FCD(SA) Part I

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain Reg No 1955/000003/08

Part I Examination for the Fellowship of the College of Dentistry of South Africa 28 August 2013 Paper 3 (3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if more than one is required for the one answer) Al die vrae moet beantwoord word. Elke vraag moet in n aparte boek (of boeke indien meer as een nodig is vir n vraag) geskryf word

A 45-year-old male presents with chronic cough and cervical lymphadenopathy. Special investigations show he has tuberculosis of his lungs and cervical lymph nodes. A Radiologist who evaluated radiographs of the patients head, neck and chest, diagnosed metastatic calcifications of the cervical lymph nodes a) Do you concur with the Radiologist that tuberculosis may cause metastatic calcification? Explain your answer. (4) b) Explain the molecular events that resulted in calcification of the patients cervical lymph nodes. (8) [12] n 45-Jarige man presenteer met n chroniese hoes en servikalelimfadenopatie. Spesiale ondersoeke wys dat hy tuberkulose in sylonge en servikale limfknope het. n Radioloogwat xstraalfotos van die pasint se kop, nek en borskas gevalueer het, het metastatie sekalsifikasie van die servikale limfknope gediagnoseer a) Stem u met die Radioloog saam dat tuberkulose metastatiese verkalking kan veroorsaak? Verduidelik u antwoord. (4) b) Verduidelik die molecule regebeure wat tot kalsifikasie van die pasint se servikale limfknope aanleiding gegee het. (8) [12] a) b) Name the different hypersensitivity reactions. (4) A 50-year-old male who is systemically healthy sustained a bee sting on his hand 2 hours ago. He now presents with periorbitaloedema and stridor. From which type of hypersensitivity reaction does the patient suffer? (2) Explain the molecular and cellular events that resulted in the clinical manifestations of this patient. (12) [18] Noem die verskillende hipersensitiwiteits reaksies. (4) n 50-Jarige man wat sistemies gesond is het 2 uregelede n bysteek op sy hand opgedoen. Hy presenteer nou met periorbitaleedeem en stridor. Aan watter tipe hipersensitiwiteits reaksiely die pasint? (2) Verduidelik die molekulre en sellulre gebeure wat aanleiding gegee het tot die kliniesebeeld waar mee hierdie pasint presenteer. (12) [18]

c)

a) b)

c)

-23 a) b) c) Define the term infarct. (2) Explain how different factors determine the macroscopic appearance of infarction. (18) Describe the cellular changes in an infarct. (4) [24] Definieerdie term infarkt. (2) Verduidelik hoe verskillende faktore die makroskopiese voorkoms van infarksie bepaal. (18) Beskryf die sellulre veranderinge in n infarkt. (4) [24]

a) b) c)

Your medical colleague developed swelling in his neck, which he suspects to be a neoplasm. He asks you to assess the tumour in order to establish whether it is benign or malignant. Explain how you will decide whether it is a benign or malignant neoplasm, using clinical information and clinical examination only. [15] U kollega het swelling in syne kontwikkel wat hy vermoed n neoplasma is.Hy vra u om die tumor te evalueer ten einde vas testel of dit benigne of maligne is. Verduidelik hoe u sal vasstel of dit n benigne of maligneneo plasma is deurslegs van kliniese inligting en kliniese ondersoek gebruik te maak. [15] a) b) c) Classify the most common lesions of the mitral and aortic valves of the heart. (4) Name the pathological cause of each of the valvular lesions mentioned for question 5a). (4) Briefly describe the clinical manifestations of each of the valvular lesions you mentioned. (8) [16] Klassifiseer die meesal gemeneletsels van die mitraal- en aortakleppe van die hart. (4) Noem die patologiese oorsaak van elke klepletsel wat u vir vraag 5a) genoem het. (4) Beskryf kortliks die kliniese manifestasies van elke klepletsel wat u genoem het. (8) [16] [15] [15]

a) b) c)

6 6

Explain the clinical spectrum of human immunodeficiency virus infection. Verduidelik die kliniese spektrum van menslike immuungebrek virus infeksie.