END OF BLOK EXAMINATION (MAN IN THE ENVIRONMENT)

MCQ

1. Regarding soil-transmitted helminth of medical important

A. Adult worms are commonly called roundworms
B. The mode of infection depend on the genus of the parasite
C. Adult parasites lines in the intestinal tract
D. Control methods include destruction of reservoir host
E. Adult worms are hermaphroditic

2. Choose the steps of arthropods transmission to stimulate disease

A. Ingestion by arthropods
B. Penetration of arthropods tissue
C. Multiplication inside arthropods
D. Migration to the site of transmission in vector
E. Introduction to host cells
3…..

4. If the vesicle inside a nerve terminal cannot hold any neurotransmitter, the following
process involving neurotransmitter will be decreased
A. Synthesis
B. Transport to nerve terminal
C. Released across synaptic cleft
D. Binding to receptors at the post synaptic neuron
E. Reuptake into post synaptic neuron

5. The evidence that a drug is stored in tissue is

A. An increase in protein plasma binding
B. Its large volume of distribution
C. A reduction in the rate of metabolites formation
D. An increase in the number of side effect produced
E. A decrease in the amount of free drug excreted in the urine

6. Regarding antimicrobial
A. Sulphanilide inhibiting synthesis of essential metabolites
B. Streptomycin inhibit DNA replication
C. Rifampin inhibit transcription
D. Streptomycin inhibits protein synthesis
E. Quinolones inhibits cell wall synthesis

7. Transudate is seen in
A. Inflammation
B. Appendicitis
C. Liver disease
D. Lymphatic obstruction
8. Regarding granulation tissue
A. Formed within first 24h of wound healing
B. Excessive formation leads to contractures
C. New blood vessel has increased permeability
D. Consist of proliferating smooth muscle cell
E. Hallmark of healing

9. Grading and staging

A. Grading can determine type of treatment
B. Staging involved in cytologic differentiation of tumor
C. Staging involved in extend spread of lymph nodes
D.
E. Staging indicate metastasis

10. Regarding carcinogenesis

A. It constituent consist of multistep to become neoplasia
B. Mutation on specific gene cause tumor progression
C. One transformed cell can lead to neoplasia
D. Tumor progression require aggressive malignant potential
E. Permanent alteration of gene causes neoplastic potential

11…

12. Endemic means

A. Occur in excess of normal expectancy
B. Habitually present in human population
C. Affect a large number of countries simultaneously
D. Exhibit a seasonal pattern
E. Prevalent among animal

13. Regarding pollutions

A. Effluent from industry can cause water pollution
B. Main source of air pollution is incinerator
C. Burning of coal release sulphur dioxide in air
D. Release of CFC can cause ozone depletion
E. Motor is the main cause of carbon monoxide in the air

14. Designing effective communication includes

A. Creating enforcement type of message
B. Conducting community needs assessment
C. Encouraging personal responsibility
D. Administering Top-Down modes of instructions
E. Priorisiting target audience
15. Regarding the following is correctly matches with the disease
A. Legionella pneumophila- legioneirra
B. Bordella pertussis- Diphteria
C. Salmonella Typhi- thypus
D. Trepanoma pallidum- gonnorhea
E. Streptococcus pyogene- sore throat

16. Selective media culture used in laboratory diagnosis

A. Blood agar
B. Nutrient agar
C. MacConkey agar
D. Lowenstein-Jensen medium
E. Nutrient broth

17. Staphylococcus
A. Gram positive
B. Flagellated
C. Present in cluster
D. Is two plane
E. Catalase negative

18. ..

19. …

20. Molecular method for viral genome detection

A. Southern blotting
B. Western blotting
C. RIBA
D. Northern blotting
E. PCR

MEQ

Question 1

A 75 year old woman presented with altered bowel function (constipation and diarrhea). She
complained of passing stool with blood, both for the pass 6 month. She was diagnosed with
familial polyposis coli at age of 30. She lost 8 kg in the past six month. She was investigated
for colon carcinoma.

1. Define carcinoma
2. State differences between familial polyposis coli and colon cancer in terms of growth and
characteristics.
3. Multistep in carcinogenesis
 There is mutation in APC TSG that encodes genes for transcription protein such as
proto-oncogene MYC that regulate cell proliferation.

4. Related to Knudson’s 2 hit hypothesis

5. How does the mutation in tumor suppressor gene (APC TSG) develop colon cancer

They formed CEA test in the serum and they found increased amount of CEA.

6. What is it and why there is increased in CEA.

There is adenocarcinoma and it involved lymph nodes enlargement..

7. State the cause of lymph nodes enlargement.

8. Pathogenesis of lymph nodes involvement.

Anti cancer drug.. Drug A: ED50-100g can kill 100% of cancer cells.. Drug B: ED50-50g
can kill 80% of the cancer cells

9. Give pharmacological differences of drug A and drug B

10. Which drug you will choose and state the reasons.
11. Side effects of anti-cancer drug.

Questions 2
Theme: Streptococcus pneumoniae.

1. What is the content of purulent discharges

2. Why there is swelling and redness in the inner ear of the patient
3. Pathogenesis of streptococcal sore throat
4. Describe alpha-hemolysis
5. How ear swab is cultured
6. Result of bacteria culture in blood agar
7. Principles of gram staining
8. Morphology of the Streptococcus pneumoniae
9. Group of antibiotic used against the bacterial infections and the modes of action.

SEQ

1. Describe primary intention wound healing

2. What causes delayed wound healing
3. Describe briefly about Virchow’s triad and give ONE example for each.
4. Classify the embolism and describe one type
5. Fate of thrombus