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Demystifying Medicine (DM)


FINAL EXAMINATION (May 2009).

In order to obtain the certificate you must attempt at least 12 questions and answer 9 of the questions correctly. For the following 18 questions, please select all the answers which are true. There is no time limit of the examination, however, it must be completed in one setting, so you cannot save your work. The exam is open-book, open-notes, and you may take it as many times as you wish.


Full Name: (to appear on your certificate)

  1. Bacterial sepsis

    A  The asialoglycoprotein receptor (Ashwell-Morell) is present on the plasma membrane of all hepatocytes.
    B  The receptor is also a good marker for lung cancer.
    C  The receptor functions to remove desialyatewd proteins and platelets from the blood.
    D  Bacterial sepsis has increased due to drug-resistant staphlococci.

  2. HIV

    A  current considerations are to treat those exposed to the virus rather than wait for AIDS to develop.
    B  20% of HIV patients are cured by modern drugs.
    C  Baltimore-DC is the nation’s current epidemic center for HIV/AIDS.
    D  HIV virus depletes helper T cells.

  3. AIDS patients usually die of

    A  secondary infections.
    B  exhaustion of CD4 cells.
    C  renal disease.
    D  drug resistance.


  4. An asymptomatic patient had positive HIV test which became negative for six years. CD4 cell count is normal. Patient’s status is

    A  cured.
    B  highly infectious.
    C  still has the virus.
    D  will remain symptom free.


  5. Intestinal bacterial infections

    A  in the steady-state, most fresh vegetables in our food chain are in transit.
    B  in Salmonella outbreaks, frequently the epidemic is over before the offending food can be identified.
    C  Industrialization of food supply has reduced the risk of foodborn infection.
    D  vaccination against foodborn typhoid infection is safe and effectuive.


  6. Melanoma

    A  suncreens can protect against melanoma.
    B  melanoma patients develop an immune response to their tumor.
    C  Il-2 is effective treatment for melanoma.
    D  melanoma does not occur in Afro-Americans.


  7. Spinal cord injury

    A  is a lethal occurrence.
    B  can be prevented by treatment with adult or embyronic stem cells.
    C  major causes are sports and auto accidents.
    D  is progressive.


  8. Diabetes Type 2

    A  obesity is not a risk factor.
    B  insulin cures diabetes.
    C  due to autoimmune dstruction of pancreatic beta cells.
    D  meticulous control of blood sugar prevents complications.
    E  prenatal maternal obesity effect development of diabetes in the child.

  9. Hypertension

    A  most patients are symptomatic.
    B  easily diagnosed and treated.
    C  results from a worldwide recessively inherited single gene.
    D  heart disease and stroke increase in hypertensive patients.


  10. Fibrous dysplasia of bone

    A  associated with precocious puberty andother endocrine abnormalities.
    B  common theme is constituitive activation of adenyl cyclase by mutation of Gs alpha.
    C  bone fractures decrease with patient’s age.
    D  bone stem cells decrease with patient’s age.
    E  only occurs in females.

  11. Macular degeneration

    A  rare inherited Mendelian gene.
    B  treatment designed to reduce free radical formation delays development of macular degeneration.
    C  smoking and alcohol are risk factors.
    D  macular degeneration produces loss of peripheral vision.

  12. Hepatocellular cancer

    A  occurs primarily in patients with liver disease, usually cirrhosis.
    B  vaccination against HBV protects against liver cancer related to HBV.
    C  diabetes and obesity are risk factors for liver cancer.
    D  gene arrays may predict development of liver cancer.
    E liver transplantation is the only current “cure” for liver cancer.


  13. Drug resistance

    A  cancers are often resistant to drugs which are taken for the first time.
    B  ABC transporters are expressed in different tissues but play no role in normal drug metabolisma asd distrbution.
    C  ABC transporter polymorphisms account for different response to various drugs.
    D  Inhibition of MDR 1 (Pgp, ABCB1) makes cancers accessible to various drugs is successful in clinical treatment..


  14. Progeria

    A  characterized by delayed aging.
    B  patients die of cardiovascular disease which is not due to cholesterol deposit (atherosclerosis).
    C  progeria results from single nucleotide mutation in Lamin A gene.
    D  in Lamin A knockout mice, farnesyl transferase inhibitors prevent development of cardiovascular disease.


  15. Fragile X

    16. A  an example of repetitve 5’UTR expansion disease.
    B  most common inheritable retardation defect.
    C  varied expression at different ages including young adults.
    D  basic mechanism involves binding of many RNAs by the repetitive sequence resulting in negative regulation of translation of many genes.


  16. Multiple myeloma

    A  a spectrum of lymphoproliferative disorders.
    B  most commonly has IgA spike in serum protein electrophoresis.
    C  current treatments prolong life but do not cure.
    D  is a cancer of B cells.
    E  is inherited as an autosomal dominant characteristic.


  17. Human Papilloma Virus

    A  responsible for most cases of cervical cancer.
    B  most infection occurs in 15-18 year olds.
    C  males are asymptomatic carriers and transmit the disease during intercourse.
    D  vaccination is effective when given after infection.
    E  pharyngeal cancer is mainly due to HPV infection acquired sexually.


  18. Hepatitis B and C

    19. A  are rarely associated with chronic liver disease.
    B  HCV can be replicated in tissue culture.
    C  IV drug abuse and sexual promiscuity are major risk factors in HBV and HCV.
    D  HCV is a major cause of death in HIV patients.
    E  vaccination against HCV is effective.


    Send brief paragraph stating your comments, suggestions and ideas about the Course in Demystifying Medicine. Did it meet your expectations? what would you improve, discard, add, etc? Send to ariasi@mail.nih.gov



    Please review your answers and make any changes that are needed. If you are done, please submit your answers and your exam will be computer graded. If you answer 9 of the questions correct, you will be forwarded to the course evaluation.