Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Re-Exam Module 4.3

Medicine and MedIS, AAU, 4th. Semester

10th. August 2015

3 hours written exam without books and lecture notes. Calculators are not

allowed.

The exam paper has to be photocopied so please write within the borders

allocated for each question. Write your study number on each page. The

space allocated for each question provides you with an idea about the maximum

length of the answer. Each question states the maximum number of points. The

box ”points achieved” is only used for marking the question.

Answers to questions can be written in Danish or English.

Additional paper is for drafting answers and not to be handed in. This paper may

NOT be removed from the examination room after completion of the exam

paper.

The exam is a mixture of short and long essay type questions.

Total number of questions: 6

Total number of points: 100

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

1 (i) Carcinogens induce mutations at the DNA and chromosomal

Level:

Using the original DNA Sequence of bases ATG AGC TAT

Change one of the bases in the second codon to show the following

mutations: (4 marks)

a. Transition

b. Transversion

c. Insertion

d. Deletion

(ii) What do you understand by somatic and germline mutations

(2 marks)

(iii) Explain why germline mutations can predispose an individual

to cancer (6 marks)

(iv) Using colon cancer as an example, describe the way in which

colorectal cancer develops (8 marks)

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

20 marks

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

2 Cancer pathology:

Describe the key steps in metastasis and how tumour cells recolonise and

grow new tumours. (10 marks)

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

10 marks

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

3 Molecular biology of cancer:

a. Explain how the cell cycle is regulated with respect to the action of the

different cyclin dependent kinases (CDK)? (5 marks)

b. Explain the importance of checkpoints in controlling progression

through the cell cycle? (4 marks)

c. How does p53 trigger cell growth arrest? (4 marks)

d. What happens when p53 is mutated? (2 marks)

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

15 marks

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

4 Clinical Case

Name: Henry McCrae

Sex: Male

Age: 82 years

When you arrive at the surgery this morning, you are told about Mr. McCrae

who has just phoned. He has some trouble with his leg and can’t get out of

bed. He has asked for an urgent visit. It does not sound very urgent to you

but, because of his previous tendency to ignore even important things, you

decide to go. Checking his records, you see that since visiting last year with

hypertension, he has been under regular review and his blood pressure has

been under reasonable control. The last time his cholesterol was measured it

was 7.2 mmol/l. When you arrive at his house you are glad you went. He is

clearly unwell and is in severe pain from his right leg. He tells you that for the

past few weeks he has been getting increasing pain in that leg on walking, but

he responded by just doing less. Last night, however, he was woken up by

severe pain in the right leg with an inability to move it. On examination, the

right leg is pale, cold and immobile. You can feel the femoral pulse but

nothing below it. The left leg looks normal and you can feel all the pulses but

there is a bruit over the femoral artery. Examination of his heart is normal

and his blood pressure is 145/95.

Questions:

a. Based on the clinical history provided make a comprehensive brain

storm to find a likely diagnosis. Define the problem and the learning

outcomes (LO) for the case? (10 marks)

b. Using your learning outcomes, present your findings as you would do so

in case closing providing the relevant information using diagrams and

summaries when appropriate. (20 marks)

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

30 marks

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

5 Explain the terminology chronic versus acute, myeloid versus lymphoid, in relation to leukaemias. (10 marks)

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

10 marks

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

6

Cancer Treatment:

a. Make a table providing 5 different types of chemotherapy treatment

with examples for each treatment. (10 marks)

b. Describe with the aid of a diagram how CML can evolve resistance to

therapy / treatment. (5 marks)

Studienummer: Module 4.3 Questions Re -Exam 10

thAugust 2015 4

th semester

15 marks