Demystifying Medicine (DM)

FINAL EXAMINATION (May 2011).

In order to obtain the certificate you must attempt all questions and answer 12 of the questions correctly. For the following 21 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)

HIV

A current recommendations are to treat those exposed to the virus rather than wait for AIDS to develop.
B 10% of HIV patients are cured by modern drugs.
C Baltimore-DC is the nation’s current epidemic center for HIV/AIDS.
D A vaccine against HIV glycoprotein prevents infection.
E HIV persists because CD4+ T cell infection exceeds their death rate.
AIDS patients usually die of

A secondary infections.
B exhaustion of CD4 cells.
C HCV liver disease.
D drug resistance.
An asymptomatic patient had a positive HIV test that 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.
Diabetes

A obesity is a risk factor.
B Islet cell transplantation cures diabetes.
C Type II diabetes is due to autoimmune destruction of pancreatic beta cells.
D meticulous control of blood sugar reduces complications.
E prenatal maternal obesity affects development of diabetes in the child.
Hepatitis B and C

A are rarely associated with liver cancer.
B HCV and HBV 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 vaccine against HCV is effective.
Chronic Granulomatous Disease

A due to mutations in NADPH oxidase.
B disease characterized by multiple infections.
C reactive oxygen promotes inflammation response.
D similar defects associated with atherosclerotic cardiovascular disease.
Fatty Liver

A due to excess triglycerides in liver.
B obesity is risk factor.
C can progress to inflammation, necrosis and cirrhosis.
D major cause of abnormal liver function tests in USA.
E associated with insulin resistance.
F Hispanics are especially prone.
Hepatocellular Carcinoma (HHC)

A transcriptome analysis can separate regenerative nodules from HCC.
B most effective management of HCC is HBV vaccine.
C HCC is the major cancer in USA.
D mainly in patients with chronic liver disease.
E major cause of geographic distribution is HBV and HCV.
F diabetes is a risk factor.
Prostate growth is androgen dependent

A True.
B false.
Treatments of prostatic cancer

A castration.
B estrogens.
C radiation.
D surgery.
E vaccination.
Malaria

A major global cause of infant death.
B P. falciparum causes disease by aggregating platelets.
C greatest risk is in first pregnancy.
D blood stage vaccine prevents severe disease.
E major cause of brain damage in african children.
F hastens HIV spread.
Helicobacter pylori

A cause of gastric and duodenal ulcers.
B non-invasive organism.
C 50% of world infected.
D chronic gastritis can result in gastric cancer.
E transmitted person-to-person.
F cured by antibiotic.
G effective vaccine available.
Staphylococcus

A infects many organs and tissues.
B MRSA (methicillin-resistant staphylococcus aureus) infection increasing worldwide.
C MRSA can occur in healthy individuals.
D infection can be prevented by hand washing.
E hand washing better than antibiotics to prevent spread.
Herpes Zoster

A Herpes zoster due to residual chickenpox virus in dorsal or cranial root ganglia.
B age and immune deficiency are risk factors.
C Shingles is transient and mild.
D antiviral drugs cure the disease.
Chronic Fatigue Syndrome

A due to mouse RNA retrovirus.
B there are several successful treatments.
C is often incapacitating.
D antiviral treatment is effective.
E women outnumber males.
Multiple Sclerosis

A affects young adults.
B nonprogressive disease.
C myelin-specific antibody CD4 T cells mediate the disease.
D patients have high serum and CSF levels of antimyelin antibody.
E reactive oxygen important in pathogenesis.
F anti-immune drugs are effective treatment.
Sleep and Circadian Rhythm

A master clock is in suprachiasmatic nucleus.
B 24-hour sleep deprivation reduces mental and physical reactions.
C work and commuting time influence when we awaken but not when we go to sleep.
D sleeping less is cumulative.
Circadian Clocks are in most organs

A True.
B False.
Circadian Clocks control

A immune response.
B reproduction.
C metabolism.
D sleep.
Cushing's Disease

A hyperadrenal cortical activity can be due to pituitary disease.
B cortisol is major mediator of hyperadrenal cortical status.
C cortisol affects virtually all metabolic activities.
D glucocorticoid receptor is regulated by cycling of transcriptional activators in chromatin.
E exogenous hormone (treatment) disturbs normal circadian cortical rhythm.
Alzheimer's Disease

A age is major risk factor.
B early-onset Alzheimer's is usually genetic.
C definitive diagnosis requires brain biopsy.
D dementia restricted to memory and language.
E drugs and diet reduce symptoms.
F clinical course is predictable.

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.