (d) Northern blotting (e) All of the above

17. During the colonisation of mucosa by Gram negative bacterial pathogens like Neisseria meningitidis there is a step of intimate adherence involving receptors on

eukaryotic cell membranes and bacterial adhesins located on: (a) pili (b) capsule (c) cell wall (d) outer membrane (e) inner membrane

18. A bacterial protease that degrades C5a will contribute to immune evasion by interfering with: (a) opsonisation (b) chemotaxis (c) phagocytosis (d) membrane lysis (e) phagosome/lysosome fusion

CONTINUED VERSION: 20312188 MEDSCI 203 -619. A nutrient essential for bacterial growth that is plentiful in the human body, but is sequestered in a protein-bound form to limit availability is: (a) iron (b) calcium (c) glucose (d) lipid A (e) folic acid

20. In toxic shock syndrome, the toxic shock syndrome toxin stimulates excessive cytokine production by promoting the interaction of which two cell types? (a) Antigen presenting cell and neutrophil (b) B cell and T helper cell (c) Neutrophil and B cell (d) Antigen presenting cell and T helper cell (e) Antigen presenting cell and B cell

21. Cholera toxin stimulates excessive production of which second messenger? (a) Diacyl glycerol (b) GTP (c) cAMP (d) Calcium (e) GDP

22. Proteases secreted during an infection are UNLIKELY to have a role in: (a) the spread of bacteria through tissue (b) releasing nutrients (c) preventing opsonisation (d) preventing chemotaxis (e) killing neutrophils

23. Lipid A endotoxin stimulates cytokine production by binding to: (a) TLR4 (b) NF-κB (c) CD14 (d) LPS binding protein (e) IL-1

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24. The production of antibodies that cross-react with human tissue is responsible for damage occurring in: (a) cholera (b) rheumatic fever (c) gastric cancer (d) meningitis (e) septicaemia

25. Excessive release of pro-inflammatory cytokines is often associated with: (a) hypertension (b) vasoconstriction

(c) rapid clearance of an infection (d) hyperthermia (e) antibody production

26. Acid hyper-secretion as a result of Helicobacter pylori infection is thought to be due to the reduced activity of: (a) parietal cells (b) gastrin secreting cells (c) mucus secreting cells (d) histamine secreting cells (e) somatostatin secreting cells

27. Which virulence factor of Helicobacter pylori is MOST STRONGLY associated with stimulating inflammation leading to the release of nutrients into the low nutrient environment of the gastric mucus? (a) VacA (b) LPS (c) CagA (d) Urease (e) Flagellum

CONTINUED VERSION: 20312188 MEDSCI 203 28. With respect to the etiology of disease: (a) most diseases have a purely environmental cause (b) most diseases arise from interacting genetic and environmental factors (c) inherited risk factors do not feature in common illnesses such as cancer and diabetes (d) genes predispose people to certain illnesses, but not not influence their subsequent development (e) late mechanistic changes in cells and tissues are the primary concern

29. An aspirate of a lesion may provide information on all the following EXCEPT:

(a) tissue architecture (b) antigen expression on cells (c) molecular abnormalities (d) cytology (e) the nature of microbes present

30. The HER2 protein: (a) is a marker of Crohn’s disease (b) has no application in disease treatment (c) contributes to disease when it undergoes loss of expression (d) is a reagent used in the treatment of certain tumours (e) is a receptor for growth factors of the epidermal growth factor (EGF) class

31. Given that kalium is the Latin word for potassium, the word hyperkalaemia would indicate a concentration of potassium that is: (a) lower than normal in heart muscle (b) lower than normal in urine (c) lower than normal in any disease condition (d) higher than normal in blood (e) higher than normal in tissue

32. A congenital disease is one that is: (a) transmitted genetically between generations (b) initiated before or during birth (c) non-genetic in origin (d) found only in children (e) caused by chronic inflammation

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33. UV radiation is associated with all of the following effects on skin EXCEPT: (a) ageing (b) cell death (c) a high frequency of base substitution mutations (d) a high frequency of DNA strand breaks (e) cancer

34. The MOST damaging of the reactive oxygen species is: (a) superoxide (b) hydrogen peroxide (c) hydroxyl radical (d) hydroxide ion (e) nitric oxide

35. Heat shock proteins: (a) have the effect of inducing apoptosis following severe cell injury (b) are produced in cells following irreversible cell injury (c) are found only in hyperplastic tissues following long-term stress (d) induce cell senescence (e) renature damaged proteins and prevent their aggregation

36. Silica and uric acid cause disease by their interaction with: (a) DNA (b) membranes (c) proteins (d) intercellular matrix macromolecules (e) surface glycoprotein receptors

37. Protein carbonylation is a marker of: (a) oxidative damage (b) bacterial infection (c) oncotic cell death with cell lysis (d) the Maillard reaction (e) abnormal storage

CONTINUED VERSION: 20312188 MEDSCI 203 - 10 38. A form of cell death that features the TNF receptor 1 and the RIP kinase is: (a) oncosis (b) apoptosis (c) necroptosis

(d) pyroptosis (e) autophagy with extreme vacuolisation

39. You might expect to find dry gangrene: (a) following an acute ischaemic event (b) after deep tissue injury that severs the blood supply and introduces soil bacteria (c) in the liver of an alcoholic (d) when the arterial supply to a tissue gradually diminishes (e) when there is extensive damage to the pancreas

40. A disease characterised by insufficient levels of apoptosis is: (a) acquired immunodeficiency syndrome, AIDS (b) long term heart failure (c) neurodegenerative conditions such as motor neuron disease (d) type 1 diabetes (e) cancer

41. Certain proteolytic enzymes are intimately associated with apoptotic cell death. These are: (a) matrix metalloproteinases (b) collagenases (c) initiator caspases (d) calcium-activated lysosomal proteases (e) complement convertases

42. Inflammation is induced by: (a) any injury that causes apoptosis (b) any injury that causes cell lysis (c) injuries involving microbial infection only (d) macrophage transforming growth factor-beta (TGFβ) (e) phagocytosis of apoptotic bodies

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43. Histamine, tryptases, and platelet activating factor (PAF) share the properties of

inducing: (a) bacterial lysis (b) vasodilatation, vasopermeability and neutrophil recruitment (c) endothelial blebbing and detachment from basement membranes (d) the acute phase response (e) pain

44. Two agents that oppose each other in their effects on platelet aggregation and blood vessel diameter are: (a) interleukin-1α and interleukin-1β (b) thromboxane A 2 and prostacyclin I2 (c) the C3a and C5a components of complement (d) tissue factor and thrombin (e) all of the above pairs of agents

45. Tumour necrosis factor-alpha (TNFα) was originally called cachectin because chronic expression leads to: (a) systemic immune response syndrome (b) leukocytosis (c) loss of fat stores and protein from the body (d) suppurative necrosis (e) granulomas

46. Which of the following might be recognised by macrophages as a damage associated molecular pattern (DAMP)? (a) Fragments of extracellular matrix, such as soluble proteoglycans (b) RNA (c) ATP (d) The HMGB1 protein and N-formylated proteins from mitochondria (e) All of the above

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47. P- and E-selectins have the function of: (a) recruiting white blood cells from the circulation (b) inducing vasodilatation (c) opsonising microbial products (d) lysing bacteria by disrupting their cell walls (e) detoxifying reactive oxygen species

48. All of the following conditions promote the differentiation of fibroblasts to myofibroblasts EXCEPT: (a) completion of the wound repair process (b) the presence of platelet-derived growth factor (PDGF) (c) the presence of transforming growth factor-beta (TGFβ) (d) tissue tension (e) deposition of extracellular ED-A fibronectin

49. Stem cells with the capacity to cause tissue regeneration following extensive injury are: (a) always in a state of vigorous proliferation (b) capable of only symmetric divisions (c) usually non-cycling cells but with a capacity to enter the cell division cycle indefinitely (d) characterised by genetic programmes which are the same as those of the differentiated cells they produce (e) absent from labile tissues such as the gut mucosa

50. The presence of the transcription factor cocktail SOX2, OCT4, KLF4 and Myc is associated with: (a) the development of Barrett’s oesophagus (b) the induction of pluripotent stem cells (c) the generation of terminally differentiated cells (d) H pylori infection of the gastric mucosa (e) maintenance of permanent cells in non-renewable tissues...