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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